Objective    To compare the clinical effects of segmentectomy and lobectomy for ≤2 cm lung adenocarcinoma with micropapillary and solid subtype negative by intraoperative frozen sections. Methods    The patients with adenocarcinoma who received segmentectomy or lobectomy in multicenter from June 2020 to March 2021 were included. They were divided into two groups according to a random number table, including a segmentectomy group (n=119, 44 males and 75 females with an average age of 56.6±8.9 years) and a lobectomy group (n=115, 43 males and 72 females with an average of 56.2±9.5 years). The clinical data of the patients were analyzed. Results    There was no significant difference in the baseline data between the two groups (P>0.05). No perioperative death was found. There was no statistical difference in the operation time (111.2±30.0 min vs. 107.3±34.3 min), blood loss (54.2±83.5 mL vs. 40.0±16.4 mL), drainage duration (2.8±0.6 d vs. 2.6±0.6 d), hospital stay time (3.9±2.3 d vs. 3.7±1.1 d) or pathology staging (P>0.05) between the two groups. The postoperative pulmonary function analysis revealed that the mean decreased values of forced vital capacity and forced expiratory volume in one second percent predicted in the segmentectomy group were significantly better than those in the lobectomy group (0.2±0.3 L vs. 0.4±0.3 L, P=0.005; 0.3%±8.1% vs. 2.9%±7.4%, P=0.041). Conclusion    Segmentectomy is effective in protecting lungs function, which is expected to improve life quality of patients.

Objective : To investigate the clinical efficacy of painless oral anesthesia combined with piezosurgery compared with ordinary cassette syringe combined with high speed turbine handpiece in the Fenestration operation of orthodontic traction of impacted maxillary anterior teeth. Methods : A total of 128 cases of impacted maxillary anterior teeth were treated with Fenestration operation and orthodontic traction, and the patients were randomly divided into two groups. Group A (64 patients) received painless oral anesthesia combined with piezosurgery. Group B (64 patients) received ordinary cassette syringe combined with high speed turbine handpiece. The cooperation of fenestration and the swelling and pain after operation were compared between the 2 groups. Results : The proportion of 0 and Ⅰ in the anesthesia group was 45.3% and 31.3% respectively, and the conventional group 0 and I accounted for 32.8% and 20.3% respectively. The difference between the two groups was statistically significant (Z=-2.676, P < 0.05). The pateints&#39; cooperative degree in group A was better than that in group B (P < 0.05). The ratio of pain and swelling in the anesthesia instrument combined with Piezosurgery group was 81.2%, the conventional group had a grade I ratio of 59.4%, and the anesthesia instrument combined with Piezosurgery group was lighter than the conventional group, The difference was statistically significant (Z=-2.777, P < 0.05); anesthesia combined with Piezosurgery group after surgery accounted for 81.2% of the swelling, the conventional group of pain accounted for 71.9%, There was significant difference between the two groups (Z=-2.097, P < 0.05). Symptoms and signs as swelling and pain degree in group A were relatively minor than those in group B (P < 0.05). Conclusion It is worthy clinical promotion to use Painless oral anesthesia combined with piezosurgery in the fenestration and orthodontic traction of impacted maxillary anterior teeth, for its better cooperation and minor post-surgery reaction.