Primary mediastinal large B-cell lymphoma: clinical analysis of 19 cases / 中华全科医师杂志

Objective To study clinical manifestations, diagnosis, treatment, as well as effect of surgical operation, of primary mediastinal large B-cell lymphoma (PMBCL).Methods Data of 19 patients of PMBCL with complete clinical and pathological records hospitalized at Peking Union Medical College Hospital during 1998 to 2008 were retrospectively reviewed and analyzed.Kaplan-Meier method was used to estimate their survival time and survival rate in comparison of efficacy in those with surgical operation to those without it.Results Overall three-year survival rate was 54% for all the 19 patients, 55% for those with surgical operation and 54% without it, respectively, with an average survival time of 44 months, 44 months for those with surgical operation and 42 months without it, respectively, but not reaching at statistical significance.Symptoms of superior vena cava syndrome in five cases at admission relieved immediately after surgical operation, but symptoms of superior vena cava syndrome in three of nine cases in non-surgical group relieved gradually one to three weeks after chemotherapy.Conclusions Surgical operation has no significant effect on survival in patients with PMBCL, but it can relieve syndrome of superior vena cava syndrome and provide accurate pathological diagnosis.

The study on improvement of survival for lung cancer surgically intervened in PUMC Hospital / 中国肺癌杂志

<p><b>BACKGROUND</b>Lung cancer is still the most common cause of cancer death. Although it is reported that the 5-year survival rate for lung cancer has been greatly increased, surgical results are controversial. The aim of this study is to investigate and evaluate the improvement of survival of lung cancer surgically intervened in PUMC hospital during the last 15 years.</p><p><b>METHODS</b>From January 1989 to December 2003, 1574 cases of lung cancer underwent surgical treatment and obtained follow-up. The results were retrospectively a- nalysed . All cases in this series were divided into two groups according to time, group A (1999-2003) and group B (1989-1998), and the differences of survival rate between group A and group B were compared.</p><p><b>RESULTS</b>The morbidity and mortality of group A decreased significantly when compared to group B (11.2% vs 19.2%, 1.06% vs 1.93%, respectively, P < 0.01). However, the 3- and 5-year survival rates had been obviously raised from 42.35% to 56.07%, and from 28.46% to 38.99%, respectively (P < 0.05 ). A significant improvement in survival was observed in patients with stageI, stage II and stage IIIA, but not in stage IIIB and stage IV. Also, the patients with lobectomy had better results but those with exploratory thoracotomy, limited resection, pneumonectomy and sleeve resection did not show better results.</p><p><b>CONCLUSIONS</b>Lobectomy associated with systematic dissection of mediastinal lymph nodes has become the standard mode for the resectable lung cancer. Combination of complete resection and lymph nodes dissection, with postoperative adjuvant chemotherapy based on platinum/3rd generation medicine, have preliminarily been justified and proved an important approach for effective improvement of long-term survival of lung cancer.</p>

Effects of huTNF-α and hIL-2 gene transfection on the expression of MDR1 and LRP genes in lung cancer cell lines / 中国肺癌杂志

<p><b>BACKGROUND</b>To study the effects of huTNF-α and hIL-2 gene transfection on the expression of MDR1 and LRP genes in lung cancer cell lines.</p><p><b>METHODS</b>huTNF-α and hIL-2 gene plasmids were constructed and transfected into A549, GLC-82, H446 and H460 cells with lipofectinmin. Positive clones were screened out by G418. The expressions of MDR1 and LRP genes were detected at mRNA level by reverse transcription polymerase chain reaction (RT-PCR) in the non transfected cells and the cloned cells.</p><p><b>RESULTS</b>MDR1 gene was positive in A549, GLC-82, H446 and H460 cell lines, LRP gene was positive in A549, GLC-82 and H460 cell lines; The transfected cell lines expressed both huTNF-α and hIL-2 gene, and the A549, H446 and H460 cell lines transfected with hIL-2 gene had no MDR1 expression at mRNA level compared with the non transfected ones.</p><p><b>CONCLUSIONS</b>MDR1 and LRP genes are expressed in lung cancer cell lines, which indicates the presence of intrinsic drug resistance before any form of therapy. MDR1 gene is not expressed in hIL-2 transfected cell lines, which demonstrates that hIL-2 gene modulates the MDR1 gene expression at mRNA level, and may reverse the multidrug resistance of lung cancer.</p>

Diagnosis and surgical management of mediastinal neurogenic tumors / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinical manifestations, diagnostic methods, surgical management and prognosis of patients with neurogenic tumors of the mediastinum.</p><p><b>METHOD</b>One hundred and ten patients with neurogenic tumors of the mediastinum were analyzed retrospectively.</p><p><b>RESULTS</b>After operation, 2 patients died in hospitalization and 8 experienced such complications as Horner's syndrome or laryngeal recurrent nerve paralysis. In 102 patients with benign tumors, 2 patients had recurrence, and 4 patients with neurofibrosarcoma or malignant neurilemmoma died within 3 years postoperatively.</p><p><b>CONCLUSIONS</b>Most neurogenic tumors of the mediastinum are benign and could be diagnosed by chest X-ray or CT. The clinical manifestations, diagnosis methods, surgical management of the dumbbell tumors differ from others. Minimal invasive surgery and video assist thoracoscopy surgery are of special value in treatment of the selected neurogenic tumors of the mediastinum. Benign neurogenic tumors rarely recur after complete resection, and malignant neurogenic tumors have poor prognosis.</p>

Diagnosis and surgical management for retrosternal thyroid mass / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To understand the clinical manifestations, diagnostic methods, surgical management and prognosis of retrosternal thyroid masses in various pathological types.</p><p><b>METHODS</b>Sixty-four cases of retrosternal thyroid masses with surgical intervention were analyzed retrospectively.</p><p><b>RESULTS</b>Trachea-compressed symptoms (65%) and shadows beside the trachea at thoracic inlet (94%) were the most common clinical findings, chest X-ray (70%) and CT scan (96%) had higher diagnostic rate. No death occurred during operation or hospitalization among these patients. Total complications occurred in 15.7% cases (11/70) (including 3 preoperative cases with hoarseness) and postoperative pathological results were mainly multinodular goiter (54.7%), thyroid adenoma (21.9%) and thyroid carcinoma (15.6%) (including local carcinomatous change).</p><p><b>CONCLUSIONS</b>Diagnosis of retrosternal thyroid mass can be correctly made by chest X-ray and CT scan. Most operations on retrosternal thyroid masses can be performed safely through cervical incision with minimal morbidity and low recurrence rate. Retrosternal thyroid carcinoma was potentially invasive and could hardly be resected completely, hence with poor prognosis.</p>

A preliminary study on the role of serum tumor necrosis factor alpha levels for diagnosis of early acute rejection after heterototpic rat heart-lung transplantation / 中华器官移植杂志

In this study an acute rejecting model of heterotopic rat heart-lung transplantation was established by using simplified technique of end to side anastomosis of donor ascending aorta with recipient abdominal aorta.The measurements of tumor necrosis factor alpha(TNF-α)in serum of rats by Sandwich-ELISA method were taken on the 3rd,5th,7th days respectively after operation.The results of this study with histological examination showed that TNF-α serum levels were increased during acute rejection episodes.and it might be a useful indicator for diagnosis of allograft rejection.

Management of Acute Respiratory Failure after Surgery for Esophageal Cancer / 中华胸心血管外科杂志

Acute respiratory failure (ARF) after operation for esophageal carcinoma is a serious challenge to medical management and usually accompanied by a high mortality rate. This paper present author's experience on the management of 10 such cases. It is emphasized that advanced age, long-history of smoking, COPD are predisposing factors and in-trathoracic surgery and its complication may trigger the ARF,which usually occurs within 48-72 hours after operation. Besides assist mechanical ventilation, thorough clearance of the secretion from the respiratory tract, control of pulmonary infection and early eradication of the intrathoracic complications are the key points of the successful treatment. Preoperative pulmonary functional studies with careful analysis in correlation with patients condition is mandatory especially in elderly patients. Prevention is more important and valuable than treatment for the patients with postoperative acute respiratory failure.