简介：Objective:Toevaluatetheshort-termoutcomesofvideo-assistedthoracicsurgery(VATS)forthoracictumors.Methods:Thedataof1,790consecutivepatientswereretrospectivelyreviewed.ThesepatientsunderwentVATSpulmonaryresections,VATSesophagectomies,andVATSresectionsofmediastinaltumorsorbiopsiesattheCancerInstitute&Hospital,ChineseAcademyofMedicalSciencesbetweenJanuary2009andJanuary2012.Results:Therewere33patientsconvertedtoopenthoracotomy(OT,1.84%).Theoverallmorbidityandmortalityratewas2.79%(50/1790)and0.28%(5/1790),respectively.TheoverallhospitalizationandchesttubedurationwereshorterintheVATSlobectomygroup(n=949)thanintheopenthoracotomy(OT)lobectomygroup(n=753).Therewerenosignificantdifferencesinmorbidityrate,mortalityrateandoperationtimebetweenthetwogroups.Intheesophagealcancerpatients,nosignificantdifferencewasfoundinthenumberofnodaldissection,chesttubeduration,morbidityrate,mortalityrate,andhospitallengthofstaybetweentheVATSesophagectomygroup(n=81)andopenesophagectomygroup(n=81).However,theoperationtimewaslongerintheVATSesophagectomygroup.Inthethymomapatients,therewasnosignificantdifferenceinthechesttubeduration,morbidityrate,mortalityrate,andhospitallengthofstaybetweentheVATSthymectomygroup(n=41)andopenthymectomygroup(n=41).However,theoperationtimewaslongerintheVATSgroup.ThemediantumorsizeintheVATSthymectomygroupwascomparablewiththatintheOTgroup.Conclusions:Inearly-stage(I/II)non-smallcelllungcancerpatientswhounderwentlobectomies,VATSiscomparablewiththeOTapproachwithsimilarshort-termoutcomes.Inpatientswithresectableesophagealcancer,VATSesophagectomyiscomparablewithOTesophagectomywithsimilarmorbidityandmortality.VATSthymectomyforMasaokastageIandIIthymomaisfeasibleandsafe,andtumorsizeisnotcontraindicated.Longerfollow-upsareneededtodete

简介：AbstractPurpose:To analyze the efficacy and outcome of percutaneous thoracic endovascular aortic repair (TEVAR) in patients with traumatic blunt aortic injury in our single-center.Methods:From January 2014 to December 2018, a total of 89 patients with traumatic blunt aortic injuries were treated with emergency TEVAR in our center. Their clinical data such as demographics, operative details and postprocedure outcomes were analyzed retrospectively in this study using SPSS 20 software. Continuous variables were expressed as mean and standard deviation or median and interquartile range. Categorical variables are expressed as the numbers and percentages of patients.Results:The median age of the patients was 37 years, and 76 (85.4%) were males. All the patients were involved in violent accidents and combined with associated injuries. Two patients died while awaiting the operations and 87 patients underwent emergency percutaneous TEVAR, with a 100% technique success. The mean time interval from admission to operating room was (90.1 ± 18.7) min, and the mean procedure time was (54.6 ± 11.9) min. Eighty (92.0%) patients were operated on under local anesthesia, while other 7 (8.0%) patients were under general anesthesia. Two cases underwent open repair of the femoral arteries because of the pseudoaneurysm formation of the access vessels. A total of 98 aortic covered stent grafts were deployed, of which 11 patients used two stent grafts (all in dissection cases). The length of the stent was (177.5 ± 24.6) mm. The horizontal diameter of aorta arch at the proximal left subclavian artery ostium was (24.9 ± 2.4) mm, the proximal diameter of the covered stent was (30.5 ± 2.6) mm, and the oversize rate of proximal site was (22.7 ± 4.0)%. The proximal landing zone length was (14.1 ± 5.5) mm. The left subclavian artery ostium was completely covered in 5 patients and partially covered in 32 patients. No blood flow reconstruction was performed. The overall aortic-related mortality was 2.25% (2/89). Among 87 patients, the median follow-up time was 24 months. Postoperative computed tomography angiography scans demonstrated no residual pseudoaneurysm, hematoma or endoleak. One patient complained of mild left upper limb weakness during follow-up due to left subclavian artery occlusion. Neither late death, nor neurological or other complications occurred.Conclusion:Emergency percutaneous endovascular repair is a less invasive and effective approach for the treatment of traumatic blunt aortic injuries. Long-term results remain to be further followed.

简介：AbstractThoracic splenosis is the autotransplantation of splenic tissue in the left thoracic cavity as a result of a splenic injury. This rare pathology is usually asymptomatic and may be discovered on incidental imaging, but the diagnosis often requires invasive procedures such as surgery in order to eliminate a neoplasic origin. We report a rare symptomatic case of a 39-year-old man presenting with chest pain and multiple nodules revealed on a computed tomography scan. The patient underwent a surgical exploration and the pathological studies concluded to a thoracic splenosis. Indeed, the previous medical history of the patient revealed a left thoraco-abdominal traumatism during childhood. The aim of this paper is to emphasize that the diagnosis can now be performed using only imaging techniques such as technetium-99 sulfur colloid or labelled heat-denatured red blood cell scintigraphy to avoid unnecessary invasive procedures including thoracotomy.

简介：无

简介：AbstractBlunt traumatic aortic injury is the second leading cause of death after motor vehicle accidents. The most frequent localisation of aortic lesion is the isthmus, especially in those who survived the accident. Here we report a case of blunt traumatic aortic injury with unusual localisation and modality. A 31 years old man sustained a motorcycle accident, being run over by a car. Computed tomography scan showed an atypical ascending aorta lesion, confirmed by intraoperative finding. The patient underwent emergency ascending aorta replacement with Dacron tubular graft. The patient was discharged uneventfully on 35th postoperative day, after multiple maxillofacial surgeries for concomitant injuries.

简介：2011年6月25日，天津肺癌研究所收到美国Thomson．Reuters公司通知，天津肺癌研究所与Wiley—Blackwell合办的ThoracicCancer自创刊号起所有文章被SCI—E收录。

简介：客观：识别简历螺丝钉的放置的thoracicextrapedicular途径的机械可行性。方法：到T_8的从T_1的五新鲜成年cadavericthoracics松被收获。螺丝钉也被虱子的途径orextrapedicular途径插入。结果统计上被观察，由经由脊椎动物的sagittal轴的虱子的螺丝钉途径和额外的虱子的螺丝钉途径的撤退力量被测量并且比较。结果：在胸的虱子的途径，小花梗全体乘务员的撤退强度是220N(288.2-1561.7N)和胸的额外的虱子的螺丝钉的接近的1001.23N±was827.01N±260N当螺丝钉通过横向的过程被插入到vertebrae时，并且954.25N±254N什么时候拧紧，通过小花梗的侧面的外皮被插入到vertebrae。与虱子的组相比，在额外的虱子的组的撤退强度被4.7%inserted通过横向的过程减少(P>0.05)并且通过侧面的外皮(P<0.05)在17.3%插入了。由额外的虱子的途径的吝啬的撤退力量被11.04%作为与虱子的途径相比减少(P<0.05)。结论：当它是难的由虱子的途径插入时，在胸的脊骨插入虱子的螺丝钉机械地是可行简历到useextrapedicular螺丝钉技术。

简介：客观：与胸或腹的损害调查polytraumapatients的早诊断和治疗。方法：有胸或腹的损害的所有polytrauma病人的数据回顾地在过去的10年期间被学习。结果:在现在的学习，有1540个polytrauma病人，为所有2368个损伤病人中的65.0%个的财务。这些病人，62.4%处于承认上的吃惊状态。起作用的率是15.0%(181/1206)并且79.9%(612/766)在有胸、腹的损害的病人(P<0.01)，5.2%(39/758)并且31.7%(142/448)在有钝、渗透的胸损伤的病人(P<0.01)，and72.4%(359/496)并且93.7%(253/270)在有钝、渗透的腹的损害(P<0.01)的病人分别地。处理腹的损害，angioembolization在43种情况中被执行，与42治好。全面死亡率是6.2%。并且在钝、渗透的亚群，死亡是7.9%(75/950)并且3.6%(21/590)，分别地(P<0.01)。大多数病人死了fromexsanguination。结论：“在损伤以后的第一个金色的小时”应该被掌握，自从在这个小时的治疗能极大地决定非常伤害的牺牲品是否能幸存。迅速的诊断和合适的治疗比这些更极大地作出贡献到牺牲品的幸存损害的真理。

简介：Theobjectiveofthisstudyistoinvestigatethehemodynamicsinpatient-specificthoracicaorticaneurysmanddiscussthereasonforformationofaorticplaque.A3-Dimensionalpulsatilebloodflowinthoracicaortawithafusiformaneurysmand3mainbranchedvesselswasstudiednumericallywiththeaverageReynoldsnumberof1399andtheWomersleynumberof19.2.Basedontheclinical2-DimensionalCTslicedata,thepatient-specificgeometrymodelwasconstructedusingmedicalimageprocesssoftware.Un...

简介：

简介：Extensiveaneurysmsinvolvingtheascendingaorta,aorticarch,andthedescendingaortastandasatherapeuticdilemmainsimultaneousmanagementofmultiplesitesofpathologyoftheaorticarchandthedescendingthoracicaorta.Wesystematicallyreviewedaboutliteraturesofstentedelephanttrunkoperation(SET)identifiedthroughsearchesoftheelectronicdatabasesEMBASEandMedline,andaimedtosummarizestudiesofpatientsundergoingSETforextensiveaneurysms.Since1996,KatoMintroducedahybridtechniquebyusingstentedgraftimplantationtothedescendingaortafortreatmentofthoracicaorticaneurysmordissection.Ithasbeendescribeagoodoptionforextensivethoracicaorticaneurysmsandinafashionsimilartotheelephanttrunktechnique.

简介：无

简介：

简介：Objective:Toexploretheepidemiology,clinicalpresentation,radiologyandsurgicaltreatmentoutcomeinChinesepatientswithmyelopathycausedbycontiguousmultilevelossificationofligamentumflavum.Methods:Medicalnotesandimagingdataof18Chinesepatients(14malesand4females,aged43-72years,mean:57years)withmyelopathycausedbycontiguousmultilevelossificationofligamentumflavumwerestudiedretrospectivelyinthisarticle.Thediagnosiswasbasedonclinicalexamination,X-rayfilms,computerizedtomography(CT)andmagneticresonanceimaging(MRI)scanningresultsandpathologicalresults.Sixteenpatientsweretreatedbylaminectomyandtwobylaminoplasty.Theaveragefollow-updurationwas34months(range,28-49months).TheoutcomewasevaluatedbyJapaneseOrthopaedicsAssociation(JOA)scope.Results:Theaveragetimeforoccurringclinicalsymptomswas7.5months(range,2days-16months).Allthe18casespresentedwithclinicalevidencesofchronicandprogressivethoracicspinalcordcompression,whichincludedbilaterallegweakness,spasticgait,numbnessinlowerlimbs,paresthesiainterminalandperineum,andurinaryincontinence.Neurologicalexaminationrevealedseverespasticparaparesis,absenceofabdominalreflexes,andreductionofthesensoryfunctionbelowthecompressionlevel.ThemeanJOAscorebeforeoperationwas3.6(range,0-6).MRIandCTscansofthethoracicspineconfirmedthepresenceofcontiguousmultilevelossificationoftheligamentumflavum.ThemeanrecoveryrateaftersurgeryintermsofJOAscorewas66.3%(range,33.3%-100%),withameanfinalJOAscoreof8.3.Thoracicdecompressionlaminectomyorlaminoplastycouldresultinagoodpostoperativeoutcome.Conclusions:ContiguousmultilevelossificationoftheligamentumflavumisnotacommoncauseofmyelopathyinChinesepopulationandshouldbetreatedasearlyaspossible.MRIandCTscanexaminationsmaydiagnosethepresenceofthoracicossificationofligamentumflavum(OLF).Posteriordecompression,especiallywit

简介：昆虫手足在变形期间从想象的圆盘或幼虫的腿发展。涉及发展从的分子的机制对成年的腿幼虫糟糕被理解。此处，我们克隆从Bombyxmori(Bmrn)圆胖的锌手指基因的完整的长度，它包含了1419bp开的读框架，并且编码了473氨基酸蛋白质。反向的抄写聚合酶链反应和西方的污点分析证明Bmrn比在测试的另外的纸巾在外皮在高水平被表示，并且它在变形期间显示出很高的表示水平。生产的Bmrn击倒在跗骨和pretarsus背叛包括tarsomeres的熔化和减小，并且pretarsus的发展拘捕。而它在果蝇的相应基因被显示了影响三个跗骨的片断(t2-t4)，我们的数据证明Bmrn涉及跗骨和pretarsus的形成，建议改变腿包含了在在进化期间的基因规定的patterning的变化。

简介：无

简介：无

简介：BackgroundRapidrightventricularpacingisoneofthemethodsforcounteractingthe'windsock'effectinthethoracicendovascularaorticrepair(TEVAR).Mostofthedoctorsaretocompletethisoperationundergeneralanesthesia.Now,ouroperationhasbeenperformedunderlocalanesthesia.Norelatedreportswerefoundastowhethercanthepatienttoleraterapidrightventricularpacingunderlocalanesthesia.MethodsFrom2009Januaryto2010January,inourhospitalalltheDeBakeyⅢaorticdissectionpatientswhounderwentTEVARwererandomlydividedintogeneralanesthesiagroup(n=50)andlocalanesthesiagroup(n=51).Allthedatawerecomparedbetweentwogroupsincludingthehemodynamicindexes,thegraftpositioningaccuracy,rapidpacingduration,operationtime,intraoperativediscomfortandpostoperativeneurologicalunderstandingfunctionchangesandthecomplications.ResultsThesuccessratewere100%inthetwogroups.Thedurationofrapidpacing,operationtime,theaccuracyofgraftlocalizationandtheintraoperativediscomfortscoresofNumericalPainRatingScaleshowednosignificantdifferencebetweenthetwogroups(P>0.05).Therewerenorapidrightventricularpacing-relatedcomplicationsinthetwogroups.ConclusionDuringthoracicendovascularaorticrepairprocedure,rapidrightventricularpacingunderlocalanesthesiaissafeandfeasible.Thusitisworthytobepopularizedinclinicalpractice.

简介：AbstractPurpose:To develop animal models of penetrating thoracic injuries and to observe the effects of the animal model-based training on improving the trainees’ performance for emergent and urgent thoracic surgeries.Methods:With a homemade machine, animal models of lung injuries and penetrating heart injuries were produced in porcine and used for training of chest tube drainage, urgent sternotomy, and emergent thoracotomy. Coefficient of variation of abbreviated injury scale and blood loss was calculated to judge the reproducibility of animal models. Five operation teams from basic-level hospitals (group A) and five operation teams from level III hospitals (group B) were included to be trained and tested. Testing standards for the operations were established after thorough literature review, and expert questionnaires were employed to evaluate the scientificity and feasibility of the testing standards. Tests were carried out after the training. Pre- and post-training performances were compared. Post-training survey using 7-point Likert scale was taken to evaluate the feelings of the trainees to these training approaches.Results:Animal models of the three kinds of penetrating chest injuries were successfully established and the coefficient of variation of abbreviated injury scale and blood loss were all less than 25%. After literature review, testing standards were established, and expert questionnaire results showed that the scientific score was 7.30 ± 1.49, and the feasibility score was 7.50 ± 0.89. Post-training performance was significantly higher in both group A and group B than pre-training performance. Post-training survey showed that all the trainees felt confident in applying the operations and were generally agreed that the training procedure were very helpful in improving operation skills for thoracic penetrating injury.Conclusions:Animal model-based simulation training established in the current study could improve the trainees’ performance for emergent and urgent thoracic surgeries, especially of the surgical teams from basic-level hospitals.

简介：无