Precisely Manipulating Molecular Packing via Tuning Alkyl Side-Chain Topology Enabling High-Performance Nonfused-Ring Electron Acceptors.

In the development of high-performance organic solar cells (OSCs), the self-organization of organic semiconductors plays a crucial role. This study focuses on the precisely manipulation of molecular assemble via tuning alkyl side-chain topology in a series of low-cost nonfused-ring electron acceptors (NFREAs). Among the three NFREAs investigated, DPA-4, which possesses an asymmetric alkyl side-chain length, exhibits a tight packing in the crystal and high crystallinity in the film, contributing to improved electron mobility and favorable film morphology for DPA-4. As a result, the OSC device based on DPA-4 achieves an excellent power conversion efficiency of 16.67 %, ranking among the highest efficiencies for NFREA-based OSCs.

Safety and economic analysis of the EasyEndo disposable endoscopic cutting and stapling device for VATS lobectomy or segmentectomy in lung cancer patients: a retrospective study.

Objective: The aim of this retrospective study was to investigate the safety and economic aspects of using the EasyEndo disposable endoscopic cutting and stapling device for video-assisted thoracoscopic surgery (VATS) lobectomy or segmentectomy in patients with lung cancer. The choice between the two staplers was influenced by changes in our hospital's procurement policy; Johnson EC45A was used before January 2022 and was then replaced by the EasyEndo stapler. Methods: We reviewed and analyzed consecutive patients with lung cancer who underwent VATS segmentectomy from March 2021 to December 2022. Inclusion criteria included patients with suspected non-small cell lung cancer (NSCLC) who were eligible for surgical resection. The surgical procedures were performed using either the EasyEndo or Johnson EC45A staplers. Intraoperative variables, postoperative outcomes, and cost analysis were compared between the two groups. Results: A total of 1556 patients were included in the study, with 775 patients in the Control group and 781 patients in the EasyEndo group. There were no significant differences in patient characteristics between the two groups. Intraoperative variables, including blood loss, blood transfusion, and operation time, showed no significant differences between the groups. Postoperative outcomes, such as hospital stay, drainage tube placement time, and incidence of complications, were also comparable between the two groups. However, there was a significant difference in the cost of stapler usage, with the EasyEndo group showing a lower cost compared to the Control group. Conclusion: The EasyEndo disposable endoscopic cutting and stapling device demonstrated comparable safety and effectiveness to the Johnson EC45A stapler in VATS segmentectomy for lung cancer patients. Moreover, the use of the EasyEndo stapler resulted in cost savings, indicating its potential economic benefits for healthcare institutions.

Sulfate ions diffusion in concrete under coupled effect of compression load and dry-wet circulation.

The diffusion of Sulfate ions in concrete is a complex process and affects the performance of concrete. Experiments on the time-dependent distribution of sulfate ions in concrete under the coupling of pressure load, dry-wet circulation, and sulfate attack, and the diffusion coefficient of sulfate ions with various parameters was tested. The applicability of the cellular automata (CA) theory to simulate the diffusion of sulfate ions was discussed. In this paper, a multiparameter cellular automata (MPCA) model was developed to simulate the impacts of load, immersion ways, and sulfate solution concentration for the diffusion of sulfate ions in concrete. The MPCA model was compared with experimental data, considering compressive stress, sulfate solution concentration, and other parameters. The numerical simulations verify the calculation results based on the MPCA model are in good agreement with the test data. Finally, the applicability of the established MPCA model was also discussed.

Effects of tadalafil on sexual behavior of male rats induced by chronic unpredictable mild stress.

Background: Few studies have investigated psychogenic sexual dysfunction including psychogenic erectile dysfunction (pED); the effect of tadalafil on sexual behavior of male rats induced by chronic unpredictable mild stress (CUMS) remains unclear. Aim: The aim was to explore the influence of CUMS on sexual behavior of male rats and the effects of tadalafil on that. Methods: Adult male rats were divided into 3 groups, including the normal group without CUMS, the model group with 6 weeks' CUMS, and the tadalafil group with treatment of tadalafil during CUMS. CUMS consists of water deprivation, food deprivation, stroboscopic lightning, white noise, cage tilting, weeding packing, and housing 2 unfamiliar rats. The apomorphine test and vaginal smear test were conducted with the aim to screen out male rats with good erectile function and make preparation for the sexual behavior test, respectively. Outcomes: At the end of the study period, the level of anhedonia and sexual function were evaluated by the sucrose preference test, sexual behavior test, and measurement of serum testosterone, dopamine, and 5-HT. Results: Sucrose preference showed significant decrease in rats after CUMS. The intromission ratio and total intromission frequency decreased significantly, while the mount latency and ejaculation latency prolonged significantly in CUMS-induced rats when compared with normal rats. Meanwhile, the treatment of tadalafil reversed the level of anhedonia and sexual function in CUMS-induced rats. However, there were no statistical differences in the levels of serum testosterone, dopamine, and 5-HT among groups. Clinical Implications: The study constructed an animal model that can provide clinical insights into the mechanism of psychogenic sexual dysfunction and supports the application of tadalafil in pED therapy. Strengths and Limitations: We found that CUMS-induced rats exhibited anhedonia and poor sexual function that could be prevented by tadalafil administration. Future research needs to construct the standard of pED model and explore the mechanism of tadalafil on central nervous system. Conclusion: Tadalafil could prevent the changes of depression and poor sexual function in rats induced by CUMS, and the method of CUMS and the sexual behavior test should be used in the future for pED modeling.

Outcomes of minimally invasive total mesoesophageal excision: a propensity score-matched analysis.

BACKGROUND: This study aimed to investigate the safety and efficacy of minimally invasive total mesoesophageal excision (TME) for esophageal cancer. METHODS: We retrospectively collected data from patients with esophageal cancer who underwent esophagectomy at our center between January 2011 and June 2017. Among 611 eligible patients, 302 underwent minimally invasive total mesoesophageal excision (the TME group) and 309 underwent non-total mesoesophageal excision (the NME group). Outcomes were compared after 1-to-1 propensity score matching, and subgroup analyses were performed for cases involving pT1-2 or pT3-4a disease. RESULTS: The propensity score matching produced 249 pairs of patients. The TME group had a shorter operative time (P < 0.001), lower intraoperative bleeding (P < 0.001), and a shorter postoperative hospital stay (P < 0.001). There were no significant differences between the two groups in the number of removed lymph nodes, 30-day mortality, or postoperative complications. In addition, both groups had similar 3-year rates of overall survival (OS) and disease-free survival (DFS). However, the 3-year recurrence rate in the esophageal bed was significantly lower in the TME group (P = 0.033). Furthermore, among patients with pT3-4a disease, the TME group had better 3-year rates of OS, DFS, and recurrence. CONCLUSION: Minimally invasive total mesoesophageal excision appears to be a safe technique that can reduce tumor recurrence in the esophageal bed. Furthermore, this technique provided survival benefits for patients with pT3-4a disease.

[Efficacy of Jujing Decoction combined with lipoic acid in the treatment of asthenospermia and teratospermia].

OBJECTIVE: To observe the clinical efficacy of Jujing Decoction combined with lipoic acid in the treatment of asthenospermia and teratospermia. METHODS: Fifty patients with asthenospermia and teratospermia meeting the inclusion criteria were randomly divided into a blank control (n = 10) and a medication group (n = 40), the former provided with fertility guidance and the latter treated with Jujing Decoction combined with lipoic acid. After 12 weeks of treatment, the clinical therapeutic effects were evaluated by comparing the semen volume, sperm concentration, percentages of progressively motile sperm (PMS) and morphologically abnormal sperm (MAS), rate of acrosome integrity, sperm DNA fragment index (DFI) and pregnancy rate between the two groups. RESULTS: Compared with the control group, the medication group achieved a significantly higher overall effectiveness rate (10% ï¼»1/10ï¼½ vs 88.89% ï¼»32/36ï¼½, P < 0.05) and pregnancy rate (0% ï¼»0/10ï¼½ vs 8.33% ï¼»3/36ï¼½, P < 0.05) after treatment. The medication group also showed remarkably increased PMS from (21.04 ± 6.49)% to (32.66 ± 7.05)%, decreased MAS from (98.31 ± 1.28)% to (96.52 ± 1.11)%, elevated acrosome integrity from (42.18 ± 16.67)% to (60.42 ± 11.61)%, and reduced sperm DFI from (21.92 ± 6.96)% to (12.37 ± 3.79)%, all with statistically significant differences compared with the blank control group. CONCLUSION: Jujing Decoction combined with lipoic acid can significantly improve sperm motility, reduce MAS and DFI and increase the pregnancy rate through antioxidant stress, and has a high clinical safety.

[Action mechanism of Professor Xu Fusong's Shuilu Erxian Dan in the treatment of premature ejaculation: An exploration based on network pharmacology and molecular docking technology].

OBJECTIVE: To analyze the potential action mechanism of Shuilu Erxian Dan in the treatment of premature ejaculation based on network pharmacology. METHODS: The TCMSP database was searched for the main chemical constituents of Euryale and golden cherry, the core components of Shuilu Erxian Dan. Oral bioavailability and medicinal properties were set as the parameters for screening active components, premature ejaculation-related disease targets retrieved from the DisGeNET, GeneCards, OMIM and TTD databases, the common targets of drug pairs and diseases identified with the Wayne diagram, and a drug-active ingredient-target-disease network map constructed with the software Cytoscape. A PPI network map designed through the STRING platform, the website Metascape used for GO and KEGG analyses of the common targets, and the protein receptors and small molecular ligands of the core genes employed for molecular docking and PyMOL visualization. RESULTS: A total of 7 chemical constituents and 171 predictive targets, 1 918 premature ejaculation targets and 113 common targets were identified. GO analysis showed significant enrichment of BP in response to toxic substances and inorganic substances, CC in membrane raft and plasma membrane protein complex, and MF in transcription factor binding and kinase binding. KEGG analysis manifested markedly enriched TNF signaling pathway, JAK-STAT signaling pathway and Cocaine addiction. The results of molecular docking exhibited a good binding energy between the core gene and the component. CONCLUSION: Network pharmacology has revealed the potential action mechanism of Shuilu Erxian Dan in the treatment of premature ejaculation, which has paved the theoretical ground for verification of the effectiveness of Shuilu Erxian Dan in the treatment of premature ejaculation via animals and cells.

[Efficacy of leech powder on hyperlipidaemia-associated erectile dysfunction in male rats].

OBJECTIVE: To investigate the therapeutic effect of the Chinese medicine leech powder (LP) on hyperlipidaemia-associated ED (HLED) in male rats. METHODS: We randomly divided 50 eight-week-old male SD rats into five groups, blank control, HLED model control, tadalafil and low- and high-dose leech powder. After establishment of the HLED model by high-fat diet, we treated the rats in the latter three groups by intragastric administration of tadalafil at 5 mg/kg/d, LP at 0.3 g/kg/d and LP at 1.8 g/kg/d, respectively, all for 4 weeks. We examined the erectile function of the rats by mating experiment, apomorphine assay, and measurement of intracavernosal pressure (ICP) and mean arterial pressure (MAP), obtained the levels of blood glucose, lipid, serum total superoxide dismutase (SOD), malondialdehyde (MDA) and oxidized low-density lipoprotein (ox-LDL), observed the pathological changes in the rat liver and penile tissue by HE staining, and determined the expressions of NF-κB, MCP-1 and PDE5A in penile tissue by Western blot. RESULTS: Compared with the HLED model controls, all the rats in the tadalafil and LP intervention groups showed significantly improved erectile function (P < 0.05), increased erection frequency, ICPmax and ICPmax/MAP ratio, even more significantly in the LP groups; the levels of LDL, TC and TG were remarkably decreased in the three treatment groups (P < 0.05), most significantly in the low-dose LP group; the content of SOD was markedly increased while those of MDA and ox-LDL decreased after intervention (P < 0.05). The results of Western blot revealed that the expressions of NF-κB and MCP-1 in the testis tissue was down-regulated in the tadalafil and high-dose LP groups while that of PDE5A up-regulated in the tadalafil and low-dose LP groups. CONCLUSION: Leech powder can improve erectile function in male rats with hyperlipidaemia-associated ED by reducing blood lipid levels and oxidative stress, which may related to the NF-κB signaling pathway.

[Prostate cancer stem cells: Current understanding].

Prostate cancer is the most common malignancy in men and seriously harms their health. The current theories on prostate cancer cannot fully explain the heterogeneity, metastatic growth, drug resistance and tumor recurrence of the disease. Prostate stem cells are small heterogeneous subpopulations in the prostate that are characterized by self-renewal and proliferation, and can produce all the lineages of prostate epithelia. According to the cancer stem cell hypothesis, prostate cancer may be a stem cell disease. Prostate cancer stem cells have a markedly increased clonogenicity and therapeutic resistance, and play a decisive role in the occurrence and development of prostatic malignancies. Therapeutic strategies for selectively targeting these stem cells have attracted widespread attention. This article focuses on the origin, identification, molecular markers and clinical application of prostate cancer stem cells, their physiological function and possible involvement in the pathogenesis of prostate cancer, paving a theoretical ground for the development of efficient and sophisticated therapeutic strategies.

The role of EEF1D in disease pathogenesis: a narrative review.

OBJECTIVE: The purpose of this paper was to investigate the role and mechanism of EEF1D in various diseases, especially in tumorigenesis and development, and explore the possibility of EEF1D as a biological target. BACKGROUND: EEF1D is a part of the EEF1 protein complex, which can produce four protein isoforms, of which three short isoforms are used as translation elongation factors. The three short isoforms play a role in anti-aging, regulating the cell cycle, and promoting the occurrence and development of malignant tumors, and the only long-form isoform plays a role in the development of the nervous system. METHODS: We searched the PubMed and Web of Science databases for literature up to January 2021 using relevant keywords, including "EEF1D", "eukaryotic translation elongation factor 1 delta", "translation elongation factor", "translation elongation factor and cancer", and "translation elongation factor and nervous system disease". We then created an overview of the literature and summarized the results of the paper. CONCLUSIONS: Through the review of relevant articles, we found that EEF1D is obviously overexpressed in a variety of tumors, and can regulate the proliferation of tumor cells and tumor growth, as well as play a role in tumor invasion. EEF1D is likely to become a new biological target for tumor therapy and diagnosis.

TPM3 mediates epithelial-mesenchymal transition in esophageal cancer via MMP2/MMP9.

BACKGROUND: Esophageal cancer (EC) is a malignant tumor with high mortality. Correlations have been found between the expression level of tropomyosin 3 (TPM3) and the depth of tumor invasion, lymph node metastasis, and the 5-year survival rate. However, the specific mechanisms underlying EC remain unclear. METHODS: Stably transfected TPM3-overexpresing and TPM3-knockdown esophageal squamous cell carcinoma (ESCC) cell lines (ECa109 and EC9706) were constructed, and the association between TPM3 and the proliferation, invasion, and migration of ESCC was investigated using molecular biology methods. The associations between TPM3 and matrix metalloproteinase (MMP)2/9 or epithelial-mesenchymal transition (EMT)-related proteins were verified, and the potential tumor-promoting mechanism was explored by Gelatin Zymography Experiment. RESULTS: TPM3 was found to promote the proliferation, migration, and metastatic potential of ESCC in vivo and in vitro, and stimulate the expression of MMP2/9 and certain EMT markers other than E-cadherin. The replenishment of MMP2/9 restored the malignant behavior of ESCC caused by TPM3. A gelatinase assay showed that the expression of TPM3 was related to the activity of MMP9. CONCLUSIONS: TPM3 promoted proliferation, migration, and metastatic potential in EC cells. Additionally, TPM3 promoted the EMT process. This function may be achieved via the regulation the expression of MMP2/9.

Exosome-mediated miR-25/miR-203 as a potential biomarker for esophageal squamous cell carcinoma: improving early diagnosis and revealing malignancy.

BACKGROUND: Esophageal squamous cell carcinoma (ESCC) is the leading cause of cancer death in men and women worldwide. The poor prognosis and rapid increase in ESCC incidence highlight the need to promote early detection and prediction. Identifying key molecular targets involved in ESCC monitoring and progression is critical for ESCC patients. METHODS: This study examined miR-25/miR-203 as a biomarker for ESCC patients. Real-time quantitative polymerase chain reaction (PCR) was used to detect miR-25/miR-203 expression levels in tissues and serum exosomes, and MiR-25/miR-203 upregulation was confirmed in ESCC. RESULTS: We found that the miR-25/miR-203 ratio in cancer tissues from 36 ESCC patients was significantly enhanced compared with that in adjacent tissues. Moreover, the serum level of miR-25/miR-203 in 57 ESCC patients was higher than that in 31 healthy volunteers. Intriguingly, in 38 ESCC patients, the level of miR-25/miR-203 decreased significantly after surgery. Using ROC curve statistical analysis, we found that each group of miR-25/miR-203 had obvious sensitivity and high specificity. The miR-25/miR-203 relationship with the clinicopathological features of ESCC patients was also analyzed. MiR-25/miR-203 was significantly associated with the ESCC TNM-stage and lymph node metastasis, which predicts the prognosis of ESCC and reflects tumor progression. CONCLUSIONS: This study highlights the feasibility of using exosome-mediated miR-25/miR-203 as a vital noninvasive biomarker for the detection and treatment monitoring of ESCC.

Exosomal miR-21/Let-7a ratio distinguishes non-small cell lung cancer from benign pulmonary diseases.

AIM: To assess the exosomal miR-21/Let-7a ratio, a noninvasive method, in distinguishing non-small cell lung cancer (NSCLC) from benign pulmonary diseases. METHODS: The exosomes were extracted from the peripheral blood serum using serum exosomal extraction kit. miR-21 and Let-7a levels were evaluated by quantitative reverse transcription polymerase chain reaction. RESULTS: We found that miR-21/Let-7a ratio of NSCLC patients was significantly higher than that of healthy people, patients with pulmonary inflammation diseases, and benign pulmonary nodules, respectively. Receiver-operating characteristic analysis revealed that as compared with healthy controls, miR-21/Let-7a produced the area under the curve (AUC) at 0.8029 in patients with NSCLC, which helped to distinguish NSCLC from healthy controls with 81.33% sensitivity and 69.57% specificity. In addition, the AUC of miR-21/Let-7a in NSCLC patients was 0.8196 in comparison to patients with pulmonary inflammation diseases. Meanwhile, the sensitivity and specificity were 56.00% and 100%, respectively. Furthermore, compared with patients with benign pulmonary nodules, the AUC of miR-21/Let-7a in NSCLC patients was 0.7539. The sensitivity and specificity were 56.00% and 82.61%, respectively. CONCLUSION: In the present study, our findings revealed that exosomal miR-21/Let-7a ratio holds considerable promise as a noninvasive biomarker for the diagnosis of NSCLC from benign pulmonary diseases.

Application of imaging technique in thoracic duct anatomy.

The thoracic duct is an important anatomical structure of the abdomen, chest and neck. An accurate understanding of the anatomy of the thoracic duct is critical to ensuring the safety and accuracy of the surgical procedure involving these areas, which can help surgeons reduce accidental injuries and provide more accurate diagnosis and intervention for patients with serious complications such as chylothorax, etc. In addition, it has great reference value to know the anatomy of thoracic duct in advance for the selection of treatment strategies in the treatment of refractory pleural effusion and ascites, chylothorax, and heart failure. Therefore, it is of practical value to be able to perform in vivo lymphangiography before surgery. However, the slender thoracic duct, the hidden position and the complicated anatomical structure variations pose a great challenge to the safety and accuracy of the surgical operation. This paper aims at a comprehensive discussion about anatomic variation of thoracic duct and the development of imaging techniques.

[Treatment of impotence based on the theory of spleen and stomach].

The treatment of impotence is mainly centered on the liver and kidney, but it is also closely related to the spleen and stomach. Spleen and stomach are the "acquired foundation", "the source of qi and blood biochemistry" and "the hub of qi rise and fall", which are of great significance to ensure the normal erectile function. The spleen and stomach is closely related to the liver and kidney, and the rise and fall of the spleen and stomach function can affect the erectile function indirectly through the two organs. At present, in clinical and scientific research, remarkable progress has been made in the treatment of impotence from the spleen and stomach. This paper intends to summarize the progress in the treatment of impotence based on the theory of spleen and stomach through the collation of literature.

Keratin 17 activates AKT signalling and induces epithelial-mesenchymal transition in oesophageal squamous cell carcinoma.

Oesophageal squamous cell carcinoma (ESCC) is an aggressive malignancy and a leading cause of cancer-related death worldwide. Lack of effective early diagnosis strategies and ensuing complications from tumour metastasis account for the majority of ESCC death. Thus, identification of key molecular targets involved in ESCC carcinogenesis and progression is crucial for ESCC prognosis. In this study, four pairs of ESCC tissues were used for mRNA sequencing to determine differentially expressed genes (DEGs). 347 genes were found to be upregulated whereas 255 genes downregulated. By screening DEGs plus bioinformatics analyses such as KEGG, PPI and IPA, we found that there were independent interactions between KRT family members. KRT17 upregulation was confirmed in ESCC and its relationship with clinicopathological features were analysed. KRT17 was significantly associated with ESCC histological grade, lymph node and distant metastasis, TNM stage and five-year survival rate. Upregulation of KRT17 promoted ESCC cell growth, migration, and lung metastasis. Mechanistically, we found that KRT17-promoted ESCC cell growth and migration was accompanied by activation of AKT signalling and induction of EMT. These findings suggested that KRT17 is significantly related to malignant progression and poor prognosis of ESCC patients, and it may serve as a new biological target for ESCC therapy. SIGNIFICANCE: Oesophageal cancer is one of the leading causes of cancer mortality worldwide and oesophageal squamous cell carcinoma (ESCC) is the major histological type of oesophageal cancer in Eastern Asia. However, the molecular basis for the development and progression of ESCC remains largely unknown. In this study, RNA sequencing was used to establish the whole-transcriptome profile in ESCC tissues versus the adjacent non-cancer tissues and the results were bioinformatically analysed to predict the roles of the identified differentially expressed genes. We found that upregulation of KRT17 was significantly associated with advanced clinical stage, lymph node and distant metastasis, TNM stage and poor clinical outcome. Keratin 17 (KRT17) upregulation in ESCC cells not only promoted cell proliferation but also increased invasion and metastasis accompanied with AKT activation and epithelial-mesenchymal transition (EMT). These data suggested that KRT17 played an important role in ESCC development and progression and may serve as a prognostic biomarker and therapeutic target in ESCC.

IL-1RA suppresses esophageal cancer cell growth by blocking IL-1α.

BACKGROUND: Interleukin-1 promotes tumor angiogenesis through VEGF production. The interleukin-1 receptor antagonist can suppress tumors by blocking this effect. METHODS: Immunohistochemistry, WB, and gene sequencing were used to analyze the expression of IL-1RA in esophageal cancer patients. WB was used to detect the expression of IL-1RA and interleukin-1α in esophageal cancer cells. Stable ESCC cell models overexpressing the IL-1RA were constructed. Their cell functions were tested, and their effects on VEGF were examined. RESULTS: IL-1RA is downregulated in primary EC tumors, and this downregulation of IL-1RA is closely related to TNM staging and survival prognosis. The overexpression of IL-1RA increased the proliferation of KYSE410 EC cells, which have a high level of IL-1α expression. Overexpression of IL-1RA in KYSE410 cells promotes a decrease in the expression of VEGF-A. However, IL-1RA expression did not cause any changes in EC9706 cells with low IL-1α expression. CONCLUSION: IL-1RA acts as a tumor suppressor, and its deletion promotes tumor progression by increasing VEGF-A expression in ESCC.

The clinical value of a new method of functional lymph node dissection in video-assisted thoracic surgery right non-small cell lung cancer radical resection.

BACKGROUND: To evaluate the safety, thoroughness and feasibility of "tunnel-type en bloc mediastinal lymph node dissection" in video-assisted thoracic surgery (VATS) for right non-small cell lung cancer (NSCLC) radical resection, which functionally dissected the lymph nodes of station 2R/4R/7. METHODS: A retrospective study was performed in the clinical data of 196 patients with VATS right NSCLC radical resection. According to the different methods of lymph node dissection of station 2R, 4R and 7, they were divided into the tunnel-type group (n=102) and the routine group (n=94). The clinical data of two group were compared. RESULTS: The analyses of the baselines of the two groups are comparable. For lymph nodes dissection of station 2R/4R/7, operation time, the total number, positive number and metastasis incidence shown no significant difference between two groups (P>0.05). However, the amount of bleeding, postoperative thoracic drainage volume, extubation time, hospitalization days, the incidence of postoperative pulmonary infection and chronic cough were significantly lower in the tunnel-type group (P<0.05). There was no significant difference in 3-year recurrence and metastasis and in 3-year survival between tunnel-type group and routine group. CONCLUSIONS: The tunnel-type group has more advantages, such as less surgical trauma, shorter hospitalization time, faster postoperative rehabilitation, even less postoperative chronic cough compared with the routine group. Therefore, we believe that the tunnel-type en bloc mediastinal lymph node dissection is a safe, thorough and feasible surgical method, which is worthy of being popularized and applied in the VATS right NSCLC radical resection.

Feasibility and strategy of common hepatic artery lymph node dissection in thoracolaparoscopic esophagectomy for thoracic esophageal squamous cell cancer.

Controversy about the adequate extent of lymph node (LN) dissection persists in surgery for thoracic esophageal squamous cell carcinoma (ESCC). The present study estimates the feasibility and strategy of common hepatic artery LN dissection during ESCC surgery.The clinical data of 482 patients with ESCC, who underwent thoracolaparoscopic esophagectomy at Fujian Medical University Union Hospital, were retrospectively selected. Among the 482 ESCC patients, 224 patients underwent thoracolaparoscopic esophagectomy with routine common hepatic artery LN dissection (cohort 1), while 258 patients underwent the same procedure without common hepatic artery LN dissection (cohort 2). The proposed operation method was introduced to safely dissect the common hepatic artery LN. Both univariate and multivariate analyses were performed to analyze the clinicopathological factors correlated to the common hepatic artery LN metastasis.The main postoperative complications were pneumonia, anastomotic leakage, vocal cord palsy and cardiovascular disease. There was no significant difference in the incidence of major postoperative complications between the 2 cohorts (P >.05), and the incidence was similar in a number of reports. The metastatic rate of common hepatic artery LNs was 4.91%, which was relatively lower. Based on the logistic regression analysis of 5 factors, tumor location and T classification were risk factors for common hepatic artery LN metastasis (P <.05).Routine common hepatic artery LN dissection is safe and feasible during a thoracolaparoscopic esophagectomy for ESCC. Although the metastatic rate is lower, common hepatic artery LN dissection should be performed for lower thoracic ESCCs, especially for tumors that invade the outer membrane.

A useful method to keep azygos arch in minimally invasive resection of esophageal leiomyoma.

Lifting azygos arch with a prolene line is a useful way to keep azygos arch in minimally invasive resection of esophageal leiomyoma without affecting surgical exposure and operative procedure.