Impacts of additional cycles of neoadjuvant immunotherapy on surgery in non-small-cell lung cancer.

Objective: Whether cycle number influences the subsequent pathological or surgical outcomes remained unclear. This study aimed to assess the efficacy and surgical safety of neoadjuvant immunochemotherapy-based treatment in the real-world setting.

Methods: Clinical data of patients who received neoadjuvant immunochemotherapy for non-small-cell lung cancer between 2018 and 2021 were collected.

Artificial intelligence for stepwise diagnosis and monitoring of COVID-19.

Background: Main challenges for COVID-19 include the lack of a rapid diagnostic test, a suitable tool to monitor and predict a patient's clinical course and an efficient way for data sharing among multicenters. We thus developed a novel artificial intelligence system based on deep learning (DL) and federated learning (FL) for the diagnosis, monitoring, and prediction of a patient's clinical course.

Methods: CT imaging derived from 6 different multicenter cohorts were used for stepwise diagnostic algorithm to diagnose COVID-19, with or without clinical data.

Minimally Invasive Carinal Reconstruction Using Bronchial Flap and Omental Flap Reinforcement.

Carinal reconstruction and omental flap harvesting are traditionally performed through open approaches. We report a case in which carinal reconstruction with bronchial flap and omental flap reinforcement was performed using minimally invasive approaches. The omental flap was harvested laparoscopically and wrapped around the anastomosis, which reduced the risk of airway anastomosis complications.

White light, autofluorescence and narrow-band imaging bronchoscopy for diagnosing airway pre-cancerous and early cancer lesions: a systematic review and meta-analysis.

Background: We aimed to summarize the diagnostic accuracy of white light bronchoscopy (WLB) and advanced techniques for airway pre-cancerous lesions and early cancer, such as autofluorescence bronchoscopy (AFB), AFB combined with WLB (AFB + WLB) and narrow-band imaging (NBI) bronchoscopy.

Methods: We searched for eligible studies in seven electronic databases from their date of inception to Mar 20, 2015. In eligible studies, detected lesions should be confirmed by histopathology.

New tubeless video-assisted thoracoscopic surgery for small pulmonary nodules.

Objectives: Problems associated with intubation, chest drainage and urinary catheterization can have a negative impact on patient's recovery after thoracic surgery. We therefore evaluated the feasibility of a new tubeless (spontaneous ventilation without tracheal intubation, urinary catheterization, and no post-operative chest drain placement) approach to perform video-assisted thoracoscopic surgery (VATS) for small pulmonary nodules (SPN) less than 2cm in diameter.

Methods: From 1 January 2012 to 31 December 2014, 34 patients with SPNs were treated using tubeless VATS in our centre.

Video-Assisted Thoracic Surgery Resection and Reconstruction of Carina and Trachea for Malignant or Benign Disease in 12 Patients: Three Centers' Experience in China.

Background: Although video-assisted thoracoscopic surgery (VATS) has been widely applied to both peripheral and central lung cancer treatment in many centers, there is great hesitation to adopt it for carinal or tracheal surgical procedures. The aims of this study were to explore the feasibility of VATS in the treatment of benign and malignant diseases involving the carina and trachea and to highlight relevant techniques.

Methods: Patients undergoing VATS carinal or tracheal procedures between May 2012 and July 2015 from three centers in China were included in this study.

Non-intubated combined with video-assisted thoracoscopic in carinal reconstruction.

Carinal reconstruction is a difficult technique combined with video-assisted thoracoscopic surgery (VATS). It has a high requirement on the operator's skills in operating thoracoscope and meanwhile requires the close cooperation from anesthesiologists. Tracheal intubation and ventilator-assisted ventilation are key steps to ensure the success of surgery.

Differences in performance of five types of aortic valve prostheses: haemodynamic assessment by dobutamine stress echocardiography.

Background: In patients being considered for aortic valve replacement, there remains controversy over which design or tissue offers the best performance. We aimed to evaluate in a single study the haemodynamic performances of five different widely used aortic valve prostheses: stentless porcine xenograft (Elan), stentless bovine pericardium (Pericarbon Freedom), stented porcine xenograft (Aspire), stented bovine pericardium (More) and mechanical (Ultracor). We also compared them with normal aortic valves and stenosed valves of variable severity.

Early impact of aortic wrapping on patients undergoing aortic valve replacement with mild to moderate ascending aorta dilatation.

Background: The management of mild to moderate dilatation of the ascending aorta of less than 5 cm is controversial, particularly when concomitant surgical correction of aortic valve is required. We investigate the impact of a simple method of aorta reduction using Dacron graft wrapping during aortic valve replacement on the rest of the aorta.

Methods: We studied 14 patients who had ascending aorta dilatation of 4-5 cm before undergoing aortic wrapping during their aortic valve replacement and compared with their post-operative imaging within a month.

Limitations of conventional approaches to identify myocyte nuclei in histologic sections of the heart.

Accurate nuclear identification is crucial for distinguishing the role of cardiac myocytes in intrinsic and experimentally induced regenerative growth of the myocardium. Conventional histologic analysis of myocyte nuclei relies on the optical sectioning capabilities of confocal microscopy in conjunction with immunofluorescent labeling of cytoplasmic proteins such as troponin T, and dyes that bind to double-strand DNA to identify nuclei. Using heart sections from transgenic mice in which the cardiomyocyte-restricted alpha-cardiac myosin heavy chain promoter targeted the expression of nuclear localized beta-galactosidase reporter in >99% of myocytes, we systematically compared the fidelity of conventional myocyte nuclear identification using confocal microscopy, with and without the aid of a membrane marker.

Randomized controlled trial on the cardioprotective effect of bone marrow cells in patients undergoing coronary bypass graft surgery.

Aims: This randomized study investigates whether bone marrow cells (BMCs) can reduce ischaemic injury during cardiac surgery.

Methods And Results: Forty-four elective coronary artery bypass grafting patients were randomized to control group or BMCs group (whereby autologous BMCs were administered with each dose of cardioplegia antegradely into the coronaries). Troponin I and CK-MB were measured during the first 48 h after surgery and were not significantly different between the control and BMCs groups.

Randomized, controlled trial of intramuscular or intracoronary injection of autologous bone marrow cells into scarred myocardium during CABG versus CABG alone.

Background: Studies of the transplantation of autologous bone marrow cells (BMCs) in patients with chronic ischemic heart disease have assessed effects on viable, peri-infarct tissue. We conducted a single-blinded, randomized, controlled study to investigate whether intramuscular or intracoronary administration of BMCs into nonviable scarred myocardium during CABG improves contractile function of scar segments compared with CABG alone.

Methods: Elective CABG patients (n = 63), with established myocardial scars diagnosed as akinetic or dyskinetic segments by dobutamine stress echocardiography and confirmed at surgery, were randomly assigned CABG alone (control) or CABG with intramuscular or intracoronary administration of BMCs.

Lineage tracing of cardiac explant derived cells.

Aims: Cultured cardiac explants produce a heterogeneous population of cells including a distinctive population of refractile cells described here as small round cardiac explant derived cells (EDCs). The aim of this study was to explore the source, morphology and cardiogenic potential of EDCs.

Methods: Transgenic MLC2v-Cre/ZEG, and actin-eGFP mice were used for lineage-tracing of EDCs in vitro and in vivo.

Mitral valve injury by cardiotomy suction during aortic valve replacement--a near miss.

Mitral valve injury due to cardiotomy suckers during aortic valve surgery has never been reported. We highlight the possibility of such injury experienced in our unit. We also discuss its preventive measures.

Massive CO2 embolism in cardiopulmonary bypass circuit - a near miss.

Objectives: We report a case of massive air embolism in the cardiopulmonary bypass (CPB) circuit to highlight the principle of its immediate management and its preventive measures.

Methods: The air embolism was caused by the accidental connection of carbon dioxide (CO(2)) supply to the monitoring arm of the retrograde cardioplegia delivery system. The CPB ceased, resulting in cardiac arrest requiring immediate internal cardiac massage.

Repair of the damaged heart by bone marrow cells: from experimental evidence to clinical hope.

Heart failure remains the leading cause of death in developed countries in spite of improvements in medical and surgical treatments. However, recent observations in experimental studies that bone marrow cells may repair cardiac tissue have offered renewed hopes for the treatment of heart failure. This optimism is further supported by encouraging results from some clinical trials, although the degree of benefits, the underlying mechanisms, and the cell types involved remain to be elucidated.

Twenty months' routine use of a new percutaneous tracheostomy set using controlled rotating dilation.

After a favorable trial period, we introduced the new percutaneous tracheostomy set, PercuTwist, in February of 2002 for our routine procedures. Over the next 20 mo, 90 procedures were performed with minimal complications. To prospectively evaluate this experience, we collected information on reasons for unit admission, operators' previous experience, the duration of prior tracheal intubation, the time needed for the procedure, the grading of the difficulty, the amount of bleeding, and the complications of the procedure.

Intrapleural tumor dissemination after video-assisted thoracoscopic surgery metastasectomy.

In a 34-year-old woman extensive intrapleural disease developed within 1 year of video-assisted thoracoscopic surgery (VATS) removal of two pulmonary metastases from a previously treated synovial sarcoma. She underwent a successful complete pleurectomy through a left thoracotomy to excise the pleural tumor and remains well 6 months later. This case highlights tumor dissemination as one of the pitfalls of VATS metastasectomy and raises concerns about using VATS in this situation.

Primary pulmonary pleomorphic adenoma. An immunohistochemical study and review of the literature.

Primary pleomorphic adenoma of the lung is an uncommon condition. We present a case of primary pulmonary pleomorphic adenoma and its immunohistologic features. The presence of immunoreactivity to both anticytokeratin and antivimentin antibodies for its epithelial components is suggestive of a primary pulmonary lesion.