Objective To summarize the experience of single incision thoracoscopic surgery (SITS),and to explore its feasibility and safety for treating thoracic diseases.Methods The clinical data in 186 cases of SITS in our hospital from August 2014 to March 2016 were retrospectively analyzed.Local lesion resection was performed in 171 cases and pulmonary lobectomy in 15 cases.Results The average operation time in local lesion resection was 46(10-75)min and average blood loss amount was 23(5-65)mL;11 cases were converted to double holes during operation and 6 cases converted to three holes;the average postoperative hospitalization stay was 4.7(3-9)d.The average operation time in the cases of pulmonary lobectomy was 152(95-215)min and average blood loss amount was 96(60-195)mL;2 cases converted to double holes during operation and 2 cases converted to three holes during operation;the average postoperative hospitalization stay was 6.7(5-9)d.No perioperative death or severe complications were observed in all cases.Conclusion SITS for treating thoracic diseases is safe,reliable and beautiful with little complications,less trauma and faster recovery.

AIM:To investigate the perfusion parameters using dynamic contrast-enhanced magnetic resonance imaging ( DCE-MRI) in rectal cancer patients so as to explore its potential value in estimating the microvascular condition including perfusion and permeability .METHODS:The data of 38 rectal cancer patients examined with DCE-MRI was ret-rospectively analyzed .The perfusion parameters of carcinoma and normal rectal wall in each case were calculated , inclu-ding volume transfer constant (Ktrans), rate constant of back flux (Kep), extravascular extracellular space fractional volume (Ve) and initial area under curve (iAUC).The mean values of tumor and normal rectal wall , mucinous and nonmucinous carcinoma, poorly and moderately-to-well differentiated carcinoma , case with or without lymph node metastasis were com-pared.RESULTS:All the parameters of rectal cancer were higher than normal rectal wall (P<0.01).No significant difference was found between poorly and moderately-to-well differentiated carcinoma in terms of K trans, Kep and Ve, neither was the case with or without lymph node metastasis .The cases with lymph node metastasis had lower iAUC than those with-out (P<0.05).CONCLUSION:Quantitative perfusion DCE-MRI answered the microvascular perfusion and permeability change of rectal cancer compared with normal rectal wall , besides it could be used to distinguish between mucinous and nonmucinous carcinoma , which demonstrated its value in the evaluation of rectal cancer .However , it should not be recom-mended to predict the degrees of tumor cell differentiation and lymph node metastasis just according to the perfusion param -eters.

Objective:To investigate the value of quantitative parameters derived from dual-layer spectral detector CT (SDCT) in characterizing regional lymph node (LN) status of colorectal cancer.Methods:From August 2019 to May 2020, 101 patients with colorectal cancer confirmed by pathology in the First Affiliated Hospital of Sun Yat-sen University were retrospectively collected. The largest regional LNs were matched with surgical pathology one by one and divided into metastatic LNs group (42 cases) and nonmetastatic LNs group (59 cases) according to pathological results. Based on preoperative venous phase contrast enhanced SDCT images he short-axis diameter (S) and the of the largest regional LN was measured, then its border and enhancement homogeneity were evaluated. Outlining the ROI along the edge of the LN on its widest cross section, the iodine density (ID) and effective atomic number (Z eff) were measured, then the normalized ID (nID) and normalized Z eff (nZ eff) were calculated. The χ 2 test, Fisher′s exact test, independent samples t-test or Mann-Whitney U test were used to compare the differences of each parameter between pathologically metastatic and nonmetastatic LNs and a logistic regression model was constructed. The ROC curves and area under the curve (AUC) were performed to evaluate the diagnostic performance of each parameter. DeLong test was used to compare the differences of each AUC. Results:The S, border, enhancement homogeneity, ID, Z eff, nID and nZ eff of LNs all showed significant differences between metastatic and nonmetastatic LNs (all P<0.001). The regression model constructed by S and Z eff of LNs had the highest value in differentiating metastatic and nonmetastatic LNs, with an AUC of 0.935, sensitivity and specificity of 85.7% and 89.8%, respectively. Its diagnostic value was higher than that of S, border, enhancement homogeneity (AUC 0.674-0.832, all P<0.05) and SDCT quantitative parameters (AUC 0.863-0.906, all P<0.05) of LNs. Conclusion:SDCT quantitative parameters facilitate the accurate diagnosis of regional metastatic LNs in patients with colorectal cancer, among which the multi-parameter regression model has the highest diagnostic value.

Objective To explore the clinical effect of mechanical perfusion for preserving kidney.Methods From May to October 2013, 36 donors’ kidneys were preserved by mechanical perfusion in the Department of Kidney in the 181st Hospital of Chinese People's Liberation Army.The donors’ kidneys were preserved , transported and perfused by the LKT-100 type Lifeport organ transporter and special software.General condition of patients and the relationship between resistance coefficient , flow velocity and occurrence of delayed graft function ( DGF) were analyzed.Results None of 36 recipients had graft loss.Thirty cases ’ (83%) renal function recovered well without DGF.Six cases developed DGF and returned to normal gradually after 3-18 days postoperative treatment.After mechanical renal perfusion for 1 h, 28 recipients with kidneys ’ resistance coefficient ≤0.3 mmHg/( ml · min ) hadn't developed DGF after transplantation.Among 8 recipients with kidneys ’ resistance coefficient >0.3 mmHg/( ml · min ) , 6 recipients developed DGF.Eight recipients with kidneys ’ flow velocity >100 ml/min hadn't developed DGF.Among 21 recipients with kidneys ’ flow velocity 60-100 ml/min, 1 case developed DGF.In 7 recipients with kidneys ’ flow velocity <60 ml/min, 5 cases developed DGF.Conclusions Mechanical perfusion for preserving kidney can improve graft quality and reduce the incidence of DGF in recipients.