To evaluate the inhibiting effect of Homoharringtonine (HHT) on the corneal haze after excimer laser photorefractive keratectomy (PRK) in rabbits. 18 healthy rabbits which underwent PRK were randomly divided into three groups (A, B and C). The refractive degree of ablation was - 10.0DS in each group. Group A was locally treated with a piece of filter paper soaked with 1 mg/mL HHT for 5 min, and then the entire cornea was repeatedly irrigated with balance solution; Group B was dropped with 0.1 mg/mL HHT after PRK for 3 months; Group C was the control group. Corneal haze, histopathology, response, ect. were investigated. The corneal haze was significantly less in group A, while the difference between group B and group C was insignificant. Keratocytes and fibrocytes in corneal stroma were more active up to 3 months in group B and group C. Intraoperative use of topical HHT can reduce corneal haze after PRK in rabbits.
Corneal Opacity/etiology ; Corneal Opacity/*prevention & control ; Endothelium, Corneal/pathology ; Harringtonines/*administration & dosage ; Myopia/*surgery ; Photorefractive Keratectomy/*adverse effects ; Random Allocation

Objective To explore the incidence and risk factors of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods The clinical data of 72 cases allo-HSCT from Oct 2004 to Dec 2008 were analyzed. Thirteen factors possibly correlated with the development of aGVHD were analyzed. Results aGVHD was developed in 32 cases (44.4 %), in which grades Ⅰ aGVHD was 11.1%, gradesⅡaGVHD was 18.1%, and grades Ⅲ-Ⅳ aGVHD was 15.3 %. The univariate analysis showed that diagnosis, the status of disease, use ATG, conditioning regimen, donor type,ABO blood group disparity between donor and recipient, CD34+ cell number, early engraftment and neutropenic infection, HLA locus were associated with the occurence of aGVHD (P ＜0.1). On the COX regression mode, an increased risk of aGVHD was associated with HLA mismatch (HR =2.58, P ＜0.005), GVHD prophylaxis without ATG (HR =2.94, P ＜ 0.001), and unrelated donor (HR =1.97, P ＜0.01). Conclusion aGVHD is a common complication after allo-HSCT, and HLA mismatch and unrelated donor are independent risk factors for aGVHD.

BACKGROUNDSome of the locally advanced non-small cell lung cancer (NSCLC) need different trachea-bronchoplasty operative styles in order to make the widest possible to resect the tumor and remain normal pulmonary function. The aim of this study is to explore the surgical problem during trachea-bronchoplasty operation.

METHODSThere were 2206 patients with NSCLC underwent surgical treatment from January 2003 to June 2005 in this hospital. Of the 2206 cases, 100 patients accepted the trachea-bronchoplasty, whose clinic data were analyzed. There were 42 cases of squamous cell carcinoma, 23 adenosquamous carcinoma, 11 adenocarcinoma, 5 mucoepidermoid carcinoma, 4 adeoid cystic carcinoma, 3 carcinoid and 12 undetermined. Thirty-four cases were in stage IB, 23 in stage IIB, 23 in stage IIIA and 20 in stage IIIB. There were 42 cases of right upper sleeve lobectomy, 1 right lower sleeve lobectomy, 24 left upper sleeve lobectomy, 4 left lower sleeve lobectomy, 8 sleeve bilobectomy, 17 carinal reconstruction, 4 sleeve lobectomy plus pulmonary artery angioplasty.

RESULTSComplete resection (R0) of the cancer was performed in 97 patients and uncomplete resection (margin positive, R1) was performed in 3 patients. Postoperative complication happened in 5 cases (the occurrence rate was 5%): Pneumonia in 2 cases, pleura cavity infection in 1 case, broncho-pleura fistula in 1 case, alveoli-pleura fistula in 1 case. One patient died of pulmonary infection, the operative mortality was 1%. The postoperative inpatient time was from 4 days to 27 days, with median of 11 days.

CONCLUSIONSTrachea-bronchoplasty is suitable for some patients of the locally advanced NSCLC and consistent to the tumor surgical treatment principle. A satisfactory cure effect can be obtained for undergoing such operative style. The key point of successful operation is the operating skill to manage trachea, bronchi and pulmonary vessels.

BACKGROUND AND OBJECTIVEProteins of the nucleotide excision repair pathway can repair DNA damage. The excision repair cross-complementing (ERCC) gene family reduce damagement of DNA by nucleotide excision and repair. The aim of this study is to investigate the expressions of ERCC1 (members of DNA repair gene family) in patients with non-small cell lung cancer (NSCLC) as well as their clinical prognostic significance.

METHODSExpression levels ofERCC1 were detected by IHC in 118 stage I NSCLC patients. Kaplan-Meier survival curve, and Cox multivariate regression analysis were used for statistical analysis.

RESULTSThe patients with high expression of ERCC1 had significantly longer survival time than those with low expression of ERCC1, and Cox multivariate regression analysis showed that expression of RRM1 was an independent prognostic factor for NSCLC patients.

CONCLUSIONNSCLC patients with high ERCC1 expression have a better survival when compared to patients with low ERCC1 expression. Therefore, an intact DNA repair mechanism may reduce the accumulation of genetic aberrations that are thought to contribute to a tumor malignant potential and therefore the risk of relapse after definitive treatment.

Aged ; Carcinoma, Non-Small-Cell Lung ; chemistry ; mortality ; surgery ; DNA-Binding Proteins ; analysis ; Endonucleases ; analysis ; Female ; Humans ; Immunohistochemistry ; Lung Neoplasms ; chemistry ; mortality ; surgery ; Male ; Middle Aged ; Neoplasm Staging

A total of 108 subjects were enrolled in this study, including 21 healthy subjects(control group), 34 non-obese patients with polycystic ovary syndrome [PCOS1 group, body mass index(BMI)<25 kg/m²], 32 obese patients with PCOS(PCOS2 group, BMI≥25 kg/m²), and 21 simple obese patients whose age and BMI matched with PCOS2(OB group). BMI, waist-hip ratio(WHR), fasting plasma glucose(FPG), postprandial 2h plasma glucose(2hPG), HbA_1C, fasting insulin(FINS), postprandial 2h insulin(2hINS), sex hormones, and lipid parameters were determined. The status of insulin resistance was assessed by homeostasis model assessment for insulin resistant index(HOMA-IR)and insulin sensitivity index(ISI). Levels of plasma galectin-3 and interleukin-6(IL-6)were detected by ELISA. The results showed that the plasma level of galectin-3 was significantly higher in PCOS group than those in control and OB groups(all P<0.05). Moreover, the level of galectin-3 was also higher in OB group compared with control group, while galectin-3 level in PCOS2 group was higher than that in PCOS1 group(all P<0.05). After adjusted by age, BMI, and WHR, correlation analysis showed that the level of galectin-3 was positively correlated with FPG, 2hPG, FINS, HOMA-IR, highly-sensitive C-reactive protein, and IL-6, while negatively correlated with ISI. A multiple linear regression analysis revealed that the plasma galectin-3 concentration was independently associated with IL-6, HOMA-IR, and BMI(all P<0.05). These data suggest that plasma galectin-3 is closely associated with glucose metabolism, chronic inflammation, and insulin resistance, which may be involved in the pathogenesis of PCOS. (Chin J Endocrinol Metab, 2018, 34: 578-582)

BACKGROUND AND OBJECTIVEThe new edition of the TNM staging for lung and pleural tumours has been finished, which put weight on the extent of primary tumor as one of the important prognosises. But little study has performed on the primary tumor extent < or = 2 cm. The aim of this study is to explore the prognosis of patients with tumor extent < or = 2 cm in stage I of non-small cell lung cancer, which helps us to choose the best treatment for these patients.

METHODSRetrospective study on the clinical response and survival time of whom underwent complete surgical resection and diagnosed as T1a of stage I NSCLC from 1998 to 2004 was analyzed. Data was analyzed by SPSS 17.0 software.

RESULTSOverall survival rate was 80.8%. By the study, age (P = 0.241), gender (P = 0.175), history of smoking (P = 0.845), pathologic type ( P =0.265), and systematic mediastinal lymphadenectomy (SML )(P = 0.918) or not, postoperative adjuvant chemotherapy or not ( P = 0.616) and visceral pleural invasion (P = 0.827) were not the prognosises of these patients. Only the tumor differentiation such as poorly differentiated was the important prognosis ( P = 0.01).

CONCLUSIONIn the tumor extent < or = 2 cm of stage I non-small cell lung cancer, the visceral pleural invasion maybe not influence the patients survival. The tumor differentiation is one of the important prognostic factors.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

Objective Analyzed surgical outcome following Flex-3D thoracoscopy among 429 cases with lobectomy and segmentectomy in this paper to define its safety and efficacy.Methods From the completion of the Olympus Flex-3D integrated operation room in Shanghai Chest Hospital in June 2015 up to December 2016,a single surgeons team carried out 429 cases of Flex-3D anatomic video-assisted thoracic surgery.Demography,preoperative condition,perioperative period complications and pathology for these patients were analyzed and discussed.Results There was a total of 429 patients including 258 males and 171 females.The age at diagnosis was ranged 21-81 yds.Lobectomy was performed in 313 cases,segmentectomy in 116 cases.Among those with 389 primary malignant tumors,39 benign tumors and 1 MALT were anatomically resected.The mean number of lymph nodes resected was 11.10 ±4.58(1-30) and mean sampled lymph node stations 6.10 ± 1.34(1-10).1patient was converted to thoracotomy because of vessel injury.The average operation time was 98.00 ±24.61 min(range,35-274 min) and the average blood loss was(97.9 ±24.6)ml(range,50-400 ml).The postoperative hospital stay was(5.6 ± 1.3) days on average.There was no operative death,and operative complications occurred in 18 patients(4.1％).The 1-year overall survival and 1-year disease-free survival for the lung cancer group were 100％ and 99.8％,respectively.Conclusion Flex-3D video-assisted thoracic surgery is a safe and effective surgical procedure featured by its added depth perception to facilitate operation and short learning curve.

To evaluate the inhibiting effect of Homoharringtonine HHT) on the corneal haze after excimer laser photorefractive keratectomy (PRK) in rabbits. 18 healthy rabbits which underwent PRK were randomly divided into three groups (A, B and C). The refractive degree of ablation was -10. 0DS in each group. Group A was locally treated with a piece of filter paper soaked with 1 mg/mi HHT for 5 min, and then the entire cornea was repeatedly irrigated with balance solution;Group B was dropped with 0.1 mg/mL HHT after PRK for 3 months; Group C was the control group. Corneal haze, histopathology, response, ect. were investigated. The corneal haze was sig nificantly less in group A, while the difference between group B and group C was insignificant.Keratocytes and fibrocytes in corneal stroma were more active up to 3 months in group B and group C. Intraoperative use of topical HHT can reduce corneal haze after PRK in rabbits.

Objective:To test and evaluate the reliability and clinical effectiveness of osteoporotic thoracolumbar fracture (OTLF) scoring and classification system.Methods:A multicenter retrospective case series study was conducted to analyze the clinical data of 530 OTLF patients admitted to 8 hospitals including Honghui Hospital Affiliated to Xi'an Jiaotong University from January 2021 to June 2022. There were 212 males and 318 females, aged 55-90 years [(72.6±10.8)years]. There were 4 patients with grade C and 18 with grade D according to American Spinal Injury Association (ASIA) classification. According to the osteoporotic thoracolumbar injury classification and severity (OTLICS) score, all patients had an OTLICS score over 4 points and required surgical treatment. Among them, 410 patients had acute symptomatic OTLF (ASOTLF), including 24 patients with type I, 159 type IIA, 47 type IIB, 31 type IIC, 136 type IIIA, 8 type IIIB, 2 type IV (absence of neurological symptoms) and 3 type IV (presence of neurological symptoms), and 120 patients had chronic symptomatic OTLF (CSOTLF), including 62 patients with type I, 21 type II, 17 type III, 3 type IV (reducible under general anesthesia), 9 type IV (not reducible under general anesthesia), 1 type V (reducible under general anesthesia), 5 type V (presence of neurological symptoms), and 2 type V (not reducible under general anesthesia). Surgical procedures included percutaneous vertebroplasty (PVP), positional repositioning plus PVP, percutaneous kyphoplasty (PKP), posterior open reduction combined with bone graft fusion and bone cement augmented screw internal fixation, posterior open reduction combined with decompression, bone graft fusion and bone cement augmented screw internal fixation, and posterior open reduction combined with osteotomy and orthopedics, bone graft fusion and bone cement augmented screw internal fixation. A weighted Kappa was used to test the interobserver and intraobserver reliability of the OTLICS score, the ASOTLF classification, and the CSOTLF classification. The visual analog scale (VAS), Oswestry disability index (ODI), ASIA classification were compared before, at 1 month after surgery and at the last follow-up. Incidence of postoperative complications was observed.Results:The percentage of mean interobserver agreement for OTLICS staging was 93.4%, with a mean confidence Kappa value of 0.86, and the percentage of mean intraobserver agreement was 93.0%, with a mean confidence kappa value of 0.86. The percentage of mean interobserver agreement for ASOTLF staging was 94.2%, with a mean confidence Kappa value of 0.84, and the percentage of mean intraobserver agreement was 92.5%, with a mean confidence Kappa value of 0.83. The percentage of mean interobserver agreement for CSOTLF subtyping was 91.9%, with a mean confidence Kappa value of 0.80, and the percentage of mean intraobserver agreement was 91.3%, with a mean confidence Kappa value of 0.81. All the patients were followed up for 6-12 months [(9.0±2.1)months]. The VAS and ODI scores were significantly lower in patients with ASOTLF and CSOTLF classifications at 1 month after surgery and at the last follow-up than those before surgery (all P<0.05). The VAS scores in patients with ASOTLF types IIA, IIB, IIC, IIIA, and IV were significantly lower at the last follow-up than that at 1 month after surgery; the ODI scores in patients with ASOTLF types I, IIA, IIB, IIIA, IIIB and IV were significantly lower at the last follow-up than those at 1 month after surgery. The VAS scores in patients with CSOTLF types II, III, IV, and V were significantly lower at the last follow-up than those at 1 month after surgery, and the ODI scores in patients with all CSOTLF types were significantly lower at the last follow-up than those at 1 month after surgery (all P<0.05). Two patients with ASIA grade C recovered to grade D, and the rest recovered to grade E at the last follow-up ( P<0.01). No major vessel or nerve injury or internal fixation failure was found during follow-up. There were 18 patients with cement leakage, none of whom showed relevant clinical symptoms. There were 35 patients with new vertebral fractures, all of whom recovered well after symptomatic treatment. Conclusions:The OTLICS score, ASOTLF classification and CSOTLF classification have a high degree of reliability. Application of stepwise treatment for patients with different levels of injury according to the scoring and classification system can reduce pain, promote recovery of the spinal function, and reduce complications, which is of some significance in guiding the selection of clinical treatment.