Needlescopic thoracic sympathectomy for palmar hyperhidrosis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of needlescopic thoracic sympathectomy for palmar hyperhidrosis.</p><p><b>METHODS</b>From March 2004 to April 2005, 62 patients, including 23 men and 39 women with a mean age of 23 years (ranged from 12 to 53 years), underwent bilateral needlescopic thoracic sympathectomy. Among all the patients 8 cases had accompanied axillary hyperhidrosis. The degree of palmar sweating was moderate in 16 cases and severe in 46 cases. The sympathetic chain on the body of the second and third ribs in all patients was cauterized and divided; the chain on the fourth rib in those with axillary hyperhidrosis was also severed. Intraoperative changes in palmar temperature and blood flow were recorded.</p><p><b>RESULTS</b>Sympathectomies were successful, and dry limbs were immediately achieved in all patients after surgery. There were no mortality or life-threatening complication, however 1 patient developed moderate pneumothorax which resolved soon after chest drainage. After all procedures, palmar blood perfusion increased significantly and mean palmar temperature elevated by 2.4 degrees C. The mean operative duration was 65 min, and the mean postoperative hospital stay was 1.2 days. No recurrence of palmar hyperhidrosis occurred after a mean follow-up of 6.3 months (ranged from 1 to 13 months). Compensatory sweating was found in 26 patients, but the symptoms were mostly tolerable and required no further treatment.</p><p><b>CONCLUSION</b>Needlescopic thoracic sympathectomy is a safe and effective technique for palmar hyperhidrosis, which is less invasive than conventional video-assisted thoracic surgery.</p>

Surgical treatment for tumors of trachea, carina and main bronchus / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To review the experience in surgical treatment for tumors of trachea, carina and main bronchus.</p><p><b>METHODS</b>From Jan. 1996 to Jun. 2004, 27 patients with tumor of trachea, carina or main bronchus underwent surgery including resection and reconstruction of trachea in 8, right/left pneumonectomy and carinal resection and reconstruction in 9 (6/3), right sleeve upper lobectomy and carnial resection with reconstruction of trachea and carina in 2, carina resection and reconstruction in 3, tumor removal through tracheal windows in 5. CPB (cardiopulmonary bypass) was used in 2 patients during surgery.</p><p><b>RESULTS</b>There were 3 peri-operative deaths caused by acute respiratory failure in 2 and severe postoperative bleeding in 1 case. After follow-up of more than 6 months, no death or post-operative complication occurred.</p><p><b>CONCLUSION</b>Resection and reconstruction for patients with tumor of trachea, main bronchus or carina can be performed with excellent results using effective surgical and anaesthetic methods with or without CPB assistance.</p>

Cardiac valve MCSF-1 and its receptor expression changes in Staphylococcus aureus induced infective endocarditis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the cellular immunology mechanism of infective endocarditis (IE), we investigated the effects of Staphylococcus aureus (S. aureus) on MCSF-1 and its receptor (c-fms) gene expression in cardiac valves.</p><p><b>METHODS</b>Thirty-two rabbits were divided into 4 groups: mitral or tricuspid valve artificial lesions with 5 x 10(4) CFU or 5 x 10(6) CFU S. aureus injection. Control rabbits (n = 7) received 5 x 10(6) CFU S. aureus injection. IE after operation were confirmed by naked eyes and electron microscope observations. MCSF-1, c-fms in mitral and tricuspid valves were detected by RT-PCR.</p><p><b>RESULTS</b>Twenty-six rabbits survived the operation and 14 rabbits developed IE (2 with 5 x 10(4) CFU and 12 with 5 x 10(6) CFU S. aureus injection) one day post operation. S. aureus injection alone did not induce IE. Compared to control rabbits, MCSF-1 mRNA was significantly upregulated and c-fms mRNA significantly downregulated after 5 x 10(4) CFU S. aureus injection with heart valve artificial lesion in mitral valves or tricuspid valves. MCSF-1 expression in mitral valves was further increased while remained unchanged in tricuspid valve after 5 x 10(6) CFU S. aureus injection compared to that in 5 x 10(4) CFU S. aureus injection group.</p><p><b>CONCLUSION</b>High dose bacterial invasion and heart valves lesion were the main factors for inducing infective endocarditis. Development of infective endocarditis was associated with valve MCSF-1/c-fms expression changes in this rabbit model.</p>

Simultaneous off-pump coronary artery bypass surgery and pulmonary resection / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experience of combined off-pump coronary artery bypass grafting (OPCAB) and pulmonary resection.</p><p><b>METHODS</b>Seven patients with unstable angina or a history of myocardial infarction and pulmonary disease underwent combined OPCAB and pulmonary resection. All of them underwent coronary angiography, and neither coronary angioplasty nor stenting was feasible. OPCAB preceded the lung resections. The preferred approach to the heart and lung was by sternotomy. Left upper lobectomy was performed in 2 patients, right upper lobectomy was performed in 1 patient, right lower lobectomy was performed in 1 patient, right upper and middle bilobectomy was performed in 1 patient, left lung volume reduction surgery (LVRS) was performed in 1 patient and bilateral LVRS was performed in 1 patient.</p><p><b>RESULTS</b>There were no hospital mortality in this group of patients, however there were one late death. Sternal dehiscence occurred in 1 patient which was observed with a need for re-sternotomy and atrial fibrillation was observed in 1 patient. Five patients were diagnosed as malignant tumor by pathology test, and 2 patients were severe chronic obstructive pulmonary disease (COPD). Follow-up ranging from 2 months to 31 months was available for these patients. None of the patients showed evidence of myocardial ischemia after surgery. In one patient, who underwent right upper and middle bilobectomy, local recurrence was found at 19 months after surgery.</p><p><b>CONCLUSIONS</b>OPCAB carried out simultaneously with lung resection is a safe and effective approach in patients diagnosed with concomitant coronary artery and pulmonary disease. OPCAB may decrease the incidence of postoperative complications.</p>

Value of cardiopulmonary bypass for locally advanced lung cancer involving the left atrium / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To review the experience and assess the value of cardiopulmonary bypass (CPB) in the treatment of locally advanced lung cancer involving the left atrium.</p><p><b>METHODS</b>From Jan. 1999 to Dec. 2002, lobectomy or pneumonectomy combined with partial resection of the left atrium were carried out in 52 such patients, which included 13 with assistance of CPB and 39 without.</p><p><b>RESULTS</b>There was one postoperative death in each of the CPB and non-CPB groups due to brbonchopleural fistula and pulmonary infection. Six patients in CPB and 14 in non-CPB groups developed postoperative cardiac complication including arrhythmia, pneumonia and heart failure. The 1-, 3-year survival rate of CPB and non-CPB groups was 69.3%, 66.7% and 38.5%, 38.5%, respectively.</p><p><b>CONCLUSION</b>Combined resection of locally advanced lung cancer with partially involved left atrium through cardiopulmonary bypass was safe and effective, and may not increase the postoperative complication and risk.</p>

Role of IL-6 induced human peripheral blood monocytes tissue factor expression in the pathogenesis of chronic rejection / 中华器官移植杂志

Objective To study the induction of IL-6 on expression and activity of tissue factor (TF)in peripheral blood monocytes(PBMCs).Methods rhIL-6 100 ng/L and rhIL-6 100 ng/L+ rhIL-6 MoAb 10?g/L were used respectively to stimulate the PBMCs for 24 h,PBMCs without any stimulation as control group,to study the changes of antigen content,mRNA expression and the ac- tivity of the TF.Results The antigen content,mRNA expression and activity of TF were increased significantly in 100 ng/L rhIL-6 group as compared with rhIL-6 100 ng/L+rhIL-6 MoAb 10?g/L and control groups(P＜0.01).Conclusions rhIL-6 can induce the increase of antigen expression,activity and mRNA expression in PBMCs,and these effects can be suppressed successfully by rhIL-6 MoAb. This study demonstrated that there was potential relations between cytokines and thrombogenesis, which may play an important role the pathogenesis of chronic rejection.