Effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy

AIM To prospectively evaluate the effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy.METHODS A total of 56 patients undergoing open hepatectomy were randomly divided into two groups:a ropivacaine group(wound infiltration with ropivacaine solution)and a control group(infiltration with isotonic saline solution).A visual analog scale(VAS)at rest and on movement was used to measure postoperative pain for the first 48 h after surgery.Mean arterial pressure(MAP),heart rate(HR),time to bowel recovery,length of hospitalization after surgery,cumulative sufentanil consumption,and incidence of nausea and vomiting were compared between the two groups.Surgical stress hormones(epinephrine,norepinephrine,and cortisol)were detected using enzyme-linked immunosorbent assay,and the results were compared. RESULTS VAS scores both at rest and on movement at 24 h and48 h were similar between the two groups.Significantly lower VAS scores were detected at 0,6,and 12 h in the ropivacaine group compared with the control group(P<0.05 for all).MAP was significantly lower at 6,12,and 24 h(P<0.05 for all);HR was significantly lower at 0,6,12,and 24 h(P<0.05 for all);time to bowel recovery and length of hospitalization after surgery(P<0.05 for both)were significantly shortened;and cumulative sufentanil consumption was significantly lower at 6,12,24,and 36 h(P<0.05 for all)in the ropivacaine group than in the control group,although the incidence of nausea and vomiting showed no significant difference between the two groups.The levels of epinephrine,norepinephrine,and cortisol were significantly lower in the ropivacaine group than in the control group at 24 and 48 h(P<0.01 for all). CONCLUSION Local wound infiltration with ropivacaine after open hepatectomy can improve postoperative pain relief,reduce surgical stress response,and accelerate postoperative recovery.

The Existence of Positive Solution for Singular Boundary Value Problems of First Order Differential Equation on Unbounded Domains

By constructing a special cone and using cone compression and expansion fixed point theorem, this paper presents some existence results of positive solutions of singular boundary value problem on unbounded domains for a class of first order differential equation. As applications of the main results, two examples are given at the end of this paper.

miR-124/VAMP3 is a novel therapeutic target for mitigation of surgical trauma-induced microglial activation

Activation of microglia and the subsequently elevated inflammatory cytokine release in the brain during surgery predispose individuals to cognitive dysfunction,also known as postoperative cognitive dysfunction(POCD).miR-124 is one of the most abundant microRNAs in the brain that regulates microglial function.Elucidating the role of miR-124 in microglial activation in the context of surgery may therefore promote understanding of as well as therapeutic development for post-surgical disorders involving microglial activation.The downstream targets of miR-124 were investigated using bioinformatic screening and dual-luciferase reporter assay validation,and vesicle-associated membrane protein 3(VAMP3)was identified as a potential target.The kinetics of miR-124/VAMP3 expression was first examined in vitro in microglial cells(primary microglia and BV2 microglial cells)following lipopolysaccharide(LPS)stimulation.LPS induced a time-dependent decrease of miR-124 and upregulated the expression of VAMP3.Manipulating miR-124/VAMP3 expression by using miR-124 mimics or VAMP3-specific siRNA in LPS-stimulated BV2 microglial cells inhibited BV2 microglial activation-associated inflammatory cytokine release.To further examine the role of miR-124/VAMP3 in a surgical setting,we employed a rat surgical trauma model.Significant microglial activation and altered miR-124/VAMP3 expression were observed following surgical trauma.We also altered miR-124/VAMP3 expression in the rat surgical trauma model by administration of exogenous miR-124 and by using electroacupuncture,which is a clinically applicable treatment that modulates microglial function and minimizes postoperative disorders.We determined that electroacupuncture treatment specifically increases the expression of miR-124 in the hypothalamus and hippocampus.Increased miR-124 expression with a concomitant decrease in VAMP3 expression resulted in decreased inflammatory cytokine release related to microglial activation post-surgery.Our study indicates that miR-124/VAMP3 is involved in surgery-induced microglial activation and that targeting miR-124/VAMP3 could be a potential therapeutic strategy for postoperative disorders involving microglial activation.