Objective To study the role of sodium nitroprusside in preventing pulmonary ische-mia-reperfusion injury and the possible mechanism. Methods Fourteen pigs were randomly divided into 2 groups: control group underwent controlled reperfusion with reperfusion solution (leukocyte-depleting blood modified buckberg perfusate = 4:1) for 10 min at lower pressure of 18 mm Hg and 37℃? 1℃ before removing the pulmonary artery clamp; experimental group were subjected to controlled reperfusion with reperfusion solution before removing the pulmonary artery clamp, followed by infusion of sodium nitroprusside (10?g?kg-1?min 1 for 10 min) via pulmonary artery. Blood oxygen pressure, pulmonary vascular resistance, pulmonary compliance and the changes in pulmonary oxygen-ation function were assessed 0. 5, 1 and 2 h later. After the trail, the contents of water, NO and MDA in pulmonary tissues were measured. Results In the experimental group, left lung oxygenation function and pulmonary compliance was significantly better (P

Objective To investigate the effect of the use of audio and video feedback on the rehabilitation of patients with ankylosing spondylitis (AS). Methods 60 AS patients were divided into two parts (32 in the experimental group and 28 in the control group) by random number table method, and two groups of patients were treated with the same drug treatment. Patients in the control group were instructed by oral instruction, in the experimental group, the use of audio and video feedback teaching guide patients family exercise, compared with the two groups of patients with four months of follow-up, family exercise compliance, joint function and quality of life, and other indicators. Results Four months after the intervention, the experimental group patients family exercise compliance was better than 84%(27/32), higher than the control group of 36% (10/28), the difference was statistically significant (χ2=9.238, P < 0.01). Patients in the experimental group in four months after the intervention, the health questionnaire to investigate the physiological function, role limitation due to physical problems, body pain, general health, vitality, social function, role limitation due to emotional problems, mental health eight dimension scores respectively were (72.7±8.4), (81.5±9.5), (57.2±8.4), (65.5±8.4), (62.9±7.2), (78.4±7.4), (67.3±6.2), (77.2±7.6) points while in the control group were (60.8±9.1), (72.1±9.6), (50.3±9.4), (60.8±7.0), (58.2±9.1), (74.4±8.7), (60.2±7.2), (74.3±7.4) points, the difference between the two groups had statistical significance (t=1.493-5.266, P < 0.05 or 0.01). Four months after the intervention, the scores of Bath Ankylosing Spondylitis Functional Index (BASFI) of patients with AS in the experimental group were (1.1± 0.8), (1.7±0.2), (1.8±1.3), (1.6±1.0), (3.1±2.1), (1.0±0.6), (1.9±1.6), (3.8±2.5), (2.6±1.7), (2.7±1.6) points, while (3.8±1.6), (2.8±1.5),(2.6±1.5)、(2.8±1.2),(4.4±2.2),(2.2±1.0),(3.3±1.6),(6.5±2.5),(5.6±2.6), (4.3 ± 1.5)control group, the two groups the difference was statistically significant (t=0.282-8.427, P<0.05). Conclusions Application of audio and video feedback teaching in patients with AS rehabilitation guidance, help patients to master the family training methods, improve the joint function of patients, improve the quality of life.

Objective To evaluate the effect of the standardized training program for resident physicians in Ruijin Hospital,and analyse the problems so as to provide reference to improve the training.Methods Questionnaire surveys were conducted among 113 resident physicians,31 teachers and 43 head nurses in Rujin Hospital by using the simple random sampling and 300.The data was analysed by Kirkpatrick's model in four layers including reaction layer,learning layer,behaviors layer and results layer.Data of reation layer was analysed by ANOVA and data of behaviors layer was compared by paired t-test.Results Reaction layer:the resident physicians' overall satisfaction score for the training is 3.45.Learning layer:all resident doctors participating in the training passed all the exams organised by the hospital.Behaviors layer:Residents made a great progress in many aspects after the standardized training program,and the difference was statistically significant (P＜0.01) according to the analysis of all questionnaires written by residents,clinical teachers and head nurses.Results layer:both the patient complaint rate and the accident rate of the 113 resident physicians was 0 while they all passed the National Medical Licensing Examination and the employment rate was 100％.Conclusions the standardized training program for resident physicians in Ruijin Hospital gets fairly good effect.Resident doctors' quality and ability in many aspects are improved and the overall satisfaction for the training is high,but in salary,benefits and sense of belonging to the hospital,the satisfaction is relatively low.

Objective:To explore superior mediastinal lymph node zoning of thyroid cancer for accurate anatomical definition as a reference for surgical access. Methods:A method for zoning superior mediastinal lymph nodes for thyroid cancer was proposed. From Sep 2018 to Nov 2019, 36 cases of thyroid cancer with superior mediastinal lymph nodes metastases were reviewed. The diagnosis, surgical approaches, pathology, characteristics of lymph node metastasis, complications and follow-up results were analyzed.Results:The superior mediastinal lymph nodes were grouped into 10 areas: 1, 2Ra, 2Rb, 2La, 2Lb, 3A, 3P, 4R, 4La and 4Lb. According to the location of the superior mediastinum metastatic lymph nodes, direct vision approach through the neck incision, laparoscope-assisted approach, thracoscepy, laparoscope-assisted combined with thrascopy approach or conventional median sternotomy was performed for regional lymph node dissection. The average follow-up time was (10±4) months. No residual or recurrence of tumor in superior mediastinal area was found.Conclusions:The zoning of the superior mediastinal lymph nodes in thyroid cancer can be used as a guide for surgical approach to lymph node dissection .

Objective To analyze the perioperative outcome of consecutive 1 000 patients undergoing robotic lung resection and summarize surgical experience. Methods We retrospectively reviewed the clinical data of 1 000 patients undergoing robotic lung resection between May 2009 and June 2018 in Shanghai Lung Tumor Clinical Medical Center. Robotic lobectomy was compared with traditional VATS over the same period using a propensity-matched analysis. There were 327 males and 673 females at average age of 56.21±11.33 years. Lobectomy was performed in 866 patients (11 bilobectomy included), sublobar resection was performed in 129 patients, sleeve lobectomy was performed in the remaining 5 patients. Pathology was as follows: adenocarcinoma in 875 patients, squamous carcinoma in 52 patients, benign tumors in 73 patients. 90.5% of the primary lung cancer were in stage Ⅰ. Results The mean operative time was 90.31±19.70 min; 95.70% of patients’ estimated blood loss was less than 100 ml. Conversion rate to thoracotomy was 0.90% (9 patients) . The average lymph node station and count harvested was 5.59±1.36 and 9.60±3.21 respectively. The mean volume of chest tube drainage on the first postoperative day was 229.19±131.67 ml. Median chest tube time was 3.85±1.43 d. There was 1 in-hospital death due to pulmonary embolism. A total of 189 patients had postoperative complications (18.90%) whose majority was postoperative air leak more than 5 days. The mean overall hospital costs was 92 710.53±12 367.23 Yuan. Compared with VATS, RATS was associated with significant reduction in intraoperative blood loss, time to chest tube removal and postoperative hospital stay. The operative time, conversion rate, lymph nodes removed, morbidity and mortality were similar between the two groups. Conclusion Robotic-assisted lung resection is safe and effective with low conversion rate and less complications, and it can overcome many disadvantages of traditional VATS.