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Airway management in complex tracheobronchial surgery (TBS) remains a challenge in thoracic surgery. The use of extracorporeal membrane pulmonary oxygenation (ECMO) in thoracic surgery is rather rare, except for lung transplantation. To report the safety and efficacy of ECMO in complex TBS, a total of 5 patients with tracheobronchial and bronchial reconstructive surgery supported by ECMO in the Department of Thoracic Surgery of Tangdu Hospital, Air Force Medical University from May 2019 to June 2024 were collected. Among them, 4 cases of tracheal tumor (including long-segment trachea resection and reconstruction, or carinal resection and reconstruction) and 1 case of acute airway obstruction caused by tracheal rupture were included, all of which were performed in veno-venous ECMO (V-V ECMO) mode. Systemic heparinization was used in 2 patients, and anticoagulation was not performed in 3 patients, which were maintained only by ECMO heparin-coated lines. 4 patients recovered well after surgery, and 1 patient died 1 month after surgery due to immune-related pneumonia. For complex TBS, or in emergency situations (tracheal stenosis with risk of asphyxiation), ECMO can provide adequate support and safeguard.

Background and objective Electromagnetic navigation bronchoscopy is a tool that can accurately navigation peripheral lung lesions. Because of electromagnetic navigation bronchoscopy (ENB) is too expensive, it has not been widely used in China. It is urgent for us to summarize experience in clinical application, especially in the diagnosis of pulmonary nodules. Methods The clinical data of patients with pulmonary peripheral lesions (PPLs) in our department undergoing ENB biopsy between July 2017 and December 2018 were retrospectively analyzed. Results There were 18 patients with 21 PPLs (10 males and 8 females). Among them, 11 patients got the final pathological diagnosis, 8 cases were diagnosed with adenocarcinoma lung cancer, 1 case was diagnosed with tuberculosis and 2 cases were diagnosed with small cell lung cancer. The positive rate of diagnosis was 61.1%. The sensitivity was 73.3%. The positive diagnosis rate is related to the size of the lesion, the positive diagnosis rate for lesions >2 cm is 100.0% (P=0.04). Conclusion Electromagnetic navigation bronchoscope is safe and effective in clinic. It has a high positive rate for the diagnosis of peripheral lung lesions larger than 2 cm, ENB has broad clinical application prospects.

Background and objective NOK (Novel Oncogene with Kinase-domain) is a newly identified receptor protein-tyrosine kinases (RPTKs) subfamily, which possesses strong oncogenic potential including enhancing cell transformation, tumorigenesis, invasion and metastasis. However, NOK protein lacks extracellular domain, and how the NOK is activated by the membrane receptor and the expression of NOK in non small cell lung cancer (NSCLC) are not clear. Our aim of this study was to investigate the expressions of NOK, EGFR proteins in NSCLC. Methods The expression rates of NOK, EGFR proteins in 155 cases with NSCLC was deteced by immunohistochemical stain; The clinical correlations between two proteins were analyzed by statistics. Results The NOK positive expression was mainly located in cytoplasm and EGFR was mainly located in the plasma membrane and cytoplasm. NOK, EGFR proteins were high expressed in NSCLC and there were extremely differences comparing the expression of NOK, EGFR proteins in squamous cell lung cancer, lung adenocarcinoma with those in corresponding normal tissue respectively (P < 0.001); and there were no significant differences between the two kinds of the cancers for their comparison of NOK, EGFR expression (P=0.099; P=0.23); however, there were significant differences for NOK and EGFR expression among histological grades and TNM stages in squamous cell lung cancers, lung adenocarcinoma (P < 0.01). There were correlation between positive and intensity of NOK and EGFR expression in whatever total NSCLC or squamous cell lung cancer or lung adenocarcinoma (P < 0.001), while the correlation coefficients(rs) were 0742, 0.722, 0.756 respectively. Conclusion The NOK proteins are highly expressed in the NSCLC, and the expression rates of NOK proteins are correlated with the cancers’ histological grades and TNM stages, which may be concern with tumorgenesis and progression; the positive expression rate and intensity of NOK protein correlate well with the expression of EGFR protein in NSCLC, which the activation of NOK probably owe to EGFR activation, all that would provide evidence for further study on the effective mechanism of NOK in the tumorigenesis or tumor progression.

Background and objective Multidrug resistance (MDR) is the main reason of the failure of chemotherapy in lung cancer. The MDR mechanism in lung cancer is complex, which relates to sorts of drug resistant genes. ABCC10 is a recently identified member of a subset of the C family of ATP-binding cassette (ABC) transporters. The drug resistance capability of ABCC10 has been partly determined. The aim of the study is to investigate the expression of ABCC10 in non small cell lung cancer (NSCLC) and normal tissues, and analyze the relationship between ABCC10 expression level and clinical features, such as TNM stages, histological types and pathological grades. Methods The expression of ABCC10 was detected in squamous cell carcinoma, adenocarcinoma and normal lung tissues by immunohistochemistry. Then the statistical analysis was performed. Results The expression of ABCC10 was mainly located in cell membrane and cytoplasm. There were significant differences between the expression of ABCC10 in NSCLC and normal tissues (P