BACKGROUND: The metacarpal fascial spaces of hand are the potential structure that is not virtual, so that difficulties are presented in diagnosis and treatment of diseases of the metacarpal fascial spaces of hand. In order to solve the difficulties,anatomical borderline and abut relationship of the metacarpal fascial spaces of hand have to be sufficiently understood. OBJECTIVE: The borderline and abut of the metacarpal fascial spaces of hand were detailedly observed and researched by fresh cadaveric dissection, thin sectional anatomy and computer image recognition technology, and the 3-D reconstruction technology was utilized to reconstructed the metacarpal fascial spaces in this paper, so the abut relationship of the metacarpal fascial spaces of hand could be displayed, and the detailed anatomical data of imaging diagnosis and surgical treatments of disease of the fascial spaces of hand could be provided. DESIGN: Repeated measuring design.SETTING: The 251 Hospital of Chinese PLA and Central Laboratory of the Third Military Medical University of Chinese PLA. MATERIALS: Twelve adult fresh cadaveric hands which involved six right hands and six left hands and wrist joint, had no organic damage by naked observation, provided by the Department of Anatomy, the Third Military Medical University of Chinese PLA, among one right hand and one left hand were waiting for being mill-cut and thin cross-section dissected and imaging reconstructed. Among ten hands were observed by fresh cadaveric anatomy. METHODS: The trial was carried out in the 251 Hospital of Chinese PLA and Central Laboratory and Department of Anatomy of the Third Military Medical University of Chinese PLA from May 2003 to February 2006. Based on the gross anatomy, thin cross-section anatomy, visible human and virtual human technology theory, the metacarpal fascial spaces of hand were three-D reconstructed in microcomputer.MAIN OUTCOME MEASURES: Anatomical borderline and about relation of the metacarpal fascial spaces of hand. RESULTS: Display of observation result of adjacent and dimension of the midpalmar space and the thenar space by fresh cadaveric anatomy combined with thin cross-section anatomy, computer image recognition technology, and the 3-D reconstruction technology: The anterior borderline of the MPS was the digital flexor tendons of middle finger, ring finger, little finger and the 2nd lumbrical muscle (LM), 3rd LM, 4th LM; the posterior borderline was the palmar interosseous fascia before 3rd palmar bone, 4th palmar bone, 5th palmar bone and corresponding interosseous muscles; the lateral borderline was the palmar intermediate septum; the medial borderline of the MPS was the medial intermuscular septum of palm. In addition, the distal section of the MPS which was separated into three little spaces by two septums of connective tissue, and 3rd 4th, 5th digital flexor tendon and 2nd, 3rd, 4th LM were respectively contained by the three little spaces. The proximal of this space opened to the posterior space of antebrachial flexor by the carpal canal; the distal of this space opened to 2nd, 3rd, 4th web space (WS) by 2nd, 3rd, compartment of 4th LM, and continuously the dorsal subcutaneous space and the subaponeurotic space. The anterior borderline of the TS was the 1st digital flexor tendon and the 1st LM; the posterior borderline was the fascia of abductor pollicis; the medial borderline was the palmar intermediate septum (PIMS); the lateral borderline was the tenden sheath of flexor pollicis longus and the lateral intermuscular septum of palm. The distal of this space opened to 1st WS by compartment of the 1st LM, and continuously to the dorsal subcutaneous space and the subaponeurotic space; the proximal of the TS was close.CONCLUSION: The proximal of the thenar space is close, the distal section of the metacarpal fascial spaces is separated into three little spaces, and the computerized three-D renconstruction of the fascial spaces of hand can provide some guidance for imaging diagnosis and surgical treatments.

Objective To retrospectively analyze the relationship between progression free survival (PFS) and overall survival (OS) in patients with non small cell lung cancer (NSCLC), and to detect the influence of plasma fibrinogen and D-dimer levels before treatment in the prognosis of advanced stage (stageⅢB-Ⅳ) of NSCLC. Methods The study comprised 134 NSCLC patients with clear pathological diagnosis. All patients were grouped by plasma fibrinogen and D-dimer levels before treatment. We set the normal values of fibrinogen as≤4 g/L and D-dimer as≤500μg/L(FEU). Patients with normal levels of fibrinogen and D-dimer were grouped into low risk group, patients with elevated fibrinogen or D-dimer were grouped into median risk group, and patients with both elevated values were grouped into high risk group. Chi-square test and one way ANOVA analysis were used to analyze the clinicopathologic features of different groups. The OS and PFS in different groups were analyzed by Kaplan-Meier analysis. Univariate analysis of PFS and OS were conducted. Then multivariate analysis was conducted with the Cox regression model in three groups. Results The clinicopathologic features showed no differences between different groups. There were significant differences in OS and PFS between high risk group and other groups. In the survival curves, the high risk group showed poor prognosis. The result of multivariate analysis showed that clinical stage (OS:RR=1.846, 95%CI 1.150-2.964,P=0.011; PFS:RR=1.762, 95%CI 1.190-2.609, P=0.005) and grouped by fibrinogen and D-dimer (OS:RR=1.415,95%CI 1.050-1.908,P=0.023;PFS:RR=1.373,95%CI 1.070-1.761,P=0.013) were prognostic factors for patients with NSCLC. Conclusion The plasma fibrinogen and D-dimer levels before treatment are closely related with the prognosis of NSCLC patients. And a high plasma fibrinogen and D-dimer levels before treatment are associated with poor prognosis in advanced stage of NSCLC patients.

In previous study, the 150-ku oxygen-regulated protein(ORP150) was identified as a candidate glycoprotein related to hepatocellular carcinoma.In order to further validate the expression level of ORP150 in hepatocellular carcinoma, protein expression was determined by Western blot and cell immunochemistry, and messenger RNA(mRNA) expression was detected by quantitative real-time polymerase chain reaction.The effect of ORP150 on apoptosis and invasive potential of hepatocellular carcinoma cells was evaluated using the small interference RNA(siRNA) technique.Both the protein and mRNA expression levels of ORP150 were significantly upregulated in hepatocellular carcinoma cell lines compared with a non-tumor human liver cell line.After transfection with the specific siRNA of ORP150, significantly greater apoptosis of hepatocellular carcinoma cells was induced compared with untransfected cells.However, no significant effect on invasive potential was found.Overexpression of ORP150 was associated with hepatocellular carcinoma, and ORP150 might promote the proliferation of hepatocellular carcinoma cells by inhibiting apoptosis.ORP150 could be a potential therapeutic target for hepatocellular carcinoma.

OBJECTIVEThis study aimed to explore the expression of tumor-derived colony-stimulating factor 1 (CSF1), its prognostic significance and underlying related mechanisms in resected lung adenocarcinoma (ADC).

METHODSImmunohistochemistry and tissue microarray were used to detect the expression of CSF1, epidermal growth factor receptor (EGFR), and CD68 in 266 patients with lung adenocarcinoma treated in our department between 2004 and 2008.

RESULTSIn the 266 ADC cases, the positive rates of expression of CSF1, EGFR and CD68 proteins were 56.4%, 42.1% and 81.2%, respectively. The expression level of CSF1 was positively correlated with TNM stage, number of involved nodal stations, tumor recurrence and EGFR expression (P<0.05). Univariate analysis indicated that TNM stage, number of involved lymph nodes, number of involved nodal stations, CSF1 expression, the combination of CSF1/EGFR and co-expression of CSF1/CD68/EGFR were statistically significant for prognosis (P<0.05). The results of multivariate analysis showed that TNM stage, co-expression of CSF1/EGFR and CSF1/CD68/EGFR were significant and independent risk factors for survival (P<0.05). Correlational analysis showed that expression of CSF1 and EGFR in the tumors was positively correlated to the degree of infiltration of interstitial tumor-associated macrophages (TAMs) (respectively; P<0.05).

CONCLUSIONSThe expression of CSF1 indicates a poor prognosis in postoperative lung adenocarcinoma. Co-expression of CSF1 and EGFR may be a valuable independent prognostic predictor, and its mechanism is probably involved in the interaction of cancer cells and TAMs in the progression of lung adenocarcinoma.

Adenocarcinoma ; diagnosis ; metabolism ; Disease Progression ; Humans ; Immunohistochemistry ; Lung Neoplasms ; diagnosis ; metabolism ; Macrophage Colony-Stimulating Factor ; metabolism ; Macrophages ; Prognosis

BACKGROUND: At present, robotic surgery is widely used in thoracic surgery, which has higher maneuverability, precision, and stability, especially for small space complex operations and reconstructive surgery. The advantages of robotic lung segment resection under full orifice artificial pneumothorax are obvious. METHODS: Based on a large number of clinical practices, we established a set of surgical methods for 4-arm robotic lung segment resection under a port-only artificial pneumothorax. 98 cases of robotic lung segment resection were performed with this method from January 2019 to August 2022. The clinical experience was summarized. RESULTS: Robotic lung segment resection under port-only artificial pneumothorax has obvious advantages in the anatomy of lung segment vessels and bronchi. It is characterized by less bleeding, shorter operation time, adequate exposure, and flexible operation. CONCLUSIONS This surgical model we propose optimizes the operation mode and technique of lung segment resection, makes each step procedural, reduces collateral damage, and is easy to learn and master, which is believed to cure more lung cancer patients with less trauma.
Humans ; Pneumothorax, Artificial ; Robotic Surgical Procedures ; Pneumonectomy ; Lung Neoplasms/surgery* ; Robotics