BACKGROUND The effectiveness of neoadjuvant therapy in esophageal cancer(EC)treatment is still a subject of debate.AIM To compare the clinical efficacy and toxic side effects between neoadjuvant chemoradiotherapy(nCRT...BACKGROUND The effectiveness of neoadjuvant therapy in esophageal cancer(EC)treatment is still a subject of debate.AIM To compare the clinical efficacy and toxic side effects between neoadjuvant chemoradiotherapy(nCRT)and neoadjuvant chemotherapy(nCT)for locally advanced EC(LAEC).METHODS A comprehensive search was conducted using multiple databases,including PubMed,EMBASE,MEDLINE,Science Direct,The Cochrane Library,China National Knowledge Infrastructure,Wanfang Database,Chinese Science and Technology Journal Database,and Chinese Biomedical Literature Database Article.Studies up to December 2022 comparing nCRT and nCT in patients with EC were selected.RESULTS The analysis revealed significant differences between nCRT and nCT in terms of disease-free survival.The results indicated that nCRT provided better outcomes in terms of the 3-year overall survival rate(OSR)[odds ratio(OR)=0.95],complete response rate(OR=3.15),and R0 clearance rate(CR)(OR=2.25).However,nCT demonstrated a better 5-year OSR(OR=1.02)than nCRT.Moreover,when compared to nCRT,nCT showed reduced risks of cardiac complications(OR=1.15)and pulmonary complications(OR=1.30).CONCLUSION Overall,both nCRT and nCT were effective in terms of survival outcomes for LAEC.However,nCT exhibited better performance in terms of postoperative complications.展开更多
Objective: To investigate the effect of dexmedetomidine combined with parecoxib sodium on the levels of inflammatory factors, blood gas analysis and stress hormone in patients undergoing radical resection of esophagea...Objective: To investigate the effect of dexmedetomidine combined with parecoxib sodium on the levels of inflammatory factors, blood gas analysis and stress hormone in patients undergoing radical resection of esophageal carcinoma during one lung ventilation. Methods:According to the random data table, 81 cases of esophageal cancer patients were divided into the control group (n=41) and observation group (n=40), the patients in the two groups underwent left thoracotomy esophageal cancer radical resection, the control group patients were treated with parecoxib sodium, and patients in the observation group were treated with parecoxib sodium combined with dexmedetomidine medetomidine treatment, before induction of anesthesia (T0), 30 min of one lung ventilation (T1) and 120 min after operation (T2) at three time points, the levels of inflammatory factors [tumor necrosis factor-α (TNF-α), C reactive protein (CRP)], blood gas analysis[oxygen partial pressure (PaO2), carbon dioxide partial pressure (PaCO2)] and stress hormone[epinephrine (E), norepinephrine (NE)] of the two groups were compared. Results: Intra group level comparison, compared with the levels of two groups at the T0 moment, the levels of TNF-α, CRPand NE of theT1 and T2 moment were significantly increased, the level of PaO2 were significantly decreased, and T2 moment levels were significantly higher than that of T1 moment, the difference was statistical significance;There were no significant differences between the two groups of the levels of TNF-α, CRP, PaO2, E and NE of the T0 moment, the levels of TNF-α, CRP, E and NE of the observation group at the T1 and T2 moment were significantly lower than the control group, at the same time the PaO2 level was significantly higher than the control group, the difference was statistically significant;There were no statistically significant differences in PaCO2 levels between groups and at any time. Conclusion: Dexmedetomidine combined with parecoxib sodium can effectively relieve the inflammatory stress, improve the levels of the blood gas analysis index and stress hormone during one lung ventilation, has an important clinical value.展开更多
<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> To explore the effects of goal-directed fluid therapy (GDFT) o...<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> To explore the effects of goal-directed fluid therapy (GDFT) on lung function, cognitive function and inflammatory response in patients undergoing radical esophageal cancer surgery under one-lung ventilation. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Sixty-seven patients undergoing radical esophageal cancer surgery were divided into GDFT group</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(GDFT therapy) and control group</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(conventional liquid therapy). The changes in patients</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;"> pulmonary function,</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">cognitive function and inflammatory response were evaluated. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Both alveolar-arterial oxygen partial pressure difference</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">[P(A-a)O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">] and respiratory index</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(RI) increased at one-lung ventilation for 30 minutes (T</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">) and decreased at one-lung ventilation for 60 minutes</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(T</span><sub><span style="font-family:Verdana;">3</span></sub><span style="font-family:Verdana;">), and after surgery (T</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;">) in the two groups, and the GDFT group </span></span><span style="font-family:Verdana;">was</span><span style="font-family:Verdana;"> lower than the control group (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05);theoxygenation index (OI) of the two groups decreased at T</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">, T</span><sub><span style="font-family:Verdana;">3</span></sub><span style="font-family:Verdana;">, and T</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> compared with</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">that at T</span><sub><span style="font-family:Verdana;">1</span></sub><span style="font-family:Verdana;"> (before one-lung ventilation), and the GDFT group was higher than the control group (P</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05). At T</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> and T</span><sub><span style="font-family:Verdana;">5</span></sub><span style="font-family:Verdana;">, the tumor necrosis factor </span><i><span style="font-family:Verdana;">α</span></i><span style="font-family:Verdana;"> (TNF-</span><i><span style="font-family:Verdana;">α</span></i><span style="font-family:Verdana;">), interleukin 6 (IL-6), central nervous system specific protein (S100</span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">), and neuron specific enolase (NSE) in the GDFT group were lower compared to the control group (P</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.05), while interleukin-10 (IL-10) was higher compared to the control group (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.05);the incidence of perioperative neurocognitive disorder (PND) in the GDFT group was lower than that in the control group (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> GDFT can help prevent lung injury during radical esophageal cancer surgery under one-lung ventilation, reduce the body</span></span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s inflammatory response, and reduce the incidence of perioperative cognitive disorder to a certain extent.</span>展开更多
文摘BACKGROUND The effectiveness of neoadjuvant therapy in esophageal cancer(EC)treatment is still a subject of debate.AIM To compare the clinical efficacy and toxic side effects between neoadjuvant chemoradiotherapy(nCRT)and neoadjuvant chemotherapy(nCT)for locally advanced EC(LAEC).METHODS A comprehensive search was conducted using multiple databases,including PubMed,EMBASE,MEDLINE,Science Direct,The Cochrane Library,China National Knowledge Infrastructure,Wanfang Database,Chinese Science and Technology Journal Database,and Chinese Biomedical Literature Database Article.Studies up to December 2022 comparing nCRT and nCT in patients with EC were selected.RESULTS The analysis revealed significant differences between nCRT and nCT in terms of disease-free survival.The results indicated that nCRT provided better outcomes in terms of the 3-year overall survival rate(OSR)[odds ratio(OR)=0.95],complete response rate(OR=3.15),and R0 clearance rate(CR)(OR=2.25).However,nCT demonstrated a better 5-year OSR(OR=1.02)than nCRT.Moreover,when compared to nCRT,nCT showed reduced risks of cardiac complications(OR=1.15)and pulmonary complications(OR=1.30).CONCLUSION Overall,both nCRT and nCT were effective in terms of survival outcomes for LAEC.However,nCT exhibited better performance in terms of postoperative complications.
文摘Objective: To investigate the effect of dexmedetomidine combined with parecoxib sodium on the levels of inflammatory factors, blood gas analysis and stress hormone in patients undergoing radical resection of esophageal carcinoma during one lung ventilation. Methods:According to the random data table, 81 cases of esophageal cancer patients were divided into the control group (n=41) and observation group (n=40), the patients in the two groups underwent left thoracotomy esophageal cancer radical resection, the control group patients were treated with parecoxib sodium, and patients in the observation group were treated with parecoxib sodium combined with dexmedetomidine medetomidine treatment, before induction of anesthesia (T0), 30 min of one lung ventilation (T1) and 120 min after operation (T2) at three time points, the levels of inflammatory factors [tumor necrosis factor-α (TNF-α), C reactive protein (CRP)], blood gas analysis[oxygen partial pressure (PaO2), carbon dioxide partial pressure (PaCO2)] and stress hormone[epinephrine (E), norepinephrine (NE)] of the two groups were compared. Results: Intra group level comparison, compared with the levels of two groups at the T0 moment, the levels of TNF-α, CRPand NE of theT1 and T2 moment were significantly increased, the level of PaO2 were significantly decreased, and T2 moment levels were significantly higher than that of T1 moment, the difference was statistical significance;There were no significant differences between the two groups of the levels of TNF-α, CRP, PaO2, E and NE of the T0 moment, the levels of TNF-α, CRP, E and NE of the observation group at the T1 and T2 moment were significantly lower than the control group, at the same time the PaO2 level was significantly higher than the control group, the difference was statistically significant;There were no statistically significant differences in PaCO2 levels between groups and at any time. Conclusion: Dexmedetomidine combined with parecoxib sodium can effectively relieve the inflammatory stress, improve the levels of the blood gas analysis index and stress hormone during one lung ventilation, has an important clinical value.
文摘<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> To explore the effects of goal-directed fluid therapy (GDFT) on lung function, cognitive function and inflammatory response in patients undergoing radical esophageal cancer surgery under one-lung ventilation. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Sixty-seven patients undergoing radical esophageal cancer surgery were divided into GDFT group</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(GDFT therapy) and control group</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(conventional liquid therapy). The changes in patients</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;"> pulmonary function,</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">cognitive function and inflammatory response were evaluated. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Both alveolar-arterial oxygen partial pressure difference</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">[P(A-a)O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">] and respiratory index</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(RI) increased at one-lung ventilation for 30 minutes (T</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">) and decreased at one-lung ventilation for 60 minutes</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(T</span><sub><span style="font-family:Verdana;">3</span></sub><span style="font-family:Verdana;">), and after surgery (T</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;">) in the two groups, and the GDFT group </span></span><span style="font-family:Verdana;">was</span><span style="font-family:Verdana;"> lower than the control group (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05);theoxygenation index (OI) of the two groups decreased at T</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">, T</span><sub><span style="font-family:Verdana;">3</span></sub><span style="font-family:Verdana;">, and T</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> compared with</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">that at T</span><sub><span style="font-family:Verdana;">1</span></sub><span style="font-family:Verdana;"> (before one-lung ventilation), and the GDFT group was higher than the control group (P</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05). At T</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> and T</span><sub><span style="font-family:Verdana;">5</span></sub><span style="font-family:Verdana;">, the tumor necrosis factor </span><i><span style="font-family:Verdana;">α</span></i><span style="font-family:Verdana;"> (TNF-</span><i><span style="font-family:Verdana;">α</span></i><span style="font-family:Verdana;">), interleukin 6 (IL-6), central nervous system specific protein (S100</span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">), and neuron specific enolase (NSE) in the GDFT group were lower compared to the control group (P</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.05), while interleukin-10 (IL-10) was higher compared to the control group (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.05);the incidence of perioperative neurocognitive disorder (PND) in the GDFT group was lower than that in the control group (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> GDFT can help prevent lung injury during radical esophageal cancer surgery under one-lung ventilation, reduce the body</span></span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s inflammatory response, and reduce the incidence of perioperative cognitive disorder to a certain extent.</span>