目的 探讨孤立性肺结节(solitary pulmonary nodule,SPN)良恶性诊断的相关临床影响因素及外科治疗策略. 方法 回顾性分析2010年11月至2012年3月在山东大学附属省立医院行手术治疗的151例SPN患者的临床及病理资料,其中男89例、女62例,年龄30～80 (57.99±0.86)岁,比较不同临床因素对恶性率影响的差异. 结果 良性SPN 29例,恶性122例.恶性SPN ⅠA期58例,ⅠB期30例,ⅡA期7例,ⅢA期25例,Ⅳ期2例.恶性SPN的平均直径大于良性(2.03 cm vs.1.77 cm,P=0.039),直径大于2 cm者的恶性率高于2 cm以下者(90.3％vs.74.2％,P=0.013),恶性患者的平均年龄大于良性患者(60.39岁vs.47.90岁,P＜ 0.01),年龄45岁以上患者的恶性率高于＜ 45岁患者(86.4％ vs.38.9％,P＜ 0.01).不同性别、有无临床症状、有无吸烟史、吸烟指数≤400支/年和＞ 400支/年、不同部位的恶性率差异无统计学意义. 结论 SPN的良恶性诊断应当综合患者的病史、年龄、结节直径、形态、动态变化进行判断,性别、有无临床症状、吸烟与否、吸烟指数及位置作为诊断参考因素的意义不大.

Objective To investigate the expression of D2-40 in thymic epithelial tumors(TET) and its significance in tumor invasion and prognosis.Methods Immunohistochemical method was used to assess the expression of D2-40 in 160 samples of thymic epithelial tumors and 40 samples of normal thymuses.All cases were followed-up for more than 5 years after operation.Statistics softwares were used to analyze the correlation between the expression of D2-40 and the tumor invasion and prognosis.Results The positive rate of D2-40 expression in 160 TET and 40 normal thymuses were 58.8%(94/160) and 20%(8/40) respectively,and the difference was statistically significant(P=0.013).The expression of D2-40 in TET was correlated with the invasion of TET(P<0.01).The 5-year-survival rates of the patients in the D2-40 expression positive group and the negative group were 32% and 90% respectively(P<0.01).Conclusion Expression of D2-40 is higher in the TET than in the normal thymus,which correlates with the aggression of TET.The patients with D2-40 positive expression have worse prognosis.

Purpose To observe the tissue regeneration of reconstruction with artificial esophagus made of medical polyurethane,and to study the feasibility of the new artificial esophagus in reconstruction of the cervical esophageal defect in a dog model.Methods Electric flexible esophagography was used to observe the artificial esophagus and granulation tissue,Gross and HE staining were used to observe regeneration of the esophageal tissues.Results The esophageal epithelium can regenerate,and it can cover the surface of defect in 3 months,The regeneration of gland,smooth muscle and striated muscle can not be found from 1 to 6 months after operation.After the articial esophagus ablated,it should be taken out to protect the epithelium.Conclusion The artificial esophagus made of medical polyurethane can be used to reconstruct the esophageal defect,The esophageal epithelium can regenerate.