Surgical resection (usually lobectomy) is considered the treatment option for individuals with stage Ⅰ and Ⅱ non-small cell lung cancer. The surgical treatment of stage Ⅰ and Ⅱ non-small cell lung cancer (NSCLC) continues to evolve in the areas of intraoperative lymph node staging (specifically the issue of lymph node dissection vs sampling), the role of sublobular resections instead of lobectomy for treatment of smaller tumors (especially peripheral carcinoma ≤2 cm in diameter), and the use of video-assisted techniques to perform anatomic lobectomy. Video-assisted thoracic surgery (VATS) lobectomy provides a minimally invasive approach for the management of early-stage lung cancer. Questions about the safety of VATS lobectomy and its adequacy as a cancer operation compared with open thoraeotomy have hindered its universal acceptance among thoracic surgeons. Evidence suggests that VATS lobectomy can be safely performed and is an adequate cancer operation for early-stage NSCLC. Recently, robots have been introduced into surgical procedures in an attempt to facilitate surgical performance. However, adequately powered well-balanced studies comparing VATS with open thoracotomy for lobectomy are lacking in the literature.

Objective:Egr-1 promoter was amplificated and Egr-PGL plasmid was constructed to study the expression of luciferase in transfected NIH3T3 cells after different doses of X-ray irradiation.Methods:Egr-1p was amlificated by PCR and inserted into PGL3-E vector.The expression of luciferase induced by X-ray was studied by counting the light of luciferase and stubstrate.Results:Egr-1 cDNA was obtained by PCR and was sequenced.The results indicated the sequence was almost correct.The Egr-1p was connected with PGL3 vector and was detected by electrophoresis.The constructs were used to transfect mouse NIH3T3 cells to characterize the regulatory function of Egr-1p after exposure to X-ray irradiation.The results indicate that the expression of luciferase of all groups irradiated is highter than that of 0 Gy group.The expression of groups irradiated is about 5-7.5 times greater than that of 0 Gy group.Conclusion:Egr-1pobtained can induce the expression of its downstream gene after different doses of X-ray irradiation.Low dose irradiation also can do it and it is may be more important in tumor gene therapy.

Objective: To investigate the anti-tumor efficiency of B16 melanoma HACs in vivo and in vitro.Methods: Tris-HCI extract and Sephacryl S-200 gel filtration were applied to prepare B16 HACs, and the cytolokicity of specific CTL induced by HACs was tested. Results: The 41, 47 and 53 tube HACs obtained by gel filtration could decrease the tumor incidences, delay the time of tumor development and decrease the mortalitites of mice.Conclusion:60 ~ 97 kD HACs from B16 melanoma cytosol have the activites of inhibiting tumor and could be used in effective anti-tumor therapy.

Objective:In present study we observed the effect of whole body irradiation (WBI) with 75 mGy X-rays on the immune function of tumor-bearing mice.Methods:Lewis lung carcinoma cells were implanted into the right thigh muscle of C57BL/6J mice.Ten days after tumor implantation,the tumor-bearing mice were administrated with 75 mGy X-rays WBI,then the mice were sacrificed 18 h after irradiation to detect the immune parameters including the spontaneous proliferation of thymocytes,the proliferative response of splenocytes to ConA and LPS,the cytotoxic activities of specific cytotoxic lymphocytes (CTL) and natural killer cells (NK),as well as lymphokine activated killer cells (LAK) in spleen.The methods we used were 3H-TdR incorporation or release assay.Results:The immune parameters of exposed tumor-bearing mice were much higher than those of sham-irradiated tumor-bearing mice (P<0.01).Conclusion:These results suggested that low dose radiation (LDR) could enhance the immune function of tumor-bearing mice,which might be of practical significance in the prevention and therapy of cancer.

Objective To investigate the changes and clinical significance of T-lymphocyte subsets in the treatment of advanced lung adenocarcinoma. Methods Ninety six patients with advanced lung adenocarcinoma who underwent treatment in Xuanwu Hospital Capital Medical University from October 2015 to May 2016 were selected as the subjects. There were 63 cases in the transferred group and 23 cases in the un-transferred group. The peripheral blood was taken, then flow cytometry was used to detect CD3+, CD3+CD4+, CD3+CD8+, CD4+/CD8+, CD3-CD16+CD56+(NK), CD8+CD28+, CD8+CD28-, Treg cells, CD3+γδ, and the results were analyzed statistically. Results The levels of CD3+γδand Treg cells in the transferred group were significantly higher than those in the un-transferred group (6.56±3.11 vs. 3.05±2.23; 25.83±6.22 vs. 20.81±9.03) (t=1.590, P=0.026; t=2.027, P=0.044). The level of CD45RA+in the effective group (52.15 ±7.99) was significantly lower than that in the untreated group (70.26 ±17.33) (t= 1.660, P= 0.024). Conclusion The detection of peripheral blood T-lymphocyte subsets in treatment of patients with advanced lung adenocarcinoma has a certain value in predicting the therapeutic effect and prognosis.

Objective The purpose of this study is to evaluate Surgical Procedure and Prognosis for elderly stage 1NSCLC patients above 70 years old.Methods The patients who were stage Ⅰ non-small cell lung cancer from 2003 to 2007were enrolled ( n =71 ).The median age was 74 years ( ranged from 70 to 84 years).The median follow-up of patients was 30months( ranged from 2 to 81 months).Results The percentages of postoperative complications after sublobar resection and lobectomy patients were 36.4％ and 46.9％,respectively.The period in hospital were 11.36 days and 12.24 days.The 3 year survival was 85.9％ for patients undergoing sublobar resection and 78.8％ for lobectomy.The 5 year survival was 56.4％ and 56.9％ respectively.No significant difference was observed between two types of surgical procedure in the elderly.Staging is the independent factor of prognosis.Conclusion Lobectomy is still the main therapy method for elderly stage Ⅰ NSCLC patients.Especially,for those who can undergo radical resection.But sublobar resection also appears to be a viable surgical treatment for patients with cardiopulmonary physiologic impairment.

Objective To investigate the clinical application of 99mTc-DTPA renography in evaluating the glomerular filtration rate (GFR) in living donor kidney transplantation and to assess the dependence of GFR on age and gender in living kidney donors. Methods There were 212 consecutive potential donors in the study. The potential donor evaluation process included as follows: general health status, liver and kidney ultrasound, hepatitis virus infection and HLA-DR matching. If the results met the general requirements for the donor selection criteria, the GFR was measured using the 99mTc-IDTPA renography according to standard procedure (gates method). The GFR ≥ 1.33 ml/s was considered normal, ＜ 1.17 ml/s was defined as the lower limit for donor GFR, and 1.17 ml/s ≤GFR ＜ 1.33 ml/s further underwent measurement of creatinine clearance (CCr). If the CCr was normal, the GFR was considered normal, and otherwise, potential donors gave up kidney donation.All the donors meeting the donor selection criteria were divided into four age groups. On the other hand, the total donors were divided into the groups aged ＞ 55 years and aged ≤ 55 years. The impact of gender and age on GFR was evaluated preoperation due to age-related changes and gender using Kendall's tau-b correlation coefficient. Results In 212 potential donors, 137 cases had a GFR ≥ 1.33ml/s, 55 cases 1.17 ml/s ≤ GFR ＜ 1.33 ml/s and 20 cases GFR ＜ 1.17 ml/s. Thirty-one cases of potential donors with 1.17 ml/s ≤ GFR ＜ 1.33 ml/s gave up kidney donation due to abnormal CCr or other security considerations. 161 (56 females, 105 males) were qualified as successful donors, and the donor age was 42. 91 ± 11.90 years (range 20 to 62 years). The preoperative total GFR (ml/s) in living kidney donors was calculated as 1.51 ± 0.22 for males, it was 1.45 ± 0.18 for females respectively (P＞0.05). Among the four age groups, there was no significant difference in GFR (P＞0.05). The GFR in the donors aged ＞ 55 years and aged ≤ 55 years was 1.48 ± 0.22 and 1.49 ±0.17 respectively (P＞0.05). Correlation analysis revealed that the GFR in all the donors was not related with age (r = -0. 033, P = 0. 69). Also, there was no correlation between age and GFR in men and women(r= -0.053, P=0.571; r= -0.019, P=0.754). Conclusion 99mTc-DTPA renography is reliable and reproducible for the determination of GFR in living kidney donors. In view of acute donor shortage and if properly screened, kidneys with 1.17 ml/s≤ GFR ＜ 1.33 ml/s can be used without increasing the risk to donor. The GFR is not correlated with the age and gender.

Objective To investigate the incidence and CT imaging features of abdominal splenosis with a previous splenectomy.Methods 94 consecutive patients with a history of splenectomy underwent abdominal contrast CT examination between April 2010 and December 2012 and were recruited for this study.These patients were devided into two groups according to the reason for which splenectomy was performed.Descriptive statistics were calculated for clinical incidence of abdominal splenosis,and subsequently CT imaging features and diagnosis of abdominal splenosis were discussed.Results In this series,29 cases (30.85％) with abdominal splenosis were found in 94 patients.Abdominal splenosis was found in all of 20 cases with more than one year history of posttraumatic splenectomy,and in 17.31％ (9 of 52) of cases with more than one year history of non-traumatic splenectomy (P ＜ 0.05).There were 60 nodules found on CT examinations in these 29 cases.All nodules were 50 mm or smaller.All nodules appeared of homogeneous soft-tissue density on plain CT scan.The nodules showed significant enhancement during arterial phase on postcontrast CT scan,with continuous significant homogeneous enhancement during portal venous phase.Conclusions Abdominal splenosis following posttraumatic splenectomy are more common than previously suggested.Knowledge of typical CT imaging appearances and the history of splenectomy may prevent mistaking as tumors.

Objective To explore the anti-tumor effects of Egr-IFNγ gene therapy combined with 125I-UdR radionuclide therapy in mice bearing H22 hepatocarcinoma and its mechanism. Methods The recombinant plasmid pcDNAEgr-IFNγ mixed with liposome was injected into tumor. 48 h later, 370 kBq 125I-UdR was injected into tumor. The tumor growth rates at different times were observed. After 3 d gene-radionuclide therapy, the concentration of IFNγ in cytoplasm of H22 cells and cytotoxic activities of splenic CTL of the mice in different groups were examined. Results The tumor growth rates of pcDNAEgr-IFNγ +125 I-UdR group were obviously lower than those of control group, 125I-UdR group and pcDNAEgr-1 +125I-UdR group 6-15 d after gene-radionuclide therapy. IFNγ protein was found in cytoplasm of H22 cells in PcDNAEgr-1FNγ+125I-UdR group after 3 d gene-radionuclide therapy. Cytotoxic activity of splenic CTL in pcDNAEgr-IFN7 + 125I-UdR group was significantly higher than that in the other groups (P<0.01). Conclusions The anti-tumor effects in vivo of pcDNAEgr-IFNγ gene therapy combined with 125I-UdR radionuclide therapy are better than those of 125I-UdR therapy.

Objective To evaluate the antitumor effects of interferon (IFN)γ-endostatin based gene radiotherapy in a metastatic breast tumor model of mice, and to elucidate the possible mechanisms involved. Methods Murine mammary adenocarcinoma 4T1 cells transfected with pEgr-IFN-γ and pEgrendostatin plasmids were irradiated with 2-20 Gy of X-rays. IFN-γ and endostatin levels in the culture supernatants were measured. Female BALB/c mice were inoculated with 1 × 105 of 4T1 cells by mammary fat pad injection, and divided randomly into control, empty vector, gene therapy (pEgr-IFN-γ and pEgrendostatin), radiotherapy, and combined gene-radiotherapy groups. Tumor/body weight ratio, lung metastases, and survival of the tumor-bearing mice were observed. Splenic cytotoxic T-lymphocyte (CTL)and natural killer (NK) cell activity and intratumor microvessel density were also assessed. Results Irradiation significantly enhanced the section of IFN-γ and endostatin from the transfected 4T1 cells.Compared with gene therapy or radiotherapy alone, combined gene-radiotherapy resulted in the maximal attenuation in tumor growth rate, lung metastases and increased survival. The activities of CTL and NK cells were significantly enhanced and intratumor microvessel density reduced ( t = 2. 120-22.140, P ＜ 0.05 ).Conclusions IFN-γ-endostatin-based gene-radiotherapy could provide a potential antitumor effect in a murine metastatic breast tumor model, which may be related to IFN-γ-stimulated CTL and NK cell activation, and endostatin-induced antiangiogenic activity. Gene-radiotherapy could serve as a neoadjuvant therapy for the locally advanced breast cancer.