Different effects of bronchoscopic interventions on children and adults with tracheobronchial mucoepidermoid carcinoma.

AIMS: To investigate the efficacy and safety of minimally invasive bronchoscopic interventions for patients with tracheobronchial mucoepidermoid carcinoma (MEC). METHODS: Patients with tracheobronchial MEC were included in this retrospective study, and the clinical features, histologic grading, treatments, and cumulative survival rates were calculated. Patients were categorized into child (n = 16) and adult (n = 19) group according to their ages. Histologic grading, treatments, and survival status were compared between the two groups. RESULTS: In pathology, high-grade MEC counts for 6.77% and 42.10% in the child and adult group, respectively. As tumor growth pattern was concerned, 93.33% and 21.05% tumors in the child and adult group present intratracheal type. Multiple bronchoscopic interventions were conducted, including rigid bronchoscopy, argon plasma coagulation (APC), dioxide carbon cryotherapy, and electric loop. Tumors could be removed by multiple bronchoscopic interventions. Bronchoscopy-associated complications were rare, including an oral mucosa injury and a glottis edema. In the child group, one patient underwent left upper lung lobectomy. In the adult group, lobectomy and/or chemotherapy and/or radiotherapy were conducted in seven patients. The 5-year survival rate was 100% and 68.90% in the child and the adult group, respectively. CONCLUSIONS: Almost all children have low-grade and intratracheal MEC; 2/5 adults have invasive high-grade MEC. Multiple bronchoscopic interventions are effective in erasing low-grade intratracheal MEC without severe complications. For high-grade invasive MEC, aggressive and comprehensive therapy should be considered.

Analysis on Pediatric Sick Role and Doctor-patient Relationship Based on Parsons’ Theory of "Sick Role" / 中国医学伦理学

With the development of medicine technology and the increasing of people’s demand for quality of life, the complexity of doctor-patient relationships is also increasing. Pediatrics is one of the departments with the most concentrated and complex doctor-patient conflicts, therefore, it is necessary to analyze the sick roles and doctor-patient relationships in pediatrics. This paper explained the connotation of the sick role and the doctor-patient social interaction pattern based on Parsons’ theory of "sick role", and analyzed the particularity of the pediatric sick roles in China according to China’s national conditions. Meanwhile, combining the group characteristics and social background of pediatric sick role, this paper elaborated the sociological crux of pediatric doctor-patient relationship in China, and conducted a critical analysis on Parsons’ theory of "sick role".

Research progress in endoscopic retrograde cholangiopancreatography-mediated photodynamic therapy for cholangiocarcinoma / 中南大学学报(医学版)

The malignant degree of cholangiocarcinoma is high, and the early diagnosis is difficult. The vast majority of patients are unresectable when they are diagnosed. The patients have low quality of life and short survival cycle. Traditional radiotherapy and chemotherapy have poor efficacy and lead to side effects, and thus lack effective control measures for cholangiocarcinoma. Endoscopic retrograde cholangiopancreatography (ERCP) is an important method for diagnosing and treating biliary tract diseases. Photodynamic therapy (PDT) is a new local treatment for cholangiocarcinoma. In recent years, ERCP-mediated PDT treatment of cholangiocarcinoma has gradually emerged. ERCP-mediated PDT can effectively relieve the symptoms of patients with cholangiocarcinoma, improve the patients' quality of life, prolong the survival cycle, and is expected to become a new treatment for cholangiocarcinoma.

Incidence and etiology of stent associated respiratory tract infection caused by coated metal and silicone airway stents / 基础医学与临床

Objective To investigate the incidence and bacterial etiology of stent associated respiratory tract infec-tion (SARTI) caused by two types of airway stents.Methods Silicone and coated metal airway stent were placed into patients with central airway stenosis caused by varied pathologies. The incidence of stent related respiratory tract infection,bacteria etiology of SARTI and improved dyspnea score were compared between two groups receiving different airway stent.Results 1)Totally 171 patients received airway stents, and among them, 39 patients (22.81%) developed SARTI.2)The incidence of SARTI in metal stent group and silicone stent group was 29.21% (26/89) vs.15.85% (13/82),P<0.05;3)Bacterial spectrum of SARTI was different in metal and silicone stent groups:staphylococcus aureus was 38.46% vs. 69.23%,respectively;candida albicans was 23.08% vs. 0%,re-spectively;Singular proteus was 7.26% vs.0%,respectively;4)The narrowed lumen was improved from 74.27%± 7.13% to 17.64%±6.22%in the metal stent group,while the data was improved from 74.94%±9.18% to 12.68%± 8.32% in the silicone stent group (P<0.01). Accordingly, the dyspnea symptomscore was improvedfrom 2.85 ± 0.89 to 0.85±0.68 in metal stent group,and from 2.88±0.91 to 0±0.61 in the silicone stent group (P<0.05). Conclusions Compared with metal airway stents,silicone stents have a lower incidence of SARTI,which mightbe due to the projections in the silicon stent surface and wider expanded in the bronchial stenosis.

An analysis on biomedical effects of bipolar electric pulses at different central frequency / 生物医学工程学杂志

Adopting the cell model of multilayer spherical symmetry and the circuit analysis, the present paper gives the calculated results of the voltages on each of several parts of malignant Tonsillar B-cells and Jurkat T lymphocytes when the first-order Gaussian pulses at different central frequency apposed on them. The relationship between the central frequency and the transmembrane voltages of plasma membrane is also given. The optimum frequency causing electroporation in nuclear envelope is given as well. The paper discusses the reasons of electroporation in membrane and DNA degradation in nuclear. The work provides a reference for usage of transient bipolar electric pulses in cancer treatment.

Primary malignant airway neoplasms in 4 children / 中华儿科杂志

<p><b>OBJECTIVE</b>Primary airway neoplasms are extremely rare in the pediatric age group. This paper reports 4 children with primary airway neoplasms to explore the clinical manifestations, safety and efficacy of bronchoscopic interventions.</p><p><b>METHOD</b>The data of pathology, photographic documentation and imaging studies were analyzed.</p><p><b>RESULT</b>Of the 4 reported lesions, 2 were characterized by low-grade (2 with mucoepidermoid carcinoma) and 2 by high grade malignant (spindle cell carcinoma and malignant lymphoma). Onset of clinical manifestations occurred at the ages of 7 months to 7 years. All of them were initially misdiagnosed as bronchitis, asthma or atelectasis. The lesions located in trachea in 2 patients, in left bronchus of 1 patient and in right middle bronchus of 1 case. Atelectases occurred in bilateral bronchus where the lesions obstructed almost the entire lumen at the time of diagnosis. The diagnosis of airway masses depends upon maintaining a high index of suspicion, complemented by imaging and timely diagnostic endoscopy. The lesions were completely removed in 3/4 patients except 1 died during bronchoscopic procedures.</p><p><b>CONCLUSION</b>The children with malignant airway neoplasms were presented with cough and wheezing without specific manifestations. Bronchoscopic interventions were effective in the treatment of non-operative cases. General anesthesia is strongly recommended for interventional bronchoscopy.</p>

Electric pulse duration and windows effect of nuclear envelope / 生物医学工程学杂志

Nuclear envelope voltages of T cells were analyzed with a lumped circuitry for cells in combination with frequency domain power density of Gaussian pulses and monocycle pulses. According to the differences in geometric and electric parameters between normal and malignant T cells, circuitry analysis was performed. Theoretical evaluations indicated that apoptosis of malignant T cells was of feasibility, which could be applied in cancer therapy. The evaluations were in accord with the published experimental findings.