From June 2008 to December 2012,video-assisted thoracoscopic surgery (VATS group) was performed for 24 cases of thymoma.Their operative procedures,postoperative complications,remission of myasthenia gravis (MG),perioperative mortality and oncological outcomes were compared with 19 cases of trans-sternal open thymectomy (OT group).Compared with OT group,VATS group had significantly shorter operation duration,less blood loss,shorter postoperative hospital stay,shorter chest tube duration and less chest drainage amount (P ＜ 0.05).The total rate of postoperative complications of VATS group was 4％ (1/24) and it was less than OT group (4/19) without significant difference (P ＞0.05).The effective remission rate of thymomatous MG was 7/9 in VATS group and it was similar to that in OT group (6/8,P ＞ 0.05).VATS group had a recurrent or metastatic rate of 0％ (0/23) and it was better than OT group with 1/17.And there was no significant inter-group difference (P ＞ 0.05).The total survival rate of VATS group was 100％ and it was similar to that of OT group (16/17,P ＞ 0.05).Thoracoscopic thymectomy is safe,feasible,efficacious and mini-invasive for thymoma.With fewer complications and a quicker recovery,it has similar short-term outcomes to conventional open thymectomy.

Objective To establish and evaluate the animal model induced by inhalation injury of airborne fine particulate matter (PM2?5). Methods We manufactured equipment for rats aerosol inhalation with PM2?5. The effects of several facters such as concentrations(100 ± 10 μg/m3、150 ± 10 μg/m3、200 ± 10 μg/m3 )、time(1w、2w、4w、8w、12w)、method (non?exposed intratracheal instillation method and aerosol inhalation) and animals (Wistar rats, BN rats and guinea pigs) were investigated to establish the model. The respiratory rate, forced vital capacity ratio of forced expiratory volume ( FEV1/FVC) and arterial partial pressure of oxygen ( PO2 ) were measured, the pathological changes of bronchial and lung tissues under light microscope were observed. The success animal model was builded as the pneumonia was observed from the pathological changes of lung tissue. Results The Wistar rats exposed to PM2?5 aerosol inhalation for 8 weeks, we can see that the weight growth rate of rat decreased, WBC count and mononuclear cells count increased, the macrophages ratio decreased in BALF, the respiratory rate of lung increased while arterial PO2 and FEV1/FVC decreased, inflammation and pulmonary fibrosis changes were observed by bronch and pulmonary pathology, inflammatory changes with a dose?response relationship were observed. Exposed to PM2?5 aerosol inhalation for different time(1 w、2 w、4 w、8 w、12 w)with same dose, the score issue lesions of lung and bronchus in Wistar rats increased and the 8w group is obvious. The Wistar rats exposed to PM2?5 with different method ( aerosol inhalation and non?exposed intratracheal instillation method) for 8w, the aerosol inhalation worked as effectively as perfusion while mortality rate of aerosol inhalation is lower. Different animals ( Wistar rats, BN rats and guinea pigs) exposed to PM2?5 aerosol inhalation for 8w, the same results were observed with three method respectively while mortality rate of Wistar rats lower. Conclusions The optional conditions that the Wistar rats were continuously inhaled for 8w PM2?5 with a dose of 150 ± 10 μg/m3 were established. The animal model could be used on a national scale, especially in Fujian province. The results would be useful for the development of the research of the prevention and countermeasures of PM2?5 pollution.

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Objective To investigate the evaluation of multimodality MR imaging on the transplantation of autologous marrow stromal cells transfected ex vivo by vascular endothelial growth factor(VEGF)gene in a porcine chronic ischemic heart disease model. Methods Pigs of chronic ischemic heart disease model were randomly divided into two groups: treatment with marrow stromal cells transfected ex vivo by VEGF(Group I,n=9) and treatment with adenovirus served as control(Group Ⅱ,n=7).Four weeks after therapy,ejection fraction,ischemic segment and infracted segment were detected by multimodality MR imaging.The percentage of infarction area,CM-DiI labeled cells on fluorescence microscopy,vessel density were detected on specimen. Results In Group Ⅰ,in comparison with Group Ⅱ,the ejection fraction was significantly improved,the ischemic and infarction segments decreased(P

Objective To study the clinical value of virtual segmentectomy based on three-dimensional computed tomography bronchography and angiography (3D-CTBA) in thoracoscopic segmentectomy for early-stage lung cancer. Methods Totally 18 patients received thoracoscopic segmentectomy from July 2015 to July 2016 were performed virtual segmentectomy based on 3D-CTBA. The preoperative planning depended on the simulation result. Results All of the 18 cases(1 right Sl, 2 right S3, 3 right S6, 1 right S8 +9, 1 right S9 + 10, 3 left S1 +2 +3, 3 left S4 +5, 4 left S6 segmentectomies)were received thoracoscopic segmentectomy successfully. The mean operation time and intraoperative blood loss were (126.8士19.4) mins and(76.6±21.4) ml respectively. Pathological examination revealed no residual tumor cells at the surgical margins and no lymph node metastases in any patients. The actual surgical margins were all larger than 2 cm(2.37±0.39)cm. Conclusion Virtual segmentectomy based on 3D-CTBA can non-invasively visualize the relationship between the safe margin and segmental vessels and bronchi. It facilitates the preoperative planning of suitable segmentectomy procedure for patients with early-stage lung cancer.

Objective:To investigate the clinical effect of thoracoscopy combined with puncture-positioned internal fixation of multiple rib fractures accompanied with hemopneumothorax.Methods:A retrospective case-control study was used to analyze the clinical data of 68 patients with multiple rib fractures accompanied with hemopneumothorax admitted to Fujian Provincial Hospital from September 2016 to December 2018, including 49 males and 19 females, aged 25-86 years [(47.3±7.4)years]. There were 55 patients with unilateral lung contusion and laceration, and rest 13 patients with bilateral lung contusion and laceration. A total of 36 patients were treated by thoracoscopy combined with puncture-positioned internal fixation (thoracoscopy group) and 32 patients by open reduction group (open reduction group). The incision length, operation time, intraoperative blood loss, chest tube drainage time, ICU hospitalization time, total hospitalization time, and complications were recorded. Numeric rating scale (NRS) score was assessed at postoperative 1, 2, 3, 7 days. The MOS 36-item short-form health survey (SF-36) was conducted at the latest follow-up.Results:All patients were followed up for 8-34 months [(18.9±4.3)months]. Thoracoscopy group showed incision length of (4.3±1.3)cm, operation time of (66.3±12.1)minutes, intraoperative blood loss of (86.5±23.4)ml, chest tube drainage time of (5.3±1.1) days, ICU hospital stay of (2.3±0.8)days, total hospital stay of (6.8±1.7)days, and total complication rate of 8%, showing significant differences compared to open reduction group [(11.6±2.2)cm, (105.9±19.4)minutes, (191.4±35.6)ml, (8.1±1.6)days, (4.7± 1.4)days, (10.6±2.1)days, 29%] ( P<0.05 or 0.01). In thoracoscopy group, the NRS scores at day 1, 2, 3, and 7 were respective (6.6±1.2)points, (5.9±1.0)points, (4.4±0.9)points and (2.7±0.7)points, significantly lower than those in open reduction group [(7.3±1.2)points, (7.0±1.1)points, (5.7±1.0)points and (3.9±0.8)points] ( P<0.05 or 0.01). The SF-36 score in thoracoscopy group was (86.4±12.1)points, significantly higher than that in open reduction group [(75.6±11.5)points] ( P<0.01). Conclusions:Compared with open reduction and internal fixation, thoracoscopy combined with puncture-positioned internal fixation for multiple rib fractures has the advantages of smaller surgical incision, shorter operation time, less intraoperative bleeding, shorter chest tube drainage time, shorter ICU hospital stay, shorter total hospital stay, and less postoperative complications. The technique can also reduce the postoperative pain and improve the patients' quality of life.

Objective:To compare the efficacy of 3D printing technology-assisted and conventional open reduction and internal fixation of multiple rib fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 61 patients with multiple rib fracture admitted to Mindong Hospital Affiliated to Fujian Medical University and Fujian Provincial Hospital from July 2018 to March 2020. There were 44 males and 17 females, with age range of 18-73 years [(45.1±12.9)years]. Unilateral lung contusion and laceration occurred in 31 patients, while bilateral in 30. There were 19 patients accompanied by hempneumothorax and 16 by flail chest. Totally, 31 patients received 3D printing technology assisted open reduction and internal fixation (3D-assisted incision group) and 30 patients received conventional open reduction and internal fixation (conventional incision group). The incision length, operation time, intraoperative blood loss, postoperative 3-day visual analogue scale (VAS), duration of pain, indwelling time of chest tube, total length of hospital stay, postoperative bone callus formation time and rate of rib bone plate loosening were comapared in two groups. The short form 36 health survey (SF-36) score (ie, physical function, physical function, physical pain, general health, energy, social function, emotional function, mental health) preoperatively, at postoperative 6-month and at the last follow-up was compareted between two groups. Complications were observed at the same time.Results:All patients were followed up for 18-38 months [(26.4±5.5)months]. In 3D-assisted incision group, the incision length was (5.9±1.3)cm, with operation time for (84.6±7.8)minutes, intraoperative blood loss for (85.5±13.9)ml, postoperative 3-day VAS for (2.5±0.5)points, duration of pain for (5.9±0.7)days, indwelling time of chest tube for (3.4±0.7)days, total length of hospital stay for (7.0±1.0)days, postoperative callus formation time for (2.6±0.7)weeks and rate of rib bone plate loosening for 3.2%(1/31). By contrast, in conventional incision group, the incision length was (10.9±2.4)cm, with operation time for (127.1±12.5)minutes, intraoperative blood loss for (183.0±30.9)ml, postoperative 3-day VAS for (6.5±0.9)points, duration of pain for (11.2±1.8)days, indwelling time of chest tube for (7.8±0.8)days, total length of hospital stay for (15.1±1.2)days, postoperative callus formation time for (4.6±0.8)weeks and rate of rib bone plate loosening for 20.0%(6/30) ( P<0.05 or 0.01). There was no significant difference in preoperative SF-36 score between the two groups ( P>0.05). At 6 months after surgery, the subscores of SF-36 in 3D-assisted incision group were higher than those in conventional incision group except for "mental health" ( P<0.05 or 0.01). At the last follow-up, all the subscores of SF-36 in 3D-assisted incision group were higher than those in conventional incision group ( P<0.05 or 0.01). There were no obvious complications such as pulmonary infection or atelectasis. Conclusions:For multiple rib fracture, 3D printing technology-assisted open reduction and internal fixation is superior to conventional open reduction and internal fixation for it can shorten incision length, operation time, indwelling time of chest tube, total length of hospital stay and postoperative bone callus formation time, reduce intraoperative blood loss, relieve postoperative pain, reduce rate of rib bone plate loosening and improve quality of life of the patients.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.