Objective To investigate the efficacy of fascia iliaca compartment block combined with general anesthesia for total hip arthroplasty.Methods Fifty patients underwent total hip arthroplasty were divided into trial group or control group by random digits table method with 25 cases each.Preoperatively,both groups were given fascia iliaca compartment block with the trial group receiving 60 ml 0.25％ ropivacaine and the control group receiving 60 ml 0.9％ sodium chloride.Both groups received general anesthesia.The consumption of general anesthetics and intraoperative hemodynamic variation in the 2 groups were recorded.The recovery time,extubation time,observer's assessment of alertness/sedation score (modified OAA/S) at 15 and 30 min postoperative and visual analog score (VAS) at postoperative instantly were compared between the 2 groups.Results The consumptions of propofol and remifentanil during maintenance of anesthesia in trial group were significantly lower than those in control group,and there were statistical differences:(250 ± 40) mg vs.(420 ± 85) mg and (300 ± 50) μ g vs.(600 ± 150) μ g,P ＜ 0.01.The recovery time and extubation time in trial group were significantly shorter than those in control group,and there were statistical differences:(7.2 ± 4.5) min vs.(16.2 ± 7.1) min and (8.0 ± 2.8) min vs.(20.0 ± 8.3) min,P ＜ 0.01.The modified OAA/S at 15 and 30 min postoperative in trial group were significantly higher than those in control group,and there were statistical differences:(4.3 ± 0.3) scores vs.(3.0 ± 1.2) scores and (4.6 ± 0.2) scores vs.(3.9 ± 0.8) scores,P ＜ 0.01.The VAS at postopcrative instantly in trial group was significantly lower than that in control group,there was statistical difference:(1.6 ± 0.9) scores vs.(4.5 ± 0.8)scores,P ＜ 0.01.The degree of satisfaction in trial group was better than that in control group,and there was statistical difference (P ＜ 0.05).Conclusion Compared with general anesthesia alone for total hip arthroplasty,the fascia iliaca compartment combined with general anesthesia has better hemodynamic stability,marked reduction of consumption of general anesthetics,rapid recovery and good postoperative analgesia.

[ ABSTRACT] AIM:To explore the role of SHARPIN in regulation of Rip1 in castration-resistant prostate cancer LNCaP-AI cells.METHODS:The LNCaP-AI cells were treated with TNF-α+Z-VAD ( an inhibitor of pan-caspase) to activate necroptosis, which were compared to the cells treated with TNF-α+Z-VAD+Nec-1 ( an inhibitor of Rip1 ) .A blank group and a TNF-α-treated group were set up as controls.The cell viability in each group was measured by MTS as-say.In addition, SHARPIN was knocked down by siRNA, and the inhibitory efficiency was evaluated by RT-qPCR.The expression of Rip1 at mRNA and protein levels after knocking down SHARPIN was determined by RT-qPCR and Western blot to explore the underlying mechanism of regulatory network of necroptosis in prostate cancer.RESULTS: Compared with blank control group and TNF-α-treated group, the viability of LNCaP-AI cells treated with TNF-α+Z-VAD decreased by 28%(P<0.05).After treated with TNF-α+Z-VAD+Nec-1, the LNCaP-AI cells showed no significant difference in the viability compared with blank control and TNF-α-treated groups.Taken together, necroptosis may be an important way of cell death in LNCaP-AI cells.Besides, the expression of Rip1 at protein level was up-regulated following the inhibition of SHARPIN using siRNA, indicating that down-regulation of SHARPIN enhanced necroptosis via activating Rip1 in
LNCaP-AI cells.CONCLUSION:Necroptosis is an important way of cell death .Inhibition of oncogenic factor SHARPIN enhances necroptosis via activating Rip1 in LNCaP-AI cells.