Objective To detect the expressions of VEGF and nm23 in non-small cell lung cancer (NSCLC) tissues and their relationships,and explore their clinical value in the diagnosis and treatment.Methods lmmunohistochemistry(SP method) was used to detect the expressions of VEGF and nm 23 in NSCLC and peritumor tissues.Results The positive expression rate of VEGF in NSCLC(63.3 ％,38/60)was significantly higher than in the peritumor tissues(16.7 ％,10/60)(x2=27.22,P＜0.01).nm 23 is on the contrary (53.3 ％,32/60)(x2=17.79,P＜0.01).The positive expression of VEGF in NSCLC was positively correlated significantly with the lymph node metastasis and histological classification(P＜0.05).The positive expression of nm 23 in NSCLC was negative correlated significantly with lymph node metastasis,P＜0.01.2-year survival rate of the VEGF-positive patients was significantly lower than that of VEGF-negative patients,and nm 23 is on the contrary(x2=5.55,P＜0.05).No correlation was found between the expressions of VEGF and nm 23 in NSCLC (x2=1.83,P＞0.05) Conclusion The VEGF and nm 23 may be closely associated to carcinogenesis and progression of NSCLC.Detection of VEGF and nm 23 are beneficial to indicate the biologic behavior of NSCLC.It has positive effect on diagnosis and treatment of NSCLC.

Objective To observe the effects and benefits of the gastroscopy-assisted thoracoscopic modified Heller operation for the treatment of achalasia of cardia. Methods Retrospective analysis was conducted on the clin﹣ical data of 33 cases in our hospital. The surgical approach was gastroscopy-assisted thoracoscopic modified Heller operation. The intraoperative and postoperative effect and complications were observed. All patients were followed up for six months. Results After operation 33 achalasia patients' symptom of obstruction is alleviated. 1 case changed to open operation because of severe adhesion; 4 cases esophageal mucosal were injured and need to be repair assisted by thoracoscope. 1 case had esophagopleural fistula after operation and was cured by conservative treatment in one month. 1 case had gastroesophageal reflux symptoms after operation and relief symptoms after conservative treatment. All patients were follow-up more than six months, only 1 patient recured eating obstruction in 3 months after opera﹣tion, and was cured by gastroscopic expanding treatment. Conclusions The results of gastroscopy-assisted thoraco﹣scopic modified Heller operation to patients with Achalasia is significant. The operation is easy to perform and the complications is less, it can be promoted and applied in clinical practice.

Objective To study the relationship between expression of G-protein-coupled bile acid receptor 1 (GPBAR1) in gallbladder mucosa and formation of lithogenic bile in patients with gallstones.Methods Gallbladder mucosa,gallbladder wall,bile and plasma were collected from 34 patients with gallstone (GS) and 15 individuals who were gallstone free (GSF).The gallbladder wall was stained with hematoxylin-eosin (HE) and immunohistochemistry to detect pathologic changes and expressions of GPBAR1,mucin 1 (MUC1) and mucin 5AC (MUC5AC).Reverse-transcription polymerase chain reaction (RT-PCR) was used to test mRNA expressions of GPBAR1,MUC1 and MUC5AC in the gallbladder mucosa.The contents of total cholesterol (TC),total bile acid (TBA),triglyceride (TG),low density lipoprotein (LDL) and high density lipoprotein (HDL) in plasma and cholesterol,TBA,phospholipid (PL) and mucin in the bile of gallbladder were measured.Results The gallbladder mucosa in all GS patients showed chronic inflammation on hematoxylin-eosin staining.The expressions of GPBAR1 and MUC5AC were more markedly increased in the GS group than in the GSFgroup (61.34±8.06 vs.43.05±7.83,P＜0.01; 52.11±9.62 vs.45.05±9.27,P＜0.05).The mRNA expressions of GPBAR1 and MUC5AC in the GS group were also more markedly increased than in the GSR group (0.87±0.07 vs.0.80±0.09,P＜0.05; 1.04±0.22 vs.0.8±0.17,P＜0.01).Serum cholesterol,as well as biliary cholesterol,cholesterol mol percentage,cholesterol saturation index and mucin in the GS group were more significantly higher than in the GSF group (5.07±1.64 vs.3.62±1.42,P＜0.01; 17.23±3.67 vs.12.47±2.31,P＜0.01; 7.47±0.65 vs.5.05±0.24,P＜0.01; 1.03±0.58 vs.0.69±0.38,P＜0.01; 92.02±20.89 vs.76.36±19.71,P＜0.05).Biliary total bile acids and bile acids mol percentage were lower in the GS group than in the GSF group (162.68±20.19 vs.180.21±26.05,P＜0.05; 71.28±1.84 vs. 73.29±0.96,P＜0.01). In the GS group,there were negative correlations between the mRNA expression of GPBAR1 and biliary TBA (γ=-0.341,P＜0.05).There were negative correlations in the GS group between the GPBAR1 expression and the level of biliary TBA (γ=- 0.403,P＜0.05),and between the GPBAR1 expression and the level of biliary total lipid (γ=-0.365,P＜0.05).Conclusions This study shows an increase in expression of GPBAR1 in gallbladder mucosa in patients with GS.It is suggested that GPBAR1 may accelerate formation of lithogenic bile by inducing re-absorption of bile acid.

Objective To evaluate the prognostic value of intraoperalive detection in rib bone marrow micmmetastasis(BMMs)of patients with non-small-cell lung cancer(NSCLC)and the relationship between the micROmetast ases and clinicopathologic factors.Method From April 2004 to May 2007,146 patients undergoing surgical treatment for NSCLC were prospectively investigated for the presence of BMMs by the immunohistochemisury method.Remits 30.82%(45/146)of NSCLC patients were detected with BMMs,15(33.33%)patients developed remote metastases of the 45 patients with BMMs,14(13.86%)patients developed metastases of the 101 patients without BMMs.Patients with BMMs demonstrated an earlier metastasis and a lower survival rate compared with patients without BMMs(P＜0.05).There Was trend for ahigher frequency and the occurrence of BMMs changed with tumor stages and the histologic differentiation of the tumor.No relationship was found between BMMs and age,T grade,as well as tumor dimension.Conclusions The detection of BMMs can predict the prognosis of NSCLC patients and identifies patients withNSCLC who are at significantly increased risk for metastasis and survival,which may be useful in evalnatingpatients for adjuvant treatment

Objective To compare the effect of postoperative intercostal nerves cryoanalgesia and patient controlled epidural analgesia (PCEA) in patients undergoing thoracic surgery. Methods From April 2006 to May 2008,89 patients undergoing thoracic surgery were randomly divided into intercostal nerves cryoanalgesia group (group A,47 cases) and PCEA group (group B,42 cases). The scores of pain, use of pain medication and time of out-of-bed activity after the operation were used to evaluate the effect of pain between two groups. Results The scores of pain in group A and group B were (1.49 ± 0.80) and (2.43 ± 1.21) scores respectively. There were significant differences in the scores of pain. The use of pain medication [(1.28 ± 0.62) times vs (2.02 ± 1.05) times]and time of out-of-bed activity after the operation [(43.15 ± 12.22) h vs (64.10 ± 14.25) hi were significant difference between the two groups(P< 0.05). Conclusions For reducing the post- thoracotomy pain,intercostal nerves cryoanalgesia is superior to PCEA. Intercostal nerves cryoanalgesia can provide satisfactory analgesia after thoracic surgery.

Objective To evaluate the prediction value on distant metastases of fib bone marrow micrometastases (BMM) of patients with non-small lung cancer ( NSCLC ). Methods From January 2003 to March 2006, 168 patients undergoing surgical treatment for NSCLC were prospectively investigated for the presence of BMM by using immnnohistochemistry. The sensitivity and specificity of the rib bone marrow micrometastases technique were also calculated. Receiver operating characteristic curve (ROC curve)was drawn according to data. Results Occult BMM were detected in 29.76 %(50/168) of patients with NSCLC. 15(29.76 %) patients developed metastases in the 50 patients with BMM and 15 (12.71%) patients developed metastases in the 118 patients without BMM. The sensitivity and the specificity of the technique was 61.54 % and 79.84 %. The false negative rate was 38.46 % and the false positive rate was 20.16 %. The positive predictive value, negative predictive value and Youden' s index were 87.5 %, 93.33 %, 74.33 % respectively. Conclusion The detection of BMM could predict the distant metastases of non-small lung cancer patients through receiver operating characteristic curve evaluation, however, the detecting sensitivity should be improved.

OBJECTIVETo investigate the role of miR-520a in regulation ErbB4 expression and the biological behavior of esophageal squamous cell carcinoma (ESCC).

METHODSThe role of miR-520a in regulating the expression of ErbB4 was investigated by Western blotting and luciferase reporter assay system. The effect of miR-520a on the proliferation and invasion of ESCC cells was detected by MTT and Transwell invasion assay, respectively.

RESULTSWestern blotting and luciferase reporter assay revealed that miR-520a down-regulated the expression of ErbB4 in vitro. miR-520a significantly inhibited the proliferation and suppressed the invasion of ESCC cell line Eca109.

CONCLUSIONmiR-520a regulates the expression of ErbB4 and suppresses the proliferation and invasion of ESCC cells in vitro, suggesting its role as a tumor suppressor.

Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Esophageal Neoplasms ; metabolism ; pathology ; Gene Expression Regulation, Neoplastic ; Humans ; MicroRNAs ; metabolism ; Receptor, ErbB-4 ; metabolism