Objective:To investigate the association of immediate preoperative hyperglycemia (IPH) with postoperative pulmonary complications (PPCs) in patients with diabetes mellitus following video-assisted thoracoscopic partial lung surgery (VATPLS).Methods:This was a retrospective cohort study. The patients with diabetes mellitus who underwent elective VATPLS at the First Affiliated Hospital of Nanjing Medical University from January, 2018 to July, 2020 were recruited. Based on immediate preoperative blood glucose levels (fasting blood glucose within 2 h before surgery), the patients were divided into hyperglycemia group (IPH group, blood glucose concentration ≥7.8 mmol/L) and non-hyperglycemia group (non-IPH group, blood glucose concentration <7.8 mmol/L). The association of IPH with the occurrence of PPCs was analyzed using the prospensity score matching.Results:Data from 438 diabetic patients who underwent VATPLS were ultimately collected in this study. Compared with non-IPH group, the incidence of PPCs was significantly increased in IPH group ( P<0.001). After propensity score matching, 128 cases were assigned to both IPH group and non-IPH group, the risk of PPCs in IPH group was 1.33 times of that in non-IPH group (relative risk 1.33, 95% confidence interval 1.02-1.73, P=0.031). There were no interactions between age factors/preoperative glycated hemoglobin and IPH. Conclusions:IPH (fasting blood glucose within 2 h before surgery ≥7.8 mmol/L) is associated with the occurrence of PPCs to some degree in patients with diabetes mellitus undergoing VATPLS.

Objective:To investigate the association of immediate preoperative hyperglycemia (IPH) with postoperative pulmonary complications (PPCs) in patients with diabetes mellitus following video-assisted thoracoscopic partial lung surgery (VATPLS).Methods:This was a retrospective cohort study. The patients with diabetes mellitus who underwent elective VATPLS at the First Affiliated Hospital of Nanjing Medical University from January, 2018 to July, 2020 were recruited. Based on immediate preoperative blood glucose levels (fasting blood glucose within 2 h before surgery), the patients were divided into hyperglycemia group (IPH group, blood glucose concentration ≥7.8 mmol/L) and non-hyperglycemia group (non-IPH group, blood glucose concentration <7.8 mmol/L). The association of IPH with the occurrence of PPCs was analyzed using the prospensity score matching.Results:Data from 438 diabetic patients who underwent VATPLS were ultimately collected in this study. Compared with non-IPH group, the incidence of PPCs was significantly increased in IPH group ( P<0.001). After propensity score matching, 128 cases were assigned to both IPH group and non-IPH group, the risk of PPCs in IPH group was 1.33 times of that in non-IPH group (relative risk 1.33, 95% confidence interval 1.02-1.73, P=0.031). There were no interactions between age factors/preoperative glycated hemoglobin and IPH. Conclusions:IPH (fasting blood glucose within 2 h before surgery ≥7.8 mmol/L) is associated with the occurrence of PPCs to some degree in patients with diabetes mellitus undergoing VATPLS.

Objective To study the effect of chest drainage and injection of pleural adhesion agent in the treatment of the malignant pleural effusion (MPE),and to discuss the influences about it.Methods The data of the in-hospital patients with MPE who received thoracostomic drainage and pleural adhesions were retrospectively analyzed.11 factors were selected as research subjects,such as sex,age,KPS score,tissue origin of primary tumor,the position of hydrothorax,the cell number,the level of protein,the level of LDH in the effusion,species of sclerosant,the fluid volume of hydrothorax in 24 hours before using sclerosant,the duration between pleurodesis and removing the tude.Then,the factors that affected the effect of pleurodesis were analyzed.Results In total 196 cases,61 patients acquired significant efficacy,71 men achieved good result,and 64 people had no effect.The total effective rate was 67.3％.Univariate analysis showed that KPS score,tissue origin of primary tumor,the position of hydrothorax,the level of protein and LDH in the effusion,species of sclerosant,the fluid volumeof hydrothorax in 24 hours before using sclerosant were related to the effect.Multivariate Logistic regression analysis indicated that KPS score,tissue origin of primary tumor,the position of hydrothorax,the level of protein and LDH in the effusion,species of sclerosant,the fluid volume of hydrothorax in 24 hours before using sclerosant were indepent factors for efficacy of the pleurodesis.Conclusion It seems that good adhesion effect achieved in patients with MPE that KPS score ≥70,primary breast carcinoma,using sapylin as a sclerosant,the fluid volume of hydrothorax ≤ 200nmL in 24 hours before using sclerosant.