Left Main Bronchus Root Prolongation to Cure 3 Patients whose Carina is Involved by Lung Cancer

Background and objective Patient whose carina is involved by carcinoma is difficult to treat by surgery. The aim of this study is to evaluate the safety and effectiveness of left main bronchus root prolongation to cure these patients. Methods Three patients with lung carcinoma received tumor, right upper lung and carina excision. And then the trachea and the carina was rebuilt by continuous suture, so that the left main bronchus root was extended by 3 cm, then the middle and lower lobe bronchus were sutured to the right lateral wall of the moved up eminence. Results All the patients left hospital successfully after three-week treatment, without anastomotic stoma fistula. And they got good quality of life after 30, 21 and 11 months’ follow-up, no recurrence or metabasis was found. Conclusion The left main bronchus root prolongation can preserve the left lateral wall, however, part of the tracheal mucous membrane and arteria trachealis can be protected without injury. It’s benifit for making productive cough and lowering complications after operation. The new carinal reconstruction process has definite indication, which refer to patient with normal left main bronchus root and the right inferior segment trachea involved by carcinoma

Small interference RNA targeting tissue factor inhibits human lung adenocarcinoma growth in vitro and in vivo

<p>Abstract</p> <p>Background</p> <p>The human coagulation trigger tissue factor (TF) is overexpressed in several types of cancer and involved in tumor growth, vascularization, and metastasis. To explore the role of TF in biological processes of lung adenocarcinoma, we used RNA interference (RNAi) technology to silence TF in a lung adenocarcinoma cell line A549 with high-level expression of TF and evaluate its antitumor effects in vitro and in vivo.</p> <p>Methods</p> <p>The specific small interfering RNA (siRNA) designed for targeting human TF was transfected into A549 cells. The expression of TF was detected by reverse transcription-PCR and Western blot. Cell proliferation was measured by MTT and clonogenic assays. Cell apoptosis was assessed by flow cytometry. The metastatic potential of A549 cells was determined by wound healing, the mobility and Matrigel invasion assays. Expressions of PI3K/Akt, Erk1/2, VEGF and MMP-2/-9 in transfected cells were detected by Western blot. In vivo, the effect of TF-siRNA on the growth of A549 lung adenocarcinoma xenografts in nude mice was investigated.</p> <p>Results</p> <p>TF -siRNA significantly reduced the expression of TF in the mRNA and protein levels. The down-regulation of TF in A549 cells resulted in the suppression of cell proliferation, invasion and metastasis and induced cell apoptosis in dose-dependent manner. Erk MAPK, PI3K/Akt pathways as well as VEGF and MMP-2/-9 expressions were inhibited in TF-siRNA transfected cells. Moreover, intratumoral injection of siRNA targeting TF suppressed the tumor growth of A549 cells in vivo model of lung adenocarcinoma.</p> <p>Conclusions</p> <p>Down-regulation of TF using siRNA could provide a potential approach for gene therapy against lung adenocarcinoma, and the antitumor effects may be associated with inhibition of Erk MAPK, PI3K/Akt pathways.</p

β-AR Blockers Suppresses ER Stress in Cardiac Hypertrophy and Heart Failure

Long-term β-adrenergic receptor (β-AR) blockade reduces mortality in patients with heart failure. Chronic sympathetic hyperactivity in heart failure causes sustained β-AR activation, and this can deplete Ca(2+) in endoplasmic reticulum (ER) leading to ER stress and subsequent apoptosis. We tested the effect of β-AR blockers on ER stress pathway in experimental model of heart failure.ER chaperones were markedly increased in failing hearts of patients with end-stage heart failure. In Sprague-Dawley rats, cardiac hypertrophy and heart failure was induced by abdominal aortic constriction or isoproterenol subcutaneous injection. Oral β-AR blockers treatment was performed in therapy groups. Cardiac remodeling and left ventricular function were analyzed in rats failing hearts. After 4 or 8 weeks of banding, rats developed cardiac hypertrophy and failure. Cardiac expression of ER chaperones was significantly increased. Similar to the findings above, sustained isoproterenol infusion for 2 weeks induced cardiac hypertrophy and failure with increased ER chaperones and apoptosis in hearts. β-AR blockers treatment markedly attenuated these pathological changes and reduced ER stress and apoptosis in failing hearts. On the other hand, β-AR agonist isoproterenol induced ER stress and apoptosis in cultured cardiomyocytes. β-AR blockers largely prevented ER stress and protected myocytes against apoptosis. And β-AR blockade significantly suppressed the overactivation of CaMKII in isoproterenol-stimulated cardiomyocytes and failing hearts in rats.Our results demonstrated that ER stress occurred in failing hearts and this could be reversed by β-AR blockade. Alleviation of ER stress may be an important mechanism underlying the therapeutic effect of β-AR blockers on heart failure

The Changes of Blood Coagulation in Surgical Patients with Lung Cancer

Background and objective Patients with malignant tumor are at high risk of thrombophilia, which contributes to thromboembolism. Surgical treatment is one of the critical risk factors. In this study, changes and clinical significances of blood coagulation of lung cancer patients pre- and post operation were investigated. Methods A prospective, controlled study were carried out in 74 lung disease patients, who were divided into lung cancer group and benign lung disease group. In each group, pre-and postoperative changes in prothrombin time (PT), activated partial thromboplastin time (APTT), platelet count (PLT), D-dimer (D-D) and fibrinogen (Fib) and clinical performances were observed and compared in intra- and intergroups. Results The concentration of Fib both in lung cancer group and its subgroup (adenocarcinoma of lung) increased, preoperative differences between benign lung disease group and subgroup (squamous cell carcinoma of lung) was significant (P < 0.05). PT(postoperative 1st to7th day) in lung cancer group prolonged, APTT (postoperative 3rd to7th day) reduced, Fib (postoperative 3rd to7th day) and D-D (postoperative 1st to 7th day) increased, PLT reduced on the 1st, 3rd day but then increased on the 5th, 7th day after operation, the difference between pre- and post-operation was significant (P < 0.05). D-D and PT in lung cancer group on the 7th day was longer than in benign lung disease group (P < 0.05). One pulmonary thromboembolism (PTE) case in lung cancer group occurred, while in benign lung disease group none venous thromboembolism (VTE) appeared. Conclusion Patients with lung cancer are in high hypercoagulable state, and prone to VTE. It is necessary to take some interventions to avoid VTE

Development, Application Details, and Prospects of Uni-VATS on Lung Cancer Radical Operation under the Concept of "Precise Medical Treatment"

Uniportal video-assisted thoracic surgery (Uni-VATS) has become one of the most exciting new developments in minimally invasive thoracic surgery in recent 5 years. With the development of better thoracoscopic cameras and the availability of endoscopic linear mechanical staplers, experts in the technique are able to use uniportal VATS to encompass the most complex procedures such as bronchial sleeve/vascular reconstructions or carinal resections. A large number of multi-center reports have confirmed that Uni-VATS lobectomy is safe and feasible; dissected node group number and total number of mediastinal lymph nodes were not less than that of traditional muli VATS; Uni-VATS gained positive results in pain, trauma and recovery time. Although the large sample multi center clinical data, such as the five year survival rate has not yet been obtained, gradually carring out of uni-VATS will be an important direction for the future development of minimally invasive thoracic surgery. This article will focus on the principle of Uni-VATS and the specific operation details, combined with the basic operation concept, with a view to put forward the orderly and standard utilization of the Uni-VATS