AIM: In vitro isolation and culture of esophageal epithelial cells are basic component of tissue-engineered esophagus. This study explored the method to culture esophageal epithelial cells for research on tissue-engineered esophagus. METHODS: The experiment was performed at experimental center of Lanzhou University from May to November 2007. Normal esophagus tissues, 2.0-3.0 cm, were harvested from patient with esophagus cancer by surgery. The informed consent was obtained from the patient. Esophageal epithelial cells for tissue engineering were obtained and passaged. The cells cultured by DMEM+F12 (1∶1) after 20 minutes, 1-4 days were observed by immunohistochemistry staining and inverted phase contrast microscope. The growth curve of cells was drawn by MTT method. RESULTS: The immunohistochemistry staining results showed that 90% of the cells were positive, which indicated the cultured cells were esophageal epithelial cells. Normal cells were big and globular, floating in the culture-medium. Cells began to adhere after 20 minutes, and most cells were polygon-like or irregular globular and adherent after 1 day; the cells began to cluster after 2 days; the cells grew at peak after about 3-4 days with abundant endochylema and large and spherical nuclear. Cells growth reached the peak after about 3 days of culture and its absorbance was significantly different compared with that on the 1st, 2nd, 5th, and 6th days (P

In December 2019, a new type of coronavirus pneumonia emerged and spread rapidly, but there is no specific antiviral vaccine or drug. At present, traditional Chinese Medicine (TCM) prevention and treatment programs have been introduced in many places in China. This paper systematically reviews and summarizes the etiology and pathogenesis of novel coronavirus pneumonia 2019 (COVID-19), the prevention programs for different populations in different regions and the treatment programs by stages. We analyzed the TCM prevention and treatment programs of COVID-19 in various regions and the clinical characteristics of the first-line patients. It is verified that the disease belongs to the category of "wet poison epidemic" according to TCM, and the disease is located in the lung and the spleen. The core pathogenesis of the disease is "dampness, heat, poison, blood stasis and deficiency" because of the rage of the disease. According to the relevant plan, TCM prevention should adopt different prescriptions according to the constitution of different populations and pay attention to comprehensive prevention according to different climates, regions and populations. Treatment should focus on eliminating filth and resolving turbidity, with clearing dampness as the key point. The corresponding treatment plan should be made according to the development of the disease, and the treatment should be divided into five stages (observation stage, initial stage, middle stage, severe stage and convalescence stage) according to the rules of syndrome development. Through the systematic analysis of the progress of TCM applied in various regions during the epidemic period, this paper hopes to provide useful help and guidance for the prevention and control of the epidemic and rational application and further research on the clinical treatment with TCM.

BACKGROUND: Surgical site infection is one of the common postoperative complications of thoracic surgery, and its harm is related to infection degree and location. Light causes local pain, prolonged hospitalization and increased cost. Severe infection can lead to severe infection, even septic shock and life-threatening. Therefore, proper treatment of incision infection can help to promote recovery, reduce the burden of disease and lay a good foundation for further treatment. The traditional surgical treatment of wound infection includes thorough drainage, intensive dressing change and antibiotic use. There are many shortcomings such as long treatment process, ineffective treatment effect and so on. The experience of using vacuum sealing drainage (VSD) in 6 cases of postoperative infection patients in our department is summarized in order to improve the traditional treatment of postoperative infection in patients after thoracic surgery. METHODS: The clinical data of patients with postoperative incision infection or fistula after thoracic surgery in our department were reviewed and summarized. 6 patients treated with VSD material for postoperative infection. The process and final clinical results of them were summarized and discussed. RESULTS: In this study, fever and wound exudation disappeared within 6 h-10 h after VSD use, 5 cases of wound infection were obviously improved, the secretion disappeared and the granulation tissue grew well at the cutting edge of the operation, the second stage operation was performed to close the chest and skin. One patient was seriously infected, and the secretion was still more after VSD removal, reposition VSD device next time, the VSD device was removed 7 d later. The wound infection were obviously improved, the secretion disappeared and the granulation tissue grew well, close the chest and skin second stage. In all 6 patients, the symptoms were relieved, the symptoms improved and the surgical incision healed well. In 2 patients with esophageal cancer, the average operation time was 427.5 min, the average hospitalization time was 40 d, the average number of times of dressing change was 8.5, the average total cost during hospitalization was 111,893.47 yuan patients with chronic empyema, the average operation time was 192.5 min. The average hospital stay was 27.75 days, the average number of times of dressing change was 5.5, and the average total expenditure during hospitalization was 48,237.71 yuan. CONCLUSIONS VSD has a good effect on the treatment of postoperative incision infection patients in thoracic surgery. It can reduce the pain and burden of patients and ensure the quality of life of postoperative infected patients.
Adult ; Drainage ; instrumentation ; methods ; Esophageal Neoplasms ; complications ; surgery ; Female ; Humans ; Lung Neoplasms ; Male ; Middle Aged ; Postoperative Complications ; etiology ; surgery ; Retrospective Studies ; Thoracic Diseases ; complications ; surgery

Objective     To summarize the clinical data about mediastinal lesions, then to analyze the treatment effect of da Vinci robot system in the surgical treatment of mediastinal lesions. Methods     We retrospectively analyzed the clinical data of 49 patients with mediastinal lesions in our hospital between January 2016 and October 2017. These patients were divided into two groups including a da Vinci robot group and a video-assisted thoracoscopic surgery (VATS) group according to the selection of the treatments. There were 25 patients with 14 males and 11 females at age of 56.5±17.9 years in the da Vinci group and 24 patient with 15 males and 11 females at age of 53.0±17.8 years in the VATS group. Results     There was no statistical difference in surgery time between the two groups (t=–0.365, P=0.681). Less intraoperative blood loss ( t=–2.569, P<0.001), less postoperative drainage amount within three days after surgery ( t= – 6.325, P=0.045), shorter period of bearing drainage tubes after surgery ( t=–1.687, P=0.024), shorter hospital stays ( t= – 3.689, P=0.021), lower visual analogue scale (VAS) scores of postoperative 48 hours (t=–7.214, P=0.014) with a statistical difference in the da Vinci robot group compared with the VATS group. Conclusion     The da Vinci robot system is safe and efficient in the treatment of mediastinal lesions compared with video-assisted thoracoscopic approach.

Objective    To evaluate the feasibility and safety of da Vinci robotic surgery for elderly patients with radical surgery of lung cancer. Methods    We retrospectively analyzed the clinical data of 59 patients aged over 70 years who underwent radical surgery of lung cancer in our hospital between 2016 and 2019. These patients were divided into two groups including a da Vinci robot group and a single-utility port video-assisted thoracoscopic surgery (VATS) group according to the patients’ selection of the treatments. There were 32 patients with 20 males and 12 females aged 73.1±2.3 years in the da Vinci robot group and 27 patients with 16 males and 11 females aged 71.2±1.3 years in the VATS group. The clinical data of the two groups were compared. Results    There was no statistical difference in surgery time between the two groups (t=–0.341, P=0.484). Compared with the VATS group, the da Vinci robot group had more number of lymph nodes dissected (t=1.635, P=0.015), less intraoperative blood loss (t=–2.569, P <0.001), less postoperative drainage amount within 3 days after surgery (t=–6.325, P=0.045), lower visual analogue scale (VAS) scores at postoperative 3rd day (t=–7.214, P=0.021). Conclusion    The da Vinci robot system is safe and efficient in the treatment for elderly patients with radical surgery of lung cancer with less trauma.

Objective    To collect the data of esophageal foreign body patients, and to evaluate the clinical effects of two different surgical methods in our hospital. Methods    The clinical data of 294 patients who were treated in Gansu Provincal Hospital from January 2012 to June 2018 were analyzed retrospectively. The clinical data were collected and analyzed by SPSS 22.0. In order to to evaluate the efficacy of flexible esophagoscope (FE) and rigid esophagoscope (RE) in the treatment of esophageal foreign bodies.The patients were divided into two groups: a RE group including 118 patients with 62 males and 56 females at age of  6 (3-37) years and a FE group including 176 patients with 84 males and 92 females at age of 6 (3-59) years. Results    There was no significant difference in age, age stratification, gender and foreign body type between the two groups. There was a statistical difference in the initial clinical symptoms (P=0.041) or in esophageal foreign bodies position (P=0.037) between the two groups. The success rate of foreign body removal was similar between the two groups (P=0.632). The success rate was 88.9% (105/118) in the RE group, 87.5% (154/176) in the FE group. The operation time was significantly longer in the RE group than that in the FE group (10.8 ±17.4 min vs. 17.5±21.6 min, P<0.001). The postoperative hospitalization time in the RE groups was longer than that in the FE group (21.5 ±24.2 hours vs. 12.5 ±21.3 hours, P<0.05). There was a statistical difference in the incidence of postoperative complications between the two groups (P=0.034). In the RE group, the main complication was mucosal edema (15.3%). And the rate of bleeding was higher (15.9%) in the FE group. There were 30 patients (25.5%) in the RE group with minor postoperative complications versus the FE group with 40 patients (22.7%); and 1 patient (0.8%) in the RE group with severe complications versus the FE group with 5 paients (2.8%). Conclusion    Based on the analysis of this study, it is found that RE has higher safety. But the indications are strict, the professional requirements of the operator and the selection of patients are stronger. The FE is convenient to use, the operation crowd is wide, and the suitable crowd is wide. Therefore, for specific patients, after improving the relevant examination and preoperative evaluation of patients, clinicians need to choose appropriate surgical methods to ensure the success of the operation, and reduce the postoperative complications as far as possible.

Objective To compare the short-term efficacy and safety of inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE) and minimally invasive transthoracic esophagectomy (MITE) in the treatment of esophageal cancer. Methods The Cochrane Library, EMbase, PubMed, Wanfang Database, VIP, and CNKI were searched. Literatures related to the short-term efficacy and safety of IVMTE and MITE in the treatment of esophageal neoplasms published from the establishment of the database to December 2023 were searched and meta-analysis was conducted by using RevMan5.4. Quality of case control study or cohort study was assessed by the Newcastle-Ottawa Scale (NOS) and quality of randomized controlled trial was assessed by Cochrane Handbook. Results A total of 14 studies (12 case control studies and 1 prospective cohort study wiht NOS score more than 7 points and 1 randomized controlled trial wiht low bias risk) were included, comprising 1 163 patients, with 525 in the IVMTE group and 638 in the MITE group. The results of meta-analysis revealed that the IVMTE group exhibited significantly shorter operative time [MD=−60.42, 95%CI (−83.78, −37.07), P<0.001] and postoperative hospital stay [MD=−2.44, 95%CI (−2.93, −1.94), P<0.01] compared to the MITE group. Moreover, intraoperative blood loss [MD=−34.67, 95%CI (−59.11, −10.23), P=0.005], three-day postoperative drainage [MD=−286.66, 95%CI (−469.93, −103.40), P=0.002], incidence of postoperative pulmonary infection [OR=0.38, 95%CI (0.26, 0.56), P<0.001], lung leakage rate [OR=0.12, 95% CI (0.02, 0.63), P=0.01] and overall complication rate [MD=0.41, 95%CI (0.22, 0.75), P=0.004] were all lower in the IVMTE group compared to those in the MITE group. However, the MITE technique demonstrated superiority over IVMTE regarding intraoperative lymph dissection number [MD=−3.52, 95%CI (−6.36, –0.68), P=0.02] and intraoperative recurrent laryngeal nerve injury [OR=1.78, 95%CI (1.22, 2.60), P=0.003]. No significant difference was observed between both methods concerning anastomotic fistula. Conclusion Compared to MITE, IVMTE has advantages such as shorter operation time, less intraoperative blood loss, shorter hospital stay, less postoperative drainage within 3 days, and a lower incidence of pulmonary complications. In terms of laryngeal recurrent nerve injury and lymphatic dissection, MITE operation offers more benefits.

At present, the application of the robot assisted surgery system in the surgical treatment of esophageal cancer is gradually emerging, and it is more and more widely used and recognized in the field of surgery. According to the domestic and foreign literatures, the robot has many advantages, and robotic assisted esophageal cancer surgery has been proved to be safe and effective, and its short-term efficacy is significantly better than thoracotomy. Other studies have shown that in long-term follow-up, the effect is comparable to video-assisted thoracoscopic surgery. In this paper, the author are systematically reviewed the development history of the robot assisted surgery system, the effect of robotic assisted esophagectomy on safety, surgical method, short-term efficacy and long-term prognosis. The traditional open surgery and thoracoscopic laparoscopic esophagectomy has been carried on the detailed comparison to provide some advice and theoretical basis for esophageal cancer surgery robot system.

Objective To systematically evaluate the short-term efficacy and safety of lung subsegmentectomy and segmentectomy in the treatment of small pulmonary nodules. Methods Computer searches were conducted on PubMed, The Cochrane Library, EMbase, Scopus, Web of Science, SinoMed, Wanfang Data, VIP, and CNKI databases to collect relevant literature on the short-term efficacy and safety of lung subsegmentectomy and segmentectomy for small pulmonary nodules from the inception to April 2024. Two researchers independently screened the literature and extracted data according to inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 software, and the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the selected literature. Results A total of 15 retrospective cohort studies with 2417 patients were included, among whom 796 patients underwent lung subsegmentectomy and 1621patients underwent segmentectomy. The NOS scores of the included literature were all≥6 points. Meta-analysis results showed that compared with segmentectomy, lung subsegmentectomy had a lower overall postoperative complication rate [OR=0.54, 95%CI (0.39, 0.75), P<0.01] and fewer lymph nodes dissected [MD=−0.43, 95%CI (−0.81, −0.06), P=0.02]. There was no statistical difference between the two surgical methods in terms of operation time [MD=5.11, 95%CI (−4.02, 14.23), P=0.27], intraoperative blood loss [MD=−14.62, 95%CI (−29.58, 0.34), P=0.06], postoperative hospital stay [MD=−0.24, 95%CI (−0.49, 0.01), P=0.06], postoperative drainage time [MD=−0.14, 95%CI (−0.46, 0.18), P=0.40], intraoperative margin width [MD=0.10, 95%CI (−0.16, 0.35), P=0.46], or recurrence rate [OR=1.57, 95%CI (0.53, 4.61), P=0.42]. Subgroup analysis results showed that when using uniportal video-assisted thoracoscopy for surgery, compared with segmentectomy, lung subsegmentectomy had less intraoperative blood loss [MD=−15.57, 95%CI (−28.84, −2.30), P=0.02], shorter postoperative hospital stay [MD=−0.49, 95%CI (−0.63, −0.35), P<0.01], shorter postoperative drainage time [MD=−0.19, 95%CI (−0.35, −0.03), P=0.02], and lower overall complication rate [OR=0.55, 95%CI (0.31, 0.98), P=0.04]. Conclusion Lung subsegmentectomy can achieve similar efficacy as segmentectomy and has a lower overall postoperative complication rate. In terms of safety, lung subsegmentectomy can achieve a margin range close to that of segmentectomy. When performing uniportal thoracoscopic surgery, lung subsegmentectomy has advantages over segmentectomy in terms of intraoperative blood loss, postoperative hospital stay, and drainage time.