Objective The aim of this study is to evaluate whether video -assisted thoracoscopic surgi-cal( VATS) lobectomy is as effective as open thoracotomy lobectomy for complete dissection of the mediastinal lymph node(MLN).Methods Patients with clinical stage N0 lung cancer who underwent lobectomy between January 2008 and June 2013were retrospectively evaluated based on the LN station resected and lobectomy proce -dure used,and a resection ratio was calculated .Nodal stage and the proportion of patients ,from whom at least three MLNs and station 7were dissected and compared by lobectomy type .Results Of the 201 patients enrolled in the study,84 and 117 underwent VATS and open thoracotomy lobectomies ,respectively.The mean number of LNs dissected at station 3a was similar in the two groups (1.34 ±2.58 vs.1.52 ±1.78;P>0.05),but the re-section ratio differed(39%sv .63%;P <0.05).However,there were no differences at stations7 and 9R in terms of the number of LNs dissected or resection ratio for the right -sided approaches (P >0.05).There were no differences in the number of LNs dissected or resection ratio between the two groups for stations 4 L,5 L6, L,7 L, and9 L for the left-sided approaches .Only station 8L showed significant differences between the VATS and open thoracotomy groups in the number of LNs dissected (0.12 ±0.44 vs.0.46 ±0.71;P<0.05)and resection ratio (8%vs.36%;P<0.05).There were no differences in the number of LNs dissected or resection ratio between groups for station 7:82.1%of patients in each group had at least three MLNs and station 7 removed(P>0.05). The Kaplan-Meier 5-year survival was also similar between the two groups (log-rank test,P>0.05).Con-clusion VATS lobectomy is as effective as open thoracotomy lobectomy for the dissection of MLNs .Thus,VATS lobotomy resection will continue to be offered as the best choice for patients with clinical stage N0.

Objective To analyze the MRI data of misdiagnosed and missed diagnosed of breast lesions and their histopathological features.Methods Data from 241 breast lesions within 121 patients were recruited in this study.The data included MRI images,uhrasounds and X-ray images were retrospectively interpreted by two radiologist and each lesion was assessed according to the BI-RADS classification.The pathologic features of miss or error diagnosed lesions on MRI were analyzed.Results In 241 breast lesions (malignance 120,bcnign 121),4 lcsions were miss diagnosed on MRI.Thcy were 2 intraductal papillomatosis and 2 fibroadenoma.All was benign.Twenty three lesions were misdiagnosed on MRI.Sixteen were overestimation,including 3 chronic inflammations,3 sclerosing adenosis,2 fibroadenoma,4 fibrocystic changes with or without atypical ductal hyperplasia (ADH),2 intraductal papilloma,1 infiltration of pectoralis major muscle and 1 axillary lymphnode metastasis.Meanwhile,there were 7 lesions were underestimation.These lesions included 2 invasive ductal carcinomas,1 mucinous adenocarcinoma,2 DCIS and 1 blunt duct adenosis with ADH and focal cancerous,1 inflammatory breast cancer underwent chemotherapy.The sensitivity and specificity and accuracy of breast MRI were 95.83 ％ (115/120),72.73 ％ (88/121),84.23 ％ (203/241),respectively.MRI findings had no difference with respect to mammogram or ultrasound was 75.10 ％ (181/241).Conclusion MRI misdiagnosis and missed often occurs in smaller breast lesions,morphologic and hemodynamic malignant manifestation atypical,especially intraductal lesions.MRI diagnosis should be combined with physical examination,X-ray mammogram and ultrasound to improve diagnostic accuracy and reduce missed diagnosis.

Objective To study the protective effect of(-)clausenamide on the damage of PC12 cells induced by serum deprivation and to explore its related mechanism. Methods The cell viability was detected by MTT assay and morphological observation. The effect of(-)clausenamide on the PC12 cell apoptosis was analyzed by flow cytometry. Then western blotting and confocal microscope was used for the further study of effect of(-)clausenamide on the protein expression of GSK-3?,Bax and Bcl-2. Results(-)Clausenamide remarkably increased PC12 cell survival rate through inhibiting the PC12 cell apoptosis induced by serum deprivation at the concentration of 1 or 10 ? mol/L(P

Aim To study the effect of synapsinⅠon synaptic transmission in rat dentate gyrus induced by(-) clausenamide.Methods The basal synaptic transmission experiment was conducted through electrophysiological recordings.The effect of(-) clausenamide on synapsinⅠ phosphorylation was measured by western blot and confocal microscopy.Results(-)Clausenamide increased the population spike(PS) of hippocampal dentate gyrus.The phosphorylation of synapsinⅠ was increased both in cortex and hippocampus,the maximum effect was observed at 5 min in hippocampus and at 15 min in cortex.Furthermore,(-)clausenamide promoted the phosphorylation of synapsinⅠat a dose-denpendent manner in PC12 cells.The phosphorylation of synapsinⅠ in PC12 cells and synaptosomes incubated with(-)clausenamide was increased and reached maximum at 1~2 min.However,H89,PKA inhibitor,blocked the effect of(-)clausenamide on synapsinⅠ phosphorylation.Conclusion(-)Clausenamide activated synapsinⅠ via PKA signal pathway,which may contribute to the effect of(-)clausenamide on potentiating basal synaptic transmission.

To observe the effect of various doses of oil of Piper longum unsaponifiable matter (OPUM) to cholesterol gallstones in experimental mice. C57BL/6 mice (n = 60) were randomly divided into 6 groups: control group, model group, OPUM (15, 30 and 60 mg x kg(-1)) group and ursodeoxycholic acid (UDCA, 60 mg x kg(-1)) group, administered for 10 weeks. The level of serum lipid and liver function enzymes were tested. The gallbladder was removed and bile was obtained by centrifugation. Next, the levels of the bile total cholesterol (TC), phospholipid (PL) and bile acid (TBA) were measured. The indicators of lipid peroxidation were determined and cholesterol saturation index (CSI) was calculated. The liver histological changes were observed by HE staining. The results showed that serum TC, TG (triglycerides) and AST (aspartate transaminase) contents, gallbladder cholesterol crystallization and CSI increased significantly (P < 0.05). In addition, the activity of SOD decreased significantly and MDA content increased significantly in liver (P < 0.05). HE staining results showed that the hepatic cord disorder and intracellular lipid droplets increased significantly. All results indicate that lithogenic diet lead to the formation of cholesterol gallstones. In OPUM (30 and 60 mg x kg(-1)) group, serum TC, TG and AST content, gallbladder cholesterol crystallization and CSI decreased significantly, the activity of SOD increased significantly and MDA content decreased significantly. HE staining results showed that OPUM can improve the morphology of liver cell, reduce the degree of hepatic cord disorders and restore the cell morphology close to normal. The cause of OPUM prevents cholesterol gallstone formation maybe due to protect the integrity of the liver cells, lower CSI, and reduce cholesterol crystal formation and hence prevent cholesterol gallstone formation.

Objective To evaluate the application of M-mode echocardiography and Doppler echocardiography in diagnosing complete atrioventricular block (CAVB) in fetus. Methods M-mode and Doppler echocardiography were used to screen the fetuses and bradycadia was established as CAVB in 10 cases. Atrial and ventricular rhythm was measured by M-mode echocardiography. Flow of mitral valve, left ventricular in-flow and out-flow tract, venous duct was measured by Doppler echocardiography. The characteristics and prognoses of CAVB fetus were compared and analyzed. Results CAVB was established as independence in rhythm of atrium and ventricle. The rhythm of atrium could be in normal range, while the rhythm of ventricle should be slower than normal. Enlarged chambers were observed in 6 cases, cardiac dysfunction in 5 cases, and pericardial effusion in 7 cases. Tricuspid regurgitation and mitral regurgitation existed in 5 and 1 case, respectively. All of the CAVB fetus in this study underwent abortions. Conclusions Fetal echocardiography is proven to be a useful tool to diagnose CAVB, which greatly influenced the cardiac function in fetuses. Clear diagnosis as early as possible is crucial to the treatment of CAVB fetus.

Objective To observe the effects of ketamine on the behavior and indoleamine 2,3-dioxygenase (IDO ) signaling pathway in the rats with pain and depression comorbidity. Methods Twenty-four male adult SD rats,aged 2 months,weighing 200-250 g,were randomized into three groups:control group (group S),saline group (group N)and ketamine group (group K), eight in each group.CFA (50 μl)was injected into the right tibiotarsal joint cavity to establish the model of pain and depression comorbidity in the groups N and K,whereas saline (50 μl)was injected in the group S.The mechanical withdrawal threshold (MWT)and the immobility time were measured 1,7,and 14 days after the CFA injection.After the behavioral tests 14 days after the CFA injection, saline (1 ml)was intraperitoneal administrated in the group N and ketamine 20 mg/kg (1 ml)was in-traperitoneal administrated in the group K 14 days after CFA injection.The MWT and immobility time were measured 1 h after administration in the three groups to evaluate the behavioral changes. Then,the hippocampus,prefrontal cortex,cingulated gyrus and plasma were harvested to determine the levels of IL-6 and IDO using an enzyme-linked immunosorbent assay after the behavioral tests. Results Compared with the group S,the MWT was decreased and the immobility time was signifi-cantly increased in the group N and group K (P <0.05).Compared with the group N,the MWT was increased (P <0.05),the immobility time was decreased (P <0.05),and the levels of IL-6 and IDO in the hippocampus,prefrontal cortex and cingulated gyrus were significantly decreased in the group K (P < 0.05 ).Conclusion Ketamine can effectively treat pain and depression comorbidity,which may be attributed to the inhibition of IDO signaling pathway in different brain regions of rats.

Objective To comparatively analyze the domestic and foreign sicentific product, academic impact and cooperation in toxicology from 1980 to 2015.Methods The countries, Chinese scientific research institutions and authors engaged in research of toxicology were analyzed according to the InCites-covered number of published pa-pers, cited papers and collaborations .The highly cited papers covered in Web of Sciene were analyzed by biblio-metric analysis.Results The number of papers on toxicology published by USA, Britian and Japan was greater than that published by other countries.The number of papers on toxicology published by China increased significantly and their academic level was notebly improved.Conclusion China should strengthen the subject system construc-tion, attach importance to frontier and retrospective analysis and international cooperation, speed up the develop-ment of toxicology and improve the academic level of its scientific achievements .

Objective To investigate the factors which may affect the secretions of human leptin and free fatty acids (FFA) by measuring plasma glucose, serum insulin, leptin and FFA levels during reduced sample number intravenous glucose tolerance tests (IVGTT) in the subjects with different status of insulin resistance and ? cell function. Methods According to oral glucose tolerance test, 7 normal, 10 overweight/obese individuals, 12 subjects with impaired glucose tolerance (IGT) and 11 with type 2 diabetes mellitus (DM) were recruited. During IVGTT, serum insulin, leptin and FFA levels at 12 time points were simultaneously measured. Results Compared to the stable secretion of leptin, during 180 min in the IVGTT, the FFA secretion showed a "U" shape profile. The correlation analysis showed that the average serum leptin and FFA levels in 3 h were independent to fasting plasma glucose concentration. The partial correlation coefficient of leptin and insulin decreased after being adjusted for FFA (before r=0.77, P0.05). Conclusion The changes of serum FFA levels in IVGTT are more significant than those of leptin after glucose loading. Fasting plasma glucose levels do not significantly affect the average serum levels of leptin and FFA. On the contrary, insulin manifests such action but does not affect the secretion profile of these parameters.

Objective To explore the relationship between serum leptin level and the hypothalamuspituitary-gonad ( HPG) axis in female adolescents with anorexia nervosa ( AN). Methods Sixteen newly diagnosed female adolescents with AN in Shanghai and Zhejiang province were investigated, and their serum leptin, FSH, LH and body composition were measured before and after 18 weeks treatment, and their menorrhea cycles were observed. The rhythm of 24 h serum leptin secretion was studied in 4 patients with AN. Twenty-six, healthy females with normal weight and without contraceptive medication were studied as controls. Results (1) All of 16 patients had amenorrhea, 3 primary amenorrhea and 13 secondary amenorrhea. At admission LH in 14 patients and FSH in 12 patients were below the low limit of the normal reference range (1.5 U/L and 4. 6 U/L respectively), and among them 5 patiend had both 15% weight gain and significantly increased serum leptin level (P