ObjectiveTo investigate the effects of etomidate postconditioning on apoptosis in a rat model of focal cerebral ischemia-reperfusion(I/R) injury.MethodsThirty-two pathogen-free male SD rats weighing 250-300 g were randomly divided into 4 groups ( n =8 each) using random number table:group sham operation ( group S); group focal cerebral I/R; group lipid emulsion (vehicle for etomidate) (group L) and group etomidate postconditioning (group Ep).Focal cerebral I/R was induced by inserting a nylon thread with rounded tip into right internal carotid artery.The thread was advanced cranially until resistance was met.Middle cerebral artery was occluded for 2 h in groups I/R,L and Ep.Normal saline,lipid emulsion and etomidate emulsion 20 mg/kg were injected peritoneally at the end of ischemia in groups I/R,L and Ep respectively.The animals were sacrificed at 24 h of reperfusion and their brains were removed for microscopic examination,assessment of apoptosis (by TUNEL) and detection of Bcl-2 and Bax expression ( by immuno-histochemistry).Apoptosis index ( AI =the number of apoptofic neurons/the total number of neurons examined × 100％ ) and Bcl-2/Bax ratio were calculated.Results I/R induced microscopic changes,significantly increased AI and Bcl-2 Bax ratio and up-regulated Bcl-2 and Bax expression in group I/R as compared with group S.Etomidate postconditioning significantly amefiorated brain damage,decreased AI,increased Bcl-2/Bax ratio,up-regulated Bcl-2 expression and down-regulated Bax expression in ischemic cerebral hemisphere in group Ep as compared with group I/R.There was no significant difference in brain damage,AI and Bcl-2 and Bax expression and Bcl-2/Bax ratio between groups I/R and L.ConclusionEtomidate postconditioning can attenuate focal cerebral ischemia-reperfusion injury in rats by inhibiting apoptosis and modulating Bcl-2 and Bax expression.

Effects of epidural block on stress response during eardiopulmonary bypass were studied. Twenty patients, undergoing open heart surgery with cardiopulmonary bypass, were randomly divided into two groups:the control group with intravenous high-dose fentanyl and enflurane inhalation (1%-1.5%);the tested group with epidural block and enflurane inhalation (0.5%-1%). The plasma norepinephine (NE) and epinephrine (E) concentrations were higher in group control than those in tested group during and after CPB,even at the end of operation (P

Objective To investigate the effects of different concentrations of sevoflurane on adhesion and expression of CD24 and CD44v6 in human lung cancer cell line A549.Methods Human lung cancer cell line A549 was obtained from Shanghai Cell Biology Medical Research Institute,Chinese Academy of Sciences and cultured in RPMI1640 culture medium containing 10％ fetal calf serum.The cells were inoculated in 24 well culture plate.After being cultured for 24 h,the cells were randomly divided into 4 groups:control group (group C) and 3 sevoflurane groups exposed to 1.7 ％,3.4 ％ and 5.1％ sevoflurane for 2,4 and 6 h respectively ( groups S1,S2,S3 ).The cells were cultured for another 48 h.Cell adhesion rate was detected by adhesion test and the expression of CD24 and CD44v6 mRNA and protein was determined by RT-PCR and flow cytometry.Results Sevoflurane significantly inhibited the cell adhesion rate and down-regulated CD24 and CD44v6 expression in a concentration and duration of exposure-dependent manner.Conclusion Sevoflurane can inhibit cell adhesion through down-regulation of CD24 and CD44v6 expression.

Objective To evaluate the effect of continuous spinal anesthesia with a "catheter-over-needle" system which diminished the leakage of CSF through the hole in the dura alongside the inserted catheter and minimizes the risk of post-dura-puncture headache. Methods Sixty ASA Ⅰ - Ⅱ patients aged over 60 yr, scheduled for transurethral prostatectomy, were randomly divided into two groups of 30 patients in each group: group I continuous spinal anesthesia (CSA); group Ⅱ continuous epidural anesthesia(CEA) . Catheter was placed at L2-3 or L3-4. Both groups received 0.5% bupivacaine for surgery. A loading dose of 1.5-2.5 ml (groupⅠ ) or 8-13 ml (group Ⅱ) was given. If the surgery exceeded 2 h a third of the loading dose was injected. For postoperative analgesia a mixture of 0.125% bupivacaine + 0.0006% fentanyl was used. In group I the PCA setting was loading dose 0.5ml, background infusion at 0.5 ml/h, bolus dose 0.5 ml and lock-out interval 8 min. In group Ⅱ the loading dose was 2 ml followed by background infusion at 2 ml/h and bolus dose was 2 ml with lock-out interval of 15 min. Onset time and level of analgesia were recorded during surgery and VAS pain score and movement of lower extremities (modified Bromage score) were assessed. Postoperative PCA was maintained for 50 h. Results The demographic data including age, height and body weight were comparable between the two groups. There was no significant difference in the duration of surgery between the two groups. The onset of block was significantly faster in group I (3.5 ?2.3) min than that in the group Ⅱ (9.5 ?3.4) min. Motor blockade was less intense in group Ⅱ as assessed by modified Bromage score. Analgesia was more satisfactory in group I as less patients received fentanyl and droperidol iv during surgery in group I . Thetotal amount of bupivacaine used during postoperative analgesia was significantly less in group I , only about one-fifth of the total amount used in group Ⅱ. Two patients complained of headache in group I but in group Ⅱ there was also one patient complaining of headache. Conclusion Continuous spinal anesthesia has the advantage of faster onset of block, better analgesia, more intense motor block with less local anesthetic.

Objective To investigate the effects of different concentrations of sevoflurane on Survivin expression in human adenocarcinoma cell line A549. Methods A549 cells were obtained from Shanghai Cell Biology Medical Research Institute, Chinese Academy of Sciences and inoculated in 96 well culture plate. After being cultured for 24 h, the cells were randomly divided into 4 groups: Ⅰ , Ⅱ , Ⅲ and Ⅳ groups exposed to 95 % O2 -5 %CO2,1.7%, 3.4% and 5.1% sevoflurane respectively. A549 cells were exposed to sevoflurane for 2, 4 and 6 h respectively and then cultured for another 48 h in Ⅱ , Ⅲ and Ⅳ groups. Proliferation of A549 cells were measured by methyl thiazolyl tetrazolium (MTT) assay, and apoptosis was detected with flow cytometer at 48 h after 2, 4 and 6 h sevoflurane exposure. The expression of Survivin in A549 cells was determined by Western blot analysis at 48h after 4 h sevoflurane exposure. Results The rate of proliferation inhibition and percentage of apoptotic cells were significantly higher while the expression of Survivin was significantly lower in a concentration-dependent manner in Ⅱ , Ⅲ and Ⅳ groups as compared with group Ⅰ . Conclusion Sevoflurane can inhibit proliferation and induce apoptosis of A549 cells by inhibition of Survivin expression.

Objective To investigate the effect of intrathecal (IT) dexmedetomidine on the expression of cAMP response element-binding protein phosphorylation (p-CREB) in spinal dorsal horn in a rat model of bone cancer pain. Methods Sixty-four adult female Wistar rats weighing 200-240 g were randomly divided into 4 groups (n = 16 each): sham operation group (group S); bone cancer pain group (group BP); normal saline group ( group NS) ; dexmedetomidine group (group D) . Bone cancer pain was induced by injecting Walker 2S6 mammary gland carcinoma cell suspension (2 ×106 cells/ml) 10μl into the medullary cavity of the tibia in BP, NS and D groups. Groups S and BP received no IT injection. Croups NS and D received IT injection of NS 10 μl and dexme detomidine 5 μg/kg respectively 7 days after successful establishment of the model. Ten animals were selected from each group at 1 day before IT administration (T0), immediately before IT administration (T1 ) and at 1, 6, 12 and 24 h after IT administration (T2-5 ) and paw withdrawal threshold (PWT) to mechanical stimuli was measured with von Frey filaments. The other 6 rats in each group were sacrificed at T4 and the spinal cord was removed for determination of p-CREB expression in the spinal dorsal horn.Results PWT was significantly decreased at T1-5 and pCREB expression up-regulated at T4 in BP, NS and D groups compared with group S ( P ＜ 0.05) . Compared with group BP, PWT was significantly decreased at T2-5 and p-CREB expression down-regulated at T4 in group D ( P ＜0.03), while no significant change in PWT and p-CREB expression was found in group NS (P ＞ 0.05) .Conclusion IT dexmedetomidine can reduce the bone cancer pain through inhibiting the phosphorylation of CREB in rat spinal dorsal horn.

Objective To determine the most appropriate combination of target effect-site concentrations (Ce) of propofol and remifentanil administered by TCI for fiberoptic bmnchoscopy in terms of depth of anesthesia and safety.Methods One hundred and eighty ASA Ⅰ or Ⅱ patients of both sexes aged 18-60 yr with body mass index ranging from 20-25 kg/m2 undergoing elective fiberoptic bronchoscopy under general anesthesia were randomized into 6 groups based on Ce of propofol (5.0,5.5,6.0 μg/ml) and remifentanil(2.5,3.0 ng/ml)(n=30 each):P5.0 R2.5,P5.5 R2.5,P6.0 R2.5,P530 R3.0,P5.5 R3.0 and P6.0 R3.0.Anesthesia was induced and maintained with TCI of propofol and remifentanil.MAP,HR,and SpO2 were continuously monitored.The examination was started when the target Ce was reached.When continuous coughing or bronchospasm occurred,2% lidocaine was given for topical anesthesia.When MAP decreased by more than 30% of the baseline value and/ or HR<55 boats per min,ephedrine was injected iv.When MAP increased by more than 30% of the baseline value and/or HR>120 beats per min,remifentanil was injected iv.TCI was stopped when the examination was over.The amount of propofol and remifentanil consumed,induction time,emergence time,duration of bronchoscopy and the number of the patients in whom ephedrine and intermittent iv boluses of remifentanil were given were recorded and compared among the 6 groups.The efficacy ofanesthesia was evaluated and the doctors' satisfaction recorded.Results The induction time and emergence time were significantly longer in P6.0 R3.0 and P6.0 R2.5 groups than in the other 4 groups ( P < 0.05). The efficacy of anesthesia was better in group P5.5 R3.0 and P6.0 R3.0 than in group P5.0 P2.5, P5.5 R2.5 and P5.0 R3.0 ( P < 0.05). Anesthesia was more satisfactory as evaluated by the doctor in group P5.5 R3.0.The number of patients who received iv bolus of remifentanil and ephedrine during bronchoscopy was smallest in group P5.5 R3.0 ( P < 0.05 ). Conclusion TCI of propofol at Ce of 5.5 μg/ml combined with remifentanil TCI at Ce of 3.0 ng/ml provides satisfactory anesthesia for flberoptic bronchoscopy.

Objective To investigate the effects of isoflurane and sevonumne on apoptosis and expression of CD44 and CD54 in human lung cancer cell line A549.Methods Human lung cancer A549 cells were obtained from Shanghai Cell Biology Medical Research Institute,Chinese Academy of Sciences,and inoculated in 24 well culture plate.After being cultured for 24 h the cells were randomly divided into 3 groups:group Ⅰ control(group C);group Ⅱ isoflurane (group Iso) and group Ⅲ sevoflurane (group Sev).A 549 cells were exposed to 1.7% isoflurane and 2.5%sevoflurane for 4 h respectively in group Iso and Sev respectively,and were then cultured for another 24 h.Apoptosis and expression of CD44 and CD54 in A549 cells were detected with flow cytometer at 0 (T0),2 h(T1) and 4 h(T2) of and 24 h after(T3) exposure to isoflurane and sevoflurane.Results The percentage of apoptotic cells wag significantly higher at T2 and T3 in group Iso than in group C.The percentage of apoptotic cells was significantly higher at T1,T2 and T3 in group Sev than in group Iso and C.The expression of CD44 and CD54 at T1,T2 and T3 was significantly decreased as compared with the baseline at T0 in group Iso and Sev and was significantly lower in group Iso and Sev than in group C.Conclusion Isoflurane and sevoflurane can induce apoptesis of human lung cancer cell line A549, and sevoflurane is more effective. Isoflurane and sevoflurane can inhibit the expression of CD44 and CD54 of human lung cancer cell line A549.

Objective To observe the effects of sevoflurane pretreatment on lung metastasis of mouse Lewis lung cancer (LLC)cells.Methods Mouse LLC cells were inoculated in culture plate. After being cultured for 24 h the cells were randomly divided into four groups:group control (CC), group 1% sevoflurane (SC1),group 2% sevoflurane (SC2),and group 3% sevoflurane (SC3).Cells of group SC1-3 were exposed to 1%,2%,3% sevoflurane for 4 h respectively,cells of group CC were exposed to 95%O 2-5%CO 2 mixture air,and were then cultured for another 24 h.The invasive activity of cells was determined by Transwell assay.The migration of cells was evaluated by wound scratch assay.The expression of MMP-2 and MMP-9 in cells were detected by ELISA.Thirty-two C57BL/6 mice were divided into four groups (n = 8):group control (CM),group 1% sevoflurane (SM1),group 2% sevoflurane (SM2),and group 3% sevoflurane (SM3).LLC cells of group SC1-3 were injected into caudal vein of mouse in group SM1-3 respectively.Cells of group CC were injected into mouse of group CM.Lung metastasis inhibitory rates were evaluated after 3 weeks. Results Compared with group CC,the invasive activity and migration of cells in group SC1-3 were decreased significantly,group SC1 >group SC2 >group SC3 (P <0.05 );the protein expression of MMP-2 and MMP-9 was significantly down-regulated with sevoflurane concentration increased,group SC1 >group SC2>group SC3 (P <0.05).Compared with group CM,lung metastasis inhibitory rates of group SM1-3 were increased significantly,group SM1 < group SM2 < group SM3 (P < 0.05 ). Conclusion Sevoflurane can inhibit the lung metastasis of mouse LLC cells,which maybe through down-regulating the expression of MMP-2 and MMP-9 in mouse LLC cells.

Objective To investigate the effects of serum from patients receiving isoflurane and sevoflurane on the invasion and migration ability of human lung adenocarcinoma cell line A549. Methods Twenty ASAⅠorⅡ lung cancer patients aged 40 ~ 68 yr undergoing radical surgery were randomly divided into sevoflurane group (SEV group, n = 10) and isoflurane group (ISO group, n = 10). The concentration of sevoflurane or isoflurane maintained 1.5 MAC during anesthesia. Ten healthy volunteers were selected as control group. Serum was separated from blood sample taken at the end of surgery. A549 cells were randomly divided into sevoflurane group (group SEV, n = 10), isoflurane group (group ISO, n = 10) and control group (group C, n = 10). Cells of SEV group and ISO group were treated with 10% serum as respect to anesthetics for 24 hours. Cells of group C were treated with serum of control group. The invasion ability of cells was evaluated by Transwell assay. The migration ability of cells was determined by wound healing assay. The expressions of MMP-2 and MMP-9 in A549 cells were detected by ELISA. Results Compared with group C and ISO group,the number of invasive cells in group SEV was reduced significantly (P < 0.05). The levels of MMP-2 and MMP-9 in group SEV were significantly decreased compared with those of group C and ISO group (P<0.05). Conclusion The serum of patients receiving sevoflurane anesthesia can attenuate the metastatic ability of A549 cells through inhibiting the expression of MMP-2 and MMP-9.