Objective To investigate the effect of intmopemtive intravenous penehyclidine hydrochloride on pulmonary function in patients undergoning thoracotomy.Methods Sixty ASA Ⅰ or Ⅱ patients aged 30-64 yr scheduled for elective radical esophagectomy for cancer were randomly divided into 2 group(n=30 each):penehyclidinc hydrochloride group and control group.Penehychdine hydrochloride 0.01 mg/kg(in nolmal saline 2 ml)was injected iv 20 min after opening the thoracic cavity in penehyclidine hydrochloride group.The equal vohlme of normal saline was injected iv in control group.Anesthesia was induced with fentanyl 2μg/kg,propofol 0.4μG/ml and rocuronium 0.6 mg/kg.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remlfentanyl 0.1μg·min-1,propofol 2.0-2.5 μg/ml and intermittent iv injecfion of rocuronium.The use of remifentanyl and pmpofol was stopped 5 min before operation.Dynamic lung compliance (Cd) and peak airway pressure were monitored and recorded immediately before penehychdine hydrechlofide administration (T0) and at 3 min(T1),5 min(T2),10 min(T3),30 min(T4),1 h(T5),2 h (T6)after penehyclidine hydrochloride administration.Results There was no significant difference in Cd and peak airway pressure among different time points in control group(P>0.05).Cd was significantly higher,while peak airway pressure lower at T1-6 than at T0 in penehychdine hydrochlofide group(P<0.05).Cd wag significantly higher,while peak airway pressure lower at T1-6 in penehyclidine hydrochloride group than in control group(P<0.05) .Conclusion Intraoperative intravenous penehyclidine hydrochloride can improve the pneumodynamics and is helpful for ventilation in patients undergoing thoracotomy.

Objective To observe the effect of single and low dose propofol administered near the end of surgery on the cardiovascular and adverse response during extnhation in patients undergoing ovarian cancer operation. Methods Fifty ASA Ⅰ - Ⅱ patients undergoing selective ovarian cancer operation were randomly allocated into group S and group P,with 25 patients in each group. In group S, inhalation of sevoflurane was discontinued at about 2 minutes before the end of operation. In group P, inhalation of sevoflurane was discontinued at about 5 minutes before the end of operation,and at the same time,0.5 mg/kg of propofol was administered intravenously. The systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) and recovery time of consciousness were recorded at 5 min before extubation (t_1),during extubation (t_2), 1 min after extubation (t_3), and 5 rain after extubation (t_4). The incidence of agitatian,bucking,nausea and vomiting were recorded by an observer who was blind to this study. Results There were statistical differences in HR,SBP,DBP at t_2-t_4 between two groups. The recovery time was (10.39 ± 1.26) min in group P,and(9.57 ± 1.25) min in group S,there was significant difference between group P (2 cases) and group S (9 cases)(P< 0.05). There was significant difference in the incidence of agitation between two groups (P< 0.05). Conclusion Low dose propofol before extubation can inhibit stress and cardiovascular response and decrease the incidence of agitation, bucking, nausea and vomiting.

Objective To compare the preemptive analgesia effect of flurbiprofen axetil with tramadol in patients undergoing laparoscopic hysterectomy. Methods Ninety patients undergoing laparoscopic hysterectomy were divided randomly into group A (n=30), group B (n=30) and group C (n=30). The patients in group A were administrated 1mg/kg flurbiprofen axetil intravenously before tracheal intubation, and in group B 2mg/kg tramadol intravenously before tracheal intubation, while in group C 1mg/kg flurbiprofen axetil were administrated intravenously at the end of operation. The postoperative analgesic effects (1, 2, 4, 8, 12, 24 hours) were evaluated by VAS score and BCS score, while the times of pain-killer boosting and the side effects were recorded. Results VAS scores of group C were significantly higher than those of group A and B at all time points (P<0.05), except for 12 hours and 24 hours after the surgery, while BCS scores of group C Were lower than those of group A and B at the same time points (P<0.05).The side effects of group A and group C were significantly lower than those of group B (P<0.05). Conclusion Preemptive analgesia with flurbiprofen axetil and tramadol in patients undergoing laparoscopic hysterectomy is effective and convenient, while flurbiprofen axetil has less side effects.

Objective Low-dose naloxone has been shown to reduce side-effects of morphine while morphine analgesia is not antagonized and may even be enhanced. The purpose of this study was to evaluate the effects of low-dose naloxone infusion (50 ng? kg-1? h-1 ) on morphine analgesia and plasma levels of opioid peptides in patients after abdominal hysterectomy.Methods Forty-two ASA Ⅰ- Ⅱ patients aged 36-50 yrs, weighing 55-67 kg undergoing abdominal hysterectomy under combined spinal-epidural anesthesia were enrolled in this study. Spinal puncture was performed at L2-3 interspace. The patients received intrathecal 0.75% ropivacaine 2.0-2.6 ml. 2% lidocaine was used for epidural injection. The block height was maintained at T8-6 . For postoperative analgesia the patients were randomized to receive either intravenous morphine infusion at 10 ?g?kg-1 ?h-1 (group M, n = 21) or IV morphine infusion (10 ?g?kg-1?h-1)+ naloxone infusion at 50 ng?kg-1?h-1 (group MN, n = 21). Pain was assessed using VAS (0-10) with 0 representing no pain and 10 representing the worst possible pain. Blood samples were taken from peripheral vein before anesthesia (T0), at the end of surgery (T1) and at 6, 24, 48 h (T2,3,4) after operation for determination of plasma levels of ?-endorphin (?-EP), dynorphin A1-13 (Dyn) and leu-enkepholin (L-EK) .Results The patients were comparable with respect to, age, weight, occupation and duration of operation between the two groups. Two patients (1 patient in each group) were excluded from the study because of their refusal to have repeated blood samples taken. The analgesia was significantly better in group MN than that in group M in terms of VAS scores. Plasma level of ?-EP was significantly lower at 6 h after operation (T2 ) but significantly higher at 24 h postop. (T3 ) in group MN compared with that in group M ( P

Objective To evaluate the clinical curative effect,survival rate and adverse reactions of three-dimensional conformal radiotherapy(3D-CRT )in combination with chemotherapy on lymph nodes metastasis of esophageal carcinoma.Methods Using supraclavicular 3D-CRT combined with chemotherapy on and simple 3D-CRT supraclavicular lymph node metastasis of esophageal cancer patients,3D-CRT com-bined synchronous chemotherapy (treatment group),51 cases,only 3D-CRT 49 cases (control group).3D-CRT combined synchronous chemotherapy 51 cases (treatment group),simple 3D-CRT 49 cases (control group).These patients 3D-CRT were given the total dose of 50 ~60Gy/25 ~30F.TN chemotherapy regi-mens were applied:paclitaxel 135 mg/m2 ,d1;Nedaplatin 25 mg/m2 ,d1,1 ~3,21 days cycle in fist week and fourth week.Results Local control and treatment group survival rates in 1,2 year were significantly higher than that of control group (P <0.05).Treatment group adverse reaction rate is higher than the con-trol group,but there was no statistically significant difference.Conclusions The recent curative effect and survival rate could be significantly improved by 3D-CRT joint TN synchronous chemotherapy regimen for pa-tients with supraclavicular lymph node metastasis of esophageal cancer,but the relatively high incidence of adverse reactions,clinical application should be considered comprehensively according to actual situation.

Objective To investigate the protective effects of transection of the cervical sympathetic trunk (TCST) on the gastric mucosal lesions in rats fastened to a board and immersed vertically in water, up to the level of xiphoid with the animals' heads up water for 6 hours. Methods Thirty male SD rats weighing 200-250 g were randomly divided into 3 groups ( n = 10 each): group A sham operation; group B sham operation + water immersion and group C TCST + water immersion. The animals were anesthetized with intraperitoneal 2.5% pentobarbital 40 mg?kg-1. Cervical sympathetic trunk was exposed at right common carotid artery bifurcation and cut. The gastric mucosal blood flow (GMBF) was measured with Doppler blood flow monitor after 6 h water immersion. Blood samples were taken from abdominal aorta for determination of plasma concentration of ET-1 and serum concentration of NO. Gastric mucosal ulcer index was determined according to Guth criteria.Results There was gastric mucosa bleeding and erosion in group B and C and the degree of injury was severer in group B than in group C. Plasma concentration of ET-1 and serum concentration of NO were significantly higher in group B than in group C and A.Conclusion TCST has protective effect on gastric mucosal blood flow in rats under stress by reducing blood ET and NO concentrations.

Objective To detect the c fos proto oncogene expression in the hypothalamus of the mice which underwent water immersion and the effects of propofol Methods Twenty four mice were divided randomly into three groups:group A (normal control), group B (water immersion) and group C (water immersion+propofol) The group C was subdivided into two sub groups: in group C1 3mg/kg propofol was administered intraperitoneally 10min after water immersion; in group C2 3mg/kg propofol was given intraperitoneally 10min before water immersion The cerebral c fos positive cells were detected by S P immunohistochemical assay and the gastric ulcer index was calculated using Guth method Results Animal in group A had no gastric mucosa injury The gastric ulcer index increased significantly (6 2?2 1) with the obvious bleeding points in gastric mucosa and the rate of c fos gene positive cell increased markedly (64 2%?2 1%) in group B as compared with those in group A The gastric ulcer index and c fos gene expression rate decreased greatly in group C1 (3 2?1 0, 21 8%?3 2%) and group C2 (2 1?0 9, 18 4%?3 5%) respectively (P

Objective To investigate the effect of hypoxia adaptation on cerebral ischemai hypoxic injury Methods Hypoxia pretreatment mouse was placed in a tightly closed 150 ml bottle with large opening Once the mouse developed dyspnea, it was taken out and placed in another tightly closed 150ml bottle filled with fresh air When the mouse was short of breath it was again taken out This process was repeated 4 times Ischemia hypoxia model the left common carotid artery was ligated under ether anethesia and 1h later the mouse was placed in a hypoxia chamber in which the oxygen concentration was maintained at 8% Twenty four Kunmin mice weighting 18 25g were divided into six groups of four animals each:(1) control group; (2) hypoxia pretreatment group; (3) ischemia hypoxia group I (group I H1): the mice stayed in hypoxia chamber for 1 h; (4) ischemia hypoxia group 2 (group I H2): the mice stayed in hypoxia chamber for 2h; (5) hypoxia pretreatment +I H1; (6) Hypoxia pretreatment +I H2 The animals were sacrificed immediately at the end of the experiment Neural apoptosis was identified by terminal deoxynucleotidyl transferase mediated dUPT biotin nick end labelling (TUNEL).Results Apoptosis cells could be seen scattered in the cerebral cortex in hypoxia adaptation group and group I H1 No apoptosis cells were found in control group and group I H2 But hypoxia adaptation increased the number of apoptosis cells in severe hypoxia ischemia group (group I H2) Conclusions Hypoxia adaptation protects brain against hypoxia ischemia injury Hypoxia adaptation induces apoptosis Hypoxia adaptation can have neurons end up in apoptosis instead of nacrosis during cerebral ischemia hypoxia

Objective To investigate the effects of esmolol on ATPase activity in myocardial mitochondria after resuscitation in rats.Methods Sixty-six male Wistar rats were randomly allocated to three groups:sham group,AD group,AD+Es group.A cardiac arrest model was reproduced by asphyxiation in rats,and then CPR was performed in these animals after 10min asphyxia.The ATPase activity of myocardial mitochondria was determined at 30th,120th and 180th minute after resuscitation.ECG,MAP,HR and temperature were measured continuously.Results Heart rates were significantly higher after adrenaline when compared with sham group.Myocardial mitochondria ATPase activity was decreased significantly in both AD and AD+Es group compared with that of sham group(P

Objective To estimate the incidence,clinicopathological characteristics and therapeutic features in children with solid pseudopapillary tumors of the pancreas(SPTP).Methods Nine eases of children SPTP after diagnosis were collected in our hospital.Routine HE,PAS staining and immunohiatochemical staining of multiple indicators were analyzed,combined with literature analysis of clinical manifestations,imaging,pathological features,surgical treatment and follow-up case.Results The average age in nine cases of SPTP was 10.3 years.The SPTP patients in children in our hospital accounted for 29.0% of pancreas solid tumors.Many clinical manifestations were abdominal pain(5 cases,55.56%),abdominal mass(3 cases,33.33%),jaundice(1 cases,11.11%),and other symptoms.B-ultrasonography and CT showed pancreatic lesions,clear boundary,was solid and cystic,and some have a little calcification.Pathological features:tumor limitations,capsule integrity,and cross-section alternating solid and cystic lesions,tumors organizations sheet hemorrhage,necrosis and cystic change.Immunohistochemically,the positive rates were 100% for α1-AT,66.7% for NSE,33.3% for S-100 and 100% for PAS.The patients were followed-up for 4 months to 10 years and were alive postoperatively,but no local recurrence and distant metastasis.Histological examination showed solid with cystic areas and papillary protrusions.Conclusion SPTP should be the second most common pancreatic tumor in children.Girls were more frequently affected.The overall prognosis following surgical resection was good.