Wenbin Zou

Background: Esophageal foreign bodies, especially fish bones, are common emergencies that may require surgery like thoracotomy. Psychological impacts such as pain and anxiety are often overlooked. This study explores patients’ psychological experiences during diagnosis, treatment, and recovery to inform effective interventions and improve outcomes. Methods: Between May 2022 and May 2023, we employed a purposive sampling technique to select 12 patients who had undergone thoracotomy for the removal of intraesophageal fishbone as participants in our study. Utilizing a phenomenological research framework, we conducted semi-structured interviews and applied Colaizzi’s seven-step method for data analysis to identify emergent themes. Results: The psychological experiences of patients at different stages of thoracotomy for intraesophageal fishbone removal can be summarized into five themes: assumptions during the event, helplessness and dependence before surgery, feelings of fatigue after surgery, sense of benefit during the recovery period, and gratitude and hope. Conclusion: It is imperative for healthcare professionals to prioritize the psychological rehabilitation of patients by implementing personalized interventions. This approach should aim to facilitate both physical and mental recovery, thereby fostering a renewed sense of hope and well-being in patients.

Objective: To evaluate the effectiveness of a staged health education pathway in the perioperative care of patients with esophageal cancer. Methods: A total of 110 patients who underwent radical surgery for esophageal cancer and were discharged from our department between January and November 2022 were enrolled in the study. Patients were divided into a control group and an experimental group (55 patients each) based on the order of admission. The control group received routine health education, in which the responsible nurses provided subjective and random health guidance based on patients’ daily treatment and condition. The experimental group received education based on a standardized staged health education pathway checklist. The two groups were compared in terms of discharge readiness scores and health education effectiveness, assessed using the Health Education Evaluation Criteria for Thoracic Surgery Patients. Results: The discharge readiness scores in the experimental group were significantly higher than those in the control group ( P < 0.01). In addition, the experimental group outperformed the control group in overall health education scores and in the dimensions of health knowledge, health beliefs, and health behaviors, with statistically significant differences ( P < 0.01). Conclusion: The application of a standardized staged health education pathway checklist in the perioperative period of esophageal cancer patients allows nurses to provide more systematic and timely health guidance. This approach helps patients and their families gain a more comprehensive understanding of the disease and better meets their health information needs.

Cyclin-dependent kinase (CDK)-4/6 inhibitors have significantly improved outcomes in several cancers but can also induce various organ system toxicities, including musculoskeletal disorders. This study aimed to comprehensively characterize the musculoskeletal adverse events (MSAEs) associated with CDK4/6 inhibitors based on real-world data. Reports of MSAEs linked to CDK4/6 inhibitors from the first quarter (Q1) of 2015 and 2023 Q4 were extracted from the FAERS. Descriptive analyses evaluated report frequencies over time and patient characteristics. Disproportionality analyses using reporting odds ratios (RORs) identified signals for specific musculoskeletal preferred terms (PTs). Time-to-onset analyses examined the temporal patterns of MSAEs. A total of 10,095 MSAE reports associated with CDK4/6 inhibitors were identified, most involving Palbociclib (n = 7819). The median age of patients was 64 years (IQR: 55–72), predominantly female (97.73%). Most reports were submitted by consumers (47.62%) and the majority of reports were from the United States (71.53%). Disproportionality analyses revealed distinct signals, with Ribociclib showing prominent signals for bone pain and bone lesions, and Abemaciclib for osteonecrosis of the jaw and pathological fractures. Palbociclib demonstrated a consistent but less pronounced signal across musculoskeletal PTs. Time-to-onset analyses demonstrated a significantly longer onset of MSAEs for Palbociclib (median 82 days, IQR[14–311]) compared to Abemaciclib (32.5 days, IQR[12–119]) and Ribociclib (34 days, IQR[8-177]) using the nonparametric Kruskal-Wallis test (P-value = 3.048e-11). Musculoskeletal toxicities is a significant adverse event that affects drug safety. Early identification and proper management of these events are crucial for patients receiving CDK4/6 inhibitors. Further research is warranted to elucidate the underlying mechanisms and improve risk mitigation strategies.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used due to their profound efficacy in glycemic control and weight management. Within real-world contexts, the manifestation of certain psychiatric adverse events (AEs) has been observed, which is potentially linked to the administration of GLP-1 RAs. The objective of this study was to undertake a comprehensive investigation and characterization of the psychiatric AEs associated with GLP-1 RAs.Methods: We retrieved reports of AEs associated with treatment with GLP-1 RAs during the period from the first quarter (Q1) of 2004 to Q1 2023 from the FDA Adverse Event Reporting System (FAERS) database. Descriptive analysis was performed to examine the clinical characteristics and time to onset of the psychiatric AEs caused by GLP-1 RAs. Moreover, disproportionality analyses were performed using the reporting odds ratio (ROR) to identify GLP-1 RA-related psychiatric AEs.Results: A total of 8,240 reports of psychiatric AEs were analyzed out of 181,238 AE reports with treatment with GLP-1 RAs. Among these cases, a higher percentage was represented by women compared to men (65.89% vs. 30.96%). The median age of these patients was 56 years, with an interquartile range (IQR) of 48–67 years, based on data available in 286 case reports. This study showed that the median time to onset of the overall GLP-1 RA-related AEs was 31 days (IQR = 7–145.4 days), which varied among GLP-1 RA regimens. Specifically, exenatide had a significantly longer onset time at 45 days (IQR = 11–213 days), with statistically significant differences from the onset times of the other five GLP-1 RAs (p< 0.0001). Moreover, eight categories of psychiatric AEs, namely, nervousness (ROR = 1.97, 95% CI = 1.85–2.11), stress (ROR = 1.28, 95% CI = 1.19–1.38), eating disorder (ROR = 1.57, 95% CI = 1.40–1.77), fear of injection (ROR = 1.96, 95% CI = 1.60–2.40), sleep disorder due to general medical condition—insomnia type (ROR = 2.01, 95% CI = 1.60–2.52), binge eating (ROR = 2.70, 95% CI = 1.75–4.16), fear of eating (ROR 3.35, 95% CI = 1.65–6.78), and self-induced vomiting (ROR = 3.77, 95% CI = 1.77–8.03), were defined as GLP-1 RA-related psychiatric AEs through disproportionality analysis.Conclusion: Our findings demonstrate a significant association between GLP-1 RAs and the development of specific psychiatric AEs. Despite the observational nature of this pharmacovigilance study and the inherent limitations of the FAERS database, our preliminary findings in this work could provide a better basis for understanding the potential psychiatric AEs that may occur with GLP-1 RA treatment, assisting clinicians to focus on these AEs and provide early intervention for optimal risk management.

During the fermentation of dark tea, theabrownins (TBs), carbohydrates, and other substances get irreversibly complex. Recent research on the biological activity of TBs is not based on free TBs. In the present study, some brown polyphenol oxidized polymers, the generalized TBs (TBs-C), were prepared via alkali oxidation from tea polyphenols (TP). We also investigated the inhibitory mechanism of TBs-C on non-small-cell-lung cancer (NSCLC). TBs-C demonstrated a stronger inhibition than TP on the NSCLC cell lines A549, H2030, HCC827, H1975, and PC9. Next, A549 and H2030 cell lines were selected as subjects to explore this mechanism. TBs-C was found to inhibit proliferation, promote apoptosis, and induce G1 cell-cycle arrest in the cells. In addition, TBs-C increased autophagic flux, which in turn promoted the death of lung cancer cells. Moreover, TBs-C suppressed the PI3K/AKT/mTOR pathway activation, promoted autophagy, and increased the expression of p21 downstream of AKT, which resulted in G1 cell-cycle arrest. In xenotransplanted NSCLC nude mice derived from A549 cells, TBs-C could significantly suppress tumor growth by inhibiting the PI3K/AKT/mTOR pathway without causing hepatotoxicity, brain toxicity, or nephrotoxicity. We believe that our present findings would facilitate advancement in the research and industrialization of TBs.

Background/Aims: KRas is usually mutated in non-small cell lung cancer (NSCLC). The mutated KRas gene is a negative prognostic indicator that promotes tumor proliferation, metastasis, and drug resistance in NSCLC, and thus has become a target for cancer therapy. This study is focused on the effects of the microRNA (miR)-202/KRas axis in regulating chemosensitivity in NSCLC. Methods: Quantitative reverse transcriptase real-time PCR analysis was performed to examine the expression of miR-202. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assays were performed to evaluate the sensitivity of cisplatin against NSCLC cells. The miR-202/KRas axis was confirmed by western blot and luciferase reporter assays. Cell apoptosis was measured by flow cytometry. KRas expression, MEK1/2 and ERK1/2 phosphorylation, and activation of caspase-9 and caspase-3 were detected by western blot. Results: A significant decrease in miR-202 expression was observed in NSCLC cells both in vivo and in vitro. In addition, miR-202 expression was associated with drug resistance. Recovery of miR-202 expression levels was found to increase the sensitivity of both NCI-H441 and A549 NSCLC cells to cisplatin treatment. Mechanically, as the Ras/mitogen-activated protein kinase (MAPK) pathway was aberrantly activated in NCI-H441 and A549 NSCLC cells, the overexpression of miR-202 was found to inhibit the Ras/MAPK pathway by targeting the KRas gene. As a result, increased miR-202 expression expanded apoptosis signaling induced by cisplatin in NSCLC cells. Conclusion: The miR-202/KRas axis controlled the chemosensitivity of NSCLC by mediating the Ras/MAPK pathway. Thus, the combination of platinum-based drugs with miR-202 may represent a novel strategy to enhance the anti-tumor effect against NSCLC.