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In cancer treatment, therapeutic strategies that integrate tumor-specific characteristics (i.e., precision oncology) are widely implemented to provide clinical benefits for cancer patients. Here, through in-depth integration of tumor transcriptome and patients' prognoses across cancers, we investigated dysregulated and prognosis-associated genes and catalogued such important genes in a cancer type-dependent manner. Utilizing the expression matrices of these genes, we built models to quantitatively evaluate the malignant levels of tumors across cancers, which could add value to the clinical staging system for improved prediction of patients' survival. Furthermore, we performed a transcriptome-based molecular subtyping on hepatocellular carcinoma, which revealed three subtypes with significantly diversified clinical outcomes, mutation landscapes, immune microenvironment, and dysregulated pathways. As tumor transcriptome was commonly profiled in clinical practice with low experimental complexity and cost, this work proposed easy-to-perform approaches for practical clinical promotion towards better healthcare and precision oncology of cancer patients.
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Regulación Neoplásica de la Expresión Génica , Neoplasias , Medicina de Precisión , Transcriptoma , Humanos , Transcriptoma/genética , Neoplasias/genética , Neoplasias/clasificación , Neoplasias/patología , Pronóstico , Perfilación de la Expresión Génica , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/clasificación , Carcinoma Hepatocelular/patología , Mutación/genética , Microambiente Tumoral/genética , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/clasificación , Neoplasias Hepáticas/patología , Oncología Médica/métodosRESUMEN
Background. Regional analgesia for tubeless, uniport, thoracoscopic wedge resection of benign peripheral nodules is generally performed by intercostal nerve block (INB). We examined the effectiveness of thoracic paravertebral block (PVB), in comparison to the traditional intercostal blocks, for the procedure. Methods. Between July 2016 and December 2016, 20 consecutive patients with solitary benign peripheral lung nodules underwent tubeless uniport thoracoscopic wedge resection using thoracic PVB (PVB group). The clinical outcomes were compared with those of 20 other consecutive patients who underwent the same procedure under the conventional INB, between January 2016 and July 2016 (INB group). In both groups, the procedures were performed without endotracheal intubation, urinary catheterization, or chest tube drainage. Results. The clinical data of patients in both groups were comparable in terms of demographic and baseline characteristics, operative and anesthetic characteristics, puncture-related complications, and postoperative anesthetic adverse events. No puncture-related complications occurred during the perioperative period in either group. The threshold values for mechanical pain at postoperative hours 4 and 8 were significantly higher in the PVB group than in the INB group. Furthermore, the incidence of nausea or vomiting in the PVB group was significantly less than that in the INB group. None of the patients required reintervention or readmission to our hospital. Conclusions. Tubeless uniportal thoracoscopic wedge resection for solitary benign peripheral lung nodules using thoracic PVB for regional analgesia is a feasible and safe procedure. Moreover, we found that thoracic PVB is less painful than INB.
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Bloqueo Nervioso , Nódulo Pulmonar Solitario , Tubos Torácicos , Drenaje , Humanos , Pulmón , Dolor Postoperatorio/epidemiología , Dolor Postoperatorio/etiología , Cirugía Torácica Asistida por VideoRESUMEN
JOURNAL/nrgr/04.03/01300535-202410000-00031/figure1/v/2024-02-06T055622Z/r/image-tiff Glutamate excitotoxicity has been shown to play an important role in glaucoma, and glutamate can induce ferroptosis. The p38 mitogen-activated protein kinase (MAPK) pathway inhibitor SB202190 has a potential ability to suppress ferroptosis, and its downstream targets, such as p53, have been shown to be associated with ferroptosis. However, whether ferroptosis also occurs in retinal ganglion cells in response to glutamate excitotoxicity and whether inhibition of ferroptosis reduces the loss of retinal ganglion cells induced by glutamate excitotoxicity remain unclear. This study investigated ferroptosis in a glutamate-induced glaucoma rat model and explored the effects and molecular mechanisms of SB202190 on retinal ganglion cells. A glutamate-induced excitotoxicity model in R28 cells and an N-methyl-D-aspartate-induced glaucoma model in rats were used. In vitro experiments showed that glutamate induced the accumulation of iron and lipid peroxide and morphological changes of mitochondria in R28 cells, and SB202190 inhibited these changes. Glutamate induced the levels of p-p38 MAPK/p38 MAPK and SAT1 and decreased the expression levels of ferritin light chain, SLC7A11, and GPX4. SB202190 inhibited the expression of iron death-related proteins induced by glutamate. In vivo experiments showed that SB202190 attenuated N-methyl-D-aspartate-induced damage to rat retinal ganglion cells and improved visual function. These results suggest that SB202190 can inhibit ferroptosis and protect retinal ganglion cells by regulating ferritin light chain, SAT1, and SLC7A11/Gpx4 pathways and may represent a potential retina protectant.
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PURPOSE: To describe the regional differences of the sclera in ocular hypertension (OHT) models with the inappropriate extension of the ocular axis. METHODS: To discover the regional differences of the sclera at the early stage, OHT models were established using circumlimbal suture (CS) or sclerosant injection (SI). Axial length (AL) was measured by ultrasound and magnetic resonance imaging. The glaucoma-associated distinction was determined by intraocular pressure (IOP) and retrograde tracing of retinal ganglion cells (RGCs). The central thickness of the ganglion cell complex (GCC) was measured by optical coherence tomography. RGCs and collagen fibrils were detected using a transmission electron microscope, furthermore, anti-alpha smooth muscle actin (αSMA) was determined in the early stage after the operation. RESULTS: Compared with the control group, the eyes in OHT models showed an increased IOP (P < 0.001 in the CS group, P = 0.001 in the SI group), growing AL (P = 0.026 in the CS group, P = 0.043 in the SI group), reduction of central RGCs (P < 0.001 in the CS group, P = 0.017 in the SI group), thinning central GCC (P < 0.001 in the CS group), and a distinctive expression of αSMA in the central sclera in the early 4-week stage after the operation (P = 0.002 in the CS group). Compared with the SI group, the eye in the CS group showed a significantly increased AL (7.1 ± 0.4 mm, P = 0.031), reduction of central RGCs (2121.1 ± 87.2 cells/mm2, P = 0.001), thinning central GCC (71.4 ± 0.8 pixels, P = 0.015), and a distinctive expression of αSMA (P = 0.005). Additionally, ultrastructural changes in RGCs, scleral collagen fibers, and collagen crimp were observed in the different regions. Increased collagen volume fraction in the posterior segment of the eyeball wall (30.2 ± 3.1%, P = 0.022) was observed by MASSON staining in the CS group. CONCLUSION: Regional differences of the sclera in the ocular hypertensive rat model induced by CS may provide a reference for further treatment of scleral-related eye disorders.
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OBJECTIVE: To examine the effectiveness of decortication to treat chronic tuberculous empyema (TE) using uniport video-assisted thoracoscopic surgery (VATS) versus conventional triport VATS. METHODS: Data from consecutive patients with stage II or III TE who underwent decortication with either uniport VATS (uniportal group) between July and December 2017, or triport VATS between January and July 2018 (triportal group), were retrospectively analysed. VATS procedures were performed under general anaesthesia with double lumen endotracheal intubation and clinical outcomes were compared between the two groups. RESULTS: Clinical data were comparable between the groups (20 patients in each) regarding demographic and baseline characteristics, operative and postoperative characteristics, surgical procedure-related complications, and postoperative adverse events. No surgical procedure-related complications occurred during the perioperative period in either group. Threshold values for mechanical pain at 8 h postoperatively were significantly higher in the triportal group versus the uniportal group. Furthermore, the incidence of nausea and vomiting was significantly lower in the uniportal versus triportal group. In the triportal group, one patient required readmission and further intervention due to recurrence. CONCLUSIONS: Uniport VATS decortication for stages II and III TE may be a feasible and safe procedure in selected patients. Moreover, uniport VATS may be less painful than triport VATS.
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Empiema Tuberculoso , Cirugía Torácica Asistida por Video , Humanos , Cirugía Torácica Asistida por Video/efectos adversos , Cirugía Torácica Asistida por Video/métodos , Empiema Tuberculoso/etiología , Estudios Retrospectivos , Neumonectomía/métodos , Dolor/etiologíaRESUMEN
Plasma cell-free DNA (cfDNA) are small molecules generated through a non-random fragmentation procedure. Despite commendable translational values in cancer liquid biopsy, however, the biology of cfDNA, especially the principles of cfDNA fragmentation, remains largely elusive. Through orientation-aware analyses of cfDNA fragmentation patterns against the nucleosome structure and integration with multidimensional functional genomics data, here we report a DNA methylation - nuclease preference - cutting end - size distribution axis, demonstrating the role of DNA methylation as a functional molecular regulator of cfDNA fragmentation. Hence, low-level DNA methylation could increase nucleosome accessibility and alter the cutting activities of nucleases during DNA fragmentation, which further leads to variation in cutting sites and size distribution of cfDNA. We further develop a cfDNA ending preference-based metric for cancer diagnosis, whose performance has been validated by multiple pan-cancer datasets. Our work sheds light on the molecular basis of cfDNA fragmentation towards broader applications in cancer liquid biopsy.
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Ácidos Nucleicos Libres de Células , Neoplasias , Humanos , Nucleosomas/genética , Metilación de ADN/genética , Fragmentación del ADN , Neoplasias/genética , Biomarcadores de Tumor/genéticaRESUMEN
Progression to a severe condition remains a major risk factor for the COVID-19 mortality. Robust models that predict the onset of severe COVID-19 are urgently required to support sensitive decisions regarding patients and their treatments. In this study, we developed a multivariate survival model based on early-stage CT images and other physiological indicators and biomarkers using artificial-intelligence analysis to assess the risk of severe COVID-19 onset. We retrospectively enrolled 338 adult patients admitted to a hospital in China (severity rate, 31.9%; mortality rate, 0.9%). The physiological and pathological characteristics of the patients with severe and non-severe outcomes were compared. Age, body mass index, fever symptoms upon admission, coexisting hypertension, and diabetes were the risk factors for severe progression. Compared with the non-severe group, the severe group demonstrated abnormalities in biomarkers indicating organ function, inflammatory responses, blood oxygen, and coagulation function at an early stage. In addition, by integrating the intuitive CT images, the multivariable survival model showed significantly improved performance in predicting the onset of severe disease (mean time-dependent area under the curve = 0.880). Multivariate survival models based on early-stage CT images and other physiological indicators and biomarkers have shown high potential for predicting the onset of severe COVID-19.
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Glaucoma is the leading cause of irreversible blindness. The progressive degeneration of retinal ganglion cells (RGCs) is the major characteristic of glaucoma. Even though the control of intraocular pressure could delay the loss of RGCs, current clinical treatments cannot protect them directly. The overactivation of N-methyl-D-aspartic acid (NMDA) receptors by excess glutamate (Glu) is among the important mechanisms of RGC death in glaucoma progression. Melatonin (MT) is an indole neuroendocrine hormone mainly secreted by the pineal gland. This study aimed to investigate the therapeutic effect of MT on glutamate excitotoxicity of mouse RGCs and R28 cells. The Glu-induced R28 cell excitotoxicity model and NMDA-induced retinal injury model were established. MT was applied to R28 cells and the vitreous cavity of mice by intravitreal injection. Cell counting kit-8 assay and propidium iodide/Hoechst were performed to evaluate cell viability. Reactive oxygen species and glutathione synthesis assays were used to detect the oxidative stress state of R28 cells. Retina immunofluorescence and hematoxylin and eosin staining were applied to assess RGC counts and retinal structure. Flash visual-evoked potential was performed to evaluate visual function in mice. RNA sequencing of the retina was performed to explore the underlying mechanisms of MT protection. Our results found that MT treatment could successfully protect R28 cells from Glu excitotoxicity and decrease reactive oxygen species. Also, MT rescued RGCs from NMDA-induced injury and protected visual function in mice. This study enriches the indications of MT in the treatment of glaucoma, providing practical research ideas for its comprehensive prevention and treatment.
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Glaucoma , Melatonina , Fármacos Neuroprotectores , Animales , Ratones , Células Ganglionares de la Retina , Fármacos Neuroprotectores/farmacología , Fármacos Neuroprotectores/uso terapéutico , N-Metilaspartato/toxicidad , N-Metilaspartato/uso terapéutico , Ácido Glutámico/toxicidad , Ácido Glutámico/uso terapéutico , Melatonina/farmacología , Melatonina/uso terapéutico , Especies Reactivas de Oxígeno , Glaucoma/tratamiento farmacológico , Receptores de N-Metil-D-Aspartato/uso terapéuticoRESUMEN
OBJECTIVE: To investigate whether tert-Butylhydroquinone (TBHQ) can ameliorate oxidative stress and inflammation induced by glutamate excitotoxicity, and mediate retinal ganglion cell (RGC) damage by activating the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway and inhibiting the nuclear factor kappa B (NF-κB) signaling pathway. MATERIALS AND METHODS: TBHQ was used to treat a glutamate excitotoxicity model of retinal cell line 28 and C57 mice. Damage to RGCs and visual function were assessed using flash visual evoked potential (FVEP), immunofluorescence, propidium iodide staining, and hematoxylin and eosin staining. Knockdown of Nrf2 used Nrf2 shRNA. The expression levels of related proteins were detected using western blot and immunofluorescence. RESULTS: Glutamate excitotoxicity down-regulated Nrf2 expression in vitro and in vivo. Nuclear factor erythroid2-related factor 2 activation by TBHQ reduced the damage to retinal ganglion cells, reduced the thinning of the whole retina and the ganglion cell complex, and shortened the latency of the FVEP forward wave after injury. In addition, the levels of NAD(P)H quinone dehydrogenase 1 (NQO1), heme oxygenase 1 (HO-1), and Nrf2 increased significantly, and those of cyclooxygenase-2 (COX2) and NF-κB decreased significantly, after TBHQ treatment. Compared with TBHQ treatment group, the expression level of p-p65 in shRNA transfected group was increased, but still lower than that in Glu group. CONCLUSION: The protective effect of TBHQ on RGC loss under glutamate excitotoxicity might be related to the activation of the Nrf2 signaling pathway, anti-oxidative stress, inhibition of NF-κB activation, and inhibition of retinal inflammation. Thus, TBHQ might be used to treat glutamate excitotoxicity -related retinopathy.
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Factor 2 Relacionado con NF-E2 , Células Ganglionares de la Retina , Animales , Potenciales Evocados Visuales , Ácido Glutámico/toxicidad , Hemo-Oxigenasa 1/metabolismo , Inflamación , Ratones , Factor 2 Relacionado con NF-E2/metabolismo , FN-kappa B , ARN Interferente Pequeño , Células Ganglionares de la Retina/metabolismoRESUMEN
Background: Minimally invasive surgical resection is a possible radical treatment for pulmonary aspergillosis; however, it is difficult and can be accompanied by a variety of complications, especially in chronic cavitary pulmonary aspergillosis (CCPA). Selective artery embolization is usually conducted as palliative management or emergent control of hemoptysis in CCPA. In this report, we share our experience of 2 CCPA patients who underwent preoperative selective artery embolization followed by robotic-assisted thoracoscopic lobectomy. Case Description: Two male patients with post-tuberculosis CCPA had recurrent hemoptysis. They underwent preoperative selective artery embolization and robotic-assisted thoracoscopic lobectomy in July-August 2022. The intraoperative blood loss volumes for the 2 patients were 160 and 200 mL, respectively. Both patients had good short-term outcomes, and the post-operative stays for each patient were 15 and 9 days, respectively. Conclusions: Robotic-assisted thoracoscopic lobectomy following selective artery embolization is a potential safe and effective treatment for CCPA. Robotic resection has a number of advantages, including the dexterity, the sharp, 3-dimensional, and magnified vision, and a minimally invasive procedure. Selective preoperative feeding artery embolization can reduce intraoperative bleeding and provide a clearer surgical vision, thus facilitating minimally invasive approaches. We expect further systematic clinical researches to validate the conclusion.
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BACKGROUND: The curative potential of various bronchoscopic treatments such as electric snare, carbon dioxide freezing, argon plasma coagulation (APC), Neudymium-dopted Yttrium Aluminium Garnet (Nd:YAG) laser and photodynamic therapy (PDT) for the treatment of intraluminal tumor has been administered previously, but this regimen is not common in the treatment of typical carcinoid. The aim of this study is to investigate the curative effects both in short-term and long-term of interventional bronchoscopy in the treatment of typical carcinoid. METHODS: We retrospectively reviewed the clinical data of typical carcinoid patients who were treated with interventional bronchoscopy for tumor suppression and they were hospitalized in the Emergency General Hospital from December 2010 to December 2020, and Wilcoxon rank sum test and chi-square test were used for analysis. RESULTS: A total of 32 patients were included, including 18 cases of preoperative bronchial artery embolization (embolization rate 56%, 95%CI: 31%-79%). The grade score of dyspnea decreased from before treatment to after treatment, and the difference was statistically significant [(1.44±1.03) score vs (0.25±0.58) score, P=0.003]; The degree of bronchial stenosis decreased from pre-treatment to post-treatment, and the difference was statistically significant [(87.50%±13.90%) vs (17.50%±6.83%), P<0.001]; There was significant difference in bronchial diameter before and after treatment [(0.14±0.18) cm vs (0.84±0.29) cm, P<0.001]. CONCLUSIONS: Bronchoscopic interventional therapy has significant short-term and long-term effects in the treatment of typical carcinoid.
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Neoplasias de los Bronquios , Tumores Neuroendocrinos , Neoplasias de los Bronquios/cirugía , Broncoscopía , Tumor Carcinoide/cirugía , Humanos , Estudios RetrospectivosRESUMEN
Immunotherapy assays using immunoadjuvants and tumor antigens could greatly increase the survival rates of patients with malignant tumors. As effective carriers, metal-organic frameworks (MOFs) have been widely utilized in cancer therapy due to their remarkable histocompatibility and low toxicity. Herein, we constructed a multimodal imaging-guided synergistic cancer photoimmunotherapy by employing a specific MOF (MIL101-NH2) as the core carrier; the MOF was dual-dressed with photoacoustic and fluorescent signal donors (indocyanine green, ICG) and immune adjuvants (cytosine-phosphate-guanine sequence, CpG) and named ICG-CpG@MOF. This nanocarrier could passively target the tumor site through the EPR effect and achieve multimodal imaging (fluorescence, photoacoustic, photothermal and magnetic resonance imaging) of the tumor. Synergistic cancer photoimmunotherapy was achieved via simultaneous photodynamic and photothermal methods with 808 nm laser irradiation. ICG-CpG@MOF achieved the GSH-controlled release of immunoadjuvant into the tumor microenvironment. Furthermore, the released tumor-associated antigen along with CpG could induce the transformation of tumor cells from cold to hot by activating the immune system, which significantly enhanced tumor cytotoxicity and achieved high cure rates with minimal side-effects. This strategy utilizing multimodal imaging and synergistic cancer photoimmunotherapy provides a promising approach for the diagnosis and treatment of cancer.
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BACKGROUND: In patients under esophagectomy, early postoperative oral feeding has traditionally been contraindicated to minimize the risk of anastomotic leaks. Because early oral feeding preserves the integrity and function of gut mucosa, the aim of this study was to investigate the impact of postoperative early oral feeding on esophagectomy. METHODS: Between Oct 2013 and Jan 2016, 41 consecutive patients with esophageal carcinoma (stages I- III), who had undergone minimally invasive Ivor-Lewis surgery, were enrolled in this study. The patients were randomly arranged into the early oral feeding (EOF) group (21 cases) and the simple tube feeding (STF) group (20 cases). The nutritional goal for both groups was 25 kcal/(kg·day). The patients in the EOF group were tube-fed with enteral nutrition and orally fed with 5% glucose in normal saline during the first 4 postoperative days, after that the patients were placed on a liquid diet. The patients in the STF group were postoperatively tube-fed with enteral nutrition for 7 days before being switched to liquid diet. The length of the postoperative hospital stay, rate of perioperative complications, and overall mortality were recorded. Preoperative and postoperative levels of serum albumin (ALB), prealbumin (PA), transferrin (TP), and C reactive protein (CRP) were also monitored. RESULTS: There were no significant differences of the incidence of postoperative complications and overall mortality between the EOF group and the STF group, but the duration of hospital stay, interval until the first liquid food, and time of ambulation in the EOF group were lower than those of the STF group (P<0.05). EOF patients also showed significantly lower CRP levels compared with the STF group (P<0.05). CONCLUSIONS: EOF might reduce the duration of hospital stays and CRP levels in esophageal cancer patients who underwent esophagectomy while the mortality and complications were not affected.
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Nutrición Enteral , Neoplasias Esofágicas , Esofagectomía , Neoplasias Esofágicas/rehabilitación , Neoplasias Esofágicas/cirugía , Humanos , Tiempo de Internación , Complicaciones PosoperatoriasRESUMEN
OBJECTIVE: To investigate the difference in color pattern reversal visual evoked potential (CPR-VEP)between primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) patients. METHODS: Vision Monitor visual electrophysiograph made by Metro Vision Inc. in France was used to record CPR-VEP in 17 eyes of 12 POAG patients, 56 eyes of 41 PACG patients, and 26 eyes of 13 age-equivalent normal persons at an ascending series of temporal frequency (1, 2, 4, 8, 16, and 32 Hz) and color stimulation (black/white, red/green, and blue/yellow). P(100) wave amplitudes and latencies of these patients were compared respectively with those of the normal group. RESULTS: With black/white stimulation, the P(100) wave amplitudes were reduced with the increase of temporal frequency in the 3 groups. The P(100) wave latencies were extended with the increase of temporal frequency with different color stimulations. The P(100) amplitudes were PACG group > NC group > POAG group and black/white > blue/yellow > red/green. The P(100) wave latencies in the POAG group and the PACG group were extended compared with the NC group, but there was no significant difference between PACG group and POAG group. CONCLUSION: CPR-VEP P(100) amplitudes in the PACG group and POAG group have their own characteristics. The P(100) amplitude of PACG is higher, and POAG is lower than normal. The P(100) wave latencies of PACG and POAG are extended.
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Visión de Colores , Potenciales Evocados Visuales/fisiología , Glaucoma de Ángulo Cerrado/fisiopatología , Glaucoma de Ángulo Abierto/fisiopatología , Estimulación Luminosa/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
OBJECTIVE: To investigate the changes of color pattern reversal visual evoked potential (CPR-VEP)of primary glaucoma using different temporal frequencies, and to search for the best temporal frequency parameters and color parameters. METHODS: Vision Monitor visual electrophysiograph (Métrovision, France) was used to record CPR-VEP at different temporal frequencies (1, 2, 4, 8, 16, and 32 Hz) and different color stimulations (black/white, red/green, blue/yellow) in 41 cases (70 eyes) with primary glaucoma (glaucoma group) and 13 normal subjects (26 eyes) (normal control group). P100 wave amplitudes were compared. RESULTS: (1) In the normal control group, P100 amplitudes declined while the temporal frequency of black/white stimulation was increasing, but they had peaks at 2 Hz and 8 Hz red/green stimulation and blue/yellow stimulation. (2) In the glaucoma group, CPR-VEP P100 declined while temporal frequency was increasing under 3 color stimulations, but had a peak at 8 Hz. At 2 Hz-16 Hz, P100 amplitudes were related with the mean defect of Humphrey visual field, especially with all 3 color stimulations at 8 Hz and with blue/yellow stimulation at 2 Hz and 16 Hz. (3) P100 amplitude was most different under the 3 color stimulations between the 2 groups at 8 Hz. CONCLUSION: The changes of CPR-VEP P(100) amplitude can objectively reflect the glaucoma visual function damage. CPR-VEP P100 amplitude has certain value in studying glaucoma under different color stimulations (black/white, red/green, blue/yellow) at 8 Hz, and blue/yellow stimulation at 2 Hz and 16 Hz.
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Pruebas de Percepción de Colores/métodos , Percepción de Color/fisiología , Potenciales Evocados Visuales/fisiología , Glaucoma/diagnóstico , Glaucoma/fisiopatología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Pulmonary tuberculoma are benign solitary pulmonary nodules representing up to 25% of all resected solitary pulmonary nodules. However, the differentiation between pulmonary tuberculoma and lung cancer, as well as between active tuberculoma and inactive tuberculoma remains a clinical challenge. The present review summarizes the recent advances in the management of pulmonary tuberculoma, including radiological findings, the response to anti-tuberculosis treatment and surgical treatments. Application of the novel tubeless video-assisted thoracoscopic surgery (VATS) technique in both the diagnosis and treatment of pulmonary tuberculoma has been found to be safe and feasible and leads to less surgical trauma, which results in reduced length of hospitalization and better post-operative quality of life.
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BACKGROUND: Enhanced recovery after surgery (ERAS) protocols provide recommendations for care in various surgical fields. However, there is scarce information on the application of these protocols in tuberculous empyema surgery. The purpose of this research is to evaluate the outcomes of ERAS recommendations for patients who received tuberculous empyema surgery. METHODS: A retrospective analysis was performed on patients who underwent tuberculous empyema surgery in our hospital from March 2011 to March 2016. The patients were divided into an ERAS group and a conventional control group. The main outcome measure was the postoperative median length of stay (including readmissions). Principles related to ERAS were documented, and the postoperative median hospital stay was analyzed statistically between the two groups. RESULTS: A total of 92 patients underwent 93 consecutive tuberculous empyema surgical treatments. The postoperative fasting time, chest tube duration, and length of stay were shorter in the ERAS group compared with the control group. The volume of chest tube drainage in the ERAS group was significantly smaller than that of the control group. No statistical differences were observed in the postoperative complications and reasons for readmission between the two groups. CONCLUSIONS: Application of ERAS recommendations in patients receiving tuberculous empyema operations decreased the length of stay and chest tube drainage compared to the control group.
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OBJECTIVE: To investigate the dynamic expression and significance of vasoactive intestinal peptide receptor 2 (VIPR2) on retina-choroid-clera in high myopia. METHODS: Twenty-one yellow chicks of 1 day old were used in the research. The right eyes were the experimental group, covered continuously for 1 week, 2 weeks and 4 weeks respectively. The left eyes were not covered as the normal control group. Both groups were detected diopter degrees using retinoscopic refraction, determinated eyeball axis using ophthalmology ultra-A, and investigated VIPR2 expression on retina-choroid-sclera in both groups at three stages by SP immunohistochemical staining. RESULTS: The experimental eyes changed from hypermetropia at pre-experiment to high myopia during the experiment stages, and the diopter degrees were deeper and eyeball axis was longer along with the period of being covered. Both groups had strong expression of VIPR2 on photoreceptor-outer segment of the retina and choroids. The expression was down-regulated with the time in both groups. Compared with the control group, VIPR2 expression of the experimental group was significantly up-regulated (P < 0.05). CONCLUSION: Form deprivation could induce high myopia. The expression of VIPR2 existed on photoreceptor-outer segment of the retina and choroids. VIPR2 may play an important role on the formation and development of myopia.