Objective To observe the clinical effect of hyperbaric oxygen and electrocoagulation in the treatment of venous ulcers on legs.Methods 36 patients with venous ulcer on legs were divided into group A of 12 cases,group B of 12 cases and group C of 12 cases.Group A was treated by hyperbaric oxygen and electrocoagulation;group B was treated by hyperbaric oxygen;group C was treated by electrocoagulation.The operation method:every one had been performed electrocoagulation,and performed improved Linton operation if traffic vein valve had functional disorder,and performed wearing ring operation if vein reflux exceed Ⅲ °.Results The time of healing:group A was ( 18.00 ± 4.66) days,group B was (28.20 ± 6.42 ) days and group C was (31.32 ± 4.88 ) days.The time was significantly different between the two groups( A and B,P ＜0.01 ;A and C,P ＜0.01 ; B and C,P ＜ 0.05).29 cases had been investigated by 6 to 40 months,the venous ulcers on legs had no recurrence.Conclusion The treatment for venous ulcer on legs by hyperbaric oxygen and electrocoagulation was a new therapy which had advantage of healing quickly and less recurrence,It ought to be popularized.

Objective To discuss the etiology and treatment of extrahepatic biliary stenosis due to iatrogenic bile duct injuries. Methods A total of 12 cases of extrahepatic biliary stenosis after iatrogenic bile duct injuries(including 5 cases of open cholecystectomy and 7 cases of laparoscopic cholecystectomy) from January 1998 to January 2005 in this hospital was reviewed.After the establishment of a percutaneous transhepatic access,choledochoscopic stone removal,balloon dilatation,and drainage stent placement were performed for treating biliary stenosis.Results A F_(20) Gruntzig balloon catheter was employed for bile duct dilatation.The plastic drainage stent at 6~8 mm in diameter was successfully placed after 2 times of dilatation in 8 cases and after 3 times of dilatation in 4 cases,for 6~12 months of indwelling.Follow-up observations in the 12 cases for 2~3 years (mean,2.6 years) found no abdominal pain,fever,or jaundice.B-ultrasonography and MRCP findings showed no biliary stenosis and recurrent stones.Conclusions Choledochoscopic stone removal,balloon dilatation,and drainage stent placement are minimally invasive,safe,and effective in the treatment of extrahepatic biliary stenosis.

Objective To investigate methods and effects of percutaneous choledochoscopy via cholangio-jejunal anastomotic stoma in the treatment of recurrent intrahepatic biliary duct stones. Methods Eight cases of recurrent intrahepatic biliary duct stones after a Roux-en-Y cholangiojejunostomy from January 2000 to February 2005 were treated with percutaneous choledochoscopy. An enterostomy was made at the afferent jejunal loop. Then a choledochoscope was introduced into the intrahepatic biliary ducts by way of the cholangio-jejunal anastomotic stoma for stone removal and intrahepatic duct or anastomotic stoma dilatation. Results The intrahepatic stones were thoroughly removed in all the 8 cases. The biliary duct stenosis in 4 cases and the anastomotic stoma stenosis in 2 cases were relieved. Follow-up checkups in the 8 cases for 1~3 years revealed no recurrence of intrahepatic stones or stenosis. Conclusions Percutaneous choledochoscopy via cholangio-jejunal anastomotic stoma is minimally-invasive, safe, feasible, and effective in the treatment of recurrent intrahepatic biliary duct stones.

Objective To investigate the clinical significance of intraperitoneal perfusion of IL-2 combined with Addi injection for ascites re-growth control after decompression of abdominal compartment syndrome induced by malignant ascites.Methods 69 patients with abdominal compartment syndrome induced by malignant ascites,after tube decompression and paracentesis,were given intraperitoneal perfusion therapy,and they were randomly divided into two groups.42 cases in the observation group were given with 0.9％ sodium chloride injection 50mL + IL-23 millions u and Addie injection 50-60mL,once a week,a total of 2-3 times;27 cases in the control group were given with 0.9％ sodium chloride injection 50mL and cisplatin 40mg,once a week,a total of 1-3 times.Results In the observation group,CR 25 cases (59.5％),PR 11 cases (26.2％),NC 6 cases (14.3％),the total effective achieved in 36 cases (85.7％).In the control group,CR 11 cases (40.7％),PR 6 cases (22.2％),NC 10 cases (37.0％),the total effective achieved in 17 cases (62.96％).The effective rate of the observation group was significantly better than that of the control group,there was statistically significant difference(x2 =4.78,P ＜ 0.05).The qualities of life of the observation group were improved,8 cases were stable,lower in 2 cases,the effective rate was 76.2％,which of the control group were improved,10 cases were stable,lower in 4 cases,the effective rate was 48.1％.The effective rate of the observation group was significantly better than that of the control group,there was statistically significant difference (x2 =5.70,P ＜ 0.05).Conclusion Intraperitoneal perfusion of IL-2 combined with Addi injection for ascites control after decompression of abdominal compartment syndrome induced by malignant ascites is a new method,which is worthy of clinical application.

Objective: To investigate the anti-tumor efficiency of B16 melanoma HACs in vivo and in vitro.Methods: Tris-HCI extract and Sephacryl S-200 gel filtration were applied to prepare B16 HACs, and the cytolokicity of specific CTL induced by HACs was tested. Results: The 41, 47 and 53 tube HACs obtained by gel filtration could decrease the tumor incidences, delay the time of tumor development and decrease the mortalitites of mice.Conclusion:60 ~ 97 kD HACs from B16 melanoma cytosol have the activites of inhibiting tumor and could be used in effective anti-tumor therapy.

Objective To explore the anti-tumor effects of Egr-IFNγ gene therapy combined with 125I-UdR radionuclide therapy in mice bearing H22 hepatocarcinoma and its mechanism. Methods The recombinant plasmid pcDNAEgr-IFNγ mixed with liposome was injected into tumor. 48 h later, 370 kBq 125I-UdR was injected into tumor. The tumor growth rates at different times were observed. After 3 d gene-radionuclide therapy, the concentration of IFNγ in cytoplasm of H22 cells and cytotoxic activities of splenic CTL of the mice in different groups were examined. Results The tumor growth rates of pcDNAEgr-IFNγ +125 I-UdR group were obviously lower than those of control group, 125I-UdR group and pcDNAEgr-1 +125I-UdR group 6-15 d after gene-radionuclide therapy. IFNγ protein was found in cytoplasm of H22 cells in PcDNAEgr-1FNγ+125I-UdR group after 3 d gene-radionuclide therapy. Cytotoxic activity of splenic CTL in pcDNAEgr-IFN7 + 125I-UdR group was significantly higher than that in the other groups (P<0.01). Conclusions The anti-tumor effects in vivo of pcDNAEgr-IFNγ gene therapy combined with 125I-UdR radionuclide therapy are better than those of 125I-UdR therapy.

Objective To investigate the incidence and CT imaging features of abdominal splenosis with a previous splenectomy.Methods 94 consecutive patients with a history of splenectomy underwent abdominal contrast CT examination between April 2010 and December 2012 and were recruited for this study.These patients were devided into two groups according to the reason for which splenectomy was performed.Descriptive statistics were calculated for clinical incidence of abdominal splenosis,and subsequently CT imaging features and diagnosis of abdominal splenosis were discussed.Results In this series,29 cases (30.85％) with abdominal splenosis were found in 94 patients.Abdominal splenosis was found in all of 20 cases with more than one year history of posttraumatic splenectomy,and in 17.31％ (9 of 52) of cases with more than one year history of non-traumatic splenectomy (P ＜ 0.05).There were 60 nodules found on CT examinations in these 29 cases.All nodules were 50 mm or smaller.All nodules appeared of homogeneous soft-tissue density on plain CT scan.The nodules showed significant enhancement during arterial phase on postcontrast CT scan,with continuous significant homogeneous enhancement during portal venous phase.Conclusions Abdominal splenosis following posttraumatic splenectomy are more common than previously suggested.Knowledge of typical CT imaging appearances and the history of splenectomy may prevent mistaking as tumors.

The clinical evidences of the guideline came from clinical trials based evidence-based medicine. Applied principle of the evidence was: systematic reviews, RCTs, the results from multiple factors ana-lysis, consensus, especially combined with Chinese experience and some lung cancer guidelines used in USA or Europe. All doctors who use the guideline in making therapeutic strategy must combine patients' conditions with the knowledge of biological behavior, dynamic change and response to treatment of lung cancer.

Objective:Immune checkpoint inhibitors have a high remission rate in the preoperative application of resectable and potentially resectable non-small cell lung cancer when combined with chemotherapy. For the unresectable stage Ⅲ non-small cell lung cancer, whether the transformation can be achieved through this regimen to provide opportunities for surgical resection is controversial. In this study, we evaluated the pattern of transformation therapy by reviewing the efficacy and safety of preoperative therapy and surgery of this group.Methods:A review of 23 patients undergoing surgical resection after transformation therapy by preoperative immunotherapy combined chemotherapy between November 2019 and November 2021 was performed. All patients must clarify the pathological diagnosis of non-small cell lung cancer by biopsy. After the multi-disciplinary treatment team and preoperative imaging assessment, the diagnosis should be consistent with unresectable stage III as described in the Expert Consensus on Multidisciplinary Management of Stage Ⅲ Non-Small Cell Lung Cancer, 2019 Edition. After 2 to 4 cycles of preoperative anti-PD-1 monoclonal antibody combined with chemotherapy, the surgical team assessed the chance of resection and performed surgery. Important indicators such as surgical resection rate, R0 resection rate, MPR, pCR, incidence of grade 3-5 adverse reactions and various other perioperative data were counted.Results:In the whole group, initial imaging evaluation was 10 of stage cⅢA and 13 of stage cⅢB.15 cases had multiple stations N2 lymph nodes metastasis, 9 had enlarged fused N2 lymph nodes metastasis, 6 had large vessel invasion(T4), and 1 had contralateral mediastinal lymph node metastasis(N3). After preoperative neoadjuvant therapy, 17 cases achieved PR, 3 achieved SD and 3 achieved PD. The surgical resection rate of the whole group was 91.3%(21/23, 1 lobectomy combined with superior vena cava reconstruction, 2 sleeve lobectomy, 5 pneumonectomy, 12 lobectomy/combined lobectomy, 1 wedge resection and 2 unresectable cases), R0 resection rate was 95.2%(20/21). MPR was achieved in 13 cases, 8 of them reached pCR. There were no perioperative deaths, median surgical time was 260(190-460) min, median bleeding volume was 100(50-750) ml, median drainage time was 5(3-9) days, and median hospitalization was 7(5-11) days. Two cases got immunotherapy-related grade 3 adverse reactions, one was interstitial pneumonia and the other was immune-related injury involving the eye, oral and genital mucosa. Two cases got surgical complications and one was persistent lung leakage, which stopped after 46 days of conservative treatment; The other was pleural effusion, which was relieved after drainage.Conclusion:For the unresectable stage Ⅲ NSCLC, immunotherapy combined chemotherapy is an effective preoperative downstage method. It can convert 91.3% cases to resectable ones while achieving a good degree of pathological remission. Its side reactions are generally controllable and safety.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.