Objective In order to improve the surgical treatment for midpiece esophageal carcinoma, different surgical ways were com-pared. Methods From January 2010 to June 2012, 110 patients with midpiece esophageal cancer in our hospital were divided into the Ivor-Lewis group (55 cases) and the Sweet group (55 cases) according to different surgical ways, that is to say Ivor-Lewis surgery via right chest and Sweet surgery through left chest. Length of specimens, rang of tumor invasion, distance of removal, incidence of residual carcinoma in the esophageal edges, number of lymph nodes removed in chest and abdomen, and positive rate of carcinoma infiltrated lymph nodes were compared between the two groups. Questions of surgical anatomy were investigated through questionnaire among surgeons of the two groups, and the scores of both groups were analysed. Results The length of resected specimens and number of lymph nodes removed in Ivor-Lewis group was significantly lager than that of the Sweet group (P<0. 01). The positive rate of carcinoma infiltrated lymph nodes in Ivor-Lewis group was 1. 82%, which was significantly lower than 21. 82% in the Sweet group (P<0. 01). Results of questionnaire showed surgeons have gieven higher scores to Ivor-Lewis group. Conclusion Ivor-Lewis surgery is recommend for upper and midpiece esophageal carcinoma while Sweet surgery is more suitable for cardial and lower esophageal cancer.

Objective:To explore the tracing effect of nano-carbon in the cervical lymph nodes of papillary thyroid carcinoma (PTC) and the guiding role of the dissection strategy of the contralateral lymph nodes.Methods:The medical records of 516 patients with PTC in Department of Endocrine and Breast Surgery, the First Affiliated Hospital of Chongqing Medical University from Jan. 2013 to Dec. 2017, including cN0 patients (436 cases) and cN1 patients (80 cases) , were retrospectively analyzed. There were 137 males and 379 females, the male to female ratio was 1.00:2.76. During the operation, nano-carbon was used to trace lymph nodes, and the number of lymph nodes in each lateral area (area II, III, IV) was collected, and the rate of black stained and non-black stained lymph node metastasis (LNM) was calculated based on the postoperative pathological results. SPSS 22.0 statistical software was used for analysis, t test was used for measurement data, and χ2 test was used for count data. Results:In 436 patients with cN0, the black-stained LNM rate in zone II ( P=0.002) , the black-stained LNM rate in zone III ( P=0.000) , and the black-stained LNM rate in zone IV ( P=0.002) were higher than those of non-black stained LNM. The rate of black-stained LNM in 80 cN1 patients (Ⅱ, Ⅲ, Ⅳ) was also higher than that of non-black-stained LNM (0.011, 0.019, 0.015) . The rate of black-stained LNM in cN0 patients affected the LNM in areas Ⅱ and Ⅳ ( P=0.000, P=0.000) . In patients with cN1, the black-stained LNM rate in zone Ⅲ had an effect on zone Ⅱ (0.030) ; it had no effect on the black-stained LNM rate in zone Ⅳ (0.315) . Conclusion:The black-stained LNM rate of the posterior zone (zone Ⅱ, Ⅲ, Ⅳ) with nano-carbon can represent the LNM rate of the lateral zone and help guide the lymph node dissection in the lateral zone. In addition, the black-stained LNM rate of zone Ⅲ can affect zone Ⅱ. The LNM rate in zone IV has the role of sentinel lymph nodes in the lateral zone.

ObjectiveTo observe and compare the efficacy of two types of microencapsulated rat islets xenotransplanted into diabetic mice. MethodsThe mice diabetic model made with injecting 3% Streptozotosin through tail vein. Four groups were assigned: control group, naked islet transplantation group, alginate-BaCl2 microencapsulated islet transplantation group, agarose-PSSa microencapsulated islet transplantation group.300 islets were transplanted under the renal envelope of each diabetic mice respectively. ResultsThere were no significant difference in mean level of the blood glucose before transplantation among four groups. One week after transplantation, the respective mean level of the blood glucose in four groups were (7.26±1.56) mmol/L in alginate-BaCl2 microencapsulated islet transplantation group, (7.14±1.04) mmol/L in agarose-PSSa microencapsulated islet transplantation group, (7.42±1.52) mmol/L in naked islet transplantation group and (22.54±1.24) mmol/L in control. There were significant difference between the two encapsulated islet groups and the other two groups. The survived period of the two encapsulated islet transplantation groups were longer than that of the other two groups. The survived period of the alginate-BaCl2 microencapsulated islet transplantation group was longer than that of the agarose-PSSa microencapsulated islet transplantation group (92 d vs 56 d),the same as the time of keeping nomal blood glucose level (76 d vs 41 d). ConclusionMicroencapsulated rat islets with this two materials can survive in diabetic mice with their biological activity, and the alginate-BaCl2 microcapsules are better than the agarose-PSSa microcapsules.

OBJECTIVETo observe the pathological changes and the expression of tumor necrosis factor alpha (TNF-alpha) and transforming growth factor beta (TGF-beta) in lung tissue of rats with radiation injury for exploring the mechanism of blood-activating and stasis-dissipating drugs in radiation injury prevention and treatment.

METHODSOne hundred and thirty SD female rats were randomly allocated into the simple irradiation group (n=60), the TCM herbs treatment group (n=60) and the blank control group (n=10). The right lung of all rats except those in the blank control group were irradiated by linear accelerator, 3 Gy each time, twice weekly, the maximum accumulated dose being 30 Gy. Ten rats in the two groups were randomly sacrificed at each of the 6 time points (1, 3, 5, 8, 12 and 26 weeks after repeated irradiation), their lung was harvested out, sliced and dyed with HE stain. The histological changes, levels of TNF-alpha and TGF-beta expression in the lung tissue were then observed by immunohistochemical technique.

RESULTSThe most serious acute radiation pneumonia was seen in the 5th week and pulmonary fibrosis was remarkable in the 26th week in the simple irradiation group, with the expressions of TNF-alpha and TGF-beta at different time phases enhanced significantly (P < 0.01). While in the TCM herbs treatment group, the pneumonia was milder, pulmonary fibrosis in late stage was not so obvious, and the expressions of TNF-alpha and TGF-beta significantly lower than those in the simple irradiation group (P < 0.01).

CONCLUSIONBlood-activating and stasis-dissipating drugs can inhibit expression of inflammation-inducing factors and fibrosis-inducing factors to lessen the inflammatory reaction of early radiation pneumonia, prolong the progression of radiation lung fibrosis, showing preventive and treating action on radiation lung injury.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Particle Accelerators ; Phytotherapy ; Radiation Injuries, Experimental ; drug therapy ; pathology ; prevention & control ; Radiation Pneumonitis ; drug therapy ; prevention & control ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta ; biosynthesis ; genetics ; Tumor Necrosis Factor-alpha ; biosynthesis ; genetics

Objective To investigate the correlation between aberrant methylation status of ras association domain family 1A (RASSF1A) , transcriptional levels of DNA methyltransferases (DNMTs) and hepatitis B virus ( HBV) infection in patients with hepatocellular carcinoma ( HCC). Methods HCC samples in 61 cases were collected. Aberrant methylation status of RASSF1A was detected using methylation specific PCR (MSP). Transcriptional levels of DNMT1, DNMT3 A and DNMT3B was measured using semi-quantitative reverse transcriptase-PCR(RT-PCR). Results RASSF1A gene with abnormal methylation in initiation zone was found in 45 cases with HCC among 61 patients (73.8%). Further analysis revealed RASSF1A methylated in 32 of 47 HBV infected cases and in 13 of 14 uninfected cases. However, there was no significant association between methylation status of RASSF1A and HBV infection (x2 =2.260, P = 0. 133). Compared with normal control, DNMTs was up-regulated in all HCC samples, HCC cell lines and HBV infected group. Analysis within each group indicated that DNMT3A and DNMT3B levels of HCC increased in MSP positive cases ( t = 3. 494, P

Objective To explore the possible relationship between alteration of cell cycle and JAK/STAT3 signal transduction pathway inhibition induced by arsenic trioxide (As_2O_3,) in myeloma cell lines U266 and RPMI8226 in vitro. Methods Multiple myeloma cell lines U266 and RPMI8226 were used as in vitro models. The influence of AS_2O_3 on myeloma cells were evaluated by MTT assay and flow cytometry. Meanwhile, methylation specific PCR and Western blotting were employed to detect the methylation status of gene SOCS-1 and protein expression level of P-STAT3 in these cells after AS_2O_3 treatment. Results AS_2O_3 significantly inhibited the growth of U266 and RPMI8226 cells in a dose-dependent manner. Furthermore, cell cycle was arrested at G0/G1 phase with inhibition of protein expression level of P-STAT3 and SOCS-1 gene demethylation after exposure to As_2O_3 for 72 h( r = 0. 85, P < 0.05). Conclusion AS_2O_3 could induce the alteration of cell cycle which might be related to JAK/STAT3 signal transduction pathway inhibition and SOCS-1 demethylation in myeloma cell lines. The study puts forward a new idea of AS_2 O_3 treatment in multiple myeloma.

Objective To explore the significance of the suppressor of cytokine signaling-1 (SOCS-1)gene methylation in the genesis, development and prognosis of diffuse large B-cell lymphoma (DLBCL).Methods The methylation state of CpG island in SOCS-1 gene were detected by methylation-specific polymerase chain reaction (PCR) and the level of SOCS-1 gene was measured by the real-time PCR. The clinical data of 30 patients with DLBCL were collected, and according to the international prognosis index (IPI), they were divided into low risk group and high risk group. Results Aberrant methylation of SOCS-1 in 17 DLBCL patients (56.7 %) were positive, however, in control group aberrant methylation was negative(P ＜0.01).The methylation level of DLBCL patients with positive SOCS-1 methylation was higher than that of patients with negative (P ＜0.05). Combined with the clinical data, the positive rate of methylation in patients with high level of serum LDH or the numbers of extra-nodal lesions＞l were significantly higher than that in patients with normal LDH level or the numbers of extra-nodal lesions ≤ 1, respectively. Hence, the positive rate of methylation in the high risk group of DLBCL was higher than that in the low risk group (P ＜0.05). Conclusion There were aberrant methylations of the SOCS-1 gene in the patients with DLBCL. The methylations of SOCS-1 can silence the gene expression, which indicates that SOCS-1 and its methylations play some role on genesis and development of DLBCL and can evaluate the prognosis of the patients with DLBCL.

Objective To observe the effect of JLP on transdifferentiation of human renal proximal tubular epithelial cells (HK-2),and to investigate the role of p38 MAPK signaling pathway in this process.Methods The knock-down plasmids of JLP were constructed.HK-2 cells were randomly divided into four groups:negative control cells (Ctrl-shRNA group),knock-down jlp cells (jlpshRNA group),negative control cells with FGF-2 treatment (FGF-2 group) and knock-down jlp cells with FGF-2 treatment(jlp-shRNA +FGF-2 group).The expressions of JLP,E-cadherin,TGF-β1,α-SMA,p-p38 MAPK protein were detected by Western blotting.After the induction of FGF-2 for 24 hours,the expressions of α-SMA,COL-Ⅰ,FN were detected by immunocytochemistry.Results Compared with Ctrl-shRNA group,the expression of JLP protein was significantly down-regulated in FGF-2 group.Compared with FGF-2 group,the expressions of TGF-β1,α-SMA,p-p38 MAPK protein were significantly up-regulated,while E-cadherin protein was significantly down-regulated (P ＜ 0.05).Compared with FGF-2 group,the expressions of α-SMA,COL-Ⅰ,FN immunostaining increased markedly in jlp-shRNA+FGF-2 group.Conclusion Scaffolding protein JLP is critical in preventing EMT in the course of fibrosis through the inhibition of p-p38 activation in HK-2 cells.

Objective To study whether there is a correlation between the content of neutrophil gelatinase-asociated lipocalin (NGAL) and extravascular lung water index (EVLWI) in patients with acute lung injury (ALI) induced by septic shock.Methods We prospectively collected 110 patients with septic shock from December 2013 to June 2015,who had already completed the initial fluid resuscitation within 6 hours according to the guide.In accordance with whether combined with ALI,patients were divided into two groups:non ALI group was A group (n =61),and ALI group was B group (n =49).Baseline information,EVLWI and other indexes of hemodynamic monitored by PICCO of each group was collected prior to admission in intensive care unit.EVWI and the content of NGAL in alveolar lavage fluid,which detected by ELISA,were gathered after the initial fluid resuscitation.Results There were no significant differences at the baseline level between the two groups (P ＞ 0.05).The risk factors of EVLWI in patients with septic shock were analyzed by multivariate linear regression analysis.The risk factors contained fluid balance,NGAL,cardiac index (CI),Global end diastolic volume index (GEDI),human albumin (ALB),globulin (GLO).The results showed that EVLWI had linear regression with NGAL and GEDI.The equation of linear regression were Y(NGAL) =2.017 + 0.035X,and Y(GEDt) =-0.671 + 0.004X,respectively.Correlation analysis indicated that there was significantly positive correlation between EVLWI and GEDI (r=0.835,P=0.000)and between NGAL and GEDI (r=0.489,P=0.000).In contrast,after immobilization of GEDI,we did not find any significant correlation between EVLWI and NGAL (r =0.381,P =0.060).Conclusions In case of fluid infusion volume is relatively too much,there is a strong correlation between NGAL in alveolar lavage fluid and EVLWI levels for early fluid resuscitation in patients with sepetic shock.

Objective To explore the efficacy of endovascular treatment for closed articular artery injuries.Methods The clinical data of 13 patients from Jan 2010 to Dec 2014 treated for closed articular artery injuries were analyzed retrospectively.The location,severity and extent of arterial injury were confirmed by intraoperative arteriography.The diameter and length of the injured arteries were measured.The guidewire was sent to the lesion site and working wire pathway was established.When the guidewire was difficult to pass through the lesion site,femoral and posterior tibial or radial artery may be used to establish working wire pathway.The stent or stent-graft was implanted through the contralateral femoral artery or distal end of ipsilateral artery.Results Intraoperative angiography confirmed intimal injury (n =2),partial transection (n =5),complete transection (n =5) and arteriovenous fistula (n =1).Eighteen stents or stent-grafts were implanted.Treatment was successful in all patients without peiropeartive death and procedure-related complications.All were followed up for 15 to 48 months and the mean follow-up was (30 ± 11) months.Three patients with stent lumen stenosis less than 50％ as showed by angiography.There was no stent fracture,displacement,or deformation.Conclusions Endovascular treatment for closed articular artery injuries is of less invasion,shorter operative time and quick postoperative recovery.