RESUMEN
@#Objective To analyse the consistency of perioperative self-reported pain scores of lung cancer patients with clinical records to provide a basis for optimal pain management. Methods The patients with lung cancer who underwent surgical treatment in the Department of Thoracic Surgery, Sichuan Cancer Hospital from November 2017 to January 2020 were selected. They were divided into two groups based on the source of pain data. The self-report group used a questionnaire in which patients self-reported their pain scores, and the pain scores for the clinical record group were extracted from the electronic medical record system. Kappa test was used to compare the concordance of pain scores between the two groups preoperatively, on postoperative 1-6 days and on the day of discharge. McNemar's paired χ2 test was used to compare the differences in pain intensity levels between the two groups. Binary logistic multi-factor regression was used to analyse the factors influencing the concordance of severe pain (7-10 points) between the two groups. Results Totally 354 patients were collected, including 191 males and 163 females, with an average age of 55.64± 10.34 years. The median postoperative hospital stay was 6 days. The consistency of pain scores between the two groups was poor (Kappa=–0.035 to 0.262, P<0.05), and the distribution of pain levels at each time point was inconsistent and statistically significant (P<0.001). The percentage of inconsistent severe pain assessment ranged from 0.28% to 35.56%, with the highest percentage of inconsistent severe pain assessment on postoperative day 1 (35.56%). Single-port thoracoscopic surgical access was an influencing factor for inconsistent assessment of severe pain on postoperative day 3 (OR=2.571, P=0.005). Conclusion Self-reported perioperative pain scores of lung cancer patients are poorly aligned with clinical records. Clinical measures are needed to improve the accuracy of patient pain data reporting by choosing the correct assessment method, increasing education, and developing effective quality control measures.
RESUMEN
Objective To evaluate the clinical curative effect of salmeterol,fluticasone propionate combined with tiotropium bromide in the treatment of elderly patients with chronic obstructive pulmonary disease (COPD),thus to provide reference for the clinical treatment.Methods 76 patients with moderate and severe COPD were randomly divided into observation group and control group,38 cases in each group.The control group on the basis of COPD conventional treatment,received salmeterol,fluticasone propionate inhalation therapy.The observation group was trea-ted with the treatment of the control group and treated with the inhalation of tiotropium bromide.The lung function tests,C reactive protein and T lymphocyte subsets were compared between the two groups before and after treatment. Results After treatment,FEV1 ,FEV1 /FVC,FEV1 % in the two groups were significantly higher than before treat-ment (t =4.25,4.43,3.98,4.1 2,4.26,4.07,all P <0.05).After treatment,FEV1 ,FEV1 /FVC,expected value for FEV1 % in the observation group were (2.45 ±0.35)L/s,(63.91 ±7.42)%,(47.29 ±7.52),which were signifi-cantly higher than those of control group (t =3.68,4.03,4.1 8,all P <0.05).After treatment,C reactive protein, CD +8 in the two groups were significantly lower than those before treatment,while CD +4 ,CD +4 /CD +8 were significantly higher than those before treatment (t =4.45,3.99,5.1 3,3.86,4.1 3,4.59,3.89,4.03,all P <0.05).After treat-ment,C -reactive protein,CD +8 of the observation group were (1 0.38 ±3.1 2)mg/L,(22.47 ±2.1 3)%,which were significantly lower than the control group,and CD +4 (31 .62 ±4.22)%,CD +4 /CD +8 (1 .43 ±0.20)were signifi-cantly higher than control group (t =4.46,4.1 7,3.92,4.72,all P <0.05).Conclusion Salmeterol,fluticasone propionate combined with tiotropium bromide in the treatment of elderly patients with COPD can significantly improve the patients'lung function,reduce the inflammation reaction,improve the patients 'immune function,alleviate the patients'disease.
RESUMEN
This study investigated the modulatory effect of synthetic cannabinoids WIN55,212-2 on 5-HT(3) receptor-activated currents (I(5-HT3)) in cultured rat trigeminal ganglion (TG) neurons using whole-cell patch clamp technique. The results showed that: (1) The majority of examined neurons (78.70%) were sensitive to 5-HT (3-300 μmol/L). 5-HT induced inward currents in a concentration-dependent manner and the currents were blocked by ICS 205-930 (1 μmol/L), a selective antagonist of the 5-HT(3) receptor; (2) Pre-application of WIN55,212-2 (0.01-1 μmol/L) significantly inhibited I(5-HT3) reversibly in concentration-dependent and voltage-independent manners. The concentration-response curve of 5-HT(3) receptor was shifted downward by WIN55,212-2 without any change of the threshold value. The EC(50) values of two curves were very close (17.5±4.5) μmol/L vs. (15.2±4.5) μmol/L and WIN55,212-2 decreased the maximal amplitude of I(5-HT3) by (48.65±4.15)%; (3) Neither AM281, a selective CB1 receptor antagonist, nor AM630, a selective CB2 receptor antagonist reversed the inhibition of I(5-HT3) by WIN55,212-2; (4) When WIN55,212-2 was given from 15 to 120 s before 5-HT application, inhibitory effect was gradually increased and the maximal inhibition took place at 90 s, and the inhibition remained at the same level after 90 s. We are led to concluded that-WIN55,212-2 inhibited I(5-HT3) significantly and neither CB1 receptor antagonist nor CB2 receptor antagonist could reverse the inhibition of I(5-HT3) by WIN55,212-2. Moreover, WIN55,212-2 is not an open channel blocker (OCB) of 5-HT(3) receptor. WIN55,212-2 significantly inhibited 5-HT-activated currents in a non-competitive manner. The inhibition of I(5-HT3) by WIN55,212-2 is probably new one of peripheral analgesic mechanisms of WIN55,212-2, but the mechanism by which WIN55,212-2 inhibits I(5-HT3) warrants further investigation.