A modified method using a two-port approach for accessing the hilar vasculature without transferring an endostapler from camera port to utility port during thoracoscopic right upper lobectomy

For thoracoscopic upper lobectomies, most cutting endostaplers must be inserted through the camera port when using a two-port approach. Access to the hilar vasculature through only the utility port remains a challenge. In this study, we describe a procedure to access the hilar vasculature without transferring the endostapler site during a thoracoscopic right upper lobectomy. A 2.5-cm utility anterior incision was made in the fourth intercostal space. The posterior mediastinal visceral pleura were dissected to expose the posterior portion of the right upper bronchus and the anterior trunk of the right pulmonary artery. The pleura over the right hilar vasculature were then peeled with an electrocoagulation hook. The anterior trunk of the right pulmonary artery was then transected with a cutting endostapler through the utility port firstly. This crucial maneuver allowed the endostapler access to the right upper lobe pulmonary vein. The hilar structures were then easily handled in turn. This novel technique was performed successfully in 32 patients, with no perioperative deaths. The average operation time was 120.6 min (range 75-180 min). This novel technique permits effective control of the hilar vessels through the utility port, enabling simple, safe, quick and effective resection.

The minimally invasive thoracic surgery for lung cancer: a voice from China

The video assisted thoracoscopic surgery (VATS) was first introduced to thoracic surgeons of China in 1990s. In the past 20 years, the VATS technique has been extensively applied in treatment of lung cancer all over the land. By the end of 2014, more than 300 thousands thoracic surgeries per year are operated that nearly half of these are finished by VATS. As China has been one of the most important forces to fight against lung cancer in the world, it is essential and inevitable to understand the status and future of China’s VATS in the treatment of lung cancer during this historic period.

Flow unit perspective on room temperature homogeneous plastic deformation in metallic glasses

A mandrel winding method, which can realize remarkable homogeneous plastic deformation at room temperature for various metallic glasses, is applied to characterize plastic flow units and study their relationship with macroscopic deformations and relaxations. The method can provide information on the activation energy, activation time, size, intrinsic relaxation time, distribution, and density of flow units. We find the plasticity of a metallic glass can be controlled through modulating the features of flow units. The results have benefits for better understanding the structural origins of deformations and relaxations, and for designing metallic glasses with improved performances.

CUG-binding protein 1 (CUGBP1) expression and prognosis of non-small cell lung cancer

BACKGROUND AND AIMS

Non-small cell lung cancer (NSCLC) is the leading cause of cancer mortality worldwide. As CUGBP1 may also play a great role in tumor genesis and deterioration, the purpose of this study was to detect the expression of CUGBP1 mRNA and CUGBP1 and assess the prognostic significance of CUGBP1 in NSCLC.

METHODS

Expression of CUGBP1 mRNA and CUGBP was detected by Semi-quantitative PCR and Immunohistochemistry, respectively, from 57 NSCLC patients. The percentage of CUGBP1 mRNA and CUGBP1 expression was correlated with clinical characteristics using χ (2) test. The prognostic significance was assessed by univariate and multivariate analyses in the Cox hazard model.

RESULTS

The expression of CUGBP1 mRNA and CUGBP1 was over-expressed in cancer group and was correlated with TNM stage and Differentiation. By both univariate and multivariate survival analyses, CUGBP1 expression (P = 0.0074, HR = 3.701, 95 % CI 1.420-9.648), TNM-stage (HR = 4.043, 95 % CI 2.098-7.794) and age (HR = 3.207, 95 % CI 1.544-6.664) were noted to be independent indicators of a shorter postsurgical survival.

CONCLUSIONS

The expression of CUGBP1 independently predicted a shorter postsurgical survival in NSCLC.

Prognostic significance of NSE mRNA in advanced NSCLC treated with gefitinib

PURPOSE

Current knowledge of the prognostic biomarkers of advanced non-small cell lung cancer (NSCLC) treated with gefitinib is poor. NSE mRNA as a potential prognostic biomarker of the effectiveness of gefitinib treatment in NSCLC, especially in the Chinese population, needs to be further validated.

PATIENTS AND METHODS

We retrospectively reviewed 168 advanced NSCLC patients treated with gefitinib between May 2006 and July 2010. NSE mRNA was measured using quantitative RT-PCR analysis for correlation with the clinical outcomes.

RESULTS

We found that NSE mRNA expression was inversely correlated with sensitivity to gefitinib in NSCLC patients. Patients without elevated NSE mRNA had a more RR (CR + RR) 45.1 % than elevated 18.9 % (P = 0.0005). Moreover, the time to progression was 6.0 versus 4.2 months, respectively. Log-rank test was marginally significant (χ(2) = 12.11, P = 0.0007) and Cox multivariate analysis revealed that NSE mRNA (HR = 3.076; 95 % CI 1.943-4.870; P < 0.0001) was an independent prognostic factor of NSCLC patients in the Chinese population.

CONCLUSION

For NSCLC patients treated with gefitinib, patients without elevated NSE mRNA had a better prognosis than those with elevated NSE mRNA. Pretreatment NSE mRNA holds great potential as a prognostic biomarker in advanced NSCLC. Therefore, it is proposed that NSE mRNA should be routinely detected to screen patients who are more likely to benefit from gefitinib-based treatment.

Plasticity of ductile metallic glasses: a self-organized critical state

We report a close correlation between the dynamic behavior of serrated flow and the plasticity in metallic glasses (MGs) and show that the plastic deformation of ductile MGs can evolve into a self-organized critical state characterized by the power-law distribution of shear avalanches. A stick-slip model considering the interaction of multiple shear bands is presented to reveal complex scale-free intermittent shear-band motions in ductile MGs and quantitatively reproduce the experimental observations. Our studies have implications for understanding the precise plastic deformation mechanism of MGs.

COX-2 inhibitors are contraindicated for treatment of combined injury

Casualties of radiation dispersal devices, nuclear detonation or major ionizing radiation accidents, in addition to radiation exposure, may sustain physical and/or thermal trauma. Radiation exposure plus additional tissue trauma is known as combined injury. There are no definitive therapeutic agents. Cyclooxygenase-2 (COX-2), an inducible enzyme expressed in pathological disorders and radiation injury, plays an important role in inflammation and the production of cytokines and prostaglandin E(2) (PGE(2)) and could therefore affect the outcome for victims of combined injury. The COX-2 inhibitors celecoxib and meloxicam were evaluated for their therapeutic value against combined injury in mice. In survival studies, the COX-2 inhibitors had no beneficial effect on 30-day survival, wound healing or body weight gain after radiation injury alone or after combined injury. Meloxicam accelerated death in both wounded and combined injury mice. These drugs also induced severe hepatic toxicity, exaggerated inflammatory processes, and did not enhance hematopoietic cell regeneration. This study points to potential contraindications for use of COX-2 inhibitors in patients undergoing therapy for radiation injury and combined injury.

Aberrant nucleocytoplasmic localization of the retinoblastoma tumor suppressor protein in human cancer correlates with moderate/poor tumor differentiation

Inactivation of the retinoblastoma (RB) tumor suppressor pathway, via elevated cyclin-dependent kinase (CDK) activity, is observed in majority of human cancers. Since CDK deregulation is evident in most cancer cells, pharmacological CDK inhibition has become an attractive therapeutic strategy in oncology. We recently showed that an oncogenic CDK4(R24C) mutation alters the subcellular localization of the normally nuclear RB phosphoprotein. Here, using 71 human cancer cell lines and over 300 primary human cancer tissues, we investigated whether changes in RB subcellular localization occur during human cancer progression. We uncover that diverse human cancers and their derived cell lines, particularly those with poor tumor differentiation, display significant cytoplasmic mislocalization of ordinarily nuclear RB. The nucleocytoplasmically distributed RB was derived via CDK-dependent and Exportin1-mediated nuclear export. Indeed, cytoplasmically mislocalized RB could be efficiently confined to the nucleus by pharmacologically reducing CDK activity or by inhibiting the Exportin1-mediated nuclear export pathway. Our observations uncover a post-translational CDK-dependent mechanism of RB inactivation and suggest that cytoplasmically localized RB may harbor a tumor promoting function. We propose that RB inactivation, via aberrant nucleocytoplasmic transport, may disrupt normal cell differentiation programs and accelerate the cancer process. These results are evidence that tumor cells modulate the protein transport machinery thereby making the protein transport process a viable therapeutic target.

[A survey of Echinococcus granulosus infection in Camelus bactrianus in north Xinjiang]

AIM

To determine the situation and characteristics of Echinococcus granulosus infection in camels (Camelus bacterianus) in our country.

METHODS

The camels slaughtered in abattoir were examined for visceral infection of larval cestode of Echinococcus. The number and diameter of cysts were recorded and the content of cysts were examined microscopically to detect the protoscoleces.

RESULTS

185 out of 375 camels were positive, the infection rate was 49.3%. The metacestodes parasitized mainly in the liver and lung, the ratio between liver and lung involved was 1:0.64. The fertile cyst rate was 39.2%, the fertile cyst-carrying rate of camels was 34.8%, the cyst index was 7.53. The cyst wall was relatively thin and the cysts located singly on the surface of liver. There was no daughter cyst seen in fertile cysts. The average diameter of fertile cysts was 5.6 +/- 2.65 cm in liver and 4.83 +/- 2.03 cm in lung. The percentage of animals harboring calcified cysts was 64.3%.

CONCLUSION

The infection rate of metacestodes of Echinococcus granulosus in Bactrian camel was very high in north Xinjiang and the characteristics of infection differ in some aspects from the local sheep and cattle and from dromedaries in Africa as well. Further study is needed to elucidate the significance of the infection of E. granulosus in Bactrian camels.

[Comparative observation on experimental infection with Echinococcus multilocularis in Cricetulus Migratorius and Meriones meridianus]

AIM

To search for an animal model with higher susceptibility to Echinococcus multilocularis and shorter experimental period.

METHODS

Cricetulus migratorius, Meriones meridianus and NIH mice were experimentally infected with protoscolices of E. multilocularis and were autopsed at different times after their infection. The development of E. multilocularis in these three species of rodents was observed and compared.

RESULTS

The average wet cyst weight and the ratio of cyst weight to body weight on the 91st day after infection were 15.0 +/- 2.1 g and 32.3% for C. migratorius, 3.3 +/- 1.1 g and 6.9% for M. meridianus, 0.6 +/- 0.6 g and 2.4% for NIH mice; and the corresponding figures on the 188th day after infection were 11.8 +/- 2.7 g and 21.7% for C. migratorius, 8.1 +/- 5.1 g and 15.4% for M. meridianus and 8.4 +/- 8.3 g and 26.7% for NIH mice, respectively. On the 91st day, matured protoscolices were found in C. migratorius and M. meridianus, whereas NIH mice had matured protoscolices on the 188th day after infection.

CONCLUSION

C. migratorius has higher sensitivity to E. multilocularis infection than the other two species of animals as manifested by high infection rate, well-developed vesicles and rapid growth speed. C. migratorius proved to be an ideal experimental animal for E. multilocularis.

Inverse correlation between E-cadherin and Snail expression in hepatocellular carcinoma cell lines in vitro and in vivo

Hepatocellular carcinoma is a well-known malignancy in the world. However, the molecular mechanism of carcinogenesis and tumour progression remains unclear. Recently, reduced E-cadherin expression due to transcriptional suppressor Snail was proven in a panel of epithelial and dedifferentiated cells derived from carcinomas of various etiologies. In the present study, we examined Snail and E-cadherin mRNA/protein expression in five hepatocellular carcinoma cell lines with variable phenotypes (HuL-1, Hep-G(2), Changliver, HLE, and HLF). The results demonstrated that the presence of Snail mRNA in HuL-1, Changliver, HLE and HLF cells detected by RT-PCR, which was further proven by in situ hybridization in tumours induced by HuL-1, Changliver, and HLF cells where Snail mRNA signals expressed in each of the sections. By contrast, E-cadherin mRNA and protein expression were only detected in Hep-G(2) cells by RT-PCR and Western blot, respectively. These results were also consistent with the data obtained from in vivo immunohistochemical staining where membranous expression of endogenous E-cadherin protein was revealed only in tumour sections induced by Hep-G(2) cells. Here we are the first to report that there is an inverse correlation between Snail and E-cadherin expression in HCC cells as well.