Objective:To analyse the intermediate-term morbidity and mortality of rheumatic heart disease in patients under the age of 20 years treated with mitral-aortic valve replacement.Methods:A retrospective study was conducted on 55 consecutive patients who underwent mechanical double-valve replacement(DVR) from January,1989 to January,2002.Among the 55 cases,33 were male and 22 female with a mean age of 16.3 years (range 10～20 years).The mean follow up was 4.6 years (maximum 11 years).Results:The operative mortality was 7.3%(4 patients).There was of 2% mortality reported(1 case) in 10 years.At a mean follow-up period of 4.6 years,there was an improvement in functional class from 2.6 to 1.1.There were no increasing incidence of thrombo-embolic and anticoagulant related hemorrhagic events in this study group.Conclusion:The functional results of survivors of DVR performed in the first 2 decades of life are satisfactory.Use of combined warfarin and antiplatelet therapy is appropriate in this age group following DVR (with mechanical valves) for RHD in the aortic-mitral position.

BACKGROUND:Studies have found that Notch pathway and Bmi-1 gene both have the ability to regulate stem cel self-renew. Functional dysfunction of the both may have a great relationship with tumorigenesis. OBJECTIVE:To investigate the expression and clinical significance of Notch1 and Bmi-1 protein in lung tissue. METHODS:Eighty-seven lung cancer tissue samples (lung cancer group) and forty pathologicaly confirmed normal lung tissue samples (normal group) were obtained from related surgeries and included as research objects. The protein expression of Notch1 and Bmi-1 in specimens of these two groups was measured by immunohistochemistry SP method. The relationship between Notch1 and Bmi-1 protein expression and clinicopathological features of lung cancer patients was analyzed. RESULTS AND CONCLUSION: The positive rate of Notch1, Bmi-1 protein expression was respectively 61% and 47%, which was significantly higher in the lung cancer group than that in the normal group (P < 0.05). In the lung cancer group, Notch1 protein expression was significantly positively correlated with Bmi-1 protein expression (r=0.567,P < 0.001). There were no significant differences in Notch1 and Bmi-1 protein expression rates between different genders and different pathological types of patients (P < 0.05). The Notch1 and Bmi-1 protein positive expression rates in poorly-differentiated, TNM stage III-IV lung cancer patients with lymph node metastasis were significantly higher than those in wel- and moderately-differentiated, TNM stage I-II lung cancer patients without lymph node metastasis (P < 0.05). These results demonstrate that Notch1 and Bmi-1 protein may have certain relationship with the occurrence and development of lung cancer.

Objective To evaluate the relationship between chemotherapy after pulmonary resection and the incidence rate of bron-chopleural fistula. Methods 246 patients who received pulmonary resection in our hospital from January 2009 to June 2014 were chosen, and they were divided into the chemotherapy group and the non-chemotherapy group. The 138 patients in the chemotherapy group received chemotherapy one month after resection while the other 108 in the non-chemotherapy group did not. Bronchopleural fistula of the two groups were diagnosed and analyzed in order to evaluate the relationship between chemotherapy after pulmonary resection and incidence rate of bron-chopleural fistula. Results There were 12 cases of bronchopleural fistula in the chemotherapy group with an incidence rate of 8. 70%, while there were 2 cases of bronchopleural fistula in the non-chemotherapy group with an incidence rate of 1. 85%. The difference between the two groups is statistically significant (P<0. 05). Conclusion Chemotherapy after pulmonary resection will increase the incidence rate of bron-chopleural fistula.

Objective To prepare CD133 specific-binding peptide conjugated liposome loaded paclitaxel and evaluate the efficiency of cellular uptake and the ability of inhibiting A549 lung cancer stem cell.Methods Liposomes were prepared by film-ultrasonic method.The partical size,zeta-potential and entrapment efficiency of liposomes were evaluated.Cellular uptake effciency of A549 lung cancer stem cell for liposomes were explored.The anti-proliferation efficiency of TLP-PTX to A549 lung cancer stem cell was evaluated by MTT assay.Tumor spheroids were used to evaluate anti-tumor ability of TLP-PTX to A549 lung cancer stem cell. Results The particle diameter of TLP-PTX was (115.8 ±8.3)nm and the entrapment efficiency of PTX was 88.5%.CD133 specific-binding peptide could enhance the efficiency of cellar uptake.The uptaken efficiency of TLP by A549 lung cancer stem cell were 2.6 times higher than that of LP(P<0.05 ).The MTT Results showed that the toxicity of TLP-PTX on A549 lung cancer stem cell was significantly stronger than LP-PTX and paclitaxel solution(P<0.05 ).The tumor inhibition test results showed that TLP-PTX has good anti-tumor effect. Conclusion TLP-PTX can specifically recognize the surface marker CD133 of A549 lung cancer stem cell,facilitate liposomes into cells and inhibit A549 lung cancer stem cell proliferation.TLP-PTX is an effective drug delivery system targeting to A549 lung cancer stem cell.

Objective　To investigate the significances of telomerase activity and P53 expression in Non-small cell lung cancer (NSCLC). Methods　The activity of telomerase in cancerous tissues was detected by PCR-ELISA, and the expression of P53 protein was detected by S-P method. Results　The telomerase activity and P53 expression were significantly higher in NSCLC tissues than in normal lung tissues. The telomerase activity and P53 expression had close association with the differentiation of cancer cells and lymph node metastasis. Conclusion　It is very valuable to measure telomerase activity and P53 expression in studying the initiation and progression of NSCLC.

Objective To construct RGD-TAT modified liposomes(RGD-TAT-LPs)and evaluate its glioma targeting efficiency.Methods RGD-TAT-LPs was constructed by film-ultrasonic method,its appearance,particle size and Zeta potential were mearsured. Cellular uptake of LPs,TAT-LPs, RGD-LPs and RGD-TAT-LPs was used to evaluate the affinity to C6 cells.C6 cells were xenografted in athymic mice to establish the animal model,which were used to evaluate the distribution of liposomes in vivo. Results The particle diameter of RGD-TAT-LPs was (1 16.5 ±1 1.3 )nm,and its Zeta potential was (23.2 ±3.5 )mV. Cellular uptake experiments demonstrated the cell uptake efficiency of RGD-TAT-LPs by C6 cells were 2.9-fold,2.3-fold and 4.7-fold than that of RGD-LPs,TAT-LPs and LPs respectively. The in vivo imaging showed that RGD-TAT-LPs had the strongest fluorescence intensity in brain. Conclusion The RGD-TAT-LPs might serve as a promising delivery system of antitumor drugs.

Objective To evaluate the role of video-assisted thoracoscopic surgery (VATS) in the diagnosis and treatment of esophageal tuberculosis. Methods We had conducted video-assisted thoracoscopic surgery and acute pathological examinations for diagnosing and treating esophageal tuberculosis in 8 patients from June 1996 to April 2004. Results All the 8 patents were clarified as having secondary esophageal tuberculosis (Six of them had been misdiagnosed as having esophageal tumors preoperatively). A lymphoidectomy was carried out in 5 patents and a focus debridement, in 3 patents. The duration of procedure was 30~50 min (mean, 45 min). The intraoperative blood loss was 50~100 ml (mean, 80 ml). Postoperatively, pleural effusion occurred in 2 patients and wound infection took place in 1. Follow-up for 5~27 months (mean, 15 months) in 7 patients revealed a remarkable relief of dysphagia and no recurrence. Conclusions VATS in combination with acute pathological examinations is a rapid, safe, accurate and minimally invasive alternative for the diagnosis and treatment of esophageal tuberculosis.

Objective To investigate the antitumor effect of special promoter-controlled Gibbon ape leukemia virus membrane fusion glycoprotein (GALV.fus) mediated by type Ⅰ herpes simplex virus (HSV-Ⅰ) on lung adenocarcinoma. Methods Recombinant HSV-Ⅰ plasmids encoding GALV.fus was introduced into green monkey kidney cells(Vero)by liposome to amplify the virus, and then the virus was transfected into lung adenocarcinoma (A549), human fetal fibroblasts (HFL-Ⅰ GNHu 5) and human lung adenocarcinoma xenografts which were established in nude mice subcutaneously to observe antitumor and cytotoxic effect in vitro and in vivo; Recombined cytomegalovirus (CMV) containing GALV.fus or enhanced green fluorescence protein were served as control. Results Recombinant HSV-Ⅰ virus were packed successfully. Heterotransplantative tumourigenicity of the tumour was 100% in nude mice after A549 cells were inoculated. Recombinant HSV-Ⅰvirus exerted obvious antitumor effects in vitro, with relative survival rate of 23%, while for CMV virus containing GALV. fus, the rate was 20%, and for CMV virus encoding EGFP, the rate was 68%. Recombinant HSV-Ⅰvirus also showed striking antitumor effect on the implanted tumor. Conclusion GALV.fus has powerful effect against lung cancer in vitro and in vivo and maybe a promising candidate for gene therapy.

Objective: To investigate the effect and underlying mechanism of Long non-coding RNAurothelial carcinoma associated 1 (lncRNA UCA1) on proliferation, invasion and migration of non-small cell lung cancer (NSCLC) A549 cells. Methods: NSCLS A549 cells were cultured and transfected with lentivirus; RT-PCR was employed to detect the levels of UCA1 in A549 cells. The relationship between UCA1 and miR-185-5p was validated by luciferase reporter assays. Cell viability ofA549 cells was measured by MTT. Cell invasion and migration were determined by Transwell and Wound healing assay, respectively; and western blotting was performed for measuring the levels of Wnt1/β-catenin pathway-related proteins. Results: sh-UCA1 significantly decreased UCA1 expression and increased miR-185-5p expression in A549 cells (all P<0.05). miR-185 inhibitor attenuated the promotion effect of sh-UCA1 on miR-1855p (P<0.05). UCA1 could significantly down-regulate miR-185-5p expression in A549 cells (P<0.05), which was reversed by miR-185 mimic (P<0.05). Luciferase reporter assay validated the binding site on UCA1 to link miR-185-5p. sh-UCA1 significantly inhibited cell proliferation, invasion and migration ofA549 cells (all P<0.05), and also decreased the protein levels of Wnt1, β-catenin and TCF-4 notably (all P<0.05); however, miR-185 inhibitor attenuated such inhibitory effects of sh-UCA1 (P<0.05). Conclusion: UCA1 could promote proliferation, invasion and migration of A549 cells through targeting miR-185-5p, and the mechanisms might be related with activation of Wnt1/β-catenin pathway.

BACKGROUND: Low dose computed tomography (LDCT) for lung cancer screening is widely employed in China as a result of increasing cancer screening awareness. Although some pulmonary lesions detected by LDCT are cancerous, most of the pulmonary nodules are benign. It is important to make effective preoperative differentiation of pulmonary lesions and to obviate the need for surgery in some patients with benign disease. METHODS: From January 1, 2017 to December 31, 2018, patients in our institution with surgical pathology confirmed benign pulmonary lesions in which malignancy could not be excluded in preoperative assessment were enrolled in this study. Retrospective analysis of clinical data was conducted. RESULTS: 297 cases were collected in this study. Prevalence of benign disease in patients underwent resection for focal pulmonary lesions is 9.8% in our institution. In 197 patients (66.3%), pulmonary lesions were detected by LDCT screening. A total of 323 assessable pulmonary lesions were detected by chest CT. The average diameter of pulmonary lesions was (17.9±12.1) mm, and 91.0% of which were greater than or equal to 8 mm. Solid nodules accounted for 65.6% of these lesions. Imaging characteristics suggesting malignancy were common, including spicule sign (71/323, 22.0%), lobulation (94/323, 29.1%), pleural indentation (81/323, 25.1%), vascular convergence sign (130/323, 40.2%) and vacuole sign (23/323, 7.1%). 292 patients (98.3%) underwent video-assisted thoracoscopic surgery (VATS). Pulmonary wedge resection was performed in 232 cases (78.1%), segmental resection in 13 cases (4.4%) and lobotomy in 51 cases (17.2%). Surgical complications occurred in 4 patients (1.3%). The most frequent findings on surgical pathology analysis were: infectious lesions in 98 cases (33.0%), inflammatory nodules in 96 cases (32.3%), and hamartoma in 64 cases (21.5%). CONCLUSIONS Solid nodules accounted for most of these benign pulmonary lesions in which malignancy could not be excluded preoperatively, and imaging characteristics suggesting malignancy were common. VATS is an important biopsy method to identify etiology and pathology for lesions. The most frequent benign pulmonary diseases that are suspected to be malignant and underwent surgical resection are: infectious lesions, inflammatory nodules and hamartoma.