Predictive value of prognostic nutritional index in complications after thoracoscopy-assisted esophagectomy / 中国胸心血管外科临床杂志

@#Objective    To investigate the predictive value of prognostic nutritional index (PNI) in complications after thoracoscopy-assisted radical resection of esophageal cancer. Methods    We collected the clinical data of patients who underwent thoracoscopy-assisted esophagectomy in the First Affiliated Hospital of Xinjiang Medical University from January 2015 to June 2020. The predictive value of PNI for postoperative complications was evaluated by establishing receiver operating characteristic (ROC) curve and the optimal cut-off point was determined. The patients were divided into a high PNI group and a low PNI group according to the cut-off point. The differences of baseline data and perioperative complications-related indicators between the two groups were compared and analyzed. Univariate and multivariate analyses were used to investigate the influence of PNI and other related indexes on postoperative complications. Results    A total of 116 patients were enrolled in this study, including 75 males and 41 females, aged 65 (58-69) years. The area under ROC curve was 0.647, and the optimal cut-off point was 51.9. According to the cut-off point, there were 45 patients in the high PNI group and 71 patients in the low PNI group. The overall complication rate (χ2=10.437, P=0.001) and the incidence of postoperative pulmonary infection (χ2=10.811, P=0.001) were statistically different between the two groups. The results of univariate analysis showed that the duration of ventilator use (Z=–3.136, P=0.002), serum albumin value (t=2.961, P=0.004), and PNI value (χ2=10.437, P=0.001) were the possible risk factors for postoperative complications after thoracoscopy-assisted esophagectomy. The results of multivariate analysis suggested that the duration of ventilator use (OR=1.015, P=0.002) and the history of drinking (OR=5.231, P=0.013) were independent risk factors for postoperative complications, and high PNI was the protective factor for postoperative complications (OR=0.243, P=0.047). Conclusion    PNI index has a certain value in predicting postoperative complications, which can quantify the preoperative nutritional and immune status of patients. Drinking history and duration of ventilator use are independent risk factors for postoperative complications of thoracoscopy-assisted esophagectomy, and high PNI is a protective factor for postoperative complications.

Association of defective HLA-I expression with antigen processing machinery and their association with clinicopathological characteristics in Kazak patients with esophageal cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>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.</p><p><b>METHODS</b>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).</p><p><b>RESULTS</b>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).</p><p><b>CONCLUSION</b>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.</p>

The clinical analysis of 93 children with pulmonary echinococcus / 中华外科杂志

<p><b>OBJECTIVE</b>To approach the clinical characteristics and surgical treatment of children with pulmonary echinococcus.</p><p><b>METHODS</b>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).</p><p><b>RESULTS</b>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).</p><p><b>CONCLUSIONS</b>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.</p>

The association analysis of catechol-O-methyltransferase gene Val158Met polymorphisms with esophageal squamous cell carcinoma in Yili Prefecture of Xinjiang / 中华消化杂志

Objective To explore the relationship between polymorphism of catechol-O-methyltransferase (COMT) gene valine (Val) 158 methionine (Met) (G to A transition)and the distribution in population and esophageal squamous cell carcinoma (ESCC) in Yili prefecture of Xinjiang.Methods A hospital based case-control study was adopted, a total of 622 subjects, which including 214 ESCC patients and 408 age, gender and ethnicity-matched normal control individuals.The polymorphism of COMT gene G to A transition was analyzed with PCR-restriction fragment length polymorphism approaches.Results The COMT genotype frequencies in 622 subjects in Yili prefecture were GG genotype accounted for 47.3%, GA type for 42.3% and AA type for 10.4%, G allele was 68.4% and A allele was 31.6%.There was no statistical difference in the COMT genotype and frequencies of allele distribution between ESCC group and control group.Furthermore, stratified analysis indicated that there was statistical difference between ESCC group and control group in subjects less than 60 years old.There was statistical difference in the allele distribution among Kazak,Uygur and Han ESCC groups.The COMT genotype and frequency of allele distribution among normal control groups of the three ethnic groups were statistically different.After corrected age and gender,there was no statistical difference in COMT Val158Met polymorphisms among Kazakh, Uygur and Han ethnic groups in both ESCC and control groups in Yili Prefecture of Xinjiang.Conclusion COMT gene Val158Met single nucleotide polymorphism may not be the genetic markers of ESCC risk in Yili Prefecture of Xinjiang.

The expression of microRNA let-7 in esophageal squamous cell carcinoma and its clinicopathological significance / 中华消化杂志

Objective To estimate the effect of microRNA (miRNA) let-7 expression on human esophageal squamous cell carcinoma(ESCC) and the relationship between let-7 level and clinicopathological parameters. Methods ESCC cell line (Eca109) was transfected with let-7 or its inhibitor by RNAi and cell transfection techniques. Normal cultured Eca109 cell was served as negative control. The proliferation of Eca109 cell was detected by MTT. The expression of let-7 in Eca109 cells and 45 paired ESCC tissues and corresponding para-cancerous tissues were measured using real-time quantitative polymerase chain reaction (qRT-PCR). The relationship between let-7 level and clinicopathological parameters in patients with ESCC was analyzed. Results The A value of let-7 in Eca109 cells transfected with let-7 was lower than negative control (P=0.005), while it was higher in Eca109 cells transfected inhibitor than that in negative control 72 hours after transfection. In comparison with negative control, the expression of let-7 in Eca109 cells transfected with let-7 was increased 33% (1.33 vs 1.00,P=0. 039) and it was decreased 50% in Eca109 cells transfected with inhibitor (0.50 vs 1.00,P=0. 014). The ratio of let-7 expression in ESCC tissue and para-cancerous tissue was 0.66 ± 0.47 with significant differece (P= 0.001). Moreover, The level of let-7 expression in Han patients with ESCC was lower than Kazakh patients with ESCC (0.48±0.43 vs 0. 88±0.51,P=0. 019). The level of let-7 expression in poorly differentiated ESCC tissue was lower than well differentiated ESCC tissue (0.42±0.30 vs 0.84±0.38,P=0. 015). The level of let-7 expression in patients with lymph node metastasis was lower than those without lymph node metastasis (0.50±0.35vs 0. 80±0.52,P=0. 032) . Conclusion It is demonstrated that let-7 can inhibit the carcinogenesis and development of ESCC. The level of let-7 expression is associated with cell differentiation,lymph node metastasis and nationalities.

Annexin A2 expression in human esophageal squamous cell carcinoma and correlation with invasion and metastasis / 中华消化杂志

Objective To explore Annexin A2 expression in human esophageal squamous cell carcinoma (ESCC) and investigate the correlation of Annexin A2 expression with invasion and metastasis of human ESCC. Methods From 2000 to 2008, specimens of Xinjiang medical University First Affiliated Hospital were collected. Pathologically confirmed ESCC surgical specimens were set as experimental group, and the corresponding tumor adjacent tissues located more than 5 cm far from ESCC center were set as control group. 22 fresh and 175 paraffin-embeded ESCC specimens with corresponding adjacent tissues were randomly collected as study samples. With qRT-PCR, Western-blot and immunohistochemistry, the expression of Annexin A2 were detected at the mRNA and protein level. The correlation between Annexin A2 expression and clinicopathological parameters was analyzed. Results In 22 pairs of fresh ESCC and corresponding tumor adjacent tissues, the expression of Annexin A2 at mRNA level was significantly higher in tumor adjacent tissues (0. 06 ± 0. 06) than that in ESCC (0. 02 ±0. 02) (P＜0.05 ). Annexin A2 expression at protein level was also significantly higher in tumor adjacent tissues (0.95±0. 42) than ESCC (0.81±0. 36) (P＜0.05). In 175 paraffin-embeded ESCC specimens and corresponding adjacent tissues, the positive rate of Annexin A2 protein expression was 82. 3% (144/175) of the ESCC samples, which was lower than corresponding tumor adjacent tissues 92. 0% (161/175)(P＜0. 05). In addition, Annexin A2 expression was correlated with lymphoid node metastasis (P＜0.05) and pathological differentiation in patients with ESCC (P＜0.05). However, there was no apparent correlation with gross type (P＞0. 05). Conclusion The low expression of Annexin A2 in ESCC maybe played a potential role in the carcinogenesis, invasion and metastasis.

1H-MRS metabonomic analysis of plasma samples of esophageal cancer patients based on different pattern recognition / 中华肿瘤杂志

<p><b>OBJECTIVE</b>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.</p><p><b>METHODS</b>(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.</p><p><b>RESULTS</b>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, β-glucose, citric acid increased in the EC patients (r total < -0.27, P < 0.05).</p><p><b>CONCLUSIONS</b>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.</p>

Metabonomic variation of esophageal cancer within different ethnic groups in Xinjiang, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the metabonomic variation between patients with esophageal cancer (EC) and healthy controls, and to analyze the variation between patients with EC.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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).</p><p><b>CONCLUSION</b>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.</p>

Effects of non-wounded ischemic preconditioning on lung ischemia/reperfusion induced lipid peroxidation / 中华器官移植杂志

Objective To investigate the protective effect of non-wounded ischemic preconditioning (N-WIP) on lung ischemia/reperfusion (I/R) injury.Methods Two animal models with N-WIP and the classical ischemic preconditioning respectively were used. Forty New Zealand White rabbits were randomly divided into 4 groups, each group having 10 animals: control group (C), ischemia/reperfusion group (I/R), classical ischemic preconditioning group (C-IP), and N-WIP group. Lung injury was assessed by arterial oxygen tension (PaO2), wet to dry weight ratio (W/D), activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) and level of malondialdehyde (MDA).Results In I/R group, PaO2 was descended constantly, especially within 30 min after reperfusion. PaO2 and the activities of SOD, GSH-PX in serum and lung tissue in N-WIP group and C-IP group were both significantly higher than those in I/R group (P