Clinical significance of heat shock protein 90 expression in patients with lung adenocarcinoma / 中国医师杂志

Objective:To investigate the expression of heat shock protein 90 (HSP90) and the relationship between the expression of HSP90 and the clinicopathological features or prognosis in patients with lung adenocarcinoma (ADC).Methods:The paraffin specimens of 193 patients with lung adenocarcinoma and 53 non cancerous lung tissues (bullae and bronchiectasis) resected in Xiangya Second Hospital of Central South University were analyzed retrospectively. The expression of HSP90 in the tissue chip was detected by immunohistochemical streptavidin-perosidase (SP) method by high-throughput tissue chip, and the relationship between its expression level and the clinicopathological characteristics of patients was analyzed; Kaplan Meier survival curve was used to analyze the difference between different expression levels of HSP90 and the overall survival time of patients with lung adenocarcinoma.Results:The positive expression of HSP90 in lung adenocarcinoma was significantly higher than that in non cancerous lung tissue ( P<0.001), the expression level of HSP90 in clinical stage Ⅲ patients was higher than that in clinical stage Ⅰ-Ⅱ patients ( P=0.008), and the expression level of HSP90 in patients with lymph node metastasis was higher than that in patients without lymph node metastasis ( P=0.024); The 10-year survival rate of lung adenocarcinoma patients with high expression of HSP90 was significantly lower than that of patients with low expression of HSP90 ( P=0.001). The 10-year survival rate of lung ADC patients with stage Ⅲ and lymph node metastasis was significantly lower than that of patients with stage Ⅰ-Ⅱ and no lymph node metastasis ( P<0.05). Multiple Cox proportional hazard regression analysis further identified that lung ADC patients with overexpression of HSP90 had a poor prognosis ( P=0.010). Conclusions:HSP90 might play an important part in the development and progression of lung ADC and might act as a novel prognostic marker for patients with lung ADC.

Clinical significance of PD / 中南大学学报(医学版)

OBJECTIVES@#To explore the expression of programmed death ligand-1 (PD-L1) as well as the correlation between the expression and the clinicopathological features or prognosis in non-small cell lung cancer (NSCLC).@*METHODS@#The expression of PD-L1 protein in 254 cases of surgically resected lung adenocarcinoma (L-ADC), 228 cases of surgically resected lung squamous cell cancer (L-SCC), and 99 cases of non-cancerous control lung tissues was detected with immunohistochemical SP method. The correlation between the PD-L1 expression and clinicopathological features was analyzed. Kaplan-Meier univariate and Cox multivariate regression analyses were performed to assess the prognosis of patients with L-ADC and L-SCC, respectively.@*RESULTS@#Positive percentage of PD-L1 protein expression was higher in the tissues of L-ADC and L-SCC than that in the non-cancerous control lung tissues respectively (both @*CONCLUSIONS@#The positive percentage of PD-L1 protein expression is higher in the L-SCC patients than that in the L-ADC patients. Positive expression of PD-L1 protein can be served as an independent prognostic factor of poor prognosis in the patients with L-ADC.

Clinical characteristics of histoplamosis in 8 patients: case report and literature review / 中南大学学报(医学版)

To explore the clinical characteristics, imaging manifestation, diagnosis and treatment for histoplasmosis and to improve therapeutic level, we retrospectively analyzed the clinical data of 8 patients with biopsy-confirmed histoplasmosis from 2004 to 2014 in the Second Xiangya Hospital of Central South University and reviewed relevant literatures. The main clinical symptoms of histoplasmosis included fever, cough, expectoration, chest pain, blood-stained sputum, lymphadenectasis, etc. The major lung imaging features were mass, node or pneumonia-like performance. No case was diagnosed as histoplasimosis firstly. Four patients whose imaging manifestations were focal pulmonary lesion received lobectomy of lung lesions or wedge resection. Clinical and imaging manifestations in 3 patients, who treated with amphotericin B or its liposomal, itraconazole or fluconazole, were improved. The clinical symptoms and imaging findings of histoplasmosis are nonspecific. It is easy for the physicians to misdiagnose histoplasmosis as bacterial infection, lung cancer, tuberculosis lymphoma, etc. Therefore, it is significant and necessary to carry out multiple biopsies combined with multiple etiological examinations for patients with difficult diagnosis.

Diagnostic value of transbronchial lung biopsy in pulmonary alveolar proteinosis / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the diagnostic value and limits of transbronchial lung biopsy (TBLB) in pulmonary alveolar proteinosis (PAP).@*METHODS@#The complete hospital data from Second Xiangya Hospital, Central South University, between June, 2006 and December, 2012, were analyzed retrospectively in 25 patients with PAP (who were diagnosed pathologically by TBLB or not by TBLB) and in 4 patients with other disease (who were misdiagnosed by TBLB).@*RESULTS@#Among the 25 patients with PAP, 14 patients were confirmed by TBLB in the fi rst time [TBLB positive rate in the first time was 56% (14/25)]; 6 patients who were misdiagnosed by TBLB in the fi rst time were confirmed by TBLB in the second time [the positive rate in the second time was 24% (6/25)]. Th e total positive rate was 80% (20/25). Th e total negative rate was 20% (5/25). Five patients with PAP, who showed negative results in TBLB analysis, were confirmed by the typical CT as well as the whole lung lavage. In addition, 4 patients with other diseases were misdiagnosed as PAP by TBLB.@*CONCLUSION@#TBLB is a very good diagnosis method. But the negative results in the first time cannot exclude PAP. TBLB should be repeated if conditions allow. If clinical manifestation and CT results are typical, it can be used for diagnosis of PAP combined with the positive results from bronchoalveolar lavage fluid check. However, for non-typical cases, it needs TBLB pathological diagnosis.

Crazy paving pattern caused by pulmonary alveolar proteinosis: CT findings and the pathologic basis / 中南大学学报(医学版)

OBJECTIVE@#To explore CT findings and pathologic basis of crazy paving pattern caused by pulmonary alveolar proteinosis.@*METHODS@#Twenty-four patients who were diagnosed pathologically as pulmonary alveolar proteinosis by transbronchial lung biopsy and bronchoalveolar lavage fluid from June 2006 to May 2012 were included in this retrospective study. All patients underwent a 64-slice CT of the lungs.@*RESULTS@#CT findings: crazy paving pattern was observed on CT imaging of all 24 patients. In 23 patients, crazy paving pattern displayed strip-shaped opacities with smooth edges, and there was a clear boundary between the pathological and normal lung tissues. The reticular opacities were connected with peripheral blood vessels and the branches were formed, and their diameters decreased slightly. Microscopically, hemangiectasis were seen in 17 patients.@*CONCLUSION@#Crazy paving pattern caused by pulmonary alveolar proteinosis displayed clear edges, and smooth reticular opacities, most of which were due to hemangiectasis of interlobular, interacinar and interalveolar septa. These findings of CT are helpful for the specific diagnosis of pulmonary alveolar proteinosis.

p53 protein expression in HER2-negative breast invasive ductal carcinoma / 中南大学学报(医学版)

OBJECTIVE@#To determine the expression of p53 and its clinical significance in HER2-negative breast invasive ductal carcinoma (BIDC).@*METHODS@#The expression of p53, ER and PR in the HER2-negative BIDC was detected by immunohistochemistry and the results were analyzed by SPSS10.0 software packet, chi-square test, spearman's correlation analysis, Kaplan-Meier survival curves and Cox regression analysis.@*RESULTS@#The positive expression of p53 protein in BIDC with pathological grade III was significantly higher than that with grade I (P<0.05), but there was no significant correlation between the expression of p53 and age, clinical stage, or lymph node metastasis status in the BIDC. The positive expression of p53 protein in BIDC with ER-positive was significantly lower than that with ER-negative (P<0.01). The positive expression of p53 protein was significantly lower in BIDC with common expression of ER and PR than that with negative expression of ER or PR (P<0.05). The HER2-negative BIDC patients with p53-positive expression had a lower 5 year survival than those with p53-negative expression.@*CONCLUSION@#The positive expression of p53 protein might have significant prognostic value and is an independent prognostic marker in HER2 -negative BIDC.

Clinical significance of EGFR mutations in non-small cell lung cancer / 中国肿瘤临床

Objective:To investigate the mutations of the epidermal growth factor receptor (EGFR) gene and its clinical signifi-cance in non-small cell lung cancer (NSCLC). Methods:The EGFR gene mutations of exons 18 to 21 in NSCLC were detected by us-ing the ADx-ARMS? detection kit method. Results:The total mutation percentage in exons 18 to 21 of the EGFR gene was 45.8%(98/214) in NSCLC. These mutations predominantly occur in exons 19 and 21. EGFR gene mutation percentages were found in exons 18 (0.93%, 2/214), 19 (22.0%,47/214), 20 (2.3%, 5/214), and exon 21 (20.6%, 44/214) in the NSCLC. Two NSCLC cases were identified to have double EGFR gene mutations of exons 19 and 21. EGFR gene mutations were more frequently observed with adenocarcinoma histology (50.3%, 93/185) than with squamous cell carcinoma (17.2%, 5/29) (P=0.001). EGFR gene mutations occur more frequently in NSCLC cases in women than in men (P=0.002). EGFR gene mutations were significantly higher in NSCLC with lymphatic metastasis (66.7%) than in NSCLC without lymphatic metastasis (39.5%) (P0.05). Conclusion:NSCLC, especially lung adenocar-cinomas, has exhibits frequent EGFR gene mutations in China. EGFR gene mutations in exons 19 and 21, combined with the clinical pathological features of lung cancer, can serve as the molecular marker to evaluate the efficacy of EGFR TKI for NSCLC patients.

Autophagy and tumors / 国际肿瘤学杂志

Recent studies show that autophagy ont only plays an important role in maintaining homeostasis in cells,but also palys a double role in the tumorigenesis and development of cancer.Studying the molecular mechanisms of autophagy and the relationship between autophagy and cancer have great significance for cancer treatment and prevention.

Lung MRI at 3T：comparison of CT and MRI in initial evaluation of pulmonary alveolar proteinosis / 中南大学学报(医学版)

Objective:To explore whether the phospholipidoproteinaceous material deposit within the alveoli by a high-ifeld 3T MRI has signal characters and its application for diagnosing pulmonary alveolar proteinosis.Methods:A total of 11 patients with pulmonary alveolar proteinosis previously diagnosed by ifberoptic bronchoscope lung biopsy underwent 64-slice helical CT scans and 3T MRI scans, and the CT scans and the MRI scans were compared. Results:hTe phospholipidoproteinaceous material deposit within the alveoli presented longer or equal T1 relaxation time and longer T2 relaxation time, without characters of fatty or deposits of protein-like substance signals and enhancement. The distribution, form, number and size of the lesions at T2WI were almost the same as those at CT, the lesions were irregular in morphology, and there was a clear boundary between the lesions and the adjacent normal lung tissues. Dynamic contrast-enhanced MRI showed thickened pulmonary arteriolae and venulae in the lesions with more obviously thickened pulmonary venulae, which were in conformity with the pulmonary artery and venule enhancement. CT scan in 1 out of the 11 cases showed lesions in both lungs mainly consisted of stripe-shaped and reticular structures, and no obvious sign of pulmonary alveolar proteinosis residue was found. MRI scan detected alveolar proteinosis that failed to be shown by CT scan. Conclusion:3T MRI T2WI can easily detect the lesions of long T2 signals formed by the lipoproteinaceous material deposit within the alveoli. In the lesions, geographic appearance was presented, and the crazy paving pattern was dimly visualized. MRI can relfect the morphological characters of PAP like CT and it is slightly better compared with CT in such aspects as evaluating the theraputic effect of lung lavage. As supplement to CT, high-field 3T MRI can serve as an important examination for lung diseases.

Role of Wnt5a and LMP1 in the nasopharyngeal carcinogenesis by high-throughput tissue microarray technology / 中南大学学报(医学版)

OBJECTIVE@#To investigate the molecular mechanism of Wnt5a and Epstein-Barr virus latent membrane protein 1 (LMP1) aberrant expression in the nasopharyngeal carcinogenesis and to estimate if it can act as a molecular marker for nasopharyngeal cancer (NPC).@*METHODS@#Immunohistochemistry combined with previously made tissue microarrays were used to study the expression of Wnt5a and LMP1 in the nasopharyngeal carcinogenesis tissues. We investigated the role of over expression of Wnt5a and LMP1 in the development and progression of NPC and their relation with the clinicopathological features of NPC and whether they could act as molecular markers in benign and malignant NPC.@*RESULTS@#The positive percentage of Wnt5a and LMP1 protein expression in the NPC was significantly increased as compared with that in atypically hyperplastic nasopharyngeal epithelium, hyperplastic nasopharyngeal epithelium and histologically normal nasopharyngeal epithelium (P<0.05, P<0.01, and P<0.01). Wnt5a and LMP1 proteins were significantly higher in atypically hyperplastic nasopharyngeal epithelium than those in the hyperplastic nasopharyngeal epithelium and normal nasopharyngeal epithelium (P<0.05 and P<0.01). The positive expression of Wnt5a and LMP1 proteins in clinical T3 and T4 staged NPC was higher than that in clinical T1 and T2 staged NPC (P<0.01 and P<0.05). The positive expression of Wnt5a protein in the NPC with lymph node metastasis was higher than that in the NPC without lymph node metastasis (P<0.01). The positive percentage of LMP1 protein was significantly increased in non-keratinizing carcinoma compared with undifferentiated carcinoma and keratinizing carcinoma (P<0.05 and P<0.05). The expression of Wnt5a protein in the NPC had significant positive correlation with LMP1 (r=0.354, P<0.001). Combined molecular phenotype of both Wnt5a and LMP1 expression was a good marker to distinguish NPC from non-cancerous nasopharyngeal epithelium.@*CONCLUSION@#The expression of Wnt5a and LMP1 protein in the NPC is positively correlated, and both wnt5a and LMP1 protein play important roles in the nasopharyngeal carcinogenesis either together or successively promoting the malignant transformation of nasopharyngeal epithelium and the development and progression of NPC. Both Wnt5a and LMP1 positive expression may act as good markers for NPC differential diagnosis.

Characteristic CT findings and pathologic basis of ground glass opacity caused by pulmonary alveolar proteinosis / 中南大学学报(医学版)

OBJECTIVE@#To explore characteristic CT findings and pathologic basis of ground glass opacity caused by pulmonary alveolar proteinosis (PAP).@*METHODS@#Retrospective analysis of CT and pathological findings of 24 patients with PAP who were pathologically diagnosed from June 2006 to August 2011.@*RESULTS@#Findings with CT: the lesions of the 24 patients mainly presented ground glass opacities. Local consolidations were seen in 8 patients. In 23 patients part of ground glass opacities bordered strip-shaped opacities with smooth edges, and there was a clear boundary between them and the bordering normal lung tissues, presenting a geographic appearance. Lesions in the 5 cases were mixed with alveoli or lobule aerocele, which made ground glass opacities present curved edges. Crazy paving pattern was detected in the 24 patients. Microscopically, the alveoli were seen to be filled with floccules proteinaceous material in various quantities in the 24 patients; hemangiectasis and congestion were seen in 17 patients, and enlarged alveolar cavities were seen in 5 patients.@*CONCLUSION@#PAP usually causes ground glass opacities with clear edges, and different from ground glass opacities with obscure edges caused by other pulmonary diseases. They are relatively specific to the imagining diagnosis to PAP.

Advance of the targeted anti-tumor drugs with small molecule compounds / 国际肿瘤学杂志

Small molecule compounds have distinct effects in the targeted anti-tumor field,which can kill tumor cells efficiently and selectively,reduce normal tissue damage,and especially can overcome the poor specificity and serious adverse reaction of the traditional chemotherapy drugs.So small m,olecule compounds play an important role in recent clinical therapy.

Transcriptomic regulation and molecular mechanism of polygenic tumor at different stages / 中南大学学报(医学版)

The research team on the National Key Scientific Program of China: "Transcriptomic regulation and molecular mechanism research of polygenic tumor at different stages" has focused on the field of transcriptomics of 4 common polygenic tumors, including nasopharyngeal carcinoma(NPC), breast cancer, colorectal cancer, and glioma. Extensive laboratory work has been carried out on the expression and regulation of tumor transcriptomics; identification of tumor suppressor/susceptible genes; mechanism of tumor epigenetics including miRNAs, and comparative study of specific gene/protein cluster of tumor transcriptomics and proteomics. Genes including SPLUNC1, LTF, BRD7, NOR1, BRCA1/2, PALB2, AF1Q, SOX17, NGX6, SOX7, and LRRC4 have been identified as the key transcriptional regulation genes during the stage of tumor initiation and invasion. Accordingly,the NPC gene signal regulation network of "SPLUNC1-miR-141-target genes", the breast cancer interaction signal pathway of "miR-193b-uPA",the glioma signal network of "miR-381- LRRC4-MEK/ERK/AKT", and the miRNA-target gene network of colorectal cancer metastasis related gene NGX6 have been thoroughly elucidated. These fruitful Results imply that the changes of key molecules in crucial signal pathway will cause severe dysfunction in signal transduction and gene regulation network in polygenic tumors, indicating that in the category of pathogenesis,these tumors may further classify as the "Disease of gene signal transduction and gene regulation network disorder". The researches have laid solid foundation for revealing the molecular mechanism and transcriptomic regulation of polygenic tumors at different stages.

Study of expression of RASSF1A and Survivin genes in non-small cell lung cancer by tissue microarray / 肿瘤研究与临床

Objective To investigate the association between the expression of RASSF1A and Survivin proteins and clinicopathological characteristics in non-small cell lung cancer (NSCLC) and their clinical significance. Methods Expression of RASSF1A and Survivin proteins in the NSCLC tissue microarrays was detected by S-P Immunohistochemistry. Results The positive expression of RASSF1A in NSCLC (46.8 %) was significantly lower than that of in the normal lung tissues (92.9 %) (P < 0.001), but the positive expression of Survivin in NSCLC (78.5 %) was significantly higher than that of in the normal lung tissues (0%) (P<0.001). The percentage of RASSFI A protein expression in the stage Ⅰ and stage Ⅱ of NSCLC was evidently higher than that of in the stage Ⅲ (P<0.001, respectively), however, the percentage of Survivin protein expression in the stage Ⅰ and stage Ⅱ of NSCLC was significantly lower than that of in the stage Ⅲ (P=0.003, P=0.001). The percentage of RASSF1A in NSCLC with lymph node metastasis was observably lower than that of in cases without lymph node metastasis (P<0.05). Furthermore, there was observably negative correlation between expression of RASSF1A protein and that of Survivin protein in NSCLC (r=-0.780, P<0.001). Conclusion The loss expression of RASSF1A protein, over expression of Survivin protein and loss balance of expression of both RASSF1A and Survivin proteins in NSCLC might play important roles in the development and progression of NSCLC; RASSF1A and Survivin proteins might be acted as one helpful molecular marker to predict the lymph node metastasis and the prognosis of NSCLC.

Diagnosis and management of lipogranuloma of the eyelids from nasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To enhance the safety of nasal endoscopic surgery and decrease its complications of eyes.@*METHOD@#Three patients of chronic rhinosinusitis and nasal polyposis with lipogranulomas of the eyelids after nasal endoscopic surgery and nasal packing of petrolatum gauze were reported and analyzed, and their treatment results were presented during the last 2 years.@*RESULT@#The medial orbital wall injury occurred in all three patients during endoscopic sinus surgery. The patients developed an ipsilateral periocular swelling, eyelid hematoma and palpebral conjunctival edema during 2 to 3 hours after surgery. Nasal packs petrolatum gauze were removed 10-24 hours after surgery. The patients were discharged from hospital when periorbital swelling and eyelid ecchymoma disappeared, and nasal cavity obstruction was improved 6 to 8 days after surgery. The swelling and nodular mass of ipsilateral eyelids (one in left upper eyelid and two in right lower eyelid) were found 12-15 days after surgery, and their eye movement and eyesight were normal. Antibiotic and corticosteroid were administered for 3 4 weeks with only improvement in eyelid swelling. These masses of eyelids were completely excised through palpebral margin 1-6 months after surgery. The histopathological examination of the surgical specimens showed lipogranuloma. No recurrence and symptom of the eyes had been observed during 4-18 months follow up.@*CONCLUSION@#The lipogranuloma of the eyelid is a rare and late complication after nasal endoscopic surgery and nasal packing with vaspetrolatum gauze. The medial orbital wall injury and bleeding during surgery, and vaseline of nasal packing permeated into the eyelid are the direct causes of this complication. The application of petrolatum gauze should be avoided when the medial orbital wall trauma is identified. The complete excision of granulomas is a best effective therapy.

The expressions of hormone receptors and oncogene in the patients with breast cancer and their clinical significance / 中国医师杂志

Objective To investigate the relationships between the expressions of estrogen receptor(ER),progesterone receptor(PR),carcinoembryonic antigen(CEA),c-erbB-2,and clinicopathologic parameters of the breast cancer and to evaluate their value in predicting the prognosis of breast cancer.Methods The databank of clinical data and expressions of ER,PR,CEA and c-erbB-2 proteins in 791 cases of breast cancer were established and the results were analyzed by using chi-square test,Kaplan-Meier(SPSS10.0).Results The positive expression rates of ER,PR,CEA and c-erbB-2 were 64.6%,66.5%,45.5% and 66.2% in the 791 breast cancers,respectively.The positive rate of ER expression in the infiltrating lobular carcinomas was significantly higher than that of the infitrating ductal carcinomas of breast(P

Comparison of anti-inflammatory effects between methotrexate and Yangqixue Qufengshi Recipe on mice arthritis induced by collagen II / 中国医师杂志

Objective To compare the anti-inflammatory effects between methotrexate(MTX) and Yangqixue Qufengshi Recipe(YQXQFSR) on mice arthritis induced by collagen II.Methods The model of rheumatoid arthritis was induced by using collagen II in C_(57)BL/6?DBA/1 mice.The rats with arthritis were treated with MTX or YQXQFSR respectively.The indexes such as the onset day of collagen induced arthritis(CIA),the level of CII-reactive antibodies and the pathological scores of CIA were assessed.Results The onset day of CIA and the level of CII-reactive antibodies were not influenced in the treatment of mice arthritis with MTX and YQXQFSR respectively.But MTX could alleviate the damage of cartilage [(1.60?1.51) vs(3.56?1.33) scores,P

Blood supply and clinical significance of extra hepatic duct / 中华器官移植杂志

Objective To observe the blood supply of the extra hepatic duct and prevent the ischemia of extra hepatic duct after liver transplantation. Methods Microdissection for the main arteries of extra hepatic duct in 15 samples was performed. Results The main arteries supplying extra hepatic duct included cystic artery’s branches and posterior superior pancreaticoduodenal artery’s branches. There were 1~3 cystic artery’s branches and 3~5 posterior superior pancreaticoduodenal artery’s branches to supply extra hepatic duct. Conclusion The posterior superior pancreaticoduodenal artery is one of the main arteries supplying extra hepatic duct. In orthotopic liver transplantation, this artery is considered to preserve.