Annals of Thoracic Medicine最新文献

Background: The aim of this study was to evaluate the effects of nitrous oxide (N₂O) and surgical position on endotracheal tube cuff (ETC) pressure, hoarseness, and sore throat (ST) after surgery under general anesthesia (GA).

Methods: This double-blind clinical trial was conducted on 212 candidates for surgery under GA. They were randomly allocated to four groups, namely a supine position group (Group S), a prone position group (Group P), a supine position and N₂O group (Group SN), and a prone position and N₂O group (Group PN). ST and hoarseness were assessed at recovery and 2, 4, 8, 12, and 24 h after surgery using a visual analog scale and a mild-to-severe scoring system, respectively. ETC pressure was also measured at 15, 30, 60, 90, and 120 min after surgery onset using an Ambu cuff pressure gauge. Moreover, the mean intraoperative propofol concentration was documented. The data were analyzed at a significance level of <0.05 and using the SPSS software (version 20.0).

Results: There was no significant difference among groups regarding surgery duration (P = 0.998), whereas ST and ETC pressure in Groups S and P were significantly less than Groups SN and PN (P = 0.001). Moreover, ST and ETC pressure in Group S were significantly less than the other groups (P = 0.001). None of the participants in Groups S and P had hoarseness, and there was a significant difference among the four groups regarding the frequency of hoarseness (P = 0.001). Moreover, none of the participants in Group SN needed postoperative analgesic, and there was no significant difference between Groups S and P regarding postoperative analgesic use (P = 0.998). Intraoperative propofol use in Group SN was significantly less than the other groups (P = 0.001).

Conclusion: ETC pressure should periodically be monitored and adjusted during lengthy surgeries in prone position and N₂O anesthesia to prevent postoperative ST and hoarseness.

Purpose: The purpose of the study was to explore the influence of table tennis combined with resistance training on coronary heart disease (CHD) rehabilitation and to evaluate its potential in improving cardiopulmonary function, arterial stiffness, blood lipids, and psychological indicators in participants with CHD.

Methods: Seventy patients with confirmed CHD were chosen and randomly separated into two groups, 35 cases each. The test group performed table tennis combined with resistance training, and the reference group (RG) received standard resistance training as the control group. By comparing the differences in cardiopulmonary function, arterial stiffness, sleep and diet, psychological indicators, and blood lipids between the two groups of patients, the role of table tennis combined with resistance training in CHD rehabilitation was evaluated.

Results: Relative to the control group, participants in the table tennis exercise combined with the resistance training group had significant improvement in cardiopulmonary function (P < 0.05). In addition, table tennis combined with resistance training can reduce patients' arterial stiffness, improve sleep and eating habits, and reduce blood lipid levels. Relative to the RG, the data possess the statistical significance (P < 0.05). Finally, the psychological quality of the two groups of patients was compared. The anxiety, depression, and confrontation ability of the patients in the test group were 7.15 ± 0.39, 7.03 ± 0.29, and 6.86 ± 0.46, respectively, which were superior to the RG. The comparison among the participants of data possesses the statistical significance (P < 0.005).

Conclusion: The research results show that table tennis combined with resistance training possesses an essential influence on CHD rehabilitation. It can significantly enhance patients' cardiopulmonary function, reduce arterial stiffness, improve sleeping and eating habits, reduce blood lipid levels, and improve psychological indicators. As a low-intensity aerobic exercise, table tennis possesses an essential influence on facilitating the recovery of patients with CHD and is worthy of further promotion and application in clinical practice.

This updated systematic review and meta-analysis pooled the results of previous clinical trials assessing the effects of pirfenidone and nintedanib on patients with pulmonary fibrosis. Scopus, the Cochrane Library, PubMed, and Web of Science were searched from the inception to April 12, 2025, to identify randomized controlled trials measuring the effect of pirfenidone and nintedanib on pulmonary fibrosis. Because of high methodological heterogeneity, we utilized a random-effects model (DerSimonian-Laird) to perform this meta-analysis. Finally, 18 articles with 20 randomized controlled trials were included in this meta-analysis. We found that compared to placebo, treatment with the two antifibrotic drugs increased forced vital capacity (FVC) predicted (weighted mean difference [WMD] 3.12%, 95% confidence interval [CI] [1.41, 4.82], I ² = 53.30%), FVC volume (WMD 87.44 ml, 95% CI [59.32, 115.57], I ² = 99.4%), and the distance walked in the 6-minute walk test (WMD 24.63 m, 95% CI [16.05, 33.22], I ² = 0.00%). However, compared to placebo, treatment with the two antifibrotic drugs did not significantly change the diffusing capacity of the lungs for carbon monoxide (WMD 1.38 ml/min/mmHg, 95% CI [-9.42, 12.18], I ² = 0.00%). Therapeutic benefits were observed for both pirfenidone and nintedanib and for both idiopathic pulmonary fibrosis (IPF) and non-IPF. Pirfenidone and nintedanib can improve lung function and functional capacity in patients with different types of pulmonary fibrosis.

Complicated hilar anatomy may be technically challenging for thoracic surgeons, especially during video-assisted thoracic surgery lobectomy. In such instances, to prevent hemorrhagic complications and conversion to open thoracotomy, several methods of proximal and distal vascular control have been proposed. Here, we present a technique of unnecessary occlusion of the main pulmonary artery and preserved pulmonary vein during a challenging thoracoscopic left lower lobectomy in patient with lung cancer and interlobar lymphadenopathy.

Objective: The objective of the study was to investigate the impact of CICARE communication nursing on the improvement of serum interleukin-10 (IL-10), interleukin-6 (IL-6), interleukin-4 (IL-4), and interleukin-2 (IL-2) and lung function in outpatients with acute bronchitis (AB).

Methods: One hundred and twenty suffers with AB who are treated in the outpatient department during Revised to 2021 to March 2023 are chosen and grouped according to the time of admission and different nursing practices. The control group consists of 60 patients from March 2021 to March 2022 who receive routine outpatient care; the experimental group consists of 60 patients from April 2022 to March 2023, and CICARE communication nursing is implemented additionally. Before and after intervention, the cognitive level of self-care knowledge, the level of peripheral blood inflammatory factors, and the improvement of lung function are compared.

Results: Before intervention, there were no remarkable differences in self-care knowledge cognition scores, peripheral blood inflammatory factors, and lung function levels between them (P > 0.05). After intervention, the cognitive scores of treatment coordination, medication method, daily attention, diet, and activity in experimental groups are superior to control group (P < 0.05). The levels of IL-10, IL-6, IL-4, and IL-2 in test groups are inferior to control group (P < 0.05). Forced vital capacity, forced expiratory volume in 1 s, maximum air volume, and peak flow rate in test groups are superior to control group (P < 0.05).

Conclusion: CICARE communication nursing can improve the cognition level of self-care knowledge of patients with AB, reduce the inflammatory response of the body, and promote the recovery of lung function.

Background: To evaluate the utility of thoracic ultrasound imaging (USI) in assessing the nature of pleural fluid (PF) using a scoring system.

Methods: The files of patients who underwent thoracic USI and thoracentesis due to PF accumulation were retrospectively examined. PF sonographic patterns and pleural thicknesses were retrieved from the USI records. Based on the Light's criteria, PFs were classified into transudative PF (TPF) and exudative PF (EPF). A scoring system was established based on the sonographic patterns and pleural thickness. Sonographic scores and other clinical, radiological, and demographic characteristics of the two groups were comparatively analyzed.

Results: Among the 64 cases analyzed, 32 (50%) were categorized as TPF. The average pleural thickness in the TPF group was 1.4 mm. The hypoechoic sonographic pattern rate in the TPF group (75%) was significantly different from that in the EPF group (p < 0.001). A hypoechoic sonographic pattern (p = 0.002) and pleural thickness >1.5 mm (p = 0.031) were independent predictors of EPF. The scoring system demonstrated a sensitivity of 84.38% and a specificity of 75.00% for predicting EPF when the sonographic score was ≥3.

Conclusion: Thoracic USI can serve as a noninvasive method to predict the nature of PFs by combining sonographic patterns and pleural thickness.

Background: This study aimed to estimate the prevalence and characteristics of rapid eye movement-related obstructive sleep apnea (REMrOSA) in the general Saudi Arabian population, contributing novel data to the field and providing insights into this specific OSA phenotype.

Methods: We analyzed data from a previously described Saudi population study targeting school employees aged 30-60 years. The study was conducted in two stages: an initial screening of 2682 participants using screening questionnaires and a confirmatory test of 346 participants using polysomnography (PSG). OSA was defined as an apnea-hypopnea index (AHI) ≥5. REMrOSA was identified on the basis of specific criteria, including a REM-AHI/non-REM (NREM)-AHI ratio ≥2, NREM-AHI <15, and REM duration ≥30 min. An extrapolation method was used to estimate the prevalence of REMrOSA in the general population.

Results: Among the 346 subjects who underwent PSG, 235 had OSA. Approximately one-third (30.64%) of these patients had REMrOSA, with a higher prevalence noted in females (38.03%) than in males (27.44%). The estimated prevalence of REMrOSA in the general Saudi population was 2.68%, with males (3.5%) being more affected than females (1.93%). Patients with REMrOSA presented lower AHI, Epworth Sleep Scale score, and arousal index than did those with non-REMrOSA (NREMrOSA). Logistic regression analysis indicated that patients with exclusive positional OSA (e-POSA) were 2.7 times more likely to have REMrOSA.

Conclusions: REMrOSA is a common condition among patients with OSA, with an estimated prevalence of 2.68% in the general Saudi population. Patients with REMrOSA tend to have milder disease, are less symptomatic, and are seen more in e-POSA.

Background: There are still disagreements about diagnostic criteria and treatment of progressive pulmonary fibrosis (PPF). Real-life data and survival analyses have a guiding role in clarifying this issue.

Methods: In this multicenter retrospective cohort study, real-life data of adult patients diagnosed with PPF and treated with antifibrotics for at least 6 months were examined.

Results: Of the 222 patients, 161 were treated with Nintedanib (N) and 61 with Pirfenidone (P). The most common PPF subtype was connective tissue disease-related interstitial lung disease (CTD-ILD) (53.2%). The progression rate was significantly higher in patients with usual interstitial pneumonia (UIP) (P = 0.003). A -3.1% (-49.2 ml) decrease was detected in forced vital capacity (FVC) in the 6^th month. The 6^th month and overall progression-free survival (PFS) rates were 83.3% and 51.8%. The 6^th month and overall clinical event-free survival (CEFS) rates were 89.6% and 53.6%. The survival rates for 6^th, 12^th, and entire follow-up periods were found to be 98.2%, 89.2%, and 77.5%. CT-ILD had the longest survival time (166.5 ± 9.2 months) and fibrotic hypersensitivity pneumonia had the shortest survival time (87.6 ± 9.2 months) (P = 0.011). N was advantageous in patients with UIP in terms of FVC loss and estimated survival. While PFS during the entire follow-up period was in favor of N, CEFS had no significant difference between drugs.

Conclusion: PPF subtypes have significant differences in terms of prognosis and survival. The effect of AF drugs on progression varies, especially among radiological patterns. An individualized approach is required in the diagnosis, follow-up, and treatment of patients with PPF.