IntroductionTreatments for multiple ground-glass opacities (GGOs) for which the detection rate is increasing are still controversial. Next-generation sequencing (NGS) may provide additional key evidence for differential diagnosis or optimal therapeutic schedules.Case presentationWe first reported a rare case in which more than 100 bilateral pulmonary GGOs (91.7% of the GGOs were pure GGOs) were diagnosed as both multiple primary lung cancer and intrapulmonary metastasis. We performed NGS with an 808-gene panel to assess both somatic and germline alterations in tissues and plasma. The patient (male) underwent three successive surgeries and received osimertinib adjuvant therapy due to signs of metastasis and multiple EGFR-mutated tumors. The patient had multiple pure GGOs, and eight tumors of four pathological subtypes were evaluated for the clonal relationship. Metastasis, including pure GGOs and atypical adenomatous hyperplasia, was found between two pairs of tumors. Circulating tumor DNA (ctDNA) monitoring of disease status may impact clinical decision-making.ConclusionsSurgery combined with targeted therapies remains a reasonable alternative strategy for treating patients with multifocal GGOs, and NGS is valuable for facilitating diagnostic workup and adjuvant therapy with targeted drugs through tissue and disease monitoring via ctDNA.

BACKGROUND:Previous studies have suggested the applicability of three classifications of subsolid nodules (SSNs). However, few studies have unraveled the natural history of the three types of SSNs. METHODS:A retrospective study from two medical centers between November 2007 and November 2017 was conducted to explore the long-term follow-up results of three different types of SSNs, which were divided into pure ground-glass nodules (pGGNs), heterogeneous ground-glass nodules (hGGNs), and real part-solid nodules (rPSNs). RESULTS:A total of 306 consecutive patients, including 361 SSNs with long-term follow-up, were reviewed. The median growth times of pGGNs, hGGNs, and rPSNs were 7.7, 6.0, and 2.0 years, respectively. For pGGNs, the median period of development into rPSNs was 4.6 years, while that of hGGNs was 1.8 years, and the time from pGGNs to hGGNs was 3.1 years (p < 0.05). In SSNs with an initial lung window consolidation tumor ratio (LW-CTR) >0.5 and mediastinum window (MW)-CTR >0.2, all cases with growth were identified within 5 years. Meanwhile, in SSNs whose LW-CTR and MW-CTR were 0, it took over 5 years to detect nodular growth. Pathologically, 90.6% of initial SSNs with LW-CTR >0 were invasive carcinomas (invasive adenocarcinoma and micro-invasive adenocarcinoma). Among patients with rPSNs in the initial state, 100.0% of the final pathological results were invasive carcinoma. Cox regression showed that age (p = 0.038), initial maximal diameter (p < 0.001), and LW-CTR (p = 0.002) were independent risk factors for SSN growth. CONCLUSIONS:pGGNs, hGGNs, and rPSNs have significantly different natural histories. Age, initial nodule diameter, and LW-CTR are important risk factors for SSN growth.

ObjectiveThe incidence of early stage multiple primary lung cancer (MPLC) has been increasing in recent years, while the ideal strategy for its diagnosis and treatment remains controversial. The present study conducted genomic analysis to identify a new molecular classification method for accurately predicting the diagnosis and therapy for patients with early stage MPLC.MethodsA total of 240 tissue samples from 203 patients with multiple-non-small-cell lung cancers (NSCLCs) (n = 30), early stage single-NSCLC (Group A, n = 94), and advanced-stage NSCLC (Group B, n = 79) were subjected to targeted multigene panel sequencing.ResultsThirty patients for whom next-generation sequencing was performed on >1 tumor were identified, yielding 45 tumor pairs. The frequencies of EGFR, TP53, RBM10, ERBB2, and CDKN2A mutations exhibited significant differences between early and advanced-stage NSCLCs. The prevalence of the EGFR L858R mutation in early stage NSCLC was remarkably higher than that in advanced-stage NSCLC (P = 0.047). The molecular method classified tumor pairs into 26 definite MPLC tumors and four intrapulmonary metastasis (IM) tumors. A high rate of discordance in driver genetic alterations was found in the different tumor lesions of MPLC patients. The prospective Martini histologic prediction of MPLC was discordant with the molecular method for three patients (16.7%), particularly in the prediction of IM (91.7% discordant).ConclusionsComprehensive molecular evaluation allows the unambiguous delineation of clonal relationships among tumors. In comparison, the Martini and Melamed criteria have notable limitations in the recognition of IM. Our results support the adoption of a large panel to supplement histology for strongly discriminating NSCLC clonal relationships in clinical practice.

Lung cancer is the most common malignant tumor and the leading cause of cancer-related death worldwide. Most of the patients have distant metastasis when visiting the doctor, which seriously affects the survival time and quality of life of the patients. With the development of molecular targeted drugs, lung cancer treatment has been transformed from traditional chemotherapy to targeted therapy and precision medicine has been gradually applied in clinical practice, which can make lung cancer patients live longer and have a better quality of life. We present a case of advanced lung cancer patient who presented to Department of Thoracic Surgery of Beijing Haidian Hospital five years ago. We chose the reasonable treatment options though the genetic tests and circulating tumor DNA tests. We summarized the adverse reactions in the whole course of treatment. The comprehensive therapy we utilized, including targeted therapy, chemotherapy, antiangiogenic agents and local radiotherapy, have resulted in our patient with remaining alive. For advanced non-small cell lung cancer with epidermal growth factor receptor (EGFR) mutation positive, individualized treatment was conducted based on precise genotyping and dynamic monitoring, which can not only control the tumor, but also have mild toxic and side effects. The survival time of the patients was prolonged and the quality of life was guaranteed.
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Qiang Liu Shuai Wang Guotian Pei Yingshun Yang Xianjun Min Yuqing Huang Jun Liu 1Department of Thoracic Surgery, Beijing Haidian Hospital, Beijing, 100000, People’s Republic of China; 2Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China Objective: This study set out to investigate the effect of miR-1253 on lung cancer progression through targeted regulation of ANXA3. Methods: RT-PCR was employed to detect the miR-1253 expression levels in lung cancer cells and its targeted gene ANXA3 mRNA determined by biological information prediction. MTT, invasion and apoptosis rate tests were employed to detect the proliferation, invasion and apoptosis rate of lung cancer cells over-expressing miR-1253 or those with low expression of ANXA3 and the expression of related proteins. Results: RT-qPCR results manifested that the miR-1253 level was down-regulated in lung cancer tissues and cells, and the ANXA3 expression increased. The miR-1253 and ANXA3 expression levels were negatively correlated. miR-1253 was correlated with tumor differentiation degree, TNM stage and lymph node metastasis of lung cancer patients. Cell tests confirmed that miR-1253 played a tumor-inhibiting function, including inhibiting proliferation and invasion of lung cancer cells and promoting apoptosis. Bioinformatics prediction and subsequent experiments proved that ANXA3 was the direct target of miR-1253. Moreover, after the ANXA3 expression in lung cancer cells was knocked down, proliferation and invasion of those cells were inhibited dramatically, the apoptosis rate increased markedly, and the expression levels of pro-apoptosis-related proteins Bax and caspase-3 were upregulated, and the anti-apoptosis-related protein Bcl-2 expression was down-regulated. Conclusion: miR-1253 can inhibit the proliferation and invasion of lung cancer cells and promote their apoptosis by targeting ANXA3. It can be used as a new potential target for lung cancer treatment.

Objective This study set out to investigate the effect of miR-1253 on lung cancer progression through targeted regulation of ANXA3. Methods RT-PCR was employed to detect the miR-1253 expression levels in lung cancer cells and its targeted gene ANXA3 mRNA determined by biological information prediction. MTT, invasion and apoptosis rate tests were employed to detect the proliferation, invasion and apoptosis rate of lung cancer cells over-expressing miR-1253 or those with low expression of ANXA3 and the expression of related proteins. Results RT-qPCR results manifested that the miR-1253 level was down-regulated in lung cancer tissues and cells, and the ANXA3 expression increased. The miR-1253 and ANXA3 expression levels were negatively correlated. miR-1253 was correlated with tumor differentiation degree, TNM stage and lymph node metastasis of lung cancer patients. Cell tests confirmed that miR-1253 played a tumor-inhibiting function, including inhibiting proliferation and invasion of lung cancer cells and promoting apoptosis. Bioinformatics prediction and subsequent experiments proved that ANXA3 was the direct target of miR-1253. Moreover, after the ANXA3 expression in lung cancer cells was knocked down, proliferation and invasion of those cells were inhibited dramatically, the apoptosis rate increased markedly, and the expression levels of pro-apoptosis-related proteins Bax and caspase-3 were up-regulated, and the anti-apoptosis-related protein Bcl-2 expression was down-regulated. Conclusion miR-1253 can inhibit the proliferation and invasion of lung cancer cells and promote their apoptosis by targeting ANXA3. It can be used as a new potential target for lung cancer treatment.

BackgroundWe investigated the safety and feasibility of intraoperative near‐infrared (NIR) imaging using indocyanine green (ICG) during sympathectomy in the management of primary palmar hyperhidrosis (PPH).MethodsWe performed a retrospective review of 142 patients (ICG group) who underwent endoscopic thoracic sympathectomy (ETS) between February 2018 and April 2019. All patients received a 5 mg/kg infusion of ICG 24 hours preoperatively. The vital signs before and after ICG injection and adverse reactions were recorded. Meanwhile, 498 patients (Non‐ICG group) who underwent ETS by normal thoracoscopy during August 2017 to April 2019 were also reviewed to compare the abnormal white blood cell (WBC) counts, alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN), and creatinine (Cr) levels before and after operation between two groups.ResultsFor ICG group, the vital signs including body temperature, heart rate and blood pressure before and after ICG injection were stable. There was no significant difference in the abnormal WBC counts, ALT, AST, BUN, and Cr levels before and after operation between two groups. Only one patient had mild adverse reaction (0.7%) after ICG injection. The visibility rate of all sympathetic ganglions was 96.7% (1369/1415). The visibility rate from T1 to T5 was 98.23% (278/283), 98.23% (278/283), 97.17% (275/283), 95.76% (271/283), and 94.35% (267/283), respectively. There was no significant difference in the visibility rate with regard to age, gender, height, weight, body mass index, and PPH grade.ConclusionsNIR fluorescence imaging with ICG for identifying sympathetic ganglions is relatively safe and feasible.Key points• Significant findings of the study.NIR fluorescence imaging with ICG for identifying sympathetic ganglions is relatively safe and feasible.• What this study adds.This technology may take the place of the rib‐oriented method as standard practice for the precise localization of sympathetic ganglions, and may improve the effect of sympathectomies.

目的 探讨老年恶性肿瘤化疗患者网织红细胞参数的变化及其临床意义.方法 选取2016年1月至2019年10月在北京市海淀医院就诊的老年恶性肿瘤患者120例纳入研究组,另选取来我院体检的健康老年人60例纳入对照组.检测对照组受试者的白细胞(WBC)、血小板计数(PLT)、网织红细胞参数,以及研究组患者化疗前和化疗后3 d、1周、2周和3周的WBC、PLT、网织红细胞参数.结果 研究组患者化疗前的高荧光强度的网织红细胞百分率(HFR％)和网织红细胞百分率(RET％)分别为(2.63±0.81)％和(1.44±0.41)％,明显大于对照组的(1.13±0.23)％和(1.10±0.32)％,差异均有统计学意义(P<0.05);两组受试者的中荧光强度的网织红细胞百分率(MFR％)、WBC和PLT值比较差异均无统计学意义(P>0.05);化疗后3 d,研究组患者的网织红细胞绝对数(RET)、未成熟网织红细胞指数(IRF)值分别为(0.51±0.04)×1012/L和(7.18±2.62)％,明显小于化疗前,且差异均有统计学意义(P<0.05);化疗后1周,研究组患者的RET和IRF值最低,分别为(0.16±0.02)×1012/L和(4.13±1.25)％,化疗后2周RET、IRF值回升,分别为(0.83±0.11)×1012/L和(8.69±2.37)％,化疗后1周和2周与化疗前比较差异均具有统计学意义(P<0.05),但化疗后3周,RET、IRF值恢复至化疗前水平,差异均无统计学意义(P>0.05);化疗后2周,研究组患者的PLT、WBC值达到最低,分别为(125.06±32.14)×109/L和(3.99±0.86)×109/L,与化疗前比较差异具有统计学意义(P<0.05);化疗后3周有所回升,与化疗前比较差异均无统计学意义(P>0.05).结论 网织红细胞参数可用来监测恶性肿瘤老年患者化疗后的骨髓造血功能的抑制作用,其中网织红细胞参数中RET和IRF在化疗后检测骨髓造血功能抑制以及恢复方面的敏感度更高,因此,在恶性肿瘤临床化疗治疗过程中,RET和IRF对治疗方案的调整、用药时机的选择具有指导意义.

e21607 Background: The mutational profile of non-small cell lung cancer (NSCLC) has been widely studied. However, the correlation between mutational profile and the prognosis of various molecular subtypes of NSCLC has not been fully investigated. Methods: We established the mutational landscape from 244 stage I-IV NSCLC patients using a 605-gene next generation sequencing panel. Molecular subtyping was performance based on the mutational status of EGFR, TP53, KRAS and STK11 genes according to reported methods. Sequencing data were analyzed with R packages and statistics analysis was performed with Graphpad PRISM 5.0 software. P ≤ 0.05 was regarded as statistically significant. Results: Differential SNV/INDEL mutation frequency across stage I-IV was found in EGFR, TP53, ATM, CDKN2A and NF1 (P < 0.05), differential CNV frequency was found in EGFR, RB1, PIK3CA, TERT, KRAS, FGFR1 and ERBB2 (P < 0.05), and differential SV frequency was found in ROS1 (P < 0.05). TMB of stage III-IV patients was higher than those of stage I (P < 0.05). TMB was higher in patients with TP53 but without EGFR mutations (P < 0.05). The association between prognosis and mutational status was further investigated in stage IV NSCLC. Patients with EGFR SNV/INDEL mutations exhibited better PFS and OS time, while patients with KRAS and/or STK11 SNV/INDEL mutations, or without mutations in EGFR, TP53, KRAS and STK11 exhibited worse PFS and OS time. However, no significant difference was observed in PFS and OS between patients with or without TP53 SNV/INDEL, EGFR CNV, ERBB2 CNV or TERT CNV variations. Further analysis showed that male or age≥62 exhibited worse OS time (P < 0.05), while smoking history, palliative surgery and palliative radiotherapy did not affect the PFS and OS time of stage IV patients. Conclusions: We found differential frequency in SNV/INDEL, CNV and SV variations across stage I-IV NSCLC. EGFR SNV/INDEL, KRAS SNV/INDEL, STK11 SNV/INDEL mutation, gender and age were found to be prognostic predicting factors for stage IV NSCLC.

e15586 Background: Next-generation sequencing (NGS) typically requires greater quantities of DNA than traditional molecular testing. Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) is a minimally invasive technique with high sensitivity in the mediastinal staging of lung cancer. This study aimed to evaluate the adequacy of EBUS-TBNA in providing adequate size specimens for genetic mutations and immunotherapy biomarkers analysis in patients with lung cancer. Methods: Tissue samples from patients with advanced lung cancer were collected by EBUS-TBNA and were formalin-fixed paraffin-embedded. NGS assay was carried on with acornmed panel including 808 genes. PD-L1 expression through immunohistochemistry was assessed. Results: A total of 98 patients was enrolled, of which 74 (76%) were adenocarcinoma and 20 (20%) were squamous cell carcinomas. Among the patients, 108 samples (including multipoint puncture of different location and retest of the same patient) were obtained. NGS assay was completed successfully on 106 of the 108 samples (98.14%), and 97.96% of patients had successful testing, identifying an average of 11.3 mutations. With a multi-gene panel comprising up to 808 tumor related genes, actionable variations were found in 93 (86%) samples. Of these, the positive rates of actionable alterations in lung adenocarcinoma samples and lung squamous cell carcinoma samples were 90% and 79%, respectively. The tumor mutation burden (TMB), Microsatellite instability (MSI) and PD-L1 expression were found High in 20 (41%), 1 (2%), and 37 (72%) patients respectively. Conclusions: NGS assay can be successfully conducted with tissue samples obtained from EBUS-TBNA. NGS assay provides more comprehensive information on genetic mutations in tumors, which greatly assists therapeutic decision making for advanced lung cancer.

e13163 Background: Tumor mutation burden (TMB) is recognized as a promising biomarker for PD-1/PD-L1 blockade therapy. However, a tissue biopsy is often not available, and hence a liquid biopsy using blood can be used to evaluate TMB (which is known as blood TMB). Unfortunately, the concordance of blood TMB (bTMB) and tissue TMB (tTMB) is not stable, and may be affected by the sample preparation methodology and sequencing depth. Therefore, e designed a study to explore the factors, which may significantly impact the concordance between bTMB and tTMB. Methods: From September 2018 to January 2019, 98 patients with pan-cancer were prospectively enrolled. For each patient, a tissue sample and paired plasma sample were collected. These samples were sequenced using a custom 605 cancer specificgene panel. Results: The data indicated that bTMB and tTMB were correlated, but the DNA input, sequencing depth and maximum somatic allele frequency (MSAF) might affect their concordance. The Spearman’s rank correlation (SRC) between bTMB and tTMB of 38 patients with > = 25ng cfDNA vs. 60 patients with < 25ng cfDNA was 0.77 vs. 0.15, respectively. Additionally, we explored the impact of sequencing depth and determined that the SRC (between bTMB and tTMB) of 25 patients with a sequencing depth > = 2,500x vs. 73 patients with a sequencing depth < 2,500x was 0.74 vs. 0.28, respectively. Finally, we showed that the allele frequency was critically important as well. We determined that the SRC (between bTMB and tTMB) of 50 patients with cfDNA MSAF > = 1% vs. 48 patients with cfDNA < 1% was 0.71 vs. -0.03. Conclusions: To improve concordance between bTMB and tTMB for better predicting efficacy of immunotherapy, we recommend that cfDNA input should be more than 25ng, and average effective sequencing depth should be higher than 2,500x, and the correlation hold for an allele frequency treating than 1%.

Background: Molecularly targeted drugs yielded significant therapeutic advances in oncogene-driven non-small cell lung cancer (NSCLC), but the majority of patients develop acquired resistance. It is important to identify new target sites that mediate lung cancer progression for new targeted drugs development. Methods: SUSD2 expression and methylation in 25 paired lung cancer and adjacent normal lung samples were investigated. In addition, the association between SUSD2 expression and prognosis was evaluated. Results: SUSD2 gene expression was down-regulated in 21 of 25 lung cancer samples. Similarly, SUSD2 protein expression was down-regulated in 20 of 25 lung cancer samples. Furthermore, 7 of 25 lung cancer samples showed a higher methylation compared to adjacent normal lung samples, suggesting that SUSD2 methylation was closely associated with silencing of the gene expression. Except for the pathology type and TNM status (P<0.05), no correlation was observed between SUSD2 expression and other clinicopathological characteristics. Conclusions: Our findings indicated that SUSD2 expression was down-regulated in lung cancer, and SUSD2 methylation might not be involved in SUSD2 gene expression, suggesting that SUSD2 could be a novel candidate gene for future mechanism research of lung cancer.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:比较手术治疗的肺部良性肿瘤与早期、中期肺癌患者的焦虑及抑郁症状的检出比率,探讨其影响因素。方法:研究对象为就诊于某三级综合医院的283例接受手术的肺部肿瘤患者,其中肺部良性肿瘤或病变患者107例,早期肺癌患者58例,中期肺癌患者118例。采用自编调查表收集社会人口学及临床相关信息,使用抑郁自评量表（SDS）和焦虑自评量表（SAS）分别评价肿瘤患者抑郁和焦虑症状,SDS标准分&gt;53分记为有抑郁症状,SAS标准分&gt;50分记为有焦虑症状。结果:肺部良性肿瘤或病变患者无明显焦虑及抑郁症状,早期和中期肺癌患者中53.40%存在焦虑症状,43.44%存在抑郁症状,差异有统计学意义（P&lt;0.001）。多重线性回归分析显示,中期肺癌（β=29.70,P&lt;0.001）及年龄65岁以上（β=2.58,P=0.018）是发生抑郁症状的危险因素,相对于良性肿瘤及早期肺癌患者,中期肺癌患者焦虑症状更重（β=27.22,P&lt;0.001）。结论:中期肺癌较良性肿瘤及早期肺癌更加容易导致患者出现焦虑和抑郁等负面心理应激;且老年肿瘤患者更容易出现抑郁症状。</span>

目的:探讨基于RNA干扰CMTM7对肺腺癌A549细胞凋亡的影响.方法:选择肺腺癌A549细胞株分为siRNA组、阴性对照组与空白对照组,在对数生长的A549细胞中转染RNA干扰CMTM7载体、脂质体空载体和不进行转染,观察A549细胞的生长、凋亡与细胞周期状况.结果:MTT实验显示siRNA转染组的抑制率明显高于阴性对照组和空白对照组(P＜0.05),阴性对照组与空白对照组的对比无明显差异(P＞0.05).流式细胞术实验表明siRNA转染组的细胞凋亡率明显高于阴性对照组和空白对照组(P＜0.05),阴性对照组与空白对照组的对比无明显差异(P＞0.05).流式细胞术实验表明siRNA转染组的G0/G1期细胞数目较阴性对照组和空白对照组增多明显(P＜0.05),同时siRNA转染组的S、G2/M期细胞数目较阴性对照组和空白对照组明显减少(P＜0.05),阴性对照组和空白对照组对比差异无统计学意义(P＞0.05).结论:RNA干扰CMTM7能够促进肺腺癌A549细胞凋亡,抑制肿瘤细胞的生长,其作用机制可能通过干扰细胞周期而实现.

Objective To Evaluate the feasibility of video-assisted thoracoscopic surgery(VATS) reoperation for recurrent primary spontaneous pneumothorax.Methods The clinical and follow-up date of 35 recurrent pneumothorax patients,who received reoperation from January 2004 to November 2013 at the Beijing Haidian Hospital and Peking University People's Hospital were retrospectively reviewed.Chi square,t test and Kaplan-Meier curve was used to evaluate risk factors.Results The relapsed 35 patients included male 30,female 5.The median age was 22 years old(range 16-50 years).The median operating time was 100 min (range 40-190 min),the median blood loss was 50 ml (range 5-200 ml) and the median postoperative stay in the hospital was 7 days(range 3-13 days).VATS was successfully performed for all patients,without conversion.No morbidity or mortality occurred.The median follow-up time was 49months(range 12-133 months).Adhesions were observed from 34 patients,wherein,the severity ranged from mild to dense.New bullae or blebs were found in 26 patients (74.29％),9 (34.62％) of which were adjacent to the stapled incisal margin.No bullae or blebs were found on the 9 patients (26.71％)that underwent reoperation within 18 months from their initial operation.No recurrence was observed during the follow-up.Conclusion The recurrence of spontaneous pneumothorax was mostly caused by the formation of new bullae or blebs near the staple lines.Reoperation for recurrent pneumothorax was safe and advocated.VATS operation includes the dissection of pleural adhesions,wedge resection of neoformative bullae or blebs and elimination of the residual apical space.

Objective To determine the indications for primary spontaneous pneumothorax in young patients after closed drainage.Methods From Jaunary 2007 to December 2012,139 young patients,who had chest tube drainage in spontaneous pneumothorax and full information by telephone follow-up,patients were divided into recurrence and recurrence-free group.The possible influence factors related to recurrence were statistically analyzed.Results Single factor and multi-factor analysis indi cated that in the aspect of self-factors,the edge of the lung in chest X-ray were independent factors for recurrence prediction (P ＜ 0.05).Conclusion If the edge of lung is not smooth in X-ray,then VATS(video assisted thoracoscopic surgery) operation is needed.

Objective By long term follow-up study to investigate the curative effect and life quality of video-assisted thoracoscopic T2 sympathetic trunk blocking in the treatment of craniofacial hyperhidrosis. Methods From January 2002 to December 2007,the clinical data of 20 cases were followed up,follow-up with telephone inquiries proceeded every year,the last follow-up time was Junuary 2014,a minimum exceeded five years of follow-up. Results The mean operating time was( 37. 5 ± 7) min( range,30 to 45min). Symptoms of craniofacial hyperhidrosis disappeared in all patients. The rates of postoperative compensatory sweating on back and chest were 96. 7%,100%,the other parts of the body like belly and leg had different degrees of compensatory sweating. The rate of satisfaction about operation was 50 percent( 10 patients),the rate of general view was 35 percent( 7 patients),the rate of dissatisfaction was 15 percent( 3 patients). The postoperative quality of life gotobvious betterin 9 patients( 45 percent),betterin 8 patients( 40 percent),no betterin 3 patients( 15 percent). Conclusions Endoscopic thoracic of T2 sympathetic trunk blocking for craniofacial hyperhidrosis is effective. The operation improves patients' quality of life and gives satisfactory outcomes,But,all patients should be informed of compensatory hyperhidrosis before performing the operation.

Pulmonary glomus tumors are extremely rare, with only 19 cases having been reported worldwide. The glomus body is considered to be related to the regulation of body temperature, but the reported cases were not associated with hyperpyrexia. Here, we describe a 28-year-old man with hyperpyrexia and anemia complicated with a coin lesion of the right lung. After resection of the upper lobe of the right lung by video-assisted thoracoscopic surgery, all of the patient's symptoms disappeared. The pathologic analysis reported a rare pulmonary glomus tumor. The disease had not recurred by 1 year after operation. (Ann Thorac Surg 2013;95:e29-31) (c) 2013 by The Society of Thoracic Surgeons