Objective    To explore the short-term efficacy and safety of pembrolizumab combined with chemotherapy in the neoadjuvant treatment of non-small cell lung cancer. Methods    The clinical data of 11 male patients with non-small cell lung cancer who underwent pembrolizumab combined with neoadjuvant chemotherapy in the Department of Thoracic Surgery, the First Affiliated Hospital of Xi';an Jiaotong University from December 2019 to June 2021 were retrospectively analyzed. The average age of the patients was 52.0-79.0 (62.0±6.9) years. The imaging data and pathological changes before and after neoadjuvant treatment were compared, and adverse reactions during neoadjuvant treatment were recorded. Objective remission rate (ORR) and main pathological remission rate (MPR) and pathological complete remission rate (pCR) were the main observation endpoints. Results    After preoperative neoadjuvant therapy with pembrolizumab combined with platinum or paclitaxel, all patients successfully underwent thoracoscopic radical resection of lung cancer. The ORR was 72.7%, and the MPR was 81.8%. Among them, 45.5% of patients achieved pCR. The main adverse reactions were hypoalbuminemia, decreased appetite and nausea. The mortality rate within 30 days after surgery was 0, and no tumor metastasis was observed. Conclusion    Pembrolizumab combined with neoadjuvant chemotherapy is safe and feasible to treat non-small cell lung cancer, and the short-term efficacy is beneficial.

Objective     To investigate the safety and feasibility of day surgery for patients with palmar hyperhidrosis based on the principles of enhanced recovery after surgery (ERAS). Methods     We retrospectively reviewed the medical records of consecutive patients who underwent endoscopic thoracic sympathicotomy (ETS) in the First Affiliated Hospital of Xi';an Jiaotong University from March 2020 to December 2021. Patients were divided into a day surgery group and a conventional group according to their perioperative management methods. The patients in the day surgery group underwent an optimized perioperative procedure under the guidance of ERAS, and were ventilated with a laryngeal or face mask during the operation. The patients in the conventional group completed the preoperative examination, operation and postoperative observation according to the conventional procedures, and were intubated with a single-lumen endotracheal tube. The demographic characteristics, operation time, hospital stay, postoperative complications, and hospitalization cost were compared between the two groups. Results     Finally 172 patients were collected, including 90 males and 82 females, with an average age of 25.97±7.43 years. There were 86 patients in each group. All patients ceased suffering from palmar sweating after surgery. No patient experienced massive bleeding or conversion to thoracotomy. There was no statistical difference in operation time between the two groups (P=0.534). Patients in the day surgery group were discharged within 24 hours. The average hospital stay in the conventional group was 2.09±0.41 days. Incidence of postoperative respiratory complications, and the hospitalization cost of the day surgery group were significantly lower than those of the conventional group (P<0.001). The satisfaction rate in both groups was greater than 95%. Conclusion     Day surgery for patients with palmar hyperhidrosis based on the principles of ERAS is safe and feasible, which can reduce postoperative complications, shorten the length of hospital stay and save the cost of hospitalization.

Resection is one of the most important treatments for esophageal squamous cell carcinoma, and routine postoperative follow-up is an effective method for early detection and treatment of recurrent metastases, which can improve patients&#39; quality of life and prognosis. This consensus aims to provide a reference for colleagues responsible for postoperative follow-up of esophageal squamous cell carcinoma patients in China, and further improve the standardization of the diagnosis and treatment of esophageal squamous cell carcinoma.

Surgery is a classic traditional method for the treatment of early-stage esophageal cancer, and it is also recognized as an effective first-choice method in the medical community. With the development of endoscopic technology, esophagus-preserving comprehensive treatment of esophageal cancer has almost the same or even better effects in some aspects in the treatment of early esophageal cancer than surgery. Many clinical guidelines have also recommended it as the first-choice treatment for early esophageal cancer. The room for surgical treatment of esophageal cancer has been further compressed. This article discusses the comprehensive treatment model of esophageal cancer from the perspective of thoracic surgery, aiming to find a new position of thoracic surgery in the treatment of esophageal cancer.

Objective To investigate the disease progression and influencing factors of human immunodeficiency virus (HIV)-infected persons in Sanya area from 2010-2020. Methods Data of HIV infected cases reported in XX region from January 2014 to January 2020 were collected through the National AIDS Comprehensive Prevention and Control Information System. The incidence of AIDS was calculated by the life expectancy method, and the single factors influencing the progression of HIV infection were analyzed from the aspects of sex, age, BMI, nationality, marital status, educational level, highly active anti-retroviral therapy (HAART), anemia, route of transmission, CD4⁺ cell count, and co-infection of other viruses. Results A total of 761 HIV-infected cases were reported in Sanya areaFrom January 2010 to January 2020, of which 103 had progressed to AIDS (13.53%), the incidence of AIDS was 6.01/100 person-years, the average incubation period was 4.63 years; There were 31 death cases, and the all-cause mortality rate was 1.81/100 person years; Gender, age, HAART treatment status, anemia, CD4⁺ cell count, and other viral infections were single factors that affect the disease progression of HIV-infected persons (χ²=16.803, 13.362, 15.954, 20.119, 16.039, 15.711, P<0.05), meanwhile, age, HAART treatment status, anemia, CD4⁺ cell count, and other viral infections were independent risk factors that affect the disease progression of HIV-infected persons (P=0.014, 0.007, 0.017, 0.009, 0.001, 0.001). Conclusion The incubation period is an important stage of the disease progression of HIV-infected patients, moreover, age, HAART treatment status, anemia, CD4⁺ cell count, and other viral infections are all independent risk factors that affect the disease progression of HIV-infected patients.

The earliest research of magnetic surgery was the application of magnetic anastomotic device to anastomose the blood vessels. Now, it has been widely used for anastomosis of blood vessels, gastrointestinal tract and biliary tract. The concept of "magnetic surgery" was named firstly by LU Yi in 2010 and magnetic surgery was classified into magnetic anchoring technique, magnetic navigation technique, magnetic compression technique, magnetic tracing technique, and magnetic suspension technique. The applications of magnetic surgery in the field of thoracic surgery mainly include magnetic compression technique, magnetic anchoring technique and magnetic navigation technique. This paper summarizes the application of magnetic surgery in thoracic surgery and prospects its future development in the field of thoracic surgery.

Objective To study and analyze the risk factors in children with type 1 diabetes and formulate preventive health measures. Methods A total of 112 children with type 1 diabetes treated in our hospital from January 2017 to October 2019 were selected as the type 1 diabetes group, and 50 healthy children who underwent physical examination during the same period were selected as the control group. Multifactor logistic regression analysis was used to analyze predisposing factors of type 1 diabetes in children, and preventive health measures was proposed. Results The results of multivariate logistic regression analysis indicated that maternal age, passive smoking during pregnancy, milk feeding time, and children&#39;s respiratory infections were independent risk factors for children with type 1 diabetes (OR: 6404, 6.903, 6.417, 8.256, P <0.05). Conclusion Maternal age, passive smoking during pregnancy, milk addition time, and children's respiratory infections were independent risk factors for children with type 1 diabetes. Strengthening health education, breastfeeding as soon as possible, and preventing respiratory infections can help reduce the incidence of children with type 1 diabetes.

AIM: To evaluate the application value of 3g/L sodium hyaluronate eye drops combined with corneal bandage contact lens in the early stage of pterygium excision surgery.

METHODS: In this double blind randomized controlled study, 90 eyes of 90 patients with unilateral primary nasal pterygium who underwent surgical treatment from March 2017 to March 2018 were sorted into three groups, named as group A, group B and group C. Group A was treated with +3g/L sodium hyaluronate eye dropsand corneal bandage contact lens; group B was treated with +1g/L sodium hyaluronate eye drops and corneal bandage contact lens; and group C with +3g/L sodium hyaluronate and patching. Ocular surface irritation symptom scores, corneal epithelial healing time and conjunctival graft edema subsidence time of the three groups were compared after treatment.

RESULTS: Ocular surface irritation symptom scores in group A were lower than those in group C at all observation time points postoperatively(all P<0.001); the corneal epithelial healing time(2.08±0.78d)and conjunctival graft edema subsidence time(4.62±1.17d)in group A were significantly shorter than those in group C with corneal epithelial healing time(5.13±2.34d)and conjunctival graft edema subsidence time(6.42±1.51d)(P=0.001, P=0.002). The corneal epithelial healing time was significantly shorterin group A when compared with group B(P=0.018), but there were no significant differences in ocular surface irritation symptom scores and conjunctival graft edema subsidence time between the two groups.

CONCLUSION: The combination of 3g/L sodium hyaluronate and corneal bandage contact lens has synergistic effect when applicated in the early stage after pterygium excision surgery, it can effectively shorten the corneal epithelial healing time as well as relieve irritation symptoms.

Objective    To analyze the effect of different drainage modes on the postoperative thoracic drainage after video-assisted thoracoscopic surgery for radical resection of lower lung carcinoma. Methods    A total of 183 patients with non-small cell lung cancer who received biportal thoracoscopic anatomical lower lobectomy combined with mediastinal lymph node dissection in the First Affiliated Hospital of Xi';an Jiaotong University from August 2017 to August 2019 were enrolled, including 113 males and 70 females, aged 31-77 (56.5±6.4) years. The patients were randomly divided into three groups, including an anterior axillary line group, a mid-axillary line group and a modified anterior axillary line group. Clinical efficacy of the three groups was compared. Results    No significant difference among these three groups in terms of gender, age, surgical site, pathological type, pathological staging, postoperative chest wall subcutaneous emphysema, postoperative pain score, and postoperative hospital stay was found (P>0.05). There were significant differences among the patients in terms of postoperative pleural effusion, re-insertion of chest tube or aspiration, total liquid quantity of thoracic drainage, drainage time and chest wall incision stitches time (P<0.05). The anterior axillary line group had higher risk of postoperative pleural effusion than the other groups (P<0.05). The occurrence of postoperative pleural effusion and rate of reposition of chest tube or aspiration were significantly reduced in the modified anterior axillary line group (P<0.05). Conclusion    Chest drainage tube with large diameter (24F) in the 5th intercostal space of the anterior axillary line combined with another micro-tube (8.5F) in the 7th or 8th intercostal space of the inferior scapular angle line can shorten drainage time to reduce postoperative pain, reduce the occurrence of postoperative pleural effusion, and shorten the time of surgical incision stitches.

Objective To investigate the rehabilitation needs and technical support for people with disabilities in rural areas. Methods From October, 2017 to February, 2018, 800 persons with disabilities, aged five to 80 years, from 23 villages in five township, Xi';an, Shaanxi, were surveyed with self-designed questionnaire and interview, including the basic situation, disability and training plan, rehabilitation support and skills maintained. Results The persons were mainly aged 50 to 80 years (58.37%), male (65.37%), accepting middle school education or less (46.63%), married (70.63%), living with their family (77.38%), income less than 2000 Yuan (66%), mainly from their family labor (62.62%). Their disabilities were mainly of grade 3 (40.63%), from hemiplegia (30.63%), dependence in living (45.38%), and no systematic rehabilitation program (55.25%). Most of them needed rehabilitation of self-care (40%), accessible guidance (30.63%) and reimbursement from medicare of Rural Cooperative Medical Scheme (50.63%), and hoped to participate social activities (41.87%). The rehabilitation supports were as that: the rehabilitation services were mobile or none (67.58%), the guiders of rehabilitation were few or none (48.88%), knew some or less rehabilitation knowledge (64.25%), the professionals accepted no continue education training (40%).Conclusion It is important to improve the rehabilitation technical support system for rural people with disabilities.