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 analyse the prevalence rate of the cardiovascular and cerebrovascular disease and their susceptible factors in employees of AISCO.Methods A total 95 912 persons,to analyse the history of cardiovascular and cerebrovascular disease,smoking,blood pressure,diabetes mellitus,TC,HDL-C,BMI,and the value of TC/HDL-C so as to find the risk stratification of cardiovascular and cerebrovascular disease.Results There were 1 910 persons with CAD(2.00%),607 with cerebrovascular(0.63%),19453 smoking(20.28%),788 with diabete(0.82%),31698 with hypertention(33.05%),8347 with hypercholesteremia(8.70%),55462 over weight(57.83%),and 10 487 with TC/HDL-C≥3.5.the probability suffer from cardiovascular were mostly in very-low-risk(68.14%)and low-risk(5.75%),and carotid atherosclerosis were mostly in high-risk(44.23%),intermediate-risd(23.21%)and very-high-risk(10.51%)without low-risk and very-low-risk.Conclusion The health condition of the investigation population was not optimism and we will make more efforts for health education.

CD4 +CD25 +Foxp3 +regulatory T cells(Tregs)are essential for tumor immunosuppressive mi-croenvironment and secrete some inhibitory cytokines IL -10,IL-35,TGF-β1 and FGL2 which are key media-tors of Treg immunosuppressive function .Tregs have been shown to be important contributors to the tumor escape immunosurveillance and play a critical role in the induction of suppression to CD 4 +T,CD8 +T and NK cell,and suppression of specific anti -tumor immunity .Further research of the role of Tregs in tumor immunosuppressive microenvironment is important to understand malignant tumor pathogenetic and immunological therapeutics .In ad-dition,Tregs and inhibitory cytokines become more critical for clinical applications ,prognosis evaluation and ther-apies.

Objective To study a improved technique by releasing the orbicularis retaining ligament in orbicularis oculi muscle supension blepharoplasty. Release of the orbicularis retaining ligament could cut off the contact between orbitomalar skin and periosteum at inferior orbital rim, and carry the point of tightening orbitomalar skin in orbicularis oculi muscle supension blepharoplasty. Methods There were 409 patients with apparent orbitmalar fold. The methods of releasing orbicularis retaining ligament and orbital septum fixation were added to improve the orbicularis oculi muscle supension blepharoplasty. Results 409 cases were treated using this method over the past 3 years. All results were satisfactory. No complications were observed. Conclusion This improved method of orbicularis oculi muscle supension blepharoplasty is useful for orbitomalar skin rolling, especially for orbitmalar fold. The release allows effective redraping and upward mobilization of the orbicularis of the lower lid and the premalar soft tissues. This method is a simple, safe and effective procedure for the correction of tear trough deformity and well-demarcated lid/cheek junction in lower eyelid belpharoplasty. It is one of the best choices for lower eyelid blepharoplasty.

Objective: To study the effects of different origins, collection and processing methods on the quality of Taraxacum mongolicum. Methods:The HPLC fingerprints of Taraxacum mongolicum were established. Totally 11 batches of Taraxacum mongoli-cum were analyzed by similarity evaluation and cluster analysis. Results:According to the results of HPLC, 11 batches of Taraxacum mongolicum had good baseline separation and showed 5 common peaks. Based on the established HPLC method, the quality of different batches of Taraxacum mongolicum showed difference according to the results of similarity evaluation and cluster analysis. The quality of batch 121231-1 was the best. Conclusion:The origin, collection and processing method show notable influence on the quality of Ta-raxacum mongolicum, and the comprehensive score method can be applied in the quality evaluation of Chinese herbs.

AIM:To investigate the role of mesenchymal stem cell-induced regulatory dendritic cells ( MSC-DCregs) in mouse acute graft-versus-host disease( aGVHD) model.METHODS: Bone marrow cells from BALB/c ( H-2 d ) mice were isolated and were induced to differentiate into DCs.The DCs were selected by flow cytometry, and after 10 d co-culture with MSCs, they were induced to be MSC-DCregs.Male 8-week-old C57BL/6 (H-2b) mice were used as do-nor mice.The female 8-week-old BALB/c (H-2d) mice, who had received 100 cm source-skin distance, 30 cm ×30 cm radiation field, 700 cGy total body irradiation (TBI) pretreatment were used as recipient mice.The recipients were divided into 5 groups:control group, TBI group ( injected with medium only) , bone marrow transplantation group ( injected with 1 ×107 bone marrow cells), aGVHD group (injected with 1 ×107 bone marrow cells and 1 ×107 spleen cells), and MSC-DCregs group (injected with 1 ×107 bone marrow cells, 1 ×107 spleen cells and 1 ×106 MSC-DCregs).The white blood cell count, recipients’ chimerism, clinical evaluation of aGVHD, survival analysis and pathological changes were deter-mined.RESULTS:Hematopoieic recovery was seen at 10 d after transplantation.The recipients’ chimerism was parallel to the donors’ at 30 d.The median survival time of the mice in aGVHD group and MSC-DCregs group was 27 d and 33 d, and the survival rates at 30 d were 20% and 100% (P<0.01), respectively.The clinical scores of the mice in MSC-DCregs group were lower than those in aGVHD group ( P<0.01) .Moreover, the pathological changes in the skin and liver of the mice in MSC-DCregs group were less serious than those in aGVHD group.CONCLUSION: The MSC-DCregs in-duce an aGVHD tolerance in vivo, and further research of its mechanism is still in great necessary.

Objective To explore the methodology of the preventing the absorption after autog-enous fat granule mammaplasty, and the main point of the operative methods.. Methods The clinical data were reviewed in 30 cases of patients with liposuction combined with fat-grafting injection for breast mammaplasty in the past four years. The tumescent technique was used in liposuction and the volume of fat tissue aspirated was between 500 ml and 3250 ml. Using appropriate way we prepared pure fat granules and then evenly injected into the layer beneath the pectoralis major muscle, submam-mary layer and subcutaneous layer of the breast, respectively. Results The effect of the method was satisfying because sucking area was significantly decreased. From six months to 10 months follow-up, grafts showed no obvious absorption. The breast looked symmetry. Conclusion Fat grafting injection is a practicable method for breast mammaplasty. The key point is to use appropriate way to get pure fat granule and to prevent infection. It deserves to be recommended.

OBJECTIVETo investigate the surgical techniques and therapeutic effect of eyelid divided nevus.

METHODSFrom January 2000 to January 2014, 27 cases with 27 eyelid divided nevi were treated by staged excision (2 cases), or full-thickness skin graft (20 cases) or frontal and facial expanded flaps (3 cases), or combined expanded flaps with skin grafts (2 cases) for large lesions. One case with skin graft underwent secondary treatment with expanded flap due to obvious scar.

RESULTSExcept for one case with residue lesion (0. 5 cm x 0. 5 cm), all the other cases underwent successful treatment with primary healing. All the patients were followed up for 3-48 months (average, 7. 4 months). Except for one case with secondary expanded flap treatment, all the other patients were satisfied with aesthetic and functional results. No occurrence happened.

CONCLUSIONSStaged excision and full-thickness skin grafts are simple and effective method for eyelid divided nevus. For large lesions, expanded flap, or combined with skin graft should be considered.

Cicatrix ; surgery ; Esthetics ; Eyelid Neoplasms ; pathology ; surgery ; Humans ; Nevus ; pathology ; surgery ; Skin Transplantation ; Surgical Flaps ; Tissue Expansion ; Wound Healing