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Objective: The aim of the present study was to evaluate the anesthetic and analgesic effects of dexmedetomidine combined with suprascapular nerve block and axillary nerve block in shoulder arthroscopy. Methods: A total of 60 patients were randomly divided into the experimental group (DEX group) and the control group (GA group) via a random number table method. Dexmedetomidine sedation combined with suprascapular nerve block and axillary nerve block was used in the DEX group, while general anesthesia with tracheal intubation combined with interscalene brachial plexus block was used in the GA group. The perioperative indexes, intraoperative hemodynamics, cerebral oxygen saturation, and postoperative pain score, as well as any complications, were compared between the two groups. Results: The anesthesia duration (p < 0.05) and postoperative monitoring time (p < 0.05) in the DEX group were significantly shorter than those in the GA group. At most time points during the anesthesia, the cerebral oxygen saturation (p < 0.05) and mean arterial pressure (p < 0.05) in the DEX group were significantly higher than those in the GA group. Additionally, the decrease in the cerebral oxygen saturation and mean arterial pressure in the GA group was significantly higher than that in the DEX group (p < 0.05). The pain score of DEX group 12 h after operation significantly lower than that in the GA group (p < 0.05), and the incidence of postoperative hypoxemia along with nausea and vomiting in the GA group was significantly higher than that in the DEX group (p < 0.05). Conclusion: Dexmedetomidine combined with suprascapular nerve block and axillary nerve block could reduce the incidence of hypoxemia, while the approach demonstrated better hemodynamic stability, fully ensured the cerebral blood perfusion, and exhibited better anesthetic and analgesic effects, meaning it could be safely and effectively applied in shoulder arthroscopy procedures.
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BACKGROUND: Microwave ablation (MWA) has recently become an established treatment option for topical therapy of lung cancer patients. In this study, we evaluated whether MWA combined with chemotherapy could improve progression-free survival (PFS) of patients with stage IV lung adenocarcinoma compared with chemotherapy alone. METHODS: A total of 49 patients were enrolled into the study; 21 patients accepted MWA therapy combined with chemotherapy, 28 patients accepted only chemotherapy. Enumeration data were analyzed using χ2 test or Fisher's exact probability test and univariate analysis was analyzed using Kaplan-Meier survival curves. Multivariate analysis was carried out with the Cox proportional hazard model. RESULTS: The treatment regimen was not correlated with clinical features of the patients, which included gender, age, smoking history, tumor site, tumor size and Eastern Cooperative Oncology Group (ECOG). The patients' 3-year overall survival (OS) was 12.5%, and median survival time was 19.3 months. The median PFS was 6.1 months and the 1-year PFS was 0.0%. The PFS was significantly associated with tumor size (P < 0.05), ECOG (P < 0.01) and treatment regimen (P < 0.01). The median time to local progression (TTLP) was 8.4 months and the 3-year TTLP was 2.0%. The TTLP was significantly associated with tumor size (P < 0.05) and treatment regimen (P < 0.01). Cox multivariate regression demonstrated that MWA combined with chemotherapy was the independent factor for both the PFS and TTLP. CONCLUSION: MWA, as a topical treatment method, when combined with chemotherapy improved the PFS and TTLP of patients with stage IV lung adenocarcinoma.
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Adenocarcinoma del Pulmón/tratamiento farmacológico , Adenocarcinoma del Pulmón/cirugía , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/cirugía , Microondas/uso terapéutico , Adenocarcinoma del Pulmón/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Cisplatino/administración & dosificación , Cisplatino/uso terapéutico , Terapia Combinada , Quimioterapia , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Análisis Multivariante , Estadificación de Neoplasias , Pemetrexed/administración & dosificación , Pemetrexed/uso terapéutico , Ablación por Radiofrecuencia , Análisis de Regresión , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
Background/Aim: To investigate the clinical and prognostic significance of MUC1 expression in patients with esophageal squamous cell carcinoma (ESCC) after radical resection. Materials and Methods: A total of 108 ESCC specimens were evaluated by reverse transcriptase-polymerase chain reaction (RT-PCR) to detect MUC1 at the mRNA level and were evaluated by immunohistochemistry (IHC) to detect MUC1 at the protein level. Results: MUC1 mRNA was found in 74 cases by RT-PCR and MUC1 protein expression was found by IHC in 70 cases. Both MUC1 mRNA and protein expression correlated with pT (<0.05), pN (P < 0.01), and pTNM (<0.01). The 5-year survival rates of the patients were 39.8%. In univariate analysis, the 5-year survival rate in the ESCC patients was significantly associated with pT (P < 0.01), pN (P < 0.01), pTNM stage (P < 0.01), and MUC1 mRNA and protein expression (P < 0.05). In multivariate analysis, pN and MUC1 expression were the independent relevant factors. Conclusion: MUC1 expression can become a useful marker to predict poor prognostic factors for 5-year survival rate in patients with ESCC after radical resection.
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Carcinoma de Células Escamosas/cirugía , Neoplasias Esofágicas/cirugía , Mucina-1/genética , Mucina-1/metabolismo , Regulación hacia Arriba , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patología , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/metabolismo , Neoplasias Esofágicas/patología , Carcinoma de Células Escamosas de Esófago , Esofagectomía , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Metástasis Linfática , Masculino , Estadificación de Neoplasias , Pronóstico , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
Signal transducer and activator of transcription 3 (STAT3) and mucin 1 (MUC1) are associated with development, progression and a poor prognosis in several types of cancer. The present study investigated the levels of STAT3 and MUC1 in patients with non-small cell lung cancer (NSCLC) following surgery. In total, 98 patients with NSCLC were enrolled into the study. STAT3, phosphorylated (p)-STAT3 and MUC1 expression in NSCLC specimens obtained from patients were investigated using immunohistochemical analysis. Enumeration results were analyzed using the χ2 test or Fisher's exact probability test. Spearman's rank correlation was used to analyze correlations between STAT3, p-STAT3 and MUC1 expression. Univariate analysis was conducted using the Kaplan-Meier estimator curve method and Cox regression multivariate analysis was performed in order to determine prognostic factors. Results demonstrated that STAT3 and p-STAT3 expression was identified in 82 and 51 patients, respectively. Furthermore, the expression of MUC1 was identified in 61/98 cases (62.2%) and STAT3 expression was significantly associated with pathological tumor-node-metastasis stage (pTNM; P<0.01). p-STAT3 expression was associated with pathological type (P<0.01), pathological lymph nodes (pN; P<0.01) and pTNM (P<0.05). MUC1 expression was associated with pathological type (P<0.05), pathological tumor pT (P<0.05), pN (P<0.01) and pTNM (P<0.01). STAT3 expression was positively associated with p-STAT3 expression (P<0.05) and p-STAT3 expression was positively associated with MUC1 expression (P<0.01). Overall, the results identified that the 3-year survival rate was 56.1% and was significantly associated with the degree of differentiation (P<0.05), pT (P<0.01), pN (P<0.01), pTNM stage (P<0.01), p-STAT3 expression (P<0.01) and MUC1 expression (P<0.05). Results obtained from the Cox multivariate regression analysis demonstrated that pN and p-STAT3 expression were independent factors associated with the 3-year survival rate.
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Mucin1 (MUC1) expression correlates with invasion and metastasis and poor survival in some cancers. The purpose of the study was to investigate the clinical significance of MUC1 expression and the risk of tumor metastatic recurrence in patients with esophageal squamous cell cancer (ESCC) after curative resection. A total of 108 ESCC patients were enrolled in this study. MUC1 expression was detected in ESCC tissues from 70 patients by immunohistochemistry (IHC). The expression of MUC1 in the cancerous tissue group was significantly higher than that in the paracancerous normal tissue group (65.4%:10.0%, p < 0.01). MUC1 expression correlated with pT (< 0.05), pN (p < 0.01) and pTNM stage (< 0.01). The 5-year survival rate of the patients was 39.8%. The 5-year tumor metastatic recurrence rate of the patients was 74.1%, and it was associated with pT (p < 0.01), pN (p < 0.01), pTNM stage (p < 0.01) and MUC1 expression (p < 0.01). Multivariate analysis confirmed that pN and MUC1 expression were independent predictive factors. In conclusion, MUC1 expression correlates with tumor metastatic recurrence in postoperative ESCC patients.