Objective To report our experience on video-assisted thoracoscopic surgery(VATS)and perioperative management for patients over 70 years old.Methods From May 1998 to May 2008,78 patients over 70 years old were treated by VATS.Operative risk was evaluated by measuring forced expiratory volume in first second(FEV1),diffuse capacity of carbon monoxide(DLCO),and left ventricular ejection fraction(LVEF),and artery blood gas analysis and exercise test before the operation.VATS(n=46)or video-assisted minithoracotmy(n=32)was carried out under general anesthesia with a double-lumen tube.Extubation was delayed in 11 patients after the procedures and mechanical ventilation was employed to smooth anesthesia recovery.Results Postoperative pathological examination showed primary lung cancer in 20 cases,benign pulmonary lesions in 26,pleural mesothelioma in 3,malignant pleural metastasis in 5,empyema in 5,benign mediastinal tumor in 15,hiatal hernia in 3,and esophageal leiomyoma in 1.Postoperative morbidity was 33.3%(26/78)in this series,none of the patients died during the operation;the perioperative mortality was 2.6%(2/78).Conclusions VATS is safe for elderly patients.Satisfying outcomes can be achieved through strict preoperative evaluation,proper operative method and active management for postoperative complications.

Objective To investigate the preparation method of hydroxyapatite by amino acids induced hydrothermal technique.Methods The hydroxyapatite nanorods were obtained using alanine and glycine as templates by hydrothermal method.The samples were characterized by X-ray diffraction (XRD),Fourier infrared spectroscopy (FTIR),transmission electron microscopy (TEM).Results The results showed that amino acids induced the formation of hydroxyapatite.Amino acids could affect crystallinity and dispersion of the formed hydroxyapatite.In addition,the substituent content of carbonate ions in hydroxyapatite was reduced by changing the ratio of amino acids.Conclusion Hydroxyapatite with high crystallinity and low carbonate ions can be prepared by hydrothermal method in the presence of amino acids.

Objective To evaluate the feasibility of keeping the consistency of bladder filing by a Bladderscan ( BS ) device during radiotherapy for rectal cancer. Methods The bladder volume was measured using a BS device and recorded. To verify the reliability of the BS measurement, the urinary output was determined by a measuring glass after complete urinary discharge. The bladder volume of 42 patients determined by the planning computed tomography ( CT) scans was used as the standard urinary volume. The bladder volume was measured using the BS device before radiotherapy every day. The chief complaint urinary volume was determined as the bladder volume when a patient felt a strong urge to urinate. The controlled urinary volume was determined as the urinary output intervened by the BS device to reach the standard urinary volume. Comparison was made by t test and data was assessed by Pearson correlation analysis. Results There was no significant difference in obtained urinary volume between the BS device and the planning CT scan ( P=0?84) . The urinary volume measured by the measuring glass was correlated with that measured by the BS device ( P=0?00 ) . The ability to hold urine in all patients was gradually weakened during treatment. The controlled urinary volume had a significantly smaller decrease after 1, 2, 3, 4, and 5 weeks of treatment than the chief complaint urinary volume ( 5% vs. 21%;6% vs. 20%;6% vs. 20%, 4% vs. 21%;11% vs. 26%;all P=0?00) . Conclusions Patients have a gradually decreased urinary volume during treatment. The intervention by the BS device gives a bladder volume close to that in the planning system, which results in a consistent bladder filling.

BACKGROUND:Transplantation of stem cell-derived islet β cells has been considered effective for the treatment of type 1 diabetes.Human umbilical cord mesenchymal stem cell is an ideal cellular source,but with a low differentiation efficiency to islet β cells. OBJECTIVE:To explore the possibility of human umbilical cord mesenchymal stem cells modified by MAFA and PDX1 to differentiate into insulin-producing cells. METHODS:MAFA-PDX1 lentivirus expression vectors were constructed.The efficiency and potentiality of human umbilical cord mesenchymal stem cells differentiated into insulin-producing cells with three methods were compared by cell morphology,RT-qPCR,and dithizone staining[protocol A:Simple lentivirus group;protocol B:Drug(nicotinamide β-mercaptoethanol)induction followed by lentivirus group;protocol C:lentivirus and drug induction group]. RESULTS AND CONCLUSION:(1)Morphological change of cells:Cell morphology was all altered after the induction of three protocols.At day 11,human umbilical cord mesenchymal stem cells induced by protocol B showed the most cell clusters among the three protocols,appearing aggregated islet-like cell clusters.(2)Islet-related gene expression detected by RT-qPCR:Horizontal comparison of the three protocols at the same induction time point showed that the expression levels of MAFA and PDX1 genes were the highest in protocol C on day 5 of induction,and those in protocol B were the highest on day 11 of induction.Human umbilical cord mesenchymal stem cells induced by protocol B had the greatest expression of GCG gene at day 5,INS and GLUT2 genes at day 11.(3)Dithizone staining to identify zinc ions:parts of the post-induced cells were stained brownish red by dithizone on day 11.The partial small island cells were stained brownish red with a darker color(positive expression)in protocol B.(4)It is concluded that the overexpression of MAFA and PDX1 can promote the differentiation of human umbilical cord mesenchymal stem cells into insulin-producing cells.The combination of MAFA-PDX1 gene modification and drug induction is superior to the single gene modification.

BACKGROUND: Segmentectomy can retains more healthy lung tissue than lobectomy, but it remains controversial in oncology for early stage lung cancer. The aim of this study is to discuss the problems of video-assisted thoracic surgery (VATS) segmentectomy in early stage lung cancer, by analyzing the clinical and pathological data of 35 cases and reviewing the literature. METHODS: There were 35 patients who received segmentectomy by complete video-assisted thoracic surgery, from May 2013 to July 2017, in single operation group in the Third Hospital of Peking University. We analyzed the patient's clinical and pathological data, intraoperative and postoperative complications, lymph node number and metastasis its situation, and compared postoperative pathology and preoperative computed tomography (CT) imaging type. In 35 cases of segmentectomy, there were 11 males and 24 females, with an average age of 57.7 years old. The lesions located in the right upper lobe were 8 cases, in the right lower lobe were 8 cases, in the left upper lobe were 13 cases, in the left lower lobe were 6 cases. The mean maximum diameter of CT imaging was 12.7 mm, and the largest diameter of hilar and mediastinal lymph nodes was less than 10 mm. 23 of them were ground glass predominating and 12 were solid components predominating. RESULTS: All 35 cases were successfully completed VATS anatomical segmentectomy. The average operation time was 153 minutes, the amount of bleeding was 51 mL. There were 10 cases of air leakage after operation, all of which were not more than 3 days. There was contralateral atelectasis in 1 case, chylothorax in 1 case. The average length of hospitalization was 6.1 days. There was no other complications outpatient related to surgery, in 30 days after discharge. The pathological changes were as follow, 2 cases of metastatic tumor, 8 cases of benign lung disease and 25 cases of primary lung cancer. In the 25 cases of primary lung cancer, there were 14 cases of invasive lung adenocarcinoma (7 cases were groundglassopacity (GGO) predominating in CT imaging), 4 cases of micro-invasive adenocarcinoma (3 cases were GGO predominating in CT imaging), 6 cases of adenocarcinoma in situ (all were pure GGO in CT imaging), 1 case of lung squamous cell carcinoma (mainly composed of solid in CT imaging). An average of 7.2 lymph nodes were removed in 25 cases of lung cancer, and all lymph nodes had no metastasis. CONCLUSIONS VATS anatomical segmentectomy is technically safe and reliable, and the indications for lung cancer need to be strictly controlled. Its advantages still need to be confirmed by prospective randomized controlled trials.
Female ; Humans ; Lung Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; adverse effects ; methods