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Chicken oil is prone to oxidation due to the high content of unsaturated fatty acids. The interaction of antioxidants was affected by their concentration, ratio, and reaction system. In this article, mixtures of zeaxanthin and tocopherols (α-tocopherol and γ-tocopherol) were chosen to enhance the oxidative stability of chicken oil. The antioxidation of zeaxanthin with tocopherols was analyzed using the Rancimat test, the free radical scavenging capacity and the Schaal oven test (the variation of antioxidant content, PV and shelf life prediction). The optimal concentration of zeaxanthin determined by Rancimat in chicken oil was 20 mg/kg. The binary mixtures have a strong synergistic effect in the ABTS experiment, and the clearance rate was up to 99%, but antagonistic effect in ORAC. The degree of synergism between zeaxanthin and tocopherols was determined by ratio. The interaction between zeaxanthin and α-tocopherol was synergistic, while the types of interaction between zeaxanthin and γ-tocopherol were affected by concentration. The main synergistic interaction mechanism was the regeneration of tocopherol by zeaxanthin. Synergistic combinations of zeaxanthin with α-tocopherol and γ-tocopherol played a key role in the primary oxidation stage of the lipid. The best synergistic combination was A3 (zeaxanthin+α-tocopherol: 15+50 23 mg/kg), which could extend the shelf life of chicken oil (92.46 d) to 146.93 days. This work provides a reference for zeaxanthin and tocopherol to improve the oxidative stability of animal fat. [ABSTRACT FROM AUTHOR]

OBJECTIVES: At present, few data exist regarding the comparisons of perioperative outcomes and recurrence of spontaneous ventilation (SV) video-assisted thoracic surgery (VATS) bullectomy using total intravenous anaesthesia (TIVA) with local anaesthesia (LA) or thoracic epidural anaesthesia (TEA).We evaluated the feasibility and safety of TIVA with LA in the management of primary spontaneous pneumothorax (PSP). METHODS: We conducted a single-institution retrospective analysis of patients undergoing VATS bullectomy between July 2011 and May 2015; 240 patients were included for analysis. Preoperative, intraoperative and postoperative variables of patients undergoing VATS bullectomy using TIVA-TEA (n = 140) were compared with those using TIVA-LA (n = 100). RESULTS: Baseline demographics were similar between groups. No patients in either group required conversion to thoracotomy. Three patients (TIVA-TEA: 2; TIVA-LA: 1) required conversion to intubated general anaesthesia. Both groups had comparable surgical duration, estimated blood loss, peak EtCO2 and lowest intraoperative SpO2 level. Postoperatively, thoracic drainage volume, duration of chest tube drainage and hospitalization cost did not differ between groups. The incidence of postoperative complications between groups was not significant (2% for TIVA-TEA vs 2% for TIVA-LA, P = 1.00). Pneumothorax recurrence rate was 3% in TIVA-TEA cases (n = 4) and 2% in TIVA-LA cases (n = 2). CONCLUSIONS: SV-VATS bullectomy using TIVA with LA or TEA is technically feasible and safe. Both groups have comparable short-term outcomes and recurrence rates; TIVA-LA seems a valid alternative to TIVA-TEA for the surgical management of PSP under SV. [ABSTRACT FROM AUTHOR]

Background: Rebiopsy is highly recommended to identify the mechanism of acquired resistance to EGFR-TKIs in advanced lung cancer. Recent advances in multiplex genotyping based on circulating tumor DNA (ctDNA) provide a strong and non-invasive alternative for detection of the resistance mechanism.Case Presentation: Here we report a multiple metastatic NSCLC patient who was detected to have pure EGFR 19 exon deletion (negative for EML4-ALK and ROS1 in both IHC-based and sequencing assay) in the primary lesion and responded to first-line and second-line EGFR-TKI treatments (erlotinib then HY-15772). At 8 months, most lesions remained well controlled except for the liver metastases which presented dramatic progression. Considering the high risk of bleeding in rebiopsy of hepatic lesions, we conducted a multiplex genomic profiling with ctDNA. Results reported coexistence of EGFR mutation and EML4-ALK gene translocation in plasma which heavily indicated that ALK was the primary reason for progression of the liver lesions. This deduction was supported by the repeated response to ALK inhibitors (crizotinib then AP26113) of the hepatic metastases.Conclusions: This is the first report of the existence of ALK rearrangement in metastatic lesions in an EGFR mutated patient. It highlighted the feasibility and advantages of using ctDNA multiplex genotyping in identifying the heterogeneity across lesions and the resistance mechanism of targeted treatments. [ABSTRACT FROM AUTHOR]

We present an innovative method using uniportal video-assisted thoracoscopic surgery under spontaneous ventilation anaesthesia (SVA) to perform tracheal surgery in a 46-year-old man with distal tracheal squamous cell carcinoma. SVA offered better exposure of the surgical field and facilitated anastomosis following a single incision. Such simplification of the ventilation strategy and uniportal incision accelerated the postoperative recovery and reduced the side effects of conventional anaesthesia. [ABSTRACT FROM AUTHOR]