BACKGROUND: AG490 is a newly found JAK kinase inhibitor, which can compete with receptor tyrosine kinase for binding site to block JAK/STAT pathway, inhibit rejection-related cytokine activation such as interferon-gamma (IFN-γ) ultimately inhibiting rejection.OBJECTIVE: To evaluate the possibility and prospect of the AG490 as a potential immunosuppressor, explore its basic mechanism in comparison with Cyclosporine A (CsA).DESIGN, TIME AND SETTING: Comparative observation was performed at the Institute of Urinary Surgery, Fujian Union Hospital from October 2007 to April 2008.MATERIALS: AG490 was purchased from Sigma, USA.METHODS: Human peripheral blood lymphocyte (both T and B) were harvested from 8 healthy donors. Lymphocyte were isolated by density gradient method and cultured with phytohemagglutinin, interleukin-2 (IL-2) or mixed lymphocyte culture to induce human lymphocyte proliferation. MAIN OUTCOME MEASURES: ELISA was used to detect the concentration of IL-2, IFN-γ and IL-6 in different culture systems with the tyrphostin (AG490), CsA or FK506. RESULTS: IL-2 and IFN-γ in culture systems of phytohemagglutinin, IL-2 or mixed lymphocyte culture were inhibited by AG490 (P < 0.05), but IL-6 was not suppressed by AG490 (P < 0.05). This effect was similar to clinical CsA or FK506. CONCLUSION: AG490 may be a potential immunosuppressor.

ObjectiveTo assess the feasibility and clinical efficacy of minimally invasive esophagectomy for esophageal cancer.MethodsFrom July 2007 to December 2009,eighty-one patients with esophageal cancer received combined thoracoscopic and laparoscopic esophagectomy with anastomosis in the neck.All clinical data were retrospectively reviewed.ResultsThe median operative time was 270.5 min (range 196-315 min).The median time of gastric mobilization and abdominal lymph node dissection was 64.5 min,and the median time of esophageal dissection and mediastinall lymph node dissection was 81.2 min.The median blood loss was 121.5 ml for the thoracic phase and 42.4 ml for abdomen phase.The mean number of disected lymph nodes was 20.4 (range 5-41) with metastastic rate of 30.9% (25/81).The mean harvest lymph node was 12.5 in chest and 7.3 in abdomen.Perioperative complications rate was 27.2%,including respiratory failure in 1 case,pulmonary infection in 10,anastomotic leak in 3,chylothorax in 2,gastric tube dilatation in 1,gastric tube leak in 1.And recurrent laryneal nerve injury in 5 .Seventy-nine patients were followed up withmMean follow up time of 14.2 months( range 2-31 months).The overall one-year survival rate was 91.1%.Postoperative complications included anastomotic stenosis in 5 cases (6.3%),reflux esophagitis in 12 (15.2%) and recurrence or metastasis in 6 (7.6%).ConclusionMinimally invasive esophagectomy for esophageal cancer can mimimus trauma,reduce post-operative complications,improve the quality of life,which is feasible and effective from the point of the clinical efficacy and the purpose of tumor therapy.

Objective To study the mutation of FLCN gene in Chinese patients with sporadic and familial primary spontaneous pneumothorax. Methods A complete genetic analysis of FLCN by use of SSCP-PCR was performed in 102 unrelated Chinese patients with isolated PSP. Results Three novel mutations (c. 924_926del, c. 1611_1631del and c. 1740C.T) and a previously reported mutation (c. 1733insC) were identified in five familial and five sporadic PSP patients. Of the 21 family members of patients with PSP including 3 previous considered as sporadic, 4 ( 19% ) had history of at least one episode of PSP and 9 (43% ) were FLCN mutant carriers without PSP. Seven of the nine (78% ) mutant carriers had pulmonary cysts detected by high-resolution computed tomography ( HRCT) . Although c. 924_926del and c. 1611 _1631 del were found in eight patients from the same geographic district, haplotype analysis demonstrated that they did not share the same affected haplotype,thus excluding common ancestry. Conclusion This study first demonstrates that FLCN mutation contributes to not only familial but also apparently sporadic' patients with isolated PSP. It suggests that mutation analysis and HRCT scan may be recommended for first-degree family members of PSP patients with FLCN mutations, irrespective of their family history status of PSP.