Objective:To investigate the application value of fluorescence imaging in single-port thoracoscopic anatomic segmentectomy.Methods:The clinical data of 280 patients (145 patients with fluorescence method and 135 patients with modified inflation-deflation method) who underwent thoracoscopic anatomic segmentectomy were retrospectively studied in the Anhui Chest Hospital from June 2020 to June 2021. There were 113 patients in the simple segmentectomy group and 167 patients in the complex segmentectomy group. The baseline data of the fluorescence method and the modified inflation-deflation method in the complex segmentectomy group were corrected by propensity score matching, and the perioperative results were compared between the groups.Results:There were no significant differences in segmental resection time, intraoperative blood loss, postoperative drainage, postoperative pain, postoperative extubation time, length of hospital stay, incidence of complications and cost of hand-holding between the fluorescence method and the modified method of the simple segmentectomy group.In the complex segmentectomy group, the time of segmental resection with the fluorescence method was significantly shorter than that with the modified inflation-deflation method( P<0.05), and other indexes had no significant difference. Conclusion:Fluorescence method single-port thoracoscopic anatomic segmentectomy has the same perioperative safety and short-term efficacy as modified inflation-deflation method, which can significantly shorten the operative time and improve the operative efficiency in complex anatomic segmentectomy.

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 summarize the clinical experience of surgical resection of synchronous multiple ground-glass nodules (SMGN), and explore the individualized diagnosis and treatment strategy of SMGN. Methods    Clinical data of 84 patients with SMGN who underwent thoracic surgery in Anhui Chest Hospital from July 2016 to August 2018 were analyzed retrospectively, including 18 males (21.4%) and 66 females (78.6%), aged 32-80 (55.6±10.3) years. The results of operation and the information of GGNs were analyzed. Results    Except for 1 patient who was converted to thoracotomy due to extensive dense adhesion of thoracic, other patients underwent video-assisted thoracoscopic surgery successfully. All patients recuperated successfully after operation, without severe perioperative complications or death. Finally, 79 patients were diagnosed as malignant tumors (94.0%), and 5 patients of benign lesions (6.0%). A total of 240 GGNs were removed, among which there were 168 pGGNs, including 68 benign lesions (40.5%) and 100 malignant tumors (59.5%), and 72 mGGNs, including 2 benign nodules (2.8%) and 70 malignant tumors (97.2%). Nodules diameter (P<0.001), consolidation/maximum diameter of nodule ratio (P<0.001), vacuole sign (P<0.001), air bronchograms sign (P=0.001), spine-like process (P=0.001), pleural indentation sign (P<0.001), lobulation sign (P<0.001), and vascular convergence (P=0.002) were correlated with malignant tumor. Conclusion    Analysis of the imaging features of GGNs by thin-section CT scan and three-dimensional reconstruction is of great value in predicting the benign and malignant nodules, which can guide the surgical decision-making and preoperative planning. Through reasonable preoperative planning and following certain principles, simultaneous surgical treatment for SMGN is safe and feasible.

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 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.

Ethanol is one of the major risk factors for esophageal cancer.The main mechanisms of ethanol induced esophageal cancer include the direct carcinogenesis of acetaldehyde,the genetic polymorphism of enzymes related to alcohol metabolism,the carcinogenic effect of reactive oxygen species,the disorder of nutrient metabolism induced by ethanol,and the synergistic effect of ethanol and tobacco.

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 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 investigate the effect of mild hypothermia on expression of autophagyrelated proteins LC3 and Beclin-1 in the hippocampus of rats with traumatic brain injury (TBI).Methods Sixty healthy male adult SD rats were divided into sham group, TBI group, hypothermiatreated group (31-33℃) according to the random number, with 20 rats per group.Rat models of TBI were established using the Marmarou's method.After 4 h of normothermia or hypothermia, the rats were killed 6, 12, 24, and 48 h later.Co-localization of LC3 with neuron specific protein (NeuN) or mammalian target of rapamycinm (mTOR) was determined by double immunofluorescence.Levels of LC3, Beclin-1 and p-mTOR proteins were detected by Western blot analysis.Results LC3 co-localization with NeuN (or mTOR) was observed under confocal laser scanning microscope.In TBI group LC3 and Beclin-1 levels were seen to rise at 6 h, peaked at 24 h and fell slightly at 48 h, but the levels were still higher than these in sham group (P ＜ 0.05).In TBI group p-mTOR level began to decrease at 6 h, reached the lowest point at 12 h, and then ascended at 24 and 48 h, but the level was still lower than that in sham group (P ＜0.05).Mild hypothermia contributed to remarkable decreases in LC3 and Beclin-I expressions, while up-regulating p-mTOR after injury (P ＜ 0.05).Conclusion Mild hypothermia appears to be neuroprotective as it inhibits autophagy in hippocampal neurons after TBI in rats through activation of mTOR signaling pathway.

Objective To investigate the correlation between the number of dissected lymph nodes ( LNs) and the prognosis of patients with node?negative Siewert type ⅡAEG. Methods 248 patients with Siewert type Ⅱ AEG treated in our hospital between January 1998 and December 2008 were retrospectively assessed. All cases underwent left transthoracic subtotal esophagogastrectomy with conventional two?field lymphadenectomy, and were histopathologically proved to be without lymph node involvement. The prognostic impact of the number of dissected LNs was analyzed. Results The overall median survival time and the 1?, 3?, and 5?year overall survival rates were 64 months, 80. 4%, 60. 8% and 51. 0%, respectively. Cox regression showed that the number of dissected LNs and the depth of tumor invasion were independent prognostic factors. Patients with a high number of negative LNs had better overall survival than patients with a low number of negative LNs ( P<0.05) . The patients had better long?term survival outcomes with more than 10 LN dissected for cases with pT1 tumor ( P<0.001) , and so did those with more than 15 LN dissected for cases with pT2?3 tumor (P=0.003, 0.018, respectively). Conclusion The number of negative lymph nodes and the depth of tumor invasion are independent prognostic factors for node?negative Siewert type ⅡAEG, and adequate lymph node dissection can improve the long?term survival.