Objective To compare the degree of pain in patients after radical gastrectomy under different anesthetic regimens.Methods One hundred and two ASA Ⅰ or Ⅱ patients of both sexes,aged 50-75 yr,weighing 45-70 kg,undergoing elective radical gastrectomy,were randomly divided into 3 groups ( n =34 each):general anesthesia (GA) group,combined general-subcostal transversus abdominis plane block (CGTA) group and combined general-epidural anesthesia (CGEA) group.The patients were sent to the postanesthesia care unit (PACU) after tracheal extubation,and the VAS score on arrival in the PACU was recorded.The degree of pain was evaluated by VAS score,and when VAS scores ＞ 3,the patients received intravenous morphine titration.When VAS scores ≤ 3,morphine titration was stopped and all the patients were connected to patient-controlled intravenous analgesia and/or epidural analgesia pump.The total amount of morphine consumed was recorded at the end of titration,and the occurrence of adverse reactions was also observed.Results Compared with groups GA and CGTA,the incidence of moderate to severe postoperative pain was significantly decreased in group CGEA (P ＜0.01).The incidence of severe postoperative pain,the VAS score on arrival in the PACU and the total amount of morphine consumed were decreased gradually in groups GA,CGTA and CGEA ( P ＜ 0.01 ).The incidence of sedation was significantly lower in group CGEA than in group GA (P ＜ 0.01 ).There were no significant differences in the other adverse reactions among the three groups ( P ＞ 0.05 ).Conclusion The degree of pain is reduced gradually in patients after radical gastrectomy under GA,CGTA and CGEA.

Objective To investigate the therapeutic effects of cFLIP-siRNA tail venous injection on acute necrotizing pancre.atitis (ANP) rats,and explore the related mechanism.Methods Three pairs of cFLIP siRNAs (cFLIP-siRNA) and negative control(siRNA-NC) were designed and synthesized.The most effective siRNA to inhibit the expression of cFLIP gene was selected for the experiment.Thirty SD rats were treated with retrograde pancreaticobiliary duct injection of 5％ taurocholic acid sodium salt solution to establish ANP rat model.They were randomly divided into ANP group,siRNA-NC group and cFLIP-siRNA group with l0 rats in each group using random number method.The same volume of normal saline,siRNA-NC and cFLIP-siRNA were injected into tail vein,respectively.The rats were sacrificed after 24 h and the blood samples were colelcted.The levels of serum amylase and endotoxin were measured.The pancreatic tissues were collected and routine pathological examination was performed.The expressions of cFLIP-S and caspase-8 protein in pancreatic tissues were detected by immunohistochemistry and Western blotting.Results The levels of serum amylase in ANP group,siRNA-NC group and cFLIP-siRNA group were (1 286 ± 209),(1 297 ± 305) and (552± 256)U/L,the level of serum endotoxin were (136± 32),(128± 56) and (46± 23)ng/L,respectively.The pancreatic pathological scores were (4.97 ± 1.16),(4.92 ± 2.03) and (1.67 ± 1.98).The expression level of cFLIP-S protein were (8.56 ± 2.72),(9.12 ± 2.45) and (3.82 ± 1.46),respectively,which were significantly lower in cFLIP-siRNA group than in ANP group and siRNA-NC group (P ＜ 0.05),and the difference was statistically significant (P ＜ 0.05).The expression level of caspase-8 protein in the three groups were (2.25 ± 1.24),(2.41 ± 1.14) and (5.56 ± 1.79),respectively,which were significantly higher in cFLIP-siRNA group than in ANP group and siRNA-NC group,and the difference was statistically significant (P ＜0.05).However,there was no significant difference between ANP group and siRNA-NC group.Conclusions Inhibition of cFLIP gene expression can reduce pancreatic injury in ANP rats.The possible mechanism was that the up-regulation of caspase-8 can inhibit pancreatic cell necrosis and promote apoptosis.

BACKGROUND: Meshes play a crucial role in hernia repair. However, the displacement of mesh inevitably leads to various associated complications. This process is difficult to be traced by conventional imaging means. The purpose of this study is to create a contrast-enhanced material with high-density property that can be detected by computed tomography (CT). METHODS: The contrast-enhanced monofilament was manufactured from barium sulfate nanoparticles and medical polypropylene (PP/Ba). To characterize the composite, stress tensile tests and scanning electron microscopy (SEM) was performed. Toxicity and biocompatibility of PP/Ba materials was verified by in vitro cellular assays. Meanwhile, the inflammatory response was tested by protein adsorption assay. In addition, an animal model was established to demonstrate the long-term radiographic effect of the composite material in vivo. Subsequent pathological tests confirmed its in vivo compatibility. RESULTS: The SEM revealed that the main component of the monofilament is carbon. In vitro cell experiments demonstrated that novel material does not affect cell activity and proliferation. Protein adsorption assays indicated that the contrast-enhanced material does not cause additional inflammatory responses. In addition, in vivo experiments illustrated that PP/Ba mesh can be detected by CT and has good in vivo compatibility. CONCLUSION These results highlight the excellent biocompatibility of the contrast-enhanced material, which is suitable for human abdominal wall tissue engineering.