Video-assisted thoracic surgery lobectomy versus open lobectomy for mini pathologic N2 non-small cell lung cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To assess early and late outcomes of patients with minimal mediastinal lymph nodes metastasis N2 non-small cell lung cancer disease unexpectedly detected during the operation, who underwent video-assisted thoracic surgery lobectomy for clinical stage I.</p><p><b>METHODS</b>This study retrospectively reviewed and analyzed the medical records of 263 patients underwent surgery between January 2004 and December 2007, who were diagnosed as having early-stage non-small cell lung cancer (clinical stage was cT1-2N0M0, stage I) before the surgery, but were found to have mini mediastinal lymph nodes metastasis disease (clinical stage was pT1-2N2M0, stage IIIa) unexpectedly detected during the operation and after the operation. All patients underwent lobectomy and systematic lymph nodes dissection as radical treatments. Among them, 63 patients underwent video-assisted thoracic surgery (VATS) lobectomy, including 37 male patients (58.7%) with a mean age of (58 ± 11) years old. Two hundred patients underwent open thoracotomy lobectomy, including 132 male patients (66%) with a mean age of (59 ± 11) years old. To compare and analyze clinical features, early and late outcomes of patients in these two groups.</p><p><b>RESULTS</b>A total of 263 patients with an average survival time (34.9 ± 1.2) months (median 31 months), 63 cases in VATS lobectomy group with an average survival time (40.3 ± 2.2) months (median 37 months), 200 cases in open pulmonary lobectomy group with an average survival time (33.1 ± 1.3) months (median 29 months). The 1-, 2-, 3-year over survival rate of all the patients was 92.0%, 57.4%, 29.3%. The 1-, 2-, 3-year survival rate of patients in VATS lobectomy group was 92.1%, 82.5%, 41.3%. The 1, 2, 3 year survival rate of patients in thoracotomy lobectomy group was 92.0%, 49.5%, 25.5%. There was significant difference between the two groups in this factor (χ(2) = 5.58, P = 0.018).</p><p><b>CONCLUSIONS</b>VATS lobectomy is feasibility and safety for unexpected mini N2 disease. Even if lymph node metastasis is unexpectedly detected during video-assisted thoracic surgery lobectomy for clinical stage I disease after rigorous evaluation of preoperative, it is no need to convert to conventional thoracotomy.</p>

Epithelial-mesenchymal transition (EMT) and its effect on microRNA expression in lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the effect of epithelial-mesenchymal transition (EMT) on the expression of microRNAs (miRNAs) in lung cancer A549 cells.</p><p><b>METHODS</b>Transforming growth factor beta-1 (TGF-beta 1) in different concentrations was used to induce EMT in lung cancer A549 cells. The morphological changes were observed under phase-contrast microscope. The changes of EMT-related proteins were analyzed by Western blot. The changes of miRNAs expression after EMT were detected by microRNA (miRNA) array. Real time quantitative RT-PCR was applied to verify the reliability of miRNA array results.</p><p><b>RESULTS</b>The lung cancer A549 cells became elongated and the cell-cell junction became loose after EMT. The epithelial protein marker E-cadherin was down-regulated and the mesenchymal protein markers vimentin and fibronectin up-regulated. There were 51 miRNAs showing statistically significant changes of expression more than double (P<0.05) after EMT. Among them 18 were up-regulated and 33 down-regulated. Of them, mir-33a was down-regulated by 92.8% and mir-193a-3p by 86.5%. Real time quantitative RT-PCR showed that mir-33a was down-regulated by 73.1% and mir-193a-3p by 56.6%.</p><p><b>CONCLUSION</b>Epithelial-mesenchymal transition has effects on the expression of miRNAs, and miRNAs may regulate the invasion and metastasis of lung cancer cells via EMT.</p>

Forensic medicine identification of manual strangulation: an analysis of 21 cases / 法医学杂志

OBJECTIVE@#To analyze and summarize the rule of manual strangulation, as well as to look for the key points of injury identification, in order to provide information for formulating and revising the identification regulations.@*METHODS@#Twenty-one cases of manual strangulation from 1963 to 2004 in Xiangfan were reviewed and analyzed according to the characters, symptoms and appraisements.@*RESULTS@#The majority of assaulters in manual strangulation was young adult male and often could find the counteracted wounds on them. The throttling mark reaction usually could be found in victims and the cardinal symptoms were contusion in throat and asphyxiation in ocular region.@*CONCLUSION@#The degree of injuries is mainly moderate and slight. There is some inadaptability in the current regulations.