Objective To explore the feasibility and advantage of the small figure-L unilateral transternal incision for the treatment of anteri or mediastinal tumor. Methods Twenty-four patients with anteri or mediastinal tumor were enrolled in the study. Under general anesthesia, after a 6 to 10 cm midline skin incision was made, a unilateral figure-L partial ste rnotomy on the side occupied by the tumor was made in the second or third interc ostals space, taking into account the tumor size and location. Tumors were resec ted with excellent exposure. Results All tumors were completely resected during the operation. In 8 cases, tumors encroached on the adjacent lu ng tissue, and lung tissue was partially resected. In 6 cases, tumors invaded th e pericardium, and the pericardium was partially removed. Mean operating time wa s 106 minutes (80~125 minutes). The mean time of hospital stay was 5 days after the operation, and there was no complication. All patients were alive with a mea n follow-up period of 14 months (3~24 months). Conclusion The figure-L unilateral mini-sternotomy is considered as an effective and useful mi nimally invasive approach for anterior mediastinal tumors.

Objective To explore the lived study feeling and experience of nursing upgrade students during blended learning model so as to provide the evidence of reforming teaching model of nursing educators.Methods Phenomenological research of qualitative research was used.Four focus groups,25 upgrade nursing students were interviewed in-depth.Results Six themes were sublimated:relief the contradiction between work and study,promote communication in double interaction,improve self-learning ability,improve selfconfidence as learning controllability,online courses lack a sense of belonging,lack of skills support.Conclusions Blended learning model meets students,needs,provides students with personalized learning and improves comprehensive quality.However,the development of blended learning model in China is in the primary stage,we should combine conditions and reference foreign experience to develop it.

80mg, P7 days, P 0.05) .The immunopotentiators could increase the morbidity of psychotic reactions .CONCLUSION: Overdose and long - course of glucocorticoid therapy may increase the morbidity of the psychotic adverse effects.

Objective To explore the measures and methods to cope with the early stage epidemic struck of H7N9 avian influenza,as the head nurses of the department of infectious diseases.Methods The main work focus of the head nurses of the department of infectious diseases were analyzed during the early stage of H7N9 epidemic struck systematically by reference to the domestic literatures.Results At the early stage of H7N9 epidemic struck,the main work focus of the head nurses of the department of infectious diseases was to draw up every emergency plans,prepare necessary protective medical supplies,train medical staff,and be ready to the preview and triage.Conclusions The head nurses of the department of infectious diseases should pay close attention to the progress of H7N9 epidemic struck,and get ready for all related work in order to ensure smooth treatment during early stage of the epidemic struck.

Objective To examine the relationship between CCT 5 ,γδ T cell and autoimmune diseases .Methods Recombinant CCT5 protein was cloned , expressed and purified in E.coli.Three peptides of CCT5 protein were used to prepare for anti-CCT5 monoclonal antibodies .Purified CCT5 protein was used to expand γδT cells from pe-ripheral blood mononuclear cells (PBMC).Plasma level of CCT5 in healthy donors, patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) were detected by ELISA assays .The correlation analysis between plasma CCT5 concentration and the percentage of different subtypes of γδT cells measured by flow cytometry was made . Results The CCT5 gene was amplified by PCR and the length of the target fragment was 1 750 bp.The expressed 65 ku CCT5 protein was purified and validated by SDS-PAGE.Two paired monoclonal anti-CCT5 antibodies were screened to detect CCT5 protein in plasma.Immobilized recombinant CCT5 protein was able to induce specific sig-nificant amplification of peripheral γδT cells.Correlation analysis of 10 healthy donors indicated significant corre-lation between the plasma CCT 5 concentration and the proportion of Vγ9 and Vδ2 γδ T cells.The plasma CCT5 concentration significantly decreased in autoimmune diseases patients , including RA and SLE .Conclusions These data suggest that CCT 5 could be a novel Vγ9δ2 γδT cell-related factor in autoimmune diseases , which deepen the understanding of Vγ9δ2 γδT cell function in autoimmune diseases .

[ ABSTRACT] AIM:To investigate the effect of phycocyanin on the apoptosis of human laryngeal cancer HEP-2 cells and to explore the inhibitory mechanism of phycocyanin to tumor.METHODS:Highly purified phycocyanin was ex-tracted from spirulina.The effects of phycocyanin at different concentrations on the growth of human laryngeal cancer HEP-2 cells were detected by MTT assay.In addition, the cell structures were observed under electron microscope.The cell ap-optosis was analyzed by flow cytometry.The production of reactive oxygen species ( ROS) was measured by flow cytometry. Enzymatic activities of caspase-3,-8 and-9 were measured by chemical colorimatry.The expression of Bax, Bcl-2, Fas, P53, caspase-3 and caspase-9 at mRNA and protein levels was determined by RT-PCR and Western blot.RESULTS:MTT test confirmed that phycocyanin inhibited the cell activity of HEP-2 cells with time and dose dependent manners.The result of electron microscope observation and flow cytometry indicated that phycocyanin induced the apoptosis of HEP-2 cells.The intracellular content of ROS was increased.The activities of caspase-3, -8 and -9 were increased.RT-PCR showed that the mRNA expression of Bax, Fas, P53, caspase-3, caspase-9 was increased and Bcl-2 was decreased.The results of Western blot were consistent with the results of RT-PCR.CONCLUSION:Phycocyanin might induce apoptosis of HEP-2 cells by down-regulating Bcl-2, up-regulating Bax, Fas and P53, and the transduction of apoptotic signals in the human laryngeal cancer cells.

AIM: To investigate the effect of diltiazem on mean pulmonary arterial pressure(mPAP) and nitric oxide synthase(NOS) in arterioles in chronic hypoxic hypercapnic rats. METHODS: Twenty-four rats were randomly divided into three groups: control group(A),hypoxic hypercapnic group(B), hypoxic hypercapnia+ diltiazem group (C), constitutive endothelial NOS(ceNOS) were observed in arterioles of rats using the technique of immunohistochemistry,ceNOS mRNA were observed by the technique of in situ hybridization . RESULTS: (1)mPAP was significantly higher in rats of B group than that of A and C group( P 0 05),but mCAP was lower in rats of C group than that in B group.(2)Light microscopy showed WA/TA (vessel wall area/total area) was significantly lower in rats of C group than that of B group ( P

Objective Toanalyzeclinicalandimagingmanifestationsofaggressiveangiomyxoma(AAM)inthepelvisandperineuminorder tomakeafurtherunderstandingofthisdisease.Methods ThemedicalrecordsofpatientswithAAMinthepelvisandperineum were reviewedfromtheelectronicmedicalrecordsystem.PubMedandChinesebiomedicaldatabaseswerealsosearchedcarefully.Theclinicaland imagingfeaturesofcaseswereanalyzedtogether.Results Accordingtoinclusionandexclusioncriteria,23referenceswereincluded. 62cases(4malesand58females)ofAAMinthepelvisandabdomenwereincluded,with1inourhospitaland61casesintheliterature.The averageagewas39.0±1.2 (range:20-75years).Thetumorslocatedinthepelviccavityfor25cases,intheperineumfor11cases, inthescrotumfor1case,inthepelviccavityandperineumfor25cases.CTimagesshowedtumorswithcysticandsolidcomponents in9cases,nodularenhancementin6cases,andswirlingstrandsorlayeringinternalpatternin21cases;whileMRIimagesshoweda slightlyhyper-intensitylesiononT1andaslightlyhyper-intensitylesiononT2.Lesionsshowedswirlingstrandsorlayeringinternalpatternon MRIenhancementin41cases.Conclusion Theswirlingstrandsorlayeringinternalpatternhaveveryimportantimagingvalueinthediagnosisandthe detectionofrecurrentlesions.

Glioma is the most common primary intracranial tumor. At present, the conventional treatment methods have limited effect and cannot significantly prolong the survival time of patients. Chemokine CCL2 is the most important member of the CC chemokine family, which can regulate glioma angiogenesis, immunosuppression, progression and invasion, and resistance to apoptosis. This article reviews the potential mechanism of CCL2 promoting the malignant progression of glioma, in order to provide new ideas and methods for the targeted therapy of glioma.

Purpose: Cancer stem cells (CSCs) are naturally resistant to chemotherapy, explaining why tumorrelapse frequently occurs after initial regression upon administration of chemotherapeuticagents in most cases. A CSC population characterized by CD13 expression has been identifiedin hepatocellular carcinoma (HCC). In the current study, we aimed to clarify the molecularmechanism by which it escapes conventional therapies. Materials and Methods: Here, we used flow cytometry to examine the percentage of CD13+ CSCs in HepG2 andHuH7 cells after chemotherapy. Using in vitro isotope labeling technique, we comparedmetabolic pathways between CD13+ and CD13– subpopulations. Using co-immunoprecipitationand western blotting, we determined the target expressions in protein levels underdifferent conditions. We also performed immunohistochemistry to detect the target proteinsunder different conditions. Animal models were constructed to verify the potential role oftyrosine metabolism in post-chemotherapeutic relapse in vivo. Results: We observed that quiescent CD13+ CSCs are enriched after chemotherapy in HCCs, andserve as a reservoir for recurrence. Mechanistically, CD13+ CSCs were dependent on aerobicmetabolism of tyrosine rather than glucose as energy source. Tyrosine metabolism alsogenerated nuclear acetyl-CoA to acetylate and stabilize Foxd3, thereby allowing CD13+ CSCscells to sustain quiescence and resistance to chemotherapeutic agents. Conclusion These findings encourage further exploration of eliminating CD13+ cells by targeting specificmetabolic pathways to prevent recurrence in HCCs.