Twenty-four cases out of 374 cases having operations to resect carcinoma of the esophagus developed respiratory complications. 16 cases of the 24 developed acute respiratory failure, of which 8 cases died. The contributing factors to the development of acute respiratory failure were operative hypotension, extensive trauma and long duration of the operation, aspiration through a cervical fistula, and infection of the thoracic cavity. Prevention of these complications from occurring can definitely decrease the incidence of acute respiratory failrue, and is also one of the important links to reduce the mortality of the operations to resect esophageal carcinoma.

The paper presents the experience of colonic interposition for scar stricture of the esophagus caused by corrosive injures in 30 cases in the past ten years. The caustic agent was lye in 27 cases (90) and acid in 3 cases (10%), in them two patients had severe gastric lesion. All cases were treated by the substernal colonic interposition procedure. The anastomotic sites were in the neck in 26 cases and in the pharynx in 4 cases. In this series transplantations with left part of colon were in 24 cases and right part of colon in 5 cases, and one case was undiscribable. There were 17 postoperative complications (56.7%) and two postoperative deaths. The commonest complication was cervical fistula (7 cases, 23.3%) and the most critical complication was part or complete necrosis (2 cases), one death was directly related to it. The most frequent cause of lye ingestion in Chongqing area and successful repair of anastomotic stenosis with flap of platysma myoides are also discussed in this paper.

Objective Tumor vessels were foundation of tumors’formation,growth and metastasis,and the destruction of a spot of them would lead to wide avascular necrosis of tumor cells,so the specific killing effect on tumor vasculature endothelial cells had become one of the most important strategies for tumor therapy. Endostar,a novel recombinant human endostatin expressed and purified with an additional nine-amino acid sequence,is a new anti-drug. This study aimed to determine how endostar to affect the behavior of endothelial cells and tumor endothelial cells in vitro and in vivo. Methods Human umbilical vein endothelial cells ( HUVEC) was isolated and cultured followed by identification with Ⅷ factor related antigens. The cells differentiated into tumor-derived endothelial cells ( Td-ECs) by co-culturing with supernatants of A549 cells. The anti-effect of endostar on Td-ECs was detected with MTT assay,cell migration assay,flow cytometry and TUNEL assay. Results Endostar had a significant effect on the proliferation of Td-EC in a time-and concentration-dependent manner. At the same time,though Endostar at a certain concentration inhibited cell migration process significantly,arrested the cells at G0 /G1 and S phases and induced cell apoptosis ( P 0. 05) . Conclusion Our study indicates a novel function of endostar,to inhibit and Td-ECs proliferation in vitro. So,using endostar for cancer therapy is worthwhile for further study in clinical trials.

Objective To retrospectively review the experience of esophageal manometry and 24-hour pH monitoring in esophagus surgery. Methods From 1982 to 2010, patients with unspecific chest pain and undergone esophageal surgery were received esophageal manometry and 24-hour pH monitoring. Results Among the patients with unspecific chest pain, 70.4%(74/105) were diagnosed as esophageal origin. Lower esophageal sphincter pressure (LESP) can be continuously maintained by using 360° fundoplication. Only a minority of patients who underwent transabdominal esophagocardiomyotomy and partial posterior fundoplication had acid reflux postoperatively. Incidence rate of achalasia of upper esophageal sphincter (UES) and pharyngeal "shoulder wave" in side-to-side stapled anastomosis is significantly lower than in traditional hand-sewn anastomosis,as well as contractive pressure in anastomosis region and occurrence of swallow discomfortableness. There is a high pressure region at the esophageal entrance in patients with bilateral platysma muscle flap for cervical esophagus defect following removal of hypopharynx cancer. And the pressure of the region is significantly lower than in healthy controls. Basal pyloric pressure and peak pressure of pylorus in phase Ⅲ of the migrating motor complex increased significantly after gastric conduit was made and anastomosed, but decreased appreciably following pyloric digital fracture. Peak pressure, frequency and duration time of isolated pyloric pressure wave ( IPPW ) decreased after pyloric digital fracture significantly. Conclusion Esophageal manometry and 24-hour pH monitoring are important tools for and diagnosing unspecific chest pain and evaluating the outcome of new surgical procedures.

Objective　To explore the expression of Fas ligan d (FasL) protein in human non-small cell lung cancer (NSCLC) and its clinic al significance. Methods　Expression of FasL protein was detecte d by immunohistochemical method in 32 resected tumors of NSCLC. Results 　FasL protein was detected in all of these 32 resected tumors with variant pos itive expression levels ranging from 3.0% to 98.7% ［mean (62.0±32.0)%］. T here wa s significant difference between the tumors of different pathological types no s ignificant difference was found between the tumors of different differentiation nor among the tumors of different pTNM stages (P>0.05). Conclusion　 The results indicated that NSCLC can counterattack the immune cells of t he body and may be the molecular basis for the easily metastasis of adenocarcino ma to in the early stage.

Objective To study the clinical significance of cryoanalgesia of intercostals nerves for relieving the chest pain and the stress after thoracotomy. Methods 166 patients undergone post-lateral thoracotomy were enrolled for study, including 107 cases of cryoanalgesia of intercostals nerves as cryo-group and 59 cases of non-cryoanalgesia as control group. The patients who had exploratory thoracotomy were excluded. The visual analogue scales (VAS), dosage of dolantin as well as the plasma levels of cortisol and ?-endorphin, and the complications after operation between the two groups were compared and analyzed. Results After operation, the VAS of cryo-group was much lower than that of control group for 7 days, so did the dosage of dolantin during the first 3 days. The complications in the control group were much more than that in the cryo-group who had lower levels of cortisol and ?-endorphin in plasma. Conclusion Cryoanalgesia of intercostals nerves was proved to be a simple, inexpensive, safe form for relieving post-thoracotomy pain. It could not only dramatically relieve the pain and stress level, but also reduce the risk of complications especially in elderly patients.

0.05) in the two periods,the ratio of tracheostomy was significantly higher (P

Objective To summarize the experience and the outcome of the reconstructive operation with colon or stomach for scarred stricture after esophageal burns. Methods This retrospective report reviews the clinical history of reconstructive operation with colon or stomach for scarred stricture after esophageal burns. 74 cases underwent esophageal reconstruction by colon without resection of scarred esophagus, 26 cases esophagogastric reconstruction with resection of scarred esophagus. Results In the group reconstructed with colon there were 5 postoperative deaths, including mediastinal infection caused by necrosis of transposition colon in 2 cases. Other postoperative complications included cervical anastomotic leakage in 14 cases and anastomotic stenosis in 4 cases. In the group reconstructed with stomach, there was no operative death and only 2 anastomotic stenosis and one empyema occurred after operation. Conclusion The proximal esophageal scarred stricture beyond the lower edges of aortic arch could be replaced by colon bypass without resecting the scarred esophagus. The esophagogastrostomy could be performed after excising scarred esophagus with the anastomosis can be made below the aortic arch. The postoperative complications in the group of reconstruction with colon were higher than the group of reconstruction with stomach. Improvement in surgical technique may decrease the complication rate of reconstruction with colon.

Objective To evaluate the therapeutic effect of single-sided lung volume reduction surgery (LVRS) with different resection volumes on obstructive emphysema in rabbit. Methods Obstructive emphysema was reproduced in 50 New Zealand white rabbits with smog and elastase, and they were randomly divided in equal number into emphysema (A), small volume LVRS (B), moderate volume LVRS (C), large volume LVRS (D), and shame operation (E) groups. LVRS with different resection volumes was carried out groups B, C, and D. Pulmonary functions, artery blood gas analysis and pulmonary histology were determined 8 weeks later. Results Compared with those in group A, vital volume (V T), 0.3 second forced expiratory volume (FEV 0.3), FEV 0.3/FVC (forced expiratory capacity), PaO 2, density of alveolar septum (Ds) and number of alveolus (Na) were increased postoperatively, and PaCO 2, total lung capacity (TLC), functional residual capacity (FRC) and diameter of alveolus (Da) were decreased in group C (P0.01). Morphological improvements of emphysema were noticed under naked eye and optical microscope only in C group. Conclusion Single-sided LVRS with appropriate resection volume can improve effectively obstructive pulmonary emphysema in rabbit.

Objective To study the feasibility and efficacy of operative method of maximal thymectomy by video-assisted thoracoscopic surgery(VATS)for myasthenia gravis(MG).Methods From August 2005 to June 2007,27 patients with MG received maximal thymectomy by VATS(VATS group).The thymus and fat tissues in the anterior and upper mediastinum were resected.Patients who received transsternal thymectomy from May 2004 to July 2005 served as a control(conventional group).Results In the VATS group,the maximal thymectomy by VATS was completed in 26 patients,one patient was converted to open surgery because of the injury to the brachiocephalic vein.Compared with the conventional group,the patients in the VATS group had fewer blood loss [(46.0?5.7)ml vs(120.0?18.8)ml,t=-19.231,P=0.000],lower level of analgesic requirement(3 vs 12,?2=7.068,P=0.008),and shorter postoperative hospital stay [(7.0?1.2)d vs(11.0?2.5)d,t=-7.379,P=0.000].There was no significant difference in the operation time,myasthenia gravis crisis,and surgical outcomes between the two groups.Conclusions Maximal thymectomy by VATS is feasible and safe for patients with MG.Patients have shorter hospitalization,less surgical trauma and pain,lower rate of complication,and quicker recovery after the treatment.Further studies are needed to investigate its long-term efficacy