Impact of thoracic paravertebral block and sufentanil on outcomes and postoperative cognitive dysfunction in thoracoscopic lung cancer surgery

BACKGROUND Postoperative pain management and cognitive function preservation are crucial for patients undergoing thoracoscopic surgery for lung cancer(LC).This is achieved using either a thoracic paravertebral block(TPVB)or sufentanil(SUF)-based multimodal analgesia.However,the efficacy and impact of their combined use on postoperative pain and postoperative cognitive dysfunction(POCD)remain unclear.AIM To explore the analgesic effect and the influence on POCD of TPVB combined with SUF-based multimodal analgesia in patients undergoing thoracoscopic radical resection for LC to help optimize postoperative pain management and improve patient outcomes.METHODS This retrospective analysis included 107 patients undergoing thoracoscopic radical resection for LC at The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital between May 2021 and January 2023.Patients receiving SUF-based multimodal analgesia(n=50)and patients receiving TPVB+SUF-based multimodal analgesia(n=57)were assigned to the control group and TPVB group,respectively.We compared the Ramsay Sedation Scale and visual analog scale(VAS)scores at rest and with cough between the two groups at 2,12,and 24 h after surgery.Serum levels of epinephrine(E),angio-tensin Ⅱ(Ang Ⅱ),norepinephrine(NE),superoxide dismutase(SOD),vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),and S-100 calcium-binding proteinβ(S-100β)were measured before and 24 h after surgery.The Mini-Mental State Examination(MMSE)was administered 1 day before surgery and at 3 and 5 days after surgery,and the occurrence of POCD was monitored for 5 days after surgery.Adverse reactions were also recorded.RESULTS There were no significant time point,between-group,and interaction effects in Ramsay sedation scores between the two groups(P>0.05).Significantly,there were notable time point effects,between-group differences,and interaction effects observed in VAS scores both at rest and with cough(P<0.05).The VAS scores at rest and with cough at 12 and 24 h after surgery were lower than those at 2 h after surgery and gradually decreased as postoperative time increased(P<0.05).The TPVB group had lower VAS scores than the control group at 2,12,and 24 h after surgery(P<0.05).The MMSE scores at postoperative days 1 and 3 were markedly higher in the TPVB group than in the control group(P<0.05).The incidence of POCD was significantly lower in the TPVB group than in the control group within 5 days after surgery(P<0.05).Both groups had elevated serum E,Ang Ⅱ,and NE and decreased serum SOD levels at 24 h after surgery compared with the preoperative levels,with better indices in the TPVB group(P<0.05).Marked elevations in serum levels of VEGF,TGF-β1,TNF-α,and S-100β were observed in both groups at 24 h after surgery,with lower levels in the TPVB group than in the control group(P<0.05).CONCLUSION TPVB combined with SUF-based multimodal analgesia further relieves pain in patients undergoing thoracoscopic radical surgery for LC,enhances analgesic effects,reduces postoperative stress response,and inhibits postoperative increases in serum VEGF,TGF-β1,TNF-α,and S-100β levels.This scheme also reduced POCD and had a high safety profile.

Early screening of lung cancers:an effort arduous but worthwhile

Cancers are a concerning health catastrophe worldwide that may become the end of lifetime for many of us--they overwhelmingly exhaust medical resources, lead to huge economic burdens, and separate people from their beloved ones. Fewer and fewer insurance agencies are willing to include primary cancers on their general health insurance plan, just because cancers have been so flummoxingly usual in our daily life that many primary cancer claims would give rise to much less profits.

Efficacy and safety of radiotherapy combined with zoledronic acid in the treatment of lung cancer with bone metastasis: a meta-analysis

Objective: To evaluate the efficacy and safety of radiotherapy combined with zoledronic acid fOr the treatment of bone metastases. Methods: Use Pubmed, Cochrane Library, Embase, CBM, CNKI, Wanfang, Weipu tools to search-related databases at home and abroad. From 2013.1 to March 2019, radiotherapy combined with zoledronic acid and radiotherapy alone for bone metastasis of lung cancer were collected. Experimental studies;quality evaluation and data extraction for each of the included studies, and Cochrane risk bias assessment tools for quality evaluation of the literature. Data processing was performed using RevMan 5.3 and Stata 15.0 software, including risk ratio (OR), 95% CI, I2, and P values. Line sensitivity test, publication bias evaluation is using Egger's, Bgge's method quantitative calculation using Revman 5.3 and Stata 15.0 software for statistical analysis. Results: The total of 8 articles was included, and the number of cases was 703. The results of the meta-analysis showed that the radiotherapy, combined with the zoledronic acid group was effective in the treatment of lung cancer with bone metastasis. The meta-analysis was Z = 6.31 (P < 0.00001), OR (95% CI = 3.57, (2.41, 5.30)), the difference was statistically significant. The combined effect of bone metastases was better than that of the single-stage group. The meta-analysis results were Z = 3.18 (P = 0.001) and OR (95% CI = 3.21, (1.57, 6.59)), indicating the therapeutic effect of the two groups in the treatment of bone metastases. The difference is statistically significant. Adverse reactions include: (1) bone marrow suppression, blood toxicity;(2) fever and rash;(3) nausea, vomiting, and fatigue;(4) liver damage and loss of appetite, meta-analysis results are: bone marrow suppression, blood toxicity: Z =0.73 ( P = 0.47), OR (95% CI = 0.58 (0.13, 2.54));fever, rash: Z = 0.36 (P = 0.36), OR (95% CI = 1.3 (0.31, 5.38));nausea, vomiting, Weakness: Z = 0.29 (P = 0.77), OR (95% CI = 0.85 (0.27, 2.62));liver function damage and loss of appetite: Z = 0.00 (P = 1.00), OR (95% CI = 1.00 (0.17, 6.00)). The P values of the four meta-analyses were all greater than 0.05, and the difference was not statistically significant, indicating that the addition of zoledronic acid to the bone metastasis of lung cancer did not aggravate the changes of the above four adverse reactions. Conclusion: Radiotherapy combined with the zoledronic acid group is better than the single radiotherapy group in treating pain caused by bone metastasis. It can effectively treat bone metastasis and will not aggravate the occurrence of adverse reactions.

Determination of breath isoprene in 109 suspected lung cancer patients using cavity ringdown spectroscopy

Background:Lung cancer is one of the most common malignant tumors worldwide.Currently,effective screening methods for early lung cancer are still scarce.Breath analysis provides a promising method for the pre-screening or early screening of lung cancer.Isoprene is a potential and important breath biomarker of lung cancer.Material and Methods:To investigate the clinical value of isoprene for diagnosing lung cancer patients,a cavity ringdown spectroscopy(CRDS)based near-real time,sensitive analysis method of breath isoprene is developed in our lab.In this paper,92 breath samples from lung cancer patients,17 breath samples from patients with benign lesions,and 107 breath samples from healthy people were collected.Results:Research indicates that breath isoprene concentration is significantly higher in healthy individuals(221:3±122:2 ppbv)than in patients with lung cancer(112:0±36:6 ppbv)and benign lung lesions(127:9±41:2 ppbv).The result of Receiver Operating Characteristic(ROC)curve suggests that the concentration of isoprene is meaningful for the diagnosis of lung cancer(AUC=0:822,sensitivity=63:6%,specificity=90:2%,P<0:01).Conclusion:This study demonstrates that the CRDS breath isoprene analysis system can effectively analyze a large sample of human breath isoprene,and preliminarily confirms the use of breath isoprene as a biomarker for lung diseases.

《中国肺癌杂志》(Chinese Journal of Lung Cancer)成为URM缔约期刊

2008年1月8日,经过《中国肺癌杂志》的申请,得到国际医学期刊编辑委员会(International Committee of Medical Journal Editors,ICMJE)通知,本刊于该日成为'生物医学期刊投稿的统一要求'(Uniform Requirements for Manuscripts Submitted to Biomedical Journals,URM)的缔约期刊(http://www.icmje.org/jrnlist.html)。这标志着《中国肺癌杂志》经过10年发展,已经全面按照国际期刊标准来办刊,以期早日成为世界知名期刊。关于ICMJE和'生物医学期刊投稿的统一要求':1978年,包括《新英格兰医学杂志》、《美国医学会杂志》、《柳叶刀》、

《中国肺癌杂志》(Chinese Journal of Lung Cancer)成为URM缔约期刊

2008年1月8日,经过《中国肺癌杂志》的申请,得到国际医学期刊编辑委员会(International Committee of Medical Journal Editors,ICMJE)通知,本刊于该日成为'生物医学期刊投稿的统一要求'(Uniform Requirements for Manuscripts Submitted to Biomedical Journals,URM)的缔约期刊(http://www.icmje.org/jrnlist.html)。这标志着《中国肺癌杂志》经过10年发展,已经全面按照国际期刊标准来办刊,以期早日成为世界知名期刊。

Comment on ‘Histological Subtypes of Lung Cancer in Chinese Males from 2000 to 2012'

Mortality from lung cancer has dramatically increased in China over the past 4 decades and investigations into its attributing factors should be designated as one of the highest priorities for its prevention and control. It has been shown that different environmental carcinogens have different particular carcinogenesis pathways in humans, resulting in different kinds of cancer or its histological subtypes in various target organs. Although the distribution of lung cancer is changing in many countries, no papers on its epidemiology in China are available. In the present study, 15 427 male lung cancer patients were identified in Cancer Hospital of the Chinese Academy of Medical Sciences, Peking Union Medial Colleg （CHCAMS-PUMC）. The number of lung cancer patients increased between 2000 and 2012 （Zou et al., Table I）, while the relative frequency of squamous cell carcinoma, a pathological sub-type of lung cancer, consistently decreased, especially in those born after 1961 （Zou et al, Figure 2）. On the other hand, the relative frequency of adenocarcinoma, a pathological sub-type of lung cancer, dramatically increased （Zou et al., Figure 2）. Adenocarcinoma has become the major histological sub-type of lung cancer in the 2011-2012 period （Zou et al., Table 3）. These findings provide important information and clues for the etiology of lung cancer and this specific field needs to be further studied.

DETECTION OF GENE MUTATION IN SPUTUM OF LUNG CANCER PATIENT

Lungcancerisacommonmalignanttumor,whichhasahighincidenceandmortalityrate.Therefore,itisnecessarytoseekanewmethodforthediagnosis,especiallytheearlydiagnosisoflungcancer.Thedevelopmentofmolecularbiologymakesthegenediagnosisoflungcancerpossible.PCR-SSCP...

A Genetic Susceptibility Study of Lung Cancer Risk Potentially Associated with Polycyclic Aromatic Hydrocarbon Inhalation Exposure

For lifetime non-smokers, lung cancer risk is mainly associated with inhalation exposure to air pollution. For the Chinese population, indoor air pollution due to solid fuel combustion has been the primary source of inhalation exposure for decades. Polycyclic aromatic hydrocarbons （PAHs） are the by-products of incomplete combustion.

CHEMOPREVENTION OF LUNG CANCER IN THE HIGH INCIDENCE AREA

Since 1984, mass screening for cancer and chemopreventive trials in the two high incidence areas of lung cancer have been carried out. Chemo preventive trials on the subjects having moderate or severe atypical hyperplasia cells in the sputum were done by treatment with R1 [N-(p-ethoxycarbophenyl) retinamide] and R2 [N-(p-carboxyphenyl) retina-mide]. Results showed that the general status of the patients had improved. IgA and IgM in the serum were increased and the arsenic skin lesions were relieved after the treatment with Rl and R2. The ratio of the incidence of lung cancer for the treated group and the control group was 1:4, and the mean degree of hyperplasia in the sputum had dropped. It is suggested that these drugs are both safe and effective in the chemoprevention of lung cancer.

Analysis of factors related to postoperative pulmonary infection in lung cancer patients after recovery from COVID-19

Objective:To explore factors related to postoperative pulmonary infection in lung cancer patients after recovery from COVID-19 and to provide methods for preventing and reducing the incidence of postoperative lung infection in patients with lung cancer.Methods:A total of 92 patients who underwent lung cancer surgery in the Department of Thoracic and Cardiac Surgery of Yichang Central People’s Hospital from January 28,2023,to March 3,2023,were selected.They were divided into a pulmonary infection group(47 cases)and a nonpulmonary infection group(45 cases)according to whether pulmonary infection occurred.General clinical data of patients were collected and collated to analyse the related influencing factors of pulmonary infection in lung cancer patients after recovery from COVID-19.Results:Univariate analysis showed that patient age(≥60 years),fever after COVID-19 infection,oral and laryngeal symptoms,digestive tract symptoms,neurological symptoms,long-term smoking history,hypertension history,and operation time(≥3 h)were correlated with pulmonary infection(all P<0.05).There was no significant correlation between postoperative pulmonary infection and sex,ocular,nasal and tongue symptoms,systemic symptoms,duration of COVID-19,COPD,lobectomy site,incision pain,mechanical ventilation time(≥6 h),drainage tube retention time(3 d),surgical method(P>0.05).Logistic multivariate analysis showed that age(≥60 years old),long operation time(≥3 h)and long-term smoking history were independent influencing factors for postoperative pulmonary infection in patients with radical resection of lung cancer(P>0.05).Conclusion:In this study,older age(≥60 years old),long-term smoking history,and long operation time(≥3 h)were risk factors for pulmonary infection after lung cancer surgery.In the future,active treatment measures can be taken to address these risk factors during the perioperative period to reduce the incidence of postoperative pulmonary infection.

The clinical application of endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer

Objective To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for staging of lung cancer. Methods The study was retrospective,a total of 52 patients underwent EBUSTBNA for known or suspected lung cancer. All patients were detected enlarged mediastinal lymph nodes on CT scan (≥ 1. 0 cm) . Results Of the 52 patients,41 patients were found with N2 or N3 disease

Depression and quality of life before and after diagnosis of lung cancer

Objective The aim of the present study was to assess the frequency of depression and quality of life(QoL) in lung cancer patients before and after diagnosis,and to investigate the potential related factors. Methods The subjects consisted of 115 consecutive adult patients newly diagnosed for lung cancer in Shanghai Pulmonary Hospital between April 2008 and October 2008. Depression

Multiple pulmonary ground-glass nodules: Challenges and advances

Multiple pulmonary ground-glass nodules(GGNs),a typical clinical manifestation of multiple primary lung cancers(MPLCs),are of great significance for the early screening,diagnosis,and accurate treatment of lung cancer.Thus,the recent increase in the detection rate of multiple pulmonary GGNs has attracted much attention.However,compared with the more widely studied single GGNs,evaluating GGNs is more challenging because of the uncertainty of the etiology,difficult differential diagnosis,and lack of optimal management standards and guidelines.Most current solutions for multiple GGNs are based on the management experiences and principles of a single GGN.Therefore,it is necessary to obtain better understanding of multiple GGNs and to optimize the diagnostic methods and treatments.Both the existing challenges and potential of new methods for diagnosing and treating multiple pulmonary GGNs are reviewed and discussed in this article,with the aim of providing a reference for the clinical management of this highly prevalent condition.