Comparison of the clinical efficacy of laparoscopic extralevator abdominoperineal excision (ELAPE) and non-ELAPE for low rectal cancer.

This study was performed to retrospectively analyze and compare the related clinical indicators between extralevator abdominoperineal excision (ELAPE) and non-ELAPE under laparoscopic for low rectal cancer. From June 2018 to September 2021, a total of 80 patients with low rectal cancer who underwent either of the above two types of surgeries at our Hospital were enrolled. Patients were divided into the ELAPE group and non-ELAPE group based on the different surgical methods. Preoperative general indicators, intraoperative indicators, postoperative complications, positive circumferential resection margin rate, local recurrence rate, hospital stay length, hospital expenses, and other related indicators were compared between the two groups. There were no significant differences in the comparison of preoperative indexes between the ELAPE group and non-ELAPE group, including age, preoperative BMI, and gender. Similarly, there were no significant differences in abdominal operation time, total operation time, and the number of intraoperative lymph nodes dissected between the two groups. However, the perineal operation time, intraoperative blood loss, intraoperative perforation rate, and positive circumferential resection margin rate were significantly different between the two groups. In the comparison of postoperative indexes, perineal complications, postoperative hospital stay length, and IPSS score were significantly different between the two groups. The use of ELAPE in treating T3-4NxM0 phase low rectal cancer was superior to non-ELAPE in reducing intraoperative perforation rate, positive circumferential resection margin rate, local recurrence rate, etc.

circ_0091579/miR-330-3p/RNF126 axis affects the proliferation, invasion and apoptosis of colorectal cancer LoVo cells / 中国肿瘤生物治疗杂志

@#目的：探讨环状 RNA circ_0091579 作为分子海绵吸附 miR-330-3p 介导环指蛋白 126（ring finger protein 126， RNF126）对结直肠癌（colorectal cancer，CRC）细胞增殖、凋亡、侵袭的影响。方法：选取 2019 年 2 月至 2020 年 5 月在大理大学 第一附属医院行手术治疗的 60 例 CRC 患者的癌组织和癌旁组织。构建 circ_0091579、miR-330-3p 的过表达或敲减的 CRC LoVo 细胞，qPCR 检测 CRC 组织和细胞中 circ_0091579、miR-330-3p 和 RNF126 的表达；MTT、Transwell、流式细胞术分别检测 细胞的增殖、侵袭、凋亡情况；生物信息学方法预测 circ_0091579 和 miR-330-3p、miR-330-3p 和 RNF126 的靶向关系并用双荧光 素酶报告实验和 RNA 免疫沉淀实验验证。结果：CRC 组织和多种细胞（HCT116、SW620、CW-2、LoVo 细胞）中，circ_0091579 和 RNF126 均高表达、miR-330-3p 均低表达（均 P<0.05）。敲减 circ_0091579 可以抑制 LoVo 细胞的增殖、侵袭而促进其凋亡 （均 P<0.05），但该影响在加入 miR-330-3p 后被逆转；过表达 miR-330-3p 使 LoVo 细胞增殖和侵袭能力减弱但凋亡程度加强 （均 P<0.05），该影响在加入 RNF126 后被抵消。circ_0091579、miR-330-3p 和 RNF126 之间存在靶向作用关系。结论：circ_0091579 通过 miR-330-3p/RNF126 轴促进 LoVo 细胞增殖、迁移和侵袭而抑制其凋亡。

[Esophageal manometry and 24-hour pH monitoring in the remnant esophagus after esophagectomy and esophagogastric anastomosis following esophageal bed].

OBJECTIVE: To investigate the motility function of remnant esophagus and stomach, and the gastroesophageal reflux after esophagectomy and esophagogastric anastomosis following esophageal bed. METHODS: Esophageal manometry and 24-hour pH monitoring were performed in 10 healthy volunteers and 20 patients who underwent esophagectomy and esophagogastric anastomosis through esophageal bed as a treatment for mid-esophageal carcinoma. These 20 patients, received examinations within 3 to 6 months after operations, were defined as study group, and 10 healthy volunteers as control group. RESULTS: (1) All the pH monitoring indexes in study group were significantly higher than those in control group (P<0.01). (2) Rest pressures of stomach, remnant esophagus and upper esophageal sphincter significantly increased in comparison with control group(P<0.01). (3) The contracting pressure, amplitude of primary peristalsis and amplitude of swallow peristalsis of remnant esophagus were reduced as compared to control group(P<0.01). (4) The contraction pressure of upper esophageal sphincter was obviously higher than that of control group (P<0.01). (5) There were no significant differences among stomach rest pressure, anastomosis rest pressure and remnant esophagus rest pressure in study group (F=3.08, P>0.05). CONCLUSION: After esophagectomy and esophagogastric anastomosis through esophageal bed in upper aortic site, the peristalsis function of remnant esophagus is poor, the function of acid clearance is reduced, no high pressure zone at the anastomosis orifice is found, the anastomosis orifice has no anti-reflux effect, and gastroesophageal reflux exists in the postoperative patients prevalently.

[Effects of fentanyl on EC50 of ropivacaine for postoperative epidural analgesia after gynecological surgery].

OBJECTIVE: To determine the effect of fentanyl on 50% effective concentration (EC50) of ropivacaine for postoperative epidural analgesia following gynecological surgery. METHODS: Sixty-five patients (ASA class I to II) scheduled for elective gynecological surgery were randomly divided into two groups to receive 20 ml ropivacaine (group R, n=33) or ropivacaine combined fentanyl (group RF, n=32) for postoperative epidural analgesia. The concentration of ropivacaine was adjusted according to double-blinded up-down sequential allocation. The efficacy was assessed using visual analog scores (VAS) and EC50 calculated using method of Dixon. RESULTS: The EC50 of ropivacaine was 0.098% in group R and 0.069% in group RF, showing significant difference (P<0.01). CONCLUSION: EC50 of ropivacaine for postoperative epidural analgesia determined by up-down sequential allocation is 0.098%, which can be decreased by the use of fentanyl.

[Changes of oxygen cost of breathing in children and adult during anesthesia and surgery].

OBJECTIVE: To investigate the changes of oxygen cost of breathing (OCB) in children and adult during general anesthesia and surgery. METHODS: This study included 12 elective surgical children and 12 adult patients receiving cerebral surgery. Mechanical ventilation was given during general anesthesia and surgery, and the indices of hemodynamics and respiratory function were measured at 5 min before induction, 1 min before the start of surgery, 30, 60, 120 and 180 min after the start of surgery and at the end of surgery, respectively. RESULTS: Mean arterial pressure (MAP) in the 2 groups did not undergo any conspicuous changes during general anesthesia and surgery (P>0.05), and the heart rate in child group was markedly faster than that in adult group during the whole course (P<0.01). Oxygen consumption (VO2) in 2 groups at 1 min before the start of surgery and 30 min after the start of surgery was significantly higher than that at 5 min before induction (P<0.01), and at these two time points after induction, child group had much higher VO2 (P<0.05) but evidently lower OCB (P<0.01) than in adult group, the latter index remained low till 60 and 120 min after the start of surgery (P<0.05). CONCLUSION: During anesthesia and surgery, VO2 in child group can be much greater than that in Adult group, while OCB markedly lower.

[Determination of EC50 of ropivacaine and bupivacaine for postoperative epidural analgesia by up-down sequential allocation].

OBJECTIVE: To determine the median effective concentration (EC50) of ropivacaine and bupivacaine for postoperative epidural analgesia, and compare the efficacy of the 2 analgesics. METHODS: Sixty-five patients (ASA I to II) scheduled for elective gynaecological surgeries were randomly assigned into ropivacaine and bupivacaine groups to receive postoperative epidural analgesia with the indicated analgesics (20 ml). The concentration was determined by the response of a previous patient to a higher or lower concentration using double-blinded, up-down sequential allocation. The analgesic efficacy was assessed with 100 mm visual analog pain scores (VAS), and effectiveness was defined as having a VAS