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.

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.

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.

BACKGROUNDΔNp73 is an isoform of the p53 homologue p73, which lacks an NH₂-terminal transactivation domain and antagonizes the induction of gene expression by p53 and p73. The aim of this study is to investigate the expression of ΔNp73 mRNA in non-small cell lung cancer (NSCLC) and to analyse its relations with clinicopathologic factors and prognosis.

METHODSSemiquantitative reverse transcriptase polymerase chain reaction (RT-PCR) was used to detect the expression of ΔNp73 mRNA in 40 resected NSCLC specimens with the neighboring noncancerous tissue. The significance of ΔNp73 mRNA expression was analyzed statistically.

RESULTSΔNp73 mRNA was highly expressed in lung cancer tissues (62.7%, 32/51) while negative in neighboring noncancerous tissue. The expression of ΔNp73 mRNA was associated with pathological TNM stage (P=0.046), but not associated with age, gender, histological type and differentiation status. Survival of patients with high ΔNp73 mRNA was significantly poorer than those with low ΔNp73 mRNA levels (P < 0.001). Multivariate analysis revealed that ΔNp73 mRNA levels were a significant prognostic factor, independent of the other conventional prognostic factors.

CONCLUSIONSNSCLC has overexpression of ΔNp73 mRNA, which is closely related to TNM stages and prognosis of patients with NSCLC. These results suggest that measurement of ΔNp73 mRNA levels in tumor tissues might be useful as a promising predictor for the prognosis of patients with NSCLC.

The incidence of thyroid cancer has grown in the past 20 years, the number of patients with surgical complications grows as well. Hypoparathyroidism is one of the severe complications which reduces the quality of life after thyroidectomy. How to preserve the structure and function of parathyroid glands and to avoid the pitfalls of the operation has always been the key point of thyroidectomy. This article reviews the recent progress of embryology and surgical anatomy of parathyroid glands, identification techniques and auxiliary imaging tools for the identification and preservation of parathyroid glands in thyroidectomy.

BACKGROUNDTo assess the effects of exogenous p73 gene on chemosensitivity of wild-type p53 human lung adenocarcinoma cell A549 to cisplatin (DDP) and adriamycin (ADM).

METHODSRecombinant eukaryotic expression vector pcDNA3 containing full-length human wild-type p73α cDNA or p53 cDNA was transfected into A549 cells which had wtp53 by lipofectamine-mediated gene transfection. The chemosensitivity of tumor cells to DDP and ADM was observed before and after transfection.

RESULTSA549-p73α could stably express P73α protein. The P73α protein expression was significantly increased in A549-p73α than that in A549 and A549-pcDNA3. The growth and colony formation of A549-p73α were significantly inhibited compared with A549, A549-pcDNA3 and A549-wtp53. Flow cytometry and DNA fragmentation analysis showed apoptosis of A549-p73α cells was significantly increased. The IC₅₀ values for DDP and ADM were reduced to approximate 1/6 and 1/70 in A549-p73α cells compared with A549 cells respectively..

CONCLUSIONSExogenous p73 gene is capable of enhancing the sensitivity of wild-type p53 human lung adenocarcinoma cell A549 to chemotherapeutic drugs. It is probably for p73 to be used in the treatment of p53-resistant tumors.

Objective: To analyze the differentially expressed genes related to the chemosensitivity with the TPF regimen for hypopharyngeal squamous cell carcinoma and to measure potential functional targeting genes expressions. Methods: Twenty-nine patients with primary hypopharyngeal cancer who underwent induction chemotherapy with TPF from January 2013 to December 2017 in Beijing Tongren Hospital were enrolled for microarray analysis, including 28 males and 1 female, aged from 43 to 73 years old. Among them, 16 patients were sensitive to chemotherapy while 13 patients were non-sensitive. Illumina Human HT-12 Bead Chip was applied to analyze the gene expressions and online bioinformatics analysis was used to analyze the differentially expressed genes. Reverse transcription and quantitative real-time PCR (RT-qPCR) was used to measure the mRNA expression of potential functional genes of TPF induction chemotherapy in 43 samples, 29 from original patients and 14 from additional patients. Graphpad prism 7.0 software was used for statistical analysis. Results: A total of 1 381 significantly differentially expressed genes were screened out. By GO analysis, up-regulated genes included sequestering in extracellular matrix, chemokine receptor binding and potassium channel regulator activity; down-regulated genes included regulation of angiogenesis, calcium ion binding and natural killer cell activation involved in immune response. With KEGG database analysis, down-regulated pathways included ECM-receptor interaction and peroxisome and up-regulated pathways included Glutathione metabolism and PPAR signaling pathway. The expressions of CD44 and IL-6R were significantly different and appeared biologically significant. CD44 was significantly upregulated in insensitive tissues (0.54±0.06) compared with sensitive tissues (0.33±0.04)(P<0.01). IL-6R was significantly downregulated in insensitive tissues (0.44±0.03) compared with sensitive tissues. (0.68±0.03) (P<0.01). Conclusion CD44 and IL-6R may be potentially functional genes of TPF induction chemotherapy in hypopharyngeal squamous cell carcinoma.

Objective:To evaluate the application of computer-assisted design and three-dimensional printing technique in reconstruction of maxillary defects with individual free fibular flap.Methods:A total of 13 patients, 7 males and 6 females with age from 12 to 55 years old, underwent the reconstruction of maxillary defects after subtotal or total maxillectomy for benign or malignant tumors between January 2016 and December 2018 were reviewed. Ther were 4 cases of subtotal maxillectomy and 9 cases of total maxillectomy. Before operation, osteotomy line was planned on three-dimensional images. A three-dimensional individual resin fibula model based on mirror images of the healthy side maxilla was obtained to fabricate an anatomically adapted osteomyocutaneous fibula free flap using computer-assisted design and forming. Oral, nasal, and eye functions and facial appearance were evaluated.Results:The 13 cases were followed up for 5-40 months, all flaps were alive except one due to flap failure and all cases were tumor free confirmed by CT or MRI. Ten patients could eat normal food without nasal food return, and 3 cases had palatal fistula. Eleven cases showed good speaking functional results. All cases had normal eye positions, no cases with diplopia and loss of vision. With evaluation by VAS, an average score of 8 was obtained, and most of patients were satisfied with their postoperative facial appearances.Conclusion:Reconstruction of maxillary defects by free fibular flap designed by three-dimensional printing and computer-assisted technique not only restored oral, nasal and eye functions, but also showed satisfactory facial appearance.

Objective:To evaluate clinical applications and efficacy of submental artery perforator flap in reconstruction surgery after removal of pharyngeal carcinoma.Methods:A total of 27 patients in the Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University were included, 23 males and 4 females with age from 40 to 70 years old, and 17 patients were hypopharyngeal carcinoma (HPC) and 10 patients were oropharyngeal carcinoma (OPC). All patients underwent tumor resection followed by simultaneously reconstruction surgery using submental artery perforator flap between January 2015 and December 2019. Of 5 patients with palatine tonsil cancer, 4 underwent the combined approach of neck and oral resection and 1 with madibulotomy. All 5 patients with tongue base cancer received transhyoid partial glossotomy with or without partial laryngectomy. Sixteen patients with pyriform sinus carcinoma received partial laryngo-pharyngectomy with preservation of laryngeal functions. One patient with posterior hypopharyngeal wall carcinoma had partial pharyngectomy. Prognosis and laryngeal functions were analyzed after reconstruction surgery with submental artery perforator flap in patients with pharyngeal carcinoma.Results:The 27 patients were followed up for 6-66 months, with a median of 13 months, of them 24 patients were alive without recurrence or metastasis, 1 patient died of recurrence, 1 patient died of esophageal carcinoma and 1 patient was alive with the recurrence of tongue base carcinoma. Postoperative complications included flap failure for 1 case, pharyngeal fistula for 1 case, subcutaneous hydrops for 2 cases and lymphatic fistula for 1 case. Total 2 and 3 year survival rates were 92.9% and 88.9%, respectively. Total decanulation rate was 92.6%; decanulation rate and intubation time were 16/17 and 3.5 months in HPC patients; and decanulation rate and intubation time were 9/10 and 2 months in OPC patients. Total oral feeding rate was 92.6% and nasogastric feeding time was 3.5 weeks in HPC patients and 3 weeks in OPC patients.Conclusion:The submental artery perforator flap is an excellent choice for reconstruction surgery after removal of oropharyngeal and hypopharyngeal carcinoma, with good outcomes of laryngeal functions.