Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 58
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Food Chem ; 304: 125446, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31491715

RESUMO

Fused coumarins recently attracted strong scientific interest due to their potent pharmacological activities. In this study, density functional theory (DFT) calculations were performed to evaluate the antiradical activities of a series of coumarin-fused coumarins. By calculating the thermodynamic parameters, three primary mechanisms including hydrogen atom transfer (HAT), electron transfer followed by proton transfer (SET-PT) and sequential proton loss electron transfer (SPLET) were examined. It was found that in the gas and benzene phases, the studied compounds prefer to undergo HAT mechanism, while SPLET is more favored in polar media. The results also reveal the possibility of double HAT and double SPLET mechanisms for compound CC-6. Interestingly, a new polycyclic compound was generated by forming a new C5-O5' bond during the second HAT process at the 5'-OH in CC-6-R6 radical. In addition, the SPLHAT mechanism is proposed as a competitive pathway for radical scavenging by CC-4, CC-5 and CC-6.

2.
Oncogene ; 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31562393

RESUMO

Cancer cells undergo significant lipid metabolic reprogramming to ensure sufficient energy supply for survival and progression. However, how cancer cells integrate lipid metabolic signaling with cancer progression is not well understood. In the present study, we demonstrated that C/EBPδ, a critical lipid metabolic regulator, is a TGF-ß1 downstream gene and promotes lung adenocarcinoma metastasis. Importantly, C/EBPδ caused significant oscillations in both lipid metabolic and epithelial to mesenchymal transition (EMT) gene networks. Mechanistically, we demonstrated that C/EBPδ recruited oncogene NCOA3 to transcriptionally activate Slug, a canonical EMT transcription factor, which in turn induced oxLDL receptor-1 (Lox1) expression and enhanced oxLDL uptake to promote cancer metastasis, which could be blocked with LOX1 neutralizing antibody. In summary, our results unveiled a previously unappreciated interplay between lipid metabolic and metastatic program, as well as the existence of a pivotal C/EBPδ-Slug-Lox1 transcription axis to promote oxLDL levels and cancer metastasis.

3.
Thorac Cancer ; 10(4): 930-941, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30883029

RESUMO

BACKGROUND: Osimertinib (AZD9291), a third-generation EGFR-tyrosine kinase inhibitor, can effectively prolong survival in non-small cell lung cancer (NSCLC) patients with EGFR mutations, particularly T790M mutations; however, acquired resistance to AZD9291 is inevitable, thus exploration of the targets of resistance is urgent. METHODS: Considering the important role of circular RNAs (circRNAs) in cancers, we established AZD9291-resistant NSCLC cell lines (H1975/AZDR and HCC827/AZDR) and used microarray analysis to determine the circRNA expression profiles of the cells. The H1975/AZDR and HCC827/AZDR cell lines were induced by gradually increasing the drug concentration. CircRNA microarray expression profiles were obtained from H1975, HCC827, H1975/AZDR, and HCC827/AZDR cells and validated by quantitative reverse transcription PCR. Expression data were analyzed bioinformatically. RESULTS: The H1975/AZDR and HCC827/AZDR cell lines were successfully established. The half-maximal inhibitory concentration and the invasion ability of H1975/AZDR and HCC827/AZDR cells were significantly enhanced. The proliferation rates of H1975/AZDR and HCC827/AZDR were much lower than H1975 and HCC827. Microarray analysis identified 15 504 circRNAs differentially expressed in H1975, HCC827, H1975/AZDR, and HCC827/AZDR cells. Among them, 7966 were upregulated and 7538 were downregulated more than two-fold. We predicted the possible miRNAs of the top dysregulated circRNAs. Furthermore, Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that the most modulated circRNAs regulate several cancers and cancer-related pathways. CONCLUSION: Our results reveal that circRNAs may play a role in NSCLC AZD9291 resistance and might be a promising molecular target candidate for gene therapy.

4.
EBioMedicine ; 41: 236-243, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30872130

RESUMO

BACKGROUND: Non-invasive lung adenocarcinoma could benefit from limited resection, nonetheless, there is a lack of method to determine preoperative tumour invasiveness. We aimed to investigate whether folate receptor-positive circulating tumour cells (FR+-CTCs) in combination with maximum tumour diameter (MTD) determines, before surgery, the invasiveness of small-sized, indeterminate solitary pulmonary nodules (SPNs). METHODS: A total of 382 patients with suspicious lung adenocarcinoma on computed tomography who were expected to undergo lung resection were enrolled in this study at three participating institutes and randomly assigned into training and validation cohorts. Before surgery, 3 mL peripheral blood was collected from all participants. FR+-CTCs were analyzed using immunomagnetic leukocyte depletion and quantitated by ligand-targeted PCR method. After surgery, the resected tissues were diagnosed by pathologists according to IASLC/ATS/ERS classification. FINDINGS: FR+-CTC levels in the peripheral blood can differentiate benign from malignant nodules with a sensitivity of 78·6%-82·7% and a specificity of 68·8%-78·4%. Both FR+-CTC and MTD are independent predictive indices of invasive tumours for lung adenocarcinoma ≤2 cm based on multivariate analyses. Further, FR+-CTC count in combination with MTD can differentiate non-invasive cancers from invasive cancers with a sensitivity of 63·6%-81·8% and a specificity of 71·4%-89·7%. INTERPRETATION: Detection of FR+-CTC is a reliable method to differentiate malignancy of indeterminate SPNs. Combining of FR+-CTC count and MTD could possibly enhance preoperative determination of the invasiveness of lung nodules and guide surgeons to select limited lung resection and avoid overtreatment for patients with non-invasive lesions. FUND: None.


Assuntos
Adenocarcinoma/sangue , Biomarcadores Tumorais/sangue , Receptores de Folato com Âncoras de GPI/metabolismo , Neoplasias Pulmonares/sangue , Células Neoplásicas Circulantes/metabolismo , Nódulo Pulmonar Solitário/sangue , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Receptores de Folato com Âncoras de GPI/genética , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Nódulo Pulmonar Solitário/patologia
5.
J Exp Clin Cancer Res ; 37(1): 323, 2018 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-30577808

RESUMO

BACKGROUND: Epithelial-to-mesenchymal transition (EMT) contributes to the invasion and metastasis of epithelial tumors. Sirtuin 6 (SIRT6), an NAD-dependent deacetylase, is known to promote metastasis of non-small cell lung cancer (NSCLC). METHODS: In this work, we determined the role of SIRT6 in the EMT of NSCLC cells and identified the key EMT-related genes involved in the oncogenic activity of SIRT6. RESULTS: We report that depletion of SIRT6 inhibits transforming growth factor-ß1 (TGF-ß1)-induced EMT in A549 and H1299 NSCLC cells, which is rescued by ectopic expression of SIRT6. Knockdown of SIRT6 leads to a reduction in Snail protein without affecting the mRNA level. Immunoprecipitation experiments demonstrate a physical association between SIRT6 and Snail. SIRT6 deacetylates Snail and prevents its proteasomal degradation. Silencing of Snail blunts SIRT6-induced NSCLC cell migration and invasion, while overexpression of Snail restores the invasion and EMT in SIRT6-depleted NSCLC cells. SIRT6 depletion leads to an upregulation of kruppel-like factor 4 (KLF4) and reduced Snail binding to the promoter of Klf4 in NSCLC cells. Knockdown of KLF4 rescues the invasive capacity in SIRT6-depleted NSCLC cells. Conversely, co-expression of KLF4 impairs SIRT6-induced aggressive behavior. In vivo data further demonstrate that SIRT6-induced NSCLC metastasis is antagonized by overexpression of KLF4. CONCLUSIONS: These findings provide mechanistic insights into the pro-metastatic activity of SIRT6 and highlight the role of the SIRT6/Snail/KLF4 axis in regulating EMT and invasion of NSCLC cells.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/genética , Fatores de Transcrição Kruppel-Like/genética , Neoplasias Pulmonares/genética , Sirtuínas/genética , Células A549 , Animais , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Carcinoma Pulmonar de Células não Pequenas/patologia , Transição Epitelial-Mesenquimal , Xenoenxertos , Humanos , Fatores de Transcrição Kruppel-Like/metabolismo , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Masculino , Camundongos , Camundongos Nus , Invasividade Neoplásica , Sirtuínas/metabolismo , Transfecção , Fator de Crescimento Transformador beta1/farmacologia
6.
J Phys Chem A ; 122(43): 8520-8529, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30296082

RESUMO

In view of the multifunctional features of coumarins and chalcones, coumarin-chalcone hybrids have attracted much attention in recent years. Herein, the free radical scavenging activities of a series of coumarin-chalcone hybrids were investigated using the density functional theory (DFT) method. Three main reaction mechanisms were explored: hydrogen atom transfer (HAT), electron transfer followed by proton transfer (SET-PT), and sequential proton loss electron transfer (SPLET). Thermodynamic descriptors associated with these mechanisms were calculated in the gas phase and solvents. The results demonstrate that the predicted antioxidant efficiencies are generally in accordance with the experimental results. HAT is proposed as the thermodynamically favored mechanism in the gas phase and nonpolar solution, while SPLET is preferred in polar media. Our results indicate that compound MPHCC possesses potential for inactivating free radicals via double HAT and double SPLET mechanisms depending upon the polarity of environment. In addition, the SPLHAT mechanism provides an alternative pathway to HAT and SPLET for radical scavenging by MPHCC and OPHCC. The results confirmed the crucial role of hydroxyl groups on the chalcone moiety in trapping radicals. 4'-OH in the catechol group is proposed as the primary target for radical attack.

7.
Zhongguo Fei Ai Za Zhi ; 21(8): 578-582, 2018 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-30172263

RESUMO

BACKGROUND: Thoracoscopic lobectomy combined with mediastinal lymph node dissection has been considered as one of the standard surgical procedures for early lung cancer. After 20 years of development, thoracoscopic lobectomy has reached a consensus on reliability and minimally invasive. At present, thoracoscopic lobectomy has a variety of incisions, which gradually evolve into four holes based on three holes, and two or one hole as the operative approach. The aim of this study was to evaluate the clinical value of four-hole unilateral dissecting lobectomy and mediastinal lymph node dissection in the treatment of non-small cell lung cancer (NSCLC). The aim of this study was to investigate the clinical value of anatomical lobectomy with mediastinal lymphadenectomy under four-hole completely video-assisted thoracoscopic surgery (C-VATS) in the treatment of non-small cell lung cancer. METHODS: The patients undergoing lobectomy with mediastinal lymphadenectomy for NSCLC were identified in the Department of Thoracic Surgery, Yangzhou First People's Hospital, Yangzhou University from March 2015 to July 2016. Preoperative clinical diagnosis of peripheral-type early NSCLC. The patients were randomly divided into four-hole monophasic group (experimental group) and three-hole group (control group) according to the number of hospitalization before surgery. According to inclusion and exclusion criteria, the 39 cases assign in experimental group and 34 cases in the control group, including 36 males and 37 females; aged 38 to 84 years. The mean operation time, average blood loss, lymph node dissection group, average drainage, average extubation time and postoperative complications were compared between the two groups for statistical analysis. RESULTS: The two groups of patients were successfully completed surgery, no death after surgery. Mean bleeding in the two groups, the number of lymph node dissection group, the average postoperative drainage, the average time of extubation, postoperative complications, with no significant difference. The average operation time of the four-hole unidirectional group was shorter than that of the three-hole group. The difference was statistically significant (P<0.05). CONCLUSIONS: The safety and efficacy of a four-hole one-way operation under VATS are satisfactory. The operation is smooth during operation, which shortens the course of operation and deserves the clinical promotion.
.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/cirurgia , Excisão de Linfonodo/métodos , Mediastino , Pneumonectomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida , Fatores de Tempo
8.
J Thorac Dis ; 10(6): 3418-3427, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30069337

RESUMO

Background: Combined small cell lung cancer (C-SCLC) is defined as small cell lung cancer (SCLC) combined with any of non-small cell lung cancer (NSCLC) histological types, such as large cell carcinoma, squamous cell carcinoma, or adenocarcinoma. Since C-SCLC is an increasingly recognized subtype of small cell carcinoma, we conducted a retrospective study in our institution to explore the value of prophylactic cranial irradiation (PCI) in patients with C-SCLC treated by surgery. Methods: Between 2005 and 2014, the records of all consecutive patients with pathologically diagnosed C-SCLC after surgery in our institution were reviewed. Overall survival (OS), disease-free survival (DFS), and brain metastasis free survival (BMFS) were estimated by Kaplan-Meier method. Survival differences were evaluated by log-rank test, while multivariate analysis was performed by a Cox proportional hazards model. Results: Of the total 91 patients included in this analysis, 11 patients (12.1%) were in PCI group and 80 (87.9%) in non-PCI group. The 5-year cumulative incidence of brain metastasis in the whole group was 22.2% (26.3% in non-PCI group vs. 0% in PCI group), and 5-year OS rate was 44.1%. Patients treated with PCI had significantly longer OS (P=0.011) and DFS (P=0.013), also had the trend to live a longer BMFS with marginal significance (P=0.092) than non-PCI-treated patients. The multivariate analysis showed that PCI [hazard ratio (HR) =0.102, P=0.024] was one of independent prognostic factors of the OS in surgery-treated C-SCLC patients. Conclusions: C-SCLC patients have a relative high risk of developing brain metastases based on our study. These data showed that PCI could improve OS and DFS, as well as tend to decrease brain metastases in surgically resected C-SCLC. However, whether PCI could be part of comprehensive treatment modalities in C-SCLC should be assessed in prospective studies.

9.
J Thorac Dis ; 10(6): 3776-3782, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30069376

RESUMO

Background: To analyze the perioperative indexes of 389 patients with non-small cell lung cancer in single center after robot-assisted thoracoscopic (RATS) lobectomy, and to summarize the surgical key points in robotic lobectomy. Methods: The clinical data of 389 stage I non-small cell lung cancer patients who underwent RATS lobectomy from May 2013 to December 2016 were retrospectively analyzed. Among them, there were 261 females (67.1%) and 128 males (32.9%); aged from 20-76 years old, with a mean age of 55.01 years; with ASA I in 106 cases, ASA II in 267 cases and ASA III in 16 cases; with BMI from 16.87-34.05, averaged at 23.09±2.79. The largest tumor in preoperative chest CT measurement was 0.3-3.0 cm, ranging from 1.29±0.59 cm; with stage Ia in 153 cases, stage Ib in 148 cases, stage Ic in 32 cases, stage IIb in 26 cases and stage IIIa in 30 cases; including 380 adenocarcinomas and 9 squamous carcinomas. Results: The operating time was 46-300 min, averaged at 91.51±30.80 min; with a blood loss of 0-100 mL in 371 cases (95.80%), 101-400 mL in 12 cases (3.60%) and >400 mL in 2 cases (0.60%); there were 4 (1.2%) conversions to thoracotomy, in which 2 patients had massive hemorrhage and 2 patients had extensive dense adhesion; there was no mortality during operation and perioperatively. The drainage on the first day after operation was 0-960 mL, averaged at 231.39±141.87 mL; the postoperative chest tube was placed for 2-12 d, averaged at 3.96±1.52 d; the postoperative hospital stay was 2-12 d, averaged at 4.96±1.51 d, with postoperative hospital stay >7 d in 12 cases (3.60%). The postoperative air leakage was the main reason (35 cases, 9%) for prolonged hospital stay, and there was no re-admitted case within 30 days. All the patients underwent systemic lymph node dissection. The total cost of hospitalization was 60,389.66-134,401.65 CNY, averaged at 93,809.23±13,371.26 CNY. Conclusions: The application of Da Vinci robot surgery system in resectable non-small cell lung cancer is safe and effective, and could make up for the deficiencies of traditional thoracoscopic surgery. The number and level of robot surgery in our center have reached international advanced level, but the relatively expensive cost has become a major limitation in limiting its widespread use. With continuous improvements in robotic technology, its scope of application will be wider, which will inevitably bring new insights in lung surgical technology.

10.
Oncol Lett ; 16(3): 3029-3037, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30127893

RESUMO

Radiation is able to inhibit tumor growth, promote tumor cell apoptosis and prolong patient survival. However, radiation resistance remains a major impediment to radiotherapy. Local and metastatic recurrences following radiation are still large impediments to overall survival. Although cyclooxygenase-2 (COX-2) inhibitors may induce radiation sensitivity in cancer cells, the underlying mechanisms are not fully understood. The present study demonstrated high potential for cell proliferation, migration and invasion in radiation-resistant lung cancer cell lines. The present study observed the overexpression of specificity protein 1 (Sp1) in these cells, and the overexpression of Sp1 induced upregulation of matrix metalloproteinase (MMP)-2, MMP-9, B cell lymphoma-2, in addition to a high potential for radiation resistance, migration and invasion in these cells. The present study revealed that the COX-2 selective inhibitor, celecoxib, enhanced radiation sensitivity and inhibited migration and invasion in these cells by inhibiting the expression and DNA-binding activity of Sp1. Furthermore, celecoxib downregulated Sp1 by inhibiting c-Jun N-terminal kinase (JNK). Taken together, the present study demonstrated that Sp1 overexpression in radiation-resistant cancer cells and COX-2 inhibitors enhanced radiation sensitivity and inhibited the migration and invasion of cancer cells, at least partially, via inactivation of the JNK/Sp1 signaling pathway and a decrease in Sp1 DNA-binding activity.

11.
J Thorac Dis ; 10(5): 2876-2880, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29997952

RESUMO

Background: To report the first and largest series of robotic-assisted mediastinal surgeries performed in a single center by the same surgical team in mainland China. Methods: From May 2009 to June 2017, 167 patients (100 males, 67 females), with a mean age of 50.2 years (range, 12-78 years), underwent robotic surgery for the treatment of a mediastinal mass. Data regarding the operation time, docking time, blood loss, conversion rate, morbidity, mortality and survival follow-up were collected and analyzed. Results: The mean operation time and docking time were 70.01±29.49 and 10.12±2.77 min. There were 56 thymomas, 52 cysts, 17 schwannomas, 9 bronchogenic cysts, 6 thymic hyperplasias, 6 foregut cysts, 4 squamous carcinomas and 17 others. The mean drainage on the first day after operation was 122.83±107.58 mL, and the mean post-operative drainage duration and post-operative hospital stay were 2.95 days, ranging from 1-7 days, and 4.09 days, ranging from 2-10 days, respectively. The post-operative complication rate was 3%, and the conversion rate was 1.8%. No perioperative mortality occurred. One patient died due to tumor recurrence. Conclusions: Our experience indicates that this robotic surgical system is a safe and established technique for mediastinal mass resection.

12.
J Thorac Dis ; 10(3): 1919-1926, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29707347

RESUMO

Background: Segmentectomy has been widely used for small-sized non-small cell lung cancer (NSCLC). The objective of this study is to determine the impact of number of harvested lymph nodes (LNs) on survival for patients undergoing segmentectomy. Methods: The clinicopathologic data of patients undergoing segmentectomy for NSCLC from July 2011 to December 2014 were retrospectively analyzed. Survival analysis was performed by Kaplan-Meier method and Cox regression analysis. Results: A total of 259 patients with NSCLC were eligible for analysis. Patients with harvested LN ≥6 had higher frequency of nodal metastasis in pathologic examination (9.4% vs. 1.5%, P=0.005). The 3-year recurrence-free survival (RFS) of patients with harvested LN ≥6 (90.2%) was significantly higher than that of patients with harvested LN <6 (73.7%, log-rank P=0.038). Multivariable Cox analysis identified harvested LN ≥6 as an independent predictor for improved RFS [hazard ratio (HR) =0.35; 95% confidence interval (CI): 0.14-0.90; P=0.029]. There was no significant difference in RFS between patients with harvested LN station ≥3 and <3 (log-rank P=0.34). Conclusions: The number of harvest LN ≥6 was independently associated with improved RFS for NSCLC patients undergoing segmentectomy, supporting the National Comprehensive Cancer Network (NCCN) guidelines of appropriate LN sampling.

13.
Zhongguo Fei Ai Za Zhi ; 21(3): 173-175, 2018 Mar 20.
Artigo em Chinês | MEDLINE | ID: mdl-29587934

RESUMO

Minimal invasive surgery with short operation time and enhanced recovery after surgery can truly achieve biological minimal invasiveness. The minimal invasive lung cancer surgery includes several kinds, such as uni-portal video-assisted thoracoscopic surgery (VATS) and multi-portal VATS. Robotic-assisted thoracic surgery (RATS) can be categorized into multi-portal VATS. As a frontier technology of minimal invasive surgical technique, surgical robotic system has been broadly applied in many areas. The average RATS operation time is (91.51±30.80) min among our team, which is much shorter than reported uni-portal VATS operation time. For now, RATS has some drawbacks and is lacking of national practice guidelines, which, we believe, will be solved by technology development and large-scale randomized controlled trials. 
.


Assuntos
Neoplasias Pulmonares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Robótica/instrumentação , Robótica/métodos , Cirurgia Torácica Vídeoassistida/instrumentação , Cirurgia Torácica Vídeoassistida/métodos
14.
Thorac Cancer ; 9(5): 580-583, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29498240

RESUMO

BACKGROUND: Vagus nerve and recurrent laryngeal nerve (RLN) injury are not rare complications of lung cancer surgery and can cause lethal consequences. Until now, no optimal method other than paying greater attention during surgery has been available. METHODS: Four patients underwent lung surgery that involved RLN or vagus nerve injury. The left RLN or vagus nerve was cut off and then reconstructed immediately during surgery. Two patients underwent direct anastomosis, while the remaining two underwent phrenic nerve replacing tension-relieving anastomosis. RESULTS: All patients were able to speak immediately after recovery. No or minimal glottal gap was observed during laryngoscopy conducted on the second day after surgery. Most patients achieved full recovery of voice quality. CONCLUSIONS: Immediate reconstruction of RLN is technically feasible and can be carried out with satisfying short-term and long-term outcomes.

15.
Ann Thorac Surg ; 105(2): 386-392, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29198623

RESUMO

BACKGROUND: Safety and short-term efficacy of video-assisted thoracoscopic surgery (VATS) for early-stage non-small lung cancer (NSCLC) has been demonstrated by observational studies previously. However, these outcomes have never been verified by a large randomized controlled trial (RCT). The aim of our RCT was to confirm that VATS is not inferior or even superior to open operation for early-stage NSCLC in terms of short-term and oncologic efficacy. METHODS: The trial was undertaken at five tertiary hospitals. Patients aged between 18 and 75 years with clinically early-stage NSCLC were randomly assigned to the VATS and axillary thoracotomy groups. Lobectomy plus mediastinal lymph node dissection was standard surgical intervention. Because patients continue to be followed up for oncologic outcome, the short-term perioperative outcomes would be reported here. RESULTS: Between 2008 and 2014, 508 patients were recruited and 425 were eligible for analyses (215 VATS and 210 axillary thoracotomy). Eight VATS procedures were converted to open operation intraoperatively (3.72%). Median operation time with VATS was significantly less than axillary thoracotomy (150 versus 166 minutes, p = 0.009). In addition, VATS was associated with less intraoperative blood loss (p = 0.001). There was no difference for postoperative pleural drainage, length of hospitalization, and rates of morbidity and mortality. Cancer residual margins were found in 1 patient with VATS and 5 with axillary thoracotomy (p = 0.128). The yield of lymph nodes from either surgical approach was similar (p = 0.389). CONCLUSIONS: Our study demonstrates that VATS lobectomy is safe and reliable to treat NSCLCs, and it may be superior to axillary thoracotomy for operation time and intraoperative blood loss. ClinicalTrials.gov identifier: NCT01102517.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/cirurgia , Estadiamento de Neoplasias , Pneumonectomia/métodos , Cirurgia Torácica Vídeoassistida/métodos , Toracotomia/métodos , Adolescente , Adulto , Idoso , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/secundário , China/epidemiologia , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/patologia , Excisão de Linfonodo , Masculino , Mediastino , Pessoa de Meia-Idade , Morbidade/tendências , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Resultado do Tratamento , Adulto Jovem
16.
Cell Stress Chaperones ; 23(2): 195-201, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28884419

RESUMO

Previous laboratory studies have demonstrated that insects can tolerate high temperatures by expressing inducible heat shock proteins (HSPs). This HSP-based tolerance, however, has seldom been studied under field conditions. Here, we cloned the HSP70 gene of Corythucha ciliata (Cchsp70), an invasive insect species with substantial thermal tolerance in subtropical China. We also compared the relative mRNA expression levels of Cchsp70 in response to controlled temperature treatments (2 h at 33-43 °C at 2 °C intervals in the laboratory) and to natural increases in temperature (08:00-14:00 at 2-h intervals, 29.7-37.2 °C) on a hot summer day in the field. The complete cDNA of Cchsp70 is 2256 bp long and has a 1917 bp open reading frame that encodes a protein (CcHSP70) with 639 amino acids. The expression levels of Cchsp70 significantly increased in response to high temperatures in both laboratory and field. At similar temperatures, however, the expression levels were much higher in the field than in the laboratory. These results suggest that CcHSP70 contributes to the thermal tolerance of C. ciliata and that factors in addition to thermal stress may induce Cchsp70 expression in the field.

17.
J Thorac Dis ; 9(11): 4592-4596, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29268530

RESUMO

Today, video-assisted thoracic surgery (VATS) was very popular and more and more common, which could be carried out at all levels of medical centers, most of which used multiple-ports VATS techniques. However, uniportal VATS was more difficult technique compared with multiple-ports VATS, and was not yet completely universal. Uniportal port VATS with 2 cm incision was more difficult surgery, and asked the surgeon to master more surgical techniques and good collaborations with each other, however, which not only could reduce the postoperative pain and skin numbness but supply cosmetology and psychological comfort for patients. To reduce unnecessary damage to patients, we minimized the incision to 2 cm. Therefore, we called it precise uniportal port VATS technique in our surgical center and introduced it here.

18.
Oncotarget ; 8(45): 79703-79711, 2017 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-29108350

RESUMO

Purpose: The aim of this study is to compare the therapeutic effect between endostar plus adjuvant chemotherapy and adjuvant chemotherapy alone in the patients with completely resected non-small cell lung cancer (NSCLC) at stage IB to IIIA. Experimental Design: This is an open, multicenter, randomized (1:1) study with 250 NSCLC patients. Completely resected NSCLC patients at stages IB to IIIA were randomized to receive adjuvant NP plus endostar (Vinorelbine 25 mg/m2 on day 1 and day 8 plus Cisplatin 75 mg/m2 on day 1, and plus endostar 7.5 mg/m2 per day iv for consecutive 14 days) or NP regimen alone. Every 21 days were set as one cycle for 4 cycles. The primary endpoint was disease-free survival (DFS). Secondary endpoints included tumor response rate, overall survival and safety. Results: The two groups had no significant difference in the incidence of toxicity reaction. Endostar plus NP prolonged the DFS of patients with completely resected NSCLC at stage IIIA (19.33±3.73 vs 17.10±9.68 months) but with no statistical difference compared to NP alone. In the endostar plus NP group, those cases with high expression of vascular endothelial growth factor (VEGF) showed a significantly better DFS than those with low VEGF expression (48.45±3.52 vs 40.18±4.54 months, P<0.05). Conclusions: Vascular targeted therapy with endostar plus NP prolongs the DFS of patients with complete resectable NSCLC in stage IIIA and significantly extends the DFS of NSCLC patients with high VEGF expression, but does not show benefits in OS for stage IB-IIIA.

19.
J Thorac Dis ; 9(7): 1997-2005, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28839999

RESUMO

BACKGROUND: This aim of this study was to compare three approaches of extended thymectomy for the treatment of early-stage thymomas, which included robot-assisted thoracic surgery (RATS), video-assisted thoracic surgery (VATS), and median sternotomy (MS) perioperative parameters. METHODS: A retrospective study was conducted on 123 patients with early stage thymomas at Shanghai Chest Hospital who underwent extended thymectomy between February 2009 and August 2014. Among them, MS was performed on 37 patients, VATS was performed on 35 patients, and RATS was performed on 51 patients. A series of outcome measures were compared between these three approaches, including operative time, intra-operative blood loss volume, occurrence of intra-operative complications, post-operative pleural drainage duration, post-operative pleural drainage volume, duration of hospital stay, and the incidence of post-operative complications. RESULTS: A series of intra- and post-operative parameters showed significant differences in intra-operative blood loss volume, mean post-operative pleural drainage duration, pleural drainage volume and mean duration of hospital stay. For these parameters, during further analysis, significant differences were also demonstrated for comparisons between any two groups. RATS reduces the post-operative drainage duration and volume (2.88 vs. 3.77 and 4.41 days, P<0.05; 352.2 vs. 613.9 and 980 mL, P<0.05) and the hospital stay versus the MS and VATS groups (4.3 vs. 5.5 and 6.6 days). Three patients experienced post-operative complications in the MS group, and no post-operative complications occurred in the RATS or VATS group. CONCLUSIONS: RATS and VATS both appear feasible and safe for the resection of early-stage thymomas as compared to MS. RATS is less invasive than VATS with a shorter post-operative pleural drainage duration time, a reduced drainage volume, and a shorter hospital stay.

20.
J Thorac Dis ; 9(5): 1190-1200, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28616268

RESUMO

BACKGROUND: To investigate the potential value of CT parameters to differentiate ground-glass nodules between noninvasive adenocarcinoma and invasive pulmonary adenocarcinoma (IPA) as defined by IASLC/ATS/ERS classification. METHODS: We retrospectively reviewed 211 patients with pathologically proved stage 0-IA lung adenocarcinoma which appeared as subsolid nodules, from January 2012 to January 2013 including 137 pure ground glass nodules (pGGNs) and 74 part-solid nodules (PSNs). Pathological data was classified under the 2011 IASLC/ATS/ERS classification. Both quantitative and qualitative CT parameters were used to determine the tumor invasiveness between noninvasive adenocarcinomas and IPAs. RESULTS: There were 154 noninvasive adenocarcinomas and 57 IPAs. In pGGNs, CT size and area, one-dimensional mean CT value and bubble lucency were significantly different between noninvasive adenocarcinomas and IPAs on univariate analysis. Multivariate regression and ROC analysis revealed that CT size and one-dimensional mean CT value were predictive of noninvasive adenocarcinomas compared to IPAs. Optimal cutoff value was 13.60 mm (sensitivity, 75.0%; specificity, 99.6%), and -583.60 HU (sensitivity, 68.8%; specificity, 66.9%). In PSNs, there were significant differences in CT size and area, solid component area, solid proportion, one-dimensional mean and maximum CT value, three-dimensional (3D) mean CT value between noninvasive adenocarcinomas and IPAs on univariate analysis. Multivariate and ROC analysis showed that CT size and 3D mean CT value were significantly differentiators. Optimal cutoff value was 19.64 mm (sensitivity, 53.7%; specificity, 93.9%), -571.63 HU (sensitivity, 85.4%; specificity, 75.8%). CONCLUSIONS: For pGGNs, CT size and one-dimensional mean CT value are determinants for tumor invasiveness. For PSNs, tumor invasiveness can be predicted by CT size and 3D mean CT value.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA