Severe tracheal stenosis can not only cause critical medical problems such as severe shortness of breath, hypoxia, and even orthopnea, but also impose overwhelming challenges on the physicians, particularly the anesthesiologist. Life-threatening airway obstruction can make the patient's gas exchange extremely difficult.Though several options could be offered regarding the treatment of tracheal stenosis, normally, tracheal resection and following reconstruction is the first choice for severe airway stenosis. Successful surgical intervention relies on the close communication and cooperation between surgeons and anesthesiologists. In these cases, airway management is the top issue for the anesthesiologist, and the level of difficulty varies with stenosis location, severity of stenosis, and surgical technique. Extracorporeal membrane oxygenation (ECMO), or cardiopulmonary bypass (CPB), is rarely utilized for the surgery, but for those impossible airways due to nearly complete tracheal obstruction, ECMO or CPB could be the final choice for anesthesiologists. Here we report a case of successful urgent airway management for tracheal resection and reconstruction assisted by temporary CPB.
Cardiopulmonary Bypass ; Emergencies ; Female ; Humans ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Trachea ; surgery

OBJECTIVE: To detect the expressions of chemokines interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), and macrophage inflammatory protein-1 (MIP-1) mRNA in non-small cell lung cancer (NSCLC) tissues, to analyze their relationship with microvessel counts (MVC), and their significance in clinic pathologic features of NSCLC. METHODS: In situ hybridization was used to measure the expressions of chemokine IL-8, MCP-1, and MIP-1 mRNA in 40 NSCLC tissues and 10 normal pulmonary tissues, and immunohistochemical staining was carried out to measure the MVC in the above tissues. RESULTS: The positive ratios of IL-8, MCP-1, and MIP-1 mRNA in the 40 NSCLC tissues were apparently higher than those in the 10 normal contrast tissues and the difference was statistically significant. The numbers varied accordingly with the different clinic pathologic features of NSCLC, showing that Group T(3) > Group T(2) or Group T(1), Group III stage> Group II stage> Group I stage Group lymph node and remote transferred > Group non-transferred, and Group of survival time no more than 3 years > Group of survival time more than 3 years. The positive expressions among IL-8, MCP-1,and MIP-1 mRNA and between these and the MVC all had mutually positive correlation. CONCLUSION Chemokine IL-8, MIP-1, and MIP-1 in NSCLC tissues might cooperate with one another to promote the tumor angiogenesis and affect the progression, metastasis and prognosis of the tumor.
Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; blood supply ; metabolism ; Chemokine CCL2 ; metabolism ; Female ; Humans ; Interleukin-8 ; metabolism ; Lung Neoplasms ; blood supply ; metabolism ; Macrophage Inflammatory Proteins ; metabolism ; Male ; Middle Aged ; Neovascularization, Pathologic ; Prognosis

OBJECTIVE: To detect tumor microvessel count (MVC), tumor associated macrophage (TAM) and Mast cell (MC) counts, and to explore their correlation and the clinical significance in non-small cell lung cancer (NSCLC). METHODS: Immunohistochemical staining (ABC method) was used to measure MVC and TAM and MC counts in 40 cases of NSCLC tissues and 10 cases of normal pulmonary tissues as contrast. RESULTS: The counts of microvessel, TAMs, and MCs in the NSCLC tissues were apparently higher than those of the normal tissues, and these counts increased with the development of T stage and clinical stage, metastasis of the tumor, and the reduction of the patient survival time. The positive correlation was showed among the counts of microvessel, TAMs, and MCs. CONCLUSION Tumor interstitial infiltrating inflammatory cells, TAMs and MCs can cooperatively promote the tumor angiogenesis,which associates with the development, invasion, metastasis and prognosis of NSCLC.
Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; blood supply ; pathology ; Female ; Humans ; Leukocyte Count ; Lung Neoplasms ; blood supply ; pathology ; Macrophages ; cytology ; Male ; Mast Cells ; cytology ; Middle Aged ; Neovascularization, Pathologic ; Prognosis

OBJECTIVE: To determine the feasibility whether the bovine jugular venous conduit (BJVC) can be fixed with polyepoxy compound (PC). METHODS: Twenty-four BJVCs were divided into 3 groups and fixed with polyepoxy compound (PC group, n = 8), glutaraldehyde (GA group, n = 8), and unfixed group (Control group, n = 8), respectively. The morphologic and mechanical properties of BJVCs in the 3 groups, including thickness, diameter, moisture content, denaturation temperature, tensile strength, elongation at break, and fixation index were measured. The rat subcutaneous model for the assessment of tissue calcification was used. The calcium content in bovine jugular vein patches and valves was determined by flame atomic absorption spectrophotometer. RESULTS: There was no difference in the wall thickness, diameter, and tissue water content between PC and the control group, but significant difference was found between GA and PC groups. The mechanical properties of PC group and GA group were not significantly different, but they were better than those of the control group. GA-fixed BJVC samples showed clear calcification, while PC fixed BJVC were calcified significantly less. CONCLUSION PC is an effective and suitable choice for the treatment of BJVC since it can effectively preserve the structure and the anti-reflow function of valves in bovine jugular vein and it has better anti-calcification properties.
Animals ; Biocompatible Materials ; Bioprosthesis ; Blood Vessel Prosthesis ; Cattle ; Cross-Linking Reagents ; pharmacology ; Epoxy Compounds ; pharmacology ; Jugular Veins ; Polymers

OBJECTIVE: To investigate the effect of decellular treatment on the framework constituents of extracellular matrix and tissue stability in bovine jugular vein conduit (BJVC), and to provide an evidence for tissue engineering of vascular prosthesis. METHODS: Bovine jugular veins were obtained fresh from a local slaughterhouse and were stored in chilled PBS. In the laboratory, any fat and loose connective tissue on the outer surface of the vessel was trimmed. BJVCs were decellularized by a 3-step extraction method as detergent Triton X-100 (0.5%), Trypsin (0.025%) EDTA (0.02%), and DNase I(30kU/L) RNaseA(0.3g/L). Histological and transmission electron microscopy (TEM) techniques were used to study the framework constituents of extracellular matrix of treated the examples, and fresh tissues were used as controls. Tissue contents of hydroxyproline(alkaline hydrolysis method) and elastin (Fastin Elastin Assay) were assayed respectively in the fresh and decellularized groups (n=10). The vascular wall heat shrinking temperature and mechanical strength were measured to evaluate the tissue stability (n=10). RESULTS: Histochemical and TEM analysis of BJVCs treated with decellularization proved a complete removal of nuclear and other cell components. Tissue collagen was well kept,but elastin was partly lessened. Tissue content of hydroxyproline increased comparatively [(25.73+/-2.97)mg/g vs. (29.25+/-2.99)mg/g, P<0.05] and the elastin content obviously decreased [(159.71+/-21.06)mg/g vs. (134.91+/-35.40)mg/g, P<0.05] in the decellular treatment group compared with the control group. The heat shrinking temperature and tensile stress of decelluarized tissue were lower than those of the fresh tissue[(72.50+/-0.53) degrees C vs. (69.75+/-0.54)degrees C ,P<0.05], [(5.19+/-0.65)MPa vs. (3.13+/-0.94)MPa, P<0.05]. CONCLUSION The basic framework of extracellular matrix in the decellularized BJVC is partly damaged and tissue stability is reduced. Decellularized BJVC should be further crosslinked before being used as a tissue engineering scaffold for clinical pulmonary artery graft.
Animals ; Blood Vessel Prosthesis ; Cattle ; Extracellular Matrix ; Jugular Veins ; Tissue Engineering ; methods ; Tissue Scaffolds

This study was purposed to investigate the reconstitution of immune system in patients with acute lymphocyte leukemia (ALL) or acute myeloid leukemia (AML) after HLA-mismatched nonmyeloablative hematopoietic stem cell transplantation (NHSCT) and its relation with infection and GVHD. 6 ALL and 4 AML patients having HLA-mismatched related donors received the nonmyeloablative precondition regimen composed of fludarabine (Fln), ATG, Ara-C, CTX and total body irradiation (TBI) in dose 2 Gy. The GVHD was prevented and treated by CsA, anti-CD25 antibody and mycophenolic mofetil (MMF) before and after transplantation. The flow cytometry was used to detect the changes of total T cells, help/inducer T cells, suppressor/killer T cells, gamma/delta T cells, B cells, NK cells, NKT cells, regulatory T cells, activated T cells, naive T cells, memory T cells and ratio of CD4/CD8 in patients with remission resulting from chemotherapy before transplantation, and analyse the relation of immunofunctional cells to infection and GVHD after transplantation, compare the difference in recovery of immune system of ALL and AML patients. The results showed that the recovery of total lymphocytes and lymphocyte subsets displayed one's own regular pattern. As compared with patients without GVHD, the counts of lymphocyte subsets in patients with GVHD was higher, while the counts of gamma/delta T cells, regulatory T cells, NK cells, the counts of B cells, NK cells, naive cells and CD4/CD8 ratio as well as the counts of B cells, naive T cells and NK cells were lower at 1 month, 2 - 3 months and 6 - 8 months after transplantation respectively. The total T cells and subsets recovered slowly, but NK cells and NKT cells recovered rapidly in patients with infection at early period after transplantation, the B cells and naive B cells recovered rapidly at 3 months after transplantation. There was no difference in lymphocyte recovery between ALL and AML patients. It is concluded that the analysis of each lymphocyte subsets may indirectly show the recovery of thymus function in patients, the changes of NK cells, B cells and naive T cells have an important significance for identifying and forecasting the GVHD and infection.
Adolescent ; Adult ; Child ; Female ; Graft vs Host Disease ; etiology ; HLA Antigens ; immunology ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute ; immunology ; Lymphocyte Subsets ; immunology ; Male ; Middle Aged ; Postoperative Period ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; immunology ; Young Adult

OBJECTIVE: To investigate the lymphangiogenesis and location of tumor lymphatic vessels induced by vascular endothelial growth factor C (VEGF-C) in primary breast cancer. METHODS: The expression of VEGF-C mRNA in 89 cases of primary breast cancer was detected by in situ hybridization, and lymphatic vessels with vascular endothelial growth factor receptor-3 (VEGFR-3) were labeled by immunohistochemistry SP method. RESULTS: VEGF-C mRNA expressed in 49 of all 89 cases of primary breast cancer, and the expression rate was 55.06%. The expression of VEGF-C mRNA was positively correlated with lymphatic vessel density (LVD) and axillary lymph node metastasis, LVD and the rate of axillary lymph node metastasis were significantly higher in VEGF-C mRNA positive group than those in the negative group (both P < 0.05). Different levels of lymphangiogenesis took place in all cases of breast cancer, but it was mainly located in tumor stroma, and apparently mature lymphatic vessels were not found in cancer nests. LVD was positive related with the clinical stage and axillary lymph node metastasis in breast cancer; the clinical stage, the LVD, the axillary lymph node metastasis in positive group were higher than those in the negative group (P < 0.05). CONCLUSION The expression of VEGF-C mRNA is positively correlated with lymphangiogenesis and axillary lymph node metastasis in primary breast cancer. Lymphangiogenesis induced by VEGF-C predominantly takes place in the tumor stroma tissue, and mature lymphatic vessels are not found in cancer nests.
Adult ; Aged ; Breast Neoplasms ; metabolism ; pathology ; Female ; Humans ; Lymphangiogenesis ; Lymphatic Metastasis ; Middle Aged ; RNA, Messenger ; biosynthesis ; genetics ; Vascular Endothelial Growth Factor C ; biosynthesis ; genetics ; Vascular Endothelial Growth Factor Receptor-3 ; metabolism

OBJECTIVETo construct an in vitro equivalent of the pigmented skin using tissue engineering methods.

METHODSSurgically removed foreskins was used as the source of keratinocytes and melanocytes harvested by routine tissue digestion. The fibroblasts were enriched by tissue block culture and seeded into the scaffold constructed using mouse tail collagens to construct the pigmented skin equivalent model. The general structure and the melanocyte distribution and growth status in this model were observed with HE staining and Fontana Masson staining. The ultrastructure of the constructed pigmented skin equivalent was observed by transmission electron microscope.

RESULTS AND CONCLUSIONThe pigmented skin equivalent model was structurally intact, and allowed optimal cell growth. Fontana Masson staining identified in the basal layer numerous melanocytes in normal growth, and the constructed model was structurally similar to normal skin tissue, suggesting successful construction of the pigmented skin equivalent model.

Animals ; Foreskin ; cytology ; Humans ; Keratinocytes ; cytology ; Male ; Melanocytes ; cytology ; Mice ; Skin Pigmentation ; Skin, Artificial ; Tissue Engineering ; methods

OBJECTIVETo observe the effect of aloesin, tea polyphenols, arbutin on melanocytes in the pigmented skin equivalent model.

METHODSFirst, we constructed the pigmented skin equivalent model in vitro. And then we detected the effect of aloesin, tea polyphenols and arbutin on the cells' shape, tyrosinase activity and formation of melanin in the constructed pigmented skin equivalent.

RESULTSThree depigmenting agents showed an inhibition effect on the tyrosinase activity of melanocytes and reduced significantly melanin content in the pigmented skin equivalent model, in which the tea polyphenols had the strongest effect, and then was the aloesin. But the tea polyphenols showed the strongest toxicity, while the aloesin and arbutin had a much lower toxicity.

CONCLUSIONSAll the three depigmenting agents showed a concentration dependent suppression effect on the tyrosinase activity and formation of melanin, in which the tea polyphenols was the strongest effect( P <0.05). Aoesin has a good suppression effect on the tyrosinase activity and formation of melanin, but has a much lower toxicity, which could be used as a safe depigmenting agent.

Arbutin ; pharmacology ; Cells, Cultured ; Chromones ; pharmacology ; Flavonoids ; pharmacology ; Foreskin ; cytology ; Glucosides ; pharmacology ; Humans ; Male ; Melanins ; biosynthesis ; Melanocytes ; drug effects ; Phenols ; pharmacology ; Pigmentation ; Polyphenols ; Skin ; drug effects ; Skin Aging ; drug effects

OBJECTIVETo investigate the effects of cycloheximide and TNF-alpha on melanocyte (MC).

METHODSMelanocyte apoptosis was studied with MTT, transmitting electron microscopy and fluorescence labeling of alive cells.

RESULTSWe added TNF-alpha and cycloheximide in melanocytes, and the typical apoptosis appeared 24 hours later, with chromatin condensation, nuclear pyknosis and apoptotic bodies formation. The results of cytometry showed the typical apoptotic peak.

CONCLUSIONTNF-alpha and cycloheximide together could inhibit MC proliferation and induce MC apoptosis.

Adolescent ; Adult ; Apoptosis ; drug effects ; Cell Proliferation ; Cycloheximide ; pharmacology ; Drug Synergism ; Humans ; In Vitro Techniques ; Male ; Melanocytes ; cytology ; drug effects ; Middle Aged ; Tumor Necrosis Factor-alpha ; pharmacology ; Young Adult