Objective To explore the influence of some factors on long-term survival of postoperative stage Ⅰ NSCLC patients. Methods 91 patients of NSCLC who underwent radical surgery of the primary tumor with dissection of the hilar and mediastinal lymph nodes were diagnosed as stage Ⅰ NSCLC postoperatively by pathology and followed up for 5 years. Its hilar and subcarinal lymph nodes were detected occult micrometastastic tumor cells by immunohistochemistry (SP method) by using the binoclonal antibody multicytokeratin (AE1/AE3) as a micrometastatic marker. To analyse the influence of micrometastasis and the clinicopathologic characteristics on long-term survivals. Results The rate of micromatastasis of stage Ⅰ NSCLC was 49 %. The five-year overall survival rate was 70.3 %. The median of survival time was 48.5months. The rate of metastasis was 32 % and the meantime of relapse and metastasis was 36.6months. Tumor size, differentiation, stage, and micrometastasis were significantly associated with relapse and metastasis (P <0.05). The tumor differentiation, stage, and micrometastasis were found to be significant independent factor on survival in multivariate analysis (P<0.05). Conclusion There was nodal micrometastasis in completely resected stage Ⅰ NSCLC, and the tumor differentiation, stage, and micrometastasis were found to be significant independent factor on survival.

Objective To detect the nodal occult micrometastasis in stage Ⅰ non-small-cell lung cancer(NSCLC),and further investigate the main factor of affecting the nodal occult micrometastasis and the rule of micrometastasis in stage Ⅰ NSCLC. Methods Occult micrometastatic tumor cells by in hilar and subcarinal lymph nodes(LN)were detected immunohistochemistry (SP method),which were removed from 91patients with completely resected stage Ⅰ NSCLC.The monoclonal antibody muhicytokeratin(MCK)was used as a micrometastatic marker.Another 45 hilar LN removed from benign pulmonary lesion patients and 45 hilar LN removed from Ⅱ and Ⅲ stage NSCLC were detected, respectively by conventional histopathologic examination as negative and positive control.Results Micrometastasis was detected in all lymph nodes that were removed from stageⅡand Ⅲ NSCLC.but no one was detected in lymph nodes that were removed from benign pulmonary lesion patients.There were 45 positive cases in 91 patients.The rate of micrometastasis in stage Ⅰ NSCLC was 49%(45/91).among them 39 subcarinal lymph nodes and 11 hilar lymph nodes were detected as positive,5 cases were detected as positive both in subcrinal and hilar lymph nodes.Logistic regression analysis indicated that tumor size,stage and differentiation affected micrometastasis significantly,odd ratios(OR) were 8.444,6.946 and 14.566 respectively.The multivariate analysis indicated that cell difierentiation and T stage may be the adverse factors for nodal micrometastasis,odd ratios(OR)were 7.028and 14.509 respectively.Conclusion There is nodal micrometastasis in completely resected stage Ⅰ NSCLC patients.The micrometastasis frequency of stage ⅠB is significantly higher than stage ⅠA;It is necessary for stage ⅠB NSCLC to be given chemotherapy after operation;cell differentiation and T stage may be the adverse factors for nodal micrometastasis.The method of lymph node micrometastasis is from hilum to mediastinum.The skip micrometastasis may be taken place in adenocarcinoma.

Objective To define the mechanical features of mitral annulus at various sites,and to investigate the specific mechanics characterization at different mitral annulus sites in evaluation consequences of left ventricular function by dual pulse-wave Doppler (DPW) technology.Methods The DPW spectrums were obtained at lateral and aboral interval,anterior and inferior and posterior mitral annular from 112 normal adults.The peak systolic velocity (Sm),peak early diastolic velocity (Em),peak late diastolic velocity (Am),the beginning time of the peak and the time to peak were measured,and E/A,Em/Am,E/Em,left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were computed.Results 1)Sm,Em,Am and Em/Am measured in the free wall annulus were significantly greater than measured in the interval annulus of mitral annular sites.However,E/Em was opposited (P ＜ 0.05).Sm of the posterior wall mitral annulus accelerated frist and experienced shortest duration in all the mitral annular sites (P ＜ 0.01).There were no significant differences of Em time parameters among different mitral annulus sites.Am of the beginning time and peak time in the free wall annulus were significantly longer than that in the interval annulus of anterior mitral annular sites.However,the acceleration time was opposited(P ＜0.05).2) Sm was correlated with LVEF and LVFS (r =0.243 and r =0.227,P ＜0.01) only at the posterior mitral annular site,Em/Am of anterior and posterior wall mitral annulus had the highest correlations with mitral orifice flow E/A(r =0.545 and 0.545 respectively,P ＜ 0.01).Conclusions There are significant differences among the mechanics patterns at different mitral annulus sites in normal adults.The mechanics characterization at different mitral annulus sites have different conclusions of left ventricular function.

Objective Toinvestigatethepossibilityandquantitativerangeofpepsinogen(PG)usedas the screening marker of gastric cancer by detecting serum pepsinogen level in different gastric mucous pathologic status.Method ThelevelofserumpepsinogenⅠ(PGⅠ)andpepsinogenⅡ(PGⅡ)bytimeresolvedfluoro-immunoassay(TRFIA)in 64 chronic atrophic gastritis patients,63 gastric mucous atypical hyperplasia patients, 67 gastric cancer patients and 20 healthy volunteers were defeeted ,and the ratio of PGR(PGⅠ/PGⅡ)was calculated.Then the three kinds of diseases were graded.The data was analyzed between groups and sub-groups.Result ①Compared with normal control group,the median PGⅠvalues were 1 24.01 ,91 .23 and 71 .23 respectively,which were all lower than that of healthy group (1 52.00).There were significant differ-ences(Z=-2.52,P=0.01 7 0;Z=-3.42,P=0.001 4;Z=-3.57,P=0.000 9).The median PGR values were 7.61 ,5.21 and 4.32 respectively,which were also lower than that of healthy group,the differences were significant(Z=-2.98,P=0.002 9;Z=-3.1 7,P=0.000 2;Z=-2.89,P=0.000 1 ).The PGⅡlevel of these diseases were not significantly different with control group.②The serum PGⅠlevel of gastric mucous atypical hyperplasia and gastric cancer were reduced significantly in contrast with atrophic gastritis (Z =-3.42,P =0.001 4;Z=-3.62,P=0.000 9);the levels of PGⅡand PGR were varied without significance (P>0.05 );③The levels of PGⅠamong atrophy gastritis and gastric cancer subgroup have no significant difference(χ2 =2.86,P=0.41 4 3;χ2 =1 .67,P=0.1 36 8).But the level of PGⅠwas significantly different in gastric atypical hyperplasia(χ2 =0.83,P=0.043 0).It decreased in light and medium grade dysplasia and went up in severe grade dysplasia.The levels of PGⅡ and PGR were varied without significance(P>0.05).④The areas under the ROC curves performed by the PGⅠ and PGR from normal control group and atypical hyperplasia group were 0.782 and 0.831 respectively;The sensitivity and specificity of PGⅠ≤72.1 2 μg/L and PGR≤4.32 for gastric dysplasia were 89.48%and 76.31%respectively.Conclusion ①The level of PGⅠand PGR were decreased along with the seriousness of gastric pathological changes and probably regarded as the screening markers of gastric mucous malignant transformation.②Serum pepsinogen level is closely correlated with gastric precancerous lesion,PGI≤72.1 2 μg/L and PGR≤4.32 has better specificity and sensitivity for gastric atypical hyperplasia in this area.

Objective To investigate the sequential biological effects and outcomes of microbubble-enhanced ultrasound (MEUS) combined with prothrombin on microwave ablation (MWA) in rabbit VX2 liver tumors using examination of transmission electron microscopy ,histopathology and contrast-enhanced ultrasound(CEUS) . Methods Eighty New Zealand rabbits with VX2 liver tumors were randomly divided into 4 groups ( 20 per group ) , including physiological saline group , prothrombin group , cavitation of microbubbles group ( cavitation group ) and cavitation of microbubbles combined prothrombin group (combined group) . After treatment ,the targeted liver tumors in all groups were ablated with MWA . On the 0 ,3 ,7 and 14 d ,the volumes of coagulated areas of 5 rabbits of each group randomly were measured using CEUS . Tissues in ablated areas ,transition areas and surrounding areas were examined under light microscopy with histopathology and transmission electron microscopy to observe the differences among 4 groups . Tumor metastasis was graded using visual method . Results On the 0 ,3 ,7 and 14 d ,the coagulated volumes in combined group were larger than those in remaining 3 groups ( all P ＜ 0 .001) . Under light microscopy with HE stain ,in transition area ,the fibra band in combined group was wider than those in remaining 3 groups on the 7 and 14 d ( all P ＜ 0 .05 ) . The observations under transmission electron microscopy showed that the cellular ultrastructure disorder in ablated area on the 0 d and mitochondrial injury in transition area on the 7 d were more severe in combined group than those in remaining 3 groups . Compared with the remaining 3 groups ,the degree of tumor metastasis in combined group was less ,and the time of ocurrence was later . Conclusions MEUS combined with prothrombin can significantly expand ablation volume ,enhance the necrosis of ablated tissues ,and inhibit tumor metastasis on rabbit VX 2 liver tumors . The fibra bands in the transition areas can promote the organization and repair the surrounding tissue in the ablation areas .

Objective To evaluate the left ventricular(LV)myocardial mechanical changes with contrast agent and different power irradiation in open-chest beagle canines.Methods The anesthetized open-chest beagle canines were assigned into two groups randomly:group A(n=6)for baseline,diagnostic ultrasound power irradiation(300 mW)5 min,combined with contrast agent irradiation 5 min and contrast agent 20 min conditions;group B(n=6)for baseline and intensity ultrasound irradiation(1 W,2 W and 3 W,5 min respectively)conditions.The peak circumferential strain(CS),longitudinal strain(LS)and radial strain(RS)of LV myocardial wall were measured and analyzed using a dedicated Syngo velocity vector imaging(VVI)method.Results In group A,the peak CS and LS were increased significantly on diagnostic power irradiation,contrast agent irradiation 5 min and contrast agent 20 min(all P <0.05,respectively) compared with baseline condition;there was no significant difference of the peak RS on diagnostic power irradiation,contrast agent irradiation 5 min and contrast 20 min compared with baseline condition(P >0.05).In group B,the peak CS and LS were higher on power 1 W than on baseline condition(P <0.05), the peak RS was increased gradually on power 1 W than on baseline condition(P >0.05);the peak CS,LS, RS were lower on power 2 W than on baseline condition(P >0.05);the peak of CS,LS were lower on power 3 W than on baseline condition(P <0.05);the peak of RS was decreased gradually without significant changes between power 3 W on baseline condition(P >0.05).Conclusions These findings indicate potential positive inotropic effects with diagnostic ultrasound power irradiation 5 min,combined with contrast agent irradiation 5 min,contrast agent 20 min conditions,power 1 W and negative inotropic effects with power 3 W on LV myocardial CS,LS deformation.LV myofiber deformation reactions appear no significant differences on LV myocardial RS deformation in same disturbed setting.

Objective To evaluate left ventricular ( LV ) myocardial mechanical transmural longitudinal displacement ( LD ) and radial displacement ( RD ) with contrast agent and different power irradiation in open‐chest Beagle canines by ultrasound velocity vector images ( VVI) workstation . Methods T he anesthetized open‐chest Beagle canines were assigned into two groups randomly :Group A ( n ＝6) for baseline ,diagnostic ultrasound power irradiation ( 300 mW) 5 min ,combined with contrast agent irradiation 5 min and contrast agent 20 min conditions ; Group B ( n ＝ 6 ) for baseline and intensity ultrasound irradiation ( 1 W ,2 W and 3 W ,5 min respectively) conditions . T he standard short‐axis and long‐axis gray‐scale view s during three complete cardiac cycles in open‐chest Beagle canine models were acquired . T he peak LD subendomyocardium ( LD‐subendo) ,LD subepimyocardium ( LD‐subepi) ,RD subendomyocardium ( RD‐subendo) and RD subepimyocardium ( RD‐subepi ) of LV were analyzed using a dedicated Syngo VVI method . Results In group A ,the LV LD‐subendo ,LD‐subepi ,RD‐subendo and RD‐subepi in the most of segments showed increasing trend in diagnostic power irradiation ,contrast agent irradiation 5 min and contrast agent 20 min compared with baseline condition ,however the differences were not significant ( P ＞0 .05 ,respectively) . T he peak LD‐subendo and LD‐subepi ,RD‐subendo and RD‐subepi of LV in group A with the same condition were significant different ( all P ＜0 .05) . In group B ,LV LD‐subendo in ultrasonic power 3 W was lower than baseline condition ( P ＜ 0 .05 ) ,LV RD‐subendo was higher compared with baseline condition ( P ＜0 .05) . T he peak LD‐subendo and LD‐subepi ,RD‐subendo and RD‐subepi of LV in group B with the same condition were significant different ( all P ＜ 0 .05) . Conclusions On ultrasonic power 3 W ,LV LD‐subendo is decreased resulting to negative inotropic effect and RD‐subendo is increased to maintain the normal heart work .LV LD and RD on diagnostic ultrasound power irradiation 5 min , combined with contrast agent irradiation 5 min ,contrast agent 20 min conditions ,ultrasonic power 1 W and 2 W are not prominent changes .

Objective To evaluate left ventricular ( LV ) myocardial mechanical synchrony with contrast agent and different power irradiation in open-chest Beagle canines . Methods The anesthetized open-chest Beagle canines were assigned into two groups randomly : Group A ( n = 6 ) for baseline , diagnostic ultrasound power irradiation ( 300 mW ) 5 min ,combined with contrast agent irradiation 5 min and contrast agent 20 min conditions ;Group B ( n = 6) for baseline and intensity ultrasound irradiation ( 1 W ,2 W and 3 W ,5 min respectively) conditions . The standard short-axis gray-scale views at levels of mitral annulus ( MV) ,papillary muscle( PM ) ,and apex( AP) during 3 complete cardiac cycles in open-chest Beagle canine models were acquired . The global radial displacement peak time ( RD-PT) and standard deviation of peak time ( RD-PT SD ) of LV subendomyocardium ( subendo ) and subepimyocardium ( subepi ) were measured and analyzed by using a dedicated Syngo velocity vector imaging ( VVI) method . Results In group A ,compared with baseline condition , the RD-PT and RD-PT SD of subendo and subepi had no significant different among diagnostic power irradiation ,contrast agent irradiation 5 min and contrast agent 20 min ( all P < 0 .05) . There was no significant different in the RD-PT and RD-PT SD between subendo and subepi in A group in all conditions ( all P < 0 .05) . In group B ,the RD-PT and RD-PT SD of subendo and subepi with power 1 W ,2 W and 3 W was higher than those with baseline condition ;the RD-PT and RD-PT SD of subendo were significant different on 2 W compared with those on baseline condition ( all P <0 .05) ;the RD-PT and RD-PT SD of subendo ,subepi were significant different on 3 W compared with baseline condition ( all P < 0 .05) ;the RD-PT and RD-PT SD were significant difference between subendo and subepi in only 3 W condition ( all P < 0 .05 ) . Conclusions Diagnostic ultrasound power irradiation 5 min and combined with contrast agent irradiation 5 min and contrast agent 20 min conditions do not effect the synchrony of LV myocardial mechanics . Power more than 1 W can induce the delay of RD-PT and RD-PT SD of LV subendo and subepi . Power 3 W can result in dyssynchrony of LV myocardial mechanics .

Objective To evaluate left ventricular ( LV ) myocardial mechanical rotation and twist with contrast agent and different power irradiation in open-chest beagle canines by ultrasound velocity vector images ( VVI ) . Methods The anesthetized open-chest Beagle canines were assigned into two groups randomly :group A ( n = 6 ) for baseline ,diagnostic ultrasound power irradiation ( 300 mW ) 5 min , combined with contrast agent irradiation 5 min and contrast agent 20 min conditions ;group B ( n = 6) for baseline and intensity ultrasound irradiation ( 1 W ,2 W and 3 W ,5 min respectively ) conditions . The standard short-axis gray-scale views at basal level (BL) ,and apical level( AL) during three complete cardiac cycles in open-chest beagle canine models were acquired . The peak subendomyocardium rotation ( subendo-rot) ,subepimyocardium rotation ( subepi-rot) of BL and AL were analyzed using a dedicated Syngo velocity vector imaging ( VVI) method and LV subendomyocardium twist ( subendo-twi) and subepimyocardium twist ( subepi-twi) were defined as apical subendo-rot/subepi-rot - basal subendo-rot/subepi-rot . Results In group A ,the LV subendo-twi ,subepi-twi ,subendo-rot and subepi-rot of BL and AL in the most of segments were significant different on diagnostic power irradiation ,contrast agent irradiation 5 min and contrast agent 20 min ( P < 0 .05 ) compared with baseline condition ;LV subendo-twi was higher than subepi-twi in group A under the same condition ( P < 0 .05) . In group B ,LV subendo-twi ,subepi-twi and subendo-rot ,subepi-rot of BL and AL on power 1 W ,2 W were higher and subendo-twi ,subepi-twi on power 3 W were lower than those on baseline condition ( P < 0 .05) ;There was no difference in subendo-rot and subepi-rot of LV BL compared with baseline condition ( P > 0 .05) ;subendo-rot and subepi-rot of LV AL were different compared with those on baseline condition ( P < 0 .05) ;LV subendo-twi and subepi-twi in group B under the same condition were significant difference ( P < 0 .05) . Conclusions LV rotation and twist increase on diagnostic ultrasound power irradiation 5 min ,combined with contrast agent irradiation 5 min ,contrast agent 20 min conditions ,1 W and 2 W ;LV twist and AL rotation decrease on ultrasound power 3 W ,but BL rotation is not affected on ultrasound power 3 W .