Fibro-bronchoscopic Cryosurgery for Unresectable Endobronchial Tumors

Background and objective Patients with tracheobronchial tumor are too frail for curative surgical treatment, and the original sites are unsuitable for radical resection. They always suffered from dyspnea, hymoptosis, obstructive pneumonia, and fever. Airway obstruction has a strong bad impact on the quality of life, and is the main cause of respiratory failure and death. An effective method of palliative is very important. We choose fibro-bronchoscopic cryosurgery for destruction of endobronchial tumors and analyze the outcomes. Methods Clinical records of 126 cases who under went endobronchoscopic cryosurgery were reviewed retrospectively from August 2004 to February 2014. Techniques and survival outcomes were analyzed. The precise position and length of the cryosurgery was evaluated through three dimension chest computed tomography (CT) and reconstruction of trachea and bronchus. Local infiltration and general intravenous anesthesia are two options before surgical procedure. Endobronchial tumor was removed by combining two methods of “Cryo-Resecion” and “Cryo-Melt”. Bronchoscopic examination was rechecked 2 weeks later to evaluate if it is necessary to redo the endobronchoscopic cryosurgery. Results The symptoms of cough, short of breath, and hemoptysis were alleviated to different extend. The rate of dramatically improved and partial improved were 65.1% and 77.0% respectively. The mortality is 0.79%. Postoperative Complications included 2 cases of airway bleeding, 4 cases of bronchial stenosis, 2 cases of trachea burning injury, 2 cases of tracheomalacia, and 3 cases of atrium fibrillation. The median survival is 14 months, 1-, 2-, 3-yr survival rates were 58.6%, 24.2%, and 12.2% respectively, based on Kaplan-Meier estimates. Conclusion Endobronchial cryosurgery is an easy and effective minimally invasive choice for controlling and releasing the airway obstructive symptoms resulting from the trachea or bronchial tumors. Besides, the problem of difficult endotracheal intubation could be resolved after removing the tracheal tumor with the benefit of cryotreatment. Some patients could get the chance for further treatment or radical resection. Therefore, the patients’ quality of life could be improved and the lifetime could be prolonged

Effects of Multiple Factors on the Prognosis of pIIIa/N2 Patients with Non-small Cell Lung Cancer

Background and objective Thoracic surgery hasn’t got consensus on therapy of pIIIa/N2 non-small cell lung cancer (NSCLC). The aim of this study is to identify prognostic factors in NSCLC with N2 nodal involvement. Methods A retrospective review of disease free survival and 5-year survival for NSCLC patients who underwent primary surgical resection without neoadjuvant chemotherapy was performed. Between January 1998 and May 2004, 133 patients were enrolled. Several factors such as age, sex, skip metastasis, number of N2 lymph node stations, type of resection, histology and adjuvant therapy were recorded and analyzed. SPSS 16.0 was used for calculating survival. Results Overall 5-year survival for 133 patients was 32.33%, and 5-year survival for single N2 station and multiple N2 station sub-group were 39.62% and 27.50%, respectively. 5-year survival for cN0-1 and cN2 sub-group were 37.78% and 20.93%, respectively. Cox regression analysis revealed that number of N2 station (P=0.013, OR=0.490, 95%CI: 0.427-0.781) and cN status (P=0.009, OR=0.607, 95%CI: 0.372-0.992) were two favorable prognostic factors of survival. Conclusion Number of N2 station and cN status are two favorable prognostic factors of survival. In restrict enrolled circumstances, after combined therapy made up of surgery and postoperative adjuvant therapy have been performed, satisfied survival can be achieved

Enhanced resolution of marine viruses with violet side scatter

International audienc

Novel and convenient method to evaluate the character of solitary pulmonary nodule-comparison of three mathematical prediction models and further stratification of risk factors.

OBJECTIVE: To study risk factors that affect the evaluation of malignancy in patients with solitary pulmonary nodules (SPN) and verify different predictive models for malignant probability of SPN. METHODS: Retrospectively analyzed 107 cases of SPN with definite post-operative histological diagnosis whom underwent surgical procedures in China-Japan Friendship Hospital from November of 2010 to February of 2013. Age, gender, smoking history, malignancy history of patients, imaging features of the nodule including maximum diameter, position, spiculation, lobulation, calcification and serum level of CEA and Cyfra21-1 were assessed as potential risk factors. Univariate analysis model was used to establish statistical correlation between risk factors and post-operative histological diagnosis. Receiver operating characteristic (ROC) curves were drawn using different predictive models for malignant probability of SPN to get areas under the curves (AUC values), sensitivity, specificity, positive predictive values, negative predictive values for each model, respectively. The predictive effectiveness of each model was statistically assessed subsequently. RESULTS: In 107 patients, 78 cases were malignant (72.9%), 29 cases were benign (27.1%). Statistical significant difference was found between benign and malignant group in age, maximum diameter, serum level of Cyfra21-1, spiculation, lobulation and calcification of the nodules. The AUC values were 0.786±0.053 (Mayo model), 0.682±0.060 (VA model) and 0.810±0.051 (Peking University People's Hospital model), respectively. CONCLUSIONS: Serum level of Cyfra21-1, patient's age, maximum diameter of the nodule, spiculation, lobulation and calcification of the nodule are independent risk factors associated with the malignant probability of SPN. Peking University People's Hospital model is of high accuracy and clinical value for patients with SPN. Adding serum index (e.g. Cyfra21-1) into the prediction models as a new risk factor and adjusting the weight of age in the models might improve the accuracy of prediction for SPN

The Common Causes of Conversion of VATS during Operation for 248 Non-small Cell Lung Cancers

Background and objective VATS-lobectomy has been used as regular surgical procedure clinically for non-small cell lung cancer. The aim of this study is to evaluate the surgical emergencies during VATS and the related factors postoperatively. Methods Clinical data were reviewed for patients who were performed with pulmonary related surgery between January 2006 and July 2008 in our department. Results 248 (117 CVATS and 131 AVATS) VATS lobectomy were performed, including 13 cases that were transferred into AVATS or OPEN. The common related reasons were bleeding of pulmonary branches, adhesion, anatomic deformity, bleeding of azygos and bleeding of middle-lobe-vein. 129 thoracotomy cases were enrolled. Compared with OPEN surgery, VATS got the merits of short in-hospital duration (20 days vs 27 days, P=0.015), less bleeding (197 mL vs 250 mL, P=0.005) and less pain (4.6 vs 6.2, P=0.003). Conclusion VATS is a safe surgical procedure for early stage NSCLC with merits of lower morbidity and sooner recovery. So it could be concluded that in some circumstances, VATS could be chosen as an alternate of thoractomy

Virioplankton distribution in the tropical western Pacific Ocean in the vicinity of a seamount

International audienc

Comparison of different models on AUC value^*.

*<p>AUC is in the range of 0.5 to 1.0. When AUC>0.5, more close to 1, higher diagnostic accuracy the model indicates. AUC In the range of 0.5∼0.7, the model has lower accuracy, 0.7∼0.9, has a certain extent of accuracy, >0.9, indicates high accuracy. When AUC = 0.5, the method shows no diagnostic value. When AUC<0.5, it does not fit the real situation.</p

Univariate analysis of quantitative factors.

*<p>Data of CEA did not achieve the homogeneity of variance, P value of rank-sum test >0.05, indicated no difference between groups. Result may relate to disperse distribution of value of CEA in malignant group, and could be positive after sum of case enlardged.</p

Histological diagnosis and initial operation options.

<p>Histological diagnosis and initial operation options.</p