Objective To determine the relationship between plasma cytokeratin polypeptide 19 (CK 19) level and prognosis of patients with first occurrence of papillary thyroid carcinoma (PTC).Methods This prospective trial enrolled 60 patients with PTC.The plasma CK19 level was determined by ELISA and the other clinical data were collected on admission.All patients were followed up for 12 months.The patients were divided into recurrence group (27 patients) and non-recurrence group (33 patients) according to the results of follow-up.Results Single factor analysis showed that age,female,history of smoking,Graves disease,occupational exposure,the level of thyroid peroxidase antibody,thyroglobulin antibody,triglyceride and CK19 between two groups had significant difference (P ＜ 0.05).Multiple factors analysis showed that female,history of smoking,occupational exposure,the level of thyroid peroxidase antibody,thyroglobulin antibody and CK19 were independent risk factors for recurrence (P =0.01).The recurrence rate of CK19 ≥4.12 μg/L patients was 79.31％ (23/29),significantly higher than that in CK19 ＜4.12 μg/L patients [12.90％ (4/31)] (x2 =5.17,P ＜ 0.05).The recurrence rate of CK19 ≥ 4.12 μ g/L was significantly higher than that in CK19 ＜4.12 μ g/L (x2 =4.11,P ＜ 0.05).Conclusions The plasma CK19 level is an independent risk factor for recurrence of PTC patients.It can be used as a significant independent predictor for recurrence of PTC patients.

BACKGROUND: Lung transplantation can improve quality of life of patients who get terminal pulmonary disease and also it can help to get better survival.Now it has become one of the best therapeutic methods for terminal pulmonary disease.However,limited donors leave the development of lung transplantation in dilemma.The emergence of living lobar transplantation and cadeveric lobar transplantation let this procedure much easier.OBJECTIVE: To evaluate the clinical probability of bilateral lobar transplantation.METHODS: Sequential bilateral lobar transplantation was performed for one 26 years old cystic fibrosis female.Cardiac pulmonary bypass was used during operation.Anti-rejection(Tacrolimus,mycophenolate,etc)and anti-infection was used postoperatively.RESULTS AND CONCLUSION: The recovery course postoperatively was smooth,and the recipient got out of hospital 7weeks later.Bilateral lobar transplantation could offer satisfied short-term pulmonary function.The long term results should be further evaluated.

The present case report was designed to summarize the clinical experience of operative technique. lung preservation, lung perfusion, and perioperative management. Of 7 cases who underwent allogenic single lung transplantation (LT), 3 were idiopathic pulmonary fibrosis, 2 were chronic obstructive pulmonary disease, 1 was silicosis, emphysema, and bulla, and I was tuberculosis in both sides and presented with destroyed lung in one side. All donors were already brain death. Donor lungs were well preserved utilizing Euro-Colins liquid or low-potassium dextran solution. Donors and recipients were matched in blood type. Of 7 cases selected,5 received single right lung transplantation, and 2 received single left LT. End-to-end anastomosis was performed for pulmonary branches and pulmonary arteries. while atrium-to-atrium anastomosis was performed for pulmonary vein. Antibiotics and immunosuppressants were routinely used prior to and subsequent to LT. Following LT, heart and lung function, usage of antibiotics, and adjustment of immunosuppressant were monitored. Stomal complications regarding bronchus and pulmonary artery and vein did not appear in any patient. Five cases survived for about 2 months, one for approximately 1 year, and one for nearly 2 years. Four cases died of multi-organ failure caused by pulmonary infection, and one of severe pulmonary hemorrhage caused by aspergillus sydowi infection. Rejection occurred in 6 cases. One case sufiered from rejection three times. Selection of indication, selection and preservafton of donor lung, LT operation and pre-and post-operative management of LT have acquired satisfactory achievements. High mortality occurred in patients with preoperative poor cardiac and pulmonary functions and postoperative severe infections accompany with application of immunosuppressant.

OBJECTIVETo Summarize the clinical experience in the treatment of late-stage emphysema by lung volume reduction (LVR) in 5 years.

METHODSWe retrospectively studied the indications, contraindications, operation procedures and complications of LVR in 22 patients.

RESULTSBefore operation, the average FEV(1) was 24.5%, RV 196.8%, and TLC 130.5%; after operation they were 27.8%, 148.8% and 112.5%, respectively. 16 patients needed inhaling oxygen before operation, and 5 after operation. 16 patients finished 6-minute walking test with an average of 198 m, all patients walked much longer with an average of 256 m after operation. 3-degree lung function was observed in 14 patients, and 4-degree before operation in 8 patients; but 2-degree lung function in 5 patients, 3-degree in 13, and 4-degree in 4 after operation.

CONCLUSIONSHeterogeneous type emphysema with clear target area, especially bullous emphysema is the best indication for LVR. Lung function and life quality could be much improved postoperatively. Homogeneous type could also be treated with LVR in highly selected cases. TLCO < 20% is not an absolute contraindication, others standards need further investigation. Video-assistant thoracoscopic surgery (VATS) with subaxillary small incision for LVR is safe, reliable and effective. Application of stapler buttressing with bovine pericardia could decrease air leakage postoperatively.

Aged ; Female ; Humans ; Male ; Middle Aged ; Pneumonectomy ; Pulmonary Emphysema ; surgery ; Retrospective Studies ; Thoracoscopy