Objective To evaluate the efficacy of video-assisted mini-thoracoscopy(VAMT) for radical resection of lung cancer.Methods From April 2002 to December 2008,radical resection of lung cancer was performed on 39 patients by VMAT in our hospital.A 1.5-cm and a 7-to 10-cm incision were made during the operation.Both standard surgical instruments and thoracoscopic set were used to treat the pulmonary vessels,perform lobectomy,and remove the lymph nodes in the mediastinum and pulmonary portal.Results The operation was completed in all of the cases.No peri-operative death occurred.The patients received chest drainage for 4 to 7 days after the operation(mean,4.5 days).Post-operative pathological examination showed primary non-small cell lung cancer(NSCLC) in 37 cases,metastatic cancer in 1,and carcinoid in 1.In the 37 patients with NSCLC,9 were stage Ⅰa,13 were Ⅰb,5 were Ⅱa,7 were Ⅱb,2 were Ⅲa,and 1 was Ⅲb.Follow-up was available in 35 patients for up to 2 to 12 months in 4,13 to 24 months in 15,25 to 36 months in 8,37 to 48 months in 6,and 49 to 60 months in 2 cases.Among the 35 cases,totally 4 patients died of tumor recurrence or metastasis,1 patient survived with tumor,and the other 30 survived without tumor.The 1-and 3-year survival rate of stage Ⅰ and Ⅱ were 100%(21/21) and 91%(10/11) respectively.All of the 3 stage Ⅲ patients died of recurrence or metastasis in 19,11,and 14 months respectively after the surgery.Conclusions VAMT is effective for radical resection of lung cancer in a short term.Combination of traditional procedure and VAMT is safe and reliable for the disease.

Objective To inspect the quality of Fructus Aurantii Immaturus formula granule. Methods Choose three batch Fructus Aurantii Immaturus to prepare formula granule and decoction. Zobax Extend C18 column was used with acetonitrile-water-phosphoric acid-sodium lauryl sulphate (12∶87∶1∶0.2) as the mobile phase, the detection wavelength was 275 nm. Result There were no differences in elution peak quantity and peak position in the HPLC spectrum of Fructus Aurantii Immaturus formula granule with corresponding cut crude drug and decoction. The relative peak area in the corresponding peak of formula granule had no significant difference with decoction, but had certain differences with cut crude drug. Conclusion HPLC spectrum showed that Fructus Aurantii Immaturus formula granule and decoction had high similarity.

OBJECTIVE: To compare the contents of main chemical components in prescription granules and decoction of Fructus aurantii immaturus. METHODS: 3 batches of cut crude drugs of Fructus aurantii immaturus were selected to prepare the granules and decoction. The assaying of water soluble extractive was conducted according to the specification of China Pharmacopeia. The assaying of hesperidin and synephrine was conducted by HPLC. RESULTS: There was no obvious difference between water soluble extractive of granules and that of decoction, while the contents of hesperidin and synephrine were higher in the prescription granules than in the decoction. CONCLUSIONS: The results provide supporting basis for the labeled amount of prescription granule of Fructus aurantii immaturus.

Purpose　The aim is to evaluate the effects of rhIL-11 made in China on hematopoietic recovery following chemotherapy-induced thrombocytopenia in cynomolgus monkeys.Methods　Chemotherapy-induced myelosuppression of cynomolgus monkeys was made by china iv cyclophosphamide ( 30 mg/kg, qd ) for 5 days, then animals were divided 6 groups(n=4), by sc rhIL-11( 50, 100, 200 μg/kg), or Neumega (GI rhIL-11 control, 100 μg/kg) for 14 days, another normal control and model control. Blood was taken before chemothery and then at day 3, 6,9,12,15,18,21 for blood cell counts and platelet congregate test. Bone marrow was aspirated day 0, 12 and 21 for evaluation of the megakaryocyte ploidy distribution.Results　Recovery of blood platelets was accelerated and reached normal levels by day 12, and was higher than normal day 18, day 21 sc rhIL-11 in cynomolgus moneys. Blood platelet congregated rate were 71.4%～74.6% by day 21 and higher than model control . megakaryocytes in bone marrow increased.Conclusion　rhIL-11 could accelerate the recovery of peripheral blood platelets in monkeys. The function of increased platelets was normal. The results supported the clinical use of rhIL-11 as a platelet restorative agent to prevent severe thrombocytopenia following chemotherapy.

Objective To analyze the clinical features of adult patients with acute intestinal obstruction secondary to Meckel's diverticulum and the experience in management of the disease.Methods The clinical data and pathological features of 9 patients with acute intestinal obstruction secondary to Meckel' s diverticulum were retrospectively analyzed. Results All patients were diagnosed with acute intestinal obstruction secondary to Meckel's diverticulum via abdominal cavity exploration and underwent surgical treatment. Before surgical treatment, 1 out of 9 patients was correctly diagnosed as acute intestinal obstruction secondary to Meckel's diverticulum, and the other 8patients were diagnosed as acute intestinal obstruction. Diverticulum was resected in 5 cases and the rest 4 cases received partial excision of small intestine including the diverticulum. Pathological examination showed that all patients had inflammatory changes in diverticulum. Some patients were complicated with mucosal erosion, small ulcers, bleeding or perforation. Forty-four percent (4/9) of diverticula contained ectopic tissue. All patients were cured. Conclusion Meckel's diverticulum is a rare cause of acute intestinal obstruction and preoperative diagnosis is difficult. Diverticulum,howere,is likelihood to develop strangulation or contains ectopic tissue, so that the surgical treatment should be performed early.

Objective To explore the correlation between liver injury,fibrosis and levels of serum interleukin(IL)-18,transforming growth factor(TGF)-β1,and HBV DNA in patients with chronic hepatitis B(CHB).Methods Sixty-seven CHB cases were collected as experimental group and 20 healthy controls were enrolled as healthy control group.Serum levels of IL-18 and TGF-β1 were analyzed using enzyme linked immunosorbent assay(ELISA),and serum HBV DNA level was measured by fluorescent quantitative polymerase chain reaction(PCR).Liver biopsy was performed in 48 cases.Data analysis was done by variance analysis and data with heterogeneity of variance were analyzed by rank sum test.Partial correlation was employed to analyze the correlations between different data.Results The serum levels of IL-18,TGF-β1,alanine aminotransferase(ALT)and total bilirubin(TBil)were all higher in patients with hepatitis B and cirrhosis than those in controls(P<0.01).With the progression of liver injury,the levels of IL-18 and TGF-β1 were correspondingly increased,and the differences of TGF-β1 level between different groups were statistically significant(P<0.01),with the highest level in the patients with liver cirrhosis.There was no significant difference of the levels of ALT and TBil between the high and low viral load groups,but compared with control group,the differences were both significant(F=10.970,F=7.528;F=14.698,F=13.395;all P<0.05).TGF-β1 level gradually increased with fibrosis stage of CHB increasing from SO to S4,and there were significant differences between two stages except S3 and S4(P<0.01 or P<0.05).The difference of IL-18 level was only significant between SO stage and other stages.There was no significant difference of HBV DNA level among all stages. Partial correlation analysis indicated that IL-18 positively correlated with ALT and TBil(r=0.4806 and r=0.5047,respectively,both P<0.01).HBV DNA had no correlation with IL-18,TGF-β1,ALT and TBil.Conclusions Serum IL-18 and TGF-β1 levels play important roles in the progression of liver injury.Serum TGF-β1 level is correlated closely with post-hepatitis cirrhosis. Serum HBV DNA level is not significantly correlated with liver injury and fibrosis.

The stretched preparation of subcutanous tissue of 120 male rats were observed by means of histochemical methods for separate and consecutive demonstration of norepinephrine and cholinesterase (ChE). In addition to adrenergic nerves, there are acetylcholinesterase (AChE) containing nerves surrounding the small arteries and arterioles. AChE is recongnized as a marker of cholinergic nerves in rat subcutanous tissue. After sympathetic gangliectomy, all adrenergic and most of cholinergic nerves disappeared, we suggested that both of them are terminals of sympathetic postganglionic nerve fibers. Using the method for the consecutive demonstration of norepinephrine (NE) and AChE, it showed a dual innervation at the same site of an arteriole, most of them are superimposed each other, their distribution were just the same; but the other one third were not. The latter is a separate sympathetic cholinergic system. Whether these superimposed terminals were coming from different neurons and travelling in the Schwann cell or they contained two kinds of neurotransmitters in the same neuron terminal were discussed.By the small arteries and arterioles of rat subcutanous tissue, there were many ChE-positive nerves, which were sensitive to iso-OMPA inhibition. Such thin unmyelineted nerve fibers are mainly non-cholinergic. They showed a variety of free nerve endings in the martrix of connective tissue, and they can be traced, in association with the whole course, to the small spinal nerve trunk that travelling in subcutanous tissue. We consider that these ChE-positive nerves and their terminals are sensory components of cerebrospinal fibers. It has been observed that some of free nerve endings are superimposed with adrenergic paravascular plexus by means of consecutive method.

Fifty two adult male rats were selected for the investigation the adrenergic and cholinergic innervation of rat heart by means of histochemical demonstration of catecholamine fluorescence and acetylcholinesterase (ACHE). Consecutive method was employed on the same section to demonstration the relation between the distribution of the sympathetic and parasympathetic nerves in various parts of rat heart, e. g. atrium, ventricular myocardium, valves, epicardium, endocardium, atrioventricular node and coronary arteries. Adrenergic and cholinergic terminals innervated all parts dually. By comparing the photographs demonstrating the fluorescence CA and AChE on the same section treated by the consecutive method, we found that the location, the density and morphology of both types of nerve terminals were more like. In other words, under light microscopy the localization of both terminals can hardly be distinguished from each other. Such kind of morphological relation may strongly support the results of interaction between sympathetic and parasympathetic nervous systems in physiological and pharmacological experiments of heart.In the cardiac ganglia there are some small intense fluorescence ceils (SIF-cells) lying besides the postganglionic cholinergic cells of the parasympathetic nervous system. Both kinds of cells were shown in close contact with each other in the same section with consecutive method. This morphological relation provided an evidence that catecholamine containing SIF-cells may control and regulate the neurotransmission of parasympathetic cholinergic neurons.

Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic nephroureterectomy (RLNU) combined with transurethral electric coagulation on upper urinary tract urothelial carcinoma (UUTUC).Methods Sixty UUTUC patients were enrolled from Jun.2012 to Apr.2013.The prospective clinical controlled analysis method was adopted in this study.All patients were divided into test group and control group according to the order of admission.Thirty cases (test group) underwent RLNU combined with electric coagulation,and 30 cases (control group) underwent RLNU combined with electric resection.The differences in operation time,blood loss,hospital stay and tumor recurrence rate between the 2 groups were compared.Results All the 60 operations for UUTUC were successful without conversion to open surgery.No intraoperative complications such as great vessels or surrounding organs damage occurred.There were 2 cases loss to follow-up in test group and 3 cases in control group.There were no significant differences in operation time,blood loss,follow-up time,tumor stage and tumor grade between the 2 groups.The hospital stay in the test group was shorter (5.5±2.0 d versus 7.1±2.2 d),the tumor recurrence rate was lower [4％ (1/28) versus 30％ (8/27)],and the differences were significant (P＜0.05).Conclusion Compared with RLNU combined with transurethral electric resection,RLNU combined with electric coagulation has advantages of shorter hospital stay and lower tumor recurrence rate.

Objective To analyze setup errors and guide the calculation of margins from clinical target volume (CTV) and planning target volume (PTV) in esophageal cancer patients treated with tomothcrapy by the MVCT image-guided system.Methods Sixty-four esophageal canccr patients trcated with tomotherapy in our hospital in 2016 were randomly selected.MVCT images were acquired after patients' positioning and co-registered with KVCT images.The setup errors of x,y,and z translations and roll rotation were analyzed with the t-test or one-way ANOVA.Meanwhile,PTV margin was calculated based on the formula of M =2.5 Σ + 0.7δ Results According to the formula,the CTV-PTV margins in the x,y and z directions are slightly different between cancers located in the cervical,upper thoracic,middle thoracic,and lower thoracic segments.In patients with upper thoracic esophageal cancer,the average setnp error in the yaxis was lower when the head-neck-shoulder thermoplastic film fixation was used than when somatic thermoplastic film fixation (P=0.000);the setup errors of z-axis with somatic thermoplastic film fixation in the fifth and sixth weeks were slightly less than those in the first several weeks (P =0.036);the setup errors acquired by three image registration patterns were similar (x-axis P=0.868,y-axis P=0.491,z-axis P=0.169,roll P=0.985).Conclusions In the treatment of patients with esophageal cancer,the setup errors are large,but the MVCT in the TOMO HD system can greatly reduce the setup errors,ensuring the accuracy of each treatment.It is further recommended that in clinical practice,different CTV-PTV margins should be used for the treatments of esophageal cancers located in different segments.Patients with upper thoracic esophageal cancer are advised to use the head-neck-shoulder thermoplastic film fixation.