Objective To evaluate the value of mediastinoscopy in the diagnosis of undifferentiated mediastinal diseases. Methods A total of 35 mediastinoscopies were performed for patients with undifferentiated mediastinal disease from November 1999 to February 2002 and suspicious tissues at peritracheal,retrosternal,subcarinal,or bilateral hilar areas were obtaiued for pathological examination. Results Thirty four of 35 patients with undetermined mediastinal diseases had definite pathologic diagnosis.The diagnosis accuracy was 97%(34/35).Of the 34 patients,18 were diagnosed as malignant accounting for 52.9%.Sixteen of the 34 were diagnosed as benign,accounting for 47.1%.The diagnostic consistency of preoperation and postoperation was 47.1%(16/34).The misdiagnosis of preoperation was 52.9%(18/34).In this series,the benigns were apt to lead to misdiagnosis.10 of 16 patients with benign disease were diagnoscd as initially malignancies,representing 62.5%.In the entire group one patient had complications (2.9%).Yet no perioperative death occurred. Conclusions Mediastinoscopy is a valuable procedure which helps mede a correct diagnosis of mediastinal diseases.Given its safety and usefulness It is suggested that mediastinoscopy should be used routinely in the diagnosis of undifferentiated mediastinal diseases.

1.0 cm) by radiographic examinations, video-mediastinoscopy showed positive results in 30 cases, and negative in 14 cases, in which the surgical exploration found no evidence of metastasis to mediastinal lymph nodes. No postoperative complications and mortality were observed. Conclusions Video-mediastinoscopy offers clear operation field, high resolution, convenient application, safety and reliability. We suggest that it be adopted as a routine method in the diagnosis of mediastinal tumor and the staging of lung cancer.

Objective: To compare the clinical value of video-mediastinoscopy (VM) and standard mediastinoscopy(SM) in diagnosis of thoracic diseases. Methods: The clinical data of 100 patients with mediastinoscopy were studied retrospectively. Of them, 54 patients underwent VM, and 46 patients underwent SM. The operative parameters including operating time, complications and post-operative hospital stay, the diagnosis accuracy of undifferentiated mediastinal diseases and the accuracy of perioperative staging of lung cancer were compared. Results: The average operating time in VM group was (53.9?17.2) mins, which was less than that in SM group (69.4?24.7)mins (t=2.05,P

Objective To evaluate the role of mediastinoscopy with biopsy on right trachea-bronchial lymph node (R4) in the diagnosis and pathologic staging of lung cancer. Methods From November 1999 to May 2004, sixty-six patients with lung cancer (47 right and 19 left) received mediastinoscopic biopsy on R4 lymph node. 17 patients were preoperative diagnosed and 49 suspected have lung cancer. The approach included cervical mediastinoscopy in 62 cases, parasternal mediastinoscopy in 1 and cervical combined with parasternal mediastinoscopy in 3. Results In total 66 patients, R4 lymph node positive was found in 49 cases, including 38 patients with right lung cancer and 11 with left lung cancer. The metastasis rate in small cell lung cancer, adenocarcinoma and squamous cell carcinoma were 100%, 82.2% and 52%, respectively. For 49 preoperatively suspected lung cancer patients, malignant tumor was confirmed by mediastinoscopy with biopsy in 40 and open thoracic surgery in 9. All the operations were successful and the patients recovered smoothly without severe postoperative complications. Conclusion R4 lymph node is one of the most common and important site for the tumor metastasis in lung cancer. Mediastinoscopy with biopsy on R4 lymph node has incomparable advantages in diagnosis and staging lung cancer over other examinations and biopsy on other sites of lymph nodes.

Objective To reveal the effects of circadian gene Per2 on growth of human lung cancer cell A549 cell and its mechanism. Methods pcDNA3.1(+)-Per2 was transfected into A549 cells and controlled with the vector pcDNA3.1(+). The expression of Per2 was confirmed with RT-PCR and western blot. The Inhibitory effect of Per2 on cell growth and proliferation was demonstrated with MTT assay and colony-forming assay. Apoptosis was detected with flow cytometry. Results The circadian gene Per2 exhibited a growth-inhibitory and apoptosis-inductory effect on A549 cells. Conclusion The results indicate that Per2 may inhibit A549 cell proliferation,which mechanism might involve cellular apoptosis.

OBJECTIVE:To provide reference for perioperative rational application of antibiotics in gynecologicalⅡandⅢinci-sion surgery. METHODS:The perioperative patients of typeⅡandⅢincision surgery were collected from our hospital during Jul.-Dec. 2013-Jul.-Dec.2014,and then divided into pre-rectification group and post-rectification group. The prophylactic application of antibiotics in 2 groups were analyzed statistically. RESULTS:After rectification,rational rate of prophylactic medication in-creased from 5.38% to 89.69%(P<0.01);rational rate of prophylactic medication time increased from 11.83% to 91.75%(P<0.01);prophylactic medication duration decreased from (12 ± 2.1)d to(5.5 ± 1.9)d(P<0.01);after rectification,both total drug cost and drug cost per capita decreased significantly (P<0.01);postoperative infection rate showed no significant change before and after rectification (P>0.05). After rectification,usage and dosage of β-lactam antibiotics were in line with pharmacokinetics, Intravenous drip was adjusted from once a day to twice a day,and its rational rate increased significantly compared to before rectifi-cation(P<0.05). CONCLUSIONS:The antibiotics special rectification activities significantly promote the rationality of periopera-tive prophylactic application of antibiotics in gynaecologyⅡandⅢincision surgery of our hospital,reduce adverse drug reactions and resistant strains due to irrational use of drugs,and decrease the drug cost.

Objective To evaluate the efficacy and safety of video-assisted thoracoscopic surgery in the treatment of esophageal leiomyoma.Methods Clinical data of 49 patients with esophageal leiomyoma from September 1996 to February 2009 treated by video-assisted thoracoscopic enucleation were reviewed retrospectively.Three or four trocars were used during the operation.The procedure of the surgery was similar to that of open thoracoscopic enucleation.Results In the 49 patients,video-assisted thoracoscopic leiomyoma enucleation was successfully completed in 42 cases.The other 7 patients were converted to open thoracotomy because of the following reasons:dense pleural adhesion in 2,location failure of small tumor(

Objective To investigate the clinical efficacy and significance of preoperative superselective endovascular embolization in treatment of patients with vascularized meningioma.Methods 3-9 days before operation, 98 patients with vascularized meningioma underwent DSA and preoperative superselective embilization with PVA particles, gelatin sponge, and silk. The surgical intervention was performed after embolization. Results The vascularized meningioma was mainly supplied by the middle meningeal artery, ascending pharyngeal artery, occipital artery, internal maxillary artery as well as submeningeal artery. After the supplying artery was embolized, tumors' staining in 42 cases disappeared completely and that of 56 cases disappeared totally or partly. Most patients were operated on 3-9 days after embolization. 64 tumors were removed completely, while other 34 cases were removed totally or partly. The average volume of bleeding during the operation was 950 ml in the former and 1 500 ml in the latter.Conclusions The best time for operation is 7～9 days after embolization. Preoperative embolization of the vascularized meningioma contributes to reduce the bleeding significantly during the operation, increase the safety of the operation and improve the total removal of the tumor. It is a safe and effective microinvasive method.

OBJECTIVE: To investigate the protective renal tubular effects ethyl acetate extract from Citrullus lanatus vine in rats with diabetic nephropathy (DN). METHODS: Healthy rates were used to establish DN models by peritoneal injection administration streptozotocin. The levels fasting blood glucose (FBG), fasting blood insulin (FBI), serum creatinine (Scr), urine creatinine (Ucr) and urinary albumin (UAlb) were detected. Pathology live was observed. RESULTS: After treatment, ethyl acetate high dose group and medial dose group Citrullus lanatus vine all significantly decreased the levels GLU, FBI, UAlb, KWI and TBI. Meanwhile, Ccr was also improved. CONCLUSION: The ethyl acetate extract from Citrullus lanatus vine can protect renal tubular in rats with DN.

Objective To analyse the difference between stage Ⅰ pure bronchioloalveolar carcinoma (BAC) and stage Ⅰ adenocarcinoma of the lung among operative cases.Methods We use the Lobectomy Cases Registration and Statistics System database (2006-2011) to compare the epidemiology,clinical presentation,image characteristics,surgical outcomes,recurrence and overall survival between BAC and adenocarcinoma groups.All the patients received lobectomy procedure in the department of thoracic surgery of Peking University People' s Hospital.Results Excluding those cases with both BAC and adenocarcinoma aspects,337 patients were enrolled.Thirty-nine patients were stage Ⅰ pure BAC and 298 patients were stage Ⅰadenocarcinoma.BAC has its proper clinical spectrum,occurring more frequently in women (69.2％ vs.52.0％,P =0.042)and in younger patients (57.4 vs.61.8,P =0.014).BAC also seems to be less dependent on tobacco exposure (12.8％ vs.29.9％,P =0.026).The percentage of ground-glass opacity (GGO) in CT scan of BAC patients was much more than that registered in adenocarcinoma patients (35.9％ vs.9.7％,P ＜0.001).And the tumor size of BAC group was smaller than that of the adenocarcinoma group (1.4 cm vs.2.3 cm,P ＜0.001).The operation method,time,blood loss and complications were similar between the two groups.Kaplan-Meier survival curves showed that both 3-year disease-free survival (DFS) and overall survival (OS) were significantly higher in patients affected by BAC (100％ vs.76.1％,P =0.030 and 100％ vs.86.1％,P =0.041).Conclusion BAC presents specificity in its epidemical,clinical,radiological and evolutionary aspects.Stage Ⅰ pure BAC patients have better prognosis following video-assisted thoracoscopic lobectomy and system lymph node dissection than the similar stage adenocarcinoma patients.