1.Significance of Serum Cholesterol and Lp-X Quantitation in Differential Diagnosis of Cholestasis
Journal of Third Military Medical University 1983;0(03):-
Serum concentrations of total and ester cholesterol and Lp-X of 82 hepatobi-liary diseases were determined. It shewed that the levels cf total cholesterol and LP-X in cholestasis due to extrahepatic obstruction are significantly higher than that in intrahepatic cholestasis. Both levels exceeded 200 mg/dl in 12 out of 18 cases of extrahepatic obstruction caused by carcinoma, but they never exceeded 200 mg/dl in 41 cases of intrahepatic cholestasis.Quantitation of both Lp-X and total cholesterol in cholestasis appears to provide more informafions than the determination of other one of them alone. Determination of free or ester cholesterol gives little clinical value in distin-quishing extrahepatic from intrahepatic cholestasis.
2.Proposal for risk control of thoracic surgery during the COVID-19 pandemic
Hui LI ; Bin YOU ; Songlei OU ; Lunxu LIU ; Xiaofei LI ; Lanjun ZHANG ; Keneng CHEN ; Gening JIANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2023;39(1):1-3
With the change of COVID-19 prevention and control strategy in China, the number of COVID-19 cases has increased significantly recently, which has also brought new challenges to the perioperative risk control of thoracic surgery. This paper puts forward several suggestions, aiming to standardize the preoperative screening and evaluation during the COVID-19 period, strictly grasp the indications and timing of surgery, optimize the medical management process, individualize surgical decision-making, and minimize the risk of COVID-19 infection to surgery.
3.Diagnostic Utility of Virtual Bronchoscopic Navigation Assisted Endobronchial Ultrasonography with Guide Sheath for Peripheral Pulmonary Lesions.
Shijie LI ; Wanpu YAN ; Mailin CHEN ; Li SUN ; Qi WU ; Keneng CHEN
Chinese Journal of Lung Cancer 2019;22(3):125-131
BACKGROUND:
Virtual bronchoscopic navigation (VBN) assisted endobronchial ultrasonography with guide sheath (EBUS-GS) has reduced the difficulty and even avoiding radiation exposure during performing transbronchus lung biopsy (TBLB). To evaluate the feasibility and safety of virtual bronchoscopic navigation assisted endobronchial ultrasonography with guide sheath for peripheral pulmonary lesions.
METHODS:
We performed a retrospective analysis of the patients with PPLs who received VBN assisted EBUS-GS-TBLB in Peking University Cancer Hospital from January 2016 to December 2017. Their clinicopathologic data and complications were assessed.
RESULTS:
A total of 121 patients were enrolled in the study. The patients included 65 men and 56 women, with a mean age of (58.8±10.3) years. A total of 121 PPLs were examined, and 108 lesions of which could be detected by EBUS. The overall diagnostic yield of EBUS-GS was 73.5%. The diagnostic yield of malignancy was 82.5%. The combination of transbronchial lung biopsy, brush smear and bronchoalveolar lavage fluid provided the greatest diagnostic yield (χ²=6.084, P=0.014). Factors that significantly affected and predicted diagnostic success were EBUS probe within the lesions (χ²=20.372, P=0.000) and PPLs located in the central two-thirds of the lung (χ²=10.810, P=0.001). 1 patient (0.8%) suffered from intraoperative bleeding which could be managed under endoscopy.
CONCLUSIONS
VBN assisted EBUS-GS-TBLB for PPLs was an effective and safe procedure.
Bronchoscopy
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adverse effects
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methods
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Endosonography
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adverse effects
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methods
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Female
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Humans
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Lung Neoplasms
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diagnostic imaging
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surgery
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Male
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Middle Aged
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Retrospective Studies
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Safety
4.Proposal for risk control of thoracic surgery during the COVID-19 pandemic
Hui LI ; Bin YOU ; Songlei OU ; Lunxu LIU ; Xiaofei LI ; Lanjun ZHANG ; Keneng CHEN ; Gening JIANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(02):159-161
With the change of coronavirus disease 2019 (COVID-19) prevention and control strategy in China, the number of COVID-19 cases has increased significantly recently, which has also brought new challenges to the perioperative risk control of thoracic surgery. This paper puts forward several suggestions, aiming to standardize the preoperative screening and evaluation during the COVID-19 period, strictly grasp the indications and timing of surgery, optimize the medical management process, individualize surgical decision-making, and minimize the risk of COVID-19 infection to surgery.
5.Challenges and countermeasures of thoracic surgery in the epidemic of novel coronavirus pneumonia
XIE Dong ; WANG Sihua ; JIANG Gening ; LIAO Yongde ; ZHU Yuming ; ZHANG Lei ; XU Zhifei ; CHEN Keneng ; FANG Wentao ; GE Di ; TAN Lijie ; CHEN Xiaofeng ; LI Hecheng ; WU Chuangyan ; TONG Song ; LIU Zheng ; DING Xiangchao ; CHEN Jiuling ; CHENG Chao ; WANG Haifeng ; CHEN Chang
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020;27(04):359-363
Since December 2019, a novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) outbreak has occurred in Wuhan, Hubei Province, and the epidemic situation has continued to spread. Such cases have also been found in other parts of the country. The spread of the novel coronavirus pneumonia epidemic has brought great challenges to the clinical practice of thoracic surgery. Outpatient clinics need to strengthen the differential diagnosis of ground glass opacity and pulmonary plaque shadows. During the epidemic, surgical indications are strictly controlled, and selective surgery is postponed. Patients planning to undergo a limited period of surgery should be quarantined for 2 weeks and have a nucleic acid test when necessary before surgery. For patients who are planning to undergo emergency surgery, nucleic acid testing should be carried out before surgery, and three-level protection should be performed during surgery. Patients who are planning to undergo emergency surgery in the epidemic area should be confirmed with or without novel coronavirus pneumonia before operation, and perform nucleic acid test if necessary. Surgical disinfection and isolation measures should be strictly carried out. Among postoperative patients, cases with new coronavirus infection were actively investigated. For the rescue of patients with novel coronavirus infection, attention needs to be paid to prevention and treatment and related complications, including mechanical ventilation-related pneumothorax or mediastinal emphysema, and injury after tracheal intubation.
6.Shanghai Pulmonary Hospital Experts Consensus on the Management of Ground-Glass Nodules Suspected as Lung Adenocarcinoma (Version 1).
Gening JIANG ; Chang CHEN ; Yuming ZHU ; Dong XIE ; Jie DAI ; Kaiqi JIN ; Yingran SHEN ; Haifeng WANG ; Hui LI ; Lanjun ZHANG ; Shugeng GAO ; Keneng CHEN ; Lei ZHANG ; Xiao ZHOU ; Jingyun SHI ; Hao WANG ; Boxiong XIE ; Lei JIANG ; Jiang FAN ; Deping ZHAO ; Qiankun CHEN ; Liang DUAN ; Wenxin HE ; Yiming ZHOU ; Hongcheng LIU ; Xiaogang ZHAO ; Peng ZHANG ; Xiong QIN
Chinese Journal of Lung Cancer 2018;21(3):147-159
Background and objective As computed tomography (CT) screening for lung cancer becomes more common in China, so too does detection of pulmonary ground-glass nodules (GGNs). Although anumber of national or international guidelines about pulmonary GGNs have been published,most of these guidelines are produced by respiratory, oncology or radiology physicians, who might not fully understand the progress of modern minimal invasive thoracic surgery, and these current guidelines may overlook or underestimate the value of thoracic surgery in the management of pulmonary GGNs. In addition, the management for pre-invasive adenocarcinoma is still controversial. Based onthe available literature and experience from Shanghai Pulmonary Hospital, we composed this consensus about diagnosis and treatment of pulmonary GGNs. For lesions which are considered as adenocarcinoma in situ, chest thin layer CT scan follow-up is recommended and resection can only be adopt in some specific cases and excision should not exceed single segment resection. For lesions which are considered as minimal invasive adenocarcinoma, limited pulmonary resection or lobectomy is recommended. For lesions which are considered as early stage invasive adenocarcinoma, pulmonary resection is recommend and optimal surgical methods depend on whether ground glass component exist, location, volume and number of the lesions and physical status of patients. Principle of management of multiple pulmonary nodules is that primary lesions should be handled with priority, with secondary lesions taking into account.
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Adenocarcinoma
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diagnosis
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diagnostic imaging
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surgery
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Adenocarcinoma of Lung
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China
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Consensus
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Hospitals
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Humans
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Lung Neoplasms
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diagnosis
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diagnostic imaging
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surgery
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Physicians
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psychology
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Positron Emission Tomography Computed Tomography
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Practice Guidelines as Topic
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Retrospective Studies
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Solitary Pulmonary Nodule
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diagnosis
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diagnostic imaging
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surgery
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Tomography, X-Ray Computed