ObjectiveTo explore the training mode for improving the innovative scientific research ability of postgraduates of thoracic surgery.MethodsTwenty-two postgraduate students enrolled in the Department of Thoracic Surgery, Ruijin Hospital from September 2016 to June 2019 were targeted for training, and the teachers were 13 doctors in our department. Training methods included grant-based learning, formative learning and translational medical learning. In addition to the postgraduate education provided by the medical school, the training content also included more than 50 lectures about thoracic surgery, including surgical video explanation, perioperative management of thoracic surgery, interpretation of clinical guidelines, and intensive reading of the literature; it also included half-year clinical internship, 100 surgical operations and management of 5 medical beds in ward.ResultsClinical ability of the postgraduates were improved. Six postgraduate students enrolled in 2016 graduated successfully. They published 15 SCI papers and won more than 20 awards.ConclusionCultivating postgraduates of thoracic surgery oriented by innovative scientific research ability is conducive to the comprehensive understanding of thoracic diseases and the ability of innovative translation research.
ObjectiveTo compare the osteogenic effect of bone marrow mesenchymal stem cells (BMSCs) transfected by adenovirus-bone morphogenetic protein 2-internal ribosome entry site-hypoxia inducible factor 1αmu (Ad-BMP-2-IRES-HIF-1αmu) and by Ad-cytomegalovirus (CMV)-BMP-2-IRES-human renilla reniformis green fluorescent protein 1 (hrGFP-1) single gene so as to optimize the source of osteoblasts. MethodsBMSCs were separated and cultured from 1-month-old New Zealand white rabbit. The BMSCs at passage 3 were transfected by virus. The experiment was divided into 4 groups (groups A, B, C, and D) according to different virus: BMSCs were transfected by Ad-BMP-2-IRES-HIF-1αmu in group A, by Ad-CMV-BMP-2-IRES-hrGFP-1 in group B, by Ad-CMV-IRES-hrGFP-1 in group C, and BMSCs were not transfected in group D. The optimum multiplicity of infection (MOI) (50, 100, 150, and 200) was calculated and then the cells were transfected by the optimum MOI, respectively. The expression of BMP-2 gene was detected by immunohistochemistry staining after transfected, the expressions of BMP-2 protein and HIF-1α protein were detected by Western blot method. The osteogenic differentiation potential was detected by alkaline phosphatase (ALP) activity and Alizarin red staining. ResultsThe optimum MOI of groups A, B, and C was 200, 150, and 100, respectively. The expression of BMP-2 was positive in groups A and B, and was negative in groups C and D by immunohistochemistry staining; the number of positive cells in group A was more than that in group B (P ﹤ 0.05). The expression of BMP-2 protein in groups A and B was significantly higher than that in groups C and D (P ﹤ 0.05), group A was higher than group B (P ﹤ 0.05). The expression of HIF-1α protein in group A was significantly higher than those in the other 3 groups (P ﹤ 0.05), no significant difference was found among the other 3 groups (P ﹥ 0.05). ALP activity in groups A and B was significantly higher than that in groups C and D (P ﹤ 0.05), group A was higher than group B (P ﹤ 0.05). Calcium nodules could be seen in groups A and B, but not in groups C and D; the number of calcium nodules in group A was higher than that in group B (P ﹤ 0.05). ConclusionThe expression of BMP-2 and osteogenic effect of BMSCs transfected by Ad-BMP-2-IRES-HIF-1αmu (double genes in single carrier) are higher than those of BMSCs transfected by Ad-CMV-BMP-2-IRES-hrGFP-1 (one gene in single carrier).
ObjectiveTo explore the safety and feasibility of spleen-preserving distal pancreatectomy for children with distal pancreatic injures.MethodsClinical data of 10 patients with severe distal pancreatic injures in The Second Affiliated Hospital of Guilin Medical University from January 2012 to July 2017 were retrospectively analyzed. The intraoperative and postoperative situation including operation time, intraoperative blood loss, postoperative blood platelet count, and perioperative complications were observed.ResultsAll the 10 patients underwent spleen-preserving distal pancreatectomy successfully. The median operation time was 3 h (2–6 h), the median intraoperative blood loss was100 mL (50–300 mL), the postoperative blood platelet count ranged from 75×109/L to 260×109/L with the median postoperative blood platelet count was 175×109/L. Two patients suffered from pancreatic leakage, one patient suffered from subphrenic infection, and one patient suffered from pulmonary infection. All patients suffered from complication recovered after symptomatic treatments. All patients were followed up in the outpatient department, the follow-up time was 4–60 months with a median of 30 months. Reexamination of abdominal ultrasound and blood routine (every 3 months after surgery) showed that, no abnormalities in blood supply, morphology, and structure of spleen, and platelet counts fluctuated within the normal range. During the follow-up period, none of the children suffered from severe infection due to hyposplenic function.ConclusionSpleen-preserving distal pancreatectomy is a safe and effective method for children with distal pancreatic injures.
ObjectiveTo explore the training mode of robotic surgical system for thoracic surgeons.MethodsThirteen surgeons enrolled in the Department of Thoracic Surgery, Ruijin Hospital from May 2015 to December 2019 were targeted for training. Training methods included learning basic knowledge of Da-Vinci robotic system, simulation platform training, physical simulation training, training on animal models, practice of thoracic surgery and video analysis.ResultsThe robotic operation skills of the surgeons were improved. Currently 4 surgeons were qualified for using robotic system to do thoracic surgery, and 9 surgeons had assistant qualification.ConclusionMultiple modes of training can help surgeons learn and master the techniques of robotic surgery, and will provide the basis for robotic training standard.
The precise localization of pulmonary nodules has become an important technical key point in the treatment of pulmonary nodules by thoracoscopic surgery, which is a guarantee for safe margin and avoiding removal of too much normal lung parenchyma. With the development of medical technology and equipment, the methods of locating pulmonary nodules are also becoming less trauma and convenience. There are currently a number of methods applied to the preoperative or intraoperative localization of pulmonary nodules, including preoperative percutaneous puncture localization, preoperative transbronchial localization, intraoperative palpation localization, intraoperative ultrasound localization, and localization according to anatomy. The most appropriate localization method should be selected according to the location of the nodule, available equipment, and surgeon’s experience. According to the published literatures, we have sorted out a variety of different theories and methods of localization of pulmonary nodules in this article, summarizing their advantages and disadvantages for references.