Objective:To evaluate the effect of intraoperative incision combined with local anesthesia in improving postoperative pain after retroperitoneal laparoscopic living donor nephrectomy.Methods:Using retrospective research methods, 28 donors who underwent hand-assisted retroperitoneal laparoscopic living donor nephrectomy at the Beijing Friendship Hospital, Capital Medical University from January 2018 to December 2020 were selected as the research group. Before the wound was sutured during the operation use 0.2% ropivacaine 20 mL+ 5 mg dexamethasone to block the transverse abdominis fascia and subcutaneously for infiltration anesthesia. The other 1∶1 matched 28 donors who had the same operation method but used on-demand systemic opioid analgesia after the operation as the control group. The demographic indicators (age, gender, body mass index, length of donor kidney), intraoperative conditions (intraoperative blood loss, operation time, warm ischemia time), 2, 12, 24, and 48 hours pain visual analogue scales(VAS) after operation were compared between the two groups of patients, postoperative systemic opioid demand rate, postoperative exhaust time, time to return to the ground, complication rate (postoperative bleeding, lung infection, lymphatic fistula, wound infection, intestinal obstruction), postoperative length of hospitalization and other information. Measurement data were expressed as mean±standard deviation ( Mean± SD), and independent sample t-test was used for comparison between groups; Chi-square test or Fisher exact probability method was used for comparison of count data between groups. Results:The pain VAS of the donors in the research group were significantly lower than those in the control group at 2 h, 12 h, 24 h, and 48 h after surgery (2 h: 1.6±1.0 vs 3.9±1.1; 12 h: 1.9±0.7 vs 3.1±1.0; 24 h: 1.6±0.5 vs 2.9±0.8; 48 h: 1.2±0.5 vs 2.3±0.8; P<0.05). The donors in the research group postoperative morphine requirement rate was also significantly lower than that of the control group (0 vs 21.4%), and the postoperative recovery time was significantly earlier than that of the control group [(25.7±4.5) h vs (30.6±6.6) h], the difference was statistically significant ( P<0.05). Lymphatic fistula was the main postoperative complication. There was no statistically significant difference between the research group and the control group (14.3% vs 25.0%) ( P>0.05). Conclusion:Intraoperative incision transversus abdominis fascia and subcutaneous combined local block anesthesia can effectively reduce the pain after laparoscopic donor nephrectomy, reduce the use of opioids, promote early postoperative activities of the donor, and will not increase postoperative complications incidence rate.

Objective    To compare the clinical efficacy between right visual double lumen tube (VDLT) intubation and right common double lumen tube (DLT) intubation in lung isolation technique. Methods    A total of 57 patients undergoing thoracoscopic surgery with right DLT lung isolation technique in the First People's Hospital of Chenzhou City and West China Hospital from June 2020 to June 2021 were randomly divided into two groups: a DLT group (n=29, 16 males and 13 females, with a mean age of 54.3±13.2 years) and a VDLT group (n=28, 18 males and 10 females, with a mean age of 55.1±13.7 years) at 1 : 1 with random number table generated by the computer. The clinical data of the two groups were compared. Results    Compared with the DLT group, the catheter positioning time in the VDLT group was statistically shorter (74.9±47.5 s vs. 151.6±88.9 s, P<0.001), the right upper lung occlusion rate (21.4% vs. 51.7%) and the intraoperative re-adjustment catheterization rate (14.3% vs. 48.3%) were lower (P<0.05). The quality of lung collapses immediately after thoracotomy (67.9% vs. 24.1%) and 20 minutes after thoracotomy (100.0% vs. 75.9%) were improved (P<0.05). There was no significant difference in the rate of fiberoptic bronchoscope assistance for positioning, or the incidence of pharynx pain and hoarseness between the two groups (P>0.05). Conclusion    Compared  with common DLT, VDLT is more efficient, accurate and intuitive in the location of right bronchial intubation.

OBJECTIVETo evaluate the published data on association between present/null polymorphism of glutathione S-transferase M1 (GSTM1) and breast cancer risk in Chinese population in order to abttain a more precise and comprehensive estimation of the relationship.

METHODSA meta-analysis was performed to investigate the association between GSTM1 polymorphism and susceptibility to breast cancer in Chinese population by searching Pubmed, Embase, Cochrane library, CNKI, VIP, Wanfang and CBD database. The data were screened according to the inclusion and exclusion criteria, and extracted, and the quality of included studies was evaluated. The pooled odds ratios (OR) with 95% confidence intervals (95%CI) were calculated using RevMan 5.2 and Stata 12.0 software. Publication bias and sensitivity analysis were also assessed.

RESULTSA total of 15 case-control studies involving 5,176 cases and 5 890 controls were included in the meta-analysis. The results showed that individuals with GSTM1 null genotype harbored a significantly increased risk of breast cancer compared to that with GSTM1 non-null genotype in Chinese population (OR=1.34, 95%CI=1.12-1.60, P=0.002). The subgroup analysis by region revealed that the individuals with GSTM1 null genotype were significantly associated with an increased risk of breast cancer in southern and northern China populations (southern: OR=1.14, 95%CI=1.01-1.28, P=0.03; northern: OR=2.65, 95%CI=2.04-3.34, P<0.01).

CONCLUSIONThe current meta-analysis demonstrates that the GSTM1 polymorphism is significantly associated with susceptibility to breast cancer in Chinese population, and the GSTM1-deficit may increase the risk of breast cancer.

Asian Continental Ancestry Group ; genetics ; Breast Neoplasms ; genetics ; Case-Control Studies ; China ; Confidence Intervals ; Female ; Gene Deletion ; Genetic Predisposition to Disease ; Genotype ; Glutathione Transferase ; genetics ; Humans ; Odds Ratio ; Polymorphism, Genetic