Objective To assess the relationship between acute exposure to gaseous air pollutants (SO2, NO2) and daily mortality in Shanghai. Methods Semi-parametric generalized additive model was used to analyze the relationship between SO2/NO2 concentrations and daily death numbers from January 1, 2001 to December 31, 2004 in the urban area of Shanghai after adjustment for the long-term trend of death, weather conditions, and "days of the week" effect. Results An increase of 10 ?g/m3 of SO2 could increase the total mortality, cardiovascular disease mortality and respiratory disease mortality by 1.25%(95%CI: 0.85%-1.65%), 1.45%(95%CI: 0.86%-2.04%) and 1.71%(95%CI: 0.72%-2.71%) respectively; as for an increase of 10 ?g/m3 of NO2, the mortalities could be increased by 1.04%(95%CI: 0.72%-1.35%), 1.05%(95%CI: 0.59%-1.51%) and 1.43%(95%CI: 0.65%-2.21%) respectively. Conclusion The air SO2, NO2 of present levels in Shanghai have an adverse effect on the daily mortality of residents.

Objective To evaluate the efficacy of percutaneous CT-guided puncture and steroid injection for the treatment of lumbar intraspinal synovial cysts (LISCs).Methods A patient with clinical symptom of LISCs was undergone percutaneous CT-guided lumbar synovial cyst puncture. After aspiration of the content and steroid injection were accomplished, visual analogue scale was used to evaluate the pain of the patient before and after the treatment.Results Excellent pain relief after aspiration and steroid injection was obtained with the symptom disappearing 4 days after the treatment.Conclusions Aspiration and steroid injection can reduce the pain of the patient with lumbar intraspinal synovial cysts,and it should be the frist choice of non-surgical treatment.

Objective To identify the short and long-term therapeutic benefits of CT-guided transforaminal epidural steroid injections in lumbar spinal stenosis. Methods Thirty six patients with lumbar spinal stenosis shown by CT underwent CT-guided transforaminal epidural steroid injections because of irresponsible to conservative treatment. Patients were evaluated by visual analogue scale (VAS) before the initial injection, at 2 weeks and 1 year after the injection.Results All patients were followed up for 2 weeks and 1 year. 19 ( 52.8%) patients had successful short-term outcome, and 15 ( 41.6%) had long-term outcome. 15 ( 41.6%) patients satisfied with the short-term result and 12 (33.3%) were satisfactory with the long-term result.Conclusions CT-guided transforaminal epidural steroid injection may reduce the pain and improve the quality of life in some patients with lumbar spinal stenosis.

Objective To investigate the effects of different doses of dexmedetomidine pretreat-ment on cardiac toxicity of bupivacaine in rats.Methods Forty eight adult male SD rats weighing 250-300 g were randomly divided into 4 groups (n=12):saline control group (group C),dexmedetomi-dine 5 μg/kg group(group D5),dexmedetomidine 10 μg/kg group(group D10)and dexmedetomidine 1 5 μg/kg group(group D1 5 ).A Ⅱ-lead electrocardiogram(ECG)was continuously monitored,the femoral artery was cannulated for direct measurement of MAP and the femoral vein was cannulated for infusion of drugs.Groups D5,D10 and D1 5 were received infusion of dexmedetomidine 5,10 and 1 5μg/kg respectively 1 5 minutes before administration of bupivacaine,while the equal volume of saline was given in group C,then all rats received infusion 0.75% bupivacaine at the rate of 2 mg·kg-1· min-1 until asystole occurred.The doses of bupivacaine and the times of bupivacaine-induced convul-sions,arrhythmia and asystole were recorded respectively,and the myocardial concentration of bupiv-acaine was observed.Results Compared with group C,the doses of bupivacaine and the times of bupivacaine-induced convulsions,arrhythmia and asystole were all increased in groups D5,D10 and D1 5 (P <0.05).Compared with group D5,the above parameters were increased in groups D10 and D1 5 (P <0.05 ).There was no statistical significance of the above parameters between groups D10 and group D1 5.Conclusion Dexmedetomidine pretreatment can raise the threshold toxic dose of bupi-vacaine,delay the time of occurrence of cardiotoxicity of bupivacaine,so that to prevent the cardiac toxicities of bupivacaine in rats,and it produces a dose-dependent protective effect within a certain dose range.

AIM:To investigate whether propofol can alter the pulmonary inflammation induced by severe acute pancreatitis(SAP)in rats during its early period.METHODS:Seventy-two adult male Sprague-Dawley(SD)rats were randomly divided into nine groups with 8 animals in each group:sham group,SAP 30,60,120,360 min groups and propofol treatment 30,60,120,360 min groups.The preparation of SAP were induced by retrograde injection of 5% sodium taurocholate into the pancreatic duct of rats.And the treatment groups received propofol with doses of 150 ?g?kg-1?min-1 injected continually immediately in vena caudalis after the preparation of ASP were made.Rats were sacrificed at different time points,and the level of AMY and LIP,the wet dry weight ratio(W/D)of pulmonary and pancreatic tissue,the pathological change of pulmonary and pancreatic tissue were examined.RESULTS:Water content and pathological score of pulmonary tissue were decreased significantly within 360 minutes after reproduction of SAP were received propofol(both P0.05).CONCLUSION:propofol can alleviate pulmonary inflammation induced by severe acute pancreatitis in its early period.But propofol can not alleviate the injury of pancreatitis tissue.

Objective To investigate the effect of intrathecal hyperbaric bupivacaine on spinal cord neurons apoptosis in diabetic neuropathic rats.Methods Thirty-two healthy male Sprague-Daw-ley rats weighing 220-300 g,8 normal rats randomly served as control group (group C),the other rats were intraperitoneal injection 1% streptozotocin (STZ)60 mg/kg to induce diabetic neuropathic (DN),and last induced thirty-seven diabetic neuropathic rats.group C and diabetic neuropathic rats administer intrathecal catheter,respectively.Twenty-four rats in which DN was successfully intrathe-cal catheter were randomly divided into 3 groups (n=8):hyperbaric bupivacaine group (group HB), isobaric bupivacaine group (group IB),glucose group (group G).Hyperbaric bupivacaine 10 μl were injected intrathecally in groups C and HB respectively,isobaric lidocaine 10 μl were injected intrathe-cally in group IB,10% glucose 10 μl were injected intrathecally in group G,once daily for 3d.After rats each administration 2 min,motor block duration were recorded;The paw withdrawal threshold to von Frey filament stimulation (PWT)were measured before induced diabetes model (T1 ),before in-jected intrathecally (T2 ),after 30 min administered 1 d (T3 ),2 d (T4 ),3 d (T5 )and end administered 4 d (T6 ).All rats were sacrificed at T6 and their lumbar intumescential spinal cord tissue were re-moved for microscopic examination.And using TUNEL assay to measure spinal neuronal apoptosis. Results PWT was lower at T2-5 in groups HB,IB and G comparing with T1 (P <0.05 ).Comparing with group C,the motor block duration was significantly prolonged(P <0.05)and spinal cord neuro-nal apoptosis cells were increased(P <0.05)in group HB.Comparing with group IB,the motor block duration was significantly prolonged(P <0.05)and spinal cord neuronal apoptosis cells were increased (P <0.05)in group HB,too.PWT was increased at T6 in group HB at T2-T5 (P <0.05).Group G did not appear motor block and spinal cord neuronal apoptosis.Conclusion Intrathecally hyperbaric bupi-vacaine can promote spinal cord neuronal apoptosis in diabetic neuropathic rats.

Objective To investigate the effects of enhanced recovery after surgery (ERAS) pathway on early cognitive function of post-hepatectomy patients after hepatectomy.Methods Ninety-six patients undergoing elective hepatectomy for liver cancer were randomly assigned into two groups:group ERAS,n =48 and group C,n =48.patients in group ERAS accepted perioperative and anaes-thetic optimization of enhanced recovery after surgery pathway,and patients in group C received peri-operative and anaesthetic management of normal surgery concept.The mini-mental state examination (MMSE)was used to test the cognitive function of the patients one day before operation (T0 ),one day after operation (T4 ),three days after operation (T5 )and seven days after operation (T6 ),and the blood levels of S100βprotein,neuron-specific enolase(NSE),IL-1β,IL-6,and TNF-α were de-tected at T0 ,30 minutes after operation (T1 ),6 hours after operation (T2 ),12 hours after operation (T3 )and T4 .Results Compared with group C,MMSE scores in group ERAS were increased at T4 ,T5 , the blood levels of S100βprotein,IL-1βand IL-6 in group ERAS were decreased at T1 ,T2 ,the blood levels of NSE in group ERAS were decreased at T2 ,T3 ,the blood levels of TNF-αin group ERAS were decreased at T1-T3 ;Compared with the baseline value at T0 ,MMSE scores were decreased at T4 ,T5 in group C and decreased at T4 in group ERAS,the blood levels of S100 βprotein in two groups were increased at T1-T3 , the blood levels of NSE in two groups were increased at T2-T4 ,the blood levels of IL-1β,IL-6,and TNF-αin two groups were increased at T1-T4 ;and the postoperative length of stay in group ERAS were decreased. Conclusion Enhanced recovery after surgery pathway is helpful in improving early postoperative cognitive function of patients after hepatectomy,and the mechanism may be related to decreased the blood levels of S100βprotein,NSE,IL-1β,IL-6 and TNF-α.

Objective To investigate the effects of penehyclidine hydrochloride(PHC)precon-ditioning on hepatic ischemia-reperfusion injury (HIRI)in rats.Methods Fifty-four male Sprague-Dawley rats,weighing 230-250 g,were randomly divided into three groups (n =18 each):sham op-eration group (group S),HIRI group (group HR)and penehyclidine hydrochloride group (group PHC).In group S,the hepatoduodenal ligaments of rats were only pulled and separated,then abdo-mens were closed.In group HR,an atraumatic vascular clip was placed on the vessels blocking the portal venous blood supply to the median and left lateral lobes of the liver for 45 minutes,which re-sulted in approximately 70% rat liver ischemia injury.In group PHC,the rats were treated with 0.45 mg/kg penehyclidine hydrochloride at 30 minutes before the portal venous and hepatic arterial were blocked like group HR.Animals were killed at 2 h (T1 ,n =6),4 h (T2 ,n =6),24 h (T3 ,n =6) after HIRI or sham surgery.Liver tissues and blood samples were taken for analysis.The serum con-centration of ALT and AST were measured as the markers of hepatic functional damage.The TNF-a and IL-1βconcentration were measured by the enzyme linked immunosorbent assay (ELISA)tech-nique.The endothelial nitric oxide synthase (eNOS ) and hypoxia-inducible factor (HIF-1α) expression were measured by immunohistochemical staining.Results Compared with group S,the expressions of ALT,AST,TNF-αand IL-1βin groups HR and PHC increased at T1-T3 (P <0.05), which were similar to the change trend of HIR-1αand eNOS expressions (P <0.05).Compared with group HR,the expression of ALT,AST,TNF-αand IL-1βin group PHC decreased at T1-T3 (P <0.05).Nevertheless expression of HIF-1αand eNOS of groups HR and HPC were increased than that of group S,and experssion of HIF-1αand eNOS of group HPC were increased than that of group HR at T1 and T2 (P < 0.05 ).Conclusion PHC preconditioning can protect the liver from HIRI.The mechanism may be associated with the up-regulation of eNOS and HIF-1α,as well as reducing the in-flammatory response.

Objective To evaluate the effect of stellate ganglion block (SGB) on cellular immune function in diabetic rats.Methods Healthy male Sprague-Dawley rats,aged 3 months,weighing 240-280 g,were used in this study.Diabetes mellitus was induced by intraperitoneal 1％ streptozotocin 60 mg/kg and confirmed by blood glucose ≥ 16.7 mmol/L 3 days later.Forty-eight rats with diabetes mellitus were randomly divided into 2 groups (n=24 each) using a random number table:diabetes mellitus group (group DM) and group SGB.Another 24 healthy rats,aged 3 months,were selected and served as control group (group C).At 1 week after successful establishment of the model,unilateral transection of cervical sympathetic trunk (TCST) was performed in group SGB,while the right cervical sympathetic trunk was only exposed in C and DM groups.Before TCST (T0) and on 1,3,7 days after TCST (T1-3),6 rats were randomly selected from each group,and blood samples were collected from the inferior vena cava for determination of the blood glucose,plasma norepinephrine (NE) concentrations (by enzyme-linked immunosorbent assay),and levels of T lymphocyte subsets CD3+,CD4+ and CD8+ in whole blood (using FACSCalibur flow cytometer).C D4+/CD8+ratio was calculated.The rats were weighed before sacrifice,and the rats were sacrificed to obtain the thymus which was weighed.The thymus index (thymus weight/body weight) was calculated.Results Compared with group C,the blood glucose was significantly increased,and the levels of CD3+ and CD4+ in whole blood,CD4+/CD8+ ratio,and thymus index were significantly decreased at T0-3 (P＜0.05),and no significant change was found in CD8+ levels in DM and SGB groups (P＞0.05),the plasma NE concentrations were significantly decreased at T1-3 in group SGB (P＜0.05),and no significant change was found in plasma NE concentrations in group DM (P＞0.05).Compared with group DM,the blood glucose and plasma NE concentrations were significantly decreased,and the levels of CD3+ and CD4+ in whole blood,CD4+/CD8+ ratio,and thymus index were significantly increased at T1-3 (P＜0.05),and no significant change was found in CD8+ levels in group SGB (P＞0.05).Conclusion SGB can improve the cellular immune function in diabetic rats.

Objective To evaluate the effect of hyperbaric factor on lidocaine-induced apoptosis in spinal neurons in rats with diabetic neuropathic pain.Methods Healthy male Sprague-Dawley rats,weighing 220-300 g,were used in the study.Diabetic neuropathic pain was induced by high-sugar high-fat diet + intraperitoneal 1％ streptozotocin (STZ) 30 mg/kg and confirmed by blood glucose level ＞ 16.65 mmol/L at 3 days after STZ injection and then intrathecal catheter was placed.Twenty-four rats with diabetic neuropathic pain in which IT catheters were successfully implanted were randomly divided into 3 groups (n =8 each):hyperbaric lidocaine group (group HL),isobaric lidocaine group (group IL),and glucose group (group G).Another 8 rats in which IT catheters were successfully inserted served as control group (group C).2％ hyperbaric lidocaine 10 μl (in C and HL groups),2％ isobaric lidocaine 10 μl (in group IL),or 10％ glucose 10 μl (in group G) was injected intrathecally once a day for 3 consecutive days.The duration of motor block was recorded at 2 min after each administration.The paw withdrawal threshold to von Frey filament stimulation (PWT) was measured before STZ injection (T1),before IT injection (T2),at 30 min after administration on 1st,2nd and 3rd days and on day 5 after the end of administration (T3-6).All the rats were sacrificed at T6 and their L4,5 segments of the spinal cord were removed for microscopic examination.The apoptosis in spinal neurons was detected using TUNEL assay.Results Compared with the baseline value at T1,PWT was significantly decreased at T2-5 in HL,IL and G groups.PWT was significantly higher at T6 than at T2-5 in group HL.Compared with group C,the duration of motor block was significantly prolonged and the apoptotic index was increased in group HL.Compared with group IL,the duration of motor block was significantly prolonged and the apoptotic index was increased in group HL.Conclusion Hyperbaric factor can promote lidocaine-induced apoptosis in spinal neurons in rats with diabetic neuropathic pain.