Objective To evaluate the feasibility and efficiency of endoluminal catheter-based ultrasonography on diagnosis of upper urinary tract diseases. Methods From January 1997 to December 2006,the clinical data of upper urinary tract of 68 cases who examined by endoluminal uhrasonography with a 10 MHz miniature ultrasound transducer and a 8 F outer catheter were reviewed.There were 30 males and 38 females aged 17-81 years with an average of 58 years.The renal pelvis and its surrounding structures were examined in 48 cases and the ureter and its surrounding structures were examined in 20 cases.The total of 73 sides had experienced by this technique.The accuracy of diagnosis with endoluminal catheter-based ultrasonography was evaluated by the pathology and clinical follow-up. Results The total success rate of the ultrasound probe introduced into ureter was 91%in 68 cases.In the pelvis group it was 96%(46/48)and the ureter group 80%(16/20).In renal pelvis abnomalities,the detectable rate of abnormal by ultrasonography was 89%(41/46).The total detectable rate in ultrasound probe group was significantly higher than that in other equipment groups(P＜0.01).The detectable rate of ultrasonography on ureter disease was 75%(12/16). Conclusion Endoluminal catheter-based ultrasonography is an effective,safe technique for the diagnosis of diseases in the upper urinary tract.

Objective:To study the effect of ischemic postconditioning(I-postC)on the lung injury following ischemia-reperfusion(I/R)of skeletal muscle in the hind limbs of rats.Methods:The rat model of hind limbs I/R injury was established by subrenal abdominal aorta cross-clamping for 4 hours.Forty-eight rats were divided into 3 groups:I/R group,IPC and I-postC group.Each group received 4 hours of ischemia and then 12 or 24 hours of reperfusion respectively.The tissue morphology,wet-to-dry weight(W/D)ratio,malondialdehyde(MDA)and myeloperoxidase(MPO) of lung tissue were compared.The expression of ICAM-1 mRNA in lung was also studied by RT-PCR or in situ hybridization.The protein product was detected by Western blot.Results:In IPC and I-postC groups,all parameters decreased significantly compared with I/R ischemia group(P

Objective To prepare two types of biodegradable modified materials (chitosan and collagen)and evaluate whether the new materials are suitable for tissue engineering cartilage.Methods Collagen and chitosan were both modified by poly-γ-benzyl-L-glutamate-co-glutamine acid (PBLG-co-PGA) with different proportions.The contact angle,degradation rate,tensile strength,cell attachment and cytocompatibility were tested and compared.Results As the PBLG-co-PGA content varied,the degradation rates of PBLG-co-PGA composites became adjustable,the hydrophilicity of PBLG-co-PGA/chitosan was improved,and the tensile strength increased in PBLG-co-PGA/collagen composite.The composites with 30％ PBLG-co-PGA were chosen for cytocompatibility and cell attachment experiments.The rabbit condrocytes grew significantly better on PBLG-co-PGA/chitosan than on other three materials(P＜0.05).Conclusion PBLG can improve the hydrophilicity,tensile strength and regulate the degradation rate of composite materials,and the cytocompatibility of the composites with 30％ of PBLG is good,among which PBLG-co-PGA/chitosan can even promote cell proliferation.It could be a new choice of scaffold for tissue engineering cartilage.

Objective To assess the efficacy and safety of using a novel channel dilator (the Corsair microcatheter) accompanied with special occlusion guide wires for coronary chronic total occlusion (CTO) recanalization. Methods From 2011 December to 2013 August,we performed 89 cases (the study group) using channel dilator and the new special occlusion guide wires for CTO recanalization. Another 89 CTO lesions treated before using the corsair microcatheter were compared as the control group.We recorded clinical characteristic, outcome of PCI,radiation exposure time, contrast utilization and the procedure time. The MACE rate was monitored during follow up. Results The intracoronary channel dilator accompanied with special occlusion guide wires were inserted into 33 left anterior descending arteries, 17 left circumlfex arteries and 38 right coronary arteries. The success rates of procedure were signiifcantly higher in the study group than in the control group (91% vs. 67.7%, P < 0.05). Procedure and lfuoroscopy time tended to be lower in the study group than in the control group. There were no serious complications related to the catheter and no death case recorded. Conclusions The channel dilator accompanied with special occlusion guide wires may facilitate the conventional approach with a higher success rate in PCI.

Objective To detect the mutation frequency of EML4-ALK fusion gene in lung cancer patients, and to inves-tigate the distribution of mutation character for EML4-ALK fusion gene in Ⅰ stage lung cancer patients and clinical features as well as provide a reference for the individual treatment of lung cancer .Methods 256 fresh tumor tissue specimens of lung cancer patients were screened from the specimen bank of our hospital and all the patients had accepted the surgical treatment from February 2013 to December 2014.Total RNA was extracted and then be transcribed into cDNA, the amplification-refrac-tory mutation system(ARMS) was used to detect mutation of EML4-ALK fusion gene.The results according to the positive con-trol, negative control and RNA quality control for EML4-ALK fusion type were analyzed.Results During the 256 patients ofⅠ stage lung cancer, there were 17 patients(6.64%) had mutations in EML4-ALK fusion gene.In lung adenocarcinoma mu-tation rate(16/207, 7.73%) was higher than that of lung squamous cell mutation rate(1/39, 2.56%), lung adeno-squamous mutation rate(0/4, 0) and large cell carcinoma(0/5, 0) of the mutation rate;young lung cancer patients( <63 years) of the mutation rate(14/139, 10.07%) was significantly higher than the high age of lung cancer patients(≥63 years old) mutation rate(3/117, 2.56%), P =0.009.EML4-ALK fusion with tumor invasion and visceral pleura group incidence (9/80, 11. 25%) was significantly higher than that of non-invasive and visceral pleura group incidence rate(8/176, 4.55%), P =0.045.Conclusion The occurence of EML4-ALK fusion correlates with patients’ age as well as whether visceral pleura is in-vaded, type 1 EML4-ALK fusion was detected more in phase I lung cancer patients.

BACKGROUNDTo explore the clinicopathological changes of non-small cell lung cancer tissues after neoadjuvant chemotherapy with MVP (MMC+VDS+DDP) regimen and its concordance with clinical evaluation, and to study the clinical value of neoadjuvant chemotherapy.

METHODSA total of 84 patients with NSCLC were randomized into combinated therapy group (42 cases) and surgical group (42 cases). The combinated therapy group were given MVP regimen for 2 cycles before operation and 2-4 cycles after operation, however, the surgical group only received surgical treatment. The efficacy of preoperative chemotherapy were determined by pathologic examination under light microscope and electron microscope and clinical evaluation.

RESULTSCombinated therapy group showed various degrees of degeneration and necrosis of tumor cells, which was not found in surgical group. The overall response rate of neoadjuvant chemotherapy was 59.5% (25/42) by both pathological and clinical evaluation. The coincidence ratio of the two evaluation methods was 71.4% (Kappa value=0.407,P < 0.01). Between the two groups, there was a significant difference in total survival rate (P=0.047). And further analysis showed that survival rate was remarkably different in patients with stage III between the two groups (P=0.037), but not in those with stage I and II (P > 0.05).

CONCLUSIONSDegeneration and necrosis with fibrosis are the main pathological phenotypes of the primary lesion after induction chemotherapy, which can be showed by clinical evaluation to chemotherapy efficacy. The preoperative and postoperative adjuvant chemotherapy may be benefical to patients with stage-III NSCLC.

BACKGROUNDTo explore the possibility of the staging of pulmonary angiography with multi slice spiral CT (MSCT) and to evaluate its value in making surgical plan for patients with lung cancer.

METHODSMSCT with two-segment injection and three-protocol scan was performed in 73 patients with central type lung cancer. According to the site and degree, the involvement of pulmonary artery was divided into three grades and blindly compared with the surgery and pathology.

RESULTSMSCT in 68 cases (93.15%, 68/73) was successfully performed. The involvement of central pulmonary artery was grade I in 4 cases (5.88%, 4/68), grade II in 9 (13.23%, 9/68), and grade III in 55 (80.88%, 55/68). All patients with grade I underwent lobectomy. There was remarkable difference of lobectomy ratio between grade II and III (Chi-square=64.03, P < 0.005) and also between IIIa and IIIb (Chi-square=68.69, P < 0.005). All patients with grade IIIc were ruled out from surgery.

CONCLUSIONSThe staging of pulmonary angiography by MSCT is useful to demonstrate the site and degree of involvement of central pulmonary artery and provides more precise evidence of images for making surgical plan.

Objective To compare the clinic characteristics, recurrences and prognosis in patients with stage Ⅰ bronchioloalveolar carcinoma (BAC) and adenocarcinoma of the lung. Methods The data of 56 patients with stage Ⅰ BAC and 169 patients with stage Ⅰ adenocarcinoma were analyzed retrospectively. Results The overall 1-, 3-, 5- year survival rates were 94.7%, 83.5% and 61.2%, respectively. Compared with adenocarcinoma of the lung, BAC showed a better survival rate(x2 =6.36, P =0.012). After surgery patients with BAC were prone to develop intrathoracic recurrence, and adenocarcinoma was equal between intrathoracic recurrence and extrathoracic metastasis. The rate of intrathoracic recurrence and extrathoracic metastasis between BAC and adenocarcinoma was significantly different (14/16 vs. 27/59, x2 =8.85, P=0.004). In both group, preoperative asymptomatic patients had better survival rate(x2 = 7.28, P = 0.007; x2 = 6.07, P = 0. 014). Univariate analysis indicated that sex, age(< 60 years and ≥60 years), location of tumor and smoking history did not significantly influence survival in patients with stage Ⅰ BAC or adenocarcinoma (P > 0.05). Conclusion The prognosis of stage Ⅰ BAC is superior to that of stage Ⅰ adenocarcinoma. BAC is prone to develop intrathoracic recurrence, and adenocarcinoma is equal between intrathoracic recurrence and extrathoracic metastasis. Early diagnosis of lung cancer could improve long-term survival.

BACKGROUNDPulmonary malignant fibrous histiocytoma (MFH) is very rare and it is worthy to study the clinical characteristics, treatment method and prognosis of primary pulmonary MFH.

METHODSFifteen patients with primary pulmonary MFH were reviewed retrospectively.

RESULTSThere were 10 males and 5 females. Their ages were 56.2 years±14.0 years (20-72 years). MFH mainly manifested as cough, hemoptysis, fever, chest pain and breathlessness. The diameters of tumors were 8.3 cm±8.0 cm, ranged from 0.3 to 35 cm. All the patients received surgical operations, including 5 pneumonect-omy, 8 lobectomy and 2 exploration. The overall 1-, 3-and 5-year survival rate of 15 patients was 56.2%, 24.1% and 16.7% respectively. Incomplete surgical excision of tumor significantly influenced survival.

CONCLUSIONSPulmonary MFH is a high-grade malignant tumor with poor prognosis, and surgery is the main treatment method.

BACKGROUNDTracheal and carinal resection and reconstruction is an important way in treatment of lung cancer invading trachea and carina. The aim of this study is to summarize the method and effect of tracheal and carinal resection and reconstruction in treatment of lung cancer.

METHODSSeventy-three patients with lung cancer who underwent tracheal and carinal resection and reconstruction were retrospectively analyzed. There were 22 cases for right pneumonectomy and carinal resection, 14 cases for right pneumonectomy and tracheobronchoplastic procedure, 12 cases for right sleeve pneumonectomy, 15 cases for tracheobronchoplastic procedure plus right upper lobectomy, 2 cases for left sleeve pneumonectomy and 8 cases for left pneumonectomy and tracheobronchoplastic procedure.

RESULTSFour cases received palliative operation. Four patients (5.48%) died in the perioperative period. The 1-, 3-and 5-year survival rate was 75.3%, 63.0% and 23.3% respectively.

CONCLUSIONSCareful preoperative assessment, skillful operation and appropriate postoperative treatment are helpful to improve the outcome of tracheal and carinal resection and reconstruction for lung cancer.