ObjectiveSummarize 500 cases of non-small cell lung cancer (NSCLC) that has accepted complete videoassisted thoracoscopic (VATs) lobectomy procedure in People's Hospital of Peking University,to report the mid-term follow-up results,and to evaluate the safety and effectiveness of VATs lobectomy.MethodsBetween September 2006 and September 2011,500 cases of non-small cell lung cancer that has accepted complete thoracoscopic lobectomy in the People's Hospital of Peking University were reviewed (267 male,233 female).Median patient age was 62.3 years.The average maximal diameter of solid tumors was 2.65cm.There are 496 cases of initial treat patients and 4 cases of operation after radiation and chemotherapy.This group consisted of lobectomies of left upper lobe ( n =129),left lower lobe ( n =73 ),right upper lobe ( n =163 ),right middle lobe x( n =47 ),right lower lobe( n =89 ).The operation procedure was complete VATs lobectomy combined with systematic lymph node resection ( at least 3 groups of lymph nodes in the mediastinum area),including 480 cases of purely lobectomy,13 cases of compound lobectomy (pulmonary lobe + pulmonary lobe,or pulmonary lobe + pulmonary segment),3 cases of segmentomy,2 cases of pneumonectomy,1 case of sleeve lobectomy and 1 case of bilateral lobectomy.ResultsAll procedures were carried out smoothly without serious complication,except 1 case of death of an advanced age patient due to multi-organ failure after the operation period.The average surgical duration was 198.1 min,and average blood loss was 214.6ml.There are 5 cases of postoperative hemorrhage,identified as pulmonary artery residual ooze blood,in which 4 cases of bleeding were stopped through re-operation,and 1 case was improved through conservative treatment.The median lymph nodes dissection was 5.7 group and median number of resected lymph nodes was 16.9.The median postoperative chest tube drainage duration was 7.8 day,and median postoperative hospital stay was 10.2 day.There were 45 cases (9.0％) of conversion to open thoracotomy and 87 cases ( 17.4％ ) of slight complications,including 32 cases of cardiac abnormalities,such as continuous arrhythmia,28 cases of air leakage beyond seven days,9 cases of pulmonary infections or atelectasis,6 cases of chylothorax,and 16 cases of other complications.The results of pathology show 363 cases of adenocarcinoma,85 cases of squamous carcinoma,12 cases of adenosquamous carcinoma,28 broncho-alveolar cell carcinoma,6 cases of large cell lung cancer and 6 cases of other lung cancer.The 1-year disease free survival (DFS) was 90.2％ and 1-year overall survival (OS) was 94.3％.The 3-year DFS was 76.4％ and 3-year OS was 81.3％.ConclusionCompletely video-assisted Thoracoscopic lobectomy procedure was a safe and effctive procedure for patients with non-small cell lung cancer.

Objective To evaluate the long term effect of video-assisted thoracoscopic thymectomy for myasth,enia gravis and the influence of concomitant thymoma.Methods 47 cases of myasthenia gravis were retrospectively reviewed who had received video-assisted thoracoscopic thymectomy from Apr.2001 through Oct.2009.The patients were separated to two groups with or without thymoma.Influence of oncologic factors was carefully studied.Results There were 20 males and 27 females with a mean age of 36.6 yrs.According to the typing system of the Myasthenia Gravis Foundation of America ( MGFA),the patients belonged to type Ⅰ 18 cases,type Ⅱ a 14 cases,type Ⅱ b 14 cases,and Ⅲa 1 case.22 patients were in the group with thymoma,and the other 25 in the group without thymoma.Until the deadline of follow-up time of Jun.2011,only two cases in non-thymomatous group were lost.Follow-up time was 20 to 122 months,mean 57 months.The complete stable remission rate(CSR),pharmacologic remission(PR),minimal manifestations(MM),worse(W),exacerbation(E) and died of myasthenia gravis(D) in non-thymomatous group were 78.3％,13.0％,4.3％,0,0 and 4.3％.In thymomatous group the values were 50.0％,22.7％,13.6％,4.5％,9.1％ and 0.Conclusion Video-assisted thoarcoscopic thymectomy has a satisfactory long term effect for myasthenia gravis.Thymomatous group has no different in overall effectiveness with that of non-thymomatous group although a probably lower complete stable remission rate is prompted.

Objective To evaluate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for CT-positive mediastinal lymph nodes. Methods From September 2009 to December 2009, 28 patients with confirmed or suspected non-small-cell lung cancer with CT scan demonstrating enlarged ( ≥ 1 cm) mediastinal lymph nodes underwent EBUS-TBNA. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were evaluated. Results 28 patients with 40 lymph nodes were studied. 27 patients had been performed successfully with enough specimens. No complications happened in the group. Mediastinal metastases were confirmed by EBUS-TBNA in 20 patients. 8 patients with benign mediastinal nodes as detected by EBUS-TBNA underwent surgery and mediastinal lymph node dissection, which confirmed N2 disease in 2 patients. Overall diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EBUS-TBNA in the detection of mediastinal metastasis were 92.9%, 90.9%,100%, 100%, 75% respectively. Conclusion EBUS-TBNA is a safe and effective technique for CT-positive mediastinal lymph nodes on CT scan.

Objective To analyze the epidemiological characteristics of epidemic mumps in Chongqing Wanzhou district,and provide scientific basis for taking effective prevention and control measures.Methods Epidemic data of mumps in Wanzhou district from January 2011 to December 2014 were investigated retrospectively.Results A total of 2 785 cases of epidemic mumps were reported,there was no death case,the incidence of mumps was 44.02/100 000.Incidence of mumps in population under 15 years old was the highest,accounting for 84.45% (2 352/2 785 ).Mumps mainly occurred among students (1 674 cases,60.11 %).The peaks were from April to July and Oc-tober to December,the number of mumps increased significantly from October to December in 2013.Difference in incidence among each year of 2011 -2014 was statistically different(χ2 =40.52,P <0.01).Incidence of mumps was statistically different between the city streets and villages/towns(63.99/100 000 vs 32.13/100 000,χ2 =20.168,P<0.01).Incidence was statistically different between the city streets and villages/ towns each year of 2011 -2014 (all P < 0.01 ),except 2012,the incidence of mumps of city streets was significantly higher than villages/ towns. Conclusion It is important to conduct “Five early”for the prevention and treatment of infectious diseases,strength-en the vaccination of measles-mumps-rubella (MMR)vaccine or vaccine against epidemic mumps,especially the vaccination for students and children in nurseries,popularize the knowledge about prevention and control of mumps, improve diagnosis and treatment level,and strengthen the epidemic monitoring.

0bjective Evaluate the clinical factors affecting the definite pathological diagnosis of solitary pulmonary odules(SPN).Methods From Jan 2000 to July 2009,390 patients(212 men,178 women,median age 57.1 years,range from 17 to 86 years)got definite pathological diagnosis of solitary pulmonary nodules in our Institute were investigated.All following clinical data were collected:age,gender,course of disease,symptoms,history and quantity of smoking,history of tumor,family history of tumor,site,diameter,calcification,spicular sign,border,lobulated,traction of pleural,vascular convergence sign,lymph nodes of mediastinum,adhesion,depression of pleural,pleural effusion.Results The surgical procedures included 20 tumor enucleation,153 wedge resection,and 217 lobectomy.There were 130 benign lesions,including hamartoma(n=33),arteriovenous istula(n=1),cyst(n=2),interstitial pneumonia(n=1),tuberculoma(n=49),lymphoproliferative(n=2),fungal ball(n=3),neurofibroma(n=1),inflammatory pseudotumor(n=27),sclerosing hemangioma(n=9),bronchiectasis(n=2).260 were malignant lesions,including Alveolar cell carcinoma(n=23),Metastatic carcinoma(n=20),Carcinoid(n=4),Squamous cell carcinoma(n=40),adenecarcinoma(n=164),Small cell carcinoma(n=9).Single factor analysis and Logistic regression analysis show that there were significant differences in age, diameter,border,calcification and depression of pleural in judgement character of SPN.In addition,there were no differences in gender,course of disease,symptoms,history and quantity of smoking,history of tumor,family history of tumor,site,spicu lar sign,lobulated,traction of pleural,vascular convergence sign,lymph nodes of mediastinum,adhesion and pleural effusion.Conclusion Age of patient,and diameter,border,calcification,pleural depression of the tumor were significant risk factors in judgment character of SPN.

Objective To develop an easy-to-use nomogram to assist clinicians in predicting major postoperative morbidity in those non-small-cell lung canccr patients who underwent VATS lobectomy.Methods A perspective multi-center study was developed to analyze the major postoperative complications of 612 non-small-cell lung cancer patients who underwent VATS lobectomy.Muhivariable logistic regression was used to model postoperative morbidity and built the nomogram to accurately predict the major complications.Results There were 606 (99％) survivors and 6 (1％) mortality.A total of 32 patients suffered from major complications.Using logistic regression to predict major complications,preoperative model for ASA score,age ≥70 years and operation time ＞ 150 nin were found to be the significant predictors(P ＜ 0.05) of morbidity and were included in our model.Conclusion We propose a nomogram to enable clinicians to better estimate morbidity in patients with VATS lobectomy.

Objective To optimize operative techniques of completely video-assisted thoracoscopic lobectomy by reviewing the experience of Peking University People's Hospital. Methods From September 2006 to August 2010, 408 patients (214 males,194 females) with median age of 58.6 years (range from 15 to 86 years) underwent completely thoracoscopic lobectomy. All procedures were conducted under general anesthesia with double lumen intubation. The thoracoscope was introduced through 7th or 8th intercostals space on the mid-axillaries line. The 4 cm long utility incision was made on the 4th or 5th intercostals space anterior axillary's line without rib-spreading. A third retraction incision located on the 7th or 8th intercostals space sub-scapular line. The surgeon stands on the ventral side of patient using an electrocautery hook and a suction device through the utility incision. Anatomic lobectomy was performed with systemic mediastinal lymph node dissection for lung cancer patients. Results All procedures were carried out smoothly with no case of serious complication. There was 1 case death because of respiratory failure of pulmonary fungal infection during the operative period. The average surgical duration was 195 minutes, and average blood loss was 249 ml with no blood transfusion required. There were 35 cases (8.6%) of conversion to open thoracotomy, including interference by lymph nodes, bleeding, inflammatory adhesion of Artery and large size tumors.The results of pathology show 322 cases of malignant disease and 86 cases of benign disease. Conclusion To grasp the core technique of completely thoracoscopic lobotomy may make the procedure undergone smoothly, and may shorten the learning curve.

Objective To evaluate the value of autofluorescence bronchoscope (AFB) in airway examination in central type lung cancer. Methods From Sep 2009 to Mar 2010 ,29 patients ( 23 men , 6 women , median age 62.2 years , range from 34 to 81 years) underwent AFB procedure. There were 3 lesions located at trachea, 1 at right main bronchus, 9 at right upper lobe, 1 at right median bronchus, 1 at right middle lobe, 4 at right lower lobe, 1 at left main bronchus, 9 at left upper lobe.There were 21 preliminary diagnostic cases and 8 postoperative surveillance cases. All procedure was performed under combination of local anaesthesia and general anaesthesia. All patients underwent white light bronchoscopy followed by AFB procedure.All of the suspicious abnormal sites were recorded and biopsied for pathological examination. Results All procedures were safely performed without death or serious complications. 100 specimens were obtained for pathologic examination. Malignant lesion was diagnosed in 39 and non-malignancy in61. All malignant sites were detected by AFB, however WLB missed 12 sites.The sensitivity of AFB and WLB for malignancy were 100% and 69.2%, respectively. In 21 preliminary diagnostic cases,AFB detected all malignancy sites, but WLB missed 23 sites, in which 9 were malignant sites. In 8 rechecked patients, AFB detected all malignancy sites, but WLB missed 7 sites, in which 3 were malignant sites. Conclusion Autofluorescence bronchoscopy could be more accurate in judging the extent of the tumor invasion, more sensitive in finding multiple lesions in airway, more sensitive in detecting early cancer recurrence in postoperative surveillance patients.

Objective: To study effects of cyclin D1 overexpression on the proliferation and differentiation of cervical squamous cell carcinoma SiHa cells and to investigate related signaling molecules. Methods: Primers were designed to amplify the full length of cyclin D1 gene and cyclin D1 gene was amplified by PCR for constructing pcDNA3.1 plasmid vector. The construct was then transfected into SiHa cells, and the cells with stable overexpression of cyclin D1 were established, cyclin D1 gene and protein expression were detected by RT-PCR and Western blot, respectively. Cell growth curve was documented by MTT assay. CK7, E-cadherin, vimentin, Snail gene and protein expression in transfected cells were detected by RT-PCR and Western blot. RT-PCR was used to detect the mRNA expression of proliferation and differentiation-related genes like CDK4, CDK2, p21, p27, cyclin E, Rb, E2F, E6/E7 and Ki-67. After synchronization of cells, RT-PCR was used to detect of cyclin D1 and p21 mRNA expression at different time points of the cell cycle. Results: The G-3 cells with cyclin D1 overexpression were successfully established. The growth curve and Ki-67 mRNA expression accelerated in G-3 cells.Vimentin and Snail expression significantly increased at both gene and protein levels, while E-cadherin, CK7 gene and protein expression significantly decreased, indicating epithelial mesenchymal transitionoccurred in G-3 cells.Meanwhile, mRNA expression of cyclin D1, CDK4, CDK2, p21, p27, cyclin E, E2F and Rb increased, while E6/E7 and p16 showed no significant change. The expression trends of p21 and cyclin D1 were almost identical with fluctuation at different time points in the cell cycle. Conclusions Overexpression of cyclin D1 induced by gene transfection promotes proliferation and epithelial mesenchymal transition in SiHa cells.The process is accompanied by up-regulation of CDK4, CDK2, p21, p27 and cyclin E genes.p21 expression increases synchronously with cyclin D1, suggesting a regulatory role in epithelial mesenchymal transition by affecting expression of vimentin in G-3 cells.

Objective To evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of thoracic sarcoidosis.Methods The study was retrospective,from September 2009 to June 2011,35 patients with suspected sarcoidosis,with enlarged hilar or mediastinal lymph nodes on computed tomography ( ≥1.0 cm),underwent EBUS-TBNA.Patients in whom EBUS-TBNA was nondiagnostic subsequently underwent surgical biopsy or a minimum of 6 months clinical and radiologic follow-up.Results EBUS-TBNA was performed on a total of 87 lymph node stations in 35 patients.Of the enlarged lymph nodes,64 (73.6％) were located in the mediastinal region and the remaining 23 ( 26.4％ ) around the hilar or interlobar area.A final diagnosis of sarcoidosis was made for 28 (80％) of the patients.In patients with a final diagnosis of sarcoidosis,EBUS-TBNA demonstrated noncaseating epithelioid cell granulomas in 25 ( 89.3％ ) of the patients.EBUS was well tolerated by all of the patients with no complications.Conclusion EBUS-TBNA is a safe procedure with a high yield for the diagnoses of thoracic sarcoidosis of stage Ⅰ or Ⅱ.