Objective To summarize the clinical results of combined procedure of resections and constructions of bronchus,great vessels and heart in the treatment of 79 patients with central lung cancer.Methods From Jun,1988 to Jun,2005,the combined procedure of resections and constructions of bronchus,great vessels and heart were carried out in 74 patients with central lung cancer.The operations included ring of bronchus or sleeve lobectomy in 57 cases,double sleeve lobectomy in 15 cases,carinal resection and reconstruction in 4 cases.Results There was no operative deaths and 7(8.86 %) patients had operative complications.The survival rates of 12,36,60 months and 10 years were 78.5%,59.5%,35.4% and 17.7% respectively.Conclusion With the treatment of sleeve lobectomy or combined with resection and reconstruction of pulmonary artery,great vessels or heart,the pulmonary function can be protected significantly,and the cure rate and the long term survival rate can be improved in patients with central lung cancer.

Adult ; Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; therapy ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Radiotherapy, Adjuvant ; Survival Rate ; Thymus Neoplasms ; diagnostic imaging ; pathology ; therapy ; Tomography, X-Ray Computed

The aim of the study is to investigate the effect of nardosinone (Nar) on neuronal injury induced by oxygen-glucose deprivation (OGD) in primary cortical cultures isolated from embryos at gestational day 14. MTT method was used to determine the dosage regimen of Nar in primary neuronal cultures and observe the influence of Nar on the neurons suffering OGD; Western blotting analysis was used to detect expressions of protein kinase A (PKA), Ras related protein 1 (Rap1), mitogen-activated protein kinase kinase 1 (MEK1) and phospho-extracellular signal-regulated kinase 1/2 (p-ERK1/2) of OGD-injured or uninjured primary cultured neurons after Nar treatment. Results showed that Nar (50 and 100 micromol x L(-1)) improved the cell viability during OGD damage (P < 0.01) and increased the expression of PKA, Rap1, MEK1 and p-ERK1/2 in injured neurons. Additionally, elevations of PKA, Rapl, MEK1 and p-ERK1/2 in uninjured neurons were caused by Nar (50, 100 and 200 micromol x L(-1)) with a dose-dependent tenclency as well (P < 0.01). In conclusion, Nar could protect against the neuronal injury exposed to OGD, which may be relevant to the promotion of PKA and ERK signaling pathway.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary cerebral small vessel disease.NOTCH3 missense mutation causes its coded cysteine occurring odd change and then affects the conformation and function of protein of NOTCH3.The abnormal NOTCH3 protein has vascular smooth muscle toxicity and finally deposits in the cerebral small blood vessels and causes the disease.Usually,CADASIL can be suspected by its typical clinical manifestations and neuroimaging findings.Its diagnosis needs genetic testing or skin biopsy to find the outer granular osmiophilic deposits of small vascular smooth muscle cells or immunohistochemical NOTCH3-ECD staining positive.For nearly two decades,the studies on genetics,pathogenesis,clinical manifestations,and diagnostic techniques of CADASIL have made great progress,however,many important questions have not been fully clarified and have new discoveries,such as the NOTCH3 gene mutation pattern and loci,and the relationship between gene phenotype and clinical phenotype,optimization of diagnosis process,depth study of pathogenic mechanism,exploration of new discoveries,new therapeutic targets and concepts.This article reviews the genetic characteristics,pathogenesis,and clinical diagnosis and treatment technology of CADASIL.

Objective To study mental status of recovered two year after in shake area crowd of gansu wen-xian. Methods Fifty former disaster crowd were assessed with SCL-90, Coping Style Questionnaire and Social Support Questionnaire two year after their discharge, 50 healthy medical staffs of gan-su CTM Affiliated Hospital of logistics ensure center were assessed with same instruments as control. Results The former disaster crowd and 5 subscores of SCL-90 with higher average scores than Chinese norm and results of control, they were somatization( F =4. 31) , phobia ( F = 5. 25) , obtrude ( F =5. 91) , P＜0. 01, depression ( F = 3. 11) anxiety ( F = 3. 74) , P ＜ 0. 05; The former disaster crowd felt more objective support, used more rationalization, but were less capable in problem solving. In former disaster crowd, problem-solving, objective social support and utility of the support were negatively correlated with subscores of SCL-90 ( r = -0. 31～-0. 40, P ＜0. 05) ; while immature coping, such as fantasy, withdrawal and rationalization were positively correlated with subscores of SCL-90 ( r = 0. 40 ~ 0. 60, P ＜ 0. 05).Conclusion Former disaster crowd still have psychosomatic symptoms and need social and psychology intervene and support.

BACKGROUNDTo maximize the preservation of functional pulmonary parenchyma, extend the indication of lung cancer operation and improve the life quality of patients with central lung cancer, reconstruction of carina, bronchoplasty and arterioplasty are widely used with good efficacy. The aim of this study is to summarize the clinical results of reconstruction of carina, bronchoplasty and arterioplasty in the treatment of 79 patients with central lung cancer.

METHODSFrom June, 1988 to June, 2005, reconstruction of carina, bronchoplasty and arterioplasty were carried out in 79 patients with central lung cancer. The ope- rations included single sleeve lobectomy in 58 cases, double sleeve lobectomy in 15 cases, carinal resection and reconstruction in 6 cases.

RESULTSThere was no operative death in this series. Seven patients had operative complications and the operative complication rate was 8.86% (7/79). The 1-, 3-, 5- and 10-year survival rates were 78.5%, 59.5%, 35.4% and 17.7% respectively.

CONCLUSIONSReconstruction of carina, bronchoplasty and arterioplasty can significantly protect pulmonary function, improve the prognosis and increase the curative rate and long term survival in patients with central lung cancer.

Acute lung injury after thoracic surgery is the main cause of perioperative death.Acute lung injury is a complex pathophysiological process involving inflammation,characterized by non cardiogenic hypoxemia and acute exudation of the lungs in imaging.Intraoperative ventilation strategy is the most important factor of postoperative acute lung injury.The core of treatment for postoperative acute lung injury is symptomatic support,and prevention is still the most effective strategy for the management of acute lung injury.In this review,the diagnosis,pathogenesis,risk factors and treatment of post-thoracic acute lung injury are introduced,and the progress of prevention strategy and treatment are discussed and summarized.

Objective To investigate the prognostic factors of postoperative single metastasis in patients with esophageal cancer after treatment.Methods The clinical data of patients with single lesion metastasis from 2002 to 2016 were analyzed retrospectively.Demographic and clinicopathologic data were reviewed.Predictors of PRS after definitive therapy for isolated EC recurrence were determined by the multivariable Cox proportional hazards model.Results Of the 1 016 curative esophagectomies,383 patients(37.7％) experienced recurrences(median followup 53 months).114 (11.2％) received definitive treatment of isolated EC recurrence(63 were treated surgically with or without chemotherapy-radiotherapy[CTRT] and 51 received definitive CTRT alone).Median time to recurrence(TTR) was 18 months.The 1-year and 3-year PRSs were 78.9％ and 38.6％ (median survival 28 months).On multivariable analysis;TTR was the only significant independent predictor for survival after recurrence (HR =0.982,95 ％ CI:0.95-1.03,P =0.036).No pronounced difference was found in disease-free survival or in PRS between recurrent patients treated with operation with or without CTRT and patients who received definitive CTRT.Conclusion A select subgroup of patients with isolated EC recurrence can be treated with curative intent.TTR was the best predictor for PRS.