ABSTRACT
Objective:To explore the clinical efficacy of simultaneous or staged video-assisted thoracoscopic surgery (VATS) anatomic segmentectomy for bilateral double primary lung cancer (DPLC).Methods:A retrospective cohort study was conducted. The clinical data of 76 patients with bilateral DPLC who underwent VATS anatomic segmentectomy in Luzhou Traditional Chinese Medicine Hospital from February 2020 to August 2022 were retrospectively analyzed, and they were classified into the simultaneous bilateral thoracoscopic surgery group (the simultaneous group, 44 cases) and the staged thoracoscopic surgery group (the staged group, 32 cases) on the basis of the surgical methods. The intraoperative conditions, perioperative indexes and postoperative complications of the two groups were compared.Results:There were no statistically significant differences in the gender, age, pathological type,postoperative TNM staging of both groups (all P > 0.05). The anesthesia awakening time of the first and second stages of surgery in the staged group was (11±3) min and (13±4) min, which was shorter than that in the simultaneous group [(16±4) min] ( t values were 5.27 and 3.51, both P < 0.05). The number of drainage tubes placed in the simultaneous group was less than that in the sum of two stages of the staged group [(1.9±0.5) tubes vs. (2.2±0.5) tubes, t = 3.40, P = 0.001]. The duration of thoracic drainage tube retention, the postoperative total drainage flow, the days of hospitalization, the first postoperative landing time, and the total treatment cost in the first and second stages of surgery in the staged group were lower than those in the simultaneous group (all P < 0.05), while the postoperative total drainage flow, the days of hospitalization, and the total treatment cost in the sum of two stages of the staged group were higher than those in the simultaneous group (all P < 0.05). The total incidence of complications in the simultaneous group was higher than that in the staged group 1 month after surgery [18.18% (8/44) vs. 3.13% (1/32)], and the difference was statistically significant ( χ2 = 4.02, P = 0.045). The scores of activities of daily living, arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide, and blood oxygen saturation in the simultaneous group were lower than those in the staged group (all P < 0.05). Conclusions:Staged VATS anatomic segmentectomy for bilateral DPLC has few complications and good ability to perform activities of daily living, whereas the treatment cost of simultaneous bilateral thoracoscopic surgery is low. Clinicians may recommend prioritizing simultaneous bilateral thoracoscopic surgery after comprehensively considering the patients ' physical and economic conditions.
ABSTRACT
BACKGROUND: Wuhuang oil has a bacteriostatic action to treat burn wound and promote traumatic healing, but the action on inhibition of scars formation remains poorly understood.OBJECTIVE: To investigate the effects of modified Wuhuang oil at different concentrations and administration times on the growth and proliferation of human fibroblasts in vitro.DESIGN, TIME AND SETTING: Comparison observation regarding cytology in vitro was performed at the Burns Institute in the First Affiliated Hospital of Nanchang University between April 2006 and January 2007.MATERIALS: Prepuce specimens were harvested from patients who underwent circumcision in Department of urinary surgery, at First Affiliated Hospital of Nanchang University and Jiangxi Provincial Children Hospital. All patients aged 2-12 years old, and informed consents were obtained from their relatives. Wuhuang oil and modified Wuhuang oil (water-solubility) were offered by Department of Pharmaceutical Preparation in the First Affiliated Hospital of Nanchang University, China. METHODS: Human fibroblasts cultured in vitro were divided into 2 groups at random, experiment and control. Experiment group was treated with 300 g/L Wuhuang oil, while control group with 300 g/L modified Wuhuang oil. Serum-free culture fluid was used to prepare 6 concentrations of oil solution: 0 (blank control), 100, 150, 200, 250, 300 g/L.MAIN OUTCOME MEASURES: MTT assay was used to determine the growth and proliferation of human fibroblasts at 2, 3, 4, 5,6 days; inhibition rate of cell growth was observed at 2, 4, 6, 8, 10 days.RESULTS: Modified Wuhuang oil (0-300 g/L) concentration positively correlated with inhibition of human fibroblast proliferation;the inhibition was not related to culture time. Modified Wuhuang oil (300 g/L) had the greatest inhibition rate of human fibroblasts at 8-10 days, there were significant differences between experiment group and control group (P < 0.01).CONCLUSION: Modified Wuhuang oil has an effective inhibition on the proliferation of human fibroblasts in vitro, and shows a dose-dependent tendency. Compared with Wuhuang oil, 300 g/L modified Wuhuang oil is superior to suppress the growth of human fibroblasts.