Neoadjuvant chemoradiotherapy plus surgery in the treatment of potentially resectable thoracic esophageal squamous cell carcinoma.

BACKGROUND: In recent years, neoadjuvant chemoradiotherapy (NCRT) combined with surgery has been gradually applied in patients with locally advanced thoracic esophageal cancer, but its effectiveness and safety remains unclear. In this clinical trial, we prospectively investigated the efficacy and safety of NCRT plus surgery in the treatment of thoracic esophageal squamous cell carcinoma (TESCC). AIM: To investigate the efficacy and safety of NCRT combined with surgery in the treatment of potentially resectable TESCC. METHODS: Thirty patients with advanced TESCC hospitalized in our hospital from July 2016 to June 2019 were prospectively studied. All patients received NCRT, which included intensity modulated conformal radiotherapy (40-44 Gy/20-22f, 2 Gy/f) and chemotherapy (paclitaxel 150-175 mg/m2d1, 22 + lobaplatin 25-30 mg/m2d2, 23 for two cycles). Surgery was performed after radiotherapy and chemotherapy. The effectiveness and safety of these treatments were observed. RESULTS: Among these 30 patients, complete response was achieved in two cases (6.7%) and partial response in 26 cases (86.7%), yielding an objective response rate of 100%. All patients underwent radical surgery successfully. The R0 resection rate was 100%, and the pathologic complete response rate was 33.3%. The incidence of grade III- IV granulocytopenia was 10% during the NCRT, and anastomotic leakage occurred in one patient after surgery. CONCLUSION: For patients with potentially resectable TESCC, NCRT can effectively reduce the tumor size, increase R0 resection rate, and achieve obvious pathological degradation, with mild adverse reactions. Thus, it is worthy of wider clinical application.

Identification of nine microRNAs as potential biomarkers for lung adenocarcinoma.

Lung cancer is a leading global cause of cancer-related death, and lung adenocarcinoma (LUAD) accounts for ~ 50% of lung cancer. Here, we screened for novel and specific biomarkers of LUAD by searching for differentially expressed mRNAs (DEmRNAs) and microRNAs (DEmiRNAs) in LUAD patient expression data within The Cancer Genome Atlas (TCGA). The identified optimal diagnostic miRNA biomarkers were used to establish classification models (including support vector machine, decision tree, and random forest) to distinguish between LUAD and adjacent tissues. We then predicted the targets of identified optimal diagnostic miRNA biomarkers, functionally annotated these target genes, and performed receiver operating characteristic curve analysis of the respective DEmiRNA biomarkers, their target DEmRNAs, and combinations of DEmiRNA biomarkers. We validated the expression of selected DEmiRNA biomarkers by quantitative real-time PCR (qRT-PCR). In all, we identified a total of 13 DEmiRNAs, 2301 DEmRNAs and 232 DEmiRNA-target DEmRNA pairs between LUAD and adjacent tissues and selected nine DEmiRNAs (hsa-mir-486-1, hsa-mir-486-2, hsa-mir-153, hsa-mir-210, hsa-mir-9-1, hsa-mir-9-2, hsa-mir-9-3, hsa-mir-577, and hsa-mir-4732) as optimal LUAD-specific biomarkers with great diagnostic value. The predicted targets of these nine DEmiRNAs were significantly enriched in transcriptional misregulation in cancer and central carbon metabolism. Our qRT-PCR results were generally consistent with our integrated analysis. In summary, our study identified nine DEmiRNAs that may serve as potential diagnostic biomarkers of LUAD. Functional annotation of their target DEmRNAs may provide information on their roles in LUAD.

Combination of 2-deoxy d-glucose and metformin for synergistic inhibition of non-small cell lung cancer: A reactive oxygen species and P-p38 mediated mechanism.

Targeting metabolism of lung cancer cells is a promising methodology for the treatment of lung cancer. In this regard, 2-Deoxy d-glucose (2-dDG) has been reported to inhibit cell proliferation by intervening the glycolytic pathway. However, phase I clinical trial of 2-dDG demonstrated cardiac side effects at higher dosage. Metformin (Met), on the other hand, has been reported to improve pathological response to chemotherapy in non-small cell lung cancer (NSCLC) patients. In this study, we propose that combination therapy of 2-dDG with Met will demonstrate enhanced cytotoxicity than either compound alone. Our results indicated that inhibition concentration 25 (IC25) for combined treatment of Met and 2-dDG showed more toxicity as compared to individual agents on a NSCLC cell line, A549. This augmented toxicity is associated with increased lipid peroxidation and decreased glutathione level as well as decreased super oxide dismutase and catalase activities. Combination of Met and 2-dDG also demonstrated enhanced DNA damage, DNA adduct formation, intracellular reactive oxygen species (ROS) level, and mitochondrial membrane potential alteration, as well as increased apoptosis, caspase-3 activity, P-p38 and P-AMP-activated protein kinase (AMPK) level. It was also shown that inhibition of caspase-3 and p38 kinase partially (75%-87%) reversed Met and 2-dDG induced cell death, without affecting the ROS levels. On the other hand, pre-treatment of cells with N-acetyl cysteine (NAC) reversed Met and 2-dDG induced cell death to >90%. Taken together, the results of this study demonstrated that combination of Met and 2-dDG showed better toxicity than individual compounds and cell death is ROS, P-p38 and caspase-3 mediated, thereby providing a proof of concept for the combination of Met and 2-dDG as a potential treatment protocol for NSCLC.

[Time-related expression of IL-6, IL-8 and TNF-alpha following explosive injury to rabbit's chest].

OBJECTIVE: To explore the relationship between the expression changes of cytokines, interleukin-6 (IL-6), interleukin-8(IL-8), and tumor necrosis factor-alpha (TNF-alpha), and the wound time following explosive injury to rabbit's chest. METHODS: The rabbit's model of explosive injury was established. The expression levels of IL-6, IL-8 and TNF-alpha in the plasma were detected by ELISA method at different wound time (0.5-12h). RESULTS: The level of IL-6 increased at 3h after wounding and reached peak at 6 h. The level of IL-8 increased at 1 h and reached peak at 6 h. The level of TNF-alpha increased at 0.5 h and reached peak at 3 h. CONCLUSION: IL-6, IL-8 and TNF-alpha have a time-related expression after explosive injury.

Isotopic tracing for calculating the surface density of arginine-glycine-aspartic acid-containing peptide on allogeneic bone.

OBJECTIVE: To investigate the feasibility of determining the surface density of arginine-glycine-aspartic acid (RGD) peptides grafted onto allogeneic bone by an isotopic tracing method involving labeling these peptides with (125) I, evaluating the impact of the input concentration of RGD peptides on surface density and establishing the correlation between surface density and their input concentration. METHODS: A synthetic RGD-containing polypeptide (EPRGDNYR) was labeled with (125) I and its specific radioactivity calculated. Reactive solutions of RGD peptide with radioactive (125) I-RGD as probe with input concentrations of 0.01 mg/mL, 0.10 mg/mL, 0.50 mg/mL, 1.00 mg/mL, 2.00 mg/mL and 4.00 mg/mL were prepared. Using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide as a cross-linking agent, reactions were induced by placing allogeneic bone fragments into reactive solutions of RGD peptide of different input concentrations. On completion of the reactions, the surface densities of RGD peptides grafted onto the allogeneic bone fragments were calculated by evaluating the radioactivity and surface areas of the bone fragments. The impact of input concentration of RGD peptides on surface density was measured and a curve constructed. RESULTS: Measurements by a radiodensity γ-counter showed that the RGD peptides had been labeled successfully with (125) I. The allogeneic bone fragments were radioactive after the reaction, demonstrating that the RGD peptides had been successfully grafted onto their surfaces. It was also found that with increasing input concentration, the surface density increased. CONCLUSION: It was concluded that the surface density of RGD peptides is quantitatively related to their input concentration. With increasing input concentration, the surface density gradually increases to saturation value.

[Combination of single-port thoracoscopy and laparoscopy for the treatment of esophageal carcinoma: report of 6 cases].

OBJECTIVE: To study the feasibility and early results of radical resection of esophageal carcinoma using single-port thoracoscopy combined with laparoscopy. METHODS: From March 2010 to December 2010, 6 patients with esophageal carcinoma underwent radical resection by single-port thoracoscopy combined with laparoscopy in the General Hospital of People's Liberation Army. With the patients at a supine position, laparoscopy was performed to complete stomach mobilization and abdominal lymph node dissection. Thoracoscopy was then carried out with the patients lying on the left to mobilize the esophagus and dissect thoracic lymph nodes. Finally, the stomach was pulled into the thoracic cavity via the hiatus of the diaphragm to construct a tube-like stomach, which was then anastomosed to the esophagus using the OrVil system. RESULTS: No patient was converted to open surgery during the operation. The total operative time ranged from 200 to 320 min. The mean laparoscopic time was 75(range, 45-90) min, and the mean thoracoscopic time 160(120-240) min. The mean intraoperative blood loss was 220(160-300) ml. The mean lymph node retrieval was 12(9-18). No anastomotic fistula, chylothorax, lung infection were found postoperatively. CONCLUSION: After esophageal resection using single-port thoracoscopic and laparoscopy, reconstruction using OrVil system is safe and feasible.

Diagnostic values of SCC, CEA, Cyfra21-1 and NSE for lung cancer in patients with suspicious pulmonary masses: a single center analysis.

We recruited 805 patients with suspicious pulmonary masses that were identified finally as lung cancer or benign pulmonary masses. The serum levels of four tumor markers, including squamous cell carcinoma antigen (SCC), carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen 21-1 (Cyfra21-1) and neuron specific enolase (NSE) were tested for every patient. Though receiver operating characteristic (ROC) curves indicated unsatisfactory diagnostic power of those four tumor markers for lung cancer, 37.3% of early-staged lung cancer could be diagnosed just on the combination assays of the four tumor markers, under adjusted cut-off values through our statistical analysis retrospectively.

Biliary cystadenocarcinoma diagnosed with real-time contrast-enhanced ultrasonography: report of a case with diagnostic features.

Biliary cystadenocarcinoma is a very rare malignant cystic tumor of the liver, which is often misdiagnosed due to a poor recognition of it. We report a case of a 60-year-old man with biliary cystadenocarcinoma with his real time contrast enhanced ultrasound (CEUS) characteristics compared to those of computed tomography (CT) and magnetic resonance imaging (MRI), which were correlated with the surgical and pathologic findings. Cystic wall enhancement, internal septations and intra-cystic solid portions in the arterial phase were observed on CEUS after contrast agent injection. The enhancement was washed out progressively and depicted as hypo-enhancement in the portal and late phases. CT revealed a large irregular cystic lesion in the left liver lobe with no clear septations and solid components. MRI showed an irregular cystic occupying lesion with septations.

Clinical and imaging features in 16 infants exposed to food contaminated with melamine and cyanuric acid.

OBJECTIVE: The objective of our study was to describe the clinical and imaging features of infants exposed to milk formula contaminated with melamine and cyanuric acid. CONCLUSION: The imaging feature of patients exposed to food contaminated with melamine and cyanuric acid was multiple calculi of the urinary tract that varied greatly in size and shape. Most patients presented with symptoms of urinary obstruction.

[Preparation and identification of polyclonal antibody to B cell epitope domain of TRP-1].

AIM: To prepare the polyclonal antibody to B cell epitope domain of TRP-1 and apply it to study the immunotherapy of vitiligo and melanoma. METHODS: The fusion protein PRSETA/TRP-1 was expressed in E.coli, the polyclonal antibody was prepared by immunizing a rabbit with the protein. The qulity of the antibody was identified by ELISA and Western-blot. RESULTS: (1)The pRSEA/TRP-1 fusion protein was correctly expressed;(2)the polyclonal antibodies to the B cell eoitope domain of TRP-1 were obtained; (3)the rabbit antiserum containing of polyclonal antibody showed high titer and possessed good binding activity to 6His-TRP1 expressed by Pichia pastoris. CONCLUSION: The polyclonal antibody could be applied to the research on B cell epitope domain of TRP-1.