Objective To explore the feasibility of the small figure-L unilateral transternal incision for the treatment of anterior mediastinal tumor.Methods Twenty patients with anterior mediastinal tumor were enrolled in the study.Under general anesthenai,after a 6 to 10cm middle skin incision was made,a unilateral figure-L partial sternotomy on the side occupied by the tumor was made in the second or third intercostals space,taking into account the tumor size and location.Tumors were resected with excellent exposure.Results All tumors were completely resected during the operation.In 7 cases,tumors encroached on the adjacent lung tissue,and lung tissue was partially resected.In 5 cases,tumors invaded the pericardium,and the pericardium was partially removed.Mean operating time was 110 minutes(85～130 minutes).The mean time of hospital stay was 7days after the operation,and there was no complication.All but one patients were alive with a mean follow-up period of 18 months(6～27 months).Conclusions The figure-L unilateral sternotomy is considered as an effective and useful minimally invisive approach for anterior mediastinal tumors.

Objective To observe the clinical effect of different surgical methods in the treatment of mediastinal tumors.Methods A total of 74 cases of August 2011 -2015 years 7 months in our hospital admissions of patients with mediastinal tumor were divided into observation group (minimally invasive medi-astinal surgery)and control group (conventional thoracotomy),37 cases,compared to two groups of clini-cal curative effect.Results The total efficiency of treatment in the observation group was 89.19%,signifi-cantly higher than that of the control group and observation group complications rate is relatively lower,sig-nificant differences (χ2 =5.33,6.79,P <0.05);observation group the operative time,amount of bleeding and hospitalization time were (15.69 ±3.21)min,(3.541 ±56.29)ml,(597 ±3.11)d were significantly lower than control group,the difference between two groups was significant (t =12.54,11.49,13.54,P<0.05).Conclusions Phase,compared with the traditional surgical treatment for open and minimally in-vasive surgery can achieve a better therapeutic effect,reduce a patient's risk of complications,alleviate the injury of surgery.For patients with postoperative rehabilitation has a positive meaning.

Liver is one of the most commonly metastases in patients with colorectal cancer.Curative hepatic resection is the first choice of liver metastasis of colorectal cancer,which can improve the survival rate ranging from 30％ to 40％ in 5-year.In this article,we will review the operation indication,mode and advance on the current treatment strategies of colorectal liver metastases,and discuss the decision-making process,emphasize a surgery - centered multidisciplinary treatment for the treatment of hepatic metastases from colorectal cancer,to improve the survival rate.

Objective To investigate the expression of CCL20 and CCR6 in the patients with gastric cancer and To examine the relationship between chemokine expression and the occurrence and development of Gastric Cancer. Methods Real-time PCR , flow cytometry and ELISA are used to measure the gene transcription and protein expression levels of chemokine CCL20 and CCR6 in the serum of 50 patients with Gastric Cancer and 30 normal controls. Results The gene expression levels CCL20 and CCR6 in Gastric Cancer group are significantly higher than that in healthy controls. The level protein of CCL20 and CCR6 in peripheral blood of patients with gastric cancer are significantly higher than that in healthy peep le[ (45.4 ±10.9) pg/mL vs (18.6±4.7) pg/mL; (7.11 ±1.03%) vs (1.83±0.43%), P＜0.01. respectively],and the increase significantlyassociated with the clinical stage of Gastric Cancer. Conclusions The method for detecting the expression of CCL20 and CCR6 in patient with Gastric Cancer has been successfully established, and their expression levels were found to be correlated with the occurrence and development of Gastric Cancer. Thus, CCL20 and CCR6 may be involved in the regulatory mechanisms associated with the development of Gastric Cancer, and may be valuable in its diagnosis and prevention.

Objective To express the major allergen of Blattella germanica (Bla g 2) in Pichia pastoris and obtain the soluble protein. Methods The known Bla g 2 gene was used to design the primers which had the restriction enzyme sites. PCR method was applied to obtain the Bla g 2 gene. The gene fragment was then cut and ligated with the Pichia expression vector pGAPZaA, resulting in a recombinant plasmid pGAPZaA-Bla g 2. The linearized pGAPZaA-Bla g 2 was transformed into Pichia pastoris GS115 through electroporation, then screened to positive transformants, and the protein was expressed in YPD medium. Purification of the recombinant protein was achieved by metal (Ni2+) chelating affinity chromatography and Western-blotting assay indicated its IgE binding capacity. Results With the expressed reeombinanl protein, SDS-PAGE showed the presence of the product in the supernatant of the culture with Mr 45 000. After 3 days culture, the recombinant protein occupied 50% of the total proteins in the supernatant. The recombinant protein was purified and Western-blot demonstrated an adequate IgE binding capacity of the product. Conclusion A recombinant protein of Bla g 2 has been obtained, which is soluble in the supernatant and therefore can avoid a process of denaturalization and renaturation of the recombinant.

Objective To identify and purify the allergens of Tyrophagus putrescentiae. Methods Tyrophagus putrescentiae extract was analyzed by SDS-PAGE and Western blotting, and was partially purified by DE52 anion-exchange chromatography and HiLoad 16, 60 Superdex 200 prep grade Size-exclusion chromatography. Results 23 bands were found after SDS-PAGE with comparative molecular weight (Mr) of 177 000, 118 000, 107 000, 70 000, 67 000, 60 000, 52 000, 45 000, 41 000, 40 000, 38 000, 37 000, 35 000, 27 000, 23 000, 22 000, 18 000, 17 000, 16 000, 15 000, 14 000, 13 00 and 12 000. Five allergens were detected by Western blotting with Mr 128 000, 67 000-70 000, 36 000-37 000, 18 000 and 16 000, respectively. The positive reaction rate of 3 allergens, with Mr 128 000, 67 000-70 000 and 36 000-37 000, were 100%, while that of other 2 allergens with Mr 18 000 and 16 000 was 77.8% and 44.4% respectively。The allergen with Mr 18 000 was purified by anion-exchange chromatography and Size-exclusion chromatography. Conclusion Four major allergens and one minor allergen from Tyrophagus putrescentiae have been identified.

Treatment of an aneurysm with a mesh stent alone becomes an emerging technique. The mechanism involves the mesh stents, when it crosses the neck of an aneurysm could change the internal circulation and induce the formation of stable thrombus and in turn assists the growth of neointima for anatomical healing of the aneurysmal neck. The mesh stent technique aimed at vascular reconstruction with expected curing effect for aneurysm together as a simple and safe way to keep the patency of the small arterial branches, just contrary to the covered stent. This technique couldn't be carried out practically in wide scale because of immaturity, therefore we give a comprehesive review in the progress of this field.

OBJECTIVE:To investigate the cause and characteristics of ADR cases induced by antibiotics in our hospital.METHODS:347 ADR cases induced by antibiotics collected from our hospital from 2005 to 2009 were analyzed statistically.RESULTS:Of total 347 ADR cases,9 kinds of antibiotics were involved.Most of ADR cases were induced by quinolones and cephalosporins,accounting for 36.60%(127 cases) and 22.77%(79 cases).Among them,levofloxacin and ceftriaxone took up the biggest proportion,accounting for 14.70% and 12.39%.Main clinical manifestations were lesion of skin and its appendants(158 cases,42.36%).175 ADR cases were caused by unreasonable use of drugs(50.43%),in which the primary cause was false selection of dosage,followed by medication for no infectious characteristics,inappropriate drug selection,unseasonable drug combination and false selection of solvent.Of 175 ADR cases caused by unreasonable use of drugs,cephalosporins antibiotics took the largest portion(46.29%).CONCLUSION:Antibiotics-induced ADR are related with many kinds of factors.It is very important to pay more attention to rational use antibiotics in case unreasonable use of antibiotics results in serious ADR.Furthermore,ADRs will be reduced greatly through reasonable and normal use of antibiotics.

Objective To explore the effect of fosinopril on plasma biomarkers of endothelial cell in elderly patients with type 2 diabetes mellitus complicated with hypertension. Methods Fourty-two patients with type 2 diabetes mellitus complicated with hypertension were treated with fosinopril (10～20)mg/d for 6 months. Twenty-four matched healthy people were selected as control. Before treatment and after 6 months of treatment,thromodulin (Tm),von willebrand factor and nitric oxide (NO) as well as systolic pressure (SBP) and diastolic pressure (DBP) were detected. The reactive congestion and nitroglycerin-induced dilation of the right brachial artery were assayed with high-resolution ultrasound. Results After 6 months of treatment in all patients,diameters of brachial artery after taking glyceryl trinitrate showed no change markedly,but the plasma levels of Tm and vW factor were decreased and NO was increased obviously than those before treatment. The diameter of brachial artery in responding to reactive hyperaemia was improved greatly and the SBP & DBP were all decreased obviously than those before the treatment. Concusion Fosinopril effectively reduces blood pressure and the endothelial-dependent vasodilatation companied with decrease of the plasma Tm & vW factor and increase of the plasma NO in patients with type 2 diabetes mellitus complicated with hypertension.

Augmenter of liver regeneration(ALR)is a novel hepatic stimulator. Owing to its peculiar characteristic of gene structure and many kinds of biological functions, it is thought to be an important hepatotrophic factor. This review summarized the advance in ALR research in recent years including characteristics of ALR gene, molecular structure, physiochemical characteristics, biological functions and roles in liver injury.