This article summarizes the methods of making rat cerebral ischemia models and comments the advantages and disadvantages of various methods in order to provide references for the selection of animal models in the basis and appfication research of cerebral ischemia.

OBJECTIVE:To discuss the effect of etomidate and propofol on early postoperative cognitive dysfunction (POCD)of elderly patients after laparoscopic cholecystectomy(LC)and significance of serum protein S100β to the occurrence of early POCD in total intravenous anesthesia. METHODS:60 patients aged 65 years old above undergoing LC in total LMA intrave-nous anesthesia were selected and randomly divided into etomidate group(group E)and propofol group(group P),with 30 cases in each group. Anesthesia was induced by etomidate 0.3 mg/kg (group E) or propofol 1.5 mg/kg (group P),and additionally in-duced by sufentanil 0.4 μg/kg and vecuronium 0.12 mg/kg. Anesthesia was maintained with intravenous pump of remifentanil 0.15 μg/(kg·min),continuous target controlled infusion of etomidate(target concentration 1.0-1.5 μg/ml)(group E)or propofol(target concentration 3.0-4.0 μg/ml)(group P);the dual brain index(BIS)values were maintained between 40 and 50 throμgh adjusting target concentration of etomidate or propofol. The blood samples were collected 1 h before operation(T0),2 h(T1),24 h(T2), 48 h(T3)after operation,and the content of S100βprotein was detected and mini-mental state examination(MMSE)score were re-corded. Meanwhile,recovery time,laryngeal mask removal time,intraoperative dosage and the occurrence of intraoperative aware-ness were observed and recorded in 2 groups. RESULTS:There was no statistically significant difference in MMSE score between 2 groups at different time points(P>0.05);MMSE score of 2 groups at T1 and T2 was significantly lower than at T0,with statisti-cal significance(P<0.05). There was no statistically significant difference in the content of S100β protein between 2 groups at dif-ferent time points(P>0.05);The contents of S100β protein in 2 groups at T1 and T2 were significantly higher than at T0,with sta-tistical significance(P<0.05). The recovery time and larynge-al mask removal time were both short in 2 groups,with statis-tical significance (P>0.05). The amount of ephedrine in group P was significantly higher than in group E,with statisti-cal significance (P<0.05). No intraoperative awareness oc-curred in 2 groups throμgh postoperative follow-up. CONCLUSIONS:Etomidate and propofol total intravenous anesthesia can be safely used in elderly patients with LC,and they can cause short-term POCD at different degrees. The amount of S100β protein has some relevance with the occurrence of early POCD .

OBJECTIVE To examine the prevalence and trends of drug resistance of nontuberculous mycobacteria(NTM)in Shanghai.METHODS All NTM strains isolated between 1998 and 2004 in Shanghai were identified with conventional biochemical tests.Antimicrobial susceptibility test for all NTM was performed by standard absolute concentration method.RESULTS The prevalence rate was determined as 1.49%,1.17%,1.98%,2.46%,2.66%,2.72% and 3.0% among mycobacteria culture positive patients per year in 1998,1999,2000,2001,2002,2003,and in 2004,respectively.These data indicated the prevalence rate has continuously increased.Distribution of NTM isolates was Group Ⅰ18.7%,Group Ⅱ 5.1%,Group Ⅲ 25.1%,and Group Ⅳ 51.1% accordingly.Group Ⅳ rapidly growing NTM accounted for majority of them.Most of NTM showed high drug resistance to general antituberculotic drug.In particular Group Ⅳ Mycobacterium chelonae and M.fortuitum appeared multi-drug resistance.CONCLUSIONS The prevalence rate of NTM in Shanghai shows increased tendency.Most of NTM isolates are Group Ⅳ rapidly growing NTM.NTM shows high drug resistance to first line antituberculotic substance.

ObjectiveTo investigate the effect of acute normovolemic hemodilution (ANH) on the apoptosis in hippocampal cells induced by global cerebral ischemia-reperfusion (I/R) in rats.Methods Thirty-six healthy 50-60 day old male SD rats weighing 280-320 g were randomly divided into 3 groups ( n =12 each):group sham operation (group S); group global cerebral I/R (group I/R) and group ANH.Global cerebral I/R was produced by 4-vessel technique described by Pulsinelli et al.in groups I/R and ANH.ANH was carried out at 24 h after cauterization of bilateral vertebral arteries,before occlusion of bilateral carotid arteries.Blood was withdrawn from femoral artery until Hct was reduced to 30％ and equal volume of hydroxyethyl starch 130/0.4 sodium chloride was infused into femoral vein simultaneously.Bilateral carotid arteries were blocked for 5 min at 10 min after ANH.The rats were sacrificed at 24 h of reperfusion and their hippocampi were isolated.Apoptosis was detected by flow cytometry.The expression of Apaf-1 mRNA and caspase-3 mRNA was determined by RT-PCR.Results Global cerebral I/R significantly increased apoptosis index and up-regulated Apaf-1 mRNA and caspase-3 mRNA expression in group I/R as compared with group S.ANH significantly attenuated apoptosis and down-regulated Apaf-1 mRNA and caspase-3 mRNA expression in group ANH compared with group I/R.ConclusionANH can reduce hippocampal cell apoptosis induced by cerebral I/R through down-regulation of Apaf-1 and caspase-3 expression in hippocampus.

Objective:To evaluate the efficacy of dexmedetomidine on painless gastroenteroscopy in the patients recovered from COVID-19.Methods:Eighty patients of either sex, aged 18-64 yr, with body mass index <30 kg/m 2, undergoing elective painless gastroenteroscopy, of American Society of Anesthesiologists physical statusⅠor Ⅱ, within 2nd to 7th weeks after diagnosis of COVID-19, who had a negative nucleic acid test or antigen test at present and presented with no respiratory symptoms in our hospital from January to February 2023, were selected and divided into 2 groups ( n=40 each) using a random number table method: dexmedetomidine group (group D) and control group (group C). Sufentanil 0.1 μg/kg was intravenously injected in two groups. Dexmedetomidine 0.2 μg/kg was intravenously injected in group D, and the equal volume of normal saline was given instead in group C. Propofol 1.5-2.0 mg/kg was intravenously injected after 2-3 min observation, and propofol 5-7 mg·kg -1·h -1 was intravenously infused to maintain sedation during operation. The development of bucking and hypoxemia during operation, total consumption of propofol, emergence time, time of hospital discharge, development of bradycardia and hypotension during operation, and scores for patients′ and endoscopic physicians′ satisfaction with anesthesia were recorded. Results:Compared with group C, the incidence of bucking and hypoxemia was significantly decreased, scores for endoscopic physicians′ satisfaction with anesthesia were increased ( P<0.05), and no significant change was found in the other parameters in group D ( P>0.05). Conclusions:Low-dose dexmedetomidine can reduce the risk of bucking and hypoxemia during operation and raise the quality of anesthesia in the patients recovered from COVID-19 undergoing painless gastroenteroscopy.

BACKGROUND:Talus cartilage injury is a common motor system disease.This type of injury will affect the patient's daily life and work ability,and may worsen the condition if left untreated.Surgical treatment is commonly used,but the selection of surgical methods and the evaluation of medium-and long-term follow-up results have always been difficult clinical problems. OBJECTIVE:To explore the influence of T1ρ technique on the range of quantitative evaluation of talus osteochondral injury on the choice of surgical method and the results of medium-and long-term follow-up. METHODS:A total of 154 patients with osteochondral injury of talus admitted to The Second Hospital of Tangshan from January 2019 to August 2022 were retrospectively selected as the study subjects.The lesion site of talus was examined by MRI before operation,and the T1ρ and T2 values of different types were compared.Different surgical methods were selected according to the different T1ρ values.Group A(n=73)was treated with microfracture surgery with T1ρ<45 ms;group B(n=81)was treated with autogenous bone and cartilage transplantation with T1ρ≥45 ms.The general clinical characteristics and curative effects of patients under different surgical methods were compared;the important factors of postoperative recurrence were analyzed by multivariate Logistic regression,and the relationship between T1ρ value and postoperative recurrence was analyzed by restricted cubic spline graph,y=1-1/(1+e-z)regression equation to build a prediction model.The stability of the model was verified by cross-checking method. RESULTS AND CONCLUSION:(1)Classification of talus osteochondral injury in 154 patients(type Ⅰ:36 cases;type Ⅱ:37 cases;type Ⅲ:40 cases;type Ⅳ:41 cases),T1ρ and T2 values of the four groups were statistically significant(P<0.05);pairwise comparison was also statistically significant(all P<0.05).(2)After treatment of 154 patients,7 cases(4.6％)had local swelling,3 cases(2.0％)had pain aggravation,and 5 cases(3.3％)had wound infection.There were 2 cases(1.3％)with poor cartilage healing.(3)After treatment,there were statistically significant differences between groups A and B in terms of American Orthopaedic Foot&Ankle Society score,visual analog scale score,plantar flexor motion range,dorsoextension motion range,subchondral bone marrow edema volume,interleukin-6,interleukin-8,C-reactive protein,procalcitonin,platelet-derived growth factor,transforming growth factor-β1,and efficacy(P<0.05).The total effective rate of group B(90％)was higher than that of group A(85％)(P<0.05).(4)Age(OR=1.589,95％CI:0.305-1.252,P=0.036),interleukin-6(OR=1.737,95％CI:0.974-5.254,P=0.049),interleukin-8(OR=1.385,95％CI:1.066-4.355,P=0.034),C-reactive protein(OR=1.957,95％CI:1.323-2.178,P=0.035),transforming growth factor-β1(OR=1.459,95％CI:0.897-2.455,P=0.038),T1-ρ(OR=1.687,95％CI:0.854-3.321,P=0.026),T2(OR=1.843,95％CI:0.657-2.454,P=0.036),complications(OR=1.719,95％CI:0.654-3.464,P=0.019),and classification of osteochondral injury of talus(OR=3.789,95％CI:1.023-5.897,P=0.028)were independent risk factors for postoperative recurrence.Microfracture surgery(OR=0.751,95％CI:0.321-1.264,P=0.012)and autogenous bone and cartilage grafting(OR=0.649,95％CI:0.246-1.356,P=0.023)were independent protective factors for recurrence after medium-and long-term follow-up.(5)When T1ρ value≤35 ms,the risk of postoperative recurrence decreased rapidly,and when T1ρ value>35 ms,the risk of postoperative recurrence increased rapidly.(6)Further stepwise regression analysis showed that these nine risk factors were most closely associated with postoperative recurrence,and the formula for postoperative recurrence was obtained.The probability of postoperative recurrence was calculated using the regression equation.When P=0.75,the maximum value of Jorden index was 77.728,indicating that the model has a better prediction effect.(7)It is indicated that the quantitative evaluation of T1ρ before operation can effectively guide the selection of surgical methods,improve the success rate of surgery and the quality of life of patients.