Background: Although several reports have shown that diabetes is a poor prognostic factor for esophageal cancer, no reports assessed prognostic impact of hemoglobin A1c (HbA1c) in the patients with esophageal cancer. Therefore, we evaluated the prognostic significance of HbA1c in patients with esophageal cancer.

Methods: A total of 137 patients with esophageal carcinoma surgically treated at our institute between 2009 and 2017 were enrolled in this retrospective study. We divided these patients into quarters according to pretreatment levels of HbA1c. We used 5.5% as a cutoff for classifying patients into low (Q1; n = 30) and high (Q2, Q3, Q4; n = 107) HbA1c groups. Univariate and multivariate analyses were then used to evaluate the clinicopathological and prognostic significance of pretreatment level of HbA1c.

Results: There was no significant relationship between HbA1c level and clinicopathological factors. The low HbA1c group had a significantly worse survival rate as compared to that of the high HbA1c group (overall survival p = 0.04, relapse-free survival p = 0.02). However, the difference was not confirmed in the multivariate analysis.

Conclusion: Although low level of pretreatment HbA1c might be associated with poor prognosis for patients with esophageal cancer, low HbA1c was not an independent risk factor.

Purpose: To discuss the necessity of anti-tuberculosis therapy after resection of asymptomatic pulmonary tuberculous nodules: is postoperative anti-tuberculosis therapy is over-treatment?

Methods: This is a single-center retrospective study. Patients with solitary pulmonary nodule (SPN) and diagnosed as tuberculosis by pathology were included. Clinical features are collected. The primary end point is tuberculosis relapse and the secondary is adverse drug reactions. Patients are divided into two groups according to the acceptance of anti-tuberculosis treatment after operation (A: treated; B: untreated). Recurrence is diagnosed by multi-disciplinary discussion. The difference of recurrence rate will be compared and the incidence of adverse drug reactions in Group A will be calculated.

Results: A total of 98 patients were enrolled, 66 in Group A and 32 in Group B. No significant difference between two groups was found in the past history of tuberculosis, erythrocyte sedimentation rate (ESR), T-spot positive rate, and the uptake value of 18F-glucose. No relapse of tuberculosis was found in both groups. The incidence of adverse drug reactions in Group A was 61% (40/66), and the rate of severe adverse reaction was 14% (9/66).

Conclusions: Postoperative recurrence of tuberculosis is rare, anti-tuberculosis treatment seems unnecessary for asymptomatic pulmonary tuberculous nodules. Adverse drug reactions should not be ignored.

Objective: To evaluate the effect of music therapy on the chronic pain and midterm quality of life of patients after mechanical valve replacement.

Methods: Patients were divided into two groups according to whether or not they received music therapy. The patients in the music group received 30 minutes of music therapy every day for 6 months after the operation. The patients in the control group received standard treatment and had 30 minutes of quiet rest time every day in the same period. The short-form of McGill Pain Questionnaire (SF-MPQ) was used to evaluate the degree of postoperative chronic pain, and the SF-36 was used to evaluate the midterm quality of life of patients.

Results: In terms of the degree of postoperative chronic pain, the score of the pain rating index (PRI) emotional item in the music group was significantly lower than that in the control group. In the evaluation of the postoperative midterm quality of life using the SF-36, the emotional function score in the music group was significantly higher than that in the control group.

Conclusion: This study preliminarily showed that music therapy can effectively reduce chronic pain and improve midterm quality of life after surgery.

Background: The TROFEO trial demonstrated that febuxostat causes greater and more rapid reduction of serum uric acid (s-UA) than topiroxostat. We compared these drugs in patients with chronic kidney disease (CKD) by sub-analysis of the TROFEO trial.

Methods: This sub-analysis targeted patients with an estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m². The primary endpoint was the s-UA level. Secondary endpoints included creatinine, eGFR, urinary albumin, cystatin-C, oxidized low-density lipoprotein (Ox-LDL), eicosapentaenoic acid/arachidonic acid ratio, lipid biomarkers, high-sensitivity C-reactive protein, and B-type natriuretic peptide (BNP).

Results: There was no significant difference of s-UA between the two groups either before or after treatment. However, s-UA did not exceed 6.0 mg/dL in febuxostat group during the study period, but it exceeded this level in seven patients from topiroxostat group, with the number being significantly higher in topiroxostat group. Serum creatinine (s-Cr) and eGFR were significantly better after 6 months of febuxostat treatment compared with topiroxostat Cystatin-C was significantly lower after 6 months of febuxostat treatment compared with topiroxostat. The Ox-LDL was significantly lower after 3 and 6 months of febuxostat treatment compared with topiroxostat.

Conclusion: Febuxostat had stronger renoprotective and antioxidant effects than topiroxostat in patients with hyperuricemia and CKD.

Objective: To compare the effects of the sounds of different types of mechanical mitral valves on the quality of life (QoL) of patients at different follow-up times.

Methods: We collected data from 150 patients who underwent mechanical mitral valve replacement. Three time points were assessed, including at discharge, the third postoperative month (POM3), and the twelfth postoperative month (POM12). The SF-36 and a self-questionnaire were used to assess the QoL.

Results: Regarding the SF-36 scores, the ATS valve was superior to the Sorin and SJM valves in terms of some items. Moreover, the scores at discharge of all three mechanical valve groups were lower than those at POM3 and POM12. For the self-questionnaire scores, with the increase in postoperative time, the number of patients affected by the mechanical valve sounds decreased gradually. Considering the relevant influencing factors, older women were more likely to be affected by the valve sounds than were younger individuals and men.

Conclusion: The overall postoperative QoL improved for patients who underwent mechanical mitral valve replacement. In the comparative study, the impact of the ATS valve was better than those of the Sorin and SJM valves, but this difference gradually disappeared over time.

An arteriovenous fistula is a rare complication of ruptured abdominal aortic or iliac artery aneurysms (IAAs). Its clinical symptoms depend on its size, with signs of heart failure dominating if the fistula is large. Herein, we present a case of arteriovenous fistula with an unusual presentation. An 86-year-old male patient presented with extreme lower extremity edema, skin erosion, and continuous lymphorrhea (starting 3 months prior). Despite the large fistula between the right common IAA and the left common iliac vein after the rupture of the aneurysm, he did not develop heart failure symptoms, as the large shunt was predominantly directed toward the left lower extremity due to iliac vein compression. Careful physical examination and a high index of suspicion could have contributed to an earlier diagnosis and management.

An 82-year-old woman was referred to our hospital because of dyspnea on effort. Echocardiography revealed severe aortic valve stenosis (AS). Simultaneously, chest computed tomography (CT) revealed a 19-mm nodule in the lower lobe of the right lung, and bronchoscopic biopsy revealed adenocarcinoma. She underwent transcatheter aortic valve implantation (TAVI) for severe AS. Three weeks later, she underwent lower lobectomy of the right lung and mediastinal dissection for the lung cancer. Her postoperative course was good, and she was discharged 8 days postoperatively. In conclusion, we encountered a patient who successfully underwent pulmonary resection for lung cancer following TAVI for severe AS. We suggest that pulmonary resection following TAVI is an acceptable choice for lung cancer in patients with severe AS because of the lack of a need for cardiopulmonary bypass, the high safety and efficacy of two-stage therapy, and the short period between the two therapies.