Search

Background: To determine the value of mediastinoscopy in N staging of lung cancer with clinical N2 disease. Methods: We retrospectively reviewed 87 patients who received mediastinoscopy for known or suspected lung cancer, including 83 cervical mediastinoscopies and 4 parasternal mediastinoscopies. All patients were clinically staged N2 for enlarged ipsilateral mediastinal and/or subcarinal lymph nodes (short axis >1.0 cm) on computed tomography scan. Results: Of the 87 patients, 61 cases proved to be N2 disease by mediastinoscopy; the other 26 mediastinoscopy-negative patients underwent thoracotomy for lung resection and mediastinal lymph node dissection in the same operation. Final pathologic N staging was consistent with mediastinoscopic sampling and surgical dissection in 24 patients, and N2 disease was found in 2 patients (false-negative by mediastinoscopy). The sensitivity, specificity, and accuracy of mediastinoscopy were 96.8%, 100%, and 97.7%, respectively. Among all 87 mediastinoscopic procedures, there was no mortality and only 1 complication (1.1%). Conclusions: Mediastinoscopy is a highly effective and safe procedure for the mediastinal staging of lung cancer with clinical N2 disease.

Background: The use of video-assisted thoracic surgery (VATS) in the treatment of thymoma is becoming more and more common. The aim of this study was to evaluate safety and effectiveness of thoracoscopic treatment of thymoma and, more importantly, to report long-term follow-up results of a large single-center cohort. Methods: A retrospective review of a prospective database was performed. In total, 150 patients who underwent VATS resection for thymoma at Peking University People’s Hospital from April 2001 to November 2014 were retrospectively reviewed. Results: Average operation time was 140.1±54.2 min, median blood loss was 50 mL (range, 10–700 mL), median post-operative drainage time was 3 days (range, 1–11 days), and median length of post-op stay was 5 days (range, 2–20 days); 134 patients (89.3%) were followed up successfully. Median follow-up was 59.5 months (range, 2–187 months). Five- and 10-year recurrence free survival (RFS) rates of entire group were 96.5% and 94.4%, respectively; 5- and 10-year RFS rates for Masaoka stages I + II were 98.1% and 98.1%, respectively; 5- and 6-year RFS rates for Masaoka stage III were 90% and 60%, respectively. One case of recurrence in ve Masaoka stage IV patients was observed, and 4-year RFS was 80%. Multivariable analysis indicated that recurrence tended to occur in Masaoka stages III + IV patients (P=0.037, HR =12.69, 95% CI: 1.17–138.22) and older patients had a lower risk of recurrence (P=0.029, HR =0.87, 95% CI: 0.77–0.99). Myasthenia gravis (MG) presented in 44 patients (29.3%), of which 36 patients (81.8%) were followed up. Nine patients achieved complete remission, and 19 patients had symptom improvement after surgery. Overall response rate of MG was 77.8% (28/36). Conclusions: VATS was a safe and effective procedure for treatment of thymomas with satisfactory prognosis. MG with thymoma treated by VATS had comparable neurological outcome to that associated with the trans-sternal approach.

Berberine is an isoquinoline alkaloid widely used in the treatment of microbial infections. Recent studies have shown that berberine can enhance the inhibitory efficacy of antibiotics against clinical multi-drug resistant isolates of methicillin-resistant Staphylococcus aureus (MRSA). However, the underlying mechanisms are poorly understood. Here, we demonstrated that sub-minimum inhibitory concentrations (MICs) of berberine exhibited no bactericidal activity against MRSA, but affected MRSA biofilm development in a dose dependent manner within the concentration ranging from 1 to 64 μg/mL. Further study indicated that berberine inhibited MRSA amyloid fibrils formation, which consist of phenol-soluble modulins (PSMs). Molecular dynamics simulation revealed that berberine could bind with the phenyl ring of Phe19 in PSMα2 through hydrophobic interaction. Collectively, berberine can inhibit MRSA biofilm formation via affecting PSMs’ aggregation into amyloid fibrils and thereby enhance bactericidal activity of antibiotics. These findings will provide new insights into the multiple pharmacological properties of berberine in the treatment of microbial-generated amyloid involved diseases.

Berberine is an isoquinoline alkaloid mainly extracted from Rhizoma Coptidis, which is an efficient therapeutic agent to combat bacterial infections. However, bioactive assay manifested that berberine exhibited poor effect on antibacterial properties. In the present paper, we reviewed the multiple activities of berberine, including inhibition of biofilm formation, anti-inflammation effect, and clinical trials, which indicate the possible mechanism of berberine in the treatment of bacterial infections.

A laboratory-scale experiment was done. And the baicalin anaerobic biodegradation curve and pathway were discussed by analyzing the results of GC-MS. After analogue of status's trend and analysis of its regression, the biodegradation kinetic equation of baicalin was obtained. And the possible biodegradation pathway was "desugar --debentures --open benzene ring --saturating --disconnect links". It took at least 47 h to biodegrade baicalin. The main products of anaerobic biodegradation were micro-molecule oxide, such as alcohols, aldehydes, acids, esters, olefin, and hydrocarbon of methane series. This result demonstrated that the rate-limiting steps of bacalin biodegradation were the hydrolyzing and acidification phase. It was suitable to use two-phase anaerobic process and long HRT to biodegrade baicalin.