A cuff technique was applied to anastomose pulmonary vein,pulmonary arery andbronchus in rat receiving lung transplantation.In 6 consecutive cases,the average graft ischemictime was 17±3 rain,and the time for operation was 61±4 min.The time for ischemia was 1essthan one third of previous reports and the time for operation one forth of previous reports.Theoperation successful rate was 75%,and the survival rate was 100%on the postoperative day 7.After contralateral pneumonectomy,the blood gas analysis was normal,showing excellent graftfunction of the oxygenaration of the animals.

Objective To compare the outcomes of traumatic flail chest with multiple injuries treated by operative fixation versus conservative approach. Methods The clinical data of 60 patients with traumatic flail chest with multiple injuries were retrospectively analysed, and the outcomes between operation group (treated by operative fixation, n=32)and non-operation group (treated by conservative approach, n=28) were compared. Results The mean time of hospital stay, ICU stay and mechanical ventilation was significantly shorter, and the prevalences of chest wall deformity, pulmonary infection, pulmonary atelectasis and respiratory failure were significantly lower in operation group than those in non-operation group (P<0.05). Six months after discharge, the pulmonary function parameters such as inspiratory capacity, forced vital capacity, forced expiratory volume in one second, peak expiratory flow, total lung capacity and maximal midexpiratory flow were significantly higher in operation group than those in non-operation group (P<0.05). Conclusion Traumatic flail chest with multiple injuries treated by operative fixation may lead to less flail chest associated complications. Operative fixation has short- and long-term benefits to flail chest.

BACKGROUNDTo investigate the relationship between the size of primary tumor, pathologic classification, cell differentiation or location of tumor and lymph node metastasis in lung cancer.

METHODSThree hundred and thirty-two patients with lung cancer underwent pulmonectomy plus extensive dissection of hilar and mediastinal nodes. The law of lymph node metastasis was analyzed.

RESULTSA total of 3 280 lymph nodes were removed. Metastatic rates of N1 and N2 were 29.9% and 22.4% respectively. The total lymph node metastatic rates of T1, T2, and T3 diseases were 8.5%, 27.4% and 61.2% respectively ( P < 0.005). No lymphatic metastasis was observed in well-differentiated squamous cell carcinoma, however, the lymph node metastatic rates in moderate- and poor-differentiated squamous cell carcinoma were 16.8% and 19.6% respectively. The lymph node metastatic rates were 27.5% and 71.6% in moderate- and poor-differentiated adenocarcinoma respectively ( P < 0.005). The total lymph node metastatic rates in central and peripheral squamous cell carcinoma were 19.6% and 11.7% respectively ( P < 0.005), while in adenocarcinoma, the rates were 57.9% and 24.0% respectively ( P < 0.005). The N2 metastatic rates in central and peripheral squamous cell carcinoma were 10.9% and 2.9% respectively ( P < 0.005), while in adenocarcinoma, the rates were 47.5% and 17.8% respectively ( P < 0.005 ). Under the same T status, cell differentiation or location of tumor, the metastatic rate of adenocarcinoma was much higher than that of squamous cell carcinoma ( P < 0.005 ).

CONCLUSIONSThe frequency of lymph node metastasis significantly correlate with size of primary tumor, pathological classification, cell differentiation and location of tumor.