Objective:To compare the clinical results of video-assisted thoracoscopic surgery (VATS) with transaxillary minithoracotomy (TAMT) for the treatment of spontaneous pneumothorax (SP).Methods:Thirty patients were treated by VATS and 43 by TAMT.The consumed time of the operation,duration of the chest drainage,the amount of the chest drainage,the percentage of the patient without using anodyne within the postoperative 24 hour and the average time of hospitalization were compared.Results:The consumed time of the operation,the duration of the chest drainage and the average time of hospitalization were significantly shorter in group VATS than in group TAMT ( P

Objective:To explore the risk factors in mechanical ventilation on patients with myasthenia gravis after thymectomy.Methods:42 patients with myasthenia gravis were treated by thymectomy from January 1987 to August 2003.Using logistic regression model,a multi-variate analysis was made with regard to age,sex,disease history,Osserman classication,pathological types,the consumed time of operation,the preoperatie dose of pyridostigmine,the preoperative usage of hormone.Results:The major risk factors that affected mechanical ventilation on patients with myasthenia gravis after thymectomy were Osserman classication and pathological types.Conclusion:Osserman classication and pathologic types might serve as indices for the prolonged mechanical ventilation.

Objective:To investigate the effect of GRP94 gene expression down-regulation on the proliferation in human lung carcinoma A549 cells and possible mechanism.Methods:Expression of GRP94 was examined in 4 lung carcinoma cells and two lung bronchial epithelial cells by qRT-PCR and Western blot.Chemically synthesized siRNA targeting GRP94 gene and transfected into A549 cells used by Lipofectamine2000.The mRNA and protein expression levels of GRP94,c-myc and cyclinD1 were detected by qRT-PCR and Western blot.CCK8 assay and Colony formation assay were used to detect the effect of specific GRP94 siRNA on cell proliferation.Results:The levels of GRP94 expression in the four lung carcinoma cells were significantly higher than that in two lung bronchial epithelial cells (P<0.05).GRP94 siRNA significantly downregulated the levels of GRP94 mRNA and protein in A549 cells, and the downregulation evidently suppressed cell proliferation.However, The c-myc and cyclinD1 expression levels in A549 cells in siRNA-GRP94 group was significantly lower than that in siRNA-NC group (P<0.05).Conclusion:The levels of GRP94 expression in lung carcinoma cells were significantly higher than that in normal lung epithelial cells.Knockdown GRP94 expression significantly inhibit the level of lung carcinoma A549 cells proliferation,which may act via influencing the expression of c-myc,cyclinD1.

According to the national residency training regulations in the teaching of clinical and scientific research, the department of thoracic surgery of First Affiliated Hospital of Chongqing Medical University has used seminar teaching , and has collected random sampling survey questionnaire of 110 students participating in seminar from September 2014 to March 2016. The investigation shows that through seminar teaching training, doctors will cultivate their clinical and research ability, and enhance their self-confidence. Therefore, the application of seminar teaching in department of thoracic surgery is helpful to improving the quality of clinical teaching and is worthy of further improvement and promotion.

Objectiove To explore the teaching effectiveness of PBL teaching methods the teaching of cardiothoracic surgery.Methods Random clinical medical intern students 2008-2009 in our department were divided into 2 groups,with PBL teaching methods used in experimental group,and traditional teaching methods in the control group.Results The excellent and failure rates of the exam scores of the students in the experimental group were 75% and 4% respectively.while in the control group were 43% and 18% respectively.After statistical treatment,compared with the excellent and failure rates in the experimental group and in the control group,the difference is of high significance.Conclusion PBL teaching method in cardiothoracic surgery in the teaching effectiveness of teaching is better,worthy of promotion.

Objective To study the effect of different warm-ischemia time on islet structure, yield and function. Methods Adult pigs were studied, and according to warm ischemic time (WIT, 0, 10, 20, 30, 45 min), the porcine pancreata were divided into 5 groups (A, B, C, D, and E group). The isolation of adult porcine pancreas was carried out by injection of Hanks into pancreatic duct and digestion with collagenase Ⅴ and Ⅰ. A discontinuous Ficoll 400 solution was applied for purifying islets. The structure, purity and viability of islets were determined by dithizone staining and AO/PI staining, and the function of islets was evaluated by the glucose stimulating insulin release test. Results There were little islets debris in group A, B and C. But it was very difficult to obtain integrate islets in group E. There was no significant difference between the groups of 0, 10 and 20 min in islet number before and after islet purification ( P ＞ 0.05 ), while the difference was significant when warm ischemic time was prolonged to 30 min and 45 min ( P ＜ 0. 01 ). In respect of islet function, the similar results were found in different groups. Conclusions When WIT is within 20 min, there is no deleterious effects on islet morphology and yield as well as function. However, when WIT is prolonged to 30 min, the loss in islet yield is severe, and the islet function is significantly impacted.

An improved method for determination of the total oxalate in spinach was proposed. Oxalate in the spinach was precipitated at alkaline in CaC2O4 form. The precipitate was obtained by centrifugation and then acidified by HCIO4. KMnO4 was added and absorptivity was determined at 525 nm at a fixed time. This method was accurate and simple. Organic impurities existed in spinach could be removed by ultrviolet ray. The range of determination was 2?g/ml-35?g/ml. The recovery rate was 93-105% and the coefficient of variation was less than 5.35%.

Objective: To analyze the clinical outcomes of the locking compression plate(LCP) fixation for the unstable sacral fracture. Methods: Nine patients with unstable sacral fracture were treated with locking compression plate fixation in our department,including 7 males and 2 females,with an average age of 34.8 years (ranged from 25 to 49 years). AO classification system found 1 B1, 4 B2, 2 B3 and 2 C1 type. Dennis classification found 6 I section sacral fracture and 3 II section sacral fracture. Incisions (6-8 cm) were made from each side of superior iliac spine to ipsilateral inferior iliac spine along iliac crest. After the fractures or dislocations were exposed and reduced, LCPs were chosen and remodeled. The iliosacral posterior ligaments were restored if injured. The LCP was pushed cutaneously to the other incision, placed on both dorsal ilia and fixed with locking screws. Each side of postal LCP was fixed with 3 locking screws for effective fixation. The reduction and fixation of fractures or dislocation were assured by radiostereoscopy. The operations lasted 45 min averagely (ranged from 30-80 minutes) and no patient needed blood transfusion. The average X-ray exposure period was 4 min(from 2-10 minutes). Results: All the patients were followed-up for a mean of 13.8 months,ranged from 6 months to 21 months. There was no iatrogenic nerve injury. The function and the feeling of sacroiliac joint and low extremities recovered to normality. According to the Majeed standards, the results were excellent in 4,good in 4,and fair in 1. Conclusion: The locking compression plate fixation is a simple and effective treatment for the unstable sacral fractures, with less trauma and complications.

Objective To observe the effect of the Chinese medicine on the patients’ thyroid autoantibodies TPOAb and TGAb of Hashimoto's thyroiditis. Methods 100 cases of Hashimoto's thyroiditis were randomly divided into group A and group B, with 50 cases in each group. Group A was given levothyroxine sodium(L-T4) to maintain thyroid function(FT3,FT4,TSH)in the normal range, at the same time Chinese medicines of soothing liver and strengthening spleen, nourishing the liver and kidney, activating blood and removing blood stasis were additionally added;while group B was taken L-T4 to maintain the thyroid function in the normal range. The levels of TPOAb, TGAb were determined before and after treatment in both groups. Results After the treatment, the level of TGAb and TPOAb[respectively(106.3±29.5)IU/ml,(871.5± 209.3)IU/ml] in group A were decreased compared with their previous level [respectively(385.5±76.6)IU/ml, (1621.5±399.2)IU/ml], the difference was statistically significant(t were 48.2、10.6,P<0.01). The level of TGAb and TPOAb [respectively(437.6±135.4)IU/ml,(1798.6±434.6)IU/ml] in group B were slightly increase than their previous level[respectively(383.9±105.8)IU/ml,(1633.2±396.5)IU/ml], with no significant difference. The levels of TPOAb and TGAb in group A had significant difference than those in group B after the treatment(t were 22.3、19.6,P<0.01). Conclusion TCM combined with L-T4 can reduce the level of thyroid autoantibodies of TPOAb and TGAb-in patients.

Objective:This study was aimed to investigate the safety and feasibility of applying duodenal feeding tube in thoracoscopy-and laparcoscopy-guided esophagectomy for esophageal carcinoma. Methods:Clinical data of 73 esophageal carcinoma patients who underwent esophagectomy and received a duodenal feeding tube by thoracoscopy and laparoscopy from March 2011 to September 2012 were analyzed retrospectively. Modes of operation included the separation of the esophagus by thoracoscopy, separation of the stomach by laparoscopy, reconstruction of the digestive tract, and so on. Results:A duodenal feeding tube was carefully placed at the site of esopha-gectomy of the patient. Operation time lasted from 180 min to 410 min, with an average of 273 min. The duodenal feeding tube was placed at 27 min into the operation. Intra-operative blood loss ranged from 50 mL to 450 mL, with an average of 120 mL. No post-operative death was encountered among the cases. After surgery, anastomotic fistula and gastrointestinal discomfort occurred in 2 and 5 of the 73 cases, respectively. Conclusion:Placement of a duodenal feeding tube at the site of esophagectomy through thoracoscopy and laparoscopy is completely safe and feasible.