Clinical analysis of progressive destroyed lung after lung cancer surgery.

Background: "Progressive destroyed lung (PDL)" refers to a state in which the normal structure and function of the lung are permanently disrupted owing to repeated inflammation. After lung cancer surgery, the remaining lung tissue can experience progressive destruction; however, the exact cause remains unclear. In this study, we retrospectively analyzed cases in which the remaining lung deteriorated after lung cancer surgery and investigated the associated risk factors. Methods: A case-control study was conducted on 31 cases of PDL and 247 cases of non-PDL among 1,234 patients who underwent surgery for primary lung cancer from 2006 to 2021. The following factors were analyzed: age, sex, medical history, smoking status, surgical procedure, lung cancer histology, surgical approach, postoperative complications, chemotherapy, radiation therapy, and lung cancer recurrence. Patients were matched 1:1 based on preoperative factors, and postoperative risk factors were evaluated using multivariate logistic regression analysis. Results: A higher proportion of men and higher prevalence of chronic lung diseases, smokers, squamous cell carcinoma (SCC), postoperative acute pneumonia, chronic pneumonia, air leak, and history of radiation therapy were noted in the PDL group than in the non-PDL group. In the analysis following propensity score matching, chronic pneumonia [odds ratio (OR): 10.1, 95% confidence interval (CI): 2.9 to 35.8] was identified as an independent risk factor for PDL. Conclusions: In this study, PDL after lung cancer surgery was associated with postoperative chronic pneumonia, including Aspergillus infection and aspiration pneumonia.

Clinical Efficacy and Gut Microbiota Regulating-Related Effect of Si-Jun-Zi Decoction in Postoperative Non-Small Cell Lung Cancer Patients: A Prospective Observational Study.

BACKGROUND: Postoperative non-small cell lung cancer (NSCLC) patients frequently encounter a deteriorated quality of life (QOL), disturbed immune response, and disordered homeostasis. Si-Jun-Zi Decoction (SJZD), a well-known traditional Chinese herbal formula, is frequently employed in clinical application for many years. Exploration is underway to investigate the potential therapeutic effect of SJZD for treating postoperative NSCLC. OBJECTIVE: To assess the efficacy of SJZD on QOLs, hematological parameters, and regulations of gut microbiota in postoperative NSCLC patients. METHODS: A prospective observational cohort study was conducted, enrolling 65 postoperative NSCLC patients between May 10, 2020 and March 15, 2021 in Yueyang Hospital, with 33 patients in SJZD group and 32 patients in control (CON) group. The SJZD group comprised of patients who received standard treatments and the SJZD decoction, while the CON group consisted of those only underwent standard treatments. The treatment period was 4 weeks. The primary outcome was QOL. The secondary outcomes involved serum immune cell and inflammation factor levels, safety, and alterations in gut microbiota. RESULTS: SJZD group showed significant enhancements in cognitive functioning (P = .048) at week 1 and physical functioning (P = .019) at week 4. Lung cancer-specific symptoms included dyspnea (P = .001), coughing (P = .008), hemoptysis (P = .034), peripheral neuropathy (P = .019), and pain (arm or shoulder, P = .020, other parts, P = .019) eased significantly in the fourth week. Anemia indicators such as red blood cell count (P = .003 at week 1, P = .029 at week 4) and hemoglobin (P = .016 at week 1, P = .048 at week 4) were significantly elevated by SJZD. SJZD upregulated blood cell cluster differentiation (CD)3+ (P = .001 at week 1, P < .001 at week 4), CD3+CD4+ (P = .012 at week 1), CD3+CD8+ (P = .027 at week 1), CD19+ (P = .003 at week 4), increased anti-inflammatory interleukin (IL)-10 (P = .004 at week 1, P = .003 at week 4), and decreased pro-inflammatory IL-8 (P = .004 at week 1, p = .005 at week 4). Analysis of gut microbiota indicated that SJZD had a significant impact on increasing microbial abundance and diversity, enriching probiotic microbes, and regulating microbial biological functions. CONCLUSIONS: SJZD appears to be an effective and safe treatment for postoperative NSCLC patients. As a preliminary observational study, this study provides a foundation for further research.

Effect of continuous nursing combined with respiratory exercise nursing on pulmonary function of postoperative patients with lung cancer.

BACKGROUND: Lung cancer is a malignant tumor with high morbidity and mortality among cancers. Surgery is currently one of the primary methods of treating lung cancer. Although it can slow down the progression of the disease by removing the lesion, this invasive surgery inevitably damages the integrity of the patient's chest. Moreover, the patient's pulmonary function may have a low compensatory capacity after surgery, causing various respiratory diseases such as atelectasis, respiratory function decline, and even serious cardiovascular disease. All of these have great negative impacts on the surgical effect and the prognosis of patients. With the continuous exploration and development of nursing, continuous nursing and respiratory exercise nursing have been gradually applied in the nursing of patients after lung cancer surgery, and have achieved good nursing results. AIM: To investigate the effect of continuous nursing combined with respiratory exercise nursing on the pulmonary function of postoperative patients with lung cancer. METHODS: A total of 80 patients with lung cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the study subjects. All subjects were randomly divided into the control group (n = 40 cases) and the experimental group (n = 40 cases). Patients with lung cancer in the control group were given conventional nursing after surgery, while the experimental group was given continuous nursing combined with respiratory exercise nursing based on conventional nursing. The recovery of pulmonary function and respiratory symptoms was observed before and after 3 mo of intervention in both groups. The pulmonary function parameters, blood gas analysis, MD Anderson Symptom Inventory-lung cancer module (MDASI-LC) scores, incidence of pulmonary complications, and Morisky compliance scores were compared between the two groups before and after 3 mo of intervention. RESULTS: There was no significant difference in pulmonary function and blood gas analysis between the two groups before intervention (P > 0.05). 3 mo after the intervention, the pulmonary function parameters in the experimental group (SpO2, VC, MVV, FEV1, FEV1% pred, and FEV1/FVC) were higher than those in the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in blood gas analysis between the two groups before intervention (P > 0.05). PaO2 in the experimental group was significantly higher than that in the control group, and PaCO2 was significantly lower than that in the control group 3 mo after the intervention. The difference had statistical significance (P < 0.05). 3 mo after the intervention, the MDASI score of respiratory symptoms in the experimental group was significantly lower than that in the control group (P < 0.05), and the incidence of pulmonary complications was lower than that in the control group (P < 0.05). In addition, the treatment compliance and nursing satisfaction of patients in the experimental group were higher than those in the control group, and the differences were statistically significant (P < 0.05). CONCLUSION: Continuous nursing combined with respiratory exercise nursing can significantly accelerate the recovery of respiratory function in postoperative lung cancer patients, reduce the incidence of postoperative complications of lung cancer as well as improve the treatment compliance of patients.

Application progress of early mobilization of lung cancer patients based on the concept of enhanced recovery after surgery / 中国实用护理杂志

Early mobilization plays a vital role in the recovery of patients after lung cancer surgery. From the perspective of enhanced recovery after surgery, this paper summarized the mobilization program, effect evaluation and expanded application of early getting out of bed in lung cancer patients, in order to provide reference for medical staff to formulate early mobilization programs.

Clinical application of high-flow nasal cannula for the respiratory failure following radical resection of pulmonary carcinoma / 中国实用护理杂志

Objective To evaluate the effects of the application of high-flow nasal cannula (HFNC)for the respiratory failure following radical resection of pulmonary carcinoma. Methods A total of 48 patients with radicalsurgeryofpulmonarycarcinoma effect postoperative failure from February 2015 to August 2016 were randomly divided into observation group(24 cases) and control group(24 cases) with digital table method.The observation group was received with HFNC,and the control group with oxygen atomization mask 8-10 L/min.The heart rate,respiratory rate,PaO2,PaCO2and oxygenation index(PaO2/FiO2)changes were evaluated before treatment,treatment for 1,6,24 h and at the end of the treatment in both groups, at the same time, noninvasive positive pressure ventilation (NPPV) rate, again intubation mechanical ventilation rate, incidence of ventilator associated pneumonia (VAP), ICU confusion assessment (CAM-ICU) positive rates and ICU stay time were compared in the course of treatment of difference. Results Through two different methods of treatment, the heart rate, respiratory rate, PaO2, PaCO2,PaO2/FiO2were(78.88±12.03)times/min,(18.96±7.53)times/min,(140.2±18.37)mmHg(1 mmHg=0.133 kPa),(37.04±7.67)mmHg,(242.83±27.13)mmHg in the observation group,respectively,compared with(88.83±16.48)times/min,(25.46±9.51)times/min,(86.08±20.83)mmHg,(45.71±10.37)mmHg and(210.71±36.34)mmHg in the control group,which had significant differences(t=-3.922-3.415,P<0.05). The ICU stay time in the observation group was( 68.71 ± 32.38) h, respectively, which was much shorter than that in the contorl group(107.67±66.15) h, the difference was statistically significant (t=2.416, P<0.05). The occurrence rates of NPPV and the positive rates of CAM-ICU were16.7%(4/24),4.2%(1/24)in the observation group,respectively,compared with 45.8%(11/24),33.3%(8/24)in the control group,which had significant differences(x2=4.752,4.923,P<0.05). Conclusions HFNC is a new and effective way of oxygen therapy that can better improve circulation oxygenation,reduce PaCO2,reduce the rate of line of NPPV and CAM-positive rate in the ICU,and can shorten the patient's ICU stay time in the treatment of lung cancer patients with postoperative respiratory failure.