Objective To explore the indications and safety of video-assisted thoracoscopic lobectomy with small auxiliary incision for benign pulmonary diseases and non-small cell lung cancer.Methods Between May 1996 and April 2007,63 cases of lobectomy were performed by video-assisted thoracoscopy.Before the operation,18 of the patients were diagnosed with benign pulmonary diseases,and 45 had pulmonary mass or malignancies.Lobectomy of the right lung was carried out on 47 patients,including the right upper lobe resection in 12,the middle lobe in 8,and the lower in 27.The other 16 patients received resection of the left upper lobe(5)or left lower lobe(11).Results Thoracoscopic lobectomy was completed in all the 63 patients,in 6 of them the incision was lengthened during the operation.No perioperative death occurred.The chest tube was withdrawn 4 to 7 days(mean,4.5 days)after the operation.Postoperative pathological examination showed NSCLC in 37 patients(58.7%),metastatic lung cancer in 1(1.6%),carcinoid tumor in 1(1.6%),and benign conditions in 24(38.1%).Among the 37 patients with NSCLC,8 were at stage Ⅰa,13 at stage Ⅰb,14 at stage Ⅱa,3 at stage Ⅱb,6 at stage Ⅲa,1 at stage Ⅲb,and 2 at stage Ⅳ.Of the patients with malignancies,34 were followed up for 2 to 60 months(2 to 12 months in 7,13 to 24 months in 10,25 to 36 months in 6,37 to 48 months in 6,and 49 to 60 months in 3),2 of them survived 11 years,5 of the patients(14.7%)died of tumor recurrence or metastasis,1(2.9%)survived with tumor,and 28(82.4%)lived free of tumor.The 1-and 3-year survival rate of the patients with stage Ⅰ or Ⅱ cancer were 100%(19/19)and 90%(9/10)respectively.In the patients with stage Ⅲ cancer,5 received follow-up,3 of them died of recurrence of metastasis.In the 2 patients who had stage Ⅳ cancer,1 died of metastasis.Conclusion Video-assisted thoracoscopic lobectomy is a safe and effective procedure and can be a regular surgical treatment for benign pulmonary disease,and peripheral type non-small cell lung cancer at stage Ⅰ or Ⅱ.

Objective To monitor right heart hemodynamic changes of patients with lung cancer during and after the procedures of pneumonectomy and discuss the effect of pneumonectomy on right heart function and risk of postoperation morbidities. Method 16 patients with lung cancer were randomly selected and the clinical database was queried and Swan-Ganz catheter was applied awake from jugular vein to pulmonary artery ,measuring mean arterial pressure(MAP) ,heart rate(HR) ,central venous pressure(CVP) ,mean pulmonary artery pressure (MPAP),mean pulmonary capllary wedge pressure(MPCWP) ,and eardiaoc output(CO) and calculating cardiac index (CI),left ventricular-stroke work index (LVSWI), right ventricular stroke work index (RVSWI) , and stroke volume index(SVI) instantaneously before anaesthesia, after anaesthesia with single lung ventilation, after pulmonary artery and pulmonary vein occlusion and supine chest dosed during the procedure of pneumonectomy. Pre-and post-operative complications were recored. Results Cardiovascular complications occurred in 6 patients(37.5%) postoperatively. There were no operative or perioperative deaths. MPAP increased significantly after the procedure of pneumonectomy compared with that of preoperation, and MPAP > 26 mm Hg was in 4 patients who got cardiovascular complications postoperatively with morbidity of 100% ,which was "significantly higher than the morbidity of 16.7% (2/12) when MPAP < 25 mm Hg. Conclusion Pneumonectomy has significant effects on right heart hemodynemic changes and as MPAP increases postoperatively, the risk of cardiovascular complications becomes higher.

Objective To investigate the risk factors,management and prophylaxis of dangerous placenta previa.Methods The clinical data of 407 cases of placenta previa were reviewed,36 cases of them with dangerous placenta previa.Comparison was made between group A (dangerous placenta previa,36 cases) and group B (non dangerous placenta previa,371 cases) in terms of age,number of pregnancy and number of ceasarean delivery.Results The incidence rates of pregnant women in group A age ≥ 35years,number of pregnancy ≥3times,and cesarean delivery≥2times were 55.6％,61.1％,25.0％,which were significantly higher than those of group B (25.6％,27.7％,2.4％),the differences were statistically significant (x2 =7.71,8.99,21.97,all P ＜ 0.01).Among the 36 cases of dangerous placenta previa,12 cases were diagnosed with concomitant placenta increta.The specificity and sensitivity for detection of placenta increta were 90.5％ (19/21) and 83.9％ (10/12) of ultrasonography respectively,and those were 100.0％ (3/3) and 87.5％ (7/8) of MRI.Of the 36 dangerous placenta previa patients,two patients were treated with induced labour due to unexpected pregnancy under 28 weeks,while the others were refer to surgical operation.5 surgical patients experienced uncontrollable postpartum haemorrhage which necessitated histectomy,while the other 31 cases received conservative operation.Rate of histectomy was 13.9(5/36).Conclusion Dangerous placenta previa is associated with advanced age,multiple pregnancy and multiple cesarean delivery.Accurate preoperational evaluation of the placenta previa should be acquired with ultrasonography and MRI to detect placenta increta,provide information for treatment selection,and prevent postpartum haemorrhage.

Objective To compare the difference of antihypertensive efficacy,the result of heart and lung function test(CPET)and 6 minutes walking distance(6MWD)in hypertension patients with different angiotensin converting enzyme(ACE)gene polymorphisms.Methods 120 patients with hypertension were randomly divided into four groups:the control group treated with nifedipine zyban,perimental group of group A(II),group B(ID),group C(DD)treated with lisinopril tablets.The blood pressure control situation,the changes of the CPET and 6MWD results were compared in the four groups 3 and 6 months after treatment.Results After 3 months,there were no significant changes in blood pressure drop of the four groups,and the differences were no statistically significant among the four groups in the range of blood pressure drop(all P>0.05),the body mass,maximum oxygen uptake(VO2/kg)and 6MWD of the four groups were not significantly changed..After 6 months,the blood pressure of the four groups decreased,and there were no statistically significant differences between the four groups in the drop of blood pressure(all P>0.05),VO2/kg(mL):the control group(17.94±1.51)mL,group A(18.04±1.85)mL,group B(19.70±1.25)mL,group C(21.25±2.20)mL and 6MWD:the control group(448.66±50.26)m,group A(445.07±41.21)m,group B(488.56±55.66)m,group C(500.54±53.25)m.The improvement range of VO2/kg and 6MWD was group C>B>A(group B compared with group A:ct=12.01,P=0.03;group C compared with group B:dt=17.26,P=0.02),there were no statistically significant differences between the control group and group A(all P>0.05).Conclusion This study found no ACE genotype associated with the antihypertensive effects of lisinopril,but found improvement of CPET and 6MWD result in different groups,DD type is superior to the ID,the ID type is better than type II.

Major depressive disorder (MDD) is a mental disorder with high prevalence,morbidity and recurrence rate.The treatment goal of acute stage is to achieve remission,which means asymptomatic.However,clinical treatments and studies found impairment of psychosocial functioning still exists even after remission,which means incomplete recovery.As is known,the normalization of psychosocial functioning is essential to the recovery and the recurrence prevention of MDD.In order to provide reference and guidance for the clinical treatments and studies,we reviewed the related studies and found many kinds of factors influencing the restoration of psychosocial functioning,including demographic factors,diseases related factors,psychological factors,social factors and therapeutic approaches.However,few interior studies focused on the recovery of MDD,and the results of foreign studies were inconsistent,while the understanding of how those factors influence the recovery of MDD is not clear enough.In order to make the characteristics of psychosocial functioning recovery and mechanisms of the influencing factors clear,more in-depth studies should be done in the future.

Objective To evaluate the diagnostic value of ultrasonography (USG) and contrast-enhanced computer tomography (CT) for thyroid carcinoma.MethodsThe results of the review of the preoperative CT and those of the original US reports were compared with the histopathologic results in 73 cases of thyroid carcinoma who underwent radical operation and central compartment dissection from November 2009 to November 2011.ResultsThe final diagnostic rate of thyroid carcinoma with USG was 69.9％,CT of that was 80.8％.There were no significant difference between them (P =0.077).The diagnostic rate of metastatic lymph node in the central compartment with USG was 61.6％,positive predictive value was 64.0％,negative predictive value was 60.4％.The diagnostic rate of metastatic lymph node in the central compartment with CT was 67.1％,positive predictive value was 61.7％,negative predictive value was 76.9％.There were not significant difference between them(P =0.848,P =0.152,P =0.489).Conclusion There was no significant difference between USG and CT in The final diagnostic rate of thyroid carcinoma and its lymph node metastasis in the central compartment.

Objective To evaluate the efficacy of ancient classical prescriptions treating middle and advanced primary liver cancer.Methods Articles were searched from Pubmed, Embase, SCI, Cochrane Liarary and CNKI, VIP, WanFang Data, CBM databases. Randomized controlled trials about ancient classical prescriptions treating advanced primary liver cancer were collected. Results 17 studies were included, a total of 994 patients. The recent efficiency of ancient classical prescription combined with symptomatic therapy increased by 28% compared with single supportive and symptomatic therapy;the stable rate of life quality increased by 23%;the efficiency of TCM syndrome increased by 29%;the survival rates of 3 months, 6 months and 1 year increased by 16%, 36.7% and 58.5% respectively;the life quality score of later increased by 6.29 on average. Conclusion Ancient classical prescription combined with supportive and symptomatic therapy in advanced primary liver cancers is superior to single supportive and symptomatic therapy on recent efficiency, survival rate (3 months/6 months/1 year), quality of life and TCM syndrome. The conclusion of this study needs randomized controlled trials with larger samples, multicenter and high quality for further verification.

Objective To analyze the clinical features,therapeutic effect and prognosis in patients with bone pain induced by malignant bone me?tastasis as well as the rationality of analgesic application,so as to improve the level of diagnosis and treatment for metastatic bone pain. Methods Totally 123 patients with pain due to malignant bone metastasis received antitumor therapy and analgesic therapy based on standardized three?step guidelines. Their clinical characteristics were retrospectively analyzed. Results The total pain relief rate was 85.4%and the pain was significantly relieved(P<0.05). The DUI value of each narcotic agent was close to 1 and the application of narcotic agents tended to be rational. The Kaplan?Meier survival analysis showed that patients with moderate pain had longer survival time than those with severe pain(P=0.015). The survival rate of patients with significant pain relief after treatment was higher than those unrelieved(P=0.021). The survival rate of patients without visceral me?tastasis was higher than those with visceral metastasis(P=0.000). The COX multivariate analysis indicated that the pain intensity and visceral me?tastasis were independent risk factors influencing patient prognosis. Conclusion Standard treatment can improve symptoms in most patients with bone metastasis and prolong survival time. Opioids have satisfactory analgesic effect for moderate to severe pain and the adverse reactions can be tol?erated.

Objective To analyze the clinical efficacy of the laparoscopic breast-conserving surgery combined with radiofrequency ablation to treat the early-stage breast cancer.Methods We collected 55 patients diagnosed early-stage breast cancer in retrospect,which started from January 2014 to December 2016.Twenty-seven of them were performed the laparoscopic breast-conserving surgery combined with radiofrequency ablation while others went through laparoscopic breast-conserving surgery without radiofrequency ablation.Meanwhile,we adopted the student t-test and the chi-square test to compare results of two groups.More specific,the main indexes of this study are including the post-operative local recurrence,the incidence of fat liquefaction or the incision-infection,operation time,post-operative hospital stay and the hospitalization expense.Results The laparoscopic breast-conserving surgery combined with radiofrequency ablation group had low local-recurrence than the laparoscopic breastconserving surgery group (0 and 7.69％).Additionally,there were no statistical differences between two groups in the incidence of fat liquefaction.However,The laparoscopic breast-conserving surgery combined with radiofrequency ablation group had more hospitalization expense than the laparoscopic breast-conserving surgery group [(4.1 ± 0.7) ten thousand yuan and (2.3 ± 0.6) ten thousand yuan,P ＜ 0.05].Conclusions Although the laparoscopic breast-conserving surgery combined with radiofrequency ablation group remarkably increased the hospitalization expense because of the utility of the radiofrequency ablation related apparatus,it may provide the probability of shaving more residual tumor cell and may low down the recurrence,especially not rising up the incidence of the post-operative fat liquefaction.Therefore,this surgery method might be one of the potential developments in the minimal-invasive of early stage breast cancer.

As the basis of cell proliferation, cytokinesis involves the division of the cytoplasm and the plasma membrane into two. In this paper a few models on the active deformation mechanism during cytokinesis process are presented. Discussions are made onvarious models, conclusions, differences between the numerical results and the corresponding experimental results.
Animals ; Biomechanical Phenomena ; Cell Proliferation ; Computer Simulation ; Cytokinesis ; physiology ; Humans ; Models, Biological