ObjectivesTo construct a symptom assessment system suitable for surgical lung cancer patients, and to objectively evaluate the types and severity of postoperative symptoms in patients so as to provide evidence-based basis for the treatment of postoperative symptoms of lung cancer patients.MethodsPostoperative symptom items of lung cancer were formed according to previous researches, literature review, the current lung cancer symptom assessment tools, and expert interviews. The Delphi method was used to conduct two rounds of expert consultation and a postoperative symptom inventory was established for lung cancer patients.ResultsNine first-level symptom items were eventually formed: cough, pain, shortness of breath, fatigue, dizziness, nausea or vomiting, subcutaneous emphysema, insomnia, and constipation. The first round of active coefficient and authority coefficient of experts were 85.0% and 0.88, and the second round were 88.2% and 0.87. The Kendall coordination coefficients of the nine first-level symptom items were 0.47 (P<0.001) and 0.43 (P<0.001), respectively.ConclusionsThe evaluation system of postoperative symptom items for lung cancer patients is highly recognized by experts and has good consistency.
目的观察腔内激光联合聚桂醇泡沫硬化剂治疗下肢静脉曲张的临床效果。 方法回顾性分析2009年2月至2013年7月期间接受腔内激光联合聚桂醇泡沫硬化剂治疗的40例下肢静脉曲张患者（联合组）和单纯接受腔内激光治疗的40例下肢静脉曲张患者（对照组）的临床资料，比较2种治疗方法的效果。 结果联合组和对照组患者的手术时间〔（43.95±6.77）min比（45.20±6.77）min〕和术中出血量〔（16.07±4.30）mL比（16.65±4.50）mL〕比较差异均无统计学意义（P＞0.05），但联合组的手术费用低于对照组〔（7 056.83±940.45）元比（7 473.81±1 476.09）元〕，P=0.044。术后对照组的并发症发生率为20.0%（8/40），高于联合组的5.0%（1/40），差异有统计学意义（P=0.029）。术后所有患者获访4～24个月、（15.5±6.7）个月。随访期间，80例患者的下肢曲张畸形静脉均消失，对照组小范围复发3例（7.5%），联合组小范围复发2例（5.0%），2组复发率的差异无统计学意义（P=1.000）。 结论对下肢静脉曲张，腔内激光联合泡沫硬化剂治疗是一种安全和有效的新微创手术方法，具有并发症发生率低的优点，值得临床推广。
ObjectiveTo explore expression of Mdm2 in the estrogen receptor α (ERα)-positive breast cancer tissues and fibroadenoma of breast tissues, and to explore the effect of MDM2-siRNA on cell proliferation, colony formation, and apoptosis for MCF-7 cells. Methods① Seventy eight ERα-positive breast cancer patients identified by histopathological examination, who underwent surgery in our hospital from June 2012 to October 2015, as well as 10 fibroadenoma of breast patients underwent surgery in the same period, were collected retrospectively to determine the expression of Mdm2, then explore the relationship between the expression of Mdm2 and clinical pathological characteristics of ERα-positive breast cancer patients. ② MCF-7 cells were divided to MDM2-siRNA group (added with MDM2-siRNA), negative control group (added with negative siRNA), and blank control group (added without any reagent). Expression of Mdm2, cell proliferation rate, number of colony formation, and apoptosis rate were determined in the MCF-7 cells of 3 groups. Results① No one of fibroadenoma of breast patients was found positive expression of Mdm2 (0/10), and 38 of 78 ERα-positive breast cancer patients were found the positive expression of Mdm2 (48.7%), which is higher than that of fibroadenoma of breast tissues (χ2=12.357, P=0.000). In ERα-positive breast cancer patients, expression of Mdm2 was related with TNM staging and number of metastasic lymph node (P < 0.050), the positive expression rate of Mdm2 was higher in patients with later TNM staging or more metastasic lymph node. ② Cell proliferation rates on 2, 3, and 4 days after transfection, expression level of Mdm2, and number of colony formation were all lower (P < 0.050), but the apoptosis rate was higher in MDM2-siRNA group (P < 0.050), comparing with negative control group and blank control group. But there was no significant difference between negative control group and blank control group on aforementioned indexes (P > 0.050). ConclusionMdm2 is a diagnostic marker in ERα-positive breast cancer patients, and treatment targeting it might has a certain therapeutic value.
The early detection, diagnosis and treatment of lung cancer are the key points to reduce mortality and improve the prognosis. Detecting tumor markers in blood is a minimally-invasive, cost-effective, easy to administer and approachable test. A microsatellite consists of a tract of tenderly repeated DNA motifs that range in length from two to five nucleotides. Microsatellite alterations (MA) have been described as two types: loss of heterozygosity (LOH) and microsatellite instability (MSI). MicroRNA (miRNA) is a noncoding RNA and protein involved in regulating gene expression in the transcription level. In recent years, some miRNA markers and microsatellite alterations show significant tumor association, tissue specific and stability. Therefore, we write this review to discuss the microsatellite alterations and microRNA in blood of lung cancer.
MicroRNA (miRNA) is a noncoding RNA and protein involved in regulating gene expression in the transcription level. Epidermal growth factor receptor (EGFR) is a protein tyrosine kinase receptor and its mutations have been confirmed in non-small cell lung cancer (NSCLC) by a large number of studies in recent years. EGFR tyrosine kinase inhibitor (EGFR-TKI) is widely used for treatment of NSCLC patients with EGFR mutation. In recent years, miRNA is more and more important in tumor metastasis. The role of EGFR mutations in NSCLC has become a hot spot as well. New researches report that the relationship between miRNA and EGFR mutations plays an important role in NSCLC metastasis. Therefore, we write this review to discuss the mechanisms of miRNA and EGFR mutations in metastasis of NSCLC.
ObjectiveTo review and analyze the treatment of chylothorax after video-assisted thoracoscopic lung cancer surgery and to discuss the best clinical treatment methods and effects.MethodsA total of 400 patients diagnosed with chylothorax at the Department of Thoracic Surgery, West China Hospital, Sichuan University from January 2012 to January 2020 were continuously collected. According to the inclusion and exclusion criteria, 37 patients were finally included. There were 20 males and 17 females with an average age of 55.55±10.49 years. Chylothorax was diagnosed primarily by triglyceride levels (above 110 mg/dL) or the Sudan triple stain test. Treatment included surgical and non-surgical treatment. The overall incidence, high risk factors and treatment methods of chylothorax after radical thoracoscopic surgery for lung cancer were analyzed. According to the treatment methods, the patients were divided into a surgical treatment group and a non-surgical treatment group. The average daily drainage volume and average hospital stay of the patients between the two groups were analyzed.ResultsIncluded patients accounted for 0.3% (37/12 515) of lung cancer thoracoscopic surgery in our hospital during the same period. The incidence of postoperative chylothorax in patients with right lung surgery (0.2%, 29/12 515) was higher than that of patients with left lung surgery (0.1%, 8/12 515). Of 37 patients with chylothorax after lung cancer surgery, 32 patients were in the non-surgical treatment group (86.5%, 32/37), and the rate was higher compared with the surgical treatment group (13.5%, 5/37, P=0.000). The average daily drainage in the surgical treatment group was 777 mL more than that in the non-surgical treatment group (95%CI 588.58 to 965.55, P<0.001). The total drainage volume of the surgical treatment group was more than that of the non-surgical treatment group (8 609.2±4 680.3 mL vs. 4 911.2±3 925.5 mL, P=0.055). The postoperative hospital stay and total hospital stay in the surgical treatment group were shorter than those in the non-surgical treatment group (P=0.162, P=0.118). The tube indwelling time (8.2±2.7 d) was shorter than that of the non-surgical treatment group (12.3±6.8 d, P=0.204).ConclusionThe treatment of chylothorax after radical resection of VATS lung cancer is still mainly non-surgical treatment. Surgical treatment should be initiated as early as possible when the drainage volume is too large 72 hours after chylothorax surgery after radical resection of VATS lung cancer.
Objective To systematically review the prognostic and clinicopathological value of FOXM1 expression in non-small cell lung cancer (NSCLC). Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), CNKI, WanFang Data and CBM were searched to collect cohort studies about the prognostic value of FOXM1 expression in NSCLC from inception to May 30th 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. Results A total of 8 cohort studies, involving 781 patients were included. The results of meta-analysis showed that FOXM1 expression was higher in tumor stage Ⅲ to Ⅳ than stageⅠtoⅡ(OR=2.24, 95%CI 1.25 to 4.01,P=0.007). Higher FOXM1 expression group had a shorter overall survival (HR=1.77, 95%CI 1.42 to 2.22,P<0.000 01) and disease-free survival (HR=1.96, 95%CI 1.04 to 3.17,P=0.04) than those of the lower FOXM1 expression group. Conclusion Current evidence shows that FOXM1 expression is associated with NSCLC stage. Furthermore, FOXM1 overexpression may be prognosis biomarker for NSCLC patients. Due to the limited quantity and quality of included studies, the above conclusions are needed to be verified by more high quality studies.
目的 探讨吻合器痔上黏膜环形切除术（PPH）治疗老年人(gt;65岁)重度痔的临床疗效。 方法 采用PPH治疗21例老年人重度痔，其中Ⅲ度痔6例，Ⅳ度痔10例，嵌顿混合痔5例，对术后疗效及并发症的情况进行分析。结果 单纯PPH手术4例（19.0%）,其余17例（81.0%）均行PPH结合其他手术。平均住院时间8 d，平均手术时间21.4 min。术后76.2%的患者痔核完全回缩，水肿消退。手术当天28.6%的患者疼痛需止痛处理。术后并发症的发生以下腹部酸胀不适（57.1%）、尿潴留（28.6%）发生多见。平均随访21.3周，无肛门狭窄、大便失禁发生，无一例复发，便血5例（23.8%），均为便后少量出血。结论 PPH是适用于老年重度痔的理想术式。
Objective To examine the clinical utility of postoperation symptom inventory. Methods According to the current cancer symptom assessment tools, clinical guidelines and expert interviews, we preliminarily selected 10 common symptoms as an alternative item. Postoperative symptom assessment scale of lung cancer patients was formulated through expert evaluation. And 383 patients in eight hospitals were evaluated and validated using the scale to analyze the reliability and validity. Results Postoperation symptom inventory was easy to operate and evaluate for postoperative lung cancer patients in 8 symptoms (pain, shortness of breath, fatigue, cough, insomnia, throat pain, sweating and constipation). The scale was with high reliability. Cronbach' s α was 0.888. This scale was also with reliable validity. Content validity index was 0.900. There were two common factors with high cumulative proportion in variance(47.70% and 57.46%). And each question had high factor load and communality (>0.40) in the exploratory factor analysis. Conclusion The postoperation symptom inventory has excellent reliability and validity in patients with lung cancer surgery.
ObjectiveTo investigate the preoperative psychological state of patients with pulmonary nodules in order to make the content of the education more "individualized and humanized".MethodsWe conducted a consecutive questionnaire study for 107 patients who were planning to undergo pulmonary resection surgery from May 2018 to July 2018 in our department. There were 54 males and 53 females with an average age of 56.8±11.2 years. The questionnaire content included two parts: personal basic information and 20 questions about surgery, complications, follow-up and hospitalization expense.ResultsThere were 60.7% of the patients diagnosed with pulmonary nodules by CT scan during physical examination, and 52.3% of the patients had strong will to undergo pulmonary surgery to resect nodules; 64.5% of patients wanted doctors to tell them the extent of the disease and whether the tumor could be cured by surgery, and 30.0% of patients concerned whether chief surgeon would complete the whole surgery. The surgery risk and postoperative complications were ignored by patients easily (5.6% and 14.9% respectively). The hospital expenses were not the primary concern of patients. Only 1.9% of patients believed that doctors used nonessentials which deliberately led to increased costs. Network follow-up was accepted by most patients (94.4%).ConclusionIt will contribute to improve preoperative education rationality and effectiveness by understanding true psychological state of patients.