Objective:To investigate the advantages and safety of subxiphoid uniportal thoracoscopic thymectomy.Methods:From October 2014 to December 2019, a total of 308 patients diagnosed with early stage thymic epithelial tumor underwent uniportal thoracoscopic thymectomy were included. Subxiphoid group including 40 males and 37 females, aged 32-80 years old, mean age(58.0±11.8)years old. Intercostal group including 114 males and 117 females, aged 25-78 years old, mean age(54.8±11.4)years old. Short-term and long-term postoperative pain scores was compared in a propensity score matching analysis.Results:Propensity score analysis revealed that 62 patients treated with the subxiphoid approach and 62 patients treated with the lateral intercostal approach had the same baseline characteristics. There were no significant differences in lesion size, stage, pathological type, intraoperative blood loss, postoperative drainage volume and postoperative hospital stay between the two groups( P>0.05). Compared with those in the intercostal group, patients in the subxiphoid group yielded lower pain scores on the first day after operation and less patients with postoperative pain lasting more than 3 months. Patients required for additional analgesic therapy in subxiphoid group was less than intercostal group. One patient in subxiphoid group developed myasthenia after operation, which prolonged the duration of mechanical ventilation. No serious perioperative complications and death occurred in other patients. Conclusion:Subxiphoid uniportal thoracoscopic thymectomy is safe and feasible, it has the advantages of no injury to intercostal nerve and less short-term and long-term postoperative pain compared with intercostal approach.

Objective Application of near-infrared fluorescent thoracoscope in visualizing thoracic sympathetic ganglions,to explore the effectiveness and safety of the technique.Methods Patients received near-infrared fluorescent thoracoscopic surgery was continuously in rolled from September 2015 to September 2016.The patient was infused indocyanine green 5 mg intravenous 24 hours before surgery.The thoracic sympathetic ganglions were observed under white and fluorescence model during surgery.The videos and photos were analyzed and the relationship between sympathetic ganglions and ribs was recorded.Results 31 patients was in rolled,including 12 males and 19 females.The average age was 47 years.The sympathetic ganglion of each patient was well visualized under fluorescence model.The signal to background ratio was 1.67.As we found that 48.8％ ganglions located in the upper edge of lower rib.Besides,26.9％ of T2 ganglions and 23.1％ of T3 ganglions located on the rib.Conclusion Near-infrared fluorescent thoracoscope was effiective and safety to visualize the thoracic sympathetic ganglions.The sympathectomy of palmar hyperhidrosis could be done by near-infrared fluorescent thoracoscope more precisely.

Objective To investigate the current situation of Chinese non-small cell lung cancer( NSCLC) surgical treat-ment in different centers.And to compare the differences of patient characteristics and treatment patterns .Methods Data of 5060 NSCLC patients out of 8387 patients from 14 provinces, 17 third-grade class-A hospitals was obtained .All included pa-tients were stage ⅠtoⅢ, and were treated with curative-intent surgeries during the years of 2013 and 2014.Patient character-istics, preoperative examinations, surgical treatment patterns and pathology et al.were analyzed.Results There were 3204 males and 1856 females.The patients' age was among 19~86(59.7 ±9.11)years old.Mean preoperative FEV1 was(2.23 ± 0.67)L, and mean FEV1/FVC was 81.8%.64.6% patients accompanied with at least one comorbidity.The mean diameter of tumor was(3.28 ±1.94)cm.Duration of surgery was(181.1 ±71.0) minutes.Pathology confirmed 59.8% as adenocarcino-ma, and 30.2% as squamous carcinoma.The ratio of adenocarcinoma/squamous cell carcinoma was 1.03:1 in all male pa-tients.And the ratio is 16.4:1 in female patients.Among all the patients that underwent lobectomies, 50.1% patients under-went micro-invasive surgeries(VATS or mini-incision surgery).The rate of micro-invasive surgery is among 8.3% to 90.2%. The number of lymph nodes stations harvested in lobectomy was 5.9(mean 3.0 -7.4).Mean hospital cost was 53830.8 ( mean 42205-100113 ) yuan.Conclusion The Chinese NSCLC patients who underwent surgeries own unique patient charac-teristics.The baseline characteristics, surgical treatment patterns and hospital cost varied among different centers.

BACKGROUND:Studies have testified that nano-ultrasound contrast agents have a strong permeability, making it possible to image the targeted tissues outside blood vessels and overcome the limitation that micron contrast agents are only available for the blood pool imaging. OBJECTIVE:To construct the folate-modified nanoparticles targeting breast cancer as ultrasound contrast agents, as wel as to observe their ability to specifical y bind to cel s and imaging effect in vitro. METHODS:Both contrast agents, pegylated lactic acid-glycolic acid copolymer wrapping liquid fluorocarbon formed nanoparticles (mPP/PFOB) and folate modified pegylated lactic acid-glycolic acid wrapping liquid fluorocarbon formed nanoparticles (mPPF/PFOB), were constructed by phacoemulsification-evaporation method. (1)Biocompatibility detection:HFF-1 and MCF-7 cel s in the logarithmic phase were cultivated with various concentrations (0, 0.005, 0.01, 0.02, 0.05, 0.1, 0.2 and 1 g/L) of mPP/PFOB or mPPF/PFOB for 24 hours respectively, and then the cel viability was measured. (2)Targeting ability detection in vitro:HFF-1 and MCF-7 cel s in the logarithmic phase were divided into three groups. Cy5-labled mPP/PFOB and mPPF/PFOB were added into groups A and B, respectively;the cel s in group C were pretreated with folate for 2 hours, and sequential y Cy5-labled mPPF/PFOB was added into group C. Fluorescence intensity was detected by flow cytometry after 0.5 hours of culture. The distribution of contrast agents in cel s was observed using confocal microscopy after 20 minutes of culture. (3)Ultrasound imaging in vitro:there were three groups:saline was as group A;the suspension of saline and mPPF/PFOB nanoparticles was prepared as group B;MCF-7 cel s were resuspended with the mixture of saline and mPPF/PFOB nanoparticles to prepare the suspension of nanoparticles and cel s as group C. In each group, the suspension was added into latex gloves, that were then tightened and immersed in water. Final y, the ultrasound was use to detect the ultrasound imaging effect in vitro. RESULTS AND CONCLUSION:Neither nanoparticles were with significant cytotoxicity. The flow cytometry showed that the mean fluorescence intensity in MCF-7 cel s of group B was significantly higher than that of groups A and C. But there were no significant differences in the mean fluorescence intensity in HFF-1 cel s among the three groups. It was observed that mPPF/PFOB mainly gathered around the MCF-7 cel membrane, while mPP/PFOB randomly distributed in the cytoplasm. After mPPF/PFOB binding to MCF-7 cel s, they could enhance ultrasound echo in vitro. These findings indicate that the targeted nanoparticles mPPF/PFOB have good biocompatibility and can specifical y bind to breast cancer MCF-7 cel s in vitro and enhance the imaging capability.