[Safety and feasibility of robotic-assisted thoracoscopic day surgery for pulmonary nodules: a retrospective analysis based on propensity score matching].

Objective: To evaluate the safety and feasibility of robotic-assisted thoracoscopic day surgery for pulmonary nodules. Methods: Clinical data of 523 patients with pulmonary nodule underwent robotic-assisted thoracoscopic surgery in the Department of Thoracic Surgery, Xiangya Hospital, Central South University from January 2021 to June 2022 were retrospectively analyzed, which including 223 males and 300 females, aged from 19 to 72 (54.0±11.7) years. Those patients were divided into the day surgery group (DSG) and inpatient surgery group (ISG) according to perioperative management methods. Propensity score matching (PSM) (1∶2) was performed according to the general baseline information, T stage of the tumor, surgery approach, and tumor position, and a total of 178 patients were finally included. Clinical outcomes of DSG were observed. The differences in incidence of postoperative complications, treatment-related costs and resource consumption between DSG and ISG were compared. Subgroup analysis was performed according to surgery method to evaluate the difference between DSG and ISG in lobectomy and sublobectomy. Results: In 81 cases DSG, eight patients were transferred to thoracic surgery ward, and the day surgery discharge rate was 90% (73/81). There was no statistically significant difference in incidence of postoperative complications between DSG and ISG (P=0.612). The length of stay after surgery, period of chest draining, average hospital cost, and drug cost of DSG were statistically significant lower than ISG, ((2.19±0.84) vs (4.74±1.81) days, (1.70±0.65) vs (3.45±1.85) days, (6.64±0.74) vs (8.29±0.97)×104 CNY, (0.35±0.07) vs (0.69±0.18)×104 CNY), respectively(all P<0.05). The drainage volume and VAS score at discharge in DSG and ISG group were(220.47±120.02) ml and(242.21±129.96) ml, 1.68±0.79 and 1.64±0.91, respectively, with no statistically significant difference (P>0.05). In subgroup analysis, there was no statistically significant difference in incidence of postoperative complications, drainage volume after surgery and VAS score at discharge between DSG and ISG both for lobectomy and sublobectomy patients. And the results of the length of stay after surgery, period of chest draining, and drug cost in DSG were also significantly lower than ISG (P<0.05). Conclusions: Robotic-assisted thoracoscopic day surgery for pulmonary nodule is safe and feasible, with the advantage of short length of stay after surgery, short period of chest draining, less average hospital cost and drug cost. There is no difference in incidence of postoperative complications between DSG and ISG.

Genetic research and the vulnerability of Native Hawaiians.

Traditional research ethics are unable to provide adequate protections for human subjects involved in research--much less genetic research. New principles need to be developed to change the paradigm and put human research subjects in a more equitable relationship with their researchers. In addition, new laws should be crafted to level the playing field for human research participants. Humans can no longer look at themselves as hereditary beings, but as stewards of intra- and inter-generational genetic material in need of protection. Recommendations are provided.

Plasminogen activation activity of urokinase determined via a cascade enzymatic reaction system.

A method for determining the plasminogen activation rate by urokinase via a cascade enzymatic reaction system is presented. A procedure of parameter estimation has been proposed for the determination of the activity of urokinase and the kinetic constants. Urokinase from urine has been successfully assayed through use of a plasminogen concentration lower than its saturating level. The methodology presented in this work may be adopted for the analysis of other cascade enzymatic reaction systems.

Estimation of potential lifetime cancer risks for trihalomethanes from consuming chlorinated drinking water in Taiwan.

Data on concentrations of trihalomethanes (THMs) in raw and chlorinated water collected from three water treatment plants in Taiwan and estimates of the lifetime cancer risk for THMs from drinking water, using age-adjusted factors and volatilization terms, are presented. Data on THM levels in drinking water were obtained from the annual reports of the Environmental Protection Administration (EPA) of Taiwan. The methodology for estimation of lifetime cancer risks was taken from the USEPA. Chloroform was the major species of THMs, especially in the water plant of south Taiwan. Chloroform contributed the majority of the lifetime cancer risks (range: 87.5-92.5%) of total risks from the three water supply areas. All lifetime cancer risks for CHCl(3), CHBrCl(2), CHBr2Cl, and CHBr3 from consuming tap water in the three water supply areas were higher than 10(-6). The sum of lifetime cancer risks for CHCl(3), CHBrCl(3), CHBr2Cl, and CHBr3 was highest (total risk for total THMs<1.94x10(-4)) for tap water from south Taiwan.