胸腔直视下肋间神经阻滞联合切口局部浸润在胸腔镜术后镇痛的应用

目的:探讨胸腔直视下肋间神经阻滞联合切口局部浸润用于胸腔镜术后镇痛的效果。方法:选择2018年4月至2021年5月在揭阳市人民医院择期行胸腔镜手术患者60例,随机分为M组和V组,每组30例。两组患者均按胸外科快速康复方案进行术前准备,采用标准化支气管插管全身麻醉方案,术后均行静脉镇痛,M组患者在术毕时由外科医生进行直视下肋间神经阻滞联合操作孔局部浸润。记录两组患者苏醒期恢复情况如拔管时间、复苏时间、RSS躁动评分;记录两组患者术后4、8、12、24、48h安静和咳嗽疼痛VAS评分;记录两组患者术后快速康复情况;记录两组患者补救性镇痛情况;记录两组患者术后不良反应发生情况。结果:M组患者RSS躁动评分明显低于V组(P<0.05),M组患者术后4、8、12、24h安静和咳嗽疼痛VAS评分明显低于V组(P<0.05),M组患者首次下床活动时间、首次肛门排气时间、首次进固体食物时间明显低于V组(P<0.05),术后48h内下床活动总次数明显高于V组(P<0.05),M组患者氟比洛芬酯、舒芬太尼补救性镇痛例数明显低于V组(P<0.05),两组患者术后均未发生嗜睡、恶...     

Down-regulation of phosphoglucose isomerase/autocrine motility factor results in mesenchymal-to-epithelial transition of human lung fibrosarcoma cells

Phosphoglucose isomerase (PGI) is one of the glycolytic enzymes and is a multifunctional enzyme that functions in glucose metabolism inside the cell while acting as a cytokine outside the cell, with properties that include autocrine motility factor (AMF) regulating tumor cell motility. Although there are many studies indicating that PGI/AMF has been implicated in progression of metastasis, no direct studies of the significance of exogenous PGI/AMF on tumor progression have been reported. Here, we report on the mesenchymal-to-epithelial transition (MET), which is the reverse phenomenon of the epithelial-to-mesenchymal transition that is associated with loss of cell polarity, loss of epithelia markers, and enhancement of cell motility essential for tumor cell invasion and metastasis. Mesenchymal human fibrosarcoma HT1080 cells, which have naturally high levels of endogenous and exogenous PGI/AMF, were stably transfected with PGI/AMF small interfering RNA (siRNA). The siRNA targeting human PGI/AMF down-regulated the endogenous PGI/AMF expression and completely extinguished the secretion of PGI/AMF in a human fibrosarcoma HT1080, whereas the control siRNA showed no effects. The PGI/AMF siRNA caused cells to change shape dramatically and inhibited cell motility and invasion markedly. Suppression of PGI/AMF led to a contact-dependent inhibition of cell growth. Those PGI/AMF siRNA-transfected cells showed epithelial phenotype. Furthermore, tumor cells with PGI/AMF deficiency lost their abilities to form tumor mass. This study identifies that MET in HT1080 human lung fibrosarcoma cells was initiated by down-regulation of the housekeeping gene product/cytokine PGI/AMF, and the results depicted here suggest a novel therapeutic target/modality for mesenchymal cancers.     

Electrophysiological characterization and modeling of the structure activity relationship of the human concentrative nucleoside transporter 3 (hCNT3)

We characterized the electrophysiology, kinetics, and quantitative structure-activity relationship (QSAR) of the human concentrative nucleoside transporter 3 (hCNT3) expressed in Xenopus laevis oocytes by measuring substrate-induced inward currents using a two-microelectrode voltage-clamp system. At membrane potentials between -30 and -150 mV, sodium activation of gemcitabine transport was sigmoidal, with a K0.5 of 8.5+/-0.3 mM for Na+ and a Hill coefficient of 2.2+/-0.25 independent of membrane potential. We measured the Imax and K0.5 for substrate at -50 mV for the nucleoside analog drugs gemcitabine (638+/-58 nA, 59.7+/-17.5 microM), ribavirin (546+/-37 nA, 61.0+/-13.2 microM), AZT (420+/-4 nA, 310+/-9 microM), and 3-deazauridine (506+/-30 nA, 50.8+/-9.90 microM). K0.5 and Imax for substrate were dependent on membrane potential (both increasing as the membrane became more hyperpolarized) for all four drugs. hCNT3 also exhibited pre-steady-state currents. The quantitative structure-activity relationship (QSAR) was examined using comparative molecular field analysis and comparative molecular similarity indices analysis of the inward currents induced by 27 nucleoside analogs with substitutions at both the ribose and the nucleobase. Two statistically significant QSAR models identified electrostatic interaction as the major force in hCNT3 transport and attributed a critical role to the 3'-hydroxyl position of hCNT3 substrates. Steric hindrance at the 3-position and positive charge at the 5-position of the pyrimidine ring were favorable for transport. Two hCNT3 pharmacophore models revealed the minimal features required for hCNT3 transport as two hydrogen bond acceptors at 3'-OH and 5'-O and the hydrophobic center occupied by the base ring.     

Theaflavic acid from black tea protects PC12 cells against ROS-mediated mitochondrial apoptosis induced by OGD/R via activating Nrf2/ARE signaling pathway

Journal of Natural Medicines - Cerebral ischemic stroke is a severe disease afflicting people worldwide. Phytochemicals play a pivotal role in the discovery of novel therapeutic approaches for the...     

帝视内镜和纤维支气管镜用于口腔颌面骨折手术患者经鼻气管插管的比较

目的评估和比较帝视内镜(Disposcope,DS)和纤维支气管镜(FOB)用于口腔颌面骨折手术患者经鼻气管插管的临床效果。方法选择择期行口腔颌面骨折手术患者60例,男32例,女28例,年龄18~65岁,ASAⅠ或Ⅱ级。患者随机分为DS组和FOB组,每组30例。两组均采取经鼻气管插管,DS组采用DS引导插管,FOB组采用FOB引导插管。记录插管时间、首次插管成功率、插管总成功率。记录术后24h患者声音嘶哑、咽痛、黏膜损伤、牙齿松动等不良反应发生情况。结果 DS组插管时间明显短于FOB组(P0.05)。两组首次插管成功率和插管总成功率差异无统计学意义。两组术后24h声音嘶哑、咽痛、黏膜损伤、牙齿松动发生率差异均无统计学意义。结论DS或FOB均有助于口腔颌面骨折手术患者经鼻气管插管,两者插管成功率和插管相关并发症相似,但使用DS插管时间较FOB缩短,且操作和维护方便,可在基层医院推广应用。     

Associations of vitamin K status with mortality and cardiovascular events in peritoneal dialysis patients

International Urology and Nephrology - Vitamin K deficiency, expressed by a high level of desphospho-uncarboxylated matrix GLA protein (dp-ucMGP), is highly prevalent in dialysis patients. However,...     

帝视观察用内窥镜在Robertshaw双腔支气管导管插管与定位中的应用

目的:本研究旨在探讨帝视内镜在Robertshaw双腔支气管导管插管与定位的应用效果.方法:选择2018年1月至2021年4月在我院行择期胸腔镜手术患者80例,随机分为内E组和M组,每组40例.两组采用Robertshaw双腔支气管导管插管全身麻醉,E组患者采用帝视内镜进行支气管插管及定位,M组患者采用Macintosh喉镜进行支气管插管,听诊法进行定位.记录两组气道评估情况;记录两组双腔支气管插管实施情况;记录两组术中单肺通气情况;记录两组患者气管插管并发症发生情况.结果:E组暴露声门时间、气管插管时间、定位时间明显低于M组(P<0.05);E组Cormach-Lehane声门暴露分级明显优于M组(P<0.05);E组首次插管成功率、MN间距明显高于M组(P<0.05),E组术中气道峰压过高、肺塌陷不良、需要调整导管位置例数明显低于M组(P<0.05),E组患者气管插管并发症总发生率明显低于M组(P<0.05).结论:帝视观察用内窥镜能安全有效应用于Robertshaw双腔支气管导管插管的定位,与Macintosh喉镜插管听诊法比较,帝视观察用内窥镜声门暴露时间、插管时间、定位时间更短、首次插管成功率更高、并发症更少,且术中单肺通气效果更好.     

Perspectives on current tumor-node-metastasis (TNM) staging of cancers of the colon and rectum

Improvements in classifications of cancers based on discovery and validation of important histopathological parameters and new molecular markers continue unabated. Though still not perfect, recent updates of classification schemes in gastrointestinal oncology by the American Joint Commission on Cancer (tumor-node-metastasis [TNM] staging) and the World Health Organization further stratify patients and guide optimization of treatment strategies and better predict patient outcomes. These updates recognize the heterogeneity of patient populations with significant subgrouping of each tumor stage and use of tumor deposits to significantly "up-stage" some cancers; change staging parameters for subsets of IIIB and IIIC cancers; and introduce of several new subtypes of colon carcinomas. By the nature of the process, recent discoveries that are important to improving even routine standards of patient care, especially new advances in molecular medicine, are not incorporated into these systems. Nonetheless, these classifications significantly advance clinical standards and are welcome enhancements to our current methods of cancer reporting.