Objective To explore the feasibility of the small figure-L unilateral transternal incision for the treatment of anterior mediastinal tumor.Methods Twenty patients with anterior mediastinal tumor were enrolled in the study.Under general anesthenai,after a 6 to 10cm middle skin incision was made,a unilateral figure-L partial sternotomy on the side occupied by the tumor was made in the second or third intercostals space,taking into account the tumor size and location.Tumors were resected with excellent exposure.Results All tumors were completely resected during the operation.In 7 cases,tumors encroached on the adjacent lung tissue,and lung tissue was partially resected.In 5 cases,tumors invaded the pericardium,and the pericardium was partially removed.Mean operating time was 110 minutes(85～130 minutes).The mean time of hospital stay was 7days after the operation,and there was no complication.All but one patients were alive with a mean follow-up period of 18 months(6～27 months).Conclusions The figure-L unilateral sternotomy is considered as an effective and useful minimally invisive approach for anterior mediastinal tumors.

Objective To observe the clinical effect of different surgical methods in the treatment of mediastinal tumors.Methods A total of 74 cases of August 2011 -2015 years 7 months in our hospital admissions of patients with mediastinal tumor were divided into observation group (minimally invasive medi-astinal surgery)and control group (conventional thoracotomy),37 cases,compared to two groups of clini-cal curative effect.Results The total efficiency of treatment in the observation group was 89.19%,signifi-cantly higher than that of the control group and observation group complications rate is relatively lower,sig-nificant differences (χ2 =5.33,6.79,P <0.05);observation group the operative time,amount of bleeding and hospitalization time were (15.69 ±3.21)min,(3.541 ±56.29)ml,(597 ±3.11)d were significantly lower than control group,the difference between two groups was significant (t =12.54,11.49,13.54,P<0.05).Conclusions Phase,compared with the traditional surgical treatment for open and minimally in-vasive surgery can achieve a better therapeutic effect,reduce a patient's risk of complications,alleviate the injury of surgery.For patients with postoperative rehabilitation has a positive meaning.

Objective To investigate the expression of CCL20 and CCR6 in the patients with gastric cancer and To examine the relationship between chemokine expression and the occurrence and development of Gastric Cancer. Methods Real-time PCR , flow cytometry and ELISA are used to measure the gene transcription and protein expression levels of chemokine CCL20 and CCR6 in the serum of 50 patients with Gastric Cancer and 30 normal controls. Results The gene expression levels CCL20 and CCR6 in Gastric Cancer group are significantly higher than that in healthy controls. The level protein of CCL20 and CCR6 in peripheral blood of patients with gastric cancer are significantly higher than that in healthy peep le[ (45.4 ±10.9) pg/mL vs (18.6±4.7) pg/mL; (7.11 ±1.03%) vs (1.83±0.43%), P＜0.01. respectively],and the increase significantlyassociated with the clinical stage of Gastric Cancer. Conclusions The method for detecting the expression of CCL20 and CCR6 in patient with Gastric Cancer has been successfully established, and their expression levels were found to be correlated with the occurrence and development of Gastric Cancer. Thus, CCL20 and CCR6 may be involved in the regulatory mechanisms associated with the development of Gastric Cancer, and may be valuable in its diagnosis and prevention.

Liver is one of the most commonly metastases in patients with colorectal cancer.Curative hepatic resection is the first choice of liver metastasis of colorectal cancer,which can improve the survival rate ranging from 30％ to 40％ in 5-year.In this article,we will review the operation indication,mode and advance on the current treatment strategies of colorectal liver metastases,and discuss the decision-making process,emphasize a surgery - centered multidisciplinary treatment for the treatment of hepatic metastases from colorectal cancer,to improve the survival rate.

Objective To analyze and compare the clinical features of community-acquired pneumonia caused by Legionella in elderly (age≥60 years) and younger patients. Methods The epidemiological, clinical, laboratory data and the outcomes of 80 cases with community-acquired Legionella pneumonia (CALP) from January 2001 to October 2009 were studied retrospectively, and the differences between elderly and younger group were compared using univariate and multivariate analysis. Results (1) Underlying diseases, such as cerebrovascular diseases, chronic obstructive pulmonary diseases, diabetes mellitus and immunosuppressive therapy were significantly more frequent in elderly group than in younger group (all P＜0. 05). (2) No significant differences were observed between the two groups in legionella serotype. (3) Malaise, hyponatremia and hypophosphatemia were all more frequent in elderly group than in younger group (x2=5. 300, 5. 520, 4. 470; P=0. 021,0. 019, 0. 034, respectively). And elderly versus younger group had higher creatinine levels [(108.55±56.57) μmmol/L vs. (75.42±17.62) μmmol/L, t= -3. 062, P=0. 002], lower PaO2/FiO2 (＜300) (57.7% vs. 29.2%, x2=4. 120, P=0.042), less leucocyte counts [(8.34±3.65)×109/Lvs. (10.63±5.02)×109/L, t=-2.287, P=0.022]. (4) Elderly patients more likely complicated with congestive heart failure (P=0.037) and their length of staying in hospital was also longer (Z=-2.194, P=0.028). No significant differences were observed between the two groups in mortality, intensive care unit admission, and the need for corticosteroids or mechanical ventilation.Conclusions Elderly patients with CALP have a higher frequency of underlying comorbidities and more organs involvement than younger patients, although greater severity of illness at onset and outcome are not significantly different between the two groups.

The rising ofmetabonomics after genomics and proteomics offers chances for the modernization of TCM.Metabonomics has much in common with TCM in the cognition of human body. Appropriate application of the methodology of metabonomics in TCM, such as TCM differential diagnosis and guidance of clinical treatment, would speed up the integration of TCM and modem life science and technology. Meanwhile the research of COPD in TCM will come into a new stage through the use of metabonomics. This article overviewed the current situation of Chinese medicine using metabolomics technology to raise its theory, science and diagnostic level, and the study of pulmonary-qi deficiency syndrome of COPD with metabonomics.

Objective To analyze the clinical,radiologic and pathological features of endobronchial metastasis from prostate cancer, and its diagnosis and treatment. Methods Ten cases of endobronchial metastasis from prostate cancer with pathological evidence in our hospital were retrospectively analyzed.The clinical, radiologie andpathological features and the diagnostic procedures and treatment of the cases were reported and analyzed while combined with literature. ResultsAn average age at diagnosis of advanced prostate cancer was 65.5 years. Emoptysis(5/10), cough (4/10), dyspnea (4/10) and weight loss (5/10) were the common symptoms.Chest X-ray disclosed hilar and mediastinal lymphadenopathy (4/10), hilar mass (3/10) or atelectasis (2/10) . Bronchoscopic examination revealed that most of lesion located in single lobar or segmental bronchus (6/10). Bilateral upper lobe were most susceptibly involved(7/10). Polypoid lesions or mass in lumen of bronchi(8/10)were more frequent than infiltrative lesion(2/10), which could obstruct the orifice of the bronchi in different extent. Immunohistochemical staining for prostate specific antigen or prostatic acid phosphatase was positive, and most patients responded well to endocrine therapy. Conclusions Clin.ical and radiologic features of endobronchial metastasis from prostate cancer are similar to those of primary bronchogenic carcinoma. Immunohistoehemical study is helpful for differential diagnosis and the short-term efficacy of endocrine therapy is significant.

Objective To express the major allergen of Blattella germanica (Bla g 2) in Pichia pastoris and obtain the soluble protein. Methods The known Bla g 2 gene was used to design the primers which had the restriction enzyme sites. PCR method was applied to obtain the Bla g 2 gene. The gene fragment was then cut and ligated with the Pichia expression vector pGAPZaA, resulting in a recombinant plasmid pGAPZaA-Bla g 2. The linearized pGAPZaA-Bla g 2 was transformed into Pichia pastoris GS115 through electroporation, then screened to positive transformants, and the protein was expressed in YPD medium. Purification of the recombinant protein was achieved by metal (Ni2+) chelating affinity chromatography and Western-blotting assay indicated its IgE binding capacity. Results With the expressed reeombinanl protein, SDS-PAGE showed the presence of the product in the supernatant of the culture with Mr 45 000. After 3 days culture, the recombinant protein occupied 50% of the total proteins in the supernatant. The recombinant protein was purified and Western-blot demonstrated an adequate IgE binding capacity of the product. Conclusion A recombinant protein of Bla g 2 has been obtained, which is soluble in the supernatant and therefore can avoid a process of denaturalization and renaturation of the recombinant.

Objective To explore the effect of fosinopril on plasma biomarkers of endothelial cell in elderly patients with type 2 diabetes mellitus complicated with hypertension. Methods Fourty-two patients with type 2 diabetes mellitus complicated with hypertension were treated with fosinopril (10～20)mg/d for 6 months. Twenty-four matched healthy people were selected as control. Before treatment and after 6 months of treatment,thromodulin (Tm),von willebrand factor and nitric oxide (NO) as well as systolic pressure (SBP) and diastolic pressure (DBP) were detected. The reactive congestion and nitroglycerin-induced dilation of the right brachial artery were assayed with high-resolution ultrasound. Results After 6 months of treatment in all patients,diameters of brachial artery after taking glyceryl trinitrate showed no change markedly,but the plasma levels of Tm and vW factor were decreased and NO was increased obviously than those before treatment. The diameter of brachial artery in responding to reactive hyperaemia was improved greatly and the SBP & DBP were all decreased obviously than those before the treatment. Concusion Fosinopril effectively reduces blood pressure and the endothelial-dependent vasodilatation companied with decrease of the plasma Tm & vW factor and increase of the plasma NO in patients with type 2 diabetes mellitus complicated with hypertension.

Augmenter of liver regeneration(ALR)is a novel hepatic stimulator. Owing to its peculiar characteristic of gene structure and many kinds of biological functions, it is thought to be an important hepatotrophic factor. This review summarized the advance in ALR research in recent years including characteristics of ALR gene, molecular structure, physiochemical characteristics, biological functions and roles in liver injury.