ABSTRACT
BACKGROUND: The study aimed to assess whether preoperative resting heart rate could be a risk factor for cardiopulmonary complications (CPCs) after lung cancer resection. METHODS: Eligible consecutive patients who underwent resection surgery for non-small cell lung cancer (NSCLC) at Ningbo NO.2 Hospital between May, 2010 and July, 2015 were included. The demographic, clinical characteristics and laboratory parameters were compared in patients with or without CPCs within postoperative 30 days. The multivariate logistic regression analysis was used to analyze the association between CPCs and risk factors. Receiver operating characteristic (ROC) curve analysis was utilized for the predictive role of preoperative resting heart rate for CPCs. RESULTS: One hundred eighty participants were enrolled into the final analysis and 42 of them had an established diagnosis of CPCs within postoperative 30 days. Elevated preoperative resting heart rate was an independent risk factor for postoperative CPCs (OR: 4.48, 95% CI: 1.17-18.42, P = 0.021) by the multivariate logistic regression analysis. ROC curve analysis indicated elevated resting heart rate as a predictor for CPCs with a cut-off value of 86 beats/min (AUC: 0.813, specificity: 80.95%, sensitivity: 72.46%, P < 0.001). CONCLUSIONS: Elevated preoperative resting heart rate was associated with an increased risk of postoperative CPCs in patients after resection for lung cancer.
Subject(s)
Carcinoma, Non-Small-Cell Lung/physiopathology , Heart Diseases/epidemiology , Heart Rate/physiology , Lung Diseases/epidemiology , Lung Neoplasms/physiopathology , Postoperative Complications/epidemiology , Aged , Carcinoma, Non-Small-Cell Lung/surgery , Case-Control Studies , China/epidemiology , Female , Humans , Male , Preoperative Period , Risk FactorsABSTRACT
PURPOSE: In the present work, we intended to explore the function of enhancer of zeste homolog 2 (EZH2) in modulated anesthetic reagent bupivacaine-induced neuronal apoptosis in spinal cord dorsal root ganglia (DRG). METHODS: Murine DRG explant was treated with 5 mM bupivacaine in vitro to induce neuronal apoptosis, which was examined by a TUNEL assay. Protein and mRNA expressions of EZH2 in bupivacaine-treated DRG were examined by western blot and qRT-PCR assays. EZH2 was downregulated by siRNA in bupivacaine-treated DRG. Its functional role in protecting bupivacaine-induced neuronal apoptosis was examined. In addition, apoptotic protein caspase-9 and EZH2-associated signaling pathway, and tropomyosin receptor kinase C (TrkC) were further investigated, by western blot assay, in EZH2-downregulated and bupivacaine-injured DRG. RESULTS: In vitro treatment of bupivacaine-induced DRG neuronal apoptosis, and upregulated EZH2 at both protein and mRNA levels. SiRNA transfection successfully downregulated EZH2, as confirmed by western blot and qRT-PCR assays. Examination of TUNEL assay showed that EZH2 downregulation rescued bupivacaine-induced DRG neuronal apoptosis. Moreover, in bupivacaine-injured DRG, EZH2 downregulation reduced caspase-9, whereas upregulated TrkC and phosphorylated-TrkC (p-TrkC). CONCLUSION: EZH2 is upregulated, whereas inhibiting EZH2 exerted rescuing effect in anesthetics (bupivacaine)-induced spinal cord DRG. The possible downstream target of EZH2 inhibition may interact with caspase and TrkC signaling pathways.
Subject(s)
Apoptosis/drug effects , Bupivacaine/pharmacology , Enhancer of Zeste Homolog 2 Protein/genetics , Neurons/drug effects , Anesthetics, Local/pharmacology , Animals , Caspase 9/metabolism , Down-Regulation/drug effects , Ganglia, Spinal/drug effects , Mice , Mice, Inbred C57BL , Phosphorylation , Protein Kinases , RNA, Small Interfering/metabolism , Signal Transduction/drug effects , Spinal Cord/pathology , Up-Regulation/drug effectsABSTRACT
BACKGROUND The aim of this study was to examine the association between serum expression of miRNA-155 and postoperative cognitive dysfunction (POCD) after laparoscopic surgery for colon cancer. MATERIAL AND METHODS We enrolled 110 patients scheduled to undergo colon tumor resection via laparotomy in Ningbo No. 2 Hospital from July 2013 to November 2015. The blood samples were collected from the participants 1 day before surgery. Multiple logistic regression analysis was used for the analysis of independent predictive biomarkers for POCD. RESULTS On the 7th postoperative day, 29 of the 110 participants developed POCD, yielding a POCD incidence of 26.4%. Age, MMSE score, duration of surgery and anesthesia, serum levels of CRP, TNF-α, urea, creatinine, and miRNA-155 were highly associated with the occurrence of POCD. Serum expression of miRNA-155 was shown by multiple logistic regression analysis to be an independent predictive indicator for POCD after surgery (OR: 2.732; 95%CI 1.415-5.233; P=0.002). CONCLUSIONS The serum expression of miRNA-155 is an independent predictive factor for POCD after laparoscopic surgery for colon cancer.
