Differential diagnosis and unusual diffuse cytokeratin expression in renal paraganglioma: A case report

Paraganglioma is a rare neuroendocrine tumor arising from undifferentiated cells of the primitive neural crest. We report a case of renal paraganglioma in a 67-year-old patient. Computed tomography demonstrated a solid mass in the middle and lower pole of the right kidney. Sonography revealed an enlarged right kidney with an irregular shape but distinct border. Renal cell carcinoma was diagnosed provisionally; the tumor was completely resected and submitted for pathological examination. Unexpectedly, histopathology and immunohistochemistry confirmed paraganglioma arising from the renal parenchyma. In this study, we report the exceptional occurrence of Paired box gene 8 (PAX-8) expression in a renal paraganglioma. In addition, we demonstrated diffuse cytokeratin positivity in this renal paraganglioma. Although our report of a paraganglioma originating from the kidney is not unique, our finding expands the known immunophenotypic spectrum of this tumor. The awareness of the possible occurrence of cytokeratin diffuse positivity in paraganglioma is relevant to avoiding misdiagnosis of paraganglioma.

TET methylcytosine oxidases: new insights from a decade of research

In primates, males compete for a mate, which is a non-sharable resource. This makes the conditions lessconducive for males to have stable relationships. One such special kind of relationship is a bond where theinteractions are reciprocated, equitable and differentiated. Bonds in macaque societies are based on the degreeof within-group contest competition for mates which is dependent on the synchronization of female fertilephase and reliability of fertility signals. Species of the Fascicularis group, including Nicobar subspecies, showintermediate reliability in the signals with mild peaks, and studies have shown reciprocity but no differentiation. We conducted a study on a group of wild Nicobar long-tailed macaques Macaca fascicularis umbrosusto understand the existing patterns of male-male relationships. We examined whether there is reciprocity inaffiliation among the individuals and whether the rate of affiliation is balanced. We also measured the dominance linearity and steepness in the group to understand the monopolizability of females. We used socialnetwork analysis to understand whether the relations are differentiated based on hierarchical position andwhether the high-ranking individuals are the most central individuals in the distribution of grooming in thegroup. We found that there is reciprocity among the males although that is not equitable. There was no rankrelated differentiation of affiliation among the males of the group. Instead, the identities of individualsinfluenced affiliation patterns. Our results correspond to the existent strong relationships but lack of social bondotherwise found in the Fascicularis group of macaques.

Contrast effect of biochars and attapulgite clay on the adsorption and removal of cadmium ions from metal contaminated aqueous solution

Aim: To study the contrasting effect of adsorption and removal of cadmium ions using wheat straw biochar, rice straw biochar and attapulgite clay in contaminated aqueous solution. Methodology: Batch sorption experiment was carried out to investigate the parameters influencing the adsorption capacity such as pH, initial cadmium concentration, adsorbent dose and contact time. The physical and chemical characteristics of biochars and clay were studied and adsorption mechanism was analyzed by scanning electron microscopy, infrared spectroscopy, Brunauer-Emmett-Teller and X-ray diffraction, which indicated high adsorption and removal of Cd+2ions by wheat straw biochar was mainly due to the presence of surface carboxyl functional groups –OH, C-O, COOH that reacted Cd2+ions. Results: The adsorption effect of wheat straw biochar (WSB), rice straw biochar (RSB) and attapulgite (ATP) clay were compared. The results showed that adsorption isotherms were best fit to Langmui isotherm model. The adsorption kinetics study well matched with pseudo second order model and the maximum adsorption equilibrium of WSB, RSB and ATP reached to 100, 160, and 120 min, respectively. The results showed that adsorption rate was maximum at pH 6 with 0.1 g dose of adsorbent, 40 mg l-1 metal concentration, and contact time of 100 min at 30°C for WSB. The maximum percent removal of cadmium ions from aqueous solution was in the order WSB>ATP>RSB, 95%, 91% and 88%, respectively. Interpretation: The results explored that wheat straw biochar has high Cd2+adsorption rate and removal efficiency in contaminated water than others. Hence, the results explored that WSB is a potential, low-cost adsorbent and can be used as cadmium decontaminant in polluted water with no secondary pollution.

Sclerosing pneumocytoma with metastasis to the mediastinal and regional lymph nodes

Sclerosing pneumocytoma (SP) is an uncommon benign tumor, and metastasis of SP has been rarely reported. Here, we report the case of a 26-year-old woman with surgically confirmed SP. The tumor diameter was 40 mm, and metastasis to mediastinal and regional lymph nodes was observed. Immunohistochemically, both surface and round cells were positive for epithelial membrane antigen, thyroid transcription factor 1, and vimentin. Only surface cells expressed creatine kinase, carcinoembryonic antigen, napsin A, and cytokeratin 7, and only round cells expressed progesterone receptor. Ki-67 was detected in ~3% of cells, and the rate of weak positive p53 staining was 3%. Both cell types were negative for chromogranin A, synaptophysin, CD3, and CK20. Multiple metastases in a young SP patient are very rare, and potential mechanisms of metastasis may be related to epithelial–mesenchymal transformation.

Effects of bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF) release from polylactide-poly (ethylene glycol)-polylactide (PELA) microcapsule-based scaffolds on bone

Multiple growth factors can be administered to mimic the natural process of bone healing in bone tissue engineering. We investigated the effects of sequential release of bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF) from polylactide-poly (ethylene glycol)-polylactide (PELA) microcapsule-based scaffolds on bone regeneration. To improve the double emulsion/solvent evaporation technique, VEGF was encapsulated in PELA microcapsules, to which BMP-2 was attached. The scaffold (BMP-2/PELA/VEGF) was then fused to these microcapsules using the dichloromethane vapor method. The bioactivity of the released BMP-2 and VEGF was then quantified in rat mesenchymal stem cells (rMSCs). Immunoblotting analysis showed that BMP-2/PELA/VEG promoted the differentiation of rMSCs into osteoblasts via the MAPK and Wnt pathways. Osteoblast differentiation was assessed through alkaline phosphatase expression. When compared with simple BMP-2 plus VEGF group and pure PELA group, osteoblast differentiation in BMP-2/PELA/VEGF group significantly increased. An MTT assay indicated that BMP-2-loaded PELA scaffolds had no adverse effects on cell activity. BMP-2/PELA/VEG promoted the differentiation of rMSCs into osteoblast via the ERK1/2 and Wnt pathways. Our findings indicate that the sequential release of BMP-2 and VEGF from PELA microcapsule-based scaffolds is a promising approach for the treatment of bone defects.

Ginsenoside Rg1 protects human renal tubular epithelial cells from lipopolysaccharide-induced apoptosis and inflammation damage

Ginsenoside Rg1, one of the most notable active components of Panax ginseng, has been widely reported to exert anti-inflammatory actions. This study aimed to reveal whether ginsenoside Rg1 also exhibits beneficial roles against lipopolysaccharide (LPS)-induced apoptosis and inflammation in human renal tubular epithelial cells, and to evaluate the potential role of the component on tubulointerstitial nephritis treatment. HK-2 cells were treated with various doses of ginsenoside Rg1 (0, 50, 100, 150, and 200 μM) in the absence or presence of 5 μg/mL LPS. Thereafter, CCK-8 assay, flow cytometry, western blot, migration assay, reactive oxygen species (ROS) assay, and ELISA were carried out to respectively assess cell viability, apoptosis, migration, ROS activity, and the release of inflammatory cytokines. As a result, ginsenoside Rg1 protected HK-2 cells from LPS-induced injury, as cell viability was increased, cell apoptosis was decreased, and the release of MCP-1, IL-1β, IL-6, and TNF-α was reduced. Ginsenoside Rg1 functioned to HK-2 cells in a dose-dependent manner, and the 150 μM dose exhibited the most protective functions. Ginsenoside Rg1 had no significant impact on cell migration and ROS activity, while it alleviated LPS-induced ROS release and migration impairment. Furthermore, the down-regulations of p-PI3K, p-AKT, and up-regulations of PTEN, p-IκBα, p-p65, Bcl-3 induced by LPS were recovered to some extent after ginsenoside Rg1 treatment. In conclusion, ginsenoside Rg1 protects HK-2 cells against LPS-induced inflammation and apoptosis via activation of the PI3K/AKT pathway and suppression of NF-κB pathway.

Meta-analysis of the association between PADI4 -92C/G polymorphism and rheumatoid arthritis in the Chinese population

Many studies have evaluated the correlation between peptidylarginine deiminase 4 (PADI4) -92C/G polymorphism and rheumatoid arthritis (RA), but the results remain inconclusive. Therefore, we performed a meta-analysis in the Chinese population to provide comprehensive data on the association between PADI4 -92C/G polymorphism and RA. Eligible studies published before May 2016 were identified in PubMed and Chinese databases. The strengths of these associations were assessed by pooled odds ratios (OR) and 95% confidence interval (CI). Eight studies documenting a total of 1351 RA cases and 1585 controls were included in this meta-analysis. In the overall analysis, a significant association between the PADI4 -92C/G polymorphism and RA was found in the Chinese population (G vs C: OR=1.32, 95%CI=1.02-1.71; GG+CG vs CC: OR=1.75, 95%CI=1.20-2.53). The subgroup analyses stratified by geographic area(s) and source of controls revealed significant results in South China, in hospital-based studies and population-based studies. In summary, this meta-analysis suggested that PADI4 -92C/G polymorphism may be associated with the RA incidence in the Chinese population, especially for South China. Further studies conducted on other ethnic groups are required for definite conclusions.

Down-regulation of single-stranded DNA-binding protein 1 expression induced by HCMV infection promotes lipid accumulation in cells

The objective of this study was to observe the infection of human cytomegalovirus (HCMV) to human umbilical vein endothelial cells, and its effect on the expression of single-stranded DNA-binding protein (SSBP1) and on lipid metabolism in endothelial cells. We screened the differential expression of mRNAs after HCMV infection by suppression subtractive hybridization and the expression levels of SSBP1 mRNA and protein after HCMV infection by real-time PCR and western blot. After verification of successful infection by indirect immunofluorescent staining and RT-PCR, we found a differential expression of lipid metabolism-related genes including LDLR, SCARB, CETP, HMGCR, ApoB and LPL induced by HCMV infection. The expression levels of SSBP1 mRNA and protein after HCMV infection were significantly down-regulated. Furthermore, we found that upregulation of SSBP1 inhibited the expression of atherosclerosis-associated LDLR, SCARB, HMGCR, CETP as well as the accumulation of lipids in the cells. The results showed that the inhibition of SSBP1 by HCMV infection promotes lipid accumulation in the cells.

Artificial pneumothorax for pain relief during microwave ablation of subpleural lung tumors.

BACKGROUND: When microwave ablation (MWA) is used for subpleural lesions, severe pain was the common side effect under the local anesthesia conditions during the procedure and postprocedure. To study the pain relief effect of artificial pneumothorax in the treatment of subpleural lung tumors with MWA. MATERIALS AND METHODS: From February 2012 to October 2014, 37 patients with 40 subpleural lung tumors underwent MWA, including 17 patients of 19 sessions given artificial pneumothorax prior to MWA (group‑I), and 20 patients of 21 sessions without artificial pneumothorax (group‑II). Patient’s pain assessment scores (10‑point visual analog scale [VAS]) at during‑procedure, 6, 12, 24, and 48 h after the MWA procedure and mean 24 h morphine dose were compared between the two groups. Complications of the artificial pneumothorax were also summarized. RESULTS: Pain VAS were 0.53, 0.65, 1.00, 0.24, and 0.18 at during‑procedure, 6, 12, 24, and 48 h for group‑I and 5.53, 2.32, 2.82, 1.21, and 0.21 for group‑II, respectively. Pain VAS in group I was significantly decreased at during‑procedure, 6, 12, and 24 h after the MWA (P < 0.001). No statistical pain VAS difference was observed at 48 h after the MWA between the two groups (P > 0.05). The mean 24 h morphine dose was 5.00 mg in group‑I and 12.63 mg in group‑II (P = 0.000). “Artificial pneumothorax” related complications occurred in two patients from group‑I, including one pleural effusion and one minor hemoptysis. No patient in group‑I and group‑II died during the procedure or in 30 days after MWA. CONCLUSION: Artificial pneumothorax is a safe and effective method for pain relief during MWA of subpleural lung tumors.

Percutaneous computed tomography‑guided iodine‑125 seeds implantation for unresectable pancreatic cancer.

BACKGROUND: To examine the safety and clinical efficacy of computed tomography (CT)‑guided radioactive iodine‑125 (125I) seeds implantation for patients with unresectable pancreatic cancer. MATERIALS AND METHODS: A group of 26 patients with pathologically confirmed unresectable pancreatic cancer underwent percutaneous CT‑guided 125I seeds implantation. Part of them received transarterial chemotherapy and/or percutaneous transhepatic cholangial drainage before or after seeds implantation. The primary endpoints were the objective response rates, local control rates, and overall survival. RESULTS: CT scan 2 months after treatment revealed complete response (CR) in 8 patients, partial response (PR) in 9 patients. Overall response rate (CR + PR) is 65.38%. Local control rate was 88.46%. Median survival of the whole group was 15.3 months, whereas for Stage III and IV was 17.6 and 9.1 months, respectively. The estimated 1‑year survival was 30.77%. CONCLUSIONS: We consider CT‑guided 125I seeds implantation as a safe, effective, uncomplicated treatment for unresectable pancreatic cancer.

Microwave ablation as palliative treatment of locally recurrent colorectal cancer.

BACKGROUND: Patients suffering local recurrence of colorectal cancer which cannot be surgically removed are troubled with severe pain and poor quality of life. The aim of this study is to evaluate the efficacy and safety of computed tomography (CT)‑guided microwave ablation (MWA) as palliative treatment for recurrent unresectable colorectal cancer. MATERIALS AND METHODS: Thirty‑one patients were suffering locally recurrent colorectal cancer underwent MWA with CT guidance. The MWA power was set at 60–80 W, 6–8 min. Effectiveness was evaluated by visual analog scale (VAS) with a follow‑up of 6‑month. Complications were also recorded. RESULTS: Technical success was achieved in all patients. Mean VAS preprocedure was 7.10. Mean VAS postprocedure were as follows: 1 week, 2.65 (P < 0.001); 1 month, 0.81 (P < 0.001); 3 months 0.45 (P < 0.001); and 6 months 0.19 (P < 0.001). No serious complications were observed including intestinal fistulas, bladder fistulas, or peripheral vascular or nerve injury. CONCLUSIONS: CT‑guided MWA as treatment of recurrent colorectal cancer can quickly and effectively relieve pain. It is a minimally invasive, safe, and efficient palliative treatment of recurrent colorectal cancer.

Computed tomography‑guided percutaneous microwave ablation of patients 75 years of age and older with early‑stage nonsmall cell lung cancer.

BACKGROUND: We aimed to assess the clinical outcome of computed tomography (CT)‑guided percutaneous microwave ablation (MWA) in patients 75 years of age and older with early stage peripheral nonsmall cell lung cancer (NSCLC). MATERIALS AND METHODS: Twenty‑eight patients, aged ≥75 years, with Stage I and lymph node‑negative IIa peripheral NSCLC underwent CT‑guided percutaneous MWA in our hospital between July 2007 and March 2015. The overall 1‑, 2‑, 3‑, and 4‑year survival rates were estimated using Kaplan–Meier analysis. Adverse events were recorded. RESULTS: The median follow‑up time was 22.5 months. The overall median survival time (MST) was 35 months (95% confidence interval [CI] 22.3–47.7 months), and the cancer‑specific MST was 41.9 months (95% CI 38.8–49.9 months). The 1‑, 2‑, 3‑, and 4‑year overall survival rates were 91.7%, 76.5%, 47.9%, and 47.9%, while the cancer‑specific survival rates were 94.7%, 73.9%, 64.7%, and 64.7%, respectively. Median time to local progression was 28.0 months (95% CI 17.7–38.3 months). Major complications were included pneumothorax (21.4%, requiring drainage), pleural effusions (3.6%, requiring drainage), and pulmonary infection (3.6%). CONCLUSIONS: CT‑guided percutaneous MWA is safe and effective for the treatment of patients 75 years of age and older with medically inoperable early stage peripheral NSCLC.

Bronchopleural fistula after lung ablation: Experience in two cases and literature review.

BACKGROUND: Bronchopleural fistula (BPF) complicating lung tumor ablation is rare but severe. The purpose of this article was to study its characteristics and treatments. MATERIALS AND METHODS: Two of 682 (0.3%) sessions of lung microwave ablation (MWA) were complicated with BPF and documented. Two electronic databases were searched for reported cases of BPF after lung tumor ablation. Case selection and data collection were done by 3 independent reviewers. RESULTS: A 56‑year‑old man and a 61‑year‑old woman developed BPF after MWA and died. Thirteen cases (mean age 63.8, 61.5% male) of BPF with adequate information were identified from 8 articles. Of the 13 cases, 5 (38.5%) had pulmonary co‑morbidity, 3 (23.1%) had a history of pulmonary surgery, 7 (53.8%) had a target tumor adjacent or abutting pulmonary pleura, and 6 (46.2%) developed severe infections. After chest tube placement, pleurodesis, endoscopic therapy, surgery, and other treatments, 12 were cured and 1 died of BPF and pneumonia. CONCLUSION: BPF is a rare but severe complication of lung ablation, and the management needs a multidisciplinary and individualized treatment strategy.

Toxicity and adverse effects of everolimus in the treatment of advanced nonsmall cell lung cancer pretreated with chemotherapy‑Chinese experiences.

BACKGROUND: There is not more treatment selection for advanced nonsmall‑cell lung cancer (NSCLC) patients who had disease progression after two previous treatments. Everolimus is an oral inhibitor of the mammalian target of rapamycin pathway, which is aberrantly activated in NSCLC. PATIENTS AND METHODS: Stage IV NSCLC patients, with one or multiple prior chemotherapy regimens, received everolimus 5–10 mg/day with or without chemotherapy until progression or unacceptable toxicity. The primary objective were toxicity of everolimus and overall disease control rate (DCR). RESULTS: 22 patients were enrolled. Common ≥grade3 events were stomatitis, dyspnea, vomiting, thrombocytopenia. Overall disease control rate was 54.5% among 22 patients, 1 had a partial response, and 11 had disease stabilization. Common ≥Grade 3 events were stomatitis, dyspnea, vomiting, and thrombocytopenia. CONCLUSION: Everolimus was well tolerated, showing the modest clinical activity in heavily pretreated advanced NSCLC.

Roles of Hippo signaling in lung cancer.

Lung cancer is the leading cause of cancer‑related mortality in the world, with more than 1 million deaths/year. Over the past years, lung cancer treatment has been based on cytotoxic agents and an improvement in the outcome and quality of life for patients has been observed. However, it has become clear that additional therapeutic strategies are urgently required to provide an improved survival benefit for patients. A major intracellular signaling pathway, the Hippo signaling pathways have been extensively studied in neoplasia, including lung cancer. Furthermore, the study of constitutively activated receptor and their downstream signaling mediators has become a promising new field of investigation for lung cancer treatment. Nevertheless for lung cancer, this approach has not been successful yet. Here, we will review the molecular basis of Hippo signaling in lung cancer and further discuss the therapeutic potential of multi‑targeted strategies involving Yes‑associated protein inhibitors.

Esculetin, a coumarin derivative, exerts in vitro and in vivo antiproliferative activity against hepatocellular carcinoma by initiating a mitochondrial-dependent apoptosis pathway

This study investigated the in vitro and in vivo antiproliferative activity of esculetin against hepatocellular carcinoma, and clarified its potential molecular mechanisms. Cell viability was determined by the MTT (tetrazolium) colorimetric assay. In vivo antitumor activity of esculetin was evaluated in a hepatocellular carcinoma mouse model. Seventy-five C57BL/6J mice were implanted with Hepa1-6 cells and randomized into five groups (n=15 each) given daily intraperitoneal injections of vehicle (physiological saline), esculetin (200, 400, or 700 mg·kg-1·day-1), or 5-Fu (200 mg·kg-1·day-1) for 15 days. Esculetin significantly decreased tumor growth in mice bearing Hepa1-6 cells. Tumor weight was decreased by 20.33, 40.37, and 55.42% with increasing doses of esculetin. Esculetin significantly inhibited proliferation of HCC cells in a concentration- and time-dependent manner and with an IC50 value of 2.24 mM. It blocked the cell cycle at S phase and induced apoptosis in SMMC-7721 cells with significant elevation of caspase-3 and caspase-9 activity, but did not affect caspase-8 activity. Moreover, esculetin treatment resulted in the collapse of mitochondrial membrane potential in vitro and in vivo accompanied by increased Bax expression and decreased Bcl-2 expression at both transcriptional and translational levels. Thus, esculetin exerted in vitro and in vivo antiproliferative activity in hepatocellular carcinoma, and its mechanisms involved initiation of a mitochondrial-mediated, caspase-dependent apoptosis pathway.

Transfer patterns of integron-associated and antibiotic resistance genes in S. flexneri during different time intervals in Tianjin, China.

Background: Shigella is one of the common genera of pathogens responsible for bacterial diarrhoea in humans. According to World Health Organisation (WHO), 800,000–1,700,000 patients in China were infected with Shigella spp. in 2000, and Shigella flexneri is the most common serotype (86%). Objectives: We investigated the transfer patterns of integron‑associated and antibiotic resistance genes in S. flexneri during different time intervals in the city of Tianjin in the People’s Republic of China. Materials and Methods: The integrase‑encoding and variable regions of the integrons of the bacterial strains were amplified by polymerase chain reaction (PCR), followed by gene sequencing. Fifty‑six S. flexneri strains, 32 of which were stored in our laboratory and the other 24 were isolated from tertiary hospitals in Tianjin during different time intervals, were tested for their sensitivity to 12 antibiotics by using the Kirby–Bauer antibiotic testing method (K‑B method). Results and Conclusion: Of the 32 strains of S. flexneri isolated from 1981 to 1983 and stored in our laboratory, class 1 integron was detected in 28 strains (87.50%), while 27 strains (84.37%) harboured an aminoglycoside resistance gene, aadA, in the variable region of their integrons. Class 1 integron was identified in 22 (91.67%) of the 24 S. flexneri strains isolated from 2009 to 2010, whereas the variable region and 3′‑end amplification were not present in any of the strains. Class 2 integron was not found in the 1981–1983 group (group A) of strains; although 19 (79.17%) of the 24 strains in the 2009–2010 group (group B) possessed class 2 integron, and the variable region of the integron harboured dfrA1 + sat1 + aadA1 genes, which, respectively, mediate antibiotic resistance to trimethoprim, streptothricin and streptomycin. Seventeen strains of the total 56 possessed both class 1 and 2 integrons. Strains belonging to group A were highly resistant to tetracycline, chloramphenicol and a combination of trimethoprim‑sulfamethoxazole; 65.63% of the strains were multi‑resistant to three or more antibiotics. In group B, the strains showed high resistance to ampicillin, trimethoprim‑sulfamethoxazole, piperacillin and tetracycline; 83.33% of the strains were multi‑resistant to three or more antibiotics. Class 1 and 2 integrons exist extensively in S. flexneri, and the 3′‑conserved segments of class 1 integron may have deletion or other types of mutations. Comparing the antibiotic and multi‑drug resistance of group A with that of group B, it is apparent that the antibiotic resistance and the incidence of genes that confer multi‑drug resistance have increased over the years in S. flexneri.

Expression of ?-catenin and c-myc during human common bile duct development: a possible role in the morphogenesis of the common bile duct

β-catenin and c-myc play important roles in the development of tissues and organs. However, little is known about their expression patterns during the development of the human common bile duct. Immunohistochemistry was used to detect β-catenin and c-myc expression in common bile duct samples from postmortem tissues of 14 premature infants and 6 spontaneously aborted fetuses. The expression of β-catenin and c-myc was also analyzed by Western blot. The samples were divided into four groups based on the stage of human fetal development: 12, 13-27, 28-37, and >37 weeks. The Image-Pro Plus v. 6.0 image analysis software was used to calculate the mean qualifying score (MQS). At fetal stages 12, 13-27, 28-37, and >37 weeks, MQS of β-catenin were 612.52±262.13, 818.38±311.73, 706.33±157.19, and 350.69±110.19, respectively. There was a significant difference in MQS among the four groups (ANOVA, P=0.0155) and between the scores at >37 and 13-27 weeks (Student-Newman-Keuls, P<0.05). At fetal stages 12, 13-27, 28-37, and >37 weeks, the MQS of c-myc were 1376.64±330.04, 1224.18±171.66, 1270.24±320.75, and 741.04±219.19, respectively. There was a significant difference in MQS among the four groups (ANOVA, P=0.0087) and between the scores at >37 and 12 weeks, >37 and 13-27 weeks, and >37 and 28-37 weeks (all P<0.05, Student-Newman-Keuls). Western blots showed that β-catenin and c-myc expression were significantly higher in fetal than in postnatal control duct tissue (P<0.05). c-myc and β-catenin are involved in the normal development of the human common bile duct.

Endostar combined with chemotherapy compared with chemotherapy alone in the treatment of nonsmall lung carcinoma: A meta-analysis based on Chinese patients.

INTRODUCTION: Lung cancer is the leading cause of cancer‑associated death world‑wide. And the lung cancer is generally divided into small cell lung carcinoma and non-small cell lung cancer. For advanced NSCLC, the chemotherapy and target therapy were the important treatment modality. This meta‑analysis was to evaluate the clinical efficacy and toxicity between endostar combined chemotherapy and chemotherapy alone in Chinese patients. MATERIALS AND METHODS: We searched the PubMed, EMBASE, and CNKI databases to find the potential relevant articles reporting the endostar combined with chemotherapy regimen in the treatment of nonsmall cell lung cancer in Chinese patients. The tumor response and toxicity difference between the two groups were demonstrated by odds ratio (OR) and its 95% confidence interval (95% CI). All the data was pooled by Stata 11.0 (http://www.stata.com; Stata Corporation, College Station, TX) software. RESULTS: We included 14 studies published in Chinese or English studies. The pooled results showed adding endostar in the chemotherapy regimen can significant increase the objective response rate (OR = 2.42, 95% CI = 1.87–3.12, P = 0.00) and disease control rate (OR = 2.22, 95% CI = 1.68–2.94, P = 0.00). For toxicities, the pooled data showed no statistical difference for grade III‑IV granulocytopenia risk (OR = 1.04, 95% CI = 0.74–1.44, P = 0.83). Nausea and vomiting (OR = 0.93 95% CI: 0.51–1.52, P = 0.78) and grade III‑IV alopecia (OR = 0.99, 95% CI: 0.76–1.29, P = 0.95). The funnel plot showed no statistical publications. CONCLUSION: Combined treatment with endostar can improve the response rate for NSCLC patients without increasing the risk of developing severe adverse event.

Feasibility and safety of early chest tube removal after complete video-assisted thoracic lobectomy.

OBJECTIVE: The aim was to evaluate the feasibility and safety of early chest tube removal after complete video‑assisted thoracic lobectomy (CVATL). METHODS: Retrospective analysis was performed on effects of chest tube removal on patients with lung cancer after pulmonary lobectomy between November 2013 and October 2014. 154 eligible patients included 97 cases for CVATL and 57 cases for open thoracic lobectomy. Patients with CVATL were divided randomly into experimental group (EG) and control group (CG), in which 51 patients in EG had chest tube removal on the 2nd day after operation; 46 patients in CG had the tube removal when the drainage volume <100 ml/day. Patients in open thoracic lobectomy group (OG) had the tubes removal as CG. The drainage volumes of the 1st and 2nd 24 h after operation, duration of chest tubes, cases of pain alleviation, and recurrent pleural effusions requiring reintervention were measured. RESULTS: The average drainage volume of the 1st 24 h after operation of CVATL group from EG and CG was significantly reduced than that in OG (260.41 ml vs. 353.16 ml, P < 0.001). The average drainage volume of the 2nd 24 h after operation of CG was significantly reduced than that in OG (163.91 ml vs. 222.98 ml, P < 0.001). The average duration of chest tube of CG for 2.98 days showed significant different compared with OG for 3.81 days (P < 0.001). Chest tube removal in CVATL group increased more chest pain alleviation than OG (80.4% vs. 56.1%, P = 0.001). The frequencies of recurrent pleural effusions requiring reintervention were 5.88% (3/51), 4.35% (2/46) and 5.26% (3/57), respectively, which had no significant differences between three groups (P = 1.000). CONCLUSIONS: Complete video‑assisted thoracic lobectomy brings less drainage volume after operation. Early removal of chest tube in CVATL shows feasible and safe and demonstrates that it may reduce postoperative pain and help fast recovery.