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Objective To evaluate the safety and feasibility of totally thoracoscopic anatomic pulmonary segmentectomy (TTAS) for the treatment of the peripheral stage ⅠA non small cell lung cancer(NSCLC).Methods The study involved 50 consecutive patients undergoing totally thoracoscopic anatomic segmentectomy (TTAS) from September 2010 to November 2012 in the First People's Hospital affiliatied to Nanjing Medical University.The diameter of the tumors were less than 2 cm [(mean diameter(1.35 ±0.48) cm].All lymph node sampling of N1 and N2 were neglive,All patients received symtematic lymph node dissection.The pulmonary vessels were individually ligated,and the bronchi were closed using an endoscopic stapler.The intersegmental plane was identified using the demarcation between the resected(inflated) and preserved(collapsed) lungs.Staplers were used for intersegmental dissection.Results The mean operative time and intraoperative bleeding were (191.5 ± 50.4) min and (49.2 ± 54.6) ml respectively.The chest tube drainage duration was (3 ± 1) days.The number of stapler cartridges used for intersegmental division was 3.9 ±0.8.The mean number of lymph nodes and nodal stations dissected were 12.6 ± 2.8 and 6.0 ± 1.5 respectively.No mortality and complications were observed 30 days after the surgery.Further,no local recurrence or metastases were observed during follow-up.Conclusion Totally thoracoscopic anatomic segmentectomy(TTAS) is a feasible and safe technique.With systematic lymph node dissection,TTAS can be a reasonable therapeutic option for stage ⅠA NSCLC.
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Objective To investigate the effect of 15-deoxyspurgualin (DSG) on graft coronary arteriosclerosis (GCA) and the platelet-derived growth factor-A (PGDF-A) mRNA expression of graft myocardium after heterotopic heart transplantation and the possible mechanism. Methods The rat heterotopic heart transplantation model was developed. Two groups of Lewis rats ( n =7 in each group) underwent heterotopic heart transplantationin from Wistar-King donors and were treated with either DSG (5 mg/kg daily, DSG group) or cyclosporine A (10 mg/kg daily, control group). Histological examinations of rejection and coronary arteriosclerosis, as well as Northern blot analysis of graft PDGF-A mRNA expression were made 60 days after transplantation. Results No significant difference in the degree of rejection was found between the two groups. However, the degree of coronary arterial intimal thickening in the DSG group was significantly less than that in the control group ( P
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Objectives:Dose-response effect of nicorandil cardioplegia at various concentrations was studied to optimize its myocardial protective effect.Methods:Forty-eight isolated working rat hearts were divided into 6 groups randomly.They were group A:control (depolarized cardiac arrest with St.Thomas solution No.2),group B,C,E,F and G:hyperpolarized cardiac arrest (nicorandil concentration were 25,50,100,125 and 150μmol/L respectively).The hearts underwent a 120-minute hypothermic arrest (15±1)℃ with cardioplegia (40 ml/kg) and reinfused with cardioplegia (40 ml/kg) at interval of 30 minutes.Mechanical arrest time,cardiac functional recoveries,myocardial content of malondialdehyde (MDA) and ultrastructure were measured.Results:The protective effect of nicorandil cardioplegia was dose-related.Conclusions:The optimal concentration of nicorandil in cardiplegia may be 100μmol/L for myocardial protection.
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Objectives:To study the clinicopathological changes of mediastinum lesions. Methods:Specimens from 405 cases of mediastinum lesions from 1967 to 1997 were studied. Results:Sex ratio, male to female was 216 to 189, median age was 26 years. There were 230(56.8%) cases of tumors and tumor-like lesions, 172(42.5%) cases manifested with myasthenia gravis. Case composition, 113 cases of thymus lesion(49.1%), 36 cases(15.7%) of germ cell tumors, 30 cases(13.0%) of neurological neoplasm, 6 cases(2.6%) of lymphoma, and 29 cases(12.6%) of cysts. Location, 165 cases(71.7%) were in the front mediastinum in which thymoma was the commonest, 6 cases(2.6%) were in the middle mediastinum in which lymphoma was the commonest, 30 cases were from the posterior mediastinum in which neurological tumors were the commonest. Follicular proliferation of the thymus was observed in 145 cases(84.3%) of MG, and 27 cases did not(15.7%) . Thirty eight cases(22.1%) of MG were from thymoma, and 12 cases(7.0%) from microscopic thymoma. Conclusions: Prognosis of MG with thymus follicular proliferation was better than those without proliferation and thymoma, fortunately, most thymus with MG were follicular proliferative. Microscopic thymoma could be discovered on pathology. Thymus tumors consisted more than half of the mediastinum neoplasm, the incident of lymphoma was low.
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From late period of 1980, the treatment of lung volume reduction surgery (LVRS) of emphysema, which is a chronic respiratory disease of intermedicine traditionally, was rerisen. The history, indications, operative technique, postoperative management, present state and some controversies about LVRS were reviewed in this article.
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0.05 ). GLDH was significantly higher (P 0.05 ). The value of CK MB was significantly lower (P 0.05 ). Myocardium water content in group Ⅰ was the lowest among the three groups (P 0.05 ). Myocardial ultrastructure study showed that group Ⅰ was better protected than the other two groups, and group Ⅱ better than group Ⅲ. Stereological quantitative analysis determined by calculation of mitochondria area density revealed significant differences between the three groups, in which group Ⅰ was lower than group Ⅱ (P