Objective Video-assisted thoracoscopic surgery is widely used in clinical practice,due to the characteristics of minimal invasion,quick recovery,low incidence of postoperative chest pain and the same effect of lobectomy as thoracotomy.However,the surgical itself has a certain degree of difficulty,and due to the effect of lymph node,intraoperative blood loss,pleural adhesions,conversion to thoracotomy surgery is needed in some cases. Understanding the risk factors of conversion to thoracotomy can help thoracic surgeons figure out the right time to operate the surgery.

Objective: To investigate the expressions of hepatocyte growth factor (HGF) and endothelin converting enzymes (ECE) in non small cell lung carcinoma (NSCLC) and their association with lymphoid metastasis and prognosis. Methods: Expression of HGF and ECE in 77 cases of patients with NSCLC were detected by immunohistochemical method. The relationship between the expressions of HGF and ECE with tumor size, smoking, histological type, differentiation degree, lymphoid metastasis, and prognosis was analyzed. Results: The positive rates of HGF and ECE expression were 44% and 45%, respectively. The expressions of HGF and ECE were positively associated with lymphoid metastasis (P = 0.003 and 0.001, r = 0. 339 and 0. 467, respectively), and negatively with clinical stage and survival time (P < 0.05). The expressions of HGF was positively associated with the expression of ECE in NSCLC. The expressions of HGF and ECE had no correlation with smoking, tumor size, histological type, and differentiation degree (P > 0. 05). Conclusion: The expressions of HGF and ECE are closely associated with lymphoid metastasis and prognosis in NSCLC. Over-expressions of HGF and ECE imply poor prognosis of NSCLC patients.

OBJECTIVETo observe thee efficacy of different ways of percutaneous coronary intervention (PCI) for treating elderly coronary heart disease (CHD) patients.

METHODSTotally 470 elderly CHD patients were classified to three age brackets (equal to or more than 85 years old, 60 to 74 years old, 75 to 84 years old). They were assigned to the transradial intervention (TRI) group (236 cases) and the transfemoral intervention (TFI) group (234 cases) according to different intervention pathways. Correlated indices and postoperative clinical efficacy were compared between the two groups.

RESULTSA higher successful rate of surgery was obviously got in patients 85 years old or older than 85 than in those 60 to 74 years old and 75 to 84 years old (P <0. 05). The incidence of major cardiovascular events (MACE) was reduced at post-operative 12 and 24 months in patients 85 years old or older than 85 (P <0. 05). The case number for changing intervention pathway were increased in the TRI group with statistical difference (P <0. 05). Compared with the TFI group, the case number for changing intervention pathway was increased; the time for arteriopuncture, the time for catheterization, and the time for X-ray exposure were prolonged; the time for postoperative bedding were obviously shortened; the incidence of vascular complications at the puncture site were lowered. The incidence of postoperative 12-month MACE was lowered, all with statistical difference (all P <0. 05). The incidence of MACE within postoperative 24-month MACE decreased in patients 60 to 74 years old and 75 to 84 years old (P <0. 05). The incidence of MACE within postoperative 24 months increased in patients 85 years old or older than 85 of the TRI group with statistical difference (P <0. 05).

CONCLUSIONTRI can be preferably chosen for PC in treating elderly CHD patients.

Aged ; Aged, 80 and over ; Coronary Artery Disease ; surgery ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Myocardial Infarction ; Percutaneous Coronary Intervention ; methods ; Radial Artery ; Treatment Outcome

Purpose:In order to determine the indications for adjuvant treatment in node-negative breast cancer.Methods:We analyzed 233 cases of node-negative breast cancer. Results:The recurrence ratio of node-negative breast cancer was 7.3 percent. The prognosis was connected with age,menstrual history , position, diameter of tumor and pathology. Among invasive lobule cancer, GradeⅢ and lymphocyte-negative cancer, the recurrence ratio was 28 percent in patients with three factors, 16 percent in patient with two factors, 7 percent in patients with one factor.Conclusions:Node-negative breast cancer cases with high recurrence factors need adjuvant treatment.

ObjectiveTo study the rationale of breast-conserving therapy (BCT) for the treatment of early-stage breast cancer. MethodsFrom March 1994 to March 1995, 25 cases of early-stage breast cancer were treated with BCT. The indication was (1) tumor size 3.0 cm; (3) preoperative mammograms were performed in order to exclude multifocal cancer and the tumor with extensive calcification. Tumors were removed with at least 2 cm normal breast tissue margin (evaluated by frozen biopsy), and the axillary nodes were dissected in levels 1 and 2. Two weeks postoperatively patients were treated with radio-therapy to control possible microscopic residual foci. The breast cosmetic results and quality of life (QOL) were analyzed. ResultsAll cases were followed-up for an average of 64.1 months. No differences at 5 year′s survival and local recurrence were found between patients undergoing BCT and those with radical mastectomy.ConclusionThe result of early-stage breast cancer treated with breast-conserving therapy is satisfactory, this therapy is superior to radical mastectomy in terms of improving QOL under condition of strict patient selection and plan design.

Objective To investigate the influence of perioperative continuing aspirin therapy on tooth extraction surgery in elderly patients with coronary heart disease.Methods A total of 926 patients with coronary heart disease who required tooth extraction were enrolled in this study.Among them,241 patients discontinued aspirin therapy before tooth extraction,685 patients continued aspirin therapy before tooth extraction.The entering rate of operation was evaluated.100 patients continuing aspirin and 100 patients discontinuing aspirin were randomly selected.Systemic pressure,diastolic pressure and heart rate before and after tooth extraction were detected.100 matched healthy elderly patients were selected as normal control group.Multivariate logistic regression analysis was used to estimate the risk for tooth extraction.Results The entering rate of operation was 67.9％ (131 cases) in 193 patients with angina pectoris discontinuing aspirin therapy and 82.1 ％ (312 cases) in 380 patients with angina pectoris continuing aspirin therapy (x2 =14.77,P＜0.01).The entering rate of operation was 41.7％ (20 cases) in 48 patients undergoing coronary revascularization and discontinuing aspirin therapy,and 80.7％ (312 cases) in 305 patients undergoing coronary revascularization and continuing aspirin therapy (x2=33.95,P＜0.01).The changes in systolic blood pressure before versus after dental extraction had a significant difference between the discontinuing aspirin group and control group [(15.9±5.5) mmHg vs.(12.2±4.7)mmHg,P＜0.05,1 mmHg=0.133 kPa],while had no significant difference between the continuing aspirin group and control group [(13.6±4.5) mmHg vs.(12.2±4.7) mmHg,P＞0.05].There were no significant differences in changes in diastolic blood pressure and heart rate in the intraoperative period between the patients and controls (P＞0.05).The bleeding rate in patients continuing aspirin therapy was not significantly different as compared with control group (P＞ 0.05).Multivariate logistic regression analysis revealed that perioperative discontinuing aspirin therapy remained the second significant risk factor for tooth extraction.Conclusions Preoperative administration of aspirin should be continued in dental extraction surgery in elderly patients with coronary heart disease.

Actins ; metabolism ; Adult ; Brain Neoplasms ; metabolism ; pathology ; surgery ; Desmin ; metabolism ; Diagnosis, Differential ; Dura Mater ; chemistry ; pathology ; Female ; Granuloma, Plasma Cell ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Meningeal Neoplasms ; pathology ; Meningioma ; pathology ; Neoplasms, Muscle Tissue ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Background Investigating the association of blue light-induced damage of retinal pigmenepithelial (RPE) cellwith intracellulaCa2+ conteniimportanfounderstanding the mechanism of retinal disorders.Objective Thistudy wato establish blue light-induced damage model of human RPE celland explore the relationship between the damage of RPE cell and intracellulaCa2+ content.MethodHuman RPE cellwere cultured and passaged.Cell vitality waassayed by trypan blue staining.Fourth-generation cellwere used in these experiments.The cellwere exposed to blue lighwith an intensity of (2000±500)lx fo3,6,9 o12 hours,and the rate of apoptosiwaassayed by TUNEL to assesthe optimal irradiation time focellcultured.The cellwere then randomized into the withouirradiation group,irradiation only group,nifedipine group,ligh+ nifedipine group,(-) BayK8644 group and ligh+ (-) BayK8644 group.The laseconfocal microscope waused to determine the fluorescence intensity of intracellulafree Ca2+ aan excitation wavelength of 488 nm and an emission wavelength of 505 nm.The cell imagewere analyzed using computesoftware.The differenceof fluorescence intensity among the differengroupwere compared by one-way analysiof variance.ResultTrypan blue staining showed thathe viability of RPE cellwamore than 90％ afteculturing and passaging.No apoptoticell waseen aftelighexposure fo3 hours.However,differennumberof apoptoticellappeared aftelighexposure fo6,9 and 12 hours.The fluorescence intensity of intracellulafree Ca2+ in the nifedipine group wasignificantly lowethan thaof the withouirradiation group othe ligh+ nifedipine group(both aP=0.000).Lasescanning confocal microscopy showed thathe fluorescence intensitieof intracellulafree Ca2+ in the irradiation only group,(-) BayK8644 group,ligh+ (-)BayK8644 group were highethan thaof the withouirradiation group,with statistical significancebetween them(all P=0.000).No significandifferencewere found in the fluorescence intensity of intracellulafree Ca2+ between the ligh+ nifedipine group and withouirradiation group awell abetween the (-)BayK8644 group and the ligh+(-) BayK8644 group(P =0.339,P =0.410).ConclusionThe optical conditionfoblue light-induced RPE cell damage were exposure of blue-ligha(2000± 500) lx fo6 hourand culturing the cellfo24 hours.Blue lighexposure can induce damage of human RPE cellprobably by triggering the increase of intracellulafree Ca2+ concentration.

Xiatianwu tablet is based on the theory of traditional Chinese medicine (TCM), combined with modern TCM pharmacology and selected 33 famous traditional Chinese crude drugs to compose. Its recipe helps cure rheumatism, relax tendons, promote blood circulation to relieve pain, et al. Although Xiatianwu tablets are widely applied to clinical remedy such as rheumatic arthritis, lumbar disc hernia, osteoarthritis and so on, there is no report about its application in fracture. This article is to observe the efficacy of compound Xiatianwu tablets in elderly patients with osteoporotic distal radius fractures and its impact on the wrist function and complications. 180 elderly patients with osteoporotic distal radius fractures, from January 2011 to June 2014, were divided into observation group and control group by the method of random number table, each group had 90 cases. The control group were gave Caltrate D after manipulative reduction and plaster immobilization, observation group were treated with compound Xiatianwu tablets in the basis of the control group. Efficacy, wrist function and complication rates were observed in two groups after treatment. The excellent and good rate was 95.56% in observation group better than 77.78% in control group, the difference was statistically significant (χ2 = 4.712, P < 0.05). The complication rate in observation group was significantly lower compared with the control group (P < 0.05). This study shows that compound Xiatianwu tablets can improve the efficacy in elderly patients with osteoporotic distal radius fractures, reduce the incidence of complications and relieve the pain of patients which plays a significant role in improving the quality of life.
Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Fractures, Bone ; drug therapy ; Humans ; Male ; Middle Aged ; Osteoarthritis ; drug therapy ; Radius Fractures ; drug therapy ; Tablets ; administration & dosage ; Treatment Outcome

Racemic (±)-F18 (10-chloromethyl-11-demethyl-12-oxo-calanolide A), an analog of nature product (+)-calanolide A, is a new anti-HIV-1 nonnucleoside reverse transcript inhibitor (NNRTI). A successful enantioseparation of (±)-F18 offering (R)-F18 and (S)-F18 was achieved by a chiral stationary phase prepared HPLC. Their absolute configurations were determined by measurement of their electronic circular dichroisms combined with modem quantum-chemical calculations. Further investigation revealed that (R)-F18 and (S)-F18 shared a similar anti-HIV activities, however, (R)-F18 was more potent than (S)-F18 against wild-type virus, K101E mutation and P225H mutation pseudoviruses.
Anti-HIV Agents ; chemistry ; Chromatography, High Pressure Liquid ; HIV-1 ; drug effects ; Pyranocoumarins ; chemistry