Effects of DEX on sedation, neurological function and cerebral oxygen metabolism in elderly patients with prostate cancer undergoing LRP

Objective:To study the sedative effect of dexmedetomidine in elderly patients with prostate cancer undergoing three hole LRP,and its effect on nerve function and brain oxygen metabolism.Methods:From August 2016 to December 2019,78 patients with LRP under general anesthesia in our hospital were randomly selected and divided into control group and observation group according to the random number table method,39 cases in each group.During the operation,the observation group was given dextromethoridine,while the control group was given the same amount of normal saline.The changes of cognitive function index(MoCA score,POCD incidence rate),neurological function index(TGF-β1,NSE,IGF-1),brain oxygen metabolism index(PaO2,map,PaCO2,rSO2)before and after operation were compared between the two groups.The visual analogue score(VAS),the amount of analgesic drugs and the times of pressing the analgesic pump were compared between the two groups.The incidence of adverse reactions was compared between the two groups.Results:Before operation,there was no significant difference in cognitive function index,neurological function index and brain oxygen metabolism index between the two groups(P>0.05).On the first and third days after operation,MOCA score of the two groups was significantly lower,MOCA score of the observation group was significantly higher than that of the control group,POCD incidence of the observation group was significantly lower than that of the control group;on the third day after operation,TGF-β1 and IGF-1 of the two groups were significantly lower,TGF-β1 and IGF-1 of the observation group were significantly lower-The NSE in the observation group was significantly lower than that in the control group(P<0.05).In this study,1 hour after the establishment of pneumoperitoneum,PaCO2 and rSO2 in the two groups were significantly increased,6 hours and 12 hours after the operation,the VAS score of the observation group was lower than that of the control group,and the dosage of analgesic pump and the number of times of compression of the analgesic pump were significantly lower than that of the control group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:DEX has a good sedative effect on the elderly prostate cancer patients undergoing LRP with three hole method.It has little effect on nerve function and brain oxygen metabolism,and has a good safety.

MicroRNA-125b regulates Th17/Treg cell differentiation and is associated with juvenile idiopathic arthritis

Background Juvenile idiopathic arthritis(JIA)is the most common rheumatic disease in childhood driven by aberrant pathways of T-cell activation.T helper 17(Th17)/regulatory T cell(Treg)imbalance plays critical roles in the pathogenesis of arthritis.MicroRNA-125b(miR-125b)was upregulated after the activation of the initial CD4^+T cells,and could regulate the differentiation of CD4^+T cells.However,the effects of miR-125b on Th17/Treg imbalance and differentiation of Th 17/Treg cells remain unknown.Methods In this study,we evaluated the expression of miR-125b in the peripheral blood mononuclear cells(PBMCs)of children with JIA,and the relationship of miR-125b with Th17/Treg imbalance.Then,we used lentivirus vector-mediated overexpression technology to investigate the regulatory function of miR-125b in CD4^+T cells or dendritic cell/CD4^+T co-culture system.Results Decreased miR-125b expression in PBMCs and CD4^+T cells of JIA patients was negatively correlated with the ratio of Th17/Treg cells.It also correlated negatively with retinoic acid receptor-related orphan receptorγt but positively with Forkhead box protein 3 at transcriptional levels.Furthermore,we found that miR-125b overexpression inhibited Th17 cell differentiation,whereas facilitated the differentiation of Treg cells.MiR-125b upregulation led to the decrease of Th 17-secreting cytokines but the increase of the Treg-secreting cytokines.Conclusions Our results demonstrate that miR-125b participated in regulating Thl7/Treg cell differentiation and imbalance in JIA patients.These findings provide novel insight into the critical role of miR-125b in the Th17/Treg imbalance of JIA,and raise the distinct possibility that miR-125b may prove to be a potential therapeutic target for JIA.