Objective To investigate the feasibility of video-assisted thoracoscopic surgery (VATS) for treating spontaneous chylothorax. Methods Four patients with spontaneous chylothorax were treated by VATS from April 2000 to October 2003. Results Operations were successfully completed in all the 4 patients. The operative time was 40, 52, 55, and 95 min, respectively (mean, 60.5 min). The postoperative chest drainage time was 3~8 d (mean, 5.2 d). The postoperative hospital stay was 8~13 d (mean, 10.5 d). No severe complications or operative mortality were seen. Conclusions Treatment of spontaneous chylothorax by VATS gives advantages of less invasion and quick recovery.

Objective Aims To investigate the dynamic changes of multi-organ functional indices in esophageal carcinoma patients during peri-operation period at flatland and moderate high altitude. Methods 44 cases of esophageal carcinoma scheduled to receive gastroesophagostomy were categorized semi-randomly into three groups: Flatland control group (FCG, n=8), moderate altitude lung protection group (MPG, n=16), moderate altitude control group (MCG, n=20). The cases in FCG and MCG underwent routine pulmonary function examination and respiratory tract preparation peri-operatively. Besides the above routine treatment, the cases in MTG received administration of Rahdiola compound capsules preoperatively, with 2 pills a day. Blood-gas and biochemical indices of multi-organs were recorded in the three groups preoperatively and at 1, 3, and 5 days postoperatively respectively. The patients' systematic reaction, the changing trend of the indices reflecting organs function and the postoperative complication were observed. Results The blood-gas parameters were different significantly both preoperatively and postoperatively between the three groups. While other indices reflecting the organs function were not different significantly between the three groups before the operation, but at 1, 3, 5 days postoperatively, the indices in MCG and MPG were significantly different with that in FCG (P

Objective To investigate the therapeutic effectiveness of video-assisted thoracoscopic surgery(VATS)and thoracotomy for spontaneous pneumothorax in high altitude.Methods 256 concecutive patients diagnosed as having spontaneous pneumothorax in high altitude between July 1997 and August 2007 were analyzed retrospectively.VATS was performed in 158 cases and thoracotomy was performed in 98 cases.The operating time,blood loss during operation,chest drainage time,postoperative hospital stay,the costs of operation,the total costs of hospital stay and postoperative complication were compared between the two groups.Results The operating time in VATS group and thoracotomy group was(55.6?5.8)min and(66.3?5.1)min respectively(t=11.678,P=0.000),the blood loss during operation(40.6?5.8)ml and(120.3?6.5)ml respectively(t=11.678,P=0.000),the chest drainage time(2.6?0.7)d and(3.2?0.8)d,respectively(t =3.024,P=0.000),the postoperative hospital stay(4.8?0.9)d and(5.2?0.6)d respectively(t =4.168,P=0.000),the the costs of operation(9876?687)Renminbi Yuan and(4948?562)Renminbi Yuan respectively(t =44.532,P=0.000),the the total costs of hospital stay(17 028?956)Renminbi Yuan and(13 892?835)Renminbi Yuan respectively(t=21.743,P=0.000),the postoperative complication 12 cases and 38 cases respectively(?2 =21.351,P=0.000).The number of recurrence after operation was not statistical significant difference(?2=0.734,P=0.512).Conclusion VATS is accepted easily by patients and the total curative effect is dominant comparing to standard thoracotomy.The VATS method is the first selection for spontaneous pneumothorax in high altitude.But the defect of VATS is higher in the costs of operation and hospital stay.Decreasing applying the consumptive material of one time can reduce the costs.

Objective To investigate the changes of myocardial combination enzyme in the early stages of gunshot wound of dogs in seawater for exploring early treatment protocol. Methods Fourteen conventional Beagles models undergoing gunshot wound in seawater were used along with another 3 dogs receiving the wound on land to serve as control. After the dogs were rescued from the seawater, the origin of blood coming from central venous pressure tube was measured (33.75?25.29) min before and after injured for indexes such as alkaline aminotransferase (ALT) , aspartate aminotransferase (AST) , creatine kinase (CK) , creatine kinase isoenzymes - MB (CK -MB) , lactate dehydrogenase (LDH) and adenosine monophosphate (AMY) in the early stages of wound, followed by statistical analysis of the results. Results There was an increase in blood CK (P0.05). As compared with the control, the experimental group in seawater was observed to have significant difference in blood AMY (P 0.05). But it was noted that CK, CK - MB , LDH , AST and ALT contents tended to increase. Conclusion The functions of respiratory, heart, liver and kidney were injured and restrained in Beagle dogs undergoing the firearms wound in natural seawater. The immediate diagnosis and treatment of the organism as well as the out - of - wound - tract injury shoud do while the firearms primal wound tract were treated in the early stages of gunshot wound.

Objective To evaluate the efficacy and side effects of whole body γ/-knife in patients with limited pancreatic carcinoma. Methods 111 patients with limited pancreatic carcinoma treated with the Stereotactie Gamma Ray Whole-Body Therapeutic System (Whole Body T-knife) were retrospectively an-alyzed. Patients were supine, fixed with a stereotactic body frame and vacuum bag, and then simulated by low-speed computed tomography. GTV, CTV and PTV were defined on the contrast-enhanced CT scans. It was required that 50% isedose line covered 100% of PTV and 70% isedose line covered more than 80% of GTV. The prescription dose was defined as 50% isodose. All patients were treated 5 fractions per week. The fractionated dose was 3-4 Gy for pancreatic head carcinoma, and 4-5 Gy for pancreatic body/tail carcino-ma. Irradiation of 40-51 Gy and 60-70 Gy were delivered to PTV and GTV margins, respectively. Re-suits The complete response rate, partial response rate and overall response rate of the primary tumors were 29.7%, 42.3% and 72.1%, respectively. The follow-up rate was 95.5%. The number of patients fol-lowed-up at 1-,2- and 3-year was 105,89 and 60. The 1-, 2- and 3-year overall survival rates were 49.3%,24.5% and 18.1%. For patients with stage Ⅰ/Ⅱ disease,the number of patients followed-up at 1-,2-,3-,4-and 5-year was 55,44,29,16 and 11 ;The 1-, 2-, 3-,4- and 5-year overall survival rates were 68%,34%, 30%, 21% and 17%, respectively. For patients with stage Ⅲ disease,the number of patients fol-lowed-up at 1-,2- and 3-year was 50,45 and 31 ;The 1-, 2- and 3-year overall survival rates were 28%,14% and 4%, respectively (χ~2=16.67, P=0.000). The acute side effects including nausea, vomiting and diarrhea were 71.2% of RTOG grade 1 -2 and 3.6% of RTOG grade 3. No treatment delay occurred.Conclusions With fractionated dose of 3-5 Gy,5 fractions per week and 40-51 Gy as total dose to PTV,whole body γ-knife is safe and effective to treat limited pancreatic carcinoma. The local control and overall survival could be improved.

In recent years, many scholars have explored the clinical application value of a number of peripheral hematology indexes in tumor patients. The significant correlation of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio with the prognosis in various tumors has also been confirmed. At present, more peripheral blood indexes have been gradually applied to the evaluation of the prognosis in patients with malignant tumors. Small cell lung cancer (SCLC) is a type of highly malignant tumor and most patients are in advanced stage at the time of diagnosis. The evaluation value of tumor stage for survival is extremely limited. Therefore, this review intends to explain the relationship between various peripheral hematology indexes and the prognosis of SCLC patients, so as to provide some academic evidence for the clinical assessment of the survival of SCLC patients and formulation of appropriate treatment strategy, which may contribute to the improvement of the prognosis.