Large cell neuroendocrine lung cancer（LCNEC） is the rare subtype of nonsmall cell lung cancer. Because of its low incidence rate and the special biological behaviour, it is hard to define in pathology. And we also know little about its epidemiological feature and the purposeful therapy view of LCNEC, and the therapeutic effect is unsatisfactory. This article will review and introduce the advance of research, clinical diagnosis and therapeutic of the LCNEC.
Objective To determine whether the basal characteristics and survival of young patients undergoing surgical resection of nonsmall cell lung cancer (NSCLC) differ from those of elderly patients. And, we would discuss the special perioperative management in elderly patients with NSCLC. Methods 178 NSCLC patients who underwent surgery in our hospital between Jan. to Dec. in 2002 were divided into two groups according to age. Young group comprised 89 patients aged 50 years or younger and elderly group comprised 89 patients aged 70 years or older. The patients’ clinical data, operative style,postoperative complications and survival results were reviewed and analysed. Results The proportion of the elderly group squamous cell carcinoma patients was higher than that of the younger group （χ2=9.281,P=0.000.）,but there was no significant difference between the gender, smoking, histology, TNM stage, type of resection, post operation chemotherapy or radiotherapy（χ2≤5.569，Pgt;0.05）. The incidence of the preoperative cardiovascular disease, chronic bronchitis in the elderly group patients were higher than those of younger group（χ2=14.053，P=0.000;χ2=13.044，P=0.000）.The incidence of postoperative complications was significantly higher in elderly group than those of younger group（χ2=12842，P=0.000）. The 1, 3 and 5year survival rates were 71.43％，33.53％ and 27.83％ in elderly group, and 77.78％，46.67％ and 44.07％ in young group, respectively. However, the 1, 3 and 5year survival rates for patients in two groups showed no difference between two groups（Pgt;0.05）. Conclusion The elderly patients have higher operative risk than that of young patients. We should pay more attention to the perioperative management of elderly patients. The elderly patients could get acceptable long term survival rates through surgical treatment. Operation is still the first choice for elderly patients with NSCLC.
目的探讨可吸收肋骨钉与记忆合金接骨板内固定两种方法治疗多发性肋骨骨折的效果。 方法回顾性分析2009年1月至2014年1月在上海市第六人民医院胸外科行手术内固定的胸部外伤致多根多处肋骨骨折患者321例的临床资料，其中可吸收肋骨钉组70例，其中男62例、女8例，年龄（48.54±9.74）岁；记忆合金接骨板组251例，其中男187例、女64例，年龄（51.44±10.22）岁。分析两组患者疗效差异。 结果两组患者术前疼痛评分（7.74±0.89 vs.7.66±0.92）、术后疼痛评分（3.80±0.79 vs.3.82±0.85），术后胸腔引流时间[（6.00±2.84）d vs.（5.68±2.98）d]差异均无统计学意义（P>0.05）。记忆合金接骨板组住院时间[（20.06±7.39）d vs.（17.77±7.68）d]，及手术时间（101.29±30.67）min vs.（71.95±29.50）min]均短于可吸收肋骨钉组，且差异有统计学意义（P＜0.05)。术后3个月随访复查胸部X线，两组患者骨折再移位差异无统计学意义。 结论可吸收肋骨钉与记忆合金接骨板均是治疗多发性肋骨骨折较理想的术式，记忆合金接骨板手术操作更为简单，可吸收肋骨钉手术无需在体内留置金属内固定装置，但固定强度较接骨板略差，应根据情况选择合适的内固定方法。