Abstract： Objective To summarize the technical characteristics and experience on the surgical treatment of esophagobrochial fistula induced by esophageal carcinoma and explore the safe and effective operation procedures. Methods This report retrospective1y summarized 12 cases of esophagobronchial fistula induced by esophageal cancer between January 2007 and November 2010 in Tangdu Hospital, Fourth Military Medical University. There were 9 male patients and 3 female patients with their mean age of 51.24 years (ranging from 37 to 62 years). Four types of surgical procedures were performed to patients according to their respective conditions: (1) Esophagectomy ＋“tunnel”esophagogastrostomy ＋ pulmonary lobectomy (2 patients)； (2) Esophagectomy ＋ stapled esophagogastrostomy ＋ pulmonary lobectomy (5 patients)； (3) Esophagectomy ＋ colon interposition for esophagus ＋ pulmonary lobectomy (4 patients)； (4) Esophagectomy ＋ esophagogastrostomy ＋ left pneumonectomy (1 patient). Results Among those 12 cases presenting to our hospital, 2 patients died during the postoperative period and the overall morality was 16.67%(2/12). One patient died of acute congestive heart failure on the 4th postoperative day after esophagectomy, “tunnel”esophagogastrostomy and left lower lobectomy of the lung for esophageal carcinoma directly invading the left lower bronchus, and another patient died of severe infection and renal failure on the 11th postoperative day after esophagectomy, stapled esophagogastrostomy and left upper lobectomy of the lung for esophageal carcinoma directly invading the left upper bronchus. Four patients developed mild empyema and 1 patienthad bronchial fistula after surgery, who finally recovered and were discharged after treatment of antibiotics and drainage. The postoperative morbidity was 41.67%（5/12）. All surviving patients were followed up from 1 month to 3 years. During follow-up, there was one death, and the other patients were alive without any clinical events. Conclusion Individualized surgical procedure is a safe and effective therapeutic choice for patients with esophagobronchial fistula induced by esophageal carcinoma.
Objective To review the expression of mechano-growth factor (MGF) and its roles in tissue repairs andregeneration. Methods The l iterature about the expression of MGF and its roles in tissue repairs and regeneration in recentyears was reviewed. Results MGF is sensitive to mechanical stimulation and can be expressed in various tissues/cells. MGF isresponsible for satell ite cell activation, myoblast proliferation, and plays important roles in the treatment of muscle coloboma,prevention of myocardial injury, and neuroprotection. Conclusion The important role of MGF in tissue repairs andregeneration has been identified, however, the detailed mechanisms remain unclear up to now and still need a further study.
Objective To discuss the safety and validity of pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) patients with severe right heart failure (RHF). Methods PEA procedures were performed on 36 patients in Fu Wai Hospital from January 2015 to April 2016. There were 28 males and 8 females, with a mean age of 46.56±11.85 years. According to the New York Heart Association (NYHA) cardiac function classification, 36 patients were divided into preoperative severe RHF group (grade Ⅲ-Ⅳ,n=28) and preoperative without severe RHF group (grade Ⅱ,n=8). Hemodynamic parameters before and after PEA were recorded and 3-18 months' follow-up was done. Results All the patients having PEA surgeries had an obvious decrease of mean pulmonary arterial pressure (from 49.53±13.14 mm Hg to 23.58±10.79 mm Hg) and pulmonary vascular resistance (from 788.46±354.60 dyn·s/cm5 to 352.89±363.49 dyn·s/cm5, bothP<0.001). There was no in-hospital mortality among all the patients. Persistent pulmonary hypertension occurred in 2 patients, perfused lung in 2 patients, pericardial effusion in 2 patients. No mortality was found during the follow-up period. All patients improved to NYHA grade Ⅰ-Ⅱ (WHO grade Ⅰ-Ⅱ), and only 2 patients remained in the NYHA grade Ⅲ (P<0.01). Conclusion The CTEPH patients having PEA surgeries had an obvious improvement in both their hemodynamics results and postoperative heart function, which in return could improve their quality of life.