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Objective To investigate the clinical effect of protective technique for intercostal nerve in the application of esophageal cancer surgery.Methods Seventy cases of esophageal and cardia cancer patients with thoracic operation were randomly divided into observation group and control group,and each group was 35 cases.Patients in the observation group were treated with improved protective technique of intercostal nerve during operation,and patients in the control group using the traditional methods of operation for treatment.All patients were treated with intramuscular injection of morphine analgesia drugs after operation.Results The pain score of every time point analgesia patients in the observation group (VAS score) was significant difference from that in the control group (t =3.041,2.854,1.827,2.156,1.965,2.706,P＜ 0.05).The incidence of adverse reactions of analgesia,the incidence of painless patients of postoperative 30 d and 60 d,morphine dosage,chest tube indwelling time and the average hospitalization time in observation group were 0,42.86％,68.57％,(10.6±5.2) mg (4.0±1.6) d,(17.6±4.5) d,and the control group were 17.14％,20.0％,34.29％,(22.8±7.6) mg,(4.8±1.8) d,(20.4±5.8) d (x2=4.56,4.24,8.24,t=7.838,1.965,2.257,P＜0.05).Conclusion The improvement protective technique for intercostal nerve in esophageal cancer surgery,not only can reduce thoracotomy acute postoperative pain,but also reduce the happening of the CPP.Meanwhile,the analgesic effect is good.It is proved with a simple operation,less adverse reaction,conducive to disease recovery after esophageal cancer surgery,indicating that it has clinical popularization value.
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Background and purpose:It was reported that nuclear factor of activated T cells (NFAT) is closely related with carcinomas. Esophageal squamous cell carcinoma (ESCC) is one of the most common carcinomas in China. The present study investigated the expression and clinical significance of NFAT isoforms in ESCC. Methods:The expression of NFAT isoforms and the differences in different pathological levels of ESCC were detected in 104 specimens of human ESCC tissues and normal esophageal tissues by immunohistochemistry. Results:This study found that the positive rates of NFAT1 (53.8%), NFAT2 (10.6%), NFAT3 (26.9%), NFAT4 (45.2%) expression were significantly higher in tumor tissues than in adjacent normal esophageal tissues (P<0.001), respectively. The positive rate of NFAT1 expression was significant-ly higher in drinkers (62.3%) than nondrinkers (37.1%, P=0.01), and also higher in patients with lymph node metastasis (68.4% vs 5.5%, P=0.002) and with late stage (58.7% vs 36.2%, P=0.02). Multivariate analysis showed that NFAT1 expression was correlated with lymph node metastasis. The positive rate of NFAT3 was significantly higher in patients with lymph node metastasis (39.4%) than in those without lymph node metastasis (19.7%, P=0.03). Conclusion:These results suggest that the overexpression of NFAT1 and NFAT3 is associated with lymph node metastasis in ESCC.
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<p><b>BACKGROUND</b>With the improvement of the surgical and anesthetic techniques, there are increasing numbers of elderly surgical patients with lung cancer. The purpose of this study is to examine the prognostic factors of surgical resection in patients more than 70 years of age.</p><p><b>METHODS</b>Data were retrospectively analyzed from 192 patients aged ≥70 years who underwent lung cancer surgery. Of these patients, 48.4% were in stage I, 20.8% in stage II, 19.3% in stage III, and 2.1% in stage IV. Patient demographics were the following: 79.2% male and 20.8% female; 21.9% ≥75 years older; and 11.5% had significant co-morbidities. Tumor characteristics: squamous cell carcinoma 49.0%, adenocarcinoma 35.9%, adenosquamous carcinoma 8.3%, small cell lung cancer 4.7%, others 2.1%.</p><p><b>OPERATIONS</b>exploration 2.1%, wedge resection 8.3%, lobectomy 72.4%, more than lobectomy 12.5%, pneumonectomy 4.7%. Of these operations, 91.1% were radical surgery. The significance of prognostic factors was assessed by univariate and multivariate COX regression analyses.</p><p><b>RESULTS</b>The total 5-year survival rate was 33.5% in this series. Age, sex, symptom and co-morbidity had no impact on survival. Multivariable COX analysis demonstrated that incomplete resection (P=0.003), advanced surgical-pathological stage (P < 0.001) and other type of the tumor (P=0.016) were significant, independent, unfavorable prognostic determinants in patients.</p><p><b>CONCLUSIONS</b>Thoracic surgery is a safe and feasible approach in elderly patients with lung cancer. Every effort should be made to detect early stage patients who might benefit from surgical treatment. Lobectomy is still the ideal surgical option for elderly patients who are able to tolerate the procedure. More limited lung surgery may be an adequate alternative in patients with associated co-morbidities.</p>