Objective Surgical treatment of lung cancer needs to follow strict quality control standard for the aims of accuracy of pathological staging and potentially improved prognosis.However,there are short of studies related to surgical quality analysis.Methods One hundred and twelve patients were enlisted with the diagnosis of lung cancer and received surgical intervention in 2007.Surgical quality of these cases were retrospectively analyzed in compliance with three international standards,National Comprehensive Cancer Network (NCCN),American College of Surgeons’ Oncology Group (ACOSOG),and International Association for the Study of Lung Cancer (IASLC).Results No surgical death was reported in this group.According to NCCN,ACOSOG and IASLC standards,qualified operations were 82 cases (80.4％),73 cases (71.6％),45 cases (44.1％) in 102 cases with R0 resection,respectively.The median total lymph nodes,median mediastinal nodes,and N1 nodes were 27 (range 0-63),16.5 (range 0-43),and 10.5 (range 0-26),respectively.The median mediastinal node stations resected were 4 (range 0-6).In the mediastinum,stations of 4R,5,6 and 7 presented the highest frequency of receiving lymph node dissection.For N1 stations,10 and 12 were among the top list.For the whole group,1-year survival,3-year survival and 4-year survival were 92％ (95％ CI,89-95),67％ (95％ CI,62-72),57％ (95％ CI,52-62),respectively.Conclusion Quality control is the essential part of surgical treatment of lung cancer,which will facilitate the baseline standardization of clinical research.Since IASLC provides the strictest standard for lung cancer surgery,we suggest that all thoracic surgeons need to follow this standard to secure the accuracy of pathological diagnosis and for a potential better prognosis.

Objective: To investigate the expression of suppressor of cytokine signaling 2 (SOCS2) in breast carcinoma tissues and to discuss its relationship with clinical pathological data of breast carcinoma patients. Methods: The tissue microarray for 171 cases of breast carcinoma specimens, 18 adjacent tissues and 20 breast benign lesions were established. Then the expression of SOCS2, ER, PR, cerbB2, p53 and Ki-67 was detected by tissue microarray technique and S-P immunohistochemistry. Results: Positive rates of the SOCS2 protein in the breast carcinoma specimens, adjacent tissues and breast benign lesion were 57. 89% (99/171), 94. 44% (17/18), and 75% (15/20), respectively. The expression of SOCS2 was significantly different in breast carcinoma tissues of different TNM classification, different histological grades, and with or without Ki-67 expression and lymphatic metasrasis(P

Objective:To examine the effects of chronic intermittent hypoxia(CIH)on the NF-κB,IL-6 and PGE2 level in rats with periodontitis.Methods:32 male SD rats(6 weeks old)were randomly divided into 4 groups(n =8),group A(normoxic control),B (normoxic periodontitis),C(CIH)and D(periodontitis +CIH).Periodontitis model was established in the upper second molars by liga-tion technique and high-glucose diet in the rats of group B and D.The rats in the group C and D were subjected to CIH in a cycle of al-ternative nitrogen and oxygen in a closed chamber.The chamber was filled with nadir and zenith ambient oxygen every 1 20 seconds per cycle for 8 hours per day.The rats were sacrificed and the gingival tissues were examined for the detection of IL-6 and PGE2 expression by ELISA,and NF-κB expression by immunohistochemistry.Results:Histology revealed apical migration of junctional epithetlium and crestal alveolar bone resorption in group B and D,and in the above phenomena of group D was the severest.The content of NF-κB,IL-6 and PGE2 in group B,C,D was higher than that in group A(P <0.05),and in group D was the highest(P <0.05).Conclusion:Chro-nic intermittent hypoxia can aggravate the inflammation of periodontitis.

ObjectiveTo explore the efficacy of several skin flaps in treating of the soft tissue defect with or without osteomyelitis at foot in cold environment. MethodsThe damaged foot should be re-warmed immediately. Several kinds of skin flaps were transplanted for 35 cases of soft tissue defect at foot in particularly, among them, 11 cases were with osteomyelitis and bone exposuring. ResultsThere were 31 cases survived by the first intention, 4 case presented partial necroses and healing by dress changing at the second intention. The appearance and function of damaged feet recovered well.ConclusionImmediate re-warming and skin flaps transplant can repair the acute or old soft tissue defect with osteomyelitis in cold environment.

Objective Surgical approech differs between China and western countries in the treatment of middle/lower aegment thoracic esophageal cancer. This study was designed to compare the effects of different surgical modalities on traumatic reaction, heal-ing process and lymph node dissection.Methods Fifty-nine petients,diagnosed with middle/lower segment of thoracic esophageal cancer, were enlisted and had undergone curative RO esophagectomy.The patients were categorized based on different approaches as the following three groups:group of Ivor-Lewis operation,group of McKeown operation and group of esophagectomy through left tran-sthoracic approach.Clinical data was summarized and malyzed.Results (1)No surgical death was reported in this study.(2)There were no statistical difference among the three groups in tenms of postoperative hospital stay,diration of systemic inflammatory re-sponse syndrome and total body fluid loes (P=0.287,0.641,0.355).(3) The number of total lymph nodes harvested from the above three groups was 22.5(11-39),26(14-56).and 17(7-44)(P=0.005),respectively.The number of abdominal lymph nodes harvested from the above three groups was 10(5-26),12(4-32),and 8(3-19)(P=0.021),respectively.No statistical difference was found to the number of thoracic lymph nodes among three groups.(4)Lymph node metastasis occurred most frequently in the station of pericardial lymph nodes,followed by middle thoracic paraesophageal nodes along the left gastric ar-tery.The range of metastasized lymph nodes dissected through left transthoracic approach was much limited compated with right tran-sthoracic approach.Conchuslon The was no difference between left and right transthoracic approach in terms of surgical trauma and overall rehabilitation.The number of lymph nodes harvested from right transthoracic approach surpassed that from the left approach, which might be due to the extent of abdoominal lymphadenectomy.Considering wide range of lymph node metastasis,We recommedn a more extended lymph node dissection for middle/lower segment of thoracic esophageal cancer for the purpose of better local control control and survival benefit.

Objective This study is to analyse the clinical feature and risk factors of morbidity after pulmonary resection for lung cancer in patients older than 70 years. Methods The clinical records of 222 patients older than 70 years who had undergone pulmonary resection for their lung cancer was reviewed. The patients were divided into 3 groups: group Ⅰ including the patients who had severe postoperative complications, group Ⅱ including the patients who had mild complications and group Ⅲ including the patients who had no complications. Moreover, the definitions were made that group A1 = group Ⅰ+ Ⅱ , group B1 = group Ⅲ, group A2 = group Ⅰ and group B2 = group Ⅱ + Ⅲ. Univariate analyses and multivariate binary logistic regressions relating postoperative morbidity to risk factors were performed between the group Al and Bl, A2 and B2, resulting in the identification of the independent risk factors for overall morbidity and major morbidity. Results Preoperative comorbidity was recorded in 161 patients (72.5%). Lobectomy (64.9% ) was the predominant surgical procedure. The median number of dissected LN was 14, with the range of 0 to 57. The overall morbidity was 63.5% , including major morbidity of 13.5%. Perioperative mortality was 1.8% (4 cases). The results of binary logistic regression analyses indicated that the independent risk factors for overall morbidity were preoperative weight loss (P =0.020), ASA score (P＜0.001), MVV (% predicted) (P=0. 020 ) and the number of dissected LN ( P = 0.004 ). The independent risk factors for major morbidity were ASA score ( P =0.003), MVV (% predicted) (P= 0.018) and the location of tumor (P=0.007). Conclusion Preoperative weight loss and numbers of dissected mediastinal lymph nodes were risk factor for lung cancer patients older than 70 years, Proper perioperative management for the elderly patients with high ASA score, low MVV (% predicted) or central tumor, could reduce the major postoperative morbidity.

ObjectiveTo describe the modified (narrowed) gastric tube and two methods on the establishmentof enteral feeding pathway in esophagectomy.MethodsFrom July 2003 to April 2006,we made traditional gastric tube for patients underwent esophagectomy to substitute the dissected esophagus while from May 2006 to November 2009,we made modified gastric tube for the same purpose.From July 2003 to November 2009,enteral nutrition tubes for all these patients are placed intraoperatively by two different ways,which made early post-operative nutrition support possible for these patients.ResultsNo perioperative death occurred among the patients.The length of the modified gastric tube ensured the anastomosis by circular stapler at the apex thorax or in the bases of cervical region.No statistical differences were found between the two group in terms of survival rate.The intraoperative establishment of enteral nutrition pathway ensured the early enteral nutrition support after the operation.ConclusionThe utility of the modified gastric tube extends the length of gastric tube to make mechanical anastomose easier and safer; meanwhile,the intraoperative establishment of enteral nutrition pathway ensures the early enteral nutrition support after the operation.

In this study, the effect of cyclosporin A (CsA) eye drop on keratoconjunctivitis Sicca (KCS) and its mechanism were studied. The KCS models were established by injecting Pertussis vaccine, complete freunds adjuvant (CFA) and antigen of conjunctiva from isotype mice. Then the KCS models were treated with cyclosporin A eye drop. Changes in breaking-up time (BUT), lacrimal secretion in 30 min and diversion in 24 h were measured. The percentage of beaker cells, the lymphocytic infiltration in conjunctiva were observed. The expression levels of Aquaporin-3(AQP3) in conjunctiva epithelial cells, beaker cells and accessory lacrimal gland were immunohistochemically detected. The results showed that there were significant differences in BUT, the percentage of beaker cells, lacrimal secretion in 30 min, the lymphocytic infiltration and the expression of AQP3 between the experimental group and an control group. It was concludedthat CsA eye drop exerts marked therapeutic effect on KCS by inhibiting T lymph cells, increasing the goblet cells and AQP3 expression in conjunctiva.

As a typical BCS Ⅱ drug, felodipine exhibits low solubility and high permeability. We herein investigated the effects of different solubilization strategies on the oral absorption of felodipine. Firstly felodipine tablets based on 200 μm, 150 μm and 25 μm particle size of bulk drug were prepared. Meanwhile, felodipine solid dispersion and felodipine nanosuspension with average particle size of (168.90 ± 6.22) nm, PDI of 0.11 ± 0.06 were prepared. The absorption rate, apparent permeability coefficient (Papp), absorption quality in duodenum, jejunum, ileum and colon of rats and in vivo pharmacokinetics of the above different felodipine preparations were investigated. The results of rat single-pass intestinal perfusion showed that the absorption of felodipine preparations in duodenum, jejunum and ileum was better than in colon. Felodipine had a wide absorption window in the small intestine, with the best absorption site in the small intestine. Papp of different felodipine preparations was greater than 2.0 × 10-5 cm/s. Thus, the low solubility was the main factor limiting the absorption. In vivo pharmacokinetic experiments demonstrated the solubilization strategies significantly improved the bioavailability. The bioavailabilities of felodipine tablets with particle sizes of 150 and 25 μm, as well as nanosuspension, and solid dispersion were 138.75%, 173.01%, 208.65% and 314.53% that of the tablets with particle size of 200 μm, respectively. Solubilization strategies can significantly improve the gastrointestinal absorption rate and absorption quality of felodipine, and thus improve its bioavailability, which provides some reference for the research on the improvement of oral absorption of BCS II drugs.

To investigate the mutation site of pathogenic gene in patients with hypertrophic cardiomyopathy (HCM) and to analyze the relationship between the genotype and clinical phenotype. Methods: Targeted exon capture sequencing was conducted in a HCM proband for 30 coding exons related HCM gene by all exon amplification and high-throughput sequencing. Furthermore, Sanger sequencing was performed in other family member and in 200 healthy volunteers for verification. The familial investigation included in clinical presentation, physical examination, electrocardiogram and echocardiography. Results: There were 3/6 blood relatives carrying cardiac myosin-binding protein gene MyBPC3 G772A heterozygous mutation, the mutation site was at 258 amino acid of MyBPC3 as glutamic acid (Glu) was substitute to lysine (Lys), such mutation was not found in rest of family member and not in healthy volunteers. The onset of proband and her daughter was rather late, they had palpitation and chest tightness; echocardiography showed interventricular septum basal segment thickening (16-18) mm. Proband was complicating paroxysmal ventricular tachycardia, malignant arrhythmia and heart failure, the maximum pressure gradient of left ventricular outflow was 56 mmHg, which with the high risk for sudden death. Conclusion: Comprehensive gene test has been helpful for clinical stratification, early diagnosis and treatment. MYBPC3 site mutation c.G772A might be the pathogenic mutation in that specific HCM family.