Thoracic paravertebral nerve block combined laryngeal mask airway with preservation of spontaneous breathing can accelerate postoperative recovery.

OBJECTIVE: This study aimed to examine the potential benefits of Thoracic Paravertebral Nerve Block (TPVB) coupled with Laryngeal Mask Airway (LMA) and the maintenance of spontaneous breathing anesthesia, in contrast to general anesthesia utilizing double-lumen endobronchial intubation, on promoting recovery following thoracoscopic surgery. PATIENTS AND METHODS: A randomized controlled trial was carried out involving sixty patients set for Video-Assisted Thoracoscopic Surgery (VATS) at the Affiliated People's Hospital of Jiangsu University from February 2021 to January 2022. Patients were randomized to either the TPVB and LMA with spontaneous breathing anesthesia group (non-intubation group, NI group) or the general anesthesia with double-lumen endobronchial intubation group (Intubation group, I group). The primary outcome measured was the duration of hospitalization. Secondary outcomes included early postoperative rehabilitation indicators, postoperative complications, Visual Analogue Score (VAS), and inflammatory response markers. RESULTS: Patients in the NI group experienced significantly shorter hospital stays than those in the I group (p < 0.05). Early postoperative recovery, assessed by metrics including the first exhaust time, food intake time, first ambulation time, and duration of chest-tube placement, was superior in the NI group (p < 0.05). Postoperative complications such as nausea and vomiting, pulmonary infection, atelectasis, sore throat, and hoarseness, along with cortisol and C-reactive protein (CRP) levels at the end of the operation and 24 h post-operation, and VAS values within the first 12 h post-operation, were significantly lower in the NI group (p < 0.05). However, blood loss, operation time, and VAS values at 24 h and 48 h post-surgery showed no significant differences between the two groups. CONCLUSIONS: Our findings suggest that TPVB, in conjunction with LMA and spontaneous breathing anesthesia, may expedite postoperative recovery in patients undergoing VATS.

Expression of miR-29 and STAT3 in osteosarcoma and its effect on proliferation regulation of osteosarcoma cells.

OBJECTIVE: STAT3 has been shown to be involved in the occurrence, progression, and resistance of various tumors. The abnormal expression of miR-29 is associated with the pathogenesis of osteosarcoma. The bioinformatics analysis showed a targeting relationship between miR-29 and STAT3 3'-UTR. This study investigated whether miR-29 regulates the STAT3 expression and affects the proliferation and apoptosis of osteosarcoma cells. PATIENTS AND METHODS: The tumor tissues of osteosarcoma patients were collected, and the adjacent tissues were used as controls to detect the expression of miR-29 and STAT3. The Dual-Luciferase Gene Reporter Assay validated the regulatory relationship between miR-29 and STAT3. The expression of miR-29 and STAT3 in normal osteoblasts hFOB1.19, osteosarcoma SJSA-1, and MG-63 was measured. SJSA-1 cells were divided into miR-NC group and miR-29 mimic group. Cell apoptosis and proliferation were detected by flow cytometry. RESULTS: Compared with adjacent tissues, miR-29 expression was decreased, and STAT3 expression was increased in osteosarcoma. There was a targeted regulation relationship between miR-29 and STAT3. Compared with hFOB1.19 cells, miR-29 expression in osteosarcoma SJSA-1 and MG-63 cells was decreased, with increased STAT3 expression. The transfection of miR-29 mimic significantly decreased the expression of STAT3 and p-STAT3 in SJSA-1 cells, inhibited cell proliferation, and increased cell apoptosis. CONCLUSIONS: Decreased miR-29 expression plays a role in the increase of the STAT3 expression and in the promotion of the pathogenesis of osteosarcoma. Increasing the expression of miR-29 can inhibit the proliferation of osteosarcoma cells and promote apoptosis by decreasing STAT3 expression.

[The clinical impact of artery-first approach combined with vascular resection and reconstruction in the treatment of pancreatic head carcinoma].

Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall. In the operation, the artery first approach was used and the whole arterial blood supply in the head of the pancreas was fully exposed and interdicted. Finally, en block resection and vascular resection and reconstruction was adopted. Results: 12 of 13 patients had pancreatoduodenectomy synchronously with vascular resection and reconstruction; the other patient had these two surgery sequentially. Four patients received blood vessel wedge resection, five had segmental resection combined with end to end suture, and four had segmental resection combined with artificial vascular graft reconstruction. Operation time was (327.2±65.5) minutes, and the amount of blood loss was (472.6±226.4) millilitres. One patient suffered from delayed gastric emptying, and two patients had pancreatic fistula. All patients recovered from postoperative complications by conservative treatment. No patients developed biliary fistula, gastrointestinal fistula, abdominal infection, pulmonary infection, diarrhea, hypoglycemia or other complications, and none died in perioperative period. Postoperative pathological findings confirmed the diagnosis of pancreatic ductal adenocarcinoma. Mean tumor diameter was (4.2±1.5)cm, and (3.8±1.5) metastasis were found in (13.6±2.5) resected lymph nodes. In 11 cases, the tumor cells were found in the outer membrane of blood vessels, 2 cases were found to have tumor invasion in the inner membrane, and all the resection margins were negative. All patients were followed up, and 2 patients died of liver metastasis 11 months and 18 months after operation, respectively. One patient survived with local recurrence of tumor 13 months after surgery. Other patients had no tumor recurrence and metastasis. Conclusions: The artery first approch combined vascular resection and reconstruction is safe effective and feasible in the treatment of pancreatic head carcinoma. It can improve the ablation rate of pancreatoduodenectomy.

A new cell culture system for infection with hepatitis B virus that fuses HepG2 cells with primary human hepatocytes.

Hepatitis B virus (HBV) infection exhibits a very narrow host range and shows a strong tropism for liver parenchymal cells, however none of the previously established experimental models can reproduce the natural process of HBV infection. In the present study, primary human hepatocytes were fused with HepG2 cells to establish the hybrid HepCHLine-4 cell line with high susceptibility to HBV. The HepCHLine-4 cells expressed HBV-specific antigen when co-incubated with HBV-positive serum from a hepatitis B patient. Post-infection, HBV relaxed circular DNA and covalently closed circular DNA were detected in HepCHLine-4 cells using a nested polymerase chain reaction, and HBV-specific particles were visualized by electron microscopy of the culture media of HepCHLine-4 cells. HepG2 cells were not susceptible to HBV infection under the same conditions. The HepCHLine-4 cells can be sub-cultured for > 12 months while maintaining susceptibility to HBV and may, therefore, be useful for studying HBV infection and the viral life cycle in human hepatocytes.

[Diagnostic value of heart-liver nuclein ratio in cirrhotic portal hypertension].

A new method for evaluating portal systemic collaterals with administering 99mTc-MIBI per rectum was described in 80 cases. The heart to liver uptake ratio (H/L) in 15 healthy subjects was 0.267 +/- 0.1, slightly increased (0.455 +/- 0.13) in 8 patients with viral hepatitis and significantly increased in 68 cirrhotics. There was a good correlation between H/L ratio and the Child-Pugh classification with the ratio in Child A group of 0.57 +/- 0.12, in Child B group of 1.0 +/- 0.19, and in Child C group of 1.19 +/- 0.25 respectively (P < 0.01). For the diagnosis of portal hypertension, tentatively taking the ratio of > or = 0.62 as positive the sensitivity was 96%, specificity 89%, and accuracy 94%. The authors believe that 99mTc-MIBI imaging is a noninvasive method very useful in evaluating porta-systemic shunts.

[Diagnosis and management of visceral artery aneurysms: report of 24 cases].

During the past 30 years 24 patients were treated for visceral artery aneurysms in our hospital. There were 12 hepatic, 7 gastroduodenopancreatic, 3 splenic, and 2 superior mesenteric artery aneurysms. Perilous ruptures occurred in 20 patients, among them 13 ruptured into the biliary tract, 4 into the upper gastrointestinal tract, and 3 into the abdominal cavity. Correct preoperative diagnosis was often difficult. Selective celiac and superior mesenteric angiography was most valuable, and 14 patients were correctly diagnosed preoperatively by the procedure. Nineteen underwent emergent surgery and 8 died. Prognosis depended on the anatomic location of the aneurysms and the general condition of the patients.

Evaluation of non-invasive diagnostic tests in detecting cancer of the pancreas.

Monoclonal antibody defined antigen (CA19-9), carcinoembryonic antigen (CEA), ultrasonography (US) and computerized tomography (CT) were carried out as the tests in 113 patients suspected to have pancreatic cancer. Of 98 patients who underwent operation, 55 were found to have pancreatic cancer, 25 benign pancreatic disease, and 18 cancer of the biliary tract. Follow-up study was carried out for more than 1 year in 15 other patients suffering from pancreatitis without surgical intervention. The accuracy of CA19-9, US, CEA and CT was 87%, 69%, 61% and 56% respectively. The sensitivity of each test was CA19-9, 98%; US, 89%; CT, 80%; and CEA, 38%. The sensitivity of parallel test combined with CA19-9 and CEA was 100%. It may be regarded as the first step to detect pancreatic cancer in suspected population. The specificity of each test was CEA, 82%; CA19-9, 76%; US, 50% and CT, 40%. And the specificity of serial tests combined with CA19-9 and US was 90%. When these two tests were both positive, pancreatic cancer was highly suspected.

Influence of medicinal herbs decocted with different utensils on colony formation of gastric carcinoma cells.

In order to elucidate the different results obtained in cancer patients with similar condition and symptoms treated by the same medicinal herbs, an investigation of the utensils used for making decoctions was carried out. It was found that the decoction made by means of glassware, enamel and earthenware pots had the best effect of inhibiting the colony formation of human gastric carcinoma cells, the next were the decoctions made by means of unrefined iron pots, stainless steel pots and copper pots, and the worst was that made with aluminium pots. It was also found that there was no difference between the water contained in those utensils and normal saline in the influence on the colony formation of human gastric carcinoma cells. Therefore, it is believed that the difference in effect of the decoctions made by means of different kinds of utensils is not due to the trace dissolution of the utensil materials, but is most likely due to the occurrence of some chemical reactions while making the decoction. That the decoctions made by means of different utensils had different peak values in the absorption spectrum also supports this proposition.