Objective:To investigate different incidences of recent complications after thoracoscopic lobectomy at different operation schedules in patients with early stage non-small cell lung cancer(NSCLC).Methods:A total of 730 patients with early stage NSCLC who underwent thoracoscopic lobectomies in the Department of Thoracic Surgery, Peking University People's Hospital from June 2013 to October 2017 were enrolled. Clinical data were collected retrospectively to calculate the incidence of postoperative complications. Meanwhile, the effects of different operation time periods(before 4pm or after 4pm, working day or weekend) on complications were compared, and the propensity score matching method was used to eliminate the confusion factors that may cause result bias. Univariate and multivariate logistic regression methods were used to analyze the independent risk factors of postoperative complications.Results:162 patients(22.2%) had complications within one month after thoracoscopic surgeries, and 53(7.3%) of them were major complications. After the propensity scores of the preoperative clinical factors were matched, there was no significant difference in the incidence of complications between weekdays and weekends(18.7% vs 23.9%, P=0.267). There was also no significant difference in the effect of complications between the group before 4pm and group after 4pm on surgery(22.1% vs 27.9%, P=0.337). Conclusion:The incidence of recent complications in patients with early stage NSCLC after thoracoscopic lobectomy was as acceptable as 22.2%. The choice of operation schedules did not affect the postoperative complications.

Objective To investigate the expression status of A Disintegrin and Metalloproteinase with Thrombospondin motifs 5(ADAMTS5 )and its clinical significance in primary human gastric cancer(GC). Meth-ods ADAMTS5 protein expression in 176 GC tissues and 24 adjacent normal tissues was detected by immunohisto-chemistry(IHC),and its correlation to clinicopathological features and prognosis in patients with gastric cancer was analyzed. Results ADAMTS5 expression was lower in GC tissues compared with adjacent normal tissues. Moreover,low expression of ADAMTS5 was associated with gender,histologic type,degree of differentiation,M stage,TNM stage and vascular invasion,which was also an independent indicator for poor prognosis for GC pa-tients. Conclusions ADAMTS5 expression was lower in GC tissues,which was associated with clinicopathological features and prognosis,suggesting a novel potential prognostic indicator and therapeutic target in GC.

OBJECTIVETo analyze the clinical characteristics and follow up record of patients with synchronous multiple lung cancers (SMLC).

METHODSThe medical records of 1 868 lung cancer patients who underwent surgical treatments From January 2007 to December 2014 were reviewed, in which 103 patients were diagnosed SMLC by Martini and American College of Chest Physicians modified guideline. The average age was 60.5 years, including 34 male and 69 female patients. According to consolidation/tumor ratio (CTR) on thin-section computed tomography, 103 cases were classified into three groups: group A (multiple ground-glass opacities, CTR ≤ 50%), group B (with one solid dominant nodules, CTR > 50%), group C (with two solid dominant nodules). The surgical procedure was determined according to CT findings and respiratory function. The Kaplan-Meier method was used to analyze the duration of recurrence-free survival (RFS) and over-all survival (OS), and differences were assessed using the Log-rank test. Multivariate analysis using the Cox proportional hazards models was used to assess the potential independent effects on RFS or OS.

RESULTSThere were 38 patients in group A (36.9%), 40 patients in group B (38.8%) and 25 patients (24.3%) in group C. More female (73.7% vs. 48.0%, χ² = 4.291, P = 0.038), less smoker (21.1% vs. 44.0%, 2 = 3.770, P = 0.052), younger (56.2 years old vs. 65.9 years old, t = -4.172, P = 0.000) and less tumor size (1.24 cm vs. 2.31 cm, t = -4.573, P = 0.000) patients in group A than in group C. The 3, 5-year RFS were 80.3% and 64.9% for all patients, respectively. The 3, 5-year OS were 87.3% and 68.6% for all patients, respectively. The 3, 5-year RFS were 100% and 100% in group A, 77.7% and 51.8% in group B, 59.6% and 44.7% in group C (P = 0.029). No significance were found in OS between the three groups (P = 0.214). Multivariate Cox analysis demonstrated that size of dominant nodule larger than 2 cm (HR = 4.475, 95% CI: 1.138 to 17.604, P = 0.032) is associated with poor prognosis, whereas postoperative chemotherapy did not affect RFS.

CONCLUSIONSMultifocal ground-glass opacities and multiple solid lung cancers are different in nature. RFS of patients with SMLC is strongly affected tumor size. Surgical resection is effective and should be performed specifically to patients.

Female ; Humans ; Lung ; pathology ; surgery ; Lung Neoplasms ; diagnosis ; pathology ; surgery ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To explore the effect of mouse proliferation-associated protein 2G4 (p38-2G4) high-expression on the proliferation and erythriod differentiation of murine erythroleukemia ( MEL ) cells.Methods To establish the recombinant lentivirus vector p 38-2G4-pLJM1, the p38-2G4-pLJM1 was cotransfected into HEK293T cells to obtain lentivirus with pCMV-VSV-G and pCMV-dR8.2.Lentivirus were infected into MEL cells to establish the stably p 38-2G4 high-expressed MEL cells.Western blotting was used to analyse the high-expression efficiency.MTT assay and benzidine staining were applied to detect the cell viability and hemoglobin synthesis of the stable cell line in presence /absence of inducers.Results Western blotting showed that the p38-2G4 high-expression stable cell strain had a higher expression of p38-2G4 as compared to the control group ( MEL) ( P <0.05).MTT result showed that there was no difference between the p38-2G4 high-expression cell strain and the control group (P>0.05), but the hemoglobin synthesis had been reduced as compared to the control group (P<0.05).Conclusion p38-2G4 high-expression does not affect the cell viability of MEL cells , but inhibits the erythriod differentiation of MEL cells in three independent experiments .

Objective To investigate the effect of a disintegrin and metalloprotease domain(ADAM8)gene on colon cancer HCT8 cell proliferation and proliferation signal transduction pathways PI3K-Akt-mTOR. Methods Colon cancer HCT8 cells were cultured in vitro,and transfected with ADAM8 overexpression plasmid and RNA interfering plasmid. Cell proliferation were detected by EdU and MTS method assays. PI3K activity was measured by PI3K activity detection kit,Western Blot method was performed to detect the ratio of Akt and p-Akt and expression of mTOR. Results Compared with control group(1.00 ±0.12),the cell proliferation in ADAM8 overexpression group(1.22 ±0.13)was significantly higher (P<0.05)and in RNA interfering group(0.78 ±0.11)was significantly lower while PI3K activity had no significant changes in three groups. After ADAM8 overexpression,and the ratio of p-Akt/Akt and mTOR expression were increased significantly,while reduced significantly after RNA interferered. Conclusion ADAM8 can promote HCT8 cell proliferation through enhancing the phosphorylation of Akt and promoting the expression of mTOR.

Objective To explore the differentially expressed proteins during erythroid differentiation .Methods The murine erythroleukemia ( MEL) cell were treated by DMSO , and the comparative proteomic was systematically analyzed and identified on different differentiating time points .ratio of cell differentiation and viability were detected by benzidine staining, MTT assay and Ter119 immunofluorescence.Using two-dimensional gel electrophoresis combined with mass spectrometry technology and bioinformatics analysis , we conducted a comparative proteomic analysis on MEL cells during the process of induced differentiation to screen and identify differential proteins .Results The MEL cells induced by 1.2%DMSO for 0 hour, 6hours, 12hours, 24hours, 36hours, 48hours, 72 hours, 96 hours, 120 hours were collected for proteomic analysis, by two-dimensional gel electrophoresis combined with mass spectrometry .A total of 87 kinds of proteins were successfully identified .MEL cells exposed to DMSO at a final concentration of 1.2% for 120 hours reached the highest differentiation rate of 67%.MTT assay showed that 1.0%, 1.2%, 1.4% DMSO had no inhibiting effect on cell vitality.Conclusion DMSO may induce MEL cells to differentiate and have no inhibiting effect on cell vitality .The 87 kinds of differentially expressed proteins from two-dimentional gel electrophoresis may be divided into twelve categories ;the most three parts are 41%enzyme protein, 15%structural protein and 13%regulatory protein.

ObjectiveTo evaluate thd cell biologic changes in thd non-small-cell lung cancer(NSCLC) which PTEN gene were activated by double-stranded RNA(dsRNA).MethodsSpecific dsRNA was designed.First,the promoter region of PTEN gene was determined by Promoter 2.0 program,then the CpG island in the promoter was found by CpGisland searcher software and the possible target non-CpG sequence that dsRNA might activate were defined by SiRNA Target Finder software.dsRNA were synthesized at Genechem Company( Shanghai,China).Then the specific dsRNA was transfected into A549 and H292 cells which were stored in our laboratory using Lipofectamine 2000 ( Invitrogen,USA) according to manufacture's instruction.Total celluar RNA was isolated.The expression of PTEN mRNA in transfected,control and mock group were determined by real-time quantitative polymerase chain reaction.Cell profiferation was investigated on days 1 to 5 by using Cell Counting Kit-8 according to the manufature's technical manual.Cell invasion ability was assessed by Transwell method that transmembrane cells were counted,and cell bycle distribution were studied by flow cytometer(FCM) using CycleTESTTM PLUS DNA Reagent Kit.ResultsAfter the introduction of dsRNA into the A549 cells,the PTEN mRNA expressin was upregulated to (4.35 ±0.42) folds compared with the mock and control cells.And in H292 cells,the mRNA expression of PTEN was upregulated to (3.92 ± 0.20) folds.It confirmed the RNA activation phenomenon in the PTEN gene in NSCLC cells.Compared with the control group,the number of alive transfected cells did not decreased in the cell proliferation assay.In the cell invasion test we found that the transmembrane A549 cells were 122.4 ±11.2 vs.150.7 ±13.1 in transfected group and control group respectively.In the cell cycle distribution we found dsRNA in duced part ofthe transfected cells arrested in G1 phase and a corresponding decrease in S-phase population was observed,though this change was not statistically significant.Conclusion The expression of PTEN mRNA could by enhanced by inducing the specific dsRNA into the A549 and H292 cells,though no evidence was found that after the activation of silenced PTEN,the cell proliferation and invasion ability were significantly changed.

Objective To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of intrapulmonary tumors located adjacent to the central airway.MethodsThe study was retrospective,from September 2009 to September 2011,33 patients with pulmonary masses located close to the central airways suspected to be lung cancer were accessed by EBUS-TBNA.Conventional bronchoscopic biopsy before EBUSTBNA was nondiagnostic in all cases.If EBUS-TBNA did not result in a formal pathological diagnosis of malignancy,patients were subsequently referred for a surgical procedure.ResultsOf the 33 patients,EBUS-TBNA confirmed lung cancer in 29 cases (4 small cell lung cancer,25 non-small cell lung cancer).Four patients were not confirmed by EBUS-TBNA,3 cases were diagnosed as squamous cell carcinoma by thoracoscoopy or thoracotomy,the other one was a pulmonary inflammatory lesion diagnosed by thoracoscopy.The sensitivity,specificity,accuracy,negative predictive value and positive predictive value of EBUS-TBNA for the diagnosis of intrapulmonary lesions was 90.2％,100％,90.9％,25％,and 100％,respectively.The procedure was uneventful,and there were no complications.ConclusionEBUS-TBNA is an effective tool with a high yield for the diagnosis of intrapulmonary lesions located adjacent to the central airway.

Objective To evaluate the feasibility of lobectomy by completely Video-Assisted Thoracoscopic Surgery (cVATS) in the management of bronchiectasis.Methods Between June 2001 and October 2010,a total of 60 major lobectomies were performed in our single center on 32 female and 28 male patients of bronchiectasis,with a mean age of 43.4( range 17 to 69)years.All lobectomies were carried out anatomically and divided into thoracotomy group and cVATS group.Pulmonary vessels and bronchus were dissected by endo-cutters.Conversion to a thoracotomy took place if severe adhesion or bleeding was encountered.Results The operations included 5 lobectomies of right upper lobe,3 of middle lobe,6 of right lowerlobe,3 of left upper lobe,26 of left lower lobe,10 of left lower lobe plus lingular segment,4 of left pneumonectomy,1 of bi-lobectomy,1 of right middle lobe plus wedge resection of lower lobe and 1 of left lower lobe plus right middle lobe.There were 25 patients in the thoracotomy group and 35 patients in the cVATS group,in which 2 operations (5.7％) converted due to severe adhesion,poor differentiation of the fissure and/or the proliferation of tortuous vessels at hilus In thoracotomy and cVATS groups,the operative time were ( 207.6 ± 88.5 ) vs.( 168.7 ± 55.9 ) min ( P =0.041 ),the blood loss were ( 522.0 ±644.2) vs.(210.1 ± 213.1 ) ml ( P =0.009),the mean chest tube duration were ( 5.4 ± 4.4) vs.(6.3 ± 3.4 ) days ( P ＞0.05 ) and the mean length of hospitalization were ( 10.2 ±4.7 ) vs.( 8.5 ± 3.5 ) days ( P ＞ 0.05 ).No mortality or severe complication occurred in both groups.The morbidity was 25.7％ (9/25)vs.17.1％ (6/35) in thoracotomy and cVATS group,with no significant difference statistically (P =0.133 ) . There were 52％ vs.62.9％ patients achieved symptomatic completely relief and significant improvement was obtained in 40.0％ vs.31.4％ patients in thoracotomy and cVATS group separately.Conclusion cVATS lobectomy is safe and effective in the management of bronchiectasis.

Objective To review the experience d EBUS-TBNA for staging of lung cancer and the value in diagnosing thoracic diseases in our single center.Methods The data of 343 patients who underwent EBUS-TBNA from September 2009 to August 2011 in our institution were retrospectively reviewed.There were 219 males and 124 females with an average age of (59.4 ± 13.6 ) years.Based on their primary indication,patyients were divided into three categories:group A:with known or strongly suspected lung cancer and enlarged mediastinal lymph nodes on chest radiographic examination ( short axis ≥ 1.0cm) ; group B:with enlarged mediastinal lymph nodes or mediastinal masses of unknown origin; and group C:with pulmonary parenchymal mass located close to the central airways.Results The average short axis diameter of the thoracic lesions was ( 1.94 ± 1.01 ) cm ( range from 0.5 to 8.0cm),and 2.66 punctures were performed per lesion.In group A ( n =208 ),151 patients were confirmed to have mediestinal lymph nodes metastasis while 51 showed negative results.Four patients were diagnosed as tuberculosis and two were confirmed to be stage Ⅱ sarcoidosis.37 in the 51 patients with negative EBUS-TBNA underwent thoracoscopic or thoracotomy for pulmonary resection and mediastinal lymph node dissection.Postoperative pathology confirmed that 32 patients did not have lymph nodes metastases.The diagnostic sensitivity,specificity,accuracy,positive predictive and negative predictive of EBUS-TBNA for the mediastiral staging of lung cancer were 96.8％ (151/156),100.0％ (32/32),97.3％ ( 183/188 ),100％ ( 151/151 ) and 86.5％ (32/37),respectively.In group B ( n =94),22 patients had malignancy and 72 had benign diseases.Thirteen patients received operative validation in the 23 cases which were diagnosed as proliferative lymph nodes by EBUS-TBNA,and by further operation two and three patients were confirmed as malignancy and other benign diseases respectively.The sensitivity,negative predictive value ( NPV ) and accuracy of EBUS-TBNA in distinguishing malignant mediastinal diseases was 88.0％ (22/25)、100％ (73/73) 、95.9％ (70/73)and 97.9％ (92/94),respectively.In group C( n =41 ),malignant diagnosis was achieved in 33 patients,while 4 patients confirmed as malignancy by further operations in the other 8 negative cases.The diagnostic sensitivity and accuracy of EBUS-TBNA for the diagnosis of unknown pulmonary parenchymal mass were 89.2％ (33/37) and 90.2％ (37/41),respectively.All the procedures were uneventful and no complication occurred.Conclusion EBUS-TBNA is a highly effective and safe procedure in the diagnosis of thoracic diseases and staging.of lung cancer.