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Background and purpose: The purpose of this study was to explore a simple, safe, accurate and noninvasive method for intraoperative localization of pulmonary nodules, so as to provide reference for more surgeons and benefit more patients with pulmonary nodules. Methods: Data of 100 patients with pulmonary nodules who underwent sublobectomy were collected. Combined with computed tomography (CT) images before operation, the localization point of pulmonary nodule on the pleural layer of the medial wall of chest wall was determined. The electric hook was left on this point, and the anesthesiologist was instructed to hold his breath after full drum and lung. The electric coagulation hook left burning point on the lung surface, which was the location point of the small pulmonary nodule on the pleura surface. After resection of the specimen, the distance between the burn point and the nodule and the distance between the nodule and the cut edge were measured to evaluate the accuracy of the localization. Results: The accuracy rate of localization was 99.1%. Only one patient had a significant deviation (>1.5 cm) between the small pulmonary nodule and the localization point. The pulmonary nodule was found after the second resection. The other patients had single resection successfully. The success rate of operation was 100.0%. No complication occurred. Conclusion: Intraoperative chest wall localization method is non-invasive, simple and safe without complication. Especially for pulmonary nodules at special location, it can achieve more accurate positioning and has obvious advantages, which is worth promoting. [ABSTRACT FROM AUTHOR]

Background: Since the popularization of computed tomography (CT) technology, the detection rate of pulmonary ground glass nodules (GGNs) with imaging follow-up as the main management method has increased significantly. The purpose of this study is to quantitatively analyze the changes of pulmonary GGNs during the follow-up process with three-dimensional reconstruction technology, explore the natural progression of pulmonary GGNs, and provide effective basis for clinical guidance for patients to conduct reasonable management of nodules., Methods: A total of 115 cases of pulmonary GGNs with regular follow-up in the Combined Outpatient Department of Zhoushan Hospital from March 2015 to November 2022 were enrolled. Quantitative imaging features of nodules were extracted by semi-automatic segmentation of 3D Slicer software to evaluate the growth of nodules and clinical intervention during follow-up., Results: The average baseline age of the patients was (56.9±10.1) yr. The mean follow-up time was (48.8±18.9) months. The two-dimensional diameter of baseline CT scan was (7.9±2.9) mm, and the maximum three-dimensional diameter was (10.1±3.4) mm. The two-dimensional diameter of the last CT scan was (9.9±4.7) mm, and the maximum three-dimensional diameter was (11.4±5.1) mm. A total of 27 cases (23.5%) showed an increase during follow-up, with a median volume doubling time of 822 days and a median mass doubling time of 1,007 days. 32 cases were surgically resected, including 6 cases of invasive adenocarcinoma (IAC), 16 cases of minimally invasive adenocarcinoma (MIA), 8 cases of adenocarcinoma in situ (AIS) and 2 cases of atypical adenomatous hyperplasia (AAH). Five nodules underwent surgical intervention due to the progression of two-dimensional diameter, which was pathologically confirmed as pre-invasive lesions, but their three-dimensional maximum diameter showed no significant change. Nodular morphology, lobulated sign, spiculated sign and vacuole signs all promoted the growth of nodules in univariate analysis. There were significant differences in age, baseline diameter, mean CT value, median CT value, 10% and 90% percentile CT number between the growth group and the stable group (P<0.05). Multivariate Logistic regression analysis showed that age and average CT value were risk factors for nodule growth (P<0.05). Receiver-operating characteristic (ROC) curve analysis results indicated that the age ≥63 years old, the baseline three-dimensional maximum diameter ≥9.2 mm, and the average CT value ≥-507.8 HU were more likely to accelerate the growth of GGNs. The maximum three-dimensional diameter ≥14.4 mm and the average CT value ≥-495.7 HU may be a higher malignant probability., Conclusions: GGNs show an inert growth process, and the use of three-dimensional measurements during follow-up is of greater significance. For persistent glass grinding nodules ≥63 years old, the baseline three-dimensional maximum diameter ≥9.2 mm, and the average CT value ≥-507.8 HU are more likely to increase. However, most nodules still have good prognosis after progression, and long-term follow-up is safe.

Background: The solitary pulmonary nodule (SPN) is a common and challenging clinical problem, especially solid SPN. The object of this study was to explore the predictive factors of SPN appearing as pure solid with malignance and to establish a clinical prediction model of solid SPNs., Methods: We had a retrospective review of 317 solid SPNs (group A) having a final diagnosis in the department of thoracic surgery, Shanghai Chest Hospital from January 2015 to December 2015, and analyzed their clinical data and computed tomography (CT) images, including age, gender, smoking history, family history of cancer, previous cancer history, diameter of nodule, nodule location (upper lobe or non-upper lobe, left or right), clear border, smooth margin, lobulation, spiculation, vascular convergence, pleural retraction sign, air bronchogram sign, vocule sign, cavity and calcification. By using univariate and multivariate analysis, we found the independent predictors of malignancy of solid SPNs and subsequently established a clinical prediction model. Then, another 139 solid SPNs with a final diagnosis were chosen in department of Cardiothoracic Surgery, Affiliated Zhoushan Hospital of Wenzhou Medical University as group B, and used to verify the accuracy of the prediction model. Receiver-operating characteristic (ROC) curves were constructed using the prediction model., Results: Multivariate Logistic regression analysis was used to identify eight clinical characteristics (age, family history of cancer, previous cancer history, clear border, lobulation, spiculation, air bronchogram sign, calcification) as independent predictors of malignancy of in solid SPNs. The area under the ROC curve for our model (0.922; 95%CI: 0.865-0.961). In our model, diagnosis accuration rate was 84.89%. Sensitivity was 90.41%, and specificity was 78.79%, and positive predictive value was 80.50%, and negative predictive value was 88.14%., Conclusions: Our prediction model could accurately identify malignancy in patients with solid SPNs, thereby it can provide help for diagnosis of solid SPNs.

Professor HE Tianyou's unique understanding and treatment characteristics for intractahle facial paralysis are introduced. In clinical practice professor HE highly values acupoint selection and manipulation application, and integrates Chinese and western medicine to flexibly choose acupoints and formulate prescriptions according to syndrome differentiation and location differentiation, besides, he creates several specialized manipulation methods including "tug-of war opposite acupuncture method" and "tractive flash cupping". Based on strengthening body and dredging collaterals. more attention is given on stimulation to local paralyzed facial nerves; meanwhile acupuncture and medication are combined to improve clinical efficacy. During the treatment, the important role of psychological counseling on patient's anxiety is emphasized, and comprehensive treatment is given physically and psychologically in order to achieve the purpose of total rehabilitation.

Objective: To investigate the nutritional status of iodine and the prevalence of thyroid carcinoma of residents in Zhoushan Archipelago, and to explore the related factors influencing the prevalence of thyroid carcinoma., Methods: The residents in Zhoushan Archipelago were selected by cluster random sampling. The subjects were surveyed by questionnaire, their thyroids were examined by B-ultrasonography, the thyroid function and the levels of urine iodine were analyzed. Pathological diagnosis was conducted to the patients suspected of thyroid carcinoma., Results: The median levels of urine iodine in urban residents, famers, salt-makers, fishermen from Zhoushan and buddhists from Putuoshan were 320.7, 188.9, 122.2, 193.6 and 271.7 microg/L respectively, while the prevalence rates of thyroid carcinoma were 215/100 000, 398/100 000 0, 407/100 000, 829/100 000,340/100 000, respectively; The age or a higher level of hTSH of a person were risk factors for suffering from thyroid carcinoma., Conclusion: The iodine intake of residents in ZhouShan Archipelago is adequate and the prevalence rate of thyroid carcinoma is high. Serum hTSH could be used as a predictor for the risk of thyroid carcinoma.

Background: At present, it has been known that the bronchogenic artery participates in the blood supply of primary bronchogenic carcinoma, but there is controversy about the blood supply from pulmonary artery in primary bronchogenic carcinoma. The aim of this study is to assess the relationship between the blood supply from pulmonary artery and pathological characteristis of patients with primary bronchogenic carcinoma., Methods: The pulmonary arteries in 43 surgical samples of bronchogenic carcinoma were marked, then the iopromide was used to selective pulmonary arteriography in digital subtraction angiography (DSA). The relationship between tumor with blood supply from pulmonary artery and the pathologic characteristics was observed., Results: There were 34 samples with blood supply from pulmonary artery ( 79.07%) , and 9 samples without blood supply from pulmonary artery (20.93%). The development rate of peripheral lung cancer (100.00%) was significantly higher than that of central lung cancer (64.00%) (P < 0.01) . The development rate of squamous cell carcinoma (91.30%) was remarkably higher than that of adenocarcinoma (61.11%) (P < 0.05). The development rate of poorly differentiated lung cancer (95.00%) was remarkably higher than that of well and moderately differentiated lung cancer (65.22%) (P < 0.05). There was a positive relationship between the tumor size and the development rate (P < 0.05)., Conclusions: In primary bronchogenic carcinoma, the pulmonary artery blood supply exists in most of tumors. There is relationship between the blood supply from pulmonary artery and general type, histopathology, cell differentiation and tumor size of lung cancer. The blood supply from pulmonary artery doesn't relate to tumor stage.

The desufurization in dilute sulfuric acid solution, acidic ferric solution, and microbial solution (Thiobacillus ferrooxidans) was studied in this paper. The concentration of ferric, pH value and time all affect the rate of desulfurization. The experimental results showed that in dilute sulfuric acid solution the absorption of SO2 was a physical absorption. In acidic ferric solution, the ion of ferric can not only catalyze but also oxidize SO2. The effects of desulfurization became obvious along with high concentration of ferric and pH value. Desulfurization rate was up to 90% when pH value was 2.0 and the concentration of ferric was 1.5 g/L. In microbial solution, the effects were also influenced by the concentration of ferric and pH value. Thiobacillus ferrooxidans had an ability of oxiding the ion of ferrous and S(IV). The results of desulfurization was the best at the concentration of ferric 1.5 g/L and pH 2.0.