Objective To study the rule of lower-cervical lymphatic metastasis in thoracic esophageal carcinoma,and make evaluation about the reasonable extent of lymphadenectomy. Methods One hundred and eight cases of thoracic esophageal carcinoma through chromatic ultrasound and CT before operation were divided into different groups selectively,while three fields lymphadenectomy (3-FL) was adopted in 31 cases,and two fields lymphadenctomy (2-FL) was adopted in 77 cases. Results The rate of lower-cervical lymphatic metastasis was 87.1%(27/31) through chromatic ultrasound and CT,and that was 25.0%(27/108) before the two up-mentioned examinations (P<0.05). In all cases, the rate of lower-cervical lymphatic metastasis in the upper pectoral esophageal carcinoma was 47.6% (10/21),that in the middle pectoral esophageal carcinoma was 21.3%(13161),and that in the middle and lower pectoral esophageal carcinoma was 19.5%(17187) ,P<0.05. Through 3-FL, the rate of lower--cervical lymphatic metastasis in the upper pectoral esophageal eareinoma was 57.1%(12/21), that in the middle pectoral esophageal carcinoma was 23.0%(14/61), and that in the middle and lower pectoral esophageal carcinoma was 21.8%(19/87), P<0.05. Conclusions The regionality metastasis is the main fashion in thoracic esophageal carcinoma with lower-cervical lymphatic metastasis. It is feasible to judge lower-cervical lymphatic metastasis through chromatic ultrasound and CT before operation.The 3-FL of the upper pectoral esophageal carcinoma is recommended. The 3-FL is selectable in the middle and lower pectoral esophageal carcinoma according to the result of chromatic ultrasound and CT.

Objective To compare the clinical features and severity of thoracoabdominal combined injuries(TACI) and thoracoabdominal multiple injuries(TAMI) so as to guide the diagnosis and management of trauma. Methods A total of 167 cases of chest trauma complicated by abdominal trauma were reviewed and divided into two groups. Group TACI(132 cases) was associated with diaphragmatic rupture but group TAMI(35 eascs)not. The injury features and the clinical characteristics of both groups were analyzed and the trauma severity of two groups e-valuated by trauma score system. Results The overall mortality was 9.6 %(16/167)of all the cases. The mortality was 14.3% in group TACI (5/35)and 8.3% in group TAMI(11/132). There was no significant difference in revised trauma score(RTS) and thoracic Abbreviated Injury Scale(MS) between the two greups(P> 0.05),but the patients in the TACI group had higher Glasgow Coma Scale(C, CS)and abdominal AIS (P < 0.05), and the patients in the TACI group had higher injury severity scale (ISS) (P < 0.01). Conclusion TACI and TAMI have differ-ence in clinical characteristics,injury severity and treatment results. So it is necessary to take different measurements to reduce the complica-tions and improve the prognosis.

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