【摘要】 目的 研究全身麻醉腹部手术患者术前焦虑对术后疼痛、镇痛药用量及对术后镇痛满意度的影响。 方法 选取2009年8月-2010年4月68例ASAⅠ～Ⅱ级，拟行气管插管全身麻醉的腹部手术患者，术前采用状态-特质焦虑量表和抑郁评分量表进行焦虑程度的测评，术后观察VAS疼痛评分、总的镇痛药用量以及患者对镇痛的满意度，分析术前焦虑与术后VAS评分、镇痛药用量及镇痛满意度的相关性。 结果 68例受试者术前STAI为50±13，BDI为16±13，术后VAS评分为4.0±2.1，术后24 h镇痛药芬太尼的用量为（0.80±0.21） mg；术后镇痛药用量、患者镇痛满意度评分与术前STAI明显相关（r=0.68和r=-0.88，Plt;0.01）。术后VAS评分与术前STAI及BDI也有一定的相关（r=0.35和r=0.3）。 结论 术前焦虑程度可以影响腹部手术患者对镇痛治疗的满意度， 显著增加镇痛药用量。【Abstract】 Objective To investigate the effect of preoperative anxiety on postoperative pain, amount of analgesics and satisfaction of postoperative pain relief for patients undergoing abdominal surgery with general anesthesia. Methods A total of 68 patients undergoing abdominal surgery with general anesthesia from August 2009 to April 2010 were selected (ASA I-II). Preoperational anxiety levels were evaluated using State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI) and postoperative VAS pain score, the total amount of analgesics used and satisfaction of pain relief were observed. The relationship between preoperative anxiety and post-operative VAS score, and total amount of analgesics used and satisfaction of pain relief were analyzed. Results The mean STAI and BDI of 68 samples were 50±13 and 16±13, respectively; the mean postoperative VAS was 4.0±2.1, and the mean amount of analgesics fentanyl used in 24 hours after the operation was (0.80±0.21) mg; the amount of post-operative analgesics used and the satisfaction of pain relief of the patients were found to be highly related to pre-operative STAI (r=0.68, -0.88; Plt;0.01). Post-operative VAS score was also related to preoperational STAI and BDI (r=0.35, 0.3). Conclusion Preoperative anxiety is closely related to the postoperative analgesics and satisfaction of pain relief for patients who had abdominal operation. Severe preoperative anxiety can significantly increase the amount of postoperative analgesics used and dissatisfaction of pain relief.
ObjectiveTo investigate the expression of microRNA (miRNA, miR)-141-3p in hepatocellular carcinoma (HCC) tissues and its effect on proliferation and invasion of HCC.MethodsBioinformatics tools were used to predict putative miRs with search potential downstream gene–GP73, hsa-miR-141-3p was selected for further analysis and observations. A dual-luciferase reporter assay was performed to validate GP73 as a target of hsa-miR-141-3p. Real time PCR (qRT-PCR) or Western blot was performed to measure the expression level of miR-141-3p and GP73 in HCC and adjacent tissue. MTT, EdU, and Transwell were used to measure cell proliferation and migration.ResultsIt was identified that the expression level of miR-141-3p was significantly lower in the HCC tissues than that of adjacent tissues (P<0.05), but different in GP73 mRNA and its protein (P<0.05). Clinical analysis indicated that decreased miR-141-3p expression was significantly correlated with advanced tumor grade, advanced TNM stage, and vascular invasion (P<0.05). MTT assay showed that the absorbance (A) value of Huh-7 cells transfected with miR-141-3p overexpression plasmid was significantly decreased compared with the miR-negative control (NC) group (transfected empty plasmid) and the blank control group (P<0.05).The EdU detection results showed that the ratio of EdU positive cells in Huh-7 and MHCC-97H cells were lower than those in the blank control group and the miR-NC group after transfection of miR-141-3p (P<0.05). Transwell test found that after transfection of miR-141-3p, the number of invading cells and the number of migrated cells in MHCC-97H cells were lower than those in the blank control group and the miR-NC group (P<0.05). The results of cytological function recovery experiments showed that the number of invading cells and the number of migrated cells in MHCC-97H cells of miR-141-3p+GP73 group were lower than those in blank control group and miR-NC group (P<0.05), but higher than those of the miR-141-3p group and miR-141-3p+GP73-NC group (P<0.05).ConclusionsThe present study revealed that miR-141-3p is reduced in HCC tissues. Additionally, GP73 expression levels are negatively correlated to miR-141-3p in HCC tissues, and that is associated with the progression of HCC. Overexpression of miR-141-3p significantly inhibit proliferation, invasion, and migration of HCC cells.Reversal of partial inhibition of miR-141-3p can be achieved by restoring the expression of the GP73 gene without the 3′ untranslated region (UTR).