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老年膝关节置换术后超声引导下的两种神经阻滞镇痛效果比较 被引量:22
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作者 王福朝 孙学飞 +2 位作者 张同军 王忠义 齐文辉 《中国现代医学杂志》 CAS 2018年第18期103-107,共5页
目的比较超声引导下髂筋膜间隙神经阻滞(FICNB)与收肌管阻滞(ACB)用于老年膝关节置换术(EKR)后的镇痛效果。方法按随机数字表法将拟行全身麻醉下膝关节置换术的120例老年患者分为A组和B组,每组各60例。两组均于术前30 min给予神经阻滞干... 目的比较超声引导下髂筋膜间隙神经阻滞(FICNB)与收肌管阻滞(ACB)用于老年膝关节置换术(EKR)后的镇痛效果。方法按随机数字表法将拟行全身麻醉下膝关节置换术的120例老年患者分为A组和B组,每组各60例。两组均于术前30 min给予神经阻滞干预,A组于超声引导下行FICNB,B组则行ACB。比较两组不同时间、不同区域感觉阻滞有效率、术后不同时间的静息和运动状态下视觉模拟评分(VAS)及股四头肌肌力和不良反应情况。结果两组股神经阻滞后有效率比较,差异无统计学意义(P>0.05);A组股外侧皮神经、闭孔神经阻滞有效率均高于B组(P<0.05);A组术后静息和运动状态下的VAS评分均低于B组(P<0.05);A组术后24 h股四头肌肌力小于B组(P<0.05);两组术后48 h股四头肌肌力、药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论超声引导下髂FICNB相比ACB用于EKR后镇痛效果更佳,前者术后24 h对股四头肌肌力影响相对大,但术后48 h影响减小,建议根据情况选择合适神经阻滞方式。 展开更多
关键词 老年膝关节置换术 超声引导 髂筋膜间隙神经阻滞 收肌管阻滞
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Cullin 4A is associated with epithelial to mesenchymal transition and poor prognosis in perihilar cholangiocarcinoma 被引量:3
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作者 tong-jun zhang Dong Xue +3 位作者 Cheng-De zhang Ze-Dong zhang Qing-Ran Liu Jian-Qiang Wang 《World Journal of Gastroenterology》 SCIE CAS 2017年第13期2318-2329,共12页
AIM To explore the functional role of cullin 4A(CUL4A), a core subunit of E3 ubiquitin ligase, in perihilar cholangiocarcinoma(PHCC).METHODS The expression of CUL4 A in PHCC cell lines was evaluated by Western blot an... AIM To explore the functional role of cullin 4A(CUL4A), a core subunit of E3 ubiquitin ligase, in perihilar cholangiocarcinoma(PHCC).METHODS The expression of CUL4 A in PHCC cell lines was evaluated by Western blot and quantitative reverse transcription-polymerase chain reaction. Immunohistochemistry(IHC) was adopted to investigate the relationship between CUL4 A expression and clinicopathological characteristics of PHCC. Univariate analysis and multivariate regression analysis were performed to analyze the risk factors related to overall survival(OS) and progression-free survival(PFS) of PHCC patients. Wound healing, Transwell and Matrigel assays were utilized to explore the function of CUL4 A in PHCC metastasis. Furthermore, expression of epithelial to mesenchymal transition(EMT) markers was verified in cells with CUL4 A knockdown or overexpression. The relationship between CUL4 A expression and E-cadherin expression was also analyzed by IHC assay. Finally, the role of ZEB1 in regulating CUL4 A mediated PHCC was detected by IHC, Western blot, Transwell and Matrigel assays.RESULTS CUL4 A overexpression was detected in PHCC cell lines and clinical specimens. Clinicopathological analysis revealed a close correlation between CUL4 A overexpression and tumour differentiation, T, N and TNM stages in PHCC. Kaplan-Meier analysis revealed that high CUL4 A expression was correlated with poor OS and PFS of PHCC patients. Univariate analysis identified the following four parameters as risk factors related to OS rate of PHCC: T, N, TNM stages and high CUL4 A expression; as well as three related to PFS: N stage, TNM stage and high CUL4 A expression. Further multivariate logistic regression analysis identified high CUL4 A expression as the only independent prognostic factor for PHCC. Moreover, CUL4 A silencing in PHCC cell lines dramatically inhibited metastasis and the EMT. Conversely, CUL4 A overexpression promoted these processes. Mechanistically, ZEB1 was discovered to regulate the function of CUL4 A in promoting the EMT and metastasis.CONCLUSION CUL4 A is an independent prognostic factor for PHCC, and it can promote the EMT by regulating ZEB1 expression. CUL4 A may be a potential therapeutic target for PHCC. 展开更多
关键词 perihilar cholangiocarcinoma epithelial to mesenchymal transition ZEB1 Cullin 4A METASTASIS PROGNOSIS
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