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Objective:To explore the treatments and outcomes of heart and kidney transplantation(HKTx)and summarize its management experiences.Methods:From October 2016 to October 2020, clinical data, treatment strategies and prognosis of 11 patients received HKTx were analyzed retrospectively.In 11HKTx cases, the ratio of male-to-female was 10∶1, the age(50.6±12.9)years and the preoperative body mass index(26.72±3.29)kg/m 2.The preoperative cardiac function was class Ⅳ and the preoperative left ventricular ejection fraction(29.40±4.48)%.All patients were in uremic state pre-operation and underwent regular dialysis.The mean duration of dialysis was 2.5(0.5-7.0)years, preoperative creatinine 753.5(434-1144)μmol/L and preoperative predictive glomerular filtration rate 5.59(3.93-17.23)ml/(min preop 2). Non-staged transplant was performed and donor heart and kidney were from the same donor.The median time of cold cardiac ischemia 2.75(2.5, 4.0)hours, the median time of cold renal ischemia 9(8.5, 15.0)hours and the median time from the end of heart transplantation to the beginning of kidney transplantation 2(1.0, 3.5)hours.The immunosuppressive regimen was a combination of tacrolimus, mycophenolate mofetil and methylprednisolone. Results:Normal cardiac function and renal function normalized in 9 cases.At Month 6 post-operation, the postoperative left ventricular ejection fraction was(57.55±2.51)%, creatinine 107.7(85-132)μmol/L and urine volume in 24h 1988(1800-2200)ml.The long-term survival time was 6-62 months.No such complications as infection or rejection occurred in 9 patients.The cardiac function was class Ⅰ at Month 6 post-operation.One patient died from pulmonary mucor infection at Month 4 post-operation.Another death was due to gastrointestinal fungal infection at Month 1 after HKTx.Conclusions:HKTx is an effective treatment for end-stage heart disease with renal failure.
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Objective To summarize the outcomes and clinical experience of combined heart and kidney transplantation.Methods The clinical data of one case of combined heart and kidney transplantation were retrospectively analyzed.The kidney transplant was completed immediately after the heart transplant.The immunosuppressive therapy strategies included tacrolimus,corticosteroids and mycophenolate mofetil.Results For heart transplantation,heart cold ischemia time was 200 min,aorta blocking time was 136 min,and extracorporeal circulation time was 201 min.The kidney was transplanted to the right iliac fossa after heart transplantation.The endotracheal tube was removed 15 h after surgery.The patient was transferred to the general ward on the 8th day after surgery.The patient was discharged from the hospital at 27th day after surgery,the renal function was normal and no activity was restricted.Conclusion Reasonable perioperative management and selection of surgical methods are the keys to the success of combined heart and kidney transplantation.
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Objective To investigate the clinical effect of caffeic acid tablets on hypocytosis induced by radiotherapy in patients with lung cancer. Methods From January 2017 to October 2015,one hundred and twenty patients with lung cancer treated by radiotherapy in No. 88 Hospital of PLA were selected and randomly divided into the observation group and the control group,60 cases in each group. Patients in the observation group were treated by oral caffeic acid tablets 0. 3 g/time,3 times/d until the end of radiotherapy. The control group was treated with radiotherapy alone and did not take any blood raising drugs. When myelosuppression appeared, recombinant human granulocyte colony-stimulating factor Injection or recombinant human interleukin 11 was given till it turned to normal blood. The incidence rate of bone marrow suppression,number of white blood cells (WBC),platelet (PLT) and the efficacy of radiotherapy were observed. Results The incidence rate of bone marrow suppression of the observation group was 16. 67％( 10/60) ,which was significantly lower than that of the control group ( 63. 33％( 38/60 ) ) . The difference was statistically significant (χ2 = 27. 22, P<0. 05 ); the incidence of bone marrow inhibition in the observation group was 0,while the control group was 15. 00％ (9/60) ,and the difference was statistically significant (χ2=9. 73,P<0. 05) . The number of white blood cells and platelets decreased significantly in the two groups after radiotherapy. The number of leukocytes and platelets in the observation group at 1,2,3 and 4 weeks after radiotherapy were significantly higher than those in the control group,the difference was statistically significant (P<0. 05). The effective rate of radiotherapy was 70. 00％ (42/60) in the observation group and 66. 67％ (40/60) in the control group,with no significant difference (χ2=0. 15,P>0. 05) . Conclusion Caffeic acid tablet is effective in preventing leukocyte and thrombocytopenia caused by bone marrow suppression in patients with lung cancer after radiotherapy.
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The incidence of dextrocardia is lower. The dextrocardia is often associated with congenital anatomical abnormalities. The patient with normal cardiac structure of dextrocardia and severe coronary heart disease that needs coronary artery bypasss is rarer. This article summarizes the perioperative management and surgical experience of dextrocardia with bypass surgery via a clinical case.
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Objective To summarize the experience of surgical treatment in patients with uremia and severe coronary artery disease, and reduce the perioperative risk thereof. Methods Sixteen chronic renal failure patients who were received haemodialysis and underwent coronary artery bypass grafting (CABG) during the period of February 2009 to December 2016 in Tianjin First Central Hospital were assessed in this retrospective study. Of the 16 patients, 8 patients and 6 patients were treated with off pump and on pump CABG respectively, one patient was treated with CABG and resection of ventricular aneurysm, and one patient was treated with CABG and tricuspid valve replacements. The renal function changes in preoperative and postoperative periods, 2-day and 1-week after surgery were observed. Echocardiography was used to evaluate cardiac function. The improvement of angina was recorded. Results Fourteen patients were successfully withdrawn from ventilator therapy within 24 h after surgery. The tracheal intubation was removed 65-hour after surgery in one patient. One patient died of multiple organ failure on the seventh day after surgery. The average length of ICU staying and in-hospital stay were (125.5 ± 21.6) h and (28.6 ± 7.4) days respectively. The serum creatinine (sCr) and blood urea nitrogen (BUN) were higher in two days after surgery than those before the operation (P 0.40, and no angina occurred. Conclusion CABG is relatively safe for patients with end-stage renal disease and severe coronary artery disease. CABG can significantly eliminate angina symptoms with satisfactory clinical effect.
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Objective To investigate the risk factors of postoperative atrial fibrillation (POAF) in patients with on-pump coronary artery bypass grafting (ONCAB). Methods The clinical data of 200 patients with ONCAB were retrospectively analyzed. The patients were divided into POAF group (n=52) and non POAF group (n=148) according to the occurrence of POAF after operation. The perioperative data including age and gender of all patients were collected and analyzed. The index of opinion of statistical results was classified by two categories Logistic regression analysis, and the related risk factors of POAF were analyzed. The receiver operating characteristic (ROC) curves of the age, red blood cell (RBC), left atrial diameter (LAD) and left ventricular ejection fraction (LVEF) were analyzed in two groups. Results The incidence rate of POAF was 26%, mostly occurred in the postoperative period from 1 d to 3 d. Compared with non POAF group, the age, the proportion of patients with age≥62.5 years or older, the proportion of patients with LAD≥35 mm, left ventricular end-diastolic diameter and perioperative transfusion of RBC were increased in POAF group, and data of mechanical ventilation time, ICU stay time and hospitalization time were prolonged, but the LVEF level decrease ( P<0.05). Among them, the elderly (≥62.5 years), increased LAD (≥35 mm), the higher perioperative transmission amount of RBC were the independent risk factors of POAF after ONCAB, and the higher LVEF was a protective factor for ONCAB. The optimal thresholds for age, RBC, LAD and LVEF were 62.5 years, 1U, 35.5 mm, and 0.34. Conclusion The occurrence of POAF after ONCAB is related with age (≥62.5 years old),LAD≥35 mm and perioperative transfusion of RBC, which can be used as clinically to predict the occurrence of POAF.
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<p><b>OBJECTIVE</b>To investigate the safety, feasibility, clinical value, indication, and distribution of diagnostic diseases in different age groups of colonoscopy in pediatric patients.</p><p><b>METHODS</b>A retrospective analysis was performed on the data of pediatric patients receiving colonoscopy from April 2013 to June 2016 at The Sixth Affiliated Hospital of Sun Yat-sen University. Pediatric patients were divided into 0-6 years group (n=57) and 7-14 years group (n=172). Indication for colonoscopy, detective events and diagnostic diseases distribution were compared between two groups.</p><p><b>RESULTS</b>A total of 229 pediatric patients (male 157 and female 72) were divided into 0-6 years group (57/229, 24.9%) and 7-14 years group(172/229, 75.1%). The main Indications for colonoscopy included abdominal pain (81/229, 35.4%), hematochezia (64/229, 27.9%), crissum abscess or fistula (40/229, 17.5%). Hematochezia was the most common complaint in 0-6 years group (40/57, 70.2%), while abdominal pain in 7-14 years group (74/172, 43.0%). Completion rate between 0-6 years group and 7-14 years group was not significantly different (87.72% vs. 85.47%, χ=0.181, P=0.671). Only one pediatric patient (1/229, 0.4%) developed transient oxygen desaturation and recovered quickly after oxygen supply and aspiration of sputum. No serious complications such as bleeding, perforation or death occurred. Including 45 pediatric patients in 0-6 years group and 102 pediatric patients in 7-14 years group, a total of 147 pediatric patients (147/229, 64.2%) were found to have colorectal lesions. Inflammatory bowel disease (57/147, 38.8%), colonic polyps (40/147, 27.2%) and other intestinal inflammation (39/147, 26.5%) were the main findings. The most frequent diagnosis in 0-6 years group was colonic polyps (28/57, 49.1%), among them, 25 pediatric patients (25/28, 89.3%) were with the complaint of hematochezia. The most frequent diagnosis in 7-14 years group was Inflammatory bowel disease (54/172, 31.4%), among them, 29 pediatric patients (29/54, 53.7%) were with the complaint of abdominal pain.</p><p><b>CONCLUSIONS</b>Pediatric colonoscopy is safe and effective. Hematochezia and abdominal pain are the most common complaints in 0-6 years group and 7-14 years group respectively. Colonic polyps and inflammatory bowel disease are the most frequent diagnosis in 0-6 years group and 7-14 years group respectively.</p>
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Objective To summarize the treatment experiences in patients with cardiac surgery-associated acute kidney injury (CSA-AKI). Methods The clinical data of 9 patients with acute renal injury after orthotopic heart transplantation in our hospital from January 2009 to July 2016 were retrospectively analyzed. Three patients were required the high-dose diuretics (furosemide, >80 mg/d) and six patients were received continuous renal replacement therapy (CRRT). The levels of serum creatinine (Cr) and estimated glomerular filtration rate (eGFR) were compared before and after heart transplantation and after the treatment of AKI. The quality of life was observed in patients in perioperative period. Results After the treatment of diuretics or CRRT, patients showed renal function recovery with significant decreased Cr levels and increased eGFR compared with the postoperation. The patients with diuretic therapy revealed a better eGFR recovery than those with CRRT. Conclusion CSA-AKI should be based on the severity of disease, and comprehensive treatment should be taken to reduce renal damage.
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<p><b>OBJECTIVE</b>To observe the impacts on post-stroke unilateral spatial neglect treated with acupuncture for "regaining consciousness, benefiting marrow and opening orifices" and rehabilitation.</p><p><b>METHODS</b>Forty patients of post-stroke unilateral spatial neglect were randomized into an observation group and a control group, 20 cases in each one. In the observation group, acupuncture was applied to the acupoints for "regaining consciousness, benefiting marrow and opening orifices", named Baihui (GV 20), Sishencong (EX-HN 1), Benshen (GB 13), Shenting (GV 24), and the bilateral-primary points and-connecting points of the heart meridian, pericardium meridian and kidney meridian, as well as the acupoints along the affected meridians. Additionally, the rehabilitation was provided. In the control group, acupuncture at the acupoints along the affected meridians and rehabilitation were adopted. The treatment was given once a day, 5 times a week. After 8 weeks of treatment the evaluation was made. the indexes of unilateral spatial neglect such as line bisection test, the score of the mini-mental state examination (MMSE), the score of simple Fugl-Meyer motor function assessment and the modified Barthel indexes were adopted for the assessment of the severity of unilateral spatial neglect, cognitive function, motor function, and the activities of daily living.</p><p><b>RESULTS</b>After treatment, the indexes of unilateral spatial neglect (line bisection test, line cancellation test, clock-drawing test and copying drawing test), MMSE score, the simple Fugl-Meyer motor function assessment and modified Barthel indexes were all improved as compared with those before treatment in the two groups (all<0.01). The improvements in the observation group were more obvious than those in the control group (<0.05,<0.01).</p><p><b>CONCLUSION</b>The combination of acupuncture treatment for "regaining consciousness, benefiting marrow and opening orifices" and rehabilitation much more effectively alleviates the severity of post-stroke unilateral spatial neglect and improves the motor function and the activities of daily living in the patients.</p>
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@#Objective To probe the therapeutic effect of ginger-salt-partitioned moxibustion on urge incontinence after stroke. Methods 40 stroke patients following urge incontinence were randomly divided into control group (n=20) and experimental group (n=20). 2 groups all received the same treatment, routine acupuncture and rehabilitation. Additionally, the experimental group received ginger-salt-partitioned moxibustion at Shenque (CV8). The curative effect was compared after treatment (4 weeks). Results 36 cases finished the treatment, 17 in the control group and 19 in the experimental group. Total number of urination, urinary incontinence and nocturia reduced, and the average volume of each urine increased (P<0.05), and volume of bladder residual urine reduced in 2 groups after treatment (P<0.001), while the experimental group was better than the control group (P<0.05). The scores of modified Barthel Index increased in 2 groups after treatment, but there was no significant difference between 2 groups (P>0.05). Conclusion The effect of ginger-salt-partitioned moxibustion at Shenque on poststroke following urination disorders is remarkable.
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Objective To probe the therapeutic effect of ginger-salt-partitioned moxibustion on urge incontinence after stroke. Methods 40 stroke patients following urge incontinence were randomly divided into control group (n=20) and experimental group (n=20). 2 groups all received the same treatment, routine acupuncture and rehabilitation. Additionally, the experimental group received ginger-salt-partitioned moxibustion at Shenque (CV8). The curative effect was compared after treatment (4 weeks). Results 36 cases finished the treatment, 17 in the control group and 19 in the experimental group. Total number of urination, urinary incontinence and nocturia reduced, and the average volume of each urine increased (P0.05). Conclusion The effect of ginger-salt-partitioned moxibustion at Shenque on poststroke following urination disorders is remarkable.
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Objective:To study the correlation among lipoprotein (a) [Lp (a)] ,its gene polymorphism and degenera‐tive calcific aortic valve disease (DCAVD) .Methods :From Feb 2010 to Jan 2014 ,a total of 164 DCAVD cases trea‐ted in our hospital were enrolled as DCAVD group ,another 164 healthy subjects undergoing physical examination in the same period were selected as normal control group .Relationship among Lp (a) level ,its gene polymorphism and aortic valvular calcification was compared and analyzed ,and Logistic regression analysis was used to analyze in‐dependent risk factors of DCAVD . Results :Lp (a ) gene possesses four point mutations in population , namely rs10455872 ,rs6415084 ,rs3798221 and rs7770628. In DCAVD group ,Lp (a) level of AG genotype was significantly higher than that of AA genotype [ (325.5 ± 108.2) mg/L vs .(211.7 ± 135.4) mg/L] in rs10455872 gene pheno‐type ,Lp (a) level of CC+TT genotype was significantly higher than that of CT genotype [ (287.9 ± 144.1) mg/L vs .(240.7 ± 127.2) mg/L] in rs6415084 gene phenotype ,and Lp (a) level of TT+ CC genotype was significantly higher than that of CT genotype [(304.1 ± 124.1) mg/L vs .(226.8 ± 101.6) mg/L] in rs7770628 gene phenotype , P<0.05 or <0.01 ;patient′s percentage of valvular calcification of AG genotype was significantly higher than that of AA genotype (90.0% vs .61.7% ) in rs10455872 , patients percentage of valvular calcification of CC +TT geno‐type was significantly higher than that of CT genotype (83.8% vs .66.7% ) in rs6415084 ,and patient′s percentage of valvular calcification of TT+CC genotype was significantly higher than that of CT genotype (87.3% vs .63.4% ) in rs7770628 , P<0.05 or <0.01. Logistic regression analysis indicated that rs10455872 ,rs6415084 ,rs7770628 and Lp (a) level were independent risk factors for valvular calcification of DCAVD (OR=1.67~2.31 , P<0.01 all) . Conclusion :Lp (a) gene polymorphism (rs10455872 ,rs6415084 and rs7770628) and plasma Lp (a) level are signifi‐cantly correlated to valvular calcification of DCAVD ,which may be susceptible genes for DCAVD occurrence .
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Objective To study the application of coronary endarterectomy (CE) in coronary artery bypass graft (CABG), and to evaluate the effect of CE plus CABG on patients with chronic total occlusion (CTO) combined with diffuse distal atherosclerosis. Methods Thirty one patients, who underwent coronary endarterectomy in our institution between Oc-tober 2009 and October 2012, were reviewed retrospectively and compared the control group with 31 patients of their age, sex, LV function, and angina class. Results Among the 31 patients, 27 patients underwent one, 4 patient underwent two coronary arteries endarterectomized. Of all these 35 total endarterectomies, 13 (37%) were at left anterior descending artery, 3(9%) were at branches of the circumflex artery, and 19 (54%) involved the right coronary artery. There was no statistical dif-ference between two groups in clinical parameters including aorta cross time, cardiopulmonary bypass time, graft runoff, pul-sation index and mechanism ventilate time (P>0.05). There was no perioperative myocardial infarctions in CE group nor in control group. All patients were followed up and no recurrent angina were present in CE group. In CE group, one patient died of fungal pneumonia and heart failure half a year after operation. Conclusion In current cardiac surgical practice, coronary endarterectomy is an indispensable adjunct to CABG. The operative mortality and major morbidity were comparable or simi-lar to coronary artery bypass grafting, but its short-term and medium-term results were more favorable than to CABG.
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@#Objective To study the effects of body weight support treadmill training (BWSTT) or Du channel electroacupuncture (DcEA) on locomotion function and expressions of nerve growth factor (NGF) and growth-associated protein-43 (GAP-43) in rats with spinal cord transection. Methods 54 adult SD rats were divided into control group (n=18), BWSTT group (n=18) and DcEA group (n=18). Each group was divided into 3 subgroups (n=6) for 8 d, 15 d and 30 d respectively. Spinal cord transection was performed at T10 level. The locomotion function was assessed with Bosso-Beattie-Bresnahan locomotor rating scale for open field (BBB scale) and the expressions of NGF and GAP-43 in spinal cord tissues to the injury caudal ends were measured with immunohistochemistry. Results The scores of BBB scales and expressions of NGF and GAP-43 were higher in BWSTT group and DcEA group than those in the control group on the 8th d,15th d and 30th d respectively (P<0.01); and were higher in DcEA group than in BWSTT group on the 15th d and 30th d respectively (P<0.01). Conclusion Both BWSTT and DcEA can improve the locomotion function in rats with spinal cord transection and increase expressions of NGF and GAP-43 in spinal cord tissues, and DcEA is more effective.
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Clinical features and related information on diagnosis and treatment of 45 cases of Castleman's disease (CD) were retrospectively analyzed.Based on the clinical classification, localized CD (LCD) was found in 26 cases, multicentric CD (MCD) was found in 19 cases.Most cases of LCD presented the symptoms of compression, while MCD had complicated and non-specific clinical manifestations, making the early diagnosis more difficult.All 26 cases with LCD underwent surgery, among which only 2 cases relapsed.Sixteen out of 19 patients with MCD were treated with glucocorticoids or combined chemotherapy, and 14 cases achieved complete or partial remission.The results show that patients with CD have variant manifestation and the diagnosis depend on CT scan or histopathology examination.Most LCD can be cured by complete surgical resection, and MCD can achieve remission by the treatment with glucocorticoids or combined chemotherapy.
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<p><b>BACKGROUND</b>Tobacco-specific 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) is the most important carcinogen in cigarette. Models induced by NNK are widely used in investigations about the mechanisms of pulmonary neoplasia and chemoprevention studies. The aim of this study is to explore the pulmonary precancerous lesions induced by NNK and its possible mechanisms.</p><p><b>METHODS</b>Fifteen Wistar rats were divided into two trial groups, in which the high-dose group was instilled with iodized oil including 10 mg (50 mg/kg) NNK into the left lower lobar bronchus, and the low-dose group received 5mg ( 25mg/kg) NNK. Another 15 Wistar rats were instilled only with iodized oil as control group. All rats were examined immediately after instillation and followed up periodically by pulmogram. The pulmonary tissues of rats were pathologically examined, and the expression of AE1/AE3, PCNA and p53 was detected by immunohistochemical method.</p><p><b>RESULTS</b>The pulmograms showed that the iodized oil localized at the bottom of left lobe and disappeared 107 days later. In trial group, 10 of 15 rats (67%) had nodus at the bottom of left lobe. All of rats in trial group (15/15) displayed atypical hyperplasia in alveolar region, showing single or multiple layers of proliferative epithelial cells along intact alveolar septa with irregular and non-discrete margins of lesion, but continuous alveolar spaces were not obliterated by proliferative epithelial cells. Ten of 15 rats in trial group showed severe atypical hyperplasia of glandular epithelium with occasional infiltrating to muscular layer. All of those atypical hyperplasia cells showed positive AE1/AE3 expression. The positive rate of PCNA was 90% (9/10) and 100% (5/5) in low-dose group and high-dose group respectively, which was significantly higher than that in control group (13%, 2/15) (P=0.000, P=0.001). The positive rate of p53 expression was 50% (5/10) and 60% (3/5) in low-dose group and high-dose group respectively, which was significantly higher than that in control group (0) (P=0.005, P=0.009). However, there was no remarkable difference in PCNA and p53 expression between low-dose group and high-dose group (P > 0.05).</p><p><b>CONCLUSIONS</b>Transbronchial instillation of iodized oil including tobacco-specific NNK can induce pulmonary lesions as atypical hyperplasia of alveolar cell and glandular epithelium in Wistar rats. This model can be used in experimental studies about tobacco-related lung cancer.</p>
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<p><b>BACKGROUND</b>To investigate the different expressions of p53 gene family members p53, p63 and p73, and their clinical significance in non small cell lung cancer (NSCLC).</p><p><b>METHODS</b>p53, p63 and p73 protein expressions were detected in 60 NSCLC tissues and 7 normal lung tissues by immunohistochemistry.</p><p><b>RESULTS</b>In NSCLC, positive rate of p53, p63 and p73 protein was 61.67%(37/60), 80.00%(48/60), 73.33% (44/60) respectively. There were significant differences in positive rate of three proteins as compared to normal lung tissue ( P < 0.05). p53 protein expression was closely associated with tumor cell differentiation degree ( P =0.023), but was not associated with histological classification, lymph node metastasis and clinical stages ( P > 0.05). Expression of p63 protein was closely related to lymph node metastasis ( P =0.028) and histological classification ( P =0.001), but not to cell differentiation degree and clinical stages ( P > 0.05). There was no significant relationship between p73 protein expression and clinical characteristics of NSCLC ( P > 0.05). A positive correlation was present between p63 and p73 protein expressions ( P =0.000 1). No statistical correlation was found between p53 and p73 ( P > 0.05).</p><p><b>CONCLUSIONS</b>p53 gene family may be related to the oncogenesis and development of NSCLC. p63 and p73 proteins may have different biological function from p53 protein, and both might play oncogenic roles.</p>
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<p><b>BACKGROUND</b>To investigate the expression of cyclooxygenase-2 (COX-2) protein and inducible nitric oxide synthase (iNOS) protein during the experimental lung carcinogenesis in rats, as well as their association with microvessel density (MVD).</p><p><b>METHODS</b>Diethylinitrosamine and 3-methylcholanthrene were instilled into the left lobar bronchus to induce lung squamous cell carcinoma in 88 Wistar rats, and 10 nomal rats as controls. COX-2, iNOS expression and MVD count of the specimens obtained from the rats were examined by immunohistochemistry.</p><p><b>RESULTS</b>A total of 155 specimens of various pathological phase during the carcinogenesis were obtained: 14 hyperplasia, 25 squamous metaplasia, 33 dysplasia, 12 carcinoma in situ, 54 infiltration carcinoma, and 17 metastasis. The immunohistochemical score (IHS) of COX-2 significantly increased in dysplasia, carcinoma in situ and metastasis (P < 0.01,P < 0.05,P < 0.01). IHS of iNOS significantly increased in hyperplasia and metastasis (P < 0.05,P < 0.01 ). Remarkably increased MVD was found in carcinoma in situ, infiltration carcinoma and metastasis (P < 0.01, P < 0.01, P < 0.01). There was a positive correlation between COX-2 and iNOS (r=0.601 6,P < 0.001) expression. Expression of COX-2 or iNOS were remarkably related to MVD count (P < 0.01,P < 0.01)</p><p><b>CONCLUSIONS</b>COX-2 and iNOS may play important roles in the carcinogenesis of experimental rat lung squamous cell carcinoma as well as its progress, and it may be associated with stimulating angiogenesis.</p>
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<p><b>BACKGROUND</b>To analyse the relationship between caspase-3 expression and cell proliferation, and to find molecular-biology markers to adjust canceration during rat lung squamous cell carcinogenesis.</p><p><b>METHODS</b>The 3-methylcholanthrene(MCA) and diethyinitrosamine (DEN) were used to induce lung squamous cell carcinoma by intra-left lobar-bronchial instillation in 50 Wistar rats, and 10 normal rats as controls. Expression of caspase-3 and PCNA were evaluated by immunohistochemistry (IHC).</p><p><b>RESULTS</b>Caspase-3 protein positive rate was 44.12% in 34 rat lung squamous cell carcinomas, and positive coefficient value was 1.38±0.95, which were significantly lower than that of normal bronchial epithelium (P=0.007, P < 0.01) and premalignant lesions (P < 0.05, P < 0.05). The mean PCNA-labeling indexes (PCNA-LI) of normal rat bronchial epithelium, premalignant lesions and lung cancer were 14.10±5.02, 28.13±8.72 and 41.88±14.24 (P < 0.05), respectively. There was a negative correlation between caspase 3 and PCNA LI (r=-0.730 6, P < 0.01).</p><p><b>CONCLUSIONS</b>Loss expression of caspase-3 may promote tumor cell growth, and it may be important in rat lung squamous cell carcinogenesis. Detection of caspase-3 and PCNA proteins can be regarded as major markers in the diagnosis of lung canceration.</p>
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<p><b>OBJECTIVE</b>To investigate the dynamic expression and its relation of gelatinase A (MMP-2), its natural inhibitor (TIMP-2) and DNA index (DI) changes during carcinogenesis, invasion and metastasis in Wistar rats.</p><p><b>METHODS</b>Squamous cell carcinoma of lung was induced with 3-methylcholanthrene (MCA) and diethyinitrosamine (DEN) in iodized oil by left intra-bronchial instillation in 80 Wistar rats. Immrno histochemistay (IHC) and in situ hybridigation were used in the monitor of MMP-2, TIMP-2 proteins and mRNA expression during invasion and metastasis of lung cancer in these rats, DNA index (DI) value was measured by guantitatove image analysis on feulgen stained sections.</p><p><b>RESULTS</b>Along with the carcinogenis, the average poritive MNP-2 and TIMP-2 expressions increased, with positive rates of 8.5% - 85.7% and 6.4% - 35.7%. DI value also underwent the same changes (1.47 +/- 0.54) - (2.87 +/- 0.55). The difference of MMP-2 expression in carcinoma in situ versus early carcinoma and early carcinoma versus metastatic carcinoma are statistically significant (P < 0.05). Companing lung carcinome, the contrel group and non-cancerous lesions, the elevation of MNP-2 and TIMP-2 expressions were also sigmificant (P < 0.01). The DI elevation in carcinoma in situ and dysplasia were obviously significant (P < 0.05). Meanwhile a negative relation was noted in TINP-2 and MMP-2 expressions during carcinogenesis. There was a positive relation between MMP-2 expression and DNA poikiloidy (P < 0.01), which was related to the close relationship between MMP-2 and metastasis in advanced rat lung carcinoma (P < 0.05).</p><p><b>CONCLUSION</b>The excess degradation and disruption of basement membranes by activated MMP-2 may be a key step in inducing lung cancer invasion and metastasis. The imbalance between MMP and TIMP may be a critical factor which affects biologic behavior of lung carcinogenesis, invasion and metastasis.</p>