Depleting NFAT1 expression inhibits the ability of invasion and migration of human lung cancer cells.

BACKGROUND: Nuclear factor of activated T-cells (NFAT) is a general name applied to a family of transcription factors shown to be important in immune response. One or more members of the NFAT family are expressed in most cells of the immune system. NFAT1 is considered to involve in the development of cardiac, skeletal muscle, nervous systems, and tumorigenesis. METHODS: In the current study, we analyzed MEKK1 expression in 159 surgically resection non-small cell lung cancer patient's samples by immunohistochemistry and determined its role in SK-EMS-1 cells via RNAi experiment. RESULTS: The abilities of invasion, motility, and adhesion of SK-EMS-1 cells were detected by transwell assay, wound healing assay and adhesion assay, respectively. The result showed NFAT1 was highly expressed in lung tumor tissues instead of adjacent lung tissues (54.1% vs 8.8%, p < 0.05); its overexpression was positively correlated with lymph node metastasis (p < 0.05). Depleting its expression in SK-EMS-1 cells can inhibit its invasion and migration abilities significantly (p < 0.05); and also can reduce proliferation of lung cancer cells (p < 0.05). CONCLUSION: Our study showed NFAT1 plays an important role in origination, invasion and metastasis of non-small lung cancer cells; its underlying action mechanism needs further study.

Tumor with watery diarrhoea, hypokalaemia in a 3-year-old girl.

Watery diarrhoea, hypokalaemia and achlorhydria (WDHA) syndrome was caused by vasoactive intestinal polypeptide (VIP)-producing tumour. A 3-year-old Chinese girl with watery diarrhoea, abdominal distension and hypokalaemia due to a thoracic paraspinal VIP-secreting ganglioneuroma is reported. The girl coughed, fevering up to 39 degrees C after a flu-like episode. She had eight to ten abundant stools daily which is not improved by dietary treatment, resulting in an important weight loss. She weighed 6.8 kg (nl P50 at 6 months of age) and is 76 cm (nl P50 at 9 months of age) in height. Blood electrolytes showed 129 mmol/L sodium, 2.42 mmol/L potassium, 94 mmol/L chloride and 18.6 mmol/L bicarbonate; urinary catecholamines were normal. Computed tomography scan evidenced a left side paravertebral mass of 4 x 6 cm in the lower thoracic region leading to the blood determination of vasoactive intestinal polypeptide which amounted 830 pmol/L(normal < 25 pmol/L). Surgical removal showed a ganglioneuroma of 160 g and was associated with disappearance of the diarrhoea and normalization of VIP level below 20 pmol/L. Review of the 63 reported cases in children with WDHA showed that many of the cases presented with non-treatable watery diarrhoea, hypokalaemia. Achlorhydria is not necessarily part of the WDHA syndrome. The male to female ratio is 1:1.5. Ganglioneuroblastoma and ganglioneuroma are the commonest tumours. Location of the tumour is variable: abdomen, chest or neck. Abdominal distension, flushing, episodic hypertension and colonic dilatation, constipation and ataxia were the other associated features. Surgical resection is the treatment of choice of VIP-producing tumours.

[Diagnosis and treatment of pulmonary aspergillosis in patients without immunodeficiency: report of 15 cases].

OBJECTIVE: To study the diagnosis and treatment of pulmonary aspergillosis in patients without immunodeficiency. METHOD: Pulmonary aspergillosis in 15 patients without immunodeficiency was reviewed. RESULTS: Twelve of the patients had underlying lung diseases (lung cancer), 2 showed masses in the lung by radiography and CT halo, and 1 had aspergilloma within the left main bronchus. The diagnosis of intra-cavitary aspergilloma had been made in all the patients with lung cancer before surgery. Only 3 cases were confirmed by fungal examination before surgery. Thirteen patients received surgical removal of the lesions, and the post-operative recovery was uneventful. Antifungal therapy and open drainage were administered in 1 patient with pleural residual cavity infection, but the treatment failed. Anti-cancer therapy alone was given in 1 patient. Sudden death occurred in another patient. CONCLUSION: In suspected cases of aspergillosis, CT halo sign, histology examination are helpful for the diagnosis. Aspergilloma complicated with underlying lung diseases and mass lesions can be cured by surgery.

Serum amyloid A protein: a potential biomarker correlated with clinical stage of lung cancer.

OBJECTIVE: To identify serum diagnosis or progression biomarkers in patients with lung cancer using protein chip profiling analysis. METHOD: Profiling analysis was performed on 450 sera collected from 213 patients with lung cancer, 19 with pneumonia, 16 with pulmonary tuberculosis, 65 with laryngeal carcinoma, 55 with laryngopharyngeal carcinoma patients, and 82 normal individuals. A new strategy was developed to identify the biomarkers on chip by trypsin pre-digestion. RESULTS: Profiling analysis demonstrated that an 11.6 kDa protein was significantly elevated in lung cancer patients, compared with the control groups (P < 0.001). The level and percentage of 11.6 kDa protein progressively increased with the clinical stages I-IV and were also higher in patients with squamous cell carcinoma than in other subtypes. This biomarker could be decreased after operation or chemotherapy. On the other hand, 11.6 kDa protein was also increased in 50% benign diseases of lung and 13% of other cancer controls. After trypsin pre-digestion, a set of new peptide biomarkers was noticed to appear only in the samples containing a 11.6 kDa peak. Further identification showed that 2177 Da was a fragment of serum amyloid A (SAA, MW 11.6 kDa). Two of the new peaks, 1550 Da and 1611 Da, were defined from the same protein by database searching. This result was further confirmed by partial purification of 11.6 kDa protein and MS analysis. CONCLUSION: SAA is a useful biomarker to monitor the progression of lung cancer and can directly identify some biomarkers on chip.

[Identification and clinical evaluation of lung cancer serum biomarker L-lactate dehydrogenase B].

OBJECTIVE: To identify potential biomarkers related with lung cancer metastasis. METHODS: Conditional media proteins collected from a primary non-small cell lung cancer cell line (NSCLC) NCI-H226 and its brain metastatic subline H226Br were analyzed by SDS-PAGE and MALDI-TOF-MS. Twelve biomarkers were identified, of which LDHB was significantly up-regulated in H226Br cell and was further validated using ELISA in sera including 105 lung cancer samples, 41 pneumonia and pulmonary tuberculosis samples and 65 healthy samples. RESULTS: The levels of LDHB were specifically elevated in NSCLC sera [A value 0.485 (0 - 1.415)] compared with pneumonia and pulmonary tuberculosis [A value 0.187 (0 - 0.609), P < 0.01] and healthy group [A value, 0.159 (0 - 0.524), P < 0.01] and were progressively increased with the clinical stage. At the cutoff point 0.260 (A value) on the ROC curve, the sensitivity, specificity and total accuracy of LDHB were 81%, 70% and 76% respectively. CONCLUSION: These findings demonstrated that secretome could open up a possibility to identify novel biomarkers related with cancer occurrence and metastasis.

[The study on freezing intercostal nerves for the relief of postoperative chest pain].

OBJECTIVE: To explore the best freezing time and the optimum analgesia modality. METHODS: In dogs, intercostal nerves were froze at -70 degrees C at different time including 30, 60, 90, 120, 180 s. Samples were got at the operative day, in 10 days and 60 days respectively, then carried on the pathology exam. In clinical study, 150 patients undergoing thoracotomy were randomly designated into 5 groups, all patients were recorded the heart rate, blood pressure, SO2, VAS, the dosage of dolantin, and observed the complications and side effects. RESULTS: At operative day, the freezing nerves appeared brown print macroscopically, and presented degeneration, necrosis of the nerve fiber microscopically with more than 90 s. After 10 days, nerves with more than 90 s became thinner than normal. After 60 days, all nerves had no obvious differentiation than normal. In clinical study, both 90 s group and 90 s with PCIA group were significantly better than 60 s group or PCIA group; The VAS of 90 s with PCIA group was significantly lower than 90 s group but had more side effects such as vomiting, nausea. CONCLUSIONS: At -70 degrees C, the freezing time should be no less than 90 s. The freezing intercostal nerves can safely and effectively relieve postoperative chest pain. The effect of analgesia of 90 s with PCIA group is the best, but has many side effects.

Early results of 18 adults, following a modified Nuss operation for recurrent pectus excavatum.

OBJECTIVES: The minimally-invasive Nuss operation has been widely used for correcting pectus excavatum in children. However, a number of adult patients require reoperations for recurrence or other complications. This work aimed to investigate the early results of recurrent pectus excavatum repair using a modified Nuss procedure, which were seldom reported in adult patients. METHODS: A retrospective chart review was conducted on 18 adult patients who underwent modified Nuss procedure in the age range of 18-31 years. The Haller index of the patients ranged from 3.2 to 6.5. In the modified Nuss technique, a small auxiliary incision was made below the xiphoid process and one finger was inserted instead of a thoracoscope. The introducer was guided by the finger, slowly advanced across the mediastinum and raised the sternum and the anterior chest wall to the desired position. The Lorenz correction bar was introduced through the tunnel, placed in position, and turned over so that the convexity faced anteriorly. RESULTS: The operations were performed successfully and no operative mortality occurred. The mean operating time was 68.5 ± 15.5 min. The postoperative results were excellent in 77.8% of patients and good in 22.2%. Early complications were mild and no late complications occurred. CONCLUSIONS: The modified Nuss procedure is an excellent reoperative correction for adult patients and has outstanding early results, considering that it is technically challenging.

Acute respiratory distress caused by esophageal duplication canceration in an adult.

Esophageal duplication (ED) in adults is rare, and ED canceration is very rare. We report a case of acute respiratory embarrassment caused by ED with squamous carcinoma in a 39-year-old man and a review of the literature.

[Analyzing chromosomal abnormality in primary esophageal cancer by comparative genomic hybridization].

BACKGROUND & OBJECTIVE: Some researches have showed that chromosomal abnormalities, including chromosomal regions of gains and losses, usually occur in primary esophageal cancer. The comparative genomic hybridization (CGH) technique can show chromosomal abnormality. This study was to analyze the characteristics of chromosomal abnormity in primary esophageal cancer by CGH, and explore its correlation to prognosis. METHODS: Chromosomal genetic changes in 16 specimens of primary esophageal cancer were detected by CGH. The correlation of chromosomal abnormality to the prognosis was analyzed. Of the 16 patients, 7 died within 2 years after operation (control group), 9 survived over 3 years after operation (survive group). RESULTS: Most of the patients had chromosomal genetic changes. The most frequent changes were gains of chromosome arms or regions 1q/p, 2q/p, 3q, 5q/p, 8q/p, 9q/p, 11q/p, 17, and 20q/p, and losses of chromosome arms or regions 1q/p, 4p, 9p, 18q, and xp. The differences in gains of chromosome arms or regions 7q/p and 19 and losses of chromosome arms or regions 4q/p and 18q between control group and survive group were significant. CONCLUSIONS: Abnormal gains and losses of chromosome arms or regions tend to occur in esophageal cancer. The differences between control group and survive group are significant.