Objective To evaluate the effect of dexmedetomidine on quality of wake-up test in the patients undergoing posterior osteotomy correction surgery.Methods Ninety-seven patients of both sexes,aged 17-59 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index 18.5-25.0 kg/m2 and global kyphosis angle＞60°,scheduled for elective posterior osteotomy correction surgery under general anesthesia,were randomly divided into 2 groups using a random number table:control group C (n=46) and group D (n =51).In group D,dexmedetomidine 1.0 μg/kg was infused over 15 min before induction of anesthesia,and group C received the equal volume of normal saline instead.Anesthesia was induced with iv midazolam,propofol,fentanyl,vecuronium and dexamethasone in C and D groups.Mechanical ventilation was performed after tracheal intubation.Anesthesia was maintained with infusion of cisstracurium,propofol and remifentanil.Dexmedetomidine 0.3 μg · kg-1 · h-1 was infused throughout the surgery in group D,and meanwhile normal saline was given throughout the surgery in group C.The anesthetic drugs for maintenance except dexmedetomidine were discontinued at the beginning of the wake-up test.The wake-up time was recorded and the wake-up quality was assessed.Ramsay sedation scores and Riker sedation-agitation scale scores were also recorded when all the patients were successfully awakened.The development of cardiovascular events during wake-up test and intraoperative awareness was recorded.Results The wake-up quality was significantly higher,Riker sedation-agitation scale scores were lower,Ramsay sedation scores were higher,the incidence of nausea and vomiting was lower,and no significant change was found in wake-up time in group D.No intraoperative awareness was observed in the two groups.Conclusion Dexmedetomidine can raise wake-up quality without prolonging wake-up time and with stable hemodynamics and fewer side effects in the patients undergoing posterior osteotomy correction surgery.

Object To study the conditions for the extraction of active ingredients in Ligusticum chuanxiong Hort by supercritical fluid extraction (SFE) Methods Conditions for the extraction were studied by orthogonal experimental design as guided by the content of ferulic acid presented in the extract Results The optimum conditions for the yield of ferulic acid were thus established Conclusion The best SFE conditions were: temperature of the extraction pot was 70 ℃ under the pressure of 35 MPa, CO 2 as the modifier with the flow rate of 25 kg/h, the time for extraction was 2 5 h

Objective: To establish the method of simultaneous determination of five effective constituents tanshinose Ⅱ A、danshensu、protcate-chualdehyde、puerarin and ferulic acid. Methods: After ultrasonic extraction, HPLC-DAD were used to determine the effective constituents on Zorbax SB-C 8 column with acetonitrile and pH3.0 water(adjusted with H 3PO 4) as a mobile phase. Under the gradient timetable the percent of acetonitrile increased from 5% to 72.5% in 45 min. The flow rate was 1.5mL?min -1 , Five constituents were detected at the most suitable detection wavelength. Results: The average recovery of the five effective constituents is within the range of 100.1%～106.9%(n=3), The test of the accuracy within one day shows that the RSD is less than 2.2%, and the RSD among days less than 2.8%(n=3). The test solution is stable in 10h. Conclusion: The method is accurate, simple, quick, and can be used for determining simultaneously the content of the five effective constituents in Compound Xinnaokang Soft Capsules

Objective To investigate the relationship between cleftpalate and secretory otitis media so that the secretory otitis media resulted from cleftpalate was treated and prevented effectively. Methods 116 children with cleftpalate and 73 normal children were investigated by tympanogram, hearing threshold and auditory brain response. Results The incidence of secretory otitis media and hearing loss had significant difference between the two groups. Conclusions Children with cleftpalate had high incidence of secretory otitis media and hearing loss. We should pay more attention to the treatment and prevention of secretory otitis media in children with cleftpalate. It is necessary for the cleftpalate children to insert the tympanal pressure equalization tubes while palatal surgery is performed.

A TLC condition has been developed to purify the extraction from the leaf of Torreya Arn. plant,then an optimized HPLC method was used to determine the amount of taxol.HPLC chromatographic conditions were:colum:Shim Pack CLC ODS(150 mm?6.0 mm,5 ?m);mobile phase:methanol water(66∶34);flow rate: 0.5 ml/min;wavelength of the detector: 227 nm;colum temperature: 35℃.Using this method,we have determined the trace level of taxol in the leaf of Torreya Arn .plant successfully.There exists better linear relationship between peak height( Y ) and the concentration of detected sample( X ) within 100 500 ?g/ml.The average recovery rate is 85.7%( n =12);RSD is 7.8%.

Objective The aim of this study was to explore possible pharmacokinetic factors and develop a population pharmacokinetic model for remifentanil in adult patients.Methods Eleven healthy patients,undergoing elective major abdominal surgery,aged 25 to 86 years,received random-ly remifentanil 0.3μg·kg-1 ·min-1 (group R3),or 0.6μg·kg-1 ·min-1 (group R6).Frequent ar-terial blood samples were drawn according to predetermined time and assayed for remifentanil concen-tration.Nonlinear mixed-effects modeling (NONMEM)was used to evaluate the time courses of the measured concentrations.The covariates include age,bodyweight (WT),gender,lean body mass (LBM),body mass index (BMI)and body surface area (BSA).Results The pharmacokinetic data of remifentanil were well described using a three-compartment linear model with first-order elimination from the central compartment.Forward analysis showed that age,height and body mass index (BMI) does not affect the pharmacokinetic parameters,which are contrast with body weight,lean body mass (LBM),body surface area (BSA)and gender;further analysis demonstrated only a significant effect of body weight on remifentanil systemic clearance (CL)and volume of the central compartment (V). For typical 60 years patients,PK parameters were:V1 =7.64 L,V2 =4.81 L,V3 =4.34 L,CL1 =2.74 L/min,CL2 = 0.738 L/min,CL3 = 0.0905 L/min.Conclusion The pharmacokinetics of remifentanil is consistent with its rapid elimination by blood and tissue esterase in Chinese patients. The systemic clearance and volume of distribution of central compartment increases with body weight in the population and the range of covariates studied,which suggests that a patient with greater body weight needs a greater initial dose and maintenance infusion rate higher to obtain a stable plasma con-centrations and clinical effects.

Objective To evaluate the effect of phosphatidylinositol-3 kinase inhibitor LY294002 combined with dichloroacetate on apoptosis in human pulmonary arterial smooth muscle cells (SMCs) and AKT/GSK-3β/HK-2 signaling pathway.Methods Human pulmonary arterial SMCs were seeded into culture plates at a density of 2 x 104 cells/ml after 3-5 passages.After being incubated for 72 h,the SMCs were cultured in the medium supplemented with 0.2％ fetal bovine serum for 24 h to induce starvation prior to experiments.The cells were then randomly divided into 6 groups (n =6 each) using a random number table:control group (group C),positive control group (group F),LY294002 group (group L),different concentrations of dichloroacetate groups (D1 and D2 groups),and LY294002 combined with dichloroacetate group (group LD1).In group C,the cells were cultured in the medium supplemented with 0.2％ fetal bovine serum.In F,L,D1,D2 and LD1 groups,the cells were cultured in the medium supplemented with 10％ fetal bovine serum.LY294002 2 μmol/L was added to the medium in group L.Dichloroacetate l0 and 20 mmol/L were added to the medium in D1 and D2 groups,respectively.In group LD1,LY294002 (2 μmol/L) was added,and 30 min later dichloroacetate 10 mmol/L was added to the medium in LD1 group.The cells were incubated for 48 h.Flow cytometry was used to measure the cell apoptosis and mitochondrial membrane potential.The expression of phosphorylated AKT (p-Akt),phosphorylated glycogen synthase kinase 3β (p-GSK-3β),and hexokinase-2 (HK-2) was detected using Western blot.Apoptosis rate was calculated.Results Compared with group C,apoptosis rate was significantly increased,and mitochondrial membrane potential was decreased in D2 and LD1 groups,the expression of p-Akt,p-GSK-3β and HK-2 was up-regulated in group F,and no significant changes were found in apoptosis rate and mitochondrial membrane potential in F,L and D1 groups.Compared with group D2,apoptosis rate was significantly increased,mitochondrial membrane potential was decreased,and the expression of p-Akt,p-GSK-3β and HK-2 was down-regulated in LD1 group.The expression of p-Akt,p-GSK-3β and HK-2 was significantly lower in D2 and LD1 groups than in group F.Conclusion LY294002 combined with dichloroacetate can promote apoptosis in human pulmonary arterial SMCs possibly through blocking AKT/GSK-3β/HK-2 signaling pathway.

Objective To systematically review the preventive efficacy of N-methyl-D-aspartate (NMDA) receptor antagonists on remifentanil-induced postoperative hyperalgesia.Methods Pubmed,EMBase,Springer and Cochrane Controlled Trials Register were searched to identify all randomized controlled trials(RCTs) about efficacy of NMDA receptor antagonists for preventing remifentanil-induced postoperative hyperalgesia.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.The data was extracted,including postoperative analgesic consumption,pain scores,time for first analgesic request and the incidence of adverse effects.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software.Results Fourteen RCTs involving 623 patients were included in our Meta-analysis.NMDA receptor antagonists significantly decreased pain scores at 4 h after operation ( P ＜ 0.05),and had no effect on postoperative analgesic consumption,time for first analgesic request and the incidence of adverse effects ( P ＞ 0.05).Conclusion NMDA receptor antagonists (ketamine and magnesium)can not prevent the occurrence of postoperative hyperalgesia induced by remifentanil.

ObjectiveTo study the effects of intrathecal injection of cyclin dependent kinase 5 inhibitor Roscovitine on the hyperalgesia induced by remifentanil in a rat model of incisional pain.MethodsForty-five SD rats were randomly divided into 5 groups ( n =9 in each group):control group ( C ),incisional pain group ( Ⅰ ),Roscovitine group(ROS),remifentanil group(R) and Roscovitine + remifentanil group ( ROS + R).Roscovitine (50μg/10μl) was injected intrathecally at 30 min before plantar incision in groups ROS and ROS + R,other groups were injected with 20％ DMSO(10μl).All groups except for C group needed to be made the model of incisional pain.In group R and ROS + R,remifentanil(0.04 mg/kg) was infused subcutaneously with a pump for 30min at the moment of surgical incision.The paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency(PWTL) were used to evaluate the behavioral changes and measured at 24 h before incision and at 2 h,6 h,24 h and 48 h after incision.ResultsCompared with group C,the PWMT and PWTL of group Ⅰ were significantly decreased after incision (P＜0.01).Compared with group Ⅰ,the PWMT and PWTL of group R were significantly decreased after incision (P ＜ 0.01 ) ; however,the PWTL was significantly increased (2h:( 20.26 ± 1.33)s,(17.97 ±0.47)s;48h:(22.15 ±0.660)s,(19.89 ±1.27) s),P＜0.05)in ROS group.Compared with group R,at 2h after incision,the significant increase of PWTL ( ( 19.13 ± 1.72)s,( 14.41 ± 2.30) s) and PWMT ( ( 10.4 ± 1.95 ) g,(6.38 ± 0.91 ) g) were observed,then lasted up to 48 h ( ( 19.24 ± 2.8 ) s,( 14.87 ± 1.95 ) s )and 24h ( (8.88 ± 1.41 ) g,( 6.83 ± 0.80) g) respectively in group ROS + R (P ＜ 0.05 ).ConclusionIn a rat model of postoperative pain,Roseovitine could reduce the thermal hyperalgesia purely induced by incision,and also could prevent the development of hyperalgesia induced by remifentanil.

Objective To determine the reliability and validity of the Chinese edition of the Amster-dam preoperative anxiety and information scale ( APAIS) for the assessment of preoperative anxiety of Chi-nese patients.Methods The APAIS was translated into Chinese version.One hundred and thirty patients undergoing elective surgery were enrolled to complete the APAIS,STAI-S,VAS-A at the day before surgery, and thirty subjects received a re-test of APAIS at the day of surgery.Results The average score of Chinese version of APAIS anxiety scale and information scale were (7.37±3.51) and (3.67±1.94),respectively. Cronbachαfor the anxiety scale was 0.84 and information scale was 0.78,respectively.Test-retest reliability were r=0.746(P<0.01) and r=0.655(P<0.01) ,respectively.Factor analysis showed anxiety and the desire for information were found,which explained 73.82%of variance.The anxiety scale of APAIS significantly corre-lated with STAI-S and VAS-A,Correlation Coefficient were r=0.720(P<0.01) and r=0.641(P<0.01) ,respec-tively.Conclusion The Chinese version of the APAIS has good reliability and validity to quick measure the preoperative anxiety and desire for information of patients.