In recent years, the incidence and detection rate of lung cancer have gradually increased, and segmentectomy has been increasingly used to treat early non-small cell lung cancer. Some scholars believe that segmentectomy is more conducive to the preservation of postoperative lung function than lobectomy. Some studies have found that the two surgical methods have little difference in postoperative cost retention. This article deals with segmentectomy and lobectomy. A review of related studies on postoperative pulmonary function changes.
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Humans ; Lung ; physiopathology ; surgery ; Lung Neoplasms ; physiopathology ; surgery ; Pneumonectomy ; adverse effects ; methods ; Recovery of Function

Objective:To evaluate the effects of remimazolam on gastrointestinal motor function in the patients undergoing gastrointestinal endoscopy.Methods:A total of 262 American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 18-64 yr, with body mass index of 18-28 kg/m 2, scheduled for elective gastrointestinal endoscopy from May 2022 to August 2022, were divided into 2 groups ( n=131 each) using a random number table method: remimazolam group (group R) and propofol group (group P). The patients in group R received intravenous remimazolam 0.20-0.25 mg/kg, and patients in group P received intravenous propofol 1.5-2.0 mg/kg. The gastrointestinal endoscopy was performed when the patients′ Modified Observer′s Assessment of Alertness/Sedation scores ≤3. During fasting before gastrointestinal preparation, before gastrointestinal endoscopy and while leaving the post-anesthesia care unit (PACU), the concentrations of serum motilin and gastrin were measured by enzyme-linked immunosorbent assay, the intestinal peristalsis rating assessed by the endoscopist during the examination was recorded, the occurrence of hypotension and hypoxemia during the examination and occurrence of abdominal distension, abdominal pain, and nausea and vomiting during stay in PACU were recorded. Results:Compared with group P, the intestinal peristalsis rating was significantly increased, the serum motilin and gastrin concentrations were increased while leaving PACU, the incidence of hypotension and hypoxemia was decreased during the examination, and the incidence of abdominal distention was decreased during stay in PACU in group R ( P<0.05). Conclusions:Remimazolam has a milder inhibitory effect on secretion of gastrointestinal hormones than propofol in the patients undergoing gastrointestinal endoscopy and is helpful for the recovery of gastrointestinal motility.

BACKGROUND: Lung segmentectomy is increasingly used to resect lung nodules. Video-assisted thoracic surgery (VATS) is widely chosen to performing lung segmentectomy, while robotic assisted thoracoscopic (RATS) was also one useful and practical method. There article was intended to compared the short-time outcomes of RATS and VATS in lung segmentectomy. METHODS: The patients with lung nodules underwent segmentectomy by either RATS or VATS from January 2016 to April 2017 were studied. Baseline characteristics and short-time outcomes (dissected lymph nodes, postoperative duration of drainage, postoperative hospital stay, incidence of pro-longed air leak, atrial fibrillation and pneumonia) were compared. RESULTS: 166 patients were included in this study: 81 patients underwent RATS segmentectomy while 85 underwent VATS segmentectomy. The number of lymph nodes dissected in RATS group was more than in VATS group ［(13.07±5.08) vs (10.81±5.74), P=0.010］. The incidence of some postoperative complications such as pro-longed air leak, atrial fibrillation was not significant different between the two approaches. CONCLUSIONS Compared with VATS, RATS has similar safety and operability, and the number of lymphadenectomy is significantly more than that of VATS.

Objective    To analyze the characteristics and risk factors of lymph node metastasis in thoracic esophageal squamous cell carcinoma (ESCC). Methods    The clinical data of 407 patients with ESCC who underwent radical resection of esophageal carcinoma from December 2012 to October 2018 in our hospital were retrospectively analyzed. There were 390 males and 17 females with a median age of 63 (38-82) years. Esophageal lesions were found in 26 patients of upper thoracic segment, 190 patients of middle thoracic segment and 191 patients of lower thoracic segment. Results    Among the patients, 232 (57.0%) were found to have cervical, thoracic and/or abdominal lymph node metastasis. The lymphatic metastasis rates of cervical, upper, middle, lower mediastinal nodes and abdominal nodes were 0.7%, 8.8%, 21.4%, 16.7% and 37.1%, respectively. The adjacent lymph node metastasis alone occurred in 50.0% patients, and the multistage or skip lymph node metastasis accounted for 29.3% and 20.7%, respectively. Multivariate analysis showed that the length of esophageal lesion, T stage, degree of tumor differentiation, vascular cancer embolus and nerve invasion were independent risk factors for lymph node metastasis. Conclusion    The rates of lymph node metastasis are similar in the upper, middle and lower thoracic ESCC. The main pattern of lymph node metastasis is the adjacent lymph node metastasis, followed by multistage and skip lymph node metastases. The length of esophageal lesion, T stage, degree of tumor differentiation, vascular cancer embolus and nerve invasion are independent factors for lymph node metastasis. The operation and dissection range should be selected according to the location of tumor and the characteristics of the lesion.

OBJECTIVE：To optimize the honey-stir-fried technology of Chelidonium majus . METHODS ：Taking the mass ratio of water to honey ，the ratio of honey water to C. majus ，stir-fired temperature ，stir-fired time as the factors ，the total contents of chelidonine ，coptisine hydrochloride ，sanguinarine，berberine，chelerythrine as response values ，Box-Behnken response surface method was used to optimize the processing technology ，and valifation test was conducted. RESULTS ：The optimum process conditions were as follows the ratio of water to refined honey 1∶1.9（g/g），the ratio of honey water to C. majus 21∶100（g/g）， stir-fried temperature 122 ℃，stir-fried time 10.40 min. After 3 times of validation ，average total contents of 5 components was 10.37 mg/g（RSD＝0.23％），relative error of which with predicted value （10.39 mg/g）was 0.19％. CONCLUSIONS ：The optimized honey-stir-fried technology of C. majus is stable and feasible.

Objective    To investigate the changes in pulmonary function after video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS) segmentectomy. Methods    A total of 59 patients (30 males and 29 females) who underwent segmentectomy in the Affiliated Hospital of Qingdao University from July to October 2017 were included. There were 33 patients (18 males and 15 females) in the VATS group and 26 patients (12 males and 14 females) in the RATS group. Lung function tests were performed before surgery, 1 month, 6 months, and 12 months after surgery. Intra- and inter-group comparisons of lung function retention values were performed between the two groups of patients to analyze differences in lung function retention after VATS and RATS segmentectomy. Results    The forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in the VATS group and the RATS group were significantly lower than those before surgery (P<0.05), and they increased significantly within 6 months after surgery (P<0.05). The recovery was not obvious after 6 months (P>0.05), and they were still lower than those before surgery. In addition, the retentions of FEV1 and FVC in the VATS group and the RATS group were similar in 1 month, 6 months, and 12 months after operation with no statistical difference(P>0.05). Conclusion    Pulmonary function decreases significantly in 1 month after minimally invasive segmentectomy, and the recovery is obvious in 6 months after the operation, then the pulmonary function recovery gradually stabilizes 12 months after surgery. FEV1 of the patients in the two groups recovers to 93% and 94%, respectively. There is no statistical difference in pulmonary function retention after VATS and RATS segmentectomy.