The effect of transversus abdominis plane block on the chronic pain after colorectal surgery: a retrospective cohort study.

BACKGROUND: Chronic postsurgical pain (CPSP) is common and would reduce the quality of life of patients. Transversus abdominal plane (TAP) block has been widely used in lower abdominal surgery and many researches demonstrated that it could improve acute postsurgical pain. We aim to determine whether TAP block could improve chronic postoperative pain at 3 months and 6 months after colorectal surgery. METHODS: A total of 307 patients received selective colorectal surgery under general anesthesia between January, 2015 and January, 2019 in a single university hospital were included: 128 patients received TAP block combined with patient-controlled intravenous analgesia (PCIA) for postsurgical analgesia (group TP) and 179 only administrated with PCIA (group P). Main outcome was the NRS score of pain at 3 months after colorectal surgery. The data was analyzed by two-way repeated measures anova and the chi-square test. RESULTS: The NRS score at rest and during movement was decreased significantly at 24 h after surgery (rest NRS 1.07 ± 1.34 vs 1.65 ± 1.67, movement NRS 3.00 ± 1.45 vs 3.65 ± 1.89; all P = 0.003) in group TP than those of group P. There was no significant difference of NRS score at 48 h after surgery (P > 0.05). At 3 months after surgery, the NRS score during movement was also lower in group TP than that in group P (0.59 ± 1.23 vs 0.92 ± 1.65, P = 0.045). There was no significant difference of NRS score at 6 months after surgery (P > 0.05). The prevalence of CPSP was 19.5% (25/128) in group TP and 20.7% (37/179) in group P at 3 months after surgery. 13.2% (17/128) of patients suffered from CPSP in group TP and 13.9% (25/179) in group P at 6 months after surgery. Both at 3 months and 6 months after surgery, there was no statistical difference of the prevalence of CPSP between the two groups (all P > 0.05) . CONCLUSIONS: TAP block reduced NRS during movement at 3 months after surgery but did not reduce the incidence of CPSP at 3 months and 6 months after selective colorectal surgery.

[Effects of single versus combined use of trastuzumab and cantide on breast cancer cells SKBR3 over-expressing HER2].

OBJECTIVE: To evaluate the in vitro cytotoxic effects of cantide or herceptin on human breast cancer SKBR3 cells over-expressing HER2. METHODS: The distribution of HER2 and hTERT protein in SKBR3 cells and the effects of cantide and/or herceptin on the subcellular localization of HER2 and hTERT were observed by indirect immunofluorescent assay. The inhibition rate of herceptin and/or cantide at different concentrations on SKBR3 cells was detected by MTT assay. And the apoptotic rate of cells was evaluated by flow cytometer. RESULTS: (1) The expressions of both HER2 and hTERT proteins in SKBR3 cells were found. HER2 protein was predominant in cell membranes while hTERT protein in nuclei. After the addition of herceptin, the cytoplasmic migration of HER2 was found while there was no distinct location change of cantide. (2) In MTT assay, the single use of cantide or herceptin and the combined use of both produced inhibitory effects on SKBR3 cells while the inhibition rate was higher for combined use. The inhibitory effects became additive in the combined use of 0.4 µmol/L cantide and 0.85 µg/ml herceptin. And there were synergistic effects in the combined use of 0.4 µmol/L cantide and 1.70, 3.40, 6.88 or 13.75 µg/ml herceptin. (3) The apoptotic rate was 25.75% for cantide alone, 11.26% for herceptin alone and 41.41% for their combined use (apoptotic cells predominant in advanced stage). CONCLUSION: Due to different localizations, cantide and herceptin have different action sites in their combined use. When in single use, the inhibition rate is linearly correlated with the concentration of herceptin or cantide. And their combined use produces additive or synergistic antitumor effects on SKBR3 breast cancer cells.

[The treatment effect of immunoglobulin in AIDS with Guillain-Barre syndrome].

OBJECTIVE: To discuss the treatment effect of immunoglobulin in acquired immune deficiency syndrome (AIDS) with Guillain-Barre syndrome (GBS). METHODS: The clinical data of AIDS with GBS, diagnosed by clinical and laboratory methods, were retrospectively analyzed, and literature retrieval analyzed. RESULTS: After treatment by immunoglobulin and antiviral. The patient's peripheral nerve injury recovered, and the number of HIV decreased. CONCLUSION: Immunoglobulin has a therapeutic effect for HIV infection related GBS, and beneficial to antiviral treatment.

[Clinical analysis in viral encephalitis patients accompanying generalized tonic clonic seizure].

OBJECTIVE: To summarize the value of clinical features, CSF, imaging and EEG in diagnosing viral encephalitis accompanying generalized tonic clonic seizure (GTCS). METHODS: The clinical, imaging and EEG characteristic of 30 patients with viral encephalitis accompanying GTCS were retrospectively analyzed. RESULTS: Of the 30 cases with viral encephalitis, 21 cases GTCS attacked (70%) within 14 days, 9 cases had GTCS (30%) in 15-28 days. 27 cases CSF were abnormal with the pressure, cell number, protein. The incidence of positive pathogenicity was 12/16; 19 cases MRI had abnormal signal. All the patients had abnormal EEG during the disease. CONCLUSION: The clinical features, CSF, imaging and EEG were all important in diagnosing and estimate of viral encephalitis accompanying GTCS.