Objective To assess the clinical value of preoperative CT-guided microcoil positioning of small solitary pulmonary nodule (SPN) in assisting video-assisted thoracic surgery (VATS) procedure to more quickly and more precisely remove small pulmonary lesions.Methods The clinical data of 90 patients with SPN,who were admitted to authors' hospital during the period from June 2014 to May 2016 to receive VATS,were retrospective analyzed.Preoperative CT-guided microcoil positioning of SPN was employed in 45 patients (group A),while other 45 patients (group B) did not receive preoperative positioning of SPN.The pulmonary lobar wedge resection time,the transfer rate of changing to open chest operation,postoperative hospitalization time,the success rate of microcoil positioning of SPN,complications,etc.of both groups were statistically analyzed.The safety of preoperative CT-guided microcoil positioning of SPN was evaluated,and its benefit-enhancing value for VATS was discussed.Results In group A,the success rate of VATS was 100％ and the success rate of SPN positioning was 95.6％.Postoperative complications included pneumothorax (n=5),pulmonay surface hemorrhage (n=6),and dislodgement of microcoil (n=2).In group B,the success rate of VATS was 84.4％ and the transfer rate of changing to open chest operation was 15.6％.In group A,the manipulation time of VATS was (17.7±2.8) min,the postoperative hospitalization time was (6.2±1.7) days,and the transfer rate of changing to open chest operation was 0％,which were strikingly lower than those in group B;the differences between the two groups were statistically significant (P＜0.05).Conclusion Preoperative CT-guided microcoil positioning of small SPN can assist VATS procedure to remove small pulmonary lesions more quickly and more precisely,it can effectively reduce the transfer rate of changing to open chest operation,shorten the manipulation time of VATS as well as the postoperative hospitalization time.

Objective:To investigate the role of a simple Nomogram model in evaluating the severity of mycoplasma pneumoniae pneumonia (MPP) in adults.Methods:The clinical data of 162 patients with MPP who received treatment in Wenzhou Central Hospital from March 2015 to October 2022 were retrospectively analyzed. These patients were divided into a severe group ( n = 67) and a common group ( n = 95) according to whether they were diagnosed with severe MPP. The clinical data of patients were recorded. Fourteen clinical variables were screened, including age, sex, onset season, fever, heat peak, fever duration, cough duration, white blood cell count, percentage of neutrophils, percentage of lymphocytes, hemoglobin, platelet count, C-reactive protein, and procalcitonin. Multivariate logistic regression analysis of statistically significant variables in univariate analysis was performed. The Nomogram model was constructed with the R language software package (version 3.6.2). The model was verified with a calibration curve and receiver operating characteristic curve. Results:Univariate analysis results showed that in the severe group, the fever peak ( Z = 5.03, P < 0.001) was higher, fever duration ( χ2 = 27.55, P < 0.001), and cough duration ( χ2 = 28.72, P < 0.001) were longer, white cell count ( t = 2.93, P = 0.004), percentage of neutrophils ( t = 9.08, P < 0.001), C-reactive protein ( t = 35.05, P < 0.001), and procalcitonin level ( t = 15.09, P < 0.001) were greater compared with the common group. The percentage of lymphocytes ( t = 1.16, P < 0.001), hemoglobin level ( t = 1.22, P < 0.001), and platelet count ( t = 2.82, P < 0.001) in the severe group were significantly lower than those in the common group. Multivariate logistic regression analysis results showed that heat peak, cough duration, and C-reactive protein were positively correlated with the severity of MPP (all P < 0.05). The percentage of lymphocytes, hemoglobin concentration, and platelet count were negatively correlated with the severity of MPP (all P < 0.05). The establishment and validation results of the Nomogram model showed that the accuracy of the model was good, with a sensitivity of 88.73%, a specificity of 77.61%, and a C-index of 0.904. Conclusion:Heat peak, cough duration, percentage of lymphocytes, platelet count, and C-reactive protein are closely related to the severity of early MPP. A simple Nomogram model can be one of the tools for early assessment of the severity of MPP.