Sclerosing pneumocytoma is now classified into adenomas of the lung tumor belonging to benign tumors . Multiple sclerosing pneumocytoma is rare .A fifty-nine years old female patient underwent minimally invasive small incision , muscle-and rib-sparing thoracotomy ( miMRST) in August 2012.A lobectomy was made for a 5-cm tumor at the right lower lobe of the lung and a wedge resection was made for another 0.7-cm tumor at the right middle lobe of the lung .Post-operative pathological diagnosis was multiple sclerosing pneumocytoma .No recurrence or metastasis was found after four years ' follow-up.

[Summary] A single-incision video-assisted thoracoscopic sublobular limited resection was performed for a 2-cm pulmonary nodule at the right lower lobe of the lung in August 2014.The post-operative pathological diagnosis was inflammatory myofibroblastic tumor of the lung.No recurrence and metastasis was found after one year’s follow-up.

AIM: The aim of this study was to investigate the hemodynamic characteristics of the denervated orthotopic transplanted hearts. METHODS: Eighteen patients with end - stage cardiopathy underwent orthotopic cardiac transplantation received immunosuppressive induction therapy. The changes of hemodynamics were closely monitored during the perioperative period and the periodic check-up of echocardiogram and electrocardiograph were followed up in the postoperative long-term period. RESULTS: All recipients were received vasoactive drug and active diuretic therapy during the perioperative period. An increase in central venous pressure in concomitance with decrease in cardiac output, cardiac index and mixed venous oxygen saturation within 24 to 48 hours and tend to stable 48 hours postoperation were detected. In the follow - up period, the cardiac functions of allografts were all recovered well. No recipient complained angina pectoris. CONCLUSIONS: The hemodynamic characteristics and clinical pharmacological therapeutic implications of cardiac denervation are very unique. Rational application of inotropic support and diuretic therapy and vasodilatation combined with prudent administration of some agents, which affect the physiology of denervated heart, are the most effective measures for the prevention of postoperative complications of cardiac allograft.

Objective To investigate the mRNA and protein expression of E3 ubiquitin ligase Iduna in non-small-cell lung cancer tissue and para-neoplastic lung tissue,and the correlation of the Iduna expression with clinicopathological factors and prognosis.Methods The expression levels of the Iduna mRNA and protein in non-small-cell lung cancer tissue and para-neoplastic lung tissue were determined by reverse transcriptase-polymerase chain reaction (RT-PCR),Western-Blot and immunohistochemistry respectively,and the correlation of the Iduna expression with clinicopathological factors and prognosis was analyzed.Results RT-PCR and Western-Blot showed the expression levels of the Iduna mRNA and protein in non-small-cell lung cancer tissue (0.468 ± 0.086 and 2.554 ± 0.544) were significantly higher than those in para-neoplastic lung tissue (0.203 ± 0.070 and 1.570 ± 0.316),there were statistical differences (P ＜ 0.05).Immunohistochemistry results showed that Iduna was negative expression in the alveolar epithelium cells,negative or weak positive expression in normal bronchial and positive expression in different degrees in the non-small-cell lung cancer tissue.Iduna high expression rate was negative correlation with tumor differentiation (P =0.002),Iduna high expression rate was positive correlation with large tumor size (P =0.044),TNM staging (P=0.015) and lymph node metastasis (P=0.009).Iduna high expression of I stage non-small-cell lung cancer patients was correlated with poor post-operative survival (P =0.016).Conclusions High expression of Iduna may be related to the process of invasion and metastasis of nonsmall-cell lung cancer.It is possible that Iduna serve as potential markers for predicting prognosis in nonsmall-cell lung cancer.

Objective:To evaluate the clinical efficacy of transanal total mesorectal excision (taTME) on transanal endoscopic microsurgery (TEM) platform in the treatment of middle and low rectal cancer.Methods:The retrospective and descriptive study was conducted. The clinico-pathological data of 28 patients with middle and low rectal cancer who underwent taTME on TEM platform in the Peking Union Medical College Hospital of Chinese Academy of Medical Science from October 2014 to October 2017 were collected. There were 21 males and 7 females, aged 59 years (51 years, 68 years). Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was conducted using outpatient examination or telephone interview to detect post-operative defecation function and survival of patients up to October 2020. Patients underwent physical examination, examination of tumor markers including carcinoembryonic antigen and CA19-9, colonoscopy, rectal magnetic resonance imaging, thoracoabdominal and pelvic enhanced computed tomography (CT) and (or) PET-CT examination during the follow-up. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M( P25,P75) or M (range), and comparison between groups was analyzed using the non parameter Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results:(1) Surgical and postoperative situations: 28 patients underwent successful surgery, without intra-operative conversion to laparotomy. Of 28 patients, 24 cases underwent colorectal anastomosis and 4 cases underwent colon-anal anastomosis. Twenty-six cases underwent primary protective enterostomy and 2 cases didn't undergo primary protective enterostomy. The operation time of 28 patients was (182±37)minutes and the volume of intraoperative blood loss was 40mL(30 mL, 55 mL). One patient with intraoperative presacral hemorrhage received compression hemostasis. Eleven patients had postoperative complications, including 4 cases with anastomotic leakage, 2 cases with alteration of intestinal flora, 2 cases with paralytic ileus, 2 cases with urinary retention, 2 cases with urinary infection, 1 case with prolapse necrosis of small intestinal stoma, 1 case with anal hemorrhage, 1 case with rectovaginal fistula, 1 case with pelvic infection; some patients had multiple complications. Three patients had non-planned reoperation. One case without primary protective enterostomy had anastomotic leakage at postoperative 3 days, and was improved after emergency transversostomy. One case had prolapse necrosis of small intestinal stoma at postoperative 3 days and was improved after emergency enterostomy and reconstruction. One case with anal hemorrhage was stopped hemorrhage under anoscopy. Patients with other complications were cured after conservative treatments. The duration of postoperative hospital stay of 28 patients was 8 days(7 days, 9 days). Results of pathological examination in 28 patients showed 16 cases of moderately differentiated adenocarcinoma, 3 cases of moderately to highly differentiated adenocarcinoma, 5 cases of highly differentiated adenocarcinoma, 1 case of mucinous adenocarcinoma, 3 cases of pathological complete response. TNM staging of 28 patients showed 3 cases in stage T0N0, 4 cases in stage T1N0, 6 cases in stage T2N0, 4 cases in stage T2N1, 7 cases in stage T3N0, 3 cases in stage T3N1, 1 case in stage T4N1. The distance from tumor to distal margin was (2.2±1.7)cm. The surgical specimens of 28 patients showed negative for proximal, distal and circumferential margins. The number of lymph node dissection was 15±7. The complete rate of total mesorectal excision was 100%(28/28). Eleven of 28 patients underwent neoadjuvant therapy and 17 patients didn't receive neoadjuvant therapy. The tumor diameter, distance from tumor to anal margin, operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 2 cm(1 cm, 4 cm), 5 cm(4 cm, 6 cm), (187±25)minutes, 45 mL(38 mL, 53 mL), 8 days(7 days, 12 days) for patients with neoadjuvant therapy, respectively, versus 3 cm(2 cm, 4 cm), 5 cm(4 cm, 6 cm), (177±35)minutes, 40 mL(30 mL, 60 mL), 8 days(7 days, 8 days) for patients without neoadjuvant therapy, showing no significant difference between the two groups ( Z=-1.127, -0.293, t=0.590, Z=-0.790, -0.876, P>0.05). (2) Follow-up: 23 of 28 patients were followed up for (44±14)months. Of the 23 patients,11 cases were classified as grade A of Williams score for defecation function at postoperative 6 months, 8 cases were classified as grade B and 4 cases were classified as grade C. Eighteen of 23 patients with follow-up had disease-free survival, 1 of whom didn't undergo stoma closure due to anastomotic stenosis at postoperative 6 months. Three patients had distant metastasis, including 1 case with parastomal implantation metastasis, 1 case with sacral metastasis, 1 case with pulmonary metastasis. Two patients died, 1 case of whom died of urinary obstruction and 1 case with mucinous adenocarcinoma died at postoperative 24 months. Conclusion:TaTME based on TEM platform is feasible for middle and low rectal cancer, which has the advantages of preserving anus and negative circumferential margin.

Background and objective Heparanase has been thought to be a good molecular marker of tumor, and the heparanase expression level was correlated closely with tumor metastasis. In this study, we investigate the effects of heparanase on angiogenesis and lymphangiogenesis of lung cancer and the relationship between heparanase expression and vascular endothelial growth factor (VEGF), vascular endothelial growth factor-C (VEGF-C).Methods Immunohistochemistry was used to detect the expression of heparanase, VEGF, VEGF-C protein and microvascular density (MVD), lymphatic vessel density (LVD) in 115 cases of non-small cell lung cancer (NSCLC) and 45 cases of adjacent normal tissue samples.Results Our results showed that heparanase expression was significantly increased in 91 (79.13%) of the 115 cases and correlated with lymph node metastasis (node positive rate 87.0%; node negative rate 36.8%; P=0.003). Heparanase positive expression cases have significantly higher concentration of microvascular density (MVD) and lymphatic vessd density (LVD) as compared with heparanase negative expression cases (P<0.01, P<0.01, respectively), heparanase expression was significantly correlated with VEGF, VEGF-C expression in NSCLC.Conclusion Heparanase overexpression was associated with angiogenesis and lymphangiogenesis of lung cancer, targeting ofheparanase may represent a significant therapeutic potential for lung cancer.

OBJECTIVETo investigate the protein and mRNA expression of E-cadherin and beta-catenin in nonsmall cell lung carcinoma (NSCLC) and to find their correlation with histological type, differentiation, metastasis and prognosis.

METHODSHigh sensitive S-P immunohistochemical method and in situ hibridization were used to detect the protein and mRNA expression of E-cadherin and beta-catenin.

RESULTSImmunohistochemistry revealed that among the 101 cases, the positive rates of E-cadherin and beta-catenin were 68.3% and 81.2% respectively. The abnormal expression rates of these two proteins were 61.4% and 64.4% respectively. There was no significant relationship between E-cadherin and beta-catenin staining and histological type of the tumor (P > 0.05). However, there was a statistically significant difference between well and moderately differentiated cells and poorly differentiated cells (P < 0.05). In cases with lymphatic metastasis, the abnormal expression rates of E-cadherin and beta-catenin were significantly higher than those in nonmetastatic cases (P < 0.05). The mean survival time in cases with abnormal E-cadherin and beta-catenin expression were significantly shorter than that in cases with the expression grading (+ +) approximately (+ + +). In situ hybridization showed that in NSCLC, the positive rate of E-cadherin and beta-catenin mRNA was 38.9% and 47.2% respectively. Their concordant rates with (+ +) approximately (+ + +) protein expression were 78.6% and 82.4%, respectively.

CONCLUSIONSThe concordant rate of E-cadherin and beta-catenin mRNA and protein expression was relatively high. They can be used as markers of prognosis of NSCLC in clinical practice.

Adult ; Aged ; Cadherins ; analysis ; genetics ; Carcinoma, Non-Small-Cell Lung ; chemistry ; mortality ; Cytoskeletal Proteins ; analysis ; genetics ; Female ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Lung Neoplasms ; chemistry ; mortality ; Male ; Middle Aged ; Prognosis ; RNA, Messenger ; analysis ; Survival Rate ; Trans-Activators ; analysis ; genetics ; beta Catenin

BACKGROUNDMetastasis is the main cause of the death of lung cancer patients. Much attention has been pain to the research of lung cancer metastasis. Metastasis-associated protein 1 (MTA1) is one member of metastasis associated protein family. Its overexpression is correlated with metastasis of esophageal carcinoma and breast cancer, but the generality of its expression in cancer and the significance for judging biological behaviors of tumor and evaluating prognosis of patients is to be investigated. The aim of the study is to study the relationship between MTA1 expression and clinicopathological factor regarding metastasis and prognosis of human non-small cell lung cancer (NSCLC).

METHODSThe expression of MTA1 was detected in 101 parafin-embedded specimens by immunohistochemistry method, as well as in 35 freshly-taken NSCLC tissues by Western blot.

RESULTSThere were 56 cases (55.4%) of NSCLC with yellow or even brown particles in nucleus of tumor cell among 101 cases, and MTA1 protein showed negative expression in epithelia of bronchi or alveoli in neighboring noncancerous tissue. Western blot analysis showed the level of MTA1 in NSCLC tissues was remarkably higher than that in normal tissues (t=3.953, P=0.000). Expression of MTA1 was remarkably higher in tumor with metastasis than that in tumor without metastasis (t=4.057, P=0.000). Expression of MTA1 significantly correlated with differentiation (Chi-square=10.131, P=0.006), lymphatic metastasis (Chi-square=8.535, P=0.003) and p-TNM stage (Chi-square=17.419, P=0.000). The survival time of pa-tients with negative MTA1 expression was (44.866±12.946) months, which was significantly higher than that of patients with positive MTA1 expression [(23.714±7.498) months] (Chi-square=10.006, P=0.002). In multivariate analysis, only lymphatic metastasis and TNM stage could be considered as independent prognostic factors.

CONCLUSIONSMTA1 might play an important role in the development and metastasis of NSCLC. Patients with MTA1 expression have a greater chance of metastasis and a poorer prognosis. However, MTA1 expression is not an independent prognosis factor.

OBJECTIVETo investigate the relationship between vascular endothelial growth factor C (VEGF-C) expression, VEGFR-3 expression, lymphangiogenesis and angiogenesis in human non-small cell lung cancer (NSCLC).

METHODSSeventy-six NSCLC samples were stained for VEGF-C, VEGFR-3 and CD34 with immunohistochemical methods. Assessment of lymphatic vessel density (LVD) and microvessel density (MVD) was performed. The expressions of VEGF-C in 24 fresh NSCLC samples were determined with Western blot assay.

RESULTSOf the 76 NSCLC cases, 55 were VEGF-C positive and 40 were VEGFR-3 positive in cancer cells. A significant positive correlation was found between VEGF-C expression and VEGFR-3 expression in cancer cells (P < 0.05). VEGF-C expression was negatively associated with differentiation of tumor cells (P < 0.05). VEGF-C expression and VEGFR-3 expression were positively associated with lymph node metastasis and lymphatic invasion (P < 0.05). LVD was positively related to VEGF-C expression, lymph node metastasis, lymphatic invasion and clinical stage (P < 0.05). There was a significant correlation between LVD and MVD (R = 0.732, P < 0.05). Patients with positive VEGF-C expression had worse outcomes than those with negative VEGF-C expression (P < 0.01).

CONCLUSIONSIn NSCLC, VEGF-C and VEGFR-3 are related to the lymphangiogenesis, angiogenesis, and occurrence and development of lung cancers. VEGF-C expression could be a useful predictor of poor prognosis in NSCLC.

Carcinoma, Non-Small-Cell Lung ; metabolism ; Endothelial Growth Factors ; biosynthesis ; Humans ; Immunohistochemistry ; Lung Neoplasms ; metabolism ; Vascular Endothelial Growth Factor C ; Vascular Endothelial Growth Factor Receptor-3 ; biosynthesis

BACKGROUNDTo study the expression of MGMT and its relationship with efficacy of chemotherapy and prognosis in patients with non-small cell lung cancer (NSCLC).

METHODSMGMT was detected in 128 NSCLC tissues and 10 normal pulmonary tissues by immunohistochemistry. According to the level of MGMT , 128 patients with NSCLC were divided into the group Mer- with negative MGMT expression and the group Mer+ with positive MGMT expression.

RESULTSMGMT positively expressed in 61 of 128 patients with NSCLC (47.66%), but none of normal group. No significant relationship was found among MGMT expression and TNM stages, lymph node metastasis and histological classification of the cancer. However, the mean survival periods and survival rates in group Mer- were significantly higher than those of group Mer+ (P < 0.01 , P < 0.05). In 45 evaluable patients, total response rates were 42.86% and 4.17% in Mer- and Mer+ patients respectively (P < 0.001); and there were remarkably longer mean survival periods and higher survival rates in Mer- patients than those in Mer+ patients (P < 0.01, P < 0.05).

CONCLUSIONSExpression of MGMT may be helpful to predict efficacy of chemotherapy and prognosis in patients with NSCLC.