Nowadays, the development of the medical instrument industry makes rapid changes in clinical practice. Hybridization of latest technology is playing an increasingly important role in the diagnosis and treatment of disease. Especially, the trend of the integration of three-channel hybrid technology in diagnosis and treatment of early lung cancer has become increasingly obvious. This paper will focus on the technical advance of the three-channel multi- mirror robot and its application in the diagnosis and treatment of early lung cancer.
Objective To investigate the association of the expression of CD15 mRNA with the invasion and prognosis of hepatocellular carcinoma (HCC) and the expression of nm23H1 mRNA. Methods In situ hybridization and immunohistochemistry methods were used to detect the expression of CD15 mRNA and protein nm23H1 mRNA in HCC.Results In 99 cases of HCC, the positive rate of CD15 mRNA,its protein and nm23H1 mRNA were 38.4%, 36.4% and 76.8%, respectively. The expression of CD15 mRNA was consistent with its protein and negatively correlated with the expression of nm23H1 mRNA. The expression of CD15 mRNA and its protein, nm23H1 mRNA were associated with the invasiveness and metastasis of HCC and the prognosis of HCC patients. Conclusion The detection of CD15 expression could be a new pathological biology index to judge the metastasis and prognosis of HCC.
ObjectiveTo investigate the expressions of Snail and VEGF gene in invasion ductal carcinoma tissues and analyze their clinicopathologic relationship. MethodsThe expressions of Snail and VEGF gene were detected on mammary gland hyperplasia (30 cases), intraductal breast cancer (30 cases), and invasion ductal carcinoma (70 cases) by in situ hybridization， to compare with the expression difference of the two genes in the different pathological changed tissues of mammary gland and among the clinicopathological facters of invasion ductal carcinoma as well as the relationship. ResultsThe expression rate of Snai mRNA in mammary gland hyperplasia， intraductal breast cancer, and invasion ductal carcinoma was 23.3% (7/30)， 46.7% (14/30), and 81.4% (57/70), respectively, there was statistical difference among them (χ 2=32.4, Plt;0.05)； The expression rate of VEGF mRNA in mammary gland hyperplasia， intraductal breast cancer, and invasion ductal carcinoma was 33.3% (10/30)， 50.0% (15/30), and 71.4% (50/70), respectively, there was statistical difference among them (χ 2=13.4, Plt;0.05). The expression rates of Snail mRNA and VEGF mRNA in lymphatic metatasis group were significantly higher than those in no lymphatic metatasis group 〔92.7% (38/41) vs. 65.5% (19/29)， χ 2=8.29, Plt;0.05； 85.4% (35/41) vs. 51.7% (15/29), χ 2=9.42, Plt;0.05， respectively 〕. The expression rates of Snail mRNA and VEGF mRNA in Ⅲ-Ⅳ stage of TNM clinical stage were significantly higher than those in Ⅰ-Ⅱ stage 〔939% (46/49) vs. 52.4% (11/21), χ 2=14.14， Plt;0.05； 81.6% (40/49) vs. 47.6% (10/21), χ 2=8.32， Plt;0.05〕. The expressions of Snail mRNA and VEGF mRNA were related to the expressions of ER, PR, HER-2, and vessel cancer embolus （Plt;0.01）. The expressions of Snail mRNA and VEGF mRNA were not related to age, tumor size, and histological grade (Pgt;0.05). There was a positive correlation between the expressions of Snail mRNA and VEGF mRNA （r=0.67， Plt;0.05）. ConclusionsThe overexpressions of Snail mRNA and VEGF mRNA in invasion ductal carcinoma has a synergetic effect on occurrence and development, therefore, combined detecting the expressions of Snail mRNA and VEGF mRNA are some significance to predict infiltration and metastasis of the invasion ductal carcinoma.
ObjectiveTo investigate the expression and relation of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in rats with diabetic retinopathy.MethodFifty-five Wistar rats were randomly divided into the control group (10 rats), and 1, 3, and 5-month-diabetes group (15 rats in each diabetes group), and the diabetic models were set up. The expressions of VEGF and bFGF were detected by situ hybridation and immunohistochemistry on retinal paraffin sections.ResultsThe results of situ hybridation showed that expression of bFGF was found in 3-month-deatbtes group with the percentage of 77.8%, and 88.9% in 5-month-deatbtes group; the positive expression of VEGF was not found in 3-month-deatbtes group but in 5-month-deatbtes group with the percentage of 66.7%. Immunohistochemistry indicated that the positive expression of bFGF started in 3-month-deatbtes group with the percentage of 55.6%, and 88.9% in 5-month-deatbtes group; the percentage of the expression of VEGF was 33.3% in 3-month-deatbtes group and 88.9% in 5-month-deatbtes group.ConclusionThe expression of VEGF occurs after the expression of bFGF in rats with DR.(Chin J Ocul Fundus Dis, 2005,21:37-40)
ObjectiveTo compare the clinical efficacy of typeⅡhybrid surgery versus Sun’s surgery in treating acute Stanford A aortic dissection. MethodsA retrospective analysis was conducted on the clinical data of patients with acute Stanford A aortic dissection who were treated at the Central Hospital of Wuhan affiliated to Tongji Medical College, Huazhong University of Science and Technology from 2016 to 2022. According to the surgical method, patients were divided into a typeⅡhybrid group and a Sun’s surgery group, and the clinical efficacy of the two groups was compared. ResultsA total of 52 patients were included, with 22 in the typeⅡhybrid surgery group and 30 in the Sun’s surgery group. The typeⅡhybrid group consisted of 18 males and 4 females, with an average age of (58.18±6.00) years, while the Sun’s surgery group consisted of 22 males and 8 females, with an average age of (53.03±11.89) years. All surgeries were successfully completed. There were 4 (13.3%) perioperative deaths in the Sun’s surgery group, including 2 patients of multiple organ failure, 1 patient of paraplegia, and 1 patient of uncontrollable postoperative bleeding. There was 1 (4.5%) perioperative death in the typeⅡhybrid surgery group, who was suspected of acute coronary syndrome and took a loading dose of dual antiplatelet drugs preoperatively. The patient underwent secondary thoracotomy for hemostasis, was re-cannulated during the operation, and finally died of circulatory failure after implantation of intra-aortic balloon pumping. There was no statistical difference in perioperative mortality between the two groups (P=0.381). Compared with the Sun’s surgery group, the typeⅡhybrid surgery group had shorter cardiopulmonary bypass time [153.00 (135.00, 185.25) min vs. 182.50 (166.50, 196.75) min, P=0.013], aortic cross-clamping time [77.00 (70.50, 92.00) min vs. 102.50 (93.50, 109.75) min, P<0.001], postoperative ICU stay [4.00 (2.83, 6.00) days vs. 8.00 (6.38, 11.78) days, P<0.001], postoperative ventilator support time [72.00 (29.50, 93.25) h vs. 87.65 (39.13, 139.13) h, P=0.138], less intraoperative blood loss [(1586.82±209.41) mL vs. (1 806.00±292.62) mL, P=0.004], postoperative 24 h drainage volume [612.50 (507.50, 762.50) mL vs. 687.50 (518.75, 993.75) mL, P=0.409], and shorter postoperative hospital stay [18.00 (13.00, 20.25) days vs. 22.00 (17.00, 29.25) days, P=0.013]. There was no statistically significant difference in the incidence of other early postoperative complications such as secondary thoracotomy for hemostasis, tracheotomy, renal dysfunction requiring dialysis, stroke, and paraplegia between the two groups (P>0.05). ConclusionFor patients with acute Stanford A aortic dissection, typeⅡhybrid surgery is safe and effective; compared with traditional Sun’s surgery, typeⅡhybrid surgery has relatively less trauma, lower incidence of complications, satisfactory short-term results, and further research is needed on long-term prognosis.
ObjectiveTo explore the single-center experience of hybrid therapy in treatment of Stanford type A aortic dissection, and to make a comparison of the clinical results of this hybrid therapy with total arch replacement surgery in the same period.MethodsFrom March 2017 to April 2020, 272 patients with Stanford type A aortic dissection underwent surgical treatment in our center, including 147 patients (126 males and 21 females) who received the aortic arch surgery. Among them, 106 patients underwent replacement of ascending aorta+aortic arch+stent trunk (total arch replacement group), while 41 patients underwent one-stop compound total arch type Ⅱ hybrid surgery (compound total arch replacement group). We tried to identify whether hybrid surgery really simplified total arch replacement surgery of the aortic dissection by comparing the operative mortality, postoperative complication rate, operative time, extracorporeal circulation time, etc.ResultsThere was no statistical difference in preoperative clinical data or death rate between the two groups. However, blood transfusion (6.74±7.35 U vs. 4.65±6.87 U, P<0.05), postoperative respiratory insufficiency [16 (15.09%) vs. 2 (4.88%), P<0.05], and apoplexy [3 (2.83%) vs. 0, P<0.05], paraplegia [2 (1.89%) vs. 0, P<0.05], in the compound total arch replacement group was significantly better than those of the total arch replacement group. The compound total arch replacement group did not shorten the total operation time, but it was significantly better in terms of extracorporeal circulation time (175.50±55.70 min vs. 129.70±48.80 min, P<0.05), aortic block time (103.10±23.70 min vs. 49.70±30.10 min, P<0.05), and the time of stopping the circulation or avoiding stopping the circulation (32.10±7.20 min vs. 0 min, P<0.05). The postoperative mechanical ventilation time was shorter in the compound total arch group (62.60±31.70 h vs. 41.30±32.60 h, P<0.05), and the time of staying in ICU (124.50±61.50 h vs. 63.40±71.20 h, P<0.05) and the postoperative hospital stay (13.50±11.20 d vs. 9.20±7.20 d, P<0.05) were significantly shorter than those in the total replacement group. A total of 138 patients were followed up for 6-38 (15.8±6.4) months. There was no statistical difference in one-year mortality or three-year mortality (P>0.05).ConclusionHybrid surgery shortens extracorporeal circulation time, while reduces or avoids the time of deep hypothermia circulatory arrest, the incidence of complications and the time of hospital stay. In conclusions, hybrid surgery simplifies the arch management of acute Stanford type A aortic dissection.
For observation of the change of transforming growth factor-beta 1 (TGF-beta 1) gene expression in the process of skin wound healing, the following experiments were performed. Sixteen Wistar rats were chosen. At each side of the rat’s back, a 1 cm x 1.5 cm middle-thick skin wound was made. After 3, 6, 9 and 12 days, the specimens were taken from the wounds. For each specimen, half of it was used for RNA extraction, and underwent dot blotting; and the other half was frozen immediately and underwent in situ hybridization. The probes were dig-labeled PDGF-BB cDNA probe and TGF-beta 1 probe. The results showed that TGF-beta 1 gene was expressed mainly in fibroblast, epithelial cell and capillary endothelial cell. The peak of TGF-beta 1 mRNA content was in the 6th day postoperatively. After that, the content of TGF-beta 1 decreased to normal. It was suggested that TGF-beta 1 gene expression was in close relation with healing process. TGF-beta 1 may play an important regulatory role in the skin wound healing.
Kommerell's diverticulum is a rare congenital abnormal aortic development. The diverticulum can occur in both left and right aortic arches, from which an aberrant subclavian artery rises to the contralateral side. Only a small number of patients with Kommerell's diverticulum present symptoms. Dysphagia, dyspnea, chest discomfort and upper extremity blood pressure difference are common in adult patients. The risk of aortic dissection or aortic aneurysm rupture is higher in such patients than that in patients with normal aorta. Early surgical intervention is recommended to improve the prognosis. Treatment options include open surgical repair, hybrid operation and total endovascular repair. The choice of surgical method depends on the specific anatomy of patients, the patients' state and the preference of surgeons. This paper reviewed and summarized the surgical methods and early results of the treatment of Kommerell's diverticulum reported in the literature from 2015 to 2020.
Aortic arch disease is one of the research hotspots and treatment difficulties in the field of aorta, including aortic arch aneurysms, pseudoaneurysm, ulcer, dissection and intramural hematoma. By summarizing the clinical data of the vascular surgery center of Fuwai Hospital of Chinese Academy of Medical Sciences in the past five years and combining with the latest theories of the cutting-edge development of aortic surgery, the authors proposed the "HENDO" concept, including using hybrid technique (H), endovascular repair (Endo) and open surgery (O), properly to treat aortic arch pathologies individually. The authors advocated the establishment of HENDO team and cooperation mechanism in large aortic centers, to eliminate technical shortcomings of a single surgeon by fully mastering the three main technology clusters by teamwork. Accordingly, the best treatment for each patient can be administrated and the survival rate and quality of life can be improved eventually.
Effect of radical operation on expression of interleukin-2(IL-2)mRNA and production of IL-2 were markedly reduced preoperatively and four weeks after operation,expression of IL-2 mRNA significantly enhanced,but it was still lower than that in the normal group.Production of IL-2 nearly reached normal level,When PBL was activated by phytohemagglutinin(PHA),expresseion of IL-2 mRNA and production of IL-2 were much higher than that in non-activated PBL.These results suggested that expression of IL-2 were much higher than that in non-activated PBL.These results suggested that expression of IL-2 mRNA and production of IL-2 are dificient in gastric cancer patients,and radical surgery will help them to recover and they can also be improved through activation with PHA.