Objective Summarize and analyze surgical treatment experience and clinical application value for severe chest trauma with multiple rib fractures (which has a positive rate of occurrence),the treatment method is to surgically fix titanium plate to ribs at the early stage of the fractures.Methods Adopted 161 severe chest trauma cases require thoracotomy from June,2007 to June,2012.The patients were arranged as two groups according to the doctor's requirements by our fulltiem horses.79 cases of normal thoracotomy operations were recorded as control group ; at the same period 82 cases thoracotomy operation with ribs internally fixed treatment were recorded as the group of internal plate fixing treatment group.Then compare the results of postoperative paradoxical respiration,oxygen concentration,lung function,chest drainage,length of stay and others after operations.Results The treatment results include oxygen saturation of blood,lung function,and length of stay,the complication rate and death rate.The results of ribs intemafly fixed group are better than the control group on average.Conclusion Apply internal plate fixing operation to ribs during the thoracotomy will effectively control thoracic paradoxical respiration and prevent respiratory failure,improve lung function,reduce death rate of chest trauma and the complication and be helpful for rapid recovery.

Objective To analyze the risk factors of lung cancer patients complicated with pulmonary infection after thoracoscopic surgery and establish a predictive nomogram model. Methods A total of 315 patients with primary lung cancer who had undergone thoracoscopic surgery from January 2018 to October 2021 in our hospital were divided into two groups according to the incidence of pulmonary infection. Two groups of clinical data were collected for single-factor and regression analyses, and independent predictors were obtained. On this basis, a risk model was constructed and its predictive effectiveness was evaluated. Results The independent risk factors of lung cancer patients complicated with pulmonary infection after thoracoscopic radical operation were as follows: age≥62.5 years, smoking index≥100, PEF≤72.1 ml/s, TNM stage Ⅲ/Ⅳ, and operation time≥188.5 min (P < 0.05). Based on the above factors, the risk model of the column chart was established. Model-verification results showed that the C-index of the model was 0.909, and the correction curve showed that the column chart model had good differentiation and consistency. Conclusion Lung cancer patients' age, smoking index, TNM stage, PEF, and operation time are closely related to pulmonary infection after thoracoscopic radical operation. The nomogram model is useful for identifying high-risk patients and reducing postoperative complications.

Pleural effusion is a common clinical pleural disease, and it is also an accompanying manifestation of many diseases. The characteristics and etiological diagnosis of pleural effusion have always been the focus of clinical attention. Pleural effusion is divided into exudate and exudative effusion, and tuberculous pleural effusion and malignant pleural effusion are more common in exudative pleural effusion. Its characteristics and the selection of appropriate diagnostic methods are crucial to the treatment and prognosis of patients. With the rapid development of experimental technology and molecular biology, some new experimental techniques and experimental indicators have emerged. In this review, the characteristics of tuberculous pleural effusion and malignant pleural effusion and the research progress of its differential diagnosis methods were reviewed.

Objective To explore the clinical effects of eustachian tube insufflation via nasal endoscopy combined with administration of hormone and antibiotics in treating secretory otitis media (SOM). Methods A total of 65 patients with SOM who were admitted to our hospital from January 2013 to October 2014 were selected. They were randomly allocat-ed to an observation group (33 patients) and a control group (32 patients) according to their conditions. The observation group was given eustachian tube insufflation via nasal endoscopy combined with oral administration, while the control group was given oral administration. After one-month treatment, clinical effects, changes of tympanogram, airway aver-age threshold measured by pure tone audiometry testing, complications and adverse events between the two groups were observed. Results The difference of total effective rate in the two groups (90.24%vs 62.16%) was statistically significant (P<0.05);proportion of type A recovery of tympanogram in the two groups was compared (53.66% vs 29.73%), and the difference was statistically significant (P<0.05); after the treatment, results of pure tone audiometry testing in the two groups (20.63±2.52 vs 26.92±2.95) were statistically significant (P<0.05);one case of one-time dizziness was seen in the observation group;relapse rates in the two groups (4.88%vs 13.51%) were not statistically significant (P>0.05). Conclu-sion Eustachian tube insufflation via nasal endoscopy combined with oral administration has definite clinical effects on SOM, which is worthy of clinical promotion.