Objective To evaluate the effect of stellate ganglion block (SGB) on cerebral vasospasm in patients undergoing intracranial aneurysm surgery. Methods Forty ASA Ⅱ or Ⅲ patients aged 14-64 yr weighing 40-81 kg undergoing intracranial aneurysm clipping were randomly divided into 2 groups ( n = 20 each): group control (group C) and group SGB. Left SGB was performed with 0.25% ropivacaine 10 ml immediately after intubation. Successful block was verified by development of Homer syndrome within 15 min after block. Anesthesia was induced with midazolam, propofol, fentanyl and vecuronium and maintained with isoflurane inhalation and intermittent iv boluses of fcntanyl and vecuronium. The patients were intubated and mechanically ventilated. PETCO2 was maintained at 30-35 mm Hg. BIS was maintained at 50-60. Right internal jugular vein was cannulated and the catheter was threaded cranially until resistance was met for blood sampling. Blood samples were collected before skin incision (T1), before clipping of aneurysm (T2), at 30 min after clipping (T3 ), and at the end of surgery (T4) for determination of plasma concentrations of endothelin (ET), calcium gene-related peptide (CGRP) and S100B protein. Transcranial Doppler was used to measure the flow rate of blood in bilateral middle cerebral artery and extracranial carotid artery at 1 and 3 days after surgery. All patients were observed for incidence of brain ischemia during 1-7 days after surgery. Results Plasma ET and S100B protein concentrations were significantly decreased, while plasma CGRP concentration was significantly increased after clipping of aneurysm at T3 and T4 in group SGB as compared with group C. The incidence of cerebral vasospasm and brain ischemia was significantly lower in group SGB than in group C. Conclusion SGB performed before operation can significantly reduce the incidence of cerebral vasospasm after clipping of intracranial aneurysm by inhibiting the release of ET and promoting the release of CGRP.

Objective To investigate the effects of stellate ganglion block (SGB) on erythrocyte immunity in patients with acute cerebral infarction.Methods Twenty-four patients (13 male, 11 female) who developed acute cerebral infarction for less than 3 days were randomly divided into 2 groups (n=12each): Group A receiving traditional treatment and Group B receiving traditional treatment + SGB.The patients ranged in age from 51 to 64 yr and weighed 52-71 kg. All patients received intravenous 5% glucose 25 ml plus citicoline sodium 1.0 g and sodium ozagrel injectio 250 ml daily for 10 days in addition to dehydration and effective control of complications and intracranial pressure. Group B received SGB on one side alternatively with 1% licocaine 10 mi once a day for 10 days. Fasting venous blood samples were taken in the early mornings of the day before treatment (baseline, T1 ) and the 1st, 5th and 10th day of treatment (T2-4) for determination of the plasma MDA concentration and SOD activity, erythrocyte C3b receptor rosette rate (RBC-C3bRR) and RBC immune complex rosette rate (RBC-ICR) and Ne+-K+-ATPase activity in erythrocyte membrane.Results The plasma MDA concentration and RBC-ICR were significantly decreased during treatment es compared with the baselines at T1 in both groups (P＜0.05 or 0.01), but were significantly lower in Group B than in Group A (P＜0.05 or 0.01 ).The activities of plasma SOD and Na+ -K+ -ATPase in erythrocyte membrane and RBC-C3bRR were significantly increased during treatment as compared with the baselines at T1 and were significantly higher in Group B than in Group A.Conclusion SGB combined with traditional treatment can increase the activities of plasma SOD and Na+ -K+ -ATPase in erythrocyte membrane, inhibit production of oxygen free radicals and enhance RBC immune function in patients with acute cerebral infarction.

Objective To investigate the effects of stellate ganglion block (SGB) on brain injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). Methods Forty ASA Ⅱ or Ⅲ patients of both sexes aged 22-50 yr weighing 40-64 kg undergoing elective cardiac valve replacement were randomly divided into 2 groups (n = 20 each): control group (group C) and SGB group. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring. A catheter was inserted into left internal jugular vein under local anesthesia and advanced cephalad until resistance was met for blood sampling. Right SGB was performed with 0.25% ropivacaine 10 ml. Successful block was confirmed by ipsilateral Homer's syndrome.ECG, BP, CVP and SpO2 were monitored. Anesthesia was induced with midazolam 0.2 mg/kg, fentanyl 5-8 μg/kg and vecuronium 0.12 mg/kg and maintained with fentanyl infusion at 8-10 μg· kg- 1· h- 1 and intermittent iv boluses of midazolam and vecuronium. Blood samples were collected for determination of plasma NO, ET-1, S100β protein and NSE concentrations and NOS activity immediately after left internal jugular vein was retrogradely catheterized (T0 ), at 30 min of CPB (T1), 10 min after release of aortic cross clamp (T2 ), 6 and 24 h after operation (T3 ,T4 ). The patients' cognitive function was assessed by using mini-mental state examination (MMSE) the day before operation and on 1st and 7th day after operation. Results The plasma ET-1, S100β protein and NSE concentrations were significantly increased during and after operation at T1-3 as compared with baseline values at T0 in both groups and were significantly lower in group SGB than in group C. Plasma NO concentration was significantly increased during CPB at T1 as compared with the baseline at T0 in both groups but was significant higher after CPB at T2 but lower after operation at T3,4 in gToup SGB than in group C. The NOS activity was significantly higher during operation at T1,2 in group SGB than in group C. The cognitive function was significantly better at 1st postoperative day in group SGB than in group C. Compared with the baseline value,NO/ET-1 ratio was significantly decreased during and after operation in group C,but no significant change in NO/ET-1 ratio was found in group SGB. Conclusion SGB can attenuate brain injury induced by CPB by improving cerebral perfusion through maintenance of relative balance of NO/ET-1.

ObjectiveTo investigate the role and mechanism of cervical sympathetic ganglia block in alleviation of cerebrovascular spasm (CVS) of rabbits after subarachnoid hemorrhage ( SAH ).Methods A total of 18 healthy male white rabbits whose cervical sympathetic ganglia were successfully blocked were randomly divided into three groups:sham operation group (Group A),SAH group (Group B) and SAH with cervical sympathetic ganglia block group (Group C).Venous blood (2 ml) and cerebrospinal fluid (2 ml) were obtained before the first blood injection ( T1 ),at 30 minutes after injection ( T2 ) and at day 7 after injection ( T3 ),respectively,and conserved in a low temperature refrigerator for spare use.Basilar artery value at T1,T2 and T3 was measured via cerebral angiography.The degree of damage to nervous system at T3 was recorded.ResultsThere was no significant difference in diameter of basilar artery at T1 among three groups.At T2 and T3,the diameters of basilar artery of Groups B and C were shorter than that of Group A,with Group B shorter than Group C,with statistical differences ( P ＜0.01 ).There were no significant differences in NO and NOS in plasma and cerebrospinal fluid at T1 among three groups (P＞0.05).NO and NOS contents at T2 and T3 were lower than those at T1,with Group A lower than Groups B and C,with statistical differences (P＜0.01 ).At T3,the nerve function of Groups B and C were better than that of Group A,with Group C better than Group B ( P ＜0.01 ).Conclusion Cervical sympathetic ganglia block relieves CVS,increases NO content and NOS activity in plasma and cerebrospinal fluid and promotes neural functional recovery after SAH.

Objective To compare the occurrence of postoperative cognitive dysfunction (POCD) in elderly patients using differentanesthetic methods.Methods Ninety-three ASA Ⅱ or Ⅲ patients,aged ≥ 65 yr,weighing 45-67 kg,scheduled for artificial femoral head replacement,were randomly divided into 2 groups:general anesthesia (group G,n =47) and combined spinal-epidural anesthesia group (group S-E,n =46).In group G,anesthesia was induced with iv injection of midazolam 0.1 mg/kg,propofol 2 mg/kg,fentanyl 3-5μg/kg,and vecuronium 0.1 mg/kg,and maintained with continuous infusion of propofol 2-3 mg· kg-1 · h-1,intermittent iv boluses of fentanyl 1 μg/kg and vecuronium 0.04 mg/kg and inhalation of 1.5％-2.0％ isoflurane.In group S-E,hyperbaric 0.5 ％ ropivacaine 2 ml was injected into the subarachnoid space over 20 s,the patients were kept in the original position for 15 min,the level of anesthesia was simultaneously adjusted to below T8 on the operated side,and 0.5 ％ ropivacaine 3-5 ml was injected into the epidural space when needed during operation.Cognitive function was assessed by mini-mental state examination at 24 h before anesthesia and 24 and 72 h after operation.Venous blood samples were collected for determination of plasma amyloid-beta levels by ELISA.Results Compared with group G,the incidence of POCD at 24 h after operation and level of plasma amyloid-beta were significantly decreased in group S-E (P ＜ 0.05).Conclusion Elderly patients are more likely to develop POCD under general anesthesia than under combined spinal-epidural anesthesia.

Objective To evaluate the role of transient receptor potential ankyrin 1 (TRPA1) in the dorsal root ganglion neurons in the development of diabetic neuropathic pain (DNP) in rats.Methods Twenty-four Sprague-Dawley rats with DNP were randomly divided into 3 groups (n-=8 each) using a random number table:DNP group,TRPA1-specific siRNA group (siRNA group) and TRPA1-negative siRNA group (NC group).Another 8 Sprague-Dawley rats with normal blood glucose served as control group (C group).In siRNA group,TRPA1-specific siRNA 45 μl was injected intrathecally.In NC group,TRPA1-negative siRNA 45 μl was injected intrathecally.In DNP and C groups,normal saline 45 μl was injected intrathecally.On 2nd day after intrathecal administration,the lumbar segment (L4-6) of the dorsal root ganglions was removed for determination of the expression of TRPA1 mRNA.On 7,14,21 and 28 days after intrathecal administration (T1-4),MWT was measured.Results Compared with DNP group,TRPA1 mRNA expression was down-regulated in siRNA and C groups.Compared with DNP group,and MWT was significantly decreased at T1.2 in siRNA group,MWT was decreased at T1-3 in NC group,MWT was increased at T1-4 in group C.Compared with siRNA group,MWT was significantly increased at T1-4 in group C.MWT was significantly higher at T1~ in group C than in NC group.Conclusion TRPA1 in the dorsal root ganglion neurons is involved in the development of DNP in rats.

Objective To investigate the antitumor and immunologic activities of Laurencia extract(LET) in Sarcoma 180(S 180).Methods The content of total terpenoids in LET was detected by RP-HPLC and its toxicity(LD 50) was estimated by Horn assay. Tumor inhibition rates, index of thymus and spleen, proliferation of spleen lymph cells, IgA,IgG,IgM were detected. The data were analyzed by SPSS software. Results The content of total terpenoids in LET was proved to be 63.29%. LET showed low toxicity with its LD 50 more than 3160mg?kg -1. Tumor inhibition rates of test groups were significantly higher than those of the control group. LET could obviously increase the levels of index of thymus and spleen. LET increase the multiplication of spleen lymph cell.Concentrations of IgA、IgG and IgM in plasma of the test groups were higher than those of the control group. Conclusion LET rich in terpenoids is safety to be taken orally. The alga extract showed obvious antitumor activities and immunologic functions.

Objective:To investigate the effect of Laurencia terpenoid extract (LET) on tumor inhibition,immune modulation and apoptosis of Sarcoma 180 cell. Method:The LD50 of LET was estimated by Horn assay. The models of S180-bearing mice were established and divided into 4 groups which were given LET 0 (control group), 25 (low-dose group), 50 (mid-dose group), 100 (high-dose group) mg/kg bw respectively for 10 d. Tumor inhibition rates were detected in treatment groups and control group respectively. To weigh exactly the thymus and spleen to calculate their indices. The proliferation effect of LET on spleen lymphocyte was evaluated by MTT assay. The apoptosis of tumor cell was assayed by flow cytometry. Results:The LD50 was more than 3 160 mg/kg bw. LET had low toxicity. The average tumor weights of the supplemented groups were all less than the control group(P

Objective To compare the clinical effects of vesselplasty and percutaneous kyphoplasty in the treatment of osteoporotic thoracolumbar vertebral fracture in the elderly.Methods A retrospective case control study was conducted to analyze 52 cases of OVCFs treated from August 2013 to May 2015.According to treatment method,the patients were assigned to vesselplasty (Group A) and percutaneous kyphoplasty (Group B).Group A (25 cases,38 vertebrae) included 11 males and 14 females,aged (63.6 ±8.3)years (range,60-89 years).In Group A,there were nine cases of T11,10 T12,13 L1,and six L2.Group B (27 cases,41 vertebrae) included 10 males and 17 females,aged (64.1 ±9.6)years (range,63-87 years).In Group B,there were seven cases of T11,13 T12,12 L1,and nine L2.The bone cement leakage before operation,after operation,and at the last follow-up were recorded.The operation time,average fluoroscopy frequency,visual analog score (VAS),vertebral reduction height,Cobb angle,and Oswestry disability index (ODI) changes were compared between two groups.Results All patients were followed up for 6-18 months (mean,12 months).The operation time was (29.3 ± 4.1)minutes in Group A and (35.7 ± 5.2) minutes in Group B (P ＜ 0.05).The number of fluoroscopy was (9.3 ± 1.5) times in Group A and (13.1 ±3.7)times in Group B (P ＜0.05).The VAS at the last follow up was (1.3 ±0.3) points in Group A and (1.4 ± 0.3) points in Group B;the ODI at the last follow up was 32.5 ± 6.7in Group A and 30.5 ± 5.3 in Group B;the injured vertebral height at the last follow up was (85.3 ±9.7)％ in Group A and (82.7 ±10.4)％ in Group B;the Cobb angle at the last follow up was (11.3 ±5.3) ° in Group A and (12.7 ± 6.1) ° in Group B.VAS,vertebral reduction height,and Cobb angle were all improved significantly compared with those before operation (P ＜ 0.05),but there was no significant difference between two groups (P ＞0.05).The leakage rate was 3％ in Group A and 26％ in Group B (P ＜ O.05).Conclusion Both vesselplasty and percutaneous kyphoplasty can quickly relieve the pain and effectively restore the height of injured vertebra.But vesselplasty can reduce bone cement leakage more effectively,thus being a better treatment for osteoporotic thoracolumbar vertebral fracture in the elderly.