Treatment of upper eyelid third-degree burns by dispersed implantation of very small autologous columnar skin grafts: A pilot study of a new method.

OBJECTIVE: This retrospective study compared the effectiveness of dispersed implantation of very small autologous columnar skin (SCS) grafts and full-thickness skin grafts (FTSGs) for treating upper eyelid third-degree burns. METHODS: Fourteen patients and 26 eyes with granulation tissue formed by third-degree upper eyelid burns were enrolled in the study from August 2017 to June 2020. The experimental group of 6 patients with 11 eyes was treated with SCS grafts. The control group of 8 patients with 15 eyes was treated with FTSGs. The survival rate of the grafts, healing time, SCS diameter, upper eyelid movement distance (ULMD), visual analogue scale (VAS) score for patient satisfaction, and Vancouver Scar Scale (VSS) score were evaluated. RESULTS: The difference in the survival rate between the two groups was not statistically significant (P = 0.06). The ULMD and VAS scores in the experimental group were higher than those in the control group (P < 0.05). The healing time was longer in the experimental group than in the control group (P < 0.05). The VSS scores of the donor site and the skin grafting site in the experimental group were lower than those in the control group (P < 0.05). CONCLUSION: Unlike classical skin grafts, SCS implantation surgery can restore the appearance of the upper eyelid, and there is no obvious scar at the donor site. This can be a viable alternative to traditional FTSGs with potential benefits.

Relation between bone mineral density, bone loss and the risk of cardiovascular disease in a Chinese cohort.

Cardiovascular disease (CVD) and osteoporosis share some common risk factors such as old age, smoking, alcoholic drinking, hypertension, diabetes mellitus, and hyperlipidemia. Although previous studies have investigated the association of bone mineral density (BMD) with CVD, the results were conflicting. There are limited studies on the association of BMD loss rate with CVD. We therefore conducted a 5-year prospective study to examine the relation among BMD, bone loss, and risk of CVD in a Chinese cohort. Of 9,657 community residents 30 to 75 years old, 6,092 were enrolled in the study and followed annually for 5 years. At baseline demographic data, BMD, smoking and drinking statuses, medical history, and blood samples were collected. Cox proportional hazards analysis was used to evaluate the association of BMD and incidence of CVD. Over the 5-year follow-up period, CVD developed in 118 subjects. Baseline BMD, bone loss rate, current smoking, daily alcoholic ingestion, and higher osteoprotegerin and leptin levels were independently associated with increased risk of CVD, whereas higher baseline adiponectin level was associated with decreased risk of CVD in women and men. In conclusion, uncovering the relation linking osteoporosis and CVD is important for understanding the pathogenesis of these 2 common disorders.

Association between the polymorphism of estrogen receptor α and coronary artery disease in a Chinese population.

BACKGROUND: The role of estrogen receptor α (ERα) polymorphism in coronary artery disease (CAD) was investigated previously in several populations. There are few data on relation between ERa polymorphism and CAD in Chinese population. Our study was to investigate the possible association between ERα polymorphism and CAD in Chinese population. METHODS: A total of 539 patients with CAD and 539 age and sex matched controls were examined for ERa polymorphism. DNA was obtained and ERa polymorphism was analyzed by the polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP). RESULTS: The frequencies of the PvuII C allele were significantly higher in CAD patients than in control individuals (P<0.05). Using T allele as a reference, the odds ratio for CAD patients with C allele was 1.24 (95%CI=1.03-1.48). Using TT genotype as a reference, the odds ratio for TC genotype was 1.17 (95%CI=0.90-1.50), and for CC genotype was 1.58 (95%CI=1.05-2.38). The odds ratio for CC genotype was 1.42 (95%CI=0.94-2.15) in women and 1.72 (95%CI=1.41-2.10) in men. There were no significant differences in XbaI allele and genotype between CAD patients and control individuals. CONCLUSIONS: The ERa PvuII polymorphism is associated with the increased risk of CAD in men of a Chinese population. Further research is needed to investigate the mechanism underlying the association between ERα polymorphism and CAD.

Prevention of stricture development after corrosive esophageal burn with a modified esophageal stent in dogs.

OBJECTIVE: We sought to test the feasibility and technical ease of a newly designed nitinol-based modified esophageal stent and its effects on preventing postcaustic stricture in mongrel dogs and to try to explain the result at the molecular level. METHODS: Twenty-four dogs were included in this controlled study. Stenosis index (wall thickness/intraluminal diameter), pathologic features, hydroxyproline quantities, esophageal compliance, and biomechanics were compared between the injured but unstented and stented dogs. Transforming growth factor beta1, Sma/Mad (Smad)3, and Smad7 mRNA expression and protein levels in esophageal tissue were detected by means of reverse transcriptase-polymerase chain reaction and Western blotting, respectively. RESULTS: The modified esophageal stent was able to be placed and retrieved successfully and conveniently and was not only intact but there was also no macroscopic esophageal mucosal injury after the stent removal 4 months later. In comparison with the injured but unstented group, esophageal compliance, biomechanics, and the stenosis index were significantly better in the stented group. Histopathologic study revealed that collagen bundles were thinner and its orientation tended toward a regular and parallel pattern. Transforming growth factor beta1 and Smad3 mRNA expression and protein levels increased and Smad7 mRNA expression and protein levels decreased significantly in esophageal tissue in the stented group. These variables showed no statistically significant difference 2 months after stent removal. CONCLUSIONS: The modified esophageal stent might be a promising stent in preventing stricture formation after corrosive esophageal burns clinically.

In vitro antitumor cytotoxic T lymphocyte response induced by dendritic cells transduced with DeltaNp73alpha recombinant adenovirus.

DeltaNp73alpha, the N-terminal truncated form of p73alpha is a candidate tumor antigen because of its selective expression in many human cancers and lack of expression in normal tissues. Therefore, we investigated the effects of dendritic cells infected with adenoviral DeltaNp73alpha (DNp73alpha) on breaking immune tolerance and induction of immunity against DNp73alpha-expressing (A549 lung cancer, K-562 leukemia) and non-expressing (MCF-7 breast cancer) cell lines. Immature dendritic cells generated in the presence of interleukin-4 and granulocyte/macrophage colony-stimulating factor from a human umbilical cord blood were transduced with a recombinant adenoviral (Ad) vector encoding full-length human DNp73alpha cDNA (Ad-DNp73alpha) or a control vector Ad-EGFP, using the centrifugal force method. Induction of DNp73alpha-specific CTL response was evaluated by a cytotoxic assay against the three human tumor cell lines with different DNp73alpha expression levels. The viability and activation status of transduced dendritic cells were assessed by flow cytometry. The dendrocyte/Ad-DNp73alpha-activated cytotoxic T lymphocytes showed significantly higher cytotoxicity against the cell lines A549/DNp73alpha, K-562 that expressed DNp73alpha than the DNp73alpha-null MCF-7 cells. The DCs/Ad-DNp73alpha showed higher survival rates than the DCs/Ad-EGFP or untransduced DCs, presumably due to the inhibition of cell death. These findings, with potential applications for immunotherapy, demonstrate that dendrocytes transduced with Ad-DNp73alpha can induce specific and sustained T cell responses against tumors expressing this variant p53-related gene.

[Analysis of the influence on the prognosis and safety of arginine in patients with severe trauma and burns--a multi-center randomized double blinded, placebo controlled, clinical trail in 86 patients].

OBJECTIVE: To observe the influence on prognosis and possible side-effects of arginine in METHODS: Multi-center clinical trial, randomized double blinded patients with severe trauma and burns. and placebo control methods were employed in the study. Eighty-six patients with severe trauma and burns were randomly divided into control (C, n = 45) and arginine treatment (Arg, n = 41) groups. The patients in Arg group received arginine in dose of 0. 4 g x kg(-1) x d(-1) orally, while those in C group received same dose of placebo (tyrosine) for 7 days. All the patients in both groups were given diet with equal calories and equal nitrogen content. The changes in the wound healing time, hospital stay, and the incidence of side-effects of the medication in both groups of patients were observed and compared before and after the supplementation of arginine. RESULTS: The wound healing time and hospital stay days of severe trauma patient in Arg group (n = 29) were 11. 1+/-2. 8 d and 19+/-6 d, which were all obviously shorter than those in C group (13. 2+/-5. 5 d, 22 +/-6 d, n =33, P <0.05). On the other hand, in severe burn patients there were no significant difference of the wound healing time (20+/-5 d vs 22+/-8 d, n = 12, P > 0. 05) and hospital stay days (28+/-6 d vs 29+/-8 d, n = 12, P >0. 05) between the Arg and C groups. In addition, in C and Arg groups, the occurrence of the side-effects were seldom (2. 44% vs 2. 22% , P = 1. 000) and it disappeared when the supplementation of drugs was stopped. CONCLUSION: Oral feeding of arginine is beneficial in enhancing wound healing, reduction of hospital stay days in severe trauma patients and with little side-effects, but it is not beneficial to improve the prognosis of severe burn patients. Maybe this is due to inadequate number of case involved in the study.

Lung volume reduction surgery allows esophageal tumor resection in selected esophageal carcinoma with severe emphysema.

BACKGROUND: Esophageal carcinoma patients with coexisting severe emphysema are high risk surgical candidates. We hypothesize that simultaneous unilateral lung volume reduction surgery (LVRS) allows us to offer esophageal tumor resection to patients previously considered inoperable. METHODS: Twenty-one patients with esophageal carcinoma were recruited. All patients had severe emphysema with impaired respiratory function and health-related quality of life (HRQL). Esophageal tumor resection with gastroesophagostomy in the thorax and then unilateral LVRS were performed at the same anesthesia. Dyspnea index, exercise capacity, pulmonary function, and HRQL were assessed at baseline and every three months up to one year postoperatively. RESULTS: There was no perioperative death or significant morbidity. Clinical improvements were observed at 3, 6, and 12 months, in terms of dyspnea index, forced expiratory volume in 1 second, residual volume, partial pressure of oxygen, arterial, partial pressure of carbon dioxide, arterial, 6-minute walking distance, dysphagia, and odynophagia (p < 0.01 or p < 0.05). The Karnofsky Performance Status score improved from baseline 36 +/- 3 to 53 +/- 3 at 3 months, 67 +/- 5 at 6 months, and 63 +/- 8 at 12 months (p < 0.01). Significant improvement was seen in all the Short-Form 36-item Health Survey HRQL domains at 3 months (p < 0.01 or p < 0.05). These improvements remained significant for up to 6 months, and for up to 12 months for physical functioning and general health. The Psychosocial Adjustment to Illness Scale score and all the scales were improved after surgery (p < 0.01). CONCLUSIONS: Our study shows that in selected patients with esophageal carcinoma who suffer from severe emphysema, simultaneous unilateral LVRS renders esophageal tumor resection safe and effective. Also, these patients may experience early improvement in pulmonary function and HRQL.

Effects of p73 gene overexpression on apoptosis and chemosensitivity of human lung adenocarcinoma cell line A549.

BACKGROUND & OBJECTIVE: It is important to overcome gene therapy resistance caused by wt-p53 in non-small cell lung cancer (NSCLC) . The p53 family member p73 is a p53 homolog. This study was to observe the apoptosis and chemosensitivity effect of p53-resistant human lung adenocarcinoma cell line A549 following wild-type p73 gene transfection alone or combined with chemotherapeutic agents. METHODS: Plasmids pcDNA3-HA-p53 or pcDNA3-HA-p73alpha were transfected into A549 cells with Dosper. Positive cell clones were selected using G418. The exogenous p53 or p73alpha gene expressions were examined by Western blot. MTT assay was used to analyze the response of transfected cells to cisplatin (DDP) or adriamycin (ADM). The drug-induced apoptosis of transfected cells was measured by flow cytometry, TUNEL technique and DNA fragmentation. The biological behavior change of transfected cells was investigated by colony formation assay. RESULTS: Transfected A549 cells stably overexpressed p53 or p73alpha. Low concentration of chemotherapeutic agents (6.25 micromol/L DDP or 0.25 micromol/L ADM) which had no obvious effects on non-transfected cells, suppressed p73-transfected cell growth significantly; the 50% inhibitory concentration (IC(50)) of DDP for A549 cells decreased from 22.65 micromol/L to 3.75 micromol/L, and the IC(50) of ADM decreased from 4.20 micromol/L to 0.06 micromol/L after p73alpha transfection. p73, but not p53, sensitized A549 cells to DDP and ADM: DDP-induced apoptosis rate was increased from 10.6% to 36.8% (P<0.01), ADM-induced apoptosis rate was increased from 13.0% to 41.1% (P<0.01) after p73 transfection. DDP and ADM significantly suppressed colony formation of p73-transfected cells compared with parental cells (P<0.01). The sensitive enhancement ratios for DDP and ADM were 2.0 and 2.4, respectively. CONCLUSIONS: Exogenous p73 gene enhances the sensitivity of A549 cells to chemotherapeutic agents by inducing apoptosis through p53-independent pathway. p73 gene could be used to treat p53-resistant tumors.

Prevention of stricture with intraluminal stenting through laparotomy after corrosive esophageal burns.

OBJECTIVE: We sought to present our experience in preventing esophageal stricture formation using modified intraluminal stenting in patients with caustic burns. METHODS: Between April 1976 and June 2005, 33 of 162 patients with corrosive esophageal burns were included in this study. Endoscopy was performed to define the degree of injury in all the patients but one. Among the 33 patients, 31 underwent modified esophageal intraluminal stenting through laparotomy 2-3 weeks after ingestion of corrosive agent and the remaining 2 patients underwent immediately after experiencing esophageal perforation. RESULTS: There was no death in this series. A 1-year-old child had aspiratory pneumonia because of poor compliance. The stent was removed without requiring anesthesia after it had been in situ for 4-6 months in the 33 patients. All the patients had a normal intake of food after removal of the stents, and stricture was not found on barium swallow. However, five patients had esophageal stenosis from 2 to 3 months during follow-up. One of them responded to esophageal bougienage, the remaining four patients required esophageal reconstruction and had a normal diet postoperatively. Twenty-four-hour pH monitoring in five patients showed that there was no gastroesophageal reflux. CONCLUSION: The modified esophageal intraluminal stent is able to prevent the formation of caustic esophageal stricture.

[Expression of ΔNp73 in human NSCLC and clinical implication].

BACKGROUND: ΔNp73 is an isoform of the p53 homologue p73, which lacks an NH2-terminal transactivation domain and antagonizes the induction of gene expression by p53 and p73. The aim of this study is to investigate the expression of ΔNp73 mRNA in non-small cell lung cancer (NSCLC) and to analyse its relations with clinicopathologic factors and prognosis. METHODS: Semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR) was used to detect the expression of ΔNp73 mRNA in 40 resected NSCLC specimens with the neighboring noncancerous tissue. The significance of ΔNp73 mRNA expression was analyzed statistically. RESULTS: ΔNp73 mRNA was highly expressed in lung cancer tissues (62.7%, 32/51) while negative in neighboring noncancerous tissue. The expression of ΔNp73 mRNA was associated with pathological TNM stage (P=0.046), but not associated with age, gender, histological type and differentiation status. Survival of patients with high ΔNp73 mRNA was significantly poorer than those with low ΔNp73 mRNA levels (P < 0.001). Multivariate analysis revealed that ΔNp73 mRNA levels were a significant prognostic factor, independent of the other conventional prognostic factors. CONCLUSIONS: NSCLC has overexpression of ΔNp73 mRNA, which is closely related to TNM stages and prognosis of patients with NSCLC. These results suggest that measurement of ΔNp73 mRNA levels in tumor tissues might be useful as a promising predictor for the prognosis of patients with NSCLC.

[Application of cardiopulmonary bypass during extended resection of locally advanced lung cancer].

BACKGROUND: Locally advanced lung cancer includes IIIA and IIIB lung cancer that tumors are localized within the chest and with no clinic and pathologic distal metastasis. In this study the results of extended resection of a portion of heart or great vessels with cardiopulmonary bypass was summarized in the treatment of locally advanced lung cancer. METHODS: Lobectomy or pneumonectomy combined with extended partial excision of the heart or great vessels were carried out in 10 patients with locally advanced lung cancer. The operations included aortic resection and reconstruction with left heart bypass in 2 cases, extended resection of left atrium with normal cardiopulmonary bypass in 5 cases, and resection and reconstruction of superior vena cava in 3 cases respectively. RESULTS: The patients had no operative complication except for one haemothorax, which was controlled by re-exploration. One patient died of brain metastasis 6 months after operation and another one died of multiple metastasis 26 months after operation. The others were alive. CONCLUSIONS: CPB is a safe and effective anesthetic procedure during extended resection of locally advanced lung cancer although it is controversial for aggravating operative trauma, complex technique and higher cost.

[Effect of p73 gene on chemosensitivity of human lung adenocarcinoma cells H1299].

BACKGROUND & OBJECTIVE: Recent studies have shown that wild-type p53 gene can enhance the chemosensitivity of the majority of non-small cell lung cancers. p73 gene and its homologue p53 gene have significant sequence and functional similarities. This study was designed to investigate the effect of p73 gene on chemosensitivity of human lung adenocarcinoma cells H1299. METHODS: The pcDNA3-HA-p73alpha plasmid were transferred into in vitro cultured human lung adenocarcinoma cell line H1299 with Dosper. The p73alpha positive cells which were resistant to G418 were selected out. The expression of exogenous P73alpha protein were examined by Western blot analysis. MTT assay were used to analyze the response of transfected cells to cisplatin (cDDP),adriamycin (ADM). The drug-induced apoptosis of transfected cells was measured by flow cytometry and TUNEL technique. The biological behavior changes of the cells were observed by colony formation assay. RESULTS: The transfected lung adenocarcinoma cell line H1299 overexpressed P73alpha protein stably. MTT assay showed that the IC(50) values for cDDP and ADM were reduced to approximate 86.2% and 99.2% in the transfected cells compared with the untransfected cells, respectively. The low concentration of chemotherapeutic drugs (1.25 micromol/L cDDP or 0.05 micromol/L ADM) without inhibition essentially suppressed the growth of the transfected cells markedly. The cDDP-induced apoptosis rate increased from 10.1% to 38.4%(P< 0.01). The ADM-induced apoptosis rate increased from 12.1% to 49.3%(P< 0.01). Colony-formation assays showed that the colony number in transfected cells was decreased significantly by chemotherapeutic drugs compared with parental cells(P< 0.01). The sensitive enhancement ratios for cDDP or ADM were 1.8 and 2.6, respectively. CONCLUSION: p73 gene was capable of enhancing the sensitivity of H1299 cells to chemotherapeutic drugs such as cDDP and ADM, and the increased sensitivity was associated with the induction of apoptosis undepend p53 gene. It suggests the possibility of using p73 gene combined with anticancer agents to improve the effectiveness of chemotherapy.

[The expression of p63 gene in human non-small cell lung cancer].

BACKGROUND: To investigate the expression of p63 gene and its significance in non-small cell lung cancer (NSCLC) and pulmonary benign disease tissues. METHODS: p63 gene mRNA expression (TAp63 and ΔNp63) was detected in 40 NSCLC and 10 pulmonary benign disease tissues by RT-PCR (reverse transcriptase-PCR) technique, and immunohistochemical method was used to observe p63 protein expression in the above tissues. RESULTS: ΔNp63 mRNA overexpression was observed in 18 squamous cell carcinoma (18/23), 1 bronchioloalveolar carcinoma (1/6) and 2 paracancerous tissues of squamous cell carcinoma (2/23). There was no expression of TAp63 both in NSCLC and benign disease tissues of the lung. Immunochemistry showed that the positive rate and intensity of p63 protein expression were significantly higher in squamous cell carcinoma than those in adenocarcinoma and benign disease tissues of the lung ( P < 0.01). CONCLUSIONS: p63 gene is mainly amplified in squamous cell carcinoma of the lung. It may act as an oncogene in the carcinogenesis and development of squamous cell carcinoma.

[Effect of exogenous p73 gene on chemosensitivity of wild-type p53 human lung adenocarcinoma cell A549].

BACKGROUND: To assess the effects of exogenous p73 gene on chemosensitivity of wild-type p53 human lung adenocarcinoma cell A549 to cisplatin (DDP) and adriamycin (ADM). METHODS: Recombinant eukaryotic expression vector pcDNA3 containing full-length human wild-type p73α cDNA or p53 cDNA was transfected into A549 cells which had wtp53 by lipofectamine-mediated gene transfection. The chemosensitivity of tumor cells to DDP and ADM was observed before and after transfection. RESULTS: A549-p73α could stably express P73α protein. The P73α protein expression was significantly increased in A549-p73α than that in A549 and A549-pcDNA3. The growth and colony formation of A549-p73α were significantly inhibited compared with A549, A549-pcDNA3 and A549-wtp53. Flow cytometry and DNA fragmentation analysis showed apoptosis of A549-p73α cells was significantly increased. The IC50 values for DDP and ADM were reduced to approximate 1/6 and 1/70 in A549-p73α cells compared with A549 cells respectively.. CONCLUSIONS: Exogenous p73 gene is capable of enhancing the sensitivity of wild-type p53 human lung adenocarcinoma cell A549 to chemotherapeutic drugs. It is probably for p73 to be used in the treatment of p53-resistant tumors.

[Sequential variation of pulmonary flow spectrum and its value on the evaluation of risk for pulmonary resection in perioperative patients with lung cancer].

BACKGROUND: To explore the sequential variation of pulmonary flow spectrum and its value on evaluation of risk for pulmonary resection in perioperative patients with lung cancer. METHODS: Forty-nine patients with lung cancer who underwent pneumonectomy (12 cases) and lobectomy (37 cases) were observed for the values of Doppler pulmonary flow spectrum before operation, on the 3-5 days and 8-10 days postoperatively. Moreover the patients were divided into different groups according to the different operative procedures and with or without postoperative cardiac arrhythmia. RESULTS: Doppler pulmonary flow spectrum changed in all cases who underwent pneumonectomy and lobectomy from 3 to 5 days postoperatively. These changs included prolonged preejection period (PEP), shortened acceleration time (ACT), increased PEP/ACT ratio, increased pulmonary artery mean pressure (PAMP), and increased pulmonary vascular resistance (PVR). There were significant differences comparing with those before operation ( P < 0.01). The patients who underwent lobectomy recovered to the same level of pre operation on the 8th to 10th postoperative days. However, the changes of pulmonary flow spectrum continuously existed in the patients who underwent pneumonectomy on the 8th to 10th postoperative days. There were significant differences of pulmonary flow spectrum between patients with postoperative arrhythmia and without postoperative arrhythmia before operation. CONCLUSIONS: Pulmonary hemodynamic obviously changes after pulmonary resection in the patients with lung cancer and the changes last longer in pneumonectomy patients. Patients with postoperative cardiac arrhythmia have marked pulmonary hemodynamic changes before operation. Doppler pulmonary flow spectrum can not only be used to analyse the pulmonary hemodynamic changes for those cases undergoing pulmonary resection after operation, but also to evaluate the risk of pulmonary resection before operation.

[Overexpression of p73 gene inhibits VEGF and bFGF mRNA expression in lung adenocarcinoma cell].

BACKGROUND: To study the effect of overexpression of p73 gene on cell growth curve and vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) mRNA expression in lung adenocarcinoma cell, and to explore its effect on angiogenesis in lung adenocarcinoma. METHODS: p73α and p73ß were transferred into A549 cell and H1299 cell by liposome, the positive cell clones were chosen by G418. The cell growth curves were drawn by cell counting. The expressions of VEGF and bFGF mRNA were detected by RT-PCR. RESULTS: Overexpression of p73 gene could inhibit the growth of A549 cell and H1299 cell. VEGF and bFGF mRNA expressions in A549 cell and H1299 cell were decreased after transfer of p73 gene (P < 0.05), VEGF mRNA was decreased more obviously after transfer of p73ß (P < 0.01). CONCLUSIONS: Overexpression of p73 gene can inhibit the growth of lung adenocarcinoma cell, decrease VEGF and bFGF mRNA expression. The results suggest that overexpression of p73 gene might be involved in the regulation of VEGF and bFGF gene expression in lung adenocarcinoma and act as an antioncogene.

[Diagnosis and surgical treatment of middle lobe disease of lung: report of 163 cases].

OBJECTIVE: To discuss the principle of diagnosis and surgical treatment of middle lobe diseases of right lung. METHODS: We analysed the clinical data and prognosis of 163 patients who suffered from middle lobe diseases of right lung and received surgical treatment. RESULTS: There were 97 men and 66 women in the group with the ratio 1.5:1, whose age arranged from 13 to 74 years. The shortest course was one week, and the longest 25 years. The average course was 30.3 months. 78 of 163 patients with tumors were malignant (47.9%) and 85 benign (52.1%). The number of the patients below 50 years old was 91 and 81.3% of them were benign, which was very markedly higher than that of the patients with malignant tumors (P < 0.01). The number of the patients above 50 years old was 72 and 84.7% were malignant, which was very markedly higher than that of the patients with benign tumors (P < 0.01); 8 of 11 patients (72.7%, 8/11) who suffered from tuberculosis combined with bronchoactesis. One of this group died from respiratory failure after operation, packed accumulation of fluid between lobes happened in seven cases (4.3%). The survival rate of 1, 3, 5 years of malignant patients at stages I, II were 88.4%, 62.8%, 51.2%, for that at stages III, IV were 76.5%, 41.2%, 14.7%. All of the four patients who received vage-resection, their malignant tumors recurred in one year after operation. No benign lesion recurred in 10 years. CONCLUSION: (1) It should be noticed that nearly half of middle lobe disease were malignant, especially to those whose ages were above 50 years old. (2) When the diagnosis is hard to be confirmed, open-thoracic exploration should be performed in order not to delay the treatment or enlarge the range of lung resection. (3) Most of middle lobe tuberculosis may be combined with bronchoactesis. (4) Setting drainage tube may be useful to decrease the risk of interlobe accumulation of fluid. (5) Vage resection is not suitable for carcinoma of middle lobe of lung.