Publications (10)12.38 Total impact
- [Show abstract] [Hide abstract] ABSTRACT: Complete video-assisted thoracoscopic surgery (c-VATS) for left upper lobectomy is difficult due to the branching pattern of the left pulmonary artery. Our purpose was to report outcomes of a modified technique of c-VATS left upper lobectomy. We retrospectively compared the outcomes of 83 patients with stage I/II non-small-cell lung cancer (NSCLC) who received left upper lobectomy between 2008 and 2011; 32 underwent conventional c-VATS and 50 received modified c-VATS. In the modified procedure, the order in which hilum of lung was treated was from the lingular segmental artery to the superior pulmonary vein to the bronchus, and then finally the pulmonary artery. The mean patient age was 63.6 ± 8.4 years, and no differences were observed in age, gender, and largest tumor diameter between the two groups. No conversion occurred in either group. The surgical time for modified c-VATS was significantly shorter than that for conventional c-VATS (210 vs. 270 min, p < 0.001). Drainage time after surgery and length of hospitalization for the modified c-VATS group were significantly less than those for the conventional group (drainage 3 vs. 4 days, respectively, p = 0.041; length of hospitalization 7 versus 12 days, respectively; p < 0.001). Surgical margins were clear in all cases. Four (8.0 %) complications occurred in the modified procedure group compared with ten (31.3 %) in the conventional group (p = 0.015). This new technique offers shorter surgical and postoperative drainage time, shorter hospital stays, and fewer complications than conventional c-VATS upper left lobectomy.
- [Show abstract] [Hide abstract] ABSTRACT: To summarize early experience in combined thoracolaparoscopic esophagectomy with two-field lymph node dissection for esophageal carcinoma. A total of 150 patients with thoracic esophageal cancer who underwent combined thoracoscopic and laparoscopic esophagectomy in Uninon Hospital, Fujan Medical University, were enrolled in this study. Locations of the tumors included upper esophagus (n=14), middle esophagus (n=95), and lower esophagus (n=41). Pathological type showed squamous cell cancer(n=142) and other types of cancer(n=8). There was no intraoperative death. Conversion to open thoracotomy was required in 6 patients and conversion to open laparotomy in 2 patients. The average total operative time was(258±45) min. The average operative thoracoscopic time was(140±33) min. The average time for gastric mobilization and neck esophagogastric anastomosis was (119±28) min. The average blood loss during the procedure was(207±130) ml. The average number of harvested lymph node with the specimen was 23.3±8.2. The tumor staging included stageI((n=39), II((n=58) and III((n=53). Postoperative complications occurred in 48(32%) patients including pneumonia (n=17), recurrent laryngeal injury (n=13), anastomotic leak (n=9), arrhythmias (n=9), chyle chest(n=5), delayed gastric emptying(n=5), ileus (n=2), volulus (n=1), and thrombocytopenia (n=1). Two patients died postoperatively due to respiratory failure resulting from pneumonia. Thoracolaparoscopic two-field lymph node dissection of esophageal cancer is a feasible minimally invasive appraoch.
- [Show abstract] [Hide abstract] ABSTRACT: The aim of the present study was to detect the expression of survivin in human lung cancer and to investigate the influence of its downregulation on the biological behavior of A549 lung cancer cells. The high expression of survivin in human lung cancer was verified by immunohistochemistry. Survivin small interfering RNA (siRNA) and unrelated sequence were synthesized and the siRNA lentiviral vector was constructed. The vector was transfected into A549 lung cancer cells, in which the clone with stable expression was screened out. We blocked the expression of survivin mRNA and protein by RNA interference (RNAi) technique. The downregulation of survivin mRNA and protein expression was confirmed by real-time quantitative PCR and western blotting. The proliferative activity and growth rate of A549 cells were determined by colony formation assay and mononuclear cell direct cytotoxicity assay (MTT assay). The reconstituted basement membrane (RBM) penetrating capacity was determined by cell invasion assay. The cell movement and migratory capacity were detected by wound-healing repair assay. The results showed that the sequence-specific siRNA significantly downregulated the expression of survivin at both the mRNA and protein levels. Downregulation of survivin expression dramatically decreased the invasive and metastatic capacities of the cells, suppressed the proliferation, decelerated the rate of growth, reduced the number of clones on soft agar and decreased the capacity of RBM penetration and migration. In conclusion, survivin, which plays an important role in carcinogenesis and development of lung cancer, can be effectively downregulated using the RNAi technique.
- [Show abstract] [Hide abstract] ABSTRACT: The survivin protein, a member of the inhibitors of apoptosis (IAP) family, has gained popularity as a therapeutic target for cancer due to its selective expression in tumor cells and its significant involvement in tumor cell viability. The aim of this study was to investigate the effect of the survivin-small interfering RNA (siRNA) plasmid on survivin expression in the human lung cancer cell line, A549, and to observe its effects on apoptosis and proliferation of A549 cells. A549 human lung cancer cells were transfected with survivin-targeting siRNA. The downregulation of survivin expression was determined by real-time polymerase chain reaction and western blotting. The proliferation of A549 cells was determined by MTT assay. The apoptotic rate and cell cycle distribution were analyzed by flow cytometry (FCM). Caspase-9 activity was also detected to study the apoptosis of lung cancer cells induced by siRNA against survivin. The sequence-specific siRNA efficiently and specifically downregulated the expression of survivin at both the mRNA and protein levels. Downregulation of survivin expression dramatically suppressed the proliferation of A549 cells and arrested the cells at the G (1)/G (0) phase. Caspase-9 activity was significantly increased in A549 cells transfected with siRNA against survivin. In this study, we found that survivin-specific siRNA can efficiently suppress the expression of survivin, increase apoptosis and inhibit A549 cell proliferation. Our findings further indicate the possibility that the antitumor effects of survivin-siRNA are mediated through the activation of caspase-9.
- [Show abstract] [Hide abstract] ABSTRACT: Survivin and Bcl-2 are generally considered to be inhibitors of apoptosis and are frequently overexpressed in several types of human cancers. However, their role in regulating the biological behavior of non-small cell lung carcinoma (NSCLC) remains controversial. We aimed to determine the expression of survivin and Bcl-2 and explore their correlation with clinicopathological features and prognosis. The expression of survivin and Bcl-2 proteins in 62 specimens of NSCLC tissues and 30 specimens of tumor adjacent tissues was detected using immunohistochemistry. The correlation between protein expression and clinicopathological features and prognosis was analyzed. The percentage of survivin-positive samples obtained from NSCLC tissues was 58.06% (36/62), which was significantly higher compared to that in normal lung tissues (10%, 3/30; P<0.05). Similarly, the percentage of Bcl-2-positive samples obtained from NSCLC tissues was statistically higher compared to that from normal lung tissues (51.61%, 32/62 vs. 6.67%, 2/30; P<0.05). Survivin expression was closely correlated with tumor differentiation, lymph node metastasis and TNM stage (P<0.05), while Bcl-2 expression was only associated with TNM stage (P<0.05). The expression of survivin was positively correlated with that of Bcl-2 (P<0.05). A five-year follow-up study revealed that the expression of survivin and Bcl-2 was negatively correlated with post-operative survival duration. Our findings suggest that survivin and Bcl-2 may act synergistically in the occurrence, development, invasion and metastasis of NSCLC, both of which are up-regulated in NSCLC tissues. The co-expression of survivin and Bcl-2, which is closely related to malignancy, may serve as a biomarker for predicting prognosis.
- [Show abstract] [Hide abstract] ABSTRACT: To discuss the application value of video-assisted thoracoscopic surgery (VATS) in treatment of esophageal leiomyoma. Clinical data of patients with esophageal leiomyoma treated by VATS from January 1999 to August 2007 were analyzed. VATS esophageal leiomyoma enucleations were performed successfully in 23 patients, and 18 patients of them were performed by pure VATS, 5 patients of them were performed with mini-thoracotomy. All the procedures of operations were completed smoothly without mortality and postoperative complications. 22 patients were pathologically diagnosed as esophageal leiomyoma after surgery (2 patients' leiomyoma came from muscularis mucosa). 1 patient was esophageal muscularis neurilemmoma. VATS leiomyoma enucleations must be a routine operation while treat thoracic esophageal leiomyoma.
- [Show abstract] [Hide abstract] ABSTRACT: Intrapleural hyperthermic perfusion is the distinctive therapy of malignant pleural effusion (MPE) caused by lung carcinoma. The expression pattern of T helper type 1 (Th1)/Th2 is an important index that reflects antitumor immunologic function. This study was to evaluate the therapeutic effect of intrapleural hyperthermic perfusion on MPE, and to investigate the impact of intrapleural hyperthermic perfusion on the immunologic reaction state of lung carcinoma patients with MPE by observing the expression pattern of cytokines Th1/Th2. A total of 24 lung carcinoma patients with MPE underwent intrapleural hyperthermic perfusion with 43 celsius warmed normal saline for 60 min under video-assisted thoracoscopic surgery (VATS). The responses of pleural effusion, adverse events, life quality and survival time were observed. The concentrations of Th1/Th2-related cytokines interferon-gamma (IFN-gamma), interleukin-2 (IL-2)/IL-4, and IL-10 in peripheral blood and pleural effusion were detected by ELISA, and their mRNA expression was detected by reverse transcription-polymerase chain reaction (RT-PCR). Neither operation-related death nor postoperative complication occurred. The total response rate of pleural effusion control was 100%, including 23 cases of complete remission (CR) and 1 case of partial remission (PR). No recurrence of MPE occurred. The quality of life of all patients had been improved. The median survival time was 18.3 months. The 1-and 2-year survival rates were 91.7% and 16.7%. The concentrations and positive rates of IL-2 and IFN-gamma were significantly lower and those of IL-4 and IL-10 were significantly higher in peripheral blood and pleural effusion before hyperthermia than in those after hyperthermia (P<0.05). Intrapleural hyperthermic perfusion under VATS is a safe and effective treatment for MPE caused by lung carcinoma. It can convert the predominant state of Th2 cytokines in lung carcinoma patients with MPE to that of Th1 cytokines.
- [Show abstract] [Hide abstract] ABSTRACT: To investigate the feasibility of ex vivo adenovirus-mediated gene transfer of human interleukin10 (hIL10) via the pulmonary vein into lung isografts, and to investigate the effect of hIL-10 gene transfer on subsequent ischemia-reperfusion injury (IRI). Fifty-six male SD rats were randomly divided into 4 equal groups: Group D, undergoing left lung isotransplantation with the improved cuff anastomosis technique (the Isografts were transvascularly transfected 5 ml of 5 x 10(9) plaque-forming units/ml adenovec-hIL-10 complex, Group C, with the Isografts transvascularly transfected with blank adenovirus vector Adenovec, Group B, with the Isografts transvascularly transfected with diluent , and Group A, undergoing sham operation. All allografts were preserved for 3 hours at 10 degrees C before transplantation. Four hours after reperfusion blood samples were collected from hr abdominal aorta to undergo blood air analysis. Lung function was evaluated by partial pressure of oxygen (PaO2). Then the rats were killed with their left lung taken out to undergo pathological examination. The graft lung wet-to-dry (W/D) weight ratio was measured. SABC immunohistochemistry was used to detect the expression of hIL-10 in the cytoplasm. ELISA was used to detect the expression of tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma). The levels of malonyldialdehyde (MDA), superoxide dismutase (SOD), and myeloperoxidase (MPO) were measured by. Pathological morphologic change was also analyzed. The PaO2 level of Group D was significantly higher than those of Groups B and C (both P < 0.01). The W/D ratio, and levels of MDA and MPO of Group D were significantly lower than those of Groups B and C (both P < 0.01), but the SOD level of Group D was significantly higher than those of Groups B and C (both P < 0.05). The TNF-alpha and IFN-gamma levels of Group D were significantly lower than those of Groups B and C (both P < 0.01). Fewer tissue edema and interstitial inflammation were found in lungs. Of Group D RT-PCR showed hIL-10 expression in the lungs of the rats of Group D, but not in other groups. Ex vivo adenovirus-mediated gene transfer of hIL-10 via the pulmonary vein into the lung isografts is feasible and effective. hIL-10 gene transfer into lung isografts ameliorates subsequent IRI and improves early posttransplant graft function.
- [Show abstract] [Hide abstract] ABSTRACT: It is still very difficult to make a definite diagnosis for some mediastinal diseases through some examinations, such as CT scan and fibrobronchoscopy. To judge the metastasis of mediastinal lymph nodes exactly for lung cancer patients and make proper staging of lung cancer are important for defining therapeutic schedule and estimating prognosis. This study was to explore the application value and summarize the experience of mediastinoscopy in the diagnosis of mediastinal diseases and the staging of lung cancer with enlarged mediastinal lymph nodes. Mediastinoscopy and biopsy were performed in 16 patients with different mediastinal diseases detected by imaging examinations and 14 lung cancer patients with enlarged mediastinal lymph nodes diagnosed by CT scan, PET, or fibrobronchoscopy. The staging of lung cancer was identified according to pathologic diagnosis. Of the 16 patients with different mediastinal diseases clarified by mediastinoscopy, 5 had nodule diseases, 3 had mediastinal lymph node tuberculosis, 2 had mediastinal lymphnoditis, 2 had lymphoma, 1 had extra-gastrointestinal type gastrointestinal malignant interstitialoma,1 had thymoma, 1 had metastatic small cell carcinoma, and 1 had metastatic adenocarcinoma. Of the 14 lung cancer patients with enlarged mediastinal lymph nodes, 6 had metastatic lymph nodes, and 8 had not; all of the 14 cases were accurately staged and received successful operations without severe postoperative complications. Mediastinoscopy is a safe, accurate and effective procedure for the diagnosis of mediastinal diseases and the staging of lung cancer.
Fujian Medical UniversityMin-hou, Fujian, China