AIM: This study aimed to observe the effects of high-glucose on proliferation and apoptosis of endothelial progenitor cells (EPCs) in type 2 diabetes mellitus patients, and tried to elucidate their possible role. METHODS: Various concentrations of glucose were added to the culture system of EPCs from 25 cases of type 2 diabetes mellitus patients (DM group) and 25 cases of healthy volunteers (control group). MTT assays were used to detect the proliferative rates. Annexin-V/PI stains were used to detect the apoptotic rates, and RT-PCR to detect the expression level of bcl-2 and bax. RESULTS: Proliferative activity of EPCs in both control group and DM group were attenuated when concentration of glucose was 33 mmol/L, while apoptotic rates increased. No significant change of proliferative rate and apoptotic rate of EPCs in DM group and control group in the presence of 5 mmol/L glucose was observed. The expression level of bax of EPCs in both DM group and control group increased while expression level of bcl-2 did not change much in the presence of 33 mmol/L glucose. CONCLUSION: High-glucose attenuates proliferative activity of EPCs and increases the apoptotic rate. Upregulation of bax may be its possible role.

Objective To study the effect and possible role of recombinant human erythropoietin(rhEPO) on the proliferation and apoptosis of endothelial progenitor cells (EPCs) from patients with diabetic nephropathy (DN). Methods Various concentration of rhEPO was added to the culture system of EPCs from 20 DN patients (DN group) and 20 normal people (control group). MTT assays were used to detect the proliferative rate, Annexin V/PI stains to detect the apoptotic rate, and Western blot assays to detect the expression level of Akt protein kinase. Results Proliferative ability of EPCs from control group and DN group was improved when concentration of rhEPO was 0.3, 0.6 and 1.2 kU/L, and it was dose-dependent. The effect from the latter was more obvious. The apoptotic rate of DN group was lowered and the expression levels of Akt protein kinase were upregulated when the concentration of rhEPO was 1.2 kU/L, while this kind of effect was blocked after Wortmannin was added to the culture system. Conclusion rhEPO can improve the number and function of EPCs from both healthy volunteers and patients with DN. PI3K/Akt pathway may play an important role.

ObjectiveTo evaluate the efficacy,safety and clinical value of anterior urethral fusion to treat diphallia.MethodsA 17-year-old male patient with complete penile diphallia was treated in March 2011.The physical examination showed two completely separated mature penis; urethrography,and urethroscope showed the two urethras were completely separated and entered the bladder respectively.Two anterior urethras were incised respectively at ventral sides ( from the meatus to bulbar urethra) and then two incised anterior urethras were splintered by a continuous suture with 4-0 polyglactin sutures in side and side.Two penises were splintered into one.The nocturnal penile tumescence test and the penis vibration thresholds were assessed before,and after surgery..ResultsThe patient was followed up for 12 months.There was no hematoma,urinary fistula,urinary incontinence and other complications postoperatively.The penis was recovered with normal appearance; urination and morning erection of penile were normal.6 months after surgery,there was no significant difference in the nocturnal penile tumescence and penis vibration thresholds detection ( P ＞ 0.05).ConclusionThe operation of anterior urethral fusion is a safe and efficient surgical treatment to treat partial complete penile diphallia with less complication and no worse effect on urination and erection of penile.

Objective:To study the in vitro effect of adipose stromal stem cells(ASC) on phenotype and secretion of cytokines of allogenetic T lymphocytes,and to elucidate the possible roles of ASC for immunomodulation.Methods:ASC was isolated and cultured.The supernatant of ASC and ASC itself were co-cultured with allogenetic T lymphocytes.MTT assays were used to detect the proliferative rates of T cells.Annexin-Ⅴ/PI staining was used to detect apoptotic rates,and flow cytometry to detect the proportion of CD4+CD25+ cells.ELISA was used to detect the secretion of IL-10 and TGF-?1.Reverse transcription-polymerase chain reaction(RT-PCR) was used to detect the expressing level of Foxp3 gene.Results:The supernatant of ASC had no deep impact on the proliferation and apoptosis of T lymphocytes.ASC had the direct inhibitory effect on growth of T lymphocytes,while the stem cells did not affect apoptosis.Both the supernatant of ASC and ASC itself increased the proportion of CD4+CD25+ cells in T lymphocytes,and increasd the level of IL-10 and TGF-?1.They could also up-regulate expressing level of Foxp3 in T cells.Conclusion:ASC can affect the function of T lymphocytes via cell-to-cell contact and secretion of cytokines.By these ways ASC exhibits negative immunomodulation and plays an important role in inducing immune tolerance.

Objective To investigate the effects of 5-aza-2'-deoxycytidine (5-Aza-dC) alone or combined with trichostatin A(TSA) on cell proliferation, promoter methylation and mRNA expression level of PDX-1 gene in pancreatic β cells induced by high glucose toxicity. Method NIT-1 cells were treated in vitro by high glucose (33.3 mmol/L), then divided into five groups, control group, HG grpup, 5-Aza-dC treatment group, TSA interfere group and 5-Aza-dC + TSA group. Proliferation of NIT-1 cells, insulin secretion, promoter methylation and mRNA expression of PDX-1 gene were detected respectively. Results 5-Aza-dC and TSA alone or in combination could promote cell proliferation and recover insulin secretion in NIT-1 cells , could also reduce PDX-1 gene methylation and enhance expression of PDX-1 mRNA. Compared with single-treatment group , combined group was significantly different (all P < 0.05). Conclusion 5-Aza-dC and TSA could activate the expression of PDX-1 and, then recover insulin secretion in NIT-1 cells induced by high glucose. Combination of them had synergistic effect.

P-450-dependent epoxygenase pathway of arachidonic acid and the products of epoxyeicosatrienoic acids (EETs) have been demonstrated to be involved in angiogenesis and tumor progression. This study examined the expression of EETs and the role of the pathway in the angiogenesis of multiple myeloma (MM). MM cell lines of U266 and RPMI8226 were cultured, and the EETs levels (11, 12-EET and 14, 15-EET) in the supernatant were determined by ELISA. Human umbilical vein endothelial cells (HUVECs) were cultured and used for analysis of the angiogenesis activity of the two MM cell lines, which was examined both in vitro and in vivo by employing MTT, chemotaxis, tube formation and matrigel plug assays. 11, 12-EET and 14, 15-EET were found in the supernatant of the cultured MM cells. The levels of the two EETs in the supernatant of U266 cells were significantly higher than those in the RPMI8226 cell supernatant (P<0.05), and the levels paralleled the respective angiogenesis activity of the two different MM cell lines. 17-octadecynoic acid (17-ODYA), as a specific inhibitor of P450 enzyme, suppressed HUVECs proliferation and tube formation induced by MM cells. Furthermore, 17-ODYA decreased the EET levels in the supernatant of MM cells. These results suggest that EETs may play an important role in the angiogenesis of MM, and the inhibitor 17-ODYA suppresses this effect.

Objective:To analyze the law of distant metastasis in patients with small lung adenocarcinoma with different CT findings, and to explore the feasibility of different preoperative examination methods for small lung adenocarcinoma with different imaging characteristics.Methods:Clinicopathological data of cT1a-cN0 lung adenocarcinoma patients admitted to the respiratory center of China-Japan Hospital from January 2017 to December 2018 were retrospectively collected. A total number of 785 patients were included, including 289 males and 496 females. SPSS 22.0 was used for statistical analysis.Results:A total number of 785 patients were included in this study, including 287 pure ground-glass nodule (GGN) patients, 111 GGN predominant patients, 221 solid predominant patients and 166 solid nodule patients. Among the included patients, 8 had distant metastasis, including 6 with bone metastasis, 1 with brain metastasis and 1 with brain and adrenal metastasis. No distant metastasis was observed in the patients with pure GGN and GGN predominant nodule, while 1 solid predominant patients had distant metastasis, and 7 patients with solid nodules had distant metastasis. The probability of distant metastasis was 0.5% for the solid predominant patients and 4.2% for the solid nodule patients. Univariate analysis results showed that CEA level ( P=0.030), the largest diameter of the lung window tumor ( P=0.003), the largest diameter of the solid component of the lung window tumor ( P<0.001), the largest area of the lung window tumor ( P=0.002), mediastinal window tumor maximum area ( P<0.001), CTR ( P<0.001), TDR ( P<0.001), and pleural indentation sign ( P=0.037) were risk factors for distant metastases. Multivariate analysis showed that CEA ( OR=1.019, 95% CI: 1.002-1.037, P=0.028) and TDR ( OR=0.000, 95% CI: 0.000-0.310, P=0.001) were independent risk factors of distant metastasis. Conclusion:For patients with pure GGN and GGN predominant nodule, preoperative examination could not be required, but for pure solid nodules, it is necessary to perform relevant preoperative examination including skull MRI before surgery to exclude distant metastasis.

Objective:The study aimed was to explore the safety and efficacy of neoadjuvant immunochemotherapy for non-small cell lung cancer (NSCLC).Methods:We retrospectively collected data of all patients who received neoadjuvant immunochemotherapy and chemotherapy for NSCLC followed by surgery in our unit between January 2019 to September 2021.Results:Forty-four patients were diagnosed with NSCLC in a stageⅠ(2 cases), ⅡA(7 cases), ⅡB(11 cases), ⅢA (15 cases), ⅢB (1 case). The average age was 63 years old(range 44-71 years old). Squamous cell carcinoma accounted for 65.91% of all patients. Central lung cancer accounted for the vast majority, with 39 patients (88.64%). There were 19 cases in the neoadjuvant immunochemotherapy group and 25 cases in the neoadjuvant chemotherapy group; the average interval between the end of neoadjuvant therapy and the day of operation was 34 days, including( 33.74±10.66 )days in the immunochemotherapy group and (33.88±11.9) days in the chemotherapy group, and there was no significant difference between the two groups. No grade 3 or more adverse events occurred in all patients. There were 13 cases (63.16%) reached PR (partial response)+ CR (complete response) according to the Response Evaluation Criteria in Solid Tumors (RECIST v. 1.1) in the neoadjuvant immunity group and 11 cases (44.00%) in the neoadjuvant chemotherapy group. There was no significant difference between the two groups. In the neoadjuvant immunochemotherapy group, 9 cases (47.37%) achieved down-staging, In the neoadjuvant chemotherapy group, 8 cases (32.00%) achieved down-staging, there was no significant difference between the two groups. Seven patients (36.84%) in neoadjuvant immunochemotherapy group showed pCR (pathologic complete remission), but there were no patients who reached pCR in the neoadjuvant chemotherapy group., the difference was statistically significant ( P=0.001). Four patients (21.05%) in the neoadjuvant immunochemotherapy group reached mPR (major pathologic response), 6 patients (24.00%) in the neoadjuvant chemotherapy group reached mPR, and the difference was no statistically significant( P= 0.817). Conclusion:The safety of neoadjuvant immunochemotherapy was satisfactory; Compared with neoadjuvant chemotherapy, neoadjuvant immunochemotherapy did not increase the preoperative grade 3 adverse events and prolong the waiting time before operation; neoadjuvant immunochemotherapy had obvious advantages in pCR, which provided the possibility for the cure of tumor.

P-450-dependent epoxygenase pathway of arachidonic acid and the products of epoxyeicosatrienoic acids (EETs) have been demonstrated to be involved in angiogenesis and tumor progression.This study examined the expression of EETs and the role of the pathway in the angiogenesis of multiple myeloma (MM).MM cell lines of U266 and RPMI8226 were cultured,and the EETs levels (11,12-EET and 14,15-EET) in the supematant were determined by ELISA.Human umbilical vein endothelial cells (HUVECs) were cultured and used for analysis of the angiogenesis activity of the two MM cell lines,which was examined both in vitro and in vivo by employing MTT,chemotaxis,tube formation and matrigel plug assays.11,12-EET and 14,15-EET were found in the supematant of the cultured MM cells.The levels of the two EETs in the supernatant of U266 cells were significantly higher than those in the RPMI8226 cell supematant (P＜0.05),and the levels paralleled the respective angiogenesis activity of the two different MM cell lines.17-octadecynoic acid (17-ODYA),as a specific inhibitor of P450 enzyme,suppressed HUVECs proliferation and tube formation induced by MM cells.Furthermore,17-ODYA decreased the EET levels in the supernatant of MM cells.These results suggest that EETs may play an important role in the angiogenesis of MM,and the inhibitor 17-ODYA suppresses this effect.

Objective:To evaluate the effect of interstitial lung disease(ILD) on postoperative morbidity and mortality in pulmonary resection for lung cancer patients.Methods:We retrospectively analyzed 971 patients undergoing pulmonary operation from January 2010 to January 2018 in our hospital. Clinical data including age, sex, history of chronic obstructive pulmonary disease(COPD), smoking history, smoking index, American Society of Anesthesiologists(ASA) classification, forced expiratory volume in 1 s(FEV1) % predict, surgical procedure, video assisted thoracoscopic surgery(VATS) or not, intraoperative blood transfusion, anesthesia time, operation time/one-lung ventilation time, blood loss, histology, postoperative morbidity, 60-days mortality, onset of acute exacerbation of interstitial lung disease(AE-ILD), drainage, extubation time, and postoperative stay were collected and analyzed.Results:There were 80(8.2%) and 891(91.8%) patients in ILD and non-ILD group, respectively. AE-ILD occurred in 5 patients, with a 60-day mortality of 80%. A multivariate regression analysis identified that the sex( P=0.023), ILD( P=0.001), COPD( P=0.027) were independent risk factors for postoperative morbidity. ILD( P=0.023) and postoperative morbidity( P=0.001) were independent risk factors for 60-day mortality in multivariate analysis. Conclusion:Patients with ILD had a higher incidence of postoperative morbidity and 60-day mortality. Based on the obvious postoperative morbidity and mortality, special attention and management should be taken in ILD patients.