Video assisted thoracic surgery(VATS) was rapidly developed in recent years.It's been widely accepted because it was minimally invasive and the patients were fast recovery with a survival rate similar to routine thoracotomy patients.However,more and more attention was paid to the side effect of general anesthesia with double cavity intubation during the surgery.Nonintubated thoracoscopic surgery for lung cancer was progressively developed.This surgery method decreases the side effect compared to general anesthesia with double cavity intubation.However,more surgical difficulty,additional surgical risk and prolonged surgery time were all inevitable become disadvantages of this new method.The less side effect of general anesthesia for patients and the more challenge for thoracic surgeon was brought simultaneous by this new method.More clinic trial should be implemented in validating the advantages and disadvantages.

[Summary] Traumatic brain injury ( TBI ) constitutes a major health and socioeconomic problem throughout the world . Increasing traffic accidents and aging of population promote the incidence of TBI .In patients with severe TBI mortality and disability rates are higher .And survivors may suffer physical activity , cognitive and psychological problems due to trauma , leading to shortened life span and higher risk of death than general population .They are also facing with long-term care and rehabilitation .This article reviewed the status and limitations on treatment of severe traumatic brain injury and its clinical significance .

AIM: To study the anti-cancer effects of octreotide on the proliferation of liver cancer cells. METHODS: The liver cancer cells SMMC-7721 were cultured in RPMI-1640 media with 10% fetal bovine serum, 100 U?ml -1 penicillin and streptomycin. 10 -5, 10 -4, 10 -3 and 10 -2 g?L -1 of octreotide were added and MTT colorimetric assay were used to detect the growth inhibition rate. DNA staining and cell cycle analysis were done at 0, 6, 12, 24 and 36 hours after medication when the concentration of octreotide was 10 -3 g?L -1. RESULTS: MTT colorimetric tests showed that octreotide suppressed the growth of liver cancer cells. 48 hours after medication, the cell growth inhibition rate was 9.33%, 12.70%, 19.70% and 20.93% when the octreotide concentration was 10 -5, 10 -4, 10 -3 and 10 -2 g?L -1 separately. Cell cycle analysis showed that the percentage of G 0-G 1 phase cells increased and the percentage of G 2-M phase cells decreased. CONCLUSION: Octreotide inhibits the cultured liver cancer cells proliferation in vitro, its mechanisms may be related to preventing the G 0-G 1 phase cells from going into G 2-M phase.

Objective To explore the immunomodulation property of bone marrow-derived mesenchymal stem cells (BMSCs) from Sprague-Dawley (SD) rats after they are isolated, cultured and identified by surface marker and differentiation potential examination. Methods BMSCs were isolated from femur and tibia of SD rats and passaged by trypsinization. The surface markers of the 3rd passage BMSCs were detected by flow cytometry and the capacity of their adipocyte and cartilage differentiation were examined. In order to explore the immunomodulation property of BMSCs, allogeneic spleen T cells of Wi?star rats were co-cultured with BMSCs through either cell-to-cell contact or transwell, then its effect on the T cell subsets and related mechanism was also examined. Results BMSCs were mainly spindle-shaped in culture. Surface marker detec?tion showed that BMSCs expressed high levels of CD29, CD44 and CD90 but no CD34 nor CD45 at the third generation. Un?der specific condition, BMSCs could differentiate into adipocytes and chondrocytes. The CD8+effector T cells (Teffs) decreas?es effectively and the CD4+CD25+regulatory T cells (Tregs) increased remarkably when BMSCs were co-cultured with allo?geneic spleen T cells for 48 hours. The expressions of IL-10 and TGF-β1 of BMSCs significantly increased after co-culture with T cells, and this effect was more obvious in cell-to-cell contact group. Conclusion The immunomodulation property of BMSCs were presumably function through cell-to-cell contacts and cytokine secretion.

OBJECTIVE: To explore whether pre-administration of Ganoderma lucidum spore (GASP) can reduce incidence of neural tube defects (NTDs) induced by all-trans retinoic acid (ATRA) in pregnant mice. METHODS: Twenty pregnant mice were randomly divided into four groups: normal control group, solvent-treated group, ATRA-induced group, and GASP-treated plus ATRA-induced group. GASP solution, which was prepared with solvent (sodium carboxymethyl cellulose), was fed to the pregnant mice in the GASP-treated plus ATRA-induced group twice a day from embryo (E) 0 d to E10.5 d. The same dose of solvent was given to the pregnant mice in the solvent-treated group. At E7.75 d, ATRA (50 mg/kg) was given to the pregnant mice in both ATRA-induced group and GASP-treated plus ATRA-induced group for single time. Embryos were sampled from pregnant mice at E10.5 d. Then the incidence rate of NTDs in mouse embryo was calculated and the crown-rump length of mouse embryo was measured. The positive rate of nestin expression and the distribution of cell cycle of embryonic neural tube neuroepithelial cells were detected by histochemical staining technique and flow cytometry respectively. Reverse transcription-polymerase chain reaction method was used to detect the gene expressions of cyclin-dependent protein kinase 2 (Cdk2) and Cdk4 mRNAs. RESULTS: The incidence rates of NTDs in mouse embryos in the ATRA-induced group and the GASP-treated plus ATRA-induced group were 79.41% and 21.67% respectively, while the crown-rump length of mouse embryos in these two groups were (3.62+/-1.27) mm and (5.84+/-0.92) mm respectively. The positive rate of nestin expression in embryonic neural tube neuroepithelial cells of mouse embryo at E10.5 d in the ATRA-induced group was 32.44%, while that in the GASP-treated plus ATRA-induced group was 77.65%. The cell cycle of embryonic neural tube neuroepithelial cells was obviously arrested at G(0)/G(1) phase in the ATRA-induced group as compared with that in the GASP-treated plus ATRA-induced group. The Cdk4 mRNA was transcripted at a high level in embryonic neural tube in the GASP-treated plus ATRA-induced group, but the Cdk2 mRNA was not detected in this group. CONCLUSION: Pre-administration of GASP can reduce the incidence of NTDs induced by ATRA in pregnant mice.

Objective To investigate the methylation status of 14-3-3σ promoter in nasopharyngeal carcinoma cell lines and the influence of de-methylation treatment on 14-3-3σ expression. Methods Methylation status of 14-3-3σ gene promoter and 14-3-3σ mRNA expression were detected by methylation specific PCR (MSP) and RT-PCR in nasopharyngeal carcinoma cell lines CNE1, CNE2,5-8F,6-10B and immortalized nonneoplastic human nasopharyngeal epithelial cell line, NP69. Four nasopharyngeal carcinoma cell lines were treated with 5-asa-2' -deoxycytidine(5-aza-2dC) in different concentration for 72 h, then 14-3-3σ promoter meth-ylation status and m RNA expression were assessed, and western-blot was performed to detect the expression of 14-3-3σ protein. Results 14-3-3σ promoter methylation was detected by MSP in all of the four nasopharyn-geal carcinoma cell lines untreated by 5-aza-2dC whereas not in the treated ones or the immortalized human na-sopharyngeal epithelial cell line, NP69. Accordingly, 14-3-3σ mRNA expression was significantly discounted in untreated nasopharyngeal carcinoma cell lines as compared with NP69. 5-aza-2dC treatment dose-depend-ently reversed 14-3-3σ promoter methylation status and consequently upregulated the expression of 14-3-3σmRNA and protein in 4 nasopharyngeal carcinoma cell lines. High-differentiated CNE1 was more sensitive to 5-aza-2dC than lowly-differentiated CNE2, 5-8F and 6-10B. Conclusion Promoter methylation directly leads to decreased 14-3-3σ gene expression in nasopharyngeal carcinoma cell lines, and 14-3-3σ promoter de-methylation perhaps indicates a new target for nasopharyngeal carcinoma treatment.

Objective To analyze the diagnostic value of 4 serum autoantibodies in nasopharyngeal carcinoma patients (anti-Rho-GDI-2, -HSP70, -CK19 and -LAP3 antibodies) using a serological proteomic approach. Methods The conditions for blocking, antigen concentrations and serum dilution were optimized to establish the ELISA method for detection of serum autoantibodies for Rho-GDI-2, HSP70, CK19 and LAP3. The serum concentrations of these autoantibodies were detected by the established method in 36 NPC patients, 20 other cancer patients and 20 healthy individuals. The statistical analysis was used to evaluate the diagnostic value of the 4 serum autoantibodies. Results The concentrations of 4 serum autoantibodies in the NPC patients were significantly higher than those in the healthy individuals(A450 values in NPC group of CK19, Rho-GDI-2, HSP70, LAP3 were 0. 188 8 ±0.047 3, 0.240 5 ± 0.024 7, 0. 116 8 ±0.025 3, 0.276 9 ±0.044 2 repectively. A450 values in healthy control group were 0.010 5 ±0.004 4, 0. 105 3 ±0. 016 9, 0. 098 6 ± 0. 014 0, 0. 149 8 ± 0. 033 1 respectively. F values were 4. 869, 15. 919, 10. 331,6. 369, respectively. P values were 0. 010, 0. 000, 0. 000, 0. 003, respectively). The sensitivities of antiRho-GDI-2, anti-HSP70, anti -CK19 and anti -LAP3 autoantibodies for diagnosis of NPC was 85.0%,75.0%, 75.0% and 75.0%, respectively, and the specificities were 58.9%, 80. 4%, 58. 9% and 57. 1%, respectively, anti-Rho-GDI-2 and anti-HSP70 achived the highest sensitivity and specificity respectively when single marker was analyzed. The sensitivity and specificity were 94. 4% and 95. 0%respectively when 4 markers was combined for analysis. Conclusion Detection of serum anti-Rbo-GDI-2,anti-HSP70, anti-CK19 and anti-IAP3 auotantibedios by ELISA may be of help in the screening and diagnosis for NPC.

Objective To compare the short-term safety and efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) for treatment of large benign thyroid nodules.Methods A total of 34 patients with large benign thyroid nodules were studied retrospectively,including 13 patients treated with ultrasound-guided RFA and 21 patients treated with MWA between Jun.,2016 and Feb.,2017 in Zhongshan Hospital.The thyroid function parameters,serum antibodies,complications and thyroid nodules volume reduction rate(VRR) were compared between the two groups during the follow-up.Results There were no statistically significant differences(P＞0.05)among those patients before and after treatment in serum free triiodothyronine (fT3),free thyroxine (fT4),thyroid stimulating hormone (TSH),anti-thyroglobulin antibodies (TG-Ab) levels,and thyroid peroxidase antibodies (TPO-Ab).One patient in the MWA group had mild hoarseness after ablation and another patient in the RFA group had intraoperative hemorrhage for about 10 mL.There were no other complications such as neck scar,postoperative infection,skin burns,tracheal and esophageal injury.One day after the ablation,all nodules were showed hypoecho and contrast-enhanced ultrasound proved there was no blood supply.One month after treatment,no statistically significant difference was found in VRR between two groups (23.8％ vs.22.6％,P =0.127).Conclusions RFA and MWA are safe and effective treatments for large benign thyroid nodules,and no significant difference was observed in short-term follow-up.

Objective To investigate the effect of α7nAchR gene 713T>C mutation on the cognitive function and Aβ expression in Alzheimer′s disease(AD)mice.Methods Twenty APPSwe transgenic APPa7KO mice(6 months old,α7nAchR gene knockout)were divided into the mutation type group and wild type group according to the random number table method,10 cases in each group.The mutation type and wild type of AVV-α7nAchR cDNA were respectively injected by lateral ventricle,once per month,for 6 times.The change of cognitive function in mice was examined by Morris water maze.The ELISA method was used to detect Aβ 40 and Aβ 42 expression levels.The Aβ plaque deposit situation was detected by the immunochemical method.Results Compared with the mice in the wild type group,the escape latency and the time of first time to find the platform of the mice in the mutation type group were significantly extended,while Hippocampal Aβ40 and Aβ42 expression levels were significantly increased,the difference was statistically significant(P＜0.05).Conclusion α7nAchR gene 713T>C mutation aggravates the cognitive function impairments in AD mice and hippocampal neuron Aβ expression level.

Objective To explore the clinical efficacy of three dimensional (3D) laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity combined with type 2 diabetes mellitus.Methods The retrospective cross-sectional study was conducted.The clinical data of 28 patients with obesity combined with type 2 diabetes mellitus who were admitted to the Qinghai Red Cross Hospital between January 2013 and April 2016 were collected.All the patients underwent 3D LSG.Observation indicators:(1) surgical and postoperative recovery situations;(2) follow-up and metabolic indexes changes.Follow-up using outpatient examination and telephone interview was performed to detect complications of patients after discharge and usages of antidiabetic drugs or insulin up to February 2017.Body mass,body mass index (BMI),hemoglobin (Hb),albumin (Alb),fasting serum C-peptide,fasting blood sugar,2-hours postprandial blood glucose (2HPBG) and glycosylated hemoglobin (GHb) were detected at month 1,3,6 and 12 postoperatively.Measurement data with normal distribution were represented as (x)±s.Repeated measurement data were analyzed by the repeated measures ANOVA.Count data were evaluated by the proportion.Results (1) Surgical and postoperative recovery situations:28 patients underwent successful 3D LSG,without conversion to open surgery.Operation time,volume of intraoperative blood loss,time of postoperative gastrointestinal function recovery and time of postoperative drainage tube removal were (133 ± 20) minutes,(45 ± 22) mL,(2.5 ± 1.2) days and (3.4 ± 0.9) days,respectively.There were no postoperative complications and perioperative death.Duration of hospital stay was (7.1 ± 1.5) days.(2) Follow-up and metabolic indexes changes:28 patients were followed up for 6-12 months,with a median time of 8 months.During the follow-up,there was no death or severe complications.Body mass,BMI,Hb,Alb,fasting serum C-peptide,fasting blood sugar,2HPBG and GHb from pre-operation to month 1,3,6 and 12 post-operatively were decreased from (113±26) kg to (78± 14) kg,from (44±6) kg/m2 to (35±5) kg/m2,from (157±19) g/L to (140±13) g/L,from (43±5)g/L to (40±4)g/L,from (2.50±0.37) μg/L to (1.20±0.33) μg/L,from (10.5±2.0)mmol/L to (5.6±0.5)mmol/L,from (16.3±3.1)mmol/L to (7.9±0.9) mmol/L,from 9.2％± 0.9％ to 6.8％ ±0.6％ with statistically significant differences between preoperative and postoperative indicators (F=396.47,328.20,111.10,21.28,161.06,127.80,243.40,234.64,P＜0.05),and showing a downward trend.Of 28 patients,25 had complete remission of type 2 diabetes mellitus at 12 months postoperatively and 3 had partial remission,with an effective rate of 100.0％ (28/28).The excess weight loss was 63％± 16％.Conclusion 3D LSG is safe and effective in the treatment of obesity combined with type 2 diabetes mellitus,with a good shortterm outcome.