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Correlation Between Lymphangiogenesis and Lung Cancer Metastasis

Lymphangiogenesis plays an active role in lung cancer metastasis. Currently, it attracts more and more attention because of its role in tumor metastasis and become a hotspot in the field. Lymph node metastasis of lung cancer is the key factor for the unfavourable prognosis of the patient suffered lung cancer. But the correlation of lymphangiogenesis and lung cancer metastasis is yet unknown. Some development about it is reviewed.

疼痛和动脉血二氧化碳分压作为肋骨骨折患者手术指征的临床分析

目的 探讨疼痛和动脉血二氧化碳分压（PaCO2）作为胸外伤肋骨骨折手术指征的可行性，为肋骨内固定手术提供一条合理、可行的手术指征。 方法 选取2006年1月至2009年9月复旦大学附属华山医院南汇分院上海南汇中心医院24例肋骨骨折3 d后主动疼痛评分gt;6分、伴或不伴有PaCO2gt;50 mm Hg患者，采取随机抽签法将24例患者分为两组，手术固定组：12例，男8例，女4例；年龄 43.80±15.00岁；行爪形钢板内固定手术；保守治疗组：12例，男7例，女5例；年龄46.20±10.70岁；采取保守治疗。术后1周、2周观察疼痛评分、PaCO2和肺部感染发生率等。 结果 术后1周手术固定组疼痛评分小于保守治疗组（1.25±0.97分vs. 6.17±1.03 分，Plt;0.05），PaCO2（44.00±5.00 mm Hg vs. 49.00±5.00 mm Hg，Plt;0.05）和肺炎发生率(8.33% vs. 50.00%，Plt;0.05)低于保守治疗组。所有患者均得到随访，随访时间2周，术后2周手术固定组疼痛评分小于保守治疗组(0.83±0.83分vs. 4.75±1.14分，Plt;0.05)。 结论 疼痛评分结合PaCO2作为肋骨内固定手术的手术指征具有可行性。

The Experimental Studies of Recombinant Adenovirus Vectormediated βGalactosidase Gene Transfected to Endothelial Progenitor Cells

Objective To determine the transfection efficiency of recombinant adenovirus to endothelial progenitor cells(EPCs) and provide the base of lung cancer therapy by transfecting human herpes simplex virusthymidine kinase（HSV-TK） gene to EPCs. Methods Admove recombinant adenovirus 5F35(AD5F35) which transfected with βgalactosidase(AD5F35LacZ) to the 24 well plate cultivated with EPCs and transfect the EPCs. Stain the EPCs with LacZ kit and calculate the transfection efficiency. Results The blue stain cells were cells transfected successfully with AD5F35LacZ under the optical microscope. The transfection efficiencies of adenovirus to EPCs were different under the premise of the different multiplicity of infection(MOI). In a certain range, the transfection efficiencies rise with the MOI rise. When MOI was 400,the proportion of blue stain cell is the highest, which was 98.38%±1.25%. Conclusion Recombinant adenovirus can transfect EPCs successfully. The transfection efficiencies rise with the MOI rise. When the MOI is 400,the transfection efficiency is the highest.

房间隔缺损修补术同期行微创漏斗胸矫治术一例

The role of bone marrow-derived endothelial progenitor cells for lung cancer neovascularization

Objective To observe endothelial progenitor cells (EPCs) participating in the formation of neovascularization in lung adenocarcinoma. Methods EPCs were transfected by recombinant adenovirus carrying LacZ gene in optimal transfection concentration, and then EPCs were injected into animal models of lung adenocarcinoma through the tail vein; afterwards, lung tissues were taken out for pathological examination in the 6th, 7th, 8th week respectively. EPCs were observed to take part in the angiogenesis in the lung adenocarcinoma through X-gal chromogenic dye. Results The optimal multiplicity of infection (MOI) of AD5F35LacZ transfected EPCs was 400. When MOI was 400, maximum transfection efficiency was 97.13±2.08. After 2 weeks, LacZ gene-transfected EPCs began to proliferate in vitro culture, then the EPCs were transplanted into animal models of lung cancer to be involved in the neovascularization formation in the 8th week after transplantation. Conclusion EPCs are involved in the formation of tumor neovascularization after transplantation.

Correlation between anastomotic angle and postoperative anastomotic stricture in the surgery of esophageal carcionma: A randomized controlled trial

Objective To investigate the correlation between end-to-side anastomotic angle and postoperative anastomotic stricture in the surgery of esophageal carcinoma. Methods From January 2011 to June 2015, 130 patients with middle/lower esophageal carcinoma or gastric cardia cancer underwent operations in Shanghai Pudong Hospital and Lishui Central Hospital, Zhejiang Province. Depending on the end-to-side anastomotic angle, they were randomly divided into two groups (n=65 in each): a 0 degree group (49 males and 16 females, aged 64.5±8.3 years) and a 45 degrees group (52 males, 13 females, aged 61.7±9.1 years). Stooler degree grading was adopted to evaluate the anastomotic stricture in each group 6 months postoperatively. Results There were two patients with anastomotic fistula in each group (P>0.05). Pathology showed squamous carcinoma in 116 patients and adenocarcinoma in 14 patients. The postoperative esophageal stricture in the 45 degrees group was significantly less than that in the 0 degree group. There was no statistical difference in the duration of chest tube (5.9±6.7 dvs. 5.8±6.8 d) and recovery of intestinal peristalsis (2.6±0.8 d vs.2.6±0.7 d) between the 45 degrees group and the 0 degree group. Conclusion Esophagogastric anastomotic angle is related to the formation of postoperative anastomotic stricture. Oblique anastomosis with 45 degrees is helpful to decrease the severity of stricture.

The relationship between Beclin 1 expression and lymph node metastasis in non-small cell lung cancer

ObjectiveTo explore the relationship between Beclin 1 level and lymph node metastasis in patients with non-small cell lung cancer.MethodA total of 204 surgical specimens of patients with non-small cell lung cancer from September 2011 to September 2016 were collected in our hospital. There were 116 males and 88 females . Beclin 1 levels were detected by Western blotting. There were 116 males and 88 females at average age of 55.3±11.2 years. The patients were divided into three groups including a group N0 (no lymph node metastasis), a group N1(intralobar and interlobar lymph node metastases, and no mediastinal lymph node metastasis), and a group N2 (mediastinal lymph node metastasis). The differences of Beclin 1 levels in tumor tissues and lymph nodes of patients with N0, N1 and N2 were statistically analyzed.ResultsAmong 204 patients of lung cancer, 36 patients were squamous cell carcinoma and 168 patients were adenocarcinoma. The levels of Beclin 1 in tumor tissues of N0, N1 and N2 groups decreased gradually with a statistical difference (P<0.05). In the three groups, the levels of Beclin 1 in the lung hilum and intrapulmonary lymph nodes (N1 Beclin 1) of N1 and N2 groups were less than that of N0 group with a statistical difference (P<0.01). In the three groups, the level of Beclin 1 in the mediastinal lymph nodes (N2 Beclin 1) of N2 group was less than that of the N0 and N1 groups with a statistical difference (P<0.01). In the N1 group, the level of N1 Beclin 1 was less than that of N2 group (P<0.01). In the N2 group, though the level of N1 Beclin 1 was less than N2 Beclin 1, there was no statistical difference (P>0.05). ConclusionBeclin 1 level can be used as a reference index to judge the benign and malignant lung masses, and lymph node Beclin 1 level can be used as an important reference index to help determine whether there is lymph node metastasis in lung cancer.

Isolation, Induction and Culture of Human Endothelial Progenitor Cells in Bone Marrow and Amplification in Vitro

Abstract： Objective To investigate and improve the method of isolation, induction and culture, amplification in vitro of human endothelial progenitor cells (EPCs) in human bone marrow, thus establish a foundation for EPCs to participate in basic research and clinical application. Methods WHuman bone marrow mononuclear cells (hBMMNCs) were isolated by density gradient centrifugation and cultured in the 6plateds coating human fibronections(HFN group), coating gelatinum (coating gelatinum group) and coating nothing (coating nothing group) respectively. After culturing for 4-7d endothelial cell basal medium-2(EBM-2) cell colonyforming units (CFUs) appeared, then select EPCsliked CFUs for cultivation which was named the pick method, CD34+ KDR+ and CD133+ KDR+ double positive cells were detected in flow cytometry, and CD133, CD34, CD31, vWF and KDR expression were detected with cell immunochemical test. Results hBMMNCs were isolated from human bone marrow more effectively with OptiprepTM cell separating medium, and induced and obtained more EPCs, and cultured and amplificated in vitro. Flow cytometer showed CD133+ KDR+ double positive cells reaching up to 70.4%±5.4%, CD34+ KDR+ double positive cells reaching up to 69.1%±8.7%. EPCs grew vigorously in coating HFN group and coating gelatinum group, both HFN and gelatinum promote EPCs adherence and growth, but there were no statistically difference in two groups (Pgt;0.05).Surface mark of adherent cells cultured 7d such as CD133, CD31, vWF and KDR showed positive, and cells cultured 14d such as CD34 showed positive. Conclusion The method of picking CFUs can obtain more EPCs from human bone marrow with success and can amplificate EPCs in vitro, thus introducing another simple and effective method to purify EPCs, further widening range and increasing method to purify EPCs.

Use of Pain Scale and Arterial Oxygen Partial Pressure as Screening Internal Fixation Indications for Patients with Multiple Rib Fractures

ObjectiveTo explore the feasibility to use pain scale and arterial oxygen partial pressure(PaO2)as screening internal fixation indications for patients with multiple rib fractures. MethodsClinical data of 48 patients with multiple rib fractures who were admitted to Shanghai Pudong Hospital from September 2010 to February 2013 were retrospectively analyzed. Visual analogue scale (VAS) was used for pain assessment. Twenty-four patients whose VAS was greater than or equal to 6 and PaO2 was less than 60 mm Hg 3 days after injury were chosen as the experimental group, including 16 males and 8 females with their age of 49.29±15.73 years. Another 24 patients whose VAS was less than or equal to 5 and PaO2 was greater than 60 mm Hg 3 days after injury were chosen as the control group, including 19 males and 5 females with their age of 48.63±13.49 years. Patients in both groups received rib internal fixation with steel plates. Three days and 1 week after surgery respectively, VAS and PaO2 were compared between the 2 groups. ResultsIn the experimental group, VAS 3 days after surgery was significantly lower than preoperative VAS (4.09±0.93 vs. 8.21±1.18, P < 0.05), and VAS 1 week after surgery was significantly lower than preoperative VAS (3.20±0.98 vs. 8.21±1.18, P < 0.05). In the control group, there was no statistical difference between VAS 3 days after surgery and preoperative VAS (P > 0.05), and there was no statistical difference between VAS 1 week after surgery and preoperative VAS (P > 0.05). Three days after surgery, PaO2 of the experimental group was significantly higher than preoperative PaO2 (61.00±3.47 mm Hg vs. 53.00±3.97 mm Hg, P < 0.05). There was no statistical difference between PaO2 3 days after surgery and preoperative PaO2 in the control group (66.71±5.15 mm Hg vs. 66.00±5.00 mm Hg, P > 0.05). Three days after surgery, pneumonia occurred in 4 patients in the experimental group and 2 patients in the control group (χ2=0.762, P > 0.05). Three days after surgery, pain scale reduction of the experimental group was significantly higher than that of the control group (4.13±1.45 vs. 0.00±0.42, P < 0.05). One week after surgery, pain scale reduction of the experimental group was significantly higher than that of the control group (5.04±1.23 vs. 0.08±0.28, P < 0.05). Three days after surgery, PaO2 increase of the experimental group was significantly higher than that of the control group (7.42±3.59 mm Hg vs. 0.21±0.98 mmHg, P < 0.05). ConclusionIt's reasonable and feasible to use pain scale greater than or equal to 6 and PaO2 less than 60 mm Hg as internal fixation indications for patients with multiple rib fractures.

胸腔镜探查治疗食管癌术后胸内吻合口瘘三例