Objective To systematically evaluate the efficacy and safety of video-assisted thoracoscopic surgery (VATS) with different numbers of ports in the treatment of spontaneous pneumothorax. Methods We conducted a comprehensive search of CNKI, PubMed, The Cochrane Library, Web of Science, EMbase, Wanfang Data, and the Chinese Medical Journal Full-text Database for clinical controlled trials on VATS with different port numbers for spontaneous pneumothorax, from their inception to March 2023. Two researchers independently screened the literature and assessed its quality.The Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of cohort and case-control studies, and the Cochrane risk-of-bias tool was used to evaluate randomized controlled trials (RCT). Meta-analysis was performed using RevMan 5.4.1 software. Results A total of 107 studies were included, comprising 35 RCT, 2 cohort studies, and 70 case-control studies. All cohort and case-control studies included in the analysis had NOS scores≥7. The meta-analysis revealed that compared to two-port VATS (2P-VATS) and three-port VATS (3P-VATS), single-port thoracoscopic surgery (SPTS) was associated with less intraoperative blood loss (SMD=–1.58, 95%CI: –1.93 to –1.22, P<0.001; and SMD=–1.59, 95%CI: –2.03 to –1.14, P<0.001, respectively), shorter postoperative hospital stay (SMD=–1.05, 95%CI: –1.29 to –0.82, P<0.001; and SMD=–1.08, 95%CI: –1.39 to –0.77, P<0.001), shorter duration of postoperative chest tube drainage (SMD=–0.75, 95%CI: –1.00 to –0.50, P<0.001; and SMD=–1.23, 95%CI: –1.72 to –0.75, P<0.001), fewer postoperative complications (OR=0.34, 95%CI: 0.26 to 0.45, P<0.001; and OR=0.47, 95%CI: 0.33 to 0.68, P<0.001), and lower pain scores at 24, 48, and 72 hours after surgery (P<0.05). The operative time for SPTS was shorter than that for 2P-VATS (SMD=–0.53, 95%CI: –0.90 to –0.16, P=0.005) but showed no significant difference compared to 3P-VATS (P=0.21). When comparing 2P-VATS with 3P-VATS, 2P-VATS demonstrated less intraoperative blood loss (SMD=–1.02, 95%CI: –1.81 to –0.22, P=0.01), shorter postoperative hospital stay (SMD=–0.59, 95%CI: –1.11 to –0.06, P=0.03), shorter duration of chest tube drainage (SMD=–0.46, 95%CI: –0.85 to –0.08, P=0.02), fewer postoperative complications (OR=0.36, 95%CI: 0.22 to 0.59, P<0.001), and lower pain scores at 24, 48, and 72 hours after surgery (P≤0.05). Conclusion Both SPTS and 2P-VATS are effective and safe surgical options for spontaneous pneumothorax, deserving further promotion and application in clinical practice. However, due to limitations in the quantity and quality of the included studies, more large-sample, high-quality research is needed to validate these findings.

Objective To systematically evaluate the efficacy of immune checkpoint inhibitors (ICIs) in treating esophageal cancer patients of different genders. Methods Computer searches were conducted on PubMed, Cochrane Library, and Embase databases to collect randomized controlled trial (RCT) on ICIs treatment for esophageal cancer patients from the establishment of the databases to January 25, 2024. Two researchers independently screened the literature and extracted data according to the inclusion and exclusion criteria. The outcome indicators were overall survival (OS) and progression-free survival (PFS), and RevMan 5.4 software was used for meta-analysis. The modified Jadad scoring scale was used to evaluate the quality of the included literature. Results A total of 10 RCT involving 5364 esophageal cancer patients were included in this study, with 2684 patients in the trial group and 2680 patients in the control group. The Jadad scores of the included literature were all ≥6 points, indicating high-quality RCT. Meta-analysis results showed that female esophageal cancer patients receiving ICIs treatment [HR=0.72, 95%CI (0.59, 0.87), P<0.001] had a more significant median OS prolongation than male patients [HR=0.73, 95%CI (0.68, 0.78), P<0.001]; while male patients [HR=0.57, 95%CI (0.52, 0.64), P<0.001] had a more significant PFS prolongation than female patients [HR=0.72, 95%CI (0.55, 0.94), P=0.01]. Female patients treated with ICIs alone [HR=0.66, 95%CI (0.50, 0.87), P=0.003] had a more significant median OS prolongation than male patients [HR=0.79, 95%CI (0.72, 0.87), P<0.001]; while male patients receiving ICIs combined with chemotherapy [HR=0.67, 95%CI (0.61, 0.74), P<0.001] had a more significant median OS prolongation than female patients [HR=0.77, 95%CI (0.59, 1.01), P=0.06]. Conclusion Female patients receiving ICIs have a slight advantage in OS compared to male patients, while male patients have an advantage in PFS. Male patients receiving ICIs combined with chemotherapy have better survival benefits than female patients, while female patients using ICIs monotherapy have better survival benefits than male patients.

Objective To compare the magnetic resonance imagings (MRI) of neonates diagnosed with cystic periventricular leukomalacia (cPVL) at different stages after birth , and to clarify the relationship of MRI and motor development outcomes.Method Data of neonates admitted to the Shengjing Hospital of China Medical Univerisity from January 2010 to May 2015 diagnosed with cPVL by MRI were studied retrospectively.Subjects were assigned into two groups according to time of diagnosis : early－diagnosed group (≤7 d) and late－diagnosed group (＞7 d).The MRI and subsequent motor development outcome were compared between two groups.Result There were 35 neonates in early－diagnosed group.The cysts were mainly located in the anterior horn of the lateral ventricle (35 infants), the body of the lateral ventricle (2 infants) and the centrum semiovale (1 infants).Only one cyst were found in 17 infants, two cysts in 14 infants, three or more cysts in 4 infants.There were 45 cases in the late－diagnosed group, the cysts were mainly located in the centrum semiovale ( 35 infants ) and the posterior horn of the lateral ventricle (34 infants), the body (20 infants) and the anterior horn (10 infants) of lateral ventricle.Only one cyst were found in 3 infants, two cysts in 5 infants, three or more cysts in 37 infants.Among the 23 infants in the early－diagnosed group with follow－up, 22 infants are clinically normal , one infant with spastic diplegia (4.3%).Among the 24 infants in the late－diagnosed group with followe－up, 4 infants are clinically normal , 20 infants with spastic hemiplegia , diplegia or quadriplegia (83.3%).There are significant differences of incidence of cerebral palsy between the two group (P＜0.05).Conclusion MRI imaging showed that the location, number of cysts are different between the early－diagnosed and late－diagnosed group, and the motor development outcome of the early－diagnosed group are better , which indicates the prognosis of cPVL that occurred in utero are better than acquired cPVL after birth.

Objective To study the prevalence and socio-demographic correlates of mental disorders in Beijing residents. Methods The multi-stage stratified cluster random sampling method was used,19 874 residents aged 18 or above who had lived for more than six months in Beijing were selected. Face-to-face assessment was conducted by trained investigators by using the Chinese version of the Structured Clinical Interview for DSM-ⅣAxisⅠDisorders-Patient Edition(SCID-Ⅰ/P)to find any mental disorders, and the Mini-Mental State Examination (MMSE) to screen for dementia and mental retardation. Those who were positive on MMSE(MMSE≤17 for those who completed elementary education or less,≤23 for those who completed middle school or above) were further assessed to confirm dementia and mental retardation by using the SCID. Results 16 032 (80.7%) out of 19 874 eligible residents completed the face-to-face assessment. Adjusted by age and gender, the lifetime prevalence of all mental disorders was 120.8‰ (1 937/16 032, 115.8‰-125.9‰), and the top three most common ones were major depressive disorder (527,32.9‰), alcohol dependence and abuse (311, 19.4‰), and anxiety disorder, NOS (270, 16.8‰). The point prevalence of all mental disorders was 75.3‰ (1 207/16 032,71.2‰-79.4‰), the top three were specific phobias (187, 11.7‰),anxiety disorder, NOS (186, 11.6‰), and major depressive disorder (162, 10.1‰).The prevalence of mental disorders was significantly higher in the elderly(OR=1.014),female(OR=1.428),unemployed(OR=1.096),people having poor rapports with family(OR=1.686) or others(OR=1.901), smoking(OR=1.129)or drinking(OR=1.262). The prevalence of mental disorders was significantly lower in the urban residents(OR=0.840), people in a higher level of education(OR=0.813), people who had got married/remarried or who had partner(OR=0.689), people who had no family history of any mental disorders(OR=0.405). Conclusions Approximately 12% of Beijing residents may meet at least one diagnosis of mental disorder in their lifetime; The prevalence of mental disorders is associated with older age,female gender,lower level of education,rural dwelling,positive family history of mental disorders,and poor social support system.

Objective To study the prevalence and socio-demographic correlates of mental disorders in Beijing residents. Methods The multi-stage stratified cluster random sampling method was used,19 874 residents aged 18 or above who had lived for more than six months in Beijing were selected. Face-to-face assessment was conducted by trained investigators by using the Chinese version of the Structured Clinical Interview for DSM-ⅣAxisⅠDisorders-Patient Edition(SCID-Ⅰ/P)to find any mental disorders, and the Mini-Mental State Examination (MMSE) to screen for dementia and mental retardation. Those who were positive on MMSE(MMSE≤17 for those who completed elementary education or less,≤23 for those who completed middle school or above) were further assessed to confirm dementia and mental retardation by using the SCID. Results 16 032 (80.7%) out of 19 874 eligible residents completed the face-to-face assessment. Adjusted by age and gender, the lifetime prevalence of all mental disorders was 120.8‰ (1 937/16 032, 115.8‰-125.9‰), and the top three most common ones were major depressive disorder (527,32.9‰), alcohol dependence and abuse (311, 19.4‰), and anxiety disorder, NOS (270, 16.8‰). The point prevalence of all mental disorders was 75.3‰ (1 207/16 032,71.2‰-79.4‰), the top three were specific phobias (187, 11.7‰),anxiety disorder, NOS (186, 11.6‰), and major depressive disorder (162, 10.1‰).The prevalence of mental disorders was significantly higher in the elderly(OR=1.014),female(OR=1.428),unemployed(OR=1.096),people having poor rapports with family(OR=1.686) or others(OR=1.901), smoking(OR=1.129)or drinking(OR=1.262). The prevalence of mental disorders was significantly lower in the urban residents(OR=0.840), people in a higher level of education(OR=0.813), people who had got married/remarried or who had partner(OR=0.689), people who had no family history of any mental disorders(OR=0.405). Conclusions Approximately 12% of Beijing residents may meet at least one diagnosis of mental disorder in their lifetime; The prevalence of mental disorders is associated with older age,female gender,lower level of education,rural dwelling,positive family history of mental disorders,and poor social support system.