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Lone-Star retractor perineal exposure method for laparoscopic abdominal perineal resection of rectal cancer

World Journal of Gastrointestinal Surgery 2024年第8期16卷 2528-2537页

作者： Jun Ma Dai-Bin Tang Yu-Quan Tang Da-Tian Wang Peng Jiang Ya-Ming Zhang department of general Surgery Anqing Municipal HospitalAnqing 246000Anhui ProvinceChina department of anesthesiology Anqing Municipal HospitalAnqing 246000Anhui ProvinceChina

BACKGROUND The abdominal perineal resection(APR),historically referred to as Mile’s proce-dure,stands as a time-honored surgical intervention for rectal cancer *** in surgical techniques and the advent of neoadjuvant therapies have significantly improved the rate of sphincter preservation among patients afflicted with rectal cancer,including those with ultralow rectal *** these improvements,APR maintains its irreplaceable role in the clinical landscape,particularly for cases involving low rectal cancer with encroachment on the external anal sphincter or levator ani *** perineal exposure stands as a pivotal phase in APR,given that the precision of this maneuver is directly correlated with both the safety of the surgery and the patient’s subse-quent long-term *** To evaluate the value of Lone-Star retractor(LSR)perineal exposure method in the treatment for laparoscopic APR of rectal *** We reviewed the records of 38 patients with rectal cancer at Anqing Municipal Hospital from January 2020 to December 2023,including 20 patients who underwent the APR procedure with a LSR perineal exposure method(LSR group)and 18 patients who underwent the APR procedure with a conventional perineal exposure method(control group).In the LSR group,following incision of the skin and subcutaneous tissue,the LSR was placed and dynamically adjusted according to the surgical plane to fully expose the perineal operative *** A total of 38 patients underwent laparoscopic APR,none of whom were found to have distant metastasis upon intraoperative *** blood loss,the postoperative hospital stays and the wound pain scores in the LSR group were significantly lower than those in the control group.A single surgeon completed the perineal operation significantly more often in the LSR group than in the control group(P<0.05).The incidence of infection via the perineal incision in the LSR group was significantly lower

关键词： Rectal cancer Lone-Star retractor Abdominal perineal resection Perineal exposure method Technique

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Clinical observation of gastrointestinal function recovery in patients after hepatobiliary surgery

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 76-84页

作者： Hua-Jun Zeng Jing-Jing Liu Ying-Chun Yang department of general Practice Nanyang First People's HospitalNanyang 473000Henan ProvinceChina department of anesthesiology Chinese People’s Armed Police Force Hospital of BeijingBeijing 100027China department of anesthesiology Beijing Fengtai HospitalBeijing 100071China

BACKGROUND The liver is an important metabolic and digestive organ in the human body,ca-pable of producing bile,clotting factors,and *** To investigate the recovery of gastrointestinal function in patients after hepato-biliary surgery and identify effective rehabilitation *** A total of 200 patients who underwent hepatobiliary surgery in our hospital in 2022 were selected as the study *** were divided into a control group and a study group based on the extent of the surgery,with 100 patients in each *** control group received routine treatment,while the study group re-ceived targeted interventions,including early enteral nutrition support,drinking water before gas discharge,and large bowel enema,to promote postoperative gastrointestinal function *** recovery of gastrointestinal function was compared between the two *** Compared with the control group,patients in the study group had better recovery of bowel sounds and less accumulation of fluids in the liver bed and gallbladder fossa(P<0.05).They also had shorter time to gas discharge and first meal(P<0.05),higher overall effective rate of gastrointestinal function recovery(P<0.05),and lower incidence of postoperative complications(P<0.05).CONCLUSION Targeted nursing interventions(early nutritional support,drinking water before gas discharge,and enema)can effectively promote gastrointestinal function recovery in patients undergoing hepatobiliary surgery and reduce the incidence of complications,which is worthy of promotion.

关键词： Liver and gallbladder patients Gastrointestinal function Postoperative recovery

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Remazolam combined with transversus abdominis plane block in gastrointestinal tumor surgery:Have we achieved better anesthetic effects?

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World Journal of Gastrointestinal Oncology 2024年第8期16卷 3368-3371页

作者： Jing Cao Xing-Liao Luo Qiang Lin department of anesthesiology North China Petroleum Bureau General HospitalRenqiu 062552Hebei ProvinceChina department of Oncology North China Petroleum Bureau General HospitalHebei Medical UniversityRenqiu 062552Hebei ProvinceChina

Laparoscopic surgery is the main treatment method for patients with gastrointestinal malignant *** laparoscopic surgery is minimally invasive,its tool stimulation and pneumoperitoneum pressure often cause strong stress reactions in *** the other hand,gastrointestinal surgery can cause stronger pain in patients,compared to other *** abdominis plane block(TAPB)can effectively inhibit the transmission of nerve impulses caused by surgical stimulation,alleviate patient pain,and thus alleviate stress *** is an acting,safe,and effective sedative,which has little effect on hemodynamics and is suitable for most *** combined with remazolam can reduce the dosage of total anesthetic drugs,reduce adverse reactions,reduce stress reactions,and facilitate the rapid postoperative recovery of patients.

关键词： Transversus abdominis plane block Remazolam Hemodynamics Gastrointestinal tumor surgery Oxidative stress

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Tissue-resident macrophages exacerbate lung injury after remote sterile damage

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Cellular & Molecular Immunology 2024年第4期21卷 332-348页

作者： Hanhui Zhong Jingjing Ji Jinling Zhuang Ziying Xiong Pengyun Xie Xiaolei Liu Jundi Zheng Wangli Tian Xiaoyang Hong Jing Tang The department of anesthesiology Affiliated Hospital of Guangdong Medical UniversityZhanjiangGuangdongChina The department of Critical Care Medicine General Hospital of Southern Theater Command of PLAGuangzhouChina The department of Respiratory Medicine Guangdong Provincial Hospital of Integrated Chinese and Western MedicineFoshanChina Pediatric Intensive Care Unit Senior Department of Pediatricsthe Seventh Medical Center of PLA General HospitalBeijingChina

Remote organ injury,which is a common secondary complication of sterile tissue damage,is a major cause of poor prognosis and is difficult to ***,we report the critical role of tissue-resident macrophages in lung injury after trauma or stroke through the inflammatory *** found that depleting tissue-resident macrophages rather than disrupting the recruitment of monocyte-derived macrophages attenuated lung injury after trauma or *** findings revealed that the release of circulating alarmins from sites of distant sterile tissue damage triggered an inflammatory response in lung-resident macrophages by binding to receptor for advanced glycation end products(RAGE)on the membrane,which activated epidermal growth factor receptor(EGFR).Mechanistically,ligand-activated RAGE triggered EGFR activation through an interaction,leading to Rab5-mediated RAGE internalization and EGFR phosphorylation,which subsequently recruited and activated P38;this,in turn,promoted RAGE translation and trafficking to the plasma membrane to increase the cellular response to RAGE ligands,consequently exacerbating *** study also showed that the loss of RAGE or EGFR expression by adoptive transfer of macrophages,blocking the function of RAGE with a neutralizing antibody,or pharmacological inhibition of EGFR activation in macrophages could protect against trauma-or stroke-induced remote lung ***,our study revealed that targeting the RAGE-EGFR signaling pathway in tissue-resident macrophages is a potential therapeutic approach for treating secondary complications of sterile damage.

关键词： tissue-resident macrophage RAGE remote sterile damage

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Metabolomic Analysis in Saliva and Different Brain Regions of Older Mice with Postoperative Delirium Behaviors

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Biomedical and Environmental Sciences 2024年第2期37卷 133-145页

作者： LIU Xiao CAO Ying LIN Xiao Wan GAO Dan Yang MIAO Hui Hui LI Tian Zuo department of anesthesiology Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China

Objective Postoperative delirium(POD)has become a critical challenge with severe consequences and increased incidences as the global population ***,the underlying mechanism is yet *** study aimed to explore the changes in metabolites in three specific brain regions and saliva of older mice with postoperative delirium behavior and to identify potential non-invasive *** Eighteen-month-old male C57/BL6 mice were randomly assigned to the anesthesia/surgery or control *** tests were conducted 24 h before surgery and 6,9,and 24 h after *** C3(C3)and S100 calcium-binding protein B protein(S100beta)levels were measured in the hippocampus,and a metabolomics analysis was performed on saliva,hippocampus,cortex,and amygdala *** In total,43,33,38,and 14 differential metabolites were detected in the saliva,hippocampus,cortex,and amygdala,respectively.“Pyruvate”“alpha-linolenic acid”and“2-oleoyl-1-palmitoy-snglycero-3-phosphocholine”are enriched in one common pathway and may be potential non-invasive biomarkers for *** changes were observed in the three brain regions,with the upregulation of 1-methylhistidine and downregulation of *** Dysfunctions in energy metabolism,oxidative stress,and neurotransmitter dysregulation are implicated in the development of *** identification of changes in the level of salivary metabolite biomarkers could aid in the development of noninvasive diagnostic methods for POD.

关键词： Metabolomic Postoperative delirium(POD) Mechanism Biological marker

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Autophagy in neuroinflammation after traumatic brain injury

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Neural Regeneration Research 2024年第5期19卷 951-952页

作者： Chinmoy Sarkar Marta M.Lipinski Shock Trauma and Anesthesiology Research(STAR)CenterDepartment of AnesthesiologyUniversity of Maryland School of MedicineBaltimoreMDUSA department of Anatomy and Neurobiology University of Maryland School of MedicineBaltimoreMDUSA

Traumatic brain injury(TBI)is an acquired injury of the brain caused by the impact of external forces on the brain(Maas et al.,2008).It is a major cause of death and disability among people of all ages(Maas et al.,2008).The primary mechanical injury to the brain initiates a cascade of secondary biochemical events that lead to acute and chronic neurodegeneration and activation of inflammatory pathways(Maas et al.,2008).Both brain-resident microglia and blood-derived myeloid cells-macrophages and monocytes that infiltrate the brain due to injury-induced blood-brain barrier damage,contribute to the inflammatory responses after TBI(Morganti et al.,2015).

关键词： damage death after

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Clinical significance of preoperative nutritional status in elderly gastric cancer patients undergoing radical gastrectomy:A singlecenter retrospective study

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2211-2220页

作者： Xi-Ning Zhao Jing Lu Hong-Yong He Sheng-Jin Ge department of anesthesiology Zhongshan HospitalFudan UniversityShanghai 200032China department of Nursing Zhongshan HospitalFudan UniversityShanghai 200032China department of general Surgery/Emergency Surgery Zhongshan HospitalFudan UniversityShanghai 200032China

BACKGROUND The population of elderly patients with gastric cancer is increasing,which is a major public health issue in *** is one of the greatest risk factors for adverse clinical outcomes in elderly patients with gastric *** To investigate the preoperative nutritional status and its association with delayed discharge of elderly gastric cancer patients following radical *** A total of 783 patients aged 65 years and older harboring gastric adenocarcinoma and following radical gastrectomy were retrospectively analyzed from the prospectively collected database of Zhongshan Hospital of Fudan University between January 2018 and May *** The overall rate of malnutrition was 31.8%.The incidence of postoperative complications was significantly higher in the malnourished group compared to the well-nourished group(P<0.001).Nutritional characteristics in the malnourished group,including body mass index,prognostic nutritional index(PNI),albumin,prealbumin,and hemoglobin,were all significantly lower than those in the well-nourished *** percentage of patients who received postoperative total nutrient admixture was lower in the malnourished group compared to the wellnourished group(22.1%vs 33.5%,P=0.001).Age≥70 years(HR=1.216,95%CI:1.048-1.411),PNI<44.5(HR=1.792,95%CI:1.058-3.032),operation time≥160 minutes(HR=1.431,95%CI:1.237-1.656),and postoperative complications grade III or higher(HR=2.191,95%CI:1.604-2.991)were all recognized as independent risk factors associated with delayed *** Malnutrition is relatively common in elderly patients undergoing *** PNI is an independent risk factor associated with delay *** strategies are needed to improve the clinical outcome of these patients.

关键词： Gastric cancer Preoperative nutritional status Malnutrition Elderly Radical gastrectomy

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Analgesic and anti-inflammatory activity of Cotinus coggygria *** in vivo

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Asian Pacific Journal of Tropical Biomedicine 2024年第6期14卷 225-235页

作者： Kai Lu Chong-Yu Yang Zhao-Hong Yan department of anesthesiology Qiantang Campus Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhou310018China department of anesthesiology 3201 HospitalHanzhong723000China department of anesthesiology The Second Affiliated Hospital of the Chinese People’s Liberation Army Air Force Medical UniversityXi’an710038China

Objective:To assess the analgesic and anti-inflammatory effects of standardized extract of Cotinus coggygria(***)in different animal ***:*** extracts(25,50,and 100 mg/kg)were administered to rats and mice(n=6)during hot plate,tail-flick,acetic acid-induced writhing,and formalin tests to determine its analgesic *** anti-inflammatory activity of *** extracts was evaluated by histamine and carrageenan-induced paw edema,cotton pellet-induced granuloma,and acetic acid-induced peritoneal capillary dye leakage ***:*** extracts(50 and 100 mg/kg)significantly alleviated thermal and chemical-induced pain in rodents(P<0.05).It also demonstrated notable anti-inflammatory properties by mitigating histamine and carrageenan-induced paw edema,granuloma deposits,and vascular permeability(P<0.05).Moreover,*** extracts remarkably reduced TNF-α,IL-1β,IL-6,COX-2,and oxidative stress in rat paws(P<0.05).Carrageenan-induced histological aberrations in hind paw tissues were effectively(P<0.05)mitigated by treatment with *** ***:*** *** show analgesic and anti-inflammatory effects via inhibition of COX-2 and inflammatory and oxidative mediators.

关键词： Antioxidant Carrageenan Cotinus coggygria Scop. Anti-inflammatory Analgesic Pain TNF-α Fustin

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Therapeutic nucleic acids in regenerative medicine and tissue repair

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Nano Research 2024年第10期17卷 8942-8976页

作者： Qimanguli Saiding Duotian Qin Soohwan An Dylan Neal Patel Muhammad Muzamil Khan Na Kong Wei Tao Center for Nanomedicine and department of anesthesiology Brigham and Women’s HospitalHarvard Medical SchoolBostonMassachusetts 02115USA

In the vanguard of biomedical innovation,regenerative medicine emerges as a transformative paradigm,concentrating its efforts on rectifying tissue deficits and functional aberrations in patients through the strategic augmentation of endogenous cellular *** to this approach is nucleic acid therapy,which offers a novel pathway for tissue regeneration by modulating key signaling *** one of the most effective ways to regulate cell function,nucleic acids are crucial for various tissue regeneration;however,their in vivo therapeutic applications face substantial challenges,including nuclease degradation,cell membrane impermeability,and targeted intracellular ***-based gene delivery systems offer a solution for stable and localized drug delivery by enabling the controlled overexpression of therapeutic nucleic acids,producing functional regulatory *** review presents examples of nucleic acid applications in regenerative medicine,highlighting the synergy between nucleic acids and biomaterial *** underlines the importance of nucleic acid delivery techniques,the choice of therapeutic nucleic acids,and biomaterials for advancing tissue *** latest developments in designing nucleic acid biomaterial-based delivery vehicles are explored,the mechanism of nucleic acids in tissue regeneration is elucidated,and their limitations are discussed while considering future directions for the clinical translation of nucleic acid-based therapeutics.

关键词： tissue repair nucleic acids biomaterials delivery systems regenerative medicine

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Single-center experience with Knee+^(TM) augmented reality navigation system in primary total knee arthroplasty

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World Journal of Orthopedics 2024年第3期15卷 247-256页

作者： Evangelos Sakellariou Panagiotis Alevrogiannis Fani Alevrogianni Athanasios Galanis Michail Vavourakis Panagiotis Karampinas Panagiotis Gavriil John Vlamis Stavros Alevrogiannis The 3^(rd)department of Orthopaedic Surgery National&Kapodistrian University of AthensKAT General HospitalAthens 14561Greece The 1^(st)department of Orthopaedic Surgery National&Kapodistrian University of AthensAttikon General HospitalAthens 14561Greece department of anesthesiology KAT General HospitalAthens 14561Greece department of Robotic Hip&Knee Orthopaedic Surgery Metropolitan General HospitalAthens 14561Greece

BACKGROUND Computer-assisted systems obtained an increased interest in orthopaedic surgery over the last years,as they enhance precision compared to conventional *** expansion of computer assistance is evolving with the employment of augmented ***,the accuracy of augmented reality navigation systems has not been *** To examine the accuracy of component alignment and restoration of the affected limb’s mechanical axis in primary total knee arthroplasty(TKA),utilizing an augmented reality navigation system and to assess whether such systems are conspicuously fruitful for an accomplished knee *** From May 2021 to December 2021,30 patients,25 women and five men,under-went a primary unilateral *** cases were excluded.A preoperative radiographic procedure was performed to evaluate the limb’s axial *** patients were operated on by the same team,without a tourniquet,utilizing three distinct prostheses with the assistance of the Knee+™augmented reality navigation system in every ***,the same radiographic exam protocol was executed to evaluate the implants’position,orientation and coronal plane *** recorded measurements in 3 stages regarding femoral varus and flexion,tibial varus and posterior ***,the expected values from the Augmented Reality system were *** we calculated the same values after each cut and finally,the same measurements were recorded radiolo-gically after the *** statistical analysis,Lin’s concordance correlation coefficient was estimated,while Wilcoxon Signed Rank Test was performed when *** A statistically significant difference was observed regarding mean expected values and radiographic mea-surements for femoral flexion measurements only(Z score=2.67,P value=0.01).Nonetheless,this difference was statistically significantly lower than 1 degree(Z score=-4.21,P value<0.01).In terms of discrepancies in the calculations of

关键词： Augmented reality Orthopedics Total knee arthroplasty Robotics Knee Navigation

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