Objective To evaluate the efficacy of dexmedetomidine mixed with ropivacaine for transversus abdominis plane (TAP) block combined with general anesthesia in the patients undergoing gynecological laparoscopy.Methods Ninety American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 20-50 yr, with body mass index of 18-24 kg/m2, scheduled for elective gynecological laparoscopic ovarian cyst resection under general anesthesia, were randomly divided into 3 groups (n =30 each) using a random number table: general anesthesia group (group G) , general anesthesia + ropivacaine for TAP block group (group G+R), and general anesthesia + dexanedetomidine mixed with ropivacaine for TAP block group (group G+DR).After the end of anesthesia induction, ultrasound-guided left-sided unilateral TAP block was performed in G+R and G+DR groups.In G+R and G+DR groups, 20 ml of 0.375％ ropivacaine and 20 ml of 0.375％ ropivacaine mixed with 1 μg/kg dexmedetomidine were injected, respectively.After induction of general anesthesia, the laryngeal mask airway (LMA) was inserted, and the patients were mechanically ventilated in the 3 groups.Anesthesia was maintenaned with iv infusion of remifentanil 0.2 μg · kg-1 · min-1 and propofol 4-8 mg · kg-1 · h-1.Narcotrend index was maintained at 37-46.Only group G received postoperative intravenous analgesia.The occurrence of TAP block-related adverse events was recorded.The emergence time, time for recovery of spontaneous breathing, time for removal of LMA, and Steward score at 5 min after removal of LMA were recorded.The occurrence of postoperative nausea and vomiting, and respiratory depression was recorded.Results Compared with G and G+R groups,the emergence time, time for recovery of spontaneous breathing, and time for removal of LMA were significantly shortened (P＜0.05 or 0.01) , and no significant change was found in Steward score in group G+DR (P＞0.05).There was no significant difference in the above parameters between group G and group G+R (P＞0.05).Compared with group G, the incidence of postoperative nausea and vomiting was significantly decreased in G+R and G+DR groups (P＜0.05).VAS score was maintained ≤ 3 after operation in the 3 groups.No TAP block-related adverse events were found in G+R and G+DR groups.Conclusion Dexmedetomidine mixed with ropivacaine provides faster recovery from anesthesia, and avoids postoperative hyperalgesia when used for TAP block combined with general anesthesia in the patients undergoing gynecological laparoscopy.

Objective To evaluate the effects of gender on the median effective target plasma concentration (EC50) of propofol inhibiting responses to laryngeal mask airway (LMA) insertion in patients.Methods Fiftyfive ASA physical status Ⅰ or Ⅱ patients,aged 20-60 yr,with body mass index 18-25 kg/m2,requiring LAM insertion,undergoing elective surgery,were divided into 2 groups according to the gender:male group (group M,n =27) and female group (group F,n =28).Propofol was given by target-controlled infusion.Anesthesia was induced with target-controlled infusion of propofol.The concentration of propofol was determined by using modified Dixon's up-and-down method.The initial target plasma concentration of propofol was 3.0 μg/ml (group M) or 2.7μg/ml (group F) and the ratio between the 2 successive concentrations was 1.1.Fentanyl 1 μg/kg was injected intravenously at about 10 min of propofol target-controlled infusion.LMA was inserted after the effect-site and plasma concentrations were balanced.The positive response to LMA insertion was defined as development of swallowing,coughing,biting LMA,body movement and laryngospasm during insertion.When the response to LMA insertion was positive,the concentration of propofol was increased in the next patient and when the response was negative,the concentration was decreased in the next patient.The EC50 and 95 ％ confidence interval of propofol inhibiting responses to LMA insertion were calculated.Results The EC50 (95 ％ confidence interval) of propofol was 3.11 (2.92-3.30) μg/ml in group F and 2.70 (2.55-2.85) μg/ml in group M (/ ＜ 0.05).Conclusion The EC50 of propofol inhibiting responses to LMA insertion is higher in female patients than in male patients.

Objective To invetstigate the effects of right stellate ganglion block (SGB) on heart rate variability (HRV) in patients with carbon dioxide pneumoperitoneum.Methods Forty ASA Ⅰ or Ⅱ patients of both sexes,aged 39-75 yr,weighing 47-75 kg,undergoing elective laparoscopic cholecystectomy,were randomly divided into 2 groups ( n =20 each):control group (group C) and right SGB group (group SGB).Right SGB was performed with 1％ lidocaine 7 ml at 10 min before induction of anesthesia.The low frequency power ( LF),high frequency power (HF),total power (TP) and LF/HF ratio were recorded before SGB (baseline,To ),at 5 and 30 min of pneumoperitoneum (T1,2),at 5 min after deflation (T3) and at the end of operation (T4 ).The LF in normalized units (LFnu) and HF in normalized units (HFnu) were calculated.Results Compared with the baseline values at T0,LF,LFnu and LF/HF ratio were significantly increased at T1-4,HF was significantly decreased at T3,4,and HFnu was significantly decreased at T2-4 in group C,and HF was significantly increased at T1-4,HFnu was significantly increased at T2-4 and LF/HF ratio was significantly decreased at T1-4 in group SGB ( P ＜ 0.05 or 0.01 ).LF,LFnu and LF/HF ratio were significantly decreased at T1-4,and HF at T1-4 and HFnu at T2-4 were significantly increased in group SGB as compared with group C ( P ＜ 0.05 or 0.01 ).Conclusion Right SGB can not only inhibit the sympathetic activity induced by carbon dioxide pneumoperitoneum,but also increase the vagal tone.

Objective To explore the health inspector effect on the score of hygienic degree of hostels. Methods Using the scale for hygienic degree of hostels, 38 health inspectors from 9 sections in the Bureau for Health Inspection and Supervision of Haidian District in Beijing, scored 621 hostels in the district. The multilevel statistics model has been used to analyze the health inspector effect, of which the index is intra-class correlation (ICC), in the double level model structured by hostels as the level 1 unit and inspectors as the level 2 unit, and in the triple level model structured by hostels as the level 1 unit, inspectors as the level 2 unit and the sections as the level 3 unit. Results In the double level model, ICC of the level 2 unit is 0.142 8. In the triple level model, ICC of the level 2 unit is 0.0000 and ICC of the level 3 unit is 0.154 1. Conclusion There is inspector effect influencing the score of hygienic degree. And the effect seems to be more similar in one section comparing with the other ones.

0.05),and their costs were 1 026.9,1 481.8,and 1 472.3 yuan respectively.CONCLUSION:The result showed that Group A was more reasonable and economical among the three schemes.

Objective To study the regional homogeneity (ReHo) of default-mode network (DMN) in patients with minimal hepatic encephalopathy (MHE) with resting state fMRI.Methods Eighteen MHE patients and eighteen healthy controls (HC) underwent standard resting state fMRI scan.The resting state fMRI data were analyzed with the ReHo method to observe the changes of DMN in the patients in contrast to the controls.Results Compared to healthy controls,MHE patients showed lower ReHo in bilateral MPFC/anterior cingulate cortex(V=13.257 cm3;MNI coordinates=3,24,66;t=-3.493 7),bilateral precuneus/posterior cingulate cortex(V=4.752 cm3;MNI coordinates=9,-54,45;t=-2.634 1),while higher ReHe in right medial prefrontal cortex(V=5.049 cm3;MNI coordinates=21,63,6;t=4.017 5).Conclusion In MHE patients,there is abnormal neuron activation in the widespread DMN regions under resting state, which indicated abnormal spontaneous activity consistency within DMN and endogenous brain function injury in MHE patients.ReHo can be used to observe DMN changes in MHE patients.

AIM:To evaluate the prophylactic effect of azasetron in different juncture injection on postoperative nausea and vomiting(PONV)during patients controlled intravenous ananlgesia(PCIA).METHODS:One hundred and twenty patients,scheduled for selective abdominal operations,were randomly divided into four groups:patients received an preoperative intravenous injection of 10 mg azasetron(Group A,n=30),patients received an intravenous injection of 10 mg azasetron during abdominal cavity(Group B,n=30),patients received an intravenous injection of 10 mg azasetron when the operation were finished(Group C,n=30),patients with no azasetron as control(Group D,n=30).The incidence rate and score of PONV,the visual analogue scales(VAS)and Ramsay scores were recorded at 4,8,12,24,48 h postoperatively.RESULTS:There was significant difference between the postoperative VAS during 12 to 48 h and that of 4 h postoperatively(?0.05).CONCLUSION:A preoperative intravenous injection of 10 mg azasetron can be used effectively to prevent PONV during PCIA.

Objective To investigate the effect of stellate ganglion block(SGB)on heart mte variability (HRV)during thyroidectomy performed under cervical plexus block.Methods Forty-five ASA Ⅰ or Ⅱ pafients of both sexy8(8 males,37 females) aged 20-60 yr,weighing 40-70 kg undergoing elective thyroidectomy under cervical plexus block were randomly divided into 3 groups(n=15 each):group Ⅰ control,group Ⅱ left SGB and group Ⅲ right SGB.The parameters of HRV included low frequency(LF),high frequency(HF),LFnu,HFnu and LF/HF ratio.SBP,DBP,HB and HRV parameters were recorded before anesthesia(To,baseline),immediately(T1) and at 5 and 10 rain after cervical plexus block(T2,T3),at the beginning and end of operation (T4,T5).Results SBP and DBP were significantly increased at different time points after cervical plexus block in all 3 groups.Compared with the baseline at T0,LFnu and LF/HF ratio were significantly increased while HR,HF and HFnu decreased during operation in group Ⅰ,LF,HF and HFnu were significantly decreased while HR increased during operation in group Ⅲ(P<0.05),but no significant change in HRV parameters was found during operation in group Ⅱ(P>0.05).Compared with group Ⅰ,HR and LFnu were significantly decreased while HF and HFnu increased in group Ⅱ(P<0.05),but no significant change was found in the indexes mentioned abovein group Ⅲ (P>0.05).Conclusion SGB can adjust cervical plexus block-induced sympathetic excitability and maintain the balance between sympathetic and parasympathetic tension.Left SGB outweighs right SGB.

BACKGROUND:Osteoblasts occupy an important role in osteogenesis, which mainly come from bone marrow mesenchymal cels, and some transcription factors or local factors may promote the osteogenic differentiation of bone marrow stromal cels.
OBJECTIVE: To study the role of Osx and Satb2 in C2C12cels in the repair process of osteoporosis.
METHODS: Twenty wild-type Sprague-Dawley rats were assigned into normal control group (n=10), sham group (n=5) and osteoporosis group (model group,n=5). Another 10 Osx-KO rats were enroled in the study. Osteoporosis models were established by removal of both ovaries in the model group and Osx-KO group. In the sham group, bilateral ovaries were exposed but not removed. Changes in body mass and femoral bone density were detected in the four groups post operation. C2C12 cels were culturedin vitro, and siRNA-Satb2 and siRNA-Osx were designed. Expressions of Osx and Satb2 and their effects on osteoporosis were observed using cel experiments, gene silencing and western blot assay.
RESULTS AND CONCLUSION:After 12 weeks, the body mass in the model and Osx-KO groups was significantly increased compared with the normal control and sham groups (P< 0.01); the bone density in the model and Osx-KO group was significantly decreased compared with the normal control and sham groups (P < 0.01). Satb2 and Osx were expressed in al the wild-type rats, but their expressions were decreased significantly in the Osx-KO rats (P < 0.001). Additionally, there was no difference in the Runx2 mRNA expression between the two kinds of rats. After silencing, the mRNA expressions of Satb2, Osx, Runx2 and ALP were al inhibited. These findings indicate that in the pathogenesis of osteoporosis, Osx and Satb2 may be protective molecules that have a regulatory role in the osteogenic differentiation, bone formation and repair.

AIM: To study the protective effect and mechanism of panax notoginseng saponinsa(PNS) for dealing with rats with middle cerebral artery ischemia reperfusion(CI/RP). METHODS: To establish the rat middle cerebral artery ischemia/reperfusion model with suture occlusion technique and record the neurologic impairment evaluation score on the basis of Zea Longa method,measured the infarct volume,and the others were detected neuron apoptosis by TUNEL technology and endogenous brain-derived neurotropic factor(BDNF) expression by immunohistochemistry technology. RESULTS: The administration of PNS to rat decreased neurologic impairment,reduced infarct volume,inhibited the neuron apoptosis,and increased endogenous BDNF expression after 24 hours CI/RP. CONCLUSION: Increasing endogenous BDNF expression after CI/RP might be the mechanisms of PNS for achieving neuroprotections.