Circulating tumor DNA detection in peripheral blood in postoperative efficacy evaluation and recurrence risk prediction of lung cancer.

This study mainly explores the application in the evaluation of postoperative efficacy and recurrence risk prediction. In this study, 50 lung cancer patients treated with thoracic surgery were selected. Collect the peripheral blood of these patients before the operation, separate the blood sample from the plasma by high-speed centrifugal separation, extract the DNA in the plasma by the magnetic bead method, and then extract the ctDNA. A liquid-phase chip capture system is used to highly concentrate target DNA. We use the IlluminaHiseq platform to sort with high throughput and high depth. As an indicator of ctDNA detection and analysis, the AF value of gene mutation frequency is used for calibration. The sensitivity of CEA detection in peripheral blood of tumor patients (TP) is 30% (15/50), and the sensitivity of ctDNA detection is significantly higher than that of CEA detection. Research results show that the number.

Complete Video-assisted Thoracoscopic Surgery for Rib Fractures: Series of 35 Cases.

BACKGROUND: Video-assisted thoracoscopic surgery (VATS) for internal fixation of rib fractures is a promising approach for treating rib fractures and flail chest. Currently the standard practice is to make 1 or several incisions on the chest wall, which will inevitably aggravate the original trauma. METHODS: We retrospectively analyzed the data of patients with rib fractures who were treated with memory alloy for internal fixation by complete VATS using a thoracoscopic transthoracic memory alloy rib coaptation board and an implantation tool through the clip applier method or the puncture, traction, and suspension method at our hospital from October 2016 to June 2019. RESULTS: Of 35 patients, 12 had traumatic flail chest injury and 23 had simple multiple rib fractures. Of the 23 patients with multiple rib fractures, 9 had fracture ends in the scapular or paravertebral region and 14 in the anterior or lateral chest walls. All surgeries were performed with complete VATS, which showed quick recovery and good thoracic appearance and function, with no complications for all patients. Follow-up for 6 to 24 months revealed no detachment of the internal fixation device. CONCLUSIONS: Internal memory alloy fixation with complete VATS for the treatment of rib fractures is a simple and minimally invasive method that enables fixing fractured ribs internally while treating thoracic trauma with a thoracoscope.

Recurrence rates of surgically resected solitary fibrous tumours of the pleura: a systematic review and meta-analysis.

OBJECTIVES: Recurrence rates of solitary fibrous tumours of the pleura (SFTP) after surgical resection vary widely in the published literature. Our objective was to systematically review the existing literature to determine an accurate estimate of SFTP recurrence rates after surgical resection and to determine risk factors associated with recurrence. METHODS: PubMed, EMBASE and the Cochrane library were systematically searched for randomized controlled trials and observational studies (prospective or retrospective) through 20 June 2020 that reported the recurrence rates after surgical resection. The outcome of interest was recurrence. RESULTS: Of the 23 included studies comparing 1262 patients, the overall recurrence of SFTP in patients who underwent surgical resection was 9% [95% confidence interval (CI) 7-12%; I2 = 52%]. In addition, pooled benign and malignant recurrence rates were 3% (95% CI 2-5%; I2 = 8%) and 22% (95% CI 15-32%; I2 = 52%), respectively. A benign SFTP was associated with a significantly lower recurrence rate than a malignant SFTP [odds ratio (OR) 0.11; 95% CI 0.06-0.20; I2 = 0%]. There was no significant difference in the recurrence rates between lesions originating from parietal versus visceral pleura (OR 1.30; 95% CI 0.28-6.02; I2 = 59%). Female sex was associated with increased recurrence (OR 5.29; 95% CI 1.66-16.92; I2 = 0%). CONCLUSIONS: Collectively, this systematic review demonstrated a 9% SFTP post-resection recurrence rate. Furthermore, the recurrence rates for benign and malignant SFTP were 3% and 22%, respectively. Histological malignancy and female sex were associated with higher risk.

Comparison of efficiency and safety of conservative versus interventional management for primary spontaneous pneumothorax: A meta-analysis.

BACKGROUND: There is growing opinion that primary spontaneous pneumothorax (PSP) patients without hemodynamic compromise could be safely and successfully managed with observation alone. The aims of this meta-analysis were to estimate the safety and effectiveness of conservative treatment compared with that of interventional management as the initial treatment option for patients with PSP. METHODS: The PubMed, Embase and Cochrane library databases were systematically searched for randomized controlled trials (RCTs) and cohort studies (prospective or retrospective) until April 25, 2020, that compared conservative treatment and interventional treatment as the initial treatment for patients with PSP. The primary outcomes were success rates and recurrence rates. The secondary outcome was complication rates. Data extraction and quality assessment from eligible studies were independently conducted by two reviewers. RESULTS: 8 trials with a total of 1342 patients were identified. The success rates of conservative management were similar with interventional treatment, with a risk ratio 1.05 (95% confidence interval 0.94 to 1.17, I2 = 69.1%). There was no significant difference of recurrence rates between these two type managements. (RR, 1.43, 95% confidence interval 0.45 to 4.55, I2 = 86.7%). Complication rates were lower in conservative treatment group (13 of 215 [6.05%]) than in interventional treatment group (57 of 212, [26.89%]), although the difference did not reach statistical significance (RR, 0.15, 95% CI, 0.02 to 1.13, I2 = 56.7%). CONCLUSIONS: Results of the meta-analysis suggest that conservative treatment offers a safe and effective alternative as compared with interventional management as the initial treatment approach for patients with PSP. However, more randomized clinical trials are need to provide more strong evidence to confirm our results.