[Analysis of surgery effect on 198 cases of pulmonary echinococcosis].

OBJECTIVE: To summarize the experience in the surgical treatment of pulmonary echinococcosis, and evaluate the operative approach to avoid recurrence. METHODS: A retrospective study was carried out to analyze the clinical data of 198 cases with pulmonary echinococcosis from January 2000 to October 2010 in the First Affiliated Hospital of Xinjiang Medical University, involving the general conditions, clinical course, epidemiology, clinical characteristics, therapeutic approaches and outcomes. RESULTS: There were 114 male and 84 female patients aged from 2 to 68 years with a mean of 25.5 years. Herdsmen accounted for 74.7% (148/198), and the juveniles occupied 21.7% (43/198). The major operative methods were complete removal of endocyst and cystectomy with needle aspiration. All the 198 cases were improved or cured. Postoperative pulmonary infection occurred in 9 case (4.5%), 7 cases (3.5%) suffered from wound dehiscence and 4 cases (2.0%) had wound infection, but cured by dressing. 165 patients (83.3%) were followed up for 1-10 years. The recurrence rate was 5.6% (11/198). Patients with recurrence were cured after operation. 198 patients received 226 operations. CONCLUSION: Complete removal of endocyst is the main method for pulmonary echinococcosis with better effect and less recurrence.

[The clinical analysis of 93 children with pulmonary echinococcus].

OBJECTIVE: To approach the clinical characteristics and surgical treatment of children with pulmonary echinococcus. METHODS: Retrospective analysis of child patients with pulmonary echinococcus from January 1980 to December 2008 was carried out, associated with clinical manifestations, diagnosis and treatment, operation methods (complete removal of endocyst and cystectomy with needle aspiration), prognosis and recurrence. There were 93 patients (54 male and 39 female) aged from 2 to 14 years. There were 82 cases lived in the echinococcosis pulmonary endemic areas, accounting for 88.1% (82/93), and 79 cases of patients had obvious contact with dogs or sheep, accounting for 84.9% (79/93). There were 68 cases with simple pulmonary echinococcus accounted for 73.1% (68/93), 25 cases suffered from complexity pulmonary hydatid, accounting for 26.9% (25/93). RESULTS: All patients were cured or improved after surgery except one dead. Six cases got postoperative pulmonary infection, 3 cases had wound infection, 1 case suffered from bile-pleura fistula. There were 76 patients (81.7%) followed up for 1 to 10 years after surgery. Five cases had recurrence, the recurrence rate was 5.4% (5/93). CONCLUSIONS: The clinical symptoms of pulmonary echinococcus in children is not typical, misdiagnosis and missed diagnosis take place easily. Complete removal of endocyst has low postoperative complications and lower relapse rate.

[1H-MRS metabonomic analysis of plasma samples of esophageal cancer patients based on different pattern recognition].

OBJECTIVE: To analyze the metabonomic (1)H-MRS of plasma samples from patients with esophageal cancer and healthy controls applying different pattern recognition methods, and to explore the potential of application of (1)H-MR-based metabonomics in clinical research. METHODS: (1)H-MR was performed on plasma samples from 109 EC patients and 50 health controls to analyze the metabonomic variation between EC patients and healthy subjects and the corresponding (1)H-MRS were recorded on Varian Unity ANOVA 600 MHz to perform principal components analysis (PCA), partial least squares discriminant analysis (PLS-DA), orthogonal partial least squares discriminant analysis (OPLS-DA), respectively. RESULTS: OPLS-DA analysis could correctly separate almost all the plasma samples from EC patients and health controls, better than both the PCA and PLS-DA. The plasma levels of leucine, alanine, isoleucine, valine, glycoprotein, lactate, acetone, acetate, choline, isobutyrate, unsaturated lipid, VLDL, LDL, 1-methylhistidine were significantly decreased in EC patients (r total > 0.27, P < 0.05), while that of dimethylamine, α-glucose, ß-glucose, citric acid increased in the EC patients (r total < -0.27, P < 0.05). CONCLUSIONS: The analysis of metabonomic (1)H-MRS of plasma samples by OPLS-DA method can eliminate the influence of non-experimental factors and decrease the heterogeneity of samples. It is useful and of great potential for application in clinical diagnosis and research of esophageal cancer.

[Metabonomic variation of esophageal cancer within different ethnic groups in Xinjiang, China].

OBJECTIVE: To investigate the metabonomic variation between patients with esophageal cancer (EC) and healthy controls, and to analyze the variation between patients with EC. METHODS: H-MR and orthogonal partial least-squares discriminant analysis (OPLS-DA) was performed on 108 plasma specimens from EC patients and 50 health controls, and the metabonomic variation between patients with EC and healthy controls analyzed. RESULTS: OPLS-DA analysis might correctly separate all plasma specimens from health controls and patients with EC, leucine (0.0043 +/- 0.0006, 0.0040 +/- 0.0006), alanine (0.0039 +/- 0.0007, 0.0033 +/- 0.0006), isoleucine (0.0067 +/- 0.0010, 0.0063 +/- 0.0009), valine (0.0037 +/- 0.0005, 0.0035 +/- 0.0006), glycoprotein (0.0123 +/- 0.0043, 0.0102 +/- 0.0022), lactate (0.0342 +/- 0.0113, 0.0258 +/- 0.0085), acetone (0.0027 +/- 0.0023, 0.0017 +/- 0.0008), acetate (0.0007 +/- 0.0001, 0.0006 +/- 0.0001), choline (0.0035 +/- 0.0006, 0.0029 +/- 0.0007), isobutyrate (0.0020 +/- 0.0004, 0.0018 +/- 0.0003), unsaturated lipid (0.0072 +/- 0.0013, 0.0059 +/- 0.0018), VLDL (0.1209 +/- 0.0589, 0.0879 +/- 0.0269), LDL (0.0885 +/- 0.0328, 0.0785 +/- 0.0288), 1-methylhistidine (0.0005 +/- 0.0001, 0.0004 +/- 0.0005) decreased in EC patient' s plasma with statistical significance (r total > 0.27, P < 0.05), dimethylamine (0.0004 +/- 0.0001, 0.0005 +/- 0.0001), alpha-glucose (0.0079 +/- 0.0013, 0.0081 +/- 0.0016), 3-glucose (0.0139 +/- 0.0024, 0.0142 +/- 0.0029), citric acid (0.0044 +/- 0.0008, 0.0106 +/- 0.0058) increase in the EC patient's plasma (r total < -0.27, P < 0.05). There were clear variation between Han and Kazak patients, alanine (0.0031 +/- 0.0005,0.0029 +/- 0.0004), glutamine (0.0010 +/- 0.0001, 0.0009 +/- 0.0001), tyrosine (0.0009 +/- 0.0001, 0.0008 +/- 0.0001), 1-methylhistidine (0.0005 +/- 0.0001, 0.0004 +/- 0.0001) increased in the Han patients (r > 0.35, P> 0.05), carnitine (0.0028 +/- 0.0006) was higher in Kazak patients than in Han patients (0.0025 +/- 0.0004), which had statistical significance (r = - 0.40, P < 0.05). Unsaturated lipid (0.0059 +/- 0.0018, 0.0047 +/- 0.0011), isoleucine (0.0062 +/- 0.0011, 0.0058 +/- 0.0007), alanine (0. 0032 +/- 0.0007, 0.0028 +/- 0.0004), glycoprotein (0.0096 +/- 0.0019, 0.0086 +/- 0.0011), glutamine (0.0011 +/- 0.0001, 0.0009 +/- 0.0001), tyrosine (0.0009 +/- 0.0001, 0.0008 +/- 0.0001), 1-methylhistidine (0.0005 +/- 0.0001, 0.0004 +/- 0.0001) were increased in Uygur patients as compared with Kazak patients, having statistical significance (r > 0.33, P < 0.05), carnitine (0.0027 +/- 0.0005) was higher in Kazak patients than in Uygur patients (0.0025 +/- 0.0004) (r = - 0.36, P < 0.05). CONCLUSION: The results indicate that 1H-MR spectra of plasma analyzed by OPLS-DA statistical methods might completely separate the EC patients from health controls. The metabonomic approach should be helpful in screening of EC patients.

Association of defective HLA-I expression with antigen processing machinery and their association with clinicopathological characteristics in Kazak patients with esophageal cancer.

BACKGROUND: It has been confirmed that defective expression of human leukocyte antigen class I (HLA-I) molecules can contribute to the immune evasion of cancer cells in some types of cancer. The aim of this study was to examine the expression of HLA class I antigen and the antigen-processing machinery (APM) components in esophageal squamous cell carcinoma (ESCC) and their role in high risk human papillomavirus (HPV) infection, and to analyze their association with histopathological characteristics in the Kazak ethnic group. METHODS: A total of 50 formalin-fixed, paraffin-embedded ESCC lesions were collected from the First Affiliated Hospital of Xinjiang Medical University, China. The expression levels of HLA-I antigen and APM components were determined by immunohistochemistry; the HPV DNA were detected using polymerase chain reaction (PCR). RESULTS: A high frequency of down-regulation or loss of expression of HLA and APM components were found in esophageal cancer in Kazak people. HLA-I, TAP1, CNX, LMP7, Erp57, Tapasin and ERAP1 were down-regulated in 68%, 44%, 48%, 40%, 52%, 32% and 20% of ESCC lesions then, respectively. The loss of expression of HLA-I antigen was significantly correlated with part of the APM components and positively correlated with high risk HPV16 infection. TAP1, CNX, LMP7, Erp57 and Tapasin loss were significantly associated with tumor grading, lymph node metastasis and depth of invasion (P < 0.05). CONCLUSION: Our results suggest that APM component defects are a mechanism underlying HLA-I antigen down-regulation in ESCC lesions, and indicate that the loss expression of HLA-I and APM components will become an important marker of ESCC and analysis of HLA-I and APM component expression can provide useful prognostic information for patients with ESCC from the Kazak ethnic group.