Objective To investigate the early clinical efficacy of minimally invasive cardiac surgery coronary artery bypass grafting (MICS CABG) via left intercostal small incision for multivessel coronary artery disease. Methods The patients who received off-pump CABG in the Central China Fuwai Hospital of Zhengzhou University from June 2021 to June 2023 were enrolled. Patients were divided into two groups according to the operative technique used, including a traditional midline sternotomy group and a left intercostal small incision group. The clinical data of the two groups were compared. Results A total of 143 patients were enrolled, including 70 patients in the traditional midline sternotomy group and 73 patients in the left intercostal small incision group. The age of the patients in the left intercostal small incision group and the traditional midline sternotomy group was (63.8±8.0) years and (63.0±7.8) years, respectively; the proportions of males were 69.9% and 74.3%, respectively. The differences were not statistically significant (all P>0.05). All patients in the two groups successfully completed the operation, and no patients in the left intercostal small incision group were converted to thoracotomy. The patients in the left intercostal small incision group showed less postoperative drainage within postoperative 24 hours [(239.4±177.7) mL vs. (338.0±151.9) mL, P<0.001], lower perioperative blood transfusion rate [32.9% (24/73) vs. 51.4% (36/70), P=0.028], higher postoperative myoglobin level within postoperative 24 hours [366.1 (247.9, 513.0) ng/mL vs. 220.8 (147.2, 314.9) ng/mL, P<0.001], shorter intensive care unit stay [45.5 (31.5, 67.5) h vs. 68.0 (46.0, 78.5) h, P=0.001] and postoperative hospital stay [(10.8±4.0) d vs. (13.1±5.3) d, P=0.028] compared to the traditional midline sternotomy group. There was no significant difference in the incidence of major adverse cardiac and cerebrovascular event between the two groups [2.7% (2/73) vs. 2.9% (2/70), P=1.000]. Conclusion Compared to the full median sternotomy, MICS CABG leads to a good clinical result with smaller trauma, faster overall recovery, and less perioperative blood transfusion.

Objective To compare perioperative outcomes of minimally invasive aortic valve surgery by a right anterior minithoracotomy (RAMT) and conventional sternotomy. Methods A retrospective analysis of patients who underwent isolated aortic valve surgeries in Central China Fuwai Hospital of Zhengzhou University between May 2021 and August 2023 with a minimal incision via the RAMT approach (a RAMT group) or conventional incision via the full sternotomy approach (a conventional group). A propensity score matching analysis was performed to balance preoperative data and compare perioperative data of the two groups. Results There were 58 patients in the RAMT group, including 46 males and 12 females with an average age of (52.0±14.1) years; 128 patients were enrolled in the conventional group, including 87 males and 41 females with an average age of (60.0±12.4) years. After propensity-score matching, there were 51 patients in each group. The RAMT group had a longer average operation time, cross-clamping time and cardiopulmonary bypass time compared to the conventional group (all P<0.05). However, ICU length of stay, ventilator-assisted time and postoperative hospital stay were significantly shorter in the RAMT group (all P<0.05). Patients in the RAMT group had lower 24 hour chest drain output (P<0.05). RAMT was associated with a trend towards a lower blood transfusion rate in comparison to the sternotomy group, although this was not statistically significant (P>0.05). The occurrence of all-cause death, and perioperative complications was also similar in both groups (P>0.05). Conclusion RAMT has less trauma, faster recovery, less postoperative drainage, and shorter hospital stay than conventional approach. RAMT in patients undergoing isolated aortic valve surgery is a safe approach.

Objective:To evaluate the scientificity, transparency and applicability of the Chinese guidelines and consensuses in medical imaging published in 2022 by the STAR scale.Methods:Medical imaging guidelines and consensuses were searched in CNKI, Wanfang data, CMB, Chinese Medical Journal Network, and Medline (PubMed). The publication date was selected from January 1 to December 31, 2022. Each guideline or consensus was independently evaluated and cross-checked by two evaluators using STAR scale.Results:A total of 65 guidelines and consensus that were published as Chinese or English were included, including 15 guidelines and 50 consensuses. Some guidelines and consensus have distinct disciplinary characteristics with topics such as artificial intelligence (4 articles) and Evidence-Based Medical Imaging-Medical Imaging Clinical Appropriateness (EB-MICA, 4 articles). In all guidelines and consensuses, the highest score was 89.9, the lowest was 3.6, and the M( Q1, Q3) was 25.0 (20.8, 35.4). There was no statistical difference in the scores of guidelines and consensuses ( P=0.383). The highest scoring areas were recommendation opinions (reporting rate of 56.0%), working groups (reporting rate of 38.2%), and clinical issues (reporting rate of 36.7%), while the lowest scoring areas were proposal (reporting rate of 9.6%), registration (reporting rate of 10.8%), and consensus methods (reporting rate of 21.8%). Conclusion:It is recommended that guidelines and consensuses initiators of medical imaging strengthen the learning of evidence-based medicine methods, such as STAR tools, in order to further improve the quality of guidelines and consensuses of medical imaging.

Objective:To evaluate the reporting quality of clinical practice guidelines in medical imaging.Methods:Medical imaging guidelines were searched in CNKI, Wanfang data, CBM, Web of Science, PubMed, and other guideline-related websites. The search period is from January 1, 2017 to February 26, 2022. According to the reporting items for practice guidelines in healthcare (RIGHT) checklist, two researchers separately extracted information from the included guidelines and evaluated the reporting quality, and cross-checked them.Results:Eighteen guidelines in Chinese were included. The average reporting rate was (56.2±14.3) %. The reporting rate of basic information in Domain 1 (75.9%, 82/108) and other information in Domain 7 (68.5%, 37/54) were the highest, while funding and declaration and management of interests in Domain 6 (25.0%, 18/72) had the lowest reporting rate. The included guidelines had a lower reporting rate in item 2 (executive summary of recommendations, 27.8%, 5/18), item 11a (type of systematic review on which the guideline is based, 5.6%, 1/18), item 14a (patient preferences and values, 22.2%, 4/18), item 15 (evidence to decision processes recommendations, 22.2%, 4/18), and item 16 (external review, 16.7%, 3/18).Conclusions:The overall reporting quality of medical imaging guidelines needs to be improved. It is recommended that future guideline developers master the guideline research and evaluation tools, such as the RIGHT statement, and fully report the details and key information to improve the transparency and comprehensiveness of the guidelines.