scholarly journals Study of ultrasound-guided ropivacaine combined with butorphanol continuous paravertebral block to prevent pain syndrome by evaluating ccl2 gene expression after radical mastectomy

2022 ◽  
Vol 67 (4) ◽  
pp. 264-273
Author(s):  
Xiaochen Ji ◽  
Wenbin Cui ◽  
Shiqiang Shan ◽  
Xiaomeng Liu ◽  
Lixian Wang ◽  
...  

This study aimed to investigate the clinical effect of ultrasound-guided ropivacaine combined with butorphanol continuous paravertebral block in preventing postoperative pain syndrome of breast cancer. For this purpose, 100 women treated for breast cancer from April 2018 to July 2019 were enrolled as research objects. Surgical procedures included local sentinel lymph node biopsy, mastectomy, sentinel lymph node biopsy for mastectomy, modified radical mastectomy, and implantation. The selected patients were randomly divided into two groups: control group (routine operation anesthesia; n = 50) and observation group (ultrasound-guided thoracic paravertebral block before induction of ropivacaine+butorphanol anesthesia; n = 50). The Real-time PCR technique was performed to evaluate CCL2 gene expression. VAS scores were recorded during the postoperative period. Compared with the control group, the observation group had lower VAS scores at six h, 24h, and 48h (P<0.05). The pain effect of the observation group was less than that of the control group. The observation group had better analgesic effects after anesthesia. The observation group had a lower incidence of pain syndrome at the 6th, 8th, and 12th months (P<0.05), and the incidence of pain syndrome in the two groups decreased with the extension of time. The observation group had lower levels of related factors (P<0.05), and the observation group had lower traumatic stress responses. The protein expression of IL-6, IL-17, and CRP in the observation group was lower than that in the control group (P<0.05). The results of CCL2 gene expression also showed that gene expression in the control group increased significantly (P=0.0047). Since the expression of this gene is one of the factors that stimulate pain signals in the body, the method used in the present study was able to reduce the amount of pain significantly. Therefore, the combination of ropivacaine combined with butorphanol ultrasound-assisted paravertebral block can reduce the intensity of postoperative pain in patients with breast cancer surgery, decrease the incidence of pain syndrome, and increase pain tolerance.

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Pengfei Liu ◽  
Hongjie Zhang ◽  
Jihai Jin

Objective: To study the clinical effect of breast conserving combined with sentinel lymph node biopsy and modified radical mastectomy in patients with early breast cancer. Methods: Female patients with early breast cancer in clinical stage I and II were selected as the main objects of this study, the study period started from July 2017 to July 2020. In the breast conserving and sentinel lymph node biopsy patients, 50 cases were randomly selected as the experimental group; 50 cases in the modified radical mastectomy patients were randomly selected as the control group. The clinical intervention effect of the two groups was analyzed. Results: the perioperative indexes of the experimental group were shorter than those of the control group, the patients recovered faster, the incidence of complications in the experimental group was lower, and the quality of life scores of the experimental group were significantly higher than those of the control group, and the difference was statistically significant, the intervention effect of the experimental group was also better. Conclusion: The application of breast conserving and sentinel lymph node biopsy in the treatment of early breast cancer can promote the recovery of patients, shorten the operation time and reduce the rate of complications, which has significant clinical significance.


2006 ◽  
Vol 72 (9) ◽  
pp. 798-801
Author(s):  
Matthew Voth ◽  
Raye Budway ◽  
Angela Keleher ◽  
Philip F. Caushaj

Women undergoing breast conservation therapy (BCT) for stage 1 breast cancer have adjuvant external beam radiotherapy (EBR). In addition, the use of brachytherapy radiation is being used. We present two local tumor recurrences for review. Our first patient underwent BCT, sentinel lymph node biopsy (SLNBx) and MammoSite® brachytherapy for a T1N0M0 infiltrating ductal carcinoma (IDC) of the right breast. Pathology: 0.6 cm poorly differentiated ER, PR, and Her-2/ Neu negative IDC. At 18 months, she had palpable axillary lymph nodes. Fine needle aspiration and ultrasound-guided core biopsy of a nodule showed IDC. She underwent modified radical mastectomy (MRM) and EBR. Our second patient underwent BCT, SLNBx, and MammoSite® brachytherapy for a T1N0M0 IDC of the left breast. Pathology: 0.8 cm poorly differentiated, ER+, PR-, and Her-2/Neu negative tumor. At 18 months, a retroareolar mass was detected. Ultrasound guided core needle biopsy showed recurrent IDC. She chose a re-excision and EBR and not MRM. Pathology: 1.3 cm poorly differentiated, ER+, PR-, and Her-2/Neu negative tumor. Our 2 recurrences were >2 cm away from the lumpectomy site and therefor outside the 1 cm treatment plan of the MammoSite® catheter. Both recurrences were biologically identical to the initial tumors and are felt to be local failures rather than new primaries.


2021 ◽  
pp. 1-10
Author(s):  
Sanaa A. El-Benhawy ◽  
Samia A. Ebeid ◽  
Nadia A. Abd El Moneim ◽  
Rabie R. Abdel Wahed ◽  
Amal R.R. Arab

BACKGROUND: Altered cadherin expression plays a vital role in tumorigenesis, angiogenesis and tumor progression. However, the function of protocadherin 17 (PCDH17) in breast cancer remains unclear. OBJECTIVE: Our target is to explore PCDH17 gene expression in breast carcinoma tissues and its relation to serum angiopoietin-2 (Ang-2), carbonic anhydrase IX (CAIX) and % of circulating CD34+ cells in breast cancer patients (BCPs). METHODS: This study included Fifty female BCPs and 50 healthy females as control group. Cancerous and neighboring normal breast tissues were collected from BCPs as well as blood samples at diagnosis PCDH17 gene expression was evaluated by RT-PCR. Serum Ang-2, CAIX levels were measured by ELISA and % CD34+ cells were assessed by flow cytometry. RESULTS: PCDH17 was downregulated in cancerous breast tissues and its repression was significantly correlated with advanced stage and larger tumor size. Low PCDH17 was significantly correlated with serum Ang-2, % CD34+ cells and serum CAIX levels. Serum CAIX, Ang-2 and % CD34+ cells levels were highly elevated in BCPs and significantly correlated with clinical stage. CONCLUSIONS: PCDH17 downregulation correlated significantly with increased angiogenic and hypoxia biomarkers. These results explore the role of PCDH17 as a tumor suppressor gene inhibiting tumor growth and proliferation.


2021 ◽  
Vol 7 (5) ◽  
pp. 3022-3028
Author(s):  
Fei Guo ◽  
Yongjun Wang ◽  
Shenghui Liu ◽  
Junrong Cao

To investigate the effect of B-ultrasound-guided nerve block on analgesia and sedation in patients with acute cholecystitis undergoing puncture and drainage. Methods 96 patients with acute cholecystitis who underwent puncture and drainage from May 2018 to November 2020 were randomly divided into control group and observation group by random number table method, with 48 cases in each group. The patients in the control group were anesthetized by local infiltration. The patients in the observation group were anesthetized by B-ultrasound-guided nerve block. Heart rate, blood pressure, analgesia score, sedation score, and oxidative stress level were compared between the two groups. Results At the time of puncture (T2), heart rate (HR) and mean arterial pressure (MAP) in the two groups were significantly lower than those before operation (T1) (P<0.05); at the end of operation (T3), HR and MAP in the control group were significantly higher than those at T1 (P<0.05); at T2, HR and MAP in the observation group were significantly higher than those in the control group (P<0.05); at T3, HR and MAP in the observation group were significantly lower than those in the control group (P<0.05). AtT2 and T3, Ramsay sedation score in both groups was significantly lower than that at T1 (P<0.05), while Ramsay score in the observation group was significantly higher than that in control group (P<0.05); atT2 and T3, visual analog scale (VAS) pain score in both groups was significantly higher than that at T1 (P<0.05), while VAS score in the observation group was significantly lower than that in the control group (P<0.05). After operation, the levels of serum malondialdehyde (MDA) and superoxide dismutase (SOD) in the two groups were significantly higher than those before operation (P<0.05), and the levels of serum total antioxidant capacity (T-AOC) were significantly lower than those before operation (P<0.05); after operation, the levels of serum SOD and T-AOC in the observation group were significantly higher than those in the control group (P<0.05), and the levels of MDA in the observation group were significantly lower than those in the control group (P>0.05). Conclusion B-ultrasound-guided nerve block anesthesia can maintain the stable hemodynamic index of patients with acute cholecystitis undergoing puncture and drainage therapy, improve the analgesic and sedative effect and reduce the oxidative stress response of the body.


2019 ◽  
Vol 2 (2) ◽  
pp. 24-31
Author(s):  
Gulraj Singh ◽  
Mulawan Umar ◽  
Nur Qodir

Abstract Introduction: Modified radical mastectomy (MRM) is a breast cancer treatment option that is still operable. One of the postoperative complications that can be found is the formation of seroma. High negative suction drain is done to treat seroma after surgery but it can contribute to increase the length of stay in hospital. Methods: This study was a clinical randomized control trial (cRCT) conducted on 30 breast cancer patients in June - July 2019 at Moehammad Hoesin Hospital in Palembang. This study divided the two sample groups, each group consisting of 15 patients. One group was given half negative pressure on suction drain (experimental group) and the other used full negative pressure on suction drain (control group). Results: There was a significant difference (p <0.005) between the full and half negative pressure groups where there were more seroma events in the full vacuum group in 9 (60%) cases and half vacuum in 2 (30%) but there were no significant differences in long period of stay (p> 0.005). Conclusion: Half negative pressure is more effective in treating seroma than full negative pressure.


2019 ◽  
Vol 14 (4) ◽  
pp. 20-23
Author(s):  
M. M. Vasilyeva ◽  
I. P. Moshurov ◽  
L. Yu. Grivtsova ◽  
N. N. Tupitsyn ◽  
N. A. Kozlov ◽  
...  

Background. A new strategy of breast cancer management is required for effective disease prevention and control. Immunotherapy is one of promising options.Objective: to evaluate the effect of immunoadjuvant polyoxidonium on pathmorphological changes in breast tumors.Materials and methods. The study was performed in 75 patients with breast cancer: 50 patients received polyoxidonium in a neoadjuvant regimen (main group), 25 patients did not receive polyoxidonium (control group). Polyoxidonium at a dose of 12 mg was administered intramuscularly 1 time per day on the days 1, 2, 3, 5 and 7 before surgery; on the day 8, radical mastectomy was performed in patients of both groups, followed by histological examination and determination of the grade of therapeutic pathomorphosis of the tumor.Results. The proportion of cases with grade I therapeutic pathomorphosis was 58 %, grade II therapeutic pathomorphosis – 6 %. Pathomorphosis in metastatic lymph nodes was observed in 22.7 % of cases.Conclusion. The anti-tumor effect of polyoxidonium was confirmed on the basis of the induction of pathomorphosis of the tumor tissue of breast cancer.


Author(s):  
Martina Farag Wahba Mekhaeil ◽  
Ayman Abd Elmaksod Yousef ◽  
Hesham Mohammed Marof ◽  
Shaimaa Farouk Abdelkader

Background: Breast Cancer is the most commonly occurring cancer affecting ‎women undergoing modified radical mastectomy, causing acute pain, and in ‎high percentage of patients it progresses to chronic pain syndromes. The Erector Spinae Plane Block (ESPB) ‎and Serratus Anterior Plane Block (SAPB) are options of regional anesthesia that can produce reliable ‎analgesia. In this study we aimed to evaluate the analgesic efficacy of ‎ultrasound guided ESPB and SAPB in patients underwent modified radical ‎mastectomy operation. Patients and Methods: Patients were randomly classified using computer generated numbers ‎concealed in ‎ sealed opaque envelopes into three equal groups; 30 patients ‎were enrolled in each group. ‎Group I: Control Group (C): Patients received intravenous (IV) systemic analgesia only, Group II: ESPB group: Patients received ‎ipsilateral ultrasound guided ESPB using 20 ml bupivacaine 0.25% at the ‎level of the 4th thoracic segment (T4). and Group III: SPB group: Patients received ipsilateral ‎serratus plane block using 30 ml bupivacaine 0.25% at the level of the 5th rib.‎ Results: In this study, 113 patients were assessed for eligibility, 16 patients ‎did not meet the criteria and 7 patients refused to participate in the study. ‎The remaining 90 patients were randomly allocated into three groups (30 ‎patients in each). All patients (90) were followed-up and analyzed ‎statistically‎. Conclusion: Ultrasound-guided SAPB and ESPB provided effective post-‎operative analgesia in patients undergoing modified radical mastectomy with ‎lower pain scores, less peri operative analgesic consumption and longer ‎duration of analgesia in SAPB.


2020 ◽  
Vol 9 ◽  
pp. 1812
Author(s):  
Solmaz Rahmani Barouji ◽  
Arman Shahabi ◽  
Mohammadali Torbati ◽  
Seyyed Mohammad Bagher Fazljou ◽  
Ahmad Yari Khosroushahi

Background: Mummy (Iranian pure shilajit) is a remedy with possessing anti-inflammatory, antioxidant and anticancer activities. This study aimed to examine mummy effects on epithelial-mesenchymal transition (EMT) and invasiveness of MCF-7 and MDA-MB-231 breast cancer (BC) cell lines with underlying its mechanism. Materials and Methods: The dose-dependent inhibitory effect of the mummy on cell proliferation in vitro was determined using the MTT assay.  Flow cytometry and 4’,6-diamidino-2-phenylindole dihydrochloride staining were respectively used for quantitative and qualitative analysis of cellular apoptosis, and gene expression analysis was conducted using real-time PCR. Results: MDA-MB-231 showed more sensitivity than the MCF-7 cell line to the anticancer activity of mummy, while mummy did not exhibit significant cell cytotoxicity against human normal cells (MCF-10A). The gene expression profile demonstrated a significant decrease in TGF-β1, TGF-βR1, TWIST1, NOTCH1, CTNNB1, SRC along with an increase in E-cadherin mRNA levels in mummy treated cells compared to the untreated control group (P≤0.05). Conclusion: Mummy triggers inhibition of EMT and metastasis in breast cancer cells mainly through the downregulation of TGFβ1 activity, and more studies required to find its specific anticancer activity with details. [GMJ.2020;9:e1812]


2021 ◽  
Vol 7 (6) ◽  
pp. 6469-6476
Author(s):  
Li Qiu ◽  
Hongli Wang ◽  
Yuan Yuan ◽  
Ying Wang ◽  
Ping Yu

To analyze the effect of nursing measures based on self-efficacy theory on the state self-esteem of breast cancer patients. 110 breast cancer patients who were treated in our hospital from October 2018 to October 2019 were randomly divided into control group and observation group. The control group was given routine nursing measures, and the observation group was given nursing measures under the guidance of self-efficacy theory. Before operation, 1 week after operation and 3 months after operation, the general data of the two groups before and after treatment were recorded. The self-efficacy level and self-esteem level of the patients before and after treatment were assessed by the self-efficacy scale (GSEs) and state self-esteem scale (SSEs). The compliance of functional exercise and shoulder joint activity (ROM) of the two groups were compared, and the physical status of the two groups were analyzed. To analyze the effect of nursing measures based on self-efficacy theory on the state self-esteem of breast cancer patients. The GSEs score of the two groups increased with the time, and there was no significant difference between the two groups before operation (P > 0.05). After 1 week and 3 months, the GSEs score of the observation group was significantly higher than that of the control group (P < 0.05). The compliance evaluation table of functional exercise in the two groups increased with the time, and the compliance evaluation table of functional exercise in the observation group was significantly higher than that in the control group, the difference was statistically significant (P < 0.05). ROM of the two groups increased with time, and ROM of the observation group was significantly better than that of the control group, the difference was statistically significant (P < 0.05). The self-esteem level of the two groups increased with time, and the self-esteem level of the observation group was significantly higherthan that of the control group, the difference was statistically significant (P <0.05). The nursing measures under tne guidance of self-efficacy theory can help patients to complete functionalexercise, improve theirquality of life, improve their self-esteem level, a nd can be widely used in clinical practice.


Sign in / Sign up

Export Citation Format

Share Document