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Objective To investigate the effect of thoracic paravertebral nerve block combined with general anesthesia in the perioperative period of elderly patients with non-small cell lung cancer (NSCLC).Methods 50 elderly patients with NSCLC in our hospital from June 2015 to June 2018 were randomly divided into control group (n =25) and observation group (n =25).The control group was given general anesthesia,while the observation group was given thoracic paravertebral nerve block combined with general anesthesia.Postoperative recovery (recovery time,extubation time,ambulation time,feeding time) and hospitalization time,visual analogue scale (VAS) score at 2,12,24 and 48 hours after operation,serum tumor markers [cyfra21-1],carbohydrate antigen 125 (CA125),CA199,carcinoembryonic antigen (CEA) were counted and compared.The heart rate (HR),mean arterial pressure (MAP) [preoperative (T1),15 minutes (T2),5 minutes (T3) after anesthesia],and the incidence of adverse reactions were recorded.Results (1) Postoperative recovery and hospitalization time:hospitalization time,recovery room stay time,extubation time,out-of-bed activity time and eating time of the observation group were shorter than those of the control group (P ＜ 0.05);(2) Pain degree:VAS score of the observation group was lower than that of the control group at 2,12 and 24 hours after operation (P ＜0.05),and 48 hours after operation VAS score of the observation group was lower than that of the control group (P ＜ 0.05).There was no significant difference between the two groups (P ＞ 0.05);(3) Serum tumor markers:there was no significant difference in serum cyfra21-1,CA125,CA199 and CEA levels between the two groups before operation (P ＞ 0.05).After operation,serum cyfra21-1,CA125,CA199 and CEA levels of the two groups were decreased,and the indexes in observation group were lower than that of the control group (P ＜ 0.05);(4) Hemodynamics:there was no significant difference in HR and MAP between the two groups at T1 (P ＞ 0.05).HR and MAP in the two groups at T2 were lower than those at T1,but the levels of each index in the observation group were higher than those in the control group (P ＜ 0.05).HR and MAP in the observation group at T3 stage returned to the level at T1,and there was significant difference between the two groups (P ＜0.05);(5) Adverse reactions:the incidence of adverse reactions in the observation group (8.0％) was lower than that in the control group (32.0％,P ＜ 0.05).Conclusions The application of thoracic paravertebral nerve block combined with general anesthesia in total thoracoscopic lobectomy is safe and can inhibit the large fluctuation of hemodynamics in elderly patients with non-small cell lung cancer,shorten hospitalization time and post-operative rehabilitation time,alleviate post-operative pain,reduce the content of serum tumor markers,and reduce the risk of adverse reactions.
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Objective@#To investigate the effect of thoracic paravertebral nerve block combined with general anesthesia in the perioperative period of elderly patients with non-small cell lung cancer (NSCLC).@*Methods@#50 elderly patients with NSCLC in our hospital from June 2015 to June 2018 were randomly divided into control group (n=25) and observation group (n=25). The control group was given general anesthesia, while the observation group was given thoracic paravertebral nerve block combined with general anesthesia. Postoperative recovery (recovery time, extubation time, ambulation time, feeding time) and hospitalization time, visual analogue scale (VAS) score at 2, 12, 24 and 48 hours after operation, serum tumor markers [cyfra21-1], carbohydrate antigen 125 (CA125), CA199, carcinoembryonic antigen (CEA) were counted and compared. The heart rate (HR), mean arterial pressure (MAP) [preoperative (T1), 15 minutes (T2), 5 minutes (T3) after anesthesia], and the incidence of adverse reactions were recorded.@*Results@#⑴ Postoperative recovery and hospitalization time: hospitalization time, recovery room stay time, extubation time, out-of-bed activity time and eating time of the observation group were shorter than those of the control group (P<0.05); ⑵ Pain degree: VAS score of the observation group was lower than that of the control group at 2, 12 and 24 hours after operation (P<0.05), and 48 hours after operation VAS score of the observation group was lower than that of the control group (P<0.05). There was no significant difference between the two groups (P>0.05); ⑶ Serum tumor markers: there was no significant difference in serum cyfra21-1, CA125, CA199 and CEA levels between the two groups before operation (P>0.05). After operation, serum cyfra21-1, CA125, CA199 and CEA levels of the two groups were decreased, and the indexes in observation group were lower than that of the control group (P<0.05); ⑷ Hemodynamics: there was no significant difference in HR and MAP between the two groups at T1 (P>0.05). HR and MAP in the two groups at T2 were lower than those at T1, but the levels of each index in the observation group were higher than those in the control group (P<0.05). HR and MAP in the observation group at T3 stage returned to the level at T1, and there was significant difference between the two groups (P<0.05); ⑸ Adverse reactions: the incidence of adverse reactions in the observation group (8.0%) was lower than that in the control group (32.0%, P<0.05).@*Conclusions@#The application of thoracic paravertebral nerve block combined with general anesthesia in total thoracoscopic lobectomy is safe and can inhibit the large fluctuation of hemodynamics in elderly patients with non-small cell lung cancer, shorten hospitalization time and post-operative rehabilitation time, alleviate post-operative pain, reduce the content of serum tumor markers, and reduce the risk of adverse reactions.
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<p><b>OBJECTIVE</b>To study the different expressions of glypican-3 in lung squamous cell carcinoma and adenocarcinoma and explore the association of glypican-3 with the prognosis of the patients.</p><p><b>METHODS</b>Glypican-3 expression was detected immunohistochemically in the tumor tissues and adjacent tissues from 48 cases of lung squamous cell carcinoma and adenocarcinoma. Kaplan-Meier method and log-rank test were used for survival analysis of the patients.</p><p><b>RESULTS</b>Glypican-3 expression was detected in the tumor tissues in 29.2% (14/48) of the cases, but not in the adjacent tissues. Of the 22 patients with lung squamous cell carcinoma, 12 (54.5%) showed positive glypican-3 expression in the tumor tissue, a rate significantly higher than that in patients with lung adenocarcinoma [7.7% (2/26), P<0.01]. In all the glypican-3-positive cases, the tumor tissues showed stronger glypican-3 expression in cases with lymph node metastasis or poor tumor differentiation. Kaplan-Meier survival analysis did not indicate a significant correlation of glypican-3 expression with the prognosis of the lung cancer patients.</p><p><b>CONCLUSION</b>Patients with lung squamous cell carcinoma have higher glypican-3 expressions in the tumor tissues than those with lung adenocarcinoma, suggesting the value of glypican-3 protein as a potential marker to detect lung squamous cell carcinoma.</p>
Subject(s)
Humans , Adenocarcinoma , Metabolism , Pathology , Carcinoma, Squamous Cell , Metabolism , Pathology , Gene Expression Regulation, Neoplastic , Glypicans , Metabolism , Kaplan-Meier Estimate , Lung Neoplasms , Metabolism , Pathology , Paraffin Embedding , PrognosisABSTRACT
Objective To investigate the diagnosis and therapy of the sclerosing hemangioma of the lung.Mothods The case history of 15 patients were analyzed retrospectively and summarized the diagnosis and therapy of the Sclerosing hemangioma of the lung.Results There were 2 males and 13 females(1:6.5).No patients were diagnosed this disease before operation for there were no specific imageology features.The tumor cell indicated pantomorphia and there were 3 cases were misdiagnosed during the operation frozen section pathology.The optimization therapy methods was to resect the tumor with the VATS.The prognosis of this disease was well and there were no cases recurrence in these 15 patients.Conclusion The sclerosing hemangioma of the lung was the benign tumor and there were no specific imageology features.The misdiagnosis was frequently before operation.To resect the tumor with the VATS was the optimal therapy method.
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Objective To investigate the therapeutic effect of single stage cavernostomy and myoplasty on the aspergillus thoracic empyema. Method Four patients suffering from aspergillus thoracic empyema were treated with single stage cavernostomy and myoplasty. They got the inflammation of aspergillus after the operation for tuberculosis in 2, bronchiectasis in 1 and lung cyst in 1. They were performed rib resection, cavernostomy, closure of the bronchial openings and total/partial obliteration of the cavity with a muscle flap as a single stage technique. Pectoralis major muscle was used for the myoplasty in 1, latissimus dorsi in 1 and intercostal muscle in 2. All patients were given the therapy of nutritional support, local pressure dressing and oral anti-fungus drugs. Result Two patients got the primary healing, the chest tube were pulled out 2 days later and they were discharged 12 days after the operation. One patient′s cavity became little and there was pus drained from the chest tube, he cured after prolonged draining and washed with the anti-fungus drugs. One patient dead for pneumonia 67 days after the operation. Conclusion Cavernostomy and myoplasty as a single stage technique is safe and reliable in the management of patients with aspergillus thoracic empyema.
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Objective To study the features of pulmonary cryptococcosis and the curative effect of thoracoscopic operation for it. Methods The authors retrospectively analyzed the clinical data of 11 patients with pulmonary cryptococcosis in this hospital between January 1996 and December 2002, consisting of 8 cases of thoracoscopic wedge resection, 2 cases of thoracoscopy-assisted modified posterolateral mini-lobectomy, and 1 case of pulmonary wedge resection. Results Ten patients were preoperatively misdiagnosed. Solitary lesions were found in 8 patients and multiple lesions in both lungs in 3 patients. Complete removal of lesions was achieved in 8 patients and pulmonary biopsy was conducted in 3 patients. Except for 3 cases of wound effusion, there were no other postoperative complications. Follow-up for (38.6?10.8) months (range, 12～72 months) found no pyothorax, bronchopleural fistula, or recurrence of cryptococcosis. Conclusions Pulmonary cryptococcosis usually makes its appearance as a solitary lesion without underlying diseases or symptoms, which is difficult to diagnose preoperatively. Video-assisted thoracoscopic surgery can remove the lesion completely, giving a minimal invasion and rapid recovery.