Objective To prepare two types of biodegradable modified materials (chitosan and collagen)and evaluate whether the new materials are suitable for tissue engineering cartilage.Methods Collagen and chitosan were both modified by poly-γ-benzyl-L-glutamate-co-glutamine acid (PBLG-co-PGA) with different proportions.The contact angle,degradation rate,tensile strength,cell attachment and cytocompatibility were tested and compared.Results As the PBLG-co-PGA content varied,the degradation rates of PBLG-co-PGA composites became adjustable,the hydrophilicity of PBLG-co-PGA/chitosan was improved,and the tensile strength increased in PBLG-co-PGA/collagen composite.The composites with 30％ PBLG-co-PGA were chosen for cytocompatibility and cell attachment experiments.The rabbit condrocytes grew significantly better on PBLG-co-PGA/chitosan than on other three materials(P＜0.05).Conclusion PBLG can improve the hydrophilicity,tensile strength and regulate the degradation rate of composite materials,and the cytocompatibility of the composites with 30％ of PBLG is good,among which PBLG-co-PGA/chitosan can even promote cell proliferation.It could be a new choice of scaffold for tissue engineering cartilage.

Background and purpose: Adenocarcinoma is the main type of lung cancer and the ages of most patients with adenocarcinoma are over-40 years, the young patients with the disease are rare, and the 5-year survival rate of the young male with lung adenocarcinorna is poor. This study was done to explore the survival and prognosis of young male with lung adenocarcinoma. Methods: A total of 110 surgically treated patients with lung adenocarcinoma were analyzed retrospectively to study the relationship between the prognostic factors and survival. Results: The analysis showed that the overall 5-year survival rate of the young male with lung adenocarcinoma was 34.5%, it was 29.0% for smokers and 42.6% for non-smokers(P<0.05). The 5-year survival rates of staging Ⅰ, lI ,Ⅲ and Ⅳ were 68.8%,35.7%, 14.3% and 0, respectively(P<0.01),the survival rates of the patients with the number of involved lymph nodes>3 compared to ≤3 were 28.5% and 48.1%(P<0.01). Conclusion: Smoking, p-TNM, the number of involved lymph nodes was correlated with the survival, effective smoking control efforts and total lymphadenectomy are important to the survival of lung adenocarcinoma among young males.

Objective To investigate the effectiveness and safety of simultaneous lung volume reduction surgery in the treatment of lung volume mismatch after single lung transplantation. Methods Twenty-four single lung transplantations were performed on 20 male and 4 female patients, with a mean age of 54. 6 ± 12. 2 years (ranging from 28 to 75 years). Indications for transplantation included end-stage chronic obstructive lung disease (COPD) in 14 cases, COPD combined with upper lobe lung destruction in 1 case, COPD combined with pneumoconiosis in 1 case, end-stage interstitial pulmonary fibrosis in 6 cases, lymphangioleiomyomatosis (LAM) in 1 case, and post-transplantation bronchiolitis obliterans syndrom (BOS) in 1 case. Sixteen cases had right-side and 8 cases had left-side lung transplantation. Lung volume reduction surgeries were performed through open thoracotomy. Graft lung volume reduction was carried out through the same incision as transplantation, and native lung volume reduction through a small anterior lateral incision contralaterally. Patients were divided into lung volume reduction group (group Ⅰ) and control group (group Ⅱ). There were 8 cases in group Ⅰ,including 5 graft lung, 2 native lung, and 1 graft and native lung volume reduction surgeries. In group Ⅱ, there were 16 cases that had no further treatment for lung volume mismatch. Differences in various clinical parameters between the two groups were compared. Results Two out of 14 (14.3%) patients with COPD accepted lung volume reduction, which was significantly lower than that in patients with other diseases (6 out of 10, 60%, P＜0. 05). Post-transplantation chest X-ray showed that 50.0% and 25% of patients had an undeflected mediastinum in group Ⅰ and group Ⅱ, respectively (P＜0. 05).None of the other clinical parameters had significant difference between the two groups (P＞0.05).But a tendency of increase in mechanical ventilation, chest tube drainage time, air leak time, volume of chest drainage, and a tendency of decrease in times and volume of thoracentesis could be observed in group Ⅰ. Lung function test was not performed on 8 cases after transplantation. Sixteen cases (4 in group Ⅰ, 12 in group Ⅱ) had complete lung function data. There was no significant difference in FEV1 improvement after lung transplantation between the two groups (P＞0. 05). Conclusion Simultaneous graft or native lung volume reduction surgery is a safe and effective way of ameliorating lung volume mismatch after single lung transplantation, probably by improving ventilation-perfusion ratio.

BACKGROUNDPulmonary carcinosarcoma (PCS) is a rare pulmonary mixed malignant tumor. The aim of this study is to explore the clinical characteristics and prognosis of 48 patients with PCS.

METHODSThe data of 48 patients with PCS from 1986 to 2004 were analysed retrospectively. Then their prognostic factors were analysed statistically.

RESULTSPCS occurred usually in males over 50 years old, often in the right lungs. The clinical and radiographic characteristics of PCS were similar to primary non-small cell lung cancer. Its diagnosis was mainly verified by postoperative pathologic findings and immunohistochemical staining. The 1-, 3- and 5-year survival rate was 77.1%, 49.5% and 22.7% respectively. The multivariate prognosis analysis and Chi-square test showed that TNM stage was an independent prognostic factor.

CONCLUSIONSTNM stage is an independent prognostic factor for PCS, so it is necessary to operate surgically in early stage to prolong the survival time of patients.

ObjectiveBronchogenic carcinoma involving the carina or tracheobronchial angle still presents a challenge due to specific problems related to surgical technique and airway management.Aim of this paper is to examine complications and long-term survival of our personal series and those reported in literature.MethodsBetween 1985 and 2010,48 patients underwent carinal resection:a right tracheal sleeve pneumoneetomy was performed in 47 patients and a left tracheal sleeve pneumonectomy in 1 patient.The anastomosis was performed with aid of high-frequency jet ventilation or introfield tube ventilation.ResultsOverall morbidity and mortality rate was 25％ and 6.3％ respectively,and there was no death in operation.5-yearsurvival rate of patients with squamous and adenocarcinoma was 27.3％ and 12.5％,respectively,P =0.04.The overall 5-year survival rate was 24.3％.Patients without nodal involvement had a significantly better prognosis than N1 and N2 patients (5-year survival:52％,13％ and 0,respectively).Multivariate analysis showed that nodal status was the only independent prognostic factor( P =0.006 ).ConclusionWith careful selection of patients and meticulous surgical technique,Tracheal sleeve pneumonectomy for bronchogenic carcinoma can be accomplished with acceptable mortality and morbidity,proriding good long-term results.

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.