Objective To investigate ZEB-l protein expression in hepatocellular carcinoma (HCC) tissues and the relevant significance. Methods Immunohistochemical method and Western blotting analysis were used to detect the ZEB-l protein expression in 62 HCC tissues,48 paracancerous cirrhotic tissues and 10 normal liver tissues. The relationship between ZEB-l protein expression and clinicopathological features of HCC was evaluated. Results Immunohistochemical staining showed that the positive rates of ZEB-l protein expression in HCC tissues and paracancerous cirrhotic tissues were 93. 5% (58/ 62) and 83.3 (40/48), respectively. Western blotting analysis showed that ZEB-l protein expression in HCC tissues was significantly higher than those in the paracancerous cirrhotic tissues and normal liver tissues (P<0. 05). We also found that ZEB-l expression was significantly correlated with the clinical stage, tumor differentiation degree, metastasis, portal vein tumor thrombus and postoperative recurrence (P<0. 05), and was not correlated with the tumor diameter, number of tumors, or serum AFP levels (P>0. 05). Conclusion High expression of ZEB-l is correlated with the development and progression of HCC. ZEB-l might also participate in the epithelial-mesenchymal transition of HCC cells, subsequently contributing to the invasion and metastasis.

BACKGROUND: Bronchopleural fistula (BPF) is one of the most serious and rare postoperative complications, especially the bronchial stump fistula after lobectomy/pneumonectomy. Common treatment options include conservative medical treatment combined with surgery. However, due to the delayed healing of the fistula, the chest cavity continues to communicate with the outside world, and the patient is prone to complicated with severe thoracic infection and respiratory failure, so that the physical condition can hardly tolerate the second surgical procedure. Endoscopic treatment provides a new option for the treatment of this complication. METHODS: A case of right pulmonary squamous cell carcinoma was admitted to the Department of Thoracic Surgery II, Peking University Cancer Hospital in June 2016. The diagnosis and treatment was retrospectively analyzed, and the literature was reviewed. RESULTS: A 65 year old male patient was admitted to hospital because of "cough with blood in sputum for 3 months". Chest computed tomography (CT) showed soft tissue density mass shadow in the right lower lobe. A tumor could be seen in the opening of the right middle lobe and basal segment of lower lobe. Biopsy confirmed squamous cell carcinoma. Diagnosis consideration: squamous cell carcinoma of the middle and lower lobe of the right lung (cT2aN2, IIIa). Patients received gemcitabine plus cisplatin neoadjuvant chemotherapy for 2 cycles, and the effect of chemotherapy showed stable disease (SD). Four weeks after chemotherapy, the patient underwent video-assisted thoracic surgery (VATS) assisted right middle and lower lobectomy and mediastinal lymph node dissection. On the 5th day after operation, the patient developed acute respiratory distress syndrome (ARDS) and was transferred to intensive care unit (ICU) again after endotracheal intubation. On the 7th day after operation, the patient developed a right intermediate trunk bronchial stump fistula, but due to ARDS, the patient's physical condition could not tolerate the second operation. Under the support of extracorporeal membrane oxygenation (ECMO), a membrane covered, expandable, hinged stent was inserted into the intermediate trunk bronchial stump through rigid bronchoscope, and was successfully blocked. Due to no improvement in ARDS and irreversible pulmonary interstitial fibrosis, the patient received double lung transplantation successfully after systemic anti-infection treatment. CONCLUSIONS Endoscopic implantation of covered stent is a simple, safe and effective method for closure of bronchial stump fistula. When the patient's clinical situation is not suitable for immediate surgery, endoscopic stent implantation can be used as a preferred treatment method to create opportunities for follow-up treatment.

Twenty five patients with tumors of the brain stem were treated with radiotherapy between 1979 and 1987. Histological diagnosis could be obtained in 6 cases, and other 19 patients were diagnosed by neurologic findings and CT or MRI. Eighteen patients were treated by radical radiotherapy and 6 patients received both operation and radiotherapy, while 1 patient received chemotherapy after radiotherapy. Total dose ranged from 50 Gy to 55 Gy. By an clinical scoring scale at 2 months after radiotherapy, no complete response was obtained, but 16 cases achieved partial response, 2 cases were stable, and 4 cases were deteriorated. The overall survival rate at 3 years was 36%. Age, performance status at diagnosis, degree of cranial nerve involvement, CT pattern of post-contrast enhancement, and clinical response by scoring scale were correlated with survival.
Brain Stem Neoplasms* ; Brain Stem* ; Brain* ; Cranial Nerves ; Diagnosis ; Drug Therapy ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Radiotherapy* ; Survival Rate

Stereotactic radiosurgery is an effective and widely used surgical procedure for the management of cerebral vascular malformations. Long-term analysis of results has led to an evolution in technique and patient selection, a better understanding of the safe and effective dose reponse, and of the risks to surrounding normal tissue. Radiosurgery is a minimally invasive technique but is not risk-free. Successful AVM obliteration depends on proper stereotactic nidus definition and delivery of an adequate radiosurgery dose.
Arteriovenous Malformations ; Intracranial Arteriovenous Malformations* ; Patient Selection ; Radiosurgery* ; Vascular Malformations

This study was executed to measure the shear bond strength of Panavia EX and Panavia 21 when the Ni-Cr-Be alloy castings were cemented to the enamel surfaces with these cements. The cast metsl plates of Ni-Cr-Be alloy were sandblasted and cemented to acid etched enamel surface with Panavia EX or Panavia 21. Their shear bond strength were measured with Instron Universal Testing machine. Within the limits of this study, following conclusions were withgdrawn. 1. The mean shear bond strength were 26.85.7Mpa, in Panavia EX and 28.35.2Mpa, in Panavia 21. 2. t-Test revealed no statistical significance between two groups(.05 level) 3. Macroscopically, bond failures were revealed compound fracture at metal and enamel interfaces, in cases of both cements, as the cement attached partly on both metal and enamel surface.
Adhesives* ; Alloys* ; Dental Enamel* ; Fractures, Open

PURPOSE: To assess the MR findings of Tolosa-Hunt syndrome and to evaluat differential point of cavernous sinus lesions. MATERIALS AND METHODS: Eleven cases of Tolosa-Hunt syndrome were evaluated by MRI with specific regard to the shape of cavernous sinus, signal intensity, and pattern of enhancement. Other associated findings were also anlaysed. RESULTS: Two patients had normal MR features of the cavernous sinus. When compared with the contralateral normal cavernous sinus, the involved cavernous sinus was enlarged in six of the nine patients. The outer dural margin was convex and bulged laterally in 6 cases, flat in 2 cases, and concave in 1 case. Of the nine patients, five had iso-signal intensity and four had low signal intensity relative to gray matter on short TR/short TE. Three had isosignal intensity and 6 were not detectale on long TR/short and long TE pulse sequence. Contrast enhancement was seen in 8 cases ;7 cases showed homogeneous enhancement, 1 case heterogeneous enhancement. CONCLUSION: In the appropriate clinical setting of painful ophthalmoplegia, MR findings of cavernous sinus abnormality that consist of iso to low signal intensity on short TR/short TE images and isointense or undetectale mass on long TR/short TE or long TR/Iong TE images may suggest the dignosis of Tolosa-Hunt syndrome.
Cavernous Sinus ; Humans ; Magnetic Resonance Imaging ; Ophthalmoplegia ; Tolosa-Hunt Syndrome*

The purpose of this report is to present the successful improvement of occlusal relationship and facial esthetics in class II division 1 malocclusion with severe labioversion of upper anterior teeth and severe overjet, and in class II malocclusion with infraversion of bilateral maxillary canines by MEAW mechanics, which enables us to get effective distal en mass movement of maxillary dentition, with upper second molar extraction. After treatment, there were natural contact points at canine and premolar regions, normal occlusal relationship and treatment results, satisfied the gnathologic concept, in this 2 cases. Compared with the routine treatment with premolar extraction, the treatment time and patients' discomfort were reduced. And the MEAW mechanics, which enables us to get effective distal en mass movement of maxillary dentition, resulted in reduction of the treatment time and getting the good treatment results. Consequently, the major concerns in orthodontic treatment are appropriate diagnosis and treatment plan, so, the application of second molar extraction with appropriate case analysis and diagnosis is very helpful to orthodontic treatment.
Bicuspid ; Dentition ; Diagnosis ; Esthetics ; Malocclusion* ; Mechanics ; Molar* ; Tooth

The porpuse of this in vito study was to evaluate the effects of different acid etching times on the enamel srface morphology, shear bond strength and debinding failure mode of orthodontic attachment. Ninety six extracted human mandibular premolars were divided into eight groups of twelve teeth. The buccal surfaces were etched with 37% phosphoric acid 5, 10, 15, 30, 45, 60, 90 and 120 seconds, respectively. Two teeth from each group were used for scanning electron mocroscope examination. On the etched buccal aurfaces of remaining teeth, orthodontic attachments(lingual buttons) were bonded with light cured orthodontic adhesive. Twenty four hours after bonding, a Instron universal testing machine was used to determine shear bond strength of orhtodontic attachment to enamel. After debonding, bases of orthodontic attachments and enamel surfaces were examined under stereoscopic microscope to determine failure mode. Statistical analysis of the data was carried out with one way ANOVA and Duncan';s multiple range test. The results were as follows : 1. There was no statistically significant difference in shear bond strengths between the various etching times(p<0.05). 2. The failure modes of orthodontic attachments had some differences. In 5, 10 and 15 seconds etching groups, the percentage of adhesive/ enamel interface failure was higher than that of adhesive/attachment interface failure. On the contrary, 30, 45, 60, 90 and 120 seconds etching groups, the recults were reersed. 3. The etching parerns of enmel surfaces had a great variation. So, we could not find any correlation between etching pattern and bond strength. 4. The findings in this study indicate that in vito reduction of the etching time to 5 seconds maintains clinically acceptable bond strength. However, further study is required to determine the cause of failure mode in 5, 10 and 15 seconds groups.
Bicuspid ; Dental Cements ; Dental Enamel* ; Humans ; Tooth

OBJECTIVETo explore the application of alar thin expanded cervical flap with pedicle in anterior neck for large scars on middle and lower face.

METHODSFrom February 2000 to July 2013, 26 patients with scars on the middle and lower face were treated with the alar thin expanded cervical flaps with pedicle in anterior neck. After the skin of anterior neck was expanded by implanting skin expanders, alar thin expanded cervical flap with pedicle in anterior neck was obtained with size of 163-275 cm(2). Then the scars on the middle and lower face with the size of 135-196 cm(2) were excised, with the area of excision allowing full coverage of the expanded flap. The flap was rotated and advanced to the middle and lower face, and the incision was closed in layers.

RESULTSThe 26 patients were followed up for 2 to 24 months. Twenty-one flaps survived, with good appearance and function. Four flaps showed venous retardation at distal part, and only one flap showed necrosis of the right edge. They were healed by free skin grafting.

CONCLUSIONSThe alar thin expanded cervical flap not only makes maximum use of expanded flap on the premise of ensuring blood supply, but also guarantees good color, texture, and contour of face and neck.

Cicatrix ; surgery ; Facial Injuries ; Humans ; Neck ; surgery ; Necrosis ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Tissue Expansion ; Treatment Outcome

BACKGROUND: IIIa-N2 non-small cell lung cancer was significant different in survival, although N stage of lung cancer based on anatomic location of metastasis lymph node. Lymph node ratio considered of prognostic factor might be the evaluation index for IIIa-N2 non-small cell lung cancer prognosis. Therefore, the aim of the study was to evaluate the correlation between lymph node ratio and clinicopathological features and prognosis of IIIa-N2 non-small cell lung cancer prognosis. METHODS: A total of 288 cases of pathological IIIa-N2 non-small cell lung cancer were enrolled who received radical resection at the Department of Thoracic Surgery II, Peking University Cancer Hospital from January 2006 to December 2016. The univariate analysis between clinicopathological variables and lymph node ratio used Pearson's chi-squared test. Cox regression was conducted to identify the independent prognosis factors for IIIa-N2 non-small cell lung cancer. RESULTS: There were 139 cases in the lower lymph node ratio group, another 149 cases in the higher lymph node ratio group. Adenocarcinoma (χ²=5.924, P=0.015), highest mediastinal lymph node metastasis (χ²=46.136, P<0.001), multiple-number N2 metastasis (χ²=59.347, P<0.001), multiple-station N2 metastasis (χ²=77.387, P<0.001) and skip N2 lymph node metastasis (χ²=61.524, P<0.001) significantly impacted lymph node ratio. The total number of lymph node dissection was not correlated with the lymph node ratio (χ²=0.537, P=0.464). Cox regression analysis confirmed that adenocarcinoma (P=0.008), multiple-number N2 metastasis (P=0.025) and lymph node ratio (P=0.001) were the independent prognosis factors of disease free survival. The 5-year disease free survival was 18.1% in the higher lymph node ratio group, and 44.1% in the lower. Lymph node ratio was the independent prognosis factor of overall survival (P<0.001). The 5-year overall survival was 36.7% in the higher lymph node ratio group, and 64.1% in the lower. CONCLUSIONS Lymph node ratio was correlative with the pathology, highest mediastinal lymph node metastasis, multiple-number N2 metastasis, multiple-station N2 metastasis and skip N2 lymph node metastasis. Lymph node ratio was the independent prognosis factor for IIIa-N2 non-small cell lung cancer.