BACKGROUND: Studies on the biomechanical properties in NUSS procedure have obtained some achievements, but the effect of scoliosis surgical correction of scoliosis on thoracic deformity remains unclear.OBJECTIVE: To explore the effect of simultaneous correction of pectus excavatum and scoliosis on thoracic deformity so as to provide reference for designing a rational orthopedic scheme.METHODS: The three-dimensional reconstruction model of the chest was established based on the CT data of the patients with pectus excavatum and scoliosis. The surgical correction of pectus excavatum and scoliosis was simulated by numerical simulation method.RESULTS AND CONCLUSION: (1) Results after correction showed that the bilateral spinous processes at T3-5 segments displaced to the left (X direction) about 1 mm, suggesting that the simultaneous correction is favorable for the correction of scoliosis. (2) Compared with the single NUSS procedure, the displacement at Y direction was increased by 13.358 mm in the simultaneous correction; meanwhile, there was significant difference in the shortest displacement between two methods.(3) In views of Von Mises stress distribution, the stress in the simultaneous correction was decreased by 24.6 MPa compared with the single Nuss procedure, indicating that the simultaneous correction can significantly reduce the Von Mises stress on the chest, which contributes to alleviate the postoperative pain. (4) Our results show that the simultaneous correction cannot only improve scoliosis, but also improve the symptoms of pectus excavatum.

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During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective    To investigate the use of opioid analgesics during the postoperative hospitalization in patients undergoing lung resection and analyse its influencing factors. Methods    The clinical data of 450 patients undergoing lung resection in Sichuan Cancer Hospital among a multicenter symptom research database (CN-PRO-Lung 1) between November 2017 and January 2020 were analyzed. There were 248 males and 202 females with an average age of 54.7±10.3 years. Results    A total of 448 (99.6%) patients used opioid analgesics. The average daily morphine equivalent dose during the postoperative hospitalization was 48.9 mg. There were statistical differences in postoperative morphine equivalent dose across patients with different sex, age, highest level of education, Charlson Comorbidity Index score, surgical approach, surgical type, operative time, postoperative hospital stay and grade of postoperative complications (all P<0.05). Multivariate analysis showed that sex, surgical approach and postoperative hospital stay were independent influencing factors for morphine use during the postoperative hospitalization in patients undergoing lung resection (all P<0.05). Conclusion    In clinical practice, attention should be paid to postoperative pain for male patients, as well as to promote the application of minimally invasive surgery, and to shorten the length of postoperative hospital stay, in order to ultimately reduce the use of opioids.