Application of hip capsule peripheral nerve block in early analgesia in elderly patients with hip fracture.

Objective: The objective of the study is to investigate the effect of pericapsular nerve group (PENG) block in early analgesia in elderly patients with hip fracture. Methods: A total of 44 elderly patients with hip fracture admitted to our hospital from August 2021 to December 2022 were selected and divided into 2 groups according to different analgesia programs. Results: At T1~T4, the resting and active visual analog scale (VAS) scores in group P were lower than group F (p < 0.05). The resting and active VAS scores at T5 in both groups were no visible differences (p > 0.05). After 30 min of block, systolic blood pressure, diastolic blood pressure, and heart rate were decreased in both groups (p < 0.05), but no obvious difference was found in the two groups (p > 0.05). Before surgery, Pittsburgh Sleep Quality Index (PSQI) and mini-mental state scale (MMSE) scores in both groups were reduced, and PSQI score in group P was lower than that in group F and MMSE score was higher than group F (p < 0.05). Conclusion: PENG technology is safe and effective in the early analgesia of elderly hip fractures. It can effectively block physiological stress response caused by acute trauma, improve pre-operative sleep quality, and reduce the incidence of cognitive dysfunction.

Objetivo: Investigar el efecto del bloqueo del grupo del nervio pericapsular en analgesia temprana en pacientes ancianos con fractura de cadera. Método: Se seleccionaron 44 pacientes ancianos con fractura de cadera ingresados en nuestro hospital entre agosto de 2021 y diciembre de 2022, divididos en dos grupos según diferentes programas de analgesia. Resultados: En T1~T4, los valores de la escala visual análoga (EVA) en reposo y con actividad en el grupo P fueron menores que en el grupo F (p < 0.05). Los puntajes de la EVA en reposo y en actividad en T5 en ambos grupos no mostraron diferencias visibles (p > 0.05). Después de 30 minutos de bloqueo, la presión arterial sistólica y diastólica, y la frecuencia cardiaca, disminuyeron en ambos grupos (p < 0.05), pero no se encontró una diferencia obvia entre ellos (p > 0.05). Antes de la cirugía, las puntuaciones del Pittsburgh Sleep Quality Index (PSQI) y de la Mini-Mental State Scale (MMSE) en ambos grupos eran reducidas, y la puntuación del PSQI en el grupo P fue menor que en el grupo F, y la puntuación del MMSE fue mayor que en el grupo F (p < 0.05). Conclusiones: La técnica de bloqueo del grupo del nervio pericapsular es segura y efectiva en la analgesia temprana de fracturas de cadera en ancianos. Puede bloquear eficazmente la respuesta al estrés fisiológico causado por un trauma agudo, mejorar la calidad del sueño preoperatorio y reducir la incidencia de disfunción cognitiva.

Tumor-associated macrophages improve hypoxia-induced endoplasmic reticulum stress response in colorectal cancer cells by regulating TGF-ß1/SOX4.

Hypoxia is a common feature of solid tumors that can induce endoplasmic reticulum stress (ERS). This study aimed to explore the mechanism behind tumor-associated macrophages (TAMs) improving the ERS response of colorectal cancer (CRC) under hypoxic conditions. Herein, it was demonstrated that TAMs reduce ERS by secreting TGF-ß1 and activating SOX4/TMEM2 signaling in CRC cells. The expression levels of TGF-ß1, SOX4, and TMEM2 in 20 pairs of tumor tissues and para-carcinoma tissues were assessed. A co-culture system of CRC cells with THP-1-derived macrophages under hypoxic conditions in vitro was investigated to determine the protective effect of TAMs on CRC cells. Moreover, to further verify the underlying mechanism, TGF-ß1 and SOX4 were knocked down in the TAMs and CRC cells, respectively. The results exposed that TGF-ß1, SOX4, and TMEM2 were abundantly expressed in tumor tissues. Moreover, the co-culture system revealed that macrophages stimulate TGF-ß1 secretion under hypoxia, which depresses the CRC cells' ERS, further promoting cell proliferation and inhibiting apoptosis. Furthermore, increased TGF-ß1 levels promoted the expression of SOX4 and TMEM2 in CRC cells. Conversely, the knockdown of SOX4 attenuated the protective effect of TAMs on TGF-ß1-stimulated CRC cells. In conclusion, these results suggest that the elevated ERS induced by hypoxia in CRC cells could be relieved by TAMs via the secretion of TGF-ß1. Finally, TGF-ß1 suppresses undue ERS response in CRC cells by activating the SOX4-TMEM2 axis.

Prevention of renal ischemia and reperfusion injury by penehyclidine hydrochloride through autophagy activation.

Penehyclidine hydrochloride (PHC) suppresses renal ischemia and reperfusion (I/R) injury (IRI); however, the underlying mechanism of action that achieves this function remains largely unknown. The present study aimed to investigate the potential role of autophagy in PHC­induced suppression of renal IRI, as well as the involvement of cell proliferation and apoptosis. A rat IRI model and a cellular hypoxia/oxygenation (H/R) model were established; PHC, 3­methyladenine (3­MA) and rapamycin (Rapa) were administered to the IRI model rats prior to I/R induction and to H/R cells following reperfusion. Serum creatinine was measured using a biochemistry analyzer, whereas aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) expression levels were detected using ELISA kits. Renal tissue injury was evaluated by histological examination. In addition, microtubule­associated protein light chain 3B (LC3B) expression, autophagosome formation, cell proliferation and apoptosis were detected in the cellular H/R model. The results demonstrated that I/R induced renal injury in IRI model rats, upregulated serum creatinine, ALAT and ASAT expression levels, and increased autophagic processes. In contrast, pretreatment with PHC or Rapa significantly prevented these I/R­induced changes, whereas the administration of 3­MA enhanced I/R­induced injuries through suppressing autophagy. PHC and Rapa increased LC3B and Beclin­1 expression levels, but decreased sequestome 1 (p62) expression in the cellular H/R model, whereas 3­MA prevented these PHC­induced changes. PHC and Rapa promoted proliferation and autophagy in the cellular H/R model; these effects were accompanied by increased expression levels of LC3B and Beclin­1, and reduced p62 expression levels, whereas these levels were inhibited by 3­MA. Furthermore, PHC and Rapa inhibited apoptosis in the cellular H/R model through increasing Bcl­2 expression levels, and suppressing Bax and caspase­3 expression levels; the opposite effect was induced by 3­MA. In conclusion, PHC suppressed renal IRI through the induction of autophagy, which in turn promoted proliferation and suppressed apoptosis in renal cells.

Effect of preintravenous injection of parecoxib, combined with transversus abdominis plane block in strategy of enhanced recovery after radical resection of colorectal cancer.

OBJECTIVE: The objective of this study was to investigate the effect of preintravenous injection of parecoxib, combined with transversus abdominis plane (TAP) block and postoperative patient-controlled intravenous analgesia (PCIA) pump, in strategy of enhanced recovery after surgery for patients with radical resection of colorectal cancer. MATERIALS AND METHODS: In this prospective study, 80 patients that underwent radical resection for colorectal cancer were randomly divided into four groups: (1) the parecoxib group, with preintravenous injection of parecoxib and postoperative PCIA after surgery; (2) the TAP group, with TAP block and postoperative PCIA; (3) the parecoxib + TAP group, with parecoxib combined with TAP block and postoperative PCIA; and (4) the control group, with only postoperative PCIA and preinjection of normal saline. The visual analog score was used to measure the pain. The mean operative time, PCIA pressing time, time for first out-of-bed activity, first anus exhaust time, hospital stay duration, and complications were recorded. RESULTS: Operative time of the TAP group and parecoxib + TAP group was significantly longer than that of the parecoxib group and control group. The first out-of-bed activity time, first anus exhaust time, and hospital stay time of the parecoxib + TAP group were significantly shorter than those of the other groups, while the control group was all significantly higher than the other groups. Complication rates in all strategy groups were significantly lower than in the control group; however, no significant difference was found among the strategy groups. CONCLUSION: The combination of parecoxib, TAP, and PCIA pump could significantly reduce patient postoperative pain and enhance recovery.