The efficacy of music therapy to relieve pain, anxiety, and promote sleep quality, in patients with small cell lung cancer receiving platinum-based chemotherapy.

PURPOSE: Chemotherapy induces a range of physical and psychological symptoms, including pain, sleep disorders, fatigue, and anxiety. We aimed to assess the efficacy of six-step music therapy in relieving pain and anxiety and improving sleep quality in lung cancer patients receiving platinum-based chemotherapy. METHODS: Between March 2013 and October 2015, we enrolled a total of 100 patients who were diagnosed with small cell lung cancer and scheduled for platinum-based chemotherapy. Patients were randomly assigned to two groups: the music therapy group (received six-step music therapy, n=50) and the control group (not received six-step music therapy, n=50). The anxiety, pain, and sleep quality of all patients were assessed using the self-rating anxiety scale (SAS), the visual analogue scale (VAS), and the Pittsburgh Sleep Quality Index (PSQI), respectively. RESULTS: There were no significant differences in the demographic characteristics and music background between the two groups. The SAS and VAS scores in the two groups were not statistically different before chemotherapy. However, patients in the music therapy group showed significantly lower SAS and VAS scores compared with the control group at both 1 day and 5 days after chemotherapy. (SAS score at 1-day post-therapy, 49.48±2.14 vs 61.46±8.8, P=0.011; SAS score at 5-day post-therapy, 39.73±1.79 vs 62.02±8.83, P=0.005; VAS score at 1-day post-therapy, 2.14±0.78 vs 4.74±1.01, P=0.005; VAS score at 5-day post-therapy, 2.06±0.79 vs 4.74±1.08, P=0.004). In addition, the total PSQI score of patients who received music therapy was also significantly higher than that of the control group after therapy (total PSQI score at 1-day post-therapy, 8.50±1.69 vs 17.81±3.01, P=0.006; total PSQI score at 5-day post-chemotherapy, 9.84±3.02 vs 18.66±2.91, P=0.012). CONCLUSION: The music therapy was an effective approach in alleviating pain and anxiety and promoting sleep quality in lung cancer patients receiving platinum-based chemotherapy. TRIAL REGISTRATION: Chinese Clinical Trial Registry (registration number: ChiCTR-TRC-13003993).

miR­221 targets HMGA2 to inhibit bleomycin­induced pulmonary fibrosis by regulating TGF­ß1/Smad3-induced EMT.

MicroRNA (miR)-221 plays an essential role in the epithelial-mesenchymal transition (EMT). High mobility group AT-hook 2 (HMGA2), is a key regulator of EMT. However, the role of miR­221 in pulmonary fibrosis, and the association between miR­221 and HMGA2 remain largely unknown. For this purpose, we examined the expression of miR­221 and HMGA2 in human idiopathic pulmonary fibrosis (IPF) tissues and pulmonary cells, namely the adenocarcinoma A549 and human bronchial epithelium (HBE) cell lines, and found that the expression of miR­221 was inhibited in both tissues and cells whereas high mRNA and protein expression of HMGA2 was observed. Additionally, transforming growth factor­ß1 (TGF­ß1) induced the EMT, characterized by the upregulated expression of the mesenchymal markers, namely N­cadherin, vimentin, α­smooth muscle actin, collagen I and collagen III, and the downregulated expression of the epithelial marker E-cadherin in A549 and HBE cells. We then performed transfection with miR­221 mimics, and found that the expression of phosphorylated-Smad3 in miR­221­overexpressing cells was significantly downregulated, compared with that in the TGF­ß1-treated cells without transfection. Furthermore, the overexpression of miR­221 decreased the expression of HMGA2, suppressed the EMT, and inhibited the proliferation of A549 and HBE cells. HMGA2 was directly targeted by miR­221 which was confirmed by the dual-luciferase reporter gene assay. Finally, a mouse model of bleomycin (BLM)­induced pulmonary fibrosis was used to confirm the effect of miR­221 on EMT. Hematoxylin and eosin staining showed that BLM induced thicker alveolar walls and more collagen deposition, whereas miR­221 treatment reduced lung fibrosis and the tissues exhibited thinner alveolar walls and normal lung alveoli. Furthermore, the EMT process was suppressed following miR­221 injection. Taken together, these findings sugest that miR­221 targets HMGA2 to inhibit BLM­induced pulmonary fibrosis through the TGF­ß1/Smad3 signaling pathway.

Effects of Intravenous Patient-Controlled Sufentanil Analgesia and Music Therapy on Pain and Hemodynamics After Surgery for Lung Cancer: A Randomized Parallel Study.

OBJECTIVE: Postoperative pain is caused by surgical injury and trauma; is stressful to patients; and includes a series of physiologic, psychological, and behavioral reactions. Effective postoperative analgesia helps improve postoperative pain, perioperative safety, and hospital discharge rates. This study aimed to observe the influence of postoperative intravenous sufentanil patient-controlled analgesia combined with music therapy versus sufentanil alone on hemodynamics and analgesia in patients with lung cancer. METHODS: This was a randomized parallel study performed in 60 patients in American Society of Anesthesiologists class I or II undergoing lung cancer resection at the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University. Patients were randomly assigned to a music therapy (MT) group and a control (C) group. The MT group underwent preoperative and postoperative music intervention while the C group did not. Both groups received intravenous patient-controlled sufentanil analgesia. The primary outcome was the visual analogue scale (VAS) score at 24 hours after surgery. The secondary outcomes included hemodynamic changes (systolic blood pressure, diastolic blood pressure, heart rate), changes on the Self-Rating Anxiety Scale (SAS), total consumption of sufentanil, number of uses, sedation, and adverse effects. The postoperative sufentanil dose and analgesia frequency were recorded. RESULTS: Compared with the C group, the MT group had significantly lower VAS score, systolic and diastolic blood pressure, heart rate, and SAS score within 24 hours after surgery (p < 0.01). In addition, postoperative analgesia frequency and sufentanil dose were reduced in the MT group (p < 0.01). CONCLUSIONS: Combined music therapy and sufentanil improves intravenous patient-controlled analgesia effects compared with sufentanil alone after lung cancer surgery. Lower doses of sufentanil could be administered to more effectively improve patients' cardiovascular parameters.