Objective To evaluate the clinical value of pulmonary vessels with multi slice spiral CT pul-monary angiography(MSCTPA) in pulmonary embolism(PE). Methods MSCTPA was performed in 23 cases sus-pected patients. All the primitive images of pulmonary vessels were produced at the console workstation. The distri-bution of pulmonary vessels emboli was evaluated from different angle. Results Spatial relationship and anatomical details of pulmonary arteries and veins could exactly be shown on all pulmonary vessels three-dimensional images in above-mentioned patients. On the basis of MSCTPA, PE could be diagnosed definitely, in addition, collateral circula-tion formation could be clearly demonstrated. Of 23 patients, PE were found in 16 cases by MSCTPA. Two hun-drends and sixty-four emboli were demonstrated in total, among which there are 149 embolilocated in segmental ater-ies and 115 in subsegmental ateries(grade 5～6 branches). The minimal diameter of pulmonary atery with thrombus was 1mm. Conclusion MSCTA has very high clinical value in detecting segmental and aubsegrnental pulmonary thrombi in PE patients, and provides useful inforrnation for the diagnosis and treatment of pulmonary vascular dis-eases.

Objective To evaluate experience for early diagnosis of pulmonary tembolism alter thoracic injury or surgery. Methods The 9 patients after thoracic injury or surgery with highly-suspected pulmonary embolism underwent chest radiograph of X-ray, helical CT pulmonary angiography, electrocardiogram, radionuclide pulmonary ventilation perfusion imaging, D dimer assay and arterial blood gas analysis respectively and the clinic data and results were analyzed. Results All patients were diagnosed and recovered after 8 patients received thrombolytic therapy and another patient received anticoagulant therapy. Conclusion If there were some symptoms such as suddenly severe dyspnea, cyanosis, with/without chest pains and the feeling of fear to death unable to be explained by original disease on those patients alter thoracic injury or surgery, it's very important for pulmonary embolism to be recognized, and early diagnosis and quickly efficient treatment is the key to prevent death. Helical CT pulmonary angiography is a safe, cheap, noninvasive and effective method for the diagnosis of pulmonary embolism with high sensitivity and specificity.

Objective To investigate and compare the applications of white blood cell count (WBC),neutrophil percentage (N%),C reactive protein (CRP)and procalcitonin (PCT)in the detection of bacterial infections.Methods Patients were randomly recruited in the study,70 patients with bacterial infection disease were recruited in the study as bacterial infection group,81 patients without bacterial infection were enrolled as no infection group.WBC,N%,CRP and PCT were detected,then comparative analysis of test results performed.Results Compared with no bacterial infection group,WBC,N%,CRP and PCT were increased in bacterial infection group(P <0.05),CRP and PCT increased obviously.The positive rate of WBC,N%,CRP and PCT in bacterial infection group was significantly higher than that of no bacterial infection group(P <0.05).In the bacterial infection group,the positive rate of N%,CRP and PCT was significantly higher than that of WBC(P <0.05),the positive rate of CRP was higher than PCT(P <0.05).But the positive rate of CRP was relatively high,and PCT was low in no bacterial infection group,suggesting that the false positive rate of CRP was higher,while that of PCT was lower,which had higher specificity.Conclusion WBC,N%,CRP and PCT all have clinical value for bacterial infections diagnosis.For the diagnosis of bacterial infections,N%,CRP and PCT is superior to WBC.CRP is more sensitive,but less specific,therefore,PCT with higher specificity was more suitable in the diagnosis of bacterial infections.

Objective: To summarize the methods of preventing and managing the complications in thoracoscopic lobectomy. Methods:The participants of this study included 317 patients undergoing lobectomy with video-assisted thoracoscopic surgery in the Department of Thoracic Surgery between January 2007 and December 2012. Intra-operative complications were observed, and countermeasures were summarized. Results: Complications occurred 28 times (8.8%), including bleeding in 16 cases because of accidental vascular injury (5.0%), accidental injury/break of bronchus in two cases (0.6%), vascular stump errhysis from cutting stapler in four cases (1.3%), lung stump air leakage in three cases (0.9%), lung injury in two cases (0.6%), and diaphragmatic injury in one case (0.3%). Conversion to thoracotomy was conducted in 17 cases, with a conversion rate of 5.4%. Thoracoscopic repair operation was performed in 14 cases that exhibited bleeding, with a success rate of 70% (14/20). No mortality was reported during the operation. Conclusion:Thoracoscopic lobectomy is a highly difficult method in thoracic surgeries. The procedure requires substantial attention on the timely prevention and correct management of intra-operative complications, particularly the injury and bleeding of major vessels, to reduce the rate of conversion to thoracotomy and the incidence of post-operative complications, as well as to promote the surgery in clinics.

Objective To explore the clinical values of the modified thoracic drainage devices that were applied in treatment of primary spontaneous pneumothorax patients who underwent single-port video-assisted thoracoscopic surgery. Methods Clinical data of 82 primary spontaneous pneumothorax patients who underwent single-port video-assisted thoracoscopic lung wedge resection and pleurodesis from January 1st, 2015 to August 31st, 2016 was analyzed retrospectively. These patients, according to the thoracic drainage devices, were divided into traditional group (Group A, n = 42) or modified group (Group B, n = 40). These statistical data, including duration of thoracic drainage, lengths of hospital stay, duration of using antibiotic, amounts of pleural drainage, scales of pain, and complications of the two groups of patients in postoperative stage, were compared. Results There was no significant differences (P > 0.05) in volumes of thoracic drainage while there were significant differences (P < 0.05) in duration of thoracic drainage, lengths of hospital stay, duration of using antibiotic, scales of pain, and complications in postoperative stage between the two groups. And patients in group B had shorter time of thoracic drainage, hospital stay, and using antibiotic, lower scales of pain and rates of complications when compared with group A. Conclusion There are some clinical values of application of modified thoracic drainage devices in treatment of primary spontaneous pneumothorax underwent single-port video-assisted thoracoscopic surgery, because of it could give the patients fast recovery and made the operations simpler.