Objective To explore the value of left parasternal anterior mediastinaotomy (Chamberlain procedure) in the diagnosis of mediastinal lymph node enlargement with unknown causes and anterior mediastinal space-taking lesions. Methods By using the Chamberlain procedure, biopsy was performed in 32 cases of enlarged mediastinal lymph nodes with unknown causes or mediastinal space-taking lesions, which were found by CT scans. Results All of the 32 cases were pathologically diagnosed, with a diagnostic accuracy of 100%. Three patients with pericardial effusion received concurrent pericardial fenestration and then their symptoms relieved. Four patients underwent concurrent lung biopsy. The operating time was (48?15) min, the blood lose was ( 40.6?23.5) ml, and the postoperative hospital stay (3.6?1.4) days. No deaths or postoperative complications occurred. Conclusions Chamberlain procedure is a safe and valuable method in the diagnosis of mediastinal space-taking lesions with unknown causes or enlargement of the fifth and sixth groups of mediastinal lymph nodes, which routine mediastinoscope cannot reach. Some other simple therapies, such as lung biopsy or pericardial fenestration, can also be employed at the same time.

A simple and sensitive method was developed to screen ?-PL p ro duced strains from soils. 150mg/L K_2Cr_2O_7 was added to th e solid medium for actinomycetes enriching. A basic dye, methylene blue, incorp orated in the agar plate to detect alkali producers, because dye reacted with th e secreted basic polymers by electrostatic interaction with the secreted basic p dymers and formed special zoon. And then dragendorff regent was used to detect alkaloid producers. Four ?-PL producers were obtained by TLC analysis. Meanw hile, phylogenetic analysis of PL6-3 strain, including morphology, physiologica l and biochemical characters and chemotaxomy were performed and phylogenetic tre e was constructed based on the 16S rDNA sequences. And the results indicated th at PL6-3 strain is a member of Kitasatospora.

Objective To analyze the safety, feasibility and operative technique details of non-grasping en bloc mediastinal lymph nodes dissection technique in uniportal video-assisted thoracic surgery(VATS) for lung cancer.Methods From April, 2014 to March, 2015,46 patients with lung cancer received non-grasping en bloc mediastinal lymph nodes dissection after uniportal VATS lobectomy.Clinical data of the cases were analyzed retrospectively.There were 19 males and 27 females.The age was(57.2 ± 9.0) (38-73) years.The first 6 cases were performed in the lateral decubitus position while the later 40 cases were all performed in the semiprone position.Results All cases accepted uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection successfully.Arm fatigue of surgeon and assistant was obviously relieved when the patient was placed in the semiprone position.The thoracic drainage time was(3.2 ± 2.1) (1-12)days and the postoperative length of hospital-stay was(6.0 ± 4.5) (2-27) days.The number of dissected mediastinal lymph nodes stations was (4.3 ± 0.8) (3-6)and the number of dissected mediastinal lymph nodes was (11.8 ± 4.9) (4-30).There were 42 cases with stage No , lease wit stage N1, and 3 cases with stage N2 in pathological examination.Five patients developed minor postoperative complications.No perioperative death occurred.Conclusion Uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection for lung cancer was safe and feasible, which could decrease the interference of the instruments and help to keep the surgical field clear.Non-grasping en bloc mediastinal lymph nodes dissection would be performed more smoothly in the semiprone position with less damage to lung and better ergonomics.

Objective To compare the influence of washing processed of banked suspended red blood cells (RBCs) by cell saver and the influence by zero-balanced ultrafiltration(Z-BUF) on the inflammatory response after cardiopulmonary bypass(CPB) in infants.Methods Sixty infants with ventricular septal defect (VSD) were randomly divided into a control group (group A,20 cases), group B(20 cases)and group C (20 cases).Banked suspended RBCs were washed by cell saver before priming in group B,in group C the banked suspended RBCs were treated with Z-BUF and in group C the banked suspended RBCs were primed directly without any pre-treatment.Samples of the arterial blood were obtained respectively before the start of the CPB (T1), when the CPB stopped(T2) ,2 h after CPB (T3), 12 h after CPB (T4) and 24 h after CPB (T5).The levels of tumor necrosis factor-α (TNF-α), interleukin(IL)-6, IL-8, IL-10 were detected and analyzed comparatively among 3 groups.Results The levels of TNF-α, IL-6, IL-8 ,IL-10 in 3 groups at T2,T3 ,T4 showed a rising trend markedly,and the above four indicators of A,B and C at T4respectivelywere:(110.3±14.0) ×10-9g/L,(90.6±10.3) ×10-gg/L,(103.3±9.7) ×10-9g/L;(54.1 ± 6.5) ×10-9 g/L,(39.3±4.2) ×10-9 g/L, (46.2±5.7) ×10-9 g/L;(96.8 ±9.2) ×10-9 g/L, (82.5 ±6.5) × 10-9 g/L,(88.4±5.1) ×10-9 g/L;(228.4 ±42.9) ×10 9 g/L,(171.5 ±26.4) ×10-9 g/L,(202.9 ±42.8) × 10-9 g/L.The levels of TNF-α and IL-8 in group B and group C were significantly lower than those in group A at T2, T3 ,T4 and T5(all P ＜0.05) ,but there was no significant differences in the levels of IL-6 and IL-10 among 3 groups at T5;the levels ofTNF-α,IL-6,IL-8 ,IL-10 in group B were significantly lower than those in group C at T2,T3 and T4(all P ＜ 0.05).Conclusions Processing of banked suspended pre-RBCs with cell saver and Z-BUF can relieve systemic inflammatory response, and the effect of washing with cell saver is better compared with that of Z-BUF.

Antineoplastic Agents ; therapeutic use ; Diagnosis, Differential ; Female ; Histiocytosis, Langerhans-Cell ; metabolism ; pathology ; Humans ; Interferons ; therapeutic use ; Leukemia, Mast-Cell ; metabolism ; pathology ; Mastocytosis, Cutaneous ; metabolism ; pathology ; Mastocytosis, Systemic ; diagnostic imaging ; drug therapy ; metabolism ; pathology ; Middle Aged ; Proto-Oncogene Proteins c-kit ; metabolism ; Radiography ; Radionuclide Imaging ; Spleen ; pathology ; surgery ; Splenectomy ; Tryptases ; metabolism

OBJECTIVETo explore the cytotoxic responses of spleen T lymphocytes (CTL) in BALB/c mice induced by recombinant HSP110-HER2/neu ICD complex.

METHODSTumor-bearing mouse model was immunized by HSP110-HER2/neu ICD complex. The IFN-γ level secreted by activated spleen T lymphocytes was detected by enzyme linked immunospot assay (ELISPOT). The corresponding CTL activity was measured by granzyme release assay.

RESULTSThe BALB/c mouse model of human mammary tumor highly expressing HER2/neu was established. HSP110-HER2/neu ICD complex immunization led to a significantly higher level of INF-γ than that in HSP110-P(789-797) immunized and HER2/neu ICD immunized mice. HSP110-HER2/neu ICD complex immunized animals also show significant CTL activity. The results of immunohistochemical staining showed that the number of blue spots in the PBS group was 4.57 ± 1.33, HSP110 group 6.83 ± 2.08, HER2/neu ICD group 16.17 ± 2.86, HSP110-P(789-797) group 43.67 ± 4.78, and SP110-HER2/neu ICD group 76.51 ± 8.17. The number of IFN-γ-secreting spleen lymphocytes in the HSP110-HER2/neu ICD group was significantly higher than that in the HSP110-P(789-797) group, and that of HSP110-P(789-797) group was significantly higher than that of HER2/neu ICD group (P < 0.01). The target cell-killing rate of the PBS group was (8.15 ± 1.27)%, HSP110 group (9.51 ± 1.51)%, HER2/neu ICD group (14.03 ± 2.45)%, HSP110-P(789-797) group (25.99 ± 3.04)% and HSP110-HER2/neu ICD group (38.15 ± 3.95)% (all P < 0.01).

CONCLUSIONSHSP110-HER2/neu ICD complex can promote the proliferation and maturation of T lymphocytes into CTLs, and might be used as anti-tumor vaccine to induce potent cytotoxic T lymophocyte immunoresponse against specific tumor cells.

Animals ; Breast Neoplasms ; metabolism ; pathology ; Cancer Vaccines ; immunology ; Cell Line, Tumor ; Cell Proliferation ; Female ; HSP110 Heat-Shock Proteins ; immunology ; Humans ; Interferon-gamma ; metabolism ; Lymphocyte Activation ; Mice ; Mice, Inbred BALB C ; Neoplasm Transplantation ; Random Allocation ; Receptor, ErbB-2 ; immunology ; metabolism ; Recombinant Proteins ; immunology ; Spleen ; cytology ; immunology ; T-Lymphocytes ; cytology ; immunology ; metabolism ; T-Lymphocytes, Cytotoxic ; immunology ; Vaccines, Synthetic ; immunology

OBJECTIVETo compare the difference in the clinical efficacy on premature ovarian failure (POF) between the acupoint catgut implantation combined with artifical periodic therapy and the simple artificial periodic therapy and explore its effect mechanism.

METHODSSixty-five patients of POF were randomized into the two groups. In a western medication group, 32 cases were treated with the artificial periodic therapy with the oral administration of medroxyprogesterone acetate tablets. In a catgut implantation + western medication group, 33 cases were treated with the acupoint catgut implantation combined with artificial periodic therapy. The acupoints of Neiguan (PC 6), Zusanli (ST 36), Guanyuan (CV 4) and Sanyinjiao (SP 6) were selected. The treatment was lasted for half a year and the follow-up visit was for another half a year in the two groups. Kupperman index was used to assess the improvements in the clinical symptoms. The levels of serum sexual hormones such as follicle stimulating hormone (FSH) and estradiol (E2) were evaluated of the patients in the two groups before and after treatment. The efficacy was compared between the two groups.

RESULTSThe scores of the clinical symptoms were all significantly improved after treatment and in the follow-up in the two groups (P < 0.01, P < 0.05). In the 6-month follow-up visit after treatment, the result in the catgut implantation + western medication group was better than that in the western medication group (8.17 +/- 1.19 vs 13.68 +/- 1.08, P < 0.01). FSH was reduced after treatment in the two groups (all P < 0.01) and E2 was increased (all P < 0.05). The curative and remarkably effective rates were 75.8% (25/33) and 81.8% (27/22) after treatment and in the follow-up visit in the catgut implantation + western medication group, which were better than 67.9% (19/28) and 53.6% (15/28) in the western medication group separately (P < 0.05, P < 0.01).

CONCLUSIONThe acupoint catgut implantation combined with artificial periodic therapy achieve the remarkable improvements in the clinical symptoms of POF in the patients and the better results as compared with the simple western medication therapy. The combined therapys efficacy is stable and the long-term efficacy is apparently superior. The effect mechanism is related to the improvements in the serum sexual hormone levels.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Catgut ; utilization ; Female ; Follicle Stimulating Hormone ; metabolism ; Humans ; Primary Ovarian Insufficiency ; metabolism ; therapy ; Prostheses and Implants ; Treatment Outcome ; Young Adult

Adrenal Cortex Hormones ; therapeutic use ; Anemia, Hemolytic, Autoimmune ; diagnosis ; drug therapy ; Female ; Humans ; Infant ; Treatment Outcome

Adolescent ; Antimetabolites, Antineoplastic ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Drug Interactions ; Drug Therapy, Combination ; Female ; Humans ; Male ; Methotrexate ; adverse effects ; therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Sex Factors ; Tetrahydrofolates ; administration & dosage ; therapeutic use ; Treatment Outcome

Background and purpose:With the improvement of skill of video-assisted thoracic surgery, thoracoscopic anatomic segmentectomy becomes more and more mature. This paper aimed to study the safety, feasibility and clinical features of thoracoscopic anatomic segmentectomy for stageⅠ lung cancer.Methods:Data from 64 patients who was diagnosed as having clinicalⅠ stage lung cancer and received thoracoscopic anatomic pulmonary segmentectomy were retrospectively analyzed from Mar. 2008 to Jan. 2014. There were 28 men and 36 women with a median age of 59 years (39-86 years).Results:Sixty-four patients underwent thoracoscopic anatomic segmentectomy successfully. The median operative time was 120 min (90-240 min). The median blood loss in operation was 50 mL (10-200 mL). The median thoracic drainage time was 3 d(2-7 d). The median postoperative length of stay was 5 d(3-23 d). There was no postoperative mortality or severe complications. There was one conversion to lobectomy but no conversion to thoracotomy. There were 51 patients with ground glass opacity (GGO). Of the 51 patients, postoperative pathology showed invasive adenocarcinoma in 30, adenocarcinoma in situ in 10, minimally invasive adenocarcinoma in 6 and benign lesions in 5.Conclusion:Thoracoscopic anatomic pulmonary segmentectomy is a feasible and safe technique for a skilled doctor. Not only can it be a method of diagnosis, but also it can be a method of treatment for clinical stageⅠ lung cancer, especially for GGO in lung.