Objective To evaluate the role of extracelluar signal-regulated kinase (ERK)-cyclic AMP response element binding protein (CREB) signaling pathway in the spinal cord in naloxone-induced withdrawal response in morphine-dependent rats.Methods Fifty male adult SD rats,aged 2 months,weighing 200-250 g,in which intrathecal catheters were successfully implanted without complications,were randomly divided into 5 groups (n =10 each):group control (group C); group morphine dependence (group MD); group morphine withdrawal (group MW); group U0126 (ERK signaling pathway blocker); group dimethyl sulfoxide (DMSO,solvent for U0126).Morphine dependence was induced by increasing doses of subcutaneous morphine for 6 days.The initial dose of morphine was 10 mg/kg twice a day and was increased by 10 mg/kg twice every other day until 50 mg/kg on 6th day in groups MD,MW,U0126 and DMSO.Morphine withdrawal response was induced by intraperitoneal naloxone 4 mg/kg at 4 h after last morphine administration in groups MW,U0126 and DMSO.U0126 150μg (in DMSO 10 μl) and DMSO 10 μl were administered intrathecally at 30 min before naloxone administration in groups U0126 and DMSO respectively.Morphine withdrawal response (0=no withdrawal response,3 =severe response)and touch evoked agitation (0 =no agitation,2 =severe agitation) were observed and scored during 1 h after naloxone administration.The animals were then sacrificed and the spinal cord was removed for determination of the expression of phosphorylated ERK (p-ERK) and phosphorylated CREB (p-CREB) by immuno-histochemistry and Western blot.Results Morphine withdrawal significantly up-regulated the p-ERK and p-CREB expression in group MW compared with group C ( P ＜ 0.05).Withdrawal response score and touch evoked agitation score were significantly increased in groups MW,U0126 and DMSO as compared with group MD ( P ＜ 0.05).U0126 pretreatment significantly attenuated naloxone-induced increase in withdrawal response score and touch evoked agitation score and down-regulated p-ERK and p-CREB expression in group U0126 as compared with group MW ( P ＜ 0.05).Conclusion ERK-CREB signaling pathway in the spinal cord is involved in morphine withdrawal response in morphine-dependent rats.

Actovegin is a drug,which can improve cellular energy metabolism,especially glycometabolism.It has an insulin-like effect,such as increasing the uptake of glucose and activating glucose metabolic enzyme.In addition,it can inhibit the production of lactic acid.Actovegin was mainly applied to the treatment of Alzheimer disease initially,but now it is indicated more and more.

Objective To investigate the effect of intraperitoneal local anesthetic on patients undergone laparoscopic cholecysteetomy (LC).Methods Thirty-six patients (ASAⅠ-Ⅱ),who were undergoing selective LC were randomly divided into there groups.GroupⅠreceived preoperational anesthetic spary with 30 ml of 0.5% ropivacaine.GroupⅡwas given the anesthetic at a same dosage after the operation.While groupⅢwas set as a control by using 0.9% NaCl instead of ropivacaine.The LC was completed under general anesthesia.After the operation,visual analog scale (VAS) was recorded at 6,24,and 48 hours to evaluate the degree of postoperative pain.Meanwhile,the number of the patients who received anesthetics after the surgery,as well as the incidence rates shoulder or back pain and nausea or vomiting were recorded.Results Postoperative VAS of the groupⅠwas significantly lower than that of the other two groups,while the VAS of groupⅡwas significantly lower than that in groupⅢ(both P0.05). Conclusions Intraperitoneal local anesthetic can significantly reduce postoperative pain after LC.It is more effective to give local anesthetic at the end of the procedure than using it before operation.

Objective The purpose of this study was to examine the effect of preoperative glucose infusion on glucose transport-4 mRNA ( Glut-4 mRNA) expression in skeletal muscle before and after thoracic operation. Methods Twelve male ASA Ⅰ - Ⅱ patients undergoing elective radical surgery for esophagus cancer were randomly divided into 2 groups : (Ⅰ ) control group; (Ⅱ) glucose infusion group. Patients with hypertension, hyperlipidemia or diabetes mellitus were excluded. The patients in both groups were premedicated with phenobarbitol and atropine. Anesthesia was induced with midazolam 0.1 mg ? kg-1 , propofol 1.5 mg ?kg-1 , fentanyl 4?g?kg-1 and vecuronium 0.15 mg?kg-1 . The patients were mechanically ventilated after trachea! intubatioa Anesthesia was maintained with continuous iv infusion of propofol (80?g ? kg-1? min-1 ) and vecuronium (1.0 ?g?kg-1?min-1) supplemented with droperidol 0.1 mg?kg-1 and fentanyl 6 ?g ?kg-1 given in several boluses. In group Ⅱ 5 % glucose (0.25 g?kg-1) was infused 2 h before operation. Blood samples and 1 g of skeletal muscle were obtained while chest was being opened and closed for determination of plasma glucose and insulin levels and Glut-4 mRNA expression in muscle. The total RNA of the muscle cells was extracted by trizol one-step template. The Glut-4 mRNA amplification products were determined using RT-PCR with ?-action mRNA as an internal control. The Glut-4 mRNA expression was expressed by desired gene/ ?-action? 100% .Results Glut-4 mRNA expression was significantly decreased ( P

Objective To study the effects of allogeneic blood transfusion on expression of CD40L on peripheral blood monocytes (PBMCs) in patients undergoing radical gastrectomy for gastric carcinoma. Methods Thirty patients classified as ASA physical status Ⅰ- Ⅱ undergoing radical gastrectomy for gastric carcinoma were randomly divided into three groups with 10 patients in each group : group A received no allogeneic blood; group B received leukodepleted blood; group C received allogeneic whole blood during operation or within 12 h after operation. The patients were premedicated with intramuscular phenobarbital sodium 0.1 g and atropine 0.5 mg. Anesthesia was induced with midazolam 0.06 mg ? kg-1 , fentanyl 2 ?g ?kg-1 , propofol 1.5 mg ?kg-1 and vecuronium 8mg and maintained with continuous infusion of propofol (100?g?kg-1?min-1) and vecuronium (5?g ?kg-1?min-1) and intermittent inhalation of 1l%-2% isoflurane. The patients were mechanically ventilated after tracheal intubation. Blood samples were taken before operation and 2, 5 and 10 days after operation. The PBMCs and plasma were separated from peripheral blood by Ficoll-Hypaque centrifugation. The PBMCs were washed and incubated with the patients own plasma (final-concentration 10% ) and PHA (final concentration 20 ?g?ml-1 ) at 37℃ in a 5% CO2 atmosphere for 48h. CD40Lexpression on PBMCs was quantified by flow-cytometry.Results The demographic data including sex, age, bodyweight and duration of operation and intraoperative blood loss were comparable among the three groups. There was no significant difference in the CD40L expression before operation among the 3 groups. In group A there was no change in CD40L expression after operation. In group B CD40L expression on PBMCs increased significantly on the 2nd postoperative day, but returned to preoperative level on the 5th postoperative day. In group C the CD40L expression on PBMCs kept increasing on the 2nd and 5th postoperative day and did not return to preoperative level on the 10th day. The increase in CD40L expression was significantly larger in group C than that in group B ( P

Objective To study the changes in the polyol pathway of glucose metabolism and oxidative stress responses induced by general thoracic surgery by measuring erythrocyte aldose reductase (AR), phosphofructokinase (PFK) and glucose-6 phospate dehydrogenase (G-6PD) activities and plasma MDA and GSH levels before and after surgery performed under different anesthetic techniques. Methods Thirty-two ASA Ⅰ-Ⅱ patients aged 45-71 yrs weighing 55-70 kg were randomly allocated to one of two groups with 16 patients in each group : group Ⅰ received isoflurane inhalation for maintenance of anesthesia and group Ⅱ isoflurane inhalation combined with epidural block. Patients with endocrine and glucose metabolism-related diseases were excluded. The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg. Anesthesia was induced with intravenous midazolam 0.1 mg?kg-1 , propofol 1.0-1.5 mg?kg-1 , fentanyl 0.1-0.15 mg, droperidol 1-2 mg and vecuronium 0.1 mg?kg-1 in both groups. The patients were mechanically ventilated (VT 8-10 ml?kg-1, RR 10-12 bpm) after tracheal intubation. Anesthesia was maintained with isoflurane inhalation at 1.2-1.6 MAC in group Ⅰ or isoflurane inhalation (0.6-0.8 MAC) combined with epidural block (T9-10) with 1 % lidocaine in group Ⅱ supplemented with fentanyl 5-10 ?g?kg-1 and droperidol 0.1-0.2 mg?kg-1 in divided doses and vecuronium infusion at 1-2 ?g? kg?min-1 . Venous blood samples were obtained before anesthesia (baseline, T0), 90 min after skin incision (T1), 60 min after surgery (T2 ) and on the 1 st and 2nd postoperative days (T3 , T4 ) for determination of erythrocyte AR, PFK and G-6PD activities and plasma glucose, MDA and GSH levels. Results In group Ⅰ plasma MDA level and AR and G-6PD activities in erythrocyte were significantly increased, while plasma GSH level and PFK activity in erythrocyte were significantly decreased on the 1st postoperative day compared to the baseline values before anesthesia (T0) (P 0.05). Conclusion Isoflurane inhalation combined with epidural block can effectively attenuate the effects of surgical trauma on glucose metabolism in theerythrocyte and the oxidative stress responses of the body.

Objective To investigate and compare the effects of pretreatment with different concentrations of trarnadol and morphine on the differentiation of hunan helper T cells (Th) in vitro. Methods Fifteen ASA Ⅰ patients of both sexes (8 males, 7 females) aged 23-59 yrs scheduled for minor day-care surgery were enrolled in this study. The patients had never taken morphine and tramadol before. Blood samples were taken from peripheral vein. Whole blood and mononuclear cells isolated from peripheral blood (PBMCs) were incubated with morphine 10, 100 or 1000 ng?ml-1(group M1 , M2 , M3) or tramadol 50, 500, 5000 ng?ml-1(group Q1, Q2, Q3) for 24 h. Then irrntants was added and incubated for another 5 or 24 h. In the whole blood the level of IL-2 and IFN-?(as markers of Th1 cells) and IL-4 and IL-10 (as markers of Th2 cells) were determined using three-color flow cytometry. In PBMCs the expression of CD4+ and CCR5+ (as markers of Thl cells) and CD4+ and CCR3+ (as markers of Th2 cells) were determined. The Th1/Th2 ratio was calculated. Results Pretreatment with morphine or tramadol significantly increased the number of Th2 cells while the number of Thl cells significantly decreased both in a dose-dependent manner leading to a significant decrease in Th1/Th2 ratio. Conclusion Tramadol and morphine can inhabit in vitro the cellular immune function in dose-dependent manner. The immunosuppressive effect of tramadol is less than that of morphine.

Objective: To investigate the effects of preconditioning with lithium on the expressions of HSP70 in gerbil after global ischemia. Methods: The transient ischemia model of gerbil global was established by clamping the bilateral common carotid arteries for 5 min.36 gerbils were randomly divided into group lithium(n=18) and group control(n=18).Gerbils in group lithium were injected with lithium intraperitoneally,5 mmol/kg,once a day for 5 consecutive days.Normal saline was used instead of lithium in group control as vehicle control.Both group lithium and control underwent ischemia after preconditioning,and were then further divided into three subgroups(n=6,in each subgroup).The garbles in lithium 1 or control 1 subgroup were sacrificed 1 day after ischemi;lithium 3 or control 3 sacrificed in 3 days;and lithium 7 or control 7 were sacrificed in 7 days.The brains were made into paraffin sections and were used for immunohistochemistry against HSP70. Results: Compared with the vehicle control,the HSP70 expression in subgroup lithium1 was inhibited in the hippocampus CA1(P

Objective To investigate the role of pentose phosphate pathway (PPP) after upper abdominal operationMethods Twenty-six patients undergoing upper abdominal surgery, were divided randomly into three groups: epidural block(EB,n=10), intravenous propofol anesthesia(PRO, n=10) and intravenous procaine balanced anesthesia(IPBA,n=6) The venous blood samples were collected to measure of erythrocytes hexokinase (HK), phosphofructokinase (PFK) and glucose-6-phasphate dehydrogenase (G-6PD), and activities, and plasma glucose before anesthesia induction, 60 min after incision,60 min after surgery, on the 1st and 2nd postoperative daysResults Compared with the values before anesthesia, the activities of erythrocyte HK and PFK decreased significantly on the 1st postoperative day in three groups (P

Objective Surgical stress induces a series of endocrine and metabolic changes including glucose metabolism and insulin-resistance. The purpose of the present study was to investigate the changes in glucose transporter-4 (Glut-4) mRNA expression in skeletal muscle after cholecystectomy under epidural block. Methods One gram of the rectus abdominis muscle was taken while abdomen was being opened and closed in patients undergoing cholecystectomy under epidural block. Total RNA of the muscle cells was extracted by trizol one-step template. RT-PCR was used to determine the Glut-4 mRNA amplification products with ?-actin mRNA as an internal control. The Glut-4 mRNA expression was expressed by (desired gene/ ?-actin?100% . The plasma glucose and insulin levels were determined at the same time. Results Glut-4 mRNA expression was significantly reduced (P 0.05 ) . Conclusions The results indicated that the synthesis of Glut-4 is suppressed by surgical stress of cholecystectomy under epidural block leading to insulin resistance.