Integrated metabolome and transcriptome analysis of differences in quality of ripe Lycium barbarum L. fruits harvested at different periods.

BACKGROUND: Wolfberry is well-known for its high nutritional value and medicinal benefits. Due to the continuous ripening nature of Goji berries and the fact that they can be commercially harvested within a few weeks, their phytochemical composition may change during the harvesting process at different periods. RESULT: The involved molecular mechanisms of difference in fruit quality of ripe Lycium barbarum L. harvested at four different periods were investigated by transcriptomic and metabolomics analyses for the first time. According to the results we obtained, it was found that the appearance quality of L. barbarum fruits picked at the beginning of the harvesting season was superior, while the accumulation of sugar substances in L. barbarum fruits picked at the end of the harvesting season was better. At the same time the vitamin C and carotenoids content of wolfberry fruits picked during the summer harvesting season were richer. Ascorbic acid, succinic acid, glutamic acid, and phenolic acids have significant changes in transcription and metabolism levels. Through the network metabolic map, we found that ascorbic acid, glutamic acid, glutamine and related enzyme genes were differentially accumulated and expressed in wolfberry fruits at different harvesting periods. Nevertheless, these metabolites played important roles in the ascorbate-glutathione recycling system. Ascorbic acid, phenolic substances and the ascorbate-glutathione recycling system have antioxidant effects, which makes the L. barbarum fruits harvested in the summer more in line with market demand and health care concepts. CONCLUSION: This study laid the foundation for understanding the molecular regulatory mechanisms of quality differences of ripe wolfberry fruits harvested at different periods, and provides a theoretical basis for enhancing the quality of L. barbarum fruits.

An Ultrasensitive Ti3C2Tx MXene-based Soft Contact Lens for Continuous and Nondestructive Intraocular Pressure Monitoring.

Wearable soft contact lens sensors for continuous and nondestructive intraocular pressure (IOP) monitoring are highly desired as glaucoma and postoperative myopia patients grow, especially as the eyestrain crowd increases. Herein, a smart closed-loop system is presented that combines a Ti3C2Tx MXene-based soft contact lens (MX-CLS) sensor, wireless data transmission units, display, and warning components to realize continuous and nondestructive IOP monitoring/real-time display. The fabricated MX-CLS device exhibits an extremely high sensitivity of 7.483 mV mmHg-1, good linearity on silicone eyeballs, excellent stability under long-term pressure-release measurement, sufficient transparency with 67.8% transmittance under visible illumination, and superior biocompatibility with no discomfort when putting the MX-CLS sensor onto the Rabbit eyes. After integrating with the wireless module, users can realize real-time monitoring and warning of IOP via smartphones, the demonstrated MX-CLS device together with the IOP monitoring/display system opens up promising platforms for Ti3C2Tx materials as the base for multifunctional contact lens-based sensors and continuous and nondestructive IOP measurement system.

High-fidelity source mask optimization for suppressing line-end shortening.

Source mask optimization (SMO) is a widely used computational lithography technique for compensating lithographic distortion. However, line-end shortening is still a key factor that cannot be easily corrected and affects the image fidelity of lithography at advanced nodes. This paper proposes a source mask optimization method that suppresses line-end shortening and improves lithography fidelity. An adaptive hybrid weight method is employed to increase the weights of the line end during the optimization, which adaptively updates the weights in each iteration according to the edge placement error (EPE). A cost function containing a penalty term based on the normalized image log slope (NILS) is established to ensure the fidelity of the overall feature when paying more attention to the line-end region. The scope of this penalty term is regulated by widening and extending the split contour to further reduce the line-end shortening. Simulation results show that the proposed method can effectively suppress the line-end shortening and improve the lithography fidelity compared with the traditional SMO method.

CircFOXN2 alleviates glucocorticoid- and tacrolimus-induced dyslipidemia by reducing FASN mRNA stability by binding to PTBP1 during liver transplantation.

We aimed to examine impacts and functional mechanism of circular RNA forkhead box N2 (FOXN2) in tacrolimus (TAC)- and dexamethasone (Dex)-induced lipid metabolism disorders. RNA level and protein contents in TAC, Dex, or combined TAC- plus Dex-treated patients and Huh-7 cells were measured utilizing quantitative real-time (qRT)-PCR and western blotting assays measured the formation of lipid droplet. Total cholesterol (TC) and triglyceride (TG) levels were determined using corresponding commercial kits and Oil red O staining. RNA immunoprecipitation and RNA pull-down verified the binding relationship among circFOXN2, polypyrimidine tract binding protein 1 (PTBP1) and fatty acid synthase (FASN). Male C57BL/6 mice were used to establish a dyslipidemia mouse model to validate the discoveries at the cellular level. Dex treatment significantly promoted TAC-mediated increase of TC and TG in serum samples and Huh-7 cells. Moreover, circFOXN2 was reduced but FASN was elevated in TAC-treated Huh-7 cells, and these expression trends were markedly enhanced by Dex cotreatment. Overexpression of circFOXN2 could reverse the accumulation of TC and TG and the upregulation of FASN and sterol regulatory element binding transcription factor 2 (SREBP2) mediated by Dex and TAC cotreatment. Mechanistically, circFOXN2 reduced FASN mRNA stability by recruiting PTBP1. The protective roles of circFOXN2 overexpression on lipid metabolism disorders were weakened by FASN overexpression. In vivo finding also disclosed that circFOXN2 greatly alleviated the dysregulation of lipid metabolism triggered by TAC plus Dex. CircFOXN2 alleviated the dysregulation of lipid metabolism induced by the combination of TAC and Dex by modulating the PTBP1/FASN axis.NEW & NOTEWORTHY Collectively, our experiments revealed for the first time that circFOXN2 alleviated the Dex- and TAC-induced dysregulation of lipid metabolism by regulating the PTBP1/FASN axis. These findings suggested that circFOXN2 and FASN might be candidate targets for the treatment of Dex- and TAC-induced metabolic disorders.

Effective multi-objective inverse lithography technology at full-field and full-chip levels with a hybrid dynamic priority algorithm.

Inverse lithography technology (ILT), such as source mask optimization (SMO), is used to improve lithography performance. Usually, a single objective cost function is selected in ILT, and an optimal structure for one field point is achieved. The optimal structure is not the case for other images at full field points where the aberrations of the lithography system are different, even in high-quality lithography tools. The optimal structure that must match the high-performance images at the full field is urgently required for extreme ultraviolet lithography (EUVL). In contrast, multi-objective optimization algorithms (MOAs) limit the application of multi-objective ILT. Assigning target priority is incomplete in current MOAs, which results in the over-optimization of some targets and under-optimization of others. In this study, multi-objective ILT and a hybrid dynamic priority (HDP) algorithm were investigated and developed. High-performance images with high fidelity and high uniformity were obtained at multi-field and multi-clip areas across the die. A hybrid criterion was developed for the completion and reasonable prioritization of each target to ensure sufficient improvement. Compared to the current MOAs, the uniformity of images at full-field points was improved by up to 31.1% by the HDP algorithm in the case of multi-field wavefront error-aware SMO. The multi-clip source optimization (SO) problem showed the universality of the HDP algorithm to deal with different ILT problems. It acquired higher imaging uniformity than existing MOAs, which indicated that the HDP is more qualified for multi-objective ILT optimization than existing MOAs.

Previous pulmonary infection impacts thoracoscopic procedure outcomes in patients with congenital lung malformations: a retrospective cohort study.

BACKGROUND AND OBJECTIVES: Patients with congenital lung malformations (CLMs) are at high risk for developing pulmonary infection. Nonetheless, prophylactic surgical excision of asymptomatic CLMs is controversial and often delayed to symptoms occurring out of concern for potential operative risks. This study aims to evaluate the impact of previous pulmonary infection on the outcome of thoracoscopic procedures in CLMs patients. METHODS: This was a retrospective cohort study of CLMs patients who received an elective operation at a tertiary care center from 2015 to 2019. Patients were divided into pulmonary infection (PI) or non-infection of pulmonary (NPI) groups according to the history of pulmonary infection. Propensity score matching was used to minimize the bias between groups. The primary outcome was conversion to thoracotomy. Postoperative outcomes were compared between patients with and without PI. RESULTS: We identified 464 patients, of whom 101 had a history of PI. Propensity score matching yielded a well-balanced cohort of 174 patients. PI was associated with higher conversion to thoracotomy (adjusted odds ratio = 8.7, 95% confidence interval, CI, 1.1-71.2, p = 0.039), blood loss (p = 0.044), and longer operative time (p < 0.001), chest tube placement time (p < 0.001), length of stay (p < 0.001), and postsurgical length of stay (p < 0.001). CONCLUSIONS: Elective operation in CLMs patients with a history of PI was associated with an increased risk of conversion to thoracotomy, operative time, blood loss, chest tube placement time, length of stay, and postsurgical length of stay. Elective thoracoscopic procedures in asymptomatic CLMs patients are safe and effective, and earlier surgical intervention may be warranted.

Learning curve for total thoracoscopic segmentectomy in treating pediatric patients with congenital lung malformation.

BACKGROUND: Total thoracoscopic segmentectomy (TTS) is a technically challenging procedure in children but results in more parenchyma preservation, better pain control, better cosmetic results, and a shorter hospital stay. However, definitive data describing the learning curve of TTS has yet to be obtained. Here, we review the safety and efficiency of our initial experiences with pediatric TTS and evaluate our learning curve. METHODS: This was a retrospective study of all pediatric patients undergoing TTS between December 2016 and January 2020. Pediatric patients who underwent TTS were included, while those undergoing lobectomy or wedge resection were excluded. RESULTS: One hundred and twelve patients were retrospectively analyzed to evaluate the learning curve and were divided chronologically into three phases, the ascending phase (A), plateau phase (B) and descending phase (C), through cumulative summation (CUSUM) of the operative time (OT). Phases A, B, and C comprised 28, 51, and 33 cases, respectively. OT decreased significantly from phases A to B (p < 0.001) and from phase B to C (p = 0.076). No significant differences were observed in the demographic factors among the three phases. The conversion rate was zero, and the complication rate was 0.9%. Differences in technical parameters, such as length of stay and chest tube duration, were statistically insignificant between phases A and B or B and C. There were no mortalities. CONCLUSION: CUSUMOT indicates that the learning curve of at least 79 cases is required for TTS in our institute. We emphasize that the learning curve should be cautiously interpreted because many factors in different institutions may influence the exact parabola and actual learning curve.

Absorbable Clips Applied in Thoracoscopic Anatomical Lung Resection in Younger Children.

OBJECTIVES: This study aims to evaluate the feasibility and safety of a 5-mm absorbable clips applied in thoracoscopic anatomical lung resection in younger children. METHODS: Demographic data and intra- and postoperative parameters of the two groups (Abs-o-lock® group and Hem-o-lok® group) were reviewed. In the Abs-o-lock® group, 5-mm absorbable clips were used in thoracoscopic anatomical lung resection on all patients from January 2020 to March 2021. In the Hem-o-lok® group, 5-mm Hem-o-lok® clips were used from January to December 2019. The primary outcomes were the one-time success rate of ligation, major bleeding rate, intraoperative dislodgement rate and operative time, which were compared between the two groups. RESULTS: There were 224 patients involved in this study, of whom 103 were in the Abs-o-lock® group and 121 were in the Hem-o-lok® group. The one-time success rate of ligation was 96.5% in the Abs-o-lock® group and 98.9% in the Hem-o-lok® group (p < 0.05). No major bleeding occurred in either group. The intraoperative dislodgement rate did not significantly differ between the two groups (p = 1.0). The operative time consumed in the Abs-o-lock® group was much longer than that in the Hem-o-lok® group for subgroups of resection of extralobar sequestration (p < 0.05), lobectomy (p < 0.05) and segmentectomy (p < 0.05). CONCLUSIONS: Compared to Hem-o-lok® clips, it is feasible and safe to apply 5-mm absorbable clips for vessel sealing during thoracoscopic anatomical lung resection in younger children.

Implicit function characterization of the curvilinear mask to realize parametric optical proximity correction with a neighborhood parallel tabu search.

The curvilinear mask structures provide significant benefits in improving lithographic resolution. Curvilinear masks, as opposed to rectilinear masks, have a wider range of structure types that can be used precisely to correct the contour of diffraction at sharp technological nodes. However, the curvilinear structure also makes the inverse design of mask in optical proximity correction (OPC) flow difficult. The current OPC of curvilinear masks uses pixel-based inverse optimization, which is extremely computationally intensive and takes up a lot of design data storage space. This paper proposes an implicit function to represent a large number of curve types with a small number of parameters to reduce computational complexity and the R&D cycle. Therefore, the ultra-high dimensional pixel-based OPC problem is transformed into a low-dimensional parameter search problem in the critical diffraction area of the mask pattern. The tabu search algorithm and neighborhood parallel computing strategy are then used to quickly search for optimal characterized parameters. The results of the simulation show that the parametric curvilinear OPC method achieves a higher image fidelity than that of rectilinear OPC. At the same time, it addresses the shortcomings of the traditional pixelated curvilinear mask OPC method, including high computational complexity, low manufacturability, and storage space occupancy.

Development of a novel tool: a nomogram for predicting in-hospital mortality of patients in intensive care unit after percutaneous coronary intervention.

BACKGROUNDS: Increased risk of in-hospital mortality is critical to guide medical decisions and it played a central role in intensive care unit (ICU) with high risk of in-hospital mortality after primary percutaneous coronary intervention (PCI). At present，most predicting tools for in-hospital mortality after PCI were based on the results of coronary angiography, echocardiography, and laboratory results which are difficult to obtain at admission. The difficulty of using these tools limit their clinical application. This study aimed to develop a clinical prognostic nomogram to predict the in-hospital mortality of patients in ICU after PCI. METHODS: We extracted data from a public database named the Medical Information Mart for Intensive Care (MIMIC III). Adult patients with coronary artery stent insertion were included. They were divided into two groups according to the primary outcome (death in hospital or survive). All patients were randomly divided into training set and validation set randomly at a ratio of 6:4. Least absolute shrinkage and selection operator (LASSO) regression was performed in the training set to select optimal variables to predict the in-hospital mortality of patients in ICU after PCI. The multivariate logistical analysis was performed to develop a nomogram. Finally, the predictive efficiency of the nomogram was assessed by area under the receiver operating characteristic curve (AUROC)，integrated discrimination improvement (IDI), and net reclassification improvement (NRI), and clinical net benefit was assessed by Decision curve analysis (DCA). RESULTS: A total of 2160 patients were recruited in this study. By using LASSO, 17 variables were finally included. We used multivariate logistic regression to construct a prediction model which was presented in the form of a nomogram. The calibration plot of the nomogram revealed good fit in the training set and validation set. Compared with the sequential organ failure assessment (SOFA) and scale for the assessment of positive symptoms II (SAPS II) scores, the nomogram exhibited better AUROC of 0.907 (95% confidence interval [CI] was 0.880-0.933, p <  0.001) and 0.901 (95% CI was 0.865-0.936, P <  0.001) in the training set and validation set, respectively. In addition, DCA of the nomogram showed that it could achieve good net benefit in the clinic. CONCLUSIONS: A new nomogram was constructed, and it presented excellent performance in predicting in-hospital mortality of patients in ICU after PCI.

Thoracoscopic lobectomy through the pulmonary hilum approach for the treatment of congenital lung malformation.

BACKGROUND: Thoracoscopic lobectomy is widely accepted for the treatment of congenital lung malformations (CLM), owing to its advantages. However, severe incomplete interlobar fissure may lead to a high rate of conversion to thoracotomy and postoperational complications. Thoracoscopic lobectomy utilizing the pulmonary hilum approach may be an effective and safe method to resolve these problems. This retrospective study was conducted to estimate the safety and efficiency of this approach. METHODS: A retrospective review of medical records was performed in our institution, from January 2014 to December 2019, and 432 patients with CLM who underwent thoracoscopic lobectomy through the pulmonary hilum approach were included in this study. Patients were divided into the incomplete fissure (IF) group and complete fissure (CF) group according to the level of fissure, which was proposed by an anatomical classification of pulmonary fissures. RESULTS: Patients in the IF and CF groups were 131 and 301, respectively. In univariate analysis, there were statistical significances between the two groups in terms of intraoperative blood loss (P = 0.04), surgical time (P = 0.01), the number of chest tube drainages (P < 0.01), and the total length of hospital stay (P = 0.03). However, no patients experienced bronchopleural fistula, postoperative pneumonia, or conversion to thoracotomy in either group. Five patients experienced prolonged air leakage in the IF group, and no prolonged air leakage occurred in the CF group. CONCLUSION: An IF would certainly increase the difficulty of CLM surgery, and thoracoscopic lobectomy using the pulmonary hilum approach is an effective and safe method for CLM patients.

Sampling-based imaging model for fast source and mask optimization in immersion lithography.

Current source and mask optimization (SMO) research tends to focus on advanced inverse optimization algorithms to accelerate SMO procedures. However, innovations of forward imaging models currently attract little attention, which impacts computational efficiency more significantly. A sampling-based imaging model is established with the innovation of an inverse point spread function to reduce computational dimensions, which can provide an advanced framework for fast inverse lithography. Simulations show that the proposed SMO method with the help of the proposed model can further speed up the algorithm-accelerated SMO procedure by a factor of 3.

M6A Regulatory Genes Play an Important Role in the Prognosis, Progression and Immune Microenvironment of Pancreatic Adenocarcinoma.

The specific roles of N6-methyladenosine (m6A) regulatory genes in pancreatic adenocarcinoma (PAAD) have not been fully elucidated. In present study, a novel risk signature was constructed by five m6A-related genes (including METTL3, METTL14, KIAA1429, ALKBH5 and YTHDF1) and was identified as an independent prognostic factor (HR = 13.192) via TCGA (185 samples) databases. The immune abundances of 22 leukocyte subtypes in each PAAD sample were exhibited via the CIBERSORT algorithm. High risk group promoted infiltration levels of Macrophages M0 and M2 cells and decreased that of B cells naive, T cells CD8 and T regulatory cells.

Exposure latitude aware source and mask optimization for extreme ultraviolet lithography.

Extreme ultraviolet (EUV) lithography is a new generation of integrated circuit manufacturing technology with great development prospects. EUV lithography has more significant demand for high exposure latitude (EL) due to greater requirements for the stability of the light source. Source and mask optimization (SMO) technology is widely used to compensate for imaging distortion. In this paper, we propose an EL-aware SMO (ELASMO) method that uses a low-resist threshold sensitivity (LRS) penalty function to improve the EL in EUV lithography. Compared to conventional SMO, the proposed ELASMO method can significantly enhance the aerial image contrast, improve the EL, and enlarge the process window while ensuring high imaging fidelity.

Vectorial pupil optimization to compensate for a polarization effect at full exposure field in lithography.

Recently, a single vectorial pupil optimization (VPO) was proposed to compensate for the polarization effect induced by thick mask and image optics at one field point in a lithography system, which does not work at full field points. In this paper, we propose a multi-objective VPO (MOVPO) method to obtain a universal vectorial pupil that can compensate for the polarization aberration at full field points. A novel multi-objective cost function, to the best of our knowledge, is built and includes uneven image pattern errors causing by polarization aberration (PA) at full field points in the MOVPO method. Comprehensive simulations demonstrate that the proposed MOVPO method can effectively improve the consistency of imaging and enlarge the overlapped process window at full field points.

Emergency Management of Acute Late-Presenting Congenital Diaphragmatic Hernia in Infants and Children.

OBJECTIVES: Acute late-presenting congenital diaphragmatic hernia (CDH) might result in mediastinal shift away from the lesion and even sudden cardiopulmonary arrest. This study aimed to discuss the prompt and effective emergency management of acute late-presenting CDH. METHODS: A retrospective review of acute late-presenting CDH cases in West China Hospital of Sichuan University and Guizhou Provincial People's Hospital from October 2010 to June 2016 was conducted. RESULTS: A total of 22 patients were included in this study. All the patients presented with respiratory symptoms. Chest x-ray revealed swollen stomach and mediastinal shift. After nasogastric tube placement, fluid infusion, and nasal oxygen breathing, the symptoms in 8 patients ameliorated, and 14 patients had no signs of obvious relief. Three patients underwent the bedside percutaneous puncture of distensible stomach, and 1 patient died in the process of emergent management for critical condition. The remaining 21 patients underwent emergency surgery. Five thoracotomies and 16 thoracoscopies were performed. Five thoracoscopies that were converted to thoracotomies were required for the difficult reduction of herniated stomach. At follow-up, all patients improved their condition. CONCLUSIONS: Acute late-presenting CDH is a clinical emergency that can be fatal. The sudden and progressive expansion of the stomach is mainly responsible for this emergent condition. The prompt and effective management is key to decrease the mortality and achieve favorable prognosis.

Long Non-Coding RNA CRNDE Regulates Angiogenesis in Hepatoblastoma by Targeting the MiR-203/VEGFA Axis.

OBJECTIVE: MiR-203 has been shown to participate in multiple malignancies, but the role of miR-203 in hepatoblastoma (HB) remains unclear. The aim of our study was to investigate the effects of miR-203 in HB. METHODS: A total of 15 pairs of HB tissues and para-tumour normal tissues were collected for the experiments. RT-qPCR and Western blotting were performed to detect the expression of CRNDE, miR-203, and VEGFA at the mRNA and/or protein levels, respectively. A dual luciferase assay verified the target relationship between miR-203 and the 3'UTR of VEGFA as well as miR-203 and CRNDE. In addition, MTT, wound healing, and tube formation assays were performed to assess the effects of miR-203, VEGFA, and CRNDE on cell proliferation, migration, and angiogenesis, respectively. RESULTS: Our data revealed that miR-203 expression was decreased in HB tissues, while long non-coding RNA (lncRNA) CRNDE expression was increased. The dysregulation of miR-203 and CRNDE was closely related to tumour size and stage. Moreover, overexpression of miR-203 inhibited angiogenesis. A dual luciferase assay verified that VEGFA is a direct target of miR-203 and that CRNDE binds to miR-203. Furthermore, our results showed that miR-203 suppressed cell viability, migration, and angiogenesis by regulating VEGFA expression. Additionally, it was confirmed that CRNDE promoted angiogenesis by negatively regulating miR-203 expression. CONCLUSION: lncRNA CRNDE targets the miR-203/VEGFA axis and promotes angiogenesis in HB. These results provide insight into the underlying mechanisms of HB and indicate that CRNDE and miR-203 might be potential targets for HB therapy.

Congenital bronchopulmonary foregut malformation: systematic review of the literature.

BACKGROUND: Congenital bronchopulmonary foregut malformation (CBPFM) is a rare congenital malformation involving both the digestive and respiratory system. Early diagnosis is difficult, and delayed recognition may result in considerable complications. The aim of the study was to identify and analyze the clinical characteristics and radiological features of CBPFMs. METHODS: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Ovid database, EMBASE were searched for relevant publications to identify all published case-reports of CBPFM since 1992. Data about the demography, clinical presentation, pathology, imaging features, treatment and prognosis were collected. RESULTS: Sixty-one cases were included in our study. Cases were aged from 1 day to 59 years with the majority aged 3 years or younger. The most common type was group III (37.7%), followed by group II (29.5%)group I (27.9%) and group IV (4.9%). The presentations included respiratory distress (32.8%), cough/choking following food intake and other presentations associated respiratory infection. Thirty-eight cases (62.3%) were diagnosed by upper gastrointestinal series (UGI). Misdiagnosis was common. Eight cases (13.1%) of the included cases died. CONCLUSIONS: Early recognition and extensive delineation of the anatomy of CBPFM are important to correct these anomalies successfully. UGI is the first choice to confirm the abnormal bronchus communicating with the esophagus. Resection of abnormal pulmonary tissue, lobe or even unilateral lung is preferred. Reconstruction procedures are feasible in selected patients.

[Retrospective Analysis on the Safety and Feasibility of Thoracoscopic Anatomical Segmentectomy in the Treatment of Congenital Lung Malformations].

OBJECTIVE: To investigate the safety and feasibility of thoracoscopic anatomical pulmonary segmentectomy in children with congenital lung malformations. METHODS: A retrospective review was conducted to analyze clinical data of children thoracoscopic anatomical pulmonary segmentectomy performed in West China Hospital of Sichuan University from Jan. 2014 to Sept. 2018. RESULTS: A total of 151 cases were recorded, including 73 males and 78 females. The average age was 9.8 months, ranging from 5 months to 13.3 years. All the patients underwent thoracoscopic surgery without conversion to open. The average operation time was 66 min, the average amount of bleeding was 5.9 mL and the average size was 4.8 cm. Two children had air leakage after the operation, but recovered after one-week tube drainage and conservative observation therapy. 56 children had postoperative fever in varying degrees, which gradually recovered 2-3 d after operation. No postoperative complications occurred such as bronchial fistula, hemorrhage, atelectasis and pulmonary infection. Postoperative pathological results showed that there were 108 cases of congenital pulmonary airway malformation and 43 cases of intralobar pulmonary sequestration. The median follow-up time was chest computed tomography of follow-up showed that all patients recovered well without recurrence. CONCLUSION: On the basis of thoracoscopic meticulous anatomy of lung lobes, Thoracoscopic anatomical segmentectomy in children is safe and feasible as a lung sparing resection.

[Clinical Report of 128 Cases of Meticulous Thoracoscopic Lobectomy in Children].

OBJECTIVE: To investigate the feasibility and effect of precise thoracoscopic lobectomy in children. METHODS: The clinical data of precise thoracoscopic lobectomy in infants and children were analyzed retrospectively in West China Hospital of Sichuan University. RESULTS: There were total 128 cases (male 69,female 59) of precise thoracoscopic lobectomy in infants and children from Oct,2013 to March,2017,which including 62 cases of congenital cyst of lungs,47 cases of cystic adenomatoid malformations,17 cases of pulmonary sequestrations,and 2 cases of lung tumors. The lesions cvere located in upper lobe of lung in 28 cases,lower lobe in 98 cases and middle lobe in 2 cases. Intraoperative pulmonary arteriovenous,bronchial and interlobar fissure tissues were precisely treated. One case was converted to open surgery because of the thoracic adhesions due to repeated infection,the remaining cases were successfully completed under the endoscopic procedure. Intraoperative bleeding was 3-5 mL,operation time was 35-120 min,mean 55 min. The closed thoracic drainage tubes were removed within 24 h postoperatively; No atelectasis,bleeding,bronchial pleural fistula,pulmonary infection and other complications occurred. The post-operative hospital day ranged 3-4 d. During the follow-up for 6-36 months,all cases were recovered well,and no recurrence occurred. CONCLUSION: Meticulous thoracoscopic lobectomy is feasible in children,and it is effective in avoiding common postoperative complications,accelerating the recovery and shortening the hospitalization time.