Objective To investigate the clinical treatment effect of tubular stomach substitute for esophagus anastomosis in the radical surgery of esophageal cancer.Methods Ninety-seven patients diagnosed with esophageal cancer in the First Affiliated Hospital of Soochow University from June 2013 to June 2015 were selected.They were divided into two groups,51 patients using the gastric tube substitute for esophagus anastomosis in the gastric tube group,and 46 patients using the traditional full stomach substitute for esophagus anastomosis in the whole stomach group.The operation times,intraoperative blood losses,the amount of postoperative gastrointestinal decompression,hospital stays,pathologic stages and incidences of complications after surgery in the two groups were observed and compared.Results There were no preoperative death in the two groups.The gastric tube group took more operating time than the whole stomach group [(287.43 ± 23.64) min vs.(266.13 ±26.47) min],with a significant difference (t =2.279,P =0.031).In the comparison of the amount of gastrointestinal decompression,the gastric tube group was less than the whole stomach group [(1 908.14 ±327.97) ml vs.(2 221.93 ± 323.87) ml],with a significant difference (t =-2.591,P =0.015).There were not significant differences in blood losses [(325.00 ± 64.30) ml vs.(356.67 ± 49.52) ml;t =-1.490,P =0.147],the numbers of lymph nodes [(10.73 ± 4.83) vs.(10.36 ± 5.31);t =0.238,P =0.813],hospital stays [(15.32 ± 3.69) d vs.(16.45 ± 3.80) d;t =-1.005,P =0.320] and pathologic stages (P =0.713) in the gastric tube group and whole stomach group.The incidence of gastroesophageal reflux in the gastric tube group was significantly less than that in the whole stomach group,with a significant difference (1.96％ vs.15.22％;x2 =5.617,P =0.025).The occurrence of the complications like anastomotic leakage (5.88％ vs.10.87％;x 2=0.795,P =0.471),postoperative pulmonary complications (13.73 ％ vs.23.91％;x2 =1.661,P =0.296)and anastomotic stenosis (7.84％ vs.13.04％;x2 =0.707,P =0.510) had no statistical difference in the gastric tube group and whole stomach group.Conclusion In the surgical treatment of esophageal cancer,tubular stomach substitute for esophagus anastomosis is better than the full stomach substitute for esophageal surgery,which can improve the life quality of postoperative patients and is worthy of clinical promotion.

Objective To investigate the effects of Shen-fu injection on pulmonary contusion rabbits. Meth-ods Sixteen rabbits were randomly divided into 2 groups: the treatment group (Shen-fu group) and the control group. The animals were induced the pulmonary contusion models. After 60min, the animals in Shen-fu group re-ceived Shen-fu injection received 5 ml/kg, and those in control group 5 ml/kg LRS. The animals were killed six hours later, the right lung tissue wet-to-dry (W/D) ratio and myeloperoxidase (MPO) activity were obtained,the pro-tein expression of nuclear factor-kappa B (NF-κB) and intercellular adhesion molecule-1 (ICAM-1) were also detec-ted. Results The lung tissue W/D, MPO, and the protein expression of NF-κB and ICAM-1 were decreased evi-dently in Shen-fu group (P<0. 01). The morphologic and ultrastructural damages in Shen-fu group were milder than in control group. Conclusion Shen-fu injection is effective on pulmonary contusion rabbits.

Objective To observe the apoptosis of human large cell lung cancer NCI-H661 cells induced by crotoxin,and to explore its mechanism. Methods The growth suppression of crotoxin on the NCI-H661 cells was detected by CCK-8 colorimetry,and the formation of NCI-H661 cells was observed by the plat colony experiment. This experiment included 4 groups:negative control group,crotoxin group(60 μg/ ml cro-toxin acted for 24 h),crotoxin + SB203580 group(pretreated cells using 5 μmol/ L SB203580 for 1 h,then 60 μg/ ml crotoxin acted for 24 h),SB203580 group(pretreated cells using 5 μmol/ L SB203580 for 1 h,then cultivated cells using complete culture solution). They were detected that the cell cycle and apoptosis rate of NCI-H661 cells treated with crotoxin by the flow cytometry. Additionally,they were tested that the change of the cell cycle and apoptosis rate after the NCI-H661 cells were treated with crotoxin and the activity of p38MAPK was inhibited by SB203580. Results When the concentration of crotoxin was greater than or equal to 30 μg/ ml,the inhibitory effect of crotoxin on the activity of NCI-H661 cells and colony formation,and inhibi-tion rate rose with increasing function of time and drug concentration. Flow cytometry showed that the apoptosis rate of crotoxin group and crotoxin + SB203580 group were(16. 70 ± 1. 38)% and(2. 15 ± 0. 54)% ,com-pared to the control group(1. 47 ± 0. 29)% ,and the former difference was statistically significant and the latter was not statistically significant(t = - 18. 763,P = 0. 000;t = - 1. 935,P = 0. 125). The G1 period cells of crotoxin group and crotoxin + SB203580 group were(57. 25 ± 1. 09)% and(48. 04 ± 1. 03)% ,compared to the control group(47. 46 ± 0. 69)% ,and the former difference was statistically significant and the latter was not statistically significant(t = - 13. 124,P = 0. 000;t = - 0. 809,P = 0. 464). Conclusion Crotoxin can promote the apoptosis of human large cell lung cancer NCI-H661 cells,and this effect may be related to the excitation of p38MAPK signal pathway.

OBJECTIVE To summarize the experience of prevention and treatment of the deep fungal infection after thoracotomy.METHODS To enhance the prevention of the deep fungal infection after thoracotomy.To watch out for the change of postthoracotomy symptom,when doubtful clinical symptom appeared in the susceptible sufferersand to track the result of culture and adopt early experiential antifungal medication to treat.RESULTS Out of 38 patients 33 were cured,5 were died(13.16%).CONCLUSIONS To enhance the prevention of the deep fungal infection after thoracotomy,the early diagnosis and treatment with experiential antifungal medication are the important measures to improve prognosis in the patients with postthoracotomy infection of deep fungi.

Objective To compare the efficacies of the treatment of sternal fracture with wire fixation and the titanium sternal fixation system. Methods Thirty patients with sternal fracture from May 2003 to July 2009 were followed up. Among them,there were 20 patients with wire fixation (wire fixation group), 10 patients with the titanium sternal fixation system (titanium sternal fixation system group). The conditions before, during and after operation,complications and effects were compared to evaluate the effieaeies of titanium sternal fixation system. Results The operative time of titanium sternal fixation system group and wire fixation group were (67.0 ± 7.9) min and (90.0 ± 8.6) min, the blood loss were (11.0 ± 5.4) ml and (48.0 ± 8.4)ml,the duration of drainage were (0.5 ± 0.4) days and (1.9 ± 0.7) days,the amount of drainage were (1.9 ± 1.3) ml and (19.0 ± 4.6) ml, the average hospitalized days were (2.3 ± 0.5) days and (6.9 ± 0.9) days, the duration of pain were (1.5 ± 0.5) days and (3.8 ± 1.1) days, there were all significant difference between two groups (P < 0.05). The rates of wound infection, delayed union or nonunion, re-fracture,plate fracture or plate shift of wire fixation group were 5% (1/20) ,5% (1/20) ,5% (1/20), 10% (2/20). But the rates of titanium sternal fixation system group were 0, there were all significant difference between two groups (P < 0.05). Conclusion The treatment of sternal fracture with titanium sternal fixation system is a simple and stable fixation,high bone union rate and few complications,especially for the sternal fracture.

As an extension of the structure-based drug discovery, fragment-based drug discovery is matured increasingly, and plays an important role in drug development. Fragments in a small library, with lower molecular mass and high "ligand efficiency", are detected by SPR, MS, NMR, X-ray crystallography technologies and other biophysical methods. Then they are considered as starting points for chemical optimization with the guidance of structural biology methods to get good "drug-like" lead and candidate compounds. In this article, we reviewed the current progress of fragment-based drug discovery and detailed a number of examples to illustrate the novel strategies.

Background and objective Video-assisted thoracoscopic surgery (VATS) lobectomy is now generally accepted for patients with lung cancer. hTe aim of this study is to review the technology of thoracoscopic lobectomy with single utility port in the treatment of peripheral lung cancer. Methods We retrospectively analyzed the clinical data of 87 patients with peripheral lung cancer who underwent single utility port complete VATS lobectomy from February 2011 to January 2013 in the First Affliated Hospital of Soochow University (single utility port group), and compared them with 75 patients with peripheral lung cancer who underwent conventional, 3-port VATS lobectomy in the same period (3-port group). hTe clinical outcomes including operation time, time to ifrst activity out of bed, postoperative hospital stay, intraoperative blood loss, post-operative drainage volume, chest drainage duration, lymph node dissection number, postoperative complications and degree of chest pain were compared between the two groups. Results No perioperative death was observed in both groups. hTere was no statistical difference in operation time (151.03±25.97 min vs 156.27±26.49 min), lymph node dissection number (13.06± 1.36 vs 12.61±1.56), intraoperative blood loss (188.62±47.03 mL vs 179.60±28.96 mL) and incidence of serious postoperative complications (18/87 vs 21/75) between the two groups. hTere were statistical differences in time to ifrst activity out of bed (11.17±8.69 h vs 13.76±7.43 h), postoperative hospital stay (7.18±1.95 d vs 7.92±2.03 d), chest drainage duration (3.85±1.21 d vs 4.43±1.43 d) and total postoperative drainage volume (671.49±178.31 mL vs 736.93±170.39 mL) between the two groups (P<0.05). hTe change of vision analogue score (VAS) score between the two groups atfer operation was also statistically sig-niifcant (P<0.01). Conclusion hTe completely thoracoscopic lobectomy with single utility port is a safe and feasible surgical procedure compared with conventional 3-port VATS lobectomy for selected patients.

Background and objective Video-assisted thoracoscopic surgery (VATS) lobectomy is generally ac-cepted for patients with lung cancer. hTe aim of this study is to explore the feasibility of the single-operation-hole thoraco-scopic lobectomy in the treatment of non-small cell lung cancer. Methods To review and analyze the single-operation-hole thoracoscopic lobectomy performed in our hospital for 113 non-small cell lung cancer (NSCLC) cases from October 2010 to October 2013. hTe incision for observation was 1.5 cm the eighth intercostal at the rear of the midaxillary line and the incision for operation was 2.0 cm-4.0 cm at the fourth or iftfh intercostal of the anterior axillary line. hTe operations were performed through the single-operation-hole. Result hTe operation processes were smooth for all the patients without any operative mor-tality occurrence. Only in 5 cases was the operation hole expanded because of the occurrence of massive hemorrhage during the operation;3 patients with postoperative complications underwent thoracoscopic lobectomy again, including 2 cases of de-layed hemorrhage and 1 case of chylothorax. hTe average surgical duration was (178.24±31.17) min, the average blood loss was (213.56±62.38) mL, and the number of lymph nodes dissected was from 5-22. All diagnose were conifrmed by pathology atfer operation. hTe average length of stay was (8.17±2.93) d. All cases recovered well during the follow-up of (2-38) months, only 5 cases had recurrence or metastasis. Conclusion hTe single-operation-hole thomcoscopic lobectomy for lung cancer is safe and feasible, further reducing the trauma, and can be used as a conventional treatment for early-or medium-term NSCLC.