Background and purpose:Single photonemisson computed tomography(PET) is recently available in many cities. It has been extensively used for the diagnosis of pulmonary lesions,especially in the differential diagnose of solitary pulmonary nodules(SPN) with PET.We retrospectively analysed 20 lung tumour patients with multifical lesions to investigate the value of PET scanning. Methods:20 cases with lung tumour patients who had multifical lesions were analyzed , the patients were treated from August 2004 to June 2005 in Shanghai Chest Hospital. All patients were examined with PET,X-ray,CT(computerized tomography) and SPECT(single photonemisson computed tomography). Some of them were detected with MRI because they were suspected to have spinal metastases. 14 cases were pathologically proved as lung cancer.Results:All(100%) of the primary lesions were positively detected by PET scanning. In addition to 100% sensitivity to the primary lesions, 6 cases of the metastatic lesions were confirmed by PET,in which 2 of them were pulmonary nodules (all bigger than 1cm in size),3 were mediastinal lymph nodes,and the other was a secondary tumor of the spine. 14 cases were negative on the PET image, 4 of 14 cases were false negative, 2 of them had pulmonary nodules (all smaller than 1cm), the other 2 were either mediastinal lymph nodes or a secondary tumors of the spine.Conclusions:PET scanning has high value in terms of improving diagnosis of the primary and metastatic pulmonary lesions, it is useful to define stage of tumor and chose proper treatment for the patients. PET scanning may not be a efficient tool when the size of nodules is smaller than 1 cm. Some of the secondary tumors of the spine maybe be PET negative.

Purpose: To evaluate the causes and management of bronchial pleural fistula after pneumonectomy. Methods: Retrqspective analysis for Bronchus-pleural fistula( BPF) of 16 cases after pneumonectomy of 820 cases of lung cancer in our hospital. BPF occurred in right peumonectomy( 13/320) is more than in left pneumonectomy(3/500) . BPF occurred in the positive stump of bronchus ( 10/41) more than in negative stump of bronchus (6/779) ; BPF occurred in preoperative chemotherapy cases( 5/110) more than in non-preoperative chemotherapy cases( 11/710), No BPF occurred in the 70 cases in which the bronchial stump was covered by autogenous tissue. The management principle in early stage is thoracocentesis and wash with antibiotics; after identification of the infection in thoracic cavity or BPF, closed drainage for thorax was done. If the results of drainage are not very good, open drainage is necessary. Results: 2 cases were discharged with completely healing, (the cavity of 1 case was washed again and again with 5% NaHC03and urokinase , another case was operated again to cover the BPF using muscle flaps 3 days after the first operation), 8 cases were discharged with closed drainage, 4 cases were discharged with open drainage changing the wound covering every day, the BPF did not heal for a long time after open drainage in 1 case, 1 case died of function failure of body organs. Conclusions: BPF is related to management of the bronchial stump and radical resection for tumor, It is a useful method to cover the bronchial stump with autogenous tissues to decrease BPF's, especially for right pneumonectomy and preoperative chemotherapy or radiotherapy cases. The management principle of BPF is thoracocentesis for early cases, especially washing with antibiotics and 5% NaHC03and urokinase repeatedly, closed drainage when necessary is also a good method for curing empyema and BPF.

Purpose:To evaluate the clinical effects and indications of surgical treatment of non small lung cancer invading the left atrium and great vessels and trachea carina. Methods:From August 1998 to Auguest 2003, we performed operations on patients with non-small lung cancer invading the left atrium in 3 cases, invading the descending aorta in 1 case, invading trachea carina in 3 cases; all the patients have been examined to exclude distant metastasis, including nuclear bone scan to exclude bone metastasis; there were 2 cases of left pneumonectomy and one of right pneumonectomy invading the left atrium, there were 3 cases of right sleeve pneumonectomy invading the trachea carina. For the cases invading the descending aorta, we performed the operation with atrium-aorta bypass, Pathology examination: all of the cases were squamous lung cancer, staging of T 4N 0M 0 for 6 cases,T 4N 2M o for 1 case. Results:No complication, follow up: 6 cases survived more than 1 year,1 case survived more than 9 months;4 cases were alive for more than 3 years, 1 case invading the atrium died in 30 months because of brain metastasis,1 case invading the carina died in 15 months because of pulmonary infection. Conclusions:For localized advanced non-small lung cancer invading the aorta and invading the carina and the atrium, if we selected the patient correctly and with a good surgical technique with complete radical resection of the tumor ,we can acquire good results.

Objective To evaluate the reliability of video-assisted mini-thoracectomy(VAMT) for the diagnosis and treatment of patients with pulmonary peripheral nodules.Methods A total of 55 patients with pulmonary peripheral nodules(1 case of multiple nodules and 54 cases of solitary nodule) underwent VAMT.The surgery included wedge resection in 23 patients and lobectomy with lymph node dissection in 32 patients(The lobectomy was performed by using conventional combined with thoracoscopic instruments.A self-made lymph node clamp was applied for lymph node dissection).Results The operation was successfully accomplished under thoracoscopy in all the 55 patients.The operation time was 35~180 min(mean,109 min) and the intraoperative blood loss was 50~400 ml(mean,122 ml).No blood transfusion was required.Postoperative complications included air leakage in 1 patient(discharge on the 32 postoperative day) and delayed wound healing in 1 patient(discharge on the 19 postoperative day).The length of postoperative hospital stay of the other 53 patients was 4~11 days(mean,8.3 days).Final pathological diagnosis showed 15 cases of benign lesions,38 cases of primary lung carcinoma,1 case of atypical adenomatous hyperplasia,and 1 case of metastatic lung cancer.The benign lesions were cured by wedge resection.Anatomic lobectomy with lymph node dissection was performed in 32 patients with primary lung cancer.Of other 6 patients with terminal lung cancer,4 patients were conservatively treated because of an extensive dissemination and 2 patients received a palliative wedge resection because of poor pulmonary functions.Conclusions Video-assisted mini-thoracectomy is helpful for the diagnosis and treatment of pulmonary peripheral nodules.Its long-term effects for clinical early-stage lung cancer need further follow-up investigations.

Background and purpose:VATS lobectomy has gained popularity for lung cancer around the world.Complete anatomic resections and node dissections are routinely being performed at many centers under VATS,but some thoracic surgeons are concerned regarding the safety,benefit and radical resection of this operative method.Our study is to evaluate the reliability and feasibility of pulmonary resection by video-assisted mini-thoractomy(VAMT) for patients with lung cancer.Methods:72 patients with lung cancer received either lobectomy and systemic lymph node dissection by video-assisted mini-thoracotomy(VAMT group;n=32) or conventional thoracotomy(conventional group;n=40),lobectomy was performed by conventional or thoracoscopic instruments,specific lymph node clamps were applied for lymph node dissection.Results:VAMT was successfully performed without significant postoperative complication and blood transfusion.No significant differences were observed in the two groups with respect to the length of operation and the total groups of dissected lymph nodes.This study showed that VAMT is a minimally invasive surgery without impairing of the outcome and needed less operative blood loss and shorter postoperative hospitalization compared to conventional thoracotomy.Conclusions:Major pulmonary resection by video-assisted minithoractomy for patients with lung cancer is safe,reliable and less invasive,it is consistant with the surgical standard of lung cancer.Its long-term benefit needs to be clarified after further follow-up.

OBJECTIVE:To establish a method for rosmarinic acid in Herba Rabdosiae Serrae. METHODS:HPLC method was performed on the column of Inertsil ODS-SP C18 with mobile phase of acetonitrile-0.4% phosphoric acid(gradient elution)at a flow rate of 1.0 ml/min,the detection wavelength was 327 nm,column temperature was 25 ℃,and injection volume 10 μl. RE-SULTS:The linear range of rosmarinic acid was 5.039-100.776 μg/ml(r=0.999 6),RSDs of precision,stability and reproducibility tests were lower than 3%;recovery was 99.53-104.38%(RSD=2.06%,n=9). CONCLUSIONS:The method is simple with good reproducibility and high accuracy,and can be used for the content determination of rosmarinic acid in Herba Rabdosiae Serrae.

The paper elucidated the necessity of programmed operation in competence education of medical postgraduate students.This paper introduced the specific methods of programmed operation mode,exactly as selection of the best,scientific combination,coordination and arrangement,allocation of responsibility to individual,exact procedures,succession and development.The seven years practice experience in their colleges testified that these operational methods aroused the enthusiasm of postgraduate students' participation in campus activities and trained postgraduate student cadres.Meanwhile,these methods activated the campus culture and atmosphere and enhanced the comprehensive competence of postgraduates wholly.

Objective:To perfect and improve the quality standard of Malloti Apeltae Radix. Methods:Microscopic identification was used to identify the transverse section and the powder. The water-soluble and the fat-soluble components were identified by TLC. Rutin was used as the reference in the characteristic chromatogram established by HPLC to determine the relative retention time and rel-ative peak area of each characteristic absorption band. A SPOLAR C18 chromatographic column ( 250 mm × 4. 6 mm,5μm) was used with acetonitrile-0. 4% phosphate solution as the mobile phase with gradient elution, the detection wavelength was set at 328 nm, the flow rate was 1. 0 ml·min-1, and the temperature was 35℃. Results: The microscopic characteristics were obvious. The spots of TLC were round and clear with good repeatability. Five characteristic absorption bands were shown in the fingerprints with the relative retention time within ± 5% of reference value of rutin, and the relative area of peak 3 and peak 4 was not lower than 0. 23 and 0. 66, respectively. Conclusion:The method is convenient, fast and repeatable, and the result is accurate and reliable, which can be used to control the quality of Malloti Apeltae Radix effectively, and as the main index of the quality standard.

OBJECTIVE:To establish a method for the determination of 100 pesticide residues in Morus alba. METHODS:LC-MS/MS was conducted on the column of ZORBAX Eclipse plus C18 with mobile phase of acetonitrile (containing 5% water, 0.1% formic acid,5 mmol/L ammonium formate)- water(containing 0.1% formic acid,5 mmol/L ammonium formate)(gradient elution)at a flow rate of 0.4 ml/min,column temperature was 40 ℃,injection volume was 5 μl;MS conditions:ionization source was electrospray ionization with positive ion mode,scanning mode was dynamic MRM,scanning time window was 2 min;atomiz-ing gas was nitrogen,atomizing gas pressure was 40 psi,drying gas flow rate was 5 L/min,capillary voltage was 4 000 V,and ion spray voltage was 500 V. RESULTS:The linear range of 100 pesticide residues was 2.4-150 ng/ml(r>0.990 0),recovery was 69.3%-128.2%,and the determination limit was 0.003-16 μg/kg. CONCLUSIONS:The method is simple,stable and reproduc-ible,and can be used for the determination of pesticide residues in M. alba.

Master of biomedical engineering degree is necessary for students to adapt to the trend of social and scientific development.Based on the social demands,staff working at academy of biomedical engineering department in Wuhan University create the master course and modify teaching methods,in order to integrate positive factors into our master of biomedical engineering course.These new teaching methods are implemented through entire course,which aims to improve students' abilities of critical thinking,creativity and operation.We also explore the new teaching methods to enabte students to be qualified with biomedical engineering work in the future.