Lidocaine is an amide local anaesthetic. In recent years, clinical evidence shows that perioperative intravenous lidocaine injection plays an active role in anti-inflammation, analgesia, anti-tumor and organ protection. Postoperative pain is severe in patients after thoracic surgery, and the incidence of pulmonary complications and cognitive impairment is high. These adverse reactions and complications are closely related to the inflammatory reaction after thoracic surgery. Intravenous infusion of lidocaine may have some effects on alleviating these adverse reactions and complications. Thus, this article reviews the current status of intravenous lidocaine injection in thoracic surgery and explores the related mechanisms to optimize the management of anaesthesia during the perioperative period of thoracic surgery.
Sleep deprivation can cause hyperalgesia, and the mechanisms involve glutamic acid, dopamine, serotonin, metabotropic glutamate receptor subtype 5, adenosine A2A receptor, nicotinic acetylcholine receptor, opioid receptor, brain-derived neurotrophic factor, melatonin, etc. The mechanisms of hyperalgesia caused by sleep deprivation are complex. The current treatment methods are mainly to improve sleep and relieve pain. This paper reviews the mechanism and treatment progress of hyperalgesia induced by sleep deprivation, and aims to provide scientific evidence for the treatment of hyperalgesia caused by sleep deprivation.
ObjectiveTo reveal the scientific output and trends in pulmonary nodules/early stage lung cancer-prediction models. MethodsPublications on predictive models of pulmonary nodules/early lung cancer between January 1, 2002 and June 3, 2023 were retrieved and extracted from CNKI, Wanfang, VIP and Web of Science Core Collection database. CiteSpace 6.1.R3 and VOSviewer 1.6.18 were used to analyze the hotspots and theme trends. ResultsA marked increase in the number of publications related to pulmonary nodules/early stage lung cancer-prediction models was observed. A total of 12581 authors from 2711 institutions in 64 countries/regions published 2139 documents in 566 academic journals in English. A total of 282 articles from 1256 authors were published in 176 journals in Chinese. The Chinese and English journals that published the most pulmonary nodules/early stage lung cancer-prediction model-related papers were Journal of Clinical Radiology and Frontiers in Oncology, separately. Chest is the most frequently cited journal. China and the United States were the leading countries in the field of pulmonary nodules/early stage lung cancer-prediction models. The institutions represented by Fudan University had significant academic influence in the field. Analysis of keywords revealed that multi-omics, nomogram, machine learning and artificial intelligence were the current focus of research. ConclusionOver the last two decades, research on risk-prediction models for pulmonary nodules/early stage lung cancer has attracted increasing attention. Prognosis, machine learning, artificial intelligence, nomogram, and multi-omics technologies are both current hotspots and future trends in this field. In the future, in-depth explorations using different omics should increase the sensitivity and accuracy of pulmonary nodules/early stage lung cancer-prediction models. More high-quality future studies should be conducted to validate the efficacy and safety of pulmonary nodules/early stage lung cancer-prediction models further and reduce the global burden of lung cancer.
Objective This study aimed to analyze the differences between the distribution of Traditional Chinese Medicine (TCM) syndrome elements and salivary microbiota between the individuals with pulmonary nodules and those without. Additionally, it seeked to explore the potential correlation between the distribution of Traditional Chinese Medicine (TCM) syndrome elements and salivary microbiota in patients with pulmonary nodules. Methods We retrospectively recruited 173 patients with pulmonary nodules (PN) and 40 healthy controls (HC). The four diagnostic information was collected from all participants, and syndrome differentiation method was used to analyze the distribution of Traditional Chinese Medicine (TCM) syndrome elements in both groups. Saliva samples were obtained from the subjects for 16S rRNA high-throughput sequencing to obtain differential microbiota and to explore the correlation between Traditional Chinese Medicine (TCM) syndrome elements and salivary microbiota in the evolution of the pulmonary nodule disease. Results The study found that in the PN group, the primary Traditional Chinese Medicine (TCM) syndrome elements related to disease location were the lung and liver, and the primary Traditional Chinese Medicine (TCM) syndrome elements related to disease nature were yin deficiency and phlegm. In the HC group, the primary Traditional Chinese Medicine (TCM) syndrome elements related to disease location were the lung and spleen, and the primary Traditional Chinese Medicine (TCM) syndrome elements related to disease nature were dampness and qi deficiency. There were differences between the two groups in the distribution of Traditional Chinese Medicine (TCM) syndrome elements related to disease location (lung, liver, kidney, exterior, heart) and disease nature (yin deficiency, phlegm, qi stagnation, qi deficiency, dampness, blood deficiency, heat, blood stasis) (P<0.05). The species abundance of the salivary microbiota was higher in the PN group than that in the HC group (P<0.05), and there were significant differences in community composition between the two groups (P<0.05). Correlation analysis using multiple methods, including Mantel test network heatmap analysis and Spearman correlation analysis and so on, showed that in the PN group, Prevotella and Porphyromonas were positively correlated with disease location in the lung, and Porphyromonas and Granulicatella were positively correlated with disease nature in yin deficiency (P<0.05). Conclusion The study concludes that there are notable differences in the distribution of Traditional Chinese Medicine (TCM) syndrome elements and the species abundance and composition of salivary microbiota between patients with pulmonary nodules and healthy individuals. The distinct external syndrome manifestations in patients with pulmonary nodules, compared to healthy individuals, may be a cascade event triggered by changes in the salivary microbiota. The dual correlation of Porphyromonas with both disease location and nature suggests that changes in its abundance may serve as an objective indicator for the improvement of symptoms in patients with yin deficiency-type pulmonary nodules.
Purpose To explore the recognition capabilities of electronic nose combined with machine learning in identifying the breath odor map of benign and malignant pulmonary nodules and Traditional Chinese Medicine (TCM) syndrome elements. MethodsThe study design was a single-center observational study. General data and four diagnostic information were collected from 108 patients with pulmonary nodules admitted to the department of cardiothoracic surgery of Hospital of Chengdu University of TCM from April 2023 to March 2024. The patients' TCM disease location and nature distribution characteristics were analyzed using the syndrome differentiation method. The Cyranose 320 electronic nose was used to collect the odor profiles of oral exhalation, and five machine learning algorithms including Random Forest (RF), k-Nearest Neighbor (KNN), logistic Regression (LR), Support Vector Machine (SVM), and eXtreme Gradient Boosting (XGBoost) were employed to identify the exhaled breath profiles of benign and malignant pulmonary nodules and different TCM syndromes. Results(1) The common disease locations in pulmonary nodules were ranked in descending order as liver, lung, and kidney; the common disease natures were ranked in descending order as Yin deficiency, phlegm, dampness, Qi stagnation, and blood deficiency. (2) The electronic nose combined with the RF algorithm had the best efficacy in identifying the exhaled breath profiles of benign and malignant pulmonary nodules, with an AUC of 0.91, accuracy of 86.36%, specificity of 75.00%, and sensitivity of 92.85%. (3) The electronic nose combined with RF, LR, or XGBoost algorithms could effectively identify the different TCM disease locations and natures of pulmonary nodules, with classification accuracy, specificity, and sensitivity generally exceeding 80.00%. Conclusion Electronic nose combined with machine learning not only has the potential to differentiate the benign and malignant pulmonary nodules but also provides new technologies and methods for the objective diagnosis of TCM syndromes in pulmonary nodules.