PurposeTo evaluate the outcomes of patients who underwent thoracoscopic wedge resection without chest drain placement.MethodsThe subjects of this retrospective study were 89 patients, who underwent thoracoscopic wedge resection at our hospital between January, 2013 and July, 2015. A total of 45 patients whose underlying condition did not meet the following criteria were assigned to the “chest drain placement group” (group A): peripheral lesions, healthy lung parenchyma, no intraoperative air leaks, hemorrhage or effusion accumulation, and no pleural adhesion. The other 44 patients whose underlying condition met the criteria were assigned to the “no chest drain placement group” (group B). Patient characteristics, specimen data, and postoperative conditions were analyzed and compared between the groups.ResultsGroup A patients had poorer forced expiratory volume in one second (FEV1) values, less normal spirometric results, significantly higher resected lung volume, a greater maximum tumor-pleura distance, and a larger maximum tumor size. They also had a longer postoperative hospital stay. There was no difference between the two groups in postoperative complications.ConclusionsAvoiding chest drain placement after a thoracoscopic wedge resection appears to be safe and beneficial for patients who have small peripheral lesions and healthy lung parenchyma.

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) could induce extensive and rapid future liver remnant hypertrophy. However, the morbidity for ALPPS is very high. This paper reports a modified ALPPS (associating microwave ablation and portal vein ligation for staged hepatectomy, AMAPS), which was successfully applied in the treatment of huge hepatocellular carcinoma with cirrhosis, and the procedure of operation was greatly simplified. Hence, AMAPS is feasible and safe in selected patients with primary hepatocellular carcinoma and cirrhosis.

Introduction: Blunt chest trauma (BCT) accounts for up to 65% of polytrauma patients. In patients with 0 to 2 rib fractures, treatment interventions are typically limited to oral analgesics and breathing exercises. Patients suffering from BCT experience symptoms of severe pain, poor sleep, and inability to perform simple daily life activities for an extended period of time thereafter. In this trial, we aim to investigate the efficacy of acupuncture as a functional and reliable treatment option for blunt chest trauma patients. Methods: The study is designed as a double-blind randomized control trial. We will include 72 patients divided into 2 groups; the acupuncture group (Acu) and placebo group (Con). The acupuncture group will receive true acupuncture using a uniquely designed press tack needle. The control group will receive placebo acupuncture treatment through the use of a similarly designed press tack needle without the needle element. The acupoints selected for both groups are GB 34, GB 36, LI 4, LU 7, ST 36, and TH 5. Both groups will receive 1 treatment only following the initial visit to the medical facility and upon diagnosis of BCT. Patient outcome measurements include: Numerical Rating Scale, Face Rating Scale, respiratory function flowmeter, Verran Snyder-Halpern sleep scale, and the total amount of allopathic medication used. Follow-up time will be scheduled at 4 days, 2 weeks, and lastly 3 months. Expected outcome: The results of this study can potentially provide a simple and cost-effective analgesic solution to blunt chest trauma patients. This novel study design can serve as supporting evidence for future double-blind studies within the field of acupuncture. Other information: The study will be conducted in the thoracic surgical department and acupuncture department in China Medical University Hospital, Taichung, Taiwan. The study will be conducted on blunt chest trauma patients and is anticipated to have minimum risk of adverse events. Enrollment of the patients and data collection will start from March 2020. Study completion time is expected in March 2022. Protocol Registration: (CMUH109-REC1-002), (NCT04318496).

As the modeling of the solar system is difficult and inaccurate, the 3D modeling of the planets in the solar system is studied by using Java3D technology. To make the revolution of simulated planets meet Kepler's laws while traveling around the sun, an improved approximate algorithm to calculate the optimum angle and the vertex coordinates of each planet is proposed. Using java3D perspective projection technique, the observation coordinate system is determined, and real-time viewpoint setting as well as roaming processing is realized. Through multiple view technique, we can observe the movement of celestial bodies from multiple aspects to obtain vivid simulation effects of planets' behavior in the solar system. Simulation results show that the virtual simulation platform developed based on java3D can improve the accuracy and naturalness of solar system simulation.