ObjectiveTo explore the effect of small incision open-window discectamy in treating protrusion of lumbar intervertebral disc.Methods71 cases with protrusion of lumbar intervertebral disc,who were treated with small incision open-window discectomy were selected.ResultsAverage operation time was (55.34 ± 15.29) min,average blood loss was(67.30 ±29.36) ml,average length of stay( 14.3 ± 1.2) days.Self-rated improvement pains were significantly reduced.JOA score was significantly better than preoperative patients( P ＜0.01 ).ConclusionCompared with the traditional methods,small incision open-window discectomy had less traumas,shorter incision length,faster recovery,and little damage.

Objective: To evaluate the influence of acute moderate hemodilution on the dose-response and timecourse of effect of vecuronium. Method:Sixty patients. ASA grade Ⅰ,aged 17-45 years,scheduled for elective plastic surgery were included in the study,of which,thirty patients underwent hemodilution during surgery and thirty patients did not receive hemodilution as controls. General anesthesia was maintained with 60% nitrous oxide in oxygen,and further increments of thiopental 2 mg/kg or fentanyl 2?g/kg as required. After anesthesia was stable,the status of acute moderate hemodilution was developed by drainage o{ venous blood and intravenous infusion of lactated Ringer'ssolution, 6% dextran and.gelofusine,during which the level of hemoatocrit dropped from 45.7% to 26.2%. Neuromuscular function was assessed by TOF stimulation of accelerometry with the percentage depression of T_1 response used as the study parameter. The dose-response relationships of vecuronium were determined with the cumulative dose-response technique. Result:During hemodilution the dose-response curve of vecuronium was parallelly shifted to the left. Compared to the control patients,ED_(50),ED_(90) and ED_(95) of vecuronium in the hemodilution patients were decreased by 22%,18% and 17%, respectively. Following an intravenous administration of total dose of vecuronium 80?g/kg, vecuronium-induced neuromuscular block was significantly longer in the hemodilution patients than in the control patients. Conclusion:Acute moderate hemodilution could significantly enhance the neuromuscular blocking effect of vecuronium and prolong its duration of action.

OBJECTIVE To analyze the superinfection and multidrug resistance of patients in ICU.METHODS(Isolation),cultivation,and identification of ESBLs and drug-sensitivity tests to 17 antibiotics in 219 clinical(specimens) from ICU were conducted.Susceptibility testing was performed by disk diffusion(KB) method,(according) the NCCLs standard to manipulate and judge the results.interim sensitivity was ascribed to resistance.RESULTS Totally 219 cases of patients with bacterial infection in ICU,in which there were 132 cases of patients with superinfection(60.3%),in the same time,100 cases of patients with bacterial infection in general wards,in which there were only 11 cases of patients with superinfection(11%),the superinfection in ICU and general wards had significant deference(P(

Objective To investigate whether naloxone postconditioning could attenuate the focal cerebral ischemia-reperfusion (I/R) injury in rats. Methods Eighty-eight adult male SD nits weighing 270-330 g were randomly divided into 4 groups (n = 22 each) : group I sham operation (S); group Ⅱ I/R; group Ⅲ , Ⅳ I/R + low and high dose naloxone ( N_1, N_2). Focal cerebral I/R was produced by occlusion of right middle cerebral artery for 90 min followed by 24 h reperfusion. In group N_1, and N_2 naloxone 1 and 10 mg/kg were injected intraperitoneally at initiation of reperfusion respectively. In group I/R normal saline was injected instead of naloxone. HR, MAP and EKG were continuously monitored throughout the experiment. He neurological deficits were scored (0 = no deficit, 4 = unable to crawl, mental dysfunction) at 2 h and 24 h of reperfusion. The animals were then decapitated. The brains were immediately removed for determination of infarct size ( n = 10) and the expression of microtubule-associated protein-2 ( MAP-2) in brain tissue ( n = 6) . In the other 6 rats in each group FICT-dextran 1 ml (50 mg/ml) was injected iv at 1 min before decapitation. The cerebral plasma volume and diameter and segment length of cerebral microvessels on the I/R side were measured using laser scanning confocal microscopy (LSCM). Results Focal cerebral I/R significantly increased neurological deficit scores, induced cerebral infarct, and decreased MAP-2 expression in the brain tissue, cerebral plasma volume and the diameter and segment length of cerebral microvessels on the I/R side. Postconditioning with 10 mg/kg naloxone significantly attenuated the above-mentioned focal cerebral I/R-induced changes. Conclusion Postconditioning with naloxone can attenuate focal cerebral I/R injury in a dose-dependent manner.

Objective To evaluate the influence of head anteflexion on airway sealing pressure during intermittent positive pressure ventilation(IPPV) with ProSeal laryngeal mask airway (PLMA) with an esophageal vent.Methods Fifty ASA Ⅰ or Ⅱ patients (20 males and 30 females), aged 18-51 ye are, weighing 50-70 kg and scheduled for elective plastic surgery under general anesthesia, were enrolled in this study. Anesthesia was induced with fentanyl 2 μg/kg, propofol 2 μg/kg and vecuromium 0.1 mg/kg. PLMA with an esophageal vent was inserted at 2 min after intravenous vecuronium injection.The airway sealing pressure, the anatomic position of the cuff and the efficacy of positive pressure ventilation were checked in the neutral and anteflexed head positions with the cuff deflated and inflated to an intracuff pressure of 60 cm H2 O, respectively.Results The lungs were better ventilated in the head anteflexion position than in the head neutral position whether the cuff was deflated or inflated. There was no significant difference in the volume of air required to achieve an intracuff pressure of 60 cm H2O between the two head positions ( P＞ 0.05). The airway seating pressure increased from (27 ± 6) cm H2O in the head neutral position to (33 ± 6) cm H2O in the head anteflexion position, with no significant difference between them ( P＞ 0.05). The expired tidal volume and the peak inspiratory pressure during IPPV were (496 ± 81 ) ml and (14.3 ± 1.9) cm H2O respectively in the head neutral position and (496 ± 81 ) ml and ( 14.5 ± 2.1 )cm H2O respectively in the head anteflexion position.Conclusion Head anteflexion can significantly improve airway sealing but does not affect the anatomic position of the cuff.Appropriate head anteflexion is a simple and effective way to improve IPPV when the airway sealing pressure is inadequate in the head neutral position.

Objective To investigate the effects of postconditioning with α7 nicotinic acetylcholine receptor (α7nAChR) agonist and ischemia on myocardial ischemia-reperfusion (IR) injury in rats. Methods Fifty adult male SD rats weighing 290-320 g were randomly divided into 5 groups ( n = 10 each): Ⅰ sham operation group, Ⅱ IR group, Ⅲ ischemic postconditioning group, Ⅳ α7nAChR agonist postconditioning group and Ⅴpostconditioning with α7nAChR agonist and ischemia group. Myocardial I/R was induced by ligation of anterior descending branch of left coronary artery for 30 min followed by 1 80 min of reperfusion. In group] the anterior descending branch was only exposed but not ligated. In group Ⅲ the hearts were subjected to 3 episodes of 10 second ischemia at 10 second intervals at the end of 30 min ischemia before 180 min reperfusion, Intraperitoneal PNU282987 2.4 mg/kg was injected at the end of 30 min ischemia before 180 min reperfusion in group Ⅳ and Ⅴ .Blood samples were taken from right internal jugular vein at 180 min of reperfusion. Then the rats were killed and hearts removed to determine the concentrations of serum cardiac troponin-I (cTnI), TNF-α and high-mobility group box 1 (HMGB1) by ELISA. The infarction size was measured by Evans blue and triphenyltetrazolium chloride staining. Results The infarction size was significantly larger in the other groups and concentrations of serum cTrI, TNF-α and HMGB1 were significantly higher in group Ⅱ than in group Ⅰ ( P ＜ 0.05). The infarction size was significantly smaller and concentrations of serum cTnI, TNF-α and HMGBI were significantly lower in group Ⅲ, Ⅴ than in group Ⅱ (P ＜ 0.05). The infarction size was significantly smaller in group Ⅴ and concentrations of serum cTnI, TNF-α and HMGB1 were significantly lower in group Ⅳ and Ⅴ than in group Ⅲ (P ＜0.05). The infarction size was significantly smaller and concentrations of serum cTnI, TNF-α and HMGB1 were significantly lower in group Ⅴ than in group Ⅳ ( P ＜ 0.05 ). Conclusion Postconditioning with α7nAChR agonist and ischemia can reduce myocardial I/R injury and the efficacy is better than that of α7nAChR agonist postconditioning or ischemic postconditioning alone.

ObjectiveTo investigate the effects of postconditioning with electric vagal stimulation on myocardial ischemia-reperfusion (I/R) injury in rats.MethodsSixty male SD rats weighing 250-350 g were randomly divided into 3 groups (n ＝ 20 each):group sham operation (group S); group myocardial I/R (group I/R) and group electric vagal stimulation postconditioning (group POES).Myocardial I/R was induced by occlusion of left anterior descending branch of coronary artery for 30 min followed by 120 min reperfusion in groups I/R and POES.In group POES right cervical vagus nerve trunk was stimulated for 30 min with continuous electric rectangular pulses (2 ms,10 Hz) starting from 15 min of myocardial ischemia.The voltage of the pulses was adjusted to decrease HR by 10％ of the baseline HR before stimulation.MAP,HR and RPP (MAP× HR) were recorded before (baseline) and at 1 and 10 min of ischemia and 30,60 and 120 min of reperfusion.Arterial blood samples were collected from 10 rats in each group at 120 min of reperfusion for determination of serum concentrations of cTnI,CK-MB,TNF-a,high mobility group box 1 protein (HMGB1),ICAM-1,IL-1,IL-6 and IL-10 (by ELISA).The animals were then sacrificed and myocardial infarct size was measured by Evans blue and TTC staining.Another 10 rats were sacrificed at 120 min of reperfusion for determination of myocardial contents of TNF-α,HMGB1,ICAM-1,IL-1,IL-6 and IL-10 (by ELISA).ResultsI/R induced myocardial infarct,significantly increased serum concentrations of cTnI,CK-MB,TNF-α,HMGB1,ICAM-1,IL-1 and IL-6 and significantly increased myocardial contents of TNF-α,HMGB1,ICAM-1,IL-1,IL-6 and IL-10 in both ischemic and non-ischemic regions in group I/R as compared with group S.Electric vagal stimulation significantly decreased myocardial infarct size and serum concentrations of cTnI,CK-MB,TNF-α,HMGB1,1CAM-1,IL-1 and IL-6 in group POES compared with group I/R.Myocardial contents of TNF-α,HMGB1,ICAM-1,IL-1 and IL-6 were significantly decreased while myocardial IL-10 content was increased in both ischemic and non-isehemic regions in groups POES compared with group I/R.ConclusionPostconditioning with electric vagal stimulation can attenuate myocardial I/R injury by inhibiting inflammatory response in rats.

Objective: To evaluate the effects of sevoflurane on the dose-response relationship and on the timecourse of recovery of rocuronium. Method: Sixty patients,ASA grade Ⅰ,aged 18 to 52 years, undergoing elective plastic surgery,were included in this study. Patients were equally allocated randomly to either the control or the sevoflurane group. Anesthesia was maintained with 60％ N_2O-O_2-thiopental in the control group,and with 1 MAC sevofurane-N_2O-O_2 in the sevoflurane group. The dose-response relationship of rocuronium was established with a cumulative dosing regimen. Result: The dose response curve of rocuronium in the sevoflurane group was shifted to the left. The ED_(50),ED_(90) and ED_95 of rocuronium were decreased by 31％, 27％ and 25％, respectively in sevoflurane group as compared with those of the control group. Following an intravenous administration of rocuronium 400ug/kg,the duration of peak effect,duration of clinical relaxation,recovery index,and the total duration of action in the sevoflurane group were significantly prolonged vs. the control group. Conclusion: Sevoflurane can significantly enhance the neuromuscular blockade effect of rocuronium and prolong its duration of action.

Objective To evaluate the protective effects of fentanyl postconditioning and remote limb ischemic postconditioning (RLIP) against myocardial ischemia-reperfusion (I/R) injury in rats. Methods Thirty-nine male SD rats aged 8 weeks weighing 250-350 g were randomly allocated into 5 groups: Ⅰ group sham operation (group S, n = 5); Ⅱ group I/R ( n = 7); Ⅲ group fentanyl postconditioning (group F, n= 9); Ⅳ group RLIP (group R, n = 9) and group Ⅴ fentanyl postconditioning + RLIP (group F-R, n = 9). The animals were anesthetized with intraperitoneal 3% pentobarbital 50 mg/kg, intubated and mechanically ventilated. Myocardial I/R was induced by occlusion of anterior desending branch of left coronary artery for 30 min followed by 180 min reperfusion. Fentanyl 30 μg/kg was injected iv at 15 min of myocardial ischemia in group F and F-R In group R and F-R the animals underwent 10 min ischemia of bilateral hind limbs starting from 15 min of myocardial ischemia. HR and MAP were recorded at 5,60,120 and 180 min of reperfusion and rate-pressure product( RPP, HR × MAP) were calculated. At the end of 180 min reperfusion, arterial blood samples were obtained for measurement of the activities of plasma lactate dehydrogenase (LDH) and creatine kinase isoenzyme MB (CK-MB), and the concentration of serum cardiac troponin Ⅰ (cTnI). The animals were then sacrificed. The infarct size was evaluated by double staining with Evans blue and triphenyl tetrazolium chloride. Results Myocardial I/R significantly increased plasma LDH and CK-MB activities and serum cTnI concentration and decreased HR,MAP and RPP as compared with group S.Fentanyl postconditioning and RLIP both decreased plasma CK-MB activity, serum cTnI concentration and infarct size and increased HR, MAP and RPP in group F, R and F-R as compared with group I/R. Plasma CK-MB activity,serum cTnI concentration and RPP were significantly lower and infarct size was smaller in group F-R than in group F. The infarct size was significantly smaller and MAP and RPP were higher in group F-R than in group R.Conclusion Fentanyl postconditioning can provide a myocardial protection against I/R injury. Myocardial protection is enhanced by combination of fentanyl postconditioning and RLIP.

Objective To investigate the role of reactive oxygen species (ROS) in the reduction of myocardial ischemia-reperfusion (I/R) injury by fentanyl postconditioning and remote limb ischemic postconditioning in rats.Methods Sixty-three male Sprague-Dawley rats,aged 8 weeks,weighing 250-350 g,were equally and randomly allocated into 7 groups:sham operation group (group S),group I/R,fentanyl postconditioning group (group F),remote limb ischemic postconditioning group (group R),ROS scavenger N-(2-Mercaptopropionyl) glycine (MPG) group (group M),MPG + fentanyl postconditioning group (group MF),and MPG + remote limb ischemic postconditioning group (group MR).Myocardial I/R was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 180 min of reperfusion.In group S the anterior descending branch was only exposed but not ligated.MPG 5 mg/kg was infused intravenously from 5 min before ischemia to 15 min of reperfusion in groups M,MF and MR,while the equal volume of normal saline was given in the other four groups.In groups F and MF,fentanyl 30 μg/kg was injected intravenously at 15 min of myocardial ischemia.In groups R and MR,the animals underwent 10 min ischemia of bilateral hind limbs starting from 15 min of myocardial ischemia.Arterial blood samples were taken at 180 min of reperfusion to determine the serum cardiac troponin I (cTnI) concentration.The rats were then sacrificed.The infarct size was measured by TTC.Results Compared with group S,the serum cTnI concentration and infarct size were significantly increased in the other six groups (P ＜0.05).Compared with group I/R,no significant change was found in the serum cTnI concentration and infarct size in M group,and the serum cTnI concentration and infarct size were significantly decreased in F and R groups (P ＜ 0.05).There was no significant difference in the serum cTnI concentration and infarct size between MF group and F group (P ＞ 0.05).The serum cTnI concentration was significantly higher and the infarct size was larger in group MR than in group R (P ＜ 0.05).Conclusion ROS is involved in the reduction of myocardial I/R injury by remote limb ischemic postconditioning in rats,but not in the myocardial protection provided by fentanyl postconditioning.