Objective To summarize the characteristics of diagnosis and surgical treatment of the leiomyoma of cardia.Methods The clinical data of 18 cases of leiomyoma of cardia confirmed by pathological examination was retrospectively analysed.Results Dysphagia,chest or epigastric pain and gastric hemorrhage were the most common presenting symptoms.The average course of disease was 9 months.Two patients was misdiagnosed as carcinoma of cardia before operation.Seventeen patients received partial gastric resection,one patient proximal subtotal gastrectomy.No surgical death and severe complications occurred in all patients.Conclusion Leiomyoma of cardia is a rare benign tumor.The differential diagnosis is important because it may be misdiagnosed as malignancy.Surgery is the most effective therapy to this disease.

Objective: To evaluate the effects of one lung ventilation on hemodynamics and blood gas during thoracoscopic surgery in piglets. Methods: Eight domestic pigs weighting (7.1±0.7) kg were included in this study. The anaesthesia was maintained with 1% isoflurance. After tracheotomy, an endotracheal tube was positioned in the left mainstem bronchus. Hemodynamic parameters as well as blood gas analyses were obtained using Swan-Ganz and arterial catheter. Results: During one lung ventilation, pulmonary artery pressure increased from (15.8±1.5) mm?Hg to (19.5±2.3) mm?Hg. Arterial oxygen saturation, blood gas analyses and other hemodynamic parameters remained unchanged. Conclusion: One lung ventilation was well tolerated in regard to hemodynamics and blood gas analyses in piglets.

Objective To investigate the changes and correlation between nuclear factor-?B (NF-?B) expression and brain water content (BWC) in perihematoma after experimental intracerebral hemorrhage (ICH) in rats. Methods Experimental ICH models of rat were made by injecting autologous blood using stereotaxic method. The expression of NF-?B in cerebral tissues was detected by immunohistochemistry technique. At the due time, BWC was measurement by day-wet method.Results NF-?B expression increased obviously at 6 h and peaked at 48 h in ICH group(P

Objective:To discuss the clinical and imaging features as well as the treatment and prognosis of primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. Methods:We retrospectively analyzed the clinical, imaging, and follow-up data of 13 patients with pulmonary MALT lymphoma in the Chinese PLA General Hospital from April 2000 to July 2012. Results:Of the 13 patients with pulmonary MALT lymphoma, 8 were male and 5 were female (1.6:1 ratio). The age of onset varies from 21 years to 67 years, and the median age is 59 years. The major clinical manifestations include chest discomfort in 6 cases, cough in 2 cases, fever in 2 cases, and chest pain in 1 case. Two cases had no observable discomfort. One patient suffered from Sj?gren's syndrome. The chest CT of the patients showed pulmonary consolidation with air bronchogram in 3 cases, patchy shadows in 3 cases, mass shadow in 4 cases, and ground-glass opacities in 4 cases. In addition, 10 cases showed bilateral pulmonary multiple changes, 4 showed mediastinal lymph node enlargement, and 1 showed pleural effusion. Operation was performed on 6 patients, 3 of which were given postoperative adjuvant chemotherapy. Four patients underwent chemotherapy involving the CHOP or R-CHOP regimen, whereas three patients received symptomatic and supportive treatment only. One case was lost to follow-up. The follow-up period ranged from 1 year to 11 years. In one patient, the disease progressed four years after the diagnosis, and the patient died after 11 years. One patient died from the side effects of chemotherapy. The remaining 10 cases were still alive and did not show any progression of the disease. Conclusion:The clinical feature of pulmonary MALT lymphoma is not typical. Thus, imaging techniques cannot detect specific changes. Surgical resection is vital in the diagnosis and treatment of this disease because it can help provide a clear diagnosis, particularly to patients with limited lesions and from which specimens could not be obtained using conventional methods. Moreover, the prognosis of this treatment is generally good.

Purpose To evaluate the correlation between T2-FLAIR hyperintense vessel sign (HVS) and the stenotic degree of internal carotid artery (ICA) and assess the HVS changes after the carotid endarterectomy (CEA). Materials and Methods Fifty-one patients with CEA were retrospectively enrolled. The stenosis of the bilateral ICA were as:≥90%, and<90%. The distribution of HVS locations was classified as three regions:sylvian fissure, sulci of temporo-occipital lobe and other areas. The presence and the location of HVS were counted. The extrension of HVS on T2-FLAIR were graded as:I:the presence of HVS was<1/3 of the MCA territory, II:the presence of HVS was≥1/3 of the MCA territory.χ2-test was performed for correlation between HVS and ICA stenosis. The difference of HVS and stenosis of ICA and their effects on CEA was accessed. Results HVS was significantly higher in the ICA stenosis more than 90%group than in the less than 90% group (χ2=23.584, P<0.001). The frequencies of HVS were 12, 34 and 15 in sylvian fissure, sulci of temporo-occipital lobe and other area, respectively. The proportion of grade II HVS was higher in the ≥ 90% group than in the<90% group (χ2=8.395, P<0.05). After CEA, HVS on 29 affected hemispheres were showed to be disappeared (n=24) or remained (n=5) in the treated side. Conclusion The presence and the grade of HVS were correlated with the stenotic degree of ICA. In the patients with ICA stenosis, HVS was most frequently found in the sulci of temporal lobe and occipital lobe, and seldom found in sylvian fissure. HVS disappeared after CEA indicating that HVS can be considered as a marker for CEA treatment.

Bronchial Fistula ; etiology ; Humans ; Pleural Cavity ; Postoperative Complications ; etiology ; Pulmonary Surgical Procedures ; adverse effects ; Surgeons ; Time Factors

Objective To evaluate the clinical effect of CT guided localization with a hook-wire system united with single port video-assisted thoracoscopic resection (VATS)for small ground glass opacity (GGO) pulmonary nodules (CT lesion diameter <1 .5 cm and no pleural changes).Methods Fifteen patients with small GGO pulmonary nodules who underwent CT-guided transthoracic localization with a hook-wire system in operation room after anesthesia were performed with single port VATS from August 2009 to March 201 3.The accuracy of puncture location,complications,resection rate and pathological results were evaluated.Results All patients underwent CT-guided hook-wire localization and single port VATS resection.The success rate of localization was 1 00%,and the average procedure time was (1 3.60 ±2.06)min,only 1 patient occurred mini-mal pneumothorax.The resection rate of single port VATS was 1 00%,and lobectomy performed in 1 patient, segmentectomy in 1 ,and local resection in 1 3.Pathological diagnosis:adenocarcinoma in situ in 9,atypical adenomatous hyperplasia (AAH)in 5,AAH and adenocarcinoma in situ in 1 .Post-operation follow-up showed all patients survived,and no recurrence and metastasis.Conclusion In operation,use of CT guided localiza-tion with a hook-wire system for small GGO pulmonary nodules (CT lesion diameter <1 .5 cm and no pleural changes)united with video-assisted thoracoscopic resection is accurate,quick and safe,and it has good clinical value.

OBJECTIVETo explore the causes, clinic diagnosis, treatment and prognosis of inflammatory myofibroblastic tumor (IMT) of the chest.

METHODSThe clinical data of 12 patients with IMT were retrospectively analyzed including 9 male and 3 female patients aged 36 to 81 years (mean 60.08 years). Five patients underwent pulmonary lobectomy and mediastinal lymph node dissection, 1 had partial lobectomy, 1 had mediastinal tumor resection and costectomy, and 2 received conservative treatment.

RESULTSAll the surgical patients recovered after surgery without lymph node metastasis detected by pathological examinations. In the follow-up lasting for 2 months to 5 years, no recurrence or metastasis occurred in these cases. In the 2 cases having conservative treatment, the tumor remained unchanged in one case at 3 month of follow-up and disappeared in the other case.

CONCLUSIONIMT in the chest is a rare benign tumor with a low incidence rate and malignancy. Pathological examination is reliable for definite diagnosis. Surgical operation is the primary therapeutic approach. All IMT patients should be closely followed up after the treatment.

Aged ; Aged, 80 and over ; Female ; Humans ; Lung Neoplasms ; diagnosis ; surgery ; Male ; Mediastinal Neoplasms ; diagnosis ; surgery ; Middle Aged ; Neoplasms, Muscle Tissue ; diagnosis ; surgery

Objective To evaluate the clinical effects of thoracic close drainage with thin drainage tube assisted to thick drainage tube after video-assisted thoracic surgery(VATS)lobectomy. Methods We ret-rospectively reviewed 89 patients received VATS lobectomy in Chinese PLA General Hospital from January 2014 to September 2014. The patients with non-small cell lung cancer were divided into two groups:treatment group (50 patients)and control group(39 patients). Treatment group took thin tube assisted to thick tube of thoracic close drainage and control group took general thoracic closed drainage tube. We studied the operation time,the bleeding of operation,the number of lymph node dissection,time of first activity out of bed,the hospitalization time of post-operation,post-operative complications,the days of post-operative drainage,drainage volume,the effect of drainage,the VAS evaluation score of post-operative pain in the two groups. Results Compared with control group,there was no statistical significance in the differences of the time of operation[(2. 58 ± 0. 57)h vs(2. 57 ± 0. 50)h;t = 0. 127,P = 0. 681],bleeding of operation[(108. 00 ± 52. 84)ml vs(114. 10 ± 107. 18)ml;t = 0. 352,P = 0. 334],the number of lymph node dissection[(14. 20 ± 5. 95)vs(11. 21 ± 4. 71);t = 2. 576,P = 0. 068)],the staying time of drainage[(5. 66 ± 2. 53)d vs(5. 82 ± 2. 02)d;t =0. 324,P = 0. 219],the postoperative drainage volume[(1 141. 76 ± 819. 26)ml vs(1 022. 95 ± 464. 84) ml;t = 0. 889,P = 0. 367]and the occurrences of the post-operative complications(8. 00% vs 10. 25% ;χ2 =1. 750,P = 0. 726). There was statistical significance in the differences of the post-operative time of off-bed [(11. 28 ± 8. 78)h vs(13. 97 ± 7. 83)h;t = 4. 027,P = 0. 045],the time from surgery to discharge [(8. 36 ± 2. 63)d vs(9. 56 ± 2. 89)d;t = 2. 952,P = 0. 043]and the drainage effect(costophrenic angle sharp:72. 0% vs 46. 2% ;χ2 = 5. 329,P = 0. 017). In the two groups,there were statistical significance differences in scores of VAS for the 24 to 72 hours resting and coughing of post-operation:24 h[(2. 78 ± 1. 13)vs(3. 74 ± 1. 68);t = 3. 226,P < 0. 001)],48 h[(1. 98 ± 0. 59)vs(3. 33 ± 1. 72);t = 5. 189,P <0. 001)],72 h[(1. 94 ± 0. 55)vs(3. 15 ± 1. 60);t = 5. 010,P < 0. 001)],coughing[(3. 64 ± 1. 23)vs (5. 33 ± 1. 95);t = 5. 005,P < 0. 001)]. Conclusion The thin drainage tube assisted to thick drainage tube for thoracic close drainage make the drainage more effective,release the pain,shorten the hopital stay;moreo-ver,it is simple and safe for operation and easy to popularize with high modified value.

Objective To study the clinical outcomes of robotic extended thymectomy and thoracoscopic extended thymectomy for thymoma patients with myasthenia gravis compared with conventional median sternotomy extended thymectomy.Methods The clinical data of thymoma patients with myasthenia gravis treated by extended thymectomy between June 2013 and June 2016 were retrospectively reviewed.The clinical outcome parameters were compared according to surgical approach.Results 41 thymoma patients with myasthenia gravis,8 cases underwent robotic extended thymecotmy,11 cases underwent thoracoscopic extended thymectomy and 20 underwent median sternotomy extended thymectomy.The resected extension included tumor,thymus tissue and adipose tissue in anterior mediastinum.There were no significant differences between robotic group and thoracoscopic group regarding operative time,blood loss,chest tube duration,hospital stay,postoperative complications and postoperative myasthenic crisis (P ＞ 0.05).The blood loss of robotic group and thoracoscopic group was significantly lower than that in median sternotomy group(P ＜ 0.05).The chest tube duration of thoracoscopic group was significantly shorter than that in median sternotomy group(P ＜0.05).The effective rates of MG after extended thymectomy in robotic group,thoracoscopic group and sternotomy group was 65.0％ 、69.2％ 、62.5％ respectively and there was no significant difference (P ＜ 0.05).Conclusion Robotic thymectomy and thoracoscopic thymecotomy are both minimal invasive surgery approach with less bleeding for thymoma patients with myasthenia gravis.The clinical outcomes of robotic thymectomy and thoracoscopic thymecotomy are similar.