Aim Cerebral ischemic tolerance can be induced by a variety of preconditioning stimuli,such as transient global and focal ischemia,hypoxia,and administration of lipopolysaccharide(LPS),proinflammatory cytokines,anesthetics.Tolerance can be established with two forms: a rapid form in which the trigger induces tolerance to ischemia within minutes and a delayed form in which development of protection takes several hours or days.During ischemia,inflammatory reaction was initiated by toll-like receptors(TLRs) that recognize host-derived molecules released from injured tissues and cells,which exacerbates ischemic injury.In the delayed form of tolerance,the preconditioning stimuli first triggers the TLRs inflammatory pathway,leading not only to inflammation but also to simultaneous upregulation of feedback inhibitors(such as anti-inflammatory cytokines,decoy receptors,and signaling inhibitors),which reduced the inflammatory response to subsequent severe ischemia.The rapid tolerance is achieved by direct interference with membrane fluidity,causing change of lipid rafts leading to inhibition of TLRs signaling pathways.The comprehension of mechanism of cerebral ischemic tolerance highlights new avenues for future prevention and treatment of ischemic brain injury

Objective To investigate the association of α-synaptophysin A53T gene polymorphism with parkinson's disease(PD) in Chinese people.Methods The conventional polymerase chain reaction was used to detect the α-synaptophysin A53T gene polymorphism in 224 sporadic PD patients(PD group)and 154 healthy individuals(control group).According to the Hoehn-Yahr(H-Y) classification standard, PD patients were divided into H-Y ≥ 3 group(n=172) and H-Y ≤ 2.5 group(n=52).Each genotype and alleles frequencies as well as the A53T gene expression and their relation to the severity of parkinson's disease were analyzed with Chi-square test of SPSS19.0.Results The frequency of the A53T genotype of A/A were 40(17.9％) and 10(6.5％) (x2 =10.267, P=0.001, OR=3.13,95％ CI =1.514-6.473) in the PD group and control group, respectively.The frequency of the allele A was 160(35.7％) and 70(22.7％) (x2 =14.543, P=0.000, OR=1.889,95％ CI =1.359-2.625) in the PD group and control group,respectively.The frequency of the A53T genotype of A/A was 30(17.4％) and l0 (19.2％) in the H-Y ≥ 3 group and H-Y ≤ 2.5 group, respectively, with significant difference (P=0.003,0.007) as compared to the control group.The frequency of the allele A was 122(35.5％) and 38(36.5％) in the the H-Y ≥ 3 group and H-Y ≤ 2.5 group,respectively, with significant difference (P=0.000,0.006) as compared to the control group.There was no statistically significant difference of the A53T genotype of A/A and the allele A between the H-Y≥3 group and H-Y≤2.5 group (P=0.768,0.841).Conclusion The A53T gene polymorphism is the risk factor of Parkinson's disease in Chinese people, but it isn't correlated to stage of sporadic parkinson' s disease.

Objective To investigate the effect of dexmedetomidine on patients with pancreatic cancer treated by high intensity focused ultrasound (HIFU) under general anesthesia.Methods One hundred and twenty ASA Ⅱ or Ⅲ patients with pancreatic cancer undergoing HIFU treatment,were divided into control group (group C) and dexmedetomidine group (group D) by random digits table method,each group with 60 cases.Dexmedetomidine was intravenously infused at 0.2 μ g/(kg· h) until the end of operation after a loading dose of 0.7 μg/kg over 15 min before induction of anesthesia in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with intravenous injection of fentanyl 2-3 μg/kg and propofol 1.5-2.0 mg/kg and cisatracurium 0.2 mg/kg at 5 min after administration of the loading dose.Anesthesia was maintained with sevoflurane,remifentanil,propofol,cisatracurium.The propofol,remifentanil and sevoflurane consumption,the incidence of postoperative agitation,delirium,delayed recovery were recorded.Results The intraoperative heart rate in group D was significantly lower than that in group C (P ＜ 0.05).The propofol,remifentanil and sevoflurane consumption in group D were significantly shorter than those in group C [(341.4 ± 45.7) mg vs.(520.5 ± 50.8) mg,(1.7 ± 0.5) mg vs.(2.3 ± 0.8) mg,(11.6 ± 4.1) ml vs.(16.7 ± 3.8) ml,P ＜ 0.05].The incidence of postoperative agitation and delirium in group D were significantly lower than those in group C [6.7％(4/60) vs.21.7％(13/60),8.3％ (5/60) vs.26.7％ (16/60),P ＜ 0.05].There was no statistically significant difference in the incidence of delayed recovery between group D and group C [3.3％ (2/60) vs.1.7％ (1/60),P ＞ 0.05].Conclusions Dexmedetomidine given HIFU treatment of pancreatic cancer patients can reduce the amount of general anesthetic,reduce the incidence of postoperative agitation and delirium,intraoperative heart rate.

Objective To investigate the effects of different infusion rates of remifentanil infusion on spontaneous ventilation in children received sevoflurane anesthesia. Methods A total of 120 children underwent strabismus surgery were randomly assigned to four groups: C group (administration of saline), L group (remifentanil 0.03 μg · kg-1 · min-1), M group (remifentanil 0.06μg · kg-1 · min-1) and H group (remifentanil 0.09μg · kg-1 · min-1). The mean blood pressure (MBP), heart rate (HR), respiratory rate (RR), tidal volume (VT), minute ventilation (MV), endtidal CO2 [p(CO2)] and endtidal SEV were recorded after laryngeal mask insertion (T1), an initial bolus dose of remifentanil (T2),10 mins after remifentanil infu-sion (T3),15 mins after remifentanil infusion (T4) and laryngeal mask remove (T5) respectively. The adverse events and time of induction, maintenance and emergence were also recoded. Results There were no significant differences in patient age, body mass index, anesthesia time, operation time, HR and MBP at different time points between four groups. No body movement and hypoxemia were observed. The values of RR and MV at T3, T4 and T5 were significantly lower in H group than those of other three groups (P <0.05). Values of p(CO2)at T3 and T4 were significantly higher in H group than those of other three groups (P<0.05). The values of RR at T3, T4 and T5 were significantly lower in L group and M group than those of C group. The values of MV at T3 and T4 were significantly lower in L group and M group than those of C group. p(CO2)at T4 was significantly higher in L group and M group than that of C group(P<0.05), but no significant difference was found be-tween L group and M group. There was no significant difference in value of VT between four groups. Conclusion Remifent-anil infusion at a rate of 0.03~0.09μg·kg-1·min-1 could depress spontaneous ventilation in children received sevoflurane an-esthesia. The respiratory depression effect is mainly manifested by reduction of RR. It is a good option to choose 0.03~0.06μg · kg-1 · min-1 infusion to keep spontaneous ventilation and avoid severe respiratory depression according to the demand of operations in children.

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Objective To investigate the status of Helicobacter pylori and “Helicobacter macacae” infection in rhesus and cynomolgus monkeys in China.Methods With the use of 16S rRNA specific primers for Helicobacter spp and Helicobacter pylori ( HP ) from published literatures, and new 16S rRNA specific primers designed for “Helicobacter macacae” ( HM ) , we investigated the infection status of these two Helicobacter spps in both of 45 rhesus and 90 cynomolgus monkeys by qPCR or conventional PCR on stool samples.Results All three primer sets for 16S rRNA exhibited excellently sensitivity and specificity.Both the infection rates of HP and HM were 100% among 45 young adult rhesus monkeys.The infection rate of HP and HM in 90 young adult cynomolgus monkeys were 100% and 97.8%, respectively.Conclusions Helicobacter pylori and “Helicobacter macacae” are present in almost every artificially bred adult rhesus and cynomolgus individuals which may adversely affect the health of laboratory monkeys and the accuracy of related animal experiments.

Objective To observe the protective effect of recombinant human endotoxin binding peptide (EBP) on a rat model of burn combined with endotoxemia. Methods A total of 78 rats of model of burn combined with endotoxemia were divided into three groups: model group ( n =36), treatment group ( n =36), and control group ( n =6). Rats in the model group were intraperitoneally injected with 1 mg/kg endotoxin (prepared with 1 ml saline) immediately after burn. After intraperitoneal injection of 1 mg/kg endotoxin (prepared with 0.5 ml saline), rats in the treatment group were intraperitoneally injected with EBP (prepared with 0.5 ml saline). Blood and liver and lung tissues of rats in the model and treatment groups were collected at 1, 3, 6, 12, 24, and 48 h after treatment. Rats in the control group were intraperitoneally injected with 1 ml saline after trichomadesis. Blood and liver and lung tissues of rats in the control group were collected for the total control. The changes of alanine aminotransferase (ALT), TNF ?, and IL 6 contents in serum were determined by biochemical velocity analysis, ELISA, and light microscopy. The pathological changes of the liver and lung tissues were observed light microscopically and electron microscopically. Results The serum TNF ? level of rats in the model group was significantly higher than that in the control at 1 h after injury ( P

Objective To investigate the effects of adenosine supplementing cold blood cardioplegia on myocardial injury in patients undergoing milral valve replacement(MVR).Methods Thirty ASA Ⅱ or Ⅲ patients aged 18-64 yr with a BMI of 18-24 kg/m2 undergoing elective MVR were randomly divided into 2 groups(n =15each):control group(C)and adenosine group(A).In group A myocardial arrest was produced by infusing adenosine 6 mg diluted in normal saline 20 ml through aortic root after aorta was cross-clamped followed by cold blood cardiaplegic solution 20 mg/kg.In group C asystole was produced with cold blood cardioplegic solution 20 ml/kg alone every 30 min.Blood samples were taken from central vein at 5 min before(T1)and 4 h after aortic crossclamping(T2)and 24 h after operation(T3)for determination of plasma cardiac troponin Ⅰ(cTnI)concentration and creatine kinase-MB(CK-MB)activity.The amount of cardioplegic solution infused,cardiac arrest induction time(from infusion of adenosine or cardioplegic solution to asystole shown by ECG),restoration of spontaneous heartbeat,the amount of dopamine administered during the 2 h after CPB and aortic cross-clamping time were recorded.Results Supplementation of cold blood cardioplegia with adenosine significantly reduced cardiac arrest induction time,the total amount of dopamine administered during the 2 h after CPB and plasma cTnl concentration and CK-MB activity in group A compared with group C.Conclusion Cold blood cardioplegia supplemented with adenosine can attenuate myocardial injury in patients undergoing MVR.

Objective To investigate the effects of sevoflurane wash-in during cardiopulmonary bypass (CPB) on myocardial injury in patients undergoing coronary artery bypass grafting(CABG).Methods Forty ASA Ⅱ or Ⅲ patients aged 50-64 yr,weighing 53-90 kg undergoing scheduled for CABG under CPB were randomly divided into 2 groups (n =20): control group (group C) and sevoflurane group(group S).Anesthesia was maintained with propofol 3-5 mg·kg-1 ·h-1 and sufentanil 0.5-1.0 μg·kg-1 ·h-1 in both groups.Sevoflurane 1％-2％ was washed into extracorporeal circuit during CPB in group S.Blood samples were taken from central vein after the induction of anesthesia (T0,baseline) and at 6,12 and 24 h (T1-3) after operation for determination of plasma cardiac troponin I(cTnI) concentration and creatine kinase-MB (CK-MB) activity.Myocardial specimens were obtained from right auricle before aortic cross-clamping and at the end of CPB for ultrastructure examination.The severity of mitochondria injury was assessment and scored (0 =normal,4 =impaired inner mitochondrial membrane integrity).Results CPB significantly increased plasma cTnI concentration at T1-3 as compared with the baseline values at T0 before CPB.Plasma cTnI concentration was significantly lower at T2 and T3 in group S than in group C.Mitochondrial injury index was significantly lower at the end of CPB in group S than in group C.There was no significant difference in plasma CK-MB activity between the 2 groups.Conclusion Wash-in of sevoflurane during CPB can attenuate myocardial injury in patients undergoing CABG.

Objective To investigate the effects of ulinastatin on the myocardial injury in patients undergoing live donor liver transplantation.Methods Forty patients (AHA classification grade A or B),aged 40-64 yr,with a body mass index of 18-25 kg/m2,scheduled for live donor liver transplantation,were randomly divided into 2 groups ( n =20 each):control group (group C) and ulinastatin group (group U).Anesthesia was induced with midazolam,sufentanil,and cisatracurium besilate.The patients were tracheal intubated and mechanically ventilated.Ulinastatin 300 000 IU in 100 ml of normal saline was infused intravenously over 30 min after anesthesia induction and then the infusion was repeated at 4 h interval until the end of operation in group U,while the equal volume of normal saline was given in group C.Blood samples were taken from the central vein immediately before skin incision (T0,baseline),at 30 min of anhepatic phase (T1),at 30 min of neohepatic phase (T2),and at 0,4 and 24 h after operation (T3-5) for determination of the concentrations of serum cardiac troponin Ⅰ (cTnI),creatine kinase-MB (CK-MB) and N-terminal pro-brain natriuretic peptide (NT-proBNP).The changing rates of cTnI and CK-MB at T1-5 were calculated.The use of cardiovascular drugs and cardiovsscular accidents were recorded during operation.Results The serum cTnI,CK-MB and NT-proBNP concentrations were significantly higher at T2-5 than at T0 in the two groups ( P ＜ 0.05).Compared with group C,the serum cTnI,CK- MB and NT-proBNP concentrations at T2-5 were significantly deceased in group U ( P ＜ 0.05).The maximal changing rates of cTnI,CK-MB and NT-proBNP concentrations were 4.71 ± 1.62,6.85 ± 1.53 and 4.96 ± 1.23 respectively in group C,decreased to 3.26 ± 1.51,4.56 ± 1.62 and 3.67 ± 1.02 respectively in group U.There was no significant difference in the incidence of cardiovascular accidents and the use of dopamine between the two groups.Conclusion Intravenous infusion of ulinastatin can attenuate the myocardial injury to some extent in patients undergoing live donor liver transplantation.