0 05) The Kappa value was 0 83 and intraobserver agreement was bet ter b etween SeO 2 and SpO 2 .ConclusionThe sensor sticked to earlobe is feasible and simple to monitor puls oxygen saturation continuousl y in children

Objective To study the effect of hepatectomy operation on circulating tumor cells of liver cancer patients during surgery. Methods Circulating blood was draw from 18 liver cancer patients before and after hepatectomy and 20 healthy volunteers. Blood routine ex-amination for leukocyte enumeration and karyote counting by microscope were taken for every blood samples to compare with the number of leukocytes and karyotes between pre-hepatectomy and post-hepatectomy blood of liver cancer patients. Immunofluorescence and cell culture techniques were used to identify the tumor cells and compare with the numbers and characteristics of the circulating tumor cells in blood sam-ples among all groups. Fluorescent antibodies,AE1/AE3 and CD133 were used to mark tumor cells. Results The number of leukocytes and karyotes in post-hepatectomy blood samples of liver cancer patients increased compared with pre-hepatectomy blood samples. The AE1/AE3 positive cells-samples were more than CD133 positive cells-samples and double positive cells-samples(P<0. 001). AE1/AE3 positive cells of healthy volunteers’ blood were more than post-hepatectomy blood of liver cancer patients(P<0. 05). No significant differences in CD133 positive cells and double positive cells were found among all groups(P>0. 05). There were no significant differences in clone formation rate after cell culture among all groups(P>0. 05). For 3 clone formed samples of liver cancer patients,there were no differences in tumor source, pathologic type and differentiation level. Conclusion The circulating blood of liver cancer patients,non-cancer patients and healthy people all exist circulating tumor cells. Hepatoma resection does not affect the number and characteristics of circulating tumor cells in liver cancer pa-tients’ blood.

Objective To investigate the sensitivity and accuracy of monitoring oxygen saturation of arterial blood flowing through descending aorta with a probe placed in the lower segment of esophagus ( SeO2). Methods This study was approved by the ethics committee of our hospital and written consent was obtained. Forty-five ASA Ⅰ-Ⅲ patients (34 males, 11 females) aged 14-79, weighing 40-90 kg undergoing elective (36 patients) or emergency (9 patients) surgery were studied. After induction of anesthesia a probe we made (patent number ZL 200320115080.2) was placed in the lower segment of esophagus and connected to a monitor (Philips-150A) . The depth of insertion and the direction of the probe were adjusted until the same waveform as SpO2 was obtained. Once the best waveform was obtained, 10-15 min stabilization was allowed. The ventilator was then disconnected. When SeO, decreased from 100% to 90% mechanical ventilation was started again. The following parameters were recorded:(1) the onset time (the time from disconnection of ventilator to the time when SeO2 and SpO2 started to decrease), (2) the time needed for SeO2 and SpO2 to decrease from 100% to 95% (T95) and 90% (T90), and (3) the recovery time (the time needed for SeO2 and SpDO2 to return to 100% after mechanical ventilation was started again. Arterial blood samples were taken for blood gas analysis when Se02 and SpO2 were 90% , 95% and 100% . Results SeO2 , SpO, and SaO2 were 100% when the patients were being ventilated with 100% oxygen. When the ventilator was disconnected SeO, dropped much faster than SpO2. It took (286?15)s for SeO2 to drop from 100% to 95% while for SpO2 it took (398 ?28)s. The most readings of SeO2 were in the range of 2 standard deviation from SaO2. SeO2 correlated well with SaO2 and SpO2. r was 0.9754 and 0.9656 respectively(P

Objective To evaluate the neurotoxicity induced by multiple exposures to sevoflurane anesthesia in the neonatal rats.Methods Thirty-two healthy SPF Sprague-Dawley rats of both sexes,aged 7 days,weighing 15-20 g,were randomly divided into 2 groups (n=16 each) using a random number table:control group (group C) and multiple exposures to sevoflurane anesthesia group (group Sev).On postnatal day 7,14 and 21,2.6％ sevoflurane was inhaled for 2 h in group Sev,while the mixed gas of oxygen and air was inhaled instead of sevoflurane in group C.Morris water maze test was carried out on postnatal day 32-36 to assess the cognitive function.On postnatal day 21 and 36,8 rats in each group were selected and anesthetized,and the cerebrospinal fluid was collected for determination of the concentrations of amyloid β-protein by enzyme-linked immunosorbent assay.Results Compared with group C,no significant change was found in the escape latency,movement time spent in the effective region of the platform,movement distance,the number of entries into the effective region,percentage of residence time,percentage of movement distance,and percentage of the number of entries (P＞0.05),and the concentrations of amyloid β-protein in the cerebrospinal fluid were significantly increased on postnatal day 36 in group Sev (P＜0.05).Conclusion Multiple exposures to sevoflurane anesthesia can induce central neurotoxicity,but do not induce changes in the cognitive function in the neonatal rats.

Objective To evaluate the protective effect on the pulmonary micmvascolar permeability and thereby to ameliorate the lungs injury attributed to cardiopuimonary bypass(CPB).Method Twenty-four adult hybrid health dogs were randomly divided into three groups(8 in each group):group C(normal saline given after CPB),group N1(NAC given intravenously just before CPB)and group N2(NAC given just after CPB).The changes of respiratory index(RI)and malondialdehyde(MDA)content in lung tissue were observed.Samples were taken three times,before CPB(T0),30 min after CPB surned off(T1)and 60 min after CPB sumed off(T2).The leucocyte count and slbumin content in bronchoalveolar lavage fluid(BAlF),the pulmonary micmvascular permeability index(PMPI),and the histological changes of lung under light microscope and electromicroscope in 3 groups were examined.Results No significant differences were found in the levels of Ri and MDA content of lung tissue between groups before CPB.However,they gradually reduced after CPB(P<0.05)in the three groups,but they still were significantly lower in group N1 and group N2 compared with those in group C at,T1 and T2(P<0.05)and those in group N1 were significantly lowere than those in group N2 at T1 and T2(P<0.05).MDA gradually increased after CPB in three groups(P<0.05),but it was still significantly lower in group N1 and group N2 than that in group C at T1 and T2(P<0.05).The leucocyte count and albumin content in BALF were significantly lower in group N1 and group N2 in comparison with those in group C(P<0.05)and they were significantly lower in group N1 compared with those in group N2(P<0.05).The PMPI were significantly lower in group N1 and sroup N2 compared with those in group C(P<0.05)and they were significantly lower in group N1 compared with those in group N2(P<0.05).By using electromicroscope,the apparent inflammatory change of lung with endothelium cellular swelling,inter-endothelial cells spaces widened,and the indistinctness,deformation or decurtation of microfilarnent were observed.And the dissolution of laminated body,swollen mitochondria and plasmolysis were found in alveolar epithelial cell Ⅱ in group C.However,these changes were markedly alleviated in group N2 and group N1.Conclusions The results clearly demonstrate that NAC could protectie effect on the CPB injured lung and reduce the pulmonary microvascalar permeability,and the protetive effect is better in group N1 than that in group N2.

Objective To evaluate the effect of emulsified isoflurane on cognitive function in rats.Methods Seventy-two adult male SD rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 3 groups:normal control group (group C,n =12),intralipid group(group E,n =12),and 8％ emulsified isoflurane group ( group EI,n =48).Morris water maze test was performed at 2 h after administration in group E and at 2 h,1,7,14 d after administration in 12 rats at each time point in group EI.The escape latency,staying time at the original platform quadrant,frequency of crossing the original platform and swimming speed were recorded.Orbital blood samples were taken from 6 rats in each group after water maze test for determination of the plasma corticosterone concentration,and then the animals were sacrificed and their hippocampi were removed for determination of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) contents.Brains were removed from another 6 rats in each group after water maze test for determination of the expression of BDNF and NGF in DG,CA3,CA2,CA1 of hippocampus.Results Compared with group C,in group EI the escape latency at 2 h after administration was prolonged,staying time at the original platform quadrant was shortened,the expression of BDNF in DG and CA3 of hippocampus was down-regulated and the BDNF content in hippocampus was decreased at 2 h and 1 d after administration( P ＜ 0.05 or 0.01).The escape latency was shortened and staying time at the original platform quadrant was prolonged at 7 and 14 d after administration,the content of NGF in hippocampus was increased at 1,7 and 14 d after administration and the expression of BDNF in DG and CA3 of hippocampus was up-regulated at 1d after administration as compared with those at 2 h after administration in group E1( P ＜ 0.05 or 0.01).There was no significant difference in the variables mentioned above between groups E and C( P ＞ 0.05 ).There was no significant difference in plasma corticosterone concentration among the 3 groups ( P ＞ 0.01 ).Conclusion The mechanism by which emulsified isoflurane results in transient cognitive impairment in rats is related to down-regulating the expression of BDNF in hippocampus,but not related to corticosterone and NGF.

Objective To observe the anesthesia and recovery results of sevoflrane and remifentanil combined anesthesia in open or laparoscopic surgeries. Methods 60 cases of ordinary surgeries from the department of gynecology and general surgeries were included in this study with 30 cases in each group. (1)recording total sevoflurane inhalation time, muscular relaxant amount, end tidal sevoflurane concentration;(2)recording BP,HR at 10 min after induction,operation staring and ending,ventilation recovery, opening eye and extubation period;also sevoflurane concentration 5 min after stopping medicine and ventilation recovery;recording time period between surgery ending and autonomous respiration recovery , eye opening and extubation. Results No any adverse events happen in each patient.the sevoflurane inhalation time in open surgery group was (157.20 ± 47.28) min, longer than that of laparoscopic surgeries group (73.50 ± 11.23)min(P<0.05), we had seen no statistical significance in all other index observed (P>0.05). Conclusion Sevoflurane combined remifentanil anesthesia can achieve stable intra-operative maintenance and rapid postoperative recovery quality , we suggest the widespread usage of it in clinic.

Obj cetive A large number of recent studies show that sevoflurane anesthesia may cause learning and memory dysfunction.The aim of this study was to explore changes of learning and memory ability and hippocampal volume in infantile rats after neonatal interrupted and repeated inhalation of 2.6% sevoflurane through detecting the learning and memory ability by Morris water maze and the hippocampus volume by MRI.Method s Thirty two neonatal SD rats were randomly devided into two groups (n=16):experimental group and control group.Rats inhalated 2.6%sevoflurane in the experimental group and 1 L/min O2 +1 L/min Air in the control group at the postnatal days of 7, 14 and 21 (P7, P14, P21). The learning and memory ability was determined by the Morris water maze test from P31 to P37;The brains of rats were scanned by mag-netic resonance imaging ( MRI) machine under anesthesia with 1%sodium pentobarbital at P37, and the brain and bilateral hippocampal volumes were measured. Results ①In the place navigation test, the escape latency had no significant difference between the two groups (P>0.05).In the spatial probe test, the dwelling time, movement distance and number of entering times in platform quadrant decreased slightly in experimental group compared with those in the control group, while there was no significant difference (P>0.05).②The brain volume [(1.53 ±0.18) cm3 vs (1.60 ±0.13) cm3] and right hippocampal volume [(16.15 ±1.76)mm3 vs(16.46 ±1.71)mm3] had no significant difference between the two groups (P>0.05).The left hippocampal volume [(16.46 ±1.71)mm3] was decreased in the experimental group compared with the control group [(18.10 ±2.53)mm3](P<0.05). Conclusion The learning and memory ability has no significant changes in in-fantile rats after neonatal interrupted and repeated sevoflurane inhalation and MRI examination of hippocampal volume is not sufficient for the diagnosis of cognitive dysfunction.

Objective To investigate the effect of sevoflurane on blood pressure in patients with different ages and the optimal concen-tration of sevoflurane. Methods 60 patients underwent selective LC operation with conventional induction and sevoflurane maintenance were divided into three groups:the youth group (34 patients), the middle age group (20 patients) and the older age group (6 patients). The SBP, DBP, MAP, CETsev, number of patients, age of patients before induction and 10 min(T1), 20 min(T2), 30 min (T3), 60 min (T4) after induction were recorded. Results Fluctuate of blood pressure were in the normal range after anesthesia maintenance, and MAP were fluctuated within the range of ± 20% before induction. The age under different CETsev were of no significant difference in each time point (P>0. 05). The age composition ratio in different CETsev were of no significant difference in each time point (P>0. 05). As the time of anesthesia extended, the number of patients under 0% ~1%CETsev decreased from 35 to 11; the number of patients under 1% ~2%CETsev increased from 10 to 20;and the number of patients under 2% ~3%CETsev maintened in 14 approximately. Conclusion The effect of sevoflurane on blood pressure of different ages is approximate. 2% ~3% CETsev is the most optimal concentration during the main-tenance of anesthesia.

Objective To evaluate the effects of isoflurane anesthesia on NR1 expression and neuronal apoptosis in the hippocampus and cortex of adult rats .Methods Thirty-six adult male Sprague-Dawley rats , weighing 250-280 g ,were randomly assigned into 3 groups using a random number table :control group (group C , n=6 ) ,O2 inhalation group (group O , n=6 ) and isoflurane anesthesia group (group I , n=24 ) .The rats were exposed to 2% isoflurane (group I) ,to pure oxygen (group O) ,or to air (group C) for 2 h .At 2 h ,and 1 ,7 and 14 days after the rats were awake (T1-4 ) ,Morris water maze test was performed .The rats were then sacrificed and brains were removed for isolation of the hippocampus and cortex .NR1 expression was detected using SABC immuno-histochemical technique and neuronal apoptosis was determined using TUNEL .Results Compared with group C , the escape latency at T2 and total swimming distance at T1 ,2 were significantly prolonged , and the expression of NR1 in hippocampi was down-regulated at T1 ,2 in group I ,and the expression of NR1 in the cortex was down-regulated in O and I groups ( P<0.05) .There was no significant difference in the apoptosis index between the three groups ( P> 0.05 ) .Conclusion Isoflurane anesthesia can decrease the cognitive function transiently ,which is related to inhibition of up-regulation of NR1 expression in the hippocampi ,but not related to neuronal apoptosis in adult rats .