Objective To compare clinical effects of mini-incision pulmonary lobectomy with or without thoracoscopic assistance. Methods A total of 64 patients, in order of precedence of the operation, were divided into two groups according to a random numbers table. The Group A was given thoracoscopy-assisted mini-incision pulmonary lobectomy while the Group B underwent simple mini-incision lobectomy. Results The length of incision was significantly shorter in the Group A (5.3?0.6 cm) than in the Group B (8.9?0.5 cm) (t=-24.360,P=0.000); the intraoperative blood loss in the Group A (279.7?74.0 ml) was significantly less than that in the Group B (331.7?42.5 ml) (t=-3.330,P=0.002); the drainage volume at the first postoperative day was remarkably less in the Group A (162.5?47.4 ml) than in the Group B (202.0?49.2 ml) (t=-3.220,P=0.002). Complications were noted in 5 patients in the Group A and 11 patients in the Group B (?~2=4.099,P=0.043). The Group A presented a significantly shorter postoperative hospital stay (8.0?2.2 d) than the Group B (9.7?1.9 d) (t=-3.280,P=0.002). There was no statistically significant difference in the operating time between the two groups (t=-1.130,P=0.262). A follow-up observation was carried out in 57 patients for 6~12 months. Local recurrence was observed in 1 patient with stage Ⅲa lung squamous carcinoma at 6 months after operation in the Group A, whereas in the Group B, distant metastasis with local recurrence was found in 2 patients with stage Ⅲa small-cell lung carcinoma and in 1 patient with lung adenocarcinoma at 7~8 months after surgery. All the 4 patients died within 1 year. Three patients ended with other diseases unassociated with the surgery. No local recurrence or distant metastasis was found in the remaining 50 patients. Conclusions As compared with simple mini-incision pulmonary lobectomy, thoracoscopy-assisted mini-incision procedure provides less surgical invasion, fewer complications, and quicker postoperative recovery.

Objective To investigate the value of cervical mediastinoscopy(CM) in the diagnosis of thoracic diseases.Methods From January 1990 to September 2008,281 patients with diseases in the chest were examined by cervical mediastinoscopy under local infiltration anesthesia or general anesthesia.Through the pretracheal space,exploration and biopsy of the neoplasms and lymph nodes around the trachea were carried out.Results Among the cases,pathological diagnosis were made in 268 patients(95.4%),including the 23 patients who were not clearly diagnosed before the operation.The accuracy of the preoperative diagnosis was 56.9%(41/72) for malignant tumors,and 87.4%(104/119) for benign lesions.Conclusions Cervical mediastinoscopy is an effective method to detect mediastinum diseases with or without other thoracic diseases,especially for simply enlarged lymph nodes in the mediastinum.For the patients with lung cancer complicated with enlarged lymph nodes in the mediastinum or those with tumors in the mediastinum,the method is also feasible.

Objective To explore the effect of preoperative pulmonary protection therapy on surfactant protein A(SP–A) content in lung tissue and postoperative complications. Methods Sixty patients with non-small cell lung cancer (NSCLC) complicated with chronic obstructive pulmonary disease(COPD) who underwent surgical treatment in Tianjin Chest Hospital from January 2015 to June 2016 were enrolled in this study. Thirty patients were included in the control group and 30 patients in the pulmonary protection group. The control group was given routine preoperative preparation, while the pulmonary protection group was given 1 week pulmonary protection therapy on the basis of routine preoperative preparation. The exhaled breath condensate (EBC) was collected and pulmonary function was re-checked after admission and before surgery. The content of SP-A in EBC was detected by ELISA. The lung tissue samples were collected during surgery, and the SP-A level was measured by Western blotting. Results The SP-A level of the pulmonary protection group was significantly higher than that of the control group (1.05±0.21 vs. 0.93±0.16, P<0.05). The SP-A content in the preoperative EBC of the pulmonary protection group was significantly higher than that after admission[(5.51 ± 1.48) ng/L vs. (4.99 ± 1.32) ng/L, P<0.01]. After pulmonary protection treatment, the preoperative pulmonary function index was significantly higher than that after admission (P<0.01). There was no significant difference in the incidence of postoperative pulmonary complications between two groups (23.3%vs. 43.3%, P>0.05). The average postoperative hospital stay was statistically significant shorter in the pulmonary protection group than that in the control group[(9.2 ± 3.1) d vs. (11.6 ± 4.8) d, P<0.05]. Conclusion Preoperative pulmonary protection therapy can not only improve pulmonary function and shorten postoperative hospital stay, but also improve SP-A content in lung tissue.

Objective To evaluate the effect of curing achalasia by transabdominally Heller-Dor operation. Methods To summarize 33 cases of achalasia treated by transabdominally Heller-Dor procedure and visit them postoperatvely. 18 patients receive pre- and post-operativemanometry and 24-hour-pH monitoring. The parameters including reflux frequency 、the longest lasting-time of reflux 、the total time(min) of pH ＜4.0 and the percentage( % ) of time of pH ＜4.0 were recorded and compared using statistical mothods. Results Symptom was significantly improved in 32 patients after surgery, while 1 patient remained dysphasia as pre-operative. The LESP, the reflux frequency、the longest lasting-time of reflux 、the total time(min) of pH ＜ 4.0 and the percentage ( % ) of time of pH ＜ 4.0 also declined after operations ( P ＜ 0. 05 ). 30 patients were followed up,22 (73.3% ,22/30) were cured and 8 had mild sypmtom. Reflux did not detected in 3 cases( 16.7% ,3/18 ) with preoperative reflux. Conclusion Transabdominally Heller-Dor operation could dramadically alleviate the symptoms of patients with achalasia, moreover, it could especially prevent the postoperative-reflux, and with the advantages of simple operations, little traumas.

Objective:To study the effectiveness and safety of programmed cell death receptor 1(PD-1) monoclonal antibody combined with chemotherapy in the preoperative neoadjuvant treatment of stage ⅢA non-small cell lung cancer(NSCLC).Methods:A total of 65 patients with stage ⅢA NSCLC who underwent preoperative neoadjuvant treatment in our hospital from January 2019 to October 2020 were selected. According to the preoperative neoadjuvant treatment plan, they were divided into control group(31 cases) and observation group(34 cases). Patients in the control group were treated with albumin-bound paclitaxel and cisplatin for injection, and the patients in the observation group were treated with immunotherapy(carrelizumab/sintilizumab) on the basis of the control group, all underwent 2 cycles of preoperative neoadjuvant treatment. Compared the clinical efficacy of imaging, T lymphocyte subsets, drug side effects, surgical resection rate, major pathological remission(MPR), complete pathological remission(pCR) and postoperative complications of the two groups of patients, and analyzed the factors those affected MPR.Results:The clinical efficacy of PR and ORR of imaging in the observation group was better than that of the control group( P<0.05). The positive rate of CD3 + cells, the positive rate of CD4 + cells, the positive rate of CD8 + cells and the ratio of CD4 + /CD8 + cells in the observation group after treatment were higher than those in the control group( P<0.05). The drug toxicity of the observation group was higher than that of the control group in RCCEP/rash, abnormal thyroid function, and abnormal myocardial enzymes( P<0.05). Compared among the observation group(carrelizumab group/sintilizumab group), the toxicity of carrelizumab group was higher than that of sintilizumab group in RCCEP/skin rash, bone marrow suppression and abnormal myocardial enzymes( P<0.05). The MPR and pCR of the observation group were higher than those of the control group( P<0.05). There was no significant difference in surgical resection rate, surgical methods and postoperative complications between the two groups( P>0.05). The results of univariate analysis showed that ECOG score, pathological type, neoadjuvant treatment plan were related to MPR( P<0.05). The results of binary logistic regression analysis showed that ECOG score and neoadjuvant treatment plan were independent risk factors affecting MPR( P<0.05). Conclusion:PD-1 monoclonal antibody combined with chemotherapy can enable patients to obtain better MPR and pCR, and can improve the immune function of patients. But the side effects caused by immunotherapy drugs are worthy of attention, and the side effects are different between different immune drugs.

Experimental research of injury on tumor tissue in vitro is conducted with homemade energy-controllable steep pulse device. With the comparison of histological assay results between treatment group and non-treatment group, basic phenomenon of electrochemical reaction and pathology reaction of tumor tissue during the experiment is observed. The results showed the irreversible breakdown penetrating effect of energy-controllable steep pulse on tumor cells and the feasibility of this therapy are also demonstrated. These results provide a consolidate theoretic and applicable basis for further study on mechanism and animal experiment in vivo.
Electric Stimulation Therapy ; instrumentation ; methods ; Electromagnetic Fields ; Female ; Humans ; In Vitro Techniques ; Male ; Middle Aged ; Neoplasms ; pathology ; therapy

Objective To compare the change features of anti-donor specific antibody (DSA) in different species of sentitized mice after skin transplantation. Methods All mice were divided into the Balb/c → C57BL/6 (6 pairs) and Balb/c → C3H skin transplantation groups (6 pairs). At d0, d2, d4, d7, d13, d17, d28, d35, d42, d49 and d56 after skin transplantation, the serum sample was prepared for detection of DSA-IgG and DSA-IgM levels. Results Moderate increase was noted in the DSA-IgG level in the sensitized mice within 1 week after skin transplantation. The IgG level was significantly increased within 1-4 week and peaked and stabilized within 4-8 week. No significant variation was observed in the DSA-IgM level at 8 weeks after skin transplantation. In the Balb/c → C57BL/6 skin transplantation group, the DSAIgG level was significantly lower than that in the Balb/c → C3H group. Statistical significance was identified in the IgG levels between two groups at d2, d17, d28, d35, d42, d49 and d56 after skin transplantation (all P<0.05). No statistical significance was noted in the DSA-IgM levels between two groups at each time point (all P>0.05). Conclusions Advancing the time of renal transplantation after skin transplantation moderately in the Balb/c → C3H group, or changing to the lower immunoreactive combination of Balb/c → C57BL/6 are aimed to establish AMR mouse models with mild rejection reaction.

Objective The mechanism of the lymph node metastasis in lung adenocarcinoma is unknown.The characteristic of the N1 and N2 lymph nodes metastasis are different.We explore the relationship between the N1 lymph node metastasis and clinicopathological factors in lung adenocarcinoma patients.Methods Data of 126 patients who had received lobectomy and systematic lymph node dissection were retrospectively analyzed.Chi-square test and Fisher exact method was used in univariate analysis,logistic regression was performed to analyze the multivariate analysis.Critical value was calculate in ROC.All the methods executed in software SPSS 19.0.Results After analyzed the N1 lymph node metastasis and clinicopathological factors,sex (P =0.016),diameter of tumor (P =0.001),pleural invasion (P =0.008),micropapillary pattern (P =0.028),solid pattern (P =0.047) has statistical significance in univariate analysis.Logistic regression analysis reveal diameter of tumor,micropapillary pattern and solid pattern were independent risk factors for N1 lymph nodes.CEA level (P =0.004),cancer embolus (P =0.029),micropapillary pattern (P =0.018),affect the groups (number of metastasis station) of the metastasis lymph nodes.Logistic regression analysis find CEA and micropapillary pattern were independent risk factors,which might lead multiple groups lymph nodes metastasis.There is only one factor could impact the location of the N1 lymph node metastasis,which is micropapillary pattern (P =0.027).Conclusion Via ROC results,there are three factors affect the N1 lymph nodes metastasis:purity of micropapillary pattern more than 27.5％,purity of solid pattern more than 15％,diameter of tumor larger than 3.0 cm.If a lung adenocarcinoma patient who was in early stage has one or more than one factors,we suggest chemotherapy followed the surgery.Higher CEA level or higher content of micropapillary pattern much more groups lymph nodes metastasis might appear,so radiotherapy and other method should be considered to added on.High content of micropapillary pattern maybe imply cancer cell has already invaded extra pulmonary lymph nodes.

Objective:To evaluate the effectiveness of the artificial intelligence-assisted diagnosis and treatment system in distinguishing benign and malignant lung nodules.Methods:Clinical data of 1 650 patients with pulmonary nodules admitted to the Tianjin Chest Hospital Affiliated to Tianjin University from January 2015 to October 2022 were retrospectively analyzed, which included a total of 1 650 nodules. The malignant probability was compared to and analyzedpredict the benign and malignant nodules.Results:A total of 1 650 nodules were included, which were divided into a malignant tumor group(n=1 391, 84.3%) and a benign lesion group(n=259, 15.7%). Between the malignant tumor group and the benign lesion group, the malignant probability was significantly different, and the malignant probability could better distinguish malignant nodules and benign lesions[(78.85±22.91)% vs.(54.91±28.68)%, P<0.001]. The area under the curve( AUC) was 0.768. The critical value of malignant probability for diagnosis of lung cancer was 81.3% with a sensitivity of 0.620 and specificity of 0.815. Stratified analysis results showed that the accuracy of the AI intelligent system for diagnosing pulmonary nodules with the sizes of 0-1 cm, 1-2 cm and 2-3 cm was also increased, and the areas under ROC curve were 0.717, 0.769 and 0.804, respectively. Conclusion:The malignant probability of lung nodules calculated by the artificial intelligence-assisted diagnosis and treatment system can be used in the assessment of the preoperative benign and malignant lung nodules.

At present, there are many problems in the nail-fold microcirculation detection devices, such as huge structure, inconvenience to carry. In addition, due to the patient's body shaking, the video is difficult to keep stable in collecting with the device, which brings great difficulties to the doctor's observation. We develop a small image acquisition device for nail-fold microcirculation based on the principle of SDF imaging principle and liquid lenses technology. An annular lighting device is fixed in front of the optical system, and the overall design of the system is based on the characteristics of human fingers. The device is small, easy to carry and conform to the fingertips. It can focus quickly through a controller. It can also achieve high quality images of the nail-fold microcirculation. This study can promote the usage of nail-fold microcirculation device at the bedside. It's an efficient tool for medical workers to observe the microcirculation of patients.
Humans ; Microcirculation