胸腔镜与传统开胸手术对早期非小细胞肺癌治疗的比较研究

目的 探讨胸腔镜肺叶切除术治疗早期非小细胞肺癌的围手术期治疗效果.方法 通过比较同时期同手术组接受全胸腔镜肺叶切除治疗非小细胞肺癌和接受传统开胸手术的病人各21例的临床资料,比较手术时间、术中失血量、淋巴结清扫的数量、胸腔引流管术后72小时内的引流量、患者术后的主观疼痛评分、术后住院时间及医疗费用;测定术前、术后1天、5天的血清C反应蛋白（CRP）、白细胞介素6（IL-6）、白细胞介素12（IL-12）.比较两组间的差异.结果 胸腔镜组手术时间显著长于开胸组（t=2.137,P=0.042）P〈0.05;术中淋巴结清扫个数两组无显著差别（t=-0.25,P=0.860）;术中失血量（t=-2.436,P=0.033）;术后疼痛程度（χ2=20.537,P=0.000）、术后72小时内胸管引流量（t=-2.528,P=0.020）、术后住院时间（t=-3.851,P=0.001）胸腔镜组明显少于开胸组;术前两组血清CRP IL-6、IL-12无显著差异,而术后胸腔镜组的CRP（术后1天t=3.851,P=0.001;术后5天t=2.471,P=0.033）、IL-6（术后1天t=7.844,P=0.000;术后5天t=2.845,P=0.010）显著低于开胸组,IL-12（术后1天t=-7.442,P=0.000;术后5天t=-8.335,P=0.000）显著高于开胸组;术后第5天胸腔镜组的血清学指标与术前已无统计学差别.结论 胸腔镜治疗早期非小细胞肺癌具有创伤小、恢复快的优点,达到开胸手术的根治要求,对患者细胞免疫功能损伤轻,有利于改善预后.     

非小细胞肺癌患者应用胸腔镜肺叶切除术的治疗效果

目的观察胸腔镜肺叶切除术对非小细胞肺癌患者免疫功能的影响。方法依照不同术式将87例非小细胞肺癌患者分为两组,观察组(n=44)采用胸腔镜手术(VATS),对照组(n=43)采用传统开胸术;比较两组患者的手术效果和T淋巴细胞亚群水平差异。结果观察组的手术时间、术中出血量、术中输血量以及住院时间均优于对照组(P0.05);两组患者术后3 d时CD_4~+、CD_8~+均较术前明显降低(P0.05),术后15 d时CD+4水平逐渐恢复至术前,术后3d、15d时CD_4~+/CD_8~+比值均较术前明显增高(P0.05),同期组间比较,治疗15d时观察组CD_4~+、CD_4~+/CD_8~+比值均较对照组明显增高(P0.05);术后3d、15d时NK细胞水平均略低于术前水平,但差异无统计学意义(P0.05)。结论胸腔镜肺叶切除术治疗非小细胞肺癌体现出微创手术优势,对患者免疫功能的抑制更轻,更利于患者的后期康复。     

胸腔镜肺癌手术治疗老年非小细胞肺癌的临床分析

目的探讨胸腔镜肺癌根治术在老年非小细胞肺癌治疗中的疗效及相关临床分析。方法选取2008年3月~2009年3月于我院手术治疗的120例非小细胞肺癌患者作为研究对象,按不同的手术方式分为观察组(行胸腔镜肺癌手术患者)和对照组(行开胸手术患者)。分析比较两组患者的术后疗效、术中出血量、术后住院时间、术后并发症以及术后7 d的血清CRP、IL-6、TNF-α、IL-10水平。结果两组患者治疗后的总有效率没有明显差异,无统计学意义(P0.05)。观察组术中出血量和术后并发症明显比对照组少,且术后术后住院时间也明显低于对照组,两组比较差异明显,具有统计学意义(P0.05)。观察组术后7 d的血清CRP、IL-6、TNF-α、IL-10水平明显低于对照组,两组差异比较具有统计学意义(P0.05)。结论胸腔镜肺癌手术治疗老年非小细胞肺癌和开胸手术治疗比较,疗效无明显差异,但是胸腔镜肺癌根治术的术中出血量及术后并发症更少,术后住院时间更短,且早期炎性反应明显较轻。     

Efficacy and safety of acupuncture combined with analgesics on lung cancer pain: A protocol for systematic review and meta-analysis

Background:Lung cancer (LC) is the malignant tumor with the highest incidence in the world, and treatment methods include surgery, radiotherapy, chemotherapy, and immunotherapy. Cancer pain is a common symptom in patients with LC, and the clinical treatment is to relieve it with analgesics. Acupuncture can relieve cancer pain. This study aims to systematically study the efficacy and safety of acupuncture combined with analgesics on cancer pain in patients with LC.Methods:From the beginning to April 2021, search Medline, Embase, Cochrane Central Controlled Trials Register (Central), China National Knowledge Infrastructure (CNKI), Wanfang Database, China Biomedical Literature Database (CBM), and Chinese Science Journal Database (VIP database). Search the international clinical trial registration platform and the Chinese clinical trial registration platform to find ongoing or unpublished trials. The main outcome indicator is the total effective rate of analgesia, and the secondary outcome indicator is pain intensity score and adverse reactions. The RevMan 5.4 software will be used for statistical analysis.Results:This study will provide the latest evidence for acupuncture combined with analgesics to relieve LC pain.Conclusion:The conclusion of this study is to evaluate the effectiveness and safety of acupuncture combined with analgesics in alleviating LC pain.INPLASY registration number:INPLASY202150051     

Comprehensive TCM treatments combined with chemotherapy for advanced non-small cell lung cancer: A randomized,controlled trial

Objective:We conducted this study to evaluate the efficacy and safety of traditional Chinese medicine (TCM) in advanced non-small cell lung cancer (NSCLC) patients who underwent chemotherapy.Design:This was a prospective, open-label, randomized controlled trial. NSCLC patients at stage IIIA, IIIB, or IV were randomly assigned to either TCM plus chemotherapy or chemotherapy alone. The comprehensive TCM treatment consisted of Kang Ai injection, herbal decoction, and Zhenqifuzheng capsules. The primary endpoint was quality of life (QOL) measured by the Functional Assessment of Cancer Therapy-Lung version 4.0. The secondary endpoints were chemotherapy completion rate, tumor response, and adverse events. All assessments were done at baseline, the third week, and the sixth week.Results:Thirty-nine participants were randomly assigned to the treatment group and 36 to the control group. The QOL scores were significantly improved in the treatment group compared with those of the control group in social well-being (cycle 1, P = .048; cycle 2, P = .015), emotional well-being (cycle 1, P = .047; cycle 2, P = 4.29E-05), and functional well-being (cycle 1, P = .030; cycle 2, P = .003), while the QOL scores in the above 3 domains declined in the control group (P < .05). Both groups had a decline in the physical well-being score (cycle 1, P = .042; cycle 2, P = .017) and lung cancer symptom score (cycle 1, P = .001; cycle 2, P = .001) after 2 courses of intervention. The deterioration in physical well-being and lung cancer symptoms was noticeably smaller in the treatment group (P < .05). There were significant differences between the 2 groups in social well-being, emotional well-being, functional well-being, lung cancer symptom domain, and the total score (P < .05). Patients in the treatment group had a significantly lower incidence of platelet reduction than the control group (P = .028) after 2 cycles of treatment. No significant difference in nonhematological adverse events (AEs) was observed.Conclusion:This study illustrated that comprehensive TCM treatment could promote the QOL of NSCLC patients, alleviate symptoms, and reduce the AEs caused by chemotherapy, verifying the synergistic and attenuating effects of TCM in NSCLC patients undergoing chemotherapy.Trial registration:Chinese Clinical Trial Registry (www.chictr.org.cn): ChiCTR-TRC-13003637     

76例单肺叶切除术术后早期肺功能的变化研究

目的比较完全胸腔镜下单肺叶切除术和传统开放式单肺叶切除术对肺癌患者术后早期肺功能变化的影响。方法选取2014年1月至2014年6月在安徽医科大学第一附属医院普胸外科行单肺叶切除术肺癌患者共76例,按照手术方法分为传统开放手术组40例及胸腔镜手术(VATS)组36例,通过术后第7天和术后第30天肺功能检查指标及血气分析指标比较单肺叶切除术中传统开放术式和胸腔镜术式对患者术后早期肺功能变化的影响。结果单肺叶切除术后早期肺功能下降明显;术后第7天胸腔镜组反映肺功能指标(VCmax、MVV、Pa O2、Pa CO2、SO2%)优于开放组,差异有统计学意义(P0.05);术后第30天胸腔镜组反映肺功能指标(VCmax、MVV、Pa O2、Pa CO2、SO2%)优于开放组,差异有统计学意义(P0.05)。结论单肺叶切除行胸腔镜手术有利于患者术后早期肺功能更快速、更有效的恢复。     

非插管与插管电视胸腔镜肺叶切除术治疗肺癌的比较

目的本研究旨在比较非插管和插管电视胸腔镜肺叶切除术治疗肺癌的早期手术效果。方法回顾分析2019年5月至2020年5月于我科同一医疗组行胸腔镜手术的患者的68例电视胸腔镜肺叶切除术(非插管式肺叶切除术34例,插管式肺叶切除术34例)。结果两组患者在年龄、性别、BMI、FEV;、DLCO、吸烟史、肺叶切除、组织学类型和病理分期等方面具有可比性。非插管组和插管组术后平均住院时间分别为9.3±3.8天和8.7±5.3天(P=0.624),闭式引流留置时间分别为3.6±2.0天和4.2±1.4天(P=0.867)。在麻醉持续时间、手术时间、出血量和术后并发症方面,两组的手术结果相似。非插管组肺叶切除术所需时间较短(非插管组平均为112.6±20.1分钟,插管组为123.7±30.4分钟)。两组间唯一有统计学意义的手术结果是淋巴结清扫数(未插管组的平均淋巴结数为13.9±7.0个,插管组为17.6±6.4个,P=0.004)。非插管组中有1例因出血需要改行单肺插管和小切口手术,插管组无中转手术。两组均无死亡病例。结论非插管电视胸腔镜肺叶切除术的早期疗效与插管组相当。非插管电视胸腔镜肺叶切除术是安全的,在技术上是可行的。然而,还需要进一步的前瞻性随机研究,以便更好地比较非插管和插管式胸腔镜肺叶切除术。     

Comparison of efficacy and safety of hybrid video-assisted thoracoscopic surgery vs. thoracotomy sleeve lobectomy for non-small cell lung cancer: a propensity score matching study

BackgroundIt is unclear whether hybrid video-assisted thoracoscopic surgery (VATS) sleeve lobectomy (SL) could be an alternative to thoracotomy SL for non-small cell lung cancer (NSCLC) treatment. The aim of the study is to investigate the safety and efficacy of hybrid VATS SL.MethodsWe collected 112 patients who received hybrid VATS SL or thoracotomy SL for primary treatment of NSCLC at Liaoning Cancer Hospital & Institute from November 2016 to September 2021. Perioperative and survival data were collected, and retrospective analysis was conducted on 91 thoracotomy and 21 hybrid VATS SL patients to evaluate the safety and efficacy of two approaches. Propensity score matching (PSM) was used to minimize selection bias. The Kaplan-Meier method was applied to compare overall survival (OS) and recurrence-free survival (RFS). Follow-up data were obtained by outpatient clinical visit and nurse-led telephone.ResultsA total of 112 patients were included in this study, including thoracotomy patients (n=91) and hybrid VATS patients (n=21). In the non-match analysis, the baseline data of patients was similar between the two groups, except regarding the receipt of neoadjuvant therapy (P=0.087). After PSM (2:1), a total of 39 thoracotomy patients and 19 hybrid VATS patients were enrolled. The baseline variables were quite similar in both groups. In the hybrid group, the number of lymph nodes (25.9±8.5 vs. 32.9±9.7, P<0.01) and positive lymph nodes (3.7±2.9 vs. 5.6±4.0, P=0.045) were significantly higher than those in the thoracotomy group. The hybrid group was associated with significantly shorter postoperative hospital stay (9.5±3.5 vs. 7.3±2.9, P=0.021) and chest tube duration time (6.6±3.1 vs. 5.3±1.5, P=0.031). No statistical difference in complications, reoperation, and recurrence were observed between the hybrid VATS SL and thoracotomy SL (P=1.0, P=1.0, P=0.472). The 30- and 90-day mortalities showed no differences between approaches (2.6% vs. 0%, P=1.0; 5.1% vs. 5.3%, P=1.0). No significant differences were found between thoracotomy and hybrid VATS SL in 3-year OS (P=0.614) and 3-year RFS (P=0.750).ConclusionsHybrid VATS SL lobectomy may be a safe and feasible approach associated with similar oncologic prognosis and better postoperative recovery compared with thoracotomy SL for NSCLC treatment.     

CRP、CEA及CA125表达水平与非小细胞肺癌患者行VATS术后疗效及预后的相关性

目的探讨C反应蛋白(C reactive protein,CRP)、癌胚抗原(carcino embryonic antigen,CEA)及癌抗原125(carbohydrate antigen 125,CA125)表达水平与肺癌患者行电视辅助胸腔镜手术(VATS)术后疗效及预后的相关性。方法选取2014年1月-2016年1月我院收治的128例肺癌VATS患者以及同期100例健康人为研究对象,分别将其作为研究组和对照组。根据研究组患者血清CRP、CEA及CA125表达水平从低到高分为低表达和高表达组各64例,对所有患者进行VATS术,观察手术疗效及CRP、CEA及CA125表达水平与VATS术后疗效及预后的关系。结果研究组肺癌患者术前血清CRP、CEA及CA125表达水平显著高于健康对照组,差异具有统计学意义(P<0.001);肺癌患者血清CRP、CEA及CA125表达水平与患者性别、年龄无关,与患者TNM分期、病理类型、以及分化程度存在显著相关性(P均<0.05);单因素分析结果显示临床分期、分化程度、CRP、CEA以及CA125表达水平高低与肺癌患者预后存在显著相关性(P<0.05)。COX回归分析结果显示临床分期、分化程度、CA125表达水平高低是影响肺癌患者术后预后的独立因素;CRP、CEA及CA125高表达组患者的术中出血量、术后置管时长及引流量、住院时长,相比同指标低水平表达组均明显增加(P<0.05)。CRP、CEA及CA125低表达组患者的中位无进展生存期分别为31.2、29.8、32.6个月,明显高于高表达组(22.6、21.3、23.6个月),差异均具有统计学意义(P<0.05)。结论肺癌患者血清中CRP、CEA及CA125表达水平与VATS疗效和预后存在显著相关性,CRP、CEA及CA125呈低水平表达患者的中位生存期相比高水平表达患者显著延长。     

Cost and effectiveness of video-assisted thoracoscopic surgery for clinical stage I non-small cell lung cancer: a population-based analysis

Background

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive alternative to conventional surgery (CS). We aimed to estimate the short-term cost-effectiveness of VATS vs. CS for clinical stage I non-small cell lung cancer (NSCLC-c-stage-I) patients from the payer’s perspective (National Health Insurance).

Methods

We identified NSCLC-c-stage-I patients diagnosed and received surgery within 2007-2009 through a comprehensive population-based database containing cancer and death registries, and reimbursement data. The duration of interest was 1 year. We included potential confounding covariables through literature searching and our own experience, and used a propensity score to construct a 1:1 population for adjustment.

Results

Our study population constituted 966 patients. The mean hospital stay [days, standard deviation (SD)] were 14.4 [7] and 16.1 (7.7) for VATS and CS respectively (P=0.002). The mean cost (2013 USD) and survival (year) was $22,316 vs. $21,976 and 0.98 vs. 0.974 for VATS vs. CS. The probability for VATS to be cost-effective (i.e., positive net benefit) was 0.49 & 0.56 at willingness-to-pay (WTP) 50,000 & 100,000 USD/life-year, respectively.

Conclusions

We provide the first empirical evidence that when compared to CS, VATS was potentially cost-effective in the short term (1 year) within the common WTP levels in Taiwan.     

胸腔镜与开胸肺叶切除术后患者慢性疼痛的对比研究

目的比较完全胸腔镜与常规开胸施行肺叶切除术后患者急、慢性疼痛的发生情况及其相互关系。方法分析2015年9月至2015年12月我院接受肺叶切除术的90例患者。45例接受微创手术,45例接受开放手术。观察术后72h内急性疼痛和术后1、2、3、6个月慢性疼痛发生情况。结果在术后4 h、6 h、12 h、24 h、48 h、72 h急性疼痛评分方面,微创组患者均显著低于开放组(P0.05)。微创组术后疼痛持续1、2、3、6个月时的发生率均较开放手术组低(P0.05)。结论相对于开胸手术,胸腔镜肺叶切除术在术后急、慢性疼痛方面均存在优势。术后慢性疼痛与早期急性疼痛的程度和处理方式相关。     

True video-assisted thoracic surgery for early-stage non-small cell lung cancer

Since its inception, minimally invasive surgery has made a dramatic impact on all branches of surgery. Video-assisted thoracic surgery (VATS) lobectomy for early-stage non-small cell lung cancer (NSCLC) was first described in the early 1990s and has since become popular in a number of tertiary referral centers. Proponents of this relatively new procedure cite a number of potentially favorable perioperative outcomes, possibly due to reduced surgical trauma and stress. However, a significant proportion of the cardiothoracic community remains skeptical, as there is still a paucity of robust clinical data on long-term survival and recurrence rates.The definition of 'true' VATS has also been under scrutiny, with a number of previous studies being considered 'mini-thoracotomy lobectomy' rather than VATS lobectomy. We hereby examine the literature on true VATS lobectomy, with a particular focus on comparative studies that directly compared VATS lobectomy with conventional open lobectomy.     

Short-term results of thoracoscopic lobectomy and segmentectomy for lung cancer in koo foundation sun yat-sen cancer center

Background

Thoracoscopic lobectomy and segmentectomy have been demonstrated to be safe and technically feasible for curative resection of lung cancer. This minimally invasive surgery is increasingly popular and adopted by the world all over. We report our short-term results of thoracoscopic lobectomy/segmentectomy operations comparing with previous surgical approach for lung cancer resection by muscle-sparing vertical minithoracotomy in Koo Foundation Sun Yat-Sen Cancer Center.

Methods

We performed a retrospective review of 317 consecutive patients who underwent lobectomy or segmentectomy either by thoracoscopic surgery (n=121) or muscle-sparing vertical mini-thoracotomy (n=195) for lung cancer in Koo Foundation Sun Yat-Sen Cancer center between Jan 2000 and Jun 2009. The operative details, postoperative complication, and length of stay were statistically analyzed.

Results

Thoracoscopic lobectomy and segmentectomy were performed successfully in 121 patients. One patient was converted to open thoracotomy during operation due to uncontrolled bleeding. There is no significant difference in age factors (p=0.763), forced expiratory volume in one second (p=0.480) or comorbidities (p=0.549) between these two groups. Thoracoscopic group had a significantly predominant percentage in women, diabetes mellitus, less smoking index and chronic obstructive pulmonary disease incidence. Patients undergoing a thoracoscopic surgery had a shorter length of stay (6.8±3.4 vs. 10.2±9.1 days, p<0.001), longer operative time (3.6±1.0 vs. 3.2±1.2 hours, p=0.004), and less blood loss (102.7±95.7 vs. 140.1±171.2 ml, p<0.029). There was no significant difference in postoperative complication rate between the two groups (18.2% vs. 23.6%, p=0.255). No surgical mortality was found in the thoracoscopic group.

Conclusions

Our findings suggested thoracoscopic surgery for lung cancer would be as safe as muscle-sparing vertical mini-thoracotomy in lobectomy and segmentectomy.     

电视胸腔镜治疗28例慢性肺脓疡的体会

目的探讨经内科常规治疗无效的慢性肺脓肿患者应用电视胸腔镜技术治疗的疗效。方法1997年10月～2007年10月期间,28例慢性肺脓肿患者应用电视胸腔镜技术实施脓肿切开、持续胸腔冲洗引流术的疗效进行回顾性分析。结果24例患者治愈,4例显效,无手术死亡及术中并发症发生。胸部失血量为60～190ml,平均（136±84）ml。术后第1d引流量为60-450ml,平均（278±112）ml,术后胸腔引流时间3—13d,平均（4．35±2．14）d,有3例出现持续漏气〉7d;术后静脉应用抗生素时间4～10d,平均（4．43±1．82）d;术后住院日为7—16d,平均（10．7±2．33）d。出院前复查胸片示脓腔消失,术后随访3～18个月,未见复发病例。结论：电视胸腔镜下切开慢性肺脓肿持续胸腔冲洗引流术具有显露清楚、创伤小、并发症少、恢复快、住院时间短的特点,而且完全可以达到常规开胸手术效果。     

Five years survival in metastatic non-small cell lung cancer patients treated with chemotherapy alone or chemotherapy and melatonin: a randomized trial

Numerous experimental data have documented the oncostatic properties of melatonin. In addition to its potential direct antitumor activity, melatonin has proved to modulate the effects of cancer chemotherapy, by enhancing its therapeutic efficacy and reducing its toxicity. The increase in chemotherapeutic efficacy by melatonin may depend on two main mechanisms, namely prevention of chemotherapy-induced lymphocyte damage and its antioxidant effect, which has been proved to amplify cytotoxic actions of the chemotherapeutic agents against cancer cells. However, the clinical results available at present with melatonin and chemotherapy in the treatment of human neoplasms are generally limited to the evaluation of 1-year survival in patients with very advanced disease. Thus, the present study was performed to assess the 5-year survival results in metastatic non-small cell lung cancer patients obtained with a chemotherapeutic regimen consisting of cisplatin and etoposide, with or without the concomitant administration of melatonin (20 mg/day orally in the evening). The study included 100 consecutive patients who were randomized to receive chemotherapy alone or chemotherapy and melatonin. Both the overall tumor regression rate and the 5-year survival results were significantly higher in patients concomitantly treated with melatonin. In particular, no patient treated with chemotherapy alone was alive after 2 years, whereas a 5-year survival was achieved in three of 49 (6%) patients treated with chemotherapy and melatonin. Moreover, chemotherapy was better tolerated in patients treated with melatonin. This study confirms, in a considerable number of patients and for a long follow-up period, the possibility to improve the efficacy of chemotherapy in terms of both survival and quality of life by a concomitant administration of melatonin. This suggests a new biochemotherapeutic strategy in the treatment of human neoplasms.     

Acupuncture in patients with chronic low back pain: a randomized controlled trial

BACKGROUND: Acupuncture is widely used by patients with low back pain, although its effectiveness is unclear. We investigated the efficacy of acupuncture compared with minimal acupuncture and with no acupuncture in patients with chronic low back pain. METHODS: Patients were randomized to treatment with acupuncture, minimal acupuncture (superficial needling at nonacupuncture points), or a waiting list control. Acupuncture and minimal acupuncture were administered by specialized acupuncture physicians in 30 outpatient centers, and consisted of 12 sessions per patient over 8 weeks. Patients completed standardized questionnaires at baseline and at 8, 26, and 52 weeks after randomization. The primary outcome variable was the change in low back pain intensity from baseline to the end of week 8, as determined on a visual analog scale (range, 0-100 mm). RESULTS: A total of 298 patients (67.8% female; mean +/- SD age, 59 +/- 9 years) were included. Between baseline and week 8, pain intensity decreased by a mean +/- SD of 28.7 +/- 30.3 mm in the acupuncture group, 23.6 +/- 31.0 mm in the minimal acupuncture group, and 6.9 +/- 22.0 mm in the waiting list group. The difference for the acupuncture vs minimal acupuncture group was 5.1 mm (95% confidence interval, -3.7 to 13.9 mm; P = .26), and the difference for the acupuncture vs waiting list group was 21.7 mm (95% confidence interval, 13.9-30.0 mm; P<.001). Also, at 26 (P=.96) and 52 (P=.61) weeks, pain did not differ significantly between the acupuncture and the minimal acupuncture groups. CONCLUSION: Acupuncture was more effective in improving pain than no acupuncture treatment in patients with chronic low back pain, whereas there were no significant differences between acupuncture and minimal acupuncture.     

全肺切除术及支气管成形肺叶切除术在非小细胞肺癌治疗中的研究

目的 探讨全肺切除术及支气管成形肺叶切除术治疗非小细胞肺癌的效果.方法 将我院114例非小细胞肺癌患者分为研究组59例,行支气管成形肺叶切除术;对照组55例,行全肺切除术.结果 研究组术后1、3、5年内生存率明显高于对照组（P〈0.05）.同时,研究组的并发症发生率为10.17%明显低于对照组的32.73%（P〈0.05）.结论 全肺切除术与支气管成形肺叶切除术各具特点,临床选择术式时要根据患者自身情况和病变的具体情况而定.     

Acupuncture for chronic pelvic pain in patients with SPID: A protocol for systematic review and meta-analysis

Background:Chronic pelvic pain (CPP) is one of the common sequela of pelvic inflammatory disease, the pathological factors are adhesions, scarring and pelvic congestion which caused by inflammation, often cause abdominal pain and lumbosacral soreness, and aggravated after fatigue, sexual intercourse and during menstruation. It is difficult to treat because special pathological changes. Although acupuncture has gained increased popularity for the management of CPP, evidence regarding its efficacy is lacking. Therefore, a systematic review of acupuncture for chronic pelvic pain in patients with SPID is required to provide available evidence for further study.Methods and analysis:We will conduct a systematic review of randomized controlled trials (RCTs) that investigate the effect and safety of acupuncture for the treatment of chronic pelvic pain patients with SPID. We will electronically search the literature in the databases of PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, the Web of Science, China National Knowledge Infrastructure (CNKI), Wan-fang Digital Periodicals, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP) and select eligible articles. Data extraction will be conducted by 2 researchers independently, and risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. The primary outcomes will be total effective rate and VAS pain score, and the secondary outcomes include the recurrence rate and adverse reaction. All data analysis will be conducted by software Review Manager V.5.3.Results:This study will provide the latest analysis of the currently available evidence for the efficacy of acupuncture for chronic pelvic pain in patients with SPID.PROSPERO registration number:CRD42020193826.     

加速康复外科在老年早期非小细胞肺癌病人诊疗中的作用

目的 探讨加速康复外科(ERAS)在老年早期非小细胞肺癌病人中的应用效果.方法 选取2018年6月至2019年5月在江苏省肿瘤医院胸外科采取胸腔镜肺叶切除术治疗的老年早期非小细胞肺癌病人248例.根据病人是否采取ERAS分为A组(采取ERAS)99例和B组(未采取ERAS)149例.观察2组病人的术后并发症(包括肺不张...     

Acupuncture treatment of hypertension with insomnia: A protocol for randomized,double-blind,placebo controlled trial research

Introduction:Hypertension patients often suffered from insomnia problems which lowered the quality of life. Studies have shown that acupuncture is effective to treat perimenopausal and cancer-related insomnia. However, there is a lack of randomized controlled trials to support the effectiveness of acupuncture on insomnia of hypertension patients.Methods and analysis:This study is a randomized, double-blind (patients and evaluators), and placebo-controlled clinical trial to investigate the effect of acupuncture in hypertension patients’ insomnia management. We will recruit 158 hypertension patients suffering from insomnia in Bao’an People''s Hospital, Shenzhen and randomly assign them into treatment group (antihypertensive drugs + acupuncture) and control group (antihypertensive drugs + sham acupuncture) in a 1:1 ratio. The patients will receive acupuncture 3 times a week for 12 weeks, and then a 6-months follow-up will be conducted after the treatment. The primary outcome is the Pittsburgh Sleep Quality Index. The secondary outcomes include sleep parameters, blood pressure dropping, sleeping pill dosage, Rating Depression Scale score, and Self-Rating Anxiety Scale score. The primary outcome will be evaluated at baseline, 4, 8, and 12 weeks, and 1, 3, and 6 months following the end of treatment. The secondary outcomes will be assessed at baseline and 12 weeks of the treatment period.