Objective To investigate the results of non dissecting thoracic duct ligation cutting in treatment of recurrent chylothorax.Methods 22 patients suffered from recurrent chylothorax after original thoracic duct ligation surgery were enrolled and their clinical characteristics were collected,including previous thoracic surgical procedure, previous surgical approach,recurrent chylothorax side and postoperative complications.The probable causes of chylothorax recurrence were analyzed and targeted improvements were made,based on the traditional mass ligation procedure of the thoracic duct.Through the previous approach,non dissecting thoracic duct ligation combined with transection of the posterior mediastinal tissue,except esophagus and thoracic aorta,was applied during the reoperation for the recurrent chylothorax.Results All the patients were recovery form chylothorax after reoperations.There were no severe postoperative complications except one patient suffered from respiratory failure.All the patients discharged evenly without chylothorax recurrence during one-year follow-up period.Conclusion Recurrent chylothorax could be successfully and safely treated by non-anatomical mass ligation combined with transection of the thoracic duct,for the anatomical foundation of chylothorax recurrence had been eliminated.

The cell killing effects and bystander effects of double suicide gene on pulmonary carcinoma cells were explored. Lung adenocarcinoma cells (A549) were transfected with different titers of adenovirus vector and followed with different concentrations of 5-FC after a recombinant adenovirus vector carrying CD/UPRT gene (Ad-CD/UPRT) was constructed. The cell viability was measured by MTT assay 4 days later. The cell viability was dropped to 30.57 %-8.62 % after 10 MOI of Ad-CD/UPRT transfected and 5-FC (10-1000 microg/mL) administration. Furthermore, Ad-CD/UPRT-infected A549 cells showed a profound neighbor cell killing effect in the same methods. These results suggested that Ad-CD/UPRT/5-FC system can effectively suppress growth of lung adenocarcinoma cells, which may provide a novel and powerful candidate for lung cancer gene therapy strategies.

The heat shock proteins (HSPs) 70 and HSP 27 expression in patients with non-small cell lung cancer (NSCLC) was studied and the relationship between HSP 70 and HSP 27 with the clinicopathological features of NSCLC was investigated. The expression of HSP 70 and HSP 27 was detected in tumor tissues from 60 patients with NSCLC by S-P immunohistochemistry. The findings were analyzed in combination with the histological types, histopathological differentiation, lymph node metastasis, patients' clinical stages, smoking history and gender. The results showed that of the 60 NSCLC tissue specimens studied, the immunoreactivity of HSP 70 and HSP 27 was detected in 47 (78.3 %) and 43 (71.7 %) specimens, respectively. A positive correlation was found between the overexpression of HSP 70 and HSP 27. The histopathological differentiation, lymph node metastasis, clinical stages and smoking history were correlated to the expression of HSP 70, but not to the expression of HSP 27. No statistical significance was observed in histological types and gender with respect to both HSP 70 and HSP 27 expression. It is suggested that the HSP 70 expression is a powerful and significant prognostic indicator and is related to histopathological differ entiation, lymph node metastasis, patients' clinical stages, smoking history, whereas HSP 27 expression is not.

The cell killing effects and bystander effects of double suicide gene on pulmonary carcinoma cells were explored. Lung adenocarcinoma cells (A549) were transfected with different titers of adenovirus vector and followed with different concentrations of 5-FC after a recombinant adenovirus vector carrying CD/UPRT gene (Ad-CD/UPRT) was constructed. The cell viability was measured by MTT assay 4 days later. The cell viability was dropped to 30.57 %-8.62 % after 10 MOI of Ad-CD/UPRT transfected and 5-FC (10-1000 μg/mL) administration. Furthermore, Ad-CD/UPRT-infected A549 cells showed a profound neighbor cell killing effect in the same methods. These results suggested that Ad-CD/UPRT/5-FC system can effectively suppress growth of lung adenocarcinoma cells, which may provide a novel and powerful candidate for lung cancer gene therapy strategies.

Objective To analyze the feasibility and advantages of non-intubated anesthesia in thoracoscopic lobectomy. Methods The clinical data of 59 patients with thoracoscopic lobectomy and non-intubated anesthesia in the Department of Thoracic Surgery, Tongji Hospital from January 2015 to December 2017 were retrospectively reviewed, including 24 males and 35 females, aged 56.86±7.13 years (an observation group); 59 patients with thoracoscopic lobectomy undergoing general anesthesia with tracheal intubation in the same period were randomly selected, as a control group, including 27 males and 32 females, aged 55.37±6.86 years. Complications such as airway injury, refractory cough, pharyngalgia, nausea and vomiting were compared between the two groups. Postoperative inflammatory factor levels, postoperative hospital stay, and intraoperative and postoperative hospitalization costs were also compared. Results There was no difference between the two groups in general conditions such as age, gender, body mass index. There was also no difference in operation time, intraoperative bleeding volume or lymph node dissection. But the observation group had lower levels of procalcitonin and C reactive protein at postoperative 1 d (0.12±0.51 ng/ml vs. 0.14±0.70 ng/ml, P=0.03; 11.30±3.60 mg/L vs. 13.33±4.41 mg/L, P=0.01), lower rate of postoperative complications of refractory cough, pharyngalgia, nausea and vomiting (3.38% vs. 15.25%, P=0.03; 5.08% vs. 20.33%, P=0.01; 3.38% vs. 15.25%, P=0.03), less retain time of thoracic duct, postoperative hospital stay, and lower intraoperative and postoperative hospitalization costs (5.89±1.37 d vs. 7.00±1.73 d, P=0.00; 10.01±1.85 d vs. 11.37±2.45 d, P=0.00; 53 810.94±5 745.44 yuan vs. 58 223.16±6 445.08 yuan, P=0.00). Conclusion Thoracoscopic lobectomy with non-intubated anesthesia can avoid traditional airway injury caused by endotracheal intubation, reduce postoperative symptoms such as refractory cough, pharyngalgia, nausea and vomiting caused by general anesthesia, reduce or even avoid lung injury caused by one-side lung ventilation, promote recovery after surgery, reduce antibiotic use, and shorten hospital stay, which is more consistent with the requirements of the concept of overall minimal invasiveness and enhanced recovery.