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Background Surgical stress induces the release of neuroendocrine mediators and cytokines during perioperative period, which may have adverse effects on cancer patients. While the surgical stress responsse can be affected by anesthetic technique. Therefore, we designed this study to assess whether subcostal transversus abdominis plane (TAP) block can affect perioperative neuroendocrine stress response, postoperative analgesia and postoperative recovery in patients undergoing radical gastrectomy under general anesthesia. Methods Sixty-five patients were recruited. Patients randomly received general anesthesia (control group), or general anesthesia combined with TAP block (40 mL of 0.375% ropivacaine) (TAP group). The primary outcome was neuroendocrine levels including norepinephrine (NE), epinephrine (E), cortisol (Cor), glucose (Glu), interleukin (IL)-6 and IL-10 during 48 h after surgery. Secondary outcomes included pain score, hemodynamic variables and recovery characteristics. Results Data from 61 of 65 patients were analyzed. The levels of NE, E, Cor, and Glu were blunt by TAP block during perioperative period. The levels of IL-6 and IL-10 were significantly lower in TAP group than in control group. TAP block efficiently relieved postoperative acute pain up to 12 h postoperatively with more stable perioperative hemodynamics compared with control group. Conclusions Subcostal TAP block blunts perioperative stress response and provides efficient analgesia, with good hemodynamic stability and minimal adverse effects.

Alzheimer’s disease (AD) is one of the most common neurodegenerative diseases and is considered to be the main cause of cognitive impairment in elderly people. The major symptom of AD is progressive dementia that eventually results in dysfunction of daily life. Due to the fact that AD has a long period of incubation before clinical symptoms emerge, the available therapeutic treatments can only improve the symptoms but not delay the progression of AD. Therefore, there is an urgent need to explore effective diagnostic approaches to catch and better treat the disease before clinical symptoms appear. Recent research revealed that abnormal expression of certain miRNA could have a crucial role in the pathological process of neurodegenerative disease including AD. Furthermore, given that AD patients show increased level of miRNAs in the blood and cerebrospinal fluid, miRNAs are considered promising non-invasive candidates for AD diagnosis and prognosis. Here, we reviewed the current research related to implications of miRNAs during the development of AD, summarized of actively used approaches to identifying potential miRNA biomarkers in body fluids, and discussed the diagnostic potential of microRNAs as biomarkers for AD.

Rationale Negative pressure pulmonary edema (NPPE) is a dangerous clinical complication and potentially life-threatening emergency without prompt diagnosis and intervention during recovery period after anesthetic extubation. Patient concerns A 25-year-old woman has undergone endoscopic thyroidectomy. After extubation, the patient developed acute respiratory distress with high airway resistance accompanied with wheezing, oxyhemoglobin saturation (SpO2) decreased to 70%. With positive pressure mask ventilation, her condition was stable, SpO2 99%. However, the patient developed pink frothy sputum with diffuse bilateral rales 30 min later after transported to surgical intensive care unit (SICU). Diagnoses Negative pressure pulmonary edema. Interventions The patient was undergone assisted ventilation with continuous positive airway pressure (CPAP) and furosemide 20 mg was given intravenously. Outcomes Postoperative day (POD) 2 her condition became stable, computed tomography (CT) scan indicated the pulmonary edema disappeared. The patient was discharged 6 days later. No abnormalities were observed during following 4 weeks. Lessons Although usually the onset of NPPE is rapid, with individual differences NPPE is still challenging. Increased vigilance in monitoring, diagnosis, and treatment are essential to prevent aggravation and further complication.

To evaluate the effect of subcostal transversus abdominis plane (TAP) block on postoperative analgesia and short-term prognosis. Forty patients were divided into T and N groups. Ultrasound-guided bilateral subcostal TAP block was performed by injection of ropivacaine or normal saline using patient-controlled intravenous analgesia pump. Postoperative hypoalgesia plane was T6-T10 in T group. Postoperative time to press PCIA pump time was (175.85±8.99) min and (64.10±27.37) min in N group. Sufentanil consumption at postoperative 0-12 h and 12-24 h and total sufentanil consumption were significantly lower than N group. Patients had significantly higher degree of satisfaction than N group. Off-bed time was (30.28±2.01) h and (39.55±2.56) h and the first flatus time was (48.95±3.83) h and (64.40±4.58) h in N group. It can offer 6 h analgesia time, enhance analgesic effect within postoperative 24 h, decrease the dosage of opiod drugs and promote intestinal tract function and mobility of recovery. Introduction For patients undergoing open radical gastrectomy, the analgesic effect of single intravenous injection was poor. acute upper abdomen pain after surgery severely reduced the comfortableness and affected respiration, off-bed time and the first flatus time and even progressed into neuropathic pain. In 2001, Rafi et al proposed the concept of transversus abdominis plane (TAP) block based upon dissection knowledge, which has been widely applied in the analgesia of lower abdominal operation[1]. Hebbard et al suggested that subcostal TAP was efficacious for upper abdominal operation[2]. Our preliminary experiment validated the good compound analgesic effect of subcostal TAP during surgery[3]. However, whether subcostal TAP could effectively supplement the postoperative intravenous analgesia and affect the quality of postoperative recovery remain unstudied, which is the starting point of this study. International Conference on Biomedical and Biological Engineering (BBE 2016) © 2016. The authors Published by Atlantis Press 258 Materials and Methods