Objective To discuss the diagnosis and treatment of pulmonary contusion. Methods A retrospective study was carried out in 132 cases of severe pulmonary contusion (injury severity score ≥20) from February 1993 to December 2003. Results Of all, 107 cases (81.1%)survived and 25 (18.9%)died. Conclusions Chest X-ray and CT are reliable for the diagnosis of pulmonary contusion. The important methods include keeping airway clear, progressively treating shock and reasonably applying ventilation, steroids as well as antibiotics. The early diagnosis and the prompt treatment of the associated injuries are key to higher cure rate.

Objective To determine the changes of patients with severe pulmonary contusion and the relationship among the serum level of alpha-granular membrane protein (CD62p), the severity of injury and prognosis. Methods The serum level of CD62p, was measured in 45 patients with severe pulmonary contusion on hour 2, hour 12,day 1,3,7 after injured. Forty-five patients were divided into two groups: the survive group and the death group. The levels of CD62p between two groups were compared. Results The serum levels of CD62p in patients with severe pulmonary contusion on 12 hours, 1,3 days after injury were higher than those on 2 hours (P<0.05). The serum levels of CD62p in the survive group and death group on 2 h, 12 hours after injury were higher than those in the control group(P<0.05), and the serum levels of CD62p in the death group were higher than those in the survive group. Conclusion It was helpful in judging the severity of head in jury and prognosis to determine the serum levels of CD62p in patients with severe pulmonary contusion.

Objective To study the operation approach and operation method for giant dumbbell neurogenic tumors of the posterior mediastinum,and summarize the experience ofthoracoscopic surgery via posterior midline approach in tumor resection.Methods The clinical data of 11 patients with posterior mediastinum dumbbell tumor,admitted to our hospital from February 2003 to May 2013,were analyzed retrospectively.Traditional posterolateral incision combined with thoracic tumor resection was performed in the 7 patients of control group;and thoracic laminectomy combined with intraspinal tumor mass resection was performed in the 4 patients of treatment group.Results The operation went smoothly.Patients in the treatment group accepted no auxiliary incision or conversion to thoracotomy,without occurrence of dysneuria and cerebrospinal fluid leakage and other serious complications.As compared with the control group,the treatment group had smaller volume of bleeding,shorter chest drainage time and hospital stays,and longer operation time.Postoperative pathology implied 8 neurofibromas and 3 schwannomas.No dysneuria or recurrence was found during the follow-up of 12-36 months.Conclusion Double-hole thoracoscopic surgery via posterior midline approach is a safe,effective,minimally invasive method in the treatment of dumbbell neurogenic tumors of the posterior mediastinum.

AIM:To explore the effect of microRNA-184(miR-184)on compensatory lung growth(CLG)af-ter lobectomy in multiple primary lung cancer(MPLC)and its mechanism.METHODS:(1)Lung tissue samples(n= 16)from MPLC patients and patients with good recovery after lobectomy(CLG)were collected,and the expression of miR-184 was measured by RT-qPCR.(2)Human alveolar epithelial cells were divided into NC-mimic group,miR-184 mimic group,OE-NC group,tissue inhibitor of metalloproteinase-2(TIMP-2)overexpression(OE-TIMP-2)group,and miR-184 mimic+OE-TIMP-2 group according to the transfection(n=3).The expression of miR-184,TIMP-2 mRNA and matrix metalloproteinase-14(MMP-14)mRNA was measured by RT-qPCR,and the protein expression of TIMP-2 and MMP-14 was determined by Western blot.The proliferation of the cells was measured by CCK-8 and colony formation assays.(3)C57BL/6J mice were divided into pneumonectomy(PNX)group and PNX+miR-184 mimic group(n=5).The flexiVent system was used to measure the vital capacity and lung compliance of the mice.Lung volume was measured by water dis-placement method,and lung tissue changes were observed by HE staining.RESULTS:The expression of miR-184 was significantly higher in the patients with better recovery after lobectomy(P＜0.01).Overexpression of miR-184 promoted the proliferation of human alveolar epithelial cells and the recovery of lung function in mice after PNX.In terms of mecha-nism,miR-184 showed targeted binding with TIMP-2,and overexpression of miR-184 promoted the expression of MMP-14 by inhibiting TIMP-2,thereby promoting the proliferation of human alveolar epithelial cells and the recovery of mouse lung function after PNX.CONCLUSION:miR-184 promotes CLG after PNX through the TIMP-2/MMP-14 axis.