With the diversification in surgical population and the progress of surgical techniques, the current clinical application of pre-operative pulmonary function assessment methods can hardly be qualified for accurately assessing whether lung cancer patients can tolerate surgical treatment and surgery-related risk. This paper focuses on the advantages and weaknesses of the commonly-used pul-monary function assessment methods, with the literature review of the clinical application status and progress of pulmonary function currently. We aim to achieve a reasonable evaluation of preoperative cardio-pulmonary function assessment, and sequentially reduce the risk and occurrence of surgical-related complications.

Purpose:To explore the clinical significance of gene diagnosis in detecting micrometastases in lymph node,peripheral blood and bone marrow from non-small-cell lung cancer patients and the correlation to e ach other. Methods:The MUC1 mRNA expression was detected in lymph nodes, p eripheral blood and bone marrow from 31 lung cancer putients and 10 benign p?lm onary lesion patients by nested RT-PCR. Results:The sensitivity of the the RT-PCR technique was 10 -6 in this study. The positive rates of MUC1 mRNA were 54.6%, 32.3% and 22.6% in lymph nodes , peripheral blood and bone marrow from lung cancer patients resp ectively , and highly correlation existed among the three groups(P

Objective To investigate the effect of short bowel syndrome treated with living-related small bowel transplantation(SBT).Methods A male patient with residual intestine 20cm in length,which resulted from subtotal small bowel resection and right hemi-colectomy owing to intestinal volvulus,received a living-related SBT.The donor was the patient′s mother.Donor specific blood transfusion,50mL/per week,was carried out for 8 weeks.Cytomegalovirus infection status in both donor and recipient was negative.A 160cm segment of intestine was transplanted.The graft ileocolic artery and vein was anastomosed to the recipient′s infrarenal aorta and inferior vena cava end-to-side,respectively.A distal ileostomy was performed.(Immunosuppression),anti-infection and anticoagulation therapy,and nutritional support were given(postoperatively).Results The donor had an uneventful recovery.No technical complications were observed.The recipient was alive and well 31 weeks after operation.No graft rejection or infection was found.The(patient) was taken off TPN 8 weeks after operation,and got a low-fat meal.The result of D-xylose test was near normal.Conclusions Living-related small intestine transplantation is an effective treatment for short bowel syndrome.

It is time to review the current clinical treatment concepts and operational procedures that the changes of enhanced recovery after surgery (ERAS) theory, surgical instruments and disease treatment types. It is support of theoretical and technical of ERAS concept from rise to perfection for day surgery with complex but low risk operation. Combined with the recent clinical practice at home and abroad, this study review the problems and measures of day surgery in patients with lung cancer. First, the necessity and feasibility of patients with lung cancer undergoing day surgery instead of inpatient surgery. Second, establishment of day surgery team and platform in lung cancer surgery. Third, operational procedures and perioperative management of day surgery need to be optimized. Fourth, the "graded diagnosis and treatment-day surgery" model was used to ensure patient safety. Fifth, Clinical application prospect of ambulatory surgery for lung cancer.

The foundation of enhanced recovery after surgery (ERAS) is closely related to the minimally invasive surgery progress. In the development of ERAS, technology is utilized and humanistic factors are integrated to make it higher than technology, thus enriching the connotation and extension of ERAS. Based on the progress of ERAS in various fields of surgery in recent years, the current situation and strategies of clinical application of ERAS are summarized. First, the clinical practice of ERAS is inevitable for minimally invasive surgery progress. Second, the development of surgery theory and technology has deepened and expanded the connotation and extension of ERAS. Thirdly, the clinical application of ERAS requires us to renew our ideas. Fourth, the clinical practice of ERAS requires reasonable choice of medical service and medical intervention. The fifth is to the practical problems and strategies in clinical application of ERAS, to understand the complete clinical significance of ERAS, and better guide clinical practice.

The development of surgical techniques and the innovation of surgical instruments promote the changes in surgical methods, which in turn, leads to the reforms of surgical idea. The concept of enhanced recovery after surgery (ERAS) results in the surgery connotation switching from "to treat an illness" to "to save patients". ERAS also causes the change of surgery denotation from "only operation" to "enhance recovery". The concept of ERAS is derived from but not only restricted to the development of surgical techniques. Also, ERAS pays more attention to patients than disease and thinks more about patient safety and recovery than surgical technique. Specifically, ERAS has three advantages: first, ERAS attaches importance to multidisciplinary assessment (patient-oriented) and select appropriate (personalized) treatment and tries to decrease the rate of complication and mortality. Second, ERAS pays attention to preoperative preparation and high-risk prevention performed by multi-disciplinary collaboration in order to prevent complication and save cost for patients. Third, ERAS always focus on optimizing the process of perioperative period and trying to change the working habits of surgeons and the old cooperation mode among doctors, nurses and rehabilitation physicians. To sum up, the goal is to apply the concept of ERAS to all the links of perioperative period and try hard to decrease patients' stress and pain, which finally helps doctors fulfill the ultimate aims of "no pain and no risk".
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Humanities ; Humans ; Length of Stay ; Postoperative Complications ; physiopathology ; prevention & control ; psychology ; Recovery of Function

The close association between chronic obstructive pulmonary disease (COPD) and lung cancer has long been known. New evidence suggests that there is an inverse relationship between the severity of pulmonary function and the risk of surgery in patients with lung cancer, COPD may play a key role in the incidence of postoperative pulmonary com-plications (PPC) and improving pulmonary function with perioperation airway management has been suggested as a possible preventive PPC. hTis review describes the current understanding and clinical application of perioperation airway management in lung cancer patients with COPD. We summarized that: (1) hTe necessity of perioperation airway management; (2) hTe status and characteristic of inhaled drug in perioperation airway management; (3) hTe clinical value in improving pulmonary function of perioperation airway management; (4) hTe optimum population of peri-operation airway management; (5) hTe problem of perioperation airway management.

In the ifeld of human cancer research, even though the vast majority attentions were paid to tumor cells as“the seeds”, the roles of tumor microenvironments as“the soil”are gradually explored in recent years. As a dominant com-partment of tumor microenvironments, cancer-associated ifbroblasts (CAFs) were discovered to correlated with tumorigenesis, tumor progression and prognosis. And the exploration of the mechanisms of CAF phenotype transformation would conducive to the further understand of the CAFs function in human cancers. As we known that CAFs have four main origins, including epithelial cells, endothelial cells, mesenchymal stem cells (MSCs) and local mesenchymal cells. However, researchers found that all these origins ifnally conduct similiar phenotypes from intrinsic to extrinsic ones. hTus, what and how a mechanism can conduct the phenotype transformation of CAFs with different origins? Two viewpoints are proposed to try to answer the quet-sion, involving genetic alterations and epigenetic modiifcations. hTis review will systematically summarize the advancement of mechanisms of CAF phenotype transformations in the aspect of genentic and epigenetic modiifcations.