Using the fluorescence method, the effect of Luteolin ( Lut) on H2O2 release of peritoneal macrophages(M(?)s) in rat was studied. The results showed that H2O2 release of peritoneal M(?)s stimulated by op-sonized Zymosan was reduced by in vitro treatment of Lut. The inhibitory effect of Lut is in a concentration-dependent manner over the range of 4 ? 10-7-10-5mol/L. When M(?)s was cultivated with Lut for 4 h, the inhibitory effect of Lut was the most obvious.

Objective To evaluate the application effect of pneumatic arm assisted single surgeon uniportal thoracoscopic surgery.Methods A total of 40 patients were admitted to our treatment group in Shanghai Pulmonary hospital in October who accepted pneumatic arm assisted single surgeon uniportal thoracoscopic surgery.All the clinic statistics of patients were collected including operative time,the volume of blood intra-operation,postoperative complications and hospitalization time.23 of 40 patients who accepted lobectomy/segmentectomy with pneumatic arm assisted single surgeon uniportal thoracoscopic surgery were assigned to the observation group,while another 30 concurrent patients who accepted lobectomy/segrnentectomy with conventional uniportal thoracoscopic surgery were assigned to the control group.Both groups were compared.Results The average postoperative hospitalization time of observation group was(4.6 ± 1.3) days.The average time for postoperative drainage tube retention was(46.7 ± 18.6) hours.The average operation time of patients in observation and control groups was(121.74 ± 25.16) min and (119.7 ± 14.26) min separately.The volume of blood intra-operation in observation group was(91.74 ± 32.88)ml and(89.00 ± 41.22) ml in control group.There is no significant difference between two groups(P ＞ 0.05).Conclusion The field of view and adjustment of camera in uniportal thoracoscopic surgery by single surgeon with pneumatic arm assistance are more accurate and steady,in which human resource can be saved.It is safe and reliable and does not prolong operative time or increase bleeding during operation,and can be applied to different kinds of diseases in thoracic surgery.It is worth promotion and application in eligible hospitals and medical institutions.

Objective To evaluate the efficacy of single or double-antibiotic regimen for the treatment of complicated appendicitis in children,with the purpose to guide the rational use of antibiotics in clinic.Methods Six hundred and sixty-three patients with acute appendicitis admitted to the department of pediatric surgery in Jinhua Municipal Central Hospital between March 2011 and February 2015.One hundred and seventy-two of 663 patients with complicated appendicitis which confirmed by intra-operative macroscopic or post-operative pathological examination were eligible for the study.These patients were divided into two groups based on the regimen of their postoperative antibiotics:single or double-antibiotic regimen(treatment group,n=66);triple antibiotics regimen(control group,n=106).Demographic data,blood routine test and C-response protein(CRP),length of hospital stay,postoperative complications and duration of antibiotic treatment were recorded and statistically analyzed.Results There was no difference between the treatment group and control group with respect to age distribution,blood routine examination and CRP, length of hospital stay, duration of antibiotic treatment or postoperative complications.Although the number of patients changed of antibiotics on the basis of bacterial culture of pyogenic fluids in treatment group were more frequently than those in the control group(7/66 vs.1/106), the therapeutic effective rate of changed of antibiotics was 100% in both two groups.The culture positive rate of peritoneal fluids was 72.09% (124/172), the most common pathogens were escherichia coli(80.15%, 105/131),pseudomonas aeruginosa(5.34%,7/131)and klebsiella pneumonia (3.05%,4/131).The results of bacterial culture of peogenic fluids showed no difference in both two groups.Conclusion Children with complicated appendicitis can be managed effectively with single or double broad-spectrum antibiotics after appendectomy,and it may be beneficial to guide the rational use of antibiotics and decrease the irrational use of multi-antibiotics combination in clinic.

Objective To investigate the clinicopathological features and diagnosis of intestinal neu-ronal dysplasia type B.Methods Between January 2004 and August 2014 , 9 patients ( 5 males and 4 females) were treated for constipation and abdominal distention,and in all of them an intestinal neuronal dys-plasia type B was confirmed histopta holoig cally.The age of 9 patients ranged from 3 months to 1 year old ( mean 7.8 months) .The specimen of 9 patients was routinely takne by paraffin-embedded full-circumference sections of lesional bowel,hematoxylin and eosin and immunohits ochemical stainign were carried out on the specimen.The patholgo ical morphology and quantitative of inet stinal en urons and ganglia were retrospectively analyzed.Results Total of the 9 patients,the number and density of myenteric ganglia increased significant-ly increased in the lesional bowel,the pathological findings included giant nerve plexus,isolated and ectopic ganglia.In the proximal bowel,the number and density of myenteric ganglia were observed abnormal on giant nerev plexus, isoal ted and ectopci ganglia was osb erved.Combinated these pathological findings and symp-toms,intestinal neuronal dysplasia type B was diagnosed.Conclusion The diagnosis of ni testinal neuronal dysplasia type B relies on typical presentations of allied disorders of Hirschsprung′s disease,giant ganglia, isolated and ectopic ganglia,and increasing the density of giant submucosal ganglia of pathologic morpholo-gy,meanwhile,excludingo thers prima ry etiologies.

Objective To investigate the prenatal diagnosis and postnatal clinical outcomes of fetal congenital choledochal cyst (CCC) to improve the recognition and treatment of fetal CCC.Methods Clinical data of 23 cases of fetal CCC which were diagnosed during routine prenatal ultrasonic examination in Jinhua Municipal Central Hospital from June 2009 to May 2015 were retrospectively analyzzed. Maternal age, gestational age at diagnosis of CCC, location and size of cyst, postnatal examination, age at operation and follow-up outcomes were recorded and statistically analyzed by Wilcoxon rank-sum test.Results (1) Among the 23 cases, six (26%) were terminated and the rest 17 continued their pregnancies (74%). (2) Results of the prenatal ultrasonography of the 23 cases indicated that hepatic portal cysts were closely related to hepatic portal veins or arteries. Six of the cysts communicated with gall bladder and eight connected to intrahepatic bile duct. The maximum diameter of the cysts in the 23 cases was 16.0-31.0 mm, averagely (24.7±3.7) mm. The maximum diameter of cysts diagnosed in the third trimester was significantly larger than that in the second trimester [ 27.0 (22.0-31.0) vs 23.0 (21.0-25.0) mm,Z=-2.134,P<0.05]. (3) Among the 17 cases of continued pregnancy, one underwent cesarean section at 35+ weeks of gestation and 16 delivered at term with the average gestational age at delivery of (38.2±1.1) weeks. All neonates were re-examined by abdominal ultrasound at 1-2 postnatal weeks and confimed prenatal diagnosed of CCC. (4) The 17 neonates were re-examined by abdominal ultrasound during the second postnatal week and the results showed that cyst size remained the same in four, decreased in one and gradually increased with the gestational age in 12 neonates. Among the 16 cases of confirmed CCC, 12 received surgery, including 11 (Ⅰa, 6;Ⅰc, 3;Ⅳb, 2) within one year-old and one (Ⅰc) around 18 months old. The prognosis was uneventful. Four out of the 16 cases rejected surgical operation and were followed up in outpatient. One neonate was diagnosed with congenital biliary atresia and transferred to Children's Hospital for operation.Conclusions When fetal abdominal cyst presented with hepatic portal cyst which communicates with gallbladder or intra-hepatic duct in ultrasonography, a congenital choledochal cyst should be taken into consideration by excluding the possibility of biliary atresia in the first place. Surgery for CCC infants without symptoms or signs is suggested to be performed around three months after birth. The postoperative prognosis of CCC is favorable, so termination is not recommended for gravidas with fetal CCC in prenatal consultation.

In recent years, convolutional neural network(CNN) has exhibited its promising prospect and research value in assisting the analysis of lung cancer. The CNN can automatically learn from the images to extract specific clinically relevant features. This review summarized the construction of CNN by inputting CT images for end-to-end analysis to predict lung cancer risk and the efficacy of clinical treatment, as well as the application of CNN for analyzing pathological slides of resected pulmonary nodules via inputting histopathologic images.

Lung adenocarcinoma is the most common histology type of lung cancer clinically in many countries.A new international multidisciplinary classification was proposed by International Association for the Study of Lung Cancer/American Thoracic Society/ European Respiratory Society(ISALC/ATS/ERS) in 2011,renewing the classification of lung adenocarcinoma in detail,in which invasive adenocarcinoma were further classified as lepidic-predominant,acinar predominant,papillary predominant,micropapillary predominant and solid predominant according to growth patterns.In 2015,World Health Organization introduced the concept of "air space invasion".As an important constituent part of air space invasion,spreading through air spaces(STAS) often occurs in lung cancer,especially early-stage lung adenocarcinoma.STAS is defined as the "spread of lung cancer cells into air spaces in the lung parenchyma beyond the edge of the main tumor".STAS is not only an independent prognostic factor besides growth patterns,but also an independent risk factor of local and distant relapse after limited resection of stageⅠlung adenocarcinoma.Therefore,it is of great guiding significance to judge the existence of STAS either preoperatively or intraoperatively in order to choose a suitable operation method and postoperative treatment of lung adenocarcinoma.This review mainly focuses on the latest research progress on the pathological appearance,related factors,mechanisms and clinical significance of STAS.

Non-small cell lung cancer(NSCLC) is one of the most common malignancies worldwide. Not only the complex molecular components but also the cellular heterogeneity in NSCLC tissues pose a great barrier for its clinical treatment. Recent years has witnessed the widespread application of single-cell sequencing in the studies regarding tumor heterogeneity. However, the disadvantages of single-cell sequencing technology itself could not be neglected. Spatial transcriptome(ST) technology allows in situ transcriptome sequencing of tissues to achieve high-throughput transcriptomic information of tissue cells with their spatial information available. In other words, ST makes it possible to acquire cellular composition and gene expression patterns without breaking intercellular communication network, which distinguishes itself from conventional single-cell sequencing, since mechanical separation and enzymatic digestion of tissue cells into single-cell suspension used to be inevitable during the performance of single-cell sequencing. To gain new insights into the spatial heterogeneity of NSCLC, we reviewed and summarized the latest progress in ST technology which has been applied to tumor sample analysis, especially to the field of NSCLC.

Background and objective Postoperative prolonged air leaks is one of the most common complications secondary to pulmonary resections.Digital drainage system (DDS) is considered as an accurate and objective device which has been found to be comfortable and well tolerated by patients,economical as well.The aim of this study is to explore the application of DDS in patients with postoperative refractory prolonged air leaks after pulmonary surgery.Methods Prolonged air leak (PAL) is defined as air leaks lasting for more than 5 d a~er video-assisted surgery or more than 7 d after thoracotomy.Postoperative refractory prolonged air leak is defined as a kind of air leak lasting for twice than PAL with grade 2 or 3 air leak,or air leak with severe complications such as subcutaneous or mediastinal emphysema in our study.A total of 8 patients who had postoperative refractory prolonged air leaks after pulmonary resection were treated with digital drainage system combined with pleurodesis from January to December in 2016 in Department of Thoracic Surgery,Shanghai Pulmonary Hospital.All the relevant clinical data of patients were collected for analysis.Results In our study,6 patients accepted lobectomy,the other 2 patients underwent segmentectomy.The average air leak and chest tube duration of the patients with postoperative refractory prolonged air leaks after pulmonary resection was (17.3±5.1) d.The average postoperative DDS duration was (5.6±3.7) d.The mean drainage volume of the patients was (2,615.6±1,741.2) mL and (935.0±242.7) mL before and after the application of DDS.The average length of hospital stay was (18.1±5.0) d.Conclusion It is safe and feasible to apply digital drainage system to patients with postoperative refractory prolonged air leaks after pulmonary resection.Compared with the conventional drainage system,digital drainage system is more accurate and objective which can offer a larger suction pressure and promote lung recruitment maneuver for pleurodesis,shortening the drainage time and length of hospital stay.