The Effects of Perineural Dexamethasone on Rebound Pain After Nerve Block in Patients With Unicompartmental Knee Arthroplasty: A Randomized Controlled Trial.

OBJECTIVES: A single nerve block provides excellent analgesia in a short time, but rebound pain after the nerve block dissipates has attracted researchers' attention. The aim of this study was to evaluate the effect of perineural dexamethasone on rebound pain after sciatic nerve block and femoral nerve block in patients undergoing unicompartmental knee arthroplasty (UKA). METHODS: In a double-blinded fashion, we recruited 72 patients undergoing UKA, each of whom received sciatic and femoral nerve block. Patients were randomly assigned to 2 groups (n=36): X (ropivacaine only) and D (ropivacaine combined with dexamethasone). The primary outcome was the incidence of rebound pain. The secondary outcomes were rebound pain score, the duration of rebound pain, the duration of nerve block, pain score, sufentanil consumption and rescue analgesic, patient-controlled intravenous analgesia, distance walked, sleep quality score, C-reactive protein levels, and adverse effects. RESULTS: Compared with group X, the incidence of rebound pain in group D was higher, the rebound pain score was higher and the duration of the nerve block was prolonged ( P <0.05). At 12, 16, and 20 hours postoperatively, the pain scores at rest in group D were lower. At 32 and 36 hours postoperatively, the pain scores at rest in group D were higher ( P <0.05). Furthermore, patients in group D had lower levels of C-reactive protein after surgery ( P <0.05). DISCUSSION: The addition of dexmedetomidine to ropivacaine for UKA effectively prolonged the duration of nerve block and decreased C-reactive protein levels, but increased the incidence of rebound pain and rebound pain score, and had no beneficial effects on the postoperative analgesia.

Expression and Prognostic Value of Tumor-Infiltrating Lymphocytes and PD-L1 in Hepatocellular Carcinoma.

AIM: To explore the difference in tumor-infiltrating lymphocytes (TILs) and programmed death-ligand (PD-L1) in primary hepatocellular carcinoma (HCC) and its adjacent tissues, and to evaluate their effect on HCC prognosis. METHODS: Liver cancer and paracancerous tissue samples were collected from 72 patients who underwent radical hepatectomy between December 15, 2017 and January 9, 2019. Flow cytometry was used to detect the distribution of TILs and PD-L1, analyze the correlation between the expression of CD8/CD3 and PD-L1 and clinical-pathological parameters, and evaluate their effect on the prognosis of HCC patients. RESULTS: The distribution proportion of CD3+T cells, CD4+T cells, and PD-L1 in liver cancer were significantly higher than in paracancerous tissues, while the distribution proportion of CD8+T cells was significantly lower (all P<0.05). In HCC, the distribution proportion of CD8+T cells was related to tumor size and stage, while the PD-L1 expression was related to the tumor stage only (all P < 0.05). Univariate analysis showed that tumor differentiation, TNM stage, expression of CD8/CD3, and PD-L1 in tumor tissue were related to disease-free survival (DFS)(P < 0.05); multivariate Cox regression analysis showed that tumor differentiation, TNM stage, CD8/CD3, and PD-L1 expression were independent influencing factors of postoperative DFS (P < 0.05). Kaplan-Meier survival curve analysis showed that the DFS of CD8/CD3 high expression group was significantly higher than that of the low expression group, and the DFS of PD-L1 low expression group was significantly higher than that of the high expression group (all P < 0.05). CONCLUSION: There are significant differences in the distribution of TILs and PD-L1 in HCC and paracancerous tissues. The expression of CD8/CD3 and PD-L1 in tumor-infiltrating lymphocytes in HCC may help evaluate the immunological indexes of prognosis after radical resection of HCC and to further the study of immunotherapy in patients with HCC.

lncRNA-XLOC_012370 Promotes the Development of Pancreatic Cancer and Inactivates the NF-κB Pathway Through miR-140-5p.

Pancreatic cancer is a high incidence, high degree of malignancy, and high mortality in the digestive system tumor. The incidence of pancreatic cancer in China has increased nearly six folds in the past 20 years, ranking fifth in the mortality rate of malignant tumors, so it is particularly important to actively explore clinical indicators with better diagnostic significance for pancreatic cancer. LncRNA performs an essential regulatory function in the occurrence, development, and metastasis of many kinds of tumors, playing both a carcinogenic role and a tumor suppressor gene. Here, we demonstrated the function and mechanism of LncRNA-XLOC_012370 in the development of pancreatic cancer. In our research, the abnormal upregulation of XLOC_012370 was observed in pancreatic cancer patients' tumor tissues. XLOC_012370 was related to tumor stage, lymph node metastasis, and overall survival. Silencing of XLOC_012370 prevented the proliferation, migration, and invasion via the NF-κB signal pathway. Further, miR-140-5p was identified as the target and downstream of XLOC_012370 and involved in pancreatic cancer progression. In vivo, knockdown of XLOC_012370 inhibited tumor growth via the NF-κB signal pathway. In conclusion, lncRNA-XLOC_012370 is closely related to some malignant clinicopathological features and prognosis of pancreatic cancer. Thus the miR-140-5p/NF-κB signal pathway might represent a promising treatment strategy to combat pancreatic cancer.