BACKGROUND: Bag-1 is a multifunctional and anti-apoptotic gene. Its anti-apoptotic ability is enhanced when binding to bcl-2 to form a complex.Now it is considered as a predictive biomarker for the early diagnosis of breast cancer. However, whether it is useful in the assessment of the prognosis of breast cancer is still elusive.OBJECTIVE: To explore the expression of bag-1 in breast cancer and its role for prognosis.DESIGN: A controlled study with breast cancer, benign breast tumor and normal breast tissues as subjects.SETTING: The Vascular and Endocrine Surgery Department of Xijing Hospital of the Fourth Military Medical University of Chinese PLA.MATERIALS:Totally 100 breast cancer specimens were obtained form May 1995 to May 2000. Ten benign breast tumor and 10 normal breast tissues were used as control. All the specimens were paraffin-embedded and came from the Pathological Department of Xijing Hospital Affiliated to Fourth Military Medical University of Chinese PLA.METHODS: Immunohostochemical strept avidin-biotin complex(SABC) method was adopted to detect bag-1 expression in these specimens.pression levels of bag-1.RESULTS: The positive expression rate of bag-1 in breast cancer (85%) was significantly different form those of benign breast tumor (10%) and normal breast (10%) (χ2= 29.98, P = 0.00). While the positive expression rates in breast cancer of different stages (stage Ⅰ, stage Ⅱ and stage Ⅲ ) were 88%, 82% and 88%, respectively, which has no significant difference (χ2 = 0. 61, P = 0.75) . In duct carcinoma, lobular carcinoma and special carcinoma, bag-1 positive expression rate was 86%, 85% and 80%,which was also no significantly different (χ2 =0.16, P =0.95). In the 94followed patients, the 5-year survival rate of positive bag-1 expression was 79% and that of negative bag-1 expression was just 9%. The difference was significant (χ2 = 0. 07, P = 0.04).CONCLUSION: High bag-1 expression exists in breast cancer and its level is not associated with the clinical stages or pathological types of the cancer.Therefore, bag-1 may be used as a predictive marker for the prognosis of breast cancer.

Objective To access the analgesia effect and side effect of flurbiprofen axetilcombined with sufentanil.Methods Thirty-eight patients underwent cardiac surgery were randomlydivided into two groups with nineteen cases each.Group S was given sufentanil 250μg diluted to 125ml via PCIA after surgery.Group F was given sufentanil 125 gg plus flurbiprofen axetil 150 mgdiluted to 125 ml via PCIA after surgery.The PCIA pump was set at a rate of 0.2 ml/h,bellus dosewas 0.8 ml.lockout time interval was 10 min. Analgesia grade was accessed,vital sign and sideeffects were recorded.Results 'Fhere was no significant difference in analgesia grade between tWOgroups.The side effects were lower in group F than those in group S.Conclusion Flurbiprofen axetilcombined with sufentanil can obtain similar analgesia effects to sufentanil alone,but can reduce sideeffects and fever temperature.

Objective To discuss the technical strategies for thoracoscopic lobectomy.Methods Between September 2006 and May 2008,a total of 91 patients underwent thoracoscopic lobectomy in our hospital.The lobectomy and lymph node resection were completed via three mini incisions with the same procedures as those in an open surgery.Among the cases,75 had primary or metastatic malignancies,and 16 showed benign tumor.By thoracoscopy,upper right lobectomy was carried out in 21 patients,right middle lobectomy in 12,lower right in 20,upper left in 18,and lower left in 20.Results Only two cases were converted to open thoracotomy.In the other 89 patients,the mean operation time for the thoracoscopy was(185.8?52.9)minutes(ragne,60-300 minutes),and the mean blood loss was 213.2 ml(range,50-650 ml).In this series,the chest drainage lasted(6.9?2.9)days;the patients were discharged from the hospital in(9.4?3.2)days after the surgery.No severe complications or perioperative death occurred in the cases except in one patient,who developed chylothorax after the treatment.Two patients,who had primary lung cancer,showed distant metastasis at 15 and 3 months respectively after the surgery.No recurrence or metastasis was found in the other cases.Conclusions Thoracoscopic lobectomy is safe and effective for patients with indications for the surgical procedure.Surgical skills for dissection of vessels and lymph nodes are the key to the operation.

Objective To review the primary experience of video-assisted rigid laser bronchoscopy in the treatment of tracheobronchial tumors. Methods From Sep.2002 to Nov.2004, 13 patients (15 procedures) with tracheobronchial tumors were treated with video-assisted rigid bronchoscope. Benign tumors with small pedicles were removed directly. For benign tumors with wide pedicles or tumors extending beyond the wall of air-way, total enucleating through thoracotomy were employed. In cases with malignant tumors, stenosis or obstructions were relieved by implantation of stents or cautering with electric argoulaser knife. For malignant but resectable primary tumors of trachea and main bronchi, rigid bronchoscopy might serue as a preparation of radical resection. Results Of the 5 patients with benign tumors, 4 received endoscopic total resection and 1 were conversed into thoracotomy. For the 8 malignant cases, 3 received stent implantation, 2 had palliative ablation and 3 got curative resections through thoracotomy. No peri-operative complications or death occurred in this group. Conclusion Total resection of benign tracheobronchial tumors or palliative therapy for tracheobronchial malignant stenosis or preparation of radical resection can be performed safely and efficiently by video-assisted rigid bronchoscopy.

Lipases have catalytic active in both aqueous phase and the non-aqueous phase and have a wide range of application in various industrial areas.However,the high cost of lipase production has restricted its extensive use in industry.Solid state fermentation possesses many advantages,such as low requirement for devices,low energy consumption,low production cost,little pollution to environment and easily being popularized,which have made it an important means in microbial production of lipases.Owing to the rapidly increased energy cost and the people's awareness of environmental protection,the solid state fermentation technique,which was regarded as low-tech in the past,has regained attention and developed rapidly since the 1990s.The production of lipase by SSF technique was reviewed.Mainly contents describe its characteristics,including physical and chemical factors and bioreactors.

Objective To explore the diagnosis and Fogarty catheter embolectomy operation management of acute arterial embolism in the extremities.Methods The clinical data of 87 cases of acute arterial embolism in the extremities treated by Fogarty catheter was ana- lyzed retrospectively,Results All cases were diagnosed through asking patient history and symptom,physical examination and the check of color Doppler while the results were proved by operation.No one case received vasography.After operation,78 cases blood stream of limb had been resumed and cure rate of 87.6% was achieved while 4 cases improved(4.5%),and no occurrence of ischemic necrosis and amputated ex- tremity.5 cases(5.6%)received amputation at the relative level and there were 2 cases(2.3%)of perioperative death.Those cases who re- ceived operations within 48 hours from the time of morbidity achieved cure rate of 100%,while those cases more than 48 hours achieved cure rate of 47.6%,improvement rate of 19.0%,amputation rate of 23.8% and mortality of 9.6%.Conclusion First,Ultrasound Doppler exami- nation should be taken for avoidance of misdiagnosis when acute extremity arterial embolism is suspected.Second,The key Intraarterial embo- lectomy using Fogarty catheter is an effective method for the treatment of acute arterial embolism in the extremities,is significant in application,Third,as soon as the diagnosis is established,embolectomy with Forgarty catheter must be carried out to avoid clot extension and necrosis of the extremity.Satisfactory therapeutic efficacy can be got,if the patient receive operation within 48 hours from onset.

Aged ; Coronary Artery Disease ; Female ; Heart Ventricles ; Humans ; Vascular Fistula

Objective Summarize 8 cases of non-small cell lung cancer (NSCLC) that has accepted completely video-as-sisted thoracoscopic sleeve lobectomy in People's Hospital of Peking University in china,to explore the safety,effectiveness indications and experience of this procedure.Methods Between September 2011 and December 2011,Medical records of 8 cases of non-small cell lung cancer that has accepted complete thoracoscopic sleeve lobectomy were reviewed (7 male,1 female).Median patient age was 62.4 years.And median maximal diameter of solid tumors was 2.3 cm.This group consisted of 5 cases of right upper lobe sleeve lobectomy,2 case of left lower lobe sleeve lobectomy and 1 case of left upper lobe sleeve lobectomy.The operation procedure was completely VATS anatomic sleeve lobectomy combined with systematic lymph node resection (at least 3 groups of lymph nodes in the mediastinum area).All procedure were underwent under general anesthesia with double-lumen endotracheal intubation.The patient was placed lateral decubitus position.Three incision were made at the seventh intercostal space on the median axillary line,the fourth intercostal space anterior axillary line and the seventh intercostal space subscapularis line.Bronchial were anastomosed combine with simple continuous suture anastomosis of membranous part of bronchus and simple interrupted suture anastomosis of cartilaginous part of bronchus,and then covered by? Surrounding tissue with blood supply? Results All procedures were carried out smoothly without serious complication.The median operative time was 240min median,the median bronchial anastomosis time was 45 min,the median blood loss was 200 ml,and median number of resected lymph nodes was 19.8.There were no conversion to open thoracotomy.Post operative show pathology squamous cell carcinoma in 7 cases and adenocarcinoma in 1 case.pTNM staging show 1 case of T1a N0 M0,4 cases of T1b N0 M0,2 case of T1b N1 M0 and 1 case of T1b N2 M0.There was 1 case of slight post operative complication.The median postoperative chest tube drainage duration was 7 days,and median postoperative hospital stay was 9 days.All patients were well during the followed up for 3-8 months.Conclusion Completely thoracoscopic sleeve lobectomy was a safe and effective surgical procedure for patients with non-small cell lung cancer; the operative incision placed at the fourth intercostal space anterior on the axillary line was convenient for anastomosis; anastomosis combine with simple continuous suture anastomosis of membranous part of bronchus and simple interrupted suture anastomosis of cartilaginous part of bronchus was a fast and secure mode; keeping azygos vein does not affect the anastomosis.

Objective To analyse the difference between stage Ⅰ pure bronchioloalveolar carcinoma (BAC) and stage Ⅰ adenocarcinoma of the lung among operative cases.Methods We use the Lobectomy Cases Registration and Statistics System database (2006-2011) to compare the epidemiology,clinical presentation,image characteristics,surgical outcomes,recurrence and overall survival between BAC and adenocarcinoma groups.All the patients received lobectomy procedure in the department of thoracic surgery of Peking University People' s Hospital.Results Excluding those cases with both BAC and adenocarcinoma aspects,337 patients were enrolled.Thirty-nine patients were stage Ⅰ pure BAC and 298 patients were stage Ⅰadenocarcinoma.BAC has its proper clinical spectrum,occurring more frequently in women (69.2％ vs.52.0％,P =0.042)and in younger patients (57.4 vs.61.8,P =0.014).BAC also seems to be less dependent on tobacco exposure (12.8％ vs.29.9％,P =0.026).The percentage of ground-glass opacity (GGO) in CT scan of BAC patients was much more than that registered in adenocarcinoma patients (35.9％ vs.9.7％,P ＜0.001).And the tumor size of BAC group was smaller than that of the adenocarcinoma group (1.4 cm vs.2.3 cm,P ＜0.001).The operation method,time,blood loss and complications were similar between the two groups.Kaplan-Meier survival curves showed that both 3-year disease-free survival (DFS) and overall survival (OS) were significantly higher in patients affected by BAC (100％ vs.76.1％,P =0.030 and 100％ vs.86.1％,P =0.041).Conclusion BAC presents specificity in its epidemical,clinical,radiological and evolutionary aspects.Stage Ⅰ pure BAC patients have better prognosis following video-assisted thoracoscopic lobectomy and system lymph node dissection than the similar stage adenocarcinoma patients.

BACKGROUNDMediastinoscopy has experienced a renaissance due to the introduction of neoadjuvant treatment protocols and recognition of the limitations of noninvasive mediastinal staging of lung cancer by CT and PET. The aim of this study is to determine the value of video-mediastinoscopy in mediastinal staging of lung cancer.

METHODSA total of 60 patients who underwent video-mediastinoscopy for known or suspected lung cancer were retrospectively reviewed. There were 52 cervical mediastinoscopies, 2 parasternal mediastinoscopies and 6 combined procedures. All the patients were found to have enlarged mediastinal lymph nodes on radiographic examination of the chest (more than 1.0cm on its shortest axis).

RESULTSOf the 60 patients, 42 patients were found with N2 or N3 disease on video-mediastinoscopy and then were confirmed pathologically. The other 18 mediastinoscopy-negative patients underwent thoracotomy for pulmonary resection and mediastinal lymph node dissection in the same operative session, in which thoracotomy-proven N0 was found in 17 patients, and N2 in 1 patient (false-negative result by video-mediastinoscopy). The sensitivity, specificity, and accuracy of video-mediastinoscopy for mediastinal staging of lung cancer were 97.7%, 100% and 98.3%, respectively. In the entire group of 60 patients, there was 1 complication (1.7%) , and no perioperative death.

CONCLUSIONSVideo-mediastinoscopy is a highly effective and safe procedure. It can be used routinely in mediastinal staging of lung cancer.