Objective To compare the short-term perioperative outcomes of video-assisted mini-thoracotomy(VAMT),multiple port-video-assisted thoracoscopic surgery(MP-VATS)and single utility port-VATS(SP-VATS)in treatment of early stage non-small cell lung cancer(NSCLC).Methods A total of 157 cases of early stage NSCLC patients were collected and divided into three groups:66 cases received VAMT treatment as group VAMT;45 cases received MP-VATS treatment as group MP-VATS;46 cases received SP-VATS treatment as group SP-VATS.The intraoperative and postoperative conditions,lung function indexes including forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and maximal voluntary ventilation(MVV)among the groups were compared.Results There were no significant differences in the operation time and the number of lymph node dissection among the SP-VATS group,MP-VATS group and group VAMT[(154.89±32.34)min vs(158.43±36.78)min vs(161.21±40.02)min,(12.34±4.55)pieces vs(12.47±3.81)pieces vs(11.78±3.32)pieces,P>0.05];the incision length,blood loss,amount and time of postoperative drainage and the postoperative ambulation in groupSP-VATS were significantly lower than group MP-VATS and VAMT[(4.11±0.65)cm vs(6.42±0.65)cm vs(12.14±2.23)cm;(170.31±45.68)ml vs(166.23±43.21)ml vs(228.96±63.21)ml;(623.42±231.56)ml vs(681.23±278.54)ml vs(924.54±324.51)ml;(5.27±1.32)d vs(7.43±2.27)d vs(7.66±2.89)d;(3.36±0.78)d vs(4.62±1.26)d vs(4.78±1.43)d,all P<0.05].The time of postoperative drainage and postoperative ambulation in group SP-VATS was significantly lower than group MP-VATS(P<0.05);The rate of postoperative complications in group SP-VATS was 2.17%,significantlylower than 15.15% in group VAMT(P<0.05);The postoperative recurrence rate within 6 months among the group SP-VATS, group MP-VATS and group VAMT were no significant difference(6.67% vs 4.44% vs 3.03%,P>0.05);After surgery,the lung function(FEV1,FVC,MVV)among the three groups were significantly decreased,and the group SP-VATS was significantly higher than VAMT group(P<0.05),but there was no significant difference with group MP-VATS(P>0.05).Conclusion The SP-VATS for early stage NSCLC has similar short-term efficacy with VAMT and MP-VATS,but SP-VATS has faster recovery and maller postoperative pulmonary dysfunction.

BACKGROUND: Liver stem cells can be induced and differentiated into mature hepatocytes. Transplanted liver stem cells would be good to recovery of damaged hepatic tissues and compensate some hepatic functions. OBJECTIVE: To introduce the research status quo of liver stem cell induced and differentiated into mature hepatocytes in vivo and in vitro RETRIEVAL STRATEGY: We searched in Pubmed for the literatures published from January 2000 to October 2007 with the of "liver stem cell,differentiation"in English. We also searched in Wanfang database for relevant articles published from January 2000 to October 2007 in Chinese. Inclusive criterion:The articles related to the induction and differentiation of liver stem cells were collected. Exclusive criteria:Repetitive investigation or Meta analysis articles were excluded. LITERATURE EVALUATION: From over 100 pieces we chosen 38 pieces of articles which focus on the induction and differentiation of liver stem cells,and those published in the more authorized journals within recent years were superiority. Of the total,5 pieces were related on isolating culture and proliferation of cells,22 pieces on induction and differentiation in vitro,and 11 pieces on induction and differentiation in vivo. From over 30 pieces of articles,we summed up and arranged those about differentiation into mature hepatocytes. Of them,28 were used as reference for review. DATA SYNTHESIS: According to origin, liver stem cells can be divided into liver-derived liver stem cells and non-liver-derived liver stem cells. The former include oval cells,differentiated liver cells,fetal liver cells and bile duct endothelial cells. The latter include embryonic stem cells,bone marrow haemopoietic stem cells,pancreas glandular epithelium cells and enterocytes. All are characterized by pleiotropia variation. Induction and differentiation of liver stem cells:①in vitro:Cell induction culture systems can be different cytokines or chemical agents or patho-microenvironment,and these systems induce liver stem cells into hepatocytes. ② in vivo:Liver stem cells transplanted in body through various kinds of methods would improve liver function and structure. CONCLUSION: The study of liver stem cells is in the period of theory and experiment study. We must strengthen the study of mechanism of its induction and differentiation,prevent stem cells differentiate into tumor cells,and promote it differentiate into mature hepatocytes,so that we can propel liver stem cells in clinical application.

This study determined the levels of serum soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecular-1 (sVCAM-1) in patients with different types of Keshan disease (KD), examined the relationship between Coxsackie B virus-specific IgM antibody (CBV-IgM) and sICAM-1 or sVCAM-1 in KD patients, and investigated the role of these adhesion molecules in the pathogenesis of KD and their clinical implications. The levels of serum sICAM-1, sVCAM-1 and CBV-IgM were measured by using enzyme-linked immunosorbent assay in 22 patients with chronic Keshan disease (CKD), 27 with latent Keshan disease (LKD) and 28 healthy controls. The subjects in different groups were adjusted for sex and age. Echocardiography was adopted to determine left ventricular ejection fraction (LVEF) in 22 patients with CKD. The results showed that CKD patients had significantly higher levels of sICAM-1 and sVCAM-1 than LKD patients and healthy controls (P<0.01 for all). And there was significant difference in the levels of the 2 adhesion molecules between LKD patients and healthy controls (P<0.05). A negative correlation was found between LVEF and sICAM-1 or sVCAM-1 in CKD patients. The percentage of CBV-specific IgM positive individuals in KD patients was significantly higher than that of healthy controls. In CVB-specific IgM positive patients, the levels of serum sICAM-1 and sVCAM-1 were significantly greater than those in CBV-specific IgM negative counterpart. It was concluded that the increase in the levels of sICAM-1 and sVCAM-1 suggests the progression of inflammation in KD. sICAM-1 and sVCAM-1 can promote the development of myocardial pathology and lead to poor myocardial function. The increased serum sICAM-1 and sVCAM-1 in KD patients may be related to CBV infection.
Cardiomyopathies/*blood ; Cardiomyopathies/etiology ; Cardiomyopathies/*virology ; Coxsackievirus Infections/*complications ; Enterovirus B, Human ; Intercellular Adhesion Molecule-1/*blood ; Selenium/blood ; Vascular Cell Adhesion Molecule-1/blood ; Young Adult

BACKGROUND:An increase in activity of muscle contraction can induce transcription of a variety of signaling molecules to activate a large number of gene expression within the nucleus through proprietary signaling pathway OBJECTIVE:To review studies related the peroxisome proliferator-activated receptor-gamma coactivator 1(PGC-1)and exercise induced skeletal muscle adaptations.METHODS:A computer-based online search of Pubmed was performed for relevant English articles published from January 1995 to January 2009 with the keywords of"PGC1,skeletal muscle,exercise,adaptations"The relevant articles about PGC-1 and exercise induced skeletaI muscle adaptations were included.and repetitive contents were excluded.PGC1 and mitochondrial oxidative metabolism,and exercise-induced skeletal muscle adaptation and PGC1s changed served as the evaluation indicators.RESULTS AND CONCLUSION:Of 57 collected articles,34 were classified and sorted according to the criteria.Endurance training results in profound adaptations for skeletal muscle,including mitochondrial biogenesis,capillary density,and fiber composition.Transcription factors are highly dependent on coactivator molecules to regulate training physiologic adaptation processes.The majority of transcription factors target genes are involved in mitochondrial biogenesis and metabolism.These transcriptional patterns may provide a basic framework for understanding the integration of mitochondrial biogenesis and function with signaling events that exercise induced energetic properties Post-transcription of PGC-1 alpha protein,there are a variety of protein modifications,with a variety of biological processes closely related to the possible adaptive mechanism of exercise-induced skeletal muscle.

BACKGROUND: Procyanidins is a kind of polyphenol compounds in regnum vegetable, which is composed of different quantities of catechin and epicatechin. Studies show that procyanidins plays a role on protecting vascular endothelium, scavenging free radicals, resisting platelet aggregation, and reducing capillary permeability. Thus, procyanidins has obviously functions of reducing blood pressure, anti-oxidant activity, anti-edema, preventing coronary heart disease and atherosclerosis.
OBJECTIVE: To study the vasorelaxant effect of procyanidins on pulmonic rings and its mechanisms.
METHODS: Rabbit thoracic pulmonary arteries were isolated. Pre-contracted with noradrenalin (1×10-6 mol/L) and their responses to different concentrations of procyanidins (0.625, 1.25, 2.5 mg/L) were investigated. After removal of the endothelium of pulmonary artery smooth muscle, the effects of different signaling pathway inhibitors on procyanidins-induced relaxation, including nitric oxide synthase inhibitor Nω-Nitro-L-arginine (1×10-4 mol/L), methylene blue (1×10-5 mol/L), prostaglandin synthase inhibitor indomethacin (1×10-5 mol/L) and blockage of the adrenergicβ-receptor propranolol (1×10-5 mol/L), were also assessed.
RESULTS AND CONCLUSION: (1) Procyanidins did not change the resting tension of rabbit’s pulmonic rings, but caused an obvious dose-dependent relaxation in 1×10-6 mol/L noradrenalin-precontracted pulmonic rings (r=0.69, P < 0.001). (2) The relaxant effect of procyanidins was significantly reduced by removal of endothelium or by treatment with either Nω-Nitro-L-arginine or methylene blue, but not by treatment with prostaglandin synthase inhibitor or blockage of the adrenergic β-receptor. (3) Procyanidins (20 mg/L) dropped the dose-effect curves of noradrenalin, KCl and on pulmonic rings denuded endothelium. Moreover, affinity index of noradrenalin, KCl and CaCl2 decreased (P < 0.01). (4) Procyanidins also inhibited the vasoconstriction caused by noradrenalin in the first phase, but had no impact on the constriction induced by CaCl2 in the second phase. (5) Procyanidins has an endothelium-dependent vasorelaxation on isolated rabbit’s pulmonic rings, which is possibly mediated by nitric oxide/cyclic guanosine monophosphate pathways. Procyanidins blocked receptor-operated and voltage-dependent calcium channels to reduce intracel ular Ca2+, and induced vasorelaxation.

Formation of coronary atherosclerotic plaques brings severe damage to human health.Macrophages play an important role during formation and development of plaques,which becomes an important marker for judging whether atherosclerotic plaques are stable or not.Therefore,recognition and quantification of macrophages become hotspot in current study.The present article made an overview on cunent frequently-used imaging techniques for de-tecting coronary plaques and macrophages inside them for now.

BACKGROUND:Umbilical cord-derived mesenchymal stem cel s are gaining more attention in clinical treatments. Cel viability prior to transplantation has a direct impact on clinical prognosis. Despite trypan blue staining is a widely performed procedure to assess the viability of umbilical cord-derived mesenchymal stem cel s, it cannot reflect the functional capacity of those cel s accurately because of some subjective factors. OBJECTIVE:To explore sensitive and accurate assay for the functions of umbilical cord-derived mesenchymal stem cel s. METHODS:Human umbilical cord-derived mesenchymal stem cel s were isolated and cultured in vitro. Cultured umbilical cord-derived mesenchymal stem cel s were preserved in 0.9%saline for 0, 2, 4 and 6 hours at 4 ℃. Various methods (trypan blue staining, AnnexinV-PI, terminal deoxynucleotidyl transferase dutp nick end labeling, cel counting kit-8, live-dead assay, cel adherent assay) were used to determine the viability of post-storage umbilical cord-derived mesenchymal stem cel s, and the results were compared with colony-forming efficiency, a measure of cel function. RESULTS AND CONCLUSION:Human umbilical cord-derived mesenchymal stem cel s cultured in vitro showed a spindle shape and attached growth, the third-generation umbilical cord-derived mesenchymal stem cel s were positive for CD29, CD44, CD105, and negative for CD 34 and CD 45. Umbilical cord-derived mesenchymal stem cel s incubated in the adipogenic and osteogenic medium were both positive. Cel viability measured with trypan blue correlated moderately with colony-forming efficiency, while the percentage of viable cel s measured with other methods correlated better with colony-forming efficiency, among which adherent assay was the most obvious. It is proved that cel adherent assay-measured viability is the most accurate indicator.

BACKGROUND:The viability of human umbilical cord-derived mesenchymal stem cel s is often declined with the commonly used transplantation storage solution in clinics, which may influence the therapeutic effects of cel ular transplantation. However, reasons for this are stil unknown. OBJECTIVE:To investigate the role of oxidative stress in the reduction of human umbilical cord-derived mesenchymal stem cel s viability in the storage process during clinical transplantation and to observe the effects of radical scavenger on the results. METHODS:Human umbilical cord-derived mesenchymal stem cel s were harvested and cultured in normal saline for 0, 2, 4 and 6 hours at room temperature. Intracel ular reactive oxygen levels were detected at those time points. Antioxidant enzyme activities and levels of malondialdehyde were measured to determine the intracel ular oxidative stress levels after storage. Cel adhesion rate changes were retested after adding N-acetyl cysteine to the storage solution. RESULTS AND CONCLUSION:The reactive oxygen levels in human umbilical cord-derived mesenchymal stem cel s were increased significantly after normal saline storage and levels of malondialdehyde were increased in a time-dependent manner. Activities of superoxide dismutase, catalase and glutathione peroxidase were al reduced. Addition of N-acetyl cysteine into the storage medium decreased the reactive oxygen levels and improved the human umbilical cord-derived mesenchymal stem cel s viabilities. Experimental findings indicate that, increased reactive oxygen species in human umbilical cord-derived mesenchymal stem cel s is one of the reasons for reduced cel viability. Adding the radical scavenger N-acetyl cysteine can improve the storage effects of human umbilical cord-derived mesenchymal stem cel s.

Objective To explore the causes of secondary breast deformity after breast conservative therapy and its preventive methods.Methods 30 cases were selected from the patients with secondary breast deformity of more than 1 year after breast conservative therapy,and more than half a year after radiotherapy and chemotherapy,and no local recurrence and distant metastasis occurred.After cicatrectomy and contracture loose solution,different methods were used according to varying degrees of the secondary breast deformity to reconstruct and repair the deformity.Results Three reconstructive methods were conducted.Local mammary flaps were used in 7 patients,latissimus dorsi myocutaneous flap in 21 patients,and transverse rectus abdominal musculocutaneous flaps in 2 patients.The shape and feeling were satisfactory in 30 patients with reconstructive breasts,in which 23were excellent (76.7 ％),and 7 were good (23.3 ％).All the patients were followed-up for average 2.5 years,and they were survived without tumor recurrence.Conclusions The secondary breast deformity after breast conservative therapy could be effectively prevented,and successfully reconstructed and repaired with different procedure according to varying degrees of the secondary breast deformity.As a result,the shape and feeling of reconstructive breasts are satisfactory.

Objective To learn the suitability and validity of readmission service at counties and townships in rural China.Methods Seven pilot counties were randomly selected from the eastern,middle and western areas of China,and five diseases of the respiratory infection and cerebral system were set as the targets,while 600 target inpatient readmitted who had any of the five target diseases from 2012 to 2013 in such counties were selected from the NRCMS database.With expert consultation and empirical evaluation,the fitness of the days of stay at township hospital and necessity of hospitalization at county hospitals were evaluated for such target inpatients.Results 64.7％ of the target inpatients were found with unfit days of stay at township hospitals,mostly too short;59.0％ of the target inpatients' hospitalization at county hospitals were found with serious risk factors during their hospitalization;18.5％ of the inpatients were found with unnecessary hospitalization.Conclusions Hierarchical medical system can enhance the efficiency of the heahhcare system,but the current validity of readmission is poor,so is the fitness of days of stay at township hospitals,and the quality of the referral pattern.These problems mostly result from poor medical competence at township hospitals and high autonomy of patients in seeking medical service anywhere in the country.