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1.
World J Psychiatry ; 14(6): 894-903, 2024 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-38984344

RESUMEN

BACKGROUND: Postoperative pain management and cognitive function preservation are crucial for patients undergoing thoracoscopic surgery for lung cancer (LC). This is achieved using either a thoracic paravertebral block (TPVB) or sufentanil (SUF)-based multimodal analgesia. However, the efficacy and impact of their combined use on postoperative pain and postoperative cognitive dysfunction (POCD) remain unclear. AIM: To explore the analgesic effect and the influence on POCD of TPVB combined with SUF-based multimodal analgesia in patients undergoing thoracoscopic radical resection for LC to help optimize postoperative pain management and improve patient outcomes. METHODS: This retrospective analysis included 107 patients undergoing thoracoscopic radical resection for LC at The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital between May 2021 and January 2023. Patients receiving SUF-based multimodal analgesia (n = 50) and patients receiving TPVB + SUF-based multimodal analgesia (n = 57) were assigned to the control group and TPVB group, respectively. We compared the Ramsay Sedation Scale and visual analog scale (VAS) scores at rest and with cough between the two groups at 2, 12, and 24 h after surgery. Serum levels of epinephrine (E), angio-tensin II (Ang II), norepinephrine (NE), superoxide dismutase (SOD), vascular endothelial growth factor (VEGF), transforming growth factor-ß1 (TGF-ß1), tumor necrosis factor-α (TNF-α), and S-100 calcium-binding protein ß (S-100ß) were measured before and 24 h after surgery. The Mini-Mental State Examination (MMSE) was administered 1 day before surgery and at 3 and 5 days after surgery, and the occurrence of POCD was monitored for 5 days after surgery. Adverse reactions were also recorded. RESULTS: There were no significant time point, between-group, and interaction effects in Ramsay sedation scores between the two groups (P > 0.05). Significantly, there were notable time point effects, between-group differences, and interaction effects observed in VAS scores both at rest and with cough (P < 0.05). The VAS scores at rest and with cough at 12 and 24 h after surgery were lower than those at 2 h after surgery and gradually decreased as postoperative time increased (P < 0.05). The TPVB group had lower VAS scores than the control group at 2, 12, and 24 h after surgery (P < 0.05). The MMSE scores at postoperative days 1 and 3 were markedly higher in the TPVB group than in the control group (P < 0.05). The incidence of POCD was significantly lower in the TPVB group than in the control group within 5 days after surgery (P < 0.05). Both groups had elevated serum E, Ang II, and NE and decreased serum SOD levels at 24 h after surgery compared with the preoperative levels, with better indices in the TPVB group (P < 0.05). Marked elevations in serum levels of VEGF, TGF-ß1, TNF-α, and S-100ß were observed in both groups at 24 h after surgery, with lower levels in the TPVB group than in the control group (P < 0.05). CONCLUSION: TPVB combined with SUF-based multimodal analgesia further relieves pain in patients undergoing thoracoscopic radical surgery for LC, enhances analgesic effects, reduces postoperative stress response, and inhibits postoperative increases in serum VEGF, TGF-ß1, TNF-α, and S-100ß levels. This scheme also reduced POCD and had a high safety profile.

2.
Life Sci ; 244: 117280, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-31926239

RESUMEN

AIMS: Recently, chemoresistance has been recognized as an obstacle in the treatment of gastric cancer (GC). The aim of this study was to investigate the biological functions and underlying mechanisms of propofol in GC chemoresistance. MAIN METHODS: CCK-8 assay, flow cytometry and immunofluorescent staining were performed to assess the IC50 concentration, cell apoptosis and autophagy activity of cisplatin in both GC chemosensitive cells (SGC7901) and chemoresistant cells (SGC7901/CDDP). The expression pattern of MALAT1 in GC cells was detected by qRT-PCR. The shRNAs and overexpressing plasmids were employed for the loss or gain-of-function. Dual-luciferase reporter assay was subjected to verify the binding relationship between MALAT1 and miR-30e. Besides, ATG5 mRNA and protein levels were determined using qRT-PCR and western blot analysis. Furthermore, GC xenograft mice model was established to validate the in vitro findings. KEY FINDINGS: Chemoresistant GC cells presented higher IC50 of cisplatin, increased autophagy activity and stronger expression of MALAT1. The application of propofol promoted cell apoptosis and reduced the activity of autophagy through downregulating MALAT1. Silencing of MALAT1 inhibited chemo-induced autophagy, whereas MALAT1 overexpression promoted autophagy in GC cells. Mechanistic researches demonstrated that MALAT1 could bind with miR-30e to regulate ATG5 expression, thus causing the suppression of autophagy. In vivo GC xenograft model treated with both propofol and cisplatin also showed significantly decreased tumor size and weight, which was enhanced by knockdown of MALAT1. SIGNIFICANCE: Altogether, our study revealed a novel mechanism of propofol of lncRNA MALAT1/miR-30e/ATG5 mediated autophagy-related chemoresistance in GC, casting new lights on the understanding of propofol.


Asunto(s)
MicroARNs/genética , Propofol/metabolismo , ARN Largo no Codificante/metabolismo , Animales , Apoptosis/efectos de los fármacos , Autofagia/genética , Proteína 5 Relacionada con la Autofagia/genética , Proteína 5 Relacionada con la Autofagia/metabolismo , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , China , Cisplatino/metabolismo , Cisplatino/farmacología , Resistencia a Antineoplásicos/efectos de los fármacos , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Humanos , Ratones , Ratones Desnudos , MicroARNs/metabolismo , Propofol/farmacología , ARN Largo no Codificante/genética , Neoplasias Gástricas/genética , Neoplasias Gástricas/metabolismo , Ensayos Antitumor por Modelo de Xenoinjerto
3.
Cancer Med ; 9(5): 1842-1854, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31953926

RESUMEN

BACKGROUND: In the present study, we aim to investigate the potential role of propofol in the tumor progression of colon cancer. METHODS: Human colon cancer cell lines were cultured and exposed with 8 µg/mL propofol. RNA interference was performed to silence the expression of HOTAIR or STAT3 to explore their biological functions in colon cancer. Cell apoptosis and invasion were assessed using flow cytometry and transwell assays, respectively. Quantitative real-time PCR, western blot, and immunohistochemistry were subjected to measure the expression patterns of HOTAIR, STAT3, Wnt signaling factors, and epithelial-mesenchymal transition-related markers, respectively. Besides, nude mice were transplanted with colon cancer cells for further exploration. Tumor formation, volume, and weight were evaluated to validate the in vitro findings. RESULTS: Propofol treatment promoted cell apoptosis and inhibited cell invasion in colon cancer cells, while the effects were reversed by HOTAIR overexpression. Additionally, STAT3 positively regulated HOTAIR expression, which was also negatively modulated by propofol. Moreover, STAT3 and HOTAIR were shown to independently regulate colon cancer cell apoptosis and invasion. Furthermore, HOTAIR could stimulate Wnt signaling pathway via inhibiting WIF-1 expression and upregulating ß-catenin expression, which was also demonstrated by in vivo study. CONCLUSION: Taken together, the current study demonstrated that propofol exerts the inhibition on cell invasion and promotion on cell apoptosis through regulating STAT3/HOTAIR by activating WIF-1 and suppressing Wnt pathway, indicating that propofol might serve as a therapeutic role for colon cancer patients in the future.


Asunto(s)
Neoplasias del Colon/tratamiento farmacológico , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Propofol/farmacología , Vía de Señalización Wnt/efectos de los fármacos , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Animales , Apoptosis/efectos de los fármacos , Apoptosis/genética , Línea Celular Tumoral , Movimiento Celular/efectos de los fármacos , Movimiento Celular/genética , Neoplasias del Colon/genética , Neoplasias del Colon/patología , Regulación hacia Abajo/efectos de los fármacos , Humanos , Ratones , Invasividad Neoplásica/genética , Invasividad Neoplásica/patología , Regiones Promotoras Genéticas/genética , Propofol/uso terapéutico , ARN Largo no Codificante/genética , ARN Largo no Codificante/metabolismo , Factor de Transcripción STAT3/metabolismo , Regulación hacia Arriba/efectos de los fármacos , Vía de Señalización Wnt/genética , Ensayos Antitumor por Modelo de Xenoinjerto
4.
J Thorac Dis ; 10(3): E210-E213, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29707376

RESUMEN

Minimally invasive esophagectomy (MIE) has been identified as an oncological method with lower mortality and morbidity. This procedure is usually performed under general anesthesia using double endotracheal tube intubation and one-lung ventilation for a good visualization like other video-assisted thoracoscopic surgery (VATS). However, it is difficult to differentiate weather the postoperative hoarseness is caused by intubation or by recurrent laryngeal nerve injury during operation, and some complications related to intubation also are the focus of thoracic surgeons. Recently, VATS without tracheal intubation were reported to be feasible and safe in a series of VATS procedures, including management of pneumothorax, wedge resection of pulmonary tumors, excision of mediastinal tumors, lung reduction surgery and lobectomy. However, there is no report about its use in MIE. In December of 2012, we successfully applied nonintubated laryngeal mask airway (LMA) general anesthesia in MIE for three patients with esophageal cancer. Here, we retrospectively report the tentative results.

5.
J Cancer Res Ther ; 12(Supplement): C277-C280, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28230036

RESUMEN

OBJECTIVE: The aim of this study was to observe the efficacy and safety of single-lumen tracheal ventilation for esophageal cancer surgery. METHODS: Thirty-eight patients with esophageal carcinoma who prepared for minimally invasive esophagectomy were included in this study. All of the included 38 patients were received single-lumen tracheal ventilation. The arterial blood gas index was monitored through the operation procedure and recorded at four-time points: before induction (T0), at the end of chest operation (T1), at the end of the abdominal operation (T2), and 30 min after extubation (T3). The heart rate (HR) and blood pressure (BP) were also monitored and recorded during the period of PetCO2 >50 mmHg. The agitation incidence rate was also recorded in awakening period. RESULTS: All the included 38 patients were successfully completed the operation without conversing to open thoracotomy or open laparotomy. The artificial pneumothorax time, artificial pneumoperitoneum time, and operation time were 136.6 ± 26.2 min, 104.4 ± 21.3 min, and 306.7 ± 42.0 min, respectively. The patients' BP and HR was slight elevated but within the normal range (HR <100 breaths/min and BP <140/90 mmHg) when the PetCO2 >50 mmHg. Arterial blood gas results showed that PaCO2 significantly increased in time point of T1, T2, and T3 compared to T0 (P < 0.05); PaO2 significantly increased in time point of T1 and T2 compared to T0 (P < 0.05); HR significantly increased during the operation procedure of the time points T1 (P < 0.05). Of the included 38 patients, 8 were observed preoperative blood gas PaO2 <80 mmHg and the patients had decreased PaO2 in the time point T3 compared to other 30 normal preoperative PaO2 patients. Electrocardiogram monitoring showed that all patients do not appear arrhythmia and myocardial ischemia in the process of surgery. Two of 38 patients were found of mild agitated during waking period. CONCLUSION: Single-lumen tracheal ventilation for esophageal cancer surgery is safe and can provide acceptable anesthesia effect.


Asunto(s)
Neoplasias Esofágicas/cirugía , Esofagectomía/métodos , Anciano , Anestesia/efectos adversos , Anestesia/métodos , Biomarcadores , Análisis de los Gases de la Sangre , Neoplasias Esofágicas/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad
6.
J Cancer Res Ther ; 11 Suppl 1: C128-30, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26323912

RESUMEN

OBJECTIVE: The objective was to evaluate the effect of patient-controlled intravenous analgesia (PCIA) in non-small cell lung cancer patients (NSLCPs) after thoracotomy. MATERIALS AND METHODS: From January 2014 to March 2015, 40 patients of non-small cell lung cancer were recruited in this study and divided into two groups, (PCIA) group and control group with 20 patients in each group. The patients in the PCIA group were connected to intravenous self-control analgesia pump which contains 2 µg/ml of sufentanil and 8 mg of ondansetron diluting to 100 ml of 0.9% saline after surgery. Initial loading dose was 2 ml, background dose was 2 ml/h, single PCIA dose was 0.5 ml, and locking time 15 min. 10 mg of morphine was intramuscular injected, if necessary. Patients in the control group use an intramuscular injection of morphine 10 mg singly. The visual analog scale (VAS) score of the two groups were recorded in the time point of 2 h, 4 h, 8 h, 12 h, and 24 h. The morphine consumption of the two groups was also compared. RESULTS: Patients in PCIA group after surgery, 2 h, 4 h, 8 h, 12 h, and 24 h VAS score were obviously lower than those in control group (P < 0.05). Moreover, the incidence of nausea and vomiting and respiratory depression of patients in PCIA group was obviously lower than control group (P < 0.05). Consumption of postoperative morphine in PCIA group was obviously less than control group (P < 0.05). CONCLUSION: Intravenous PCIA-controlled intravenous analgesia can significantly decrease the VAS score without increasing the toxicity in NSLCP after thoracotomy.


Asunto(s)
Analgesia Controlada por el Paciente , Carcinoma de Pulmón de Células no Pequeñas/complicaciones , Neoplasias Pulmonares/complicaciones , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/etiología , Toracotomía/efectos adversos , Analgesia Controlada por el Paciente/efectos adversos , Analgesia Controlada por el Paciente/métodos , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Femenino , Humanos , Neoplasias Pulmonares/cirugía , Masculino , Morfina/administración & dosificación , Manejo del Dolor/efectos adversos , Manejo del Dolor/métodos , Dimensión del Dolor , Dolor Postoperatorio/diagnóstico , Toracotomía/métodos , Factores de Tiempo
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