Objective To investigate the efficacy of lateral lung volume reduction with small incision and ligation for the treatment of serious chronic obstructive pulmonary disease(COPD).Methods From April 1994 to May 2006,36 patients suffering from serious COPD complicated with severe emphysema underwent lateral lung volume reduction in our hospital.Small incision and ligation were used during the operation.Results After the surgery,6 patients developed pulmonary air-leak,and were cured after 180-minute to 5-day treatments(mean,1.6 days).No perioperative death in this series.One year after the operation,the patient had significantly higher FEV1 and PaO2,and lower TLC and RV than those determined preoperation [(839.9?76.0)ml vs(589.0 ?80.5)ml,t=18.451;(72?10)mm Hg vs(62?8)mm Hg,t=4.686;(5167.6?639.9)ml vs(6725.8?976.6)ml,t=8.116;(3062.4?722.0)ml vs(4329.6?669.9)ml,t=7.720;all P=0.000].In addition,they had significantly longer 6MWT than that before the operation [(306.0?24.8)m vs(223.8?36.7)m,t=11.135,P=0.000].Conclusion For the patients with COPD who had indications for lateral lung volume deduction,resection of emphysemic tissues by the procedure using small incision and ligation can improve their symptoms and physiological conditions.

OBJECTIVE:To investigate the effect of different doses ambroxol hydrochloride on lung protection of patients in perioperative thoracotomy. METHODS:60 patients in perioperative thoracotomy were randomly divided into control group(30 cas-es)and observation group(30 cases). Control group received 30 mg Ambroxol hydrochloride injection from 1 week before surgery to 1 week after surgery,adding into 100 ml 0.9% Sodium chloride injection,intravenously,twice a day. Observation group re-ceived 300 mg Ambroxol hydrochloride injection from preoperative 1 week to postoperative 1 week,adding into 100 ml 0.9%Sodi-um chloride injection,intravenously,twice a day. All patients received the second-generation cephalosporin antimicrobial drugs for anti-infection after surgery. lung surfactant-associated protein A(SP-A),intercellular adhesion molecule(ICAM-1)levels preopera-tive 1 week and postoperative 1 week,and incidence of postoperative complications in 2 groups were observed. RESULTS:Preop-erative 1 week,there were no significant differences in the SP-A and ICAM-1 in 2 groups(P>0.05). Postoperative 1 week,SP-A and ICAM-1 in control group and ICAM-1 in observation group were significantly higher than preoperative 1 week,but SP-A and ICAM-1 in observation group were lower than control group,the differences were statistically significant(P<0.05),there were no significant differences in SP-A in preoperative 1 week and postoperative 1 week(P>0.05). The incidence of postoperative compli-cations in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CON-CLUSIONS:The effect of high-doses ambroxol hydrochloride on lung protection of patients in perioperative thoracotomy is signifi-cantly superior to small dose,which can reduce the incidence of lung complications.

This study was aimed to explore the possibility of reducing postoperative inflammatory response and lung injury degree by observing the effect ofTan-Re-Qing(TRQ) Injection on perioperative period of lung cancer patients complicated with chronic obstructive pulmonary disease (COPD). A total of 39 lung cancer cases complicated with COPD (phlegm-heat obstructing the lung) were randomly divided into the tested group of 18 cases and the control group of 21 cases. All patients underwent small incision surgery with video-assisted thoracoscopic surgery (VATS). The control group was treated with routine western medicine. TRQ injection was added in the tested group. On the preoperative 1D (T1), 1D after operation (T2), 3D after operation (T3), 7D after operation (T4), serum samples were collected for the determination of serum concentrations of TNF-α, IL-6, IL-8 and IL-10. At T1 and T2 time, there were no significant differences on levels of TNF-α, IL-6, IL-8 and IL-10 between two groups of patients (P > 0.05). At T3 time, levels of TNF-α, IL-6, IL-8 of the tested group were lower than that of the control group with statistical significance (P < 0.05). The level of IL-10 in the tested group was higher than that of the control group with statistical significance (P < 0.05). At T4 time, the levels of TNF-α, IL-6 and IL-8 of the tested group were lower than that of the control group with statistical significance (P < 0.05). The levels of TNF-α, IL-6 and IL-8 of both groups gradually declined at T3 and T4 time, compared with T2 time level with statistical significant (P < 0.05). It was concluded that TRQ injection reduced the releasing of inflammatory cytokines during perioperative period, increased levels of anti-inflammatory cytokine, thereby reducing the degree of inflammatory reaction and relieving lung injury for the protection of lung function of lung cancer patients complicated with COPD.