Objective To compare the clinical efficacy between single span video-assisted thoracoscope (VATS) surgery and traditional VATS surgery for spontaneous pneumothorax in elderly patients.Methods A total of 88 elderly patients diagnosed as spontaneous pneumothorax by chest X-ray and CT were selected and randomly divided into single span VATS group and traditional VATS group (n=44,each).The bleeding volume,duration of operation,hospitalization time,time of postoperative analgesic use,chest tube indwelling time,postoperative complications and adverse reactions were observed.All patients were follow-up for 1-2 years to record the recurrence rate and death rate.Results All patients were received VATS surgery successfully.Their clinical symptoms disappeared and X-ray showed that pneumothorax disappeared.There were significant differences in bleeding volume,time of postoperative analgesic use,hospitalization time between single span VATS group and traditional VATS group [(46.7±18.8)ml vs.(46.7±18.8)ml,(1.7±0.9)d vs.(2.4± 1.7)d,(6.3±1.7)d vs.(9.1±2.1)d,t=3.04,2.18,5.59,respectively,all P＜0.05].The duration of operation and chest tube indwelling were shorter in single span VATS group than in traditional VATS group (both P＜0.05).Patients with chest pain and incision numb after operation were less in single span VATS group than in traditional VATS group (11 cases vs.26 cases,7 cases vs.21 cases,t=10.50,10.26,both P＜0.05).There were no significant differences in recurrence rate and death rate between the two groups.Conclusions Single span VATS surgery is an safe and effective treatment for spontaneous pneumothorax in elderly patients,which has a better postoperative recovery and fewer adverse reactions.

Objective To investigate whether recombinant human endostatin can create a time window of vascular normalization prior to vascular pruning to alleviate hypoxia in Lewis lung carcinoma in mice. Methods Kinetic changes in morphology of tumor vasculature in response to recombinant human endostatin were detected under a confocal microscope with immunofluorescent staining in Lewis lung carcinomas in mice. The hypoxic cell fraction of different time was assessed with immunohistochemical staining . Effects on tumor growth were monitored as indicated in the growth curve of tumors . Results Compared with the control group vascularity of the tumors was reduced over time by recombinant human endostatin treatment and significantly regressed for 9 days. During the treatment, pericyte coverage increased at day 3, increased markedly at day 5, and fell again at day 7. The vascular basement membrane was thin and closely associated with endothelial cells after recombinant human endostatin treatment, but appeared thickened, loosely associated with endothelial cells in control tumors. The decrease in hypoxic cell fraction at day 5 after treatment was also found. Tumor growth was not accelerated 5 days after recombinant human endostatin treatment. Conclusions Recombinant human endostatin can normalize tumor vasculature within day 3 to 7, leading to improved tumor oxygenation. The results provide important experimental basis for combining recombinant human endostatin with radiation therapy in human tumors.