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.

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.

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.

Objective To investigate the effects of arsenic trioxide (AS2O3)on SOCS-1 gene methylation and expression of P-STAT3 in multiple myeloma (MM) cells.Methods MM cell lines U266 and CZ-1 were used as in vitro models.Methylation status of SOCS-1 gene was detected by the methylation specific PCR (MSP)while P-STAT3 protein expression was determined by Western blotting assay before and after AS2O3 treatment.Meanwhile growth inhibition and apoptosis of MM cells were determined by flow cytometry.Results Hypermethylation of SOCS-1 gene was observed in each MM cell line compared with wide type.After exposure to AS2O3,it was shown that SOCS-1 gene was demethylated obviously,meanwhile the expression level of P-STAT3 protein and cell proliferation was inhibited significantly in each cell line.The apoptosis rate was increased.When U266 and CZ-1 were treated with AS2O3 of 0,0.5,1.0,2.0 μmol/L respectively,the total cell apoptosisis ratio of U266 was 0.06％,0.56％,48.96％,61.07％ (X2 =9.19,P ＜ 0.05); and the total cell apoptosisis ratio of CZ-1 was 4.2％,,40.3％,,47.72％,,68.49％ (X2 =8.96,P ＜0.05 ).Conclusion AS2O3 could inhibit JAK/STAT signal transduction pathway by inducing SOCS-1 gene demethylation in MM cells which might be related to cell apoptosis.

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 evaluate the efficacy of pegaspargase (PEG-ASP) combined with GEMOX regimen for the treatment of extranodal natural killer (NK) / T-cell lymphoma (ENKL),and to observe the changes of coagulation function.Methods 35 patients with histologically confirmed ENKL were enrolled from January 2010 to December 2014.All patients received 180 cycles of PEG-ASP combined with GEMOX chemotherapy and the efficacies were observed.The coagulation items such as prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fbg) and international normalized ratio (INR) were tested respectively on day 1st,day 8th and day 14th of every treatment cycle.Results Among 35 patients,11 patients (31.43 ％) were in stage Ⅰ-Ⅱ,and 24 patients (68.57 ％) were in stage Ⅲ-Ⅳ.All patients were subjected to 180 cycles of PEG-ASP combined with GEMOX chemotherapy,and each case was estimated to receive 6 cycles.The overall response (CR+PR) rate (ORR) was 71.43 ％ (25/35),the ORR was 81.82 ％ (9/11) in stage Ⅰ-Ⅱ group,and 66.67 ％ (16/24) in stage Ⅲ-Ⅳ group.The increased PT and APTT and decreased Fbg were observed on day 8th of the chemotherapy.The increased APTT and decreased Fbg were still observed on day 14th of the chemotherapy.Compared the data of patients one day before chemotherapy with healthy persons,the changes had statistical significance (P ＜ 0.05).Conclusions PEG-ASP combined with GEMOX regimen in the treatment of ENKL is safer and more effective compared with traditional chemotherapy,but the abnormal alternations of coagulation might be common during therapy.Dealing with the bleeding risk and supplement with plasma,PPSB or Fbg in time should be necessary.

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 detect the significance of the SHP-1,p15 and SOCS-1 genes methylation status in the genesis and development of diffuse large B-cell lymphoma (DLBCL).Methods The methylation state of SHP-1,p15 and SOCS-1 genes CpG islands were measured by methylation-specific polymerase chain (MSP) reaction.Results The positive rates of aberrant methylation for SHP-1,p15 and SOCS-1 genes in 50 specimens of DLBCL were 96 ％ (48/50),52 ％ (26/50) and 56 ％ (28/50) respectively.In control group,however,15 specimens of benign lymph node proliferation showed no methylation in CpG island of SHP-1,p15 and SOCS-1 genes promoter.Conclusion Aberrant methylations of the SHP-1,p15 and SOCS-1 genes exist in the patients with DLBCL.The methylations of SHP-1,p15 and SOCS-1 genes may be associated with the occurrence and development of DLBCL.This study provides a theoretical basis of treatment methylation for DLBCL.

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.