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So far, liver cancer is still a highly malignant tumor with a high incidence rate in China, and it seriously affects the life and health of Chinese people. Previous studies have shown that the development of liver cancer is associated with various factors such as virus, smoking, drinking, and nonalcoholic fatty liver disease. With continuous exploration, more and more studies have pointed out that nutritional factors and living environment are associated with the development and progression of liver cancer. Folic acid is a necessary nutrient for cell growth and reproduction, and its level in human body has an impact on the growth of tumor cells and is closely associated with liver cancer. This article reviews the research advances in the association between folic acid and liver cancer in recent years, so as to provide new reference and basis for the prevention and treatment of liver cancer.
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Reflux Esophagitis (RE) is a gastroesophageal motility disorder mainly caused by lower esophageal sphincter disorder caused by a variety of injury factors, acid-suppressing drugs such as Proton Pump Inhibitors (PPIs) are often used clinically. With the increase of PPIs-resistant reflux esophagitis cases, the demand for the pharmacokinetics and pharmacodynamics of acid-suppressing drugs is higher. In recent years, the emergence of a new class of acid-suppressing drugs, potassium-competitive acid blockers (P-CABs), has solved some clinical deficiencies of traditional proton pump inhibitors. It has the characteristics of effective, longer-lasting acid suppression, the inhibitory effect on gastric acid secretion is not affected by the state of gastric acid secretion, the individual differences in drug metabolism and efficacy are smaller, and the drug efficacy is not affected by food intake or not. It has obvious advantages in the efficacy of severe erosive esophagitis and PPIs-resistant severe erosive esophagitis, and is more cost-effective, and is expected to replace PPI as the first-line treatment for reflux esophagitis.
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Objective:To compare the effects of esketamine and opioids on postoperative cellular immune function in the patients undergoing laparoscopic gynecological surgery.Methods:Fifty patients, of American Society of Anesthesiologists physical statusⅠor Ⅱ, aged 20-65 yr, with height 150-180 cm, weighing 50-80 kg, who underwent laparoscopic non-oncologic gynecological surgery with general anesthesia in the Second Hospital of Shanxi Medical University from September 2020 to February 2021, were divided into 2 groups using a random number table method: esketamine group (group K) and opioid analgesic group (group O), with 25 patients in each group.Anesthesia was induced as follows: esmketamine 0.25-0.50 mg/kg was intravenously injected in group K, sufentanil 0.2-0.4 μg/kg was intravenously injected in group O, and propofol 2 mg/kg and rocuronium 0.6-0.9 mg/kg were intravenously injected in two groups.Anesthesia was maintained as follows: esketamine was intravenously infused at 0.5 mg·kg -1·h -1 in group K, remifentanil was intravenously infused at 10-20 μg·kg -1·h -1 in group O, and propofol 4-10 mg·kg -1·h -1 was intravenously infused, and rocuronium 0.2-0.3 mg/kg was intermittently injected in two groups.Blood samples from elbow veins were collected before anesthesia induction (T 1) and immediately after extubation (T 2) for determination of T lymphocyte subsets (CD3 + , CD4 + , CD8 + , CD4 + CD25 + CD127 low) and NK cells and B lymphocyte (by flow cytometry) and serum interleukin-6 (IL-6) and IL-10 concentrations (by multiplexed fluorescent microsphere immunoassay). Routine blood tests were performed on preoperative day 1 and postoperative day 3, and neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were calculated. Results:Compared with group O, the percentages of CD3 + and CD4 + cells, ratio of CD4 + /CD8 + and percentage of NK cells were significantly increased, serum IL-6 concentrations were decreased, and serum IL-10 concentrations were increased after extubation, white blood cell, monocyte and neutrophil counts were increased, and lymphocyte count was decreased on postoperative day 3 ( P<0.05), and no significant change was found in neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in group K ( P>0.05). Conclusion:Compared with opioid analgesics, esketamine has less inhibition of postoperative cellular immune function in the patients undergoing laparoscopic gynecological surgery.