Objective:To investigate the changes of alpha adrenergic receptors(?-AR) mRNA expression in heart and mesenteric artery in autonomic dysreflexia(AD) rats after spinal cord transection,so as to explore the possible mechanism of AD.Methods: The spinal cord of rats was exposed and the fourth thoracic spinal cord was transected;4 weeks later,rats' rectum was stimulated by self-made catheter and those with a mean arterial blood pressure increased by more than 15 mmHg(1 mmHg=(0.133) kPa) were chosen as AD group(n=16).Heart and mesenteric arteries along with their branches were harvested.mRNA expression of ?_(1A)-,?_(1B)-,?_(1D)-,?_(2A)-,?_(2B)-and ?_(2C)-AR was quantified by real time PCR and the result was compared with that in sham-operated group(the fourth thoracic spinal cord was exposed but not transected).Results: Compared with sham-operated group,rats in AD group had a lower expression of ?_(1A)-AR mRNA(P

Objective To investigate the effect of autologous transplantation of circulating endothelial progenitor cells (EPCs) on oleic acid-induced acute lung injury (ALI) in rabbits. Methods Thirty New Zealand long ear rabbits weighing 1.8-2.0 kg were randomly divided into 2 groups ( n = 15 each): normal saline group (group NS) and EPC group. ALI was induced by iv oleic acid 80 mg/kg. EPC (106/200 μl) or equal volume of normal saline (NS) was administered iv at 4 h after iv oleic acid injection. Arterial blood samples were obtained before (T0) and at 4, 8, 12, 24 and 48 h (T1-5) after oleic acid injection for blood gas analysis and determination of serum vascular endothelial growth factor (VEGF) concentration. The animals were then scrificed (at T5 ) and the lungs were removed for microscopic examination and determination of W/D lung weight ratio, Pulmonary infiltration of PMN and non-PMN was counted and hyaline membrane formation and hemorrhage were examined. Results PaO2/FaO2 ratio and serum VEGF concentration were significantly higher in group EPC than in group NS. Infiltration of leukocytes in the lung was significantly reduced by EPC transplantation. EPC also decreased lung water content, hyaline membrane formation and hemorrhage in the lungs. Conclusion Autologous transplantation of circulating EPC can ameliorate oleic acid-induced acute lung injury in rabbits.

Enhanced recovery after surgery (ERAS) emphasizes applicating a series of sophisticated measures with the synergy effect of optimized combination to minimize various physical and mental stress reaction.The aim of ERAS is to accelerate postoperative recovery,shorten duration of hospital stay and hospital expenses,improve postoperative life quality of patients.ERAS includes minimally invasive surgery,anesthetic management,reasonable postoperative management,among which anesthetic management is very important.

Objective To analysis the causes of cardic arrest during liver transplantation, and investigate the preventive measures. Methods Clinical records about 5 patients with cardiac arrest in liver transplant were studied retrospectively. Results Occurrence of cardiac arrest was 2.1 % (5/240). All the events happened at 3-6 min after graft reperfusion, and arrest lasted 3-8 min. Two patients died of resuscitation failure. After graft reperfusion, CVP and MPAP were much high in 5 patients. All of them had hypothermia and hypocalcemia. Three of them also had acidosis and two complicated with hyperkalemia. In one case, the difference between PaCO_2 and P_ETCO_2 was 47 mm Hg. Conclusion Many factors, such as disturbances of electrolyte and acid-base equilibrium or hypothermia, seemed to have some contribution to cardiac arrest occurrence after reperfusion. Various methods should be used to counter it.

[Objective]To investigate the relationship between neurogenic pulmonary edema(NPE)and the changes of substance P in serum and bronchoatveolar lavage fluid(BALF)in acute spinal cord injured rats during isoflurane inhalation.[Method]Thirty male SD rats with body weight of 300-330g were randomly divided into 3 groups:1.5% isoflurane group,chloral hydrate group and sham operation group,ten in each group.Epidural balloon compression of the T8 spinal cord was performed.Alt animals were sacrificed 10 min after being compressed.The content of substance P and protein concentration in serum and BALF were measured.Then the lung permeability index(LPI)was calculated.[Result]The content of substance P in serum and BALF in 1.5% isofiurane group was higher than that in chloral hydrate group(P0.05).[Conclusion]1.5% isofturane can stimulate the release of substance P to take part in the development of neurogenic pulmonary edema in rats.

Objective To evaluate the changes in peripheral?1-adrenergic receptor sensitivity in a rat model of chronic high spinal cord injury (SCI)Methods Thirty male 18-week-old Wistar rats weighing 290-310g were randomly divided into 2 groups: SCI group (n=24) and control group (C n=6) . The animals were anesthetized with intraperitoneal 2 % pentobartital 50 mg?kg-1 and subjected to spinal cord injury (SCI) at T4 according to modified Allen's method. Successful high SCI was confirmed by bilateral hindlimb flaccid paralysis. Three weeks after SCI the animals were further divided into 4 subgroups (n=6) receiving 4 different doses of phenylephrine 1, 2, 3 and 4 ?g?kg-1 i.v. Femoral artery was connulated for BP (SBP and DBP) and HR monitoring. HR and SBP and DBP were recorded before and after i.v. phenylephrine injection. In control group phenylephrine (PE) 1,2,3 and 4 ?g?kg-1 were injected i.v. successively at an 1h interval. % changes in HR, SBP and DBP were calculated: % change = (post-injection value- baseline value) / baseline value. Results The animals lost weight and HR was significantly slower and SBP and DBP were significantly lower 3 weeks after SCI as compared with control group. In both group C and SCI, HR was significantly decreased and SBP and DBP were significantly increased after i.v. PE injection as compared to the baseline value before PE. The % changes in HR, SBP and DBP were significantly greater in group SCI than in group C. Conclusion In a rat model of chronic high SCI, peripheral?1-adrenergic receptor sensitivity is significantly increased 3 weeks after high SCI.

Objective To observe the reactivity of spinal cord transection (SCT) rat abdominal aorta to ?-AR agonists and the infuence of propofol on vascular reactivity, so as to explore the mechanism of autunomic dysreflxia. Methods The rats were divided into sham-operated group and SCT group. 4 weeks after transection of the fourth thoracic spinal cord, the rats were killed, then abdominal aorta rings were adopted to assay their sensitivity to noradrenaline, phenylephrine, clonidine and propofol in isolated organ perfusion system. Results Compared with the rats in sham-operated group, the abdominal aorta reactivity of SCT rats to noradrenaline and clonidine was significantly higher (P

Objective:To discuss the early diagnosis of malignant hyperthermia(MH) and its treatment regimen without dantrolene.Methods: A patient of American Society of Anesthesiologist class Ⅰhad sudden muscle spasms and masseter muscle spasm during induction of anesthesia for idiopathic scoliosis surgery,and was diagnosed as having MH.Without using dantrolene,the patient was treated promptly with removal of inducement,control of temperature,adequate oxygen supply,maintaining of pH,water and electrolyte balance,and protection of renal function.The dynamic changes of the myoglobin in the blood and urine,serum creatine kinase,the blood gas indicators,and EtCO2,together with the pathological changes of the quadriceps were observed.Our experience on diagnosis and treatment was summarized.Results: The patient fully recovered and was discharged without any complications.The myoglobin in the blood and urine,serum creatine kinase and its isoenzyme increased rapidly and reached the peak one hour after MH,and maintained for about ten hours,then returned gradually to normal level about five days later.The temperature and EtCO2 increased immediately after development of MH,arterial blood gas quickly showed hypercapnic acidosis,but pH maintained normal or partial alkali during the treatment due to sodium bicarbonate administration;the alkali maintained obviously higher.Some quadriceps muscle cell had vacuolar degeneration and lysis.Conclusion: Non-ventilation induced increase of EtCO2 is a reliable indicator for early diagnosis of MH.Anesthetics,such as succinylcholine,should be avoided in patients at high risk of MH,and EtCO2 should be monitored.Once MH is diagnosed,dantrolene is the first choice.When without dantrolene,satisfactory outcome can be achieved through early diagnosis,timely removal of incentives,control of temperature,adequate oxygen supply,maintaining of stable internal environment,control of arrhythmia and protection of renal function.

Objective To compare the efficacy of supraclavicular approach and infraclavicular approach in ultrasound-guided brachial plexus block(BPB).Methods One hundred and twenty patients,ASA Ⅰ-Ⅲ,aged 18-80 yr,scheduled for upper extremity surgeries of both gender,were randomized into two groups(n =60):supraclavicular group(group SCB)and infraclavicular group(group ICB).The anesthetic mixture consisted of ropivacaine 0.375％ and lidocaine 1％ in equal volumes with epinephrine 1∶200 000,the total dose was 0.5 ml/kg.The block performance time,duration of anesthesia and success of anesthesia(surgery was accomplished without supplementary block)were recorded.A blinded observer assessed pinprick sensory block in the seven distal nerve territories(axillary,radial,musculocutaneous,median,ulnar,medial antebrachial and medial brachial cutaneous nerves)every 5 min up to 30 min after injection.Success of nerve block,side effects and complications were recorded during and after operalion.Results Group ICB was superior in success rate of anesthesia and nerve block of ulnar,medial antebrachial and medial brachial cutaneous nerves,the rate of parasthesia was lower and the block performance time was longer compared with group SCB(P ＜ 0.05).No major complications occurred in both groups.Conclusion Under ultrasound guidance,infraclavicular BPB is superior to supraclavicular approach.

Objective: To observe the controlled hypotension effects of nicardipine in 2 different ways for spinal tumor operalion. Methods: Twenty-four adult patients, scheduled for selective spinal tumor operation, were randomly divided into 2 groups. In groupⅠ(n=12), the nicardipine was infused at a rate of 10 μg*kg-1*min-1 and the infusion continued until MAP was at the level of 7.33-8.66 kPa, and then the rate was decreased to 1 μg*kg-1*min-1. In Group Ⅱ(n=12), nicardipine was given 0.01-0.02 mg/kg as the load dose, then infused at 1-2 μg*kg-1*min-1. Results: During the period of controlled hypotension, cardiac index(CI) increased significantly, other hemodynamic variables were stable and no hypertension rebound occurred in both groups. Reaching time of target blood pressure in groupⅡ was shorter than that in groupⅠ（P＜0.05）. The dose required to obtain target blood pressure in group Ⅱwas less than that in group Ⅰ（P＜0.05）. BP recovery time from discontinuing nicardipine infusion to pre-hypotension level,bleeding volume and transfusion volume were similar between 2 groups（P＞0.05）.During mass bleeding,　serious arrhythmia and oliguria did not occur in any case. Conclusion: Controlled hypotension with nicardipine is rapid, stable and easily controlled without hypertension rebound. Nicardipine has considerable protective effects on heart and kidney during mass bleeding. The method of bolus injection followed with intravenous infusion is more suitable to clinical application.