ABSTRACT
Objective To study the microRNA-related mechanism of acupuncture in promoting postoperative gastrointestinal motility of patients with colorectal cancer. Methods Thirty cases of postoperative gastrointestinal motility disorder patients with colorectal cancer were randomly divided into acupuncture group and control group, 15 cases in each group. The control group received conventional symptomatic and supportive therapy, and acupuncture group received acupuncture at bilateral foot triple points of Zusanli,Sanyinjiao,Taichong daily on postoperative day 1-5 on the basis of conventional therapy for the control group. Time for the first anal exsufflation and time for the first defecation after operation were observed for the evaluation of clinical efficacy. Meanwhile, miR-19a expression level in serum and miR-222 expression level in the cancer tissue were detected by polymerase chain reaction (PCR). Results (1)The total effective rate of acupuncture group was 80.0％,and that of the control group was 46.7％,the difference being significant (P<0.05). (2)Time for the first anal exsufflation and time for the first defecation after operation in acupuncture group were shorter than those in the control group, the difference being significant (P < 0.05). (3) Serum miR-19a expression level in acupuncture group was decreased obviously on postoperative day 5 compared to day 1 (P < 0.05), and the decrease in acupuncture group was superior to that in the control group (P<0.05). (4)The expression of miR-222 in the cancer tissue was positively relevant to time for postoperative first anal exsufflation in both groups (P<0.05),and the expression level in ineffective patients was higher than that in effective patients (P < 0.05). Conclusion Acupuncture can regulate serum miR-19a expression level and promote the recovery in postoperative gastrointestinal motility of patients with colorectal cancer. The recovery of postoperative gastrointestinal motility in patients with colorectal cancer and the acupuncture effect are affected by miR-222 expression in the cancer tissue.
ABSTRACT
Objective To observe the effect of acupuncture on cystathionine gamma-lyase(CSE)and myeloperoxidase (MPO) in the colonic tissues of rats and to explore its mechanism for recovering the function of interstitial cells of Cajal(ICCs)in rats after colonic anastomosis . Methods Thirty SD rats were randomized into normal control group, model group(receiving colonic anastomosis) and acupuncture group. The acupuncture group received foot three-needle therapy on bilateral Zusanli(ST36), Sanyinjiao(SP6) and Taichong(LR3), once a day for 3 days after colonic anastomosis. And then the propulsive rate of the small intestine was measured. The count of ICCs with positively expressive c-kit in rat colonic tissues was measured by immunohistochemistry, the activity of CSE was observed by enzyme-linked immunosorbent assay (ELISA) and the activity of MPO was tested by biochemical method. Results Compared with the normal control group, the small intestinal propulsive rate in the model group was decreased, the number of ICCs with positively expressive c-kit was reduced, while the activities of CSE and MPO were increased(P<0.05). The acupuncture group had higher intestinal propulsive rate, more ICCs with positively expressive c-kit, and lower CSE and MPO activities than the model group(P<0.05).Conclusion Acupuncture can promote the recovering of postoperative gastrointestinal function, and its mechanism may be related to the regulation of CSE and MPO activities in the colonic tissues and to the restoration of ICCs function in the focus with positive c-kit.
ABSTRACT
BACKGROUND: Postoperative ileus and pain are concerns among surgical patients. Epidural anesthesia and analgesia with local anesthetics can decrease the duration of postoperative ileus and pain. Significant systemic absorption of local anesthetics occurs during epidural use. The object of the study was to define the effect of intravenous (iv) lidocaine on postoperative ileus and pain. METHODS: In a double-blind prospective study, 24 patients undergoing foot surgery were studied with one half of the patients receiving a lidocaine bolus (1.5 mg/kg) and infusion (2 mg/min) (n=12 Lidocaine group); the other half received a saline infusion (n=12 Control group). IV lidocaine initiated before general anesthesia and continued 1h postoperatively. We compared faces pain rating scale (at recovery room, op. day 7 PM, postop. 1 day 7 PM, postop. 2 day 7 PM), the total amount of analgesic use, the return of bowel function (first passage of flatus), hospital stay, side effects, patient satisfaction. RESULT: Perioperative IV lidocaine infusion reduced the pain scale at recovery room, op.day 7 PM, postop. 1 day 7 PM but not postop. 2 day 7 PM. No significant difference was found in return of bowel function, additional analgesics use, hospital stay, subjective satisfaction between 2 groups. No specific side effect due to lidocaine was found. CONCLUSION: IV lidocaine-treated patients has less pain postoperatively, but no faster return of bowel function in patients undergoing foot surgery.
Subject(s)
Humans , Absorption , Analgesia , Analgesics , Anesthesia, Epidural , Anesthesia, General , Anesthetics, Local , Foot , Ileus , Length of Stay , Lidocaine , Patient Satisfaction , Prospective Studies , Recovery RoomABSTRACT
BACKGROUND: Postoperative ileus and pain are concerns among surgical patients. Epidural anesthesia and analgesia with local anesthetics can decrease the duration of postoperative ileus and pain. Significant systemic absorption of local anesthetics occurs during epidural use. The object of the study was to define the effect of intravenous (iv) lidocaine on postoperative ileus and pain. METHODS: In a double-blind prospective study, 24 patients undergoing foot surgery were studied with one half of the patients receiving a lidocaine bolus (1.5 mg/kg) and infusion (2 mg/min) (n=12 Lidocaine group); the other half received a saline infusion (n=12 Control group). IV lidocaine initiated before general anesthesia and continued 1h postoperatively. We compared faces pain rating scale (at recovery room, op. day 7 PM, postop. 1 day 7 PM, postop. 2 day 7 PM), the total amount of analgesic use, the return of bowel function (first passage of flatus), hospital stay, side effects, patient satisfaction. RESULT: Perioperative IV lidocaine infusion reduced the pain scale at recovery room, op.day 7 PM, postop. 1 day 7 PM but not postop. 2 day 7 PM. No significant difference was found in return of bowel function, additional analgesics use, hospital stay, subjective satisfaction between 2 groups. No specific side effect due to lidocaine was found. CONCLUSION: IV lidocaine-treated patients has less pain postoperatively, but no faster return of bowel function in patients undergoing foot surgery.