Concurrent laparoscopic sleeve gastrectomy with uvulopalatopharyngoplasty in the treatment of morbid obesity comorbid with severe obstructive sleep apnea: a retrospective cohort study.

STUDY OBJECTIVES: This study aimed to evaluate the safety and short-term effect of contemporaneous surgeries (bariatric surgery plus uvulopalatopharyngoplasty [UPPP]) in the treatment of morbid obesity comorbid with severe obstructive sleep apnea (OSA). METHODS: A retrospective cohort study was performed to identify patients with obesity and severe OSA who underwent laparoscopic sleeve gastrectomy (LSG) with or without UPPP surgeries between December 2019 and December 2021 in our center. Patients were divided into 2 groups according to different surgical methods (contemporaneous group [LSG with UPPP] vs LSG-only group). Data about surgical safety, OSA remission, and effectiveness of weight loss were collected and analyzed between the 2 groups before and 12 months after surgery. RESULTS: A total of 101 patients were included in this study (contemporaneous group [LSG with UPPP], n = 42 vs LSG only group, n = 59). There was no significant difference in surgical safety between the 2 groups, and both OSA and obesity were significantly improved at 12.5 ± 2.1 months postoperative follow-up. The apnea-hypopnea index decreased from 68.7 ± 30.4 events/h to 10.2 ± 7.0 events/h in the contemporaneous group (P < .001) and from 64.7 ± 26.2 events/h to 18.9 ± 9.8 events/h in the LSG group (P < .001). Moreover, the apnea-hypopnea index decreased to below 5 events/h in 50% of patients (21/42) in the contemporaneous group but only in 13.5% of patients in the LSG group (P < .001). In the LSG group 20 (34%) patients achieved a reduction in apnea-hypopnea index < 15 events/h and resolution of daytime sleepiness. CONCLUSIONS: Contemporaneous surgery (concurrent bariatric and UPPP surgeries) is feasible and an effective option for patients with obesity and severe OSA. However, our finding suggests that approximately a third of patients undergoing LSG with UPPP may not derive significant benefit from the UPPP portion of the contemporaneous surgical approach. CITATION: Yang C, Yu W, Yao K, et al. Concurrent laparoscopic sleeve gastrectomy with uvulopalatopharyngoplasty in the treatment of morbid obesity comorbid with severe obstructive sleep apnea: a retrospective cohort study. J Clin Sleep Med. 2024;20(4):555-564.

Natural compounds modulating mitophagy: Implications for cancer therapy.

Cancer is considered as the second leading cause of mortality, and cancer incidence is still growing rapidly worldwide, which poses an increasing global health burden. Although chemotherapy is the most widely used treatment for cancer, its effectiveness is limited by drug resistance and severe side effects. Mitophagy is the principal mechanism that degrades damaged mitochondria via the autophagy/lysosome pathway to maintain mitochondrial homeostasis. Emerging evidence indicates that mitophagy plays crucial roles in tumorigenesis, particularly in cancer therapy. Mitophagy can exhibit dual effects in cancer, with both cancer-inhibiting or cancer-promoting function in a context-dependent manner. A variety of natural compounds have been found to affect cancer cell death and display anticancer properties by modulating mitophagy. In this review, we provide a systematic overview of mitophagy signaling pathways, and examine recent advances in the utilization of natural compounds for cancer therapy through the modulation of mitophagy. Furthermore, we address the inquiries and challenges associated with ongoing investigations concerning the application of natural compounds in cancer therapy based on mitophagy. Overcoming these limitations will provide opportunities to develop novel interventional strategies for cancer treatment.

The Subjective Will and Psychological Experience of Home-Based Exercise in Lung Cancer Patients During Interval of Chemotherapy: A Qualitative Study.

Purpose: This qualitative study explores the subjective will and psychological experience of home exercise in patients with lung cancer during the interval of chemotherapy. Methods: Semi-structured interviews were conducted with 15 lung cancer patients undergoing chemotherapy. Following the Colaizzi 7-step analysis method, the interview data were read carefully, meaningful statements related to the research questions were extracted, coded, collected and described in detail, and the authenticity of the theme was verified. Results: The analysis revealed the home-based exercise experience of patients' in the interval period of chemotherapy, and identified three themes: 1) the perception experience of home-based exercise (beneficial home-based exercise experience, negative home-based exercise experience); 2) the influencing factors of home-based exercise (exercise rehabilitation knowledge, disease symptoms and adverse effects of chemotherapy, exercise history, exercise self-efficacy, social support, restrictions on objective conditions); 3) Patients with lung cancer expected to get professional guidance about home-based exercise rehabilitation knowledge from medical care providers. Conclusion: Patients' perception and attitude towards home-based exercise behavior is affected by many factors during the interval of chemotherapy, and they expect professional guidance from medical care providers. Medical care providers should know the problems and the influencing factors in the process of home-based exercise of patients, and formulate personalized exercise measures for patients based on their own characteristics and needs, so as to relieve the symptoms of discomfort and improve the quality of life of patients with lung cancer.

Comparison of contrast-enhanced ultrasound characteristics of inflammatory thyroid nodules and papillary thyroid carcinomas using a quantitative time-intensity curve: a propensity score matching analysis.

Background: This study aims to compare the contrast-enhanced ultrasound (CEUS) characteristics of inflammatory thyroid nodules with those of papillary thyroid carcinomas using time-intensity curve (TIC) analysis. Methods: This was a retrospective cohort study. Among the thyroid nodules in 2161 patients who underwent CEUS from July 2014 to April 2018, 44 nodules in 44 patients ultimately diagnosed as inflammatory nodules and 44 nodules in 44 patients confirmed as papillary carcinomas (enrolled from July 2016 to April 2018) were included after propensity score matching analysis (1:1). The average diameters of lesions in the inflammatory and malignant groups (n=44 each) were 0.92±0.34 cm and 0.89±0.42 cm, respectively. CEUS patterns were evaluated and classified into four types, namely concentric hypo-enhancement, heterogeneous hypo-enhancement, hypo-enhancement with a sharp margin, and homogeneous hyper/iso-enhancement. The measured TIC parameters included peak intensity (PI), rise time (RT), time to peak (TTP), maximum slope rate of the ascending curve (AS), and maximum slope rate of the descending curve (DS). The CEUS patterns and TIC parameters were compared between the inflammatory nodules and papillary carcinomas. Results: The heterogeneous hypo-enhancement CEUS pattern was predominantly present in the inflammatory nodules. The concentric hypo-enhancement pattern was identified as a valuable predictive pattern for papillary carcinomas. For the TIC, inflammatory nodules had a lower PI [55.42 (45.41, 76.91) vs. 84.43 (74.93, 90.92)] [median (interquartile range)] and a smaller AS [22.39 (13.37, 29.93) vs. 29.54 (19.37, 44.77)], compared with papillary carcinomas (P<0.05). Conclusions: CEUS patterns with TIC parameters could provide effective and quantitative information for characterizing microvascular perfusion of inflammatory thyroid nodules and papillary carcinomas.

Publication trends of research on conjunctival melanoma during 1997-2022: A 25-year bibliometric study.

Background: Conjunctival melanoma (CM) is a life-threatening ocular tumor with a high rate of local recurrence and metastasis. Our objective is to analyze research trends in CM field and compare contributions from different countries, institutions and authors. Methods: We extracted all CM-related publications published from 1997 to 2022 from the Web of Science database and applied Microsoft Excel and VOSviewer to review publication data, analyze publication trends, and visualize relevant data. Results: A total of 708 publications were identified. The United States contributed the most publications (280) and citations (8,781 times) with the highest H-index value (47). The Ophthalmic Plastic and Reconstructive Surgery, British Journal of Ophthalmology, American Journal of Ophthalmology and Cornea were the most productive journal concerning CM, and Shields CL, Shields JA, Jager MJ as well as Finger PT had published the most papers in the field. Keywords were classified into three clusters: clinical research, management-related research and genetic research. The keywords "primary acquired melanosis", "metastasis" and "BRAF mutations" were most frequently emerged. According to the average appearing year (AAY), targeted therapy (AAY of 2019.0) and nivolumab (AAY of 2018.7) were identified as the main focuses of the field in the near future. Conclusion: In the past 25 years, the United States, Germany, England and the Netherlands held the leading position in the CM research. A group of scholars made important contributions to CM research and will continue to guide cutting-edge research. Treatments that have been shown to be effective for advanced cutaneous melanoma, such as targeted therapy and immunotherapy, are potential focuses for future CM research.

Safety and Efficacy of Mild Moxibustion on Cancer-Related Fatigue in Non-Small-Cell Lung Cancer Patients Undergoing Chemotherapy.

Objective: Cancer-related fatigue (CRF) is a well-recognized issue for cancer patients undergoing chemotherapy; however, research on nonpharmacological alternatives have been underreported. This study is aimed at investigating the effect of mild moxibustion on CRF in patients with non-small-cell lung cancer (NSCLC) undergoing chemotherapy. Methods: A randomized controlled trial was performed on 126 NSCLC patients undergoing initial chemotherapy and were divided into the following three groups: mild moxibustion group, sham acupoint group, and control group. Moxibustion was performed on two groups of acupuncture points, Dazhui and Geshu acupoints in the prone position and Qihai, Guanyuan, and Zusanli acupoints in the supine position, during the chemotherapy for 30 min with one of the groups of acupuncture points per day. Moxibustion of the sham group was performed 1 cm away from the true acupoint, while only routine nursing care was given to the routine group. The efficacy and safety of the treatments were assessed based on the Chinese version of the Revised Piper Fatigue Scale (RPFS-CV), the quality of life (QoL) questionnaire for Chinese cancer patients receiving chemobiotherapy (QLQ-CCC), and liver and kidney function indexes. Results: A total of 118 cases completed all interventions. There was no significant difference in the baseline indicators among the three groups of NSCLC patients. Although all three groups demonstrated raised RPFS-CV scores over the chemotherapy cycle, comparatively, the mild moxibustion group had significantly lower RPFS-CV scores and better relief of CRF symptoms (P < 0.05). The QLQ-CCC results indicated that the QoL of NSCLC patients dramatically decreased following chemotherapy, even with mild moxibustion. Further, mild moxibustion intervention did not show significantly different levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (Scr), and blood urea nitrogen (BUN) compared with the two other groups (P > 0.05). Conclusion: Chemotherapy is accompanied by elevated fatigue scores and decreased life quality in NSCLC patients. Although mild moxibustion intervention could alleviate CRF in the patients and was not associated with any adverse events and liver and kidney toxicity when combined with chemotherapy, it could not improve their QoL.

The Effect of Symptom Clusters and Sleep Disorder on Quality of Life among Patients with Chronic Obstructive Pulmonary Disease.

Background: Symptoms (cough, dyspnea, fatigue, depression, and sleep disorder) in chronic obstructive pulmonary disease (COPD) are related to poor quality of life (QOL). Better understanding of the symptom clusters (SCs) and sleep disorder in COPD patients could help to accelerate the development of symptom-management interventions. Objective: We aim to explore the effect of sleep disorder and symptom clusters on the QOL in patients with COPD. Methods: 223 patients with stable COPD from November 2019 to November 2020 at the Affiliated People's Hospital of Ningbo University in China were included in this cross-sectional survey. A demographic and clinical characteristics questionnaire, the Revised Memorial Symptom Assessment Scale (RMSAS), the Pittsburgh Sleep Quality Index (PSQI), and the St George Respiratory Questionnaire for COPD (SGRQ-C) were completed by the patients. Exploratory factor analysis was conducted to extract SCs, and logistic regression analysis was performed to analyze the risk factors affecting QOL. Results: Three clusters were extracted: respiratory functional cluster, emotional cluster, and fatigue-sleep cluster. 70.4% of the participants were poor sleepers. Subgroup analysis showed that COPD patients with poor sleep quality were significantly different in QOL, emotional cluster, and fatigue-sleep cluster compared with patients with normal sleep. In multiple regression, sleep quality and respiratory functional cluster were associated with QOL. Conclusion: In patients with stable COPD, three symptom clusters were explored. Symptom clusters correlate with clinical features and negatively affect QOL. Appropriate interventions are expected to inform future approaches to symptom management. Future studies are needed to test interventions that may be effective at improving the QOL of COPD patients.

Evaluation of characteristics of thyroid nodules on contrast-enhanced ultrasonography: a retrospective analysis of 252 cases.

AIM: This study investigated the enhancement patterns observed on contrast-enhanced ultrasound (CEUS) images for differentiating thyroid nodules. MATERIAL AND METHODS: A retrospective review was conducted of CEUS cine loops of 252 nodules by two independent readers. Seven categories of enhancement patterns were identified: concentric hypoenhancement; heterogeneous hypoenhancement; hypoenhancement with sharp margin; homogeneous hyper/isoenhancement; hyper/isoenhancement with ring-like vascularity; island-like enhancement; and no perfusion. Associations between these patterns and the confirmed pathological/cytological outcomes (178 malignant, 74 benign) were analyzed and the sensitivity, specificity and positive predictive values (PPVs) determined. The agreement of the readers' assessments was evaluated by Kappa value. RESULTS: For malignant nodules, the predominant 3 patterns were: concentric hypoenhancement, heterogeneous hypoenhancement and homogeneous hyper/isoenhancement. For each of these, the diagnostic specificity was above 87% and the PPV more than 85%. Combining these patterns for malignancy the rates of sensitivity, specificity and PPV for reader 1 (reader 2) were 96.1% (98.9%), 71.6% (71.6%), and 89.1% (89.3%), respectively. For benign nodules, the predominant 4 patterns were: hypoenhancement with sharp margin; hyper/isoenhancement with ring-like vascularity; island-like enhancement; and no perfusion. The specificity for each was above 98% and the PPV more than 70%. Combining these patterns for benignity, the rates of sensitivity, specificity and PPV for reader 1 (reader 2) were 71.6% (71.6%), 96.1% (98.9%) and 88.3% (96.3%), respectively. The inter-reviewers agreement for classifying enhancement patterns was excellent (κ = 0.84, 95% CI: 0.79-0.89). CONCLUSIONS: Enhancement patterns of thyroid nodules on CEUS investigation, enable differentiation between malignant and benign lesions with good diagnostic sensitivity, specificity and PPV.

Association Between Nicotine-dependent Gene Polymorphism and Smoking Cessation in Patients With Lung Cancer.

BACKGROUND: Patients with lung cancer continue to smoke owing to complex factors. Failure to quit smoking (defined as nicotine dependence) is significantly associated with genetic status. This study aimed to investigate the relationship between polymorphisms in nicotine dependence genes and smoking status after the diagnosis of lung cancer. PATIENTS AND METHODS: A total of 240 patients with lung cancer were included from July 2017 to March 2018. According to the actual smoking condition after lung cancer diagnosis, eligible patients were divided into 3 groups: the never-smoking group, the failure to quit smoking group, and the successful smoking cessation group. Fagerstrom Test for Nicotine Dependence scores were used to evaluate the smoking status of each group. Three nicotine-dependent genes with 6 loci were detected. RESULTS: Among the 240 patients, 86 were never-smokers, 51 failed to quit smoking, and 104 successfully quit smoking. The initial age of smoking in the failure to quit smoking group was significantly younger than those in the successful smoking cessation group (P = .001). There was a significant difference in the GG and AG and AA genotype distributions of CHRNA3 (rs578776) among the 3 groups (P = .003). There was also a significant difference in the distribution of CHRNA4 (rs2229959) genotypes among the 3 groups (P = .003). However, there was no significant difference in the genotype distribution of CHRNA5 (rs588765) among the 3 groups (P = .277). CONCLUSIONS: Gene polymorphisms of CHRNA3 (rs578776) and CHRNA4 (rs1044396 and rs2229959) were associated with the success of smoking cessation after the diagnosis of lung cancer, which should be considered in the management of smoking cessation after patients are diagnosed with lung cancer.

Risk factors for nicotine dependence in Chinese patients with lung cancer.

OBJECTIVE: Smoking is a poor prognostic factor for lung cancer. Nicotine dependence remains the major cause of failure of smoking cessation. We investigated the risk factors for nicotine dependence in patients with lung cancer. METHODS: Eligible patients were identified from November 2014 to February 2015. Age, marital status, educational level, annual household income, occupation, histology of lung cancer, tumor stage, smoking status, neuron-specific enolase (NSE) level, drive gene mutations, sleep quality, and patient personality were assessed. Physical nicotine dependence was assessed by the Fagerstrom Test for Nicotine Dependence (FTND). RESULTS: In total, 202 smokers were included in this study. Univariate analysis showed that marital status and pain were significantly correlated with nicotine dependence. Pearson's correlation analysis showed that age at the initiation of smoking, attempts to quit, NSE level, and sleep quality were significantly correlated with FTND scores. CONCLUSIONS: Pain, more attempts to quit, and poorer sleep quality were significantly associated with nicotine dependence. These risk factors could help to prevent smoking in Chinese patients with lung cancer.

Viral infection in community acquired pneumonia patients with fever: a prospective observational study.

BACKGROUND: Patients with community acquired pneumonia (CAP) caused by viruses can develop severe complications, which result in hospitalization and death. The purpose of this study was to analyse the aetiology, incidence, clinical characteristics, and outcomes of CAP patients with fever during non-pandemics, and then to provide theoretical basis for accurate diagnosis and treatment in CAP patients. METHODS: An enrolment system was established for monitoring the CAP patients with fever. Multiplex polymerase chain reaction (mPCR) kits were used to detect 10 viruses [influenza A and B, adenovirus (ADV), respiratory syncytial virus (RSV) A and B, picornavirus, parainfluenza virus (PIV), coronavirus, human metapneumovirus (HMPV), and bocavirus]. Data on age, gender, underlying diseases, complications, laboratory indexes, and outcomes were collected by physicians. RESULTS: This prospective study included 320 patients with fever. Among them, 23.4% were viral-positive by mPCR, with influenza virus most prominent followed by picornavirus. Strong variation in seasonal distribution was shown in viral infections, with peak months from December to February. Patients with influenza infection were likely to be taken to emergency rooms and have respiratory failure with higher creatinine kinase levels and lower white blood cell counts. Streptococcus pneumoniae followed by haemophilus influenzae were the most common bacteria in viral co-infections, which accounted for one third of virus-positive patients. Viral CAP and mixed CAP were not independent factors for death. In addition, lactate dehydrogenase (LDH) >246 IU/L [odds ratio (OR) =7.06, 95% confidence interval (CI): 2.15-23.2, P=0.001], and serum calcium <2.18 mmol/L (OR =6.67, 95% CI: 1.42-31.3, P=0.016) were associated with death. CONCLUSIONS: Viruses play an important role in CAP patients with fever, a systematic clinical, radiological and biological analysis of these patients can contribute to effective therapy that may prevent the development of CAP and improve the outcomes. The present work showed an elaborate analysis evidence of viral infection among fever CAP inpatients.

Value of time-intensity curve analysis of contrast-enhanced ultrasound in the differential diagnosis of thyroid nodules.

OBJECTIVE: To assess the feasibility of time-intensity curve (TIC) analysis of contrast-enhanced ultrasound (CEUS) in demonstrating features of benign and malignant thyroid nodules. METHODS: CEUS images of 98 patients with 103 thyroid nodules were retrospectively analyzed. The final diagnosis was confirmed by histology after surgical excision, or cytology after fine needle aspiration (FNA). Among the benign nodules, which were confirmed using cytology and not surgically removed, those with a >50% cystic component that showed no changes for 1 year on follow-up US, were diagnosed as clinically benign nodules. Similarly, nodules with a <50% cystic component that were aspirated twice and showed no changes for 1 year on follow-up US were also regarded as clinically benign nodules. TIC parameters, including perfusion parameters of relative values (RV) of peak intensity (PI) (△PI), RV of rise time (△RT), RV of time to peak (△TTP), RV of maximum slope coefficient (MSC) of wash-in (△MSCWI), RV of area under the rising curve (△AUCR), clearance parameters of RV of area under the falling curve (△AUCF), RV of MSC of washout (△MSCWO), comprehensive parameters of RV of mean transit time (△MTT), and area under the falling curve (△AUCF) were observed. RESULTS: Compared with benign thyroid nodules, malignant nodules on TIC analysis of CEUS showed a lower △PI (119.73 (115.34, 129.7), -15.82 (-17.7, -4.31)), later △RT (-0.27 (-0.51, -0.2), 0.58 (-0.26, 0.65)) and △TTP (-0.52 (-0.55, -0.36), 0.69 (-0.04, 0.74)), gentler △MSCWI (6.18 (5.29, 7.44), -6.1 (-7.6, 2.14)), and smaller △AUCR (75.7 (56.95, 93.22), -88.43 (-108.89, -73.21)) in perfusion parameters; a smaller △AUCF (112.92 (87.77, 137.58), -75.55 (-105.28, -59.32)) in clearance parameters; and a smaller △AUC (181.7 (151.50, 219.06), -160.64 (-200.08, -144.11)), and an earlier △MTT (2.00 (1.85, 3.14), -2.09 (-2.48, -0.95)) in comprehensive parameters (P < 0.05). Multivariate analysis of RV of TIC parameters demonstrated that △MSCWI (OR = 0.112; 95% confidence interval [CI], 0.025-0.507) and △MTT (OR = 0.099; 95% CI, 0.028-0.346) were protective factors. CONCLUSIONS: TIC of CEUS is a very promising and valuable technique for differentiating benign and malignant thyroid nodules.

Effect of nicotine dependence on quality of life and sleep quality in patients with lung cancer who continue to smoke after diagnosis.

BACKGROUND: Hundreds of millions of Chinese individuals continue to smoke and rates of lung cancer still continue to rise. However, there were few studies that examined the effects of nicotine dependence on quality of life (QOL) and sleep quality in lung cancer patients. This study aimed to investigate the effect of nicotine dependence on QOL and sleep quality in lung cancer patients who continue to smoke after diagnosis. METHODS: This cross-sectional survey study included 202 patients with lung cancer. Smokers were separated into two groups based on the Fagerstrom Test for Nicotine dependence: the low dependence (LD) (<4 score) group (n=59) and the high dependence (HD) (≥4 score) group (n=143). Both Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30) and Chinese version of Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the two groups of lung cancer patients. Then we analyzed the difference of QOL and sleep quality between two distinct nicotine dependence groups. RESULTS: Physical functioning, role functioning, emotional functioning, cognitive functioning, global health status and social functioning items in the LD group were significantly higher than the HD group (P<0.001). Fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, diarrhea and financial problems in the LD group were significantly lower than those in the HD group (P<0.001). Significantly higher scores in the HD group were found concerning the three sleep components including sleep duration, sleep efficiency and daytime function. The mean global PSQI score in the HD group was significantly higher than the LD group (P=0.014). CONCLUSIONS: These findings suggest that lung cancer patients who continue to smoke after diagnosis should receive health education in order to improve their QOL and quality of sleep after the word education. This can be useful for clinicians and nurses who are trying to motivate smokers to quit smoking.

Effects of silibinin-loaded thermosensitive liposome-microbubble complex on inhibiting rabbit liver VX2 tumors in sub-hyperthermia fields.

In the present study, the effects of silibinin-loaded thermosensitive liposome-microbubble complex (STLMC) on rabbit liver VX2 tumors in sub-hyperthermia fields were investigated using two-dimensional ultrasonography (2D US), contrast-enhanced US (CEUS), hematoxylin and eosin (H&E) staining, immunohistochemistry and ultrastructure observation. 50 rabbits with VX2 liver tumors were divided into five groups: Sub-hyperthermia microwave ablation group (SHM), STLMC injection group (STLMC), SHM ablation plus STLMC injection group (SHM + STLMC), microbubble injection group and blank control group without any treatment. Rabbits in each group were examined using 2D US and CEUS in order to evaluate the tumor volume and diameter before treatment and at day 7 and 21 after treatment. Morphology, expression of CD163 and CD206, and ultrastructure of the tumors were assessed. The average post-treatment volume of tumors in group SHM + STLMC was 1.17±0.88 cm3 at day 7 and 2.15±0.96 cm3 at day 21, which was significantly decreased compared with all other groups (P<0.05). H&E staining indicated that the number of disordered macrophages in the SHM + STLMC group significantly increased compared with the other groups (P<0.05). Immunohistochemical results demonstrated that in the SHM + STLMC, the expression of CD163 and CD206 significantly decreased compared with all other groups (P<0.05). These results suggested that STLMC has a potential function in preventing tumor growth, which may be due to its inhibitory effect on tumor-associated macrophages in the tumor microenvironment.

Transcutaneous electrical acupoint stimulation (TEAS) ameliorates chemotherapy-induced bone marrow suppression in lung cancer patients.

BACKGROUND: To investigate the effect of percutaneous electrical stimulation on chemotherapy-induced bone marrow suppression in patients with lung cancer. METHODS: From December 2014 to August 2015, one hundred ninety-one non-small cell lung cancer patients with chemotherapy naive were randomly divided into control group, medication group, and transcutaneous electrical acupoint stimulation (TEAS) group. Patients with the control group received routine nursing care, the medication group was treated by oral administration of prophylactic agents, and TEAS group received electrical stimulation of acupoints including Dazhui (DU14), Geshu (BL17), Zusanli (ST36), Sanyinjiao (SP6), and Hegu (LI4). The primary end point was the blood routine indexes and secondary end point was the degree of comfort. RESULTS: The white blood cell in the TEAS group was significantly higher than the control group on day 8 and day 14 (P<0.05). The platelet count in the TEAS group was significantly higher than control group on day 5, day 8 and day 11 (P<0.05). The comfort score in the TEAS group was significantly higher than control group on day 8 (P<0.05). CONCLUSIONS: Percutaneous electrical stimulation of acupoints could prevent chemotherapy-induced bone marrow suppression in lung cancer patients and ensure a smooth continuation of chemotherapy.

The impact of microbubble-enhanced therapeutic ultrasound combined with prothrombin on microwave ablation in the rabbit liver.

AIM: This study aimed to investigate the effect of microbubble-enhanced ultrasound (MEUS) combined with prothrombin on regional hepatic circulation and microwave ablation (MWA) in rabbit livers. MATERIALS AND METHODS: High-pressureamplitude therapeutic ultrasound (TUS) was used to treat 52 surgically exposed livers of healthy New Zealand rabbits: 13 livers were treated with MEUS alone, 13 with MEUS and prothrombin (PMEUS), 13 with ultrasound plus normal saline and 13 with ultrasound plus prothrombin as controls. Contrast-enhanced ultrasound (CEUS) imaging was performed on the exposed livers before and after treatment, and acoustic quantification was done to assess liver perfusion. Then, the liver was divided into two parts, one was used for pathologic examination and the other was ablated with microwave (MWA) and then processedfor pathologic examination. RESULTS: The CEUS images and Peak value after treatment in the PMEUS group were significantly reduced as compared to the remaining 3 groups (p<0.05). Occasional piecemeal hemorrhage was evidenced in the pathological examination in the MEUS group. Obvious cellular degeneration and necrosis with thrombosis were observed in the PMEUS group. Electron microscopy showed endothelial damage in both the MEUS group and PMEUS group. After MWA, coagulated volumes (V) in the PMEUS group were larger than in the remaining 3 groups (p<0.05). The cell ultrastructure disorder wasmore severe in the PMEUS group than in remaining 3 groups. CONCLUSION: PMEUS promotes endothelial injury and produces more obvious thrombotic occlusion, improving the therapeutic effect of MWA on the rabbit liver.

Effect of electric acupoint stimulation on gastrointestinal hormones and motility among geriatric postoperative patients with gastrointestinal tumors.

OBJECTIVE: To evaluate the effects of electric acupoint stimulation on gastrointestinal hormones and motility among geriatric postoperative patients with gastrointestinal tumors, and to explore an efficient and noninvasive method for postoperative recovery of bowel functions. METHODS: Forty patients were randomly and evenly assigned into a regular nursing care group (RNC) and an acupoint electric stimulation group (AES). Patients in the RNC group received regular nursing care and patients in the AES group received regular nursing care plus electric stimulation of acupoints. The serum levels of gastrin (GAS), motilin (MOT), and cholecystokinin (CCK), and an electrogastrogram (EGG) of all the patients were evaluated on the first, third, and fifth day after surgery. The time to first flatus after surgery and the number of patients with side effects such as abdominal pain, abdominal distention, and diarrhea were recorded. RESULTS: There were significant differences between the two groups in GAS, MOT, EGG, time to first flatus, abdominal pain, abdominal distention, and diarrhea (P < 0.05). CONCLUSION: Electric stimulation on acupoints could increase levels of GAS and MOT, promote the recovery of gastrointestinal functions, and decrease complications among postoperative senile patients with gastrointestinal tumors.

Self-reported depression among patients with non-small cell lung cancer.

BACKGROUND: Lung cancer is a disease with a poor prognosis and psychological impact. Lung cancer causes both physical and psychological burdens on patients, and financial burdens on families and society. The aim of this study was to examine the relationship between depression and influencing factors in non-small-cell lung cancer (NSCLC) patients. METHODS: A quantitative study was applied. Data was obtained from the Shanghai Pulmonary Hospital in China. One hundred and four patients with NSCLC were surveyed. Self-rating depression scale (SDS), social support rating scale (SSRS), and visual analog scale (VAS) were used. RESULTS: Among the 104 patients, 48 (46.1%) were diagnosed with depression. Gender (P = 0.000), disease duration (P = 0.006), self-care ability (P = 0.004), and pain (P = 0.003) were statistically significant predictors of self-reported depression in non-small-cell lung cancer patients. CONCLUSIONS: Self-reported depression is highly prevalent in NSCLC patients. In addition, gender, disease duration, self-care ability, pain and social support may increase self-reported depression.

[Effects of low-dose chlorpyrifos exposure on dopaminergic neurons in the midbrain substantia nigra and neural behavioral development in neonatal rats].

OBJECTIVE: To explore the effects of low-dose chlorpyrifos (CPF) exposure on dopaminergic (DA) neurons in the midbrain substantia nigra and neural behavioral development in neonatal rats. METHODS: Postnatal 11 day old Sprague-Dawley rats were randomly assigned into CPF, menstruum dimethysulfoxide (DMSO) and normal saline (NS) groups. The rats in the CPF group were injected with low-dose CPF (5 mg/kg?d) on postnatal days 11-14. The two control groups were injected with DMSO or NS respectively. The rats were sacrificed on postnatal days 15, 20, 30, and 60. Body weight gain, outward appearance of brain tissue, the coefficient of brain and the water content of brain tissue were measured. Tyrosine hydroxylase (TH) expression in DA neurons in the midbrain substantial nigra was examined by immunohistochemical straining. Immune electron microscopy was used to examine the subcellular structure of DA neurons. Open field test, grip strength test, slope test and Morris water maze test were used to examine the neurobehavioral changes. RESULTS: The outward appearance of brain tissue was normal in the three groups. There were no significant differences in the absolute value of body weight gain, the coefficient of brain and the water content of brain tissue among the three groups. CPF exposure decreased the level of TH immunoreactivity (P<0.05) in the substantia nigra of CPF group since postnatal day 30 compared with the DMSO and NS groups. The subcellular structures of some DA neurons in the CPF group were impaired. Decreased motor activity and learning and memory impairments were observed in the CPF group compared with those in the DMSO and NS groups (P<0.05) since postnatal day 30. CONCLUSIONS: CPF exposure during the neonatal period can cause long-term motor activity and learning and memory impairments in accompany with DA neurons damage in the midbrain substantia nigra.