Objective To explore the safety and efficacy of thoracoscopy-guided thoracic paravertebral block (TPVB) in thoracoscopic pulmonary resection, and to provide strategies for enhanced recovery after surgery (ERAS) in thoracoscopic lung resection. Methods Patients who underwent thoracoscopic pulmonary resection (including sublobar resection and lobectomy) in the 987th Hospital of Joint Logistics Support Force of People's Liberation Army, General Hospital of Central Theater Command of the People’s Liberation Army, and the First Affiliated Hospital with Nanjing Medical University between May 2021 and June 2023 were prospectively enrolled. The patients were randomly allocated into three groups in a single-blind manner using a random number table. Group A (incisional nerve block group) received a subcutaneous injection of ropivacaine (0.375%, 2 mg/kg) around the incision during chest closure. Group B (ultrasound-guided TPVB group) received an ultrasound-guided injection of ropivacaine (0.375%, 2 mg/kg) at the paravertebral space after chest closure. Group C (thoracoscopy-guided TPVB group) received a thoracoscopy-guided intrathoracic injection of ropivacaine (0.375%, 2 mg/kg) at the paravertebral space during chest closure. Perioperative adverse drug reactions, pain scores, postoperative analgesic consumption, and postoperative length of hospital stay were compared among the three groups. Results A total of 180 patients were included, comprising 108 females and 72 males, with a mean age of (62.15±7.36) years. There were no statistical differences among the three groups in baseline characteristics, including age, weight, gender, prevalence of comorbidities, operative time, number of surgical incisions, number of chest tubes, or intraoperative dosages of sufentanil and propofol (P>0.05). No adverse anesthesia events occurred during surgery in any of the groups. The pressing frequency of the patient-controlled intravenous analgesia (PCIA) pump, Visual Analogue Scale (VAS) pain scores, the rate of postoperative rescue analgesic use, and the incidences of postoperative cough and dizziness in the group C were significantly lower than those in the other two groups (P<0.05). The postoperative length of hospital stay in the group B and group C was significantly shorter than that in the group A (P<0.05). Conclusion Thoracoscopy-guided TPVB during chest closure can effectively alleviate postoperative pain without increasing postoperative side effects, which facilitates the enhanced recovery after thoracoscopic lung surgery.

Objective To observe effects of propofol versus urapidil on perioperative hemodynamics in patients with gallbladder opera-tion during tracheal extubation. Methods From 2010 January to 2012 December, 128 patients who were diagnosed by color B ultra /CT and then underwent gallbladder selective operation (ASAⅡ~IV) were selected, and they were divided into the propofol group (n=64) and the urapidil group (n=64). At the end of operation, patients of the two groups were given intravenous injection of propofol 1. 5 mg/kg and ura-pidil 2. 5mg/kg which were diluted with normal saline to 8 mL respectively. Sputum suction immediately after medication, and then wiped out the endotracheal tube and gave oxygen masks for 10 min. Record the systolic/diastolic blood pressure ( SBP/DSP) , heart rate ( HR) , pH, PaO2 , PaCO2 and SaO2 under double blind trial before induction, after medication, at the time of sputum suction, at the time of extuba-tion, 5 min after extubation and 10 min after extubation. At the same time, agitation during the extubation period and patients awake time were recorded. Results After extubation, cough (4. 7% vs. 26. 6%), agitation (3. 1% vs. 17. 2%) and glossoptosis (12. 5% vs. 21. 9%) in propofol group was significantly lower than urapidil group (P<0. 05). SBP/DSP and heart rate of propofol group and urapidil group were significantly increased (P<0. 05) before induction, after medication, at the time of sputum suction, at the time of extubation, 5 minafter extubation and 10 min after extubation. The recovery time of propofol group and urapidil group were of no significant differences (P>0. 05). During perioperation extubation, there was no significantly difference in terms of changes of pH, PaO2, PaCO2 and SaO2 be-tween the groups (P>0. 05). Conclusion Propofol is better than urapidil in preventing adverse effect of extubation for patients with gall-bladder operation, and it will not affect the recovery time of patients.

Our earlier research has shown that mono-substituted N-phenyl-2, 2-dichloroacetamide exhibited much higher anti-cancer activity than the lead compound sodium dichloroacetate (DCA). In this paper, a variety of multi-substituted N-phenyl-2, 2-dichloroacetamides were synthesized and biologically evaluated. The results showed that 3, 5-disubstituted N-phenyl-2, 2-dichloroacetamide analogues had satisfactory potency. Among them, N-(3, 5-diiodophenyl)-2, 2-dichloroacetamide had an IC50 of 2.84 micromol x L(-1) against non-small cell lung cancer cell line A549 and could induce cancer cell apoptosis.