[The effect of deep neuromuscular block combined with low pneumoperitoneum pressure on postoperative pain in patients undergoing laparoscopic radical colorectal surgery].

Objective: To investigate the effect of deep neuromuscular blockade (DNMB) combined with low pneumoperitoneum pressure anesthesia strategy on postoperative pain in patients undergoing laparoscopic colorectal surgery. Methods: This study was a randomized controlled trial. One hundred and twenty patients who underwent laparoscopic colorectal surgery at Cancer Hospital of Chinese Academy of Medical Sciences from December 1, 2022 to May 31, 2023 were selected and randomly divided into two groups by random number table method. Moderate neuromuscular blockade [train of four stimulations count (TOFC)=1-2] was maintained in patients of the control group (group C, n=60) and pneumoperitoneum pressure level was set at 15 mmHg(1 mmHg=0.133 kPa). DNMB [post-tonic stimulation count (PTC)=1-2] was maintained in patients of the DNMB combined with low pneumoperitoneum pressuregroup (group D, n=60) and pneumoperitoneum pressure level was set at 10 mmHg. The primary measurement was incidence of moderate to severe pain at 1 h after surgery. The secondary measurements the included incidence of moderate to severe pain at 1, 2, 3, 5 d and 3 months after surgery, the incidence of rescue analgesic drug use, the doses of sufentanil in analgesic pumps, surgical rating scale (SRS) score, the incidence of postoperative residual neuromuscular block, postoperative recovery [evaluated with length of post anesthesia care unit (PACU) stay, time of first exhaust and defecation after surgery and length of hospital stay] and postoperative inflammation conditions [evaluated with serum concentration of interleukin (IL)-1ß and IL-6 at 1 d and 3 d after surgery]. Results: The incidence of moderate to severe pain in group D 1 h after surgery was 13.3% (8/60), lower than 30.0% (18/60) of group C (P<0.05). The incidence of rescue analgesia in group D at 1 h and 1 d after surgery were 13.3% (8/60) and 4.2% (5/120), respectively, lower than 30.0% (18/60) and 12.5% (15/120) of group C (both P<0.05). The IL-1ß level in group D was (4.1±1.8)ng/L at 1 d after surgery, which was lower than (4.9±2.6) ng/L of group C (P=0.048). The IL-6 level in group D was (2.0±0.7)ng/L at 3 d after surgery, which was lower than (2.4±1.1) ng/L of group C (P=0.018). There was no significant difference in the doses of sufentanil in analgesic pumps, intraoperative SRS score, incidence of neuromuscular block residue, time spent in PACU, time of first exhaust and defecation after surgery, incidence of nausea and vomiting, and length of hospitalization between the two groups (all P>0.05). Conclusion: DNMB combined with low pneumoperitoneum pressure anesthesia strategy alleviates the early-stage pain in patients after laparoscopic colorectal surgery.

MicroRNA-207 enhances radiation-induced apoptosis by directly targeting Akt3 in cochlea hair cells.

MicroRNAs (miRNAs) have important roles in various types of cellular biological processes. Our study aimed to determine whether miRNAs function in the regulation of ionizing radiation (IR)-induced cell death in auditory cells and to determine how they affect the cellular response to IR. Microarray and qRT-PCR were performed to identify and confirm the differential expression of miRNAs in the cochlea hair cell line HEI-OC1 and in vivo after IR. Upregulation or downregulation of miRNAs using miRNA mimics or inhibitor were detected to characterize the biological effects of the indicated miRNAs. Bioinformatic analyses, luciferase reporter assays and mRNA knockdown were performed to identify a miRNA target gene. We determined that miR-207 was significantly upregulated after IR. MiR-207 enhances IR-induced apoptosis and DNA damage in HEI-OC1 cells. Furthermore, Akt3 was confirmed to be a direct target of miR-207. Downregulation of Akt3 mimics the effects of miR-207. MiR-207 enhances IR-induced apoptosis by directly targeting Akt3 and anti-miR-207 may have a potential role in protecting cochlea hair cells from IR.

Analysis of the efficacy and prognosis of limb-salvage surgery for osteosarcoma around the knee.

AIM: Limb-salvage surgery has become the standard of care for extremity osteosarcoma. In this study, we investigated the survival and functional outcomes of patients with osteosarcoma around the knee who were treated with limb-salvage surgery. METHODS: We retrospectively reviewed the clinical data for 120 patients with osteosarcoma around the knee who were treated with limb-salvage surgery between 1998 and 2008. The sample included 75 males and 45 females. The mean age of the patients was 18.9 years. Osteosarcoma was diagnosed in the distal femur in 78 patients and in the proximal tibia in 42 patients. Statistical analyses were conducted to process and record the patient data and analyse the surgery's efficacy, prognosis and survival rates. RESULTS: All patients were followed for 6-144 months (mean of 56.8 months). The overall 5-year survival rate was 61.8%. Lung metastasis developed in 31 patients. Local recurrence developed in 9 patients. The average Musculoskeletal Tumor Society Score (MSTS) was 25.5 points on a 30-point scale. Sixteen patients underwent prosthesis revision and twelve patients underwent amputation. The overall survivorship of the prosthesis based on Kaplan-Meier estimates was 77% at five years and 71% at ten years. There was a higher incidence of extensor lag for the patients with osteosarcoma in the proximal tibia than for those with osteosarcoma in the distal femur (P < 0.01). CONCLUSIONS: Treating osteosarcoma around the knee with limb-salvage surgery can preserve most of the knee's functionality. Attention must be paid to prevent the relatively high incidence of postoperative complications.