Comparing the Efficacy of Video-Assisted Thoracoscopic Surgery and Open Thoracotomy in Sleeve Lobectomy for the Treatment of Central-Type Non-small Cell Lung Cancer: A Systematic Review and Meta-Analysis.

Objective: Central-type Non-small Cell Lung Cancer (NSCLC) treatment involves different surgical techniques, including Video-Assisted Thoracoscopic Surgery (VATS) and Open Thoracotomy Sleeve Lobectomy. However, there remains a lack of consensus on the most effective treatment modality. Methods: This study strictly adhered to PRISMA guidelines. Four electronic databases were searched without time or language limitation, and studies comparing VATS and Open Thoracotomy in patients with central-type NSCLC undergoing sleeve lobectomy were included. Primary outcomes were perioperative outcomes (blood loss, operation time, intraoperative lymph node dissection count, postoperative hospital stay, and complication rates), 3-year Progression-Free Survival (PFS) rate, and Overall Survival (OS) rate. Results: The meta-analysis included six studies with 569 patients. VATS was associated with longer operation time [SMD = 0.75, 95% CI (0.29, 1.21)], less intraoperative blood loss [SMD = -0.23; 95% CI (-0.44, -0.01)], and shorter hospital stay [SMD = -0.53; 95% CI (-0.73, -0.34)]. There were no significant differences in the number of lymph nodes dissected, postoperative complications, and 3-year PFS and OS rates between the two groups. Conclusions: VATS sleeve lobectomy for central-type NSCLC results in less surgical trauma and quicker postoperative recovery without adversely impacting tumor prognosis compared to open thoracotomy sleeve lobectomy. Despite a longer operation time, VATS could be considered an alternative to open thoracotomy sleeve lobectomy. VATS sleeve lobectomy is a safe and effective alternative to open thoracotomy in treating central-type NSCLC, as it results in less surgical trauma and quicker postoperative recovery without impacting tumor prognosis negatively. More well-designed randomized controlled trials are required to verify these findings.

DNA Damage Checkpoints Govern Global Gene Transcription and Exhibit Species-Specific Regulation on HOF1 in Candida albicans.

DNA damage checkpoints are essential for coordinating cell cycle arrest and gene transcription during DNA damage response. Exploring the targets of checkpoint kinases in Saccharomyces cerevisiae and other fungi has expanded our comprehension of the downstream pathways involved in DNA damage response. While the function of checkpoint kinases, specifically Rad53, is well documented in the fungal pathogen Candida albicans, their targets remain poorly understood. In this study, we explored the impact of deleting RAD53 on the global transcription profiles and observed alterations in genes associated with ribosome biogenesis, DNA replication, and cell cycle. However, the deletion of RAD53 only affected a limited number of known DNA damage-responsive genes, including MRV6 and HMX1. Unlike S. cerevisiae, the downregulation of HOF1 transcription in C. albicans under the influence of Methyl Methanesulfonate (MMS) did not depend on Dun1 but still relied on Rad53 and Rad9. In addition, the transcription factor Mcm1 was identified as a regulator of HOF1 transcription, with evidence of dynamic binding to its promoter region; however, this dynamic binding was interrupted following the deletion of RAD53. Furthermore, Rad53 was observed to directly interact with the promoter region of HOF1, thus suggesting a potential role in governing its transcription. Overall, checkpoints regulate global gene transcription in C. albicans and show species-specific regulation on HOF1; these discoveries improve our understanding of the signaling pathway related to checkpoints in this pathogen.