Background X-linked inhibitor of apoptosis （XlAP）-associated factor 1 （XAF1） is a new tumor suppressor. Low expression of XAF1 is associated with poor prognosis of human cancers. However, the effect ...of XAF1 on lung cancer remains unknown. In this study, we investigated the expression of XAF1 and its role in squamous cell lung cancer. Methods Cancer tissues, cancer adjacent tissues and normal lung tissues were collected from 51 cases of squamous cell lung cancer. The expression of XAF1 mRNA was determined by reverse transcription-polymerase chain reaction （RT-PCR）. The expression of XAF1 protein was determined by Western blotting and immunohistochemical staining. Ad5/F35-XAF1 virus was generated. Cell proliferation and apoptosis were measured by 3-（4, 5-dimethylthiazol-2-yl）-2, 5-diphenyltetrazolium bromide （MTT） method and flow cytometry （FACS）, respectively. Results The levels of XAF1 protein and mRNA in cancer tissues were significantly lower than those in cancer adjacent and normal lung tissues （P 〈0.05）. The low expression of XAF1 was associated with tumor grade, disease stage, differentiation status and lymph node metastasis in squamous cell lung cancer patients. The restoration of XAF1 expression mediated by Ad5/F35-XAF1 virus significantly inhibited cell proliferation and induced apoptosis in a dose- and time-dependent manner. Conclusion XAF1 is a valuable prognostic marker in squamous cell lung cancer and may be a potential candidate gene for lung cancer therapy.
Therapy-related acute myeloid leukemia(t-AML) refers to a heterogeneous group of myeloid neoplasms that develop in patients following extensive exposure to either cytotoxic agents or radiation.The ...development of t-AML has been reported following treatment of cancers ranging from hematological malignancies to solid tumors; however, to our knowledge, t-AML has never been reported following treatment of gastric cancer.In this study, we report the development of t-acute promyelocytic leukemia in a cT 4N1M0 gastric cancer patient after an approximate 44 mo latency period following treatment with 4 cycles of oxaliplatin(OXP)(85 mg/m2 on day 1) plus capecitabine(1250 mg/m2 orally twice daily on days 1-14) in combination with recombinant human granulocyte-colony stimulating factor treatment.Karyotype analysis of the patient revealed 46,XY,t(15;17)(q22;q21)15/46,idem,-9,+add(9)(p22)2/46,XY3, which, according to previous studies, includes some "favorable" genetic abnormalities.The patient was then treated with all-trans retinoic acid(ATRA, 25 mg/m2/d) plus arsenic trioxide(ATO, 10 mg/d) and attained complete remission.Our case illuminated the role of certain cytotoxic agents in the induction of t-AML following gastric cancer treatment.We recommend instituting a mandatory additional evaluation for patients undergoing these therapies in the future.
Background Indoleamine-2,3-dioxygenase （IDO） is proven to suppress hepatitis B virus （HBV） specific immune response and depletion of IDO may be a useful approach for HBV therapy. To test this ...concept, we constructed recombinant adenovirus with human IDO and HBV preS, which would form the basis for future in vivo experiments.Methods The fragment of human IDO and HBV preS cDNA were subcloned into multiple cloning sites in an adenoviral vector system containing two cytomegalovirus （CMV） promoters. Recombination was conducted in the Escherichia coli BJ5183. The recombinant adenovirus containing hlDO gene and HBVpreS gene was packaged and amplified in 293 cells.Integration was confirmed by polymerase chain reaction as well as the quantification of viral titers. HepG2 cells were infected with the recombinant adenovirus and mRNA and protein specific for hlDO and HBVpreS was detected by RT-PCR and Western blotting respectively.Results The recombinant adenovirus was produced successfully. Its titer was 2.5x109 efu/ml. IDO and HBVpreS mRNA as well as the encoded proteins could be found in transfected HepG2 cells, but not in control HepG2 cells.Conclusion The transfer of hlDO-HBVpreS with double-promoter adenoviral vector was efficient. The recombinant adenovirus with hlDO and HBVpreS would provide the experimental basis for future studies.
AIM:To explore a prophylactic procedure to prevent splenic artery steal syndrome(SASS),as well as a therapeutic intervention to correct it.METHODS:Forty-three liver transplant patients were enrolled ...in a non-randomized controlled trial,with the eligible criterion that the diameter of the splenic artery is more than 5 mm and/or 1.5 times of the diameter of the hepatic artery.The procedure of splenic artery banding was performed in 28 of the 43 patients,with the other 15 patients studied as a control group.SASS and other complications were compared between these two groups.A new therapeutic intervention,temporary incomplete blockade of the splenic artery with a balloon,was performed to treat SASS in this study.RESULTS:The incidence of SASS was decreased by banding the splenic artery(0/28 vs 5/15,P = 0.006),and the same result was observed in total complications associated with prophylactic procedures(2/28 vs 6/15,P = 0.014).Five patients in the control group developed SASS within 5 d after OLT,2 of whom were treated by coil embolization of the splenic artery,whereas the other 3 by temporary blockade of the splenic artery.Reappeared or better hepatic arteries with improved systolic amplitude and increased diastolic flow were detected by Doppler ultrasonography in all the 5 patients.Local splenic ischemic necrosis and nonanastomotic biliary stricture were diagnosed respectively in one patient treated by coil embolization,and no collateral complication was detected in patients treated by temporary blockade of the splenic artery.CONCLUSION:SASS should be avoided during the operation by banding the splenic artery.Temporary blockade of the splenic artery is a new safe and effective intervention for SASS.
Background Video-assisted thoracoscopic sympathectomy had replaced open surgery. The aim of this study was to compare the outcomes of using a single port and two ports to perform video-assisted ...thoracoscopic sympathectomy for palmar hyperhidrosis. Methods Between April 2006 and February 2008, 20 cases underwent video-assisted thoracoscopic sympathectomy through one port （uniportal group） and 25 cases through two ports （biportal group）. The variables including the operating time, hospital stay, pain scores, postoperative complications, incidence of symptom recurrence and patient satisfaction were compared. The mean postoperative follow-up period was 11.5 months （range, 3-25 months）. Results The hands of all patients were warm and dry after operation. No conversion to open surgery was necessary, and no operative mortality was recorded in either group. The mean inpatient pain scores were significantly higher in the biportal group （1.2±0.6） than that in the uniportal group （0.8±0.5, P=0.025）. For the first three weeks after operation, four out of 20 （20%） patients in the uniportal group constantly suffered from mild or moderate residual pain while eight out of 25 （32%） cases in the biportal group （P=0.366）. Among them, two cases in the uniportal group and five cases in the biportal group need to take analgesics. Our mean operative time （bilateral sympathectomy） in the uniportal group （（39.5±10.0） minutes） was shorter than that in biportal group （（49.7±10.6） minutes, P=0.02）. There were no significant differences between two groups in terms of the mean hospital stay, compensatory sweating, and patient satisfaction. Two patients in the biportal group and three in the uniportal group experienced a unilateral pneumothorax. None of them required chest drainage. No patient experienced Homer＇s syndrome, and no recurrent symptoms were observed in either groups Conclusions Both uniportal and biportal video-assisted thoracoscopic sympathectomy are effective, safe, and minimally invasive for palmar hyperhidrosis. Comparing with the biportal approach, the uniportal approach causes less postoperative pain and less operative time, and is a more reasonable procedure in treatment of palmar hyperhidrosis.
To assess the spectrum of causes, clinical features, differences between disease phases, and prognosis of extrinsic allergic alveolitis (EAA).
Patients with EAA diagnosed at Peking Union Medical ...College Hospital from August 1983 to May 2007 were analyzed retrospectively. Their medical records were examined to gather clinical, laboratorial, radiological, and histopathological data. Patients were divided to three phases (acute, subacute, and chronic) according to clinical presentations. Follow-up data regarding treatment response, subsequent radiological and pulmonary function studies, and clinical outcomes were collected.
A total of 21 cases were enrolled. Among them, 11 were subacute, 10 were chronic. The most common exposure was pet birds (6 cases, 28.6%). The primary abnormality of pulmonary function was restriction and/or reduction in diffusing capacity (12 cases, 63.2%). The most common findings on high-resolution computed tomography (HRCT) were ground-glass opacities (13 cases, 68.4%) and centrilobular nodules (8 cases, 42.1%). Airway obstruction in pulmonary function test, emphysema, lung cysts, and fibrosis on HRCT were more frequently seen in chronic than in subacute patients, though the differences were not statistically significant. Bronchoalveolar lavage fluid (BALF) showed lymphocytosis. The total cell count and the percentage of neutrophils were significantly higher in subacute than in chronic patients (P<0.05). Nonnecrotizing granulomas were seen in 8 (47.1%) cases. Improvement or normalization in symptoms, radiography, and pulmonary function test after treatment were seen in all 18 patients with available follow-up data. Five patients recurred.
The characteristic abnormalities of pulmonary function, findings on HRCT, and pathology are essential for all phases of EAA, and the atypical manifestations such as obstruction and fibrosis can also be present frequently, particularly in chronic cases. Differential cell counts of BALF are related to the phase of the disease. The treatment response and prognosis of EAA are good.
Background Many treatment options for lower limb ischemia are difficult to apply for the patients with poor arterial outflow or with poor general conditions. The effect of medical treatment alone is ...far from ideal, especially in patients with diabetic foot. A high level amputation is inevitable in these patients. This study aimed to explore the effect of transplantation of autologous bone marrow mononuclear cells on the treatment of lower limb ischemia and to compare the effect of intra-arterial transplantation with that of intra-muscular transplantation.
Methods In this clinical trial, 32 patients with lower limb ischemia were divided into two groups. Group 1 （16 patients with 18 affected limbs） received transplantation of autologous bone marrow mononuclear cells by intra-muscular injection into the affected limbs; and group 2 （16 patients with 17 affected limbs） received transplantation of autologous bone marrow mononuclear cells by intra-arterial injection into the affected limbs. Rest pain, coldness, ankle/brachial index （ABI）, claudication, transcutaneous oxygen pressure （tcPO2） and angiography （15 limbs of 14 patients） were evaluated before and after the mononuclear cell transplantation to determine the effect of the treatment.
Results Two patients died from heart failure. The improvement of rest pain was seen in 76.5% （13/17） of group 1 and 93.3% （14/15） of group 2. The improvement of coldness was 100% in both groups. The increase of ABI was 44.4% （8/18） in group 1 and 41.2% （7/17） in group 2. The value of tcPO2 increased to 20 mmHg or more in 20 limbs. Nine of 15 limbs which underwent angiography showed rich collaterals. Limb salvage rate was 83.3% （15/18） in group 1 and 94.1% （16/17） in group 2. There was no statistically significant difference in the effectiveness of the treatment between the two groups.
Conclusions Transplantation of autologous bone marrow mononuclear cells is a simple, safe and effective method for the treatment of lower limb ischemia, and the two approaches for the implantation, intra-muscular injection and intra-arterial injection, show similar results.
Background Excessive iodine intake and viral infection are recognized as both critical factors associated with autoimmune thyroid diseases. Toll-like receptors （TLRs） have been reported to play an ...important role in autoimmune and inflammatory disorders. In this study, we aimed to clarify the possible mechanism of TLR3 involved in polyinosine- polycytidylic acid （poly（I：C）） promoting excessive iodine intake induced thyroiditis in non-obese diabetic （NOD） mice. Methods Both NOD and BALB/c mice were randomly assigned to four groups： control group （n=5）, high iodine intake （HI） group （n=7）, poly（I：C） group （n=7） and combination of excessive iodine and poly（l：C） injection （HIP） group （n=7）. After 8 weeks, mice were weighed and blood samples were collected. All the mice were sacrificed before dissection of spleen and thyroid gland. Then, thyroid histology, thyroid secreted hormone, expression of CD3＋ cells and TLR3 as well as inflammatory mRNA level were evaluated. Results Both NOD and BALB/c mice from HI and HIP group represented goiter and increasing thyroid relative weight. Thyroid histology evidence indicated that only HIP group of NOD mice showed severe thyroiditis with lymphocytes infiltration in majority of thyroid tissue, severe damage of follicles and general fibrosis. Immunofiuorescence staining results displayed a large number of CD3~ cells in HIP NOD mice. Real-time polymerase chain reaction （PCR） results suggested interferon （IFN）-a increased over 30 folds and IFN-y expression was doubled compared with control group, but interleukin （IL）-4 remained unchanged in HIP group of NOD mice thyroid. Meanwhile, over one third decrease of blood total thyroxine （TT4） and increased thyroid-stimulating hormone （TSH） was observed in HIP group of NOD mice. Only HIP group of NOD mice represented significantly elevation of TLR3 expression. Conclusion Poly（l：C） enhanced excessive dietary iodine induced thyroiditis in NOD mice through increasing TLR3 mediated inflammation.
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