This paper summerized the surgical treatment of primary bronchogenic carcinoma in 3568 cases between 1957-1991. The resectability rate was 90. 3%, postoperative morbidity rate 8.32% and operative mortality 0. 89%. Pathological diagnoses of the resected specimens included squa-mous cell carcinoma for 48.7%, adenocarcinoma 22.9%, small cell cancer 15. 4%, large cell cancer 1. 3% and squa-mous-adenocarcinoma in 10.1%. The follow-up rate was 93%. The 5-and 10-year survival rates were 34.6% and 22.79% respectively. Analyses of the data demonstratad that the histologic type, pathological stage and metastasis of mediastinal lymph node are the important factors affecting the prognosis. According to UICC P-TNM,42. 6% of the patients in this group were in stage III. The 5 year survival rate was 19% in IIIa patients and 6% in IIIb. According to authors experience, it is recommended that in IIIa patients with nonsmall cell cardinoma, active surgical treatment should be adopted; in patients with small cell carcinoma, chemotherapy and radiotherapy should be given pre-and postoperatively, in IIIb patients with small cell carcinoma, surgical treatment is generally not indicated.

The effects of highly active antiretroviral therapy (HAART) to patients with AIDS in Hubei province of China were investigated in order to provide scientific evidence to reinforce the management of HAART. Self-made questionnaires and descriptive method of epidemiology were used to collect and describe the changes of clinical symptoms, HIV RNA concentration, and immune function of patients with AIDS. After HAART, the effective rate of fever, cough, diarrhea, lymphadenectasis, weight loss, tetter, debility and fungous infection was 92.4%, 90.85%, 92.91%, 90.73%, 93.69%, 89.04%, 92.34%, and 83.1%, respectively. Of 117 patients with detected HIV RNA concentration, 41.03% had declined over 0.5 log, and 52.99% less than 0.5 log. CD4(+)T cell count was obviously increased: the average number after HAART for 3 or 6 months was 237/microL (26-755/microL) and 239/microL (17-833/microL), respectively. HAART can improve AIDS patients' clinical symptoms, reduce HIV RNA concentration, and maintain immune function. It is very important for the effectiveness of HAART to raise clinical adherence of patients with AIDS and have a persistent surveillance.

Objective To evaluate the clinical significance of dissection of pulmonary ligament was operated on videoassisted thoracic surgery(VATS) with bullectomy for spontaneous pneumothorax.Methods From Jan 2012 to Dec 2013, 232 patients (188 males, 44 females) underwent VATS with bullectomy for spontaneous pneumothorax or hemopeumothorax, whose age were between 14 and 45 years and mean age was(26.4 ± 10.1) years.202 patients resulted from upper lobe spontaneous pneumothorax, 23 patients for lower lobe spontaneous pneumothorax, 7 patients for hemopeumothorax, and 18 cases because of recurrence after bullectomy (7.7 ％, 18/232).all the patients were accepted bullectomy with or without dissection of pulmonary ligament.Results Between 112 patients who underwent upper lobe bullectomy with dissection of pulmonary ligament, at 1 st postoperative day, it was found 92 patients whose pleural effusion were less than 300 ml (82.1％ ,92/112);20 patients whose pleural effusion were greater than or equal to 300 ml(17.9％, 20/112), and the mean drainage from thoracic cavity was(147.0 ± 61.0)ml.At 3 rd day, the mean drainage was(33.4 ± 20.0) ml.Within 23 cases who underwent lower lobe bullectomy with dissection of pulmonary ligament, the mean drainage from thoracic cavity, at 1 st postoperative day, was (155.2 ±41.1)ml,and the mean drainage, at the 3rd day, was(52.1 ± 21.3)ml.Also,within 90 patients who underwent bullectomywithout dissection of pulmonary ligament, 9 patients whose pleural effusion, at 1 st postoperative day, were less than 300ml(10％ ,9/90);81 patients whose pleural effusion were greater than or equal to 300ml (90％, 81/90);the mean drainage for 90 patients was(65.1 ± 28.0)ml.At the 3rd day, 40 patients' pleural effusion were greater than or equal to 300ml (44.4％,40/90) , and the mean drainage was(40.2 ± 25.5) ml.2 of 7 hemopeumothorax patients bled for the vessels injury during pulmonary ligament avulsion.Conclusion There was significant difference in clinical outcomes between two groups, and the dissection of pulmonary ligament was able to reduce the pooling of pleural effusion, facilitate the drainage of pleural effusion, and prevent pneumothorax recurrence, but there is no convincing evidence that dissection of pulmonary ligament can lead to bronchial deformation, stenosis, and reduce the free thoracic space.

BACKGROUND: Benign prostatic hyperplasia is a common disease of older males. Although the etiology remains unclear, the factors of life style and habits may have an effect on the disease.OBJECTIVE:To examine the association of cigarette smoking and body mass index with the risk of clinical benign prostatic hyperplasia.DESIGN: A hospital-based case-control study SETTINGS:Department of Epidemiology and Statistics, Public Health School,Tongji Medical College, Huazhong University of Science and Technology; Department of Preventive Medicine, Liaoning Medical College.PARTICIPANTS：Totally 343 males with benign prostatic hyperplasia of 50-82 years old (patient group),who were surgically treated between May 2004 and May 2006,were selected from the Department of Urinary Surgery of the First Affiliated Hospital and Third Affiliated Hospital of Liaoning Medical College (former Jinzhou Railway Central Hospital),Jinzhou Central Hospital and Jinzhou Second People's Hospital．Inclusive criteria：① males above 50 years old；intemational prostatic symptom score(IPSS)＞7；②Digital recta examination (DRE) after miction indicated prostate grade Ⅰ(transverse diameter＞3 cm); ③prostatic volume≥30 g;④maximum unnary flow rate＜15 mL／s；Meanwhile，361 inpatients with diseases irrelative to the risk factors of benign prostatic hyperplasia,prostatic cancer and prostatitis were selected trom the above hospitals as the control group,they were 50-82 years of age with an average of 65 years old．Informed contents were obtained from all the enrolled subjects．METHODS：All the patients and controls were interviewed using an anonymous questionnaire．All participants were asked to report whether they had smoked 20 packs of cigarettes or more in their lifetimes and,if yes,they were smokers,on the contrary they were non-smokers．Based on usual number of cigarettes reported in the questionnaire, men were categorized as 1-10，11-20，21-30 and ＞30 cigarettes per day．Based on duration of smoking,the participants were funher classified as never smoke，1-19,20-29 and ≥30 years．Body mass index(BMI)was assessed from measured body mass and body height，and che standards of BMI in adults in China was 18．5-23．9 for normal,24．0-27．9 for overweight and ≥28．0 for obesity)，then the participants were further classified as BMI＜18．4，18．5-23．9,24．0-27．9 and ≥28．0 subgroups respectively．Years of education(＜7,7-11,and≥12) and occupation(worker,peasant, Intellectual and others) were also investigated．The results of the investigation were input into computer to establish database，the odds ratios (OR) and the 95％ confidence interval(CI)in relation to the various measures were estimated using unconditional multiple logistic regression models, including number of cigarettes smoked per day，BMI,years smoked，years of education,occupation．MAIN OUTCOME MEASURES：Relationships of number of cigarettes smoked per day,years smoked．BMI,years of education and occupation with benign prostatic hyperplasia．RESULTS：Totally 343 cases in the patient group and 361 cases in the control group were involved in the analysis of results．①Patients smoked≥30 cigarettes per day had an elevated risk of benign prostatic hypertrophy as compared with the non-smokers(OR=1．32，95％ CI:0．92-2．58，P＜0．01)．②The risks of benign prostatic hypertrophy in overweight and obesity were significantly increased as compared with non-smokers(OR=1.68,95％ CI: 1．32-3．67；OR=2．35，95％CI:1．83-4．16)，③Manual worker (peasant) was negatively correlated with the risk of benign prostatic hyperplasia (χ2=6．62，P＜0．01)．CONCLUSION:Smoking 30 cigarettes per day was positively related to benign prostatic hyperplasia.For male who were both overweight(BMI 24.0-27.9)and obesity(BMI≥28.0)，smoking was significantly associated the increased risk of surgically treated benign prostatic hyperplasia.

Objective:To investigate the associations of serum amyloid A (SAA) with the overall burden of cerebral small vessel disease (CSVD) and early neurological deterioration (END) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS admitted to the Department of Neurology, Baise People's Hospital from August 2021 to August 2023 were included retrospectively. END was defined as an increase of ≥2 in the National Institutes of Health Stroke Scale (NIHSS) score within 72 hours of onset compared to the admission score. The baseline data of patients with different CSVD burden group, as well as END and non-END groups were compared. Multivariate logistic regression analysis was used to determine the independent correlation factors for the overall burden of CSVD and END. Results:A total of 131 patients with AIS were enrolled, including 78 males (59.54%), aged 63.80±7.34 years. Sixteen patients (12.2%) were in the CSVD overall burden 0-point group, 58 (44.3%) in the 1-point group, 29 (22.1%) in the 2-point group, 22 (16.8%) in the 3-point, and 6 (4.6%) in the 4-point group; and 52 (39.7%) experienced END. There were significant differences in age, diabetes, smoking, drinking, NIHSS score at admission, total burden of CSVD, previous stroke or transient ischemic attack history, homocysteine, fasting blood glucose, uric acid and SAA between the END group and the non-END group (all P<0.05). Multivariate logistic regression analysis showed that SAA was an independent risk factor for END (odds ratio 4.703, 95% confidence interval 2.492-8.875; P<0.001). There was a significant difference in SAA among different CSVD burden groups ( P<0.001), and SAA increased with the increase of CSVD burden score. Ordinal multivariate logistic regression analysis showed that SAA was independently correlated with the overall burden of CSVD (odds ratio 4.576, 95% confidence interval 2.542-8.239; P<0.001). Conclusion:SAA is associated with the overall burden of CSVD and END in patients with AIS.

Objective To investigate the safety, reliability and effectiveness of supra - aortic artery stenting angioplasty via transradial access in treating supra-aortic artery occlusion or stenosis. Methods The clinical data of 325 consecutive patients with supra-aortic artery occlusion or stenosis, who were admitted to authors' hospital during the period from January 2012 to January 2016 to receive stenting angioplasty, were retrospectively analyzed. According to patient's own will, the 325 patients were divided into transradial access group (n=52) and transfemoral access group (n=273). The results of the puncturing, the operative results, the duration of operation, the amount of intraoperative blood loss, the postoperative complications, the time of postoperative rest in bed, the average time of hospitalization of both groups were recorded. Results No statistically significant differences in the success rate of puncturing, the success rate of operation and the amount of intraoperative blood loss existed between the two groups (P＞0. 05). In 73. 1％ of patients (38/52) of the transradial access group the duration of operation was ≤30 min, while only in 43. 2％ of patients (118/ 273) of the transfemoral access group the duration of operation was ≤30 min, the difference between the two groups was statistically significant (P＜0. 000 1). After the operation, in transradial access group puncture point bleeding was seen in 8 patients and hematoma at the puncture site in one patient, the complication rate was 17. 3％ (9/52), while in transfemoral access group puncture point bleeding was observed in 23 patients, hematoma at the puncture site in 7 patients, pain of puncture site in one patient, and cerebral hemorrhage in one patient, the total complication rate was 11. 7％ (32/273); but the difference between the two groups was not statistically significant (χ2=1. 236, P=0. 266). Patients in the transradial access group could get out of bed immediately after the operation. No statistically significant difference in the average time of hospitalization existed between the two groups (P＞0. 05). Conclusion In performing endovascular stenting angioplasty for supra-aortic artery occlusion or stenosis, both transradial access and transfemoral access are safe, reliable and effective. Transradial access can be used as a replacement of transfemoral access. (J Intervent Radiol, 2018, 27:207-210)

OBJECTIVETo find the sexual reproduction characteristics and improve the seed propagation and new variety breeding of Fritillaria cirrhosa.

METHODFlower, anther and pistil development were observed. Pollinating in different development period and bagging were used to measure stigma maturity situation and natural outcrossing rate.

RESULTS AND CONCLUSIONIt took 12 days from floral bud emergency to finished flowering. It was observed that anther opened in longitudinal direction and pollen was ejected for 2-4 days continuously. Pistil matured earlier, and chapiter could be fertilized from middle bud stage the third day after flowering, but the most suitable time was 2-3 day after the corolla opening. The natural outcrossing rate was 81.9%. F. cirrhosa is a typical xenial plant.

BACKGROUNDWith the development of social industrialization and aging of the population, patients with lung cancer have the tendency of becoming youthful and elderly, therefore the way of treatment should be also changed. In resent years, lung cancer in young and elderly patients have been reported respectively, but simultaneous contrast analysis of clinical feature and prognosis in elderly, normal and youthful patients have been rarely reported. Based on the clinic data in the patients, the clinical feature and prognosis of patients with non-small cell lung cancer at different ages were analyzed.

METHODSFrom January 1996 to January 2003, 1380 patients with NSCLC were treated surgically in thoracic department in our hospital, the patients were divided into three group based on their age, group 1 (G1) (range ≤40), group 2 (G2) (range 41-69), group 3 (G3) (range ≥70). The clinical feature and prognosis were analyzed in each group.

RESULTSThe mean age in the whole group was 58.16±0.26, and 35.76±0.57 (range 12-40) in G1, 58.00±0.22 (range 41-69) in G2, 72.30±0.21 (range 70-80) in G3. The ratio of lung cancer in female between G1 and G3 was significant different (P=0.024). The coexisting diseases in G3 were more common than those of other groups (P=0.000). Squamous cell carcinoma was the main type in histology, accounting for 41.79% (28/67), 54.12% (644/1190) and 58.54% (72/123) in each group respectively (P=0.080), but the ratio of adenocarcinoma, higher than that of other groups, were 43.28% (29/67), 29.50% (351/1190) and 26.82% (33/123) (P=0.036). Lobectomy and pneumonectomy were the main surgical procedures, accounting for 58.21%, 65.29%, 78.86% (P=0.004) and 34.33%, 26.22%, 12.20% (P=0.001), respectively. The ratio of stage III were 43.28% (29/67), 38.82% (462/1190), and 26.02% (32/123) in each groups (P=0.015). 55.22% (37/67) in G1 received adjuvant chemotherapy, 47.48% (565/1190) in G2, and 29.27% (36/123) in G3 (P=0.000). 5-year survival rate was 38.96% in the whole group, 29.99% in G1, 39.61% in G2, and 37.99% in G3 (P=0.494).

CONCLUSIONSIn young patients with non-small cell lung cancer, female and adenocarcinoma make up the majority of the number, and a lot of patients are in advanced stage and likely to adopt adjuvant chemotherapy. While in elderly, squamous cell carcinoma accounts for the majority of the number, and more coexisting diseases are accompanied, much more complications occur after surgical procedure. Nevertheless, their prognosis has no significant difference.

BACKGROUNDThere are many factors that affect the prognosis of non-small cell lung cancer (NSCLC). This study aims to analyze the influential factors and prognosis in patients with NSCLC following operation.

METHODSFrom January 1996 to January 2003, 1380 patients with NSCLC treated surgically were retrospectively studied. The correlation between clinicopathological characteristics and prognosis was evaluated by univariate and multivariate analyses.

RESULTSIn the whole group, 1-, 3- and 5-year survival rate was 78.85%, 49.78% and 38.96% respectively, and median survival time (MST) was 38.77 months. According to univariate analysis, tumor size, pathologic type, clinical type (central or peripheral), TNM stages, lymph node involvement, surgical procedure, postoperative chemotherapy, and cycles of chemotherapy were significantly related to the survival of patients. By multivariate analysis, tumor size, TNM stages, lymph node status and postoperative chemotherapy were independent prognostic factors.

CONCLUSIONSTumor size, TNM stages, lymph node involvement and postoperative chemotherapy are independent prognostic factors for NSCLC following the surgical procedure.

BACKGROUNDTo summarize the operative indication, surgical technique and perioperative ma-nagement of resection and reconstruction of carina for advanced lung cancer involving the carina.

METHODSThere were 67 patients with lung cancer invaded the carina, right central lung cancer in 46 cases, peripheral lung cancer in 4 cases, involved superior vena cava (SVC) or with bilateral anonymous veins in 11 cases, left central lung cancer in 17 cases, respectively. Surgical procedure included carinal right pneumonectomy or lobectomy in 50 cases, concomitant replacement of SVC or with bilateral anonymous veins with vascular prosthesis in 11 cases, carinal left pneumonectomy in 17 cases. Follow-up was performed in long-term.

RESULTSPerioperative death occured in 8 cases (11.94%), circulatory failure in 6 cases (8.96%), and respiratory failure in 2 cases (2.99%). The overall 1-, 3- and 5-survival rate was 77.21%, 48.23% and 32.54% respectively.

CONCLUSIONSComplete resection and reconstruction of carina, SVC or bilateral anonymous veins combined with postoperatively multiple modality therapy can get good prognosis for the patients with advanced lung cancer.