ABSTRACT
Objective To summarize the experiences of diagnosis and treatment for blunt tracheobronchial injuries ( BTI) . Methods From January 1993 to December 2013, 15 patients were diagnosed with BTI and underwent surgical treatment at our hospital.Mean age of the 15 patients (11 men and 4 women) was 26.4 ±4.5 years.All the patients had a history of trauma, which included crushing injury in 8 cases, deceleration injury in 4, fall injury in 2, and traction-type injury in 1.BTI loca-tion: right main bronchus in eight cases, left main bronchus in four cases, upper trachea in one case, lower trachea with the right main bronchus in one case, and cervico-thoracic trachea with left main bronchus in one case .Thoracic computerized tomo-graphy was performed in 15 patients, which showed pneumothorax, subcutaneous emphysema, pneumomediastinum or falling lung sign of Kumpe.Preoperative fiberoptic bronchoscopy examination was performed in 15 cases, which included bronchial atresia in 9 cases, bronchial transection in 3 cases, laceration of trachea in 2 cases, and tracheal transection in 1 case.An e-lective surgical procedure after BTI was performed in 10 cases, and emergency surgery was performed in 5 cases.Tracheo-bron-chial laceration repair were performed in 2 cases, tracheal end-to-end reanastomosis in 1 case, and bronchial end-to-end re-anastomosis in 12 cases.Results There was no operative death, and one case was complicated with anastomotic stenosis.The average operation time was 205.7 ±41.3 minutes, and the average blood loss was 268.4 ±109 ml.The postoperative hospi-tal stay was 11.6 ±3.7 days on average.Follow-up was completed in 15 patients (mean, 29.3 months), and 15 patients were all symptomatic improvement .Conclusion The most common site of BTI was the right main bronchus near Carina parts .Al-though the diagnosis and treatment are often delayed , our findings indicate that chest CT and endoscopic findings could be used for the diagnosis of BTI.Surgical resection and reconstruction are effective methods to repair BTI successfully even many months after they occur.Often they do not require the resection of pulmonary parenchyma .
ABSTRACT
<p><b>BACKGROUND</b>E-cadherin is a subclass of the cadherin family that plays an important role in the maintenance of intercellular junctions in normal epithelium.Decreased expression of E-cadherin might be closely related to invasiveness and dedifferentiation in human cancers.There is increasing evidence that modulation of the E-cadherin-catenin cell-cell adhesion complex is an important step in the initiation and progression of human cancers.The aim of this study is to investigate the relationship between the level of E-cadherin mRNA expression and pathological grades and clinical stages of non-small cell lung cancer(NSCLC).</p><p><b>METHODS</b>RT-PCR was used to measure the level of E-cadherin mRNA expression in 53 specimens of NSCLC,46 of para-cancer lung tissues,5 of benign nodal lung diseases,and the stages of disease was determined according to the results of surgery,pathology and imaging diagnoses.Then analyses were carried out between the level of E-cadherin mRNA expression and the clinical variables.</p><p><b>RESULTS</b>45.3%(24/53) and 45.7%(21/46) specimens of NSCLC and para-cancer lung tissue were positive for E-cadherin mRNA expression respectively(P > 0.05);NSCLC with low differentiation,advanced stages and nodal metastases showed a magnificantly lower expression of E-cadherin mRNA(P < 0.05).The median survival time for E-cadherin mRNA positive and negative patients were 15.5 months and 46 months,respectively,but the expression of E-cadherin mRNA did not correlate with patient's survival(P > 0.05).</p><p><b>CONCLUSIONS</b>E-cadherin expression is related to the differentiation,lymph node metastasis and pathological staging of NSCLC,but probably does not effectively affect its prognosis.</p>