Experience of a modified chest tube suture-fixation technique in uniportal thoracoscopic pulmonary resection.

OBJECTIVE: This study aimed to explore the feasibility and advantages of a modified chest tube suture-fixation technique in uniportal video-assisted thoracic surgery for pulmonary resection. METHODS: A retrospective analysis was conducted on 116 patients who underwent uniportal video-assisted thoracic surgery (U-VATS) for lung diseases in Zhengzhou People's Hospital between October 2019 and October 2021. Patients were stratified into two groups based on the applied suture-fixation methods, i.e., 72 patients in the active group and 44 patients in the control group. The two groups were subsequently compared in the terms of gender, age, operation method, indwelling time of chest tube, postoperative pain score, chest tube removal time, wound healing grade, length of hospital stay, incision healing grade, and patient satisfaction. RESULTS: There was no significant difference between the two groups in terms of gender, age, operation method, indwelling time of chest tube, postoperative pain score, and length of hospital stay (P = 0.167, 0.185, 0.085, 0.051, 0.927, and 0.362, respectively). However, the chest tube removal time, incision healing grade, and incision scar satisfaction in the active group were significantly better compared with those of the control group (P = < 0.001, 0.033, and < 0.001, respectively). CONCLUSION: In summary, the new suture-fixation approach can minimize the number of stitches, and time necessary for chest tube removal process, and avoid the pain experienced when removing the drainage tube. This method is more feasible, has better incision conditions, and provides a convenient tube removal, making it more suitable to patients.

Paraganglioma of the anterior superior mediastinum: Presentation of a case of mistaken diagnosis so long and review of the literature.

INTRODUCTION AND IMPORTANCE: Mediastinal paraganglioma is a rare tumor with neuroendocrine activity, highly susceptible to misdiagnosis. Herein, we present a case misdiagnosed as Castleman disease for nearly a decade, significantly enlarged, lost the opportunity of thoracoscopic surgery, and was removed by median thoracotomy. CASE PRESENTATION: A 59-year-old woman complained of having a mediastinal mass, was diagnosed with Castleman disease for nearly a decade and was admitted to the hospital due to neck tightness. The tumor size was significantly enlarged. We proceeded to interventional angiography with gelatin sponge angioembolization, and the tumor was resected through a median sternotomy on the second day. The operation was smooth, and the tumor was gray and slightly brittle. Postoperative pathology confirmed paraganglioma; lymph node metastasis was not detected (0/3). CLINICAL DISCUSSION: Mediastinal paraganglioma is a rare tumor and can be either functional or nonfunctional. It can be differentiated from many diseases. The SSTR-PET-CT labeled with 68Ga-somatostatin analog, plasma metanephrine, and normetanephrine are essential for the diagnosis. Surgical resection is the most effective form of treatment. Pre-operative embolization of the feeding artery is considered to have a low rate of intraoperative bleeding. We recommend making comprehensive preparations to ensure perioperative safety and long-term survival. CONCLUSION: When a vascularized mass is discovered in the mediastinum, surgeons should consider the possibility of a paraganglioma. Multidisciplinary consultation should be involved in the formulation of treatment plans. Lifelong surveillance for residual tumor growth and recurrence is required.

Application of bilateral simultaneous sequential single-incision video-assisted thoracic surgery in multiple nodules both lungs: a single-center experience of 10 cases.

OBJECTIVE: To discuss the application of bilateral simultaneous sequential single-incision video-assisted thoracic surgery in multiple nodules in both lungs. METHODS: A retrospective analysis of 10 patients in Zhengzhou People's Hospital who underwent single-incision thoracoscopic surgery to treat multiple nodules in both lungs at the same time from September 2019 to January 2021, and analyze the perioperative indicators (general condition, smoking history, family history, follow-up time of pulmonary nodules, size, location, height and weight, pulmonary function, intraoperative blood loss, operation time, color and volume of drainage fluid, catheterization time, perioperative complications, length of stay, pathology, patient satisfaction, etc.). RESULTS: All 10 patients used single-incision thoracoscopy to complete bilateral simultaneous sequential operations, aged 32 to 70 years, 8 female patients, 2 male patients, preoperative follow-up time ranging from 1 day to 2 years, a total of 23 lung nodules were removed except for the benign lesions in one nodule in the 2 patients, the other nodules were tumorous lesions (91.3%). The average total hospital stay was 10.5 days (8-14 days), and the average operation time was 194.5 min (145-292 min). The blood loss ranged from 10 to 280 ml, all patients had no serious complications during the perioperative period, and they recovered well and were discharged smoothly, and the satisfaction reached 100%. CONCLUSION: Single-incision bilateral simultaneous sequential thoracoscopy have certain advantages in the treatment of patients with multiple nodules in both lungs, conforms to the concept of rapid recovery, and is a feasible choice in the shared decision making of doctors and patients.

Peripheral blood oxidative stress markers for obstructive sleep apnea-a meta-analysis.

OBJECTIVES: The purpose of this study was to clarify the relationship between obstructive sleep apnea (OSA) and oxidative stress markers in blood. METHODS: We conducted a systematic literature search on databases including Pubmed and Embase for studies reporting circulating oxidative stress markers in patients with OSA and controls that were published between 1988 and June 2019. Standardized mean differences (SMDs) and 95% confidence intervals (95%CI) were calculated. RESULTS: Of the 2226 articles initially retrieved, 52 were included in our meta-analysis, covering a total of 12 oxidative stress markers. The concentrations of malondialdehyde (SMD = 1.18; 95%CI: 0.87, 1.49; p < 0.001), thiobarbituric acid reactive substances (SMD = 1.82; 95%CI: 0.79, 2.86; p = 0.001), advance oxidative protein products (SMD = 0.68; 95%CI: 0.14, 1.23; p = 0.014), total oxidant capacity (SMD = 1.32; 95%CI: 0.33, 2.31; p = 0.009), and asymmetric dimethylarginine (SMD = 0.32; 95%CI: 0.16, 0.47; p < 0.001) in the blood of patients with OSA were higher than those of the control group, whereas the concentrations of thiols (SMD = - 0.37; 95%CI: - 0.60, - 0.15; p = 0.001) and nitric oxide (SMD = - 2.61; 95%CI: - 4.02, - 1.21; p < 0.001) were lower than those of the control group. CONCLUSIONS: The oxidative stress markers in the blood of patients with OSA were aberrant, indicating an imbalanced state of oxidation and antioxidation in OSA.

The Preparation and Properties of Multilayer Cu-MTa2O5 Composite Coatings on Ti6Al4V for Biomedical Applications.

For the enhancement of the anticorrosion and antibacterial performance of the biomedical alloy Ti6Al4V, a novel Cu incorporated multilayer Ta2O5ceramic composite coating Cu-Ta2O5/Ta2O5/Ta2O5-TiO2/TiO2/Ti (coating codeCu-MTa2O5) was developed by radio frequency (RF) and direct current (DC) reactive magnetron sputtering. Meanwhile, to better display the multilayer Ta2O5 coating mentioned above, a monolayer Ta2O5 ceramic coating was deposited onto the surface of Ti6Al4V alloy as a reference. The surface morphology, microstructure, phase constituents, and elemental states of the coating were evaluated by atomic force microscopy, scanning electron microscopy, X-ray diffraction, and X-ray photoelectron spectroscopy, respectively. The adhesion strength, wettability, anticorrosion and antibacterial properties of the coating were examined by a scratch tester, contact angle measurement, electrochemical workstations, and plate counting method, respectively. The results showed that the deposited coatings were amorphous and hydrophobic. Cu doped into the Ta2O5 coating existed as CuO and Cu2O. A Ta2O5-TiO2/TiO2/Ti multi-interlayer massively enhanced the adhesion strength of the coating, which was 2.9 times stronger than that of the monolayer Ta2O5coating. The multilayer Cu-MTa2O5 coating revealed a higher corrosion potential and smaller corrosion current density as compared to the uncoated Ti6Al4V, indicating the better anticorrosion performance of Ti6Al4V. Moreover, a 99.8% antibacterial effect of Cu-MTa2O5 coated against Staphylococcus aureuswas obtained.

A meta-analysis of the association between BRAF mutation and nonsmall cell lung cancer.

BACKGROUND: Previous studies investigating the association between BRAF mutations and nonsmall cell lung cancer (NSCLC) remain controversial. To address the issue, we performed an updated meta-analysis of related articles. METHODS: We conducted a comprehensive literature search in the electronic databases including ISI Science Citation Index, EMBASE, PubMed, and CNKI (up to January 2016). The odds ratios (ORs) and 95% confidence interval (CI) were assessed based on random-effects or fixed-effects models according to the heterogeneity of eligible studies. RESULTS: A total of 16 studies enrolled 11,711 patients with NSCLC were involved in the meta-analysis. The overall BRAF mutation rate was 2.6% (303/11,711). There was a significant association between BRAF mutations and adenocarcinomas (ADCs) in NSCLC compared with non-ADCs (OR = 3.96, 95% CI = 2.13-7.34, P < 0.0001). No significant difference was observed in smoking and stage in patients with BRAF mutations. However, a significant difference of BRAF mutation rate was observed between women and men (OR = 0.72, 95% CI = 0.55-0.95, P = 0.02). In addition, the BRAF mutations were more frequent in women (OR = 0.45, 95% CI = 0.26-0.77, P = 0.004) and never smokers (OR = 0.12, 95% CI = 0.05-0.29, P < 0.00001). CONCLUSIONS: BRAF mutations in ADCS and female significantly increased the risk of NSCLC compared to non-ADCS and male, respectively. BRAFV mutation in NSCLC patients was significantly associated with female and nonsmokers.

Original Research: miR-194 inhibits proliferation and invasion and promotes apoptosis by targeting KDM5B in esophageal squamous cell carcinoma cells.

Increasing evidence suggests that miR-194 is down-regulated in esophageal squamous cell carcinoma tumor tissue. However, the role and underlying mechanism of miR-194 in esophageal squamous cell carcinoma have not been well defined. We used DIANA, TargetScan and miRanda to perform target prediction analysis and found KDM5B is a potential target of miR-194. Based on these findings, we speculated that miR-194 might play a role in esophageal squamous cell carcinoma development and progression by regulation the expression of KDM5B. We detected the expression of miR-194 and KDM5B by quantitative real-time reverse transcription PCR (qRT-PCR) and Western blot assays, respectively, and found down-regulation of miR-194 and up-regulation of KDM5B existed in esophageal squamous cell carcinoma cell lines. By detecting proliferation, invasion and apoptosis of TE6 and TE14 cells transfected with miR-194 mimics or mimic control, miR-194 was found to inhibit proliferation and invasion and promote apoptosis of esophageal squamous cell carcinoma cells. miR-194 was further verified to regulate proliferation, apoptosis and invasion of esophageal squamous cell carcinoma cells by directly targeting KDM5B. Furthermore, animal studies were performed and showed that overexpression of miR-194 inhibited the growth of esophageal squamous cell carcinoma tumors in vivo. These results confirmed our speculation that miR-194 targets KDM5B to inhibit esophageal squamous cell carcinoma development and progression. These findings offer new clues for esophageal squamous cell carcinoma development and progression and novel potential therapeutic targets for esophageal squamous cell carcinoma.