In recent years, with the development of some new techniques based on bronchoscopic skills, such as endobronchial ultrasonography, autofluorescence bronchoscopy, electromagnetic navigation bronchoscopy, fibered confocal fluorescence microendoscopy and optic coherence tomography of the advent of technology, which solved the shortcomings of traditional technology from different areas and dimensions. Although these techniques need to be improved and clinical verified further, it was believed that the great impact on diagnosis and treatment of lung cancer should be made by them.

Aim To investigate the gender differences in electrophysiology and neuroanatomy of myelinated and unmyelinated visceral and baroreceptor afferent neurons(VANs and ABNs) of adult rats.Methods VANs and ABNs were isolated enzymatically and Vagus-nodose slice preparation was also applied in this study.For identification of ABNs,aortic depressor nerve(ADN) was labeled using fluorescent dye.Whole-cell patch technique was used to record action potential(AP).Electronic microscopy was selected for morphological analysis of ADN.Results(1) A-and C-type VANs were identified and significant differences of AP discharge profiles between female and male were not established;(2) except for the traditionally classified A-and C-types,myelinated Ah-type VGNs were also identified with faster conduction velocity,lower firing threshold,and higher neuronal excitability.Importantly,these Ah-types were found in female rats with a similar frequency like A-types but rarely seen in males.(3) Ah-type ABNs were also identified by fluorescence.(4) Morphological data showed that myelinated fiber in ADN was ~25% of total and this result was consistent with our electrophysiological data.(5) Firing frequency of Ah-types(20~40 Hz) was lowered than that of A-types(40~150 Hz,P

Carcinoma of the esophagogastric junction can be radically resected through thorax or abdomen.Because abdominal operation can achieve more ideal abdominal lymph node dissection and less injury of respiratory function,it is ideal for the elderly patients and patients with poor pulmonary function.The classic laparoscopic radical gastrectomy needs a small abdominal incision for making tubular stomach and installation of stapling devices.All the procedures were completed via the main operating trocar.In November of 2011,a 65-year-old male patient with poor pulmonary function and carcinoma of the esophagogastric junction underwent modified total laparoscopic esophagogastric anastomosis.During the operation,the thorax esophagus was mobilized about 5 cm above the esophageal hiatus,then it was pulled to the abdominal cavity and transected.After inserting the OrVil via the mouth,the esophagogastric anastomosis was done.The operation went through smoothly and the procedure was completed conveniently and quickly.The patient recovered well after operation with no local recurrence and metastasis.

Bronchiectasis combined with pulmonary carcinoma in situ is very rare condition.This study reported four cases and reviewed some literatures.The data of 66 cases treated from August 2012 to October 2013,whose initial diagnoses as bronchiectases were analysed.Four cases were diagnosed postoperatively as bronchiectasis with pulmonary carcinoma in situ after sugery,accounted for 6％ of surgical patients for bronchiectasis.Bronchiectasis has the risk of combined with pulmonary carcinoma in situ,this should be brought to the attention.

Objective To promote the successful treatments of massive hemoptysis by summarizing the clinical data of 14 patients receiving surgery.Methods 14 cases of massive hemoptysis were retrospectively analysed,Eight male and 6 femal,aged 27-64 (45 ± 18) years including the application of CT,bronchoscopy and extracorporeal membrane oxygenation (ECMO).Results 14 patients received preoerative bronchoscopy and emergency operation.In addition,hymoptysis had not occurred after the surgery in these cases.Conclusion The standardized clinical pathways for massive hemoptysis and the application of preoerative bronchoscopy is essential for emergency treatment of massive hemoptysis.

Objective Summarize the experience of diagnosis and treatment of esophageal rupture.Methods Twelve cases of esophageal rupture were treated with surgical intervention and clinical data were analyzed retrospectively.Diagnosis was confirmed in all patients by chest X-cays,Closed thoracic drainage,upper gastrointestinal contrast,chest CT scan and gastroscopy.In this series,there were 6 cases of spontaneous esophageal rupture,2 cases of iatrogenic esophageal rupture,4 cases of foreign body in esophagus rupture.For surgical treatment of 8 cases,including emergency esophageal stitching issue and diaphragmatic muscle or greater omentum to cover 6 cases;Esophageal ligation and resection of rupture area on both closes of the near and far,phase ii gastroesophageal anastomosis of esophagus resection in 2 cases,including 1 case of esophagus repair failure after turning the operation).Esophageal resection of gastroesophageal anastomosis in 1 case (for into the outer court misdiagnosed patients);4 cases were conservative.Results Initial diagnosis of spontaneous esophageal rupture and iatrogenic esophageal rupture 7 patients were cured,17 to 53 days of hospital stay,Follow-up for 3 months to 5 years,no esophageal related complications.Exception 1 patient died of postoperative infection(misdiaguosed for a long time).4 cases of esophageal foreign bodies to rupture were cured and these cases' fissure were less than 5 mm by chest CT scan and gastroscope diagnosis.Conclusion Complete collection of medical history,chest X-cays,Closed thoracic drainage,upper gastrointestinal contrast,chest CT scan and gastroscopy may clear diagnosis.Choose the proper method according to the patients as early as possible by general closed gap is the key to the treatment,at the same time be adequate drainage,control of infection and nutrition support treatment.

Objective To compare volumetric size, conformity index (CI), degree of inclusion (DI) of internal gross target volumes (IGTV) delineated on 4D-CT-MIP and PET-CT images for primary thoracic esophageal cancer. Methods Fifteen patients with thoracic esophageal cancer sequentially underwent enhanced 3D-CT, 4D-CT and PET-CT simulation scans. IGTVMIP was obtained by contouring on 4D-CT maximum intensity projection ( MIP). The PET contours were determined with nine different threshold methods (SUV≥2?0, 2?5, 3?0, 3?5), the percentages of the SUVmax(≥20%, 25%, 30%, 35%, 40%) and manual contours. The differences in size, conformity index (CI), degree of inclusion ( DI) of different volumes were compared. Results The volume ratios ( VRs) of IGTVPET2. 5 to IGTVMIP , IGTVPET20% to IGTVMIP, IGTVPETMAN to IGTVMIP were 0?86, 0?88, 1?06, respectively, which approached closest to 1. The CIs of IGTVPET2?0,IGTVPET2.5,IGTVPET20%,IGTVPETMAN and IGTVMIP which were 0?55, 0?56, 0?56, 0?54,0?55, respectively, were significantly larger than other CIs of IGTVPET and IGTVMIP (Z= -3?408-2?215,P <0?05). There were no statistical significance in the DIs of IGTVMIP and IGTVPET2.5,IGTVMIP and IGTVPET20%, IGTVMIP and IGTVPETMAN(0?77,0?82,0?71,0?67, 0?68,0?82,P>0?05). Conclusions The targets delineated based on SUV threshold setting of≥2?5, 20% of the SUVmax and manual contours on PET images correspond better with the target delineated on maximum intensity projection of 4D-CT images than other SUV thresholding methods.

Objective To investigate the risk factors for childhood acute leukemia complicated with streptococcus mitis bacteriaemia and to explore a better therapeutic regimen of antibiotics.Methods Seventy-eight cases of childhood acute leukemia complicated with bacteriaemia hospitalized in Zhujiang Hospital of Southern Medical University from January 2012 to December 2016 were collected,among them there were 8 cases (10.26％) caused by streptococcus mitis.The susceptible factors,clinical manifestations,drug susceptibility,treatments and outcomes of 8 cases of streptococcus mitis bacteriaemia were summarized and analyzed.Results All of 8 cases were attacked during the agranulocytosis phase lasting for more than 1 week after chemotherapy for acute leukemia.Four cases of them had been exposed to the third-generation cephalosporins for more than 7 days,and 5 cases exposed to proton pump inhibitor (PPI) for more than 10 days.The incidence of remittent fever,shiver,stomatitis and pneumonia was 100.0％ (8/8 cases),62.5％ (5/8 cases),62.5％ (5/8 cases) and 62.5％ (5/8 cases),respectively.And severe pneumonia occurred at a rate of 37.5％ (3/8 cases).The sensitivity to Linezolid,Vancomycin,Penicillin and Cefotaxime was 100.0％,100.0％,37.5％ and 25.0％,respectively.Five of the 7 cases treated with Meropenem had a fever 3 days later and then they took Linezolid as a replacement according to the drug sensitivity.One case was treated with Cefoperazone-Sulbactam.The duration time of fever,positive blood culture,agranulocytosis and course of antibiotics therapy was 1-19 d(10.4 d on average),4-22 d(13.4 d on average),10-30 d (21.6 d on average),9-26 d (18.3 d on average),respectively.Among 3 patients with severe pneumonia,1 patient received the respirator assisted ventilation for 1 week.Conclusions Streptococcus mitis is one of the major causes of severe infection among children with acute leukemia.Agranulocytosis after chemotherapy,stomatitis,exposure to PPI and antibiotics may be the risk factors for streptococcus mitis infection.Fever,stomatitis,respiratory and digestive symptoms are the common clinical manifestations.Streptococcus mitis is resistant to Penicillin and Cefotaxime,but sensitive to Linezolid,which can shorten the course of infection and improve the outcomes.Thus,Linezolid may serve as an optional therapy for streptococcemia mitis bacteriaemia.

A kind of active catheter used for minimally invasive surgery and actuated by shape memory alloy (SMA) was developed in this paper. The outer diameter of the catheter is 1.25 mm. The catheter was designed to consist of several bending units for achieving a large bending angle, but at the same time not increasing the outer diameter too much. It was considered that the deflection curve of axis of the catheter is determined by the output force of the SMA actuators. Based on large deflection theory, the deflection curve equation of the axis of the catheter was set up using precise form of the curvature. Through integral transform, the length and output force of each SMA actuator under the anticipative attitude of the tip of the active catheter were obtained, and the accurate coordinate of the center of the joint was givein. This study has provided great convenience to get control of the catheter, and has improved, to a certain extent, the design philosophy of problems such as active catheter.
Alloys ; Blood Vessels ; anatomy & histology ; Catheterization ; instrumentation ; Computer-Aided Design ; Elasticity ; Equipment Design ; Humans ; Minimally Invasive Surgical Procedures ; instrumentation ; Models, Theoretical

Objective To extract the loci of murine MHC gene and construct plasmids.Methods The RNA of mice was extracted and reversely transcribed into cDNA.By using nested PCR,the products were connected with T vector,cloned,and sequenced.Subsequently,the genes were digested by endonucleases,connected with expression vector,and sequenced again to choose the correct clones.Results After the nested PCR,the products were approved by sequencing.After being connected with the vectors,they were approved again by sequencing and the correct clones were chosen.Conclusion All of the loci of the MHC gene can be obtained by nested PCR.The plasmids from the correct clone can be used in the further experiments of transferring the gene to mitigate the transplantation rejection.