Objective To compare dexmedetomidine versus lidocaine for suppression of fentanyl-induced coughing during induction of general anesthesia in patients.Methods Two hundred ASA physical status Ⅰ or Ⅱ patients,aged 36-50 yr,undergoing elective gynecological operations under total intravenous anesthesia,were randomized into 2 groups (n =100 each):dexmedetomidine group (group D) and lidocaine group (group L).Dexmedetomidine 0.5 μg/kg was intravenously infused over 10 min at a rate of 0.05 μg· kg-1· min-1 starting from 20 min before induction of anesthesia in group D.Lidocaine 0.5 mg/kg was injected intravenously at 1 min before induction of anesthesia in group L.For induction of anesthesia,fentanyl was given first,and 2 min later the other drugs were given.The development and degree of coughing were recorded within 1 min after fentanyl injection.The occurrence of adverse events was recorded.Results The incidence of coughing was significantly higher and the degree of coughing was severer in group L than in group D (P ＜ 0.05).There was no signihicant difference in the incidences of hypotension and severe sinus bradycardia between groups D and L (P ＞ 0.05).Conclusion Dexmedetomidine 0.5 μg/kg injected before induction of anesthesia has better suppressive effect on fentanyl-induced coughing during induction of general anesthesia than lidocaine 0.5 mg/kg in patients.

Purpose To purify recombinant angiogenesis inhibitor r-K4K5 and investigate its inhibitoryeffects on bovine capillary endothelial (BCE) cell proliferation, chick embryo chorioallantoic membrane(CAM) angiogenesis and growth of experimental human non-small cell lung cancer (adeno). Methodsr-K4K5 was obtained by salting out and gel filtration with the purity of 95% determined by SDS-PAGE.BCE cells were cultured with DMEM media containing r-K4K5. The cells were counted in 24,48,72 hrespectively. r-K4K5 was injected daily into all 7-day chick embryo CAMs and CAM angiogenesis wasobserved at 72 h after incubation. The Balb/c (nu/nu) mice implanted with human SPC-Al tumor pieceswere grown for 10 days and then randomly divided into three groups. One group was treated with PBS, theother two groups were treated with local subcutaneous injection of purified r-K4K5 at 8 μg and 80 μg lpermouse every other day. They were daily observed and sacrificed in 14 days. Each tumor was weighed.Results The number of BCE cells, blood vessels diameter less than 50 μn of chick embryo CAM and theaverage weight of experimental tumor were decreased markedly in all the groups treated with r-K4K5.Conclusions r-K4K5 inhibits proliferation of BCE cells, angiogenesis of chick embryo CAMs and thegrowth of experimental human SPC-A1 non small lung cancer (adeno).

Objective　To evaluate the effect of modified suction ring in laser in situ keratomileusis(LASIK) for special eyeballs.Methods　Those eyeballs that couldn't be sucked successfully with regular suction ring were performed with modified suction ring, and the characteristic of those eyes was analyzed.Results　Fifteen eyes of 9 cases were included in this study and were sucked successfully with modified suction ring with intact corneal flap.Eight eyes of 5 cases had small corneal power especially in the peripheral section. The corneal power in the peripheral section of 7 eyes was less than 41D. Corneal diameter of 1 eye was 9.5mm and 6 eyes of 3 cases had small palpebral fissure.Conclusions　The modified suction ring is safe and effective for those eyes with flat cornea, small corneal diameter and small palpebral fissure.

Objective 　To assess the association between the gene of complement C4A, C4B deficiency and schizophrenia. Methods　192 patients with schizophrenia and 142 healthy controls were tested with the amplification restriction fragment length polymorphism (Amp-RFLP) technique.Results　The frequency of C4AQ0/C4AQ0 homozygote was higher in the patient group than in the control group (χ2=8.54, P＜0.01). The relative risk (RR) of C4AQ0/C4AQ0 homozygote for schizophrenia was 6.8. There was no increased frequency of C4B deficiency in patients with schizophrenia (χ2=0.11, P＞0.05, RR=0.73).Conclusions　These results indicate that there is a positive association between complement C4A dificiency and schizophrenia. Moreover, our study did not support a widespread association between a deficiency in complement component C4B and schizophrenia.

Objective To evaluate the changes in the expression of spinal aquaporin-4 (AQP4) during remifentanil-induced hyperalgesia in a mouse model of incisional pain.Methods Seventy-two pathogen-free healthy adult male CD1 mice,weighing 25-30 g,were divided into 4 groups (n=18 each) using a random number table:control group (group C),incisional pain (group I),remifentanil group (group R) and remifentanil plus incisional pain group (group R+I).Normal saline was infused subcutaneously in group C.An incision was made in the left hind paw in group I.Remifentanil 80 μg/kg was subcutaneously infused for 30 min at a rate of 0.8 ml/h in group R.Remifentanil was infused subcutaneously before establishment of the model in group R+I.The thermal paw withdrawal latency (TWL) and mechanical paw withdrawal threshold (MWT) were measured at 1 day before establishment of the model (T0) and 6 h and 1,2 and 7 days after establishment of the model (T1-4).After measurement of the pain threshold at T3,12 animals were sacrificed randomly,and the lumbar segment of the spinal cord was removed for determination of the distribution and expression of AQP4 by Western blot.Results Compared with group C,the TWL was significantly shortened at T1-3,and the MWT was decreased at T2-4 in R and R + I groups,and the expression of AQP4 was significantly up-regulated at T3 in I,R and R+I groups (P＜0.05).Compared with group I,the TWL was significantly shortened at T2,3,and the MWT was decreased at T2.4 in group R,and the TWL was significantly shortened at T1-3,the MWT was decreased at T2.4,and the expression of AQP4 was up-regulated at T3 in group R+I (P＜0.05).Conclusion The mechanism by which remifentanil induces hyperalgesia is related to up-regulation of AQP4 expression in the spinal cord in a mouse model of incisional pain.

Objective To evaluate the effect of intraoperative application of dexmedetomidine on acute post-traumatic stress disorder (PTSD) in female patients with lower limb fracture.Methods Ninety female patients with lower limb fractures caused by traffic accident,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 20-35 yr,weighing 40-72 kg,scheduled for elective internal fixation,were divided into 3 groups (n =30 each) using a random number table:control group (group C),low-dose dexmedetomidine group (group D1) and high-dose dexmedetomidine group (group D2).Ropivacaine (0.75％) 10-15 ml was injected into the epidural space,and operation was started after pain disappeared at the plane T8-10.Two percent lidocaine 5-10 ml was intermittently injected to maintain the anesthetic plane at T10.After successful epidural anesthesia,dexmedetomidine 0.5 and 1.0 μg/kg were intravenously infused over 30 min in D1 and D2 groups,respectively,while the equal volume of normal saline was given in group C.Patient-controlled epidural analgesia was performed with 0.15％ ropivacaine after operation and lasted until 48 h postoperatively,maintaining visual analogue scale score ≤ 3 (baseline).Morphine 3 mg was intravenously injected for rescue analgesia when visual analogue scale score＞3.The requirement for rescue analgesia within 48 h after operation was recorded.Acute Stress Disorder Scale (ASDS),Self-Rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores were assessed at 1 h before operation and on 1,3 and 7 days after operation.The patients were followed up for 3 months by telephone,and the PTSD Checklist-Civilian Version score was evaluated.The occurrence of acute PTSD (PTSD Checklist-Civilian Version score ＞ 38) was recorded.Results Compared with group C,the ASDS,SAS and SDS scores were significantly decreased on 1,3 and 7 days after operation,and the incidence of acute PTSD was decreased in D1 and D2 groups (P＜0.05).Compared with group D1,the ASDS scores were significantly decreased on 1,3 and 7 days after operation,and the incidence of acute PTSD was decreased (P＜0.05),and no significant change was found in SAS or SDS scores at each time point in group D2 (P＞ 0.05).There was no significant difference in the requirement for rescue analgesia between the three groups (P＞0.05).Conclusion Intraoperative application of dexmedetomidine can reduce the occurrence of acute PTSD and it is dose-related in female patients.

Objective To study the effects of sleep inertia (SI) of different time course sleeps on sleep stages and cognitions in healthy men after 30 h sleep deprivation,and also to investigate the mechanism of cognitive functions impairment in sleep inertia stages and the influential factors of sleep inertia.Methods Ten healthy men (age,(20.8 ±2.1) years) participated in the program.The program was divided into 2 stages.First,participants attended a series of tests after 20 min nap(20 min nap group)after 30 h sleep deprivation.The testing series included 3 parts:the continuous performance task,the Stroop Tests,and the Addition Tests.The series of tests were done 3 times immediately after the volunteers were awoken and each lasted about 15 minutes with an interval of 10 minutes between each test.The polysomnogram (PSG) was recorded during the nap.The following 7 days was set as washing-out period to ensure a complete recovery.Participants repeated the similar processes with 2 h nap(2 h nap group) instead of 20 min nap.The cognitive performance of each group was compared with each other along with the best cognitive performance in awakening to estimate whether or not the cognitive abilities regained the normal condition.Results ( 1 ) Sleep latency became shortened in both groups after 30 h sleep deprivation.There were no slow wave sleep (SWS) and rapid eye movement sleep (REM) sleep stages in the 20 min naps,while the percentage of SWS was increased and percentage of REM declined in 2 h naps.(2)In the early of SI (5 min after awaking),cognitive tasks showed that the abilities of continuous attention,selected attention and addition ability were all impaired (continuous performance task:(371.8 ± 21.3 ) times/3 min vs (334.4 ± 22.4) times/3 min,( 373.2 ± 19.0) times/3 min vs ( 323.7 ± 23.8) times/3 min,t =10.443,7.774,both P＜0.01; Stroop tests:(20.3 ±1.5) points vs(17.3 ± 1.0) points,(21.5 ±0.8)points vs( 16.1 ± 1.4 ) points,t =8.478,4.934,both P ＜ 0.05 ; Addition Tests:( 222.2 ± 13.2 ) s vs ( 266.6 ±23.7 ) s,( 226.3 ± 10.9) s vs ( 267.6 ± 23.4 ) s,t =5.748,6.685,both P ＜ 0.01 ).The cognitive functions impairments of 2 h nap group were more severe at the initiation of sleep inertia,but regained the normal condition more quickly.Different cognitive tasks recovered at different speeds.The dispersion of SI needed 30 min.Conclusions ( 1 ) There are difference in the sleep construction and awaked sleep stage between 20 min nap and 2 h nap groups.(2) SI exerts negative influences on cognitive performances of continuous attention,selected attention and addition after sleep deprivation.Many factors may influence the dispersion of SI,including sleep debt,compensation of sleep debt and others.(3) Fragments of sleep are unfavorable to the recovery of body.

Objective:To evaluate the effect of stellate ganglion block on nighttime sleep quality in the patients with primary sleep disorders.Methods:Sixty patients of both sexes with primary sleep disorders, of American Society of Anesthesiology physical status Ⅰ or Ⅱ, aged 18-64 yr, weighing 40-75 kg, were randomized to 2 groups ( n=30 each): control group (group C) and stellate ganglion block group (group S). In group S, 0.2% ropivacaine 5 ml was injected into the surface of the right longus colli muscle where the the stellate ganglion was located under ultrasound guidance once a day for 7 consecutive days starting from 1 h before bedtime.While the equal volume of normal saline was given instead in group C. Patients′ Subjective Sleep Quality was assessed using the Pittsburgh Sleep Quality Index Questionnaire before treatment (T 0) and 1-7 days after treatment.The objective sleep quality was evaluated with polysomnography.A bispectral index(BIS)monitor and a cerebral and regional blood oxygen monitoring system were used to monitor the BIS value and regional cerebral oxygen saturation (rSO 2) during sleep, which were recorded once every 30 min, and the 7-day average was calculated.The patients′ daytime advanced cognitive function was assessed for 3 consecutive days after the end of treatment (T 8-10), including the Continuous Attention Test and the Behavioral Test for Performing Defect Syndrome, and the 3-day average value was calculated.Venous blood samples were collected at T 0 and T 8 to measure the plasma noradrenaline, cortisol, and serotonin concentrations by high-performance liquid chromatography. Results:Compared with group C, the individual and total scores of Pittsburgh Sleep Quality Index were significantly decreased, the sleep latency, awakening time and fast wave sleep latency were shortened, the number of awakening was increased, the total sleep time was prolonged, the sleep efficiency and proportion of fast wave sleep were increased, S 1-S 2 ratio in slow-wave sleep was decreased, S 3-S 4 ratio was increased, BIS value was decreased, rSO 2 was increased, each parameter of Continuous Attention Test was decreased and each parameter of Behavioral Test for Performing Defect Syndrome was increased after treatment, and plasma noradrenaline level was decreased at T 8 in group S ( P<0.05). Conclusion:Stellate ganglion block can improve nighttime sleep quality in patients with primary sleep disorders.

OBJECTIVE To reveal the role of the basal forebrain(BF)GABAergic neurons in the regulation of isoflurane anesthesia and to elucidate the underlying neural pathways.METHODS The activity of BF GABAer-gic neurons was monitored during isoflurane anesthesia using a genetically encoded calcium indicator in Vgat-Cre mice of both sexes.The activity of BF GABAer-gic neurons was manipulated by chemogenetic and opto-genetic approaches.Sensitivity,induction time and emer-gence time of isoflurane anesthesia were estimated by righting reflex.The electroencephalogram(EEG)power and burst-suppression were monitored by EEG recording.The effects of activation of GABAergic BF-thalamic reticu-lar nucleus(TRN)pathway on isoflurane anesthesia were investigated with optogenetics.RESULTS The activity of BF GABAergic neurons was generally inhibited during isoflurane anesthesia,obviously decreased during the induction of anesthesia and gradually restored during the emergence from anesthesia.Activation of BF GABAergic neurons with chemogenetics and optogenetics promoted behavioral emergence from isoflurane anesthesia,with decreased sensitivity to isoflurane,delayed induction and accelerated emergence from isoflurane anesthesia.Optogenetic activation of BF GABAergic neurons prom-oted cortical activity during isoflurane anesthesia,with decreased EEG delta power and burst suppression ratio during 0.8%and 1.4%isoflurane anesthesia,respectively.Similar to the effects of activating BF GABAergic cell bod-ies,photostimulation of BF GABAergic terminals in the TRN also strongly promoted cortical activation and behav-ioral emergence from isoflurane anesthesia.CONCLU-SION The GABAergic neurons in the BF is a key neural substrate for general anesthesia regulation that facilitates behavioral and cortical emergence from general anesthe-sia via the BF-TRN pathway.