Objective To investigate the feasibility of mini-incision muscle-sparing thoracotomy for pulmonary diseases. Methods The operation was performed through a subaxillary mini-incision along the 5th,6th,or 7th intercostals space and 8.5~13.5 cm in length.The latissimus dorsi muscle was pressed backwards,and the serratus anterior muscle was opened along the direction of muscle fibres.The intercostal muscles and the pleura were cut through along the midline between the two adjacent ribs or the superior border of the rib,for the resection of pulmonary benign or malignant lesions.Results The operation was successfully accomplished via mini-incision thoracotomy in all the 38 cases,including 17 cases of wedge resection,1 case of lesion resection of pulmonary sequestration,18 cases of lobectomy,1 case of lower right lobectomy,and 1 case of left total pneumonectomy.The duration of procedure was 50~150 min(mean,96 min),and the intraoperative blood loss was 100~400 ml(mean,220 ml).No complications were seen.Pleural effusion developed in 1 case postoperatively,and then subsided after drawing-off of fluid.Conclusions The mini-incision muscle-sparing thoracotomy has advantages of clear exposure and minimal invasion.But this procedure is not advisable in patients scheduled for a re-operation or with extensive pleural adhesion or tumor involvement to the chest wall.

Objective To evaluate the clinical value of high thoracic washing in leakage of thoracic esophageal anastomosis.Methods 16 cases of anastomosis leakage after esophageaoctomy were treated with high thoracic washing.Results 13 of 16 patients were cured,with a cure rate of 81.25% and the average hospital time of 46 days.One patient died of bleeding and one died of lung infection and respiratory failure.The other one gave up therapy and discharged selfishly.Conclusion High thoracic washing in treating leakage of thoracic esophageal anastomosis is a reliable way with effect,simple procedure and less complication

A new triterpene ester,α-amyrin caffeate(1),was isolated from the seeds of Impatiens balsamina L.

Objective To investigate the effects of nuclear factor κB(NF-κB) antisense oligodeoxynucleotides (AS-ODNs) on transforming growth factor β1 (TGF-β1)-induced epithelial mesenchymal transition (EMT) in human renal tubular epithelial cells. Methods NF-κB AS-ODNs were transferred into the human renal tubular epithelial cells (HK-2), and the cells were stimulated by 10 μg/L TGF-β1 for 24 hours. The expression of NF-κB mRNA and α-SMA mRNA were measured by RT-PCR. α-SMA protein expression was assessed by fluorescence spectrum.Results TGF-β1 significantly up-regulated the expression of NF-κB mRNA, which was 8 folds of blank control (P<0.01). TGF-β1-indueed epithelial mesenchymal transition was inhibited by NF-kB AS-ODN and the NF-KB mRNA expression of AS-ODNs was decreased by 75%(P<0.05).The expression of α-SMA mRNA and protein was also down-regulated obviously (P<0.05).Conclusion NF-κB AS-ODN can inhibit the expression of NF-κB and the epithelial-mesenchymal transition, which may be a new therapeutic strategy against tubulointerstitial fibrosis.

Intravoxel incoherent motion (IVIM) can distinguish the molecular diffusion from the pseudo-diffusion of microcircular perfusion to obtain true diffusion coefficient (D),pseudo-diffusion coefficient (D*) and perfusion fraction (f),which are sensitive to detect alterations in cellularity and microcirculation perfusion.IVIM can also evaluate early therapeutic effects,optimize treatment plan,predict prognoses,and provide information for choosing appropriate treatment methods.In this paper,the principle of IVIM and its application in tumor response evaluation were reviewed.

Objective To study the changes of cytokines in aqueous humor of patients with proliferative diabetic retinopathy (PDR)after intravitreal bevacizumab (IVB) and the correlation of these cytokines.Methods Fifty-six patients(63 eyes) with severe PDR underwent pars piana vitrectomy (PPV) with IVB pretreatment in our hospital from April,2014 to February,2015 were collected.All the patients received IVB therapy from 3 days to 7 days before PPV.Aqueous humor samples were collected at the time of IVB and PPV treatment.The concentrations of vascular endothelial growth factor (VEGF),interleukin-6 (IL-6),interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1) were measured by cytoinetric bead array (CBA).The changes of these cyto-kines after IVB were analyzed by using Wilcoxon rank sum test for paired data.The correlation between these cytokines was analyzed by using Spearman rank test.Results From 3 days to 7 days after IVB,the concentration of VEGF in aqueous humor was (6.57 ± 12.29)pg · mL-1,lower than the pre-operation of (278.71 ±340.20)pg · mL-1,the difference was statistically significant (P ＜ 0.05).The concentration of IL-8 was (385.60 ± 1099.47) pg · mL-1,higher than pre-operation of(298.87 ± 1005.79) pg ·mL-1,the difference was statistically significant (P ＜ 0.05).IL-6 and MCP-1 were increased after IVB,but the difference was not statistically significant (all P ＞ 0.05).VEGF,IL-6,IL-8 and MCP-1 had an obviously relationship between each two factors(all P ＜ 0.05).Conclusion Angiogenesis in patients with PDR are regulated by a variety of cytokines,and targeted reduction of VEGF may compensatory increase the concentration of other inflammatory cytokines.

Objective To investigate the incidence and risk factors of acute kidney injury (AKI) after craniocerebral injury.Methods A single cohort of 791 patients who suffered from craniocerebral injury from January 2008 to January 2010 in the Second Hospital of Lanzhou University were prospectively analyzed.Craniocerebral injury was defined according to definite medical history of craniocerebral injury,the verification of CT and Glasgow coma scale (GCS) score.AKI was defined as a relative 50％ increase or an absolute increment of 26.4 μmol/L in Scr within 48 hours and/or urine volume ＜0.5 ml·kg-1·h-1 up to 6 h.Multivariate Logistic regression analysis was used to evaluate possible risk factors associated with post-craniocerebral injury AKI.Results Of the 791 patients,the incidence of AKI was 39.4％.In hospital mortality of AKI patients was 27.9％,which was 5.065 times of non-AKI patients (P＜0.01).The incidence of AKI in patients with lower GCS score (≤8 score,heavy group)was 69.7％,which was significantly higher as compared to moderate and mild groups (P＜0.01).Unconditional multivariate Logistic regression analysis revealed that lower GCS score (≤ 8 score),hypotension (systolic pressure＜90 mm Hg),elderly and male were the independent predictors of AKI episodes,the corresponding OR values were 2.932,2.176,1.789,1.544 respectively.Conclusions AKI is a common complication after craniocerebral injury.Lower GCS score,hypotension,elderly and male are the independent risk factors of AKI in patients after craniocerebral injury.

Objective To investigate the characteristics and risk factors of anemia in renal transplant recipients over 60 years old.Methods Clinical data of one hundred and sixty-eight renal transplant recipients over 60 years old were retrospectively analyzed.Logistic regression analysis was used to determine the risk factors of anemia.Results In 168 cases of renal transplant recipients,the incidence of anemia was 45.2％(76/168).Forty cases were normocyte and normochromic,26 cases were microcytic hypochromic,10 cases were hemolytic anemia.In these anemic recipients,51 cases were short of erythropoietin (EPO),25 were EPO resistance.The incidence of malnutrition and cardia-cerebrovascular complication was higher in recipients with anemia than those without anemia (P＜0.01).The incidence of anemia in CsA+Aza+Pred treatment was 57.1％,which was significantly higher as compared to other three treatments (P＜0.01).Unconditional multivariate Logistic regression analysis revealed that male,creatinine level,acute reject reaction,delayed graft function (DGF) were the independent predictors of anemia,the corresponding OR values were 1.089,5.156,6.345,1.876.Conclusions Anemia is a common and serious complication in renal transplant recipients over 60 years old.Male,creatinine level,acute reject reaction,DGF are the independent risk factors of anemia in renal transplant recipients over 60 years old.

Objective:This paper analyzes the factors influencing the development of discipline construction in a tertiary specialized hospital, explores discipline improvement measures, so as to provide possible references for other medical institutions.Methods:Taking Henan Eye Hospital as an example, we analyze the current status of discipline construction, review the managing practice for the development in recent years, find out the factors influencing the development of disciplines and new challenges, and puts forward improvement measures.Results:The managing practice showed that the affecting factors of discipline construction included discipline orientation, talent teams, original innovation, medical level, academic exchanges and research platforms. Facing to the new problems under the further goal, to figure out the novel way is a guarantee for the smooth development of the medical institute.Conclusions:These measures may foster the development of discipline construction, which include focusing on discipline direction, strengthening the construction of talents, encouraging scientific and technological innovation, developing medical services, deepening the domestic and international cooperation and exchange and constructing platforms. It is important to achieve high-quality development of high-level specialized medical institutions for reaching the goal of health for all citizens.

Objective To prospectively evaluate the short-term test-retest reproducibility of intravoxel incoherent motion (IVIM) parameters for lung cancer,and to investigate its impact factors.Methods Thirty-eight lung cancer patients underwent twice free breathing IVIM scanning (0.5-1.0 h interval).Two radiologists independently analyzed IVIM images to obtain true diffusion coefficient (D),pseudo-diffusion coefficient (D*) and perfusion fraction (f).All the parameters were compared between repeated measurements and scans.Intra-and inter-observer,test-retest reproducibility was assessed with interclass correlation coefficients (ICCs).The impact of lung cancer type (peripheral and central),size (the largest diameter ≥2 cm and ＜2 cm) and location (upper,mid,and lower lung field) on short-term reproducibility were compared by using coefficient of variations (WCVs).Results There was no significant difference between repeated measurements for all parameters (all P＞ 0.05).All the parameters showed good intra-and inter-observer agreement.WCVsof D* and f (19.88％-36.83％) were higher than those of D (2.97％-4.62％).WCVs of D were higher for central lung cancer and the largest diameter ＜2 cm,and increasing from apical to lower zone.WCV of f was larger in the central lung cancer and the largest diameter ≥2 cm,while D* was greatly influenced by type,size and location of lung cancer.Conclusion The test retest reproducibility of D is good,while of D* and f are poor in lung cancer.The type,size and location of lung cancers are the impact factors of IVIM parameters.