[Characteristics of Ozone Concentration in Shanghai and Its Associated Atmospheric Circulation Background During Summer Half-years from 2006 to 2021].

It is of great importance to scientifically evaluate the impact of weather and climate conditions on the occurrence of O3 pollution in order to improve the accuracy of O3 pollution forecasts， as well as to reasonably control and reduce the adverse effects of O3 pollution. The characteristics of O3 concentration and climate background were analyzed based on daily O3 concentration data， meteorological factors， and NCEP/NCER reanalysis data from 2006 to 2021 in Shanghai. In addition， the differences in atmospheric circulation situations during years with anomalous O3 concentrations were compared and diagnosed from the perspective of climatology. Additionally， the monthly O3 concentration prediction model （seasonal autoregressive integrated moving average with exogenous regressors， SARIMAX） was further established by adding the key meteorological factors. The results indicated that both the whole-year average and summer half-year average O3 concentrations in Shanghai were increasing with fluctuation， and the summer half-year average was much higher than the annual average， up to 36.2%. Furthermore， there was a significant negative correlation between O3 concentration and wind speed （correlation coefficient of -0.826） and a significant positive correlation with the frequency of static wind and the number of days in which the low cloud cover was less than 20% （correlation coefficients of 0.836 and 0.724， respectively）. The monthly mean O3 concentration had a clear periodicity， showing a pattern with a high concentration in the middle period （April to September） and a low concentration at the beginning and end of the periods. High O3 concentration years （2013-2021） were accompanied by more polluted days， lower average wind speed， more small wind （≤1.5 m·s-1） days， more days of low cloud cover of less than 20%， more days of high temperature， higher direct solar radiation， and more sunshine hours. When the location of the stronger West Pacific subtropical high was westward and southward in the summer half-year， Shanghai was influenced by an anomalous westerly wind， which was not conducive to the transportation of clean air from the sea to Shanghai and thus led to the high concentration of O3 pollution. When the long wave radiation emitted from the ground was low in the summer half-year， it was favorable for the increase in ground temperature and caused a high concentration of O3 pollution. Adding direct solar radiation， maximum temperature， and wind speed as exogenous variables to the monthly O3 forecast model could significantly improve the effectiveness of the monthly forecast， with the root mean square error decreasing by 47.7% （from 22 to 11.5） and the correlation coefficient increasing by 11.2% （from 0.819 to 0.911）， which could be applied to the practical prediction of monthly O3 concentration.

[Diagnostic value of enhanced computed tomography plus vascular endothelial growth factor C expression in hilar and mediastinal lymph node metastasis of non-small cell lung cancer].

OBJECTIVE: To explore the diagnostic value of preoperative enhanced computed tomography (CT) plus vascular endothelial growth factor C (VEGF-C) expression in hilar and mediastinal lymph nodes metastasis of non-small cell lung cancer. METHODS: A total of 87 patients with non-small cell lung cancer (NSCLC) received preoperative chest enhanced CT scans and underwent standard radical operation and systematic lymph node dissection. Pathologic examination was selected as the gold standard to determine lymph node metastasis. The immunohistochemical method was used to detect the expression of VEGF-C. The predicting values of chest enhanced CT, VEGF-C expression and their combination for the diagnosis of hilar and mediastinal lymph nodes metastasis were evaluated through comparing the sensitivity, specificity and accuracy. RESULTS: The sensitivity of CT scan was 75.0%, specificity 59.6% and accuracy 66.7%. The positive expression rate of VEGF-C was 78.2% (68/87) and strong positive rate 13.8% (12/87). The sensitivity of VEGF-C was 97.5%, specificity 38.3% and accuracy 65.5%. The combination of CT and VEGF-C had a better accuracy (74.7%) and the sensitivity and specificity were 80.0% and 70.2% respectively. CONCLUSION: Compared with CT scan or VEGF-C expression alone, the combination of CT and VEGF-C improves the specificity and accuracy of diagnosing lymph nodes metastasis in NSCLC. If this combination method is employed before therapy, the accuracy of clinical nodal staging may be enhanced.

[Diagnostic accuracy research of needle puncture biopsy during operation for pulmonary single nodules].

OBJECTIVE: To investigate the diagnostic accuracy of needle puncture biopsy and pathological examination of frozen during operation for pulmonary nodules, and whether this diagnostic method can replace tumor resection examination. METHODS: Totally 50 patients (28 males and 22 females, average age was 59 years) who had the single nodule after imaging examination without any pathological diagnostic from January to October 2010 were selected in this research work. During open operation or video assisted thoracic surgery, needle (14 G model) was used to puncture biopsy for pathological examination of frozen. All the adverse events during puncture biopsy would be recorded. The resection specimens would be accepted paraffin pathological examination. The relationship between puncture frozen pathological and paraffin pathological examination was analyzed. RESULTS: All tumor sizes were ranged from 1.0 cm × 0.6 cm to 5.6 cm × 9.0 cm. The paraffin pathological examination after operation as the golden standard, there were 7 cases of benign tumor and 43 cases of malignant tumor. The diagnostic sensitivity of puncture biopsy was 90.7%, the specificity was 100%, the positive predictive value was 100% and the negative predictive value was 63.6%. There were 11 cases of benign tumor diagnosed by needle puncture biopsy, among which 4 cases were proved as malignant tumor by paraffin pathology, and the false negative rate was 9.3%. The main risk of puncture biopsy was bleeding after puncture immediately, and the rate was 4.0% (2/50). CONCLUSIONS: The puncture biopsy during operation had a high specificity for malignant lung tumor, and there was a certain false negative rate for benign tumor. Puncture biopsy and pathological examination of frozen tissue can replace tumor section biopsy in a way.

[Role of pulmonary segmental and sub-segmental lymph nodes in pathological staging of lung cancer].

OBJECTIVE: To investigate the metastatic rate of segmental and/or sub-segmental lymph nodes and their roles in pathological staging after a major pulmonary resection. METHODS: This prospective study recruited 90 cases of pulmonary resection performed at our department from February 2007 to February 2008. Hilar lymph nodes (No. 10), interlobar nodes (No. 11), lobar nodes (No. 12), segmental nodes (No. 13) and subsegmental nodes (No. 14) were resected and their clinic data analyzed. RESULTS: (1) The median number of total lymph nodes harvested, mediastinal nodes, nodes from No. 10-14 and nodes from No. 13-14 were 29 (11-50), 17 (6-35), 12 (2-26) and 4 (1-17) respectively. Lymph node metastatic rate from No.10, No. 11, No. 12, No. 13 + 14 were 12.2%, 6.7%, 23.3% and 38.9% respectively. (2) Forty-two cases of N0 and 27 cases of N1 were diagnosed in this group. The N1 subgroup included 12 cases of No. 13-14 metastasis solely and 15 cases of No. 10-12 and No. 13-14 metastasis simultaneously. If an analysis of No. 13-14 was omitted, the diagnostic accuracy of N0 could only reach 77.8% and 44.4% cases would be under-staged from N1. (3) In 33 cases of peripheral lung cancers smaller than 3 cm in diameter, 12.1% of metastatic lymph nodes from No.12-13 would be left in the original place if a segmental resection was performed. Similarly, 18.2% of metastatic lymph nodes could be neglected for wedge resection cases. CONCLUSION: Metastasis to segmental or subsegmental lymph nodes accounts for a large part of lung cancer patients. Therefore an analysis of these nodes can improve the accuracy of pathological staging. Secondly, limited pulmonary resection needs to follow a strict indication in consideration of the potential metastasis to segmental or subsegmental lymph nodes in peripheral small lung cancers.

[Characteristics of Aerosol Particulate Concentrations and Their Climate Background in Shanghai During 2007-2016].

We use daily aerosol particulate matter<10 µm (PM10) concentration data from 2006 to 2016 in Shanghai along with meteorological elements (wind and temperature), atmospheric stability, temperature inversion, and upper atmosphere circulation data, to analyze the variation characteristics of the PM10 concentrations and differences of the winter climate background. We establish a multivariate linear stepwise regression equation, and also compare and analyze differences in the upper atmospheric circulation by selecting the years with the highest and lowest PM10 concentrations. The results showed an oscillating downward trend in the annual average concentrations of PM10 in Shanghai, whereas seasonally, PM10 concentrations were relatively high in winter and showed two peaks with a low in between. PM10 concentrations were negatively correlated with the daily average wind speed and the daily mixing layer height at 20:00, and positively correlated with the frequency of northwest wind, the mean daily temperature, and the frequency of stable weathers and thermal inversion at 20:00. When the 500 hPa height field in the northern part of China was a positive anomaly in winter, a warm winter prevailed and led to high PM10 concentrations. When the 500 hPa height field was a negative anomaly, cold air frequently moved southward to result in relatively low temperatures, which caused relatively low PM10 concentrations. When the wind field at 850 hPa was easterly, the wind speed was relatively large and resulted in relatively low PM10 concentrations.

CircRNA_102179 promotes the proliferation, migration and invasion in non-small cell lung cancer cells by regulating miR-330-5p/HMGB3 axis.

Non-small cell lung cancer (NSCLC) accounting for 85 % of all lung cancer was one of the main causes of death worldwide. In this study, we investigated the role of circRNA_102179 in NSCLC development. The levels of circRNA_102179 in NSCLC tissues and cell lines were determined by quantitative real-time PCR assay (qRT-PCR). CCK8 and colony formation assays were applied to explore the effect of circRNA_102179 on the growth of NSCLC cells in vitro. Transwell assay was utilized to analyze the impact of circRNA_102179 on the migration and invasion of NSCLC cells. Target prediction and luciferase reporter assay were used to identify the interacting miRNA of circRNA_102179. The interaction among circRNA_102179/ miR-330-5p/HMGB3 was further validated by colony formation and Transwell invasion assays. Finally, the mouse xenograft NSCLC model was used to explore the role of circRNA_102179 in the tumor growth of NSCLC cells in vivo. CircRNA_102179 was overexpressed in NSCLC tissues and cells compared with normal lung tissues and human bronchial epithelial cells (HBEs). The down-regulation of circRNA_102179 markedly reduced the proliferation, migration, and invasion of NSCLC cells. Moreover, down-expression of circRNA_102179 significantly increased the level of miR-330-5p/HMGB3 in NSCLC cells. Further functional experiments indicated that over-expression of miR-330-5p reversed the inhibitory effect of circRNA_102179 on NSCLC cells growth, migration, and invasion. Our results reveal that circRNA_102179 facilitates the proliferation, migration, and invasion of NSCLC cell via modulating miR-330-5p/ HMGB3 axis in NSCLC cells.

[Application of the 2007 lung cancer staging system by International Association for the Study of Lung Cancer].

OBJECTIVE: To compare the prognoses of non-small cell lung cancer patients based respectively on the 6th-Edition Staging System for NSCLC (the 6th-Edition Staging System) and the new staging system by the International Association for the Study of Lung Cancer (IASLC) (new staging system). METHODS: Data were collected from 136 operated NSCLC patients from Sep. 2003 through Oct. 2007. Those data were staged based respectively on the 6th-Edition Staging System and the new staging system. The 2-year no-recurrence survival rate was calculated, and life span was analyzed using the Kaplan-Meier method of SPSS 13.0 software. RESULTS: (1) In this series, using the 6th-Edition Staging System, there were 56, 23, 53 and 4 patients in stage I, stage II, stage III and stage IV respectively; using the new staging system, there were 50, 31, 54 and 1 patients in stage I, stage II, stage III and stage IV respectively. There were 6 patients in stage I according to the 6th-Edition Staging System who had become 6 patients in stage II according to the new staging system, 1 patient in stage II 1 in stage III, 3 patients in stage III 3 in stage II, 1 patient in stage III 1 in stage IV, and 4 patients in stage IV 4 in stage III. (2) According to the 6th-Edition Staging System, the 2-year no-recurrence survival rates for Ia, Ib, IIa, IIb,IIIa, IIIb and IV were 95.0%, 83.3%, 100.0%, 63.6%, 52.1%, 80.0% and 50.0% respectively, and according to the new staging system, the 2-year cumulative survival rates for I a, Ib, IIa, IIb, IIIa, IIIb and IV were 95.5%, 89.3%, 68.4%, 63.6%, 52.8%, 50.0% and 0.0% respectively. After Chi square analysis, there was no distinguished difference between the 2 staging systems for the 2-year cumulative survival rate. (3) According to the 6th-Edition Staging System, the difference between the no-recurrence rate of stage I and stage II was not statistically significant (P = 0.232), and the difference between the no-recurrence rates of stage II and III was statistically significant(P = 0.023); according to the new staging system, the difference between the no-recurrence rates of stage I and stage II as well as between those of stage II and stage III were both statistically significant (P = 0.023 and 0.014 respectively). (4) The differences between the no-recurrence rates of the patients on the two sides, above and below the tumor maximum diameter cutpoint 2 cm, as well as the cutpoint 5 cm were statistically significant (P = 0.025; P = 0.023). CONCLUSION: The new staging system by NSCLC has better staging specificity than the 6th-Edition Staging System and could be used for Chinese patients.

[Analysis of serum protein fingerprints on non-small cell lung cancer lymphatic metastasis].

OBJECTIVE: To establish a classification model and serum proteomic patterns in non-small cell lung cancer (NSCLC) patients with lymph node metastasis by surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS). METHODS: The relative contents of serum proteins of 84 NSCLC patients with different N stages (35 N0 cases, 19 N1 and 30 N2 respectively) were detected by CM10 chip and SELDI-TOF-MS; two decision trees were generated to distinguish lymph nodes metastasis (N0 versus N1 + N2) and mediastinal lymph nodes metastasis (N0 + N1 versus N2) respectively. RESULTS: The model in which 50 patients were randomly chosen differentiated patients with lymph nodes metastasis from N0 patients with a sensitivity of 96.3%(26/27) and a specificity of 95.7%(22/23) in the training set, a following blind test was taken. Subsequently, compared with 49 patients with lymph node metastasis (N1 + N2), 15 patients with total negative lymph nodes (including lobar, segmental and subsegmental nodes necessarily) were defined as "true" N0 and were chosen to form a better predictive model with a 77.6% (38/49) sensitivity and a 93.3% (14/15) specificity respectively. And 6682.0Da, together with other five proteins, had significant difference between two groups; the result of this model for distinguishing the mediastinal lymph nodes metastasis is more accurate than thoracic CT analyses by Alongi F and many other clinical centers. It had a sensitivity of 80.0% (24/30) and a specificity of 77.8% (42/54) respectively. CONCLUSION: SELDI-TOF-MS showed a potential value for predicting lymph nodes metastasis in NSCLC patients. And further studies are required to confirm the models and identify the related proteins.

[Effect of bilateral intercostal nerve protection on post-thoracotomy pain relief: a prospective single-blinded randomized study].

OBJECTIVE: To study the efficacy of bilateral intercostal nerve protection on pain relief after thoracotomy. METHODS: Sixty patients in need of thoracotomy were randomized into 3 groups: Group C (control group, undergoing standard posterolateral thoracotomy, n = 18), Group U (unilateral intercostal nerve protection group, undergoing protection of intercostal nerve above the incision based on the standard posterolateral thoracotomy, n = 20), and Group B (bilateral intercostal nerve protection group, undergoing protection of intercostal nerves above and below the incision based on the standard posterolateral thoracotomy, n = 22). Numeric rating scale (NRS) was adopted to document the severity of pain at different time points after surgery. The amount of analgesic use was recorded as well. RESULTS: The pain scores recorded on the postoperative days 2 to 7 and 1 month after surgery of Group B were all significantly lower than those of Group C (all P < 0.05). Significant pain relief was observed in Group U within the 7 postoperative days compared with Group C; however, there were not significant differences in pain scores among different groups 1 month after surgery. Pain relief after the removal of chest tubes was found only in Group B (P = 0.020). The incidence of morbidity was similar among the 3 groups. CONCLUSION: Protection of bilateral intercostal nerves around the incision contributes to significant pain relief after operation without increase of the morbidity of complications.

[Expression of TR4-associated protein in non-small cell lung cancer].

OBJECTIVE: To investigate the expression and significance of TR4-associated Protein (TRA16) in human non-small cell lung cancer (NSCLC) tissues. METHODS: Immunohistochemistry (IHC) and tissue array were employed to investigate the expression of TRA16 in NSCLC cases of different pathological types, benign lung lesions and normal lung tissues. RESULTS: The abundant expression of TRA16 was observed in nucleus and/or cytoplasm of NSCLC cells with a positive expression rate of 88.64%, whereas normal lung tissue and benign lung tumor rarely expressed TRA16 protein. The expression of TRA16 showed no apparent difference at pathotypes and differentiation levels. CONCLUSION: In this study we demonstrated an abnormal overexpression of TRA16 in NSCLC tissues. The unique expression pattern of TRA16 indicated its probable role in tumorigenesis and progression, supporting the development of TRA16 as a novel potential NSCLC marker.

[Diagnosis and treatment of intralobar pulmonary sequestration].

OBJECTIVE: To summarize the diagnosis and surgical treatment of intralobar pulmonary sequestration (PS). METHODS: The clinical data of 7 cases of intralobar PS, 5 males and 2 females, aged 15 - 38, was collected and analyzed. Macroscopic and microscopic pathological findings were recorded. The expression of protein p53 and carcinoembryonic antigen (CEA) was evaluated immunohistochemically in 6 samples obtained from lobectomy. RESULTS: All 7 patients were admitted with major features of intermittent lung infection. Diagnosis was confirmed in all 7 cases before operation by contrast enhanced helical CT or MRI. All patients were treated with surgical excision, of which lobectomy was performed in 6 cases and wedge resection in 1 case. No surgical death was reported. All the aberrant systemic arteries arose from the thoracic aorta. The histological pictures showed polycystic lesion in sequestrated area with fibrosis formation and chronic inflammatory cell infiltration in the surrounding pulmonary stroma. Hyperplasia of epithelium occurred in some parts of the cystic lesions. Positive protein p53 staining and diffuse CEA expression were detected in all the 6 cases, showing stronger protein p53 staining in whose superficial layer of hyperplastic epithelium than in the basal layer. The normal bronchial epithelium was not stained with p53 or CEA. CONCLUSION: The diagnosis of intralobar PS can be confirmed by enhanced contrast helical CT with 3-dimensional reconstruction, a non-invasive method. Surgical intervention, such as lobectomy, can be applied after complete control of pulmonary infection. Aberrant accumulation of p53 protein and CEA expression in the cystic epithelium inside PS tissues show a relationship with chronic inflammation.

Autocrine Complement Inhibits IL10-Dependent T-cell-Mediated Antitumor Immunity to Promote Tumor Progression.

UNLABELLED: In contrast to its inhibitory effects on many cells, IL10 activates CD8(+) tumor-infiltrating lymphocytes (TIL) and enhances their antitumor activity. However, CD8(+) TILs do not routinely express IL10, as autocrine complement C3 inhibits IL10 production through complement receptors C3aR and C5aR. CD8(+) TILs from C3-deficient mice, however, express IL10 and exhibit enhanced effector function. C3-deficient mice are resistant to tumor development in a T-cell- and IL10-dependent manner; human TILs expanded with IL2 plus IL10 increase the killing of primary tumors in vitro compared with IL2-treated TILs. Complement-mediated inhibition of antitumor immunity is independent of the programmed death 1/programmed death ligand 1 (PD-1/PD-L1) immune checkpoint pathway. Our findings suggest that complement receptors C3aR and C5aR expressed on CD8(+) TILs represent a novel class of immune checkpoints that could be targeted for tumor immunotherapy. Moreover, incorporation of IL10 in the expansion of TILs and in gene-engineered T cells for adoptive cell therapy enhances their antitumor efficacy. SIGNIFICANCE: Our data suggest novel strategies to enhance immunotherapies: a combined blockade of complement signaling by antagonists to C3aR, C5aR, and anti-PD-1 to enhance anti-PD-1 efficacy; a targeted IL10 delivery to CD8(+) TILs using anti-PD-1-IL10 or anti-CTLA4-IL10 fusion proteins; and the addition of IL10 in TIL expansion for adoptive cellular therapy. Cancer Discov; 6(9); 1022-35. ©2016 AACR.See related commentary by Peng et al., p. 953This article is highlighted in the In This Issue feature, p. 932.

Evaluation of the 7th edition of the TNM classification in patients with resected esophageal squamous cell carcinoma.

AIM: To evaluate the prognostic factors and tumor stages of the 7(th) edition TNM classification for esophageal cancer. METHODS: In total, 1033 patients with esophageal squamous cell carcinoma (ESCC) who underwent surgical resection with or without (neo)adjuvant therapy between January 2003 and June 2012 at the Thoracic Surgery Department II of the Beijing Cancer Hospital, Beijing, China were included in this study. The following eligibility criteria were applied: (1) squamous cell carcinoma of the esophagus or gastroesophageal junction identified by histopathological examination; (2) treatment with esophagectomy plus lymphadenectomy with curative intent; and (3) complete pathologic reports and follow-up data. Patients who underwent non-curative (R1) resection and patients who died in hospital were excluded. Patients who received (neo)adjuvant therapy were also included in this analysis. All patients were restaged using the 7(th) edition of the Union for International Cancer Control and the American Joint Committee on Cancer TNM staging systems. Univariate and multivariate analyses were performed to identify the prognostic factors for survival. Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was used to evaluate differences between the subgroups. RESULTS: Of the 1033 patients, 273 patients received (neo)adjuvant therapy, and 760 patients were treated with surgery alone. The median follow-up time was 51.6 mo (range: 5-112 mo) and the overall 5-year survival rate was 36.4%. Gender, "pT" and "pN" descriptors, (neo)adjuvant therapy, and the 7(th) edition TNM stage grouping were independent prognostic factors in the univariate and multivariate analyses. However, neither histologic grade nor cancer location were independent prognostic factors in the univariate and multivariate analyses. The 5-year stage-based survival rates were as follows: IA, 84.9%; IB, 70.9%; IIA, 56.2%; IIB, 43.3%; IIIA, 37.9%; IIIB, 23.3%; IIIC,12.9% and IV, 3.4%. There were significant differences between each adjacent staging classification. Moreover, there were significant differences between each adjacent pN and pM subgroup. According to the pT descriptor, there were significant differences between each adjacent subgroup except between pT3 and pT4 (P = 0.405). However, there was no significant difference between each adjacent histologic grade subgroup and between each adjacent cancer location subgroup. CONCLUSION: The 7(th) edition is considered to be valid for patients with resected ESCC. However, the histologic grade and cancer location were not prognostic factors for ESCC.

Omentoplasty in preventing anastomotic leakage of oesophagogastrostomy following radical oesophagectomy with three-field lymphadenectomy.

OBJECTIVES: Anastomotic leakage is a major cause of mortality in oesophageal surgery. Whether omentoplasty after oesophagogastrostomy could reduce anastomotic leakage is still controversial. The aim of this study is to investigate the function of omentoplasty to reinforce cervical oesophagogastrostomy after radical oesophagectomy with three-field lymphadenectomy. METHODS: A total of 184 patients who underwent radical oesophagectomy with three-field lymphadenectomy took part in this prospective study. Patients were randomized to receive either the omentoplasty or non-omentoplasty. In the omentoplasty group, the omentum was wrapped around the oesophagogastric anastomosis after oesophagogastrostomy. Age, gender, location of carcinoma, stage, body mass index, diabetes, coronary artery disease, peripheral vascular disease and performance of omentoplasty were recorded. The anastomotic leakage and stricture and recurrence site were followed up for three years after the operation. RESULTS: The two groups were comparable in terms of age, gender, location of carcinoma, stage, body mass index, diabetes, coronary artery disease and peripheral vascular disease (P > 0.05). In contrast to the non-omentoplasty group with a postoperative anastomotic leakage rate of 9.8%, the omentoplasty subjects demonstrated a significantly lower rate of 3.3% (P < 0.05). No lethal leakage was found in the omentoplasty group, while two non-omentoplasty patients developed incurable empyema and mediastinitis due to leakage and ultimately died. The rate of incidence of anastomotic stricture in the omentoplasty and non-omentoplasty groups were 4.3% and 2.2% respectively. Of the five cases of death during the hospital stay, two were found in the omentoplasty group and three in non-omentoplasty. There was no significant difference of lethal leakage, stricture and death rate between the two groups (P > 0.05). The hospital stay was significantly longer for non-omentoplasty patients, compared with that for the omentoplasty subjects (P < 0.05). Tumour recurrence in lymphatic- or haematogenous metastasis was similar in both groups (P > 0.05). CONCLUSION: Omentoplasty may prevent anastomotic leakage of oesophagogastrostomy following radical oesophagectomy with three-field lymphadenectomy.

[Perioperative nutrition support for esophageal cancer complicated with diabetes mellitus].

OBJECTIVE: To compare the efficacy between perioperative enteral and parenteral nutrition support for esophageal cancer patients complicated with diabetes mellitus. METHODS: Thirty esophageal cancer patients complicated with diabetes mellitus between September and November 2012 were prospectively enrolled in this trial. According to random number table, 30 cases were randomly divided into enteral group (n=15) and parenteral group (n=15). During the period between 3 days before operation and 8 days after operation, patients received enteral nutrition (AnSure) and parenteral nutrition support respectively. The daily dynamic monitoring of blood glucose was performed. Nutritional indexes (albumin and prealbumin) were evaluated 1-day before operation and 8-day after operation. Postoperative recovery time of gastrointestinal function and complications associated with nutritional support were observed. The cost of nutritional support was calculated. RESULTS: Patients in the two groups achieved satisfactory perioperative blood glucose control. Finger tip blood glucose was 5.0-9.0 mmol/L before meal, 7.0-10.0 mmol/L 2-hour after meal, and 4.0-8.0 mmol/L at 10 PM and 3 AM. No hypoglycemia (<3.5 mmol/L) was found in all the patients. The time to first flatus after surgery was (62.4±15.7) in the enteral group, significantly earlier than (90.8±22.4) h in the parenteral group (P<0.01). Postoperative nutritional indices and associated complications were not significantly different between two groups (all P>0.05). Cost in the enteral group was significantly lower than that in the parenteral group [(650.8±45.8) RMB vs. (3016.5±152.6) RMB, P<0.01]. CONCLUSION: Perioperative nutrition support can effectively control blood glucose and improve perioperative nutritional status simultaneously for esophageal cancer patients with diabetes mellitus. Compared with parenteral nutrition, enteral nutrition can accelerate the recovery of gastric bowel function and reduce the cost of nutritional support.

[Effect of PC cell-derived growth factor RNA interference on biological behavior of esophageal squamous carcinoma cells].

OBJECTIVE: To investigate the effect of PC cell-derived growth factor (PCDGF) RNA interference on esophageal squamous carcinoma cells Eca-109 in vitro. METHODS: The PCDGF-shRNA expression vector was transfected into the Eca-109 cells by liposome. After transfection, the mRNA and protein expressions of PCDGF were detected by RT-PCR and Western-blot respectively. Cell Counting Kit-8 (CCK-8) assay and Boyden chamber method were performed to measure the cell proliferation and invasion ability respectively. RESULTS: The expression levels of PCDGF mRNA and protein were both decreased in Eca-109 cells transfected with PCDGF-shRNA expression vector (transfection group). Twenty-four, 48 and 72 h after transfection, the cells proliferation in the transfection group was inhibited, and the inhibition rate was 20.4%, 21.1% and 20.9% respectively. The cell proliferation activity in the transfection group was significantly lower than that in the non-transfection group, liposome group and negative vector group (all P<0.05). The number of cell migration in the non-transfection group,negative vector group, liposome group and transfection group was 118.8±12.0, 100.8±9.0, 114.3±4.7, and 53.5±16.3 respectively. The differences were statistically significant between the transfection group and the other 3 groups (all P<0.05). CONCLUSIONS: PCDGF RNA interference can inhibit the proliferation and invasion abilities of esophageal squamous carcinoma cells in vitro. PCDGF gene may be the new target of gene therapy.

[Study of different enteral nutrition formulation treatment after esophagectomy].

OBJECTIVE: To compare the efficiency of different early enteral nutrition (EN) with Ensure, Nutrison, and Peptison in postoperative patients with esophageal carcinoma. METHODS: A total of 45 postoperative patients with esophageal carcinoma were randomly divided into three groups using random digit table: Ensure group (n=15), Nutrition group (n=15), and Peptison group (n=15). Enteral nutrition was given using nasogastric tube from the 2nd postoperative day for 8 days. Albumin and prealbumin were detected on the day before surgery and postoperative day 9 after fasting. The time to gastrointestinal tract function recovery, complications, and the cost of enteral nutrition were compared among the three groups. RESULTS: There were no significant differences in postoperative nutrition indices(albumin and prealbumin) and EN-related complications among the three groups(all P>0.05). The time to gastrointestinal tract function recovery in Ensure group [(52.4±15.7) h] and Nutrison group [(50.8±12.4) h] was less than that in Peptison group [(60.3±16.8) h] (P<0.05). The expense of Ensure group [(443.3±45.8) RMB] was obviously less than that of Nutrison group[(639.5±52.6) RMB] and Peptison group [(990.5±95.5) RMB](both P<0.01). CONCLUSIONS: Ensure, Nutrison and Peptison can be used for postoperative early enteral nutrition in patients with esophageal carcinoma, and the efficacy and complication are comparable. The cost of Ensure is the lowest.

[Clinical application of minimally invasive esophagectomy for esophageal carcinoma].

OBJECTIVE: To investigate the feasibility and safety of minimally invasive esophagectomy (MIE) for esophageal carcinoma. METHODS: Clinical data of 298 esophageal carcinoma cases who were treated by MIE in the Fujian Provincial Cancer Hospital from June 2008 to April 2012 were retrospectively reviewed. RESULTS: All the patients underwent MIE successfully except one conversion to open surgery. The mean operative time was (242.3±58.7) min. The postoperative length of hospital stay was (17.4±9.8) d. The number of harvested lymph nodes of total, the mediastinum, the abdomen and the cervix was 27.5±12.2, 10.7±5.7, 13.3±7.8, and 7.7±8.1, respectively. Postoperative complication rate was 29.9%, including pneumonia (n=41), recurrent laryngeal nerve injury (n=25), anastomotic leak (n=9), wound infection (n=7), and others (n=7). After follow up of 2 to 47 months, 3 patients were found to develop anastomotic stricture. There were no recurrence, metastasis, or death. CONCLUSION: Minimally invasive esophagectomy is a safe, feasible, effective and minimally invasive surgical technique.

[Expression of autophagy-related genes Beclin1 and MAPLC3 in non-small cell lung cancer].

BACKGROUND & OBJECTIVE: Some studies have indicated that the down-regulation of autophagy-related genes might result in tumorigenesis. This study was to investigate the expression and significance of autophagy-related genes Beclin1 and microtubule-associated protein 1 light chain 3 (MAPLC3) in human non-small cell lung cancer (NSCLC). METHODS: The expression of Beclin1 and MAPLC3 in tumor tissues, adjacent non-cancerous tissues, and normal tissues from 72 specimens of NSCLC were detected by immunofluorescence staining, Western blot, and reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The positive rates of Beclin1 and MAPLC3 were significantly lower in NSCLC tissues than in adjacent non-cancerous tissues and normal tissues (8.3% vs. 100% and 100% for Beclin1, chi2=199.40, P<0.01; 13.9% vs. 100% and 100%for MAPLC3, chi2=182.75, P<0.01). The mRNA levels of Beclin1 and MAPLC3 were significantly lower in NSCLC tissues than in adjacent non-cancerous tissues and normal tissues (1.30+/- 0.44 vs. 1.69+/-0.59 and 1.67+/-0.48 for Beclin1, F=6.6, P<0.01; 4.55+/-1.23 vs. 6.73+/-1.31 and 6.90+/-1.87 for MAPLC3, F=14.1, P<0.01). The protein levels of Beclin1 and MAPLC3 were significantly lower in NSCLC tissues than in adjacent non-cancerous tissues and normal tissues (3.49+/-0.72 vs. 5.31+/-1.16 and 6.33+/-1.58 for Beclin1, F=9.73, P<0.01; 2.43+/-0.35 vs. 3.12+/-0.73 and 3.41+/-0.90 for MAPLC3, F=3.22, P=0.04). CONCLUSION: The expression of autophagy-related genes are down-regulated in NSCLC, which may relate to tumorigenesis and development of lung cancer.