RESUMO
OBJECTIVE: Limited evidence exists regarding the efficacy of preoperative exercise in reducing short-term complications after minimally invasive surgery in patients with non-small cell lung cancer. This study aims to investigate the impact of preoperative exercise on short-term complications after minimally invasive lung resection. METHODS: In this prospective, open-label, randomized (1:1) controlled trial at Xiangya Hospital, China (September 2020 to February 2022), patients were randomly assigned to a preoperative exercise group with 16-day alternate supervised exercise or a control group. The primary outcome assessed was short-term postoperative complications, with a follow-up period of 30 days postsurgery. RESULTS: A total of 124 patients were recruited (preoperative exercise group n = 62; control n = 62). Finally, 101 patients (preoperative exercise group; n = 51 and control; n = 50) with a median age of 56 years (interquartile range, 50-62 years) completed the study. Compared with the control group, the preoperative exercise group showed fewer postoperative complications (preoperative exercise 3/51 vs control 10/50; odds ratio, 0.17; 95% CI, 0.04-0.86; P = .03) and shorter hospital stays (mean difference, -2; 95% CI, -3 to -1; P = .01). Preoperative exercise significantly improved depression, stress, functional capacity, and quality of life (all P < .05) before surgery. Furthermore, preoperative exercise demonstrated a significantly lower minimum blood pressure during surgery and lower increases in body temperature on day 2 after surgery, neutrophil-to-lymphocyte ratio, and neutrophil count after surgery (all P < .05). Exploratory research on lung tissue RNA sequencing (5 in each group) showed downregulation of the tumor necrosis factor signaling pathway in the preoperative exercise group compared with the control group. CONCLUSIONS: Preoperative exercise training decreased short-term postoperative complications in patients with non-small cell lung cancer.
RESUMO
Recently, coronary microthrombosis has received attention owing to its involvement in the pathophysiological process of no-reflow after acute myocardial ischemia/reperfusion. Due to the small size of coronary microthrombi, there are no precise detection and treatment methods available in the clinic so far. In experimental study, bimodal molecular probes for both detecting and dissolving coronary microthrombi have not yet been reported. In this study, multimodal and multifunctional PLGA-cRGD-PFH-ICG NPs (PLGA: poly(lactic-co-glycolic) acid, cRGD: cyclic arginine-glycine-aspartic acid, PFH: perfluorohexane, ICG: indocyanine green, NPs: nanoparticles) were constructed through a three-step emulsification process, and the corresponding physical and chemical characteristics of the NPs were also tested. The in vitro and in vivo experiments showed that PLGA-cRGD-PFH-ICG NPs could bind to the activated platelets of coronary microthrombi through cRGD and could achieve bimodal molecular imaging (photoacoustic and near-infrared fluorescence) through ICG. Moreover, the PLGA-cRGD-PFH-ICG NPs could permeate more deeply into the thrombus than other common NPs before being triggered by low-intensity focused ultrasound (LIFU), and thrombolysis was carried out through the cavitation effect of PFH after triggering by LIFU. In summary, PLGA-cRGD-PFH-ICG NPs, constructed with safe and approved materials, serve as an excellent theranostic contrast agent that paves the way for the clinical diagnosis and treatment of coronary microthrombosis.