Robot-assisted Lobectomy under Port-only Mode with Artificial Pneumothorax / 中国肺癌杂志

BACKGROUND@#Da Vinci robotic system is currently widely used in thoracic surgery. The ports employment and procedures vary in different medical center in China. Usually, a small incision was used for assistant.@*METHODS@#Based on clinical practice, we summarized domestic and foreign experience, combined with the characteristics of the Chinese body anatomy, employ portal technique and artificial pneumothorax, summarized a set of simplified and easier surgical method.@*RESULTS@#Port-only artificial pneumothorax robot-assisted lobectomy has further improvement in anatomical safety, hemostatic effect and aesthetic appearance of the wound.@*CONCLUSIONS@#This study optimizes the procedure of port-only artificial pneumothorax robot-assisted lobectomy in order to serve lung cancer patients better.

Value of application of sevoflurane anesthesia induction in anesthesia management of foreign matter removal from trachea in children / 中国医师杂志

Objective Tc explore the value of application of Sevoflurane anesthesia induction in anesthesia management of foreign matter removal from trachea in children.Methods Sixty five cases of children with tracheal foreign matter related in our hospital from January 2015 to December 2016 were selected as the study objects,and were divided into two groups according to random number table method.The control group of 32 cases was given 2.5 mg/kg propofol to induce anaesthesia,and the observation group of 33 cases was given 8％ Sevoflurane inhalation to induce ancsthesia.One shot success rate,deoxygenation time,operation time,recovery time and the relative parameters (systolic pressure,diastolic pressure,respiratory rate and pulse oxygen saturation) at entrance time,before and after setting the mirror were contrasted and analyzed,and the intraoperative and postoperative adverse reactions were recorded in the two groups.Results There were no significant differences in respiratory rate,blood oxygen saturation,systolic blood pressure and diastolic blood pressure between two groups at entrance time and before setting the mirror (P ＞ 0.05).The respiratory rate and blood oxygen saturation of the observation group were higher than those of control group after setting the mirror and at withdrawing mirror time,with statistically significant differences (P ＜ 0.05).No statistically significant differences in other indexes (P ＞ 0.05).Deoxygenation time,operation time and recovery time of the observation group were significantly lower than those in the control group (P ＜ 0.05).The total incidence of adverse reactions in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusions Sevoflurane anesthesia induction can obviously shorten operation time and recovery time in foreign matter removal from trachea in children,and reduce the incidence of intraoperative and postoperative adverse reactions.It has good clinical effect.

High expression of WNT5A in small cell lung cancer and promotion of cell migration by phosphorylation of JNK / 中国肿瘤临床

Objective: The expression of WNT5A is associated with aggressive tumor biology and poor clinical outcomes of various types of cancer. However, its function in the cell migration of small cell lung cancer (SCLC) should be elucidated. Methods:The expres-sion of WNT5A in SCLC and normal lung tissues was detected by immunohistochemisty. The correlation between the expression and clinical characteristics of WNT5A was analyzed. The function of WNT5A in regulating cell migration was studied in DMS153 cell line in vitro. Small interfering RNA (SiRNA) was used to knock down WNT5A. Wound healing and Transwell tests were used to determine the migration rate of DMS153. The phosphorylated JNK expression was detected by Western blot analysis. Results:The WNT5A expression was higher in SCLC tissues than that of normal lung tissues. WNT5A was correlated with clinical stages, lymph nodes, and distance me-tastasis in SCLC. The high expression of WNT5A was accompanied by abnormal levels of NSE and Pro-GRP. The WNT5A phosphoryla-tion of JNK promoted cell migration in vitro. Conclusion:The expression of WNT5A in SCLC is high and correlated with tumor metasta-sis. The influence of WNT5A/JNK on the cell migration property of DMS153 supports the concept that WNT5A can initiate the cell mi-gration of SCLC, which suggested that WNT5A may be a marker and can be potentially used as an effective therapeutic target for the SCLC metastasis.

Biological xenogeneic ligament graft combined with bone marrow mesenchymal stem cells to repair anterior cruciate ligament injury / 中国组织工程研究

BACKGROUND:Xenogeneic ligament is readily available, which has ligament scaffold structure and is conducive to tissue ingrowth and creeping substitution. After processing, the xenogeneic ligament, with the presence of good growth scaffold function, can be completely eliminated antigenicity that can cause immune rejection. OBJECTIVE:To study the feasibility of biological xenogeneic ligament graft instead of alogeneic ligament graft for reconstruction of goat anterior cruciate ligament. METHODS: Twenty-four healthy adult goats were randomly divided into A, B, C groups, and then, the left knee joints of goats were removed to establish animal models of anterior cruciate ligament injury in the three groups. After the establishment of the tibia and femoral bone tunnel, groups A, B, C were respectively transplanted with biological xenogeneic ligament graft combined with bone marrow mesenchymal stem cels, biological xenogeneic ligament graft alone, and alogenic ligament. RESULTS AND CONCLUSION: After implantation, no rejection but good biocompatibility was found in the group A, in which, the transplanted ligament as a functional scaffold for anterior cruciate ligament reconstruction, and new tissues in-grew and replaced the scaffold under intraarticular environment to form the new ligament with good bone tendon healing. However, there were no differences in histology, immune response, biomechanical findings between groups A and C. Additionaly, in the group A, the host tissues were found to grow into the scaffold and establish a micro-circulation. These findings indicate that xenogeneic ligament combined with bone marrow mesenchymal stem cels can accelerate the establishment of micro-circulation and promote the growth of ligaments, especialy improve the ligament revascularization significantly, but has no influence on the biological characteristics of the ligament.

CT-guided preoperative hookwire localization of lung nodule in video-assisted thoracic surgery / 中国肿瘤临床

Objective:To explore the feasibility and safety of CT-guided hookwire localization of small lung nodule in video-as-sisted thoracic surgery. Methods: Preoperative localization of small lung nodule was performed using the CT-guided hookwire tech-nique, followed by video-assisted thoracic surgery in the wedge resection. The next mode of operation depends on the results of frozen biopsy. Results:Preoperative localization with CT-guided hookwire was performed in 34 patients between February 2012 and March 2014. The diameter of lung nodule ranged from 5 mm to 22 mm. CT-guided hookwire localization was successful in all patients, with a median positioning time of 23 min. Puncture needles were detached from two of the total patients during the surgery, and three other pa-tients showed pneumothorax by CT scan after localization. Conclusion:Preoperative hookwire localization of small lung nodule is an accurate and safe approach to improve the rate of wedge resection in video-assisted thoracic surgery.

Cetuximab in combination with icotinib overcomes the acquired resistance caused by EGFR T790M mutation in non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to investigate the effects of combination of icotinib and cetuximab on the acquired drug resistance caused by T790M mutation of EGFR in NSCLC, and provide experimental evidence for rational treatment of NSCLC.</p><p><b>METHODS</b>The effects of these two agents on cell proliferation, apoptosis, and EGFR-dependent signaling were evaluated using 3-(4, 5-dimethylthiazol-2-yl)- 5-diphenyltetrazolium bromide (MTT) assay, annexin V staining, and Western blotting. The expression of molecular markers of tumor proliferation PCNA and Ki-67 protein was further examined by immunohistochemistry, and the expression of EGFR-signaling-related proteins in tissue sections taken from H1975 tumor xenografts was assessed by Western blot assay. Sensitivity to EGFR inhibitors was detected in human H1975 tumor xenograft in nude mice.</p><p><b>RESULTS</b>The in vitro experiment showed that the proliferative ability of H1975 cells was inhibited in a dose-dependent manner, along with the increasing doses of cetuximab and icotinib, and the combination of cetuximab with icotinib resulted in a more pronounced growth inhibition of the H1975 cells. The apoptosis rate of H1975 cells after treatment with 0.5 µmol/L icotinib and 1 µg/ml cetuximab was (22.03 ± 2.41)% and that after treatment with 5 µmol/L icotinib and 10 µg/ml cetuximab was (42.75 ± 2.49)%, both were significantly higher than that after treatment with the same dose of icotinib or cetuximab alone (P < 0.05). The nude mouse experiment showed that the transplanted tumor was growing to (614.5 ± 10.8) mm(3) in the blank control group and to (611.2 ± 8.7) mm(3) at 28 days after icotinib treatment, but (30.8 ± 2.0) mm(3) in the cetuximab treatment group and 0 mm(3) in the cetuximab combined with icotinib group. There was a significantly decreased expression of Ki-67 and PCNA proteins and down-regulation of phosphorylation of EGFR signaling-related proteins in the cetuximab combined with icotinib group.</p><p><b>CONCLUSIONS</b>The combination of icotinib with cetuximab can exert synergistic inhibitory effect on the acquired drug resistance caused by T790M mutation of EGFR in NSCLC H1975 cells, interrupts the EGFR-downstream signaling pathway, and enhances the anticancer activity of chemotherapeutic drugs. Our results provide further experimental evidence for the clinical studies of combination of icotinib with cetuximab in the treatment of NSCLC patients associated with secondary drug resistance caused by T790M mutation of EGFR.</p>

Establishment of a rat model of trigeminal neuralgia induced by photochemical nerve injury / 中国药理学通报

Aim To investigate the behavioral changes of the pain related neuromodulation and neurotransmission in peripheral and central nervous systems in rats with trigeminal neuralgia (TN)and provide a disease relevant animal model for mecha-nism study of TN.Methods The male SD rats were randomly divided into sham operation group and TN surgical group.The latter group was further divided into model group and gabapentin group (100 mg · kg-1 ). TN was induced by intravenous erythrosine B injection and laser irradiation.The pain behavior of rats was evaluated using mechanical pain threshold measured with Von Frey hairs.Fluorescence quantitative PCR technique was deployed to study the change of Tac1 mRNA expressions in trigeminal ganglia.Utilizing microdialysis technique followed by high performance liquid chromatography fluorescence detection (HPLC-FLD),the extracellular striatum fluid was collected and glutamate(Glu)concentration was determined.Results In the model group,the average mechanical pain threshold in facial ar-ea innervated by the trigeminal nerve remained below 4g after 7 days post surgery.The mechanical threshold of the model group (1.63 ±1.27)g was significantly lower (P<0.01)than the control group (24.17 ±4.49)g on day10 post surgery.In gen-eral,the mechanical withdraw threshold was decreased from the preoperative value of 26g to the postoperative value of (1.60 ± 1.74)g (P<0.01),and maintained stable at (0.71 ±1.24) g during the whole dynamic monitoring period from day7 to day60.The successful rate of this model was 63%.After sur-gery,Tac1 mRNA expression in trigeminal ganglia and extracel-lular Glu levels in striatum were significantly up-regulated (P<0.05 ) in the model group. Animals receiving Gabapentin showed significant improvement in pain symptoms,as well as re-ductions of Tac1 mRNA expression in trigeminal ganglia and ex-tracellular Glu concentration in striatum (P<0.05 ).Conclu-sions The above described photochemically induced TN rat model can partially mimic the clinical TN symptoms and its pathophysiology.Considering its overall high stability,it is very likely that this model could be used in preclinical mechanism study or drug screening of TN.

Comparison of structural characteristics and anticoagulation activity of enoxaparin sodium with different degree of 1,6-anhydro derivatives / 药学学报

The fine structure of enoxaparin sodium samples with different degree of 1,6-anhydro derivatives were analyzed with polyacrylamide gel electrophoresis, high performance liquid chromatography, ultraviolet spectroscopy, infrared spectroscopy and nuclear magnetic resonance spectroscopy. A further study of anticoagulation activity of enoxaparins was performed, including those on their inhibition activities of coagulation factor Xa (FXa) and thrombin (FIIa). The results showed that the anti-FXa and -FIIa activities of enoxaparins with different degree of 1,6-anhydro derivatives (20.0%-39.7%) with similar structure characteristics, had decreasing tendency when the degree of 1,6-anhydro derivatives increased. Especially, the anti-FXa activity was sensitive to the change of the degree of 1,6-anhydro derivatives.

The Expression of TSLP and Its Relationship with the Number of Infiltrating Regulatory T Cells in Lung Cancer / 中国肿瘤临床

Objective: To investigate the expression of TSLP in human lung cancer tissue and the correla-tion between TSLP expression and number of regulatory T cells (Tregs). Methods: The expression of TSLP mRNA and protein was detected in different pathological lesions of the lung by Q-RT-PCR and immunohisto-chemistry. Immunohistochemistry was used to detect Foxp3+ Tregs. The correlation of TSLP with the number of Tregs was analyzed. Results: TSLP gene was expressed in tumor tissues (n=37), latero-tumor tissues (n=29) and non-tumor lung tissues (n=24), without statistical difference (P=0.148). TSLP protein was expressed in the cytoplasm and was observeed in 69.57% of tumor tissues, 13.33% of benign lesions and 30.00% of non-tumor lung tissues, with a significant difference (P<0.05). The expression of TSLP protein was correlated with tumor size (P=0.000) and lymph node metastasis (P=0.018). The number of Tregs in TSLP positive group was more than that in TSLP negative group (P<0.05). Conclusion: The expression of TSLP in lung tu-mor tissues is increased and is correlated with the number of Tregs, indicating that TSLP could induce Treg to play an important role in tumor immunotolerance.

Study of the correlation of integrin β1 and VEGF with invasion and metastasis of gastric carcinoma / 肿瘤研究与临床

Objective To investigate the expression of integrin β1 and VEGF in gastric carcinoma and evaluate its correlation with invasion and metastasis.Methods Immunohistochemistry techniques were used to study the expression of integrin β1 and VEGF in 63 gastric carcinoma specimens.We analyzed the variance with histological grade and stage and classification of clinical date.Results No significant relationship was observed among age,sex and histological classification of the expression of integrin β1 in the gastric cancer group (P>0.05).With the depth of invasion and lymphatic metastasis increasing,integrin β1 expression improved.The positive rate of integrin β1 among tubular adenocarcinoma,papillary carcinoma,mucinous carcinoma and undifferentiated carcinoma was 70.00 %,55.56 %,57.14 % and 64.86 %.No significant relationship was observed in it.Integrin β1 in cases with lymphnode metastasis was significantly higher than those without lymph node metastasis (P<0.05).No significant relationship was observed among VEGF expression and age,sex,histological classification and depth of invasion (P>0.05).Significant relationship was observed among VEGF expression and lymphatic metastasis.VECF in cases with lymph node metastasis was significantly higher than those without lymph node metastasis (P<0.05).Conclusion Immunohistochemistry techniques indicated that integrin β1 participated in the procession of invasion and metastasis.The expression of integrin β1 and VEGF are important factor,forecasting the invasion and metastasis.VEGF is an important factor for lymphnade metastasis of gastric carcinoma.VEGF in cases with lymphnode metastasis was significantly higher than those without lymphnode metastasis(P<0.05).The usage of integrin β1 and VEGF will improve the rightness in forecasting the invasion and lymph node metastasis of gastric carcinoma.