BACKGROUND: Chinese herb digan oral liquid promotes manufacture of hematopoietic cells. During irradiative injury, how are the therapeutic effects of intervention with Chinese herbal compound on expressions of stromal cellular adherent molecule (SCAM) and cyclin gene that are closely related to hematopoietic cells?OBJECTIVE: Mouse model with irradiative injury was established to assay the effects of Chinese herbal compound-digan oral lipid on the expression of medullary cyclinD1mRNA and the expressions of hematopoietic stem cells (HSCs), stromal cellular adherent molecular CD45 (SCAMCD45) and vascular cellular adherent moldecular-1 (VCAM-1).DESIGN: Randomized controlled experiment was designed.SETTING: Department of Integrated Traditional Chinese and Western Medicine, Wuhan General Hospital of Guangzhou Military Area Command of Chinese PLA; Institute of Hematology of Tongji Medical College and Institute of Hepatology of Hubei College of Traditional Chinese Medicine.MATERIALS: The experiment was performed in Institute of Hematology of Tongji Medical College and Institute of Hepatology of Hubei College of Traditional Chinese Medicine from January 2001 to June 2002, in which,48 outbred Kunming mice were employed, aged varied from 8 to 12weeks, mass-weighted varied from 18 to 22 g, of either sex. Drugs: 100% digan oral lipid is composed of shudihuang (radix rehmanniae preparata) and zhigancao (radix glycyrrhizae preparata). At ratio of 2/1, water decoction was prepared and concentrated as 100% oral liquid (containing raw herb 1 g/mL). METHODS: Totally 48 mice were randomized into 4 groups, 12 mice in each one. Normal group: no any management. Oral lipid group: Digan oral lipid was applied for gastric perfusion in model with irradiative injury,0.02 ml/g, twice a day. Model group: After modeling, physiological saline was used for gastric perfusion with the same dosage as the above. Batilol group: After modeling, batilol suspension was used for gastric perfusion (0.1 g/kg). Gastric perfusion was done continuously for 9 days in each group. On the 10th day, hybridization in situ was used to assay cyclinD1 mRNA expression of medullary mononuclear cell (MNC), Immuniohisto chemical SABC method was used to assay medullary VCAM-1 expression and flow cytometry (FCM) was used to assay CD45 content.MAIN OUTCOME MEASURES: CyclinD1 mRNA expression of medullary mononuclear cell (MNC) and expression of medullary stromal cellular VCAM-1 and CD45 antigenRESULTS: After modeling, there were 12 mice in normal group and 10 mice in rest groups. In result analysis, 5 mice were randomized in each group. ① In oral liquid group, the expression of medullary cellular cyclinD1 mRNA and VCAM-1 were higher significantly than model group[oralliquid group: (27.34±4.49), (53.94±8.67)% and model group: (16.06±4.57),(31.92±5.01)%, P＜ 0.01]. ② Expression of CD45 antigen iroral liquid group was higher significantly than model group [(41.38±5.76), (19.24±4.98)%, P ＜ 0.01]. Both digan oral liquid and batilol improved the expressions of cyclinD1,VCAM-1 and CD45 antigen.CONCLUSION: Chinese herbal compound-digan oral liquid enhances the expression of adherent molecule of hematopoietic stem cells, promotes the expression of stroma] cellular adherent molecule and improves the transcription of medullary cellular cyclinD1, which induces hematopoietic cells to be differentiated more maturely and to be transported peripherally so as to supplement blood.

Objective To investigate the effects of total intravenous anesthesia (TIVA) and combined intravenous and inhalation anesthesia on blood glucose and cortisol in spinal neurosurgery.Methods Forty-four spinal neurosurgery patients were divided into propofol combined with remifentanil group (PR group) and sevoflurane combined with remifentanil group (SR group ), 22 cases in each group,they were induced with propofol, sufentanil and rocuronium. Anesthesia was maintained with sevoflurane in SR group while propofol in PR group. Depth of anesthesia adaption according to bispectral index (BIS)(45 -55). Blood glucose, cortisol, haemodynamics were observed at different time points. Results The mean arterial pressure(MAP) was higher after induction in PR group than that in SR group(P ＜ 0.05 ). Sixty minutes after induction, MAP was lower than that before induction in PR group (P ＜ 0.05 ). Heart rate ( HR )in both SR group and PR group were lower at 60 and 120 minutes after induction than those before induction (P ＜ 0.05). HR was lower at 5 minutes after induction in PR group than that in SR group (P ＜ 0.05). No significant difference was showed in blood glucose and cortisol between the two groups (P ＞ 0.05 ). Cortisol level was significantly lower at 120 minutes after induction than that before induction [(40.6 ± 18.3) μg/L vs. ( 129.7 ± 36.7 ) μg/L, P ＜ 0.05 ] and at 24 hours postoperative [ (93.6 ± 19.8 ) μg/L ] recovered to the level before induction in PR group. Cortisol level was significantly higher before induction than 120 minutes after induction [ ( 130.5 ± 32.1 ) μg/L vs. (51.6 ± 16.8 ) μg/L, P ＜ 0.05 ] and 24 hours postoperative was (75.9 ± 18.2) μg/L in SR group. Conclusions Two anesthetic regimens are compatible during spinal neurosurgery, with no apparent fluctuations of perioperative blood glucose. However, longer cortisol inhibition is probably happened when using sevoflurane.

Following the blood pressure, pulse, breathing and body temperature, pain was identified as the fifth vital signs.Postoperative pain of the spine and spinal cord surgery was a neuropathic pain, it was severe and may affect multiple systems of the patients.Therefore, postoperative analgesia of spine and spinal cord surgery is very important.

Objective To evaluate the effects of different positions on cerebral blood flow in patients undergoing laparoscopic surgery.Methods Thirty patients of both sexes,aged 23-64 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic surgery,were included.Patients' position was changed using a random number table after induction of anesthesia.Patients were placed in the supine position and tilted 15° head-up or 15° head-down,and the parameters of the middle cerebral artery were monitored using the transcranial Doppler ultrasound.After admission to the operating room (baseline),after induction of anesthesia and before pneumoperitoneum,in the supine position,at head-up tilt and at head-down tilt,the mean blood flow velocity,pulsatility index,resistance index,mean arterial blood pressure (MAP) and heart rate were recorded.Results Compared with the baseline in the supine position,the MAP and bilateral mean blood flow velocity were significantly decreased at head-up tilt,and the MAP and bilateral pulsatility and resistance indices were significantly increased at head-down tilt (P＜0.05).Conclusion During laparoscopic surgery,head-up tilt can lead to a decrease in cerebral blood flow,and head-down tilt exerts no effect on cerebral blood flow.

OBJECTIVE: To elucidate which one of &mgr;, delta and kappa opioid receptors is involved in the cardiovascular depression following traumatic hemorrhagic shock. METHODS: With traumatic hemorrhagic shock rat models, the changes of myocardial and brain &mgr;, delta and kappa opioid receptors and cardiovascular functions and their relationship with hemodynamic parameters were observed. The effects of delta and kappa opioid receptor antagonists on hemodynamic parameters of traumatic hemorrhagic shock rats were observed. RESULTS: Following traumatic hemorrhagic shock, the number of myocardial and brain delta and kappa opioid receptors significantly increased, their affinity did not alter, and the increased number of delta and kappa opioid receptors was significantly associated with the decreased hemodynamic parameters. However, &mgr; opioid receptor in heart and brain did not obviously change. delta opioid receptor antagonist ICI174,864 and kappa opioid receptor antagonist Nor-binaltorphimine (50 &mgr;g, Icv) could significantly reverse those decreased hemodynamic parameters. CONCLUSIONS: It suggests that opioid receptors, especially delta and kappa opioid receptors are closely related to the pathogenesis of traumatic hemorrhagic shock, and they play important roles in the depression of cardiovascular function following traumatic hemorrhagic shock.