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Background: Hypokalemia is common in hospitalized patients. In fact, untreated hypokalemia is associated with the incidence and mortality of adverse cardiac events. Timely recognition and treatment of these diseases are essential. Indeed, a little research has been conducted on the level of K+ in perioperative patients. In this study, by comparing the changes of K+ from when patients were admitted to hospital and to after they had entered the operating room, we analyzed the related factors of K+ disorder after operating-room entry and identified factors related to the occurrence of perioperative K+ disorder. Methods: This single-center retrospective study included non-cardiac surgery patients who underwent admission blood gas analysis and blood gas analysis upon entering the operating room in the China-Japan Union Hospital of Jilin University between June 2019 and September 2020. Results: Among the 258 patients who underwent non-cardiac surgery with anesthesia, 19 cases (7.4%) were hypokalemic on admission, and 102 cases (39.5%) were hypokalemic after admission to the operating room. The K+ levels after operating-room entry were positively correlated with the K+ concentration at admission (r=0.363; P<0.05). Female sex [odds ratio (OR) =0.451; 95% CI: 0.263-0.775; P=0.004], hypertension (OR =0.499; 95% CI: 0.281-0.885; P=0.017), and preoperative bowel preparation (OR =0.471; 95% CI: 0.258-0.860; P=0.014) were risk factors for hypokalemia for patients after operating-room entry. Conclusions: Hypokalemia was found to be common in patients after operating-room entry. Even patients with normal K+ at admission could have hypokalemia due to undergoing an operation, with female sex, hypertension, and bowel preparation being the risk factors for this condition.
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Background: This study aimed to evaluate the impact of patients' positioning before and after intubation with mechanical ventilation, and after extubation on the lung function and blood oxygenation of patients with morbid obesity, who had a laparoscopic sleeve gastrectomy. Methods: Patients with morbid obesity (BMI ≥ 30 kg/m2, ASA I - II grade) who underwent laparoscopic sleeve gastrectomy at our hospital from June 2018 to January 2019 were enrolled in this prospective study. Before intubation, after intubation with mechanical ventilation, and after extubation, arterial blood was collected for blood oxygenation and gas analysis after posturing the patients at supine position or 30° reverse Trendelenburg position (30°-RTP). Results: A total of 15 patients with morbid obesity were enrolled in this self-compared study. Pulmonary shunt (Qs/Qt) after extubation was significantly lower at 30°-RTP (18.82 ± 3.60%) compared to that at supine position (17.13 ± 3.10%, p < 0.01). Patients' static lung compliance (Cstat), during mechanical ventilation, was significantly improved at 30°-RTP (36.8 ± 6.7) compared to that of those in a supine position (33.8 ± 7.3, p < 0.05). The PaO2 and oxygen index (OI) before and after intubation with mechanical ventilation were significantly higher at 30°-RTP compared to that at supine position, and in contrast, the PA-aO2 before and after intubation with mechanical ventilation was significantly reduced at 30°-RTP compared to that at supine position. Conclusion: During and after laparoscopic sleeve gastrectomy, patients with morbid obesity had improved lung function, reduced pulmonary shunt, reduced PA-aO2 difference, and increased PaO2 and oxygen index at 30°-RTP compared to that supine position.
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BACKGROUND: Propofol, a commonly used intravenous anesthetic during cancer resection surgery, has been found to exhibit tumor inhibitory effects in vitro and in vivo. The role of propofol in lung cancer has been previously reported, whereas its action mechanism remains unclear. This study further investigated the effects of propofol on lung cancer A549 cell growth, migration and invasion, as well as the underlying mechanisms. METHODS: Cell viability, proliferation, migration, invasion and apoptosis were assessed by CCK-8 assay, BrdU assay, two chamber transwell assay and flow cytometry, respectively. The regulatory effect of propofol on microRNA-372 (miR-372) expression in A549 cells was analyzed by qRT-PCR. Cell transfection was used to change the expression of miR-372. The protein expression of key factors involving in cell proliferation, apoptosis, migration and invasion, as well as Wnt/ß-catenin and mTOR pathways were analyzed by western blotting. RESULTS: Propofol inhibited lung cancer A549 cell viability, proliferation, migration, and invasion, but promoted cell apoptosis. Moreover, miR-372 was down-regulated in propofol-treated A549 cells. Overexpression of miR-372 abrogated the effects of propofol on proliferation, migration, invasion and apoptosis of A549 cells. Knockdown of miR-372 had opposite effects. Furthermore, propofol suppressed Wnt/ß-catenin and mTOR signaling pathways by down-regulating miR-372. CONCLUSION: Propofol inhibits growth, migration and invasion of lung cancer A549 cells at least in part by down-regulating miR-372 and then inactivating Wnt/ß-catenin and mTOR pathways.
