Pain and immune function in patients undergoing gastric cancer surgery following stellate ganglion block with total intravenous anesthesia

BACKGROUND Stellate ganglion block is a commonly used sympathetic nerve block technique that restores the balance of the sympathetic and vagal nervous systems of the body and inhibits sympathetic nerve activity.AIM To analyze the effect of a stellate ganglion block combined with total diploma intravenous anesthesia on postoperative pain and immune function in patients undergoing laparoscopic radical gastric cancer(GC)surgery to provide a refe-rence basis for the formulation of anesthesia protocols for radical GC surgery.METHODS This study included 112 patients who underwent laparoscopic radical surgery for GC between January 2022 and March 2024.There was no restriction on sex.The patient grouping method used was a digital random table method,and the num-ber of cases in each group was 56.The control group was administered total intravenous anesthesia,and the observation group compounded the stellate gan-glion block according to the total intravenous anesthesia protocol.Postoperative hemodynamics,pain levels,and immune indices were compared between the groups.RESULTS The heart rate and mean arterial pressure in the observation group after in-tubation were lower than those in the control group(P<0.05).Pain levels were compared between the two groups at 2 hours,12 hours,24 hours,and 48 hours after surgery(P>0.05).The number of CD3+,CD4+,and CD4+/CD8+cells at the end of surgery was higher in the observation group than in the control group,and the number of CD8+cells was lower in the observation group than in the control group(P<0.05).There were no significant differences between the two groups in terms of propofol dosage,awakening time,extubation time,or postoperative adverse reactions(P>0.05).CONCLUSION The application of a stellate ganglion block combined with total intravenous anesthesia had no significant effect on postoperative pain levels in patients undergoing laparoscopic radical GC surgery.However,it can safely reduce the effect of surgery on the immune function of patients and is worth applying in clinical practice.

Effect of NLRC5 on activation and reversion of hepatic stellate cells by regulating the nuclear factor-κB signaling pathway

BACKGROUND The formation of liver fibrosis is mainly caused by the activation of hepatic stellate cells(HSCs)and the imbalance of extracellular matrix(ECM)production and degradation.The treatment of liver fibrosis mainly includes removing the cause,inhibiting the activation of HSCs,and inhibiting inflammation.NOD-like receptor(NLR)family,caspase activation and recruitment domain(CARD)domain containing 5/NOD27/CLR16.1(NLRC5)is a highly conserved member of the NLR family and is involved in inflammation and immune responses by regulating various signaling pathways such as nuclear factor-κB(NF-κB)signaling.It has been found that NLRC5 plays an important role in liver fibrosis,but its specific effect and possible mechanism remain to be fully elucidated.AIM To investigate the role of NLRC5 in the activation and reversion of HSCs induced with transforming growth factor-β(TGF-β)and MDI,and to explore its relationship with liver fibrosis.METHODS A total of 24 male C57BL/6 mice were randomly divided into three groups,including normal,fibrosis,and recovery groups.Twenty-four hours after a liver fibrosis and spontaneous reversion model was established,the mice were sacrificed and pathological examination of liver tissue was performed to observe the degree of liver fibrosis in each group.LX-2 cells were cultured in vitro and treated with TGF-β1 and MDI.Real-time quantitative PCR(qPCR)and Western blot were used to analyze the expression levels of NLRC5,α-smooth muscle actin(α-SMA),and collagen type I alpha1(Col1a1)in each group.The activity of NF-κB in each group of cells transfected with NLRC5-siRNA was detected.RESULTS Compared with the normal mice,the expression level of NLRC5 increased significantly(P<0.01)in the fibrosis group,but decreased significantly in the recovery group(P<0.01).In in vitro experiments,the content of NLRC5 was enhanced after TGF-β1 stimulation and decreased to a lower level when treated with MDI(P<0.01).The expression ofα-SMA and Col1a1 proteins and mRNAs in TGF-β1-mediated cells was suppressed by transfection with NLRC5-siRNA(P<0.01).Western blot analysis showed that the expression of NF-κB p65 protein and phosphorylated IκBα(p-IκBα)was increased in the liver of mice in the fibrosis group but decreased in the recovery group(P<0.01),and the protein level of nuclear p65 and p-IκBαwas significantly increased after treatment with NLRC5-siRNA(P<0.01).CONCLUSION NLRC5 may play a key role in the development and reversal of hepatic fibrosis through the NF-κB signaling pathway,and it is expected to be one of the clinical therapeutic targets.

A Novel Genetic Algorithm for Global Optimization

This paper presents a novel genetic algorithm for globally solving un-constraint optimization problem.In this algorithm,a new real coded crossover operator is proposed firstly.Furthermore,for improving the convergence speed and the searching ability of our algorithm,the good point set theory rather than random selection is used to generate the initial population,and the chaotic search operator is adopted in the best solution of the current iteration.The experimental results tested on numerical benchmark functions show that this algorithm has excellent solution quality and convergence characteristics,and performs better than some algorithms.

Optimal Portfolio and Consumption Rule with a CIR Model Under HARA Utility

In the real-world environments,different individuals have different risk preferences.This paper investigates the optimal portfolio and consumption rule with a Cox–Ingersoll–Ross(CIR)model in a more general utility framework.After consumption,an individual invests his wealth into the financial market with one risk-free asset and multiple risky assets,where the short-term rate is driven by the CIR model and stock price dynamics are simultaneously influenced by random sources from both stochastic interest rate and stock market itself.The individual hopes to optimize their portfolios and consumption rules to maximize expected utility of terminal wealth and intermediate consumption.Risk preference of individual is assumed to satisfy hyperbolic absolute risk aversion(HARA)utility,which contains power utility,logarithm utility,and exponential utility as special cases.By using the principle of stochastic optimality and Legendre transform-dual theory,the explicit expressions of the optimal portfolio and consumption rule are obtained.The sensitivity of the optimal strategies to main parameters is analysed by a numerical example.In addition,economic implications are also presented.Our research results show that Legendre transform-dual theory is an effective methodology in dealing with the portfolio selection problems with HARA utility and interest rate risk can be completely hedged by constructing specific portfolios.