Study on anxiety, depression, and subjective wellbeing of patients with bladder cancer in their different chemotherapy stages.

Aims and objectives: This study aims to explore the changes in anxiety, depression, and subjective wellbeing in patients with bladder perfusion during different stages of their chemotherapy, and analyze the correlation among their anxiety, depression, and subjective wellbeing. Methods: A total of 174 patients with bladder cancer who received bladder perfusion chemotherapy were selected. The questionnaire survey was conducted with SAS, SDS, and GWB. The patients were surveyed and the data were analyzed. Results: The results of patients' anxiety, depression, and subjective wellbeing show a dynamic change trend. The change is most obvious after 1 month of chemotherapy and tends to be flat after 3 months of chemotherapy. The scores of anxiety, depression, and subjective wellbeing in patients with bladder perfusion at different stages are statistically significant (P < 0.05). There is a negative correlation among anxiety, depression, and subjective wellbeing in patients (r = -0.605, 0.601). Conclusion: Patients' emotions change obviously in the first 3 months of their chemotherapy. Clinical workers can take active intervention measures in this period, guide patients to relieve their anxiety and depression, increase their subjective wellbeing level, and improve their quality of life, which is helpful to ensure the successful completion of chemotherapy.

Diaphragm ultrasound to evaluate the antagonistic effect of sugammadex on rocuronium after liver surgery in patients with different liver Child-Pugh grades: study protocol for a prospective, double-blind, non-randomised controlled trial.

INTRODUCTION: The use of muscle relaxants is an indispensable in the general anaesthesia but is prone to accidents, which are often related to residual muscle relaxant. Therefore, how to timely and effectively eliminate the residual effect of muscle relaxants after surgery has become an urgent clinical problem. Rocuronium is a non-depolarising muscle relaxant that is primarily metabolised by the liver. Patients with liver dysfunction can affect the metabolic process of rocuronium, thereby delaying the recovery of muscle relaxation. Sugammadex (SUG) is a novel-specific antagonist of aminosteroidal muscle relaxants, which can effectively antagonise muscle relaxants at different depths. However, whether liver dysfunction affects the antagonistic effect of SUG against rocuronium has not been reported. Therefore, we hypothesise that with the increase of patients' liver Child-Pugh grade, the recovery time of rocuronium antagonised by the same dose of SUG after surgery will be prolonged, and the incidence of muscle relaxation residual will be increased in the short term. METHODS AND ANALYSIS: This study is a prospective, double-blind, low-intervention, non-randomised controlled clinical trial involving 99 patients with American Society of Anesthesiologists (ASA) Ⅰ-Ⅲ, body mass index 18.5-24.9 kg/m2, who will undergo laparoscopic radical resection of liver cancer under general anaesthesia in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Ultrasonography will be applied to monitor the change rate of diaphragm thickness at different time after extubation to evaluate the occurrence of residual muscle relaxant, which indirectly reflects the dose-effect relationship of SUG antagonising against rocuronium in patients with different liver Child-Pugh grades preoperatively. ETHICS AND DISSEMINATION: The protocol was reviewed and approved by the Medical Ethics Committee of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology (UHCT21012). The findings will be disseminated to the public through peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER: NCT05028088.

Development and validation of a PBRM1-associated immune prognostic model for clear cell renal cell carcinoma.

Alteration in the polybromo-1 (PBRM1) protein encoding gene PBRM1 is the second most frequent mutation in clear cell renal cell carcinoma (ccRCC). It causes a series of changes in the tumorigenesis, progression, prognosis, and immune response of ccRCC patients. This study explored the PBRM1-associated immunological features and identified the immune-related genes (IRGs) linked to PBRM1 mutation using bioinformatics methods. A total of 37 survival IRGs associated with PBRM1 mutation in ccRCC patients were identified. To further explore the role of these IRGs in ccRCC and their association with immune status, eight IRGs with remarkable potential as individual targets were selected. An immune model that was constructed showed good performance in stratifying patients into different subgroups, showing clinical application potential compared to traditional clinical factors. Patients in the high-risk group were inclined to have more advanced stage and higher grade tumors with node metastasis, distant metastasis, and poorer prognosis. Furthermore, these patients had high percentages of regulatory T cells, follicular helper T cells, and M0 macrophages and exhibited high expression levels of immune checkpoints proteins, such as CTLA-4, PD-1, LAG-3, TIGIT, and CD47. Finally, a nomogram integrating the model and clinical factors for clinical application showed a more robust predictive performance for prognosis. The prediction model associated with PBRM1 mutation status and immunity can serve as a promising tool to stratify patients depending upon their immune status, thus facilitating immunotherapy in the future.

Association Between Intermediate-Acting Neuromuscular-Blocking Agents and Short-Term Postoperative Outcomes in Patients with Gastric Cancer.

PURPOSE: This study examined whether different neuromuscular-blocking agents (NMBAs) work differently on the short-term outcomes of gastric cancer patients in terms of laboratory test results and severity of postoperative illness, and whether the effect is dose-related. PATIENTS AND METHODS: Data of 1643 adult patients receiving gastric cancer surgery were analyzed by employing generalized linear models (GLMs), to explore the effects of different NMBAs on neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR) at postoperative day 1 (POD1), POD3, POD7, and return to intended oncologic therapy (RIOT), among others. We adjusted multiple covariants, including patient-, anesthesia-, and surgical complexity-related risk factors. RESULTS: Without adjusting dosage of NMBAs, POD1NLR, POD1PLR (P < 0.05), POD3NLR, POD7NLR, POD3 lymphocytes, POD7LMR (P < 0.01) in gastric cancer patients administered with benzylisoquinoline NMBAs worsened, and the administration of aminosteroidal NMBAs was associated with less risk of transfer to ICU (P < 0.01); without adjusting the types of NMBAs, the highest dose of NMBAs postponed the RIOT (P < 0.05) and was negatively associated with POD3NLR, POD7NLR and POD7LMR (P < 0.01), and increased risk of postoperative transfer to ICU (P < 0.01). When patients given benzylisoquinolines were re-divided in terms of five equal quintiles, from low to high dose, RIOT was delayed and POD7LMR decreased significantly in the fourth and fifth quintile groups as compared to the first quintile group. A higher risk for postoperative transfer to ICU was found in the fifth quintile group as compared to the first quintile group. CONCLUSION: Patients with gastric cancer given benzylisoquinoline NMBAs had more unfavorable short-term outcomes, such as more severe inflammation and increased risk of transfer to ICU than their counterparts administered aminosteroidal NMBAs, and the effect of benzylisoquinolines was dose-related. The effect of aminosteroids on short-term outcomes was not dose-related in the dosage range we used.

Efficacy and Safety of Neuromuscular Blockade in Overweight Patients Undergoing Nasopharyngeal Surgery.

BACKGROUND Adequate muscle relaxation and rapid recovery of neuromuscular function are essential in the perioperative period. We therefore compared various anesthetic regimens of neuromuscular blockers and antagonists administered to overweight patients undergoing nasopharyngeal surgery. MATERIAL AND METHODS This prospective, randomized, double-blind study was conducted in overweight patients undergoing nasopharyngeal surgery. We randomly assigned 102 patients into 3 groups (each n=34) treated with various muscle relaxant agents and antagonists: rocuronium and sugammadex (Group RS), rocuronium and neostigmine (Group RN), and cisatracurium and neostigmine (Group CN). Then, we compared the efficacy and safety indexes of the 3 groups. RESULTS Onset times of muscular relaxation in Group RS and Group RN (110 s and 120 s) were shorter than in Group CN (183 s). Time from administration of antagonist to recovery of the TOF ratio to 0.9 was shorter in Group RS (3.3 min) than in other groups (20.7 min and 19.1 min, respectively). The incidence of postoperative residual curarization (PORC) was significantly lower in Group RS (5.9%) than in the other 2 groups (both 41.2%). The hemodynamic parameter changes before extubation were significantly higher in Group RN and Group CN than in Group RS. The postoperative pain scores were lowest in Group RS. CONCLUSIONS For overweight patients undergoing nasopharyngeal surgery, the use of rocuronium with sugammadex had the shortest onset time of neuromuscular relaxation, accelerated the reversion of neuromuscular blockade, effectively reduced the occurrence of PORC, relieved postoperative pain, and maintained hemodynamic stability before extubation. The combination of rocuronium and sugammadex may be the best anesthetic regimen for overweight patients undergoing nasopharyngeal surgery.

A new phenylethanoid glycoside from Orobanche cernua Loefling.

A novel phenylethanoid glycoside, 3'-O-methyl isocrenatoside (1), along with two known compounds, methyl caffeate (2) and protocatechuic aldehyde (3), were isolated from the fresh whole plant of Orobanche cernua Loefling. All the isolated compounds (1-3) were elucidated on the basis of spectroscopic analysis including IR, MS and NMR data. The cytotoxic activities of these compounds were evaluated. Results showed that 3'-O-methyl isocrenatoside (1) and methyl caffeate (2) exhibited significant cytotoxicity, with IC50 values of 71.89, 36.97 µg/mL and 32.32, 34.58 µg/mL against the B16F10 murine melanoma and Lewis lung carcinoma cell lines, respectively.

[Research achievements on structures and activities of polysaccharides from Panax ginseng].

Panax ginseng C. A. Meyer (P. ginseng) has been used as traditional medicine in Asian countries for more than 2,000 years. P. ginseng contains many active components such as ginsenosides, peptides, essential oil and polysaccharides, among which, P. ginseng polysaccharides were reported to have immunomodulating, anti-cancer, anti-adhesive and antioxidant activities. For better understanding of the structures and biological activities of all the ginseng polysaccharides, here the recent research achievements were reviewed. This review would be helpful for the relevant researchers to get useful information.