Objective To investigate the effect of positive end expiratory pressure (PEEP) on thermo-regulatory function during general anesthesia in patients addicted to smoking. Methods Twenty adult male ASA Ⅰ or Ⅱ patients who had been smoking more than or equal to 10 cigarettes per day for more than or equal to 6 years were studied. The patients underwent intra-abdominal surgery under general anesthesia and were randomly divided into 2 groups ( n = 10 each): control group (group C) and PEEP group (group P). Anesthesia was induced with propofol, fentanyl and vecuronium and maintained with inhalation of 1%-2% isoflurane and continuous iv infusion of remifentanil and vecuronium. The patients were mechanically ventilated after tracheal intubation. In group P PEEP of 10 cm H2O was added. Temperature probe was inserted into the lower segment of esophagus and placed on the anterior chest wall, medial surface of thigh anterior surface of forearm and palmar surface of the tip of index finger. Mean skin temperature (TMSK) was calculated according to Roberts. MAP, HR, TES, TMSK and the difference between TES and TMSK (TES-MSK) were recorded before induction of anesthesia (T0 ,baseline) and every 30 min after tracheal intubation. Esophageal temperature was taken as threshold of thermo-regulatory peripheral vasoconstriction when the difference between forearm and finger tip temperature = 0 ℃. The gain in the threshold was calculated according to Sessler. Results TES and TES-MSK significantly decreased,while TMsK increased after tracheal intubation in both groups ( P ＜ 0.05). There was no signifieant difference in TES, TMSK, TES-MSK, MAP, HR, the threshold of vasoconstriction and gain between the 2 gronps ( P ＞ 0.05). Conclusion PEEP cannot improve thermo-regulatory function during general anesthesia in smoking-addicted patients.

Three ASA Ⅱ patients, aged 24-32 yr, weighing 56-74 kg, undergoing caesarean section with nitroglycerine for uterine smooth muscle relaxation, from May 2005 to April 2007 in our hospital, were studied. Among the 3 cases, 2 cases (39 or 40 weeks of gestation) were singleton pregnancy and 1 case (34 weeks of gestation) was twin pregnancy.Combined spinal-epidural block with an injection was used in the 3 patients and the block level was at T4-6-S3-5. The excess contraction of uterine occurred in the patient at 40 week gestation about 140 s after uterus incision and it was difficult in delivery of the fetus, trananasal administration was then performed with nitroglycerine 0.5 nag, but it was inefficient after 60 s observation. Nitroglycerine 0.2 nag was injected intravenously, 32 s later the uterine smooth muscle relaxation was good and the fetus was delivered smoothly. In the patients at 39 and 34 week gestation, nitroglycerine 0.2 mg was injected intravenously when the excess contraction of uterine occurred about 140 s after uterus incision and the 2rid fetus started to be. delivered respectively. The uterine smooth muscle relaxation was good 45 or 35 s after injection and the fetuses were delivered smoothly. Apgar score was 6-8 and 10 at 1 and 5 min after delivery in the 3 patients. The duration from hysterotomy to delivery was 195-240 s. Intravenous drip of oxytocin 20 U was given immediately after delivery, and then uterus contracted. No obvious adverse reactions were found.

Objective To investigate the effect of ramipril on urinary protein in elderly type 2 diabetic patients with nephropathy in different periods.Methods 120 type 2 diabetic patients with nephropathy (64 males, 56 females) with mean aged (68±3) years were randomized into treatment group and control group (n =60, each).According to test results of 24 h proteinuria and renal function, they were divided into 3 subgroups: the normal urine albumin (normal control) group, the early diabetic nephropathy group, and the clinical diabetic nephropathy group.The control group received conventional treatment, while the treatment group used conventional treatment combined with ramipril 2.5 mg/d.Both groups had treatment course of 3 months.The changes in 24 h urinary total protein and urinary albumin before and 1 and 3 months after treatment, and the changes in blood urea nitrogen and serum creatinine levels in patients with renal dysfunction before and 3 months after treatment were observed and compared.Results 24 h urinary total protein and urinary albumin were significantly decreased along with the extended treatment time (P＜0.05 or 0.01).The blood urea nitrogen and serum creatinine levels were significantly declined at 3 months after treatment versus pre-treatment (P＜0.05 for both).There were no significant differences in 24h urinary total protein and urinary albumin in control group before versus after treatment (P＞0.05 for both).At 1 and 3 months after treatment, there were significant differences both in the decrement of 24h urinary total protein and urinary albumin, and in the blood urea nitrogen and serum creatinine levels between the clinical diabetic nephropathy treatment group and the control group (P＜0.05 or 0.01).Conclusions Ramipril combined with conventional treatment can effectively reduce proteinuria and promote the recovery of renal function for type 2 diabetic patients with nephropathy.

One hind leg(7 %TBSA)of the rat was scalded and the changes of the reduction-oxidation state and protein degradation in the soleus muscle were observed 72 hours postinjury both in vitro and in vivo.It was found that the lactate/pyruvate (L/P) and malate/pyruvate(M/P)ratios of the soleus muscle were significantly lower and the protein degradation rate much higher in the scalded leg than in the unscalded legs and the control.After the addition of insulin to the medium significant elevation of L/P and M/P ratios and reduction of the protein degradation rate in the soleus muscle could be observed.There findings suggest that there is a good correlation between the changes of the reduction-oxidation state and the protein degradation rate in the cytosol of the soleus muscle after scalding in the rat.

Objective To evaluate the accuracy of monitoring the neuremuscular blockade intraoporatively by transcutaneous electrical stimulation at the P6 acupuncture point. Methods Thirty-five patients, ASA Ⅰ - Ⅲ, BMI≤35 kg/m2 scheduled for abdominal surgery were selected. Anesthesia was induced by sufentunil 0.2-0.3 μg/ kg iv, propofol 2,5-3.5 mg/kg iv. Neuromuscular monitoring was performed by TOF Watch SXR at the P6 acupuncture point on the left forearm and ulnar nerve on the right. The current intensity and gain were recorded frem all the patients;onset time, recovery time of TOF ratio 25% and TOF ratio 90% of atrucurium were also obtained by TOF stimulation on the P6 acupuncture point and the ulnar nerve in patients who were administered a single bolus of atracurium 0.5 mg/kg iv during operation. Controlled ventilation commenced after endotracheal intubation. Results There were no significant differences between the P6 acupuncture point and the ulnar nerve in stimulus intensity or gain ( P > 0.05 ). There were no significant differences between the P6 acupuncture point and the ulnar nerve in onset time, recovery time of TOF ratio 25% and TOF ratio 90% (P > 0.05).Conclusion Transcutaneous electrical stimulation at the P6 acupuncture point can be used to monitor neuromuscular blockade intraoperafively.

Objective To investigate the protective effects of Shenfu injection on myocardium against ischemia and reperfusion injury in rats. Methods Twenty-four healthy male SD rats weighing 230-280 g were randomly divided into three groups (n = 8,each): sham-operation group(Sham), ischemia and reperfusion group (I/R), Shenfu injection group(SF) . In Sham group, the anterior descending branch of left coronary artery was exposed and a piece of silk thread was placed around the artery but untied. The ischemia and reperfusion injury models in I/R and SF groups were made by temporary ligation of the anterior descending branch of left coronary artery,ischemia lasted for 30 min and reperfusion for 60 min. In SF group, the Shenfu injection(10 ml/kg) was intraperitoneally injected 30 min before ischemia. In Sham and I/R groups, normal saline (10 ml/kg) was intraperitoneally injected. After 60 min reperfusion, the blood samples of all rats in each group were collected from the left carotid arterial catheter for determination of the concentrations of plasma TNF-?, IL-6 ( ELISA) . The myocardium samples were obtained for ultrastructure observation (Electron-microscope) .Results Compared with that in Sham group, the plasma concentrations of TNF-? and IL-6 in I/R group significantly increased( P

Objective To investigate the effect of angiotensin Ⅱ type Ⅰ receptor antagonist losartan on the infarct size and ultrastructure of myocardium and activation of NF-?B induced by myocardial ischemia and reperfusion (I/R) and the possible underlying mechanism. Methods Forty-two healthy male SD rats weighing 215-285 g were randomly divided into 4 groups: in control group ( n = 6) the anterior descending branch of left coronary artery (LCA) was exposed but not occluded; in I/R group (n = 12) the anterior descending branch of LCA was occluded for 30 min followed by 60 min reperfusion; in group LOS1 ( n = 12) and group LOS2 ( n = 12) losartan 5 mg (LOS1) or 10 mg (LOS2) was injected i.v. 15 min before myocardial ischemia. At the end of 60 min reperfusion the animals were killed and the hearts were harvested for determination of (1) myocardial infarct size (by TTC) , (2) ultrastructure of myocardium (electron microscope) and (3) activation of NF-?B.Results The infarct size in group LOS1 (34.6%?2.2%) and LOS2 (21.8%?4.0%) was significantly smaller than that in I/R group (45.4%?2.4%). Myocardial ultrastructure was well preserved in group LOS1 and LOS2 as compared to I/R group. NF-?B activity was significantly increased in I/R group and losartan pretreatment significantly reduced the increase in NF-?B induced by I/R. Conclusion Angiotensin Ⅱ type Ⅰ receptor antagonist losartan has cardioprotective effect on myocardium against I/R in a dose-dependent manner. Modulation of NF-?B activated by I/R may be involved in the mechanism.

Objective To investigate the effects of thiopental on expression of nuclear factor kappa B (NF-?B) and content of TNF-? and IL-1? in the lungs induced by lipopolysaccharide (LPS) .Methods Twenty-four male Kunming mice weighing 15-25 g were randomly divided into 4 groups (n = 6 each) : I control group received intraperitoneal (i.p.) normal saline (NS) 1 ml?kg-1 ; Ⅱ LPS group received i.p. LPS 5 mg?kg-1 ; Ⅲ LPS + thiopental (TH) received intrapentoneal TH 60 mg?kg-1 20 min after i.p. LPS 5 mg?kg-1 and Ⅳ TH group received i.p. TH 60 mg?kg-1 alone. The animals were bled to death at 3 h after LPS administration. The lungs were immediately removed for determination of expression of NF-?B p65 (Western blot) and TNF-? and IL-1? content (ELISA) in the lung. Results The expression of NF-?B p65 was significantly increased and the level of TNF-? and IL-1? in the lungs were significantly increased after LPS stimulation as compared with control group ( P

Objective To study the molecular biological mechanism of the protective effect of angelica on myocardium during ischemia reperfusion Methods The myocardial ischemia/reperfusion was induced with the 40 min cross clamp/120 min declamping of anterior decending coronary artery Forty SD rats were randomly divided into 3 groups: group A without myocardial ischemic reperfusion , group B with intravenous adminisrtration of normal saline 0 8ml/100g before ischemia reperfusion , and group C with intravenous adminisrtration of 25% angelica 0 8ml/100g before ischemia reperfusion The content of protein kinase C (PKC) in cardiac myocyte was measured with immunohistochemical method, and the PKC activity with the isotope lable method Results Compared with those in group B, the myocardial infarct size reduced significantly in group C (P0 05) but increased obviously in group C (P0 05) The PKC activity was significantly higher in group C than that in group A(P

Objective To examine the effect of endotoxin on myocardial lipid metabolism and determine it′s possible mechanism Methods Sixty nine male Wistar rats (350 450g) were randomly divided into 2 groups: in vivo group and in vitro group In in vivo group endotoxin 0 1?g?kg -1 (small dose)or 1mg?kg -1 (large dose) was injected intrabdominally 3h after endotoxin administration the animals were anesthetized Heart was excised and passively perfused in a Laugendorff apparatus with oxygenated Krebs Heuseleit buffer at 37℃ Non esterified fatty acids (NEFA)and triacylglycerols(TAG) were used as energy supplying substance when the isolated heart had been stabilized for 15min NEFA or TAG was slowly added to the perfusate circuit 1 ml of perfusate was drawn every 10 min until the end of experiment (80 min ) for determination of the effects of endotoxin on NEFA or TAG oxidation and utilization by isolated heart At the end of experiment heart was harvested and frozen for measurement of myocardial lipids and lipoprotein lipase activity In in vitro group endotoxin was added to perfusate (1mg/ml) after the heart was excised and passively perfused In control group endotoxin was replaced by normal saline Results Large dose of endotoxin administered in vivo decreased NEFA oxidation rate by 30% in perfused isolated heart and caused increased accumulation of lipid in myocardial tissue By contrast endotoxin administered in vitro increased oxidation rate of TAG accompanied by an increase in myocardial lipoprotein lipase activity Administration of endotoxin in vivo and in vitro also caused accumulation of various exogenous lipids in myocardium in both NEFA and TAG perfused heart Conclusions This study shows that endotoxin has a significant effect on myocardial lipid metabolism The effect of endotoxin could be either direct or indirect according to the different lipids available