This study evaluated the biological stability and cytotoxicity of rabbit thoracic aorta cross-linked by dye-mediated photooxidation in vivo environment of blood flow. Rabbits, whose allogenic thoracic aorta was cross-linked by dye-mediated photooxidation (DMP, n=6) and glutaraldehyde (GA, n=6), were in the DMP group and GA group, respectively; rabbits, whose homogenic abdominal aorta was orthotopic transplanted (OT, n=6), were in the OT group. Then the donor arteries were transplanted into the position of the abdominal arteries of rabbits. After operation, the animals were fed for 1 month, then each of graft arteries was removed for observation. Biological stability was evaluated through histological analysis under optical microscope. Cytotoxicity was evaluated through ratio of coverage of endothelial cell (ES) under scanning-electron microscope. The results showed that no statistically significant difference was noted between DMP group and OT group (P>0.05); however, there was a significant difference between DMP group and GA group (P<0.01). The stability index in DMP group was much higher than that in GA group. There was a statistically significant difference between DMP group and GA group (P<0.01). Ratio was much higher in DMP group than in GA group. In conclusion, the arteries cross-linked by dye-mediated photooxidation treatment appeared to have higher biological stability and lower cytotoxicity in rabbit allogenic transplation model.
Animals ; Aorta, Abdominal ; transplantation ; Aorta, Thoracic ; cytology ; drug effects ; surgery ; Bioprosthesis ; Blood Vessel Prosthesis ; Coloring Agents ; chemistry ; Cross-Linking Reagents ; Endothelial Cells ; cytology ; Female ; Male ; Oxidants, Photochemical ; pharmacology ; Oxidation-Reduction ; Photochemistry ; Rabbits ; Random Allocation

Objective:To investigate the efficacy of Da Vinci robot-assisted surgery for mediastinal tumor, and summarize the value of Da Vinci system in mediastinal surgery.Methods:The clinical data of 339 cases of robot-assisted mediastinal mass in Shanghai Chest Hospital from April 2015 to September 2020 were retrospectively analyzed, to compare perioperative outcomes of robotic surgery and conventional video-assisted thoracoscopic surgery 2 949 cases.Results:All the operations were successfully completed as planned. No residual lesions, conversion or second operation was observed in the consecutive cohort. The operating time[(81.8±36.8)min vs.(95.6±58.3)min, P=0.015]and post-operation stay[(3.1±1.9)days vs.(3.8±2.3)days, P=0.002] were statistically shorter in robotic group than those inconventional thoracoscopic group. Intraoperative blood loss in two groups was similar[(43.2±22.6)ml vs.(44.0±33.4)ml, P>0.05]. Conclusion:The Da Vinci robot system in mediastinal surgery is safe and feasible with great perspective in the new age of minimally invasive thoracic surgery. Compared with thoracoscopic surgery, it can shorten the operation time and reduce the postoperative hospital stay. It has certain advantages in operator experience and patient recovery.

Thymic tumors are the most common malignant tumors of the anterior mediastinum. Surgical resection is the main treatment for thymic tumors, but the need for adjuvant radiotherapy after surgery is controversial. For tumors that cannot be completely resected, the role of postoperative radiotherapy is certain. However, for completely resected thymic tumors, deciding on whether to supplement with postoperative radiotherapy depends on the tumor stage and histological type. This article reviews the application of postoperative radiotherapy in the treatment of completely resected thymic tumors.

Patients with thymoma without preoperative myasthenia gravis may develop symptoms of myasthenia gravis after tumor resection. A comprehensive understanding toward this rare clinical phenomenon is lacking. Recent studies indicate that post-operatively new onset myasthenia gravis (ponoMG) is the result of multiple mechanisms and their interactions, which may be related to the thymoma-mediated production, release and long-term presence of abnormal T cells and autoimmune antibodies in the periphery, as well as the presence of ectopic thymus and late recurrence of thymoma. Preoperative antibody titer is the main predictor. The treatment strategy is based on anticholinesterase drugs and hormonal therapy. In this study, we review the incidence, pathogenesis, predictors, and prevention and treatment strategies of ponoMG.

Minimally invasive surgery (MIS) is currently mainly used for the treatment of early thymic tumors. In recent years, minimally invasive thymic surgery has been rapidly promoted at home and abroad. However, because of the low incidence of thymic tumors, the unbalanced experience of doctors, there are still many issues worthy of discussion in MIS. Standard MIS must follow similar oncological and resection principles. This paper involves the definitions of minimally invasive thymic surgery and general principles that should be adhered to when performing MIS for thymic malignances.

Objective To observe the effects of total enteral nutrition ( TEN) and early combined parenteral nutrition ( PEN+TEN) in patients with esophageal cancer after operation .Methods The prospective,random, controlled clinical trial was adopted.One hundred patients receiving esophageal cancer operation were randomly assigned to the TEN group (50 cases) and the PEN+TEN group(50 cases).The differences in nutritional status, inflammatory response, immune status and postop-erative complications were compared in the two groups before and after operation.Results The levels of total serum protein, albumin or retinol binding protein were higher in the PEN group than the TEN group at the 10th day after operation, respective-ly[(60.1 ±6.2)g/L vs(55.3 ±9.3)g/L,(36.4 ±4.2)g/L vs(34.6 ±1.6)g/L,(43.3 ±5.9)g/L vs(34.9 ±3.3)g/L, P<0.05] .The levels of ESR or CRP were higher in PEN +TEN group than the TEN group at the 10th day after operation, re-spectively [(54.9 ±25.8)mm/h vs(31.8 ±14.2)mm/h,(30.9 ±13.2)g/L vs(15.8 ±6.1)g/L, P<0.01] .The levels of CD3+, CD4 +, or CD8 +were higher at the 10 th day after operation than at the day before surgery in TEN group [(59.6 ±9.8)％vs(68.3 ±4.4)％,(41.7 ±7.8)％vs(46.5 ±5.5)％,(23.2 ±5.5)％vs(20.0 ±2.7)％, P<0.05], but not in PEN+TEN group.The levels of IgA or IgG were significant higher in the TEN group than the PEN +TEN group at the 10th day after operation[(1.9 ±0.5)g/L vs(1.6 ±0.3)g/L,(11.9 ±3.3)g/L vs(9.4 ±2.2)g/L, P<0.01].Con-clusion The inflammatory reaction and immune function in TEN group are better than those in PEN +TEN group.Although the nutritional status is worse in the TEN group than that in the PEN group , but the rate of postoperative complications has not increased.

Surgery is the most important therapy for thymic malignances. The last decade has seen increasing adoption of minimally invasive surgery (MIS) for thymectomy. MIS for early stage thymoma patients has been shown to yield similar oncological results while being helpful in minimize surgical trauma, improving postoperative recovery, and reduce incisional pain. Meanwhile, With the advance in surgical techniques, the patients with locally advanced thymic tumors, preoperative induction therapies or recurrent diseases, may also benefit from MIS in selected cases.
Humans ; Minimally Invasive Surgical Procedures ; methods ; trends ; Retrospective Studies ; Thymoma ; surgery ; Thymus Neoplasms ; mortality ; pathology ; surgery

BACKGROUND: So far there's no tumor maker applied in diagnosis and treatment of thymic epithelial tumors. This study is to assess the correlation between serum cytokine 19 fragment (Cyfra 21-1) and clinicopathological features and prognosis of thymic epithelial tumors (TETs). METHODS: The clinical data of 159 patients with TETs in Shanghai Chest Hospital was retrospectively analysed. Patients were divided into groups according to different tumor stages and histotypes. Serum Cyfra 21-1 was thus compared. In addition, the possible relationship between perioperative serum Cyfra 21-1 level and the recurrent status was carrid out. RESULTS: Preoperative Cyfra 21-1 serum concentrations in patiants with advanced stage (T4) and thymic carcinomas were significantly higher than that in others (P<0.001, P<0.001, respectively). When the preoperative serum level exceeds the out-off of 1.66 ng/mL, it possibly indicates the recurrence during follow up. Furthermore, the sensitivity, specificity, and positive as well as negative predictive value (PPV and NPV) of postoperative Cyfra 21-1 to predict tumor recurrence were evaluated. At a cut-off of Cyfra 21-1 of 2.66 ng/mL, the sensitivity was 0.7, the specificity was 0.925, the PPV was 0.5 and the NPV was 0.966. CONCLUSIONS The elevated level of preoperative serum Cyfra 21-1 indicates an advanced stage of tumor or a more malignant histotype (thymic carcinoma). It also probably suggests a higher risk of tumor recurrence. During the oncological follow up, in addition to regular imaging examinations, the blood test of serum Cyfra 21-1 is also suggested to improve the diagnosis of tumor recurrence in order to improve the prognosis.
Biomarkers, Tumor ; blood ; Female ; Follow-Up Studies ; Humans ; Keratin-19 ; blood ; chemistry ; Male ; Middle Aged ; Neoplasms, Glandular and Epithelial ; blood ; diagnosis ; pathology ; Peptide Fragments ; blood ; Prognosis ; ROC Curve ; Retrospective Studies ; Thymus Neoplasms ; blood ; diagnosis ; pathology

Thymic epithelial tumors are the most common tumors in anterior mediastinum. They are used to be considered rare in incidence, with an indolent nature of biological behaviors, which led to the lack of high level evidence obtained from prospective randomized controlled trials to guide the clinical treatment. At present, the experience of diagnosis and treatment of thymic tumors varies greatly in different regions. And there are still many problems remain to be solved. This paper aims to establish a standardized surgical treatment based on the latest researches in surgical indications, resection extent, surgical approach, lymph node dissection and postoperative management of thymic tumors.

Hospital culture plays an important role in the orderly operation of large shelter hospitals as well as epidemic prevention and control.From April to May 2022, the shelter hospital of the National Convention and Exhibition Center(Shanghai) had created the large shelter hospital culture co-built by doctors and patients with a greater sense of belonging by taking measures such as joint party building between doctors and patients, giving play to the vanguard force of party members, carrying out various forms of cultural, sports and science popularization activities, encouraging enthusiastic patients to participate in activity planning, focusing on key groups, formulating shelter " residents convention", and so on. These measures ultimately formed cultural adaptation, cultural synchronization and cultural shaping, which were conducive to enhancing the empathy of doctors and patients, improving the effectiveness of medical implementation, and promoting the standardization of shelter management system. This harmonious, warm and autonomous culture co-built by doctors and patients effectively ensures the safe and orderly operation of the shelter hospital, and provides reference for the construction of the cultural system of large shelter hospitals in China.