Objective To assess the safety of combined lung resection and cardiac surgery in patients with synchronously occurring lung tumor and heart disease. Methods Fourteen patients with synchronously lung tumor and heart disease received lung resection combined with open heart surgery between 2003 and 2008 in our hospital. There were 11 men and 3 women with a mean age of 64 years. Lung resection consisted of lobectomy in 8 patients, sleeve lobectomy in 1, and wedge resection in 5.Pulmonary tumor pathology was squamous cell in 4 patients, adenocarcinoma in 6, undifferentiated carcinoma in 1, hamartoma in 2 and sclerosing hemangioma in 1. Cardiac procedure included coronary artery bypass grafting (off-pump) in 12 cases, mitral valve replacement in 1 and valve repair in 1. Results No patient died or needed to do re-exploration for bleeding. One patient developed atrial fibrillation postoperatively and recovered soon. One patient developed pneumonia and ARDS who bad to receive tracheostomy but finally he discharged from hospital one month later after the operation. Conclusion Combined lung tumor resection and cardiac surgery are relatively safe in selected patients, especially concomitantly with off pump coronary artery bypass grafting. Lung resection and system medinstinal lymph node dissection for lung canner through second incision had low and acceptable operative morbidity.

Objective To screen the glycoproteins as biomarkers for intracranial aneurysm (ⅠA) in cerebrospinal fluid (CSF) and evaluate the specificity and sensitivity of the biomarker candidates.Methods A complementary proteomic approach integrated with multidimensional chromatography was employed to simultaneously measure relative changes in the gylcoproteins of cerebrospinal fluid (CSF) obtained from patients with ruptured ⅠA (RIA) and unruptured ⅠA (UIA) compared to the healthy controls (HC) and disease controls (DC).One protein-receptor tyrosine kinase Axl with a unique change in RIA was validated in CSF and plasma.The sensitivity at 95％ specificity of Axl in CSF and plasma was evaluated with receiver operating characteristic curve (ROC curve).Results Firstly,a total of 294 glycoproteins were identified in human CSF with believable evidence.Secondly,the proteomic findings showed the quantitative changes in RIA and UIA as compared to HC and DC.Of 294 identified CSF proteins,59,24 and 33 proteins displayed quantitative changes unique to RIA,UIA or IA,respectively.At last,one of these unique proteins-receptor tyrosine kinase Axl with unique increase in RIA was confirmed both in CSF and plasma.ROC curve analysis showed that the sensitivity at 95％ specificity of Axl in CSF to differentiate RIA from UIA was 60％.When compared to CSF,the sensitivity at above setting in plasma to differentiate RIA from HC was 40％ and to differentiate RIA from UIA was 25％.Conclusions A glycoprotein biomarker Axl might be used as a promising biomarker to predict the rupture of ⅠA.The further investigation of the relations between Axl and IA formation as well as rupture might help to elucidate the underlying pathogenesis and find new therapeutic targets.