Objective To analyze the survival statistics and perioperative parameters of clinical stage Ⅰ non-small cell lung cancer patients who received systemic or selective mediastinal lymphadenectomy,and explore the value of selective mediastinal lymphadenectomy for clinical stage Ⅰ non-small cell lung cancer.Methods The clinical data of 984 patients with clinical stage Ⅰ non-small cell lung cancer who underwent lobectomy and systemic/selective lymph node dissection in Zhongshan Hospital from January 2005 to December 2010 were analyzed retrospectively.There were 581 males and 403 females with an average age of(59.6 ± 10.2) (24-84) years.786 patients received systemic mediastinal lymphadenectomy,and 198 patients received selective mediastinal lymphadenectomy.Results Average operation time of selective mediastinal lymphadenectomy group was(132.3 ±30.3) minutes,and that of systemic mediastinal lymphadenectomy group was(150.7 ±41.8) minutes with significant difference(P ＜ 0.01).Average amount of intraoperative bleeding of selective mediastinal lymphadenectomy group was (96.2 ± 53.5) ml,and that of systemic mediastinal lymphadenectomy group was (124.4 ± 65.4) ml with significant difference(P ＜0.01).There was no significant difference in overall survival rate between two groups(P =0.844).Recurrence rates were 25.3 ％ and 27.5 ％,respectively (P =0.533).Subgroup analysis showed no significant difference of 5-year survival rates between the two groups.Conclusion For patients with clinical stage Ⅰ non-small cell lung cancer,selective mediastinal lymphadenectomy can reduce operation time and amount of intraoperative bleeding.Survival of patients who received selective mediastinal lymphadenectomy was no worse than that of patients who received systemic mediastinal lymphadenectomy.

Adolescent ; Angiography ; Child, Preschool ; Female ; Hemoptysis ; diagnostic imaging ; drug therapy ; Humans ; Male

Objective This paper aimes to analyze the scientific research development trend,research emphasis and cooperation situation of Chinese Center for Disease Control and Prevention since its establishment,to provide the suggestions for policy making of scientific management and related decisions.Methods Based on GoPubMed,Literature quantitative analysis was used to analyze the publication time and journal distribution,research topics and core authors of the scientific papers from 2002 to 2015.Results A total number of 4 501 research papers had been published in 576 different kinds of periodicals.Research topics were based on population health with special focus on the epidemiological,microbiological and etiological studies of infectious disease.Chronic non-communicable disease and health research were paying more and more attention to.Core author group and the core research team have been formed.Conclusions The capability to conduct scientific research was increased and the international influence was increasing year by year,the ability of infectious disease control was strengthened,and the scientific research team worked together more closely.Thus,the Chinese Center for Disease Control and Prevention should reinforce scientific management,develop advanced disciplines,as well as improve the quality of scientific research in the future.

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 explore the interaction between serum melatonin and the status of disease and probe the effect factor of serum melatonin change in asthmatic children.Methods Serum melatonin was measured in asthmatic children with 15 cases of mild persistent asthma,15 cases of moderate persistent asthma,15 cases of severe persistent asthma,15 cases of stable asthma and 15 cases of normal subjects by enzyme-linked immunosorbent assay(ELISA).Results The levels of serum melatonin in the 5 groups of mild persistent asthma,moderate presistent asthma,Severe Persistent asthma,Stable asthma,control subject were(22.76?5.16)ng/L,(16.79?3.35)ng/L,(11.54?1.45)ng/L,(22.06?3.36)ng/L,(28.72?4.32)ng/L,respectively.There were significant differences between any of them(Pa

Objective To explore a new methodology for surgical treatment of severe retracted nipple in women. Methods 20 patients with inverted nipple and 4 recurred patients were involved in this study. Firstly, the site of neonipple tip was marked in the central part of the inverted nipple and its mean diameter usually was 1.2-1.5 cm. Then two shallow and deep triangular pedicled flaps were designed, respectively, in both superior and inferior areas near areola. With temporary traction of the nipple apex provided by a stay suture, the fibrotie bands underneath the nipple base might be cautious-ly released. Moreover, the shallow skin flaps should be about 0.5 cm in thickness and their blood sup-ply was from the subdermal arterial rete of the areola, which were used to cover and reconstruct the neck area of neonipple after a clockwise rotation and advancement simultaneously. While the deep fas-cia tissue flaps were revolved and advanced either horizontally to the opposite pedicle or upward to the inner tip through the tunnel underneath the nipple base in order to improve the height or width of the neonipple neck and prevent flattening as the supporting tissue and their blood supply was from some small perforating branch arteries in the deep part of mammary gland. Finally, purse-string suture was necessary in the base of neonipple which played a key role in avoiding recurrence of nipple inversion. Four vertical diamond-shaped excision-suturation treatment in neck area could make improvemts on the height of those stout and short nipples. Results In all 24 cases corrected by shallow and deep triangu-lar flaps rotation, after 3-6 months' follow-up, there were no complications related to surgery such as infection, hematoma, permanent sensory disturbance, or nipple necrosis, and postoperative recovery was rapid and uneventful. Especially, follow-up data revealed no evidence of recurrence of inversion and all patients were satisfied with their results. Conclusions Triangular flaps and fascia-tissue flaps in shallow and deep areola rotation is effective and easy to be popularized in correction of inverted nip-ple. This technique can improve both the diameter and height of the nipple, and certainly lower the re-currence rate of nipple inversion and achieve good aesthetic results.

Objective To evaluate effects of the daily average temperature on the daily number of outpatient visits for eczema in Lanzhou city.Methods Clinical data were obtained from outpatients with eczema in the Department of Dermatology of 2 third-grade class-A hospitals in Lanzhou city from January 1st 2007 to December 31st 2015,and meteorological data during this period were also collected.Controlling for confounding factors like long-term trends and day of the week,a distributed lag non-linear model (DLNM) fitted with quasi-Poisson link function was used to assess the effects of daily average temperature on the daily number of outpatient visits for eczema,and the analysis was stratified by season,age and gender.Results The exposure-response relationship between the daily average temperature and daily number of outpatient visits for eczema could be roughly described by a W-shaped curve.Stratification analysis showed that the effect of the daily average temperature on outpatient visits for eczema was strongest in autumn and winter,followed by summer,and weakest in spring.Low temperature may have lagged,cumulative and persistent effects on the daily number of outpatient visits for eczema,with the maximum relative risk (RR) value (1.12 [95％ CI:1.03-1.22]) observed at-9 ℃ on lag day 14.With a 1 ℃decrease in the temperature,16％ (RR =1.16,95％ CI:1.00-1.03),14％ (RR =1.14,95％ CI:1.02-1.26) and 13％ (RR =1.13,95％ CI:1.02-1.25) increases in the daily number of outpatient visits for eczema were observed in men,teenagers and middle-aged adults respectively (P ＜ 0.05).However,low temperature had no significant effects on outpatient visits for eczema among women or the elderly (P ＞0.05).The effect of high temperature usually occurred following exposure without lag periods,and was gradually weakened over lag time (P ＞ 0.05).Conclusions In Lanzhou,the effect of daily average temperature on outpatient visits for eczema was strongest in autumn and winter.Changes of the daily temperature may be one of risk factors for eczema.Low temperature had lagged effects on the daily number of outpatient visits for eczema,and the effects were strongest on lag day 14.

Sphingosine kinase (SphK), sphingosine-1-phosphate (S1P) and S1P receptor (S1PR) are involved in the tumor biological processes such as tumor cell proliferation and migration, and play an important role in the development of cancer. In recent years, researchers have increasingly focused on the interaction between cancer cells and the tumor microenvironment. The tumor microenvironment is genetically stable and can be induced to an antitumor phenotype, which has significant therapeutic advantages. Studies have shown that SphK/S1P/S1PR can regulate multiple aspects of the tumor microenvironment. This review summarizes the effects of SphK and S1P/S1PR signaling on the tumor microenvironment from four perspectives: tumor immune microenvironment, cancer associated fibroblasts, tumor angiogenesis and tumor hypoxic microenvironment, and also outlines potential drug research related to these signal molecules, aiming to elucidate the role of SphK/S1P/S1PR in tumor occurrence and development and provide new ideas for the research of anti-tumor drugs.

Objective:To study the clinicopathological features and differential diagnosis of metaneph-ric adenoma (MA).Methods:The clinicopathological data of 16 cases with MA diagnosed and treated in Peking University First Hospital from 2004 to 2016 were retrospectively analyzed,and the clinical characteristics,pathologic parameters,differential diagnosis,treatment options and prognosis of MA were analyzed with literature review.Results:The patients included 10 females and 6 males.The age of pa-tients ranged from 14 to 83 years (mean =33.7 years).The partial nephrectomy was carried out for most patients.All cases were located in renal codex with 3 growing into the renal sinus.Histologically,the tumor was composed of tubules,papillary or glomeruloid structures and psammoma bodies were focally seen.Immunohistochemical study showed that all the cases expressed vimentin,and 94% cases ex-pressed CD57,63% WT1,75% AE1 /AE3,19% cytokeratin 7 (CK7 )and 13%α-methylacyl-CoA racemase (AMACR),and negative expressions for MA included CD10,neuron-specific enolase (NSE) and CD56.Follow-up information from 1 to 125 months was available in all the patients;and none of the patients showed any evidence of recurrence and metastasis.Conclusion:The benign tumor characteris-tics of MA are not obvious for preoperative imaging diagnosis,and the diagnosis of MA should be based on the unique pathological features.Positive immunostain of CD57 is a useful indicator for MA diagnosis and differential diagnosis.The partial nephrectomy surgical treatment can achieve good clinical cure with good prognosis.

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.