Human immunodeficiency virus (HIV) infection mainly attacks the human immune system, causing a variety of opportunistic infections and tumors, among which neoplastic diseases are serious and life-threatening. In recent years, with the popularization of highly effective anti-retroviral virus, the disease spectrum of HIV infected people has changed greatly, the incidence of non-acquired immune deficiency syndrome (AIDS) related tumors has increased significantly, and the diagnosis rate of esophageal cancer patients with HIV/AIDS has also increased. However, there is no consensus on how to standardize the diagnosis and treatment of esophageal cancer patients with HIV/AIDS. This article reviews the epidemiological characteristics, diagnosis and treatment of esophageal cancer patients with HIV/AIDS.
Objective To explore the feasibility，safety and clinical applicability of combined complete thoracoscopicand laparoscopic esophagectomy for the treatment of esophageal carcinoma. Methods Clinical data of 34 patients with esophageal carcinoma who underwent combined complete thoracoscopic and laparoscopic esophagectomy in the Departmentof Thoracic Surgery of our hospital from January 2012 to June 2013 were analyzed retrospectively. There were 33 males and1 female with their age of 63 （41-76） years. Results One patient received conversion to laparotomy and 1 patient diedpostoperatively. Mean operation time was 362.1 （300-560） minutes，including 90.6 （60-220） minutes for thoracoscopicprocedure in 34 patients and 61.1 （45-85） minutes for laparoscopic procedure in 33 patients. Mean intraoperative blood loss was 206.5 （100-500） ml. Average number of dissected lymph nodes was 18.0 （13-31） for each patient with positivemetastatic rate of 44.1% （15/34）. Postoperative pathological diagnosis was squamous cell carcinoma in 33 patients and smallcell carcinoma in 1 patient. Postoperative pathological staging was stageⅠB in 1 patient，stageⅡA in 1 patient，stageⅡB in 15 patients，stageⅢA in 11 patients，stageⅢB in 3 patients and stageⅢC in 3 patients. Postoperative hospital stay was 15.2 （6-35） days. Two patients received bedside bronchoscopic sputum suction. Postoperative complications occurred in32.4% （11/34） of all patients，including pulmonary infection in 4 patients （11.8%），respiratory failure in 2 patients （5.9%），chylothorax in 1 patient （2.9%），cervical anastomotic leak in 4 patients （11.8%） and hoarseness in 2 patients （5.9%）. We followed up 33 patients for 1-16 months. Two died，Two were lost. The other 29 patients survived. Conclusion Combined complete thoracoscopic and laparoscopic esophagectomy is a minimally invasive，feasible and safe surgical procedure for the treatment of esophageal carcinoma with quick postoperative recovery，and is worthy of furtherclinical application.
Tuberculosis (TB) remains a major global public health threat. The World Health Organization's (WHO) 2020–2024 Global TB Reports provide a comprehensive overview of the TB situation from 2019 to 2023. In 2023, TB re-emerged as the world's leading infectious killer, with an estimated 10.8 million new cases. While the growth in the incidence rate slowed, the number of deaths decreased to 1.25 million. The COVID-19 pandemic significantly disrupted TB control efforts in 2020–2021. As control measures are gradually restored, a positive trend in TB control is emerging. However, significant regional disparities in incidence persist, with eight high-burden countries (HBCs), including India and China, accounting for over two-thirds of the global total. In 2023, global treatment coverage for drug-resistant TB (DR-TB) was 44.00% with a treatment success rate of 68.00%; yet, with 400 000 new drug-resistant cases, the control situation remains severe. China has achieved remarkable progress in TB control: new cases fell to 741 000 in 2023 (an incidence of 52 per 100 000); mortality decreased significantly; its share of the global DR-TB burden dropped from 14.00% to 7.30%; and the TB/HIV co-infection rate declined from 1.68% in 2019 to 0.66% in 2023, outperforming the global average. Globally, control measures continue to be optimized: treatment coverage increased from 70.00% in 2019 to 75.00% in 2023, the number of people receiving preventive therapy grew to 4.7 million, and rapid diagnostic coverage reached 48.00%. In China, the number of patients treated recovered to 565 000 in 2023, and rapid diagnostic coverage rose to 74.00%. Although technological innovations have enhanced the efficiency of prevention, screening, diagnosis, treatment, and management, achieving the 2030 End TB Strategy goals will require strengthening TB management, building primary healthcare capacity, and targeting interventions for high-risk populations, while balancing resource allocation with technological innovation to address the challenges of a heterogeneous global epidemic.
Morgagni hernia is a rare form (accounting for 2%) of congenital diaphragmatic hernia. The traditional treatment for Morgagni hernia includes thoracotomy and laparotomy. However, surgical trauma limits its adoption. We reported the results of 2 patients with congenital Morgagni hernias in adults and described the operation methods of the patients. The 2 patients recovered uneventfully. No evidence of recurrence was found after 5 years follow-up. Laparoscopic repair for Morgagni hernia with mesh is applicable for obese, aged and bilateral Morgagni hernias patients.
Objective To collect and store all interactions relating to medical information between our center and allied specialized hospitals by constructing a database system for thoracic surgery and pulmonary tuberculosis. Methods We collected all related medical records of patients who had been clinically diagnosed with pulmonary tuberculosis and tuberculous empyema using the CouchBase Database, including outpatient and inpatient system of the Department of Thoracic Surgery at the Public Health Clinical Center of Chengdu between January 2017 to June 2023. Then, we integrated all medical records derived from the radiology information system, hospital information system, image archiving and communication systems, and the laboratory information management system. Finally, we used artificial intelligence to generate a database system for the application of thoracic surgery on pulmonary tuberculosis, which stored structured medical data from different hospitals along with data collected from patients via WeChat users. The new database could share medical data between our center and allied hospitals by using a front-end processor. ResultsWe finally included 124 patients with 86 males and 38 females aged 43 (26, 56) years. A structured database for the application of thoracic surgery on patients with pulmonary tuberculosis was successfully constructed. A follow-up list created by the database can help outpatient doctors to complete follow-up tasks on time. All structured data can be downloaded in the form of Microsoft Excel files to meet the needs of different clinical researchers. Conclusion Our new database allows medical data to be structured, stored and shared between our center and allied hospitals. The database represents a powerful platform for interactions relating to regional information concerning pulmonary tuberculosis.
ObjectiveTo investigate the efficacy of combined telephone and WeChat follow-up for patients discharged with an indwelling closed thoracic drainage tube after surgery for stage Ⅲ tuberculous empyema. MethodsPatients with stage Ⅲ tuberculous empyema who were discharged with an indwelling drainage tube from the Department of Thoracic Surgery, Public Health Clinical Center of Chengdu, between November 2021 and November 2022 were enrolled in this study. They were divided into an observation group (combined telephone and WeChat follow-up) and a control group (telephone-only follow-up). The quality of life (QoL), treatment adherence, and recovery outcomes were compared between the two groups. Results A total of 81 patients were included. The observation group consisted of 49 patients (31 male, 18 female) with a mean age of (38.63±15.86) years. The control group consisted of 32 patients (27 male, 5 female) with a mean age of (36.91±17.33) years. The observation group showed significantly higher postoperative QoL scores in the domains of physical functioning, emotional functioning, physical symptoms, global health status, and overall QoL compared to the control group (all P<0.05). Regarding treatment adherence, the observation group demonstrated superior performance in daily activity duration, use of a respiratory trainer, and adherence to coughing exercises compared to the control group (all P<0.001). The duration of chest tube indwelling was significantly shorter in the observation group (P<0.001). Furthermore, the observation group showed better recovery in albumin and hemoglobin levels (P<0.001). ConclusionA combined telephone and WeChat follow-up approach can significantly improve the QoL and treatment adherence for patients discharged with an indwelling drainage tube. This method effectively shortens the duration of postoperative tube drainage, promotes nutritional recovery, and accelerates overall postoperative rehabilitation.
[Abstract]In recent years, the Chengdu Municipal Thoracic Surgery Quality Control Center has preliminarily established a regional quality control system for thoracic surgery through the development of standards, data reporting, and on-site supervision, achieving phased improvements. This review summarizes the current development of Chengdu’s thoracic surgery quality control system, including its organizational structure and scoring methodology, quality indicators based on structure–process–outcome, information technology infrastructure, and multicenter collaboration experiences, and outlines trends in surgical volume, minimally invasive procedure rates, human resources, and care quality metrics. It also analyzes existing challenges such as inter-hospital quality disparities and insufficient interoperability among information platforms. Drawing on domestic and international best practices, we propose development strategies to further enhance the homogenization and continuous improvement of thoracic surgery quality in the region. The Chengdu experience could offer a valuable model for building regional thoracic surgery quality control systems nationwide and for integration with the national quality control platform.
ObjectiveTo analyze the incidence of complications, duration of chest tube indwelling, and nutritional status in tuberculosis (TB) patients undergoing pulmonary surgery, and to explore perioperative nutritional management strategies and rehabilitation measures by identifying nutritional factors influencing postoperative chest tube duration. MethodsA retrospective analysis was conducted on clinical data of TB patients who underwent lobectomy at the Department of Thoracic Surgery, Chengdu Public Health Clinical Medical Center from 2022 to 2023. Patients were grouped based on chest tube duration (≤7 days vs. >7 days) and propensity score matching (PSM) was performed. Complications, drainage volume, and nutritional status were compared between groups. Univariate and multivariate logistic regression analyses were used to identify factors associated with prolonged chest tube duration. ResultsAmong 276 enrolled patients, 163 had chest tube duration ≤7 days [pre-PSM: 91 males, 72 females, mean age of (34.88±14.10) years] and 113 had duration >7 days [pre-PSM: 69 males, 44 females, mean age of (39.04±13.28) years]. After PSM (45 patients per group), no significant differences were observed in pleural or pulmonary infection rates between groups (P>0.05). Univariate analysis revealed statistical differences in preoperative albumin-to-globulin ratio (A/G), 24-hour postoperative A/G, 24-hour postoperative prognostic nutritional index (PNI), pre-discharge A/G, and pre-discharge hemoglobin (P<0.05). Multivariate logistic regression identified the following independent risk factors for prolonged chest tube duration: preoperative A/G, 24-hour postoperative A/G, 24-hour postoperative PNI, pre-discharge A/G, and pre-discharge hemoglobin. ConclusionPreoperative A/G, 24-hour postoperative A/G and PNI, and pre-discharge A/G and hemoglobin significantly influence chest tube duration in TB patients. Preoperative nutritional-immunological indicators independently predict prolonged drainage, while dynamic postoperative monitoring provides comprehensive recovery assessment. Integrating these parameters enables early identification of high-risk patients, facilitates personalized drainage management, and may reduce hospitalization duration while improving prognosis.
ObjectiveTo analyze the influencing factors for postoperative thoracic drainage duration in patients with cavitary pulmonary tuberculosis and clinical nursing strategies. MethodsA retrospective analysis was conducted on the clinical data of patients with cavitary pulmonary tuberculosis who underwent surgical treatment in the Department of Thoracic Surgery at Public Health Clinical Center of Chengdu from December 2022 to December 2024. Patients with a drainage time ≤7 days were included in the recovery group, while those with a drainage time >7 days were included in the control group. Data on patients' preoperative Hamilton anxiety and depression scores, perioperative nursing conditions were collected, and factors affecting chest drainage time were analyzed. ResultsA total of 186 patients were included in this study, including 119 males and 67 females, with an average age of (36.10±15.20) years. The average chest drainage tube retention time was (10.59±9.24) days. Preoperative Hamilton anxiety and depression assessments showed that 47.31% (88/186) of patients were anxious, and 31.72% (59/186) were depressed. Multivariate analysis indicated that having a smoking history, undergoing open-chest surgery, prolonged postoperative use of analgesic pumps, preoperative anxiety, and depression were independent risk factors for chest drainage time >7 days (P<0.05); frequent coughing and longer average daily activity time postoperatively were protective factors for chest drainage time >7 days (P<0.05). ConclusionPatients undergoing surgery for pulmonary tuberculosis often experience anxiety and depression preoperatively. In the clinical nursing of patients with cavitary pulmonary tuberculosis, efforts should be made preoperatively to help patients adjust their anxious and depressed emotions, control smoking, and prefer minimally invasive surgery; postoperatively, reducing analgesic duration, increasing cough frequency, promoting effective coughing, and extending average daily activity time can effectively shorten the postoperative chest drainage time, facilitating the rapid recovery of patients after surgery for pulmonary tuberculosis.