The aims of this study are to obtain a suilablc condition for the cardioplasty with the fundoplication and an observation of the effect of the antircflux function following the operations. The results show that a suppcrting dcvicc of a round tube with 1 - 1.2 ctn diamcter is used as a guide to establish a good lovver esophageal sphinctcr(LES). The experimental ani-mais may survive very long. The pressure in the sphimcter is cvenly the same as that after the operation immediately. The gastroesophageal reflux is never occurred except intragastric pres-sure is the same as or higher than LES. The lower csophagcal high pressure zone formed is similar to the smooth muscle in the lower part of csophagus at the sile of opcralions . The new formed cardia plays an excellent role of anturc flux function . This report suggists that the cardioplasty with fundoplication is useful for the treatment of esophageal achalasia and somc other abdpminal disorders.

Objective　To study the expression of p73 in human non-small cell lung cancer (NSCLC) and the relationship between p73 expression and clinico-pathological parameters. Methods　Expression of p7 3 gene was detected by RT-PCR in 32 human NSCLC tissues, tissues adjacent to ca ncer and non-cancer lung tissues. Results　p73 gene expression up-regulated substantially and detected in 87.5%(28/32) of human NSCLC tissues while expressed at low level in tissues adjacent to cancer and non-cancer lung tissues. Conclusion　Marked up-regulation of p73 gene expres sion is found in human NSCLC.

Objective　To explore the risk factors and causes affecting the operative mortality in esophagectomy patients with esophageal can cer. Methods　1400 cases with a curative esophagectomy for neopl asm of esophagus hospitalized from Mar,1973 to June, 2000 were reviewed. There w ere 31 died within 30 d or during hospitalization after esophagectomy as a group , and 1 369 survival cases, after operation, as another group. Sixteen factors t hat may influence the operational mortality were selected. A multi-variate anal ysis of these individual variables was performed by the computer′s logistic reg ression model. Results　The operative mortality was 2.2%(31/1400 ). The causes of death included respiratory complication 17 cases (including res piratory failure caused by pneumonia or atelectasis), 15 cases, and adult respir atory distress syndrome (ARDS) 2 cases, the mortality was 54.8% in the death gro up), anastomotic leak 11 cases (34.5%), Chylothorax 2 cases (6.5%) and postopera tive digestive tract hemorrhage 1 case (3.2%). The results showed that the major risk factors that affected operative mortality in cases with esophageal cancer were history of long-herm heavy smoking, duration of operation and the year of operational (P<0.05). Conclusion　To minimize operative mort ality of esophagectomy, some means must be noticed, including the reinforcemen t of the perioperative care, the improvement of anastomotic methods and surgical skill, reduing operative time as p ossible, disposing pulmonary complications in time and using respirator if neces sary.

Objective To investigate the cardioprotective effects of the inhibitor of JAK/STAT pathway on ischemia-reperfusion injury in cultured immature rat cardiacmyocytes.Methods The cultured immature rat cardiacmyocytes were randomly divided into normal control group,ischemia-reperfusion group,AG490 treatment group and RMP treatment group.The cell viability was measured by MTT method.The contents of lactate dehydrogenase(LDH) and malondialdehyde(MDA),the superoxide dismutase(SOD) activity and the rate of cell apoptosis were detected.Results Compared with the normal group,the cell viability decreased significantly,the contents of LDH and MDA in the supernatant of the cells increased significantly,the SOD activity decreased and the rate of apoptosis of cells increased significantly in ischemia-reperfusion group(all P

This paper is to report the result of the surgical treatment of 12 cases of carcinoma of the hypopharynx and cervical esophagus in a period of 3 years.Ten out of the 12 cases were explored and resection of the tumor was perforr med on 8 cases. In 7 cases out of the 8. the esophagus was stripped out and the stomach was transposed without thoracotomy and total pharyngolaryngectomy was performed in addition on 3 of them. In the 8th resected case, the pharynx, larynx and the cervical esophagus were resected and then a segment of jejunum was isolated ar.d transplanted to reconstruct an esophagus.All the cases stood the operation rather well. Postoperatively 3 cases developed serious complications; one died of cardiac failure, one developed salivary fistula and the third one developed partial ischemic necrosis of the transposed stomach. The last patient was treated with intraluminal intubation and he could take soft food when he was discharged. Six cases were followed up for years;two died one year after operation and 4 are living.The operative indications, the method of approach, and the postoperative complications were discussed. It is concluded that carcinoma of the hypopharynx and cervical esophagus is not an uncommon disease with high resectability and better survival rate as compared with carcinomas of other sites, but early detection and prompt operation are imperative for a cure.

Objective　To estimate the value of applying left heart bypass technique in esophageal carcinoma resection and gastroesophageal reconstruction. Methods　The operation was performed under lef t he art bypass. Results　Applying left heart bypass during esophagea l carcinoma resection and gastroesophageal reconstruction increased the probabil ity of the resection. The patient lived better and without operative complicatio n. Conclusion　In case of esophageal carcinoma with invasion of descending aorta by carcinoma, left heart bypass may increase the probability of the resection and enhance the safety of surgical treatment.

BACKGROUND: The role of p53 gene in human lung cancer has been confirmed. Since the discovery of p63 gene as the homologue of p53, its role and possible mechanism-have aroused the attention of investigators all over the world. But the principle concerning transcription and expression of p63 in small-cell lung carcinoma (SCLC) remains unclear.OBJECTIVE: To investigate the level of the expression of p63 gene in SCLC and lung adenocarcinoma tumor tissues, peri-carcinoma tissues and normal tissues, and observe the expression of p63 protein in these tissues so as to understand the principle and clinical significance concerning p63gene expression in SCLC and lung adenocarcinoma.DESIGN: Controlled experiment.SETTING: Department of Thoracic and Cardiovascular Surgery, Research Institute of Field Surgery of Daping Hospital of Third Military Medical University of Chinese PLA.PARTICIPANTS: Six SCLC specimens dissected during the surgical operation in Daping Hospital, Third Military Medical Univers ity of Chinese PLA, between October 2000 and September 2002 , were recruited. There were 4 male and 2 female patients aged 42 to 67 years (mean age of 50.7years); 15 specimens of lung adenocarcinoma were also collected at the same time. Tumor tissues, peri-carcinoma tissues and normal tissues were chosen in each specimen.METHODS: Reverse transcriptase polymerase chain reaction (RT-PCR)was used to detect and compare the transcription expression of two subtypes of p63 gene (TAP63 and △NP63)in the tumor tissues of 6 cases of SCLC and 15 cases of lung adenocarcinoma. At the same time, immunohistochemical staining technique was used to detect the expression of p63protein in the above tissues.MAIN OUTCOME MEASURES: ① Expression of p63 protein detected by RT-PCR in tissue specimens. ② Expression of p63 protein detected in tissue specimens detected by immunohistochemical staining technique.RESULTS: ① Expression of p63 protein detected by RT-PCR in tissue specimens: The positive expression of △Np63 gene could be found in 5cases (83%, 5/6) of SCLC cancer tissues and 1 case of SCLC peri-carcinoma tissues (17%, 1/6), and the expression of TAp63 was not observed in all of the tumor, peri-carcinoma and normal tissues of SCLC. There was no expression of △Np63 or TAp63 in tumor, peri-carcinoma and normal tissues of lung adenocarcinoma. ② Expression of p63 protein detected by immunohistochemical staining in tissue specimens: The positive expression rate of p63 protein in SCLC tumor tissues was significantly higher than that in lung adenocarcinoma tissues [83% (5/6), 17% (1/6), P ＜ 0.01].CONCLUSION: p63 gene shows positive expression in SCLC, among which the expression level of △NP63 is increased while the expression level of p63 protein is obviously higher in SCLC than in adenocarcinoma tissues, which may be related to its regulatory role in the occurrence and development of SCLC. It is presumed that△NP63 gene has high transcription expression level in SCLC, which might inhibit cellular apoptosis, promote the proliferation of tumors, play the role as an oncogene. It suggests that p63 may be one of the factors influencing the prognosis of SCLC.

BACKGROUNDTo study the effect of overexpression of p73 gene on cell growth curve and vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) mRNA expression in lung adenocarcinoma cell, and to explore its effect on angiogenesis in lung adenocarcinoma.

METHODSp73α and p73β were transferred into A549 cell and H1299 cell by liposome, the positive cell clones were chosen by G418. The cell growth curves were drawn by cell counting. The expressions of VEGF and bFGF mRNA were detected by RT-PCR.

RESULTSOverexpression of p73 gene could inhibit the growth of A549 cell and H1299 cell. VEGF and bFGF mRNA expressions in A549 cell and H1299 cell were decreased after transfer of p73 gene (P < 0.05), VEGF mRNA was decreased more obviously after transfer of p73β (P < 0.01).

CONCLUSIONSOverexpression of p73 gene can inhibit the growth of lung adenocarcinoma cell, decrease VEGF and bFGF mRNA expression. The results suggest that overexpression of p73 gene might be involved in the regulation of VEGF and bFGF gene expression in lung adenocarcinoma and act as an antioncogene.

Objective:To investigate high mobility group protein 1(HMGB1), tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels and their clinical significance in elderly patients with viral pneumonia.Methods:One hundred and sixty elderly patients with viral pneumonia admitted to the Sixth Hospital Affiliated to Anhui Medical University were enrolled as research subjects.In addition, 40 elderly people who underwent regular physical examination were considered as the control group.Patients with viral pneumonia were divided into the low-risk group, middle-risk group and high-risk group according to CURB-65 scores and pneumonia severity index(PSI)scores.HMGB1, TNF-α and IL-6 levels were compared between different groups.The correlations of CURB-65 scores and PSI scores with HMGB1, TNF-α, IL-6 levels were analyzed.Multivariate Logistic regression analysis was used to examine influencing factors for the severity of viral pneumonia in elderly patients.Results:HMGB1, TNF-α and IL-6 levels were higher in research subjects than in the control group.As the severity of viral pneumonia increased, so did HMGB1, TNF-α and IL-6 levels(all P<0.05). HMGB1, TNF-α and IL-6 levels in the severe viral pneumonia group were significantly higher than those in the non-severe viral pneumonia group( P<0.05). HMGB1, TNF-α and IL-6 levels were positively correlated with CURB-65 scores and PSI scores(CURB-65 score: r=0.463, 0.392 and 0.497, P=0.015, 0.003 and 0.025; PSI score: r=0.596, 0.515 and 0.381, P=0.007, 0.011 and 0.009). HMGB1, TNF-α and IL-6 levels were influencing factors for the severity of viral pneumonia in elderly patients( OR=1.344, 1.422 and 1.351, P=0.006, 0.015 and 0.009). Conclusions:HMGB1, TNF-α and IL-6 levels are closely correlated with the severity of viral pneumonia and are helpful for early assessment of viral pneumonia.

BACKGROUNDLocally advanced lung cancer includes IIIA and IIIB lung cancer that tumors are localized within the chest and with no clinic and pathologic distal metastasis. In this study the results of extended resection of a portion of heart or great vessels with cardiopulmonary bypass was summarized in the treatment of locally advanced lung cancer.

METHODSLobectomy or pneumonectomy combined with extended partial excision of the heart or great vessels were carried out in 10 patients with locally advanced lung cancer. The operations included aortic resection and reconstruction with left heart bypass in 2 cases, extended resection of left atrium with normal cardiopulmonary bypass in 5 cases, and resection and reconstruction of superior vena cava in 3 cases respectively.

RESULTSThe patients had no operative complication except for one haemothorax, which was controlled by re-exploration. One patient died of brain metastasis 6 months after operation and another one died of multiple metastasis 26 months after operation. The others were alive.

CONCLUSIONSCPB is a safe and effective anesthetic procedure during extended resection of locally advanced lung cancer although it is controversial for aggravating operative trauma, complex technique and higher cost.