Objective To retrieval the ways of prevent complications of video-assisted thoracoscopic surgery. Methods The operation included bullectomy in 462 patients, resection of mediastinal tumor or cyst in 86; esophageal diseases in 94, lobectomy or wedge resection of lung in 140, VATS hemostasis in 22, partial pericardial or pleural excision in 54 and biopsy for undetermined chest diseases in 54. Combined anesthesia with intubations of double lumen tracheal tube was performed in 866 patients and single-lumen tracheal tube in 46. Results 886 operations were completed by VATS, and 26cases were converted into thoracotomy for various reasons. Complications occurred in 36 patients (3.95%), including 10 cases occurred during the operation (esophageous mucous rupture in 4, nerve injury in 2 and insufficient hemostasis leading to postoperative bleeding in 4). 26 cases (2.85%) developed complications postoperatively, including persistent air leak (≥7 days) in 19, pleural effusion making a second water-sealed drainage necessary in 3, atrial fibrillation in 2 and infection in 1. One died for respiratory failure on the fifth postoperative day. Conclusion VATS experience should be gained systematically. In order to reduce the complications, more attentions must be paid to training of the thoracic surgeons in order to master the skill and the correlated knowledge of VATS.

To evaluate and summary clinical experience in video assisted thoracoscopic surgery (VATS)for some thoracic diseases, clinical data of 616 patients (644 times) subjected to thoracoscopic surgery in our hospital from December 1993 to December 2001 were retrospectively analyzed. Among them, spontaneous pneumothorax occurred in 276 patients, emphysema in 44, mediastinal tumor or cyst in 55, esophageal diseases in 78, pulmonary malignant or benign diseases in 75, and other diseases in 65. Double lumen tracheal tubes were placed in 576 patients, single one was placed to ensure one lung ventilation in 6 patients and two lung ventilation in 34 patients. surgical procedures were completed by VATS in 593 cases, and 23 cases were converted into thoracotomy because of pleural adhesion or tumor invasion. Postoperative complications occurred in 24 cases with a morbidity rate of 4 0%. Persistent air leak (over 7 days) were noted in 15 cases and postoperative bleeding in 3. One case with spontaneous pneumothorax and type Ⅱ respiratory failure died of repiratory failure on the fifth day postoperatively. Six of 276 patients with spontaneous pneumothorax relapsed. VATS has more advantages than tranditional thoracotomy for some selected chest diseases,so thoracic surgeons shoulds convert tranditional thoracotomy method to perfom VATS step by step.

Objective To discuss the necessity of mediastinal lymph node dissection in the resection of lung cancer. Method 740 patients with lung cancer underwent lobectomy or pneumonectomy during Jan. 1987 to Dec. 2002 in our hospital were retrospectively analyzed. Totally 3492 lymph nodes were removed and checked up pathologically. Result Lymph nodes with metastasic were confirmed in 362 out of the 740 cases, and the metastasis ratio was 48.9%, and among them in 276 patients suffered N_2 lesion, with the ratio of 37.3%. The statistic result showed that lymph node metastasis was correlated to the location, cell type, the size, T stage and differentiation of lung cancer. Conclusion Lymph node metastasis in lung cancer is common and related to multiple factors. In order to obtain radical cure, both mediastinal and hilar lymph nodes should be removed.

Objective To monitor right heart hemodynamic changes of patients with lung cancer during and after the procedures of pneumonectomy and discuss the effect of pneumonectomy on right heart function and risk of postoperation morbidities. Method 16 patients with lung cancer were randomly selected and the clinical database was queried and Swan-Ganz catheter was applied awake from jugular vein to pulmonary artery ,measuring mean arterial pressure(MAP) ,heart rate(HR) ,central venous pressure(CVP) ,mean pulmonary artery pressure (MPAP),mean pulmonary capllary wedge pressure(MPCWP) ,and eardiaoc output(CO) and calculating cardiac index (CI),left ventricular-stroke work index (LVSWI), right ventricular stroke work index (RVSWI) , and stroke volume index(SVI) instantaneously before anaesthesia, after anaesthesia with single lung ventilation, after pulmonary artery and pulmonary vein occlusion and supine chest dosed during the procedure of pneumonectomy. Pre-and post-operative complications were recored. Results Cardiovascular complications occurred in 6 patients(37.5%) postoperatively. There were no operative or perioperative deaths. MPAP increased significantly after the procedure of pneumonectomy compared with that of preoperation, and MPAP > 26 mm Hg was in 4 patients who got cardiovascular complications postoperatively with morbidity of 100% ,which was "significantly higher than the morbidity of 16.7% (2/12) when MPAP < 25 mm Hg. Conclusion Pneumonectomy has significant effects on right heart hemodynemic changes and as MPAP increases postoperatively, the risk of cardiovascular complications becomes higher.

Objective·To identify the relationship between the estimated fetal weight (EFW) discordance and birth weight (BW) discordance, and evaluate the accuracy of ultrasonography in predicting birth weight discordance (△BW) of twin pregnancy. Methods·The ultrasound was used to detect the growth of twins at different gestational weeks and the data were analyzed to compare the difference between EFW discordance (△EFW) and ?BW. Results·About 15.9 percent of twins (totally 277 cases) had severe △BW (△BW ≥20%) in our study, and the percentages of dichorionic-diamniotic twin (DCDA) and monochorionic-diamniotic twin (MCDA) were 68.2% and 31.8%, respectively (P>0.01). Compared with △EFW in other gestational weeks,△EFW last time before parturition was most consistent of △BW. Furthermore, the negative predictive value of MCDA was highest (94%) at 22-24 gestational weeks. Conclusion·Twin △BW was relatively better predicted by △EFW last time before parturition. Twin pregnancy without severe △EFW (△EFW<20%), especially MCDA with △EFW<20% at 22-24 weeks, had low probability of selective intrauterine growth restriction in the future.

This paper was aimed to study the albiflorin activity of Tang-Bi-Kang (TBK) granules in protecting Schwann cells (SCs) of rat's sciatic nerve.The establishment of SCs oxidative stress model was the condition of 150 mmol×L-1 Dglucose with different concentrations.And the incubation time was 48 h.The experiment groups were the high-dose,middle-dose and low-dose (100 μM,20 μM,4 μM) albiflorin group,the model group,the vitamin C (100 μM) group,and the normal group.Flow cytometry was used to detect the content of ROS in SCs.Fluorescence microscope was used to observe the condition of ROS fluorescence in SCs.And CCK-8 was used to detect the cell activity.The results showed that by using CCK-8 to detect cell proliferation,after 48 h,there was a significant difference between the model group and the normal group (P＜0.01);the albiflorin group compared with the model group (P＜0.01).It indicated that albiflorin can promote the proliferation of SCs.Detecting the ROS fluorescence content,it showed that compared with the model group (Glu 150 mM),the 100 μM,20 μM,and 4 μM albiflorin group,it was P＜0.01 for each group.It showed that albiflorin could relieve the ROS in SCs and alleviate oxidative stress.It was concluded that albiflorin can increase the proliferation of SCs and improve the state of oxidative stress with the protection of SCs.

Through comprehensively characterizing components in blood after oral administration of Tang-Bi-Kang (TBK) granules by UPLC-ESI-MSn,this study was aimed to explain the pharmaceutical material basis of TBK initially.UPLC-LTQ-Orbitrap was used under both positive and negative ion modes of electrospray ionization.The blank serum and rat serum after oral administration of TBK were analyzed.Components in rat serum were identified and characterized based on ion fragment information,evenelectron law,nitrogen rule and so on.Reference data was used to establish the UPLC-ESI-MSn method.The results showed that after oral administration of TBK granules,15 components were detected in the serum,of which 13 components were taken as the prototype to blood and 2 metabolites.It was concluded that constituents of TBK granules in rat serum were generated from compatibility of all herbal medicines.In rat serum,most of the components had been absorbed by rat's metabolism;a few were absorbed as the prototype.This research provided references for pharmacodynamic material basis and metabolism of TBL granules in vivo.

This paper was aimed to study the effect of ethyl acetate extracts of Gentianella acuta on the gene and protein of insulin significant signal IRS-1 and Akt in insulin resistance (IR) HepG2 cells.The CCK-8 method was used to detect the HepG2 cell activity.HepG2 cells of human liver cancer were cultured with high concentration insulin (10-6 mol· L-1)for 36 hours to establish IR cell model.According to the results of CCK-8,the control group,model (IR) group,ethyl acetate extracts of Gentianella acuta IR + 50 μg· mL-1,IR + 500 μg· mL-1 group,and the metformin group were divided.Glucose consumption was measured with a glucose assay kit.The expressions of IRS-1 and Akt gene in IR HepG2 cells were detected by RT-PCR after 6-hour using of ethyl acetate extracts of Gentianella acuta.Western blot was used to detect the expression of IRS-1 and Akt protein after 6-hour using of ethyl acetate extracts of Gentianella acuta.The results showed that when the concentration of ethyl acetate extracts of Gentianella acuta was 500 μg· mL-1,the survival rate reached 95％.When the concentration was higher than 500 μg· mL-1,the survival rate decreased.Compared with the IR group,the IR + 50 μg· mL-1 group and the IR + 500 μg· mL-1 group promoted glucose consumption of IR HepG2 cells,but its effect was less than that of the metformin hydrochloride group.The expression of IRS-1 and Akt in IR HepG2 cells was significantly increased by using RT-PCR in the group of IR + 50 μg· mL-1 and IR + 500 μg·mL-1 compared with the IR group after 6-hour using of ethyl acetate extracts of Gentianella acuta.The expression of IRS-1 and Akt protein in the group of IR + 50 μg· mL-1 and IR + 500 μg· mL-1 was significantly higher than that in the IR group after 6-hour medication detected by western blot.It was concluded that the ethyl acetate extracts of Gentianella acuta can increase the expression of IRS-1,Akt gene,the expression of IRS-1 and Akt protein in HepG2 cells,which may be the mechanism of IR improvement.

Objective To assess the therapeutic effect of bone marrow‐derived mesenchymal stem cells (BMSCs) on osteoporotic fracture healing .Methods Bone marrow of the rat bilateral femur and tibia bone tissue were collected ,and BMSCs were isolated by the whole bone marrow adherence method .Sixty female 11‐week‐old SD rats were ovariectomized (OVX) to induce osteoporosis followed by bilateral fracture generation .Twenty rats were left without giving any further treatment (OVX controls) ,20 received injection of saline (OVX+placebo control) and 20 were given injection of BMSCs (OVX+BMSCs) .X‐ray scan was performed at 3‐day ,4‐week and 8‐week post‐fracture ,respectively .Results Flow cytometry analysis revealed that the isolated BMSCs express sur‐face antigens similar to those reported previously .X‐ray results showed that compared with OVX and OVX+placebo groups ,BM‐SCs treatment markedly accelerated fracture healing of in osteoporotic rats .Conclusion Transplantation of BMSCs can effectively improve the healing of primary osteoporotic fracture .

Objective HGF and its receptor ( c-met) are principal mediators of mesenchymal-epithelial interac-tion in several different systems.Moreover, hair follicle is a model of mesenchymal-epithelial interaction.The aim of this study was to explore whether HGF/c-met signal plays a role in the control of hair follicle growth cycle.Methods To ex-amine the localization of HGF/c-met in anagen, catagen and telogen in the hair follicle of ICR mice.Results HGF was mainly located in the dermal papilla and sebaceous gland, and c-Met in the hair matrix, root sheath and epidermis.Both HGF and c-met expressions peaked during anagen, not found in catagen, and increased during telogen-anagen phase.Con-clusions Our results demonstrate a regulatory role of HGF and c-met in the control of hair follicle growth in ICR mice.