Design and application of micro-courses in thoracic surgery teaching / 中华医学教育探索杂志

Objective:To investigate the effects of micro course in teaching of thoracic surgery.Methods:According to the teaching content of thoracic surgery and the previous teaching experience of the Department of Thoracic Surgery, the micro learning resource base with characteristics was established. We enrolled 20 students of Grade 2014 as the experimental group and 20 students of Grade 2013 as the control group. The micro learning resource base was used for teaching in the experimental group, and the traditional course teaching was carried out in the control group (the teachers were not changed). The teaching effect was evaluated through questionnaires and examinations.Results:The micro learning resource base of thoracic surgery consisted of 11 modules. The learning interest, effect and acceptance in the experimental group were significantly higher than those in the control group (all P<0.05), and there was no significant difference in understanding ability ( P>0.05). Moreover, the experimental group revealed much higher scores in the basic knowledge [(85.3±10.6) vs. (72.5±9.6)] and clinical ability [(87.3±11.5) vs. (75.9±12.2)] than the control group (both P<0.05). Conclusion:It is worth popularizing to establish a micro learning resource base and teaching application model suitable for thoracic surgery, which can help improve students' interest in learning and achieve better learning results through students' targeted and active learning.

Changes in serum protease and cytokine in patients with silicosis, tuberculosis, and lung cancer / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the changes in serum protease and cytokine in patients with silicosis, tuberculosis, and lung cancer.</p><p><b>METHODS</b>Serum samples of patients with silicosis, tuberculosis, and lung cancer were collected. The variation trends of the expression of granzyme A, cathepsin G, apolipoprotein A, and interferon-β (IFN-β) were analyzed using enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>The concentration of apolipoprotein A of the silicosis group was 200 µg/ml, significantly higher than those of the tuberculosis and lung cancer groups (P < 0.05), and the lung cancer group had a significantly higher concentration of apolipoprotein A compared with the tuberculosis group (P < 0.05). The silicosis group had significantly higher expression of cathepsin G compared with the tuberculosis and lung cancer groups (P < 0.05), and the tuberculosis group and lung cancer group showed no significant difference in the concentration of cathepsin G (P > 0.05). The tuberculosis group had a significantly higher concentration of granzyme A than the silicosis and lung cancer groups (P < 0.05), and the silicosis group and lung cancer group had similar protein concentration trends (P > 0.05). The tuberculosis group and lung cancer group had significantly higher concentration of IFN-β compared with the silicosis group (P < 0.05), and the tuberculosis group and lung cancer group showed no significant difference in IFN-β concentration (P > 0.05).</p><p><b>CONCLUSION</b>This study may offer diagnostic markers for the clinical diagnosis of silicosis, tuberculosis, and lung cancer, and could provide a basis for the research, as well as potential molecular targets for the diagnosis and treatment of these diseases.</p>

Significance of transbronchial needle aspiration and transbronchial biopsy in the diagnosis of central lung cancer / 中国综合临床

Objective To investigate the diagnostic value of transbronchial needle aspiration (TBNA) and transbronchial biopsy(TBB) in central lung cancer.Methods Retrospectively analyzed the diagnostic data of 150 patients with central lung cancer who underwent TBNA followed by TBB in our hospital from January 2011 to October 2012.Results Among 150 patients with central lung cancer,33 cases had intracavity mass.Thirtythree cases (100％) were confirmed by TBB and 32 cases (97.0％) confirmed by TBNA.There was no statistically significant difference between the diagnosis of TBB and TBNA(P =0.90).There were 26 cases with simple stenosis,among which 1 case(3.9％) confirmed by TBB and 26 cases(100％) confirmed by TBNA.And there was statistically significant difference was observed between the diagnosis by TBB and TBNA (P =0.01) Sixteen cases belonged to the lumen external pressure type with 2 cases(12.5％) were confirmed by TBB and 16 cases(100％) confirmed by TBNA.And there was statistically significant difference was observed between the diagnosis by TBB and TBNA (P =0.02).Forty-seven cases had luminal stenosis combined with mucosal diffuse lesions with 25 cases(53.2％) confirmed by TBB and 40 cases(85.1％) confirmed by TBNA.And there was statistical difference was observed between the diagnosis of TBB and TBNA(P =0.04).Twenty-eight cases had mixed type central lung cancer with 27 cases(96.4％) confirmed by TBB and 28 cases(100％) confirmed by TBNA.No statistically significant difference was observed between the diagnosis of TBB and TBNA (P =0.87).Conclusion According to endoscopic performance of central lung cancer,accurate and reasonable choice of biopsy method can minimize inspection costs on the basis of maintaining positive rate of diagnosis in order to achieve optimal titer.

Clinical evaluation of non small-cell luny cancer operated by autofluorescence bronchoscopy / 中国基层医药

ObjectiveTo explore the role of autofluorescence bronchoscopy in lung cancer operation and the meaning of choice lung cancer operation mode.MethodsTo retrospectively analyze 32 non-small cell lung cancer patients.Before lung cancer operation,white light bronchoscopy (WLB) and autofluorescence bronchoscopy (AFB) had been done routinely.Compared the different invasive tumor conditions by WLB and AFB,operation modes were decided by the edge of the tumor which were proved by biopsy pathology.ResultsIn 32 cases,19 cases underwent pulmonary lobectomy.One case underwent carinal resection and reconstruction.8 cases underwent sleeve lobectomy.4 cases underwent other therapy because of tumor airway metastasis.In 8 cases which underwent sleeve lobectomy,3 ca ses were found by WLB and AFB together,5 cases were found only by AFB.In 4 cases who had no operation chance,2 cases were found by WLB and AFB together,2 cases were only by AFB.The sensitivity for the detection of bronchial premalignant lesions was extremelyhigher withthe addition of AFB than WLBalone ( P ＜ 0.05 ).ConclusionAutofluorescence bronchoscopy is a safe and efficient technique which could improve the sensitivity of diagnosis in lung cancer than WLB.It is important to select operation mode.

Mini-incision video-assisted thoracoscopic versus conventional surgery for lung cancer / 中国微创外科杂志

Objective To investigate the clinical value of video-assisted thoracoscopic surgery (VATS) in the treatment of lung cancer. Methods The study included 49 patients with non-small cell lung cancer at stage Ⅰ~Ⅱ from January 2005 to June 2006. Lobectomy with mediastinal lymph node resection was performed by using VATS in 22 patients (Thoracoscopic Group) and by using conventional surgery in 27 patients (Conventional Group). The pulmonary functions and levels of C-reactive protein (CRP) were compared between the two groups. Results In the Thoracoscopic Group, a conversion to thoracotomy (12~15 cm of incision length) was required in 2 patients for treating blood vessels safely. The concentrations of CRP rose to the highest on the first day in both of groups. As compared with the Conventional Group, the CRP levels were significantly lower in the Thoracoscopic Group on the first day (56.1?10.9 mg/L vs 73.8?15.1 mg/L; t=-4.603, P=0.000). At 1 week after operation, the Thoracoscopic Group presented significantly lower minute ventilation volume (MV) (95.6?16.4 L vs 81.9?12.7 L; t=3.296, P=0.002) and forced expiratory volume in one second (FEV_1%) (51.7?5.7% vs 51.4?6.9%; t=3.105, P=0.003) than the Conventional Group. Conclusions VATS can be routinely adopted in patients with lung cancer at stage I or Ⅱ, with lesion