Objective     To compare the short-term efficacy and long-term survival of patients with non-small cell lung cancer (NSCLC) treated by uniportal or three portal thoracoscopic radical resection. Methods     A total of 388 patients who underwent uniportal or three portal thoracoscopic radical resection of lung cancer in the Department of Thoracic Surgery of Anhui Chest Hospital from 2015 to 2016 were analyzed retrospectively. The patients were divided into two groups including an uniportal group and a three portal group according to the procedure. The clinicopathological features, perioperative data and long-term survival of the two groups were compared. Results     Finally, we included 205 patients with 105 males and 100 females at an average age of 58.73±10.93 years. There were 102 patients in the uniportal group and 103 patients in the three portal group. There was no statistical difference in clinicopathological features between the two groups (P>0.05). But compared with the three portal group, the uniportal group had less postoperative drainage, shorter postoperative catheterization time and postoperative hospital stay (P<0.05). There was no statistical difference in the number of lymph node dissection stations between the two groups (P=0.058). The pain score at 24 hours after operation in the uniportal group was significantly lower than that in the three portal group (P<0.001). There was no  statistical difference in the total incidence of complications and the incidence of pulmonary complications between the two groups (P=0.161 and P=0.275). The median survival period and the 1st, 3rd, and 5th year survival rate in the uniportal group was 63.0 months and 95.0%, 75.2%, 51.5%, respectively. The median survival period and the 1st, 3rd, and 5th year survival rate in the three portal group was 61.0 months and 89.3%, 70.9%, 50.5%, respectively. There was no satistical difference in the survival results between the two groups (P=0.440). Conclusion     Uniportal thoracoscopic radical resection of lung cancer is more minimally invasive and safe and effective in the treatment of NSCLC. It can make patients recover faster after operation.

Objective:To report 7 cases of vitiligo caused by eyebrow tattooing.Methods:Seven cases of vitiligo caused by eyebrow tattooing were collected from Department of Dermatology, Henan Provincial People′s Hospital from December 2017 to May 2019, and their clinical features were retrospectively analyzed.Results:One month to 1 year after eyebrow tattooing, several eyebrows became white in the 7 patients. In the early stage, only several eyebrows became white, and the surrounding skin was normal, but white patches with unclear boundaries gradually appeared around the eyebrows in the later stage. Reflectance confocal scanning microscopy of skin lesions on the eyebrow showed depigmentation in the basal layer and around hair follicles, and highly refractive amorphous substances (colorants) in the superficial and middle dermis. The 7 patients all showed negative patch test reactions to eyebrow colorants but positive reactions to sodium dodecyl sulfate.Conclusion:No depigmentation was observed on the eyebrow skin in the early stage of vitiligo caused by eyebrow tattooing, and reflectance confocal scanning microscopy of eyebrow lesions may be beneficial in reducing its misdiagnosis.

Objective To establish trimester-specific reference intervals of thyroid hormones for pregnancy in normal iodine intake.Methods A total of 716 pregnant women were selected as research subjects ,and another 307 normal women without pregnancy were served as control group .The serum thyroid stimulating hormone (TSH), free thyroxine(FT4),free three iodine thyroid gland originalacid(FT3) were measured by chemiluminescent microparticle immunoassay.The changes of thyroid indicators in different gestational period were analyzed ,and the thyroid reference range during pregnancy was established .Results The levels of TSH,FT3 and FT4 in non-pregnant women and women in different pregnancy were significantly different (F =78.901,249.571,137.090,all P <0.05),in which the TSH increased with the increase of gestational age ,while the FT3 and FT4 decreased with the increase of gestational age.The reference range of TSH in the early ,middle and late gestational weeks were 0.12-4.82mIU/L,0.60-4.25mIU/L,0.37-4.03mIU/L;the reference range of FT3 in the early,middle and late gestational weeks were 3.81-6.10pmol/L,3.40-5.20pmol /L,3.00-5.00pmol /L;and the reference range of FT4 in the early,middle and late gestational weeks were 12.85-22.12pmol/L,10.81-17.66pmol /L,10.96-18.20pmol /L,respectively. The diagnostic rates for thyroid dysfunction of reference values ,non-pregnancy reference values and reference values established by American Thyroid Society (ATA) were 5.17%,5.45% and 6.01%,respectively,which showed no statistically significant difference among the three groups (χ2 =0.498,P >0.05).However,the difference among the three diagnostic criteria for subclinical hypothyroidism was statistically significant ( χ2 =9.661, P <0.05 ). Conclusion The thyroid function indicators of pregnant women are significantly different from those of normal people,and there are differences in different stages of pregnancy .Establishing a region-specific reference range can effectively prevent misdiagnosis or missed diagnosis of thyroid disease and reduce adverse pregnancy outcome .

Objective To identify mutations in keratin genes (KRT1 and KRT10) in a pair of twins with bullous congenital ichthyosiform erythroderma (BCIE),and to explore the relationship between the causative genes and phenotypes.Methods Clinical data were collected from a pair of twins with BCIE and their family members.Peripheral blood samples were obtained from the twins,their old brother and parents,and DNA was extracted from these blood samples.Polymerase chain reaction (PCR)was performed to amplify all the coding exons and their flanking sequences of the KRT1 and KRT10 genes,and 100 unrelated healthy persons served as controls.Results The 11-year-old male proband presented with recurrent blisters,hypertrophy and desquamation all over the body for 11 years.His twin brother had similar skin lesions.Skin examination of the proband showed diffuse erythema covered with thick scaly crusts on the trunk and extremities.Blisters,bullae and erosions due to ruptured blisters were observed locally with tenderness on palpation.There were obvious hyperkeratotic and hard lesions on the big joints of the extremities.Diffuse hyperkeratosis could be seen on the palms and soles.A mutation c.591 + 1G ＞ A was identified at position 1 in intron 1 of the KRT1 gene in the twins,but not in the 3 healthy family members or the 100 unrelated healthy controls.Conclusion The mutation c.591 + 1G ＞ A at position 1 in intron 1 of the KRT1 gene may contribute to the clinical phenotype of the twins with BCIE.

Objective To study the feasibility of Brainlab plus 6-degree-of-freedom(6D) couch in the radiotherapy of head and neck by using their setup error.Methods Twenty-four patients with head and neck neoplasms in our hospital during AugustOctober 2016 were taken as the examples.After positioning by technician,each Brainlab was carried out,the setup errors in 3 translation directions of left-to-right(X),head-to-foot(Y) and abdomen to-back(Z) and 3 pivoting directions of Rx,Ry and Rz were obtained after registration of positioned CT image.After adjustment,Brainlab re-scanning was conducted for getting corrected errors.Results The online correction by Brainlab plus 6D obviously reduced the setup errors.The setup errors in all directions approached to 0,in which the difference between Ry and Rz directions had no statistical significance(P＞0.05),while the difference among the X,Y,Z and RX directions was statistically significant(P＜0.05).Conclusion The online corrections of Brainlab combined with 6D considerably reduces the errors in translation and rotation directions in radiotherapy of head and neck neoplasms,thus reduces normal tissue received amount and increases the radiotherapeutic accuracy.

Objective To explore the A2AR activation after traumatic brain injury mechanisms and the role of excessive tau protein phosphorylation.Methods With no specific mice experiment research of specific pathogens, position in the left parietal cortex in mice, by the method of controllable cortical against brain trauma model model, 15 min after injury in mice abdominal injection of A2AR specific inhibitors ZM241385 or use A2AR knockout mice, testing the brain neuron loss and tau protein phosphorylation level;Use specific agonists CGS21680 activate the original generation of nerve cells in the hippocampus and the A2AR human neuroblastoma cells, using immunocytochemistry and immunofluorescence test tua protein phosphorylation level of change, to observe axon transport function of mitochondria.Results Immunohistochemical results accumulation of optical density analysis showed that inhibition of A2AR activation can significantly reduce after cerebral trauma Ser404 tua protein loci phosphorylation levels, reduce excessive tua protein phosphorylation with nerve pathological change;A2AR activation after tua phosphorylation of proteins at a Ser404 site level increased significantly, nerve axons per unit length processes in the mitochondria number decreased significantly, resulting in axoplasmic transport dysfunction;To activate the original generation of nerve cells in the hippocampus and after the A2AR human neuroblastoma cells, tua protein phosphorylation Ser404 locus levels increased significantly.Conclusion A2AR activation after cerebral trauma has obvious influence on tua protein phosphorylation levels, may be a function by influencing the axoplasmic transport, eventually forming cognitive dysfunction.

Objective To analyze and evaluate changes of the brain gray matter in patients with Parkinson's disease (PD).Methods 46 patients with PD and 19 normal control(NC) subjects(matched to the patients in age and gender) were selected in this study.46 cases of PD were divided into early PD group(ePD,25 cases) and middle-advanced PD group(maPD,21 cases) by improved Hoehn-Yahr(H-Y) stages.All the subjects underwent 3.0T MR scanning,and data of high resolution T1-weighted imageing (T1WI) were acquired.Gray matter volume differences between PD group and NC group,or ePD group and maPD group were assessed by voxel-based morphometry (VBM) combined diffeomorphic anatomical registration through exponentiated lie (DARTEL) method.Results The gray matter volume of the bilateral frontal lobes, temporal lobes, insular lobes, cingulum gyrus, hippocampus, fusiform gyrus, cerebellum and right cuneus lobe and precuneus lobe in the PD group was smaller than that in the NC group.The gray matter volume of the bilateral frontal lobes, temporal lobes,insular lobes,cingulum gyrus,rectus gyrus,lingualis gyrus,fusiform gyrus,hippocampus,amygdaloid and cerebellum in the maPD group was smaller than that in the ePD group.Conclusion VBM reveals a widespread volume reduction of the gray matter in PD patients,and detectes a correlation with disease duration and severity.These changes located in special distribution may be in line with the pathology of PD.

Objective: To identify the long-term outcome of patients with myasthenia gravis (MG) after extended thymectomy, and to analyze the prognostic factors. Methods: The medical data and follow-up results in 72 patients with MG who underwent extended thymectomy in Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University from January 2006 to October 2015 were retrospectively reviewed and analyzed. There were 32 male and 40 female patients, aging from 10 to 70 years with a mean age of 39.5 years. The outcome-related factors including gender, age while being operated on, duration of preoperative period, whether taking steroid before operation, modified Osserman classification, pathology type of thymus were analyzed by χ² test and multivariate regression analysis. Results: All patients were followed up from 6 to 75 months (median 37 months). Among them, 21 patients (29.2%) achieved complete stable remission, 18 patients (25.0%) experienced pharmacological remission, 20 patients (27.8%) improved, 9 patients (12.5%) reminded stable and 4 patients (5.6%) deteriorated. Both univariate and multicariate analysis revealed that duration of preoperative period (OR=22.871, 95% CI: 2.813 to 185.917, P=0.003) and Osserman classification (OR=0.103, 95% CI: 0.014 to 0.774, P=0.027) showed significantly associated with the surgical curative effect. Conclusions Extended thymectomy is an efective measure for MG. The duration of preoperative period and Osserman classification are prognostic factors for thymectomized MG. Those patients with generalized MG or whose duration of preperative period is less than 6 months are likely to have better prognosis.

Objective To investigate the current situation and related risk factors of healthcare-associated infection (HAI),so as to provide evidence for making prevention and control measures of HAI.Methods On November 26, 2014,a combination method of bedside visiting and medical record reviewing was adopted to survey HAI status, pathogen examination,and antimicrobial application in all hospitalized patients in a tertiary first class military hospi-tal.Results A total of 1 657 hospitalized patients were investigated,66 patients developed 71 times of HAI,HAI rate and HAI case rate were 3.98% and 4.28% respectively.The top 4 departments with HAI prevalence rates were departments of neurosurgery (24.49%),hematology(19.05%),cadre ward(13.73%),and burn surgery (10.91 %).The top 5 HAI sites were lower respiratory tract (40.85%),urinary tract(23.94%),upper respirato-ry tract(12.68%),surgical site(9.86%),and gastrointestinal tract(5.63%).Of 66 cases of HAI,39 (59.09%) patients sent specimens for culture,a total of 48 pathogens were cultured,the major isolated bacteria was Esche-richia coli (n = 10,20.84%),followed by Staphylococcus aureus ,Klebsiella pneumoniae ,and Pseudomonas aeruginosa ,each was 7 (14.58 %)respectively.The usage rate of antimicrobial agents was 34.40%,specimen de-tection rate in patients receiving therapeutic and therapeutic+prophylactic antimicrobial agents was 59.28%.Risk factors for HAI were age <2 years old or >60 years,with respirator,tracheotomy,urinary tract catheterization, arteriovenous catheterization,hemodialysis,and surgery,difference was significant(all P <0.05).Conclusion Mo-nitoring on key departments and key sites of HAI should be strengthened,antimicrobial agents should be used rationally based on pathogenic detection results,specimen pathogenic detection rate should be improved,and effective prevention and control measures needs to be taken according to the risk factors of HAI.

Objective To investigate the status of social participation of young and middle-age peritoneal dialysis patients and analyze its influencing factors. Methods Descriptive study was used to investigate the general information and social participation of 113 cases of young and middle-age patients with peritoneal dialysis, and we analyzed the influencing factors of social participation using ordinal Logistic regression analysis. Results In the 113 cases of young and middle-age patients with peritoneal dialysis, 97. 3%of patients could take care of themselves. Rating of social participation showed that 63. 7% of patients were in grade three, that was, to take care of themselves, and to carry out at least one of the social participation; the unemployed people accounted for 76. 1%. The status of social participation was related to age, marriage, education, social support, self efficacy and other factors. Conclusions The unemployed rate of young and middle-age peritoneal dialysis patients is high. To pay attention to the peritoneal dialysis population at work age, and improve the social participation of young and middle-age patients with peritoneal dialysis, the matter needs the joint efforts of medical personnel and social forces.