Postoperative analgesic effect and impact on immune function of ultrasound guided transversus abdominis plane block used in elderly patients after laparoscopic radical resection of rectal cancer / 中国内镜杂志

Objective To observe the effect of ultrasound guided transversus abdominis plane block used in laparoscopic radical resection of rectal cancer in elderly patients on postoperative analgesic and impact on immune function. Methods Sixty cases need laparoscopic radical resection of rectal cancer in elderly patients with admission order number to take the digital randomized method was divided into abdominal transverse muscle block group and saline control group. The transversus abdominis plane block group underwent ultrasound guided transversus abdominis plane block after induction of general anesthesia while accepted intravenous injection of 0.25%ropivacaine hydrochloride of 30 ml; Saline control group took equal volume intravenous saline. After operation all were given analgesia pump: Sufentanil 1.00 μg/kg + Ondansetron 16.00 mg + Dezocine 10.00 mg + saline to configure for 100 ml, and set 2 ml/h and 15 min of automatic control time. To observe visual analogue score (VAS) and related indexes of hemodynamics before anesthesia (T0), 1 h after operation (T1), 12 h after operation (T2), 24 h after operation (T3) and 48 h after operation (T4) between two groups; Record 24 h analgesia pressing times and total postoperative Sufentanil; And take venous blood to measure CD4+%, CD8+% level by flow cytometry and determinate interferon gamma (IFN-γ) by enzyme-linked immunosorbent assay; Then compare postoperative adverse reactions of two groups. Results Compared with saline control group,transversus abdominis plane block group' MAP decreased in T1, T2, and HR decreased in T2 and T3 (P < 0.05). Transversus abdominis plane block groups' MAP in T1 was higher than T0, and HR in T1, T2 was higher than that of T0 (P < 0.05). Compared with saline control group, transversus abdominis plane block group' VAS scores were lower at the T1, T2, T3, T4, else postoperative 24 h pressing times and amount of Sufentanil were decreased (P < 0.05). Compared with saline control group, transversus abdominis plane block group' CD4+% levels increased in T1, T2, T3 and T4, IFN-γ levels in T2, T3 points were higher (P < 0.05). Compared with the saline control group, transversus abdominis plane block group' rate of adverse reactions was lower (P < 0.05). Conclusion Ultrasound guided transversus abdominis plane block used in laparoscopic radical resection of rectal cancer in elderly patients has better postoperative analgesic effect, stable hemodynamics and less postoperative pain, and it has protective effect on immune function and lower incidence of adverse reactions, so clinical application is safety.

Postoperative analgesic effect and impact on immune function of ultrasound guided transversus abdominis plane block used in elderly patients after laparoscopic radical resection of rectal cancer / 中国内镜杂志

Objective To observe the effect of ultrasound guided transversus abdominis plane block used in laparoscopic radical resection of rectal cancer in elderly patients on postoperative analgesic and impact on immune function. Methods Sixty cases need laparoscopic radical resection of rectal cancer in elderly patients with admission order number to take the digital randomized method was divided into abdominal transverse muscle block group and saline control group. The transversus abdominis plane block group underwent ultrasound guided transversus abdominis plane block after induction of general anesthesia while accepted intravenous injection of 0.25%ropivacaine hydrochloride of 30 ml; Saline control group took equal volume intravenous saline. After operation all were given analgesia pump: Sufentanil 1.00 μg/kg + Ondansetron 16.00 mg + Dezocine 10.00 mg + saline to configure for 100 ml, and set 2 ml/h and 15 min of automatic control time. To observe visual analogue score (VAS) and related indexes of hemodynamics before anesthesia (T0), 1 h after operation (T1), 12 h after operation (T2), 24 h after operation (T3) and 48 h after operation (T4) between two groups; Record 24 h analgesia pressing times and total postoperative Sufentanil; And take venous blood to measure CD4+%, CD8+% level by flow cytometry and determinate interferon gamma (IFN-γ) by enzyme-linked immunosorbent assay; Then compare postoperative adverse reactions of two groups. Results Compared with saline control group,transversus abdominis plane block group' MAP decreased in T1, T2, and HR decreased in T2 and T3 (P < 0.05). Transversus abdominis plane block groups' MAP in T1 was higher than T0, and HR in T1, T2 was higher than that of T0 (P < 0.05). Compared with saline control group, transversus abdominis plane block group' VAS scores were lower at the T1, T2, T3, T4, else postoperative 24 h pressing times and amount of Sufentanil were decreased (P < 0.05). Compared with saline control group, transversus abdominis plane block group' CD4+% levels increased in T1, T2, T3 and T4, IFN-γ levels in T2, T3 points were higher (P < 0.05). Compared with the saline control group, transversus abdominis plane block group' rate of adverse reactions was lower (P < 0.05). Conclusion Ultrasound guided transversus abdominis plane block used in laparoscopic radical resection of rectal cancer in elderly patients has better postoperative analgesic effect, stable hemodynamics and less postoperative pain, and it has protective effect on immune function and lower incidence of adverse reactions, so clinical application is safety.

Isolation and molecular characterization of an ethylene response factor NtERF1-1 in Nicotiana tabacum cv. Xanthi.

Apetala2/Ethylene Response Factors (AP2/ERF) play important roles in regulating gene expression under abiotic and biotic stress in the plant kingdom. Here, we isolated a member of the AP2/ERF transcription factors, NtERF1-1, from Nicotiana tabcum cv. Xanthi NN carrying the N gene, which is resistant to Tobacco mosaic virus (TMV). NtERF1-1 encoded a putative protein of 229 amino acids with a predicted molecular mass of 24.58 kDa. Nucleotide sequence analysis showed that NtERF1-1 contained a conserved DNA-binding domain at the N-terminal. Comparison of amino acid sequences revealed that NtERF1-1 possessed high similarities to ERFs from diverse plants. Semi-quantitative and real-time quantitative RT-PCR analyses indicated that NtERF1-1 was up-regulated following TMV infection. In addition, we speculated that NtERF1-1 might participate in the signal transduction pathway of defence response inducted by the interaction between the N gene and TMV.

Absence of musculocutaneous nerve associated with variations of distribution patterns of the median nerve / Ausencia del nervio musculocutáneo asociada con variaciones de los patrones de distribución del nervio mediano

Variations in the brachial plexus and the distribution patterns of its branches are not uncommon. A communicating branch, which is the most frequent variation, often arises from musculocutaneous nerve to median nerve. However, the branches arising from lateral cord of the brachial plexus and median nerve instead of musculocutaneous nerve are very rare. Detailed description of the abnormalities is important for surgical procedures. Our case study reports the musculocutaneous nerve was absent, a branch from the medial cord innervated the coracobrachialis muscle and two branches from the median nerve innervated the biceps and brachialis muscles, respectively. Moreover, the median nerve gave off the lateral antebrachial cutaneous nerve. This report provides evidence of such possible anatomical variations to surgeons, anesthetists and neurologists during clinical practice.

Las variaciones en el plexo braquial y los patrones de distribución de sus ramos no son infrecuentes. Un ramo comunicante, que es la variante más frecuente, a menudo surge desde el nervio musculocutáneo al nervio mediano. Sin embargo, los ramos que surgen del fascículo lateral del plexo braquial y nervio mediano en vez de nervio musculocutáneo son muy raros. La descripción detallada de las anomalías es importante para procedimientos quirúrgicos. En nuestro caso el nervio musculocutáneo estaba ausente, un ramo del fascículo medial inervó el músculo coracobraquial y dos ramos del nervio mediano inervaron los músculos bíceps y braquial, respectivamente. Por otra parte, el nervio mediano originó al nervio cutáneo antebraquial lateral. Este informe proporciona evidencia de algunas variaciones anatómicas útiles para cirujanos, anestesistas y neurólogos durante la práctica clínica.

Effects of Combined siRNA-TR and-TERT on Telomerase Activity and Growth of Bladder Transitional Cell Cancer BIU-87 Cells / 华中科技大学学报（医学）（英德文版）

The effects of combined RNA interference(RNAi)of human telomerase RNA(hTR)and human telomerase reverse transcriptase(hTERT)genes on telomerase activity in a bladder cancer cell line(BIU-87 cells)were investigated by using gene chip technology in vitro with an attempt to evaluate the role of RNAi in the gene therapy of bladder transitional cell cancer(BTCC).Three TR-specific double-stranded small interfering RNAs(siRNAs)and three TERT-specific double-stranded siRNAs were designed to target different regions of TR and TERT mRNA.The phTR-siRNA,pbTERT-siRNA,and the combination of both plasmids phTR+phTERT-siRNA were transfected into BIU-87 cells.The expression of hTR and hTERT mRNA was detected by quantitative fluorescent reverse transcription-polymerase chain reaction,and a telomeric repeat amplification protocol was applied to detect telomerase activity.Growth inhibition of BIU-87 cells was measured by MTT assay.Gene chip analysis was performed to evaluate the effects of the combined RNAi of hTR+hTERT genes on telomerase activity and growth of BIU-87 cells in vitro.The results showed that the expression of hTERT and hTR mRNA was inhibited by pRNAT-hTERT-Ⅲ,pRNAT-hTR-Ⅲ,and pRNAT-hTR-Ⅲ+hTERT-Ⅲ in BIU-87 cells.The inhibition efficiency of pRNAT-hTERT-Ⅲ,pRNAT-hTR-Ⅲ,pRNAT-hTERT-Ⅲ+pRNAT-hTR-Ⅲ was 67% for TERT mRNA,41% for TR mRNA,57% for TR mRNA and 70% for TERT mRNA in BIU-87 cells respectively.The growth of BIU-87 cells was inhibited and telomerase activity was considerably decreased,especially in the cells treated with combined RNAi-hTR and-hTERT.Gene chip analysis revealed that 21 genes were down-regulated(ATM,BAX,BCL2,BCL2L1,B1RC5,CD44,CTNNB1,E2F1,JUN,MCAM,MTA1,MYC,NFKB1,NFKBIA.NME4,PNN,PNN,SERPINE1,THBS1,TNFRSF1A,and UCC1).The results indicated that hTR-siRNA and hTERT-siRNA,especially their combination,siRNA hTR+hTERT,specifically and effectively suppressed the expression of both hTR and hTERT mRNA and telomerase activity.Molecular biological mechanism by which combined siRNA-TR and-TERT inhibited telomerase activity and growth of BIU-87 cells in vitro may involve the down-regulation ofthe 21 genes.

Balò's concentric sclerosis presenting with benign clinical course and multiple sclerosis-like lesions on magnetic resonance images.

Balò's concentric sclerosis (BCS) is a rare primary demyelinating disease of central nervous system (CNS) and is considered to be a variant of multiple sclerosis (MS). It is characterized by a severe, rapidly evolving course with CNS lesions consisting of concentric rings of demyelination alternating with myelination in the white matter. We report a patient with BCS from mainland China diagnosed on magnetic resonance imaging (MRI) findings. In addition to two contrast enhanced open ring lesions. MRI also showed multiple small white matter lesions in both the hemispheres. The patient had a good response to corticosteroids and had a benign prognosis during a follow-up period of two years.