Objective To evaluate the effects of dexmedetomidine on the activity of c-Jun N-terminal kinase (JNK) during cerebral ischemia-reperfusion (I/R) in rats.Methods Eighty-one pathogen-free male Sprague-Dawley rats,aged 8 weeks,weighing 180-220 g,were randomly divided into 3 groups (n=27 each) using a random number table:sham operation group (group S);cerebral I/R group (group CI/R);dexmedetomidine group (group Dex).The rats were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.Cerebral ischemia was induced by occlusion of the middle cerebral artery for 2 h followed by 24 h of reperfusion in CI/R and Dex groups.The middle cerebral artery was only exposed but not occluded in group S.Dexmedetomidine 3 μg/kg was injected via the tail vein immediately before ischemia followed by infusion at a rate of 3 μg · kg-1 · h-1until 24 h of reperfusion in group Dex,while the equal volume of normal saline was given in S and CI/R groups.The rats were sacrificed at 24 h of reperfusion,and their brains were removed for determination of cerebral infarct size (by TTC staining),brain water content ((wet weight-dry weight)/wet weight × 100％),cell apoptosis (by TUNEL) and expression of phosphorylated JNK (p-JNK) protein (by Western blot analysis).Apoptotic index was calculated.Results Compared with group S,the brain water content,apoptotic index and cerebral infarct size were significantly increased,and the expression of p-JNK was up-regulated in CI/R and Dex groups.Compared with group CI/R,the brain water content,apoptotic index and cerebral infarct size were significantly decreased,and the expression of p-JNK was down-regulated in group Dex.Conclusion Dexmedetomidine reduces cerebral I/R injury through decreasing the activity of JNK and inhibiting cell apoptosis in rats.

Objective To assess the feasibility of laparoscopic hepatic lobe procurement for living donor liver transplantation. Methods The technique included pneumoperitoneum with CO2,ports placement, porta hepatis dissection, laparoscopic ultrasound mapping, mobilization of the liver,and transection of the parenchyma into right and left lobes. The vascular structures were stapled and sectioned just prior to removal of the specimen. Results Hepatic lobectomies were successfully performed laparoscopically in 9 adult pigs. One pig was dead due to bleeding in IVC and following gas embolism during the parenchymal transection. The operative time was 208±25 min. The duration of warm ischemia was 8 ± 2. 3 min. The blood loss was 313 ± 75 mL. The vascular and biliary structures were preserved to allow for subsequent transplantation. Conclusion Laparoscopic living donor procurement for liver transplantation in a porcine model is safe and feasible.

Objective To explore the bacterial spectrum and drug resistance that separated from respiratory tract of schizophrene.Methods 311 samples taken from the respiratory tract of schizophrenes were investigated and analyzed.Results From 311 samples 58 pathogenic bacteria were separated,the gram negative was 55.93% and the gram positives was 44.07%;5 most pathogenic commoly bacteria were klesbsiella pneumoniae and S.aureus and escherichia coli and streptococcus and enterococcus;Except that all the staphylococcus were sensitive to vancomycin,enterobacteriaceae were sensitive to imipenem,all the other separated strains showed total resistance to the agents tested in different levels,also the multidrug resistance emerged in lower respiratory tract infections with mulitidrug resistance in high levels.Conclusion The most common pathogenic bacteria separated from these schizophrene are klesbaiella pneumoniae and S.aureus.In clinical therapy,sensitive antibiotics should be selected according to the drug sensitive tests,combine with other agents when necessary to accelerate the clearance of bacteria from infectious respiratory tract in schizophrene.

Objective To evaluate the effects of propofol on the expression of hippocampal γ-aminobutyric acid (GABAA) and NMDA receptor in a rat model of inflammatory pain (IP).Methods A total of 32 female Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 4 groups (n =8 each):control group (group C),group IP,and different doses of propofol groups (P1,2 groups).IP was induced by injection of formalin.In group C,normal saline and dimethyl sulfoxide (DMSO) 0.1 ml/kg were injected intraperitoneally.In group IP,normal saline and DMSO 0.1 ml/kg were injected intraperitoneally,and 5 min later formalin was injected.In P1,2 groups,propofol 30 and 100 mg/kg were intraperitoneally injected,respectively,and 5 min later formalin was injected.The pain behavior of rats was observed within 1 h after injection of formalin and pain intensity scoring (PIS) value was calculated.The animals were sacrificed at 1 h after injection of formalin and the hippocampi were isolated for determination of GABAA and NMDA receptor expression by immunohistochemisty.Results Compared with group C,PIS value was significantly increased,GABAA and NMDA receptor expression was up-regulated in IP and P1.2 groups.Compared with group IP,PIS value was significantly decreased,GABAA receptor expression was up-regulated,and NMDA receptor expression was down-regulated in P1,2 groups.PIS value was significantly lower,GABAA receptor expression was higher,and NMDA receptor expression was lower in group P2 than in group P1.Conclusion Intraperitoneal propofol can down-regulate NMDA receptor expression in hippocampi of rats with IP,thus inhibiting responses to pain sensitivity; intraperitoneal propofol can up-regulate hippocampal GABAA receptor expression,thus enhancing endogenous mechanism of analgesia.

Objective To determine the median effective dose (ED50) of hemocoagulase agkistrodon (HCA) inhibiting the bleeding after trans-bronchial lung biopsy (TBLB).Methods ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 45-75 yr,body mass index 19-24 kg/m2,scheduled for elective TBLB,were enrolled in this study.TBLB was performed after routine anesthesia.HCA diluted in normal saline 5 ml was locally injected into the biopsy site at 2 min before surgery.The initial dose of HCA was 1.4 U.The dose of HCA was determined by up and down sequential method.Each time the dose of HCA increased/decreased in the next patient depending on whether nor not the bleeding was observed in the biopsy wound under fiberoptic bronchoscope.The ratio between the two successive concentrations was 1.2.The ED50 and 95 ％ confidence interval of HCA were calculated by Dixon's up-and-down method.Results ED50 of HCA inhibiting the bleeding after TBLB was 0.9 U,and 95 ％ confidence interval was 0.7-1.1 U.Conclusion ED50 of HCA inhibiting the bleeding after TBLB is 0.9 U.

Objective To evaluate the role of mitochondrial ATP-sensitive potassium (mito-KATe) channels in attenuation of cerebral ischemia-reperfusion (I/R) injury by dexmedetomidine in rats.Methods One hundred and twenty healthy male Wistar rats,weighing 290-340 g,were randomly assigned into 5 groups (n =24 each) using a random number table:sham operation group (group S) ; group I/R; dexmedetomidine group (group D) ; 5-HD (a specific blocker of mito-KATPchannel) group and 5-HD + dexmedetomidine group (group 5-HD + D).The rats were anesthetized with intraperitoneal chloral hydrate.Focal cerebral I/R was produced by 2 h middle cerebral artery occlusion followed by reperfusion.In group D,dexmedetomidine 50 μg/kg was injected intraperitoneally before ischemia and after onset of reperfusion.In group 5-HD,5-HD 30 mg/kg was injected intraperitoneally at 1 h before ischemia.In 5-HD + D group,5-HD 30 mg/kg was injected intraperitoneally at 1 h before ischemia and the other procedures were similar to those previously described in group D.Twelve rats were chosen at 24 and 48 h of reperfusion to assess the neurological deficit score (NDS).The animals were then sacrificed and brains were removed for determination of cerebral infarct size by TTC staining.Results Compared with S group,NDS and cerebral infarct size were significantly increased at each time point in the other four groups (P ＜ 0.05).Compared with group I/R,NDS and cerebral infarct size were significantly decreased in D and 5-HD + D groups (P ＜ 0.05),and no significant change was found in the parameters mentioned above in 5-HD group (P ＞ 0.05).Compared with group D,NDS and infarct size were significantly increased in group 5-HD + D (P ＜ 0.05).Conclusion Mito-KATP channels are involved in reduction of I/R-induced cerebral injury by dexmedetomidine in rats.

Objective To investigate the role of autophagy in the lung injury in the septic mice.Methods Thirty-six male C57BL/6 mice, aged 6 weeks, weighing 20-25 g, were randomly divided into 3 groups (n=12 each) using a random number table: sham operation group (group S);cecal ligation and puncture (CLP) group;CLP + autophagy inhibitor 3-methyladenine (3-MA) group (group CLP+3-MA).Sepsis was produced by CLP.In group CLP+3-MA, 3-MA 10 mg/kg was injected intraperitoneal at 1 h after operation.Arterial blood samples were taken at 24 h after operation for blood gas analysis, and the oxygenation index was calculated.The lungs were removed for microscopic examination of pathologic changes which were scored, and for determination of wet/dry lung weight ratio (W/D ratio) , myeloperoxidase (MPO) activity (using colorimetric method) and the expression of autophagy protein microtubule-associated protein 1 light chain 3 Ⅱ] (LC3 Ⅱ), Beclin-1 and lysosomes-associated protein Rab7 and lysosome-associated membrane protein-2 (LAMP2) (by Western blot).The lung was lavaged, and broncho-alveolar lavage fluid (BALF) was collected for determination of the total cell count and polymorphonuclear leukocyte (PMN) count.Results Compared with group S, the pathological score, W/D ratio, MPO activity, and the total cell and PMN counts in BALF were significantly increased, and oxygenation index was decreased in CLP and CLP +3-MA groups, and the expression of LC3 Ⅱ , Beclin-1, LAMP2 and Rab7 was up-regulated in group CLP (P＜0.05).Compared with group CLP, the pathological score, W/D ratio, MPO activity, and the total cell and PMN counts in BALF were significantly increased, the oxygenation index was decreased, and the expression of LC3 Ⅱ , Beclin-1, LAMP2 and Rab7 was down-regulated in group CLP+ 3-MA (P＜0.05).Conclusion Autophagy is involved in the endogenous protective mechanism of acute lung injury in the septic mice.

8 hours and without and binding nursing in these 3 groups respectively. Observed the condition of respiratory tract infection in 3 groups. Results The incidence rate of respiratory tract infection in binding nursing groups was 50%, which was significant higher than that of in no binding nursing group (P8 hours group was 66.67%, and this rate had an tendency of rising with the time of binding nursing lasting (P

Objective For benign or tumor of borderline malignancy in the distal pancreas,a spleen-preserving distal pancreatectomy can be carried out.This study aimed to assess the safety and feasibility of this operation.Methods Between June 2009 and March 2012,7 patients underwent laparoscopic distal pancreatectomy assisted by the da Vinci Robotic System (RDP) for benign or pancreatic tumor with borderline malignancy.The clinical data were analyzed.Results Robotic-assisted spleen-preserving laparoscopic distal pancreatectomy was successfully carried out in 6 patients,with robotic assisted splenectomy and distal pancreatectomy on the remaining patient.Among them,to the 6 patients with distal pancreatectomy,one patient received right adrenal tumor resection and another patient received cholecystectomy.The average operation time was 368 minutes,and the blood loss was 200 ml.One patient developed postoperative bleeding,and was treated conservatively with hemostatic drugs (grade Ⅱ).There was no conversion to laparotomy.According to the international pancreatic fistula research team's classification of postoperative pancreatic fistula,1 patients were diagnosed to have pancreatic fistula (grade A).The mean postoperative hospital stay was 8.7 days.There were no other complications.Conclusions Robotic-assisted spleen-preserving laparoscopic distal pancreatectomy was safe and feasible.The Kimura operation was used in spleen-preserving operations because its 3D visual field and stability in control helped to preserve splenic blood supply and reduced the chance of postoperative regional portal hypertension.

OBJECTIVE To evaluate the effect of lamivudine on prophylaxis against hepatitis B virus(HBV) reinfection following orthotopic liver transplantation(OLT).METHODS The clinical data of 14 CLT recipients with HBV-related diseases received lamivudine(100mg/day) were retrospectively analyzed in our hospital.Hepatitis B serum markers,serum HBVDNA,and YMDD district variation were detected every two weeks.HBsAg and HBcAg in the liver specimens were examined by immunohistochemistry.Liver biopsy was conducted from the donor during operation and from the recipient postoperatively in a regular interval.RESULTS The reinfection took place in 4 patients and postoperatively(28.6%),HBV-DNA was transfered to the positive in 2 cases,and among them was 1 YMDD district produced and made a variation. Two cases with positive HBV-DNA before liver transplantation had higher HBV reinfection rate postoperatively.CONCLUSIONS Lamivudine monotherapy can effectively and definitely;preven HBV reinfection after liver transplantation HBV reinfection can produce YMDD district and make a variation again;HBV relevant diseases patient should negatively turn the HBV-DNA at the time of competent liver transplantation.