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Immune checkpoint inhibitors (ICIs) have become an important treatment strategy for advanced esophageal cancer in the first and second line. Currently, the use of ICIs in neoadjuvant therapy is very limited. However, neoadjuvant immunotherapy may bring better survival benefits for patients with early esophageal cancer or with resectable locally advanced esophageal cancer. The authors review relevant studies to discuss the current status and future of neoadjuvant immunotherapy for esophageal cancer.
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Objective To compare the postoperative analgesic effect between serratus plane block and thoracic paravertebral block in patients undergoing thoracoscopic surgery.Methods Sixty patients undergoing thoracoscopic surgery, 38 males and 22 females, aged 18-65, BMI 18-25 kg/m2, falling into ASA physical status I or II.They were divided into groups S and T by random number table, 30 cases in each group.Two groups of patients were treated with general anesthesia with endobronchial intubation and PCIA after operation.Group S performed Ultrasound-guided serratus plane block and group T performed thoracic paravertebral block, 0.4%ropivacaine 30 ml were used in the two groups.The two groups of patients were observed 30 min after block, and the sensory block plane was measured with acupuncture and recorded.Recording operation time, onset time and duration of the block.Resting and cough VAS score were recorded at 2, 4, 8, 12, 24, and 48 hafter surgery.The first pressing time of the analgesic pump and times of press analgesic pump, the amount of sufentanil used and times the number of cases of useing piperidine were recorded within 48 hafter operation.Block related complications and analgesic related adverse reactions were recorded.Results Compared with group T, the operation time of the block obviously shortening but the duration obviously lengthening (P<0.01).Resting and cough VAS score at 12 hafter surgery significantly was lower (P<0.01).The first pressing time of the analgesic pump obviously lengthening, the number of press analgesic pump and the amount of sufentanil used significantly were reduced (P<0.01) in group S.Conclusion Ultrasound guided SP block and TPVB block can provide good postoperative analgesia for patients undergoing thoracoscopic surgery, but SP block is more durable, with less operation time and complications than TPVB block, and can effectively reduce the opioid demand and incidence of nausea and vomiting after operation.
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Objective To investigate the effect of dexmedetomidine combined with sufentanil on postoper-ative analgesia in patients undergoing thoracoscopic lobectomy. Methods Sixty patients undergoing thoracoscopic lobectomy were randomly divided into the dexmedetomidine group(DS group)and the control group(S group). The two groups were treated with PCIA.The Group DS:dexmedetomidine 2 μg/kg+sufentanil 1.5 μg/kg+ondan-setron 8 mg;and the group S:sufentanil 2 μg/kg+ondansetron 8 mg,in which all drugs were dissolved in 100 mL 0.9 normal saline. Parameters:loading dose 2 mL;infusion speed 2 mL/h;PCA dosage 2 mL each time;lock time:15 min. The mean arterial pressure(MAP),heart rate(HR),resting(VASR)and cough(VASC)VAS score,and Ramsay sedation score were recorded at 2,6,12,24,36 and 48 h after surgery.The number of press analgesic pump,the amount of sufentanil used,the incidence of adverse reactions such as,the nausea and vomit-ing,respiratory depression,bradycardia and so on were recorded within 48 h after operation. Results Compared with the group S,the MAP and HR of patients in the group DS decreased significantly at each time(P < 0.05), the scores of VASR and VASC decreased obviously at 6,12,24 h after surgery(P<0.05),the number of press analgesic pump,the amount of sufentanil used,the incidence of nausea and vomiting decreased obviously within 48 h after operation(P<0.05).Conclusions Dexmedetomidine combined sufentanil administration in PCIA after thoracoscopic lobectomy can obtain satisfactory analgesic effect and more stable hemodynamics,and reduce the dosage of sufentanil,the incidence of nausea and vomiting.
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Objective To investigate the effect of the compound administration of levobupiva-caine and magnesium sulfate in ultrasonography-guided femoral block on postoperative analgesia of anterior cruciate ligament reconstruction.Methods A total of 107 patients,66 males and 41 females, aged 25-60 years,ASA physical status Ⅰ or Ⅱ,undergoing arthroscopic anterior cruciate ligament (ACL)reconstruction,were randomly divided into magnesium sulfate group (n = 56 )and control group (n = 51 ).Both groups were treated with ultrasound-guided ipsilateral femoral nerve block before anesthesia induction.The patients in the magnesium sulfate group were treated with 0.25%levobupivacaine and 2% magnesium sulfate mixture 20 ml,and the control group was treated with 0.25% levobupivacaine 20 ml.The blocking of sensation and movement of femoral nerve was recor-ded.The VAS scores of resting and exercise were recorded at 4,6,12,24 and 48 h after operation. The additional analgesics,tramadol dosage,satisfaction score at postoperative 48 h,incidence of nau-sea and vomiting and other adverse reactions at 48 h after surgery were recorded.Results At postop-erative 12 h,VAS score was significantly lower in the magnesium sulfate group than that in the con-trol group (P <0.05).There were 5 cases (8.9%)needing additional analgesics in the magnesium sulfate group,significantly lower than 10 cases (19.6%)in the control group (P <0.05).The tram-adol dosage of magnesium sulfate group was significantly lower than that in the control group (P <0.05).The duration and onset time of sensation and movement block and Likert satisfaction score in the magnesium sulfate group were significantly superior to that of control group (P <0.05).The inci-dence of adverse reactions between the two groups were not statistically different.Conclusion The combined applications of levobupivacaine and magnesium sulfate in ultrasound-guided ipsilateral femo-ral nerve block could shorten the onset time and prolong the duration of blocking,improve the post-operative analgesic effect and patients' satisfaction, reduce the dosage of analgesic drugs. Additionally,it dose not increase the incidence of adverse reactions.
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on,size and the extent structures of atrial septal defect on line.
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0.05).Conclusions The expression of galetin-3 was obviously increased in liver metastasis from colon cancer,and MCP can effectively inhibit the development of liver metastasis of colon cancer.