Objective To compare the postoperative enhanced recovery outcomes of lobectomy performed under non-intubated video-assisted thoracic surgery (NIVATS) versus intubated video-assisted thoracic surgery (IVATS). Methods Computerized searches were performed in the following databases: China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Information, China Biomedical Literature Database (CBMdisc), Web of Science, Clinicaltrials.gov, The Cochrane Library, EMbase, and PubMed. We collected randomized controlled trials (RCTs) and observational studies comparing NIVATS and IVATS. The search period extended from the inception of each database to April 1, 2023. Two independent researchers screened the literature and assessed study quality. Results A total of 14 studies were included, comprising 4 RCTs, 7 retrospective cohort studies, and 3 propensity score matching studies, involving 1 840 patients. Meta-analysis results indicated that, compared to IVATS, NIVATS was associated with significantly shorter operative time [MD=–13.39, 95%CI (–20.16, –6.62), P<0.001], shorter length of hospital stay [MD=–0.81, 95%CI (–1.39, –0.22), P=0.005], shorter chest tube duration [MD=–0.73, 95%CI (–1.36, –0.10), P=0.02], shorter postoperative anesthesia recovery time [MD=–20.34, 95%CI (–26.83, –13.84), P<0.001], and shorter time to oral intake after surgery [MD=–5.68, 95%CI (–7.63, –3.73), P<0.001]. Furthermore, NIVATS showed a lower incidence of postoperative airway complications [OR=0.49, 95%CI (0.34, 0.71), P<0.001] and less total chest tube drainage volume [MD=–251.11, 95%CI (–398.25, –103.98), P<0.001], all contributing to significantly accelerated postoperative enhanced recovery for patients. Conclusion NIVATS is a safe and technically feasible anesthesia method in thoracoscopic lobectomy, which can to some extent replace IVATS.

Objective:To explore the impact of coronary CT angiography (CCTA) image quality and related factors on the diagnostic performance of CT-derived fractional flow reserve (CT-FFR).Methods:Based on the CT-FFR CHINA trial, the prospective multicenter trial enrolled patients with suspected coronary artery disease who underwent CCTA, CT-FFR and FFR measurement. The subjective and objective assessments of CCTA image were performed on a per-vessel level. The objective assessments included the enhancement degree of coronary artery, the signal-to-noise ratio (SNR) of the aortic root. We used χ 2 test and DeLong test to compare the diagnostic performance of CT-FFR with FFR as the reference standard in different subjective groups (non-artifact vs. artifact), enhancement degree of coronary artery groups (≤400 vs. 401-500 vs.>500 HU), SNR of the aortic root groups (≤16.9 vs.>16.9), body mass index (BMI) groups (<25 kg/m 2 vs.≥25 kg/m 2) and heart rate groups (<75 bpm vs.≥75 bpm). FFR and CT-FFR values≤0.80 was identified as myocardial ischemia. Results:The study enrolled 317 patients with 366 vessels. All target vessels in CCTA images were successfully analyzed by CT-FFR. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of the non-artifact group were 90.45%, 86.75%, 93.10%, 90.00%, 90.76% and 0.928, respectively, and those of the artifact group were 83.23%, 87.21%, 79.01%, 81.52%, 85.33% and 0.869, respectively. The differences in accuracy and specificity were statistically significant (χ 2=4.23, P=0.040; χ 2=8.55, P=0.003). The diagnostic efficacy of CT-FFR had no statistically significant differences among different objective groups (all P>0.05). Conclusions:The artifact of CCTA image has an effect on CT-FFR in the diagnosis of myocardial ischemia. The degree of vascular enhancement, SNR, BMI, and heart rate have no significant effect on the diagnostic performance of CT-FFR.

Objective To detect the serum levels of angiopoietin-like protein 2 (ANGPTL 2) and vascular endothelial growth factor (VEGF) in patients with rheumatoid arthritis (RA),and to analyze their value in the differential diagnosis of RA in order to clarify whether they are synergetic in the pathogenesis of RA.Methods Seventy-seven patients with RA and 25 subjects for heath check-up in the same period were selected.According to the relevant clinical information,the RA patients were divided into three subgroups:high disease activity group [(DAS28)＞5.1],moderate disease activity group (3.2＜DAS28 ≤5.1),low disease activity group (DAS28 ≤3.2).Enzyme-linked immunosorbent assay (ELISA) was used to masure the levls of ANGPTL2 and VEGF of those groups.The data were analyzed by t test,Mann-Whitney U test,Kruskal-Wallis H test and Speraman correlation analysis.Results ① The serum levels of ANGPTL2 and VEGF in RA patients were significantly higher than those in control group [(5.3±1.1) ng/ml vs (3.3±0.9) ng/ml,Z=-6.644;(106±30) pg/ml vs (93±12) pg/ml,Z=-4.4115,P＜0.05].② Serum level of ANGPTL2 in RA patients with high disease activity was higher than low disease group and healthy control group {[5.7(1.3)] ng/ml vs [4.5(0.3)]ng/ml,H=4.257,P＜0.05;[5.7 (1.3)] ng/ml vs [3.3 (0.9)] ng/ml,H=7.639,P＜0.05}.Serum level of VEGF in RA patients with high disease activity was higher than low disease group and healthy control group {[116(37)]pg/ml vs [96(8)] pg/ml,H=3.579,P＜0.05;[116(37)] pg/ml vs [92.90(12.24)] pg/ml,H=5.698,P＜0.05].③ There was a positive correlation between the serum level of ANGPTL2 and DAS28 score,erythrocyte sedimentation rate,swollen joint count and tender joint count (rDAS28=0.703,rESR=0.311,rSJC=0.503,rTJC=0.670,P＜0.05),so was VEGF (rDAS28=0.553,rESR=0.260,rSJC=0.399,rTJC=0.538,P＜0.05).④ In RA patients,there was a positive correlation between ANGPTL2 and VEGF (r=0.853,P＜0.05).Conclusion ANGPTL2 might coordinate with VEGF and be involved in the immune process of RA,and it might be regarded as one of the reference indexes of RA activity,so that it may contribute to access and monitor the condition of RA.

Objective To investigate the effects of high-fat diet on the formation of colorectal adenomas in rats.Methods Twenty Wistar rats were evenly divided into two groups,one group were fed with common food and the other group were fed with high fat-diet.The rats of two groups were intraperitoneally injected with 1,2-dimethyl-hydrazine (DMH) (40 mg/kg) once a week for 10 consecutive weeks.Rats with common diet and DMH were assigned to SDT group,and those with high-fat diet and DMH were assigned to HFDT group.The expression of Ki-67 was detected by immunohistochemistry and the expression of proliferating cell nuclear antigen (PCNA) and cyclooxy-genase 2 (COX2) was detected by immunofluorescence.The levels of serum triglyceride,cholesterol,insulin like growth factor-1 (IGF-1),insulin,leptin and tumor necrosis factor-α were determined by enzyme linked immunosorbent assay.Student's t test and Mann-Whitney test were performed for statistical analysis.Results At the 18th week,the numbers of Ki-67 positive cells of SDT group and HFDT group were 24.00± 1.84 and 75.17 ± 3.17,respectively,and the difference was statistically significant (t=13.960,P＜0.01).The fluorescence intensity of PCNA of SDT group and HFDT group was 213.70±21.61 and 333.30±30.44,respectively,and the difference was statistically significant (t =4.987,P＜0.01).The levels of serum triglyceride of SDT group and HFDT group were (0.43 ± 0.05) mmol/L and (1.14±0.07) mmol/L,respectively,and the difference was statistically significant (t=8.366,P＜0.01).The levels of cholesterol were (3.75±0.'26) pmol/L and (7.77±0.79) pmol/L,respectively,and the difference was statistically significant (t=4.851,P＜0.01).Conclusion High-fat diet can promote the genesis and development of adnomas through influencing the body's endocrine metabolism,increasing cell proliferation cycle and regulating inflammatory reaction.

Objective To explore the effect of fat on 1,2-dimethylhydrazine (DMH)-induced colon tumors.Methods A total of 50 7-week-old male Wistar rats were further divided into four groups:standard diet feed control group (n =10),standard diet feed plus DMH-induced tumor group (SDT,n =15),high-fat diet feed control group (n =10) and high-fat diet feed plus DMH-induced tumor group (HFDT,n =15).Rats were killed 18 weeks later,and enzyme-linked immunosorbent assay was used to detect serum triglyeeride,tumor necrosis factor (TNF-α),and colonic TNF-α,interleukin-6.After the intestinal tracts were removed,the location,amount,and size of the tumors were observed.The pathological changes of the tissue sections were observed,and the distributions of TNF-α and Ki-67 in the normal tissues and tumors were detected by immunohistochemistry.Results Upon the completion of the study,the mortality rate of rats was 20.00％ in the SDT group and 26.67％ in the HFDT group,the tumor formation rate was 75.00％ in the SDT group and 81.82％ in the HFDT group,and the tumor-bearing rate was 117％ in the SDT group and 191％ in the HFDT group.No statistical significance difference between the two groups in mortality rate,tumor formation rate (P =0.545) and tumor bearing rate (x2 =1.343,P =0.247).The average tumor volume was significantly different between the standard diet feed control group and high-fat diet feed control group (28.57％ vs 66.67％,P =0.030).Also,the serum triglyceride and TNF-α levels significantly differed between the SDT group and HFDT group [TG (1.39 ± 0.31) mmol/L and TNF-α (124.80 ± 21.69) ng/L in the HFDT group and TG (0.46 ±0.20) mmol/L and TNF-α (85.83 ± 17.45) ng/L in the SDT group] (P =0.000).The expressions of TNF-α,IL-6,and Ki-67 in colonic mucosa were significantly higher in the high-fat diet feed control group than in the standard diet feed control group [TNF-α:(6.22 ± 0.63) ng/g vs (2.33 ± 0.44) ng/g,P=0.020; IL-6:(13.50±0.67) ng/gvs (7.31 ±0.41) ng/g,P=0.000; and Ki-67:40％ vs 10％,P =0.028].The Ki-67 expression rate was 90.48％ in the HFDT group,compared to 50％ in the SDT group (P =0.015).Conclusions High-fat diet can increase the serum triglyceride and TNF-α levels in rats,upregulate the expressions of TNF-α,IL-6 and Ki-67,and thus promote inflammation and cell proliferation,and ultimately affect the tumor formation and development.However,the effect of fat on DMH-induced colon tumors warrants further studies.

Objective To analyze and solve problems in spreading out the power supply system in mobile field hospital during the earthquake relief.Methods According to the layout of the mobile field hospital and the need of electrical power,the sketch map of electric circuit was drawn out and spread with load as less as possible.Results Current supply and its safety in mobile field hospital are guaranteed.Conclusion This kind of power supply system meets the requirement of the mobile field hospital in emergent rescue tasks.