Cognitive decline is a common complication after cardiac surgery with cardiopulmonary bypass (CPB), but as such no pharmacological therapy has been shown to be efficacious in preventing the decline. However, gastrodin has been shown to have multi-pharmacological effects on neurological functions. We undertook this study to test the hypothesis that gastrodin would potentially prevent CPB-associated neurocognitive decline. We randomly assigned 200 patients undergoing mitral valve replacement surgery to receive either gastrodin (40 mg/kg) or saline after the induction of anesthesia and subsequently evaluated cognitive function before surgery, at discharge, and at 3rd month after surgery by using a battery of five neurocognitive tests, or adverse effects of gastrodin postoperatively. Neurocognitive decline in postoperative function was defined as a drop of 1 SD or more in the scores on tests of any one of the four domains of cognitive function. Cognitive decline occurred in 9% of the patients in the gastrodin group in contrast to 42% in the control group (P<0.01) at discharge. Cognitive outcome could be determined at 3rd month in 87 patients in the gastrodin group and 89 in the control group. Cognitive decline was detected in 6% in the gastrodin group and 31% in the control group (P<0.01). The incidences of possible adverse effects were similar between two groups. These results indicate that gastrodin is an effective and a safe drug for the prevention of neurocognitive decline in patients undergoing mitral valve replacement surgery with CPB.

Objective To study the effects of two types of crystalloids on postoperative inflam-matory reaction during the process of cesarean section.Methods Sixty patients undergoing cesarean section were randomly divided into Ringer lactate solution group (RL)and Ringer acetate solution group (RA)with 30 cases in each group.Before anesthesia,10 ml/kg crystal solution was infused, the infusion rate was 1 5-20 ml·kg-1 ·h-1 .The patients were performed epidural anesthesia in left lateral position.Crystal solution was infused to maintain the blood pressure during the operation.Ve-nous blood was drawn at the beginning of the operation (T1 ),the end of the operation (T2 ),four hours after operation (T3 ),twenty-four hours after operation (T4 )in order to measure the blood plasma value of IL-6,TNF-α,CRP.Results The blood plasma value of IL-6,TNF-α,CRP had no significant differences at T1 ,T4 ;but the value of group RA was significantly higher than that of group RL (P <0.05)at T2 ,T3 .Conclusion Ringer acetate solution causes more significant postop-erative inflammatory cytokine release than Ringer lactate solution does during the process of cesarean section.

Objective To compare the degree of liver injury during resuscitation with different crystalloid solutions in a rat model of hemorrhagic shock.Methods Forty-eight SPF healthy male SpragueDawley rats,aged 7-9 weeks,weighing 280-320 g,were assigned into 4 groups (n=12 each) using a random number table:sham operation group (group S),normal saline group (group NS),Ringer's lactate solution group (group RL) and Ringer's malate solution group (group RM).Hemorrhagic shock was induced by withdrawing blood from the right internal jugular vein until mean arterial pressure was reduced to 35-45 mmHg which was maintained for 1 h.The internal jugular vein and artery were cannulated after anesthetization,but no animals were subjected to hemorrhage in group S.The crystalloid solution (2 times the volume of blood loss) was infused intravenously over 30 min starting from 1 h of shock.The animals were resuscitated with 0.9％ sodium chloride solution in group NS,with Ringer's lactate solution in group RL,and with Ringer's malate solution in group RM.Mean arterial pressure was continuously monitored and recorded during the experiment.Before shock (T1),at 1 h of shock (T2) and at 4 h after resuscitation (T3),blood samples were collected from the right internal jugular vein for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations by enzyme-linked immunosorbent assay.Rats were sacrificed at T3,and livers were removed for measurement of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity in liver tissues (using colorimetric method) and for examination of pathological changes of liver tissues (with light microscope).Results Compared with group S,the serum ALT and AST concentrations at T2.3 and SOD activity and MDA content at T3 were significantly increased in NS,RL and RM groups (P＜0.05).Compared with group NS or group RL,the serum ALT and AST concentrations were significantly decreased,the SOD activity was increased,and the MDA content was decreased at T3 (P＜0.05),and the pathological changes of liver tissues were significantly attenuated in group RM.Conclusion Ringer's malate solution produces better efficacy than normal saline and Ringer's lactate solution when used for resuscitation and mitigating liver injury in a rat model of hemorrhagic shock.

Cognitive decline is a common complication after cardiac surgery with cardiopulmonary bypass (CPB),but as such no pharmacological therapy has been shown to be efficacious in preventing the decline.However,gastrodin has been shown to have multi-pharmacological effects on neurological functions.We undertook this study to test the hypothesis that gastrodin would potentially prevent CPB-associated neurocognitive decline.We randomly assigned 200 patients undergoing mitral valve replacement surgery to receive either gastrodin (40 mg/kg) or saline after the induction of anesthesia and subsequently evaluated cognitive function before surgery,at discharge,and at 3rd month after surgery by using a battery of five neurocognitive tests,or adverse effects of gastrodin postoperatively.Neurocognitive decline in postoperative function was defined as a drop of 1 SD or more in the scores on tests of any one of the four domains of cognitive function.Cognitive decline occurred in 9％ of the patients in the gastrodin group in contrast to 42％ in the control group (P＜0.01) at discharge.Cognitive outcome could be determined at 3rd month in 87 patients in the gastrodin group and 89 in the control group.Cognitive decline was detected in 6％ in the gastrodin group and 31％ in the control group (P＜0.01).The incidences of possible adverse effects were similar between two groups.These results indicate that gastrodin is an effective and a safe drug for the prevention of neurocognitive decline in patients undergoing mitral valve replacement surgery with CPB.