Objective To compare the clinical outcomes of subxiphoid robot-assisted thoracoscopic surgery (SRATS) and intercostal robot-assisted thoracoscopic surgery (IRATS) in the treatment of anterior mediastinal tumors. Methods A retrospective analysis was conducted on patients with anterior mediastinal tumors who underwent robot-assisted surgery in the Department of Thoracic Surgery, Gansu Provincial Hospital, from May 2020 to July 2022. According to the surgical approach, patients were divided into an SRATS group and an IRATS group. Perioperative data were compared between the two groups. Results A total of 87 patients were included. There were 41 patients in the SRATS group [23 males, 18 females; mean age, (44.51±11.28) years] and 46 patients in the IRATS group [21 males, 25 females; mean age, (46.67±8.76) years]. Compared with the IRATS group, the SRATS group had significantly less intraoperative blood loss [(24.41±6.67) mL vs. (37.93±9.23) mL, P<0.001], shorter postoperative drainage duration [(1.73±0.59) days vs. (2.54±0.50) days, P<0.001], lower postoperative drainage volume [(94.46±34.08) mLvs. (116.72±24.90) mL, P=0.001], lower visual analogue scale (VAS) pain scores on postoperative day 1 [(3.66±0.76) points vs. (4.15±0.84) points, P=0.005] and day 3 [(2.41±0.59) points vs. (2.89±0.82) points, P=0.003], shorter postoperative hospital stay [(4.12±0.81) days vs. (4.98±1.02) days, P<0.001], and lower hospitalization costs [(4.51±0.65) ten thousand yuan vs. (4.86±0.68) ten thousand yuan, P=0.020]. There were no statistical differences between the two groups in operative time or incidence of postoperative complications (P>0.05). Conclusion Both SRATS and IRATS are safe and effective for the treatment of anterior mediastinal tumors. However, SRATS is less invasive and more conducive to enhanced postoperative recovery.

Ischemic stroke is a disease resulting from the cerebral ischemia and hypoxia caused by the blockage of brain vessels in the brain,and is characterized by the focal neurological signs.Pathologically,neuronal necrosis in the infarcted area and the neuronal degeneration or delayed death of neurons in the ischemic penumbra,contribute to the morphological basis of the disease.Ischemic stroke is regulated by multiple processes,including ferroptosis,apoptosis,and autophagy.Ferroptosis,a type of iron-dependent cell death,is closely associated with ischemic stroke.Nuclear factor erythroid 2-related factor 2(Nrf2),a key transcription factor,plays a critical role in maintaining cellular redox balance and regulating inflammatory responses.Nrf2 promotes the expression of solute carrier family 7 member 11(SLC7A11)and glutathione peroxidase 4(GPX4),thereby activating the Nrf2 signaling pathway to counteract ferroptosis and protect cells from damage.This article reviews and analyzes recent experimental studies on traditional Chinese medicine(TCM)therapy targeting the Nrf2/SLC7A11/GPX4 pathway to suppress ferroptosis.The studies have found that TCM therapy with herbal compounds,Chinese patent medicines,single herbal components and their active ingredients,and acupuncture and moxibustion can inhibit ferroptosis by activating the Nrf2/SLC7A11/GPX4 signaling pathway,which will provide novel strategies for the TCM intervention of ischemic stroke.

Objective To evaluate the efficacy and safety of concurrent chemoradiotherapy versus sequential chemoradiotherapy in the treatment of locally advanced non-small cell lung cancer. Methods The relevant literature was searched in PubMed, Web of Science, CNKI and Wanfang databases from the inception to October 15, 2023, and the literature was screened according to the inclusion and exclusion criteria. Review Manager 5.3 software was used for meta-analysis of the literature, and the Cochrane bias risk assessment tool was used to evaluate the quality of the literature. Results Finally, 14 randomized controlled studies were included covering a total of 1048 patients. The results of meta-analysis showed that the overall response rate [OR=2.39, 95%CI (1.83, 3.11)], 1-year survival rate [OR=1.81, 95%CI (1.39, 2.35)], 2-year survival rate [OR=1.75, 95%CI (1.27, 2.42)] and 3-year survival rate [OR=2.33, 95%CI (1.49, 3.66)] were superior to sequential chemoradiotherapy (P<0.001). In terms of safety, concurrent chemoradiotherapy increased the incidence of radiation esophagitis (P<0.05), but there was no statistical difference in the incidence of leukopenia and radiation pneumonia (P>0.05). Conclusion For patients with locally advanced non-small cell lung cancer, the short-term efficacy of concurrent chemoradiotherapy is better than that of sequential chemoradiotherapy and can improve the 1-, 2- and 3-year survival rates, but the toxic side effects of the treatment are slightly greater than those of the sequential chemoradiotherapy.

Hypertriglyceridemia （HTG） is the second leading cause of acute pancreatitis in China and can be caused by primary factors， namely gene mutations， which may lead to recurrent hypertriglyceridemic acute pancreatitis （HTG-AP） and difficulties in effective control of triglyceride. This article reports an adult Chinese male patient who experienced eight attacks of HTG-AP and was found to carry a de novo heterozygous mutation， p.K327N， of the GPD1 gene， which may cause the persistent high level of triglyceride and recurrent attacks of HTG-AP.

Objective To compare the short-term efficacy and safety of inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE) and minimally invasive transthoracic esophagectomy (MITE) in the treatment of esophageal cancer. Methods The Cochrane Library, EMbase, PubMed, Wanfang Database, VIP, and CNKI were searched. Literatures related to the short-term efficacy and safety of IVMTE and MITE in the treatment of esophageal neoplasms published from the establishment of the database to December 2023 were searched and meta-analysis was conducted by using RevMan5.4. Quality of case control study or cohort study was assessed by the Newcastle-Ottawa Scale (NOS) and quality of randomized controlled trial was assessed by Cochrane Handbook. Results A total of 14 studies (12 case control studies and 1 prospective cohort study wiht NOS score more than 7 points and 1 randomized controlled trial wiht low bias risk) were included, comprising 1 163 patients, with 525 in the IVMTE group and 638 in the MITE group. The results of meta-analysis revealed that the IVMTE group exhibited significantly shorter operative time [MD=−60.42, 95%CI (−83.78, −37.07), P<0.001] and postoperative hospital stay [MD=−2.44, 95%CI (−2.93, −1.94), P<0.01] compared to the MITE group. Moreover, intraoperative blood loss [MD=−34.67, 95%CI (−59.11, −10.23), P=0.005], three-day postoperative drainage [MD=−286.66, 95%CI (−469.93, −103.40), P=0.002], incidence of postoperative pulmonary infection [OR=0.38, 95%CI (0.26, 0.56), P<0.001], lung leakage rate [OR=0.12, 95% CI (0.02, 0.63), P=0.01] and overall complication rate [MD=0.41, 95%CI (0.22, 0.75), P=0.004] were all lower in the IVMTE group compared to those in the MITE group. However, the MITE technique demonstrated superiority over IVMTE regarding intraoperative lymph dissection number [MD=−3.52, 95%CI (−6.36, –0.68), P=0.02] and intraoperative recurrent laryngeal nerve injury [OR=1.78, 95%CI (1.22, 2.60), P=0.003]. No significant difference was observed between both methods concerning anastomotic fistula. Conclusion Compared to MITE, IVMTE has advantages such as shorter operation time, less intraoperative blood loss, shorter hospital stay, less postoperative drainage within 3 days, and a lower incidence of pulmonary complications. In terms of laryngeal recurrent nerve injury and lymphatic dissection, MITE operation offers more benefits.

Objective To systematically evaluate the efficacy of adjuvant radiotherapy after thymoma resection. Methods The PubMed, EMbase, The Cochrane Library, Web of Science, Wanfang, VIP, CNKI databases were systematically searched to find relevant literature comparing the efficacy and effectiveness of thymoma resection and thymoma resection+postoperative radiation therapy (PORT) for treating thymoma published from inception to January 2024. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of included retrospective studies, and Review Manager 5.4 software was used to perform meta-analysis. Results A total of 23 articles were included, all of which were retrospective studies. There were a total of 13742 patients, including 6980 patients in the simple surgery group, with 3321 males and 3659 females, and an average age of 54.08 years; 6762 patients in the surgery+PORT group, with 3385 males and 3377 females, and an average age of 53.76 years. The NOS scores of the included literature were all≥7 points. The results of the meta-analysis showed that compared with the simple surgery group, the surgery+PORT group had higher 1-year overall survival rate [OR=0.32, 95%CI (0.25, 0.42), P<0.001], 3-year overall survival rate [OR=0.55, 95%CI (0.48, 0.64), P<0.001], 5-year overall survival rate [OR=0.66, 95%CI (0.58, 0.75), P<0.001], 10-year overall survival rate [OR=0.71, 95%CI (0.57, 0.88), P=0.002], 1-year disease-free survival rate [OR=0.47, 95%CI (0.23, 0.93), P=0.030], 5-year disease-free survival rate [OR=0.61, 95%CI (0.45, 0.84), P=0.003], 3-year disease-specific survival rate [OR=0.44, 95%CI (0.35, 0.55), P<0.001], 5-year disease-specific survival rate [OR=0.53, 95%CI (0.44, 0.63), P<0.001] and 10-year disease-specific survival rate [OR=0.53, 95%CI (0.35, 0.82), P=0.004]. But there was no statistically significant difference between the two groups in terms of 3-year disease-free survival rate [OR=0.86, 95%CI (0.61, 1.22), P=0.400], 10-year disease-free survival rate [OR=0.70, 95%CI (0.47, 1.05), P=0.080] and 1-year disease-specific survival rate [OR=0.83, 95%CI (0.55, 1.26), P=0.380]. Conclusion PORT after thymoma resection has more advantages than simple surgical treatment in terms of 1-, 3-, 5-, and 10-year overall survival, 1- and 5-year disease-free survival, and 3-, 5- and 10-year disease-specific survival.

Since the first case of corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the end of 2019, the virus has spread rapidly around the world and has become a global public health problem. In the process of this virus epidemic, compared with the general population, cancer patients are considered to be highly susceptible people, especially the lung cancer patients. Some studies have shown that angiotensin converting enzyme 2 (ACE2) may be the pathway for SARS-CoV-2 to infect the host. At the same time, ACE2 is often abnormally expressed in non-small cell lung cancer. Therefore, understanding the respective mechanisms of ACE2 in COVID-19 and non-small cell lung cancer has extremely important reference value for the study of vaccines and therapeutic drugs, and also provides meaningful guidance for the protection of patients with lung cancer during the epidemic. This article reviews the possible invasive mechanism of ACE2 in SARS-CoV-2 and its abnormal expression in non-small cell lung cancer.

Objective    To systematically evaluate the efficacy and safety of nedaplatin versus cisplatin combined with fluorouracil in the treatment of esophageal neoplasms. Methods    PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang, VIP and CBM databases were searched by computer to investigate the randomized controlled studies about the clinical effects of nedaplatin combined with fluorouracil versus cisplatin combined with fluorouracil in the treatment of esophageal neoplasms. The retrieval time was from the establishment of the database to January 2021. And meta-analysis was performed using RevMan 5.4. Results    A total of 12 randomized controlled studies involving 744 patients were included. The results of meta-analysis showed that the total effective rate of the nedaplatin group was better than that of the cisplatin group (P<0.05). The incidence of nausea, vomiting, diarrhea and renal impairment in the nedaplatin group was lower than that in the cisplatin group (P<0.05), but the incidence of leukopenia and hemoglobin decline was higher than that in the cisplatin group (P<0.05). There was no statistical difference in the incidence of liver injury, or platelet decline between the two groups (P>0.05). Conclusion    Nedaplatin combined with fluorouracil has more advantages than cisplatin combined with fluorouracil in the treatment of esophageal cancer, the incidence of nausea, vomiting and diarrhea is lower, and the damage to kidney function is also smaller.

Objective:To explore the relationship between lipid accumulation product (LAP) and disease activity, nutritional status in patients with Crohn disease (CD).Methods:The clinical data of 74 patients with CD in the Affiliated Hospital of Yangzhou University from July 2020 to June 2021 were retrospectively analyzed. The patients were divided into active group (32 cases) and remission group (42 cases) according to simplified Crohn disease activity index (CDAI). The general clinical data, laboratory examination results and body fat indexes were recorded, body fat indexes including body mass index (BMI), waist circumference, waist-to-height ratio, LAP and nutritional risk screening 2002 (NRS2002) score. Spearman method was used for correlation analysis; the receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of LAP in predicting the disease activity and nutritional status in patients with CD.Results:The proportion of males, body weight, hemoglobin, albumin, total cholesterol, triglyceride and high-density lipoprotein cholesterol in active group were significantly lower than those in remission group: 46.9% (15/32) vs. 71.4% (30/42), (53.58 ± 8.13) kg vs. (61.05 ± 9.38) kg, (109.94 ± 23.70) g/L vs. (134.19 ± 18.03) g/L, (34.01 ± 5.71) g/L vs. (39.15 ± 4.27) g/L, (3.23 ± 0.68) mmol/L vs. (3.66 ± 0.74) mmol/L, (1.12 ± 0.36) mmol/L vs. (1.34 ± 0.55) mmol/L and (0.91 ± 0.23) mmol/L vs. (1.04 ± 0.33) mmol/L, the nutritional risk rate, platelet count, C-reactive protein and erythrocyte sedimentation rate were significantly higher than those in remission group: 68.8% (22/32) vs. 19.0% (8/42), (317.97 ± 130.19) ×10 9/L vs. (194.00 ± 51.91) × 10 9/L, 14.15 (6.15, 41.35) mg/L vs. 1.51 (0.22, 5.58) mg/L and 40.00 (20.50, 64.25) mm/1 h vs. 9.00 (3.00, 20.00) mm/1 h, and there were statistical differences ( P<0.01 or <0.05); there were no statistical difference in age, height, total protein and low-density lipoprotein cholesterol between the two groups ( P>0.05). The BMI, waist circumference, waist-to-height ratio and LAP in active group were significantly lower than those in remission group: 19.46 (17.70, 21.45) kg/m 2 vs. 21.08 (18.87, 23.12) kg/m 2, (72.51 ± 5.92) cm vs. (77.67 ± 7.27) cm, 0.44 ± 0.03 vs. 0.46 ± 0.04, 13.42 (5.07, 17.72) cm·mmol/L vs. 15.49 (9.37, 31.71) cm·mmol/L, the NRS2002 was significantly higher than that in remission group: 3.00 (1.00, 3.75) scores vs. 1.00 (0, 2.00) scores, and there were statistical differences ( P<0.01 or <0.05). Spearman correlation analysis result showed that LAP was positively correlated with BMI, waist circumference and waist-to-height ratio ( r = 0.701, 0.766 and 0.829; P<0.01); LAP was negatively correlated with NRS2002 score, platelet count and erythrocyte sedimentation rate ( r =- 0.609, - 0.249 and - 0.243; P<0.01 or<0.05). ROC curve analysis result showed that the areas under the curve of LAP predicting disease remission and nutritional status improvement in patients with CD were 0.645 and 0.832 (95% CI 0.520 to 0.770 and 0.739 to 0.925), the best cut-off values were 20.89 and 12.86 cm·mmol/L, the sensitivities were 45.2% and 81.8%, and the specificities were 87.5% and 73.3%. Conclusions:LAP has good predictive value for disease remission and nutritional status improvement in patients with CD.