Objective:To study the effect of ischemic postconditioning(I-postC)on the lung injury following ischemia-reperfusion(I/R)of skeletal muscle in the hind limbs of rats.Methods:The rat model of hind limbs I/R injury was established by subrenal abdominal aorta cross-clamping for 4 hours.Forty-eight rats were divided into 3 groups:I/R group,IPC and I-postC group.Each group received 4 hours of ischemia and then 12 or 24 hours of reperfusion respectively.The tissue morphology,wet-to-dry weight(W/D)ratio,malondialdehyde(MDA)and myeloperoxidase(MPO) of lung tissue were compared.The expression of ICAM-1 mRNA in lung was also studied by RT-PCR or in situ hybridization.The protein product was detected by Western blot.Results:In IPC and I-postC groups,all parameters decreased significantly compared with I/R ischemia group(P

Objective Severe bronchial stricture due to endobronchial tuberculosis is often accompanied by complex complication,such as obstructiv pneumonia,destroyed lung and bronchiectasis.Its treatment is very diffucult.The present report is to investigate and analyze the indication and efficacy of surgical treatment of bronchial stricture due to severe endobronchial tuberculosis.Methods Reviewed the clinico-pathological records documenting the surgical outcomes in 81 bronchial stricture due to severe endobronchial tuberculosis who underwent lobectomy or pneumonectomy enrolled in our hospital between January 1990 and December 2010.There were 29 male and 52 female.Mean age was(36 ± 12) years (ranged 16-66 years).The three most common reasons of surgery were bronchial stricture accompanied by pulmonary atelectasis,destroyed lung and bronchiectasis(76 cases,93.8％).79 cases had elective operation,whereas one patients required emergency surgery.Pueumonectomy in 51,lobectomy in 16,sleeve resection in 11,segmental resection in 2,and exploratory thoracotomy in 1.If frozen pathological examination showed that endobronchial tuberculosis remained in the bronchial stump,it was covered with muscle flaps,including intercostal muscle flap in 6 cases,latissimus dorsi muscle flap in 5 cases,serratus anterior muscle flap in 5 cases.The mean operative time was 3.2 h (range between 2 h and 5.5 h) and the blood loss averaged 546 ml (range between 100ml and 4 000 ml).The post operative hospital stay averaged(12 ±8)days.Results No intraoperative or early postoperative death occurred.Nine patients developed complications,including BPF in 2,pulmonary infection in 2,empyema in 1,hemorragic shock in 1,hemothorax in 1,incision infection in 1,chylothorax in 1.All 9 cases recovered well after treatment.Pathological examination showed that tuberculosis bronchial remained in the brinchial stump in 13 cases.Neither BPF nor empyema occurred in all the 13 cases.Multivariate analysis revealed that destroyed lung was significant risk factor of postoperative complication.There were 3 late deaths.Five year survival rate was 96.2％.Conclusion Surgical treatment is still the recommeded treatment modatity for bronchial stricture caused by endobronchial tuberculosis due to its excellent results.It should be performed in time when the drug and intraluninal treatment were no effect for avoiding of being progeressed into destroyed lung.

Objective To determine the prognosis and staging non small cell lung cancer (NSCLC) that extends across the fissure into adjacent lobe after surgery.Methods 3752 patients with histopathologically confirmed non small cell lung cancer (NSCLC) received surgical reeessetion from January,1997 to April,2007.Among them,163 patients have a tumor invasion beyond fissure.After matching by pathologic TNM staging (7th),326 patients whose tumor defined in a single lobe were eligible for analysis.Results Histopatholngic staging of matched patients was I a:10 patiens(6.1％ ),I b:79 patients (48.5％),Ⅱa:5 patients (3.1％ ),111:44 patients (27.0％) and Ⅲa:25 patients( 15.3％ ).5 years survival in patients with stage 1 tumors crossing the interlobar fissure was 51％,while in patients not cross the interlobar fissure was 63％ ( P ＜0.05 ).There was no difference in survival for tumors stage Ⅱa and above with regard to importance of interlobar extension.The T2 tumor extending across a lung fissure had a reduction in survival compared with T2 tumor not cross the lung fissure and similar to the T3 tumor without the fissure invasion.Conclusion Our results suggest that TNM staging should be modified for tumor extends the fissure into adjacent lobe.

Objective To evaluate the complications and prognostic factors of lung transplantation performed in a single center.Methods A rettospective analysis of demographic and outcome data of lung transplantation was performed.Survival analyses were performed using Kaplan-Meier estimation.Results Between January 2003 and April 2011,42 lung transplant procedures were performed.Overall survival rate at 1,3,and 5 years were 89％,59％ and 38％,respectively.1,3,and 5 years survival in patients with COPD was 83％,66％ and 45％,respectively,which were better than other primary end stage lung diseases ( 78％,17％ and 17％,respectively,P =0.013).Postoperative complications included pulmonary bacterium infection in 8 patients (20％),fungal infection in 12 (30％),and airway complications in4 (9.5％).35％ of patients had at least 1 episode of acute rejections within the first year,and 22.5％ of patients had BOS.2 patients underwent single lung retransplantation.Conclusion In this single center study,patients with COPD may have a good long-term survival.The most common postoperative complications were pulmonary infection and airway complication.

Objective To compare the clinic characteristics, recurrences and prognosis in patients with stage Ⅰ bronchioloalveolar carcinoma (BAC) and adenocarcinoma of the lung. Methods The data of 56 patients with stage Ⅰ BAC and 169 patients with stage Ⅰ adenocarcinoma were analyzed retrospectively. Results The overall 1-, 3-, 5- year survival rates were 94.7%, 83.5% and 61.2%, respectively. Compared with adenocarcinoma of the lung, BAC showed a better survival rate(x2 =6.36, P =0.012). After surgery patients with BAC were prone to develop intrathoracic recurrence, and adenocarcinoma was equal between intrathoracic recurrence and extrathoracic metastasis. The rate of intrathoracic recurrence and extrathoracic metastasis between BAC and adenocarcinoma was significantly different (14/16 vs. 27/59, x2 =8.85, P=0.004). In both group, preoperative asymptomatic patients had better survival rate(x2 = 7.28, P = 0.007; x2 = 6.07, P = 0. 014). Univariate analysis indicated that sex, age(< 60 years and ≥60 years), location of tumor and smoking history did not significantly influence survival in patients with stage Ⅰ BAC or adenocarcinoma (P > 0.05). Conclusion The prognosis of stage Ⅰ BAC is superior to that of stage Ⅰ adenocarcinoma. BAC is prone to develop intrathoracic recurrence, and adenocarcinoma is equal between intrathoracic recurrence and extrathoracic metastasis. Early diagnosis of lung cancer could improve long-term survival.