Objective To evaluate the clinical outcomes of double-port video-assisted thoracoscopic lobectomy. Methods We retrospectively analyzed the clinical data of 72 patients who underwent double-port video-assisted thoracoscopic lobectomy(DP group)from October 2014 to December 2015 in our hospital.A paired comparison was made with 72 patients who had the same lesion location and the nature(benign or malignant)and underwent three-port video-assisted thoracoscopic lobectomy(TP group)in the same period.The clinical outcomes included operation time, intraoperative blood loss,the number of lymph node, the chest tube time,postoperative hospital stay, incision pain VAS scores within three days and complications.Postoperative follow-ups were taken with telephone calls or out-patient reviews. Results No operative morality occurred in both groups.There were no statistical significances between the DP Group and the TP Group in intraoperative blood loss[(107.9 ±56.6)ml vs.(95.0 ± 46.8)ml,t=1.490,P=0.138],the number of lymph node(13.9 ±2.7 vs.14.5 ±2.6,t=1.358,P=0.177)and complication rate[11.1%(8/72)vs.9.7%(7/72),χ2=0.074,P=0.785].The DP group had significant longer operation time[(153.6 ± 22.6)min vs.(143.6 ±25.8)min, t=2.474, P=0.015], shorter chest tube time[(5.2 ±1.7)d vs.(6.4 ±1.1)d, t=5.029,P=0.000],shorter postoperative hospital stay[(6.1 ±1.6)d vs.7.6 ±1.2, t=6.364, P=0.000], and lower incision pain VAS scores within three days[(12.3 ±1.9)points vs.(14.4 ±1.8)points, t=6.808, P=0.000]as compared to the TP group.No short-term complication was noticed in both groups during a follow-up time ranged from 6 to 20 months. Conclusions Double-port video-assisted thoracoscopic lobectomy is safe and feasible.It is a preferred surgical mode for selected cases.

Objective To compare the transplant-related toxicity and the efficacy of busulfan/fludarabine (Bu/Flu) and busulfan/cyclophosphamide (Bu/Cy) as conditioning regimen in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia(AML) in the first complete remission (CR1).Methods Totally 32 AML-CR1 patients underwent allo-HSCT were divided into Bu/Cy (Bu 3.2 mg· kg-1 · d-1,7-4 days before transplantation; Cy 60 mg · kg-1 · d-1,3-2 days before transplantation) and Bu/Flu (Bu 3.2 mg · kg-1 · d-1,5-2 days before transplantation; Flu 30 mg · m-2·d-1,6-2 days before transplantation) groups.The regimen-related toxicity (RRT),incidence and severity of graft-versus-host disease (GVHD),3-year cumulative relapse rate,non-relapse mortality (NRM),3-year event-free survival (EFS) rate and overall survival (OS) rate were compared between the two groups.Results The median follow-up duration was 617.5 (6-1261) days.All patients achieved successful engraftment on 30 day after transplantation.There were no significant differences in the median time to neutrophil engraftment (P =0.121) and platelet engraftment (P =0.171) between the two groups.The median duration of neutrophil count under 0.1 × 109/L and platelet count under 20 × 109/L in the Bu/Cy group were significantly longer than those in the Bu/Flu group (P =0.000 and P =0.047).The incidence of grades Ⅱ-Ⅳ RRT were 68.8％ and 25.0％ (P =0.032) in the Bu/Cy and the Bu/Flu groups,respectively.There were no significant differences in the incidence of acute GVHD (P =0.149),chronic GVHD (P =0.149),incidence of NRM (P =0.333),3-year cumulative relapse rates (P =0.834),3-year EFS rate (P =0.362) and OS rate (P =0.111) between the two groups.Conclusion Compared with Bu/Cy,Bu/Flu is a myeloablative condition regimen with milder bone marrow suppression and lower RRT incidence rate in allogeneic HSCT for AML-CR1 patients without compromising the efficacy.

ObjectiveTo investigate the therapeutic effects of the conditioning regimen with or without total body irradiation on allogeneic hematopoietic stem cell transplantation in acute leukemia.Methods We retrospectively evaluated clinical outcomes in 287 allo-HSCT recipients with acute leukemia (ALL- 105,AML-129,and AUL-53) who received myeloablative conditioning regimen with or without total body irradiation from January 2002 to August 2011.Two hundred and six patients obtained complete remission (CR) and 81 non-remission (NR) before transplantation.One hundred and ninety-nine patients received conditioning with total body irradiation (TBI+ Cy group,9 Gy given over 2 days),and 88 patients received busulfan (BuCy group,3.2 mg·kg-1 ·d-1 ),both followed by cyclophosphamide.ResultsThere were no statistically significant differences in hematopoietic reconstitution,regimen-related toxicity (RRT),graft-versus-host disease (GVHD) and relapse between two groups.For patients with AML and AUL,there was no significant difference in the 5-year survival between the two regimens (P＞ 0.05),while for ALL-CR patients,the TBI + Cy regimen had a higher over survival rate (52.0％ vs.31.3％,LogRank=4.249,P＜0.05) and DFS (50.4％ vs.27.8％,LogRank =4.445,P＜0.05) than BuCy.In TBI + Cy group and BuCy group,the proportion of CD19+ B cells at the first month after HSCT was (4.04 ± 1.86)％ and (1.47 ±0.99) ％ (P＜0.05),that of NK cells at 12th month after HSCT was (23.38 ± 12.19) ％ and (13.11± 7.99) ％ (P＜0.05),and that of CD4+ CD45RO+ cells at 9th month after HSCT was (14.63 ±6.17)％ and (9.07 ± 3.12)％ (P＜0.01),respectively.ConclusionUsing TBI-containing regimen was more effective for treating ALL-CR patients than busulphan-containing regimen,but no difference was found for long-term outcomes in patients with AML and AUL between the two regimens.The 9 Gy TBI-based regimens may not affect recipients' thymic function,T-cells reconstitution and immune tolerance,coming out a non-increase of GVHD.

Objective To explore the clinical curative effect of theTaohong-Siwu decoction combined with manipulation in the treatment of the acute phase of lumbar disc herniation (LDH) and its effect on serum inflammatory factors.Methods According to the random number table method, 102 patients with the acute phase of LDH were divided into control group and research group from May 2014 to September 2016, 51 cases in each group. Patients in control group were treated by traction and non-steroidal anti-inflammatory drug for a month, while patients in research group were treated by manipulation combined withTaohong-Siwu decoction for a month. After treatment, the overall efficacy was observed. The Visual analogous scale (VAS) and JOA scores were recorded before and after the treatment. The IL-1β, IL-6 and TNF-α levels of inflammatory factors were detected by enzyme-linked immunosorbent assay.Results The total effective rate of patients in research roup was significantly higher than that of the control group [90.20％ (46/51)vs. 43.14％ (22/51),χ2=19.329, P=0.006]. After treatment, the VAS scores of patients in both groups were significantly decreased, and JOA score increased markedly, which the differences were statistically significant (Ps<0.05). After treatment, the VAS score of research group was significantly lower than the control group (4.26 ± 0.56vs. 5.13 ± 0.87;t=4.843, P=0.027), and JOA score was significantly higher than the control group (18.42 ± 3.92vs.17.33 ± 4.21;t=5.127, P=0.022). After treatment, the IL-1β, IL-6 and TNF-α levels of of patients in the research group were significantly lower than those of the control group (0.57 ± 0.11μg/Lvs. 0.90 ± 0.13μg/L, 112.26 ± 15.17μg/Lvs. 130.38 ± 18.29μg/L, 2.01 ± 0.34μg/Lvs. 2.37 ± 0.51μg/L;t=5.429, 6.317, 5.011,P<0.05). ConclusionsThe Taohong-Siwu decoction combined with manipulation on treatment of the acute phase of LDH was effective. The combined therapy can improve the VAS score and JOA score, and reduce the levels of inflammatory cytokines.

Objective To clarify the applied anatomy of Chinese female breasts,to improve the breast reduction mammoplasty,and to compare the quality of life in women with symptomatic macromastia before and after reduction mammoplasty with the modified round block technique.Methods The blood supply and innervation of the nipple-areolar complex were dissected in 6 Chinese adult females (12 breast specimens).Special attention was paid to the Würinger horizontal septum and the medial and lateral ligaments.The specific beneficial effects of reduction mammoplasty were evaluated with the modified round block technique,and a general questionnaire the Short Form-36 Health Survey Questionnaire (SF-36) was used in this study,which has good reliability and validity.The scores of the patients before and after the surgery were collected respectively.Results In 12 breast specimens,there existed Würinger horizontal septum and the medial and lateral ligaments.The blood supply and nerve innervation of nipple-areolar complex went along Würinger horizontal septum.In all the patients enrolled,SF-36 showed significant higher quality of life after the operation with regard to 7 of 8 investigated domains.Role of emotion increased most significantly.Increased self-esteem and increased personal and public self-consciousness after surgery were observed.Conclusions The incidence of postoperative complications is reduced after using the modified round block technique.Patients have a higher degree of satisfaction overall.These data are further evidence that breast hypertrophy is not solely an esthetic problem.The reduction mammoplasty with the modified round block technique is an ideal technique.

Objective To explore the effects of information-motivation-behavioral (IMB) skills model based WeChat education on the treatment compliance, the self-efficacy and the quality of life of diabetic nephropathy patients.Methods A total of 92 patients with diabetic nephropathy treated in Danyang People's Hospital from January 2015 to June 2016 were selected as the research object by convenient sampling method and randomly divided into observation group and control group according to the random number table, with 46 cases in each. The control group received conventional WeChat health education, and the observation group implemented WeChat health education based on IMB model. The treatment compliance, the self-efficacy and the quality of life were compared between the two groups 6 months after the nursing intervention. Results There was no statistically significant difference between the two groups of all dimensions and the total scores of treatment compliance before intervention (P>0.05). All the dimensions of treatment compliance of the observation group were higher than those of the control group after intervention, and the differences were statistically significant (t=3.365, 3.258, 3.989, 2.655, 3.513, 4.674, 3.747, 4.187,3.578;P<0.01). The change degree of the 10 dimensions of self-efficacy and total scores were all greater than those of control group, the differences were statistically significant (t=4.854, 5.632, 4.854, 4.241,3.896, 3.785, 3.789, 3.325, 3.314, 3.817,4.123;P<0.01). The improvement of all the dimensions of patients' life quality and its total score were all higher than the control group after intervention, with significant statistical difference (t=5.965, 4.763, 4.746, 4.547, 3.869;P<0.01).Conclusions Application of IMB model based WeChat health education on diabetic nephropathy patients can significantly improve the patient's treatment compliance, self-efficacy and quality of life.

Background and objective Prolonged air leak (PAL) after anatomic lung resection is a common and challenging complication in thoracic surgery.No available clinical prediction model of PAL has been established in China.The aim of this study was to construct a model to identify patients at increased risk of PAL by using preoperative factors exclusively.Methods We retrospectively reviewed clinical data and PAL occurrence of patients after anatomic lung resection,in department of thoracic surgery,Anhui Provincial Hospital Affiliated to Anhui Medical University,from January 2016 to October 2016.359 patients were in group A,clinical data including age,body mass index (BMI),gender,smoking history,surgical methods,pulmonary function index,pleural adhesion,pathologic diagnosis,side and site of resected lung were analyzed.By using univariate and multivariate analysis,we found the independent predictors of PAL after anatomic lung resection and subsequently established a clinical prediction model,Then,another 112 patients (group B),who underwent anatomic lung resection in different time by different team,were chosen to verify the accuracy of the prediction model.Receiver-operating characteristic (ROC) curve was constructed using the prediction model.Results Multivariate Logistic regression analysis was used to identify six clinical characteristics [BMI,gender,smoking history,forced expiratory volume in one second to forced vital capacity ratio (FEV1％),pleural adhesion,site of resection] as independent predictors of PAL after anatomic lung resection.The area under the ROC curve for our model was 0.886 (95％CI:0.835-0.937).The best predictive P value was 0.299 with sensitivity of 78.5％ and specificity of 93.2％.Conclusion Our prediction model could accurately identify occurrence risk of PAL in patients after anatomic lung resection,which might allow for more effective use ofintraoperative prophylactic strategies.

Objective To investigate the activity of Acorus tatarinowii extracts against dust mites, and to isolate and characterize active ingredient of A. tatarinowii extracts. Methods The essential oil components were extracted from A. tatarinowii rhizome powder by rotary evaporation with methanol as solvents, followed by petroleum ether extraction and rotary evaporation. The essential oil was mixed with Tween-80 at a ratio of 1:1 and diluted into concentrations of 1.000 00%, 0.500 00%, 0.250 00%, 0.125 00%, 0.062 50% and 0.031 25%, while diluted Tween-80 served as controls. A. tatarinowii essential oil at each concentration (200 μL) was transferred evenly to filter papers containing 100 adult mites, with each test repeated in triplicate, and controls were assigned for each concentration. Following treatment at 25 °C and 75% relative humidity for 24 h, the mean corrected mortality of mites was calculated. The essential oil components were separated by silica gel column chromatography, and the essential oil was prepared in the positive column of medium pressure; and then, each component was collected. Silica gel column chromatography was run with the mobile phase that consisted of petroleum ether solution containing 10% ethyl acetate and pure ethyl acetate, detection wavelength of 254 nm, positive silica gel column as the chromatography column, and room temperature as the column temperature. Each component of the purified A. tatarinowii essential oil was diluted into 1.000 00% for acaricidal tests. The components with less than 100% acaricidal activity were discarded, and the remaining components were diluted into 50% of the previous-round tests for subsequent acaricidal tests. The components with acaricidal activity were subjected to high-performance liquid chromatography, liquid chromatography-mass spectrometry and pulsed-Fourier transform nuclear magnetic resonance spectroscopy. The structure of active monomer compounds was determined by standard spectral library retrieval and literature review. Results A. tatarinowii essential oil at concentrations of 1.000 00%, 0.500 00%, 0.250 00% and 0.125 00% killed all dust mites, and the corrected mortality was all 100%. Exposure to A. tatarinowii extracts at an effective concentration of 0.062 50% for 24 hours resulted in 94.33% mortality of dust mites. Six components (A to F) were separated using gel column chromatography, and components D and E both showed a 100% acaricidal activity against dust mites at a concentration of 0.50000%. In addition, Component D was identified as isoeugenol methyl ether, and Component E as β-asarinol. Conclusion The extract of A. tatarinowii essential oil has acaricidal activity, and the isoeugenol methyl ether shows a remarkable acaricidal activity against dust mites.

Dendritic cell-based cancer vaccines (DC vaccines) have been proved efficient and safe in immunotherapy of various cancers, including melanoma, ovarian and prostate cancer. However, the clinical responses were not always satisfied. Here we proposed a novel strategy to prepare DC vaccines. In the present study, a fusion protein SNU containing a secretin-penetratin (SecPen) peptide, NY-ESO-1 and ubiquitin was designed and expressed. To establish the DC vaccine (DC-SNU), the mouse bone marrow-derived DCs (BMDCs) were isolated, pulsed with SNU and maturated with cytokine cocktail. Then peripheral blood mononuclear cells (PBMCs) from C57BL/6 mice inoculated intraperitoneally with DC-SNU were separated and cocultured with MC38/MC38