Epidural analgesia with low-concentration levobupivacaine plus fentanyl provides satisfactory postoperative analgesia with few side effects for patients after colorectal surgery.

The aim of the present study was to construct and characterize human epidermal growth factor receptor 2 (Her2) lipid magnetic ball (H-lMB) for separating circulating tumor cells (cTcs) in patients with gastric carcinoma (Gc) and to compare the result of separated cTc counts with that of next-generation sequencing (nGS) for single-gene analysis to verify the consistency for evaluating the association between the detection results and the progress of clinical treatment, so as to facilitate early diagnosis and dynamic monitoring of Gc. a lipid magnetic ball (lMB), coated with Fe 3 o 4 nanoparticles, was synthesized by microemulsion technique and an anti-Her2 antibody was conjugated to the surface of lMB to form H-lMB, followed by the characterization of the prepared H-lMB. The detection of capture efficiency of LMBs in GC cells was tested by MTT and expression of Her2 mrna was determined by reverse transcription-quantitative Pcr. The positive detection rate of HER2 was verified by HER2-fluorescence in situ hybridization (FiSH) test on the separated cTcs from Gc. Further verification was performed based on the consistency between the result of separated cTcs and that of single-gene nGS assay of Her2, associated with the determination of clinical consistency. The constructed H-LMB exhibited good stability and specificity. The mutation rate of Her2 by the FiSH test was 14% in the blood samples of 50 patients with Gc and was 14% by nGS assay. The mutation rate of Her2 was 12% in H-lMB and the positive detection rate was 85.7% compared with the results of the FiSH test, indicating consistency with the clinical diagnosis and pathological examination results. in conclusion, the anti-HER2 antibody-modified LMB can separate cTcs with Her2 abnormal expression, which exhibits an application potential in Gc diagnosis and treatment and is of great clinical significance for the diagnosis and evaluation of its therapeutic effect on Gc.

The aim of this study was to investigate the effects of dexmedetomidine on perioperative stress response and cellular immunity in elderly patients with posterior lumbar surgery. Sixty patients with lumbar degenerative disease requiring posterior lumbar surgery were included and randomly divided into the dexmedetomidine group (the test group, [Formula: see text]) and the control group ([Formula: see text]). After the experimental group entered the room, dexmedetomidine was intravenously pumped 10[Formula: see text]min before induction of anesthesia and dexmedetomidine was continuously pumped after anesthesia. The control group replaced dexmedetomidine with the same amount of normal saline, and the other operations were exactly the same as the experimental group. Hemodynamic parameters were routinely monitored and the percentages of T lymphocyte subsets were analyzed by flow cytometry. Samples for stress response parameters were sent to the Clinical Laboratory of our hospital, and perioperative pain, postoperative adverse reactions and complications were evaluated during the study. The levels of postoperative stress hormones, including noradrenaline (NE), epinephrine (E), cortisol (Cor) and acetylcholine (Ach), were reduced in the test group compared with those in the control group ([Formula: see text]). Proportions of CD3[Formula: see text], CD4[Formula: see text], CD8[Formula: see text] and NK as well as the CD4[Formula: see text]/CD8[Formula: see text] in the control group were significantly decreased at postoperative Day 1 (T6), Day 3 (T7) and Day 7 (T8) compared with those at preoperative Day 1 (T-1) ([Formula: see text]), while the proportions of CD4[Formula: see text] and NK in the test group were significantly increased at T6, T7 and T8 compared with those at T-1 ([Formula: see text]). The mean arterial pressure (MAP) of the test group was decreased compared with that of the control group at each time point ([Formula: see text]). After the operation, the heart rate (HR) of the patients in the test group was significantly decreased compared with the control group ([Formula: see text]) and the VAS score of the control group were increased compared with the test group at each time point ([Formula: see text]). Dexmedetomidine can decrease the stress response and improve postoperative cellular immune function in patients with posterior lumbar surgery by reducing postoperative stress hormones to alleviate the postoperative cellular immunosuppression and the pain in patients.