Objective To investigate the clinical application of subaxillary curved mini-incision thoracotomy in thoracic operations. Methods Through a subaxillary curved mini-incision between the latissimus dorsi muscle and the serratus anterior muscle (length of incision, 8~14 cm), thoracic operations were performed in 65 patients with thoracic diseases, including pneumothorax or hemopneumothorax (13 patients), pulmonary benign tumor (23 patients), mediastinal tumor (4 patients), and esophageal benign or malignant tumor and cardiac cancer (25 patients). Results All the patients were successfully operated on. No surgery-related deaths occurred. The incidence of complications was 6.2% (4/65), including pleural effusion in 1 patient, pulmonary infection in 2 patients, and anastomotic leakage of esophagogastrostomy in 1 patient.Conclusions Subaxillary curved mini- incision thoracotomy, characterized by minimal invasion, little blood loss, mild influence on cardiopulmonary functions, quick recovery, and good cosmetic outcomes, is an ideal option for the treatment of thoracic diseases.

Background::There is a need for effective and safe therapies for psoriasis that provide sustained benefits. The aim of this study was to assess the efficacy and safety of tildrakizumab, an anti-interleukin-23p19 monoclonal antibody, for treating moderate-to-severe plaque psoriasis in Chinese patients.Methods::In this multi-center, double-blind, phase III trial, patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned (1:1) to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4. Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12, 16, and every 12 weeks thereafter. Patients in the tildrakizumab group continued with tildrakizumab at week 16, and every 12 weeks until week 52. The primary endpoint was the Psoriasis Area and Severity Index (PASI 75) response rate at week 12.Results::At week 12, tildrakizumab demonstrated significantly higher PASI 75 response rates (66.4% [73/110] vs. 12.7% [14/110]; difference, 51.4% [95% confidence interval (CI), 40.72, 62.13]; P <0.001) and Physician’s Global Assessment (60.9% [67/110] vs. 10.0% [11/110]; difference, 49.1% [95% CI, 38.64, 59.62]; P <0.001) compared to placebo. PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups, reaching maximal efficacy after 28 weeks (86.8% [92/106] vs. 82.4% [89/108]) and maintained up to 52 weeks (91.3% [95/104] vs. 87.4% [90/103]). Most treatment-emergent adverse events were mild and not related to tildrakizumab. Conclusion::Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.Trial registration::ClinicalTrials.gov, NCT05108766.