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Objective To investigate the effects of dexmedetomidine preventive on chronic postsurgical pain (CPSP) in patients undergoing hysterectomy.Methods Eighty patients scheduled for elective abdominal hysterectomy,aged 18-65 years,ASA physical status Ⅰ or Ⅱ were recruited,and randomly divided into dexmedetomidine group (group D) and the control group (group C).All patients received total intravenous anesthesia with propofol and remifentanil.The patients in group D were administered intravenously dexmedetomidine 0.5μg·kg-1 ·h-1 from anesthesia induction to extubation at the end of surgery,while the patients in group C were administered normal saline 0.125 ml·kg-1· h-1.All patients received patient-controlled analgesia with fentanyl postoperatively.Intraoperative vital signs,the dose of analgesic and sedatives,and adverse reactions were recorded.CPSP and neuropathic pain (NP) were evaluated through the telephone follow-up in 3,6 and 12 months postoperatively.Results The peri-operative vital signs of both groups were stable,and no obvious adverse reaction were observed.The dosage of tramadol used for resue analgesia in group D was lower than that in group C [(58.8±15.4) mg vs (78.9±24.5) mg,P＜0.05].Seventy-one of eighty patients completed all follow-up (37 in group D,34 in group C).The incidence of CPSP in postoperative 3,6 and 12 months were 10.8％,5.4 ％,2.7 ％ in group D,significantly lower than 35.3 ％,26.5 ％,17.6％ in group C,respectively (P＜0.05).The incidence of NP in postoperative 3 and 6 months were 2.7％,0％,significantly lower than 17.6％,14.7％ in group C,respectively (P＜0.05).Conclusion Dexmedetomidine preventive analgesia alleviate chronic post-hysterectomy pain.
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Objective To investigate the expression of ADAM8 in patients with hepatocellular carcinoma (HCC) and its clinical significance.Methods The protein expression of ADAM8 in HCC tissues was analyzed using immunohistochemical analysis.Serum levels of ADAM8 were measured by ELISA in 126 patients with HCC,50 patients with liver cirrhosis (LC) and 50 healthy individuals.The relationship between patients' pathological features and serum ADAM8 level was analyzed.Results Immunohistochemical analysis showed that ADAM8 expression was associated closely with serum AFP elevation,tumor size,histological differentiation,and tumor stage.The ELISA assay showed that the serum levels of ADAM8 in the HCC were significantly higher than those in LC and healthy groups.Kaplan-Meier survival analysis showed that high expression of serum ADAM8 exhibited a significant correlation with poor prognosis for HCC patients.Multivariate analysis revealed that serum ADAM8 expression is an independent prognostic parameter for the overall survival rate of HCC patients.Conclusion ADAM8 expression was closely associated with tumor size,serum AFP elevation,tumor differentiation,tumor stage and prognosis in hepatocellular carcinoma.Therefore,ADAM8 expression may serve as a biomarker for predicting the prognosis of patients in hepatocellular carcinoma.
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Aim To investigate the relationship between spinal cord noradrenergic neurons ? 1 adrenoceptors and the spinal analgesia of ketamine. Methods Kunming mice were used. Analgesia tests were investigated with warm water tail flick test. The effects of intrathecal injection (ith) of ketamine (50,100,200 ?g)on tail flick latency of animals were observed. And the effect of pretreatment with intrathecal 6 hydrodoapa(6 OHDA, 6?g ) and ? 1 adrenoceptor antagonist prazosin (5, 15 ?g) or terazosin (5, 15 ?g) , respectively on the spinal analgesia of ketamine (100 ?g,ith) was studied. Results Dose dependent analgesia was observed following ith ketamine (100,200 ?g, P
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0.05). Pretreatment with intrathecal prazosin (30 ?g) significantly reduced the antinociception of ketamine 10 min after injection but not 10?g (P