Objective:To evaluate the feasibility and safety of uniportal video-assisted thorascopic pneumonectomy for non-small cell lung cancer patients, as well as the surgical techniques.Methods:From January 2017 to June 2018, 23 non-small cell lung cancer patients who underwent uniportal VATS pneumonectomy in our hospotal were retrospectively evaluated. There were 20 males and 3 females with a mean age of(60.3±6.0) years. The clinical data, complications and operative mortality were analyzed.Results:All 23 patients with lung cancer were operated safely. There was no conversion to thoracotomy. The mean operating time was(160.8±65.0) min. The mean blood loss was(131.3±121.3) ml. The mean hospital stays were(14.0±6.3) days. The mean postoperative hospital stays were(8.0±4.5) days. Postoperative morbidity occurred in 4 patients(17.4%). There was no perioperative mortality. Pathology examination of all patients were lung cancer(5 cases of adenocarcinoma, 15 cases of squamous carcinoma, 2 cases of large cell carcinom, 1 case of adenocarcinoma combined with large cell carcinoma).Conclusion:Uniportal video-assisted thorascopic pneumonectomy is a feasible operation that could be performed safely in a selected group of patients by experienced surgeons.

ObjectiveTo explore the effect of psychological strengths on life satisfaction among university students， and to analyze the mediating roles of general self-efficacy and coping style. MethodsA random sample of 913 undergraduates and postgraduates from a university in Zhejiang were enrolled， and completed an online questionnaire including Strengths Knowledge and Strength Use Scale （SKSUS）， Coping Inventory for Stressful Situations （CISS）， General Self-Efficacy Scale （GSES） and Satisfaction with Life Scale （SWLS）. Then the mediating effect analysis was conducted using Bootstrapping method. Results① Strength knowledge， strength use， task-oriented coping style and GSES scores were positively correlated with SWLS score （r=0.390， 0.522， 0.345， 0.500， P<0.01）. ② Strength use， task-oriented coping style and general self-efficacy acted as mediators between strength knowledge and life satisfaction （the indirect effect was 0.387， accounting for 96.03% of the total effect）. ③ Emotion-oriented coping style acted as mediator between strength knowledge， strength use and life satisfaction （the indirect effect was 0.011， accounting for 2.73% of the total effect）. ConclusionStrength knowledge may affect life satisfaction of college students through the mediating effects of strength use， task-oriented coping style， emotion-oriented coping style and general self-efficacy.

Objective To investigate the expression of BRCA1 in familial thyroid cancer (FTC) and the relationship between BRCA1 expression and clinicopathologic features.Methods The expression of BRCA1 protein and mRNA was detected respectively by immunohistochemistry and RT-PCR in 37 FTC tissues,35 sporadic thyroid carcinoma tissues and 35 normal thyroid tissues.Results BRCA1 mRNA expression was significantly downregulated in FTC (0.210±0.025) compared with sporadic thyroid carcinoma(0.943±0.021) and normal thyroid tissues(1.001±0.087)(P＜0.01).The positive rate of BRCA1 protein expression was significantly lower in FTC(56.8％,21/37) than that in sporadic thyroid carcinoma(85.7％,30/35) and normal thyroid tissues(94.5％,33/35) (P＜0.05).There was a correlation between BRCA1 protein expression and FTC clinicopathologic features (P＜0.05).FTC patients with lower BRCA1 protein expression tended to have higher risk for bilateral carcinoma,lymph node metastasis,capsular invasion,morbidity under 30 years old and more than 2 patients in a family.Conclusions The expression of BRCA1 protein and mRNA is downregnlated in FTC.BRCA1 protein might serve as a potential biomarker for predicating biological behavior and prognosis of FTC.

Objective: To observe the clinical efficacy of different dialysis frequency and methods in the treatment of chronic renal failure uremia patients, and to provide a reliable reference for clinical practice. Methods: From February 2016 to February 2017, 140 chronic renal failure uremic patients who admitted to the Department of Nephrology at Taizhou Central Hospital were selected and divided into the observation group and the control group by complete random distribution method, with 70 cases in each group.The patients in the control group received 3 times of regular hemodialysis treatment per week, while the observation group received 3 times of regular hemodialysis combined with 1 time of hemodiafiltration treatment per week.The clinical treatment effects and complications of the two groups were compared. Results: Compared with blood uric acid(BUA)[(532.09±71.05)mmol/L], serum creatinine(Scr)[(734.34±63.08)μmol/L], blood urea(BUN)[(23.84±2.58)mmol/L], serum phosphorus[(1.98±0.37)mmol/L], parathyroid hormone(PTH)[(464.37±113.92)ng/L], β₂ microglobulin(β₂-MG)[(13.48±6.38)mg/L]in the control group, BUA[(495.89±58.23)mmol/L], Scr[(684.34±77.32)μmol/L], BUN[(20.62±1.77)mmol/L], serum phosphorus[(1.74±0.44)mmol/L], PTH[(352.14±123.25)ng/L], β₂-MG[(9.58±5.45)mg/L] were significantly lower in the observation group, the differences were statistically significant (t=3.29, 4.19, 8.61, 3.49, 5.59, 3.88, all P<0.01). Compared with the incidence rate of pruritus in the control group(61.43%), the incidence rate of pruritus in the observation group(34.29%) was significantly lower (χ²=9.72, P<0.01), the incidence of other complications had no statistically significant differences(χ²=1.14, 1.58, 3.08, all P>0.05). Conclusion Hemodialysis 3 times combined with 1 time of hemodiafiltration per week has significant advantage in the treatment of chronic renal failure uremia patients, which can effectively remove urine toxin molecules and reduce the incidence of complications, and it is worthy of clinical application.

Objective To investigate the safety and efficacy of total thoracoscopic pneumonectomy for malignant lesion from a single-center pneumonectomy database.Methods A retrospectively analysis of 43 cases of malignant lesions in patients underwent total thoracoscopic pneumonectomy from surgical database of Shanghai Pulmonary Hospital from December 2013 to August 2017 was conducted,and then the mortality,complications,and disease recurrence were summarized.Results All lesions in 43 patients were pathologically comfirmed malignant,including 39 non-small cell lung cancers and 3 small cell lung cancers and 1 pulmonary metastasis.Complete thoracoscopic pneumonectomy was pedormed in 43 patients.The average operation time was (181.1 ± 68.0) min,blood loss was (146.5 t 113.6) ml,mean tube length was (8.4 ± 3.4) days.Perioperative mortality was 2.3％ (1/43).The complication rate of grade 3 or above was 16.3％.Median follow-up was 18 months,with 9 cases occuning local recurrence or distant metastasis;6 cases suffered from cancer-related death while non-cancer related death happened in 1 patient.Conclusion For selected locally advanced pulmonary malignant lesion,total thoracoscopic pneumonectomy is an alternative to open thoracic surgery with a better perioperative safety and satisfied mid-term oncologic survival.

Objective:To summarize our experience in diagnosis and treatment of patients with pulmonary mucosa-associated lymphoid tissue-derived(MALT) lymphoma and to explore the role of surgery.Methods:We retrospectively analyzed the clinical and follow-up data of 86 patients with pulmonary MALT lymphoma in Shanghai Pulmonary Hospital from January 2000 to December 2018. 86 cases were identified with 44 males and 42 females. The mean age was(56.7±10.6) years old. 38(44.2%) cases had symptoms mainly presenting as cough and sputum at diagnosis. The chest CT scan of the patients showed pulmonary consolidation in 39 cases, nodule/mass shadow in 37 cases, usually with air bronchogram. Only 8(9.3%) cases could be diagnosed by non-surgical approach. 58 cases received complete resection, 10 of which followed chemotherapy. 8 of 17 cases who received incomplete resection accepted chemotherapy. The rest 11 cases who experienced surgical biopsy because of uncertain diagnosis were treated by chemotherapy or radio-chemotherapy or just watch-to-wait.Results:The median follow-up of 83 cases was 64 months, ranged from 24 to 219 months. The estimated 5-year and 10-year OS rates were 95.0% and 76.8%, while 5-year and 10-year PFS were 75.7% and 35.1% respectively. Patients who received complete resectionhad better PFS( P<0.001)but similar OS( P=0.395), compared with those received incomplete resection. There were no significant difference in OS and PFS between patients who received complete resection accepted chemotherapy or not( P>0.05). Conclusion:Pulmonary MALT lymphoma has an indolent nature with an excellent long-term survival. Diagnosis is difficult to be made by non-surgical approach. Surgery plays an important role of treatment of pulmonary MALT lymphoma, due to significant improvement of diagnosis rate and radical treatment of localized disease by complete resection.

Objective: To investigate the clinical features of ciliated muconodular papillary tumor(CMPT) of the lung. Methods: We retrospectively reviewed 11 cases with final pathology being diagnosed as CMPT in our department from April 2017 to April 2018. There were 8 males and 3 females with a mean age of(63.7±5.6) years. The clinical data, histopathological features, treatment, and prognosis were reviewed. All patients received CT scan before operation. Results: The radiological features of CMPT include: located peripherally and most in right lower lobe; most CMPT lesions are GGO, some with air spaces in center and few being solid. All patients underwent video-assisted thoracic surgery(VATS) successfully, and there were no severe perioperative complications. The mean operating time was(78.0±28.2) min. The mean blood loss was(37.3±14.9) ml. The mean postoperative hospital stays were(3.45±0.93) days. Pathology examination of all patients were CMPT. Follow-up time ranged from 6 to 18 months and no recurrence was found. Conclusion CMPT is rare tumor, without specific clinical manifestation, but sometimes misdiagnosed as adenocarcinoma in situ or minimally invasive adenocarcinoma. VATS is feasible and safe for CMPT, and the prognosis is good.

Objective    To explore the safety and feasibility of uni-portal video-assisted thoracic surgery (VATS) for the treatment of bronchopulmonary sequestration (BPS). Methods    The clinical data of BPS patients with surgical resection in Shanghai Pulmonary Hospital from February 2010 to June 2021 were reviewed. The patients were divided into a VATS group and a thoracotomy group according to the operation method. The operation time, intraoperative blood loss, hospital stay and postoperative complication rate were compared between the two groups. The VATS group was subdivided into a uni-portal VATS group and a multi-portal VATS group for subgroup analysis. Results    Finally 131 patients were enrolled, including 62 males and 69 females with an average age of 39.3±13.2 years. There were 103 patients in the VATS group and 28 patients in the thoracotomy group. A total of 104 patients were diagnosed with left lower BPS, 26 with right lower BPS and 1 with bilateral lower BPS. The main symptom was cough (88 patients, 67.2%). There were 119 patients diagnosed by thoracic enhanced CT before operation. Compared with the thoracotomy group, the operation time was not statistically different (P=0.717), but the blood loss was less, the rate of postoperative complication was lower and hospital stay was shorter in the VATS group (P<0.05). The rate of conversion to open surgery in the uni-portal VATS group and multi-portal VATS group was 11.8% and 13.5%, respectively. Meanwhile, patients in the uni-portal VATS group had shorter operation time and postoperative hospital stay, less blood loss and lower postoperative complication rate than those in the multi-portal VATS group (P<0.05). Conclusion     In order to improve the rate of diagnosis, the lung enhanced CT scan should be selected as an optimal noninvasive method in adult suspected patients (especially those with solid cystic and solid lesions in the lower lobe). Uni-portal VATS is a safe and feasible method for BPS which can be widely promoted.