Objective To evaluate the indications and surgical procedure of bronchial-pulmonary arterial sleeve resection for patients with centrally located non-small cell lung cancer (NSCLC),and to prevent complications. Methods From October 1987 to December 2004, 96 cases of central NSCLC were treated with bronchial-pulmonary arterial sleeve resection and reconstruction. The results were retrospectively analyzed. Results The complication rate was 19.8%(19/96), the mortality rate in 30-day postoperation was 3.1%(3/96), the overall 1, 3, 5 year survival rates were 82.6%(76/91), 57.8%(37/64) and 39.1%(18/46) respectively. Conclusion Bronchial-pulmonary arterial sleeve resection and reconstruction in the treatment of patients with central NSCLC can not only maximize preservation of functional pulmonary parenchyma and improve the quality of life, but also provide an opportunity for those patients with poor pulmonary function to receive surgical resection of the tumor.

Objective To investigate the effects of health-education on the behaviors of following doctor's instructions of the patients receiving anticoagulation after valve replacement. MethodsThirty patients who received anticoagulation after valve replacement took part in this study. Health-education for knowledge of anticoagulation after valve replacement was implemented among these patients, and questionnaires investigating compliance for medication were subjected to all cases after their discharge of ward. The awareness of knowledge of anticoagulation was compared between patients of pre- and post-health-education,and the compliance of medication after discharge was also analyzed. ResultsHealth education improves the patient's understanding and knowledge about anticoagulation and also improves their attention to the doctor's instructions. Conclusion Health-education can increase the awareness of the knowledge of anticoagulation and the compliance among patients.

ObjectiveTo investigate the effects of imatinib mesylate as a tyrosine kinase inhibitor on the biological activity of and Wnt/β-catenin pathway in Hs294T melanoma cells.MethodsAfter Hs294T cells were incubated with imatinib mesylate at various concentrations(4,8,10,16,20 and 24 μmol/L) for 24 hours or imatinib mesylate at 10 μmol/L for 24,48 and 72 hours,methyl thiazolyl tetrazolium (MTT) assay was performed to estimate the proliferation of cells and to determine the effects of imatinib mesylate on the proliferation of Hs294T cells.Then,Hs294T cells were treated with imatinib mesylate at 10 μmol/L or dimethyl sulfoxide (DMSO) for different durations,followed by the detection of cell apoptosis with flow cytometry,localization of β-catenin with annexin V/propidium iodide-double staining and laser confocal microscopy,quantification of β-catenin and cyclin D1 protein with Western blot,and measurement of LEF1 and C-myc mRNA expression with real time fluorescence-based quantitative PCR.Matrigel invasion assay was performed to evaluate the invasiveness of Hs294T cells after treatment with imatinib mesylate at 5 μmol/L or DMSO for 24 hours.ResultsImatinib mesylate at 4-10 μmol/L elicited a dose-dependent decline in the proliferation of Hs294T cells (F =125.3,P ＜ 0.05),and imatinib mesylate at 10 μmol/L induced a time-dependent decrease from 24 to 72 hours(F =714.6,P ＜ 0.01 ).The percentage of early and late apoptotic cells was markedly increased,while the invasiveness was decreased by about 48％(P ＜ 0.01 ),together with a downregulation in the expression of LEF1,C-myc and Cyclin D1 in imatinib mesylate-treated Hs294T cells compared with the DMSO-treated cells.No obvious changes were observed in the protein expression of β-catenin,but a decline in the nuclear localization of β-catenin was noted in Hs294T cells after being treated with imatinib mesylate.ConclusionImatinib mesylate may suppress the proliferation and invasion of,but promote the apoptosis in,melanoma cells,by downregulating the Wnt/β-catenin pathway.

Objective To explore an effective pulmonary function training health education approach for patients after cardiothoracic surgery. Methods 100 patients after cardiothoracic surgery were randomly divided into experimental group (50 cases) and control group (50 cases). The patients in the control group were given conventional health education, while those in the experimental group were given standard pulmonary function training health education approach. Their incidence of complications, duration of chesttube and hospitalization were compared. Results The incidence of complications, duration of chesttube and hospitalization were all less in the experimental group than the controls （P<0.05）. Conclusion Standard pulmonary function training health education approach can accelerate the recovery of patients after cardiothoracic surgery.

ObjectiveTo investigate the correlation of polymorphism and loci interaction of nucleic acid binding oligomeric domain-like receptor heat protein domain associated protein 3 (NLRP3) gene and susceptibility to coal workers' pneumoconiosis (CWP) in Xinjiang Region. Methods A total of 109 CWP were selected as the case group, and 69 coal miners with similar age, years of dust exposure and work types were selected as the control group by convenient sampling method. Blood samples of individuals in workers in these two groups were collected, and the genotypes of single nucleotide polymorphism loci, rs1539019, rs4612666, rs4925650 and rs7525979, in the NLRP3 gene were detected using an improved multiplex ligation detection reaction. The optimal genetic model was selected based on the Akaike information criterion. Results The results of unconditional logistic regression analysis showed that individuals with the C allele of rs1539019 or rs4612666 had a higher risk of CWP than those with the A or T allele (all P<0.05), and individuals with the AA genotype of rs1539019 or the TT genotype of rs4612666 had a lower risk of CWP than those with the CC genotype (all P<0.05), after adjusting for age, years of work, alcohol, and smoking. The optimal genetic models for rs1539019 and rs4612666 were the recessive model and the additive model, respectively, and these differences were associated with the susceptibility to CWP at the Bonferroni-corrected level (all P<0.05). No correlation was found between rs4925650 and rs7525979 and the susceptibility to CWP (all P>0.05). In the smoking population, the rs1539019 co-dominant model, recessive model, and additive model were associated with a decreased risk of CWP (all P<0.05). The rs4612666 co-dominant model, dominant model and additive model were associated with an increased risk of CWP (all P<0.05), with the optimal genetic models being the recessive model and the additive model among smokers. The rs1539019 and rs4612666 were not found to be associated with the increased risk of CWP in non-smokers (all P>0.05). The rs4612666 dominant model and additive model were associated with an increased risk of CWP (all P<0.05), and the rs4925650 recessive model and over-dominant model were associated with a decreased and increased risk of developing CWP (all P<0.05), with the optimal genetic models being the dominant model and the over-dominant model in drinkers. The rs1539019 co-dominant model, dominant model, recessive model, and additive model were associated with a decreased risk of developing CWP (all P<0.05), and the rs4612666 co-dominant model, recessive model, and additive model were associated with an increased risk of developing CWP (all P<0.05), with the optimal genetic models being the additive model and the recessive model in non-drinkers. The result of haplotype analysis showed that the ACAC and ACGC haplotypes were associated with a reduced risk of CWP (all P<0.05). Conclusion The rs1539019 and rs4612666 loci of the NLRP3 gene are associated with susceptibility to CWP. This study provides clues for further research on the risk of CWP in coal workers.

To introduce the diagnosis and treatment, as well as the result of a patient with fat embolism at cerebral and ophthalmic artery, following fronto-temporal autologous fat transplantation. The patient, a 39-year-old woman, who received fronto-temporal autologous fat transplantation in other hospital in May 2018. Hemiplegia and right eye blindness happened right after autologous fat transplantation. The patient was transferred to the 940th Hospital of PLA Joint Service Support Force 5 hours after operation, but the function of the limbs and the right eye were not well restored after intensive treatment. Fat embolism is the most serious complication in fat transplantation. Once it occurs, the prognosis is poor. Therefore, the process of autologous fat transplantation should be standard to prevent related complications.

Objective To analyze the risk factors for delayed tricuspid regurgitation after aortic valve replacement.Methods A total of 104 cases of aortic valve replacements due to aortic valve lesion in this hos-pital from January 2016 to December 2017 were retrospectively analyzed.The perioperative data were collected and the follow up was performed.The appearance of moderate or more regurgitation in the tricuspid valve was defined as having regurgitation,and mild and below mild regurgitation was defined as no regurgitation.The in-dependent influencing factors for delayed tricuspid regurgitation were analyzed by using univariate and multi-variate logistic regression.Results The average follow-up period was (6.0±0.7)years.There were 39 cases lost the follow-up,5 cases died (1 case died of brain hemorrhage and 4 cases died of heart failure).The inci-dence rate of delayed tricuspid regurgitation after aortic valve operation was 15.4％.The univariate analysis showed that atrial fibrillation (70.0％ vs. 9.1％,P<0.001) and pulmonary artery pressure (x2=9.785,P=0.016) were related with tricuspid regurgitation.The multivariate logistic regression analysis showed that at-rial fibrillation (OR=15.008,P=0.003) was the independent risk factor for the delayed tricuspid regurgita-tion after aortic valve surgery.Conclusion The patients with simple aortic valve surgery should pay attention to the atrial fibrillation situation to prevent the occurrence of delayed postoperative tricuspid regurgitation.

OBJECTIVETo explore the timing and suitable method of reconstructing penile defects caused by devastating electrical burn.

METHODSThirteen patients with penile defects after devastating electrical burn, hospitalized from September 1998 to August 2013, were included in this study. After the necrotic tissues in the wounds were removed by dressing changes, a local or a hinge-like flap constructed from scrotum or abdominal wall, a prelaminated hinge-like flap from forearm, or a free forearm flap was selected, according to the injury degree of the penis, for the repair of the defect or reconstruction of penis respectively.

RESULTSThe flaps survived and the wounds healed well in 2 patients repaired with local flaps from scrotum or abdominal wall. Urethritis occurred in 2 patients 6 to 9 months after the transplantation of hinge-like flaps from scrotum, and they were cured by appropriate drugs. Functions of urination and erection of penis were recovered in these 4 patients. All flaps survived in the 5 patients repaired with hinge-like flaps from abdominal wall or prelaminated flaps from forearm. The wounds in 2 patients healed; wound dehiscence occurred in the other 3 patients in different degrees, and they healed after suturing for 2 or 3 times. The function of erection of penis recovered in these 5 patients, but with discontinuity of urinary stream during urination. Among them, 3 married patients enjoyed satisfactory sexual life. All free forearm flaps survived and the wounds healed well in 4 patients. Urinary fistula occurred in 1 patient, and it was repaired by a secondary operation. These 4 patients experienced normal urination function, but only 2 patients in whom corpus spongiosum partially remained retained the function of erection of penis to certain degree. All these 4 patients could not perform normal sexual intercourse. All patients were followed up for 6 to 13 months after surgery. Under ordinary state, the length of penis was 5.9-9.3 cm, and the circumference of penis was 8.4-10.0 cm. Wound scar was not obvious in all cases. Nine patients reported a restricted erection.

CONCLUSIONSPenile defect caused by devastating electrical burn should be repaired with a suitable flap after necrotic tissues are removed with dressing change. To repair affected penis with necrosis of a small part of cavernous body and/or corpus spongiosum, or combined with urethra defects, local flaps from scrotum or abdominal wall or hinge-like flap from scrotum should be employed. To repair those with necrosis of a large part or the whole of corpus spongiosum combined with urethra defects, hinge-like skin flaps from abdominal wall or prelaminated flaps from forearm should be employed. In patients with necrosis of a large part of cavernous body and corpus spongiosum combined with urethra defect, or total loss of penis, free forearm flaps should be employed to reconstruct penis.

Burns, Electric ; surgery ; Free Tissue Flaps ; Humans ; Male ; Necrosis ; Penis ; injuries ; surgery ; Postoperative Complications ; Reconstructive Surgical Procedures ; methods ; Scrotum ; Skin Transplantation ; Surgical Flaps ; Time Factors ; Treatment Outcome ; Wound Healing

The keystone design perforator island flap(KDPIF)is suitable for wound with large defect that skin graft repair cannot be applied. It has been widely used in most parts of the body and has been constantly improved in clinical application. This flap has the characteristics of simple design, short operation time and reliable blood supply. By searching relevant literatures, this paper retrospectively analyzed the characteristics, surgical technique, classic surgical method, improved surgical method, latest clinical application and limitations of KDPIF.