Uniportal video-assisted thoracoscopic fissureless right upper lobe anterior segmentectomy for inflammatory myofibroblastic tumor:A case report

BACKGROUND Inflammatory myofibroblastic tumors(IMTs)are exceptionally rare neoplasms with intermediate malignant potential.Surgery is the accepted treatment option,aiming for complete resection with clear margins.CASE SUMMARY A 39-year-old woman presented with a growing solitary pulmonary nodule measuring 2.0 cm in the right upper lobe(RUL)of the lung.The patient underwent a RUL anterior segmentectomy using uniportal video-assisted thoracoscopy.A preliminary tissue diagnosis indicated malignancy;however,it was later revised to an IMTs.Due to the absence of a minor fissure between the right upper and middle lobes,an alternative resection approach was necessary.Therefore,we utilized indocyanine green injection to aid in delineating the intersegmental plane.Following an uneventful recovery,the patient was discharged on the third postoperative day.Thereafter,annual chest tomography scans were scheduled to monitor for potential local recurrence.CONCLUSION This case underscores the challenges in diagnosing and managing IMTs,showing the importance of accurate pathologic assessments and tailored surgical strategies.

Combined laparoscopic and thoracoscopic repair of adult right-sided Bochdalek hernia with massive liver prolapse: A case report

BACKGROUND A Bochdalek hernia(BH)is a congenital diaphragmatic hernia that often develops in the neonatal period.BH typically occurs on the left side of the diaphragm.A right-sided BH in an adult is rare.CASE SUMMARY A 45-year-old man was referred to our hospital because of an abnormal shadow seen on chest radiography during a medical check-up.A chest radiograph showed elevation of the right hemidiaphragm.Computed tomography showed prolapse of multiple intraabdominal organs into the right thoracic cavity,corresponding to a right-sided BH.The herniated contents included the stomach,transverse colon,and left lobe of the liver.The left lobe of the liver was enlarged,particularly the medial segment.Laparoscopic surgery was performed.However,the left lobe of the liver was completely trapped in the thoracic cavity.Therefore,thoracoscopic manipulation had to be performed to return the liver to the abdominal cavity.The hernia was repaired with interrupted nonabsorbable sutures and reinforced with mesh.CONCLUSION Combined laparoscopic and thoracoscopic surgery was successfully performed for right-sided BH with massive liver prolapse and abnormal liver morphology.

Primary repair of esophageal atresia gross type C via thoracoscopic magnetic compression anastomosis:A case report

BACKGROUND Esophageal atresia(EA)is a life-threatening congenital malformation in newborns,and the traditional repair approaches pose technical challenges and are extremely invasive.Therefore,surgeons have been actively investigating new minimally invasive techniques to address this issue.Magnetic compression anastomosis has been reported in several studies for its potential in repairing EA.In this paper,the primary repair of EA with magnetic compression anastomosis under thoracoscopy was reported.CASE SUMMARY A full-term male weighing 3500 g was diagnosed with EA gross type C.The magnetic devices used in this procedure consisted of two magnetic rings and several catheters.Tracheoesophageal fistula ligation and two purse strings were performed.The magnetic compression anastomosis was then completed thoracoscopically.After the primary repair,no additional operation was conducted.A patent anastomosis was observed on the 15th day postoperatively,and the magnets were removed on the 23rd day.No leakage existed when the transoral feeding started.CONCLUSION Thoracoscopic magnetic compression anastomosis may be a promising minimally invasive approach for repairing EA.

Anesthesia for extracorporeal membrane oxygenation-assisted thoracoscopic lower lobe subsegmental resection in a patient with a single left lung:A case report

BACKGROUND It is difficult and risky for patients with a single lung to undergo thoracoscopic segmental pneumonectomy,and previous reports of related cases are rare.We introduce anesthesia for Extracorporeal membrane oxygenation(ECMO)-assisted thoracoscopic lower lobe subsegmental resection in a patient with a single left lung.CASE SUMMARY The patient underwent comprehensive treatment for synovial sarcoma of the right lung and nodules in the lower lobe of the left lung.Examination showed pulmonary function that had severe restrictive ventilation disorder,forced expiratory volume in 1 second of 0.72 L(27.8%),forced vital capacity of 1.0 L(33%),and maximal voluntary ventilation of 33.9 L(35.5%).Lung computed tomography showed a nodular shadow in the lower lobe of the left lung,and lung metastasis was considered.After multidisciplinary consultation and adequate preoperative preparation,thoracoscopic left lower lung lobe S9bii+S10bii combined subsegmental resection was performed with the assistance of total intravenous anesthesia and ECMO intraoperative pulmonary protective ventilation.The patient received postoperative ICU supportive care.After surgical treatment,the patient was successfully withdrawn from ECMO on postoperative Day 1.The tracheal tube was removed on postoperative Day 4,and she was discharged from the hospital on postoperative Day 15.CONCLUSION The multi-disciplinary treatment provided maximum medical optimization for surgical anesthesia and veno-venous ECMO which provided adequate protection for the patient's perioperative treatment.

循证护理在降低肺癌患者PORT并发症中的应用效果

目的:评估循证护理在降低肺癌患者植入式静脉输液港(PORT)相关并发症中的应用效果。方法:选取2021年1月—2023年6月江苏省肿瘤医院确诊肺癌并行PORT植入化疗的150例患者,根据护理方式的不同分为对照组和观察组,每组75例。对照组给予常规护理,观察组给予循证护理。比较两组的并发症发生率、情绪状态、知识掌握度评分。结果:观察组PORT相关性并发症总发生率低于对照组,差异有统计学意义(P<0.05)。护理前,两组不良情绪评分比较,差异无统计学意义(P>0.05);护理后,观察组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于对照组,差异有统计学意义(P<0.05)。观察组知识掌握度评分均高于对照组,差异有统计学意义(P<0.05)。结论:循证护理在降低肺癌患者PORT并发症发生率、改善患者心理状态和生活质量方面效果显著,值得临床中应用。

基于port write事件触发的RapidIO节点动态管理方法

针对现有大规模的综合化电子信息系统中RapidIO节点管理实时性不强、CPU资源占用多的问题,提出了一种基于port write事件触发的RapidIO节点动态管理方法。该方法利用RapidIO交换芯片的port write包上报退网或者入网的节点信息,通过该信息动态管理RapidIO网络中的所有节点。工程应用实测结果表明,该方法实时性高,CPU资源占用少。

Basilic vein variation encountered during surgery for arm vein port:A case report

BACKGROUND Venous variations are uncommon and usually hard to identify,and basilic vein variation is particularly rare.Basilic vein variation usually presents without any clinical symptoms and is often regarded as a benign alteration.This case was a patient with congenital basilic vein variation encountered during surgery for an infusion port.CASE SUMMARY We documented and analyzed an uncommon anatomical variation in the basilic vein encountered during arm port insertion.This peculiarity has hitherto remained undescribed in the literature.We offer remedial strategies for addressing this anomaly in the future and precautionary measures to circumvent its occurrence.We conducted a comprehensive review of analogous cases in the literature,offering pertinent therapeutic recommendations and solutions,with the aim of enhancing the efficacy and safety of future arm port implantations.CONCLUSION Venous variation is rare and requires detailed intraoperative and postoperative examination to ensure accuracy,so as not to affect subsequent treatment.

Early Application Study of Intravenous Pain Pump Combined with Parecoxib Injection in Relieving Pain in Patients after Thoracoscopy

Objective: To explore the clinical effectiveness of combined use of intravenous pain pump with Parecoxib injection in alleviating pain in patients during the early postoperative period after thoracoscopic surgery. Methods: Eighty patients who underwent thoracoscopic surgery in a tertiary hospital were selected as the study subjects and randomly divided into two groups, with 40 patients in each group. The control group received routine postoperative treatment with intravenous pain pump, while the experimental group received Parecoxib in addition to the standard postoperative pain pump treatment. Visual Analog Scale (VAS) pain scores were used to evaluate postoperative pain relief in both groups, along with adverse reactions, postoperative complications, and patient satisfaction with pain relief. Results: Patients who received Parecoxib injection in addition to the routine use of intravenous pain pump had VAS pain scores lower than 3 points at 6 h, 12 h, 24 h, and 36 h postoperatively compared to those in the control group. The incidence of postoperative lung collapse, pleural effusion, and pulmonary infections was also significantly lower in the experimental group. The differences between the two groups were statistically significant (P Conclusion: Early combined use of Parecoxib injection in the early postoperative period after thoracoscopic surgery has shown good clinical efficacy. It can reduce the level of pain in patients, promote effective coughing and expectoration, facilitate early mobilization of patients, improve patient compliance, reduce complications, shorten hospital stay, and expedite patient recovery. Therefore, it is worth promoting the widespread clinical application of Parecoxib injection in this setting.

The Impact of Privatization on Terminal Efficiency: A Case Study of Tema Port

Port and terminal efficiency are of utmost importance to the container shipping industry due to their significance in enhancing the competitive advantage of ports within a region. Consequently, there have always been notable variations of studies around it. This paper analyzes the impact of privatization on terminal efficiency using the Port of Tema as a Case Study. The main objective of this paper is to analyze the efficiency trends of the public and private terminals in the port over the years. To achieve this objective, DEA-CCR methodology was employed to calculate the annual technical efficiency trends of the private and public terminals using four input variables and three output variables. The main results of the paper indicated that the public and private terminals were efficient for multiple years. However, the efficiency scores over the years demonstrated inconsistency, exhibiting notable fluctuations. The findings of this study will aid policymakers across the region on policies relating to the efficiency and ownership structure of ports and terminals.

Impact of thoracic paravertebral block and sufentanil on outcomes and postoperative cognitive dysfunction in thoracoscopic lung cancer surgery

BACKGROUND Postoperative pain management and cognitive function preservation are crucial for patients undergoing thoracoscopic surgery for lung cancer(LC).This is achieved using either a thoracic paravertebral block(TPVB)or sufentanil(SUF)-based multimodal analgesia.However,the efficacy and impact of their combined use on postoperative pain and postoperative cognitive dysfunction(POCD)remain unclear.AIM To explore the analgesic effect and the influence on POCD of TPVB combined with SUF-based multimodal analgesia in patients undergoing thoracoscopic radical resection for LC to help optimize postoperative pain management and improve patient outcomes.METHODS This retrospective analysis included 107 patients undergoing thoracoscopic radical resection for LC at The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital between May 2021 and January 2023.Patients receiving SUF-based multimodal analgesia(n=50)and patients receiving TPVB+SUF-based multimodal analgesia(n=57)were assigned to the control group and TPVB group,respectively.We compared the Ramsay Sedation Scale and visual analog scale(VAS)scores at rest and with cough between the two groups at 2,12,and 24 h after surgery.Serum levels of epinephrine(E),angio-tensin Ⅱ(Ang Ⅱ),norepinephrine(NE),superoxide dismutase(SOD),vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),and S-100 calcium-binding proteinβ(S-100β)were measured before and 24 h after surgery.The Mini-Mental State Examination(MMSE)was administered 1 day before surgery and at 3 and 5 days after surgery,and the occurrence of POCD was monitored for 5 days after surgery.Adverse reactions were also recorded.RESULTS There were no significant time point,between-group,and interaction effects in Ramsay sedation scores between the two groups(P>0.05).Significantly,there were notable time point effects,between-group differences,and interaction effects observed in VAS scores both at rest and with cough(P<0.05).The VAS scores at rest and with cough at 12 and 24 h after surgery were lower than those at 2 h after surgery and gradually decreased as postoperative time increased(P<0.05).The TPVB group had lower VAS scores than the control group at 2,12,and 24 h after surgery(P<0.05).The MMSE scores at postoperative days 1 and 3 were markedly higher in the TPVB group than in the control group(P<0.05).The incidence of POCD was significantly lower in the TPVB group than in the control group within 5 days after surgery(P<0.05).Both groups had elevated serum E,Ang Ⅱ,and NE and decreased serum SOD levels at 24 h after surgery compared with the preoperative levels,with better indices in the TPVB group(P<0.05).Marked elevations in serum levels of VEGF,TGF-β1,TNF-α,and S-100β were observed in both groups at 24 h after surgery,with lower levels in the TPVB group than in the control group(P<0.05).CONCLUSION TPVB combined with SUF-based multimodal analgesia further relieves pain in patients undergoing thoracoscopic radical surgery for LC,enhances analgesic effects,reduces postoperative stress response,and inhibits postoperative increases in serum VEGF,TGF-β1,TNF-α,and S-100β levels.This scheme also reduced POCD and had a high safety profile.

AGV Scheduling Optimization of Automated Port Based on Disruption Management

The recent rapid development of China’s foreign trade has led to the significant increase in waterway transportation and automated container ports. Automated terminals can significantly improve the loading and unloading efficiency of container terminals. These terminals can also increase the port’s transportation volume while ensuring the quality of cargo loading and unloading, which has become an inevitable trend in the future development of ports. However, the continuous growth of the port’s transportation volume has increased the horizontal transportation pressure on the automated terminal, and the problems of route conflicts and road locks faced by automated guided vehicles (AGV) have become increasingly prominent. Accordingly, this work takes Xiamen Yuanhai automated container terminal as an example. This work focuses on analyzing the interference problem of path conflict in its horizontal transportation AGV scheduling. Results show that path conflict, the most prominent interference factor, will cause AGV scheduling to be unable to execute the original plan. Consequently, the disruption management was used to establish a disturbance recovery model, and the Dijkstra algorithm for combining with time windows is adopted to plan a conflict-free path. Based on the comparison with the rescheduling method, the research obtains that the deviation of the transportation path and the deviation degree of the transportation path under the disruption management method are much lower than those of the rescheduling method. The transportation path deviation degree of the disruption management method is only 5.56%. Meanwhile, the deviation degree of the transportation path under the rescheduling method is 44.44%.

Seroprevalence Survey of HIV and Hepatitis B Virus and Behavioral Characteristics among Heavy Truck Drivers along Port Sudan-Khartoum Highways

The prevalence of human immunodeficiency virus (AIDS) and hepatitis B virus among heavy truck drivers and their assistants has been well documented globally in correlation with their behavioral characteristics. The present study aimed to screen for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and behavioral characteristics among heavy truck drivers in Port Sudan. A cross-sectional study was conducted on 274 heavy truck drivers and their assistants who used the highway Port Sudan-Khartoum in Port Sudan city during 2019-2021. Data on behavioral characteristics and substance use habits were collected using a structured questionnaire, and an ELISA test was used to screen for HIV and HBV infections in the study participants. The chi-square test, odds ratio, and confidence intervals were used to find the association between behavioral characteristics and seropositive HIV/HBV. Of the 274 enrolled participants, the seroprevalence rates of HIV were 2.7% and HBV was 23.7%. Ninety-four (34.3%) of them had a history of high-risk sexual behavior outside of marriage;only two (0.7%) used condoms;14.2% of participants reported alcohol use;and 1.1% reported drug use. Univariate analysis revealed that having a sex history outside of marriage with ≥1 sex partner and never using a condom with a spouse or casual partner were significant risk factors for HIV and HBV among drivers. Fortunately, we found that most of the drivers reported low alcohol and drug use. Concerning this study, the seroprevalence of HIV and HBV is highly associated with a history of having sex outside of marriage and sexual behavior among truck drivers and assistances. Additional studies are needed to further investigate other STIs and behavioral characteristics associated with factors in truck drivers/assistance in different truck stop regions in Sudan.

Function Evolution and Landscape Planning Strategy of Inland Rivers in Beilun Port City of Ningbo

In the history, the main roles of inland rivers in Beilun Port City of Ningbo were desalination,blocking tides, shipping, and flood control. Nowadays, with the continuous spread and deepening ofurbanization, the ecological environment of river courses has been destroyed. In the past, remediationmeasures based on engineering and technology played a certain role, but can not “cure the root cause”. Itshould respect the historical evolution process of river courses, and highlight the ecological service functionand leisure tourism value of river courses from the coordination perspective of urban and rural ecologicalenvironment, economic industries, society and culture in the planning ideas of ecology, production, andlife integration. Four aspects of the measures are as below: protecting and repairing the ecological matrixof river courses;building green space system and maintaining flood control functions through the waternetwork;protecting cultural heritage along the rivers;developing waterfront leisure tourism scenic area.

Impact of coupling coordination development of port and city environments on urban economic competitiveness:Evidence from the coastal port cities in eastern China

Promoting the coupling coordination development of port and its hinterland city environments is an important way to improve urban economic competitiveness.Based on relevant data of 13 coastal port cities in eastern China from 2000 to 2018,this study explores the coupling coordination development of port and city environments and its impact on urban economic competitiveness by constructing the coupling coordination degree model and the panel threshold model.The research results show that:(1)In terms of the coupling coordination development of port and city environments,most coastal ports and their hinterland cities are in a state of moderate or serious disorder.Overall,the degree of coupling coordination of port and city environments needs to be further improved;(2)The coupling coordination degree of port and city environments has a significant impact on urban economic competitiveness,and this effect gradually increases with the development of the ports and the urban economy.Among the variables that impact the urban economic competitiveness,fixed assets investment and foreign trade are significant factors that can enhance urban economic competitiveness.(3)At present,there is a“U-shaped”relationship between the coupling coordination degree of port-city environments and the urban economic competitiveness.This relationship lies on the right side of the inflection point of the“U-shaped”curve.Therefore,following the concept of assigning priority to ecological development,expanding fixed assets investment and actively developing foreign trade can further enhance the urban economic competitiveness.

Innovative Exploration and Research on International Exchange and Cooperation Mechanisms under the Background of Hainan Free Trade Port

In order to explore and foster innovation in international exchange and cooperation,this study focuses on the background of the construction of the Hainan Free Trade Port.It delves into the current development status,characteristic demands,and potential challenges of its international exchange and cooperation mechanisms.Through a comprehensive analysis of relevant cases,survey questionnaires,and literature,this study aims to provide feasible innovative models and recommendations to promote the sustained development of the Hainan Free Trade Port in the field of international exchange and cooperation,injecting new vitality into China’s economic globalization.This exploration contributes to a deeper understanding of the development of free trade ports and provides insights and references for other countries and regions.

Thoracoscopy in Cameroon: Indications, Technics and Short Term Results

Introduction: Thoracoscopy is a video-assisted surgical approach that mirrors the techniques used in thoracotomy. Our aim is to map the current state of thoracoscopy practice in Cameroon’s hospitals. Methods: This was a descriptive study that collected both retrospective and prospective data over 57 months across four hospitals in Cameroon. It included 13 patients and focused on variables such as socio-demographic factors, clinical profiles, surgical procedures, and postoperative follow-up. Results: Thirteen patients, predominantly male (84.6%, n = 11), with a mean age of 37.5 ± 16 years, were enrolled. Alcohol use (61.5%) and smoking (38.5%) were the most common past histories. The major complaints were dyspnea (84.6%) and chest pain (58.3%). The primary surgical procedure was clot-free thoracoscopy in 30.8% of cases, mainly for persistent hemothorax (41.8%). Most surgeries were elective (76.9%) and performed under general anesthesia with selective intubation (61.5%). The most common approach was single-port thoracoscopy (U-VATS) (76.9%), with no reported difficulties;however, one intraoperative incident occurred and was successfully treated. Drainage was performed systematically in all patients, and one case required conversion to open surgery. Postoperative complications were minor (Clavien-Dindo grade I) and mainly consisted of pain, with a mortality rate of 15.4%. No significant association was found between risk factors and the occurrence of complications or postoperative mortality. Conclusion: Thoracoscopy, a novel approach in our context, primarily focuses on minor thoracic surgeries.

同质化管理模式在胃肠癌PORT患者冲管护理中的应用

目的:探讨同质化管理模式在胃肠癌静脉输液港(PORT)患者冲管护理中的应用效果。方法:将2019年6月1日~2022年12月1日收治的90例胃肠癌PORT患者作为研究对象,根据随机数字法将患者分为对照组和观察组各45例,对照组实施常规护理模式,观察组实施同质化管理模式;比较两组患者冲管满意度、不良事件发生率、护理人员知识掌握度及工作质量评分情况。结果:观察组患者冲管满意度高于对照组(P<0.05);观察组不良事件发生率低于对照组(P<0.05);观察组护理人员工作质量评分及知识掌握度高于对照组(P<0.05)。结论:实施同质化管理模式可降低胃肠癌PORT患者冲管中的不良事件发生率,提升冲管满意度,从而提高护理人员知识掌握度及工作质量。

PICC和PORT静脉输液技术综合输液效果比较

目的对PICC和PORT的综合效果指数进行测算,以评价两种中心静脉输液技术的综合输液效果。方法抽取上海市某三级甲等医院采用PICC或PORT行中长期静脉输液的肿瘤患者为研究对象,通过回顾性队列研究和横断面调查收集两种静脉输液技术的安全性、有效性及患者体验相关指标,测算并比较两种中心静脉输液技术在总留置时间、留置3~个月、6~个月及9~12个月的综合效果指数。结果PICC和PORT置管患者分别纳入377例、293例,PICC留置时间显著短于PORT,置管及维护过程中次要并发症发生率显著高于PORT,生活质量得分显著低于PORT(均P<0.05)。PICC在总留置时间、留置3~个月、6~个月及9~12个月的综合效果指数值均小于PORT。结论PORT的综合输液效果优于PICC,从输液效果角度,建议优先选择PORT作为中长期静脉输液的血管管路。

Nonintubated uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

Objective： The objective of the current study was to evaluate the feasibility and safety of nonintubated nniportal video-assisted thoracoscopic surgery （VATS） for the management of primary spontaneous pneumothorax （PSP）. Methods： From November 2011 to June 2013, 32 consecutive patients with PSP were treated by nonintubated uniportal thoracoscopic bullectomy using epidnral anaesthesia and sedation without endotracheal intubation. An incision 2 cm in length was made at the 6th intercostal space in the median axillary line. The pleural space was entered by blunt dissection for placement of a soft incision protector. Instruments were then inserted through the incision protector to perform thoracoscopic bullectomy. Data were collected within a minimum follow-up period of 10 months. Results： The average time of surgery was 49.0 rain （range, 33-65 rain）. No complications were recorded. The postoperative feeding time was 6 h. The mean postoperative chest tube drainage and hospital stay were 19.3 h and 41.6 h, respectively. The postoperative pain was mild for 30 patients （93.75%） and moderate for two patients （6.25%）. No recurrences ofpneumothorax were observed at follow-up. Conclusions： The initial results indicated that nonintubated uniportal video-assisted thoracoscopic operations are not only technically feasible, but may also be a safe and less invasive alternative for select patients in the management of PSP. This is the first report to include the use of a nonintubated uniportal technique in VATS for such a large number of PSP cases. Further work and development of instruments are needed to define the applications and advantages of this technique.

Evolving thoracic surgery: from open surgery to single port thoracoscopic surgery and future robotic

Thoracic Surgery is a continuous evolving specialty. In the past, thoracic surgeons had to make large incisions in order to operate any pathology inside the chest. This often meant big, painful and ugly scars and long recovery times after surgery. But he history of thoracic surgery changed since the begining of video-assisted thoracoscoDic surgery （VATg3