Purpose: To retrospectively analyze the incidence and predictors of complications related to hookwire localization in patients with single and multiple nodules, and to evaluate the usefulness of a single-stage surgical method of single hookwire localization combined with video-assisted thoracoscopic surgery (VATS) in synchronous multiple pulmonary nodules (SMPNs). Methods: A total of 200 patients who underwent computed tomography (CT)-guided hookwire localization and subsequent VATS resection were enrolled in this study. For each patient, only 1 indeterminate nodule was implanted with a hookwire. There were 145 patients in the single-nodule group (Group S) and 55 in the multiple-nodule group (Group M). Univariate and binary logistic regression analyses were used to assess incidence and predictors of complications associated with hookwire localization. Results: The technical success rate of hookwire implantation was 97.5%. The incidence of pneumothorax and hookwire dislodgement was 17.0% and 2.5%, respectively. Binary logistic regression analysis showed that 1 transpleural puncture through the pleura (odds ratio [OR] = 0.433, P = .033) was the only independent protective factor for pneumothorax, and pneumothorax (OR = 26.114, P < .01) was the only independent risk factor for dislodgement. The volume of blood loss during VATS was significantly higher in group M than in group S, and the time of postoperative hospitalization was significantly longer in group M than in group S. About 44 patients in group M with additional 58 nodules without localization had undergone direct surgical resection simultaneously, and bilateral surgery was performed in 13 patients (29.5%). The intrathoracic recurrence rate was 4.8% during follow-up CT. Conclusion: Single-stage surgery via an approach of single hookwire localization combined with VATS is feasible and safe for SMPNs.

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ObjectiveAcute coronary syndrome (ACS) is associated with several clinical syndromes, one of which is acute non-ST-segment ACS (NSTE-ACS). S100A1 is a calcium-dependent regulator of heart contraction and relaxation. We investigated the association between the serum S100A1 level and the Global Registry of Acute Coronary Events (GRACE) risk score in patients with NSTE-ACS and the potential of using the serum S100A1 level to predict the 30-day prognosis of NSTE-ACS.MethodsThe clinical characteristics of 162 patients with NSTE-ACS were analyzed to determine the GRACE score. The serum S100A1 concentration was determined using fasting antecubital venous blood. The patients were divided into different groups according to the serum S100A1 level, and the 30-day NSTE-ACS prognosis was evaluated using Kaplan–Meier analysis.ResultsThe serum S100A1 levels differed significantly among the groups. Correlation analysis showed that the serum S100A1 level was positively correlated with the GRACE score. Kaplan–Meier analysis revealed that the number of 30-day cardiac events was significantly higher in patients with an S100A1 level of >3.41 ng/mL.ConclusionsS100A1 is a potential biomarker that can predict the progression of NSTE-ACS and aid in its early risk stratification and prognosis.