Remifentanil reduces the proliferation, migration and invasion of HCC cells via lncRNA NBR2/miR-650/TIMP3 axis.

Cancer cell hyperproliferation and metastasis are major causes of cancer-associated mortality. Although the use of anaesthetics and analgesics may affect cancer cell metastasis, the underlying molecular mechanism remains unclear. This study aimed to explore the mechanisms of action of remifentanil on hepatocellular carcinoma (HCC) progression. Cell viability was measured by the 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-h-tetrazolium bromide assay. Quantitative real-time polymerase chain reaction and Western blotting were performed to assess the expression levels of long non-coding RNA (lncRNA) neighbour of BRCA1 gene 2 (NBR2), microRNA (miR)-650 and tissue inhibitor of metalloproteinase-3 (TIMP3) in HCC cells. Wound healing and transwell assays were employed to evaluate the migration and invasion of HCC cells respectively. The target relationships between miR-650 and NBR2/TIMP3 were confirmed by dual luciferase reporter assay. Remifentanil reduced the viability of HCC cells in a dose-dependent manner. Remifentanil treatment significantly increased the expression of lncRNA NBR2 and TIMP3, and repressed miR-650 expression in HCC cells. Decreased lncRNA NBR2 or increased miR-650 promoted the proliferation, migration and invasion of remifentanil-treated HCC cells. LncRNA NBR2 targeted miR-650, and miR-650 further targeted TIMP3. Moreover, miR-650 down-regulation or TIMP3 up-regulation reversed the effects of lncRNA NBR2 knockdown that caused an enhancement of cell viability, migration and invasiveness in remifentanil-treated HCC cells. Thus remifentanil reduces the proliferation, migration and invasion of HCC cells via the lncRNA NBR2/miR-650/TIMP3 axis in vitro.

Evaluation of Ultrasound-guided Genitofemoral Nerve Block Combined with Ilioinguinal/iliohypogastric Nerve Block during Inguinal Hernia Repair in the Elderly.

To evaluate the anesthetic effect of ultrasound-guided (USG) ilioinguinal/iliohypogastric nerve (II/IHN) block combined with genital branch of genitofemoral nerve (GFN) block in the elderly undergoing inguinal hernia repair, 54 old patients (aged 60-96years, ASA I-III) with indirect hernia were enrolled and scheduled for unilateral tension-free herniorrhaphy. Patients were grouped randomly to receive either USG II/IHN plus GFN block (Group G) or USG II/IHN block alone (Group I). The intraoperative visual analogue scale (VAS) scores were recorded at skin incision, at spermatic cord/round ligament traction and at sac ligation. The resting and dynamic VAS scores were recorded postoperatively. The requirements of extra sedatives and analgesics for intra- and postoperative analgesia were assessed. Occurrence of complications of the block, postoperative nausea and vomiting and femoral nerve palsy was also reported. Both groups showed similar sensory block. When stretching spermatic cord/round ligament, the patients in group G had significantly lower VAS scores than in group I. And group G used much fewer adjuvant sedatives and analgesics to achieve adequate anaesthesia. In addition, group G was presented with better intraoperative anaesthesia and lower postoperative dynamic VAS scores at all time points tested. No significant difference was found in the postoperative requirement of rescue medication. Both groups showed no complications related to the block and group G reported no femoral nerve palsy. The addition of GFN block to II/IHN block improves the quality of perioperative anesthesia and analgesia in the elderly and reduces the consumption of extra sedatives and analgesics during the surgery.

[Comparison the applications of tracheal intubation with GlideScope video laryngoscope and Macintosh direct laryngoscope in snoring patients].

OBJECTIVE: To compare the efficacy and safety of applications of GlideScope video laryngoscope (GSVL) and Macintosh direct laryngoscope (MDLS) during endotracheal intubation under general anesthesia of abdominal snoring surgeries. METHOD: Forty patients ranged from American Society of Anesthesiologists I to II scheduled for snoring surgery under general anesthesia with endotracheal intubation were randomly divided into GSVL group and MDLS group (20 cases in each group), After traditional induction, endotracheal intubation (ETT) performed by GSVL or MDLS. Glottic exposure, the time of endotracheal intubation(from mask ventilation ending to successful intubation), the times of tracheal intubation operation were recorded in both groups. The mean artery pressure(MAP), heart rate(HR) were monitored before induction (basic value T0), before tracheal intubation (T1), after tracheal intubation (T2), 1 min after tracheal intubation (T3), 3 mins after tracheal intubation (T4). RESULT: The glottic exposure of GSVL group is superior to that of MDLS group. There was no significant difference in the time of tracheal intubation between MDLS group (27 +/- 11)s and GSVL group (26 +/- 11)s (P < 0.05). Compared with T0, MAP of T1 was lower in two groups (P < 0.05), while HR were similar both in two groups (P > 0.05). MAP of T2 and T3 increased and HR became faster (P < 0.05). MAP of T4 declined, but HR still increased (P < 0.05). Between the two groups, there was no significant difference of MAP or HR (P > 0.05). CONCLUSION: Compared with MDLS,the GSVL is of benefit to improve the glottic exposure in endotracheal intubation to the snoring patients,so as to improve the success rate of tracheal intubation. But there is no obvious advantages via GSVL in preventing hemodynamic reaction during tracheal intubation.

[The effect of dexmedetomidine on post-operative blood pressure after controlled hypotension in endoscopic sinus surgery].

OBJECTIVE: To observe the variance of blood pressure (BP) after controlled hypotension in endoscopic sinus surgery with dexmedetomidine. METHOD: Sixty patients undergoing elective endoscopic sinus surgery were randomly assigned to receive dexmedetomidine (Group D) or physiological saline (Group S). For the two groups, after the same induction of anesthesia procedure, Group D were injected with dexmedetomidine with 0.8 microg/kg of priming dose in 10 min and 0.5 microg/(kg x h) of maintenance dose i. v. drip for 30 min. The Group S were injected with physiological saline in the dose the same as Group D. The measurement of the mean aortic pressure(MAP), heart rate (HR) and the colouration of the Nasal packing material and exudation were taken at the end of the surgery (T1), at the time of extubation (T2), 10 min after extubation (T3), 30 min after extubation (T4), 2 h after extubation (T5), and 4 h after extubation (T6). RESULT: The MAP and HR of Group S at the points T2-T6 were significantly higher compared with those at the point T1 (P < 0.05). The MAP and HR of Group D at each time point did not change significantly (P > 0.05). The MAP and HR of Group S at each time point were higher compared with Group D (P < 0.05). The number of cases with postoperative nasal exudate in Group S was significantly more than in Group D (27:18) (P < 0.05). CONCLUSION: The perioperative dexmedetomidine medication can significantly reduce fluctuations in BP in endoscopic sinus surgery, so that to stable hemodynamics and reduce nasal bleeding.