Objective To investigate the effects of two different methods of double-lumen endotracheal intubation in minimally invasive thoracoscopic surgery. Methods Based on different methods of endotracheal intubation,120 patients with bullae and spontaneous pneumo-thorax were randomly divided into the single left intubation group (60 cases) and the left and right intubation group (60 cases). The opera-tion time,blood loss,chest drainage volume,the time of pulmonary air leaks,white blood cell count and other indexes of the two groups were evaluated. Results The proportion of patients whose atelectasis degree was over 50% in the left and right intubation group occupied 48%, and it occupied 32% in patients whose atelectasis degree was over 70%. While the corresponding data in the single left intubation group were 5. 00% and 93% respectively. The differences were statistically significant (P<0. 01). The operative time and postoperative indicators of the single left intubation group were more significantly lower than those in the left and right intubation group. Conclusion The left double-lu-men endotracheal intubation has obvious advantages in maintenance and control of lung expansion and pulmonary ventilation during surgery, and it should be used in video assisted thoracoscopy surgery.

Objective To improve the radiological diagnosis of breast cancer .Methods The authors collected 15 cases of breast carcinoma confirmed by operation and pathology. All these cases were misdiagnosed by mammography.Mammographic manifestations and data of clinic were analyzed retrospectively. Results 4 cases changed like small fibroadenoma, 3 cases showed microcalcification, 3 cases showed localized mammary gland architecture distrotion,2 cases showed multiple small patchy shadows in the hyperplasic mammary gland, 2 case showed small focus of increased density, 1 case no abnormal sign, 4 cases among of them can not be palpated mass .Conclusion The combination between palpation and radiology is valuable for diagnosis of breast carcinoma and decreasing misdiagnosis.

Objective To analyze radiological features of rare tumor of breast.Methods To analyze retrospectively radiological features of 11 cases with rare tumor, all cases were confirmed by operation or pathology. Results Among the 11 cases ,1 case was non Hodgkin lymphoma(NHL). 1 case was malignant pleomorphic adenoma. 1 case was primary squamous cell carcinoma of breast. 1 case was osteosarcoma.2 cases were lobate cystadenosarcoma. 5 cases were hamartomas.Osteosarcoma shows bone tissues in the mass. Malignant pleomorphic adenoma shows more big mass with leaning-edge and abnormal vessel.Lobate cystadenosarcoma is a low-degree malignant tumor with long history, shows big mass, cleaning-edge and big calcification in it, there was a vitellary membracnce around the mass, usually no metastasis to armpit .Hamartoma’s density is highly uneven, the area of high density likes island. Primary squamous cell carcinoma of breast and NHL have no specific X-ray features.Conclusion Rare breast tumors have no specific radiological featare.Qualitative diagnosis needs sythetical analysis.

Background::Clinical opportunistic screening is a cost-effective cancer screening modality. This study aimed to establish an easy-to-use diagnostic model serving as a risk stratification tool for identification of individuals with malignant gastric lesions for opportunistic screening.Methods::We developed a questionnaire-based diagnostic model using a joint dataset including two clinical cohorts from northern and southern China. The cohorts consisted of 17,360 outpatients who had undergone upper gastrointestinal endoscopic examination in endoscopic clinics. The final model was derived based on unconditional logistic regression, and predictors were selected according to the Akaike information criterion. External validation was carried out with 32,614 participants from a community-based randomized controlled trial.Results::This questionnaire-based diagnostic model for malignant gastric lesions had eight predictors, including advanced age, male gender, family history of gastric cancer, low body mass index, unexplained weight loss, consumption of leftover food, consumption of preserved food, and epigastric pain. This model showed high discriminative power in the development set with an area under the receiver operating characteristic curve (AUC) of 0.791 (95% confidence interval [CI]: 0.750–0.831). External validation of the model in the general population generated an AUC of 0.696 (95% CI: 0.570–0.822). This model showed an ideal ability for enriching prevalent malignant gastric lesions when applied to various scenarios.Conclusion::This easy-to-use questionnaire-based model for diagnosis of prevalent malignant gastric lesions may serve as an effective prescreening tool in clinical opportunistic screening for gastric cancer.