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.

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:The previous literatures have reported that the aneurysmal bone cyst has a high recurrence rate after curettage treatment.
OBJECTIVE:To investigate the effect of less invasive stabilization system plate fixation combined with bone cement in the treatment of distal femoral aneurysmal bone cyst.
METHODS:A retrospective analysis was conducted in 19 patients with distal femoral aneurysmal bone cyst who treated with less invasive stabilization system plate fixation combined with bone cement in the First Hospital of Qinhuangdao between January 2002 and January 2012. The purpose of the treatment of aneurysmal bone cyst was to completely remove the cyst and prevent recurrence, and to repair and reconstruct the structure and function of the damaged tissues through implant fixation.
RESUTLS AND CONCLUSION:The 19 patients were fol owed-up for 1-3 years after treated with less invasive stabilization system plate fixation combined with bone cement, and 18 cases recovered wel , one case had recurrence at 2 years after treatment. Complete removal of aneurysmal bone cyst is the key for the prevention of recurrence. The less invasive stabilization system plate is the combination of advantages of intramedul ary nail and the biological locking plate technology, which has many advantages in the treatment of aneurysmal bone cyst. Fil ing the lesion area with bone cement had certain kil ing effect on tumor, and can increase the bone strength in the lesion area. The surgical treatment of distal femoral aneurysmal bone cyst is to clear the cystic lesions firstly, and then to prevent the recurrence through less invasive stabilization system plate fixation combined with bone cement.

Objective To study the initial application of 3.0T high field intensity intraoperative magnetic resonance(iMR)for cranial tumors.Methods Forty-three patients with cranial tumors including 23 glioma cases,12 pituitary tumor cases,3 brain stem cavernous hemangioma cases,2 meningioma cases,2metastatic tumor cases,1 neurilemmoma case,received operation examined with GE Signa HDX 3.0T iMR system.The operation process and influence of iMR were reviewed.Results In 43 patients,average iMR examination was 1.3(1-3)times.In 16 patients the first iMR examination revealed tumor remnants,and in 13 of them continued surgical interventions and complete resection.The rate of complete resection was increased from 63％(27/43)to 93％(40/43).No complications related to iMR occurred.Conclusion 3.0T high field intensity iMR can provide accurate positioning and real-time navigation for the surgery,increase the rate of complete resection,improve the accuracy and safety of cranial tumor resection,and decrease complications.

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.

Objective To investigate the proliferation and identification of dendritic cells(DC)de- rived from peripheral blood of patients with bladder cancer in vitro.Methods The mononuclear cells were prepared from peripheral blood of patients with bladder cancer by Ficoll-Hypaque centrifugation method,and were induced by the recombinant cytokines hGM-CSF(50 ng/ml),hlL-4(10 ng/ml)and hTNF-?(50 ng/ ml)for 2 weeks.The growth and morphology of DC were observed through the phase contrast or electron mi- croscope,and their pheuotypes were determined by flow cytometry.The capacity of DC to activate T cell-de- pendent anti-tumor immune responses was tested by MTT method.Results The DC cultured in vitro turned into suspensive growth from adhesive situation on the 6th day,then the number of DC increased con- tinuously and the cells showed the irregular morphologic appearance of DC with veiled edges on the 8th day. Flow cytometry showed that the mature DC expressed high levels of specific markers such as CD_(1a),CD_(83), CD_(86)and HLA-DR.T cells activated by DC showed strong cytotoxicity to bladder cancer cell line BIU87 with a killing rate of(48.8?3.7)%,while the killing rate of T cells which were not activated by DC was(25.7?1.5)%;the difference of the rate between them was significant(P＜0.01). Conclusions The DC can be cultured from peripheral blood of patients with bladder cancer by induction of rhGM-CSF,rhIL-4 and hT- NF-?in vitro.This may lay an experimental foundation for further research on DC vaccine.