Comparative effectiveness and safety of open triple-branched stent graft technique with stented elephant trunk implantation in treating Stanford type A aortic dissection: A trial sequential meta-analysis.

BACKGROUND: The optimal surgical intervention for Stanford type A aortic dissection is controversial. The aim of this trial sequential meta-analysis was to investigate the comparative effectiveness and safety of open triple-branched stent graft and stent elephant trunk implantation for total aortic arch reconstruction in Sandford type A aortic dissection. METHODS: PubMed, Embase, Cochrane library, Chinese Biomedical Literature database (CBM), and China National Knowledge Infrastructure (CNKI) were searched for retrieving relevant studies from inception to February 28, 2022. We evaluated 30-day mortality, procedure-related time including cardiopulmonary bypass (CPB), aortic cross-clamp (ACC), and selective cerebral perfusion (SCP), the incidence of postoperative complications including paralysis, cerebral embolism, and acute renal failure, intensive care unit (ICU) time, and medical expenditure. Statistical analysis was performed by RevMan 5.4 and trial sequential analysis (TSA) software. RESULTS: Six studies involving 260 dissection cases were included eventually. Total aortic arch reconstruction with open triple-branched stent graft was comparable to the stented elephant trunk implantation in 30-day mortality, incidence of postoperative complications, ICU time, and medical expenditure, but open triple-branched stent graft was related to shorter procedure-related time including CPB (mean difference [MD] = -46.11, 95% confidence interval [CI] = -67.24 to -24.98, p < .001), ACC (MD = -42.82, 95% CI = -66.74 to -18.90, p < .001), and SCP (MD = -17.88, 95% CI = -33.36 to -2.39, p = .02). TSA confirmed robustness of findings. CONCLUSIONS: Our analysis suggested that total aortic arch reconstruction with open triple-branched stent graft may be an effective and simplified procedure than the stented elephant trunk implantation.

Application of three-dimensional reconstruction combined with dial positioning in small pulmonary nodules surgery.

BACKGROUND: With the popularization of HRCT and VATS, the incidence of early stage lung cancer is increasing recent years. About 63% of small pulmonary nodules can not be accurately identified in VATS. We use 3-D reconstruction combined with dial positioning to analyze its accuracy and impact on patients undergoing VATS in our hospital. METHOD: All patients underwent HRCT scanning and 3-D reconstruction preoperatively to determine the scope of surgery. The precise positional relationship between the nodule and the nearest rib must be recorded. Locate the plane of pulmonary nodule on CT, rotate the plane to make the affected side upwards, take the highest point of pleura as 12 o'clock on the dial, record the corresponding point of the nodule meticulously, mark the pulmonary nodule on the skin of the patient. A 18G indwelling needle was used to puncture through the marker into the visceral pleura. Electrocautery mark was made on the bleeding point of the lung surface. Then wedge resection or segmental resection was made. MATERIALS AND RESULT: From September 2019 to December 2020, 74 patients underwent VATS pulmonary nodule resection in our institute, with an average age of (56.4 ± 11.7) years old. A total of 83 nodules were resected in 74 patients, 23 nodules received segmentectomy and 60 nodules received wedge resection with 16 benign nodules and 67 malignant nodules. The distance between the nodules and pleura was (0-25) mm, with an average of (8.0 ± 3.9) mm. The target nodules were found in all patients, the positioning accuracy was 97.6%. All patients were satisfied with the positioning method, and there was no scar left at the skin puncture point after operation. CONCLUSION: 3-D reconstruction combined with dial positioning method can reduce patients' anxiety preoperatively, avoid various complications, reduce hospitalization expenses, and has an acceptable accuracy and short learning curve, which can be further promoted and applied in clinic.

A practical technique for subacute hemorrhagic pericarditis, a case report.

BACKGROUND: We used pericardioscope operation for a patient who suffered from subacute hemorrhagic pericarditis which usually have to had a sternotomy. CASE PRESENTATION: A pericardioscope was used in the operation rather than sternotomy on a 66-year-old male who was diagnosed with subacute hemorrhagic pericarditis after PCI(Percutaneous Coronary Intervention). He was discharged 7 days after the operation with an uneventfull postoperative course. CONCLUSIONS: We believe that this technique is a safe procedure without any major complications.

Association between KIF1B (rs17401966) polymorphism and hepatocellular carcinoma susceptibility: a meta-analysis.

INTRODUCTION: The results of the earlier published studies on the association between KIF1B (rs17401966) polymorphism and hepatocellular carcinoma (HCC) risk are inconclusive. Hence, we performed this meta-analysis to evaluate the relationship between KIF1B (rs17401966) polymorphism and HCC risk. METHODS: Databases including PubMed, Web of Science and the Cochrane Library and bibliographies of relevant papers were screened to identify relevant studies published up to March 25, 2018. Pooled ORs and 95% CIs were calculated to evaluate the association. The subgroup analysis was conducted based on ethnicity, age, region and environment. A total of 19 studies from 11 eligible articles published from 2010 to 2016, with 8,741 cases and 10,812 controls, were included. RESULTS: The pooled results indicated that the association between KIF1B (rs17401966) polymorphism and the decreased HCC risk was significant. Subgroup analysis stratified by ethnicity showed the same association in Chinese, but not in non-Chinese population. When stratified by age, both old and young patients showed a decrease in HCC risk. When stratified by region, we detected the same association in Chinese in southern China. Similarly when stratified by environment, we observed the same association in Chinese in inland areas; however, no statistically significant association was observed in those in coastal areas. CONCLUSION: This meta-analysis suggested that KIF1B (rs17401966) polymorphism could decrease HCC risk in Chinese and in overall population, but not in non-Chinese. This association remained significant in Chinese in southern China and inland areas, but not in those in northern and central China and coastal areas. Further large-scale multicenter studies are warranted to confirm these findings.

Association between rs11200014, rs2981579, and rs1219648 polymorphism and breast cancer susceptibility: A meta-analysis.

BACKGROUND: Research on the polymorphism of breast cancer (BC) helps to search the BC susceptibility gene for mass screening, early diagnosis, and gene therapy, which has become a hotspot in BC research field. Previous studies have suggested associations between rs11200014, rs2981579, and rs1219648 polymorphisms and cancer risk. The aim of this study was to evaluate the relationship between rs11200014, rs2981579, and rs1219648 polymorphism and BC risk. METHODS: PubMed, Web of science, and the Cochrane Library databases were searched before October 11, 2015, to identify relevant studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the strength of associations. Sensitivity and subgroup analyses were conducted. All included cases should have been diagnosed by a pathological examination. RESULTS: Twenty-six studies published from 2007 to 2015 were included in this meta-analysis. The pooled results showed that there was a significant association between all the 3 variants and BC risk in any genetic model. When stratified by Source of controls, the results showed the same association between rs2981579 polymorphism and BC susceptibility in hospital-based (HB) group, although there was not any genetic model attained statistical correlation in population-based (PB) group. Subgroup analysis was performed on rs1219648 by ethnicity and Source of controls, and the effects remained in Asians, Caucasians, HB, and PB groups. CONCLUSION: This meta-analysis of case-control studies provides strong evidence that fibroblast growth factor 2 (FGFR2; rs11200014, rs2981579, and rs1219648) polymorphisms are significantly associated with the BC risk. For rs2981579, the association remained in hospital populations, while not in general populations. For rs1219648, the association remained in Asians, Caucasians, hospital populations, and general populations. However, further large-scale multicenter epidemiological studies are warranted to confirm this finding and the molecular mechanism for the associations need to be elucidated in future studies.

Association between FGFR2 (rs2981582, rs2420946 and rs2981578) polymorphism and breast cancer susceptibility: a meta-analysis.

The association between fibroblast growth factor receptor 2 (FGFR2) polymorphism and breast cancer (BC) susceptibility remains inconclusive. The purpose of this systematic review was to evaluate the relationship between FGFR2 (rs2981582, rs2420946 and rs2981578) polymorphism and BC risk. PubMed, Web of science and the Cochrane Library databases were searched before October 11, 2015 to identify relevant studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the strength of associations. Sensitivity and subgroup analyses were conducted. Thirty-five studies published from 2007 to 2015 were included in this meta-analysis. The pooled results showed that there was significant association between all the 3 variants and BC risk in any genetic model. Subgroup analysis was performed on rs2981582 and rs2420946 by ethnicity and Source of controls, the effects remained in Asians, Caucasians, population-based and hospital-based groups. We did not carryout subgroup analysis on rs2981578 for the variant included only 3 articles. This meta-analysis of case-control studies provides strong evidence that FGFR2 (rs2981582, rs2420946 and rs2981578) polymorphisms were significantly associated with the BC risk. For rs2981582 and rs2420946, the association remained significant in Asians, Caucasians, general populations and hospital populations. However, further large scale multicenter epidemiological studies are warranted to confirm this finding and the molecular mechanism for the association need to be elucidated further.