Objective To study the expressions of metadherin (MTDH) and cyclinD1 in esophageal squamous cell carcinoma (ESCC) and their clinical significances. Methods The protein expressions of MTDH and cyclinD1 were detected by immunohistochemistry in 78 cases of ESCC. Results The positive expression rate of MTDH in ESCC was 71.79%(56/78) and the positive expression rate of cyclinD1 in ESCC was 74.36%(58/78). The expressions of MTDH and cyclinD1 were significantly correlated with the degree of differentiation and lymph node metastasis (both P< 0.05), but not with the age, gender of patients and depth of tumor invasion (all P> 0.05). Conclusion The over expressions of MTDH and cyclinD1 protein may involve in the occurrence and development of esophageal carcinoma, which play important roles in the invasion and metastasis of esophageal cancer.

Objective To investigate the biological function of IFN-λ in 7 human esophageal carcinoma cells. MethodsThe gene expression of IL-28α, IL-10β and antiviral molecule was examined with PCR. The MHC molecules expression and the profiles of cell cycle were analyzed with flow cytometer. Cell proliferation was evaluated with MTT assay. ResultsAll of esophageal carcinoma cells express the gene of II-28α and IL-10β. IFN-λ induced or augmented the gene expression of antiviral molecules, 2′5′-OAS and MxA. IFN-λ enhanced the MHC class Ⅰ molecule expression. IFN-λ inhibited the growth of esophageal carcinoma cells through the regulation of cell cycle distribution. ConclusionEsophageal carcinoma cells express the IFN-λ receptor complex. IFN-λ has the antiviral, anti-proliferative and immunoregulation activity.

ObjectiveTo evaluate the feasibility of the completely thoracoscopic lobectomy for clinical N0 and postoperatively pathological N2 non-small-cell lung cancer(NSCLC).MethodsFrom Sep.2006 to Jan.2010, 216 patients with NSCLC received completely thoracoscopic lobectomy in our center.Two hundred and six patients were clinical N0 preoperatively(103 males and 103 females, median age of 62.3 years, rang 29 to 85 years).They were divided into two groups based on postoperatively pathological staging, pN0 group and pN2 group.Some perioperative factors including age, gender,tumor size,tumor location,pathological type, pathological differentiation,rate of conversion to thoractomy,operation time,blood loss,lymph node dissection, time of drainge, hospitalization and complications were studied and compared between two groups.Results There were 203 cases of lobectomy, 2 cases of composite lobectomy and 1 case of pneumonectomy.All procedures were carried out safely without serious complication except for one operative death result from respiratory failure.There were 168 cases in pN0 group and 38 cases in pN2 group.Age and gender were similar between two groups.The tumor size in pN0 group was smaller than that in pN2 group [ (2.6 ± 1.6) cm vs (3.7 ± 1.9) cm, P = 0.001 ].The tumors in pN0 group were lesser appearance in the bilateral lower lobes (31.0％ vs 50.0％, P = 0.026).There was a approximate proportion of adenocarcinoma in two groups (82.7％ vs 73.7％, P = 0.181), but the proportion of poorly differentiated carcinoma in pN0 group was significantly lower than that in pN2 group(19.0％ vs 42.1％, P = 0.002).There were no differences in the rate of conversion to thoractomy(7.1％ vs 7.9％, P = 1.000), operation time[ (196.1 ± 53.7) min vs (208.6 ± 56.8) min, P = 0.202 ], blood loss[ (253.2 ±247.9) ml vs(279.0±183.3) ml, P=0.475], time of drainage[ (7.7 ±3.2) days vs (9.7 ±6.3) days,P=0.066], hospitalization[ (10.6 ±4.6) days vs (13.0 ±7.6) days, P =0.063]and complications(12.5％ vs 21.1％,P =0.171).The stations of mediastinal lymph node dissection were equivalent in two groups(3.1 ± 1.2 vs 3.3 ± 1.1, P =0.237) , but there were fewer numbers of mediastinal lymph node dissection in pN0 group (9.9 ± 6.8 vs 12.7 ± 8.4, P =0.038).ConclusionCompletely thoracoscopic lobectomy is a feasible surgical therapy for cN0-pN2 non-small-cell lung cancer without loss of curability.

Objective To investigate protection by immunization with recombinant Ferritin vaccine of Echinococcus granulosus against protoscolices.Methods ICR mice were randomized into 3groups of 12 mice in each.The mice in group A and B were immunized three times with an interval of two weeks and those in group C did nothing.The animals in all the 3 groups were challenged with 1100 protoscolices intraperitoneally on the 8th week.Serum samples were collected before each inoculation and challenge injection.Seven months later, all the mice were killed and examinated for hydatid cysts.Result The number of cysts was significantly lower in the group A than in group B and C (P＜0.05).The levels of protection afforded were found to be 73% and 85%, respectively.Meanwhile,the number of cysts was markedly lower in group B than in group C(P＜0.05).The rate of protection afforded was 42%.Conclusion Recombinant Ferritin vaccine of Echinococcus granulosus shows partial immune protection.Therefore, it might be a suitable candidate for cocktail vaccine study in the future.

Objective To evaluate the effectiveness of midazolam and morphine combined with TCI of propofol for endobronchial ultrasound-guided transbronchial needle aspiration ( EBUS-TBNA ). Methods Forty ASA Ⅰ or Ⅱ patients undergoing elective EBUS-TBNA were randomly divided into 2 groups according to the plasma concentration (Cp) of TCI of propofol (n=20 each): group Ⅰ Cp = 3 μg/ml (group P1) and group Ⅱ Cp = 4 μg/ml (group P2 ). Midazolam 0.03 mg/kg and morphine 0.05 mg/kg were administered iv followed by topical anesthesia of laryngopharynx with 4% hdocaine. TCI of propofol was started at 5 min before surgery. The patients kept spontaneous breathing during operation. MAP, HR and SpO2 were continuously monitored and recorded before anesthesia (baseline) and at 30 min after beginning of surgery and emergence from anesthesia. Arterial blood gas analysis was performed at 30 min after beginning of surgery and PETCO2 was measured at the end of surgery. The amount of 4% lidocaine used for topical anesthesia, the adverse reactions and the level of patient's satisfaction were recorded. Results PaO2 and pH value were significantly lower while PaCO2 and PET CO2 higher in group P2 than in group P1. There was no significant difference in the emergence time, the amount of 4% lidocaine used,the adverse reactions and the level of patient's satisfaction between the 2 groups. Conclusion TCI of propofol at Cp of 3 μg/ml can provide satisfactory anesthesia for EBUS-TBNA with less respiratory depression and more rapid emergence than that at Cp of 4 μg/ml.

Motivation ; Forensic Psychiatry ; Violence ; Wounds and Injuries ; Crime/psychology*

Objective To discuss the safety, completeness and efficiency of the completely thoracoscopic lobectomy for non-small-cell lung cancer(NSCLC) which the tumor's diameter was larger than 5 centimeters. Methods From September 2006 to December 2009, 214 patients of NSCLC received completely thoracoscopic lobectomy in our center. There were 108 males and 106 females with median age of 62.5 years( range from 29 to 85 years). Patients were divided into two groups, group A ( diameter≥5 cm) and group B ( diameter ＜5 cm). We compared all the factors of age, gender, pathological type, location,rate of conversion to thorsctomy, operation time, blood loss, lymph node dissection, pathological stage, time of drainge, hospitalization, complications, overall survival and recurrence between two groups. Results Surgical procedures included lobectomy in 211 cases, composite lobectomy in 2 and pneumectomy in 1. All procedures were carried out safely without serious complication except one operative death result from respiratory failure. There were 30 cases in group A and 184 in group B. Age and gender were similar between two groups. The proportion of squamous cell carcinoma in group A was higher than it in group B (46.7% vs. 13.6% ,P ＜0.001 ). There were no differences in safety factors such as rate of conversion to thorsctomy( 16.67% vs. 7.61%,P =0.204), operation time[(214.0 ±58.1)min vs. (198.6 ±55.1)min, P=0.160], blood loss [(283.3 ±179.7)ml vs. (248.5 ±25.7)ml, P=0.559] and complications (13.33% vs. 14.67%,P=1.000). The completeness factors of lymph node dissection stages (5.0 ± 2.4 vs. 5.0 ± 1.7, P = 0.990 ) and numbers( 19.1 ± 10.1 vs.15.8 ± 8.8, P = 0.065 ) were equivalent between two groups. The estimated overall survival at 1 year was 81.25% for group A and 92.63% for group B ( P = 0.226). The recurrence of two groups was 3.45% vs. 2.23% (P = 0.532 ), respectively.Conclusion Completely thoracoscopic lobectomy can be done safely,completely and efficiently for non-small-cell lung cancer which the tumor's diameter was larger than 5 centimeters.

Objective: To evaluate the postoperative quality of life after surgery of patients with hepatic hemangioma. Methods: The retrospective and descriptive study was conducted. The clinical data of 104 patients who underwent surgery for hepatic hemangioma at Shengjing Hospital of China Medical University from September 2011 to February 2017 were collected. There were 28 males and 76 females, aged (49±8)years, with a range of 27-78 years. Enucleation of hepatic hemangioma or hepatectomy was selected according to tumor location of patients. Observation indicators: (1) surgical and postoperative situations; (2) assessment of quality of life in patients; (3) assessment of quality of life in patients comorbid with other chronic digestive diseases. Measurement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M (range). Repeated data were analyzed using repeated ANOVA. Count data were represented as absolute numbers. Results: (1) Surgical and postoperative situations: of 104 patients, 67 underwent enucleation of hepatic hemangioma, 37 underwent hepatectomy. The tumor diameter, volume of intraoperative blood loss, duration of postoperative hospital stay were (10±4)cm, 200 mL (range, 10-3 000 mL), (11±5)days. Seven patients had complications, including 5 of massive abdominal ascites, 1 of abdominal infection, and 1 of pulmanory obstruction. There was no death occurred. (2) Assessment of quality of life in patients with hepatic hemangioma: the total scores of Gastrointestinal-related Quality of Life Index (GIQLI), the scores of subjective symptoms, physiological status, mental and psychological status, and social activities were 121.0±8.3, 69.2±4.1, 18.5±2.6, 19.5±1.8, and 13.8±1.4 at preoperation. The above indices were 121.9±6.9, 71.2±3.8, 17.2±2.5, 19.6±2.3, and 13.8±1.3 of 104 patients with hepatic hemangioma at one month after surgery, respectively. The above indices were 127.8±6.2, 73.2±3.6, 19.8±2.5, 20.8±2.4, and 14.1±1.0 at 6 months after surgery. There were significant differences in changing trends of above indices (F=68.4, 64.6, 71.4, 17.8, 3.3, P<0.05). The scores of subjective symptoms and physiological status at one month after surgery showed significant differences compared with those of preoperation (t=-5.780, 6.640, P<0.05), but the total scores of GIQLI, the scores of mental and psychological status, and social activities showed no difference (t=-1.569, -0.705, 0.240, P>0.05). The total scores of GIQLI, scores of subjective symptoms, physiological status, and mental and psychological status at 6 months after surgery showed significant differences compared with those of preoperation (t=-8.897, -9.919, -5.375, -5.024, P<0.05), but the score of social activities showed no difference(t=-1.919, P>0.05). The total scores of GIQLI, the scores of subjective symptoms, physiological status, mental and psychological status, and social activities at 6 months after surgery were significantly different from those at one month after surgery (t=-10.835, -6.787, -12.277, -4.560, -2.476, P<0.05). (3) Assessment of quality of life in hepatic hemangioma patients comorbid with other chronic digestive diseases: 29 of 104 patients were comorbid with chronic gastritis, biliary diseases, and appendicitis. For the 29 patients comorbid with other chronic digestive diseases, the total scores of GIQLI, the scores of subjective symptoms, physiological status, mental and psychological status, and social activities were 117.5±7.5, 67.8±4.2, 17.4±2.2, 19.0±1.5, and 13.2±1.3 at preoperation. The above indices were 118.7±6.9, 69.5±4.5, 16.7±2.0, 19.2±1.9, and 13.2±1.3 at one month after surgery, respectively. The above indices were 124.6±6.5, 70.9±4.5, 19.8±2.1, 19.9±2.4, and 14.0±0.9 of 29 patients comorbid with other chronic digestive diseases at 6 months after surgery. There were significant differences in changing of the total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities (F=15.0, 9.0, 27.6, 7.5, P<0.05), except the score of mental and psychological status (F=1.6, P>0.05) . The scores of subjective symptoms and physiological status at one month after surgery showed significant differences compared with those of preoperation (t=-2.612, 2.191, P<0.05), but the total scores of GIQLI, the scores of mental and psychological status, and social activities showed no difference (t=-1.128, -0.587, -0.157, P>0.05). The total scores of GIQLI, scores of subjective symptoms, physiological status, and social activities at 6 months after surgery showed significant differences compared with those of preoperation (t=-4.002, -3.441, -4.604, -3.266, P<0.05), but the score of mental and psychologica status showed no difference (t=-1.522, P>0.05). The total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities at 6 months after surgery were significantly different from those at one month after surgery (t=-4.819, -2.313, -7.081, -3.172, P<0.05), but the score of mental and psychological status had no significant difference (t=-1.154, P>0.05). Conclusions The quality of life in patients with hepatic hemangioma can be improved by surgery. Surgical treatment is still effective for improvement of the total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities for those combined with other digestive diseases.

Objective To evaluate the value of autofluorescence bronchoscope (AFB) in airway examination in central type lung cancer. Methods From Sep 2009 to Mar 2010 ,29 patients ( 23 men , 6 women , median age 62.2 years , range from 34 to 81 years) underwent AFB procedure. There were 3 lesions located at trachea, 1 at right main bronchus, 9 at right upper lobe, 1 at right median bronchus, 1 at right middle lobe, 4 at right lower lobe, 1 at left main bronchus, 9 at left upper lobe.There were 21 preliminary diagnostic cases and 8 postoperative surveillance cases. All procedure was performed under combination of local anaesthesia and general anaesthesia. All patients underwent white light bronchoscopy followed by AFB procedure.All of the suspicious abnormal sites were recorded and biopsied for pathological examination. Results All procedures were safely performed without death or serious complications. 100 specimens were obtained for pathologic examination. Malignant lesion was diagnosed in 39 and non-malignancy in61. All malignant sites were detected by AFB, however WLB missed 12 sites.The sensitivity of AFB and WLB for malignancy were 100% and 69.2%, respectively. In 21 preliminary diagnostic cases,AFB detected all malignancy sites, but WLB missed 23 sites, in which 9 were malignant sites. In 8 rechecked patients, AFB detected all malignancy sites, but WLB missed 7 sites, in which 3 were malignant sites. Conclusion Autofluorescence bronchoscopy could be more accurate in judging the extent of the tumor invasion, more sensitive in finding multiple lesions in airway, more sensitive in detecting early cancer recurrence in postoperative surveillance patients.

Objective To optimize operative techniques of completely video-assisted thoracoscopic lobectomy by reviewing the experience of Peking University People's Hospital. Methods From September 2006 to August 2010, 408 patients (214 males,194 females) with median age of 58.6 years (range from 15 to 86 years) underwent completely thoracoscopic lobectomy. All procedures were conducted under general anesthesia with double lumen intubation. The thoracoscope was introduced through 7th or 8th intercostals space on the mid-axillaries line. The 4 cm long utility incision was made on the 4th or 5th intercostals space anterior axillary's line without rib-spreading. A third retraction incision located on the 7th or 8th intercostals space sub-scapular line. The surgeon stands on the ventral side of patient using an electrocautery hook and a suction device through the utility incision. Anatomic lobectomy was performed with systemic mediastinal lymph node dissection for lung cancer patients. Results All procedures were carried out smoothly with no case of serious complication. There was 1 case death because of respiratory failure of pulmonary fungal infection during the operative period. The average surgical duration was 195 minutes, and average blood loss was 249 ml with no blood transfusion required. There were 35 cases (8.6%) of conversion to open thoracotomy, including interference by lymph nodes, bleeding, inflammatory adhesion of Artery and large size tumors.The results of pathology show 322 cases of malignant disease and 86 cases of benign disease. Conclusion To grasp the core technique of completely thoracoscopic lobotomy may make the procedure undergone smoothly, and may shorten the learning curve.