Objective:To explore the feasibility of the newly developed micro‐irrigation tube in the application to fistula complicated with empyema after esophagectomy .Methods:From Jan 2012 to Dec 2014 ,5 patients with fistula complicated with empyema after esophagectomy ,admitted in Zhongshan Hospital ,Fudan University ,accepted the therapy with a new type of micro‐irrigation tube .Among them ,4 patients were male and the other 1 was female .Three patients accepted left transthoracic esophagectomy and the other 2 underwent right thoracoabdominal esophagectom .Four patients got anastomotic stoma fistula , and the other 1 patient got stump fistula .The micro‐irrigation tube was composed of anesthesia epidural catheter ,double pipe joint and bottle water seal joint .Along the chest dralnage tube ,the micro‐irrigation tube was placed into the empyema cavity . Results:There was no serious adverse reaction except for the symptoms of cough and acid reflux in 2 patients .All the 5 patients were discharged smoothly with fistula healed and chest tube drawn .Conclusions:The application of micro‐irrigation tube in fistula complicated with empyema after esophagectomy is safe and feasible .

Objective:To explore the relationship and between the postoperative anastomotic leak in esophageal cancer and the anatomy of thoracic inlet .Methods:The clinical data of 91 patients ,who underwent cervical thoracoabdominal incision for radical resection of esophageal cancer combined with cervical esophagogastrostomy ,from January 2012 to January 2014 ,were retrospectively analyzed .13 cases suffered postoperative anastomotic leak .The anatomy of thoracic meatus was evaluated by measuring the related distance in preoperative CT (computerized tomography ) image .Correlation between the anatomy of thoracic inlet together with associated clinical factors and the postoperative anastomotic leak was analyzed . Results:Postoperative anastomotic leak was related to the gap between trachea and vertebral body at the thoracic inlet ,and it was also related to the location of tumor and the shape of tubular gastro (P<0 .05) .Conclusions:Narrow thoracic inlet may increase the incidence of postoperative anastomotic leak in esophageal cancer .Thus ,it’s necessary to evaluate the size of thoracic inlet before operation .

[Objective]To discuss the causes of coronary heart disease with depression and other body and spirit diseases,which are related to river water,and propose the corresponding treatment methods.[Methods]By using the method of image thinking,this paper links the transformation of cloud and rain with the Qi and blood of human body,which is the common cause of body and spirit diseases.At the same time,this paper links the cause of coronary heart disease with depression with river water,and treats the disease with the method of treating water.[Results]The transformation between clouds and rain in nature is similar to the transformation of Qi and blood in the human body.Qi and blood come from the same source and affect each other,and Qi and blood remain smooth,so as not to cause physical and mental diseases.The root cause of coronary heart disease with depression is that Qi and blood are not smooth,and a series of lesions they produce are similar to the blockage of the river,so it is necessary to regulate Qi and blood according to the different stages of the disease,with the method of strengthening the spleen,promoting blood circulation,detoxification and opening depression.[Conclusion]Inspiring ideas through the analogy of image thinking can correctly understand and treat coronary heart disease with depression,which is also the purpose of image thinking.