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 .

We investigated the psychological condition of 70 inpatients who had esophageal and cardiac carcinoma before radical operation with Hamilton Anxiety Scales.For the patients with anxiety,we carried out psychological intervention before operation which includes general care,follow-up,collective psychotherapy,keep disease condition individually and so on.The results showed the treatment had great benefit to most of the patients.

Leaf senescence is considered as one of important factors to decrease ornamental values of foliage plants. In the attempt to study and understand the molecular mechanism of leaf senescence, a senescent leaf cDNA library of Coleus blumei was constructed and a small EST library was obtained. According to the sequence of an EST fragment with a cystathionine beta synthase (CBS) domain, a novel leaf senescenceassociated gene (SAG) full-length cDNA encoding a CBS-domain-containing protein, denoted Cbcbs, was rapidly cloned using a strategy of RACE combined with cDNA library. The full length of the Cbcbs gene was 859 bp long (accession No. EF076754) and contained a 609 bp open reading frame (ORF) encoding a 202amino acid protein. One stop codon (TAA) was found in 5' UTR and one possible polyadenylation signal,AATAAA, and a pentanucleotide motif, ATTTA, were found in 3' UTR. The CbCBS contained a predicted mitochondrial targeting peptide in the N-terminal region, two conserved and intact CBS domains, four casein kinase Ⅱ (CK Ⅱ) phosphorylation sites, three protein kinase c (PKC) phosphorylation sites and one tyrosine sulfation (TS) site. Sequence comparisons and phylogenetic analysis showed that CbCBS was a novel senescence or stress-associated protein. The prediction analysis of secondary structure and three dimensional structure of CbCBS suggested that the chief function of the protein was decided by the CBS domain pair. The expression pattern of Cbcbs in leaves was analyzed by RT-PCR. It was demonstrated that Cbcbs gene was a senescence-associated gene (SAG) and expressed in all leaf stages, young stage (Y) being the lowest and terminal senescence stage (S3) being the highest, and was upregulated along with the leaf senescence.Function analysis showed that the mature CbCBS maybe acts as a sensor of cellular energy status and directly or indirectly regulates cellular energy levels to increase ATP content in mitochondria during periods of metabolic stress of senescent leaves.

Objective To study the effect of parecoxib sodium preemptive analgesia on the postoperative cognition and inflammatory cytokines in elderly patients.Methods Sixty elderly male patients undergoing replace-ment of total hip were randomly divided into two groups:the control group(group C,30 cases) and the parecoxib sodi-um group(group P,30 cases).In group C,physiological saline 5 ml was injected after induction of anesthesia.Pare-coxib sodium 40 mg was injected after induction of anesthesia in group P.Peripheral venous blood was collected at the following time points:2h before operation(T0 ),and 4h(T1 ),24h(T2 ) and 48h(T3 ) after operation.And the serum concentrations of IL -1β,IL -6,tumor necrosis factor α(TNF -α) were measured by enzyme linked immunosorbent assay(ELISA).Cognitive function was assessed by mini -mental state examination(MMSE) at the time of T0 -T3 . Results The MMSE scores in group P[(25.4 ±0.6) points,(27.2 ±0.1)points] were significantly higher than those in group C at T1 and T2 .The concentrations of IL -1β,IL -6 and TNF -αin group P[T1:(18.43 ±4.45)pg/mL, (165.34 ±9.57)pg/mL,(34.43 ±3.83)pg/mL;T2:(14.59 ±2.59)pg/mL,(98.99 ±7.28)pg/mL,(22.32 ± 3.81)pg/mL]were lower than those in group C[T1:(23.97 ±3.85)pg/mL,(204.19 ±12.44)pg/mL,(37.77 ± 4.81)pg/mL;T2:(19.33 ±3.18)pg/mL,(121.35 ±9.67)pg/mL,(29.01 ±3.39)pg/mL]at T1 ,T2 .The concen-trations of IL -1β,IL -6 and TNF -αand the MMSE scores had no differences in group P and group C at T3 .The concentrations of IL -1β,IL -6 and TNF -αin group P at T1 and T2 [(9.57 ±2.24)pg/mL,(46.15 ±6.18)pg/mL, (14.48 ±3.14)pg/mL] were lower than those at T0,and had no difference at T3 .Conclusion Parecoxib sodium preemptive can reduce the incidence of POCD in elderly patients by inhibiting the release of early postoperative pro -inflammatory cytokines.

Objective To observe the effect of continuous pumped dexmedetomidine on hemodynamics, awakening quality and stress response in double -lumen tube extubation patients.Methods 60 patients with thoracic surgery were divided into saline group(group N,n =30)and Dex group(group D,n =30).Both two groups were continuously pumped NS and dexmedetomidine respectively 20min before anesthesia.MAP,HR and SpO2 at different time points during the surgery were recorded.Extracted 5ml arterial blood at the time point of T0 and T3,centrifugated and stored at -80 ℃ for testing renin levels.The extubation time,restlessness incidence,orientation recovery time, extubation quality score were recorded.Results The values of MAP in group D at time points of T0,T1,T2,T3,T4 were (97 ±15)mmHg,(102 ±12)mmHg,(103 ±11)mmHg,(98 ±12)mmHg,(96 ±13)mmHg.The values of HR in group D at different time points were (69 ±9)times/min,(80 ±6)times/min,(90 ±7)times/min,(74 ±5)times/min,(73 ±6)times/min.The values of SpO2 in group D at different time points were (95 ±3)%,(98 ±2)%,(98 ± 2)%,(95 ±3)%,(96 ±2)%.The values of MAP in group N at time points of T0,T1,T2,T3,T4 were (96 ± 15)mmHg,(112 ±16)mmHg,(120 ±12)mmHg,(117 ±14)mmHg,(102 ±15)mmHg.The values of HR in group N at different time points were (68 ±7)times/min,(84 ±8)times/min,(105 ±6)times/min,(89 ±6)times/min, (80 ±7)times/min.The values of SpO2 in group N at different time points were (96 ±2)%,(98 ±2)%,(97 ± 3)%,(93 ±3)%,(92 ±4)%.The values of MAP,HR,SpO2 at different time points in group D were significantly lower than those in group N,the differences were statistically significant (the t values of MAP at different time points were tT1 =2.74,tT2 =5.72,tT3 =25.63,tT4 =1.66,all P <0.05;the t values of HR at different time points were tT1 =2.20,tT2 =8.91,tT3 =10.52,tT4 =4.16,all P <0.05;the t values of SpO2 at different time points were tT1 =0.00,tT2 =1.52,tT3 =2.58,tT4 =4.9,PT3 <0.05,PT4 <0.05).There was significant difference between the two groups in orientation recovery time[(3.3 ±2.2)min vs (5.2 ±2.3)min,P =0.0018].There was significant difference between the two groups in agitation score[(1.3 ±0.9)vs (2.4 ±1.2)].There was significant difference between the two groups in extubation quality score[(2.1 ±1.2)vs (3.2 ±1.4),P =0.0018].There was statistical difference between the two groups in T3 adrenal hormones[(N:120 ±25.3)pmol/L,(D:93.4 ±23.2)pmol/L,P =0.00].The dose of sufentanil (60.5 ±9.2)μg in group N was higher than (40.4 ±10.2)μg in group D (P =0.001).The dose of remifentanil (3.3 ±0.8)mg in group N was higher than (2.4 ±0.9)mg in group D (P =0.001).Conclusion Continuous pumped dexmedetomidine can effectively improve awakening quality of patients with double -lumen tube.

OBJECTIVE:To observe the effects of remifentanil-induced controlled hypotension (CH) on postoperative cogni-tive dysfunction (POCD) and serum S100β protein in elderly patients underwent spinal surgery,and to investigate their relation-ship. METHODS:Sixty elderly patients undergoing selective laminectomy decompression internal fixation of lumbar or thoracic fractures under general anesthesia were selected prospectively from orthopedics department of our hospital during Jan. 2014-Dec. 2015,and then divided into CH group and non-CH group in accordance with random number table,with 30 cases in each group. Both groups received general anesthesia of injection and inhalation via endotracheal intubation. Mean arterial pressure (MAP) of CH group were reduced to 70%-80%of the basic values by adjusting remifentanil infusion rate;those of non-CH group were main-tained at basic level. Surgery duration,anesthesia duration,intraoperative blood loss,the incidence of POCD and serum concentra-tion of S100β protein were observed in 2 groups. The relationship of serum concentration of S100β protein with POCD was ana-lyzed,and the occurrence of ADR was recorded. RESULTS:The intraoperative blood loss of CH group was significantly less than that of non-CH group,with statistical significance (P<0.05). There was no statistical significance in the incidence of POCD be-tween 2 groups on the 1st and 7th day after surgery(P>0.05). The incidence of POCD and serum concentration of S100β protein in CH group were significantly higher than in non-CH group on the 2nd and 3rd day after surgery,with statistical significance(P<0.05). The serum concentration of S100β protein may be related to the incidence of POCD (r=0.992 7,P=0.001 3). CONCLU-SIONS:Remifentanil CH used in elderly patients underwent spinal surgery can reduce intraoperative blood loss,but increase the se-rum concentration of S100βprotein and the incidence of POCD at early stage.

Objective To observe the curative effects of applying laryngeal masks in the airway management in total laparoscopic hysterectomy in obese patients.Methods 60 cases of obese patients who underwent total laparoscopic hysterectomy were collected and were randomly divided into,the Endotracheal intubation (ET) group(n =30) and the laryngeal mask (LMA) group (n =30).The pre-operative co-existent diseases,applications of analgesia and intra-operative vital signs,the peak airway waves (Paw) 60min after pneumoperitoneum,blood gas;revival time;the incidences of complications were observed.Results 60min after pneumoperitoneum,MAP,HR,Paw and SpO2 values were:ET group:[(114.6 ± 22.4) mmHg,(108.2 ± 19.6) times/min,(25.4 ± 3.1) mmHg,(96.1 ± 1.2％)] LMA group:[(97.5 ±20.8)mmHg,(86.5 ±20.7) times/min,(22.6 ±3.7)mmHg,(98.9 ±0.8％)].The difference was statistically significant (P ＜ O.05);The blood gas analysis,PH,PaO2,PaCO2 and BE values are:ET group:[(7.34 ± 0.05),(177.5 ± 44.5) mmHg,(42.6 ± 6.1) mmHg,(-4.9 ± 0.8) mmol/L],LMA group:[(7.38 ± 0.05),(216.7 ± 46.6) mmHg,(38.4 ± 5.5) mmHg,(-3.1 ± 0.6) mmol/L].The difference was statistically significant (P ＜ 0.05);the status of complications:23 cases in ET group,accounting for 77％,10 cases in LMA group,accounting 30％,presenting significant differences (P ＜ 0.05).Conclusion The application of laryngeal masks in the airway management in total laparoscopic hysterectomy in obese patients facilitated the maintaining the stability of hemodynamics and blood gas,resulted in smooth post-anesthesia recovery and fewer complications.

Objective To explore the expression and the changes of ski with time in the injured spinal cord in rats. Methods Sixty adult female Sprague-Dawley rats were randomly divided into sham group (n=30) and injury group (n=30), each group were further divided into 1 week, 2 weeks, 4 weeks, 8 weeks and 12 weeks subgroups, with 6 rats in each subgroup. Spinal cord injury at T10 was established with modi-fied Allen's technique (10 g × 25 mm) in the injury group. The hindlimbs behavior of rats was rated with Basso-Beattie-Bresnahan (BBB) scores 1 day, 3 days, 1 week, 2 weeks, 4 weeks, 8 weeks and 12 weeks after spinal cord injury. Three rats in each subgroup were stained with HE staining to observe the pathological changes of the spinal cord and the formation of cavity. The other 3 rats were analyzed with im-munofluorescence staining of ski and semi quantitative analysis. Results The BBB scores of each time point were less in the injury group than in the sham group (P<0.05). Necrosis was the major pathological change in the injury groups 1 and 2 weeks after injury;cystic cavity completely formed 4 weeks after injury, with dense scar tissue around it;there was no significant change in the cavity and scar 8 and 12 weeks after injury, however, the adjacent spinal cord was obviously thinner. Ski expressed little in the normal spinal cord, and expressed more and more after injury, peaked at 8 weeks and decreased then. Ski was mainly observed in white matter in the sham group and 12 weeks injury subgroup, which was in gray matter 2, 4 and 8 weeks after injury. Ski was highly expressed around the cavity in injury center and formed high expression band. Conclusion Ski expresses after spinal cord injury in rats, that may be associated with the activation and prolif-eration of astrocytes and the formation of glial scar.

Objective To explore the expression and change of ski-interacting protein (SKIP) in rats after spinal cord injury. Methods A total of 60 adult female Sprague-Dawley rats were randomly divided into sham group (n=30) and spinal cord injury (SCI) group (n=30), each group was further divided into five time points including one day, three days, five days, seven days, and 14 days with six rats in each time points. The model was established at T10 with modified Allen's technique, and the sham group only bit the lamina of rats. The hindlimbs behavior was assessed with Basso-Beattie-Bresnahan (BBB) score at each time point. The pathological changes of spinal cord neurons were detected with Nissl staining. The expression of SKIP were observed with immunofluorescence staining. Results The BBB scores were signif-icantly lower in each time point in SCI group than in the sham group (t>48.267, P<0.001). Compared with the sham group, Nissl bodies in the cytoplasm of spinal cord neurons began to disintegrate, coalesce and irregularly distribute, the neurons began to degenerate and die on the fifth day, and the damage deteriorated on the 14th day. Immunofluorescence staining showed that SKIP expression was mainly expressed in the gray matter of the spinal cord and little expressed in the white matter. The expression of SKIP gradually increased after SCI, and reached a peak on the fifth day (t=-17.035, P<0.001) and decreased significantly on the 14th day (t=3.853, P<0.05). Conclusion SKIP may be a new signaling molecule, which play an important role in neuronal apoptosis after SCI.

OBJECTIVETo prepare ginkgolide B-loaded self microemulsifying drug delivery system (SMEDDS) and evaluate its quality.

METHODThe solubility of ginkgolide B in different oil, surfactant and co-surfactant were measured by HPLC-ESI-MS. The GB-SMEDDS formulation was optimized by the self emulsifying efficiency of various combinations of oil and mix-surfactant evaluated by using pseudo-temary phase diagram. The preliminary stability of GB-SEMEDDS was evaluated by the variety of loading rate of GB and dispersed medium. The morphology, the particle size and the formulation stability were evaluated after diluting by 0.1 mol x L(-1) HCl.

RESULTThe blank self microemulsified system was composed of ethyl oleate-( cremophor EL-lecithin-ethanol, 4: 1:2) (40: 60), the loading dosage was 2.5%. Little influence of GB and emulsified medium was observed on the stability of GB-SEMDDS. After diluted with 0.1 mol x L(-1) HCl, the morphology of the microemulsion was homogeneous small spherical drops observed under electro-microscope. The particle size was (41.6 +/- 1.11) nm, the self microemulsifing time was around 2 min. The formulation was stable within 8 h, without significant changes in particle size and separation of drugs.

CONCLUSIONGB-SMEDDS is easy to prepare and its quality is stable. The solubility of GB was significantly improved by SMEDDS.

Chemistry, Pharmaceutical ; instrumentation ; methods ; Drug Delivery Systems ; instrumentation ; methods ; Emulsions ; chemistry ; Ginkgolides ; chemistry ; pharmacokinetics ; Lactones ; chemistry ; pharmacokinetics ; Particle Size ; Solubility ; Surface-Active Agents ; chemistry