Video-assisted thoracic surgery (VATS) is high-skilled operation,which is tacit,scene-related,hard to transfer and individualized.The action formation of VATS is implemented by action orientation,imitation,integration,training and automation.The skill acquisition of VATS involves four overlapping steps:studying examples to do analogy,developing abstract rules,slowly moving to the use of production rules and retrieving specific examples.Research on teaching methods of VATS in the view of tacit knowledge helps to learn this skill better and more quickly.

Objective To investigate the correlations of the expressions of CXCR4 and vascular endothelial growth factor (VEGF) in esophageal cancer and their associations with patients' clinicopathological features.Methods The paraffin-embedded samples of 127 patients with esophageal cancer treated by thoracic surgery in Zhongshan Hospital in 2005 were collected. The CXCR4 and VEGF expressions in esophageal cancer tissues were detected with immunohistochemical technique. The immunostaining was evaluated according to the staining area and intensity. Results The overall expression rate was 88.2% and 79.5%, respectively. CXCR4 expression was significantly associated with tumor grade, size, tumor depth, regional lymph node metastasis and TNM stage (P<0.05);VEGF expression was significantly associated with tumor depth, TNM stage and tumor grade.In addition, there were significant correlations between CXCR4 and VEGF (P<0.01). Conclusions There was significant association between CXCR4, VEGF expressions and clinicopathological features of esophageal cancer. There might be some potential correlation between CXCR4 and VEGF expression in esophageal cancer.

Aged, 80 and over ; Dyspnea ; etiology ; Glottis ; pathology ; Hematoma ; complications ; Hemophilia A ; complications ; Humans ; Laryngeal Diseases ; complications ; Male

BACKGROUND: A good many researches believe that the gene polymorphism of vascular endothelia nitric oxide synthase(eNOS) correlate with diseases of heart, brain and kidney. However, it is still not clear whether eNOS Glu298Asp correlates with myocardial infarction in the elderly Chinese.OBJECTIVE: To investigate the distribution of Glu298Asp polymorphism of vascular eNOS in the elderly as well as correlation between Glu298Asp polymorphism of eNOS and myocardial infarction in the elderly Chinese.DESIGN: A case-controled study based on diagnosis.SETTING, PARTICIPANTS and METHODS: A total of 37 patients with myocardial infarction were selected into case group, which all of them were patients from either outpatient department or inpatient department of the First Affiliated Hospital of Nanjing Medical University. Thereinto, 20 cases without hypertensive history were allocated into case subgroup. Totally 172 subjects selected from the re-testees of physical checkup of our hospital were assigned into control group, of which 92 cases without hypertensive history were allocated into control subgroup. Indices like height, body mass and fasting blood sugar were detected respectively in all participants of all groups. The polymorphism of Glu298Asp of eNOS gene was assayed by polymerase chain reaction(PCR), and restriction fragment length polymorphism (RELP).MAIN OUTCOME MEASURES: The polymorphism of Glu298Asp of eNOS gene as well as the allelic frequency of 298Asp in the elderly of four groups.RESULTS: Genotype of Glu/Asp of the case group was higher than that of the control group(32.43% and 18.02% respectively) . The genotype composition of Glu298Asp polymorphism had significant difference between the case group and the control group(x2 = 3.87, P < 0. 05) . Between normotensive subgroups, Genotype Glu/Asp of the case subgroup was higher than that of the control subgroup(35.00% and 10. 87% respectively) . The genotype composition of Glu298Asp polymorphism of the eNOS gene also had significant difference between the case subgroup and the control subgroup (x2 = 7.43, P < 0.01) . The allelic frequency of 298Asp of the case group was higher than that of the control group without statistical significance (16. 22% and 9.01% respectively, P > 0. 05) . Between normotensive subgroups, the allelic frequency of 298Asp of the case subgroup was significantly higher than that of the control subgroup(17.50% and 5.43% respectively, x2 = 6.82, P < 0.01 ) ).CONCLUSION: Glu298.Asp polymorphism of the eNOS gene exists in the elderly Chinese. The genotype of Glu/Asp and allelic frequency of 298Asp might be a genetic susceptible marker of myocardial infarction in the elderly Chinese.

Adult ; Angioplasty, Balloon, Coronary ; adverse effects ; Balloon Occlusion ; Cardiac Tamponade ; etiology ; Catheter Ablation ; adverse effects ; Catheterization ; adverse effects ; Coronary Disease ; surgery ; therapy ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve Stenosis ; therapy ; Retrospective Studies ; Stents ; adverse effects

Objective To explore the association of Glu298Asp polymorphism of the endothelial nitric oxide synthase gene (eNOS) with myocardial infarction in Chinese aged people based on a case-control study. Methods Thirty-seven patients with myocardial infarction and 172 sex- and age-matched healthy control subjects were enrolled. Their height, weight and blood pressure were measured and the fasting plasma lipid concentrations were examined. Glu298Asp polymorphisms of the eNOS gene were examined using PCR and RFLP methods. Results Genotype Glu/Asp in the patient group was higher than that in the control group (32.4% vs 18.0%). The genotype composition of Glu298Asp polymorphism showed significant difference between the patient group and the control group ( =3.87, P 0.05). Among the normotensive subgroup, the allelic frequencies of 298Asp in the patient subgroup was higher than that in the control subgroup (17.5% vs 5.4%). The allelic frequencies of 298Asp had significant difference between the patient subgroup and the control subgroup ( =6.82, P

Objective: in order to provide rapid and reliable method. Methods: Encoded Annexin Ⅴ cDNA was amplifyed from U937 cDNA libary by PCR and then subcloned into E coli expression vector. MS2-Annexin Ⅴ fusion protein could be overexpressed in E　coli. The MS2 bacteria protein could be removed by thrombin digestion.The mature Annexin Ⅴ was obtained by ion exchange chromatography and the FITC labled Annexin Ⅴ could be used in the detection of apoptosis. Results:Up to 37% of the total bacterial proteins was rhAnnexin Ⅴ as showed by SDS-PAGE. The purification of Annexin Ⅴ is over 99%. The FITC labled Annexin Ⅴ could efficiently detect apoptosis. Conclusion: We successfully established the technique procedure of obtaining a large quantity of Annexin Ⅴ and provided the basic routine for popularizing the detection of apoptosis' with high effciency.

Animals ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; physiopathology ; Carcinoma, Small Cell ; metabolism ; pathology ; physiopathology ; Cell Differentiation ; Chromogranin A ; metabolism ; Humans ; Male ; Neuroendocrine Cells ; metabolism ; pathology ; Prostatic Neoplasms ; metabolism ; pathology ; physiopathology

To determine the distribution and drug resistance tendency of Gram-negative bacillus so as to provide a reasonable selection for antibiotic in clinical treatment.The clinical isolates bacillus were mainly Gram-Negative bacillus during three years.The detection out ratio for Gram-Negative bacillus had decreased gradually but the ratio for non-fermental gram-negative bacillus had increased.The combinations of antibiotic and enzyme inhibitor has more antibacterial activity to non-fermental gram-negative bacillus than antibiotic.The detection out ratio for ESBLs had gradually increased.

Objective To analyze safety,efficacy and resection methods of video-assisted thoracic surgery(VATS) for the treatment of intralobar pulmonary sequestration(IPS).Methods Data of 17 patients who were diagnosed as IPS and received VATS from December 2006 to September 2011 were retrospectively analyzed.The patients were 7 males and 10 females with the mean age of 40.3 (14-61) years.Diagnosis was confirmed in 9 patients by enhanced CT and unconfirmed in 8 patients.Three ports were used for surgery.After the aberrant artery was confirmed,liner stapler was used in 16 patients to cut it and Hem-o-lok was used in 1 patient because the aberrant artery was about 3 mm in diameter and long enough.If the diameter of the aberrant artery was longer than 10 mm,a stapling device without knife was used to occlude it centrally and a second stapling device was used to cut it peripherally.Wedge resection or lobectomy was performed due to the different conditions.When the lesion was small with linited range in CT image and the lesion was easily distinguished from normal lung tissue during operation,wedge resection was preferred.Results Seventeen patients underwent VATS successfully without any conversion to thoracotomy or any serious complications.Five patients were planned to receive wedge resection and one was converted to lobectomy.Another 12 patients were planned to receive lobectomy and all succeeded.The mean operating time was 128 (80-170)min.The mean blood loss was 80 (5-200) ml.The mean days of chest tube maintained were 4.0 (2-6) days.The mean postoperative hospitalization days were 7.6 (4-11) days.All patients were diagnosed as IPS according to operating in-sight and postoperative pathology.There was no patient suffering from chronic cough,bloody sputum or recurrent pneumonia during the follow-up.Conclusion VATS for the treatment of IPS is safe and feasible.If conditions permit,wedge resection or segmentectomy may be preferred.