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Objective To investigate the clinical efficacy and application value of submucosal tunneling endoscopic resection(STER)for upper gastrointestinal submucosal tumors(SMTs). Methods A retrospective analysis was performed on the endoscopic and clinical data of 44 cases with SMTs who received STER from January 2015 to June 2016 in Chinese PLA General Hospital. Results The rate of complete resection was 88.6%(39/44). The operating time was 60.1±30.6 min. The hospitalization time was 10.1± 3.3 days. The rate of complications was 6.8%(3/44). The diagnosis of SMTs by pathology and endoscopic ultrasonography(EUS),the size of SMTs measured by EUS and ruler after STER,and the growing direction judged by EUS and CT were consistent. Conclusion STER for SMTs has a higher complete resection rate, shorter operating time and hospitalization time, and fewer complications. EUS combined with CT is an effective method for preoperative evaluation.
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Objective To investigate the efficacy of dexmedetomidine-assisted topical anesthesia in patients undergoing bronchoalveolar lavage ( BAL). Methods Twenty-four ASA Ⅱ or Ⅲ patients in ICU, aged 24-64 yr, weighing 50-80 kg, scheduled for BAL, were randomly divided into 2 groups ( n = 12 each) : topical anesthesia group (group A) , topical anesthesia + dexmedetomidine group (group B) . In group A, 0.9% normal saline 5 ml was injected intravenously 30 min before operation, 2% lidocaine 5-10 ml was given via a tracheal tube or cannula 5 min before operation and then an increment of 2% lidocaine 5 ml was given using fibreoptic bronchoscope every 15-30 min as required (the total amount was within 20 ml) . In group B, dexmedetomidine 0.5-1.0 μg/kg was injected (time of injection≥ 10 min) followed by infusion at 0.1-0.5 μg·kg-1 ·h-1 and the topical anesthesia was performed as the method described in group A. The time of lavage, adverse reactions and adverse cardiovascular events were recorded. Blood samples were taken 20 min before lavage, 20 min after the start of lavage and 20 min after the end of lavage (T1-3 ) for determination of the concentrations of plasma catecholamine and serum cortisol. Results The incidences of adverse reactions and adverse cardiovascular events were significantly lower and the operation time was significantly shorter in group B than in group A ( P < 0.05). The concentrations of plasma catecholamine and serum cortisol were significantly higher at T2，3 in group A, while lower at T2，3 in group B than at T1 ( P < 0.05) . The concentrations of plasma catecholamine and serum cortisol were significantly lower in group B than in group A ( P < 0.05). Conclusion Dexmedetomidine-assisted topical anesthesia can be used safely and effectively in BAL.
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<p><b>BACKGROUND</b>To observe the CT appearance and pathological changes of VX2 tumor in rabbit lung after radio-frequency ablation.</p><p><b>METHODS</b>After VX2 tumor tissue suspension was injected into the lungs, the transplanted lung cancer models were established in 36 New Zealand white rabbits. Twenty-eight rabbits were treated with radio-frequency ablation, and another 8 rabbits without any treatment as control. The CT appearances and pathological changes were observed in different time intervals after the treatment in 14 rabbits out of experimental group. The survival periods of the rabbits were recorded in the rest 14 rabbits of experimental group and the control group respectively.</p><p><b>RESULTS</b>Coagulative necrosis and cell apoptosis appeared in the tumor tissues after the ablation, and inflammatory cells were found in the lung tissues around the areas of ablation. Wadding shadows appeared in CT images after the treatment and disappeared with the inflammation vanished, but the tumor shadows ceased to increase. In the experimental group, tumor tissues were almost necrosed in the target areas of 21 rabbits, however, peripheral residual nests of histologically viable tumor were found in the target areas of the other 7 rabbits. The survival periods of rabbits in the experimental group and the control group were 38 days±3.4 days days and 26 days±2.8 days respectively (P < 0.05).</p><p><b>CONCLUSIONS</b>Radio-frequency ablation may be an effective method in the treatment of lung cancer.</p>
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<p><b>BACKGROUND</b>To study the biological effects of multi-electrode radiofrequency ablation on pulmonary tissues of rabbits.</p><p><b>METHODS</b>Under the guidance of computer tomograph, electrodes were inserted into right lungs of New Zealand white rabbits and radiofrequency was performed. The biological effects were observed through CT image and microscopy.</p><p><b>RESULTS</b>Coagulative necrosis was found immediately in ablation area after the procedure. On the 7th postradiofrequency ablation day, fibrous tissues appeared in the necrotic lesions. On the 30th postradiofrequency ablation day, bronchial and alveolar epithelium began to proliferate. Within 60 to 90 days after treatments, the necrotic lesions were almost replaced by normal pulmonary tissues. In group with electrodes into the right hilum, time for treating and initial impedance were significantly different from those with electrodes into the peripheral sites of the right-lower lobes (P < 0.01, P < 0.01).</p><p><b>CONCLUSIONS</b>Multi-electrode radiofrequency ablation can be safely and effectivly performed in pulmonary tissue and cause coagulative necrosis within a certain extent.</p>
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Objective To reproduce a pulmonary carcinoma model by injecting VX2 tumor tissue block suspension into rabbits' lung,and to compare the result with that of injecting VX2 tumor cells suspension.Methods A total of 50 New Zealand white rabbits were divided into two groups randomly with 25 in each.The VX2 tumor tissue block suspension and cell suspension were injected respectively into the right lower lung of each rabbit in two groups.The growth and metastasis of tumor in the thorax were observed with CT scan.The general condition of the animals was observed as well.Results The pathological pictures of the VX2 tumors were the same in two groups.The ratio of successful transplantation was 100% in the tissue block suspension group,while it was 48% in the cells suspension group,a remarkable difference in the success rate of tumor transplantation was found between the two methods(P