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An analysis was made of the chromosome karyotype from the peripheral blood taken from a couple who had experienced consecutive abortions for four times. The karyoype was determined as Rob(13;21) through G-band and high resolving power.

Recently, neoadjuvant therapy has become the focus of interest in an effort to prolong survival and reduce recurrence rates in patients with oesophageal cancer. This study was designed to evaluate the tolerance and the short-term outcome of chemoradiotherapy followed by surgery for patients with locally advanced esophageal squamous carcinoma, to observe effects of chemoradiotherapy on tumor resection rate, incidence of complications after surgery, and perioperative mortality.From January 2000 to September 2003, Thirty-four consecutive patients with locally advanced esophageal squamous carcinoma were entered into this phase II study. The clinical pre-treatment staging of the tumors were determined by chest CT scan, abdomial CT Scan, EUS, and bronchoscopy examination. Chemotherapy and radiotherapy were performed concurrently. The chemotherapy consisted of Vinorelbine (or 5-Fluorouracil) and Cisplatin. 5-Fluorouracil at 2.4 g/m(2) was administered in continuous infusion for days 1-3 and days 22-25. Vinorelbine at 25 mg/m(2) per day was administered in bolus infusion on d1, d8, d22 and d29. Cisplatin at 75 mg/m(2) was administered by intravenously infusion on d1 and d22. A total radiotherapy dose of 40 Gy was delivered in 20 daily fractions of 2.0 Gy each (given 5 d/wk for 4 weeks). After completion of chemoradiotherapy, clinical restaging was performed. Esophagectomy and lymphadenectomies were performed 3-5 weeks after chemoradiotherapy.Thirty-three patients completed the planned chemoradiotherapy, and 32 patients underwent surgery. The toxicities of chemoradiotherapy such as myelotoxicity, pulmonary toxicity, esophagitis were grade I or II. No death was resulted from chemoradiotherapy. The clinical response rate of chemoradiotherapy was 85.3%, the pathological complete response rate was 25%, the resectability rate was 100%. Postoperative pulmonary infection occurred in 8 patients (22.9%), anastomotic leak in 3 patients (9.4%). Two patients (6.3%) died perioperatively because of ARDS and anastomotic leak complicated with heart failure.The short-term results of this study suggest that the strategy of chemoradiotherapy followed by surgery is safe,although it caused considerable toxicity and increased operation-related complications rate and perioperative mortality rate compared with surgery alone at the same period. Preoperative chemoradiotherapy is able to significantly reduce the tumor stage, and achieve substantially high clinical response rate and pathological complete response rate.

Few research of surgery for superior mediastinal metastasis from thyroid carcinoma has been reported. Previous surgical approach from neck had the problems of easy damage of nerve and vessels and the difficulty of clearance of lymph nodes. This study was designed to assess the value of systemic superior mediastinal lymph node dissection via sternotomy for superior mediastinal metastasis from differentiated thyroid carcinoma.A retrospective study was performed to analyze the clinical pathologic data as well as the outcome of 12 cases of differentiated thyroid carcinoma treated with systemic superior mediastinal lymph node dissection via sternotomy approach from April 1995 to April 2002, including 7 cases of papillary adenocarcinoma and 5 cases of medullary carcinoma.Pathologically, the incidence rates of metastasis to anteriotracheal lymph node, paratracheal lymph node, anterior superior vena cava, and anterior innominate artery lymph nodes were 55.6% (25/45), 57.1% (36/63), 42.1% (8/19) and 30% (3/10), respectively. All cases are still alive in one to seven years follow-up period. The median follow-up was 32 months. Upper mediastinal lymph nodes were recurrent in one case; distant metastasis occurred in two cases.Systemic superior mediastinal lymph node dissection via sternotomy approach can be employed in treating superior mediastinal lymph node metastasis from differentiated thyroid carcinoma due to its safety and relatively satisfactory outcome.

To evaluate the benefits of post-stenting radiotherapy and/or chemotherapy for unresectable esophageal carcinoma.Fifty-three patients with unresectable esophageal carcinoma were randomly divided into two groups: patients in group A (n = 27) were treated with stenting alone, and those in group B (n = 26) were treated with stenting followed by radiotherapy and/or chemotherapy. Comparison was made by assessing their survival time, quality of life (QOL), degree of dysphagia, and stenting-related morbidity, respectively.There was no statistically significant improvement in dysphagia and QOL between the two groups. Although there was no difference in the frequency of stenting-related complications, re-stenosis occurred much less frequently in group B patients (P = 0.007). The mean survival time of patients was 245 +/- 41 days and 262 +/- 43 days in group A and group B, respectively. There was no significant difference between the two groups (P = 0.813).Besides decreased recurrence of stenosis, post-stenting radiotherapy and/or chemotherapy does not provide additional benefits for survival.

To study the optimal surgical resection length for esophageal carcinoma.Specimens of seventy patients with esophageal squamous cell carcinoma resected and collected in our hospital were made into pathologic giant sections. Direct intramural infiltration, multicentric carcinogenic lesion and leaping metastasis were observed in the large slice by microscope. The actual length during the operation was calculated by the ratio of shrinkage.Direct intramural infiltration was found in 51 (72.9%) patients, 39 proximal and 36 distal to the tumor. The mean length of direct intramural infiltration was 0.9 +/- 0.8 cm (4.0 cm maximum) proximally and 0.5 +/- 0.3 cm (2.0 cm maximum) distally. Multicentric carcinogenic lesion was found in 11 (15.7%) patients, 5 proximally, 8 distally and 2 on both sides. Proximal to the tumor, the mean distance between the multicentric carcinogenic lesion and the main lesion plus the length of the multiple carcinogenic lesion was 3.2 +/- 1.5 cm (4.7 cm maximum). Distal to the tumor, it was 3.6 +/- 2.4 cm (9.1 cm maximum). Leaping metastasis was found in 9 (12.9%) patients, 7 proximally and 4 distally. The mean distance between the leaping metastasis and the main lesion plus the length of the leaping metastatic lesion was 1.9 +/- 0.6 cm (2.9 cm maximum) proximally and 1.4 +/- 1.0 cm (2.7 cm in maximum) distally.The optimal surgical resection length for esophageal carcinoma should be at least 5 cm proximal to the tumor and total length on the distal side.

There are many factors affect the prognosis of the patients with unresectable esophageal carcinoma who underwent intubation, however, it is unclear which ones are main causes so far. This study was designed to analyze the prognostic factors of unresectable esophageal carcinoma after stenting in order to find the reasonable modalities of palliative therapy.Consecutive 102 patients with unresectable esophageal carcinoma who were eligible for inclusion criteria were analyzed after stenting. Twelve factors including gender, age tumor site, tumor length, stricture degree in diameter, pathologic type, grade of cell differentiation, clinical tumor stage (T, N, M), pre-stenting therapy and post-stenting therapy (radiotherapy and/or chemotherapy) were used for Cox regression model analysis. The survival rate was calculated by life table.The technical sucess rate of stenting was 98.3%. There were significant improvement on the grade of swallowing function (P = 0.000) and quality of life (KPS scores, P = 0.000). The incidence rate of complications was 43.1% (44/102). The survival rates of 3, 6, 9, 12 months were 67.53%, 40.59%, 27.43%, and 18.65%, respectively. The results of Cox regression showed that invasion degree of primary tumor (T, P = 0.0410) and distal metastasis (M, P = 0.006) were the statistically significant prognostic factors. The odds ratio(ORT) was 1.750 (95% CI, 0.996-3.074) on T stage of primary carcinoma, ORM was 1.527 (95% CI, 1.126-2.069) on M stage. There was no statistical significance in the survival of the patients affected by radiotherapy and/or chemotherapy after intubation.T stage and M stage are the major prognostic factors affecting the survival of patients with unresectable esophageal carcinoma after stenting. There is no benefit for survival of patients treated with radiotherapy and/or chemotherapy after intubation.

AIM: To investigate the influence of nodal status on response and clarify the optimal treatment for operable esophageal squamous cell carcinoma (OSCC). METHODS: We retrospectively analyzed 1490 OSCC patients who underwent transthoracic esophagectomy and lymphadenectomy between December 1996 and December 2009 at the Sun Yat-sen University Cancer Center. The surgical approach and the number of resected lymph nodes (LNs) were considered in the assessment of surgery. Patients were classified according to their nodal statuses (N0 vs N1 vs N2-3). Overall survival was defined as the time from the date of death or final follow-up. Survival analysis was performed using the Kaplan-Meier method and differences between curves were assessed by the log-rank test. Univariate and multivariate Cox regression analyses were used to identify factors associated with prognosis. Statistical significance was assumed at a P < 0.05. RESULTS: With a median time from surgery to the last censoring date for the entire cohort of 72.2 mo, a total of 631 patients were still alive at the last follow-up and the median survival time was 35.5 mo. The surgical approach (left transthoracic vs Ivor-Lewis/tri-incisional) was verified as independent prognostic significance in patients with N0 or N1 status, but not in those with N2-3 status. Similar results were also observed with the number of resected LNs (≤ 14 vs ≥ 15). Compared with surgery alone, combined therapy achieved better outcomes in patients with N1 or N2-3 status, but not in those with N0 status. For those with N2-3 status, neither the surgical approach nor the number of resected LNs reached significance by univariate analysis, with unadjusted HRs of 0.826 (95%CI: 0.644-1.058) and 0.849 (95%CI: 0.668-1.078), respectively, and aggressiveness of surgery did not influence the outcome; the longest survival was observed in those patients who received the combined therapy. CONCLUSION: Combined therapy has a positive role in OSCC with LN metastasis, and aggressive surgical resection does not improve survival in patients with N2-3 status.

To evaluate whether preoperative mean corpuscular volume (MCV) is a prognostic indicator in patients with resectable esophageal squamous cell carcinoma (ESCC).A total of 298 consecutive, prospectively enrolled patients with histologically diagnosed ESCC who underwent surgery with curative intent from 2001 to 2011 were retrospectively evaluated. Patients were excluded if they had previous malignant disease, distant metastasis at the time of primary treatment, a history of neoadjuvant treatment, had undergone non-radical resection, or had died of a non-tumor-associated cause. Survival status was verified in September 2011. Pathological staging was performed based on the 2010 American Joint Committee on Cancer criteria. Preoperative MCV was obtained from blood counts performed routinely within 7 d prior to surgery. Receiver operating characteristic (ROC) curve analysis was used to determine a cutoff for preoperative MCV.The 298 patients consisted of 230 males and 68 females, with a median follow-up of 30.1 mo. ROC analysis showed an optimal cutoff for preoperative MCV of 95.6 fl. Fifty-nine patients (19.8%) had high (95.6 fl) and 239 (80.2%) had low (≤ 95.6 fl) preoperative MCV. Preoperative MCV was significantly associated with gender (P = 0.003), body mass index (P = 0.017), and preoperative red blood cell count (P0.001). The predicted 1-, 3- and 5-year overall survival (OS) rates were 72%, 60% and 52%, respectively. Median OS was significantly longer in patients with low than with high preoperative MCV (27.5 mo vs 19.4 mo, P0.001). Multivariate analysis showed that advanced pT (P = 0.018) and pN (P0.001) stages, upper thoracic location (P = 0.010), lower preoperative albumin concentration (P = 0.002), and high preoperative MCV (P = 0.001) were negative prognostic factors in patients with ESCC. Preoperative MCV also stratified OS in patients with T3, N1-N3, G2-G3 and stage III tumors.Preoperative MCV is a prognostic factor in patients with ESCC.

To compare postoperative complications and prognosis of esophageal squamous cell carcinoma patients treated with different routes of reconstruction.After obtaining approval from the Medical Ethics Committee of the Sun Yat-Sen University Cancer Center, we retrospectively reviewed data from 306 consecutive patients with histologically diagnosed esophageal squamous cell carcinoma who were treated between 2001 and 2011. All patients underwent radical McKeown-type esophagectomy with at least two-field lymphadenectomy. Regular follow-up was performed in our outpatient department. Postoperative complications and long-term survival were analyzed by treatment modality, baseline patient characteristics, and operative procedure. Data from patients treated via the retrosternal and posterior mediastinal routes were compared.The posterior mediastinal and retrosternal reconstruction routes were employed in 120 and 186 patients, respectively. Pulmonary complications were the most common complications experienced during the postoperative period (46.1% of all patients; 141/306). Compared to the retrosternal route, the posterior mediastinal reconstruction route was associated with a lower incidence of anastomotic stricture (15.8% vs 27.4%, P = 0.018) and less surgical bleeding (242.8 ± 114.2 mL vs 308.2 ± 168.4 mL, P0.001). The median survival time was 26.8 mo (range: 1.6-116.1 mo). Upon uni/multivariate analysis, a lower preoperative albumin level (P = 0.009) and a more advanced pathological stage (pT; P = 0.006; pN; P0.001) were identified as independent factors predicting poor prognosis. The reconstruction route did not influence prognosis (P = 0.477).The posterior mediastinal route of reconstruction reduces incidence of postoperative complications but does not affect survival. This route is recommended for resectable esophageal squamous cell carcinoma.

The title compound, C(20)H(32)ClNO(3), was obtained via a tandem asymmetric Michael addition-elimination reaction of (5S)-3,4-dichloro-5-(l-menth-yloxy)furan-2(5H)-one and 4-methyl-piperidine in the presence of potassium fluoride. The furan-one ring is approximately planar [maximum atomic deviation = 0.022 (2) Å] while the cyclo-hexane ring adopts a chair conformation. Weak inter-molecular C-H⋯O hydrogen bonding is present in the crystal structure.

The title compound, C18H26ClNO3, was obtained via a tandem asymmetric Michael addition–elimination reaction of 3,4-dichloro-5-(S)-(l-menthyloxy)furan-2(5H)-one and 2,5-dihydro-1H-pyrrole in the presence of potassium fluoride. In the molecule, the nearly planar dihydropyrrole ring [maximum atomic deviation = 0.019 (3) Å] is oriented at a dihedral angle of 10.73 (8)° to the the nearly planar furanone ring [maximum atomic deviation = 0.011 (2) Å]; the cyclohexane ring adopts a chair conformation. In the crystal, molecules are linked via weak intermolecular C—H...O hydrogen bonds, forming supramolecular chains running along the b axis.

The title compound, C20H30BrNO3, was obtained via a tandem asymmetric Michael addition–elimination reaction of 3,4-dibromo-5-(S)-(l-menthyloxy)-2(5H)-furanone and diallylamine in the presence of potassium fluoride. In the molecule, the five-membered furanone ring is approximately planar [maximum atomic deviation = 0.030 (3) Å], and the six-membered cyclohexane ring adopts a chair conformation.

The title compound, C8H10ClNO5, was obtained via a tandem Michael addition–elimination reaction of 3,4-dichloro-5-methoxyfuran-2(5H)-one and glycine methyl ester in the presence of triethylamine. The molecular structure contains an approximately planar [maximum atomic deviation = 0.010 (2) Å] five-membered furanone ring. The crystal packing is stabilized by intermolecular N—H...O and weak C—H...O hydrogen bonding.

In the the title compound, C19H18BrNO3, the furanone ring is almost planar [maximum atomic deviation = 0.019 (3) Å] and is nearly perpendicular to the two phenyl rings, making dihedral angles of 88.96 (17) and 87.71 (17)°. Intermolecular C—H...O hydrogen bonding is present in the crystal structure.

The ultrastructures and cytochemistry of pollen grains with different longevities of three grass species, rice (Oryza sativa L.), maize (Zea mays L.) and pennisetum (Pennisetum alopecuroides Spreng.), were studied by transmission electron microscopy. The pollen wall of rice is the thinnest and that of pennisetum the thickest. The exine of rice pollen grains is loose and porous with communication channels, or microchannels, and thick columellae, but that of pennisetum pollen grains is very dense and nearly without microchannels and columellae. The tectum of pennisetum pollen wall is also the thickest of the three species. In the pollen walls of rice and maize, the microchannels traverse the tectum and foot layer. The exinous microchannels are slightly more abundant in rice pollen wall than in pennisetum pollen wall and the intines of the pollen walls of rice and pennisetum have higher electron densities than that of maize. In rice pollen wall glucose-6-phosphate dehydrogenase (G6PD) and succinate dehydrogenase (SDH) are located in the exine, mainly on the surface, along the microchannels and in the spaces between columellae, and in the intine. However, they occur mainly in the intine of maize pollen wall and on the surface of pennisetum pollen wall. Under natural conditions, rice’s thinnest pollen wall with richer exinous microchannels, G6PD and SDH, appears to be related to the short life of the pollen grains, while the opposite characteristics of pennisetum pollen grains are associated with greater longevity.

Introduction The postoperative prognosis of peripheral adjacent lobe invasion non-small cell lung cancer (NSCLC) is unclear. The purpose of this study was to determine the postoperative prognosis of NSCLC with direct adjacent lobe invasion by comparing it with that of visceral pleural invasion (primary lobe) T2 disease, and parietal pleural invasion T3 disease, and hence determine its most appropriate T category. Methods A retrospective analysis was conducted to assess the survival of patients with peripheral direct adjacent lobe invasion NSCLC (group A), and it was compared with that of patients with visceral pleural invasion of the primary lobe (group B) and parietal pleural invasion (group C). All patients were node-negative on pathologic examination. Kaplan-Meier method was used to compare the postoperative survival between groups. Results A total of 263 patients were analyzed. The overall survival rates in groups A (n = 28), B (n = 167), and C (n = 68) at 5 years were 40.7, 54.6, and 41.9%, respectively; corresponding median survival in three groups were 53, 71, and 40 months, respectively. The survival difference among three groups was statistically significant (p = 0.031). A similar survival was observed between groups A and C, whereas group B had a much better survival than other groups. Conclusions Peripheral adjacent lobe invasion NSCLC has a similar survival prognosis with that of parietal pleural invasion T3 disease and hence should be classified as T3 rather than T2. However, further studies are warranted.

Background MicroRNAs (miRNAs) are a novel class of powerful, endogenous regulators of gene expression. This study was designed to ascertain if miR-30a is involved in the cardioprotective actions of salvianolic acid B (Sal B) against myocardial ischemia–reperfusion (I–R) injury through suppression of autophagy. Methods Murine myocardial cells that had undergone primary culture were induced by I–R and incubated with Sal B (25, 50, 100 μM) in the presence of a miR-30a mimic or miR-30a inhibitor. Expression of miR-30a, beclin-1, LC3-II and p-Akt protein, cell viability, and lactic acid dehydrogenase (LDH) release were assessed. Results miR-30a expression was down-regulated remarkably in I–R cells, and this suppression could be reversed by Sal B in a dose-dependent manner. Sal B repressed autophagy in I–R myocardial cells. Sal B improved cell viability and reduced the rate of LDH leakage, which suggested that autophagy suppression was beneficial for cell survival. Knockdown of miR-30a with a miR-30a inhibitor could reverse the anti-autophagy effect of Sal B against I–R injury. Furthermore, we confirmed that Sal B has a protective role in miR-30a-mediated autophagy through the PI3K/Akt signaling pathway, which was abrogated by the PI3K inhibitor LY294002. Conclusions These data suggest that miR-30a is involved in Sal B-mediated cardioprotection against I–R injury through the PI3K/Akt signaling pathway. Electronic supplementary material The online version of this article (doi:10.1186/s12906-016-1275-x) contains supplementary material, which is available to authorized users.

Background Autophagy can result in cellular adaptation, as well as cell survival or cell death. We investigated how ginsenoside Rg1(G-Rg1) regulates the relationship between autophagy and apoptosis induced by continuous starvation. Methods H9c2 cells under continuous starvation were treated with or without ginsenoside Rg1, and autophagy and apoptosis related proteins were assessed over a continuous time course by Western blot. Dynamic fluorescence intensity of green fluorescent protein (GFP)-LC3 was used to assess autophagosome formation by live cell imaging. Cyan fluorescent protein (CFP) -Beclin1(BECN1) and yellow fluorescent protein (YFP) -Bcl-2 were co-transfected into cells to observe ginsenoside Rg1 regulation of BECN1/Bcl-2 interaction using Fluorescence Resonance Energy Transfer (FRET). Immunoprecipitation was also used to assess BECN1/Bcl-2 interaction over a continuous time course. Results In H9c2 cells, starvation induced both apoptosis and autophagy. Cell apoptosis was significantly attenuated in ginsenoside Rg1-treated conditions, while autophagy was promoted. Ginsenoside Rg1 weakened the interaction between Beclin1 and Bcl-2, inhibiting apoptosis while promoting autophagy. Our results suggest that autophagy is beneficial to starved cardiac cells over a period of time. Furthermore, we describe the effect of ginsenoside Rg1 on the relationship between autophagy and apoptosis during starvation. Conclusions Our findings provide valuable evidence for employing ginsenoside Rg1 as a specific promoter of autophagy and inhibitor of apoptosis. Electronic supplementary material The online version of this article (doi:10.1186/s12906-016-1112-2) contains supplementary material, which is available to authorized users.

Background TRPV6 is over-expressed and promotes the proliferation and invasion in many cancers. The association between the expression of TRPV6 and clinical outcome in esophageal squamous cell carcinoma (ESCC) has not been studied yet. We aim to elucidate the role of TRPV6 in predicting prognosis of patients with ESCC. Methods In the retrospective study, mRNA level of TRPV6 was examined in patients (N = 174) from Sun Yat-sen University Cancer Center (mRNA cohort) and protein level of TRPV6 was examined in patients (N = 218) from Linzhou Cancer Hospital (protein cohort). Statistical analysis was performed to test the clinical and prognostic significance of TRPV6. Results TRPV6 was down-regulated in ESCC tissues and cell lines. Patients with downregulation of TRPV6 trended to have a higher rate of advanced pT stage in both mRNA cohort (P = 0.089) and protein cohort (P = 0.073), though not statistically significant. No significant association was observed between TRPV6 expression and disease-specific survival (DSS) in both two cohorts. However, stratified survival analysis based on the gender showed that in mRNA cohort, downregulation of TRPV6 was associated with an unfavorable 3-year DSS in patients with male (47.3 % vs 63.6 %, P = 0.027) and with favorable 3-year DSS in patients with female (66.7 % vs 43.0 %, P = 0.031). The result was confirmed in protein cohort. Male patients with downregulation of TRPV6 had a poor 3-year DSS (20.0 % vs 57.1 %,P

Background The correlation of S-phase kinase–associated protein 2 (Skp2) with metastasis and prognosis in esophageal squamous cell carcinoma (ESCC) is controversial. The purpose of this study was to explore whether there was a correlation between the expression of Skp2 evaluated by immunohistochemistry and the clinical outcome of patients with operable ESCC, and to further determine the possible mechanism of the impact of Skp2 on survival. Methods Tissue microarrays that included 157 surgically resected ESCC specimens was successfully generated for immunohistochemical evaluation. The clinical/prognostic significance of Skp2 expression was analyzed. Kaplan-Meier analysis was used to compare the postoperative survival between groups. The prognostic impact of clinicopathologic variables and Skp2 expression was evaluated using a Cox proportional hazards model. A cell proliferation assay and a colony formation assay were performed in ESCC cell lines to determine the function of Skp2 on the progression of ESCC in vitro. Results Skp2 expression correlated closely with the T category (p = 0.035) and the pathological tumor-node-metastasis (TNM) stage (p = 0.027). High expression of Skp2 was associated with poor overall survival in resectable ESCC (p = 0.01). The multivariate Cox regression analysis demonstrated that pathological T category, pathological N category, cell differentiation, and negative Skp2 expression were independent factors for better overall survival. In vitro assays of ESCC cell lines demonstrated that Skp2 promoted the proliferative and colony-forming capacity of ESCCs. Conclusions Negative Skp2 expression in primary resected ESCC is an independent factor for better survival. Skp2 may play a pro-proliferative role in ESCC cells.