Non-intubated video-assisted thoracoscopic surgery vs. intubated video-assisted thoracoscopic surgery for thoracic disease: a systematic review and meta-analysis of 1,684 cases.

BACKGROUND: Non-intubated video-assisted thoracoscopic surgery (NIVATS) has been increasingly used in lobectomy, bullectomy, wedge resection, lung volume reduction, sympathectomy and talc pleurodesis, which may reduce postoperative complications. However, the benefits of non-intubated and intubated methods of VATS remain controversial. METHODS: We comprehensively searched PubMed, Web of Science, Embase and the Cochrane Library, and performed a systematic review to assess the two techniques. Random and fixed-effects meta-analytical models were used based on the low between-study heterogeneity. Study quality, publication bias, and heterogeneity were assessed. RESULTS: Compared to intubated methods, NIVATS had a lower postoperative complications rate [odds ratio (OR): 0.63; 95% confidence interval (CI), 0.46-0.86; P<0.01], shorter global in-operating time [weighted mean difference (WMD): -35.96 min; 95% CI, -48.00 to -23.91; P<0.01], shorter hospital stay (WMD: -1.35 days; 95% CI, -1.72 to -0.98; P<0.01), shorter anesthesia time (WMD: -7.29 min; 95% CI, -13.30 to -1.29; P<0.01), shorter chest-tube placement time (WMD: -1.04 days; 95% CI, -1.75 to -0.33; P<0.01), less chest pain (WMD: -1.31; 95% CI, -2.45 to -0.17; P<0.05) and lower perioperative mortality rate (OR: 0.13; 95% CI, 0.02-0.99; P=0.05). CONCLUSIONS: NIVATS is a safe, efficient and feasible technique for thoracic surgery and may be a better alternative procedure owing to its advantage in reducing postoperative complications rate, hospital stay, and chest pain.

[Analysis of Flame Spectrum at the Initial Stage of 0 # Diesel Oil Combustion].

With small-scale oil pool experimental and spectral analysis method, the flame spectrum in initial stage of 0(#) diesel oil combustion was conducted a preliminary study for the first time, which was used to develop the technique of intelligent identification and suppression of fire extinguishing at the initial stage of diesel oil combustion. It educed the overall characteristics flame spectrum at the initial stage of 0(#) diesel oil combustion: in 200～380 nm wavelength of near-ultraviolet bands, the spectral intensity is the weakest, the spectral intensity does not change with wavelength, the number of characteristics spectral bands is minimum, the number of obvious characteristics spectral peaks is almost none; in 380～780 nm wavelength of visible bands, the spectral intensity is the strongest, the spectral intensity increases with wavelength, the number of characteristics spectral bands is maximum, the number of obvious characteristics spectral peaks is large; in 780～1 100 nm wavelength of near-infrared bands, the spectral intensity is relatively strong, the inflection point of spectral intensity appears in 780 nm, the appeared intensity decreases with wavelength, the number of characteristics spectral bands is relatively large, the number of obvious characteristics spectral peaks is at a certain number. It is educed through further analysis of the flame spectrum that: the primary intermediate radicals includes OH, CN, CH, C(2), H(2)O, etc; the primary characteristic spectral bands includes the OH racial bands of 3 064  System and Vibration-Rotation bands, the CN racial bands of Violet System and Red System, the CH racial bands of 4 315  System, the C2 racial bands of The Swan system and Phillips Near Infra-red System, the H(2)O molecular Vibration-Rotation bands, etc; the bands and time distribution of primary intermediate radicals and its main generation mechanism; the existence of potassium in this experimental batches of 0(#) diesel oil and the spectral peak of spectral lines in 766 and 769 nm is obvious; the peak of spectral intensity in 431, 512, 516, 547, 589, 766, 769, 891, 927 nm is obvious, and it suitable for the sign of flame identification at the initial stage of 0(#) diesel oil combustion.

[Sporadic cutaneous infections due to nontuberculous mycobacteria: a retrospective study of 37 cases].

OBJECTIVE: To study the clinical and pathological characteristics of sporadic cutaneous infections due to nontuberculous mycobacteria (NTM), and investigate the diagnostic criteria and therapeutic principal. METHODS: Totally 37 cases of sporadic cutaneous infections due to NTM were confirmed in the Department of Dermatology, Peking University People's Hospital from January 2000 to March 2014. The microbiologic and clinical data were reviewed, and their skin biopsy specimens were reassessed. RESULTS: Of all the 37 patients, 30 cases were Mycobacterium marinum infection, 6 were Mycobacterium abscessus infection, and one was Mycobacterium chelonea and Mycobacterium fortuitum infection. Identification of mycobacterial species by analysis of hsp65 gene in tissue DNA was more sensitive than traditional bacterial culture. The most common risk factors were traumatic injuries (21 of 37) and aquarium or fish-related job (21 of 37). One case of Mycobacterium abscessus infection occurred after autologous fat filling. Nodule and plaque were most common lesions in Mycobacterium marinum infection. Twenty-four of the 30 cases of Mycobacterium marinum infection presented with multiple lesions or sporotrichoid spread lesions. Ulceration, papules, abscess, and purulent discharge were observed in cases of Mycobacterium abscessus infection. Infective granuloma was most common histopathological appearance. For the treatment of Mycobacterium marinum infection, rifampin, ethambutol, and clarithromycin were commonly used (combination of two antibiotics, or three antibiotics), with the cure rate 90.00%. Four of the six Mycobacterium abscessus infections cases were cured, and one patient died. CONCLUSION: The most common species of sporadic cutaneous infections due to NTM is Mycobacterium marinum. Traumatic injuries, aquarium or fish-related job, and cosmetic surgeries are common risk factors. Mycobacterium marinum infection often presents with nodules, plaques, and sometimes sporotrichoid spread lesions. Lesions of Mycobacterium abscessus infection may vary. Pathological changes were not species specific, final diagnosis must be made depending on the identification of the microorganism. For the treatment of Mycobacterium marinum infection, excellent outcomes can be achieved by the combination of rifampin and ethambutol, and the combination of clarithromycin and rifampin or ethambutoland. Treatment regimens of Mycobacterium abscessus infection should be decided according to the results of antibiotic susceptibility testing.