Objective To explore the curative effect of the single pore video-assisted thoracoscopic surgery and thoracic closed drainage for patients with acute pyothorax by comparing the advantage and disadvantage of two methods.Methods The clinical data of 65 patients with acute pyothorax in our hospital from January 2012 to June 2015 were retrospectively analyzed.Of which 30 patients underwent single pore video-assisted thoracoscopic surgery were as observation group,35 cases received thoracic closed drainage were as the control group.The cura-tive effect of two methods for acute pyothorax was compared by analyzing the result data of two groups.Results The postoperative chest tube indwelling time,length of hospital stay,postoperative antibiotics of observation group were significantly less than those of the control group,the difference was statistically significant(P<0.05).And the incidence of postoperative complications,the proportion of the chronic pyothorax and secondary tube rate of observation group were lower than those of the control group,the difference was statistically significant(P<0.05). Conclusion The single pore video-assisted thoracoscopic surgery is safe and effective for treatment of acute pyothorax, which is worth promoting.

Objective To explore the correlation between BCL2 binding component 3 (BBC3) expression and postoperative survival time of lung squamous cell carcinoma (LUSC),and investigate its molecular mechanism.Methods The expression of BBC3 in 39 patients was detected by using qRT-PCR assay.Meanwhile,clinical data of all patients were collected by follow-up visit.Then,the survival analysis was performed by using Kaplan-Meier and log rank tests.Moreover,multiple factors analysis was performed using COX proportional hazard model.At last,BBC3 was over-expressed in NCI-H226 cell lines,then detected the effects of BBC3 expression on cell proliferation and apoptosis by using MTT assay and flow cytometry.Results BBC3 expression were significantly correlated with the tumor metastasis (r=0.556,P=0.023),tumor size (r=0.532,P =0.042),T staging (r =0.551,P=0.021) and TNM staging (r=0.524,P=0.047).Meanwhile,the results of Kaplan-Meier and log rank tests found that BBC3 expression was significantly correlated with survival time of patients with LUSC,and the length of survival time in patients with high BBC3 expression was longer than that in patients with low BBC3 expression (x2 =7.542,P=0.006).The COX proportional hazard model indicated that tumor metastasis,T staging,TNM staging and BBC3 expression were independent factors which significantly affected survival time.Moreover,the proportion of apoptotic cells in the recombinant plasmid BBCs group was higher than that in the empty plasmid group and control group (P＜0.05).Conclusion BBC3 expression could suppress the proliferation of tumor cells and promote apoptosis,and are significantly correlated with survival time of patients,so which may be assistant biomarkers for prognosis of LUSC.

Objective:To investigate the promotive effect of 4,5,6,7-tetrabromobenzotriazole (TBB) on the apoptosis of the human cervical cancer HeLa cells,and to clarify its effect mechanism in related signaling pathways.Methods:The human cervical cancer HeLa cells at logarithmic growth phase were divided into control group(without TBB) and experiment group(with TBB).MTT assay was used to detect the survival rate of the HeLa cells;the morphology of HeLa cells was observed under inverted microscope;Annexin Ⅴ-FITC/PI double staining and flow cytometry(FCM) were used to determine the apoptotic rates of the HeLa cells;the expression levels of apoptosis-related proteins p-Akt,Akt,Bcl-2,Bax,cleaved-caspase-3,and Pro-caspase-3 were detected by Western blotting method.Results:The MTT results showed that the survival rates of the HeLa cells in experiment group were significantly decreased(P<0.01) in a dose-dependent manner compared with control group.The apoptotic morphology of the HeLa cells in experiment group were found as cell shrinkage and karyopyknosis under inverted microscope.The Annexin Ⅴ-FITC/PI double staining and FCM results showed that the apoptotic rates of the HeLa cells in experiment group (3,6,12 and 24 h) were higher than that in control group (P<0.05 or P<0.01).The Western blotting results showed that compared with control group,the expression levels of the anti-apoptotic proteins p-Akt and Bcl-2 in HeLa cells in experiment group were decreased obviously,whereas the expression levels of the pro-apoptotic proteins Bax and cleaved-caspase-3 were increased and the expression levels of Pro-caspase-3 were decreased.Conclusion:TBB may promote the apoptosis of human cervical cancer HeLa cells by inhibiting the Akt signaling pathway.

OBJECTIVETo compare the accuracy of intaoperative methylene blue alone and in combination with (99m)Tc-sulfur colloid isotopic tracing for detection of sentinel lymph nodes (SLNs) in early-stage non-small cell lung cancer (NSCLC).

METHODSSixty-one patients with operable NSCLC who did not receive previous radiotherapy or chemotherapy were enrolled. Methylene blue and (99m)Tc-sulfur colloid were injected into the subserosal layer adjacent to the tumor, and SLNs were defined as those with blue staining or those containing 3 times more radioactivity than the surrounding tissue detected with a gamma probe. The SLN were removed with systematic lymph node dissection. All the removed lymph nodes were examined histopathologically with HE staining and immunohistochemistry.

RESULTSMethylene blue alone showed a low detection rate (60.0%) and sensitivity (58.33%) for SLNs compared with the combination of methylene blue and isotope tracing (96.15% and 92.86%, respectively).

CONCLUSIONThe combination of methylene blue and (99m)Tc-sulfur colloid isotopic tracing allows accurate detection of the SLNs in early-stage NSCLC.

Carcinoma, Non-Small-Cell Lung ; diagnosis ; Colloids ; Humans ; Immunohistochemistry ; Isotopes ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Methylene Blue ; Sentinel Lymph Node Biopsy ; Sulfur ; Technetium Tc 99m Sulfur Colloid

Objective:To analyze the local recurrence patterns after concurrent chemoradiotherapy (CCRT) for thoracic esophageal squamous cell carcinoma (ESCC) through image fusion, and to explore the risk factors of local recurrence and its relationships with dosimetric indices.Methods:A retrospective analysis was conducted for 209 thoracic ESCC patients who received radical CCRT in Fourth Hospital of Hebei Medical University during 2016-2019. For the patients diagnosed as the local recurrence of esophageal lesions, their CT images were fused with the original planning CT images using image registration software to identify the recurrence sites. Through 1∶1 propensity score matching (PSM) of the clinal data of patients with local recurrence (the recurrence group, nbefore = 81, nafter = 62) and those without local recurrence (the recurrence-free group, nbefore = 128, nafter=62), the dose and volume parameters of the treatment plans for the two groups were compared. Univariate and multivariate analyses were conducted using the Kaplan-Meier method and the Cox regression model to analyze the factors affecting the overall survival (OS), progression-free survival (PFS), and recurrence-free survival (RFS). Results:All patients had 1-, 3-, and 5-year OS rates of 80.9%, 42.6%, and 33.0%, respectively, 1-, 3-, and 5-year PFS rates of 67.9%, 34.0%, and 27.9%, respectively, and 1-, 3-, and 5-year RFS rates of 71.3%, 39.2%, and 30.5%, respectively. T stage, N stage, and radiation dose were independent prognostic factors for the OS, PFS, and RFS ( HR = 1.42-1.87, P < 0.05) of the patients, respectively. Among 68 patients with local recurrence, 62 cases (91.2%) suffered recurrence within the gross tumor volume (GTV). The dose and volume parameters of patients with local recurrence, such as GTV- D95%, clinical target volume (CTV)- D95%, GTV- D50%, CTV- D50%, and planning target volume (PTV)- D50%, GTV- V60, CTV- V60, and PTV- V60, were significantly lower than those of patients free from the local recurrence ( t=1.90-2.15, P < 0.05). Conclusions:Local recurrence of patients with thoracic ESCC after radical CCRT occurs mainly within the GTV. Increasing radiation doses may contribute to their survival benefits. The D50% for each target volume in the radiotherapy plan may be related to local recurrence, and it is necessary to conduct further research.

Objective:To evaluate the effects of high mobility group protein box 1 (HMGB1) on clinical prognosis of esophagus squamous cell carcinoma (ESCC) patients treated with chemoradiotherapy and the radiosensitivity of xenograft in nude mice.Methods:A total of 90 endoscopic biopsy specimens were obtained from ESCC patients treated with chemoradiotherapy. The expression level of HMGB1 was determined by immunohistochemical staining. High expression level was defined when staining was observed on ≥50% of the tumor cells. All patients were divided into the high expression group ( n=48) and low expression group ( n=42), and their survival information was retrospectively analyzed. Cell transfection was performed with the plasmid carrying human HMGB1-shRNA to knockdown HMGB1 expression in ECA109 cells and xenograft mouse models were established. The tumor volume and mass were calculated after irradiation with a dose of 15 Gy. The cell apoptosis in xenograft tissues were detected. Survival analysis was performed using Kaplan-Meier method. Univariate prognostic analysis was conducted by log-rank test. Intergroup comparison was performed by analysis of variance (ANOVA). Results:The expression level of HMGB1 was significantly associated with gross tumor volume, longest diameter of tumor, T staging and distant metastasis ( χ2=9.663, 5.625, 4.068, 7.146, all P<0.05). In the low expression group, the overall survival (OS) ( χ2=4.826, P=0.028), progression-free survival (PFS) ( χ2=4.390, P=0.036) were longer compared with that in the high expression group. Further analysis of HMGB1-high expression patients showed that the radiation dose and the combination of chemoradiotherapy did not significantly affect the OS or PFS of ESCC patients. We observed that knockdown of HMGB1 slowed the growth rate of xenograft, decreased the tumor volume and increased the apoptosis rate after irradiation. Conclusions:ESCC patients with high expression level of HMGB1 obtain poor prognosis after chemoradiotherapy, which can be enhanced by increasing the sensitivity to radiotherapy and chemotherapy. HMGB1 knockdown can effectively increase the radiosensitivity of xenograft in ESCC nude mice.