More and more solitary pulmonary nodules (SPN) are discovered with the development of imaging technology. Early and appropriate evaluation of SPN is of great importance for following treatment and patients' prognosis, as early differentiation between benign and malignant is difficult, while its possibility of being malignant does exist. In this review, we make a comprehensive evaluation about diagnostic value of some risk factors of solitary pulmonary nodules, including age, nodule diameter, doubling time, nodule location, air bronchogram, ground-glass opacitie, vacuole, lobulation, spiculation, vascular convergence, pleural indentation, nodule calcification, past medical history, smoking history, past symptoms and nodule density. Future perspective of diagnostic strategies is also discussed.
In vivo transplantation of tracheal grafts utilizes natural environment in vivo to improve cell adhesion, growth and scaffold properties, which can not only promote graft revascularization, but also induce immune tolerance and increase postoperative survival rate. Decellularized trachea with stem cells covering the outside layer and airway epithelial cells covering the inside layer can achieve complete mucosa re-epithelialization, cartilage cell growth and revascularization, using own body as a natural bioreactor to boost the maturity of tissue engineered trachea. Then transplantation at a normotopic in situ positioning is performed. This transplantation strategy provides a promising approach for the treatment of long-segment tracheal defects. This review focuses on the significance and research progress of constructing tissue engineered trachea in vivo.
A variety of benign and malignant disorders affecting the trachea can theoretically be treated by simple resection and subsequent end-to-end anastomosis of remained trachea. Unfortunately, it is feasible only when the affected tracheal length does not exceed 50% of the entire length in adults and about 30% in children. Tracheal transplantation may be a treatment option for those patients, but still has many problems to be solved, such as immunological rejection, revascularization, infection and granulation tissue hyperplasia. This review focuses on how to use different methods to inhibit immunological rejection of tracheal transplantation, and current research progress of immunological rejection in tracheal allograft.
Tissue-engineered tracheal transplantation has been reported and the technique of decellularized scaffold's preparation is mature. Regeneration of epithelium, cartilage and blood vessel is particularly important during tracheal transplantation. With the increasing improvement on cell acquisition and cell culture, as well as the factor of auxesis and cell differentiation, tissue-engineered technique provided possibility and clinical value for regeneration of epithelium, cartilage and blood vessel. This review focuses on the improvement and prospect of regeneration of epithelium, cartilage and blood vessel during tracheal transplantation.
Primary palmar hyperhidrosis is a kind of benign disease characterized by abnormally increasing sweat. Various treatments for it exist in clinic currently and the one of them is endoscopic thoracic sympathectomy. But due to the different choice of surgery path, surgery method and the way or the level to block the sympathetic chain, the surgical curative effect and the incidence of postoperative complications vary hugely. This review provides an update report on the surgery method and the way or the level to block the sympathetic chain to treat palmar hyperhidrosis by endoscopic thoracic sympathectomy.