After decades of development, thymus minimally invasive surgery has derived a variety of surgical methods. In selected cases, it can achieve equivalent therapeutic effect as open surgery. Because mediastinal disease is rare compared with other chest diseases, there is a lack of large-scale comparative study among different surgical methods, and the choice of surgical approaches is mostly based on the experience and habit of the operator. The purpose of this review is to discuss the evolution of minimally invasive thymus surgery, summarize several kinds of minimally invasive thymus surgery approaches that are widely used in and abroad, and analyze the integration and improvement strategies of minimally invasive thymus surgery in China.

ObjectiveTo observe the killing effect on hepatocellular carcinoma(HCC) cell lines by growth response-1(Egr-1) promoter activated herps simplex virus thymidine kinase (tk). MethodsPlasmid pET was constructed by fusing of Egr-1 promoter to the upstream of tk gene and transfect human hepatocellular carcinoma cell lines SMMC-7721(SMMC/ET) with lipofectamine as a delivery system. The cloned cells, after selected with G418, and exposure to ?-radiation by a 60Co source, were added with prodrug GCV. The viability of cell lines was observed. ResultsAfter irradiation, transfected cell lines (0.07?0.03) was killed by prodrug GCV at higher percentage compared with control group(0.88?0.12)(P

Objective:To evaluate the clinical efficacy of benazepril in combination with valsartan in treating chronic kidney patients with proteinuria and hypertension.Method:75 chronic kidney patients were divided into benazepril group(n=28)and valsartan group(n=26)and combination treatment group(n=21).The changes of 24 hours urinary protein excretion and blood pressure and serum BUN and SCr were observed before the treatment and 4 and 8 weeks after it. Result:The 24 hours urinary protein excretion and blood pressure in all the groups showed significant decreases after the treatment(P0.05),but the levels of SUA were significantly lower in the valsartan group and combination treatment group than those in the benazepril group(P

Objective To investigate the risk factors and clinical features of mild cognitive impairment (MCI) in patients with ischemic cerebral small vessel disease (SVD) for early diagnosis and prevention.Methods Montreal Cognitive Assessment Scale (MoCA) was used to screen MCI.The related risk factors and other clinical data were collected,and other neuropsychological tests were conducted.SVD was divided into leukoaraiosis (LA),lacunar infarction (LI),and LA + LI.Results A total of 143 patients with SVD were enrolled (68 in an MCI group,75 in a non-MCI group).Univariate analysis showed that there was no significant difference in the constituent ratio of age and gender between the MCI group and the non-MCI group,but the years of education in the MCI group was shorter than that in the non-MCI group,while the composition ratios of hypertension (69.11％ vs.45.33 ％;x2 =8.215,P =0.004),diabetes (57.35％ vs.40.00％;x2 =4.301,P =0.038),hyperlipidemia (48.53％ vs.24.00％ ; x2 =9.352,P =0.002),carotid atherosclerosis (41.18％ vs.21.33％ ;x2 =6.592,P =0.010),and smoking (32.35％ vs.14.67％ ;x2 =6.285,P =0.012),as well as the levels of uric acid (351.81 ± 83.21 mmol/L vs.323.03 ± 80.43 mmol/L; t =2.102,P =0.037) and total cholesterol (5.26 ± 1.26 mmol/L vs.4.56 ± 1.23 mmol/L; t =3.326,P =0.001) were significantly higher than those in the non-MCI group.Multivariate logistic regression analysis showed that hypertension (odds ratio OR]2.227,95％ confidence interval [CI],1.001-4.954; P =0.026),diabetes (OR 2.056,95％ CI 1.862-4.937; P =0.046),hyperlipidemia (OR 2.528,95％ CI 1.361-5.770; P =0.028),carotid atherosclerosis (OR 2.658,95％ CI 1.110-6.367; P =0.029),smoking (OR 2.566,95％ CI 1.017-6.474; P =0.046),and years of education (OR 0.825,95％ CI 0.745-0.914; P =0.000) were the independent risk factors for the occurrence of MCI in patients with SVD.The subscores in the MCI group,including MoCA total score (18.44 ± 5.60 vs.27.09 ± 1.37; t =-12.422; P =0.000),as well as visuoconstructional skills (2.65 ± 1.39 vs.4.49 ± 0.74; t =-9.762; P =0.000),attention (4.48 ± 1.70vs.5.89 ± 0.31; t =6.706,P=0.000),language (1.69 ± 0.80vs.2.41 ± 0.95 ; t =4.893,P=0.018),abstraction (0.85 ± 0.69 vs.1.71 ± 0.53; t=-7.081,P=0.000),delayed recall (1.29 ±1.01 vs.4.04 ± 0.99; t =13.824,P =0.000) were significantly lower than those in the non-MCI group,and there were no significant differences in naming and orientation scores.In the MCI group,the subscores such as theMoCA total score in the LA+LI group (17.04 ± 6.15 vs.21.04 ± 3.98; P＜0.05),as well as visuoconstructional skills (1.68 ± 1.16 vs.3.24 ± 1.13; P ＜ 0.05),attention (3.92 ± 2.03 vs.5.19 ±0.87; P ＜0.05),delayed recall (1.35 ± 1.01 vs.1.86 ± 1.58; P ＜0.05) were significantly lower than those in the LI group; the subscores such as the MoCA total score in the LA group (18.18 ± 5.31 vs.21.04 ± 3.98; ＜ =0.05),as well as visuoconstructional skills (2.56 ± 1.78 vs.3.24 ± 1.13; P＜0.05),language (0.64 ± 0.23 vs.1.24 ± 0.83; P ＜0.05),delayed recall (0.69 ± 0.58vs.1.86 ± 1.58;P＜0.01)were significantly lower than those in the LI group; the visuoconstructional skills in the LA + LI group was significantly lower than that in the LA group (1.68 ± 1.16 vs.2.56 ± 1.78; P＜0.05) and the LI group (1.68 ± 1.16 vs.3.24 ± 1.13; P＜ 0.05).Conclusions Hypertension,diabetes,hyperlipidemia,carotid atherosclerosis,smoking,and the low level of education were the independent risk factors for MCI in patients with SVD.After SVD,the cognitive impairment in MCI presented as multiple cognitive domains impairments,including visuoconstructional skills and delayed recall.Cognitive impairment differed among the different types of SVD.

Objective To explore the association of risk factors with amnestic versus nonamnestic of mild cognitive impairment.Methods All the subjects with mild cognitive impairment (MCI) aged 65-75 years were recruited from Neurology Department of 3 third-class hospitals of Qingdao,admitted from January 2011 to September 2011.They were systematically evaluated with mini-mental state examination( MMSE )and Montreal cognitive assessment (MoCA),then health conditions were collected.According to Petersen's standards,patients were divided into 89 cases with amnestic mild cognitive impairment(aMCI) and 51 cases with non-amnestic mild cognitive impairment (non-aMCI)groups to compare different risk factors between them.Results There were statistical differences in high total cholesterol (P=0.011),diabetes mellitus (P=0.009),MoCA score (P=0.040) between aMCI and non-aMCIgroups.MoCAscore (OR=1.081,95％CI:1.001-1.204,P=0.040) in the aMCI group was lower than that in non aMCI group.Diabetes mellitus ratio (OR=0.258,95％CI:0.096-0.695,P=0.009) was higher in non-aMCI group than in aMCI group.The level of total-cholesterol(OR=13.345,95％CI:1.127-158.085,P=0.011) in aMCI group was higher than that in non-aMCI group.The high total cholesterol was a independent risk factor for aMCI.Conclusions Different risk factors appear to exert different effects for aMCI and nonaMCI.

Objective To evaluate the endoscopic precut sphincterotomy for malignant biliary obstruction. Methods Endoscopic precut sphincterotomy was performed in different ways for 46 patients with malignant biliary obstruction and difficult biliary cannulation according to the anatomic structure of the papilla and cannulation. Ways of precut were summarized and complications were analyzed. Results Precut sphincterotomy was performed with bow-like knife in 4 patients, with needle-knife in 24, with trans-pancreatic sphincterotomy in 12 and with combined ways in 6. The procedure succeeded in 35 cases (76. 1%, 35/46). Post-procedure complications included bleeding in 3 patients, pancreatitis in 1, hyper-amylasemia in 2and cholangitis in 1. No perforation was found. Conclusion Endoscopic precut sphincterotomy is not only able to improve the therapeutic endoscopy achievement rate in patients with malignant biliary obstruction, but also to lower the incidence of complications if used adequately.

The aim of this study was to propose an algorithm for three-dimensional projection onto convex sets (3D POCS) to achieve super resolution reconstruction of 3D lung computer tomography (CT) images, and to introduce multi-resolution mixed display mode to make 3D visualization of pulmonary nodules. Firstly, we built the low resolution 3D images which have spatial displacement in sub pixel level between each other and generate the reference image. Then, we mapped the low resolution images into the high resolution reference image using 3D motion estimation and revised the reference image based on the consistency constraint convex sets to reconstruct the 3D high resolution images iteratively. Finally, we displayed the different resolution images simultaneously. We then estimated the performance of provided method on 5 image sets and compared them with those of 3 interpolation reconstruction methods. The experiments showed that the performance of 3D POCS algorithm was better than that of 3 interpolation reconstruction methods in two aspects, i.e., subjective and objective aspects, and mixed display mode is suitable to the 3D visualization of high resolution of pulmonary nodules.
Algorithms ; Humans ; Imaging, Three-Dimensional ; Lung ; pathology ; Multiple Pulmonary Nodules ; diagnosis ; Tomography, X-Ray Computed

This study was to explore a better three-dimensional (3-D) culture method of chondrocyte. The interpenetrating network (IPN) gel beads were developed through a photo-cross linking reaction with mixed barium ions and calcium ions at the ratio of 5:5 with the methacrylic alginate (MA), which was a chemically conjugated alginate with methacrylic groups. The second generation of primary cartilage cells was encapsulated in the MA gel beads for three weeks. In the designated timing, HE stain, Alamar blue method and Scanning electron microscopic were used to determine the cartilage cells growth, proliferation and the cell distribution in the scaffolds, respectively. The expression of type II collagen was investigated by an immunohistochemistry assay and the glycosaminoglycan content was quantitatively evaluated with the spectrophotometry of 1, 9 dimethylene blue assay. Compared to the alginate control group, the deposition of glycosaminoglycan was significantly upregulated in IPN-MA gel beads with higher cell proliferation. The secretion of extracellular matrix and proliferation of chondrocyte in methacrylic alginate gel beads were higher than that in Alginate beads. Cells were able to attach, to grow well on the scaffolds under scanning electron microscopy. The result of immunohistochemistry staining of collagen type II was positive, confirming the maintenance of chondrocyte phenotype in methacrylic alginate gel beads. This study shows a great potential for three-dimensional culture of cartilage.
Alginates ; chemistry ; Barium ; chemistry ; Calcium ; chemistry ; Cartilage ; cytology ; Cations ; Cell Culture Techniques ; instrumentation ; Cells, Cultured ; Chondrocytes ; cytology ; Collagen Type II ; chemistry ; Glucuronic Acid ; chemistry ; Glycosaminoglycans ; chemistry ; Hexuronic Acids ; chemistry ; Metals ; chemistry ; Microscopy, Electron, Scanning

Background and purpose: High-dose chemotherapy followed by autologous stem cell transplantation (auto-HSCT) is considered as the ifrst line treatment for patients with relapse/refractory lymphoma after conventional chemotherapy. However, most of these patients still relapse the second time. The purpose of this study was to analyze the efifcacy of the consolidation chemotherapy after autologous stem cell transplantation (HSCT) refractory/relapse lymphoma in high risk. Methods:A total of 38 patients with relapsed/refractory lymphoma including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) were included, who were underwent auto-HSCT in our transplan-tation department from Jan. 2010 to Dec. 2013. In treatment group, 19 patients received 2 courses of consolidation che-motherapy after auto-HSCT every 2 to 3 months, with the regimen of mini-BEAM or modiifed mini-CBV. Another 19 patients had no chemotherapy after auto-HSCT as control group. Results:The median follow-up duration was 17.2 and 7.5 months in the treatment and control group respectively. The follow-up data demonstrated prolonged progression-free survival (PFS) in the treatment group than the control group [24.7 months vs 7.8 months, P=0.029 under intend-to-treat analysis ITT;24.7 months vs 5.2 months, P=0.01 under per protocol analysis(pp)]. There is also a trend of improved overall survival (OS) in the treatment group (P=0.055, ITT). Conclusion:Consolidation chemotherapy after auto-HSCT for refractory/relapsed lymphoma patients delay the relapse and tend to improve the overall relapse rate.

Caenorhabditis elegans (C.elegans), has developed into an useful model for biomedical research, particularly in the targets of novel drugs and the related mechanism.C.elegans, combining with cost-effective cultivation, simple biological structure, make for high-throughput screenings in vivo model.In this review, we explore the feasibility of C.elegans in drug activity evaluation of complex systems.Because of the body independence of C.elegans, it provided good platform for the efficacy and mechanism of research on new drugs as well as Chinese herbal extract in vivo, showing a good prospect.