Objective To determine the median effective dose (ED50) of 0.375 ％ ropivacaine for ultrasound-guided subgluteus approach to the sciatic nerve block in the elderly patients.Methods Thirty ASA Ⅰ-Ⅲ patients of both sexes,aged 65-85 yr,scheduled for foot or ankle surgery under the sciatic nerve block,were enrolled in this study.The patients were placed in the Sim's position and received the sciatic nerve block using the posterior subgluteus approach guided by ultrasound.The initial dose of 0.375％ ropivacaine was 14.5 ml in the first patient and the ratio between the 2 successive doses was 1.2.The ED50 and 95 ％ confidence interval of ropivacaine were calculated by up-and-down technique.Results The ED50 and 95％ confidence interval of 0.375％ ropivacaine resulting in complete block of the sciatic nerve by using the ultrasound-guided subgluteus approach were 13.4 and 11.5-16.2 ml,respectively.Conclusion The ED50 of 0.375 ％ ropivacaine for ultrasound-guided subgluteus approach to the sciatic nerve block is 13.4 ml in the elderly patients.

Objective To assess the efficacy of laryngeal mask airway Supreme (LMA Supreme) used in patients undergoing gynecological laparoscopic surgery. Methods Eighty ASA Ⅰ or Ⅱ patients, aged 40-64 yr,weighing 50-70 kg, undergoing elective gynecological laparoscopic surgery, were randomized into 2 groups ( n = 40 each): LMA Supreme group (group S) and LMA ProSeal group (group P). Mallampati test was performed before operation in both groups. The patients were classified as Ⅰ or Ⅱ . LMA Supreme and LMA ProSeal were inserted in group S and P respectively after induction of anesthesia with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 3 μg/kg and vecuronium 0.1 mg/kg. A gastric tube was inserted through the drain tube of the LMA. The number of attempt, success rate, LMA placement time, success rate of gastric tube placement, cuff volume, peak airway pressure, and airway seal pressure, BP, HR, ECG, SpO2, PET CO2 and complications were recorded. The duration of surgery and pneumoperitoneum, and emergence time were also recorded. The fiberoptic bronchoscope scores were assessed after successful LMA placement. Results There were no significant differences in the duration of operation and pneumoperitoneum, emergence time between the two groups (P ＞ 0.05). The BP, HR,SpO2, PET CO2 and peak pressure were within the normal range during operation in both groups. The first attempt success rates of LMA placement and gastric tube placement were significantly higher, the LMA placement time was significantly shorter, and the fiberoptic bronchoscopic scores were significantly higher in group S than in group P ( P ＜ 0.05). Conclusion LMA Supreme is helpful for ventilation during operation with less complications and can be used effectively for gynecological laparoscopic surgery.

Objective To evaluate the efficacy of fiberoptic bronchoscope (FOB)-guided tracheal intubation with laryngeal mask airway i-gel (LMA i-gel) in patients undergoing cervical spine surgery. Methods Forty ASA Ⅰ or Ⅱ patients, aged 36-62 yr, weighing 57-78 kg, scheduled for cervical spine surgery under general anesthesia, were randomly divided into 2 groups (n = 20 each): FOB-guided tracheal intubation with oropharynx ventilation tube group (group O) and FOB-guided tracheal intubation with LMA i-gel (group I). Anesthesia was induced with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 2-3 μg/kg and rocuronium 0.9 mg/kg. The intubation time, fiberoptic bronchoscope score, the number of successful intubation, hypertension, tachycardia and hypoxemia were recorded. All the patients were followed up postoperatively for adverse effects like sore throat or hoarseness, etc. Results The rate of successful LMA i-gel placement at first attempt was 100%, placement time was (10 + 3) s, and the rate of successful intubation in the two groups was 100%. The intubation time was significantly shorter, the rate of successful intubation at first attempt and fiberoptic bronchoscope score were significantly higher in group I than in group O (P ＜ 0.05). Hypertension, tachycardia and hypoxemia were not found in the two groups. There was no significant difference in the incidence of adverse effects between the two groups (P ＞0.05). Conclusion FOB-guided tracheal intubation with LMA i-gel can provide adequate ventilation during operation, improve the success rate of FOB-guided intubation and shorten the intubation time in patients undergoing cervical spine surgery.

Objective To investigate the effect of ultrasound-guided transverses abdominis plane (TAP)block on the efficacy of postoperative analgesia in patients undergoing abdominal hysterectomy. Methods Sixty ASA Ⅰ - Ⅱ patients scheduled for abdominal hysterectomy under general anesthesia were randomly divided into 2groups (n = 30 each): ropivacaine group (group R) and normal saline (group NS). After induction of anesthesia,ultrasound-guided bilateral TAP block was performed, and 0.375% ropivacaine 40 ml was injected in group R,while the equal volume of normal saline was used instead in group NS. The patients received patient-controlled intravenous analgesia (PCIA) with sufentanil after operation. The VAS score was maintained ≤ 3, the level of sedation was evaluated with Ramsay sedation score, and the comfort level was evaluated with Bruggrmann comfort scale (BCS) score at 2, 6, 8, 12 and 24 h after operation. The hemodynamic parameters were recorded. The consumption of sufentanil during operation and within 24 h after operation, the number of successfully delivered doses ( D1 )and the number of attempts ( D2 ) within 24 h after operation were recorded. D1/D2 was calculated. The adverse reactions were also recorded. Results SP, DP, HR, SpO2 and RR were in the normal range and there was no significant differences between the two groups ( P ＞ 0.05). The consumption of sufentanil were significantly lower,while the BCS score and D1/D2 higher in group R than in group NS (P ＜ 0.05). There were no adverse reactions in both groups. Conclusion Ultrasound-guided TAP block reduces the perioperative sufentanil consumption and enhances the efficacy of postoperative analgesia in patients undergoing abdominal hysterectomy.

OBJECTIVE To investigate the effect of overexpession of 18 ku translocator protein (TSPO) on the hippocampal dentate gyrus. METHODS Lentiviral (LV) vectors containing TSPO or the lentiviral sequence were infused into the hippocampus bilateral dentate gyri (2 × 108 TU · mL-1,1 μL per side)of mice. Behavioral tests were carried out. The anxiolytic-like behavior of mice was examined by such means as the elevated plus maze test , the staircase test , light dark box test for 12, 14 and 16 d, two behavioral despair models, tail suspension test and the forced swimming test for 16 and 18 d,respec?tively. Western blotting and ELISA were used to evaluate the TSPO expression and the concentration of allopregnanolone in hippocampal tissue (3 mm in diameter around the injection site on both sides) at the end of tests. RESULTS The results of behavioral experiments showed that TSPO overexpression group deneloped anxiolytic and antidepression-like behavior. LV-TSPO significantly increased the retention time in the central area〔14 ± 4 vs (25 ± 12)s,P<0.05〕. LV-TSPO significantly increased the percentage of entry into open arms entries percentage and the percentage of time spent in open arms time without changing total entries and total time in the elevated plus-maze test〔(13±8)%vs (26±18)%, P<0.05;(6 ± 6)%vs (27 ± 6)%, P<0.05)〕. LV-TSPO significantly decreased the number of rearings without changing the number of steps in staircase test (21±7 vs 12±5,P<0.05). LV-TSPO increased entries into the light area and retention time in light-dark transition test〔(18 ± 8)% vs (26 ± 7)%, P<0.05;72 ± 36 vs (191 ± 90)s, P<0.05)〕but significantly decreased immobility time in the tail suspension test and forced swimming test〔94±33 vs (36±20)s, P<0.01;137±36 vs (90±37)s, P<0.05)〕, without excitatory or inhibitory actions on the central nervous system. At the same time, the level of TSPO expression in hippocampal tissues (3 mm in diameter around the injection site on both sides) was significantly increased, so did the concentration of allopregnanolone (P<0.05). CONCLUSION Overexpression of TSPO in the hippocamus dentate gyrus of mice can induce anxiolytic and antidepressant-like behavior, and the downstream allo?pregnanolone biosynthesis at least partially mediates the behavioral effects.

Objective To understand whether or not artesunate (Art. ) combined with naphtho-quine (Nap. ) can delay the resistance of Plasmodium falciparum to Art. Methods In Group A, P. falciparum was cultured in culture medium and was stimulated by Art/Nap disconnectedly, and in Group B, stimulated by Art disconnectedly. When P. falciparum recovered to normal growth level, the changes of sensitivity (ID50) to the drugs were compared between the two groups after P. falciparum touched on the drug. Results In Group A, the times P. falciparum recovered to normal growth level were 24, 37 d respectively when it contacted the drugs in the first and second times; P. falciparum didn't recover to normal growth level in 90 d when it contacted the drugs in the third time. In Group B, the times P. falciparum recovered to normal growth level were 16. 7 d (15-20) on average. ID50(s) of Art/Nap were 2.42/37.81, 1. 70/26.30 nmol/L before and 65 d after contacting the drugs in Group A; ID50(s) of Art were 9. 60, 30. 61, 85.12 nmol/L before and 68 and 129 d after contacting the drug in Group B. Conclusion Artesunate-resistant P. falciparum can be cultured by touching artesunate at intervals in vitro; Artesunate combined with naph-thoquine may delay the resistance of P. falciparum to artesunate in vitro.

Objective To investigate the effects of controlled low central venous pressure (CLCVP) on cerebral oxygen metabolism during orthotopic liver transplantation (OLT),and study the safety of CLCVP in OLT.Method Forty-six patients subject to OLT were randomly divided into CLCVP group (CL group) and CVP group (C group).Blood samples were taken from radial artery and jugular simultaneously for blood gas analysis before operation (T1,baseline),immediately blocking inferior vena and portal vein (T2),30 min after anhepatic phase (T3),30 min after graft reperfusion (T4),2 h after graft reperfusion (T5),and 24 h after graft reperfusion (T6).Cerebral arterial oxygen content (CaO2),jugular oxygen content (CjvO2),cerebral arterial-venous oxygen content difference (Ca-jvO2),cerebral oxygen extraction rate (CERO2),and cerebral blood flow/ cerebral metabolic rate of oxygen (CBF/CMRO2) were calculated by the Fick formulae.Meanwhile,blood samples were taken from jugular simultaneously for serum creatinine (Cr) and urea nitrogen (BUN) a different time points.We also recorded the whole operation time,anhepatic phase time,volume of blood loss and transfusion,and urine volume.Results As compared with C group,CaO2,CjvO2,Ca-jvO2,SjvO2,CERO2 and CBF/CMRO2 in CL group were nearly not changed at different time pioints (P＞0.05),but in the same group,as compared with T1 and T2,the CaO2,CjvO2,Ca-jvO2 and CERO2 in T3,T4 and T5 were decreased significantly (P＜0.05),and the SjvO2 in T3,T4 and T5 was increased remarkably.The operation time and anhepatic phase time had no significant difference in both groups.As compared with C group,the volume of blood loss and transfusion in CL group were decreased (P＜0.05),and the urine volume in CL group CL was increased significantly (P＜0.05).Cr and BUN showed no significant difference in both groups and at the same time points of C group and CL group.Conclusion CLCVP can decrease volume of blood loss and transfusion,increase urine volume during OLT,and it does not change the cerebral oxygen metabolism during OLT.

Objective To investigate the effect of intravenous injection of 20% lipid emulsion on neurotransmitters imbalance in central nerve system induced by local anesthetics.Methods Thirty adult Sprague-Dawley rats were randomly divided into two groups:normal group (group C,n =10) and local anesthetics group (group L,n =20).Based on different treatment,the rats in group L were assigned into two subgroup:control group (group S,n =10)and 20% long-chain lipid emulsion in-jection group (group I,n =10).The rats of group L were injected with 0.75% levobupivacaine at 50μl/min from the right ventricle of brain.When convulsions wave of electroencephalogram EEG ap-peared,20% long-chain lipid emulsion was administrated continuously 0.25 ml·kg-1 ·min-1 (group I)or normal saline (group S).The rats in group C were without any treatment.All the rats were con-tinously monitored by EEG,ECG and SpO 2 .The primary outcome included seizure duration and threshold and rats’mortality of postoperative 24 h.Secondary outcome included the concentrations of neurotransmitters GABA and Glu in cerebrospinal fluid,expression of NMDAR1 in cortex,Glu/GA-BA concentration ratio (Glu/GABA),and analysis the correlation between expression of Glu and NMDAR1.Results The convulsion time and mortality of rats in group S were significantly increased compared with those in group I (P <0.05).The seizure threshold of levobupivacaine was much lower in group S than group I (P <0.05).Compared with group C,the concentrations of Glu and GABA in cerebrospinal fluid,expression of NMDAR1 in hippocampus and Glu/GABA significantly increased in groups S and I(P < 0.05 ),and at same time these data in group S were significantly higher than group I (P < 0.05 ).There is a positive correlation between concentration of Glu in CSF and expression of NMDAR1 in hippocampus (r =0.884,P <0.01 ).Conclusion Intravenous infusion of 20% long-chain lipid emulsion can effectively improve neurotransmitters imbalance in central nerve system induced by intraventricular injection of local anesthetics.

OBJECTIVE To investigate the relationship between the anti-post-traumatic stress disorder(PTSD)effect of sertraline and nitric oxide in fear conditioning rats. METHODS Conditioned fear stress was established by electric shock with a cue tone,and fear extinction training was carried out by giving the rats only tone signals the next day. The rats were treated with sertraline(15 mg · kg-1) intragastrically within 1 h before the experiment for 8 d. Freezing time was tested at the 1st,4th and 7th day after the extinction training in rats. The NO contents were detected by Griess method and the nNOS and iNOS level on amygdala was detected by Western blotting. RESULTS The behavior tests showed that compared with normal control group ,the freezing time was significantly increased in extinction control group and extinction training group(P<0.01),indicating that the conditioned fear model of rats was successfully established. At the 1st and 4th day after conditioned fear extinction training in the rats,freezing time in sertraline(15 mg·kg-1)group was decreased compared with extinction training group (P<0.05). At the 7th day,the freezing time was significantly decreased(P<0.01),indicating that ser?traline reversed the fear response. At the same time,the contents of NO,nNOS and iNOS on amygdala of rats in sertraline group were lower than that in extinction training group(P<0.01). CONCLUSION Sertraline can promote extinction of conditioned fear memory,suggesting that sertraline has anti-PTSD effects on the model of fear condition in rats. The underlying mechanisms may be connected with NO.

OBJECTIVE To investigate the protective effect of selective 18 ku translocator protein (TSPO) ligand YL-IPA08 on corticosterone(CORT)-induced apoptosis of BV-2 cells and its potential mecha?nisms. METHODS BV-2 Cells were pretreated with selective TSPO ligand YL-IPA08 1-100 nmol · L-1 and(or) TSPO antagonist PK11195 100 nmol · L-1 for 2 h,and then co-incubated with CORT for another 24 h. The apoptosis rate was measured by flow cytometry. CCK-8 kit was used to test BV-2 cell viability. The protein expression of TSPO was determined by Western blotting. The level of allopreg?nanolone was detected by ELISA kit. RESULTS In line with positive drug-AC-5216, the cell apoptosis rate decreased in YL-IPA08 1-100 nmol · L-1 and CORT co-treatment groups(P<0.01), which was antago?nized by PK11195 100 nmol · L-1 treatment(P<0.05). Cell viability increased in YL-IPA08 100 nmol · L-1and CORT co-treatment groups (P<0.01), which was blocked by PK11195 100 nmol·L-1 treatment(P<0.01). The expression of TSPO and the level of allopregnanolone(P<0.01) were enhanced by YL-IPA08 100 nmol · L-1 pretreatment followed by CORT treatment. The enhancement of allopregnanolone level was blocked by PK11195 100 nmol·L-1 treatment(P<0.05). CONCLUSION YL-IPA08 can protect BV-2 cells from CORT induced apoptosis. The protective effect of YL-IPA08 may be conferred by the increasing level of TSPO expression and allopregnanolone.