Objective To discuss the technical points and clinical effects of thoracic reconstruction after resection of the sternal tumnors with autogenous rib graft and pedicle oinental flap. Method A retrospective study was made on 12 patients,who underwent resection of sternal tumors and thoracic reconstruction with autogenous rib graft and pedicle omental flap between January 2004 and March 2010. The tumor involved the manubrium in 4 patients and the sternal body in 8 patients. Results All operations of 12 patients were succeed with no perioperative mortality or severe complications. Incisions healed by primary intention healing,and no paradoxical breathing was found. The postoperative period was uneventful.Conclusion It's an effective way to treat sternal tumors by the resection and thoracic reconstruction with autogenous rib graft and pedicle omental flap.

Objective To introduce an efficient method to isolate and identify the dedifferentiation derived epidermal stem cells. Methods HEKa cells obtained from Casacade (USA) were induced to reverse their differentiated process and produce immature, stem-like cells-the dedifferentiation derived epidermal stem cells (dHEK cells)-by basic fibroblasts growth factors (bFGF) in vitro. Improved collagen Ⅳ-coated adhesion method was used to isolate and cultivate the dHEK cells. Subsequently, morphological features and phenotypic changes of these immature dHEK cells were immunochemically stained and studied with confocal microscopy and flow FACS array. Results Immunocytochemical analysis proved that dHEK cells and their subunits were positive for ?1 integrin, keratin 19 and 14, yet negative for the expression of keratin 10, which was considered as an established marker of differentiated cells. Double staining immunofluorescence demonstrated that markers such as ?6 integrin and CD71 were co-expressed in dHEK cells, and it was shown that there was important regional differences in the distribution of ?6 integrin and CD71 in dHEK cells and their subpopulations. More importantly, two-color flow cytometric analysis of ?6 integrin and CD71 consistently revealed two phenotypically discrete populations of cells in the isolated dHEK cells, i.e. a major subpopulation exhibiting high levels of both ?6 and CD71 expression (?6+CD71+ representing 66.97%?5.04% of the total cells) and a minor population characterized by high level of ?6 expression and low level of CD71 expression (?6+CD71- representing 24.52%?7.88% of the total cells) (n=3). Conclusions The dHEK cells isolated by collagen Ⅳ-coated adhesion method have some characteristics of native epidermal stem cells, and perhaps it may act as a new vehicle for non-genetic manipulation and therapy for both skin disorders and systemic deficiencies. Additionally, although viewed as an ideal substitute of ESCs, the safety of dHEK cells and their functional difference with native epidermal stem cells are still unclear, which need further research.

Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected and single-layer continuous suture with 5-0 Prolene was used for suturing of the carina of the reconstructed segmental bronchi to form lobular bronchi. Then, single-layer continuous suture with 4-0 Prolene was employed to anastomose the "lobular bronchi" with main bronchi. Our results showed that the 15 bronchoplasties were successfully performed. The tumors were completely removed and postoperatively, the pulmonary functions of the patients were substantially improved. No broncho-pleural fistula and stomal stenosis took place in all the cases. The quality of life of the patients were obviously improved. It is concluded that multisegmental bronchoplasty can completely remove the tumor of central non-small-cell lung cancer and conserve more non-involved lung. The procedure is especially suitable for those patients with severely impaired lung functions and it expands the indications of surgical resection of lung cancer.
Anastomosis, Surgical ; Bronchi/*surgery ; Carcinoma, Non-Small-Cell Lung/*surgery ; Lung Neoplasms/*surgery ; Pneumonectomy/*methods ; Pulmonary Surgical Procedures/*methods ; Recovery of Function ; Treatment Outcome

Objective To investigate gene polymorphisms and distribution features of glutathione Stransferase Omega-1 (GSTO 1 ) gene in Ala 140Asp site in 16 Chinese populations.MethodsA total of 1369 samples were from the human genome project(HGP)-the establishment and preservation program of Chinese minority genetic resources.The phenotypes of Ala/Ala (C/C),Ala/Asp (C/A),and Asp/Asp (A/A) of GSTO1 Ala140Asp were determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).With analysis of molecular variance(AMOVA),the genetic variation levels among nations and regions were analyzed by estimating the evolutionary distance of alleles or genotypes.ResultsOf the 1369 individuals analyzed,979 (71.51％) were carriers of the wild homozygous allele Ala/Ala(C/C),365 (26.66％) were heterozygotes Ala/Asp(C/A) and 25 (1.83％) were mutant homozygotes Asp/Asp(A/A),with an overall frequency of the GSTO 1 mutant allele A 15.16％ [ (365 +50)/( 1369 × 2)].AMOVA analysis showed that the difference was statistically significant(P ＜ 0.05) of genetic variations of GSTO1 gene Ala140Asp among the 14 ethnic groups,and was significant between the northem and southern populations (P ＜ 0.05 ).Conclusion In different regions and populations the GSTO1Ala140Asp mutant allele frequencies are different.

Objective To investigate and evaluate the polymorphism distribution of arsenic(+3 oxidation state)methyhransferase(AS3MT)5'-UTR VNTR in Chinese populations.Methods Genomic DNA was extracted from peripheral blood anti-coagulated with ACD of 1440 individuals in a standard phenol-chloroform protocol.The phenotypes of AS3MT 5'-UTR VNTR were determined by polymerase chain reaction(PCR)associated with agarose gel electrophoresis.Results Of the 1440 individuals,771(53.5%),426(29.6%),211(14.7%),16(1.1%)and 16(1.1%)were carriers of the V2/V3(AB/A2B),V3/V3(A2B/A2B),V2/V2(AB/AB),V2/V4(AB/A3B)and V3/V4(A2B/A3B)genotype,respectively.The AB(V2),A2B(V3)and A3B(V4)allele frequency was 41.9%,57.0%,1.1%respectively.The differences of AB(V2)and A2B(V3)allele frequency were all significant between the northern and southern populations respectively(χ2=23.39,χ2=33.28,P＜0.007).Conclusions In different regions the AB(V2)and A2B(V3)allele frequency is different,the AS3MT 5'-UTR VNTR polymorphism can be used to evaluate the susceptivity of arsenieosis.

Objective An effective reproducible protocol for complete plant regeneration via somatic embryogenesis has beendeveloped for Herpetospermum pedunculosum,an endangered Tibetan medicinal herb.Methods The cotyledonexplants used in this study were excised from seedlings germinated in vitro.Callus was induced from cotyledonexplants on Murashige and Skoog's medium,supplemented with 2,4-dichlorophenoxyacetic acid(2,4-D,0.1-1.0mg/L)alone or in combination with 6-benzylaminopurine(BA,0.5,1.0,and 2.0 mg/L).Results The calli showeddifferentiation of globular embryos after three weeks of incubation on MS medium supplemented with variouscombinations of BA and NAA.Sixty-two percent of the embryogenic calli produced somatic embryos in MS basalmedium supplemented with BA(1.0 mg/L)+NAA(2.0 mg/L).The addition of KN(0.5 mg/L)to MS mediumcontaining both BA and NAA(2.0 mg/L each)significantly increased the frequency of somatic embryogenesis.Themaximum percentage of embryogenic calli formation was 83%,and globular embryos formed and germinatedsuccessfully in this medium.Then,transferring the regenerated plants from this medium to hormone-free MSmedium will further enhanced the development of the plants,and the healthy plantlets are formed successfullywithin four weeks.The plantlets were transferred to soil to acclimatize under greenhouse conditions and 75%survived.Conclusion Somatic embryogenesis protocol as reported here can play a key role in the propagation andconservation of this endangered species.

Objective To investigate the diagnosis and the causes of misdiagnosis of skull base chondrosarcoma.Methods The clinical data of 7 cases of skull base chondrosarcoma confirmed by pathology from April 2009 to February 2014 were analyzed retrospectively.Results Only 1 case of preoperative diagnosis was correct in 7 cases of skull base chondrosarcoma, other 6 cases were misdiagnosed, of which 2 cases were misdiagnosed as trigeminal schwannoma, 3 cases were misdiagnosed as chordoma, 1 case was misdiagnosed as meningioma,the misdiagnosis rate was 85.7％.Conclusion Chondrosarcoma of the skull base is rare, so clinicians are lack of knowledge, and non-characteristic clinical features and non-characteristic radiographic manifestations contribute to misdiagnosis.Strip calcification on CT and honeycomb reinforced on enhanced MRI existing at the same time,which prompts to diagnosis chondrosarcoma of the skull base.

Objective To review the effects of preventive management during the operation for post-operative chylothorax in patients with lung cancer of state Ⅲ. Methods Total 425 patients underwent pulmonary resection (at least lobectomy) and systematic mediastinal lymph node dissection for lung cancer of state Ⅲ from January 1998 to June 2005. Took some especial management during the operation to prevent post-operative chylothorax in 132 patients after March 2004. According to the surgical procedure,all patients were divided into preventive group and non-preventive group. Results There were 14 patients (4.8%) with post-operative chylothorax in the group of inchoate 293 patients before March 2004. Only 1 patient (0.07%) among 132 patients who underwent treatment for chylothorax during the operation after March 2004 had post-operative chylothorax (P

ObjectiveTo explore sensitivities and specificities of Nutritional Risk Screening 2002 ( NRS 2002),Subjective Global Assessment (SGA),and Mini Nutritional Assessment (MNA) in the detection of blood prealbumin level.MethodsTotal 126 patients were consecutively enrolled from the oncology departments of three hospitals from November,2010 to March,2011.Nutritional screenings or assessments were performed on the next morning of hospital admission by nutritionists and medical oncologists using NRS 2002,SGA,and MNA.Prealbumin ( ＜ 180 g/L) was used as the reference standard of malnutrition (undernutrition) for assessing the sensitivities/specificities of these tools.ResultsAll 126 patients completed nutritional screening or assessment using the above three tools.The prevalence of malnutrition (undernutrition) determined by NRS 2002,SGA and MNA was 67.0％,46.2％,and 64.8％,respectively.With prealbumin in relation to clinical outcome as the reference standard,the sensitivities ofNRS 2002,SGA,and MNA were 78.2％,58.2％ and 89.1％,and the specificities were 50.0％,72.2％,and 27.8％,respectively.ConclusionsAmong these three tolls,NRS 2002 detects the nutrition risks,whereas SGA and MNA detect malnutrition.Since prealbumin is not an appropriate reference standard,it can not be used for the comparison among the three tools.Nevertheless,NRS 2002 reflects the clinical outcomes,and therefore is suitable for inpatients.

Objective To examine the induction effects of bone marrow mesenchymal stem cells(BMSCs) transfected with bone morphogenetic protein 7 (BMP7) gene differentiating into chondrocytes. Methods We observed the phenotype of cells which were stained with alcian blue and HE climbing to the six pore plate with invert microscope. The glycosaminoglycan (GAG) value in culture medium was detected in control group,BMP7 transfect and culture medium induced groups after 7,14 and 21 days using standard curve method. Standard curve was described using galacturonic-acid as reference substance. The content of collagen Ⅱ was detected by ELISA method. Results HE and Alcian blue staining showed that BMP7 gene transfection group and the group induced by fluid possess the characteristics of chondrocyte. BMP7 induced BMSCs differentiation to chondrocyte which secrete specific protein called collagen Ⅱ and GAG. Content of GAG were (17.1±3.4),(39.5±5.4),(40.8±6.1)mg/L in control group,BMP7 gene transfected group and induced group,collagen Ⅱ were (89.7±14.3),(152.8±14.5),(155.5± 19.3)μg/L in these three groups separately. Comparing with control group,GAG and collagen Ⅱ of BMP7 gene transfected group and culture medium induced group increased obviously(all P < 0.05),but there was no significant difference between BMP7 gene transfeeted group and culture medium induced group (P > 0.05). Conclusion This active protein induces BMSCs differentiating into chondrocyte,in a level similar to that of inducing medium.