Objective The aim of this study was to explore the feasibility and efficacy of single port video-assisted thora coscopic surgery(S-VATS) lobectomy for lung cancer.Methods Clinical data of consecutive 140 cases of lung cancer patients underwent S-VATS lobectomy with systematic lymph nodes dissection by the same group of surgeons between January 2013 and January 2016 was retrospectively analyzed,wbich was compared with 60 cases of multi-port VATS(M-VATS,M group) lobectomy in this period.The patients of S-VATS were divided into four groups according to the sequence of surgery(group A,B,C and D,35 cases in each group).The operation time,blood loss,number of dissected lymph nodes and nodal stations,the rate of S-VATS conversion to M-VATS or thoracotomy,postoperative complications,postoperative chest drainage as well as hospital stay were compared respectively between the five groups.Results There were no significant difference between the groups in terms of age,gender,BMI,comorbidity and T staging(PP ＞ 0.05).No one was converted to thoracotomy,and all of the sur gical specimens were negative (R0).Besides,the operation time of group A[(200.3 ± 46.3) min] was noticeably longer than that in group B [(170.9 ± 27.7) min],group C [(154.6 ± 25.0) min],group D [(142.6 ± 32.8) min] and group M [(137.3 ± 27.7) min] (P ＜ 0.05).Besides,the operation time of group B was longer than group D and M (P ＜ 0.05) while the operation time of group C was longer than group M(P =0.026),and there was no significant difference between group D and M (P =0.996).In addition,the blood loss in group A [(304.3 ± 119.0) ml] was significantly more than that of group B [(282.9 ±89.1)ml],group C[(232.9 ±82.2)ml],group D[(202.8 ±72.7)m1] and group M[(200.0 ±70.7)ml] (P ＜ 0.05) whilst the blood loss of group B was markedly more than that of group D and M (P ＜ 0.05),and no significant difference was indicated between group C,D and M(P ＞ 0.05).Moreover,there were 6 cases of blood vessel injury and 7 cases conversion to multi-port VATS in group A,which was evidently more than the other groups(P ＜ 0.05).Furthermore,the pain score of group A was remarkably higher than the other groups (P ＜ 0.05).However,the number of dissected lymph nodes,postoperative complications and chest drainage and hospital stay were similar among all the groups (P ＞ 0.05).Conclusion S-VATS lobectomy for treatment of lung cancer is feasible and effective with learning curve of nearly 70 cases,but it does not demonstrate any advantage compared with M-VATS.

Objective To investigate the role of growth arrest-specific 6(Gas6)/Mer tyrosine kinase(MerTK)signaling pathway in ferroptosis in diabetes retinopathy(DR).Methods Human retinal pigment epithelial cells(ARPE-19)were divided into control group,HG group,HG+sh-Gas6 group,and HG+Gas6 group.Cells were exposed to 25 mmol/L D-glucose for simulating an in vitro hyperglycemic(HG)environment.The control group was exposed to a 20 mmol/L mannitol+5.5 mmol/L glucose environment.Rats were randomly divided into normal control group,DR group,and DR+Gas6 group,with 20 rats in each group.A DR model was established by intra-peritoneal injection of STZ solution.Cell proliferation was evaluated using the cell count kit 8(CCK-8)assay.Lip-id reactive oxygen species(ROS)levels were measured by flow cytometry,and levels of malondialdehyde(MDA),superoxide dismutase(SOD),and glutathione peroxidase(GSH-Px)were measured by biochemical assays to eval-uate iron death.The expression of Gas6 and MerTK proteins was analyzed by Western blot.Results Compared with HG group,the cell viability,SOD,GSH-Px levels in HG+Gas6 group increased significantly(P＜0.05),while the levels of lipid-ROS and MDA decreased significantly(P＜0.05).In HG+sh-Gas6 group,the cell via-bility,SOD and GSH-Px levels decreased significantly(P＜0.05),while the levels of lipid-ROS and MDA in-creased significantly(P＜0.05).In addition,the expression of GPX4 protein in HG+Gas6 group was significant-ly higher than that in HG group(P＜0.05),and the expression of GPX4 protein in HG+sh-Gas6 group was sig-nificantly lower than that in HG group(P＜0.05).Compared with the control group,the average thickness of reti-nal nerve fiber layer in DR group significantly decreased(P＜0.05),while that in DR+Gas6 group increased sig-nificantly(P＜0.05).In addition,the levels of MDA and iron in retinal pigment epithelium(RPE)tissues of DR+Gas6 group decreased significantly(P＜0.05),while the levels of GSH and the expressions of Gas6,MerTK and GPX4 proteins increased significantly(P＜0.05).Conclusion HG treatment accelerates the clearance of GPX4 by inhibiting the Gas6/MerTK signaling pathway,inducing ferroptosis and cell growth inhibition in ARPE-19 cells.In addition,up-regulating the expression of Gas6/MerTK signal in DR rat retina can alleviate ferroptosis and oxidative stress in RPE tissue,and help to restore the average retinal nerve fiber layer thickness.