ObjectiveTo observe repairing process of trachea epithelium cells in chlorine-induced airway epithelial injury.MethodsTwelve mice were exposed to chlorine gas and prepared the mice model of airway damage. Three mice were executed respectively on 2nd, 4th, 7th, 10th day after exposure to chlorine gas, and tracheal tissues were collected. In addition 3 normal mice served as control. Airway repair and cell proliferation were detected by EdU labeling method. The basal cell markers keratin 5 (K5), keratin 14 (K14) were adopted as the tracheal epithelial markers for locating the position of the proliferation of repairing cells. Morphological analysis was adopted to measure the proliferation rate as well as the recovery of the false stratified epithelium.ResultsIn the control group, cell proliferation rate was very low, all basal cells expressed K5, and most basal cells did not express K14. Most of epithelial cells shed from the trachea epithelium after exposure to chlorine gas. 2-4 days after chlorine exposure, K5 and K14 expression basal cells increased, K14 expression cells increased greatly. In the peak period of cell proliferation, only a small number of ciliated cells appeared in the repairing trachea area. Epithelial cells repaired fast and widely at the bottom of the trachea.ConclusionThe trachea residual basal cells play roles of progenitor cells and repair the airway epithelium after chlorine damage in mice.
Abstract： Objective To compare clinical outcomes and postoperative quality of life （QOL） of difference surgical strategies for patients with esophagogastric junction （EGJ） cancer， and investigate the best surgical strategy. Methods A total of 148 patients with EGJ cancer underwent surgical treatment in Xuzhou First People’s Hospital from July 2007 to October 2011. There were 111 male patients and 37 female patients with an average age of 64 （47-77）years. All the patients were divided into 3 groups according to different surgical strategies for them based on their respective preoperative assessment and tumor invasion degree. In group A， 81 patients underwent proximal subtotal gastrectomy and subaortic gastroesophageal anastomosis. In group B， 20 patients underwent total gastrectomy and esophagojejunostomy. In group C， 47 patients underwent proximal subtotal gastrectomy and jejunal interposition. Postoperative mortality and morbidity were compared among the three groups. Cancer metastasis rate and 1-year survival rate were also compared among the three groups. QOL questionnaire （EORTC QLQ C-30 and tumor specific module QLQ-OES24） was used to evaluate patients’ QOL during follow-up. Results There was no statistical difference in postoperative morbidity （P=0.762）and mortality （P=0.650）among the three groups. There was no statistical difference in cancer metastasis rate at 1 year after surgery among the three groups （P=0.983）. One-year survival rate was 100% in all the three groups. At 1 year after surgery， physical functioning score （P=0.037，0.000） and global health score （P=0.035，0.006） of group A and group C were significantly higher than those of group B， and there was no statistical difference in physical functioning score and global health score between group A and group C （P＞0.05）. Emotional function score of group B was significantly lower than that of group C （P=0.015）. Fatigue score （P=0.040，0.006）， anorexia（P=0.045，0.025）， nausea and vomiting symptom score （P=0.033，0.048） of group A and group C were significantly lower than those of group B. Pain score of group A was significantly lower than that of group C （P=0.009）. Insomnia score of group A was significantly higher than that of group C （P=0.028）. Reflux score of group A was significantly higher than that of group B and group C （P=0.025，P=0.021）. Conclusion Postoperative QOL in patients with EGJ cancer who undergo total gastrectomy is comparatively unsatisfactory. Proximal subtotal gastrectomy and jejunal interposition can significantly improve postoperative QOL. Postoperative QOL evaluation is helpful to choose better surgical strategies for patients with EGJ cancer.