Objective To assess the effect of thoracoscopic surgery under laryngeal mask anesthesia and explore the nursing strategies. Methods Thirty-five patients from April to December in 2014 undergoing video-assisted thoracoscopic surgery (VATS) were given intubation anesthesia and another thirty-five ones undergoing the same surgery in 2015 received laryngeal mask anesthesia. The two groups were compared in terms of surgery conditions, surgery complication and ambulation time. Results No significant differences were found in surgery time or blood loss between two groups (P>0.05). The postoperative waking time in the mask anesthesia group was significantly shorter than that of the intubation anesthesia group (P<0.05), and ambulation time was significantly shortened (P<0.05). The rates of throat discomfort, hoarseness and gastrointestinal reactions were significantly lower. Conclusions Laryngeal mask anesthesia used in small thoracoscopic surgery for airway management is safe and feasible. Combined with training in respiration and limb function, better analgesia and nursing, it can keep away complications related to intubation anesthesia, shorten hospital stay and accelerate postoperative rehabilitation.

Objective To evaluate the feasibility and safety of thoracoscopic radical resection of non-small cell lung cancer(NSCLC)patients under laryngeal mask anesthesia. Methods A total of 40 patients with NSCLC from March to August 2016 in NanFang Hospital of Southern Medical University were recruited and divided into two groups,the laryngeal mask anesthesia(n=20)and the intubation anesthesia group(n=20). Patients from two groups were followed up. Post-operativerecovery ,systemic inflammation response and quality of life were assessed. Results There was no significant difference between the laryngeal mask anesthesia and the intubation anesthesia group in the operation time ,the lowest oxygen saturation ,the maximum end-tidal carbon dioxide partial pressure and the surgical field and the satisfaction of anesthesia and blood loss. Post-operative time to eat ,postoperative use of antibiotics , postoperative hospital stay and drainage time were much shorter in the laryngeal mask anesthesia group ,which also had lowerlevel of white blood cells ,neutrophils and C-reactive protein. Patients with NSCLC undergoing laryngeal mask anesthesia had much higher scores in the quality of life evaluation. Conclusion Thoracoscopic radical resectionunder laryngeal mask anesthesia is safe and feasible for NSCLC patients. It has advantages in reducing the systemic inflammatory response ,accelerating the recovery rate and improving postoperative life quality.

Objective To investigate the influence of benzopyrene on extracellular matrix(ECM) protein deposition of human airway smooth muscle cells(HASMC) and the related pathway mechanism.Methods HASMC were primarily cultured and the 2-6 generations cells were applied in this experiment.The expression amount of ECM gene and protein was detected by real time PCR and Western Blot the phosphorylation level was analyzed by using the Western Blot method.Results Benzopyrene could to increase the expression of HASMC collagen Ⅰ α1 protein (P＜0.01) and ECM protein (including collagen Ⅰ α1,versican,fibronectin,laminin α2) mRNA(P＜0.05).Benzopyrene could induce the rapid increase of ERK1/2 phosphorylation level (P＜0.01).Furthermore,the ERK pathway inhibitor PD98059 could significantly inhibit the increase of benzopyrene-induced collagen Ⅰ α1 (P＜0.01)and ECM protein(including collagen Ⅰ α1,versican,fibronectin,laminin α2) mRNA expression(P＜0.01).Conclusion Benzopyrene induces the ECM protein deposition of HASMC by activating the ERK1/2 pathway,blocking the ERK1/2 signal pathway can inhibit the benzopyrene-induced airway remodeling.

Objective To investigate the effects of somatostatin (SST) on levels of IL-6,IL-8 and TNF-αduring CPB in pigs. Methods Twenty four healthy pigs were randomly divided into control group (SS00) and 3 experimental groups, SS05, SS10 and SS20. All pigs were performed by CPB for cardiac arrest in 45 min. the levels of IL-6, IL-10 and TNF-αwere tested and compared. Results The TNF-α, IL-6 and IL-10 levels were higher than T0 among all groups after CPB(P<0.05);The levels of TNF-αand IL-6 after CPB in SS10, SS20 groups were lower than SS00 group(P<0.05), and the IL-10 level was higher(P<0.05). Conclusion Infusing with a certain dose of SST before CPB could down-regulate acute inflammatory response;SST has no impact on the operative safety.

Objective To investigate the impact of surgical resection on patients with Ⅱ-Ⅲ A stage small cell lung carcinoma (SCLC). Method Data of 61 in-patients who diagnosed as Ⅱ-ⅢA stage SCLC from Jan 1st 2009 to Feb 1st 2014 were analyzed. 23 patients underwent surgical resections were enrolled as the treatment group, while 38 patients without surgical resection were enrolled as the control group. Disease progression was confirmed by monthly examination. The grouping is balanced by propensity score match. The progression-free survival (PFS) time and overall survival(OS) were analyzed with Kaplan-Meier survival method and Cox regression is applied to analyze the covariates. Fisher's exact test was applied to compare one-year survival rate and two-year survival rate. Results The PFS and OS of the treatment group is longer than that of the control group (P < 0.05). Both one-year and two-year survival rates of the treatment group outnumber those of the control group (P < 0.05). Cox regression indicates that surgical resection is an independent prognostic factor (P < 0.05). Conclusion Surgical resection on tolerable patients with stage Ⅱ-Ⅲ A small-cell lung carcinoma is effective on improving the progression-free survival time,one-year and two-year survival rates,and also shows a propensity of a higher overall survival time.

Objective To investigate the consistency in 18F-deoxyglucose positron emission tomography (18F-FDG PET-CT) examination and histopathological analyses in the diagnoses of resectable lung tumors. Methods Retrospective reviews over the clinical data of lung tumor patients by preoperative PET-CT diagnosis and postoperative histopathological diagnosis were conducted to investigate the effects of the two diagnostic methods in terms of lung tumor properties , mediastinal lymph node metastasis , and pulmonary hilar lymph node metastasis. Results The diagnoses by preoperative PET-CT was consistent in differentiation of non-malignancy and malignancy of pathologic lung tumors by 87.3%, at a medium level (κ = 0.401, P < 0.001). McNemar test showed P = 0.508, indicating the two diagnostic methods were insignificantly different in the diagnosis of pulmonary tumors. The preoperative PET-CT was consistent in the diagnosis of the metastasis of pathologic mediastinal lymph node by 85.9%, at a medium level (κ = 0.697, P < 0.001). McNemar test showed P =0.754, indicating no significant difference between the diagnostic methods. The preoperative PET-CT was consistent with postoperative pathological examinations in the differentiations of the metastasis of pulmonary and hilar lymph node by 77.4%, at a medium level (κ=0.523, P < 0.001). McNemar test showed P = 0.454, indicating the two diagnostic methods were no significantly different. Conclusion Preoperative PET-CT and histopathologic examinations may be consistent in lung tumor diagnosis , which provides a basis for a certain significance in the surgical options.

Objective To investigate of the effect and mechanisman of SERCA2 on the phenotype modulation of HASMCs. Methods HASMCs were starved for 5 days and divided into different groups ,then we observed morphology change of the cells from the microscope and detected a-actin、SERCA2 and p-ERK by Western Blot,cells proliferation was observed by CCK-8 method. Results Compared with the control group,PDGF could reduce a-actin of HASMCs and increased the cells proliferation ability ,TSG could significantly inhibit the effect (P<0.01), PDGF could also significantly inhibit SERCA2 protein and increased the expression p-ERK (P<0.01), while U0126 significantly inhibited the effect (P < 0.01). Conclusion PDGF may induce HASMCs phenotype modulation through the regulation of SERCA2 and p-ERK.

OBJECTIVETo compare the complications associated with mechanical and manual cervical esophagogastric anastomosis following esophagectomy for esophageal cancer.

METHODSFrom September, 2004 to June, 2007, 227 patients with middle and upper thoracic esophageal cancer underwent cervical esophagogastric anastomosis after esophagectomy. The patients were randomized into two groups and cervical esophagogastric anastomosis was performed using a stapler (n=102) or manually (n=125). The incidence of postoperative complications and operative time were compared between the two groups.

RESULTSIn manual anastomosis group, anastomotic leak and anastomotic stricture occurred in 14.4% (18/125) and 8.8.% (11/125) of the patients, significantly higher than the incidences of 2.9% (3/102) and 3.9% (4/102) in the mechanical anastomosis group (P<0.01). Manual anastomosis required a significantly longer operative time than mechanical anastomosis (52∓12 vs 25∓5 min, P<0.01).

CONCLUSIONThe use of circular mechanical stapler in cervical esophagogastric anastomosis is associated with a lower rate of anastomotic leak and a shorter operative time, and is easy to learn and standardize to reduce the complications of the anastomosis.

Adult ; Aged ; Anastomosis, Surgical ; methods ; Anastomotic Leak ; Constriction, Pathologic ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Sutures ; Treatment Outcome

OBJECTIVETo assess the feasibility and safety of thoracoscopic bulla resection under laryngeal mask anesthesia with low tidal volume high-frequency lung ventilation.

METHODSSixty patients with pulmonary bulla were randomized into two groups (n=30) to undergo video-assisted thoracoscopic surgery (VATS) for bulla resection with laryngeal mask anesthesia and high-frequency low tidal volume lung ventilation general anesthesia and or with intubation anesthesia and one-lung ventilation through double-lumen endotracheal intubation.

RESULTSNo significant differences were found in anesthesia time, surgery time, intraoperative lowest SpO2, intraoperative highest PetCO2, operative field, anesthetic effects, or blood loss between the two groups. The post-operative WBC and NEU% showed significantly smaller increments in the mask anesthesia group than in the intubation group, and the postoperative awake time, initial eating time, ambulation time, in-hospital stay, and drainage time were significantly shortened in the former group with also lower incidences of gastrointestinal reactions, throat discomfort and hoarseness.

CONCLUSIONThoracoscopic bulla resection under laryngeal mask anesthesia with low tidal volume high-frequency lung ventilation is safe and feasible and results in better patient satisfaction and shorter in-hospital stay than procedures performed under intubation anesthesia with one-lung ventilation.

Adolescent ; Adult ; Aged ; Anesthesia, General ; methods ; Blister ; Child ; Female ; High-Frequency Ventilation ; Humans ; Intubation, Intratracheal ; Laryngeal Masks ; Lung Diseases ; surgery ; Male ; Middle Aged ; One-Lung Ventilation ; Thoracic Surgery, Video-Assisted ; Young Adult

OBJECTIVETo summarize our experience with video-assisted thoracoscopic (VATS) removal of esophageal leiomyoma located with endoscopy during operation.

METHODSBetween January 2006 and December 2010, 55 patients with esophageal leiomyoma underwent VATS enucleation. The surgical procedure was similar to that of open thoracotomy with intraoperative endoscopic location of the tumor and examination of the mucosal integrity especially for tumors less than 1 cm in diameter.

RESULTSOf the 55 patients undergoing VATS tumor removal, 54 patients completed the procedures smoothly, and 1 patient experienced ventricular fibrillation during the operation to require an open thoracotomy. Endoscopy was used in 38 patients during the operation. VATS enucleation differed significantly from open thoracotomy in the volume of bleeding, postoperative fasting days and postoperative hospital stay (P<0.05). The symptoms were completely relieved after the operation without postoperative complications. The patients were followed up for 8 to 59 months (mean 23.0 months) and no recurrence was found.

CONCLUSIONVATS removal of esophageal leiomyomas is minimally invasive, safe and effective and can serve as the primary option for surgical removal of esophageal leiomyomas.

Adolescent ; Adult ; Aged ; Esophageal Neoplasms ; surgery ; Female ; Gastroscopy ; methods ; Humans ; Leiomyoma ; surgery ; Male ; Middle Aged ; Thoracic Surgery, Video-Assisted ; methods ; Thoracoscopy ; Thoracotomy ; Treatment Outcome ; Young Adult