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Objective To compare the clinical efficacy of single utility port and multiple utility ports thoracoscopic lobectomy in the treatment of peripheral lung cancer, and to study the operation skills, relative merit and feasibility of the single utility port thoracoscopic lobectomy. Methods The clinical data was analyzed retrospectively for 223 cases with stage Ⅰ orⅡ of peripheral lung cancer who underwent thoracoscopic lobectomy from July 2011 to November 2014 in Shanxi Provincial Cancer Hospital. Among 223 cases, 78 cases received single utility port thoracoscopic lobectomy (single utility port group), 145 cases received 2 or 3 utility ports thoracoscopic lobectomy (multiple utility ports group). The clinical outcomes involved time of operation, intraoperative blood loss,chest drainage, postoperative hospital stay, stations of lymph node dissection, numbers of lymph node dissection, rate of turn to open, postoperative complications, 2-year survival rate and disease free survival rate. Results No perioperative death occurred in both groups. There was no statistical difference between single utility port group and multiple utility ports group in operation time [(157.4 ±13.6) min vs. (151.3 ±23.2) min], intraoperative blood loss [(180.77 ±59.97) ml vs.(171.31 ±77.51) ml],chest drainage [(370.26 ±146.09) ml vs. (351.17 ±159.07) ml], lymph node dissection stations (4.29±0.65 vs. 4.21±0.73), lymph node dissection number (11.50±2.30 vs. 11.04±2.29), rate of turn to open [(5.13 ％ (4/78) vs. 4.83 ％ (7/145)], incidence of postoperative complications [17.95 ％ (14/78) vs. 15.86％(23/145)], postoperative hospital stay [(8.74±0.51) d vs. (9.48±0.63) d], 2-year survival rate [96.15 ％(75/78) vs. 93.79％(136/145)] and 2-year disease free survival rate [80.77 ％ (63/78) vs. 82.07 ％ (119/145)] (all P>0.05). Conclusions The single utility port thoracoscopic lobectomy could achieve the same clinical results as the multiple utility ports. The single utility port thoracoscopic lobectomy is a safe, effective and feasible surgical procedure.
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Objective To evaluate the effects of preoperative continued dual antiplatelet therapy (DAPT) with aspirin and clopidogrel on early outcomes in patients underwent off-pump coronary artery bypass grafting (OPCABG). Methods A single-center study was conducted. The 279 unstable angina patients underwent first-time isolated OPCABG at our institution from January 2015 to May 2016 were divided into DAPT group (preoperative aspirin 100 mg/d and clopidogrel 75 mg/d were given until the time of surgery, n=148) and control group (stopped DAPT for 5 days before surgery, n=131). The total chest-tube output, blood-product transfusion requirements, re-exploration rate for bleeding, major adverse cardiac events (MACE) and other in-hospital outcomes were collected and compared between the two groups. Results There were no significant differences in demographic and preoperative clinical characteristics between the two groups. The total chest-tube drainage volume and perioperative transfusion requirements (rate and volume) including red blood cell, fresh plasma and platelets were statistically higher in the continued DAPT group than those of control group (P < 0.05). There were no significant differences in hemostatic re-exploration rate, length of operation, postoperative nonfatal myocardial infarction, ICU stay, ventilation time and duration of postoperative hospitalization between the two groups. Stroke and other severe outside chest bleeding and all-cause mortality were not observed in both groups during the postoperative period and prior to discharge. Conclusion Preoperative continued DAPT is associated with the increased chest-tube drainage and higher blood-product transfusion requirements but it does not increase the dection rate of thoracotomy because of bleeding. This antiplatelet strategy does not alter other investigated outcomes in primary isolated OPCABG patients. The preoperative DAPT may be able to be safely continued in patients referred for primary isolated OPCABG.
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Objective： Our aim was to purity the modifier protein of glyceraldehyde-3-phosphate dehydrogenase (G3PD) from African green monkey Vero-E6 line. Methods：Exposure of Vero-E6 cells to medium with a reduced K concentration (3.2 mmol/L) stimulated the growth and activation of G3PD. The increase of enzyme activity was mediated by a cytosolic modifier protein that was purified using affinity and anion-exchange high-performance liquid chromatograph. Results：The apparent molecular mass of the protein was 62 kDa. Western blotting and quantiative enzyme-linked immunosorbent assay showed that the amount of modifier protein increased progressively for 2 hours in cells exposed to low-K+ medium, and then returned to the control value, a kinetic profile similar to that the modifier protein is a constituent of renal epithelial cells and accummulated transiently in the low-K+ mitogenic signal. Conclusion: We obtained a modifer protein from monkey kidney epithelial cells (Vero-E6). It could activate G3PD and cell growth.