Objective To summarize the characteristics of diagnosis and surgical treatment of the leiomyoma of cardia.Methods The clinical data of 18 cases of leiomyoma of cardia confirmed by pathological examination was retrospectively analysed.Results Dysphagia,chest or epigastric pain and gastric hemorrhage were the most common presenting symptoms.The average course of disease was 9 months.Two patients was misdiagnosed as carcinoma of cardia before operation.Seventeen patients received partial gastric resection,one patient proximal subtotal gastrectomy.No surgical death and severe complications occurred in all patients.Conclusion Leiomyoma of cardia is a rare benign tumor.The differential diagnosis is important because it may be misdiagnosed as malignancy.Surgery is the most effective therapy to this disease.

Objective: To evaluate the effects of one lung ventilation on hemodynamics and blood gas during thoracoscopic surgery in piglets. Methods: Eight domestic pigs weighting (7.1±0.7) kg were included in this study. The anaesthesia was maintained with 1% isoflurance. After tracheotomy, an endotracheal tube was positioned in the left mainstem bronchus. Hemodynamic parameters as well as blood gas analyses were obtained using Swan-Ganz and arterial catheter. Results: During one lung ventilation, pulmonary artery pressure increased from (15.8±1.5) mm?Hg to (19.5±2.3) mm?Hg. Arterial oxygen saturation, blood gas analyses and other hemodynamic parameters remained unchanged. Conclusion: One lung ventilation was well tolerated in regard to hemodynamics and blood gas analyses in piglets.

Objective To investigate the changes and correlation between nuclear factor-?B (NF-?B) expression and brain water content (BWC) in perihematoma after experimental intracerebral hemorrhage (ICH) in rats. Methods Experimental ICH models of rat were made by injecting autologous blood using stereotaxic method. The expression of NF-?B in cerebral tissues was detected by immunohistochemistry technique. At the due time, BWC was measurement by day-wet method.Results NF-?B expression increased obviously at 6 h and peaked at 48 h in ICH group(P

Objective:To discuss the clinical and imaging features as well as the treatment and prognosis of primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. Methods:We retrospectively analyzed the clinical, imaging, and follow-up data of 13 patients with pulmonary MALT lymphoma in the Chinese PLA General Hospital from April 2000 to July 2012. Results:Of the 13 patients with pulmonary MALT lymphoma, 8 were male and 5 were female (1.6:1 ratio). The age of onset varies from 21 years to 67 years, and the median age is 59 years. The major clinical manifestations include chest discomfort in 6 cases, cough in 2 cases, fever in 2 cases, and chest pain in 1 case. Two cases had no observable discomfort. One patient suffered from Sj?gren's syndrome. The chest CT of the patients showed pulmonary consolidation with air bronchogram in 3 cases, patchy shadows in 3 cases, mass shadow in 4 cases, and ground-glass opacities in 4 cases. In addition, 10 cases showed bilateral pulmonary multiple changes, 4 showed mediastinal lymph node enlargement, and 1 showed pleural effusion. Operation was performed on 6 patients, 3 of which were given postoperative adjuvant chemotherapy. Four patients underwent chemotherapy involving the CHOP or R-CHOP regimen, whereas three patients received symptomatic and supportive treatment only. One case was lost to follow-up. The follow-up period ranged from 1 year to 11 years. In one patient, the disease progressed four years after the diagnosis, and the patient died after 11 years. One patient died from the side effects of chemotherapy. The remaining 10 cases were still alive and did not show any progression of the disease. Conclusion:The clinical feature of pulmonary MALT lymphoma is not typical. Thus, imaging techniques cannot detect specific changes. Surgical resection is vital in the diagnosis and treatment of this disease because it can help provide a clear diagnosis, particularly to patients with limited lesions and from which specimens could not be obtained using conventional methods. Moreover, the prognosis of this treatment is generally good.

Purpose To evaluate the correlation between T2-FLAIR hyperintense vessel sign (HVS) and the stenotic degree of internal carotid artery (ICA) and assess the HVS changes after the carotid endarterectomy (CEA). Materials and Methods Fifty-one patients with CEA were retrospectively enrolled. The stenosis of the bilateral ICA were as:≥90%, and<90%. The distribution of HVS locations was classified as three regions:sylvian fissure, sulci of temporo-occipital lobe and other areas. The presence and the location of HVS were counted. The extrension of HVS on T2-FLAIR were graded as:I:the presence of HVS was<1/3 of the MCA territory, II:the presence of HVS was≥1/3 of the MCA territory.χ2-test was performed for correlation between HVS and ICA stenosis. The difference of HVS and stenosis of ICA and their effects on CEA was accessed. Results HVS was significantly higher in the ICA stenosis more than 90%group than in the less than 90% group (χ2=23.584, P<0.001). The frequencies of HVS were 12, 34 and 15 in sylvian fissure, sulci of temporo-occipital lobe and other area, respectively. The proportion of grade II HVS was higher in the ≥ 90% group than in the<90% group (χ2=8.395, P<0.05). After CEA, HVS on 29 affected hemispheres were showed to be disappeared (n=24) or remained (n=5) in the treated side. Conclusion The presence and the grade of HVS were correlated with the stenotic degree of ICA. In the patients with ICA stenosis, HVS was most frequently found in the sulci of temporal lobe and occipital lobe, and seldom found in sylvian fissure. HVS disappeared after CEA indicating that HVS can be considered as a marker for CEA treatment.

Objective To evaluate the clinical effect of CT guided localization with a hook-wire system united with single port video-assisted thoracoscopic resection (VATS)for small ground glass opacity (GGO) pulmonary nodules (CT lesion diameter <1 .5 cm and no pleural changes).Methods Fifteen patients with small GGO pulmonary nodules who underwent CT-guided transthoracic localization with a hook-wire system in operation room after anesthesia were performed with single port VATS from August 2009 to March 201 3.The accuracy of puncture location,complications,resection rate and pathological results were evaluated.Results All patients underwent CT-guided hook-wire localization and single port VATS resection.The success rate of localization was 1 00%,and the average procedure time was (1 3.60 ±2.06)min,only 1 patient occurred mini-mal pneumothorax.The resection rate of single port VATS was 1 00%,and lobectomy performed in 1 patient, segmentectomy in 1 ,and local resection in 1 3.Pathological diagnosis:adenocarcinoma in situ in 9,atypical adenomatous hyperplasia (AAH)in 5,AAH and adenocarcinoma in situ in 1 .Post-operation follow-up showed all patients survived,and no recurrence and metastasis.Conclusion In operation,use of CT guided localiza-tion with a hook-wire system for small GGO pulmonary nodules (CT lesion diameter <1 .5 cm and no pleural changes)united with video-assisted thoracoscopic resection is accurate,quick and safe,and it has good clinical value.

Bronchial Fistula ; etiology ; Humans ; Pleural Cavity ; Postoperative Complications ; etiology ; Pulmonary Surgical Procedures ; adverse effects ; Surgeons ; Time Factors

Objective To study the clinical outcomes of robotic extended thymectomy and thoracoscopic extended thymectomy for thymoma patients with myasthenia gravis compared with conventional median sternotomy extended thymectomy.Methods The clinical data of thymoma patients with myasthenia gravis treated by extended thymectomy between June 2013 and June 2016 were retrospectively reviewed.The clinical outcome parameters were compared according to surgical approach.Results 41 thymoma patients with myasthenia gravis,8 cases underwent robotic extended thymecotmy,11 cases underwent thoracoscopic extended thymectomy and 20 underwent median sternotomy extended thymectomy.The resected extension included tumor,thymus tissue and adipose tissue in anterior mediastinum.There were no significant differences between robotic group and thoracoscopic group regarding operative time,blood loss,chest tube duration,hospital stay,postoperative complications and postoperative myasthenic crisis (P ＞ 0.05).The blood loss of robotic group and thoracoscopic group was significantly lower than that in median sternotomy group(P ＜ 0.05).The chest tube duration of thoracoscopic group was significantly shorter than that in median sternotomy group(P ＜0.05).The effective rates of MG after extended thymectomy in robotic group,thoracoscopic group and sternotomy group was 65.0％ 、69.2％ 、62.5％ respectively and there was no significant difference (P ＜ 0.05).Conclusion Robotic thymectomy and thoracoscopic thymecotomy are both minimal invasive surgery approach with less bleeding for thymoma patients with myasthenia gravis.The clinical outcomes of robotic thymectomy and thoracoscopic thymecotomy are similar.

Objective The aim of this study is to evaluate clinical outcomes of patients with acute type A intranural hematoma of the aorta(IMH) received surgical treatment.Methods We analyzed 40 consecutive patients with acute type A aortic IMH in Fuwai hospital.The patients are from 2012.1.1 to 2015.12.31.The average age of patients is(56 ± 11) years.Clinical outcomes and morphological evolution by CT were analyzed for 2 years.Results Most of the patients were treated medically during their initial hospitalization.There were 2 patients died in in-hospital and no 2-year mortality.16 patients (40％) were received acute surgery,24 patients(60％)were received normal surgery.Conclusion Surgical treatment would be a favorable treatment option in type A acute IMH.

Objective To summarize the prevention and management of common intraoperative complications during thoracoscopic lobectomy. Methods During June 2007 to December 2009, 96 patients received thoracoscopic lobectomy through 3 mini-incisons, including right upper lobectomy in 28 cases, right middle lobectomy in 7, right middle and lower lobectomy in 3, right lower lobectomy in 28, left upper lobectomy in 12, and left lower lobectomy in 27. Results All procedure were carried out safely. No severe complications or perioperative death occurred in all cases. The common intraoperative compliations during the surgery included: the bleeding of wounds and vessels, thoracic cavity extensive adhesion, and air leak of bronchus stumps. There were four patients conversed to open thoracotomy. The mean operation time was ( 180 ±59) minutes (range,90 - 360 minutes), and the mean blood loss was ( 191 ± 92 ) ml ( range,50 - 700 ml ), including 2 cases blood transfusio(n). The chest drainage lasted (4.6 ± 2.4 ) days, the average length of stay after operation was ( 8.0 ± 3.2 ) days. Pathological diagnosis included primary lung cancer in 85 cases, sclerosing hemangioma in 3, bronchiectasis in 3, tuberculoma in 2, pulmonary sequestration in 2, and fungus ball in 1. Conclusion It is helpful to master the prevention and management of common intraoperative complications for thoracoscopic lobectomy.