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Objective: To share the results of laparoscopic assisted proximal gastrectomy λ- shaped modified double tract reconstruction. Method: This study retrospectively included 3 patients during January 2024 from the Department of Gastric Surgery at the First Affiliated Hospital of Nanjing Medical University using the λ-shaped modified double tract reconstruction. The procedure of the λ-shaped modified double tract reconstruction is as follows. After completing proximal gastrectomy, the jejunum is transected 15 cm from the Treitz ligament. A suture is made 18-20 cm from the distal jejunum to mark the esophagojejunal anastomosis site. A circular stapler anvil is inserted through the distal jejunum, and the remaining end of the jejunum is turned to the right. The circular stapler is pierced through the marked site for an esophagojejunal end-to-end anastomosis, which is reinforced with a barbed suture continuously. A 60mm linear stapler is used to close the remaining end of the jejunum. We then mark the gastric side of the gastrojejunal anastomosis with suture in the middle of the anterior wall of the residual stomach, and mark the jejunal side of the gastrojejunal anastomosis at a distance of about 2 cm and 8 cm from the residual end of the distal jejunum. We make an opening of about 0.5 cm and use a 60 mm linear stapler to perform anastomosis on the jejunal side of the anterior wall of the residual stomach according to the markings, so that the distance between the esophagojejunal anastomosis and the gastrojejunal anastomosis is 10-12 cm. The common opening is closed with barbed wire. About 50 cm below the esophagojejunal anastomosis, the small intestine opening is anastomosed side to side using a circular stapler and the common opening is closed. Return the jejunum into the abdominal cavity to complete the reconstruction of the λ-shaped double tract reconstruction. We analyzed the surgery and postoperative conditions, including surgery time, anastomosis time, intraoperative bleeding, tumor size and pathology, postoperative mobilization, passage of gas and water intake time, discharge time, postoperative complications, and postoperative gastrointestinal imaging to observe the passage of food through the gastric and intestinal loops. Results: Three patients successfully received laparoscopic assisted proximal gastrectomy with λ-shaped modified double tract reconstruction. The surgical time was 155 minutes, 240 minutes, and 160 minutes, respectively; The postoperative time for first ambulation was 20 hours, 18 hours, and 26 hours, respectively. The time for passage of gas was 59 hours, 83 hours, and 75 hours, respectively. The drinking time was 66 hours, 87 hours, and 90 hours, respectively. The postoperative discharge days were all 7 days. No surgical related complications occurred. On the 6th day and 3 months after surgery, gastrointestinal angiography was performed. The contrast agent passed smoothly through the jejunal loop and residual stomach jejunal loop, and both sides were unobstructed. No contrast agent was found to retrograde to the esophagojejunal anastomosis. Conclusion: Laparoscopic assisted proximal gastrectomy with λ-shaped modified double tract reconstruction is safe and feasible, as it improves the diversion of food through the residual stomach while ensuring anti-reflux effects.

In Shijiazhuang City, ozone （O 3 ） pollution occurs frequently in June every year. In June 2023, the average O 3 8 h concentration （O 3 -8h） pollution exceeded 80% of the days in the month, and O 3 was the primary pollutant, accounting for 100%. For an O 3 heavy pollution process from June 11 to 18, the air quality model WRF-CMAQ was used for simulation, and the average error data MFB and MFE were -10.47% and 17.96%, respectively, which was within the ideal error range. The CMAQ process analysis module was used to simulate the physical and chemical processes in Shijiazhuang City, and the dry deposition （DDEP） contribution concentration was -23.88 μg·m -3 , which was the main process of O 3 consumption, whereas the transport process （TRAN） was the main source of O 3 , among which the contribution was more significant in vertical transport （VTRA）. At the same time, the source analysis module （ISAM） was used to analyze the O 3 contribution of local and surrounding areas in Shijiazhuang City. The results showed that the contribution rate of local industry sources in Shijiazhuang City was as follows： traffic source （12.54%） > industrial source （6.94%） > residential source （6.56%） > power source （4.75%）. The long-distance transmission source （BCON） continued to be in the first place with a high contribution rate of 63.31%. In the heavy pollution period under stable weather, the contribution concentration of BCON in the D02 layer of the nested domain to Shijiazhuang City was lower than the sum of the marked area. Among the surrounding cities, Baoding City had the highest contribution rate under stable weather, accounting for 26.21%. In the late period, the contribution concentration of Xingtai City increased rapidly under the action of high-value southwest wind. To effectively reduce O 3 pollution, it is necessary to reduce emissions in the city and to control the upwind cities in advance, and the implementation of inter-regional joint prevention and control is the key.

Objectives: To investigate the reliability and accuracy of deep learning technology in automatic sex estimation using the 3D reconstructed images of the computed tomography (CT) from the Chinese Han population., Methods: The pelvic CT images of 700 individuals (350 males and 350 females) of the Chinese Han population aged 20 to 85 years were collected and reconstructed into 3D virtual skeletal models. The feature region images of the medial aspect of the ischiopubic ramus (MIPR) were intercepted. The Inception v4 was adopted as the image recognition model, and two methods of initial learning and transfer learning were used for training. Eighty percent of the individuals' images were randomly selected as the training and validation dataset, and the remaining were used as the test dataset. The left and right sides of the MIPR images were trained separately and combinedly. Subsequently, the models' performance was evaluated by overall accuracy, female accuracy, male accuracy, etc., Results: When both sides of the MIPR images were trained separately with initial learning, the overall accuracy of the right model was 95.7%, the female accuracy and male accuracy were both 95.7%; the overall accuracy of the left model was 92.1%, the female accuracy was 88.6% and the male accuracy was 95.7%. When the left and right MIPR images were combined to train with initial learning, the overall accuracy of the model was 94.6%, the female accuracy was 92.1% and the male accuracy was 97.1%. When the left and right MIPR images were combined to train with transfer learning, the model achieved an overall accuracy of 95.7%, and the female and male accuracies were both 95.7%., Conclusions: The use of deep learning model of Inception v4 and transfer learning algorithm to construct a sex estimation model for pelvic MIPR images of Chinese Han population has high accuracy and well generalizability in human remains, which can effectively estimate the sex in adults.

Lung is the largest organ of the respiratory system. During hypoxia, pulmonary cells undergo rapid damage changes and activate the self-rescue pathways, thus leading to complex biomacromolecule modification. Death from mechanical asphyxia refers to death due to acute respiratory disorder caused by mechanical violence. Because of the absence of characteristic signs in corpse, the accurate identification of mechanical asphyxia has always been the difficulty in forensic pathology. This paper reviews the biomacromolecule changes under the pulmonary hypoxia condition and discusses the possibility of application of these changes to accurate identification of death from mechanical asphyxia, aiming to provide new ideas for related research.

Objective: To Summarize the safety, clinical outcome and technical evolution of laparoscopic gastric cancer surgery. Methods: A retrospective cohort study was carried out. Clinical data of 3012 patients who underwent laparoscopic radical gastrectomy for gastric cancer from January 2010 to March 2022 at Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University were retrospectively collected and analyzed. Case inclusion criteria were gastric malignancies confirmed by pathology, without distant metastasis by examination before operation and exploration during operation, patients undergoing laparoscopic radical gastrectomy, intact function of important organs and with complete data. Exclusion criteria were patients who underwent emergency gastric cancer resection due to gastric bleeding, perforation or obstruction, etc., tumor found to invade adjacent organs such as pancreas or transverse colon during the operation, conversion to open surgery during the operation, those who had other malignant tumors (except thyroid cancer) within 5 years, and those had severe cardiopulmonary, liver, or kidney insufficiency before surgery. Outcomes included: (1) baseline information of patients; (2) trend of the quantity of laparoscopic radical gastrectomy year by year; (3) evolution of the mode of digestive tract reconstruction; (4) periopertive outcome short-term complication was defined as complication occurring within 30 days after operation and classified accordiny to the clavien-Dindo criteria; and (5) 5-year overall survival. SPSS software was used for statistical analysis. Continuous variables that obeyed the normal distribution were expressed in the form of Mean±SD. Days of hospital stay that did not follow a normal distribution were expressed as median ( Q 1 , Q 3 ), and the Mann-Whiney U test was used for comparison. Discrete variables were expressed as cases (%), and chi-square test or rank sum test was used for comparison between groups. Linear regression analysis was used to analyze the relationship between the amount of surgery and the year of surgery. Kaplan-Meier method and log-rank test were used for survival analysis. Two-tailed P <0.05 was considered as statistically significant. Results: Among the 3012 cases, 2114 were male and 898 were female. The patients' average age at surgery was (61.1±10.7) years old. According to the number of cumulative cases, the patients were divided into three groups: early, intermediate and late, with 1004 patients in each group. The early group consisted of patients undergoing operation from January 2010 to October 2018, the intermediate group consisted of patients undergoing operation from October 2018 to January 2021, and the late group consisted of patients undergoing operation from January 2021 to March 2022. (1) General information: There were 691 (68.8%), 699 (69.6%) and 724 (72.1%) male patients in early, intermediate and late groups respectively; the average age increased from 56.6 years in 2010 to 62.8 years in March 2022. As for the tumor stage T1, T2, T3, T4, there were 49.0%, 14.4%, 23.9% and 12.6% in the early group; 47.5%, 12.9%, 26.9% and 12.6% in the intermediate group; 39.7%, 14.6%, 30.0%, and 15.6% in the late group, respectively. Patients with N0, N1, N2, N3a, N3b stage were 56.8%, 13.7%, 13.4%, 11.0%, and 5.0% in the early group; 55.7%, 12.9%, 12.8%, 11.6%, and 6.9% in the intermediate group; 51.0%, 16.1%, 12.8%, 12.5%, and 7.5% in the late group, respectively. (2) Year-by-year change in the number of gastric cancer operations: From 19 cases per year in 2010 to 786 per year in 2021, the annual number of gastric cancer operations was proportional to the year of operation (y=47.505x, R 2 =0.67). The proportion of patients with stage I disease showed a fluctuating downward trend over time, while the proportion of patients with stage III disease increased slightly, accounting for 34% until March 2022. (3) Evolution of digestive tract reconstruction methods: Except in 2010, the digestive tract reconstruction method of distal gastrectomy focused on Billroth-II+Braun anastomosis among patients undergoing laparoscopic gastric cancer surgery in other years, whose proportion had gradually increased from less than 20% in 2016 to about 70% after 2021; the gastrointestinal reconstruction methods after total gastrectomy had gradually increased in π anastomosis and overlap anastomosis since 2016, of which π anastomosis reached about 65% in 2019, and overlap anastomosis reached almost 30% in 2020; the anastomosis methods after proximal gastrectomy had been mainly double-channel anastomosis (54%) and esophagogastric anastomosis (30%) since 2016, and double-channel anastomosis accounted for up to 70% in 2019. (4) Operation time: The operation time of early, intermediate and late group was (193.3±49.8) min, (186.9±44.3) min and (206.7±51.4) min respectively. Intermediate group was significantly shorter than early group ( t =3.005, P =0.003), while late group was significantly longer than early group ( t =5.875, P <0.001) and intermediate group ( t =9.180, P <0.001). (5) Postoperative hospital stay: The median length of hospital stay for gastric cancer patients in early, intermediate and late groups was 9 (8, 11) d, 8 (7, 10) d, and 8 (7.5, 10) d respectively. The postoperative hospital stay of intermediate group and late group was significantly shorter than that of early group ( Z =-12.467, Z =-5.981, both P <0.001), but there was no significant difference between intermediate group and late group ( Z =0.415, P =0.678). (6) Postoperative complication: The morbidity of short-term complication in early, intermediate and late group was 20.4% (205/1004), 16.2% (163/1004), and 16.2% (162/1004) respectively, and above morbidity of intermediate group and late group was significantly lower than that of early group (χ 2 =5.869, P =0.015; χ 2 =6.165, P =0.013), while there was no significant difference between intermediate group and late group (χ 2 =0.004, P =0.952). The morbidity of short-term complication of grade IIIor higher was 8.0% (80/1004), 7.6% (76/1004), and 4.9% (49/1004) in early, intermediate and late group respectively, and above morbidity of late group was significantly lower than that of early and intermediate group (χ 2 =7.965, P =0.005; χ 2 =6.219, P =0.013), while there was no significant difference between intermediate group and early group (χ 2 =0.111, P =0.739). (7) Survival analysis: The follow-up deadline for survival data was December 31, 2021, and the median follow-up time was 29.5 months. The overall 5-year survival rate of all the patients was 74.7%. The 5-year survival rates of stage I, II and III patients were 92.0%, 77.2%, and 40.3% respectively and 5-year survival rates of patients with stage IA, IB, IIA, IIB, IIIA, IIIB and IIIC were 93.2%, 87.8%, 81.1%, 72.7%, 46.2%, 37.1%, and 34.0% respectively. Conclusions: The number of laparoscopic gastric cancer operation in our center is increasing year by year. With the maturity of laparoscopic technology, the morbidity of complication in laparoscopic gastric cancer surgery is decreasing.

Objectives: To retrospectively analyze homicide cases of death after injection and provide reference for forensic identification., Methods: Six homicide cases of death after injection which were investigated by the Criminal Investigation Team of Shanghai Public Security Bureau were collected and analyzed, including case situation, scene investigation, autopsy and other materials., Results: The 6 cases were premeditated crimes, 5 cases took place in private spaces, and 5 cases involved the victims approached by suspects' decoy. There were no obvious abnormalities at the scene of the 6 cases. In 6 cases, the victim's body surface injury was mild or no, lividity color was abnormal, and the needlestick injury showed different manifestations from conventional medical measures., Conclusions: Death after injection is a highly concealed crime and easy to be ignored. For the suspected injection injury found in autopsy, it is necessary to carefully examine, identify and analyze, be alert to the situation of injecting poison (drug) and do a good job in evidence fixation and material extraction.

Objectives: To find the appropriate method for age estimation for different ages and sexes., Methods: The costal cartilage, sternum and pubic symphysis of 91 unknowns from 2000 to 2020 from the Forensic Department of the Criminal Investigation Team of Shanghai Public Security Bureau were collected. Costal cartilage, sternal and pubic symphysis inferences were used to estimate the age, and the consistency between the estimated results and the actual physiological age of the unknowns was tested. The accuracy of age estimation of different samples was compared, and the relationship between accuracy and age and sex was analyzed., Results: Using the costal cartilage method, the inference errors of males, females and the whole population under 40 years old were (0.608±2.298) years, (0.429±1.867) years and (0.493±2.040) years, while those over 40 years old were (-1.707±3.770) years, (-3.286±4.078) years and (-2.625±4.029) years. The differences between different age groups in these three populations were statistically significant ( P <0.05). Using the sternum method, the inference errors of males and females under the age of 40 were (0.921±3.019) years and (0.452±1.451) years, while those over the age of 40 were (-5.903±5.088) years and (-1.429±2.227) years. The differences between different age groups in males and females were statistically significant ( P <0.05). Using the pubic symphysis method, the inference errors of males and females under 40 years old were (-0.204±1.876) years and (0.238±2.477) years, while those over 40 years old were (1.500±2.156) years and (-2.643±4.270) years. The differences between different age groups in males and females were statistically significant ( P <0.05). Using the sternum method and pubic symphysis method for age estimation of over 40 years old, the difference between different sexes was statistically significant ( P <0.05)., Conclusions: All three methods of age estimation are stable and effective and more accurate for people under 40 years old. For age estimation of unknowns over 40 years old, the pubic symphysis method is preferred in males and the sternum method is preferred in females.

Ginsenoside Rg&#95;1, one of the main active components of precious traditional Chinese medicine Ginseng Radix et Rhizoma, has the anti-oxidative stress, anti-inflammation, anti-aging, neuroprotection, and other pharmacological effects. Diabetic retinopathy(DR), the most common complication of diabetes, is also the main cause of impaired vision and blindness in the middle-aged and the elderly. The latest research shows that ginsenoside Rg&#95;1 can protect patients against DR, but the protection and the mechanism are rarely studied. This study mainly explored the protective effect of ginsenoside Rg&#95;1 against DR in type 2 diabetic mice and the mechanism. High fat diet(HFD) and streptozotocin(STZ) were used to induce type 2 diabetes in mice, and hematoxylin-eosin(HE) staining was employed to observe pathological changes in the retina of mice. The immunohistochemistry was applied to study the localization and expression of nucleotide-binding oligomerization domain-like receptors 3(NLRP3) and vascular endothelial growth factor(VEGF) in retina, and Western blot was used to detect the expression of nuclear factor-kappa B(NF-κB), p-NF-κB, NLRP3, caspase-1, interleukin-1β(IL-1β), transient receptor potential channel protein 6(TRPC6), nuclear factor of activated T-cell 2(NFAT2), and VEGF in retina. The results showed that ginsenoside Rg&#95;1 significantly alleviated the pathological injury of retina in type 2 diabetic mice. Immunohistochemistry results demonstrated that ginsenoside Rg&#95;1 significantly decreased the expression of NLRP3 and VEGF in retinal ganglion cells, middle plexiform layer, and outer plexiform layer in type 2 diabetic mice. According to the Western blot results, ginsenoside Rg&#95;1 significantly lowered the expression of p-NF-κB, NLRP3, caspase-1, IL-1β, TRPC6, NFAT2, and VEGF in retina of type 2 diabetic mice. These findings suggest that ginsenoside Rg&#95;1 can significantly alleviate DR in type 2 diabetic mice, which may be related to inhibition of NLRP3 inflammasome and VEGF. This study provides experimental evidence for the clinical application of ginsenoside Rg&#95;1 in the treatment of DR.

Objective: To investigate the related factors of unprotected sexual behaviors among male students who have sex with men in Beijing. Methods: Male students who have sex with men were recruited from May 2018 to July 2018 at two voluntary counseling and testing (VCT) clinics in Beijing by convenient sampling method. Information being collected during in-depth personal interviews with a semi-structured outline included ways to seek sexual partners, sexual partners characteristics, attitude of condom use, incidence and causes of unprotected sexual behaviors, rush poppers and alcohol use. The text information was summarized and analyzed by Nvivo 11.0 software. Results: A total of 35 male students who have sex with men were recruited and interviewed, the median of age was 22 years old ( P (25)- P (75): 21-24 years old). We found that incomprehensive knowledge of condom use, low risk perception of non-anal sexual behaviors, rush poppers and alcohol use were risk factors of unprotected sexual behaviors on individual level. Besides, sex with regular sex partners, partners who were much older or not from campus, and insertive partners are more likely to be unprotected. Furthermore, refusal of condom use by sexual partners and low self-efficacy of decision-making on condom use were the main reasons for unprotected sexual behaviors among male student who have sex with men. Conclusion: Lack of condom use knowledge, low risk perception of non-anal sexual behaviors and insufficient ability to refuse non-condom requirements for regular sex partners, partners who were much older or not from campus, and insertive partners are related factors of unprotected sexual behaviors among male students who have sex with men.

Periplaneta americana is an important medicinal insect. A series of new drugs developed from it have remarkable clinical effects and are in great demand in the market. Because of unclear biology, the quality and yield of P. americana are affected. Understanding the developmental threshold temperature and effective accumulated temperature of P. americana can provide theoretical basis for standardized culture of P.americana. Under climate chamber, the threshold temperature and effective accumulated temperature for egg development of P. americana to were determined through effective accumulated temperature law. The threshold temperature was （15.8±0.71）°C, the effective accumulated temperature was 415.8±38.05 degree days. A model of the relationship between temperature and developmental rates was established., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Objectives: To investigate the effect of β-catenin interacting protein 1 (ICAT) silence in Wnt signaling pathway and sterol drug NSC67657 induced cell differentiation of HL60 cell. Methods: HL-60 cells were treated with NSC67657, the cell surface antigen CD14 expression was detected by flow cytometry. Lentivirus LV-ICAT-RNAi vector was constructed and infected HL-60 cells. Then the ICAT gene and protein expression were analyzed using real-time qPCR and Western blot technique. Furthermore, Co-immunoprecipitation assay was used to confirm the interaction of β-catenin/ICAT proteins, and Western blot was employed to compare the expressions of Wnt signaling pathway downstream targets Cyclin D1, TCF-1 and c-Jun between Lentivirus LV-ICAT-RNAi vector infected HL-60 (HL-60i) cells and un-infected HL-60 (HL-60v) cells. The cellular differentiation of HL-60i and HL-60v cells treated with NSC67657 for 24 h was evaluated by Wright's staining, transmission electron microscopy and flow cytometry analysis. Results: HL-60 cells could be induced to differentiate into monocytes by 10 μmol/L NSC67657. The CD14 positive cells could reach to (92.30±5.14) % after NSC67657 treatment for 5d. The co- immunoprecipitation assay demonstrated that ICAT protein did interact with β-catenin protein, and the absorbance of protein electrophoresis bands increased in differentiated cells. The expressions of Wnt signaling pathway downstream target proteins in HL-60i cells were higher than that in HL-60v cells when they were treated by 10 μmol/L NSC67657, but lower than NSC67657 untreated cells. CD14 positive HL-60i cells were significantly lower than that of HL-60v cells[ (8.33±3.14) % vs (19.08±4.73) %]when treated with NSC67657, but still higher than that of uninfected and untreated HL60 cells[ (0.60±0.03) %] ( F =119.24, P =0.010) . The results of cellular morphology and ultrastructure observation were also in accord with that of cell surface antigen analysis. Conclusions: ICAT does participate in HL-60 cells monocytic differentiation induced by NSC67657, and Wnt/β-catenin signaling pathway might play a bridge role.

New complex [Tb(2,2′-oba)2(phen)2]-(H+3O) (2,2′-oba=2,2′-oxybis(benzoic acid), phen=1,10-phenanthroline) was synthesized under hydrothermal condition and characterized with X-ray single crystal diffraction. Complex reveals mononuclear structure containing TbO4N4 unit. Complex displays the emission peaks at 489，546，584 and 622 nm, corresponding to the 5D4→7FJ(J=6-3) transitions of Tb(Ⅲ) ion. The emission band at 546 nm corresponds to the 5D4→7F5 transition of the Tb(Ⅲ) ion, which gives an intense green luminescence output for the solid sample. The recognition for metal ions was discussed with fluorescent spectroscopy. The results show that it has high selectivity for Fe3+ via a fluorescence quenching mechanism. Luminescent investigations reveal that it can detect Fe3+ with relatively high sensitivity and selectivity, even when pH 4.0～8.0，which leads to its application in biotic and environmental system.

Objective: To evaluate the interference of hemoglobin variants J-Bangkok on glycated hemoglobin (HbA(1)c) detected by five measurement systems., Methods: Seventy cases of blood samples were collected at Zhongshan Hospital of Sun Yat-sen University from July 2012 to January 2014, the blood samples were divided into the normal control group (40 cases) and Hb J-Bangkok variant group (30 cases), and the normal control group was divided into healthy control group (20 cases) and diabetic group (20 cases). HbA(1)c measurement systems were Primus Ultra2, Variant Ⅱ, Variant Ⅱ Turbo, Modular P and Leadman. Based on the standard of the American National Glycosylated Hemoglobin Standardization Program (NGSP), Primus Ultra2 was used as comparative system, and the other 4 systems were test systems. Comparative analysis and bias evaluation were conducted on the results from five detection systems in different groups, statistical analysis were used for evaluating the differences. The estimated average glucose (eAG) was calculated by HbA(1)c values and fasting plasma glucose (FPG) of Hb J-Bangkok variant group with the different detection systems. Deming regression analysis was used to determinate whether Hb J-Bangkok produced significant clinical effect on HbA(1)c results. HbA(1)c ± 10% and relative bias at 6% and 9% HbA1c were evaluation limits., Results: The differences of the 95% confidence interval (95%CI) between the test systems and the comparative system in control group were within ±0.7% HbA(1)c, bias were less than 6%, there were no statistically significant difference (P>0.05). In Hb J-Bangkok group, the eAG calculated from HbA(1)c measured by using Primus Ultra2, Modular P and Leadman were (8.14±2.99), (8.10±3.06) and (8.23±3.00)mmol/L, which had no statistically significant difference compared with FPG ((8.21±3.12)mmol/L, t=0.996, 1.091, 1.479, all P>0.05), and the differences of 95%CI between the results measured by Modular P and the comparative system were all within ±0.7% HbA(1)c, bias were -4.3%-0.4% and -5.2%-4.9%, there were no statistically significant difference (P>0.05). At 6% and 9% HbA(1)c concentrations, the mean differences of the results from the three detection systems were less than the clinically acceptable range. These results showed that the systems of Primus Ultra2, Modular P and Leadman were not affected by Hb J-Bangkok. However, the eAG values calculated from HbA(1)c of Variant Ⅱ and Variant Ⅱ Turbo were (5.58±2.12) and(5.00±2.13)mmol/L, which showed statistically significant lower results compared with FPG level (t=12.29, 13.23 , all P<0.001). Compared with Primus Ultra2, the differences of 95%CI were outside of ± 0.7% HbA1c, bias were -31.9%--12.0% and -42.0%- -17.6% , greater than 6%, showed a negative bias.At 6% and 9% HbA(1)c concentrations, the mean differences of the results were all greater than the clinical acceptable range. These results indicated that Hb J-Bangkok had significantly clinical interference on Variant Ⅱ and Variant Ⅱ Turbo systems., Conclusion: Hb J-Bangkok has different interference on different HbA(1)c measurement systems, when performs the HbA(1)c test, clinical laboratory should pay attention to identify Hb variants, and select the appropriate methods to measure the HbA(1)c values in order to prevent the occurrence of interference by Hb variants.

Objective: To investigate the changes in human airway smooth muscle cell (HASMC) migration and related signaling pathway after interference with PTEN gene expression., Method: HASMCs were infected with an adenovirus vector and RNA interference vector of human PTEN gene to establish the cell model with PTEN gene over-expression (Ad-GFP-PTEN-HASMC) and one with PTEN gene silencing (Ad-shPTEN-HASMC), using Ad-GFP-infected and a blank cells as the negative controls and LY294002 as the positive control. Fluorescence microscopy and flow cytometric analysis were used to evaluate the transfection efficiency, and Western blotting was performed to examine the expression of PTEN and the activation of AKT and ERK1/2 signal pathway. Transwell assay and wound healing assay were used to assess the migration of HASMCs., Results: The adenovirus over-expression vector and RNA interference vector significantly affected the expression of human PTEN gene. Up-regulation of PTEN gene resulted in a slow-down of the HASMC migration, an inhibition of PI3K/AKT signal pathway at the protein level but no changes in Ras-Raf-MEK1/2-ERK1/2 signal pathway. Down-regulated PTEN gene expression, however, was not associated with an enhancement of HASMC migration, but activated PI3K/AKT signal pathway and inhibited Ras-Raf-MEK1/2-ERK1/2 signal pathway., Conclusion: Upregulation of PTEN gene can effectively inhibit airway smooth muscle cell migration, the effect of which is probably mediated by the PI3K/AKT pathway.

Objective: To investigate the outcome for surgical treatment of bilateral thoracotomy in patients with lesions of left main bronchus invading carina by bilateral thoracotomy., Methods: The clinical data of 4 patients with lesions of left main bronchus invading carina undergoing bilateral thoracotomy were retrospectively reviewed., Results: There were two male and two female patients with a median age of 37.5 (range: 27 - 55) years old. Four patients were all accessed by bilateral thoracotomy, and received carinal reconstruction. Of these 4 patients, three patients received left pneumonectomy and one patient received carinal resection without concomitant pulmonary resection. Pathological results showed that one patient had tuberculosis. And other three patients were of 1 squamous cell carcinoma and 2 adenoid cystic carcinomas. Three patients received mechanical ventilation for a period of 3 - 21 days. one patient died of anastomotic dehiscence at 5 days postoperatively., Conclusion: Bilateral thoracotomy is an alternative approach for relatively young patients with decent cardiopulmonary functions with lesions of left main bronchus invading carina. Operation type should be based on histopathological type and length of involved left main bronchus.

Objective: To investigate the rule of lymph node metastasis of adenosquamous carcinoma of the lung., Methods: The data of 361 surgically treated patients with adenosquamous carcinoma of the lung from October 1965 to June 2003 were collected and retrospectively reviewed. The classification of regional lymph node stations and TNM stage were determined according to the UICC criteria (1997). The route and patterns as well as influencing factors of lymph node metastasis were analyzed by SPSS 10.0 software. The median follow-up period was 5.5 years (range, 1.4 to 23.4 years)., Results: The analysis of the route of mediastinal lymph node metastasis in the 361 cases showed that the tumor originated in the left upper lobe firstly metastasized to station 5 (A-P window), tumor in the right upper lobe to the station 4 (lower paratracheal), then secondly to station 7 (subcarinal), lastly to station 3 from the tumor in the left upper lobe or to the station 2 from the tumor in the right upper lobe. It was found that the tumors originated from the lower lobe, firstly metastasized to station 7, secondly to station 9 or 4 from the right lobe; or station 5 from left lower lobe, lastly to station 3 or 2 in the mediastinum. For the tumor in the middle lobe, mainly metastasized to station 7, 4 and 2. The skip mediastinal lymph node metastasis but N1 negative most commonly metastasized to station 7, then to station 4 from the tumor in the right lung and 5 from the tumor in the left lung. The prognosis of patients with a single skipping metastasis to mediastinal lymph node (N1-, SMLN) was better than that in the other patients with mediastinal lymph node metastases., Conclusion: The lung cancer growing in a different location has a different route and skipping metastasis to mediastinal lymph nodes. The patterns of lymph node metastasis affect prognosis. The prognosis of patients with single skipping metastasis to mediastinal lymph nodes but negative pulmonary hilar lymph node is better than that in the other patients with multiple station mediastinal lymph node metastases. The "N1-, SMLN" pattern ought to be considered as a special lymph nodal metastasis with better prognosis.

Objective: To explore the potential anti-inflammatory and analgesic activities of carboxyamidotriazole (CAI)., Methods: A variety of animal models, including the croton oil-induced ear edema, the cotton-induced granuloma, the rat adjuvant-induced arthritis, were used to evaluate anti-inflammatory effect of CAI. Vascular endothelial growth factor (VEGF)--or histamine-stimulated local vascular permeability in mouse modulated by CAI was also determined. In addition, we assessed the effect of CAI on the levels of proinflammatory cytokines tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-beta) at the site of inflammation and in sera. Moreover, antinociceptive effect of CAI on inflammatory pain was assessed using acetic acid-induced writhing model and the formalin test., Results: CAI significantly inhibited acute and chronic phases of inflammation, reduced VEGF or histamine-induced vascular permeability, and showed marked inhibition of proinflammatory cytokines such as TNF-alpha and IL-1 beta. CAI also showed potential therapeutic effect on peripheral inflammatory pain., Conclusion: CAI is a promising anti-inflammatory and analgesic agent.

Objective: To observe the effect of exogenous phophatase and tensin homolog deleted on chromosone 10 (PTEN) gene transfer via recombinant adenoviruses on the proliferation of human airway smooth muscle cells (HASMCs) in vitro and investigate the possible mechanisms., Methods: With a recombinant adenovirus vector containing PTEN (Ad-PTEN) constructed using the pAdxsi system, PTEN gene was transiently transfected into HASMCs and the transfection efficiency was determined by fluorescence microscope. RT-PCR and Western blotting were performed to detect the expression of PTEN mRNA and protein in the infected cells. MTS/PMS assay was used to analyze the proliferation of HASMCs, and the cell cycle changes of the transfected cells were evaluated by flow cytometry with PI staining. The expression levels of Akt and p-A kt proteins were detected by Western blotting, and P21 mRNA expression determined by RT-PCR., Results: The recombinant adenovirus Ad-PTEN showed a wild-type PTEN gene transfer efficiency of 98% at the multiplicity of infection (MOI) of 100. RT-PCR and Western blotting showed that infection with the recombinant adenovirus resulted in PTEN overexpression in the HASMCs, causing also increased ratio of G(0)/G(1) cells and proliferation inhibition of the ASMCs. The overexpression of PTEN significantly decreased the expression level of p-Akt but increased P21 mRNA expression., Conclusion: The recombinant adenovirus containing PTEN can be successfully transfected into HASMCs cultured in vitro, resulting in PTEN overexpression at both the mRNA and protein levels. PTEN overexpression can efficiently inhibit the proliferation of HASMCs possibly through the PI3K/PKB/AKt and P21 pathways.

Objective: To evaluate the immunogenicity, safety and stability of the manufacture process regarding three consecutive lots of influenza split vaccines (Anflu)., Methods: A double-blind, randomized and controlled clinical trial was conducted in healthy volunteers. A total of 566 subjects aged 18 to 60 years were recruited and stratified into four age groups before randomly assigned into four groups. Each group would receive one dose of influenza vaccine from either one of the three lots of Anflu or one lot of the licensed control vaccine. Each dose of the vaccines contained 15 microg of each of the H1N1, H3N2 and B type antigen. Safety was assessed through 30-minute observation for immediate allergic reaction and three-day observation after vaccination. HI antibody titers were determined before vaccination and on day 21, after vaccination., Results: Mild adverse reaction was reported and the overall incidence rates on fever of the four groups were from 1.4% to 2.8% but no significant difference was observed between groups. Seroconversion rates of the three viral strains in four groups were 80.3% and above with fold increase as > or = 11.1 and protection rate was > or = 93.4%. For the three lots of investigated vaccines, all of the indexes of the three viral strains in four groups exceeded the standards on EMEA and FDA for influenza vaccine., Conclusion: The three consecutive lots of Anflu appeared to be good, with both consistent immunogenicity and safety, indicating the stability of manufacture process.

A LIBS setup was built in the Institute of Modern Physics. In our experiments, LIBS spectra produced by infrared radiation of Nd:YAG nanosecond laser with 100 and 150 mJ pulse energy, respectively, were measured by fiber optic spectrometer in the ranges of 230-430 nm and 430-1 080 nm with a delay time of 1.7 and gate width of 2 ms for potato and lily samples prepared by vacuum freeze-dried technique. The lines from different metal elements such as K, Ca, Na, Mg, Fe, Al, Mn and Ti, and nonmetal elements such as C, N, O and H, and some molecular spectra from C2, CaO, and CN were identified according to their wavelengths. The relative content of the six microelements, Ca, Na, K, Fe, Al, and Mg in the samples were analyzed according to their representative line intensities. By comparison we found that there are higher relative content of Ca and Na in lily samples and higher relative content of Mg in potato samples. The experimental results showed that LIBS technique is a fast and effective means for measuring and comparing the contents of microelements in plant samples.

Objective: To identify the proteins which play key roles during the formation of cholesterol gallstone, differential analysis was carried out that the proteome of vesicular phase and micellar phase of gallbladder bile from cholesterol gallstone patients., Methods: Vesicular and micellar phases were isolated by the density gradient ultracentrifugation method. Total proteins from the two phases were extracted, and the protein expressional profiles were established by two-dimensional electrophoresis respectively. The differentially expressed protein spots analyzed by ImageMaster two-dimensional electrophoresis analysis software were identified with matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS)., Results: The concentrations of proteins from vesicular phase and micellar phase of gallbladder bile from cholesterol gallstone patients were (1.5358 +/- 0.0682) mg/ml and (7.1222 +/- 0.2022) mg/ml (P < 0.01) respectively. The average matched protein spots were 120 +/- 24 and 198 +/- 37 in the two groups respectively. There were 72 +/- 16 matched spots in the two representative gels maps and the matched rate was 45.30%. Eight differentially expressed protein spots were identified from the two cholesterol-carrier phases. Among them, 6 were up-regulated with 2 down-regulated in vesicular phase compared with micellar phase. The abundance differentiation of RBP and HSA was confirmed by immunoblotting., Conclusions: The differential protein profiles of vesicular phase and micellar phase of gallbladder bile from cholesterol gallstone patients were established and 8 differential protein spots were identified successfully. The data may be a basis for further screening the key regulators of formation of cholesterol gallstone.

Objective: To analyzed the indication and prognostic factors of surgical treatment of lung cancer invading left atrium and great vessels (T4)., Methods: We retrospectively reviewed the database of 136 T4 lung cancer (tumors invading left atrium and great vessels) patients who received surgical treatment in Cancer Hospital of Chinese Academy of Medical Science (CAMS) from September 1981 to January 2007. There are 114 men and 22 women, the median age was 58 years (range 28 - 76). All patients were divided into three subgroups according to the invading site: tumor invading left atrium group, tumor invading superior vena cava group and tumor invading pulmonary artery group. All patients were divided into two subgroups according to the character of operation: complete resection group and incomplete resection group. Patients were divided into three subgroups according to pathological lymph node status: N0, N1 and N2 group., Results: One hundred and thirty six lung cancer patients received resection of primary lesions plus arterioplasty of pulmonary artery (PA) (n = 83) and/or angioplasty of superior vena cava (SVC) (n = 21) and/or partial resection of left atrium (LA) (n = 32). Complete resection was possible in 120 patients and 16 patients underwent incomplete resection. Five-year survival was 43.0% for entire group, 52. 8% for PA group, 18.2% for SVC group and 18.4% for LA group. Factors significantly influencing the overall 5-year survival were the pathologic N status (5-year survival 15.1% for N2, 5-year survival 44.9% for N1, 5-year survival 74% for N0 group; N2 versus N1 versus N0, P = 0.028) and the completeness of resection (5-year survival 37.5% for complete resection, 5-year survival 22.4% for incomplete resection group; complete versus incomplete, P = 0.042). Pathological lymph node status but not histology and character of operation was an independent prognostic factor using Cox regression analysis (P = 0.01, RR = 1.923, 95% CI: 1.172 -3. 157)., Conclusion: Pathological lymph node status is an independent prognostic factor for T4 lung cancer. Patients with pathological N0-1 lung cancer invading left atrium and great vessels (T4) may benefit from surgical treatment. In the preoperative workup, every possible effort should be made to achieve a careful evaluation of mediastinal lymph noda status. Compared with incomplete resection group, complete resection group may have a better prognosis. Tumor invading extrapericardial PA may be defined as T2.

Pulsed streamer discharge can generates high energy electrons with energy higher than 11. 03 eV and enough to excite N2 to its C3 pi(u) state from the ground state, so the density of the high energy electrons can be obtained by diagnosing the relative emission spectrum intensity of the N2 (C 3 pi(u) --> B 3 pi(g)) emitted from the pulsed streamer discharge. In the present paper, the density distributions of high energy electrons in the wire-plate DeSO2 reactor with pulsed streamer discharge were studied in air at room temperature and 1 atm, and the influences of pulsed voltage and wire-to-wire spacing on the density distributions of high energy electrons were also studied. The experimental results show that high-energy electrons mainly centralize around the discharge wire of the wire-plate reactor, and the electron density reduces with the increase of the distance from the discharge wire. The pulse voltage has a great influence on the high energy electron density, and the high energy electron density increases linearly with increasing the pulsed voltage. Under a fixed wire-to-plate spacing, when the wire-to-wire spacing is 0. 6-1 times the wire-to-plate spacing, the density distributions of the high energy electrons are more uniformity.

Objective: To investigate the protective effects of recombinant SCR15-18 domain of human soluble complement receptor type 1 (sCR1-SCR-15-18) in rats underwent myocardial ischemia and reperfusion (I/R)., Methods: Sprague-Dawley rats were randomly divided into three groups (n = 12 each group): sham (SO); 30 min ischemia/3h reperfusion (I/R) and I/R plus sCR1-SCR15-18 (15 mg/kg before I/R, sCR1). Serum LDH, CK and cardiac myeloperoxidase (MPO) activity were measured. Infarct size, myocardial histopathological changes and myocardial C3c were also compared among groups., Results: Infarct size [(16.1 +/- 3.3)% vs. (22.9 +/- 3.0)%, infarct zone/left ventricular mass, P < 0. 05] and CK [(2532.5 +/- 597.1) U/L vs. (3400.9 +/- 534.9) U/L, P < 0. 05] and LDH [(5436.2 +/- 611.3) U/L vs. (6572.0 +/- 476.3) U/L, P < 0. 05] as well as MPO activity in infarct zone [(0.81 +/- 0.14) U/g vs. (1.12 +/- 0.13) U/g, P < 0.05] were significantly decreased post sCR1 compared to I/R group. sCR1 also significantly attenuated histological myocardial injury and reduced the deposition of C3c in infarct zone., Conclusion: sCR1-SCR15-18 protein exerts cardioprotective effects in this rat I/R model.

Objective: To assess the efficacy, tolerability, and safety of the domestic Acarbose capsule (DAC, produced by Luzhou Baoguang Pharmaceutical Co. LTD) in treating patients with type 2 diabetes mellitus., Methods: One hundred and seventy nine type 2 diabetic patients were randomly divided into DAC (group A, 89 patients) and Glucoby (group B, 90 patients) treatment groups. The trial consisted of a 2-4 weeks equilibrated period followed by an 8 week course of treatments. All of the patients were followed up at the 4th week and 8th week after the commencement of the treatments. One hundred and sixty five patients completed the trial, with 81 in group A and 84 in group B., Results: At the 4th week of the treatments, an average reduction of 1.81 and 2.08 mmol/L of fasting blood glucose (FBG) was found in group A and group B, respectively (P > 0.05); and an average reduction of 5.43 and 5.09 mmol/ L of postprandial blood glucose (PBG) was found in group A and group B, respectively (P > 0.05). At the 8th week, an average reduction of 2.35 and 2.62 mmol/L FBG was found in group A and group B, respectively (P > 0.05); and an average of reduction of 5.93 and 5.98 mmol/L of PBG was found in group A and group B, respectively (P > 0.05); The mean HbA(1c) was lowered by 1.07% and 1.20% by DAC and Glucoby respectively (P > 0.05). The incidence rate of side effects in group A was 32.53%, less than that in group B (48.81%). Flatulence was the most common side effect. The clinical effects of both Glucoby and DAC were more significant at the 8th week than at the 4th week., Conclusion: DAC is as effective and safe as Glucobay for treating type 2 diabetic patients.

Background & Objective: Along with the progress of tumor diagnosis, the detection of multiple primary tumors (MPT) of the lung combined with other organs is increasing, but their clinical features and prognosis are unclear yet. This study was to investigate clinical features and prognosis of MPT of the lung combined with other organs., Methods: Of the 281 patients with MPT of the lung combined with other organs, treated in our hospital from Jan. 1990 to Dec. 2000, 115 had lung cancer diagnosed first (Group A), 116 had other cancers diagnosed first (Group B). Clinical features and prognosis of the patients were analyzed., Results: There was no significant difference in sex distribution between the 2 groups (P=0.51). At the diagnosis of the first cancer of MPT, the median age of the patients was significantly older in Group A than in Group B (62.5 years vs. 54.5 years, P=0.02), while at the diagnosis of the second cancer, it showed no significant difference between the 2 groups (64.5 years vs. 63.5 years, P=0.08). The interval between first and second primary tumors was significantly shorter in Group A than in Group B (36.0 months vs. 49.0 months, P<0.001). The proportion of stage I-II lung cancer was significantly higher in Group A than in Group B (83.9% vs. 63.7%, P<0.01). Since the diagnosis of first primary cancer, the medium survival time was shorter in Group A than in Group B (69.0 months vs. 87.5 months), and the 5-year survival rate was significantly lower in Group A than in Group B (59.0% vs. 70.0%, P<0.001). Since the diagnosis of second primary cancer, no significant difference in medium survival time and 5-year survival rate was observed between the two groups (25.0 months vs. 28.0 months, 10.5% vs. 13.5%, P=0.92). Second primary cancers occurred in the lung, upper respiratory tract, breast, esophagus, colon, rectum, stomach, and cervix. Smoking was a significant risk factor in the development of MPT of the lung combined with upper respiratory tract., Conclusions: Lung cancer is closely correlated to upper respiratory tract tumors among MPTs of the lung combined with other organs, and smoking is a potential risk factor. Compared with the patients who had lung cancer diagnosed first, the patients who had other cancers diagnosed first are younger at the first diagnosis, and have longer interval between first and second primary tumors, with better prognosis.

Objective: To evaluate the significance of upper mediastinal lymph nodes dissection for thyroid carcinoma patients., Methods: The clinical data of 79 thyroid carcinoma patients who underwent the upper mediastinal lymph node dissection (between January 1984 and December 1998) were retrospectively analysed. There were 45 male and 34 female with a median age of 47 years (range 10 to 74 years). Follow-up was ended on December 31, 2003., Results: Histopathologically, there were 58 (73.4%) papillary carcinoma, 14 (17.7%) medullary carcinoma, and 7 (8.9%) follicular carcinomas. Four of them had poorly-differentiated carcinoma. Upper mediastinal lymph node dissection was carried out in 62 patients through trans-cervical approach, in 10 through an inverted T-shaped incision, and in 7 through a midline sternotomy. Seventy-six patients had 93 neck lymph node dissection procedures, and 47 patients developed paratracheal lymph node metastasis. The overall 5- and 10-year cumulative survival rate was 64.6% and 63.1%, respectively. Mediastinal lymph node recurrence developed only in 10 patients after initial upper mediastinal lymph node dissection. Nine patients died of upper mediastinal lymph node metastasis. Postoperative complications were observed in 11 patients without perioperative death., Conclusion: Upper mediastinal lymph node metastasis is most frequently found in papillary thyroid carcinoma. Surgical dissection of upper mediastinal metastatic lymph nodes through either cervical incision or mediastinotomy is safe and effective with low rate of perioperative complications. It may improve the life quality and survival of thyroid carcinoma patients.

Objective: To evaluate the surgical therapeutic strategy for non-small cell lung cancer (NSCLC) with (N2) mediastinal lymph node metastasis., Methods: The clinical data of 325 patients with N2 NSCLC treated surgically between 1961 and 1995 were analysed., Results: The over-all 5-year survival rate was 19.6%. Survival was higher in patients with radical resection than with palliative resection, with squamous-cell carcinoma than with adenocarcinoma, with sleeve lobectomy and pneumonectomy than with regular lobectomy, with 1 to 3 mediastinal metastatic lymph nodes than those over 4, and with adjuvant therapy (chiefly postoperative radiotherapy) than without. All these differences were statistically significant (P < 0.05). There was no 5-year survivor in patients with T3 or T4 tumor, nor in those with distant metastasis., Conclusion: It is suggested that surgery is the best choice for N2 NSCLC patients with T1 or T2 tumor, with non-adenocarcinoma, and with metastatic mediastinal lymph nodes less than 4 in number. Surgery is probably not a good choice in those with T3 tumor varieties. At operation, radical resection of the tumor and systematic removal of all hilar and mediastinal lymph nodes are essential for disease staging and survival improvement. Adjuvant therapy may improve long-term survival and is especially indicated in patients with residual tumor and/or metastatic mediastinal lymph nodes over 3 in number.

Objective: We retrospectively analyzed the cause and death risk of 114 postoperative respiratory failure patients found in 3519 patients with esophageal cancer and 1495 patients with carcinoma of gastric cardia surgically treated between January 1992 and May 2003., Methods: To analyze the reasons causing postoperative respiratory failure in surgically treated esophageal or gastric cardia cancer patients, and the correlation between the death risk of postoperative respiratory failure and preoperative pulmonary function tests, postoperative complications, operation modes, history of preoperative accompanying diseases and so on using Binary Logistic Regression analysis and Chi-square tests (chi(2)) in SSPS statistics software., Results: In this series, postoperative respiratory failure developed in 97 of 3519 (2.76%) esophageal cancer patients and 17 of 1495 (1.14%) gastric cardia cancer patients, which were mainly caused by severe respiratory tract infection (37.7%, 43/114) and operative complications (35.1%, 40/114) such as: anastomotic leakage or perforation of thoracic stomach, extensive bleeding during operation, chylothorax, etc, totally accounting for 72.8% (83/114). In contrast with lung cancer patients, most of the postoperative respiratory failure (69.3%) occurred in the patients who had perioperative complications but almost always normal preoperative pulmonary function tests. Other reasons to cause postoperative respiratory failure were: extubation in unconscious patients at the end of general anesthesia; over-infusion during operation; pulmonary artery embolism; severe arrhythmia and so on. All patients except 2 were treated in ICU by mechanic ventilation through intubation and/or tracheotomy. Eighty patients (70.2%) were intubated and/or had tracheotomy within 3 days postoperatively. Seventy patients (61.4%) were rescued successfully, whereas 44 cases (38.6%) died of postoperative respiratory failure and/or other postoperative complications. Univariate analysis and multivariate analysis by binary logistic regression indicated that: severe perioperative complications, more postoperative complications, poor preoperative pulmonary function, radical preoperative radiotherapy, intubation and/or tracheotomy after the second postoperative day and long period of mechanic ventilation were the major risk factors leading to death once the postoperative respiratory failure developed. The former 3 factors were independent risk factors leading to death with OR of 2.50, 2.37, 1.68, respectively. Age, sex, operation modes, history of preoperative accompanying disease, prophylactic antibiotics were not demonstrated as statistically significant risk factors correlated with death., Conclusion: Severe perioperative complications and respiratory tract infection are the two major causes of postoperative respiratory failure in patients with cancer of esophagus and gastric cardia. Patients with severe perioperative complications or poor preoperative pulmonary function or association with more than two kinds of postoperative complications have much higher death risk than other patients when they develop postoperative respiratory failure. Careful manipulation during operation and effective perioperative management are the most important measures to avoid postoperative respiratory failure and high mortality.

The chromosomal C-banding karyotype in the spermatogenesis of 2 species of Genus Asiotmethis, Uvarov 1943 from China were investigated. It was found that the diploid chromosome number of Asiotmethis zacharjini (Bei-Bienko, 1926) was 2n (male) =18, the neo-X was a submetacentric chromosome and the rest were acrocentric chromosomes. C-banding pattern showed that all chromosomes presented a paracentromeric block, an interstitial C-band near the centrometic C-block and additional C-band in the distal region. And, the mechanism for sex determination lay in neo-XY (male). In Asiotmethis jubatus (Uvarov, 1926), the diploid chromosome number was 2n (male) =19. All autosomes and X-chromosomes were acrocentric with paracentromeric C-band only, and the mechanism for sex determination lay in XO (male). The difference in heterochromatin content between the 2 species was significant at 0.05 level.

Objective: An accurate clinical TNM staging of lung cancer is essential for the precise determination of the extent of the disease in order that an optimal therapeutic strategy can be planned. This is especially true in patients with marginally resectable tumors. Clinical over-staging of the disease may deny a patient the benefit of surgery, whereas under-staging may oblige a patient to accept a fruitless or even harmful surgery. We aimed to analyze preoperative clinical (c-TNM) and postoperative surgico-pathologic staging (p-TNM) of lung cancer patients in order to evaluate the accuracy of our clinical staging and its implications on the surgical strategy for lung cancer., Methods: We did a retrospective comparison of c-TNM and p-TNM staging of 2007 patients with lung cancer surgically treated from January 1999 to May 2003. Preoperative evaluation and c-TNM staging of all patients were based on physical examination, laboratory studies, routine chest X-ray and CT scan of the chest and upper abdomen. Other examinations included sputum cytology, bronchoscopy, abdominal ultrasonography, bone scintiscan, brain CT/MRI, and mediastinoscopy whenever indicated., Results: In the present study the comparison of c-TNM and p-TNM staging of 2007 patients with lung cancer revealed an overall concurrence rate of only 39.0%. In the entire series the extent of disease was clinically underestimated in 45.2% and overestimated in 15.8% of the patients. Among all c-TNM stages the c-IA/B stage of 1105 patients gave the highest rate (55.2%) of underestimating the extent of disease. Clinical staging of T subsets was relatively easy with an overall accuracy rate of 72.9%, while that of N subsets was relatively more difficult with an overall accuracy rate of 53.5%. Analysis also showed that c-IV stage may not be an absolute contraindication to surgery, because in half of the patients, c-M1 turned out to be p-M0, providing the possibility of resectional surgery depending on the status of T and N., Conclusion: For reasons to be further determined, the present preoperative clinical TNM staging of lung cancer remains a crude evaluation. Further efforts to improve its accuracy are needed.

Sequence-based gene isolation has been a practical approach for plant resistance gene cloning. In this study, RS13, a cloned rice sequence with the NBS (nucleotide-binding site) domain of resistance genes, was used as a probe to screen a bacterial artificial chromosome (BAC) library of rice variety IR64,and four positive clones were obtained. Of them the clone 14E19 covered the other three clones and was sequenced through a shotgun approach. The whole sequence of the insert fragment of 14E19 was assembled into approximately 73 kb in length. Genes on the whole assembled sequence were predicted,and four genes encoding NBS and LRR (leucine-rich repeat) domains were found, named as NL-A, B, C and D respectively. For further analysis, another longer BAC clone,106P13, covering 14E19 on the same chromosome position was identified from a BAC library of IRBB56 which had the same genome background with IR64. Ten NL-homologous copies were discovered on the sequence of the BAC clone 106P13, and four copies were identical with those on 14E19. The similar homologous sequences were also found in the genomic sequences of Nipponbare,93-11 and Guangluai4. However, NL sequences were less homologous with the known NBS-LRR resistance genes. This result indicated that NL was a new NBS-LRR gene family and was composed of ten members at least. RT-PCR and cDNA screening displayed that NL-B expressed in a bacterial blight-resistant rice variety IRBB4, indicating the gene was possibly involved in resistance reactions.

Objective: To review the experience of the diagnosis, surgical treatment and prognosis of metachronous second primary lung cancers., Methods: Between January 1983 and April 2004, 32 patients with metachronous second primary lung cancers were operated in our department. Clinical data of all these patients were reviewed retrospectively., Results: The initial procedures for their first primary lung cancers were lobectomy or pneumonectomy. Lobectomy or completion pneumonectomy for the second primary lung cancers were performed in 17 cases, limited pulmonary resection was done in 14 cases and exploration was in 1 case. The postoperative morbidity and mortality were 12% (4/32) and 3% (1/32), respectively. The 1-, 3-, and 5-year survival rate after second operation were 66% (19/29), 32% (9/28) and 19% (4/21), respectively., Conclusions: The incidence of metachronous second primary lung cancers has been increasing gradually during recent years. The closely follow-up for patients undergoing resection for their first primary lung cancers is most important factor for improvement of the diagnosis of metachronous second primary lung cancers. Limited resection and incomplete lymph node dissection might be the factors contributing to the poor prognosis.

Objective: To investigate micro-metastasis in mediastinal lymph nodes (mLN) of patients with clinical stage I approximately II lung cancer and its clinical significance., Methods: A total of 181 mLN from 32 lung cancer patients in clinical stage I approximately II were collected during operation and their frozen sections at two different levels were examined immunohistochemically (IHC) with an anti-epithelial cell monoclonal antibody Ber-Ep4. Routine HE staining was done for comparison. The results were processed by Chi-square tests in SPSS 10.0 soft ware., Results: Fifteen of the 32 patients (46.9%) were found to have micro-metastasis in 21 of 181 mLN (11.6%) examined by immunohistochemical staining though routine histopathological examinations were negative. Of those 15 cases, micro-metastasis was detected in 9 only by IHC and in 6 both by IHC and HE stainings. The positive rate of micro-metastasis in N0, N1, and N2 stratified by routine pathology was 36.8% (7/19), 33.3% (2/6) and 85.7% (6/7), respectively (N0 vs N2, P < 0.05). When stratified according to clinical staging (cTNM), pathological staging (pTNM) and pathological staging on the basis of IHC (iTNM), the frequencies of N2 cases were 0, 18.8% and 46.9%, respectively (differences among the three groups: P < 0.01). Nine cases reported as N0(7) and N1(2) by routine histopathological examination were found to have micro-metastasis in mLN by IHC staining, therefore they were actually N2 cases., Conclusion: IHC staining with a monoclonal antibody specific for epithelial cells (Ber-Ep4) is more sensitive in the detection of mediastinal micro-metastais than routine HE staining. Underestimation of the extent of mLN metastasis by cTNM and/or pTNM stagings frequently exists in patients with clinically early lung cancer.

Background & Objective: Clinical symptoms and imaging presentations of inflammatory pseudotumor of the lung (IPL) lack of specialties, and always result in misdiagnoses. This article was to summarize features of IPL, and to improve diagnosis accuracy and appropriate operation selection., Methods: Records of 51 patients with pathologically confirmed IPL, treated surgically in Department of Thoracic Surgery, Cancer Institute/Hospital, Chinese Academy of Medical Sciences from Jan. 1990 to Mar. 2000, were retrospectively reviewed. All patients were followed-up for at least 3 years., Results: Of the 51 patients, before operation, only 3 (5.9%) had been correctly diagnosed, 24 (47.1%) were suspected having tuberculoma or other benign lung tumors, 10 (19.6%) with undefined occupied lesion in the lung, 14 (27.4%) were misdiagnosed as lung cancer. All patients received surgery, including lobectomy in 23 patients (45.1%), tumor excision in 22 patients (43.1%), wedge resection in 4 patients (7.8%), and segmental resection in 2 patients (3.9%). Only 1 (2.0%) had postoperative complication. No death occurred with a follow-up rate of 94.1% (48/51)., Conclusion: Preoperative diagnosing IPL is quite difficult. Surgery should be performed as early as possible. The selection of surgery patterns, mainly include lobectomy and limited resection, depends on intraoperative pathology.

Background & Objective: The idea of double primary lung cancer (DPLC) has been generally accepted. Recently, an increasing incidence of synchronous DPLC has been reported, while the diagnostic standard and treatment strategies remain to be improved. This study was to investigate effective surgical treatment, and prognosis of synchronous DPLC., Methods: From Jan. 1983 to Apr. 2004, 31 patients with synchronous DPLC were operated in our department. Clinical data, such as surgical pattern, postoperative complication, and survival status, of all these patients were reviewed retrospectively., Results: The 31 patients with synchronous DPLC accounted for 0.67% of all 4 649 patients operated for primary lung cancer in our department during the same period. Both tumors of synchronous DPLC were resected with lobectomy or pneumonectomy in 12 patients, while among the other 19 patients, at least 1 tumor was treated with partial pulmonary resection. The postoperative morbidity was 29% (9/31), including 1 case of respiratory insufficiency, 3 cases of atelectasis, 2 cases of atrial fibrillation, 1 case of haemoptysis, 1 case of pleural effusion, and 1 case of wound fat necrosis. No death occurred during operation or within 30 days postoperatively. The postoperative 1-, 3-, and 5-year survival rates were 52%, 29%, and 20%, respectively., Conclusions: The incidence of synchronous DPLC is low. Aggressive and reasonable surgical approach can achieve satisfactory outcomes in patients with synchronous DPLC. The postoperative morbidity is low. Some patients might achieve long-term survival.

Objective: To evaluate the results of surgery and the diagnosis of stage I non-small-cell lung cancer (NSCLC)., Methods: The survival of 274 stage I NSCLC patients who underwent surgery from 1991 to 1998 were statistically analyzed by the Kaplan-Meier method. Comparison of the differences in survival rates among groups were made according to the Logrank test. The follow-up time was at least 5 years with a follow-up rate of 97.8%., Results: The overall 1-, 3-, 5-year survival rates for patients with pathologic stage I lesion were 92.9%, 79.6% and 66.1%. The 5-year survival rates for patients with squamous-cell carcinoma, adenocarcinoma, adenosquamous and alveolar-cell carcinoma were 73.3%, 55.3%, 52.2%, 71.7%, respectively. The 1-, 3-, 5-year survival rates for T1N0 were 95.0%, 83.2%, 74.3% whereas those of T2N0 lung lesions were 90.8%, 75.9%, 59.9% (P < 0.05). The 1-, 3-, 5-year survival rates of regular lobectomy were 94.1%, 79.3%, 67.5% and of conservative resection (segmentectomy and wedge resection) were 76.5%, 50.0%, 38.3% (P < 0.05). There was no perioperative mortality. The postoperative complications were: intrathoracic hemorrhage (2 patients, successfully treated by second thoracotomy) and chylothorax (1 patient, healed after conservative treatment)., Conclusion: The 5-year survival rate of pathologic stage I non-small-cell lung cancer is 66.1%. The outcome of patients with squamous-cell carcinoma (73.3%) is similar to that of alveolar-cell carcinoma (71.7%) which, however, is better than that of adenocarcinoma (55.3%) or adenosquamouscarcinoma (52.5%). The overwhelming superiority in result of IA (T1N0) lesion (74.3%) over the IB (T2N0) disease (59.9%) is quite impressive. Regular lobectomy plus radical mediastinal lymph node dissection is the appropriate management for stage I non-small-cell lung cancer.

Objective: The aim of this study was to analyses the clinicopathologic features of the patient with myasthenia gravis (MG) occurring after resection of thymoma., Methods: Data of 15 patients were collected. The follow-up range from 8 to 178 (average 76.7) months. A retrospective analysis was performed through comparison with data of all 112 cases without MG, which had not occurred MG during our average 5.5 years follow-up, operated for thymoma in same period. The statistics analysis adopted chi(2) and t test., Results: (1) According to Masaoka's classification of thymoma, stage I in 7 cases, stage II in 4, stage III in 4. Histologic Bernatz's classification: lymphocyte predominant type in 4, epithelial type in 3, mixed type in 7, unknown in 1. According to Osserman's classification of MG, grade I in 7, IIa in 4, IIb in 3, III in 1. The MG onset times was the postoperative narcotic waking duration-137 (average 33.9) months, and the average remission time was 30.9 (0.5 - 120) months. (2) 4 cases who occur MG as soon as pull up narcotic tube, all adopted nondepolarizing muscular relaxants. (3) MG was discovered in 3 cases (3/67) during postoperative radiotherapy until a average dosage of 36 Gy was received in average 24 days. (4) The tendency of occurring MG following resection was found in female patients with longer duration of disease, mixed type, larger and later stage thymoma as compared with the thymoma group., Conclusions: The factors including the operation, relatively using overdose relaxation control, choosing unfavorable muscle relaxant and postoperative radiotherapy could induce postoperative MG. An intensive care should be put on the cases with the tendency of occurring postoperative MG.

Objective: To investigate the clinicopathologic features of thymic carcinoma and assess its prognostic factors., Methods: A retrospective analysis was performed in 54 patients with thymic carcinoma who underwent surgical resection. Eighteen patients were treated by total resection of the tumor, 17 partial resection and 10 exploratory thoracotomy. The clinical stage was determined according to Masaoka's classification. The survival time and prognostic factors were evaluated by the log-rank and Cox multivariate analysis model., Results: The overall 5-year survival rate was 44.4%. Being located in anterior mediastinum and noncalcification in the tumor pathognomonically played an important role in the differential diagnosis. According to the multivariate analysis, tumor maximum diameter (OR = 1.84), histological subtype (OR = 1.70), completeness of resection (OR = 1.37), tumor invasion of peritumoral organs (OR = 1.32) and postoperative recurrence (OR = 1.26) were significant prognostic factors. Compared with other subtypes, carcinoid tumor had the characteristics of earlier lesion, better resection rate and better prognosis., Conclusion: The most important prognostic variables for thymic carcinoma are tumor maximum diameter, histological subtype, completeness of resection, tumoral invasion and postoperative recurrence. Complete resection followed by chemoradiotherapy should be considered as favorable on the basis of a definitive pathologic diagnosis.

Objective: To analyze the influence of the number of lymph node metastasis on survival and prophylactic postoperative radiotherapy after radical resection of thoracic esophageal carcinoma., Methods: Four hundred and ninety-five patients with thoracic esophageal squamous cell cancer who had undergone radical resection were randomly divided into surgery group alone (S, 275) and surgery plus radiotherapy group (S + R, 220). The patients were classified into three groups: Group A: 234 patients (47.2%) without lymph node involvement; Group B: 146 patients (29.5%) with 1 to 2 involved lymph nodes and Group C: 115 patients (23.2%) with >or= 3 involved lymph nodes., Results: 1. The 5-year survival rate in Groups A, B and C for the same T stage (T3) was 52.6%, 28.8% and 10.9%, respectively (P = 0.0000); the 5-year survival rate in group C was 0% in S group and 19.3% in S + R group (P = 0.0336); 2. In the positive lymph node group, the metastatic rate of intra-thoracic and supraclavicular lymph node was 35.9% and 21.2% in S group and 19.7% and 4.4% in S+R group (P = 0.014 and P = 0.000). In the negative lymph node group, the metastatic rates of intra-thoracic lymph node was 27.8% in S group and 10.3% in S + R group (P = 0.003). The metastatic rate of intra-abdominal lymph node in Groups A, B and C was 3.9%, 9.4% and 17.5%, respectively (P = 0.0000). The occurrence of hematogenous metastasis was most frequent in group C (27.8%) with >or= 3 positive lymph nodes., Conclusion: 1. The number of metastatic lymph node is one of the important factors which affects the survival of thoracic esophageal carcinoma. 2. Chemotherapy might be given to the patients with three or more lymph nodes involved who have the possibility of developing hematogenous metastasis. Postoperative radiotherapy can reduce the occurrence of intra-thoracic and supraclavicular lymph node metastasis and improve the survival of patients with three or more lymph nodes involvement.

Aim: To study the effects of oxyphenamone (Oxy) on activation of Ca(2+)-activated K+ channels in rabbit mesenteric vascular smooth muscle cells., Methods: To measure the effect of Oxy on the Ca(2+)-activated K+ channel (BK (Ca) channel) activity in rabbit mesenteric vascular smooth muscle cells by using whole cell patch clamp techniques., Results: Oxy reversibly increase BK (Ca) channel activity in rabbit mesenteric artery smooth muscle cells. Application of Oxy (0.1 mumol.L-1) to the perfusion solution caused significant increase in outward currents and its effect was completely abolished by washout; The outward currents K+ was inhibited by TEA (7.5 mmol.L-1); Oxy activated the BK (Ca) channel in a dose-dependent manner (0.01-10 mumol.L-1)., Conclusion: Oxy directly increase the activity of BK (Ca) channel activity in rabbit mesenteric vascular smooth muscle cells in dose-dependent manner.

Objective: To summarize the clinical experiences in treating primary tracheal tumors by surgery., Methods: The clinical data concerning 70 surgically treated patients between 1968 and 2001 were retrospectively analyzed., Results: There were 39 sleeve tracheal resections, 13 carinal resections, 10 lateral tracheal wall resections, 5 local enucleations, and 1 pneumonectomy. The tumors in 2 patients were unresectable. The morbidity rate was 31% (22/70) and operative 30-day mortality for resection with primary reconstruction was 8% (4/52). The tumors were benign in 14 and malignant in 56 cases. The most common malignant tumors were adenoidcystic carcinoma (45%) and squamous cell carcinoma (23%). The cases of benign tracheal tumors were followed up for an average of 5.7 years. After resection for malignant tumors, the overall 5- and 10-year survival rates were 64% (21/33) and 54% (14/26), respectively., Conclusions: Surgical resection is the most effective treatment of tracheal tumors. Tracheal resection and reconstruction is the treatment of choice for primary tracheal tumors. Benign tumors should be resected conservatively with preservation of tracheal parenchyma. The reduction of operative complications are key points of good surgical results.

Objective: To study the clinical significance of serum CEA, SCC and Cyfra21-1 test in the diagnosis, prediction of prognosis and postoperative monitor of recurrence in esophageal cancer., Methods: The concentration of serum CEA and Cyfra21-1 was measured by electrochemiluminescence immunoassay (ECLIA) using Elecsys 2010, CEA kit and Cyfra21-1 kit. Serum SCC was measured by microparticle enzyme immunoassay (MEIA) using IMx System and SCC kit. Serum of 206 patients with esophageal cancer (203 squamous cell carcinoma, 2 small cell carcinoma and 1 adenosquamous carcinoma) was measured preoperatively, 71 of whom also measued 8 to 12 days after resection., Results: The cut-off value of CEA and Cyfra21-1 was < or = 3.25 ng/ml and < or = 2.61 ng/ml, which were determined by the data of 45 healthy Chinese measured during the same period. The positive ratios of serum CEA and Cyfra21-1 in 206 cases were 29.1% and 45.1%. The combined positive ratio of CEA and Cyfra21-1 was 57.3%. The CEA positive ratios, according to the pathological stage of 165 resectable patients, were 16.6% (stage I), 26.8% (II) and 30.8% (III). For Cyfra21-1, they were 27.8%, 37.5% and 50.5%. For CEA combined with Cyfra21-1, they were 38.9%, 50.0% and 63.7%. The mean value of CEA, SCC and Cyfra21-1 (especially SCC and Cyfra21-1) was found to be well correlated with the tumor volume, TNM stage and depth of tumor invasion. Patient with bulky tumor or advanced tumor (T4) usually had much higher mean value than those with early stage tumors. One week after radical resection, the level of the three tumor markers fell to normal level in 92.9% of 71 patients. The level of serum CEA and Cyfra21-1 varied greatly in a small part of the patients. Extremely elevated serum CEA and Cyfra21-1 usually indicated advanced lesion or tumor metastasis., Conclusion: Preoperative and postoperative measurement of serum CEA, SCC and Cyfra21-1 (especially Cyfra21-1) is helpful in the diagnosis, prediction of prognosis and monitor of postoperative recurrence in patients with esophageal cancer.

Based on the 16S rDNA of 8 species (belonging to 8 families of Acridoidea) from China and keyed to 8 relative species of Orthoptera from GenBank, the homologus sequences were compared. The used frequency of nucleotide was calculated and the molecular phylogenetic tree constructed by MEGA microsoft. In the 480 bp fragment of mitochondial 16S rDNA, A + T was about 70.7% and G + C only 29.3%. The sequence data revealed considerable variation in 188 nucleotide sites among the analyzed individuals from 8 different families. The variation rate of transversion was larger than or approach to transition. The results showed that the ranges of the 16S rDNA nucleotide divergence within species, among species of a genus, among genera of a family, and among the same family and suborder were 1.5%, 3.5%-3.6%, 4.8%-15.8% and 15.2%-25.6%, respectively. The members of the same genus and family were grouped together. The phylogenetic relationships of 8 families were Pyrgomorphidae-->Chrotogonidae-->Pamphagidae-->Oedipodidae-->Acrididae--> Arcypteridae-->Gomphoceridae-->Catantopidae. Pyrgomorphidae had closer relationships with Chrotogonidae as well as being the most ancestral group. Arcypteridae and Gomphoceridae were the sister groups and had closer relationships with most evolutionary Catantopidae. Tridactylidae was divided firstly as a suborder, which differs from the recent taxonomy distinctly. Haglidae (Tettigonoidea) and Gryllidae were grouped into suborder Ensifera, Tetrigidae and 8 families of Acridoidea were grouped into suborder Caelifera, as same as recent taxonomy.