BACKGROUNDNon-small cell lung cancer (NSCLC) is the leading cause of cancer mortality worldwide. Platelet activation may play an important role in pathologic progress in lung cancer. In this study, we aimed to clarify the influence of activated platelets on lung cancer generation and growth, and the relationship among these functional and ultrastructural changes of platelets and the severity of pathogenetic condition in these patients with NSCLC.

METHODSOne hundred and thirty-six cases of patients with pathologically confirmed NSCLC were included in this study. Fifty-four healthy people were enrolled as controls. The change of ultra microstructure and activity of blood platelets were observed under the transmission and scanning electron microscope. Simultaneous determination of plasma granule membrane protein 140 (GMP-140) was made.

RESULTSTransmission electron microscopy showed remarkable changes of ultra microstructure of platelets in patients with NSCLC, including swelling, increase of a-granules, vesicles, and glycogenosome. Scanning electron microscopy showed many more surface processes and wrinkles on platelets in patients with NSCLC. The reference plasma levels of GMP-140 of healthy controls were (18.2 +/- 2.7) microg/L. The plasma levels of GMP-140 in patients with NSCLC were (47.8 +/- 12.3) microg/L, which were much higher than those of the controls. There was a medium positive correlation between plasma levels of GMP-140 and amount of a-granules (r = 0.514, P < 0.01) and a high positive correlation between plasma levels of GMP-140 and area of platelet (r = 0.84, P < 0.01) in patients with NSCLC. The Kaplan-Meier survival curve analysis showed significant shift to the left in patients with NSCLC whose a-granules per platelet were 19 or more compared to those 18 or less (Log rank statistic, chi(2) = 17.38, P < 0.01).

CONCLUSIONSThere are significant activated changes of ultra microstructure and increased activity of blood platelets in patients with NSCLC. These activated platelets may play an important role in the generation and growth of lung cancer. These changes can be used as a diagnostic index of severity, progression, and prognosis of NSCLC.

Adult ; Aged ; Blood Platelets ; ultrastructure ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; mortality ; ultrastructure ; Female ; Humans ; Male ; Microscopy, Electron, Transmission ; Middle Aged ; P-Selectin ; blood ; Survival Analysis

Objective To investigate the molecular-epidemiologic characteristics and genotypes of human calicivirus (HuCVs) in acute diarrhea patients in Hangzhou from 2009 to 2010.Methods Epidemiologic data and fecal specimens were collected from patients with acute diarrhea.HuCVs of 920 specimens were detected by PCR.PCR products of several positive samples were randomly selected and sequenced.All the sequences were analyzed,phylogenetically.Results 201HuCVs positive cases were identified from 920 facal specimens (21.8％).25 isolates would include norovims G Ⅰ -type,G Ⅱ -type for 170 strains and sapovirus for 1 1 strains.Norovirus G Ⅰ -type and G Ⅱ -type were detected in four specimens at the same time.Other specimens were mixed infection with norovirus G Ⅱ -type and sapovirus.Genotypes of HuCVs showed that norovirus G Ⅰ subtypes were G Ⅰ -1 (3 strains) and G Ⅰ -2 (1 strain).Norovirus G Ⅱ subtypes were G Ⅱ -4/2006b variant strains (7 strains),GⅡ-2 (1 strain),G Ⅱ -7 (1 strain) and G Ⅱ -4/2008 variant strains (2 strains) ;Sapovirus subtypes were G Ⅰ -2 (5 strains),G Ⅰ -1 (4 strains) and G Ⅱ-1 ( 1 strain).The prevalence rates of HuCVs were different in seasons and age groups.Conclusion HuCVs were one of the major pathogens causing acute diarrhea.Both multiple viruses and genotypes of HuCVs were found in the specimens.G Ⅱ-4/2006b variant and similar strains were identified,probably as the prevalent strains from 2009 to 2010 in Hangzhou,Zhejiang province.

Objective: To summarize the clinical features and treatment status for elderly in-hospital patients with mitral regurgitation (MR). Methods: A single center retrospective study was conducted in 1 741 patients admitted in our hospital from 2014-05-01 to 2015-04-30 with echocardiography confirmed moderate to severe MR. The patients were divided into 2 groups: Elderly group, n=680(39.06%)patients≥60 years of age and Non-elderly group,n=1 061(60.94%)patients<60 years.Clinical features and treatment status were studied and compared between 2 groups. Results: The mean age in Elderly group was (66.98±5.94) years and the most common type was degenerative MR (41.18%). Compared with Non-elderly group, Elderly group had more patients combining coronary artery disease (37.79% vs 17.43% ), more risk factors of atherosclerosis such as hypertension (45.44% vs 25.17%), diabetes (19.56% vs 8.48%) and hyperglycemia (35.29% vs 19.51%) all P<0.05; Elderly group had the higher EuroSCORE Ⅱ score (5.54±2.42) vs (3.15±1.66), greater left ventricular end diastolic diameter (57.72±12.37) mm vs (57.33±10.19) mm and less patients combining multiple valve disease (35.59% vs 40.81%), less patients received surgical treatment (54.71% vs 63.9%), all P<0.05. The surgery procedures (mitral valve replacement or mitral-plasty) were similar between 2 groups; compared with Non-elderly group, Elderly group had the higher application rate of bio-prosthetic valve (53.88% vs 18.67%), P<0.001. Conclusion: About 40% in-hospital moderate to severe MR patients were the elderly crowd, the most common pathogenesis was degenerative changes which leaded the higher incidences of cardiac complications, worse cardiac function and the higher risk scores for surgical treatment, there were less patients received surgery.