Objective To study the clinical features, diagnosis and surgical treatment of thoracic malignant lymphoma. Methods Clinical data of 22 patients with malignant lymphoma were retrospectively analyzed. Among them 16 were classified as non-Hodgkin's lymphoma (B cell lymphoma 12 cases and T cell lymphoma 4 cases), and 6 were classified as Hodgkin's lymphoma (nodular sclerosing lymphoma 5 cases and 1 case of mixed cellularity type lymphoma). Most of the tumors were located in anterior mediastinum or middle superior mediastinum, and 2 of the tumors located in upper left lung, another 2 located in upper right lung. Cough, stethocatharsis, chest distress and chest pain were the main clinical symptoms. Abnormal masses in mediastinum were seen on X ray film, occasionally with changes in lung. Before the operation, 4 cases were misdiagnosed depended on the results of intracranial puncture examination, and the other 18 cases were misdiagnosed as either lung cancer with mediastinal lymph nodes metastasis or thymoma based on the imaging findings. All patients received either total tumor resection or partial excision. After the operation, 16 cases with non-Hodgkin's lymphoma received CHOP chemotherapy (2 cases received radiotherapy and 2 cases received autologous hematopoietic stem cell transplantation after chemotherapy), 6 cases with Hodgkin's lymphoma received ABVD regimen (2 case received radiotherapy). Results Fourteen cases with non-Hodgkin′s lymphoma (2 cases for stage Ⅰ, 4 cases for stage Ⅱ, 3 cases for stage Ⅲ, 5 cases for stage Ⅳ) had survived for 1-112 months until the follow-up, 6 cases with Hodgkin′s lymphoma (2 cases for stage Ⅰ, 1 case for stage Ⅱ, 1 case for stage Ⅲ, 2 cases for stage Ⅳ) had survived for 3-46 months. Two cases with non-Hodgkin′s lymphoma died 18 and 35 months after operation, respectively. Conclusions The preoperative diagnosis to thoracic malignant lymphoma is difficult for the special clinical features limited. Surgical excision is important for diagnosis and treatment of thoracic malignant lymphoma. Comprehensive treatment after surgery includes radiotherapy, regular chemotherapy and immunotherapy.

Objective To explore the effect of surgical treatment of bronchioloalveolar carcinoma (BAC). Methods Data were collected from 94 patients with BAC (including 67 cases with pure bronchioloalveolar carcinoma, 16 cases with BAC by local infiltration and 11 cases with adenocarcinoma having BAC character). All patients were proved pathologically bronchioloalveolar carcinoma from January 1989 to December 2003. Clinical features, characteristics of radiology, methods of treatment and survival status were studied retrospectively. Surgical treatment and efficacy approaches according to different TNM stages and clinical patterns were also analyzed. Results Ninety-eight patients underwent complete resection and 4 underwent palliative operation and 2 underwent exploratory thoractomy. The 1-, 3-, 5-year survival rates were 75.5 %, 53.2 %, 41.5 %. According to international staging system of lung cancer, there were marked difference in stage Ⅰ group, stage Ⅱ group and stage Ⅲ group (P <0.01). According to pathological classification, there were marked difference in pure bronchioloalveolar carcinoma, BAC with local infiltration and adenocarcinoma having BAC character (P <0.01). Conclusion Bronchioalveoar carcinoma is a special form of lung cancer. It has its own characteristics on biology,radiology,clinic or pathology. Lobectomy is performed commonly in patients with bronchioloalveolar carcinoma. It may be concluded that the early diagnosis, early therapy are the key points for improving the survival rate of BAC.

Objective To investigate the results and effects of freezing phrenic nerves for the patients of pulmonary lobectomy.To optimize the best freezing time by studying the effects of different time at-65 ℃.Methods 50 patients of pulmonary lobectomy were randomly entered into 5 groups,including control group,30 seconds group,60 seconds group,90 seconds group,120 seconds group.After operation,the patients' cardiotach,blood pressure,SaO2,breath rate,time period of pulling out drainage tube and VAS about referred pain of scapular region were noted.After pulling out the intrathoracic drain tube,the routine chest normal X ray film and chest ultrasonic inspection were processed and the post-operation remnant cavity were observed.The chest normal fluoroscopy was inspected in 90 days after operation in order to observe the motion information of trouble side diaphragmatic muscle.Results The chest fluid [first day (329±178) ml,(345±150)ml,(268±51) ml,(227±36) ml,second day (251±131) ml,(269±112) ml,(208±61) ml,(158±110) ml,time of pulling out intrathoracic drain tube (5.8±1.75) days,(4.6±1.77) days,(3.9±0.74) days,(3.6±1.07) days] and VAS [(3.6±2.9) scores,(2.2±2.4) scores,(1.0±1.3) scores,(0.7±1.2) scores] about referred pain of scapular region of freezing groups were obviously lower than those in the control group [(375±136) ml,(309±132) ml,(5.7±2.36) days,(4.0±3.3) scores].90 s and 120 s freezing groups were lower than that of 30 s and 60 s groups,andthe 90 s freezing group did not significantly different from the 120 s group.The heart rate,blood pressure,saturation of blood oxygen and breathing rate of each group also had no difference.The remnant cavity sizes were larger in the control group (＞200 ml),they also had more fluidity (＞200 ml),and one case had been taken punctuation.The remnant cavity sizes of freezing groups were small and didn' t need special treatment.The diaphragmatic muscle' s movement of each group were fine after 3 months of operation.Conclusion The freezing phrenic nerves can effectively reduce the chest fluid,the post-operation remnant cavity and the time of pulling out intrathoracic drain tube.The freezing phrenic nerves can reduce the pain of referred pain of scapular region.The best freezing time should be 90 s.The freezing phrenic nerves do not influence the respiration function,and should be advantages of for the clinic researches and applications.

Objective To evaluate ligation of the intersphincteric fistula tract plus core-out fistulectomy for complex cryptoglandular anal fistulas.Methods Forty-one patients were divided into ligation and control group randomly.In ligation group (20 cases),patients underwent ligation of the intersphincteric fistula tract plus core-out fistulectomy procedure.While in control group (21 cases) fistulotomy on low sphincter with cutting-seton on high sphincter procedure was performed.The primary end points of the study were healing rate and continence by using the Wexner score.Secondary end points were postoperative pain in the third and seventh day with the use of the visual analog scale,length of hospital stay and followed measures for a recurrent fistula.Comparison of measurement data using independent samples t-test or paired samples t-test,compared with the count data using Fisher's exact test.Results There was no statistical difference in the healing rate between ligation group (90％) and control group (95％) (P ＞0.05).Postoperatively,one case in ligation group reported incontinence for gas,compared to 7 cases in control group,among these 7 cases 2 cases also had incontinence for watery stool.Statistical differences were found between two groups in Wexner scores,visual analog scale scores and length of hospital stay (P ＜0.05).Conclusion Ligation of the intersphincteric fistula tract plus core-out fistulectomy is an economical,safe,little painful,recovery enhanced and minimally invasive technique to treat complex anal fistulas.

ObjectiveTo evaluate the therapeutic effect of endoscopic full-thickness resection (EFTR) for gastric stromal tumors.MethodsA total of 33 patients with gastric stromal tumor orgination from deep muscularis propria layer received EFTR from January 2010 to July 2011.The effectiveness and safety of EFTR were compared with those of other 34 patients with gastric stromal tumor origination from muscularis propria layer who underwent endoscopic submucosal dissection (ESD).ResultsExcept in 2 patients with lesions larger than 3.0 × 3.0 cm,EFTR was successful in others 31 patients,who recovered well and had no recurrence during the follow-up within 12 months.There were no significant differences in resection rate,incidence of complications,body temperature,white blood cell counts or recovery time between 2 procedures (P ＞ 0.05 ).However,the number of clips used in EFTR ( 7.0 ± 3.5 vs.4.9 ± 3.1,P =0.013 ) and postoperative fasting days (3.4 ± 1.5 vs.2.0 ± 1.0,P =0.001 ) were significantly higher than those of ESD procedures.ConclusionEFTR is effective and safe for gastric stromal tumors with no higher risk than ESD,but it is more complex technically.EFTR can be used as an expanding method of ESD in endoscopic treatment of gastric stromal tumors.

Objective: To explore the effect of recombinant human interleukin-17AI (IL-17A) on the growth of colon cancer cells, and to investigate the related mechanism. Methods: The colon cancer SW480 cells were divided into control group and experimental group. The SW480 cells in control group were untreated and the SW480 cells in experimental group were added with 50 fig • L_1IL-17A. The proliferation abilities of SW480 cells in two groups were detected by CKK-8 method. The levels of IL-17A in the SW480 cells in two groups were detected by ELISA, and the expression levels of signal transducers and activators of transcription 3 (STAT3) and p-signal transducers and activators of transcriptions 3 (p-STAT3) were examined by Western blotting methed. Results: Compared with control group, the proliferation ability of the SW480 cells in experimental group was increased (P < 0 . 05). The level of IL-17A in the SW480 cells in experimental group was significantly higher than that in control group (P< 0. 01). Compared with control group, the expression levels of STAT3 and p-STAT3 proteins in the SW480 cells in experimental group were significantly higher than those in control group (P < 0 . 01). Conclusion: Recombinant protein IL-17A can stimulate the growth of colon cancer SW480 cells, which may be related to the activation of STAT3 signaling pathway.

Objective: To explore the expressions of interleukin-17E (IL-17E), interleukin-17F (IL-17F) and their receptors interleukin -17RB (IL-17RB), interleukin -17RC (IL-17RC) in enteritis, intestinal polyps and colorectal carcinoma tissues, and to analyze their relationships with the malignancy of colorectal carcinoma. Methods: Immunohistochemistry staining was used to detect the expressions of IL-17E, IL-17RB, IL-17F, and IL-17RC in the tissues of enteritis (n=15), intestinal polyps (n=5) and colorectal carcinoma (n=30). The relationships between IL-17E and IL-17RB, IL-17F and IL-17RC, and the relationships between IL-17E, IL-17F and malignancy of colorectal carcinoma were analyzed. Results: IL-17E, IL-17F, IL-17RB and IL-17RC mainly expressed in glandular epithelial cells, mononuclear cells and vascular endothelial cells as well as partial carcinoma cells. The positive expression rates of IL-17E in enteritis and intestinal polyps tissues were higher than that in colorectal carcinoma tissue (P<0. 05). Compared with enteritis tissue, the positive expression rates of IL-17F in intestinal polyps and colorectal carcinoma tissues were increased (P < 0. 05), which was increased with the increasing of malignancy of coloretal carcinoma. Compared with colorectal carcinoma tissue, the positive expression rates of IL-17RB in enteritis and intestinal polyps tissues were increased (P

Objective To investigate the relationship between serum resistin,leptin and adiponectin with microangiopathy in the patients with type-2 diabetes mellitus(T2DM).Methods One hundred and twenty patients with T2DM in our hospital were selected and divided into the non-microangiopathy group (NON-MAP,60 cases) and microangiopathy group (MAP,60 cases) according to whether complicating microangiopathy.Other 60 individuals undergoing healthy physical examination were selected as the normal control group(NC).Fasting serum resistin,adiponectin and leptin levels were detected in each group.Fasting blood glucose,insulin and blood lipid levels were also detected.The insulin resistance was evaluated by using insulin resistance index(HOMA-IR).Results The levels of serum resistin,leptin,free fat acid(FFA) and hs-CRP in the NON-MVP group and MVP group were signifi cantly higher than those in the NC group,while the adiponectin level was sigrnificantly lower than that in the NC group,the difference was statistically significant(P＜0.05).The correlation analysis showed that serum resistin and leptin levels had positive correlation with hs-CRP,FFA,HOMA-IR and TG(P＜0.05),and had negative correlation with HDL-C(P＜0.05);the adiponectin level was negatively correlated with hs-CRP,FFA,HOMA-IR and TG,while positively correlated with HDL-C(P＜0.05);serum resistin and leptin levels had positive correlation,both had significantly negative correlation with adiponectin;with serum resistin,leptin and adiponectin as the dependent variables,the multiple stepwise linear regression analysis showed that HOMA-IR and waist to hip ratio had maximal influence on them.Conclusion Serum resistin and leptin levels increase and adiponectin level decrease in T2DM patients suggests that serum resistin,leptin and adiponectin are correlated with T2DM occurrence as well as microangiopathy occurrence.

Objective To establish a stable orthotopic model with high green fluorescent protein (GFP) expression in nude mice and observe its biological features.Methods Human HCT116 colon cancer cells transfected with GFP pLPCX retroviral plasmid were used to build a subcutaneous tumor model in nude mice.Fifteen BALB/C nude mice were selected to underwent orthotopic transplantation of colon when the GFP-labeled tumor grew to 10 mm × 10 mm as observed by in vivo fluorescent microscopy.The growth and metastasis of orthotopically implanted colon cancer cells were observed with fluorescent imaging system at different time points.The differences of the tumor size measured by peripheral vernier caliper and fluorescent imaging system were analyzed using the t test,and the differences in different groups were analyzed using the analysis of variance.Results GFP-labeled colon cancer models were successfully established in all the 15 nude mice,and there was no surgery-related complications or death.Tumors marked by GFP were observed under fluoroscope in week 3.The size of the tumors progressively increased with time.The volumes of the orthotopically transplanted tumors obtained from global measurement using fluorescent imaging system were greater than those measured by peripheral vernier calipers at postoperative week 3,4,5,6,7,while no statistically significant difference was observed (t =-1.280,-1.115,-0.718,-0.199,-0.386,P ＞0.05).There was a significant difference in the interation of measure method and different time points (F =29.546,P ＜ 0.05).Eight nude mice survived at the end of the experiment,and tumor metastasis was observed in 6 mice.Conclusions It is technically feasible to construct GFP-labeled colon cancer orthotopic transplantation model.The mice model could be used for real-time,in vivo,non-invasive and dynamic observation and analysis of the growth and metastasis of tumor cells.

Background and purpose:Bladder cancer is the most common urological tumor, and its pathogen-esis is still not fully understood. The study was aimed to observe the expressions of key genes in many tumor-associated signaling pathways in normal bladder tissue and bladder carcinoma, and to provide further evidence for the subsequent study of bladder cancer recurrence and metastasis.Methods:Twenty-seven cases of bladder cancer specimens were col-lected, and normal bladder tissues and bladder cancer tissues were distinguished by frozen section. Then, the expressions of 84 genes of cancer-related signaling pathways in bladder cancer tissues and normal bladder tissues were screened by Cancer Pathway Finder PCR Array produced by QIAGEN company.Results:Compared with the normal bladder tissues, the bladder carcinoma tissues had 8 up-regulated genes and 19 down-regulated genes. In this study, the impact of epithe-lial-mesenchymal transition (EMT) signaling pathway was selected as a research direction in which theGSC,KRT14,DSP were up-regulated,SNAI2,SNAI3 were down-regulated. ThereforeGSC,KRT14,DSP,SNAI2 andSNAI3 were chosen as target genes, and verified by qRT-PCR in many examples. The result showed that the expressions ofGSC gene in bladder cancer tissues were up-regulated, but with no statistical significance;KRT14,DSP expressions in bladder cancer were higher than those in normal bladder tissues (P<0.05);SNAI2,SNAI3 expressions in bladder cancer were lower than those in normal bladder tissues (P<0.05), andSNAI3 showed the most obvious expression differences.Conclusion:KRT14,DSP andSNAI3 may play an important role in bladder cancer’s occurrence, development and metastasis.