Objective To examine the effect of modified electroconvulsive therapy (MECT) on the plasma oxida-tive stress level in bipolar depression. Methods Forty-two patients with bipolar depression were randomly divided into two groups. The intervention group (n=18) received antidepressants and 12 times MECT for 6 weeks and the control group (n=24) received antidepressants and Li2CO3 for 6 weeks. The Chinese versions of the 17 items Hamilton Depression Rating Scale (HAMD-17), Young Mania Rating Scale (YMRS), Clinical Global Impression Scale (CGI-S) and Treatment Emergent Symptom Scale (TESS) were used to assess participants at baseline and after 6 weeks of treatment. The plasma levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA)were detected at baseline and after 6 weeks to assess the level of oxidative stress. Results Repeated measures analysis of variance showed that the plasma level of SOD was higher in MECT group than in Li2CO3 group (F=15.26, P<0.01), and the level of MDA was higher in Li2CO3 group (F=18.18, P<0.01). The interactive effect of group and time was significant in GSH-Px level (F=6.39, P=0.02). The level of GSH-Px was lower in MECT group than in Li2CO3 group after 6 weeks (P<0.05). The CAT level was higher in the response patients than in non-response patients after 6 weeks (P<0.05). Con-clusions Both MECT treatment and Li2CO3 treatment can alter oxidative stress levels in patients with bipolar depression. The mechanisms underlying its therapeutic regimen may correct the imbalance of the plasma CAT level.

Objective:The extensive development of anatomical pulnonary segmentectomy requires thoracic surgeons to be familiar with the anatomical variations of the lung segment. The purpose of this study is to analyze the anatomical patterns of the right upper lobe lung segment using three-dimensional reconstruction, and to count rare variant types.Methods:From October 2017 to March 2020, 101 patients with small pulmonary nodules who were undergo segmental resection in our center were subjected to preoperative three-dimensional reconstruction of the lung structure, and the reconstruction data was retained for the statistics and analysis of the anatomical structure in the right upper lung lobe.Results:The right upper lobe bronchus is the most common with three branches(77/101), followed by two branches(16/101) and four branches(7/101). The two branches(70/101) of the right upper lobe pulmonary artery are the most common, followed by single branch(19/101) and three branches(11/101). In rare cases, four branches(1/101 cases) can be seen. The two branches(63/101) of the right upper pulmonary vein were the most common, followed by three branches(32/101) and single branch(6/101). In addition, a total of 12 rare mutations were counted. There were 2 variants in the bronchus, totaling 2 cases; 4 rare variants in the pulmonary artery, 13 cases total; 6 rare variants in the pulmonary vein, 10 cases total.Conclusion:The lung anatomy is complex and has many variations. The surgeon should fully grasp the anatomical structure of the lung segment of the patient's operating area before surgery, the data in this article will be a valuable reference for thoracic surgeons to carry out the upper right lobe segmentectomy.

Four hundred and twenty two patients with ureteral calculi undergoing surgical treatment from January 2016 to December 2016 were enrolled in the study.Urine samples were taken from upper and lower ureter of stone obstruction,pathogen examination and drug susceptibility tests were performed.Twenty nine strains of pathogens were isolated from the upper segment of ureter with a detection rate of 6.9%;22 strains were gram-negative bacteria(75.9%)and 3 strains were gram-positive bacteria(10.3%)and 4 strains were fungi(13.8%).Forty eight strains of pathogenic bacteria were isolated from the lower segment with a detection rate of 11.4%;37 strains were gram-negative bacteria(77.1%),11 strains were gram-positive bacteria(22.9%),no fungi was isolated.In 20 cases the positive results were obtained only from upper ureter urine samples, and in 39 cases the positive results were obtained only from lower segment samples.The same pathogens were detected from both upper and lower ureter of stone obstruction in 7 cases, and different pathogens were identified in 2 cases.The most common pathogens were Escherichia coli, followed by Proteus mirabilis, Klebsiella pneumoniae, Enterococcus faecalis and Enterococcus faecium.The resistance to quinolones in gram-negative bacteria was higher than that to cephalosporins.The resistance rate of Escherichia coli to cephalosporin was 36.7%-63.3%,that to ciprofloxacin and levofloxacin was 86.7%-100.0%; the resistance rate of Enterococcus to erythromycin was 100.0%.It is suggested that ureteral calculi obstruction may lead to negative culture results of conventional mid-stream urine samples.It is of clinical value to investigate the distribution and antibiotic resistance of pathogens both from upper and lower segments of ureter in patients with ureteral calculi.

Objective To explore the application of the standard of Chinese lymph node dissection in minimally invasive esophagectomy.Methods Methods Between April 2014 to September 2015,63 patients with esophageal carcinoma received minimally invasive esophagectomy by the same group of surgeons.Wedescribed in detail the methods of thoracic esophagus mobilization and lymph node dissection in the peri-esophageal space.We analyzed the surgical effect,postoperative complications and follow-up results.Resnits The average operation time was(280.48 ± 44.28) mins,the median intraoperative blood loss was 100 ml,the mean number of lymph nodes was 22.25-± 11.18;the incidence of postoperative pulmonary infection in 28.57％,hoarseness was 17.46％,anastomotic leakage was 12.70％,postoperative 1 year survival rate was 84.1％,3 year survival rate of 61.1％.Conclusion Mobilization of thoracic esophagus based on peri-esophageal space and dissection lymph nodes guided by the Chinese standard of grouping lymph node would achieve good clinical effects.

Objective: To evaluate the application of panning axial turnover in placement of surgical positions before thoracic surgery. Methods: From June 2017 to September 2017, altogether 140 patients who underwent thoracic surgery were enrolled in and randomly divided into two groups: the observation group and the control group. The control group was treated with traditional turnover method, while the observation group were treated with axial turnover. Results: No significant changes were found in blood pressure, heart rate and respiratory rate (P>0.05) after turning over. There was no significant difference between the observation group and the control group about turn over time, (7.06±0.78)s vs. (7.01±0.81)s (P>0.05). The subjective evaluation results of the medical staff in the observation group were significantly better than those of the control group (Z=-7.111, P<0.01) and the shift rate of double-lumen endotracheal tube in the observation group was 3.7% (2/54), which was significantly lower than 21.6% (11/51) of the control group (χ²=6.158, P<0.05). Conclusions The panning axial turnover properly guided the turn-over work with the principle of human body mechanics, which was more labor-saving and requires less operators. Besides, the panning axial turnover effectively reduced the double-lumen tracheal intubation shift rate. It′s worthy of clinical promotion.

Objective     To investigate the safety and feasibility of day surgery for patients with palmar hyperhidrosis based on the principles of enhanced recovery after surgery (ERAS). Methods     We retrospectively reviewed the medical records of consecutive patients who underwent endoscopic thoracic sympathicotomy (ETS) in the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to December 2021. Patients were divided into a day surgery group and a conventional group according to their perioperative management methods. The patients in the day surgery group underwent an optimized perioperative procedure under the guidance of ERAS, and were ventilated with a laryngeal or face mask during the operation. The patients in the conventional group completed the preoperative examination, operation and postoperative observation according to the conventional procedures, and were intubated with a single-lumen endotracheal tube. The demographic characteristics, operation time, hospital stay, postoperative complications, and hospitalization cost were compared between the two groups. Results     Finally 172 patients were collected, including 90 males and 82 females, with an average age of 25.97±7.43 years. There were 86 patients in each group. All patients ceased suffering from palmar sweating after surgery. No patient experienced massive bleeding or conversion to thoracotomy. There was no statistical difference in operation time between the two groups (P=0.534). Patients in the day surgery group were discharged within 24 hours. The average hospital stay in the conventional group was 2.09±0.41 days. Incidence of postoperative respiratory complications, and the hospitalization cost of the day surgery group were significantly lower than those of the conventional group (P<0.001). The satisfaction rate in both groups was greater than 95%. Conclusion     Day surgery for patients with palmar hyperhidrosis based on the principles of ERAS is safe and feasible, which can reduce postoperative complications, shorten the length of hospital stay and save the cost of hospitalization.