Bronchiolitis obliterans complicating a pneumothorax after Stevens-Johnson syndrome induced by lamotrigine.

Bronchiolitis obliterans (BO) was defined as a nonreversible obstructive lung disease in which the bronchioles are always compressed and narrowed by fibrosis or inflammation. In the severe event of lung collapse after BO, surgical intervention is often recommended, and conservative therapy is thought to be ineffective. Here, we report the case of a 9-year old girl clinically diagnosed as having bronchiolitis obliterans with abrupt occlusion of the right B4b bronchus. After a lamotrigine-induced Stevens-Johnson syndrome (SJS) occurred, she presented with total collapse of the right lung on admission, which was subsequently complicated by a pneumothorax during conservative treatment, but with the re-expansion of the right upper lobe after intervention. The case indicates the possibility of reversing pulmonary atelectasis in BO. Thus, surgery may not be necessary.

Effects of lipid emulsions in parenteral nutrition of esophageal cancer surgical patients receiving enteral nutrition: a comparative analysis.

BACKGROUND: Olive oil-based lipid emulsion (LE) and medium chain triglyceride/long chain triglyceride (MCT/LCT) emulsion are both LEs with low ω-6 polyunsaturated fat acids (PUFAs) content. However, which one of these LEs is associated with a lower infection risk in patients receiving parenteral nutrition (PN) remains unclear. The aim of the study was to compare the effects of the two LEs in PN in esophageal cancer patients undergoing surgery. METHODS: Patients with resectable esophageal carcinoma were recruited and allocated randomly to two groups. The test group was given enteral nutrition (EN) with PN containing olive oil-based LE after tumor resection for ≥7 days, and the patients in the control group were supported by EN with MCT/LCT emulsion-based PN after surgery for the same time period. Immunological markers and inflammatory indicators were tested and perioperative clinical outcomes were determined. The trial was registered in the Chinese Clinical Trial Register, number ChiCTR-TRC-13003562. 94 Patients were recruited, and grouped (olive oil-based LE, n=46 and MCT/LCT, n=48), matched for sex, age, body mass index, histological type, TNM stage, and nutrition risk screening (NRS) 2002 score. RESULTS: There were no differences in perioperative fever (>38 °C), infectious complications, length of hospital stay (>14 days), length of critical care stay (>2 days), time for oral food intake, and in-hospital mortality between the two groups. The test group showed a higher increase in IgG level compared with the MCT/LCT group (p=0.028). There was no difference in other immunological markers and inflammatory indicators between the two groups. CONCLUSION: PN containing olive oil-based or MCT/LCT LEs had similar effects on perioperative outcome, cell-mediated immune function and inflammatory response in esophageal cancer patients who had undergone surgery and were receiving EN.

Isolated Crohn's disease of the esophagus with esophago-mediastinal fistula formation.

Isolated Crohn's disease of the esophagus is rare, and accurate diagnosis and treatment in its early course are difficult. Most cases are often found very late, when severe strictures or other complications have occurred. We report the case of a male 60-year-old patient with complaints of progressive dysphagia for more than two months and the sudden appearance of heartburn for seven consecutive days. Clinical examination revealed severe esophageal stricture with a suspected fistula and mediastinitis. The patient received a successful esophagectomy. The resected specimen and pathological results confirmed a deep linear ulcer, chronic and noncaseating granulomatous inflammation, as well as a circular stricture of the esophagus with fistula into the mediastinum due to isolated esophageal Crohn's disease.

A case report of para-esophageal bronchogenic cyst with esophageal communication.

Paraesophageal bronchogenic cyst was one of common mediastinal congenital cystic lesions of foregut origin. Because of an intimate embryologic relationship with the esophagus, they were usually found intramural (intramural esophageal bronchogenic cysts) with the local esophageal mucosa being intact and the paraesophageal bronchogenic cysts were rarely communicated with esophageal lumen. We report a case of para-esophageal bronchogenic cyst communicating to the esophageal lumen thorough a pedicle of canal, which looked liked a diverticulum on X-ray. During the operation, a communication of paraesophageal bronchogenic cyst with esophageal was found and the pathology diagnosis were made then. The symptoms of chest pain and dysphagia were relieved immediately after operation. The follow-up was well 2 years after the surgery.

CT-guided percutaneous microwave ablation of pulmonary malignancies: Results in 69 cases.

BACKGROUND: Microwave ablation (MWA) has attracted a worldwide attention gradually in treating inoperable pulmonary malignancies. However, in the lung tissues treated with MWA recurrence of tumor may still occur and few data in large patient groups till now were reported about the safety or effectiveness of microwave ablation in treating primary lung cancer and metastatic pulmonary malignancies. The purpose of this study is to evaluate the clinical curative effect (local control, survival data) MWA and its safety as well. METHODS: From 1 January 2005 to 1 January 2008, retrospective analyses, 69 patients underwent computed tomography (CT)-guided percutaneous MWA of pulmonary malignancies. All patients were deemed medically inoperable. The correlation of tumor sizes and local progression after ablation was analyzed and the survival rates within 3 years post surgery were compared between non-small-cell lung cancer and pulmonary metastases groups also. RESULTS: Pneumothorax was the most frequent complication and occurred in 24.64% patients after ablation. Neither needle track implantation was found nor did patient death occur in these patients within 30 days. The 1-, 2-, and 3-year overall survival rates were 66.7%, 44.9% and 24.6%, respectively. The overall survival rates for NSCLC patients in 1 year, 2 years, and 3 years were 75.0%, 54.2%, and 29.2%, respectively. The overall survival rates for pulmonary metastatic tumor patients in 1 year, 2 years, and 3 years were 47.6%, 23.8%, and 14.3%, respectively. The recurrence-free survival rates for NSCLC patients in 1 year, 2 years, and 3 years were 72.9%, 50.0%, and 27.1%, respectively. The mortality rates for pulmonary metastatic tumor patients in 1 year, 2 years, and 3 years were 47.6%, 19.0%, and 14.3%, respectively. CONCLUSIONS: Percutaneous microwave coagulation therapy was one safe and effective method and could be beneficial for the improvement of inoperable pulmonary malignancies treatment effect.

[Expression and its clinical significance of SLC22A18 in non-small cell lung cancer].

BACKGROUND AND OBJECTIVE: It has been proven that multidrug resistance (MDR) is the main cause of chemotherapy failure in lung cancer. Research on emergence mechanisms of MDR has great clinical significance in improving the curative efficiency of lung cancer chemotherapy. Proteins encoded by the SLC22A18 gene, which is similar to the transmembrane transporter, may influence the sensitivity of chemotherapeutics as well as the metabolism and growth of cells. In addition, these proteins probably have some effect on the development of lung cancer MDR. The aim of the present study is to investigate the expression of SLC22A18 protein in non-small cell lung cancer (NSCLC) as well as in corresponding normal lung tissue. Furthermore, the relationship between SLC22A18 expression and pathological grade and TNM stage is analyzed. METHODS: The expression of SLC22A18 was detected by EnVinsion in 96 cases with NSCLC and in corresponding normal lung tissue. Statistical analysis was performed using SPSS 17.0 statistical software. RESULTS: SLC22A18 was mainly located in cell membrane and cytoplasm. The expression level of SLC22A18 in NSCLC was significantly higher than that in normal tissue (P<0.01). The positive rates in squamous cell lung cancer and lung adenocarcinoma were 68% and 78.2%, respectively (P<0.05). Moreover, the higher expression of SLC22A18 was associated with lower histological grade and later TNM stage (P<0.05). CONCLUSION: SLC22A18 protein is overexpressed in NSCLC, and its expression is correlated with pathological grade and TNM stage. These findings provide the experimental basis for investigating the role of tumor and chemoresistance.

[Experimental study on acute respiratory distress syndrome and analysis of relevant factors in rabbits subjected to thoracic blast trauma].

OBJECTIVE: To reproduce acute respiratory distress syndrome (ARDS) model in rabbit induced by chest blast injury and to analyze the pathogenesis and causes of early death in order to provide the basis for the early diagnosis of lung blast injury and its early warning system to facilitate an early treatment. METHODS: Sixty healthy New Zealand white rabbits were divided into six groups according to the different explosion distance with the random number table method. The survival rate and its resulting pathological changes were observed and patho physiological indexes and lung fluid content were determined at sequential time points post explosion. RESULTS: Shock wave pressure less than 1 210.5 mm Hg (1 mm Hg=0.133 kPa, group A, B) resulted in limited injury to the lung within grade 2 as assessed with the abbreviated injury scale (AIS). The rabbits in these groups recovered soon and survived without any complication. Shock pressure higher than 2 036.1 mm Hg (group D, E) caused severe injuries to the lung, including deep laceration , disruption of lung hilus and large hematoma in the lung, and the injury severity of lungs was assessed above grade 5 as assessed with AIS. All rabbits died within 1 hour post explosion. The groups described above failed to meet the demand of an ARDS model for the present study. Shock wave pressure at 1 917.3 mm Hg (group C) produced extensive contusion from grade 4 to grade 5 as assessed with AIS. The rabbits survived in poor general condition, and arterial partial pressure of oxygen (PaO(2)) lowered within 6 hours . Pathological examination showed extensive and constant multi focal bleeding involving more than four lobes. The alveolar wall was edematous, with partial rupture and alveolar fusion in lung tissues was observed in the group C. Alveoli were filled with inflammatory cells, and hyaline membrane was formed occasionally . Compared with control group, the wet to dry weight ratio (W/D) in lungs increased obviously (6.46±0.24 vs. 3.98±0.19, P<0.01) in group C within 6 hours postinjury. The contents of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in plasma and bronchoalveolar lavage fluid (BALF) were also increased distinctly compared with the control group [TNF-α (ng/L) in plasma: 328.89±6.26 vs. 62.12±2.98, TNF-α (ng/L) in BALF: 164.87±4.59 vs. 29.51±1.12; IL-6 (ng/L) in plasma: 128.51±4.13 vs. 19.32±1.53, IL-6 (ng/L) in BALF: 94.97±1.14 vs. 22.72±0.19, all P<0.05]. CONCLUSION: In an airtight environment, rabbit ARDS model can be reproduced successfully by blast injury with 1 917.3 mm Hg explosion pressure; TNF-α and IL-6 are involved in the pathogenesis and development of ARDS in blast injury. Pneumothorax as a result of lung rupture is the chief reason for early death and dysfunction of circulatory system is also an important reason in producing early death.

Is radiofrequency thermal ablation a safe and effective procedure in the treatment of pulmonary malignancies?

OBJECTIVE: Radiofrequency ablation (RFA) has been recently applied as an alternative option of pulmonary surgery in the treatment of pulmonary malignancies. In this study, we assessed the risk associated with percutaneous RFA, and discussed its safety and efficacy. METHODS: The clinical data of 329 consecutive patients with primary (n = 237) and metastatic (n = 92) lung tumor treated with RFA from 1999 to 2006 in this hospital were considered for this study, and the character and clinical data of these patients were analyzed. Complications, local progression, and overall survival at 1, 2 and 5 years of these patients were evaluated. RESULTS: Following the procedure 63 (19.1%) patients presented with pneumothorax, 14 (4.2%) with hemoptysis (one death), 10 (3.0%) hemothorax, 15 (4.5%) pneumonia, and three (0.9%) pericardial tamponade (one death); the 30-day mortality after the procedure was 0.6%. Needle-track implantation was observed in six (1.8%) patients. Median progression-free interval was 21.6 months. The overall survival at 1, 2 and 5 years was 68.2%, 35.3%, and 20.1%, respectively. A total of 78 (23.7%) patients developed local progression during the follow-up. Significant difference in the risk of local progression was found in tumors more than 4 cm; however, no significant difference was found in tumors less than 3 cm and 3-4 cm in our group. CONCLUSION: RAF is a safe and well-tolerated procedure with satisfied efficacy in the treatment of malignant lung nodules. To avoid complications with potential fatal outcome, adequate training and careful patient selection by a multidisciplinary team might be helpful.

Bone morphogenetic protein-2 stimulation of cartilage regeneration in canine tracheal graft.

BACKGROUND: Graft stenosis is among the most serious post-surgical complications that can occur after tracheal transplantation. Typically, stenosis is caused by resorption of tracheal cartilage. Bone morphogenetic protein-2 (BMP-2) is efficient at stimulating bone or cartilage regeneration. In this study, BMP-2 is tested for its effects on stimulation of cartilage regeneration in tracheal transplantation. METHODS: For tracheal autotransplantation, 24 mongrel dogs were divided equally into four groups and BMP-2 was injected between the cartilage rings at doses of 1, 3, 5 or 7 mg. For tracheal allotransplantation, 12 mongrel dogs were divided equally into two groups. One group received 5 mg of BMP-2 per graft, and the other received collagen only as a control. The grafts were harvested after 4 weeks and subjected to pathologic analysis. The diameter of the graft lumen and areas of new cartilage regeneration were measured. RESULTS: Regenerated cartilage areas were found in both the injected area and around the perichondrium. The areas of regenerated cartilage, as well as the diameter of the tracheal lumen, increased significantly with increasing concentrations of BMP-2. Five milligrams per milliliter was the most effective dose of BMP-2 in this study. CONCLUSIONS: BMP-2 can significantly stimulate cartilage regeneration in tracheal grafts and also can be used to prevent stenosis after tracheal transplantation.

Repair of massive stent-induced tracheoesophageal fistula.

OBJECTIVE: The purpose of this report was to discuss a new surgical procedure in treating esophageal stent related large tracheoesophageal fistula without tracheal resection. METHODS: Clinical records of 5 patients with esophageal stent-related large tracheoesophageal fistulas treated in this hospital between 1997 and 2006 were reviewed. RESULT: All patients had insertion of a covered self-expanding esophageal stent, 1 for benign esophageal stricture and 4 for esophageal perforation resulting from various causes. A double patch technique, in which the esophageal wall was used as a protective patch repairing the defect on the trachea, was performed with an esophagectomy and gastric replacement. No significant complications occurred in the perioperative period. All patients recovered uneventfully. CONCLUSIONS: Use of the adjacent esophageal wall as a patch to close a defect on the trachea is a safe procedure with a favorable outcome. It should therefore be recommended as a reliable surgical procedure in treating massive stent-induced tracheoesophageal fistulas and other complicated tracheoesophageal fistulas that tracheal resection could not safely address. However, the esophagus was damaged to a certain degree.

Lung cancer A549 cells migrate directionally in DC electric fields with polarized and activated EGFRs.

Endogenous direct-current electric fields (dcEFs) occur in vivo in the form of epithelial transcellular potentials or neuronal field potentials. A variety of cells respond to dcEFs by migrating directionally, and this is termed galvanotaxis. The mechanism by which dcEFs direct cell movement, however, is not yet understood, and the effects on lung cancer cells are entirely unknown. We demonstrated that cultured human lung adenocarcinoma A549 cells migrate toward the cathode in applied dcEFs at 3 V/cm. Fluorescence microscopy showed that both epidermal growth factor receptors (EGFRs) and F-actin are polarized to the cathode. EGFR inhibitors, cetuximab and AG1478, reduced the migration rate and directed motility in dcEFs. Western blots showed that ERK and AKT signaling pathways were prominently promoted by dcEFs. EGFR inhibitors could reduce this promotion but not completely. These data suggest that polarization of EGFRs and the activation of their downstream signals play an important role in the galvanotaxis of A549 cells in dcEFs.

Enhancement of radiosensitivity by roscovitine pretreatment in human non-small cell lung cancer A549 cells.

Roscovitine has been reported to have anti-proliferative properties and is in process of undergoing clinical trials. In addition to its intrinsic anticancer properties, it has recently been suggested that roscovitine may also enhance the activity of traditional chemo- and radio- therapies in certain cancer cell lines. The purpose of this study was to define the activity of roscovitine in increasing radiosensitivity of human non-small cell lung cancer (NSCLC) cell line A549 cells in vitro. A549 cells were exposed to ionizing radiation (IR) of gamma-ray with or without roscovitine pretreatment. Clonogenic assay was performed and cell cycle and apoptosis were analyzed by flow cytometry. Expression of PARP, Ku70 and Ku80 proteins was detected by Western blot. The active form of caspase-3 positive cells were measured by flow cytometry. Our results showed that roscovitine caused dose-dependent apoptosis in A549 cells. Pretreatment with minimally toxic concentration of roscovitine significantly radiosensitized A549 cells by inhibiting colony formation. We then examined potential mechanisms that may contribute to the enhanced radiation response induced by roscovitine. Our results showed that the combination treatment significantly induced apoptosis in A549 cells compared to roscovitine or IR treatment alone. Meanwhile, in the co-treatment group, the percentage of cells with the active form of caspase-3 was markedly increased, while roscovitine or IR alone had little effect. Roscovitine decreased S phase cells when used alone or in sequential combination with IR. Furthermore, this combination treatment blocked DNA repair process after IR, indicated by down regulation of Ku70 and Ku80 proteins, while the singly used treatment did not. Taken together, these results suggest that roscovitine has the potential to act as a radio-sensitizer in A549 cells by promoting caspase-3 activity and increasing apoptosis, affecting cell cycle distribution and impairing DNA repair process.

[The expression of ABCG4, V-ATPase and clinic significance of their correlation with NSCLC.].

BACKGROUND: It has been proven that the multiple drug resistance is main reason for failure of chemotherapy in lung cancers and ABC transporter play a main role for chemoresistance in mediating drug efflux. So searching for new drug resistant protein of the ABC family and elucidating its resistant mechanism is very important. ABCG4 is one of ABC family and is expected to be candidate drug resistant protein; and the drug resistance probably correlated with pH value around cancer cell, while, V-ATPase play key role in modulating the pH. So our aim is to investigate the expressions of ABCG4, V-ATPase proteins in non small cell lung cancer (NSCLC), and analyze relationship of ABCG4, V-ATPase protein expressional rate in these cancers with the cancers' pathological grade and TNM stages. METHODS: To detect the expression rates of ABCG4, V-ATPase protein in NSCLC with immunohistochemical method and immuno- fluorescent method, and to observe the location, the collocation of the proteins under light microscope and confocal laser scanning microscope; the differences of the protein expression and their correlations were analyzed by statistics. RESULTS: ABCG4 protein was high expressed in squamous cell lung cancer, lung adenocarcinoma respectively, and between the two kinds of the cancers there was a significant difference (P =0.001) for their comparison; there were significant differences between pathological grade II and II-III of squamous cell lung cancer, between different differentiated lung adenocarcinoma. V-ATPase protein were also high expressed in these two kinds of cancers, and there was significant difference for their comparison; there were significant differences between pathological grade II and II-III of squamous cell lung cancer, between different differentiated lung adenocarcinoma; there were no significant differences among the squamous cell lung cancer and lung adenocarcinoma for TNM stages respectively. The P values of correlationship test of positive intensity between ABCG4 and V-ATPase expression in the total squamous cell lung cancer and lung adenocarcinoma, in the pathological grade II and II-III of the squamous cell lung cancer, in the moderately differentiated lung adenocarcinoma were all 0.000, while the correlation coefficients were 0.771, 0.765, 0.714, 0.777, 0.865 respectively; however, the P values of correlationship test of between ABCG4 and V-ATPase expression in the low differentiated lung adenocarcinoma was 0.048, and the correlation coefficient was 0.35. The ABCG4 and V-ATPase positive expression was mainly located in the plasma membrane and cytoplasm, and there was collocation among the ABCG4 and V-ATPase proteins. CONCLUSIONS: The ABCG4 and V-ATPase proteins are highly expressed in the NSCLC, and the expression rates of ABCG4, V-ATPase proteins are correlated with the cancers' pathological grades and TNM stage; and there are all having correlationship between ABCG4 and V-ATPase proteins in the squamous cell lung cancer, in the lung adenocarcinoma, in all their pathological grades.

A rat surgical model of esophageal metaplasia and adenocarcinoma-induced by mixed reflux of gastric acid and duodenal contents.

Recent clinical data have revealed that mixed reflux (MR) of gastric acid and duodenal contents frequently occurs in patients with gastroesophageal reflux disease and a progressive increase of MR occurs with increasing severity across gastroesophageal reflux disease. Herein we report a novel rat surgical model in which esophageal metaplasia and adenocarcinoma develop as complications of MR. The model was created by performing an esophagojejunostomy and a gastrojejunostomy 5 mm proximal to the esophagojejunal anastomosis in 40 rats. Severe inflammatory and proliferative changes, high prevalence of esophageal metaplasia (78%), and adenocarcinoma (50%) were observed in the lower part of the esophagus of rats 20 weeks after surgery. The resulting esophageal lesions resembled those described in humans and supported a progression from intestinal metaplasia to dysplasia and, ultimately, esophageal adenocarcinoma. Such a model may provide a useful tool in study of human reflux-induced carcinogenesis.

[The initial value evaluation of ¹8F-fluorodeoxyglucose positron emission tomography in the diagnosis of chest malignant tumors].

BACKGROUND: ¹8F-fluorodeoxyglucose positron emission tomography (¹8F-FDG PET) is considered as one of the most valuable diagnostic methods of chest malignant tumors, except for pathological diagnosis. But in clinic, the cases whose diagnosis of ¹8F-FDG PET is different from pathological diagnosis are not rare. This study is to evaluate the initial value of ¹8F-FDG PET in the diagnosis and staging of the chest malignant tumors. METHODS: Fifty-one cases of chest tumors in Xi'an who underwent ¹8F-FDG PET were collected. Additionally, pathologic diagnosis had also been experienced on the patients through operation, percutaneous puncture, bronchoscopy or film preparation of pleural fluid. By the comparison of ¹8F-FDG PET diagnosis and the pathologic diagnosis, accuracy, sensitivity, specificity, false positive rate, positive predictive and negative predictive of ¹8F-FDG PET were calculated. RESULTS: In 51 patients, there were 34 patients whose ¹8F-FDG PET diagnoses were consistent with the pathological diagnoses, including 31 true positive, 3 true negative. Out of another 17 patients, 11 were false positive, including 2 sarcoidosis, 6 tuberculosis of the lung, 2 inflammatory pseudotumor of the lung and 1 pulmonary cryptococcosis, and 6 were false negative. The calculated values were 66.67% on the overall accuracy, 83.78% on sensitivity, 21.43% on specificity, 78.57% on false positive rate, 16.21% on false negative rate, 73.81% on positive predictive value and 33.33% on negative predictive value. CONCLUSIONS: Currently, ¹8F-FDG PET is still one of the most advanced unwounded technologies for the chest malignant tumor diagnosis. However, this technology experiences difficulties in detection of some high metabolized benign disease, such as tuberculosis from malignant tumor. Hence, in order to take advantage of ¹8F-FDG PET technology and have more accurate diagnosis of chest tumors, both results from the ¹8F-FDG PET and the clinic actuality should be considered.

[Association of MMP1 -1607(1G>2G)single nucleotide polymorphism with susceptibility to lung cancer in Northwestern Chinese population of Han nationality].

OBJECTIVE: Matrix metalloproteinase 1 (MMP1) plays an important role in the development of lung cancer. This study was to investigate the relation to associate the single nucleotide polymorphism(SNP)in MMP1 gene with the susceptibility to lung cancer in Northwestern Chinese population of Han nationality. METHODS: By using the methods of polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP), MMP1 -1607(1G>2G) polymorphisms in 150 patients with lung cancer, and 200 healthy controls were detected to evaluate the relationship between different genotypes and susceptibility of lung cancer. RESULTS: Individuals with 2G/2G genotype had 1.77 fold risk suffering from lung cancer, when compared with ones with 1G/2G and 1G/1G genotypes. Smokers with 2G/2G genotype exhibited 3.20 fold elevated risk for lung cancer (OR 3.20; 95% CI 1.50-6.82). CONCLUSION: The -1607(1G>2G) in promoter region of MMP1 is associated with susceptibility to lung cancer in Northwestern Chinese population of Han nationality. The genotype 2G/2G enhances the susceptibility to lung cancer.

[c-fos antisense oligodeoxynucleotide reduces VIP-induced upregulation of VEGF expression in small cell lung cancer cells].

BACKGROUND: It has been known that vasoactive intestinal peptide (VIP) has the effect of promoting the growth of some malignant tumors, but its mechanism is not clear. The aim of this study is to use c-fos antisense oligodeoxynucleotide (ASO) to block c-fos expression and to explore whether c-fos can directly regulate VIP-induced VEGF expression in small cell lung cancer (SCLC) cells. METHODS: Expression levels of c-fos and VEGF genes were detected in SCLC cell line H446 treated with VIP by RT-PCR. After c-fos ASO was added to the H446 cells, the change of VEGF mRNA expression level was analyzed. RESULTS: Administration of VIP resulted in increased expression of c-fos and VEGF mRNA in the H446 cells. The expression of c-fos mRNA reached the peak level at 2h and 4h after VIP treatment, which was significantly higher than that at 0h (P < 0.01). Whereas, the highest expression level of VEGF mRNA was observed at 8h and 16h after VIP treatment, which was significantly higher than that at 0h (P < 0.01). c-fos ASO significantly reversed VIP-induced upregulation of VEGF mRNA expression (P < 0.01) CONCLUSIONS: VIP can increase the expression and secretion of VEGF in lung cancer cells by activating the transcription factor c-fos, then promote the angiogenesis of lung cancer and thus play an important role in the pathogenesis of lung cancer.

[Vasoactive intestinal peptide enhances the expression of vascular endothelial growth factor mRNA in non-small cell lung cancer cells].

BACKGROUND: Some researches have found that the development of tumor could be encouraged by vascular endothelial growth factor (VEGF) and vasoactive intestinal peptide (VIP), but how about the mode of VIP? The aim of this study is to examine the effects of VIP on expression of VEGF mRNA in non-small cell lung cancer (NSCLC) cells. METHODS: Expression of VEGF mRNA was detected in NSCLC and small cell lung cancer (SCLC) cell lines by reverse transcriptase-polymerase chain reaction (RT-PCR) technique. RESULTS: VEGF mRNA was detected in NSCLC cell lines A549, GLC-82, H157, H460 and SCLC cell line H446. VIP could enhance the expression level of VEGF mRNA in NSCLC cell lines A549 and H157. The expression level of VEGF mRNA reached a peak at 8h and 16h after VIP administration, which was significantly higher than that at 0h (P < 0.01). CONCLUSIONS: VIP may promote the angiogenesis of lung cancer through increasing the expression and secretion of VEGF in lung cancer cells, and thus plays an important role in the pathogenesis of lung cancer.

Surgical management of esophageal strictures after caustic burns: a 30 years of experience.

AIM: To analyze a 30-year historical series of patients treated in our hospital, who ingested corrosive substances, and to assess the effectiveness of surgical therapy administered in patients with strictures after caustic injury in esophagus during this period. METHODS: A total of 79 cases of caustic burns in esophagus were treated in Tangdu Hospital from 1971 to 2001. Their clinical and pathological data were reviewed, and collected from the medical records of patients and interviews with them. RESULTS: More men (n = 61) than women (n = 18) ingested caustic substances with a sex ratio of 3.4:1 during the 30-year period. The caustic materials were liquid lye and acids (54 cases and 25 cases, respectively). Sixty-eight patients were given esophageal replacement in more than three months after caustic injury with no postoperative death, of which 17 cases developed postoperative complications making a complication rate of 25%. The most common one was cervical anastomotic leakage. All patients had improvement in swallowing afterwards. CONCLUSION: The presence and severity of injuries are correlated with the amount of caustic substances ingested. Surgical treatment is a good option in patients with severe strictures, and colonic interposition might be the best surgical process. The most important factors to guarantee a successful outcome for surgery are good vascular supply and absence of tension in the anastomosis.