Objective To investigate the efficacy of lateral lung volume reduction with small incision and ligation for the treatment of serious chronic obstructive pulmonary disease(COPD).Methods From April 1994 to May 2006,36 patients suffering from serious COPD complicated with severe emphysema underwent lateral lung volume reduction in our hospital.Small incision and ligation were used during the operation.Results After the surgery,6 patients developed pulmonary air-leak,and were cured after 180-minute to 5-day treatments(mean,1.6 days).No perioperative death in this series.One year after the operation,the patient had significantly higher FEV1 and PaO2,and lower TLC and RV than those determined preoperation [(839.9?76.0)ml vs(589.0 ?80.5)ml,t=18.451;(72?10)mm Hg vs(62?8)mm Hg,t=4.686;(5167.6?639.9)ml vs(6725.8?976.6)ml,t=8.116;(3062.4?722.0)ml vs(4329.6?669.9)ml,t=7.720;all P=0.000].In addition,they had significantly longer 6MWT than that before the operation [(306.0?24.8)m vs(223.8?36.7)m,t=11.135,P=0.000].Conclusion For the patients with COPD who had indications for lateral lung volume deduction,resection of emphysemic tissues by the procedure using small incision and ligation can improve their symptoms and physiological conditions.

This study was aimed to explore the possibility of reducing postoperative inflammatory response and lung injury degree by observing the effect ofTan-Re-Qing(TRQ) Injection on perioperative period of lung cancer patients complicated with chronic obstructive pulmonary disease (COPD). A total of 39 lung cancer cases complicated with COPD (phlegm-heat obstructing the lung) were randomly divided into the tested group of 18 cases and the control group of 21 cases. All patients underwent small incision surgery with video-assisted thoracoscopic surgery (VATS). The control group was treated with routine western medicine. TRQ injection was added in the tested group. On the preoperative 1D (T1), 1D after operation (T2), 3D after operation (T3), 7D after operation (T4), serum samples were collected for the determination of serum concentrations of TNF-α, IL-6, IL-8 and IL-10. At T1 and T2 time, there were no significant differences on levels of TNF-α, IL-6, IL-8 and IL-10 between two groups of patients (P > 0.05). At T3 time, levels of TNF-α, IL-6, IL-8 of the tested group were lower than that of the control group with statistical significance (P < 0.05). The level of IL-10 in the tested group was higher than that of the control group with statistical significance (P < 0.05). At T4 time, the levels of TNF-α, IL-6 and IL-8 of the tested group were lower than that of the control group with statistical significance (P < 0.05). The levels of TNF-α, IL-6 and IL-8 of both groups gradually declined at T3 and T4 time, compared with T2 time level with statistical significant (P < 0.05). It was concluded that TRQ injection reduced the releasing of inflammatory cytokines during perioperative period, increased levels of anti-inflammatory cytokine, thereby reducing the degree of inflammatory reaction and relieving lung injury for the protection of lung function of lung cancer patients complicated with COPD.

OBJECTIVE:To investigate the effect of different doses ambroxol hydrochloride on lung protection of patients in perioperative thoracotomy. METHODS:60 patients in perioperative thoracotomy were randomly divided into control group(30 cas-es)and observation group(30 cases). Control group received 30 mg Ambroxol hydrochloride injection from 1 week before surgery to 1 week after surgery,adding into 100 ml 0.9% Sodium chloride injection,intravenously,twice a day. Observation group re-ceived 300 mg Ambroxol hydrochloride injection from preoperative 1 week to postoperative 1 week,adding into 100 ml 0.9%Sodi-um chloride injection,intravenously,twice a day. All patients received the second-generation cephalosporin antimicrobial drugs for anti-infection after surgery. lung surfactant-associated protein A(SP-A),intercellular adhesion molecule(ICAM-1)levels preopera-tive 1 week and postoperative 1 week,and incidence of postoperative complications in 2 groups were observed. RESULTS:Preop-erative 1 week,there were no significant differences in the SP-A and ICAM-1 in 2 groups(P>0.05). Postoperative 1 week,SP-A and ICAM-1 in control group and ICAM-1 in observation group were significantly higher than preoperative 1 week,but SP-A and ICAM-1 in observation group were lower than control group,the differences were statistically significant(P<0.05),there were no significant differences in SP-A in preoperative 1 week and postoperative 1 week(P>0.05). The incidence of postoperative compli-cations in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CON-CLUSIONS:The effect of high-doses ambroxol hydrochloride on lung protection of patients in perioperative thoracotomy is signifi-cantly superior to small dose,which can reduce the incidence of lung complications.

OBJECTIVETo investigate whether telomerase activity, human telomerase RNA (HTR) and human telomerase reverse transcriptase (HTERT) expression were associated with tumor development in lung cancer and whether telomerase is regulated at gene level or transcriptional level.

METHODSExpression of HTR and HTERT was detected by reverse transcription-polymerase chain reaction (RT-PCR) in 68 human lung cancer and in 68 adjacent-neoplatic lung tissues. And telomerase activity was examined by a quantitative telomeric repeat amplification protocol (TRAP).

RESULTSIn 68 lung cancer tissues, telomerase activity, HTR and HTERT were expressed in 79%, 98.5% and 91.2% respectively, whereas all adjacent non-neoplastic lung tissues were telomerase negative. Most normal lung tissues expressed HTR (91.2%) and HTERT was detected in only 7 of 68 non-neoplastic tissues.

CONCLUSIONSThe relatively high frequency of telomerase activity in lung cancer whereas the detection of no telomerase activity in normal lung tissues suggested that telomerase may play an important role in tumorigenesis of lung cancer. Compared to HTR, HTERT expression was better associated with telomerase activity with a concordance of 88.9%. Telomerase activity may be regulated at transcription level or translation level.

DNA-Binding Proteins ; Gene Expression Regulation, Enzymologic ; Gene Expression Regulation, Neoplastic ; Humans ; Lung Neoplasms ; enzymology ; genetics ; RNA ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Telomerase ; genetics

BACKGROUNDTo investigate the relationship between the telomerase activity and telomerase component expression in lung cancer, and to explore whether telomerase activity is regulated at the gene or transcriptional level.

METHODSExpression of the hTR and hTERT were detected in 68 human lung cancer tissues and responsive adjacent non-neoplastic lung tissues by semi-quantitative reverse transcription-polymerase chain reaction. Telomerase activity was detected by telomeric repeat amplification protocol.

RESULTSIn 68 lung cancer tissues, the positive rate of the telomerase activity, hTR and hTERT expression were 79.4% (54/68), 98.5% (67/68) and 91.2% (62/68) respectively. Whereas most adjacent non-neoplastic lung tissues expressed hTR (62/68, 91.2%) also, hTERT was detected in only 7 (10.3%) normal lung tissues and no telomerase activity were detected in the 68 non-neoplastic lung cancer tissues. As compared with hTR, hTERT expression was closely related to telomerase activity. The concordance was 89.0% (121/136), whereas the concordance between telomerase and hTR was 43.4% (59/136).

CONCLUSIONSThe results suggest that telomerase may play an important role in tumorigenesis of lung cancer. Telomerase activity may be regulated in transcription level or translation level.

Objective To summarize our experience in surgical intervention of patients with mediastinal hemangioma.Methods From January 1994 to August 2017,18 patients underwent surgical treatment were diagnosed with mediastinal hemangioma in our department.There were 9 females and 9 males,with the average age of(50.9 ± 14.0) years.Seven patients were seen with signs and symptoms related to the tumor,and the other 11 patients had no symptom.Three cases were located in the anterior mediastinum,1 case in the middle mediastinum and 14 cases in the posterior mediastinum.All of the cases experienced chest computed tomography(unenhanced or contrast-enhanced CT scan).Most mediastinal hemangiomas manifested as well-marginated masses at CT.Seven hemangiomas showed heterogeneous enhancement at contrast-enhanced CT.Calcifications were demonstrated in 2 patients.Preoperative diagnosis was not confirmed in all patients.Two cases were suspected to be hemangioma preoperatively,other cases were suspected to be thymoma,neurofibroma or malignancy.Eight cases were treated by video-assisted thoracic surgery approach,3 of those converted to thoracotomy due to high risk of hemorrhage.Ten cases experienced traditional thoracotomy.Results Seventeen patients had total excision,but one experienced biopsy because of hemorrhage.There were no operative death and major complications.The average operation time was(105.0 ± 49.6) minutes,and the average blood loss was(111.7 ± 138.9) ml.The postoperative hospital stay was (4.7 ± 3.5) days on average.Follow-up time ranged from 1 to 18 months(median,9.6 months).No recurrence was found in the patients with total excision at the time of follow-up.The patient undergoing biopsy showed no progression of the disease for 12 months.Conclusion Mediastinal hemangiomas were rare tumors,without relatively specific clinical manifestation.Calcification and phleboliths on CT scan were helpful in suggesting the vascular nature of the mass.Preoperative diagnosis of mediastinal hemangioma was usually very difficult.Mediastinal hemangiomas were mainly treated by surgical approach and had good prognosis.