'Social beings' model of standardized training program for residents in Shanghai is one of the important measures in the health care reform. According to the requirements of the standardized training of residents in thoracic surgery, the article preliminarily explored the standardized training model for residents from four aspects such as individualized treatment of different professional backgrounds, focus-ing on the training needs of residents with different starting point of social beings, developing training programs for different training time and combining the master's degree graduate education. And based on the characteristics of thoracic surgery, it also summed up the past experience and explored the clinical practice teaching.

This study was aimed to observe the effects of herbal pair of Semen ziziphi spinosae (SZS) and A lbizia julibrissin flower (AJF) on the quality of life (QOL) among elderly patients with depression. A total of 70 elderly patients with depression were enrolled and randomly divided into two groups. The Chinese medicine group (with 35 cases) was given SZS-AJF decoction, and the western medicine group (with 35 cases) was given venlafaxine hydrochloride sustained-release tablets. The HAMD scale score, QOL Assessment Questionnaire (GQOLI-74), and the Side-Effects Scale Score (TESS) were detected 8 weeks before and after the treatment. The results showed that there was no significant difference on the clinical efficacy between two groups. On the comprehensive assessment of QOL, the physical function dimension, mental function dimension and QOL total score of Chinese medicine group were higher than the western medicine group with significant difference (P < 0.05). There were no significant differences on the material function dimension or social function dimensions between two groups. The HAMD score, physical function dimension, mental function dimension, social function dimension and score of QOL were all higher than the pretreatment score with significant differences in both groups (P < 0.05). The TESS score in Chinese medicine group was lower than the western medicine group. And the main adverse reactions in the Chinese medicines group were nausea and vomiting. It was concluded that the herbal pair of SZS and AJF had antidepressant efficacy. It can improve the QOL among elderly patients with depression.

Objective:Esophageal cancer has high morbidity in China, and surgery is the main treatment for this disease. Postop-erative nutrition is also important for the patients. In this article, we discuss the possibility of retrosternal route gastrostomy feeding (RGF). Methods: The data of 127 esophageal cancer patients between 2011 and 2013 were retrospectively analyzed. RGF was per-formed in all the patients, and post-operation complications were studied. Results: Bowel obstruction, catheter displacement, and wound infection did not occur. Conclusion:RGF is a safe and effective nutrition method for patients who underwent retrosternal recon-struction.

Objective:To explore the clinicopathologic features and renal prognosis of patients with post-transplant membranous nephropathy (MN).Methods:Patients with allograft biopsy-proven MN were reviewed retrospectively and divided into unknown etiology group (A, n=12) and recurrent membranous nephropathy (rMN) group (B, n=7). Their clinicopathological data and renal prognosis were assessed and compared.Results:No differences existed in the proportion of living-related donor or post-transplant allograft function. Group B had recurrence at 16.4 months after transplantation and it was significantly shorter than group A. Allograft impairment manifested as proteinuria, nephrotic syndrome and/or renal insufficiency in both groups. The positive rate of serum anti-PLA2R antibody and renal PLA2R staining was significantly higher in group B than that in group A. Similarly, the intensity of IgG4 subtype staining was also stronger in group B than that in group A. The 5-year cumulative renal survival rates from end-stage renal disease (ESRD) were 77.8% and 66.7% in groups A and B respectively. No significant inter-group difference existed in renal prognosis.Conclusions:Anti-PLA2R antibody plays an important role in the recurrence of rMN after renal allografting. PLA2R staining is useful for detecting primary disease and its sensitivity is higher than that of serum anti-PLA2R antibody. Rituximab is an effective treatment for post-transplant MN. Follow-up studies with a larger sample size are required for further verification.

Severe tracheal stenosis, which commonly results from tumor of trachea, tracheal trauma, congenital deformity constitutes a threaten for patient life, thus it needs for tracheal resection and reconstruction.For defects less than 5 cm, it can be repaired by direct end-to-end anastomosis. But for large area (more than 6 cm), it needs numerous different types of materials and techniques. These alternatives include allograft transplantation, autologous tissue transplantation, tissue engineering materials, and so on. In recent years, due to the rapid development of surgical techniques, the tracheal surgery has considerable development. In this paper, we will discuss tracheal allograft transplantation and tissue engineering trachea in tracheal replacement research progress.

Objective    To investigate the safety and efficacy of 3D single-portal inflatable mediastinoscopic and laparoscopic esophagectomy for esophageal cancer. Methods    Clinical data of 28 patients, including 25 males and 3 females, aged 51-76 years, with esophageal squamous cell carcinoma undergoing single-portal inflatable mediastinoscopic and laparoscopic esophagectomy from June 2018 to June 2019 were retrospectively analyzed. Patients were divided into two groups according to different surgical methods including a 3D mediastinoscopic group (3D group, 10 patients) and a 2D mediastinoscopic group (2D group, 18 patients). The perioperative outcome of the two groups were compared. Results    Compared with the 2D group, the 3D group had shorter operation time (P=0.017), more lymph nodes resected (P=0.005) and less estimated blood loss (P=0.015). There was no significant difference between the two groups in the main surgeon's vertigo and visual ghosting (P>0.05). The other aspects including the indwelling time, postoperative hospital stay, pulmonary infection, arrhythmia, anastomotic fistula, recurrent laryngeal nerve injury were not statistically significant between the two groups (P>0.05). Conclusion    The 3D inflatable mediastinoscopic and laparoscopic esophagectomy for esophageal cancer, which optimizes the surgical procedures of 2D, is safe and feasible, and is worthy of clinical promotion in the future.

Objective    To investigate the safety and efficacy of naked eye 3D thoracoscopic surgery in minimally invasive esophagectomy. Methods    Clinical data of 65 patients, including 50 males and 15 females aged 47-72 years, with esophageal cancer who underwent minimally invasive thoracoscopic esophagectomy from October 2018 to April 2019 were retrospectively analyzed. Patients were divided into two groups according to different surgical methods including a naked eye 3D thoracoscopic group (group A: 30 patients) and a traditional 2D thoracoscopic group (group B: 35 patients). The effects of the two groups were compared. Results    The operation time in the group A was significantly shorter than that in the group B (P<0.05). The number of dissected lymph nodes in the group A was more than that in the group B (P<0.05). The thoracic drainage volumes on the 1th-3th days after operation in the group A were significantly larger than those in the group B (P<0.05), but there was no significant difference between the two groups on the 4th-5th days after operation (P>0.05). The indwelling time in the group A was longer than that in the group B (P<0.05). Postoperative hospital stay, pulmonary infection, arrhythmia, anastomotic leakage, and recurrent laryngeal nerve injury were not significantly different between the two groups (P>0.05). Conclusion    Naked eye 3D thoracoscopic surgery for minimally invasive esophagectomy is a safe and effective surgical procedure. Compared with traditional 2D minimally invasive thoracoscopic surgery, it is safer in operation and more thorough in clearing lymph nodes. The operation is more efficient and can be promoted.

Objective    To investigate the safety and efficacy of 3D thoracoscopic surgery in uniportal lobectomy. Methods    Clinical data of 248 patients with lung cancer who underwent uniportal thoracoscopic lobectomy in our hospital from September 2018 to May 2019 were retrospectively analyzed. Patients were divided into two groups according to different surgical methods, a 3D thoracoscopic group (76 patients, including 52 males and 24 females with an average age of 58.59±7.62 years) and a 2D thoracoscopic group (172 patients, including 102 males and 70 females with an average age of 57.75±8.59 years). Statistical analysis of clinical and pathological data, lymph node dissection, surgical complications, postoperative hospital stay, etc was performed. Results    Compared with the 2D thoracoscopic group, the 3D thoracoscopic group had shorter operation time, more lymph nodes dissected and pleural effusion on the first day after operation (P<0.05). There was no significant difference in the postoperative chest tube duration, postoperative hospital stay, incidence of pulmonary infection, arrhythmia, bronchopleural fistula, or recurrent laryngeal nerve injury between the two groups. Conclusion    Compared with the traditional 2D thoracoscopic minimally invasive surgery, uniportal lobectomy with 3D thoracoscopic surgery is safer and more efficient during operation, and lymph node dissection is more thorough, which is worth promoting.

Objective    To introduce the application of mixed reality technique to the preoperative and intraoperative pulmonary nodules surgery. Methods    One 49-year female patient with multiple nodules in both lobes of the lung who finally underwent uniportal thoracoscopic resection of superior segment of left lower lobe and wedge resection of left upper lobe was taken as an example. The Mimics medical image post-processing software was used to reconstruct the patient's lung image based on the DICOM data of the patient's chest CT image before the surgery. The three-dimensional reconstructed image data was imported into the HoloLens glasses, and the preoperative discussions were conducted with the assistance of mixed reality technology to formulate the surgical methods, and the preoperative conversation with the patients was also conducted. At the same time, mixed reality technology was used to guide the surgery in real time. Results    Mixed reality technology can clearly pre-show the important anatomical structures of blood vessels, trachea, lesions and their positional relationship. With the help of mixed reality technology, the operation went smoothly. The total operation time was 49 min, the precise dorsal resection time was 27 min, and the intraoperative blood loss was about 39 mL. The patient recovered well and was discharged from hospital smoothly after surgery. Conclusion    Mixed reality technology has certain application value before and during the surgery for pulmonary nodules. The continuous maturity of this technology and its further application in clinics will not only bring a new direction to the development of thoracic surgery, but also provide a wide prospect.