Objective To investigate the expression of LRP16 gene in lung cancer, and explore its clinicopathological significance. Methods Fresh resected tissues from 54 patients with primary lung cancer were collected and the clinicopathological data were gathered. The expression of LRP16 protein in cancer tissues and the matched normal tissues were determined by Western blotting, and the relationship between LRP16 expression and clinicopathological data was analyzed. It was defined as overexpression when the LRP16 expression of cancer tissues was twice or more higher than that of matched normal tissues. Results The LRP16 was overexpressed in 15 out of 54 patients with lung cancer (27.8%). Among the 23 patients with adencarcinoma, the overexpression of LRP16 was found in 11 cases (47.8%), while in the patients with squamous carcinoma, the overexpression of LRP16 was only found in 4 out of 27 cases (14.8%), and there was a significant difference between the two groups (Pearson test, P=0.0258). Besides, very low expression or non-expression of LRP16 was found in 2 large cell lung cancer and 2 small cell lung cancer. The overexpression rate of LRP16 was 20.0% (2/10) in tumor with diameter less than 3cm and 29.5% (13/44) in tumor with diameter ≥3cm, and there was no significant difference between the two groups (Pearson test, P=0.7224). Conclusions There were significant differences of LRP16 overexpression in cases of adencarcinoma or squamous carcinoma with or without lymphatic metastasis. It is suggested that LRP16 is a tumor-related gene of lung cancer, and may play an important role in molecular staging of lung cancer.

Objective To review and sum up the clinicopathologic features and surgical therapeutic efficacy of intrathoracic Castleman′s disease (CD). Methods 14 patients with intrathoracic Castleman′s disease, 7 in each sex, aged from 19 to 52, admitted during 1982 to 2005, all underwent surgical treatment, among which 11 with localized type and 3 with multicentric type, were retrospective analyzed on their clinicopathologic features, radiological signs, treatment and prognosis. Results Clinically, 3 patients of localized type were with systematic symptoms; all the patients of multicentric type were with various severity systematic symptoms. Pathological type: 9 cases with hyaline vascular type (HV), 2 cases with Plasma type (PC), and 3 cases with Mixed type (Mix). A different pattern of pathologic alterations existed between HV、PC and Mix types of CD. Radiological features: in localized type of CD, the lesion presented as a solitary soft-tissue mass with a mean diameter of 5.05cm, the mean CT value was 37.39HU. In 3 cases with multicentric type of CD, diffuse mediastinal lymphadenopathy and pleural effusion were observed. All patients survived after surgical resection, long-term survival was achieved in 11 cases with localized type and 2 cases with multicentric type, no recurrence occurred in the 13 patients. Recurrence occurred twice in a patient with multicentric Mix type in the fourth and the ninth year after surgery, respectively, thus the operative treatment followed. Conclusions The diagnosis of CD is based mainly on its histopathological features. The patients with intrathoracic localized type of CD and part of the patients with multicentric type CD could be cured, while part of the patients with multicentric type CD got a poor therapeutic efficacy and unfavorable prognosis even underwent with radiotherapy and integrated treatment.

Thoracoscopic esophagectomy is an alternative to open thoracotomy in treatment of esophageal carcinoma, but its role in esophageal surgery is still controversial. Between May 2000 and May 2002, 9 patients affected by esophageal carcinoma underwent esophagectomy with thoracoscopic dissection of the esophagus. Seven patients were male, 2 were female,and the mean age was 51 (range, 42～56) years.One patient had the carcinoma at cervical segment, 2 at upper third thoracic segment, 5 at middle third, and 1 at lower third.All tumors were squamous cell type and were below stage II.Thoracoscopy and cervical esophagogastrostomy were successfully performed in 8 patients except in one case, in whom conversion to thoracotomy was necessary because of extensive tumor invasion.Thoracoscopic dissection took an average of 70 (range,40～120) minutes and the mean operative time was 252(range,230～270) minutes. the mean operative blood loss was 250ml (range,150～400ml) and the mean number of thoracic lymph nodes harvested was 7(range,5～12).One patient experienced a cervical infection,which healed with conservative treatment.One patient had a temporary left recurrent nerve palsy that disappeared during the following 6 months.These initial data indicate that thoracoscopic esophagectomy is safe and feasible. The short term result of thoracoscopy is comparable with that of open thoracotomy, and the long term result and its role in esophageal surgery deserve further investigation.

Objective To summarize the characteristics on diagnosis and therapy of adult diaphragmatic eventration. Method The clinical data of 26 patients with adult diaphragmatic eventration, hospitalized in General Hospital of PLA from 1988 to 2009, were retrospectively analyzed. The 26 patients, 14 males and 12 females, were aged from 26 to 66 (mean 44.0?5.7), with disease course of 8 months to 17 years. Among them 25 suffered from left and 1 from right diaphragmatic eventration; 24 with total and 2 with localized diaphragmatic eventration; of them 2 without symptoms were detected in physical examination, and among the 24 remainders 18 were with the symptoms of thoracic discomfort after eating, 8 with dyspnea after activities, 14 with hiccup, vomiting and abdominal discomfort. Most of the patients had more than one symptom. All patients received operations via the chest cavity under general anesthesia, 24 cases were performed by double mattress suture with diaphragm discission, while 2 cases by fold suture without diaphragm discission. Results Symptoms relief was reported in 24 patients at the early stage after operation. Eighteen patients were followed up for one year, and 15 of them received chest radiograph, among whom the normal diaphragm localization were in 13 cases and relatively higher diaphragm localization in 2 cases, while the other 3 patients received no re-examination of chest radiograph. Among the 18 cases receiving one year of follow-up, 10 cases got complete disappearance of symptoms, 6 cases got symptoms relieved or partially disappeared, and 2 patients got symptom relapsed. Conclusion Surgical outcome, especially the double mattress suture is satisfactory for adult diaphragmatic eventration.

Objective: To investigate the high risk factors of occurring the syndrome of cerebral-internal organs in the patients with acute cerebral hemorrhage(ACH).Methods: The serum concentrations of follicle-stimulating hormone(FSH),thyroid-stimulating hormone(TSH) and adrenocorticotrophic hormone(ACTH) were measured by electrochemical radiation in acute period of 37 cases with ACH and 24 cases with cerebral infarction,and compared to those of the 30 healthy controls.The correlations among levels of serum FSH,TSH,ACTH and condition of illness,amount of hemorrhage,critical chamber hemorrhage and the displacement of cerebral mid-line structures were observed.Results: The levels of FSH and TSH were significantly lower,and the levels of ACTH were obviously higher in cases with ACH and cerebral infarction than those of healthy volunteers,and their changes in levels were more obvious in patients with ACH than in patients with cerebral infarction (all P

BACKGROUND:Under physiological conditions, nerve roots can move along with the movement of limbs and spine. However, the mechanisms of nerve root stretch injury under physiological conditions and the neurological dysfunction after injury are unclear.
OBJECTIVE:To review the reason of nerve root stretch injury, and to analyze the mechanism of nerve function from biomechanics, pathology and neurophysiology.
METHODS:A computer-based online search of PubMed database was undertaken by the first author to identify the articles related to the research of nerve root injury and nerve stretch injury between 1990 and 2012, with the key words of“nerve root, nerve, stretch injury”. A total of 391 articles were screened out. The articles on the anatomy and biomechanics research of nerve root were included, as wel as the pathology and neurophysiology research after nerve root stretch injury. Final y, 44 articles were included for review.
RESULTS AND CONCLUSION:Nerve root can be stretched along with limbs and spine movement. However, diseases or trauma may cause pathological nerve root stretch, and thus leading neurological dysfunction. The nerve root is often influenced stretch because of its anatomical and tissue structure. Mechanical injury mechanism of stretch composes of peripheral (peripheral nerve conduction stress) and central mechanism (displacement of spinal cord content). Pathological studies found that the local fibrosis is caused by the extracted serum protein that difficult to remove after injury, and this is because of the shortage of lymphatic system in nerve roots. Fibrosis can cause nerve root ischemia, affect the nerve function, and change the biomechanical properties of nerve root. Nerve root injury can cause primary and secondary injury of internal axons, and this is the main reason for neurological dysfunction after injury.

Objective To evaluate the implementation and effectiveness of comprehensive control measures of schistosomia?sis in Caidian District, Wuhan City. Methods The data of implementation of the schistosomiasis control measures in Caidian District was collected and analyzed statistically. Results The number of Oncomelania hupensis snail environments and snail area decreased from 213 sites and 223.47 hm2 in 2003 to 59 sites and 51.20 hm2 in 2013, with the decreasing rate of 72.30%and 77.09%, respectively. The infection rate of schistosomiasis of human decreased from 1.58%in 2006 to 0.24%in 2013, with the decreasing rate of 84.81%. The positive rate of stool tests of cattle was 2.19%in 2006 while it was 0 in 2013. Conclusion The comprehensive control measures of schistosomiasis are effective.

OBJECTIVETo discuss the therapeutic effect of free anterolateral thigh flap for the treatment of burn scar carcinoma.

METHODSFrom Jun. 2005 to Feb. 2013, 10 cases with burn scar carcinoma at craniofacial area and extremities underwent radical excision and transposition of free anterolateral thigh flaps for the leaving wounds.

RESULTSThe flaps in 10 cases survived completely and primarily without any complications. The operation time was 7 hours in average. The patients were followed up for 5 months to 2 years (1 year, in average) without no recurrence and no functional morbidity in donor sites. The cosmetic results were satisfactory in all the cases, even with hair growth in 6 cases.

CONCLUSIONThe free anterolateral thigh flap is suitable for the treatment of burn scar carcinoma.

Adult ; Aged ; Burns ; complications ; Cicatrix ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Surgical Flaps

Objective To evaluate the technique of finger palpation in thoracoscopic localization in patients with pulmonary nodules,and to summarize its technical details,especially with exploit of chest computed tomography (CT) facilitating it.Methods 95 patients with total amount of 109 pulmonary nodes 20 mm or smaller in size shown with lung window of CT,were reviewed.They were located subpleurally,with a median depth of 8.2 mm and a median size of 10.0 mm.The value of their depth over their size (D/d value) could be used as the extent of localizing difficulty.Each node had its own radiographic fealures for being localized,which was built preoperatively.Under thoracoscopic vision,nodules were finger-palpated by index finger via the 4th or 5th intercostal space on anterior axillary line,followed by wedgectomy or lobectomy for instant histopathological diagnosis to further decide the final surgical type.The distance between the nodule and the origin of segmental bronchus (L value) were also calculated out,as it might be relevant to the way the nodule could be biopsied.Results All nodules were successfully localized and resected for biopsy goal,105 by wedgectomy,4 by lobectomy.After intraoperative diagnosis was made by the pathologist,VATS lobectomy and lymph node dissection were further performed in 55 patients.L value of 4 cases being biopsied by lobectomy ranged from 18.3 to 30.3 mm,averaging 26.1 mm.Conclusion Finger palpation is viable in any cases of pulmonary nodules.Detailed reference of CT digital information,and enough detachment of mediastinal pleura,can greatly facilitate thoracoscopic localization by finger palpation.Lobectomy or segementectomy is preferable when L value is less than 30 mm.

Background The fate of adult stem cells is associated with its surrounding microenviroment.Our previous work found that embryonic stem cells (ESCs) micro-environment enhance the stemness of human limbal stem cells (LSCs),but its mechanism has not been elucidated.Objective This study was to explore the molecular mechanism of ESC micro-environment enhancing the stemness and inhibiting the apoptosis of LSCs.Methods Human LSCs were cultured by explant culture method with CnT-20 medium and CnT-20+20％ ES culture supernatant (ESC-CM),respectively.Colony formation assay was used to analyze the proliferation ability of cells.Telomerase reverse transcriptase (TERT) siRNA (19-25nt siRNA) or siRNA (sc-37007) was transfected into the cells of ESCCM group.Apoptosis and mitochondrial membrane potential were assayed by flow cytometry,and the expressions of telomerase and reactive oxygen species (ROS) in TERT siRNA-or siRNA-F-transfected cells by immunofluorescence and flow cytomery.RT-PCR,immunofluorescence staining and Western blot were employed to determine the expressions of p63,ATP-binding cassette transporer G2 (ABCG2),integrin β1 mRNA and proteins and cytokeratin 3 (C K3) in the cells.The levels of focal adhesion kinase (FAK),Akt,glycogen synthase kinase 3β (GSK3β) and p21 protein and phosphorylation proteins in the cells were detected by Western blot.Results The LSCs presented an increased proliferative capacity and passaged to the eighth generation with the colony-forming efficiency (CFE) of (7.6±0.6) ％ in ESC-CM group,but the cells to the sixth generation with the CFE of (5.6±0.6)％,showing a significant difference between them (t =4.454,P =0.011).The apoptotic rates of the cells from 2 through 6 generations were lower in the ESC-CM group than those in the CnT-20 group (all at P＜0.05).The apoptotic rate of the cells was (7.67± 1.31)％ in the siRNA-F transfected group,which was significantly lower than (32.33 ±3.13)％in the siRNA-TERT transfected group (t =-12.588,P =0.000).No significant differences were seen in the expression levels of p63,ABCG2,integrin β1 mRNA and proteins and TERT protein in the primary cells between the ESC-CM group and the CnT-20 group (all at P＞0.05),but significantly declined expressions of CK3 mRNA and protein were found in the ESC-CM group compared with the CnT-20 group (all at P＜0.01).However,the expressions of p63,ABCG2,integrin β1 mRNA and proteins and TERT protein in the second generation of the cells were significantly higher in the ESC-CM group compared with the CnT-20 group (all at P＜0.01).The telomerase activity was (4.83±0.67) ％ in the siRNA-TERT transfected group,which was significantly lower than (46.71±1.22) ％ of the siRNA-F transfected group (t =52.116,P =0.000).The expression of pFAK,pAkt,pGSK3β proteins were weakened,but the expression of p21 was increased in the ESC-CM group after addition of FAK inhibitor,GSK3β inhibitor and TERT-siRNA transfected group.Mitochondrial membrane potential in the second generation of cells was elevated in the ESC-CM group in comparison with the CnT-20 group and the siRNA-TERT transfected group (all at P＜0.01),and the rates of ROS positively reaction was lower in the ESC-CM group and the siRNA-F transfected group than those of the CnT-20 group and siRNA-TERT transfected group (all at P＜0.01).Conclusions ESC-CM culture system can effectively keep the stemness of LSCs and inhibit apoptosis.ESC-CM culture system plays functions probably via telomerase-p21-mitochondrial axis and the activation of the FAK/Wnt signaling pathways.