不同麻醉方式对腹腔镜全子宫切除2型糖尿病患者细胞免疫及血清炎症因子水平的影响

目的探讨不同麻醉方式对腹腔镜全子宫切除2型糖尿病(T_(2)DM)患者细胞免疫及血清炎症因子水平的影响。方法选取2016年1月—2019年1月邯郸市中心医院收治的120例拟行腹腔镜全子宫切除术的T_(2)DM患者,采用随机数字表法分为A、B组,每组60例。A组采用靶控输注丙泊酚和瑞芬太尼全身麻醉,B组在A组基础上复合吸入七氟醚全身麻醉。比较两组T淋巴细胞(CD3^(+)、CD4^(+)及CD8^(+))、NK细胞(CD3-CD16^(+)CD56^(+))、血清白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、IL-10水平及术中不良反应。结果两组麻醉前(T0)、建立气腹前(T_(1))、建立气腹后90 min(T_(2))、术后第1天(T_(3))及术后第3天(T_(4))CD3^(+)、CD4^(+)、CD8^(+)、CD3-CD16^(+)CD56^(+)和IL-6、hs-CRP、PCT、IL-10水平比较,在不同时间、不同组间及变化趋势上有差异(P<0.05)。B组苏醒时间、拔管时间短于A组(P<0.05)。两组麻醉维持时间、术中恶心呕吐、牵拉反应及低血压发生率比较,差异无统计学意义(P>0.05)。结论靶控输注丙泊酚和瑞芬太尼复合七氟醚吸入全身麻醉可降低全子宫切除术T_(2)DM患者围手术期血清炎症因子水平,保护细胞免疫功能,且不增加术中不良反应,具有一定的临床应用价值。

Ultrasound-guided paravertebral nerve block anesthesia on the stress response and hemodynamics among lung cancer patients

BACKGROUND Thoracic surgery for radical resection of lung tumor requires deep anesthesia which can lead to an adverse inflammatory response,loss of hemodynamic stability,and decreased immune function.Herein,we evaluated the feasibility and benefits of ultrasound-guided paravertebral nerve block anesthesia,in combination with general anesthesia,for thoracic surgery for lung cancer.The block was performed by diffusion of anesthetic drugs along the paravertebral space to achieve unilateral multi-segment intercostal nerve and dorsal branch nerve block.AIM To evaluate the application of ultrasound-guided paravertebral nerve block anesthesia for lung cancer surgery to inform practice.METHODS The analysis was based on 140 patients who underwent thoracic surgery for lung cancer at our hospital between January 2018 and May 2020.Patients were randomly allocated to the peripheral+general anesthesia(observation)group(n=74)or to the general anesthesia(control)group(n=66).Patients in the observation group received ultrasound-guided paravertebral nerve block anesthesia combined with general anesthesia,with those in the control group receiving an epidural block combined with general anesthesia.Measured outcomes included the operative and anesthesia times,as well as the mean arterial pressure(MAP),heart rate(HR),and blood oxygen saturation(SpO;)measured before surgery,15 min after anesthesia(T1),after intubation,5 min after skin incision,and before extubation(T4).RESULTS The dose of intra-operative use of remifentanil and propofol and the postoperative use of sufentanil was lower in the observation group(1.48±0.43 mg,760.50±92.28 mg,and 72.50±16.62 mg,respectively)than control group(P<0.05).At the four time points of measurement(T1 through T4),MAP and HR values were higher in the observation than control group(MAP,90.20±9.15 mmHg,85.50±7.22 mmHg,88.59±8.15 mmHg,and 90.02±10.02 mmHg,respectively;and HR,72.39±8.22 beats/min,69.03±9.03 beats/min,70.12±8.11 beats/min,and 71.24±9.01 beats/min,respectively;P<0.05).There was no difference in SpO;between the two groups(P>0.05).Postoperative levels of epinephrine,norepinephrine,and dopamine used were significantly lower in the observation than control group(210.20±40.41 pg/mL,230.30±65.58 pg/mL,and 54.49±13.32 pg/mL,respectively;P<0.05).Similarly,the postoperative tumor necrosis factor-αand interleukin-6 levels were lower in the observation(2.43±0.44 pg/mL and 170.03±35.54 pg/mL,respectively)than control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION Ultrasound-guided paravertebral nerve block anesthesia improved the stress and hemodynamic response in patients undergoing thoracic surgery for lung cancer,with no increase in the rate of adverse events.

Correlation of serum bFGF and CXCL16 levels with cancer cell growth and invasion in patients with cervical cancer

Objective: To investigate the correlation of serum bFGF and CXCL16 levels with cancer cell growth and invasion in patients with cervical cancer. Methods: A total of 119 patients who were diagnosed with cervical cancer in Panyu District Shiqiao Hospital and Guangzhou First People's Hospital between October 2013 and October 2016 were collected as observation group, and 100 patients with cervical polyp (benign) who were treated in the hospitals during the same period were selected as control group. bFGF and CXCL16 levels in serum as well as proliferation and invasion gene expression in cervical lesions were detected, and Pearson test was used to further evaluate the correlation of serum bFGF and CXCL16 levels with cancer cell growth and invasion in patients with cervical cancer. Results: Serum bFGF and CXCL16 levels of observation group were higher than those of control group, and LATS1, SFRP2 and TET1 mRNA expression in cervical tissue were significantly lower than those of control group while HERC4, HMGB-1, HIF-1α, YAP1, Twist and RbAp48 mRNA expression were higher than those of control group;serum bFGF and CXCL16 levels in patients with cervical cancer were negatively correlated with LATS1, SFRP2 and TET1 mRNA expression in cervical tissue, and positively correlated with HERC4, HMGB-1, HIF-1α, YAP1, Twist and RbAp48 mRNA expression. Conclusion: Serum bFGF and CXCL16 levels abnormally increase in patients with cervical cancer, and they are directly correlated with the proliferation and invasion activity of cancer cells.