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Chinese Medical Journal 2021年第12期134卷 1489-1491页

作者： Yu Shen Kak Khee Yeung Qing-Sheng Lu Department of Vascular Surgery Changhai HospitalSecond Military Medical UniversityShanghai 200433China Department of Vascular Surgery VU University Medical Center AmsterdamAmsterdamThe Netherlands

Physician-modified fenestrated stent-graft for thoracic endovascular aortic repair(TEVAR)has economic advantages and can be used in acute situations for aortic dissection and aneurysm involving aortic arch.[1]However,accurate alignment of fenestrations and branch arteries of the aortic arch is challenging,especially for multi-fenestration.[2]Once misaligned,complications such as branch occlusion or cerebral ischemia will occur.Details about how to align fenestrations with branch arteries of the aortic arch in TEVAR with physician-modified triple fenestrated stent-graft are elaborated in this article.

关键词： aortic thoracic acute

ALK-positive anaplastic large cell lymphoma of the thoracic spine occurring in pregnancy: A case report

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World Journal of Clinical Cases 2019年第18期7卷 2857-2863页

作者： Sen Yang Wei-Min Jiang Hui-Lin Yang Department of Orthopedics The First Affiliated Hospital of Soochow University

BACKGROUND Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin’s lymphoma (NHL). ALCL is rare as a bone lesion and in pregnancy. CASE SUMMARY We present the first case of anaplastic lymphoma kinase (ALK)+ ALCL of the thoracic spine during pregnancy. A 25-year-old pregnant woman was presented to us at 24 wk’ gestation with severe back pain and weakness in the left lower limb. Imaging examination showed lesions at T10 and T11. She underwent posterior pedicle screw fixation and vertebroplasty. Pathological examination showed ALK+ ALCL. The patient chose to have therapeutic abortion after surgery and received chemotherapy in the hematology department. She now remains disease free with no neurological deficit after 30 mo’ follow-up. CONCLUSION ALK+ ALCL with the thoracic spine involvement is uncommon, especially in pregnancy. Many symptoms can be misunderstood during pregnancy;therefore, when a pregnant patient has persistent back pain or lower limb neurological symptoms, imaging examinations should be performed.

关键词： Anaplastic large cell lymphoma Pregnancy thoracic spine Surgical treatment Chemotherapy Case report

thoracic endovascular aortic repair with left subclavian artery reconstruction for blunt traumatic aortic injury in elderly patients

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Journal of Interventional Medicine 2019年第4期2卷 150-153页

作者： Li Zhang Huaping Wu Xiang Li Kaiping Lv Huanhuan Song Cunliang Zeng Jianlin Liu Department of Vascular Surgery Dazhou Central HospitalDazhou635000PR China Department of Vascular Surgery The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an710000PR China

Introduction:Blunt thoracic aortic injury(BTAI)is rare in elderly patients.As the population ages and life expectancy increases,the frequency of this injury will increase,while the treatment and outcomes remain unclear.Methods:We retrospectively analyzed the collected data of patients>60 years old with BTAI to investigate the mechanism of trauma;time interval from injury to diagnosis;type and timing of surgical intervention;aortic arch pattern;choice of left subclavian artery reconstruction;endograft to treat BTAI;length of the endovascular procedure;endoleaks;complications including stroke,paraplegia,and renal failure;length of hospital stay(LOS)and intensive care unit stay(L.ICUS);and 30-day mortality.Results:Five elderly trauma patients were found to have BTAI.Four(80%)were males,the cohort mean age was68 years,the major mechanism of trauma was fall injury,and the associated injury was thoracic trauma.All patients were transferred to our hospital,and emergency computed tomography angiography showed BTAI in each patient.The average time interval from injury to diagnosis was 2.7 days.Two patients suddenly showed signs of instability in their vital signs and underwent immediate endovascular repair,while 3 patients underwent delayed endovascular repair.The injury site was located in the aortic isthmus just distal to the origin of the left subclavian artery;the aortic arch pattern was II(80.0%)in 4 cases and III in 1 case(20.0%).The choice of left subclavian artery reconstruction included chimney,double chimney,prefenestration,and chimney combined with in situ fenestration.Endografts to treat BTAI included the Ankura(Lifetech Scientific,Shenzhen,China)and the C-TAG(W.L.Gore&Associates,Flagstaff,AZ USA).The length of the endovascular procedure was 75.4 min;there were no endoleaks and no complications including stroke,paraplegia,or renal failure.The average LOS was25 days,and the average L.ICUS of 2 patients was 15 days,with no 30-day mortality.Conclusion:Elderly patients with fall injury should promptly exclude BTAI

关键词： Blunt traumatic aortic injury thoracic endovascular repair Reconstruction of left subclavian artery

Video-assisted thoracic resection of a rare ectopic mediastinal bronchial artery aneurysm

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Chinese Medical Journal 2021年第7期134卷 857-858页

作者： Li Li Luo Zhao Ying-Zhi Qin Jia He Zhi-Jun Han Department of thoracic Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

To the Editor:Bronchial artery aneurysm(BAA)is a rare but potentially fatal disease.BAA is reported in less than 1%of all selective bronchial arteriographies.[1]The primary treatment is endovascular therapy,including transcatheter arterial embolization or aortic stent-graft placement.Surgical treatment can be considered for patients with treatment failure,recurrence or contraindications to endovascular therapy.Herein,we present a rare case of an ectopic mediastinal bronchial artery aneurysm that was successfully resected via video-assisted thoracic surgery(VATS).

关键词： bronchial aneurysm thoracic

Non-invasive thoracic electrical bioimpedance technique-derived hemodynamic reference ranges in Chinese Han adults

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Chinese Medical Journal 2021年第20期134卷 2515-2517页

作者： Qing-Long Meng Yan Sun Hui-Jing He Hao Wang Guang-Liang Shan Department of Echocardiography Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Institute of Basic Medical Sciences Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

To the Editor:Continuous monitoring of hemodynamic status can be used to detect early abnormal circulation and is very helpful for the management of the critically ill.Today,different minimally invasive and non-invasive monitoring systems can measure functional hemodynamic parameters to guide treatment planning and improve patient care.Among them,the thoracic electrical bioimpedance(TEB)technique is widely available and is accurate for most patients,especially after open-heart surgery.However,there are ethnicity-related differences among hemodynamic characteristics and the hemodynamic response to the same cardiovascular disease differs among racial groups.Currently,no nationwide hemodynamic parameter reference ranges can be used for healthy Chinese Han adults.A large-scale,forward-looking research investigation of the hemodynamic state markers in China has not been wholly reported.Therefore,it is necessary to establish ethnicity-specific hemodynamic reference ranges for the Chinese Han population and evaluate the relationship between these parameters and age/sex,in order to promote efficient and accurate judgment in clinical practice.From July 2012 to September 2017,a prospective,nationwide study led by the Ministry of Science and Technology of the People’s Republic of China was designed,organized,and performed to establish normal reference ranges of hemodynamic parameters for the Chinese Han population and to confirm the impacts of age and sex on these parameters.

关键词： hemodynamic invasive thoracic

Application of a continuous respiratory sound monitoring system in thoracic surgery

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The Journal of Biomedical Research 2021年第6期35卷 491-494页

作者： Hong Wang Alper Toker Ghulam Abbas Le Yi Wang Department of Anesthesiology West Virginia UniversityMorgantownWV 26506USA Department of Cardiovascular and thoracic Surgery West Virginia UniversityMorgantownWV 26506USA Department of thoracic Surgery West Virginia UniversityMorgantownWV 26506USA Department of Electrical and Computer Engineering Wayne State UniversityDetroitMI 48202USA.

Dear Editor,We would like to present a novel system for monitoring double-lumen tube(DTL)positions in thoracic surgery by respiratory sounds at the trachea and the bronchi,based on our previously described methodology,algorithms,and patented technology[1-2].Most thoracic surgeries require one-lung ventilation(OLV).A DLT or a bronchial blocker(BB)is the most common means for managing OLV.Intraoperative DLT or BB malposition is a critical issue that needs to be accurately and promptly detected to prevent the incidence of hypoxemia and unintended re-expansion of operated lung during OLV[3-4].A multi-center study of 2127 patients requiring OLV during thoracic surgery revealed that DLTs were used in 95%of patients with a malposition rate of 14%,and BBs were used in 5%of patients with a malposition rate of 33%[5].

关键词： thoracic surgery respiratory

Progress in Intraoperative Neurophysiological Monitoring for the Surgical Treatment of thoracic Spinal Stenosis

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Chinese Medical Sciences Journal 2017年第4期32卷 260-264页

作者： Yongsheng Liu Yu Zhao Department of Orthopedics Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100730 China

thoracic spinal stenosis (TSS) is a group of clinical syndromes caused by thoracic spinal cord compression, which always results in severe clinical complications. The incidence of TSS is relatively low compared with lumbar spinal stenosis, while the incidence of spinal cord injury during thoracic decompression is relatively high. The reported incidence of neurological deficits after thoracic decompression reached 13.9%.Intraoperative neurophysiological monitoring (IONM) can timely provide information regarding the function status of the spinal cord, and help surgeons with appropriate performance during operation. This article illustrates the theoretical basis of applying IONM in thoracic decompression surgery, and elaborates on the relationship between signal changes in IONM and postoperative neurological function recovery of the spinal cord. It also introduces updated information in multimodality IONM, the factors influencing evoked potentials,and remedial measures to improve the prognosis.

关键词： thoracic spinal stenosis intraoperative neurophysiological monitoring motor evoked potentials somatosensory evoked potentials prognosis

Radiation pneumonitis complicated by Pneumocystis carinii in patients with thoracic neoplasia:a clinical analysis of 7 cases

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Cancer Communications 2019年第1期39卷 430-433页

作者： Zhixue Fu Xu Yang Nan Bi Yirui Zhai Dongfu Chen Wenqing Wang Lei Deng Tao Zhang Zongmei Zhou Jun Liang Department of Radiation Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021P.R.China

Dear editor,Patients with neoplastic disease may have immunosup-pression due to primary disease or related treatment[1].They have an increased risk of bacterial infections and Pneumocystis carinii pneumonia(PCP).Symptomatic radiation pneumonitis(RP)is an important clinical toxic response in patients receiving thoracic radiotherapy.The incidence is 15%-40%in patients receiving concur-rent chemoradiotherapy for non-small cell lung can-cer(NSCLC)[2].RP can reduce the quality of life and uncommonly result in oxygen dependence or death.RP complicated by PCP is rarely reported and the clinical characteristics are unclear.Here,we reported 7 cases of thoracic neoplastic patients with RP complicated by PCP treated at the Cancer Hospital,Chinese Academy of Medical Sciences(Beijing,China)between October 2014 to March 2017 to study their clinical characteristics and treatment outcomes(Additional file 1:Table S1).

关键词： clinical thoracic patients

Crossed Intralaminar Screws for Fusion of the Cervicothoracic Junction and the thoracic Spine: The Experience in an Iberic Service with Case Series and Review of the Current Literature with Technique Description

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Surgical Science 2023年第3期14卷 203-220页

作者： Marcel Sincari Margarida Conceição Neurosurgeon Centro Hospitalar Tondela-Viseu Viseu Portugal

The treatment of pathologies in the thoracic spine is a challenge. The periodic failure of pedicle screw insertion and anatomical variations make the search for an alternative to pedicle screws in thoracic spine surgery necessary. The interlaminar crossed screws is a well-known and secure method for fusion in cervical spine, and in thoracic spine there used to be insufficient clinical data to support this technique, until now. We demonstrate in an initial series of 10 cases treated with interlaminar fusion in association of other fusion techniques in the thoracic spine with good results. Objective: Intralaminar screws have been shown to be a biomechanical salvage technique in the thoracic spine, especially in long cervicothoracic, thoracic and thoracolumbar fixation. The goals of this article are to demonstrate our initial experience and the range of indications for thoracic crossed intralaminar screws. Methods: In this article we describe our initial series performed at São Teotónio Hospital in Viseu, Portugal, and our results, and also provide a comprehensive review of the recent literature in the use of intralaminar crossed fixation.

关键词： Crossed Intralaminar Spinolaminar Angle thoracic Imaging Lamina Screws Spinal Fusion/Instrumentation/Methods thoracic Vertebrae

Case Report:Pulmonary actinomycosis:a case undergoing resection through video-assisted thoracic surgery (VATS)

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2007年第10期8卷 721-724页

作者： LIN Ming-shian LIN Wea-lung LUH Shi-ping TSAO Thomas Chang-yao WU Tzu-ching Department of Medicine Chia-Yi Christian Hospital600 Taichung Taiwan China Department of Pathology Chung-Shan Medical University and Hospital402 Taichung Taiwan China Department of Surgery Chung-Shan Medical University and Hospital402 Taichung Taiwan China Department of Medicine Chung-Shan Medical University and Hospital402 Taichung Taiwan China

Actinomycosis is an uncommon disease, which is usually manifested as cervicofacial infection and related to poor oral hygiene or compromised immune function. Pulmonary actinomycosis is rare, but its diagnosis is changing due to its variable presentation and the similarity in appearance to other intrapulmonary diseases. Here we report an 80-year-old man with a solitary pulmonary nodule over the left upper lobe. Pulmonary neoplasm was highly suspected in this patient and thus resection of the mass was undertaken through video-assisted thoracic surgery (VATS). Histopathological examination demonstrated this patient had an Actinomyeces infection. While the application of VATS in patients with pulmonary actinomycosis has rarely been reported in literature, we conclude that VATS is valuable for the diagnosis and treatment of patients with undetermined pulmonary nodule(s).

关键词： Pulmonary actinomycosis Video-assisted thoracic surgery (VATS) Resection