Mechanism underlying long non­coding RNA ILF3­AS1­mediated inhibition of cervical cancer cell proliferation, invasion and migration, and promotion of apoptosis.

Long non­coding RNA ILF3 divergent transcript (ILF3­AS1) displays a tumor­suppressing effect. StarBase predicted that the potential target microRNA (miR) of ILF3­AS1 was miR­454­3p; therefore, the present study investigated the effect of ILF3­AS1 and its target miR­454­3p on cervical cancer (CC). Gene Expression Profiling Interactive Analysis was used to predict the expression of ILF3­AS1 in CC and the overall survival rate of patients. The present study demonstrated that ILF3­AS1 expression was significantly downregulated in human CC tissues and cells compared with adjacent tissues (ANTs) and normal cervical epithelial cells (NCEs), respectively. Patients with CC with high ILF3­AS1 expression displayed higher survival rates compared with patients with low ILF3­AS1 expression. Cell viability, apoptosis, migration and invasion were detected by performing Cell Counting Kit­8, flow cytometry, wound healing and Transwell assays, respectively. Compared with the negative control (NC) group, ILF3­AS1 overexpression significantly inhibited CC cell viability and migration, but significantly increased CC cell apoptosis. Moreover, ILF3­AS1 overexpression significantly upregulated E­Cadherin expression levels, but significantly downregulated N­Cadherin and snail family transcriptional repressor 1 expression levels compared with the NC group. miR­454­3p expression was negatively correlated with ILF3­AS1, and highly expressed in CC tissues and cells compared with ANTs and NCEs, respectively. PTEN, which was predicted and verified as the target gene for miR­454­3p, was significantly downregulated in CC tissues and cells compared with ANTs and NCEs, respectively. ILF3­AS1 expression was positively correlated with PTEN expression, and ILF3­AS1 overexpression partially reversed the inhibitory effect of miR­454­3p on PTEN expression. In conclusion, the present study indicated that ILF3­AS1 inhibited CC cell proliferation and migration, and promoted CC cell apoptosis by inhibiting epithelial­mesenchymal transition, and ILF3­AS1 overexpression partially reversed the inhibitory effect of miR­454­3p on PTEN expression.

The Effect and Optimal Dosage of Dexmedetomidine Plus Sufentanil for Postoperative Analgesia in Elderly Patients With Postoperative Delirium and Early Postoperative Cognitive Dysfunction: A Single-Center, Prospective, Randomized, Double-Blind, Controlled Trial.

BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are common complications after major surgery among elderly patients. Dexmedetomidine (DEX) is less frequently explored for its effects in patients with postoperative neurocognitive disorders. This study investigated the effect and optimal dosage of DEX for patient-controlled analgesia (PCA) on POD and early POCD after major surgery among elderly patients. METHODS: Patients in four groups received continuous infusion of DEX 0, 100, 200, and 400 µg with sufentanil 150 µg for PCA immediately after surgery. POD and POCD were assessed on postoperative days 1, 2, 3, and 7 by using the Confusion Assessment Method (CAM) and Mini-Mental State Examination (MMSE) scales. Furthermore, the incidence of POD and POCD of all the four groups in postoperative 7 days classified by high risk factors (age, education, surgical site, and surgical category), sedation level, postoperative pain intensity, and side effects were assessed. RESULTS: The overall incidence rates of POD and early POCD 7 days after surgery were lower in the DEX 200 µg 400 µg groups than in the DEX 0 µg and 100 µg groups (P < 0.05). Compared with DEX 200 µg, DEX 400 µg reduced early POCD in patients who underwent open surgery (P < 0.05). There were no intergroup differences in the postoperative sedation level, pain intensity, and side effects. CONCLUSION: The continuous infusion of DEX 200 µg or DEX 400 µg in PCA significantly decreased the incidence of POD and early POCD after major surgery without increasing any side effects. Compared with DEX 200 µg, DEX 400 µg was preferred for reducing early POCD in patients who underwent open surgery.

Combined use of transversus abdominis plane block and laryngeal mask airway during implementing ERAS programs for patients with primary liver cancer: a randomized controlled trial.

The incidence and mortality of primary liver cancer are very high and resection of tumor is the most crucial treatment for it. We aimed to assess the efficacy and safety of combined use of transversus abdominis plane (TAP) block and laryngeal mask airway (LMA) during implementing Enhanced Recovery After Surgery (ERAS) programs for patients with primary liver cancer. This was a prospective, evaluator-blinded, randomized, controlled parallel-arm trial. A total of 96 patients were enrolled (48 in each group). Patients in the control group received general anesthesia with endotracheal intubation, while patients in the TAP + LMA group received general anesthesia with LMA and an ultrasound-guided subcostal TAP block. The primary end-point was postoperative time of readiness for discharge. The secondary end-points were postoperative pain intensity, time to first flatus, quality of recovery (QoR), complications and overall medical cost. Postoperative time of readiness for discharge in the TAP + LMA group [7 (5-11) days] was shorter than that of the control group [8 (5-13) days, P = 0.004]. The postoperative apioid requirement and time to first flatus was lower in the TAP + LMA group [(102.8 ± 12.4) µg, (32.7 ± 5.8) h, respectively] than the control group [(135.7 ± 20.1) µg, P = 0.000; (47.2 ± 7.6) h, P = 0.000; respectively]. The QoR scores were significantly higher in the TAP + LMA group than the control group. The total cost for treatment in the TAP + LMA group [(66,608.4 ± 6,268.4) CNY] was lower than that of the control group [(84,434.0 ± 9,436.2) CNY, P = 0.000]. There was no difference in complications between these two groups. The combined usage of a TAP block and LMA is a simple, safe anesthesia method during implementing ERAS programs for patients with primary liver cancer. It can alleviate surgical stress, accelerate recovery and reduce medical cost.

HOE-642 improves the protection of hypothermia on neuronal mitochondria after cardiac arrest in rats.

HOE-642 has been shown to provide significant protection in a variety of models of cerebral and myocardial ischemia/reperfusion injury. In this study, we examined the impact of HOE-642, a selective Na+/H+ exchanger 1 inhibitor, with or without hypothermia on neuronal and neuronal mitochondrial function during resuscitation. Cardiac arrest was induced by 8 min of asphyxia in rats. Five groups were included in this study: sham; normothermia (N); HOE-642 (HOE, 1 mg/kg); hypothermia (Hypo, 33±0.5°C); and HOE-642 plus hypothermia (HOE+Hypo). Survival and neurological deficit scores (NDS) were evaluated after 24 h of resuscitation. ΔΨm, mitochondrial swelling, ROS production, mitochondrial complex I-IV activity, and ultrastructural changes of the hippocampal mitochondria were evaluated. Survival in the HOE+Hypo group (85.7%) was higher than in the N group (42.9%) and HOE group (31.8%), P<0.05. NDS in the Hypo and HOE+Hypo groups were lower than in the N and HOE groups, P<0.05. ΔΨm in the HOE group (2.7±0.9) were higher than in the N (1.3±0.3) and Hypo (1.4±0.4) groups, P<0.05. Mitochondrial swelling in the N group was severe than in the HOE and Hypo groups, P<0.05. The production of ROS in the HOE and HOE+Hypo groups were lower than in the N group, P<0.05. Complex I-IV activity in the HOE+Hypo group was higher than in the other groups. The ultrastructure of mitochondria in the N group was severely damaged. The mitochondria maintained structural integrity in the HOE, Hypo and HOE+Hypo groups. HOE-642 plus hypothermia during resuscitation was beneficial than HOE-642 or hypothermia alone.

Effect of flurbiprofen axetil on postoperative delirium for elderly patients.

OBJECTIVES: Proinflammatory cytokines triggered by surgery and postoperative pain are major causes of postoperative delirium (POD). This study investigated the effects of flurbiprofen axetil on POD when used for postoperative analgesia after major noncardiac surgery in elderly patients. METHODS: Patients over 65 years old were randomly divided into two groups: the sufentanil group (S group), in which 150 µg of sufentanil was used in the patient-controlled analgesia (PCA) pump for 3 days; the sufentanil combined with flurbiprofen axetil group (SF group), in which 150 µg of sufentanil was combined with 300 mg of flurbiprofen axetil in the PCA pump for 3 days. The Confusion Assessment Method scale was used for POD evaluation. The pain intensity, side effects, and risk factors (age, gender, surgical position, and category of surgery) for POD were evaluated. RESULTS: Ultimately, 140 patients were included. The overall incidence of POD was not significantly different between the S and SF groups. The incidence of POD was significantly lower in the SF group than in the S group among patients over 70 years (5.1% vs. 20.7%, p = 0.045, odds ratio = 0.146, 95% confidence interval = 0.020-1.041). The incidence of POD was no difference in patients classified by the category of surgery, surgical position, or gender between groups. Sufentanil and flurbiprofen axetil in the PCA pump was completely used within 72 hr. The pain intensity, consumed sufentanil dosage of the PCA, and the side effects was not different between groups. CONCLUSIONS: Flurbiprofen axetil might reduce POD in patients over 70 years undergoing major noncardiac surgery.

Exploration of the optimal dose of HOE-642 for the protection of neuronal mitochondrial function after cardiac arrest in rats.

INTRODUCTION: It has been demonstrated HOE-642 ameliorates ischemic contracture, prevents post-resuscitation diastolic dysfunction, and favors the earlier return of contractile function. This study is the first report to explore the optimal dose of HOE-642 in protecting the neuronal mitochondrial function after cardiac arrest. METHODS: Cardiac arrest was induced by 8 min asphyxia in rats. There were Sham (S), Normothermic (NORM), and Hypothermic (HYPO) groups. The NORM or HYPO groups consist of four subgroups: NORM/HYPO + HOE-642 0, 1, 3, and 5 mg/kg. Survival and NDS were evaluated after 24 h of resuscitation. ΔΨm, mitochondrial swelling, ROS production, and mitochondrial complex IIV activity of the hippocampus were detected. RESULTS: Survival in the HYPO + 1 mg group was the best and significantly higher than in the NORM + 0 mg and NORM + 1 mg groups. NDS in the HYPO + 0 mg, HYPO + 1 mg, and HYPO + 3 mg groups was significantly lower than in the NORM + 0 mg group. ΔΨm in the NORM + 1 mg (n = 5) group was significantly higher than in the NORM + 0 mg (n = 8), NORM + 3 mg (n = 5), and NORM + 5 mg (n = 5) groups. The ROS production in the NORM + 1 mg and NORM + 3 mg groups were significantly lower than in the NORM + 0 mg and NORM + 5 mg groups. Complex I and III activities in the HYPO + 1 mg (n = 5) group were significantly higher than in the HYPO + 3 mg (n = 5), and HYPO + 5 mg (n = 5) groups. Complex II and IV activities in the NORM + 3 mg and HYPO + 3 mg groups were significantly higher than in the NORM + 0 mg, NORM + 1 mg, and HYPO + 0 mg (n = 4)groups. CONCLUSIONS: HOE-642 1 or 3 mg/kg showed benefits compared to HOE-642 5 mg/kg used when initiating resuscitation. When combined with hypothermia after cardiac arrest, HOE-642 1 or 3 mg/kg improved survival and neurological function compared with hypothermia or HOE-642 alone, however, HOE-642 5 mg/kg plus hypothermia did not.

A prospective, randomized, double-blind, placebo-controlled trial of acute postoperative pain treatment using opioid analgesics with intravenous ibuprofen after radical cervical cancer surgery.

This study assessed the efficacy and tolerability of intravenous ibuprofen in the improvement of post-operative pain control and the reduction of opioid usage. Patients were randomly divided into placebo, ibuprofen 400 mg and ibuprofen 800 mg groups. All patients received patient-controlled intravenous morphine analgesia after surgery. The first dose of study drugs was administered intravenously 30 min before the end of surgery and then every 6 hours, for a total of 8 doses after surgery. The primary endpoint of this study was the mean amount of morphine used during the first 24 hours after surgery. Morphine use was reduced significantly in the ibuprofen 800 mg group compared with the placebo group (P = 0.04). Tramadol use was reduced significantly in the ibuprofen 400 mg and ibuprofen 800 mg groups compared with the placebo group (P < 0.01). The area under the curve of visual analog scale pain ratings was not different between groups. Safety assessments and side effects were not different between the three groups. Intravenous ibuprofen 800 mg was associated with a significant reduction in morphine requirements, and it was generally well tolerated for postoperative pain management in patients undergoing radical cervical cancer surgery.

Thickness measurement of frequency domain OCT on photoreceptor cell layer in diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To compare the outer nuclear layer ( ONL) , inner and outer segments (IS/OS), photoreceptor cell layer in healthy people and diabetic retinopathy by frequency-domain optical coherence tomography ( OCT) .·METHODS: Totally 100 eyes of 50 healthy people were selected as control group. According to conventional mydriasis for examination of fundus and fundus fluorescein angiography ( FFA ) examination, all diabetic cases were divided into 3 groups: normal retina group ( NDR ) , non - proliferative diabetic retinopathy group (NPDR), proliferative diabetic retinopathy group (PDR). Using OCT measure the thickness of ONL, IS/OS and photoreceptor cell layer of fovea and parafovea ( nasal side and temporal side) in the four groups.·RESULTS: Compared with the control group, the ONL and photoreceptor cell layer's thickness of macular fovea and temporal parafovea in NPDR group and PDR group were statistically significant(all P<0. 05). The differences between ONL and photoreceptor cell layer's thickness of macular fovea and temporal parafovea in NDR group and PDR group were not statistically significant(P>0. 05). The IS/OS of macular fovea and temporal parafovea was not significantly different among those groups (P>0. 05). The thickness of different layers of nasal parafovea were not different (P>0. 05).·CONCLUSION: The thickness of macular fovea and temporal parafovea has relation with degree of DR; the change of photoreceptor cell layer's thickness occurs mainly in ONL, but IS/OS no change; the change in temporal parafovea more obvious than in nasal parafovea. Frequency-domain OCT can quantitatively and qualitatively observe the subtle diabetic macular changes in diabetic patients with macular disease, and provides a reliable detection for the early diagnosis and treatment.