贲门癌误诊为贲门失驰症一例报告

贲门癌误诊为贲门失驰症一例报告戈烽李秉潞李单青张志庸李泽坚患者，女，７５岁。因“间歇性”吞咽困难８个月门诊入院。入院前的钡餐检查显示食管下段鸟嘴样改变，诊为“贲门失弛症”。此后在２个月内连续做４次胃镜检查（包括两次食管下段气囊扩张术），均通过贲门困难...     

经皮冠状动脉腔内成形术失败后急诊冠状动脉旁路移植术二例

经皮冠状动脉腔内成形术失败后急诊冠状动脉旁路移植术二例中国医学科学院中国协和医科大学北京协和医院＊胸心外科于洪泉任华苗齐张志庸孙成孚李泽坚经皮冠状动脉腔内成形术（ＰＴＣＡ）已成为对一些冠状动脉粥样硬化性心脏病（冠心病）患者的首选治疗方法。但这项有创治...     

EARLY AND LATE RESULTS OF TOTAL GASTRECTOMY IN TREATMENT OF ADVANCED ADENOCARCINOMA OF THE CARDIA

Sixty-six patients with advanced adenocarcinoma of the cardia underwent total gastrectomybetween 1978 and 1986.The operative morbidity rate was 7.5% and the hospital mortalityrate (1 month) was 1.5%.The postoperative 1,3,4,and 5 year survival rates were 69%.50.7%,20% and 13.8% respectively.The quality of life after surgery was improved.Patho-logical type,lymph node metastasis,completeness of resectionand postoperative chemotherapywere the main factors influencing postoperative survival time.Indications for total gastrec-tomy and the advantages of transthoracic total gastrectomy are discussed.     

E-cadherin在非小细胞肺癌组织中的表达及临床意义

目的探讨非小细胞肺癌(NSCLC)组织中的E-cadherin(E-cad)表达情况与NSCLC临床病理特征的关系及其对预测肿瘤转移的意义。方法利用SP免疫组化法检测北京协和医院胸外科2009年6月至2010年6月收治的69例NSCLC患者的肿瘤标本的E-cad表达情况,并对患者治疗后进行为期一年的随访。结果 E-cad在患者肿瘤组织中的表达与患者组织学类型、年龄、性别无关(P分别为0.277、0.281、0.378),而低分化、晚期或淋巴结转移者E-cad表达率较低(P分别为0.001、0.049、0.040)。治疗后的E-cad(-)的Ⅰ~Ⅲ期患者比E-cad(+)患者更易发生转移(16.7%vs0,P=0.018)。结论 E-cad表达与NSCLC的侵袭和转移性有关,可以作为预测NSCLC转移的分子标志之一。     

FACTORS AFFECTING REMOVAL AND PROGNOSIS OF THYMIC TUMORS

One hundred and ten cases of thymic tumors were intervened surgically, including 92 thymoma, 8 thymie earcinoid, and 10 thymic carcinoma. In this series, 50. 9 % of the cases were complicated with various syndromes, 44. 5 % with myasthenia gravis (MG). Resection rate was correlated with the size and invasion of the tumor. There was significant difference in resection rate among thymoma, thymic carcinoid and thymic carcinoma. The degree of invasiorl undoubtely influenced on resection. The 3-, 5- and 10- year suvival rate of the thymoma were 82. 7 %, 68. 1 % and 40. 0 %, respectively. The prognosis depended on the pathoioglcal classification and the severity of the neighbouring invasion, but MG had no sianificant effect on prognosis. Recurrence and metastasis of the tumor were the main cause of late death.     

DIAGNOSIS AND SURGICAL TREATMENT OF BRONCHOGENIC CYSTS

Between 1974 and 1993, 22 patients with bronchogenic cysts were operated on in our hospital; there were 14 men and 8 women, ranging in age from 11 to 62 years, The cyst locations were mediastinal in 13 (59.1%) and intrapulmonary in 9 (40.9%). There were symptoms (chest pain and recurrent bronehiolits) in 20 patients (91%). The preoperative complications included infection in the lung and in the cyst and dysphagia due to esophageal eornpression. Chest pain was the main symptom in mediastinal cyst and recurrent infection of lung in intrapulmonary cyst. Plain chest radiograms showed that a rousd shadow, occasional air-fluid levels, and peripheral calcification may be found in cysts. An operation is the best treatment for cysts. All cysts were completely excised. No postoperative complieations, late complica-tions, or recurrence developed in our patients.     

Wada手术治疗成人漏斗胸

我院1987年1月～1993年10月间Wada手术治疗成人漏斗胸10例(男7例,女3例),平均年龄18岁(14～32岁).术前胸廓指数为0.28±0.09,肺功能平均1秒用力呼气量(?V_1)为71.6%,最大呼气中间流量(MMF)为2.3L/S,最大肺活量(%FVC)为67.8%.胸廓指数越大,肺功能越好.4例胸廓指数>0.30,其肺功能指标明显高于胸廓指数<0.30的6例病人.术后并发症:1例胸骨后感染,与纵隔引流不畅及组织坏死较多有关.1例术后左侧肺不张,经吸痰等治疗后好转.2例病人术后3周内低热.胸骨翻转术应注意减少组织坏死及胸骨后感染,故应尽可能保留胸廓内动脉、清除胸骨上多余的软组织、胸骨翻转后肋软骨应尽量用骨膜包裹、放置有效引流管等以减少并发症.