Objecitve To observe the diffusion and distribution of imported Oncomdania snails in non-endemic areas of schistosomiasis.so as to provide scientific basis for developing the scheme of snail surveillance.Methods Oncomelania snails from the msrshland of Dongting Lake were imported in a waste land in March,2008,Qingxin County,which belonged to non-endemic areas of schistosomiasis.and their diffusion and distribution condition were observed from May to December in the same year.Resuits A total of 1 600 Oncomelania snails were imported.The occurrence rate of frame with snails in sunny days and cloudy rainy days were22.88%and 29.24%,respectively,and there was a statistically significant difference between them(χ~2=4.113,P=0.043).Those in waste Land and the sides/bottoms of the ditches were 9.38%and 35.99%,respectively,and the difference between them also showed a statistical significance(χ~2=67.246,P<0.001).The average density of living snails in sunny days and cloudy rainy days were 0.79 and 1.11 No./0.1 m~2,respectively,and those in waste land and the sides/bottoms of the ditches were0.11 and 1.34 No./0.1 m~2.The furthest diffusion distance of snailswas 4.5 m.Conclusions The detective opportunity of imported snails is relatively high in cloudy rainy days,which mainly distribute at the sides/bottoms of ditches and diffuse along the ditches.

Objective:To review the experience of closure of the left-main-bronchial stump fistula using endoscopic liner cutter staplers through the right thoracic approach and I stage or staged treatment for the left pyothorax.Methods:6 patients with the left-main-bronchial stump fistula after left pneumonectomy combined with pyothorax were treated by closing the left-main-bronchial stump using endoscopic liner cutter staplers through the right thoracic approach, and pleura was used to cover the distal and proximal incisional margin of the stump respectively. The thoracic T-tube drainage was used in the I stage or staged treatment for the left pyothorax.Results:All patients were survived without recurrence of the bronchopleural fistula. 4 patients were observed to have no recurrence of pyothorax when 1 patient had recurrence of pyothorax and was treated with intermittent T-tube drainage.1 patient operated with left-thoracic fenestration in the past was treated with drainage waiting for secondary operation.Conclusion:The right thoracic approach seemed to be a safer and more effective method than the transsternal transpericardial approach in cases with the left-main-bronchial stump fistula combined with pyothorax. The use of endoscopic liner cutter staplers reduced the risk of bleeding, infection and recurrence of fistula. The T-tube drainage in the I stage or staged treatment for the left pyothorax was considered to be an easier way for treatment.

Objective:To summarize the experience of surgical methods without repairing the fistula for 92 cases with gastrointestinal intrathoracic fistula.Methods:The surgical methods without repairing the fistula were performed through VATS, small incision assisted with VATS or thoracotomy. The focus of the surgery was to promote lung expansion, eliminate the residual cavity of chest cavity and keep effective drainage. After entering the chest cavity from the affected side, wash chest cavity with a large amount of warm normal saline and sterilize intermittently with iodophor to ensure the sterile environment in the pus cavity. Then completely remove the pleural cellulose or fiberboard on visceral pleura to promote lung expansion, eliminate the residual cavity of the chest cavity. The fistula was covered tightly and supported firmly by the visceral pleura on the lung. Multiple T-tubes were placed in thoracic cavity and fistula to keep effective postoperative drainage.Results:Among 92 cases, 85 cases were cured and the cure rate was 92.4% (85/92).7 cases died and the mortality rate was 7.61% (7/92). The 7 dead cases include 5 cases with esophagogastric anastomotic fistula (the death of 3 cases was cause by aortic esophagogastric fistula, the death of 1 case was cause by thoracic gastric tracheal fistula and 1 case was dead because of pulmonary infection and respiratory failure), 1 case with esophageal rupture (the cause of death was septic shock ), and 1 case with esophageal perforation(the cause of death was pulmonary infection and respiratory failure).Conclusion:Most of the surgeries without repairing gastrointestinal intrathoracic fistula are conducted simply through VATS or small incision assisted with VATS., which is safe and effective.