Objective To determine the optimum dose of dexmedetomidine (DEX) for endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients when combined with propofol.Methods Ninetytwo ASA physical status Ⅰ or Ⅱ] elderly patients,aged 65-80 yr,with body mass index 18-25 kg/m2,scheduled for elective ERCP,were randomly assigned into 4 groups (n =23 each) using a random number table:fentanyl group (F group),low-dose DEX group (D1 group),medium-dose DEX group (D2 group) and high-dose DEX group (D3 group).Fentanyl 1.0 μg/kg and DEX 0.4,0.7 and 1.0 μg/kg (in normal saline 20 ml) were infused over 10 min via a pump in F,D1,D2 and D3 groups,respectively.At the end of infusion,propofol targetcontrolled infusion was started with the target plasma concentration set at 4 μg/ml,and after the mirror passed through the throat,the target plasma concentration of propofol was adjusted to 2.5 μg/ml.At 10 min after admission to the operating room,immediately after completion of fentanyl or DEX infusion,immediately after the effect-site concentration of propofol reached 4 μg/ml,immediately after the mirror passed through the throat,while pulling the stone,at end of surgery and when the patients were awake,the depth of sedation (NT value) was reccorded and the development of hypoxemia was also recorded.Arterial blood samples were collected at 10 min after admission to the operating room and at the end of operation to record PaCO2.The consumption of propofol,duration of ERCP,and emergence time were recorded.The body movement and requirement for vasoactive drugs were also recorded.Results Compared with F group, NT value and the incidence of hypoxemia were significantly decreased in D1-3 groups,PaCO2,the incidence of body movement and amount of propofol consumed were decreased in D2 and D3 groups,and the emergence time was prolonged and the requirement for atropine was increased in D3 group (P ＜0.05).Compared with D1 group,the PaCO2,NT value,incidence of body movement and amount of propofol consumed were decreased in D2 and D3 groups,the emergence time was prolonged and the requirement for atropine was increased in D3 group (P ＜ 0.05).Compared with D2 group,the consumption of propofol was decreased,the emergence time was prolonged,aud the requirement for atropine was increased in D3 group (P ＜ 0.05).Conclusion The optimum dose of dexmedetomidine is 0.7 μg/kg for ERCP in elderly patients when combined with propofol.

Objective To evaluate the role of interleukin-4 receptor (IL-4R) in renal fibrosis following renal ischemia-reperfusion (I/R) injury in mice.Methods Twelve male wild type BALB/C mice and 12 IL-4Rα gene-knockout mice,aged 8-10 weeks,weighing 20-30 g,were used in the study.The mice of either type were divided into 2 groups (n =6 each) using a random number table:sham operation group (group S) and group I/R.In group I/R,renal I/R was induced by occlusion of the right renal artery for 1 h with atraumatic microclips followed by 2 weeks of reperfusion.The right renal artery was only isolated in group S.At 2 weeks of reperfusion,blood samples were taken from the orbital vein for determination of the concentrations of serum blood urea nitrogen (BUN) and creatinine (Cr).The renal tissues were obtained,and the renal fibrosis area was measured by Sirius Red staining.The expression of fibronectin (FN),collagen Ⅰ (COL-Ⅰ) and α-smooth muscle actin (α-SMA) in renal tissues was detected by immunofluorescence.The expression of signal transducer and activator of transcription 6 (STAT6) and phospho-STAT6 in renal tissues was determined by Western blot.The ratio of phoshop-STAT6 to STAT6 was calculated to reflect the phosphorylation of STAT6.Results Compared with group S of wild type mice,the serum BUN and Cr concentrations and renal fibrosis area were significantly increased,the expression of FN,COL-Ⅰ and α-SMA in renal tissues was significantly up-regulated,and the phosphorylation of STAT6 in renal tissues was significantly increased in group I/R of wild type and IL-4Rα KO mice (P＜0.05).Compared with group I/R of wild type mice,the serum BUN and Cr concentrations and renal fibrosis area were significantly decreased,the expression of FN,COL-Ⅰ and α-SMA in renal tissues was significantly down-regulated,and the phosphorylation of STAT6 in renal tissues was significantly decreased in group I/R of IL-4RαKO mice (P＜0.05).Conclusion The mechanism of renal fibrosis following renal I/R injury is partially related to IL-4R,and IL-4R results in renal fibrosis through promoting activation of STAT6 signaling pathway in mice.

Objective To evaluate the effect of propofol on invasiveness of human gastric cancer MKN-45 cells.Methods Human gastric cancer cell line MKN-45 were seeded in culture plates.After being cultured for 24 h,the cells were randomly divided into 5 groups(n =12 each):control group (group C),intralipid group (group Ⅰ),4 μg/ml propofol group (group P1),8 μg/ml propofol group (group P2) and 16μg/ml propofol group (group P3).The cells were treated with 10％ intralipid and 4,8 and 16 μg/ml propofol for 24 h in I and P1-3 groups,respectively.The cells were then cultured for another 24 h.The migration of cells was determined by cell scratch test.The invasion of cells was determined by Transwell invasion assay.The expression of RhoA and ROCK1 was detected by Western blot.Results Compared with group C,the cell migration and invasion were significantly decreased,and the expression of RhoA and ROCK1 was down-regulated in P1-3 groups,and no significant changes were found in the parameters mentioned above in group Ⅰ.With the increasing concentrations of propofol,the cell migration and invasion were gradually decreased,and the expression of RhoA and ROCK1 was gradually down-regulated in P1-3 groups.Conclusion Propofol can inhibit the invasiveness of human gastric cancer MKN-45 cells cultured in vitro dose-dependently and inhibition of RhoA/ROCK1 signaling pathway may be involved in the mechanism.

Objective To investigate the effect of different doses of dexmedetomidine(Dex)on sevoflurane consumption in patients undergoing laparoscopic oophorocystectomy.Methods Eighty ASA Ⅰ or Ⅱ patients aged 25-50 yr with body mass index 18-25 kg/m2 undergoing laparoscopic oophorocystectomy were randomly divided into 4 groups (n =20): control group (group C),low dose Dex group(group DL),medium dose Dex group(group DM) and high dose Dex group(group DH).Normal saline 20 ml and Dex 0.3,0.6,0.9μg/kg was infused iv over 10 min at 10 min before skin incision in groups C,DL,DM and DH,respectively.End-tidal sevoflurane concentration (ETsev) was recorded before Dex administration(T1 ),skin incision(T2 ),immediately after pneumoperitoneum (T3 ),10 min of pneumoperitoneum(T4 ) and the end of surgery (T5 ).Duration of anesthesia,consumption of sevoflurane,emergence time,extubation time were recorded and restlessness at 10 min after extubation was also recorded.The concentrations of blood glucose and corticosteroid were measured by quickly by glucose analyzer and radio-immunity gefore anethesia induction (T0) and at T3,T4,T5 respectively.Results The consumption of sevoflurane per hour,ETsev at T2-5,concentrations of blood glucose and corticosteroid at T3-5 were decreased gradually in groups C,DL,DM and DH ( P ＜ 0.05).The emergence time and extubation time were shorter and the incidence of restlessness was lower in groups DL,DM and DH than in group C ( P ＜ 0.05 ).Conclusion Dexmedetomidine can reduce the consumption of sevoflurane in a dose-dependent manner in patients undergoing laparoscopic oophorocystectomy.

Objective To evaluate the value of transrectal real-time tissue elastography (RTE) targeted prostate biopsy in the peripheral zone combined with peak strain index.Methods One hundred and forty-one patients with suspicious prostate lesions in the peripheral zone were evaluated from February 2011 to February 2014.All the patients underwent RTE with a mean age of 71.6 years,PSA of 30 ng/ml,prostate volume of 50.3 ml and measured peak strain index (PSI).The diagnostic value of PSI was assessed by receiver operating characteristic (ROC) curve.Two-core RTE combined with PSI targeted prostate biopsy was taken and subsequently a 10-core systematic biopsy was taken.The value of RTE was evaluated.The data of targeted biopsy and systematic biopsy in prostate were both reviewed and statistically compared.Results Cancer was detected in 72 of 141 patients (PSI,mean 24.79),and 69 patients had benign prostate disease (PSI,mean 3.02).PSI value of prostate cancer was significantly higher than that of the benign lesions (P ＜ 0.05).Prostate cancer could be predicted with the highest sensitivity (87.5％) and specificity (88.6％) using the cutoff value of PSI ≥ 5.97 with an area under the curve of 0.95.RTE targeted biopsy combined with PSI could detect 95.6％ of moderate or high risk prostate cancer.One hundred and fifty-nine suspicious areas detected by RTE in 141 patients were biopsied with 2 cores for each area.The positive incidence of prostate cancer in RTE-targeted biopsy cores was 44％ and in systematic biopsy was 30.2％ (P ＜ 0.05).Among the 72 prostate cancer patients,63 cases (87.5％) were detected by RTE-targeted biopsy,62 cases (86.1％) by systematic biopsy (P ＞ 0.05).Conclusions RTE combined PSI can improve the detection rate of prostate cancer in the peripheral zone and likewise guide targeted biopsy combined with svstematic biopsy to detect more moderate or high risk prostate cancer.

Objective To compare the quality of emergence from TCI of sufentanil and remifentanil supplementing propofol-sevoflurane anesthesia in patients undergoing radical colo-rectal cancer resection.Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 40-64 yr undergoing elective radical colo-rectal cancer resection were allocated into 2 groups ( n =20 each):sufentanil group (group S) and remifentanil group (group R).Anesthesia was induced with propofol TCI at plasma concentration (Cp) of 4.0 μg/ml in both groups and sufentanil TCI (effect-site concentration Ce =0.4 ng/ml ) or remifentanil TCI ( Cp =4.0 ng/ml).Tracheal intubation was facilitated with vecuronium 0.1 mg/kg.The patients were mechanically ventilated (VT =8-10 ml/kg,RR =12-16 bpm).PErCO2 was maintained at 30-40 mm Hg.Anesthesia was maintained with propofol TCI-sevoflurane supplemented with sufentanil (Ce=0.25 ng/ml) or remifentanil (Cp=2.5 ng/ml).The depth of anesthesia was maintained at Narcotrend index of 37-56 by adjusting Cp of propofol TCI and sevoflurane concentration.The infusion of sufentanil was discontinued at 40 min before the conclusion of the operation while remifentanil was administered until the end of surgery.The incidence of postoperative adverse events,the time from the end of operation to eye openg and the time to extubation were recorded.Reesults The two groups were comparable with respect to demographic data.Neither group developed prolonged emergence and respiratory depression but the time from the end of operation to eye opening and the time to extubation were significantly longer in group S than in group R.The incidence of hypertension and tachycardia,agitation,shivering aad coughing were significantly lower in group S than in group R.Conclusion The quality of emergence from sufentanil supplementing propofol-sevoflurane anesthesia is higher than that from remifentanil.

Objective To evaluate the effects of the right stellate ganglion block on the expression of β3adrenoceptor (β3-AR) in rabbits with heart failure.Methods Forty-eight Japanese white rabbits of both sexes,weighing 2.5-3.0 kg,were randomly divided into 3 groups (n =16 each):sham operation group (group S),heart failure group (group HF) and right stellate ganglion block group (group RSGB).Heart failure was induced by occlusion of left anterior descending branch of coronary artery and confirmed by ultrasonic cardiography 4 weeks later.A PE-10 catheter was inserted into the right stellate ganglion for administration of drugs.0.25％ bupivacaine 2 ml was injected through the catheter once a day for 2 weeks in group RSGB,while the equal volume of normal saline was injected instead of bupivacaine in S and HF groups.The left ventricular end-diastolic diameter (LVEDD),left ventricular end-systolic diameter (LVESD),ejection fraction (EF) and left ventricular fractional shortening (LVFS) were measured at 1 day before ligation (T0),before catheter insertion (T1),before 8th administration (T2),and 1 day after the last administration (T3).Eight rabbits were sacrificed at T1 and T3 in each group and myocardial specimens were obtained from the apex of the left ventricle for determination of the expression of β3-AR by Western blot.Results Compared with group S,the LVEDD and LVESD were significantly enlarged and LVEF and LVFS were decreased at T1-3,and the expression of β3-AR was up-regulated at T1,3 in groups HF and RSGB (P ＜ 0.05).Compared with group HF,the LVEDD and LVESD were significantly decreased,LVEF and LVFS were increased,and the expression of β3-AR was significantly down-regulated at T3 in group RSGB (P ＜ 0.05).Conclusion The right stellate ganglion block can improve the cardiac function of rabbits with heart failure through down-regulating the expression of β3-AR in myocardium.

Objective To evaluate the changes in autophagy in spinal neurons of rats with diabetic neuropathic pain (DNP).Methods Forty-eight male Sprague-Dawley rats,weighing 220-250 g,were randomly divided into control group (group C,n =8) and group DNP (n =40) using a random number table.Diabetes mellitus was induced by a single intraperitoneal injection of streptozotocin (STZ) 60 mg/kg.Before STZ injection and at 1,2,4,and 8 weeks after STZ injection,8 rats randomly chosen from each group were used to measure mechanical pain threshold.The animals were sacrificed after measurement of mechanical pain threshold and the spinal cords were removed for determination of the expression of LC3-Ⅰ,LC3-Ⅱ,Beclin-1 and p62 protein.LC3-Ⅱ/LC3-Ⅰ ratio was calculated.Results Compared with group C,mechanical pain threshold was significantly decreased at 2,4,and 8 weeks after STZ injection in group DNP.The expression of LC3-Ⅱ and Beclin-1 in the spinal cord was significantly up-regulated,p62 protein expression was down-regulated,and LC3-Ⅱ/LC3-Ⅰ ratio was increased at 2,4,and 8 weeks after STZ injection as compared with the baseline value before STZ injection in group DNP.Conclusion Enhanced autophagy in spinal neurons may be involved in the development and maintenance of DNP in rats.

Objective To evaluate the accuracy of target-controlled infusion (TCI) of sufentanil from termination of cardiopulmonary bypass (CPB) until the end of surgery in the patients undergoing cardiac surgery.Methods Twenty adult patients,aged 25-64 yr,of ASA physical status Ⅱ or Ⅲ,scheduled for elective coronary artery bypass graft under CPB,were enrolled in the study.Immediately after termination of CPB,sufentanil was given by TCI using Gepts pharmacokinetic parameters.The initial target effect-site concentration (Ce) of sufentanil was 0.4 ng/ml.The Ce increased by 0.2 ng/ml every 10 min until it finally decreased to 0.8 ng/ml,and then the Ce decreased by 0.2 ng/ml every 10 min until it finally decreased to 0.4 ng/ml which was maintained until the end of surgery.At 10 min of infusion at each preset target Ce 0.4,0.6,0.8 and 0.6 ng/ml (T1-4) and 1,3,5,10,20,40 and 60 min of infusion at the last concentration of 0.4 ng/ml (T5-11),arterial blood samples were collected for measurement of sufentanil concentrations by using ELISA.For each sample,the bias,accuracy and wobble were calculated.Results Compared with the predicted plasma concentrations of sufentanil,the measured plasma concentrations of sufentanil were significantly decreased at T1-11.The bias,accuracy and wobble were-37.63 ％,37.63％ and 5.09％,respectively.Conclusion The accuracy of sufentanil TCI using Gepts pharmacokinetic parameters is not high from termination of CPB until the end of surgery in the patients undergoing cardiac surgery.

Objective To evaluate the effect of curcumin preconditioning on the activation of mast cells during intestinal ischemia/reperfusion (I/R) in rats.Methods Twenty-four female Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (S group),intestinal I/R group (I/R group),and curcumin preconditioning group (Cur group).Intestinal I/R was produced by occlusion of superior mesenteric artery (SMA) for 75 min followed by reperfusion.At 5 days before I/ R,curcumin 200 mg/kg (in 20 mg/ml normal saline) was given through a gastric tube in Cur group,while the equal volume of normal saline was given instead in S and I/R groups.All the rats were sacrificed at 4 h of reperfusion,and the intestinal specimens were obtained for microscopic examination and for determination of tryptase expression and β-hexosaminidase content.Intestinal damage was assessed and scored according to Chiu.Results Compared with S group,Chiu's score and β-hexosaminidase content were significantly increased,and the expression of tryptase was up-regulated in I/R and Cur groups.Compared with I/R group,Chiu' s score and β-hexosaminidase content were significantly decreased,and the expression of tryptase was down-regulated in Cur group.Conclusion The mechanism by which curcumin preconditioning attenuates intestinal I/R injury is related to inhibited activation of mast cells of rats.