Objective In addition to myocardial ischemia,massive inflammatory mediators and different enzymes are released and free radicals increase during cardiopulmonary bypass(CPB) due to the contact of blood with foregin material Leukocytes play an important role The purpose of this study was to evaluate the myocardial protective effect of leukocyte depleted blood perfusion during open heart surgery Methods Thirty adult ASA II IV patients scheduled for elective orthotopic valve replacement received fentanyl enflurane anesthesia A bolus of 3 mg/kg intravenous heparin was given before CPB Cardiac arrest was induced with 4 ℃ hyperkalemic crystalliod cardioplegic solution Patients were randomly allocated to one of 3 groups based on the types of cardioplegic solution used during CPB: crystalloid solution(group CS, n=10),whole blood (group WB,n=10), and leukocyte depleted blood (group LD,n=10) Blood samples were taken from peripheral artery before heparinization, 5 min after initiation of CPB ,5 min before and 30 min, 1 h, 2 h and 24 h after declamping of aorta respectively for determinations of creatine kinase MB(CK MB), interleukin 8(IL 8) and tumor necrosis factor alpha(TNF?) Myocardial tissuses were obtained from right atrium before cross clamping of aorta, before and 15 min after declamping of aorta for determinations of water content,Ca 2+ content and ultrastructure examination of myocardium Results After declamping plasma concentrations of CK MB and IL 8 significantly increased in all groups as compared to the values before declamping (P

0. 5mV or change in color of myocardium in the ischemic area. Blood samples were taken from right atrium for determination of plasma levels of TXB2 and 6-keto-PGFla before epidural block (T0), 40 min after occlusion of coronary artery(T1 ) and 1, 3 and 5 h after reperfusion was started(T2-4 ) . Results There was no significant changes in MAP, HR and CVP in group Ⅱ while in group Ⅰ MAP decreased by 22%, HR 25% and CVP 28% after epidural block as compared with the baseline at T0 . TXB2 levels and TXB2/6-keto-PGF1a ratio increased gradually and significantly from T2-4 as compared with the baseline (T0) and those at T1 in both groups. TXB2 levels and TXB2/6-keto-PGF1a ratio were higher in group Ⅱ those in group 1111111 at T1-4 (P

0.5 mV and change in color of myocardium. Blood samples were taken from right atrium for determination of plasma SOD activity and plasma MDA level and from coronary sinus and artery for determination of blood lactate level before occlusion of LAD ( T0 ) , before reperfusion (T1),1,2,3,4,5,6 h after reperfusion (T2-7 ) . Myocardial lactate production was calculated from the difference between coronary sinus and arterial blood lactate concentrations. Results ( 1) In HTEA group HR, MAP and CVP decreased by 22% , 25% and 28% after epidural blockade, while in control group there was no significant change after epidural saline. (2) In HTEA group plasma SOD activity started increasing at T6 and blood MDA level decreased at T4 and T5, whereas in control group blood SOD activity started decreasing and blood MDA level started increasing at T3 . (3) Myocardium released no lactate before ischemia. Myocardial lactate release greatly increased during ischemia and started decreasing after reperfusion in both groups. But myocardial lactate production was significantly less in HTEA group than that in control group. (4) One animal died from ventricular fibrillation at the beginning of reperfusion in HTEA group while in control group four animals died. Conclusion HTEA can alleviate the myocardial ischemia-reperfusion injyry by blocking sympathetic nervous activity.

Objective To determine 2, 3, 4, 5, 6-pentafluorobenzyl monofluoroacetate (PFB-MFA) as the derivative of monofluoroacetate anion ion by gas chromatography, by which fluoroacetamide, one of the raticides may be analyzed. Methods The calibration curve and limit of detection were obtained by quantification of standardized PFB-MFA using GC/ECD and GC/MS. Results The linear ranges for PFB-MFA were 0.01～0.1ng/?for GC/ECD,1～100ng/?l for GC/MS SCAN and 5?10~(-3)～1 ng/?l for GC/MS SIM. The limit of detections for fluoroacetate anoin were 1.31?10~(-4)ng/?l for GC/ECD, 0.13 ng/?l for GC/MS SCAN, and 1.76?10~(-4) ng/?l for GC/MS SIM. Conclusion The monofluoroacetate anion derivative (MFAPFB) can be deterimined accurately with high sensitivity by GC/ECD and GC/MS SIM, which may be used for analysis of fluoroacetamide in forensic practice.

A total of 6004 cases of acute poisoning with 532 kinds of related poisons from 63hospitals were analyzed.According to the classification of pharmaceutical,pesticide,chemical,animal,plant and other poisons,the numbers of poison categories were 217,148,61,34,36 and 36 kinds accounting for 40.8％,27.8％,11.5％,6.4％,6.8％,6.7％ of total number of poisons respectively.According to the case count,they were divided into three groups of low,medium and high morbidity and their poison numbers were 462,59 and 11 kinds accounting for 86.8％,11.1％,2.1％ of total number of poisons respectively.According to the types of poisons,they were divided into five groups of poisoning 1,2,3,4,5 years and their poison numbers were 320,91,34,33 and 54 kinds accounting for 60.2％,17.1％,6.4％,6.2％,10.1％ of total number of poisons respectively.According to the time of poisoning,they were divided into three groups of 1-year,discontinuous and perennial poisoning and their poison numbers were 320,158 and 54 kinds accounting for 60.2％,29.7％,10.1％ of total number of poisons respectively.

Objective To investigate the effect of sevoflurane preconditioning-postconditioning on thromboxane A2 and prostaglandin I2 during myocardial ischemia-reperfusion (I/R) in rats. Methods Fifty healthy male Wistar rats weighing 250-280 g were randomly divided into 5 groups (n = 10 each) : sham operation group (group S) , I/R group, sevoflurane preconditioning group (group Spr), sevoflurane postconditioning group (group Spo)and combination of sevoflurane preconditioning and postconditioning group (group Spr + po). Myocardial I/R was produced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 2 h reperfusion in anesthetized rats. In group S the anterior descending branch was only exposed but not ligated. Group Spr received 15 min inhalation of 2.5 % sevoflurane and 15 min wash-out 30 min before ischemia. Group Spo received 5 min inhalation of 2.5% sevoflurane 1 min before reperfusion. Arterial blood samples were taken at 2 h of reperfusion for determination of the levels of MB isoenzyme of creatine kinase (CK-MB) , lactate dehydrogenase (LDH) , cardiac troponin I (cTnI), thromboxane B2(TXB2), and 6-keto-prostaglandin (6-keto-PGF1α) and platelet maximum aggregation rate. TXB2/6-keto-PGF1α ratio was calculated. The myocardial tissues were taken for microscopic examination. Mitochondria] injury was assessed by using Flameng score and stereology (Specific surface, δ and Numerical density on area, NA) .Results Compared with group S, the levels of CK-MB, LDH, cTnI, TXE2 and 6-ketoPGF1α, TXB2/6-keto-PGF1α ratio, platelet maximum aggregation rate and Flameng score were significantly increased, while δ and NA were significantly decreased in group I/R (P < 0.05 or 0.01) . The levels of CK-MB,LDH and cTnI, TXB2/6-keto-PGF1α ratio and Flameng score were significantly lower, and 6-keto-PGF1α level, δand NA were significantly higher in Spr and Spo groups than in group I/R ( P < 0.05 or 0.01) . The levels of CKMB, LDH, cTnI and TXB2 , TXB2/6-keto-PGF1α ratio, platelet maximum aggregation rate and Flameng score were significantly lower and 6-keto-PGF1α level,δ and NA were significantly higher in group Spr + po than in Spr and Spo groups(P < 0.05). Conclusion Sevoflurane preconditioning-postconditioning can reduce myocardial I/R injury through inhibiting the release of thromboxane A2 and promoting the release of prostaglandin I2 in rats.

Objective To investigate the role of acid-sensing ion channels (ASICs) in global cerebral ischemia-reperfusion (I/R) injury in rats. Methods Forty-eight adult male Sprague-Dawley rats weighing 250-310 g were randomly divided into 4 groups ( n = 12 each): sham operation group (group S); global cerebral I/R group (group I/R); normal saline group (group NS) and specific ASIC blocker amiloride group (group A). Global cerebral I/R was produced by occlusion of 3 vessels ( 10 min occlusion of the bilateral common carotid arteries and basilar artery) followed by reperfusion. In group NS and A, NS 6 ml/kg and amiloride 0.6 mg/kg were injected through femoral vein immediately before reperfusion respectively. Six rats in each group were selected, the dialysate in CA1 area was collected before ischemia (baseline), immediately after ischemia and during 20 min reperfusion (once every 10 min) for determination of lactate concentrations. The left 6 rats in each group were elected at 8 h of reperfusion and the open field test and inclined plane test were peeformed to assess neurological behavior.The rats were then sacrificed and brain tissues taken for microscopic examination and brain water content was calculated. Results Compared with group S, the concentration of lactate in the dialysate and brain water content were significantly increased and neurological deficits developed in group I/R and NS (P ＜ 0.05). Compared with group I/R, the concentration of lactate in the dialysate and brain water content were significantly decreased and neurological deficits were improved in group A ( P ＜ 0.05 ), but no significant change in the parameters mentioned above was found in group NS ( P ＞ 0.05). Microscopic examination showed that the damage to the brain tissues was attenuated in group A compared with group I/R. Conclusion ASICs are involved in the development of global cerebral I/R injury in rats.

OBJECTIVE:To compare anesthesia effects of 3 anesthesia methods,to investigate anesthesia improvement method for bronch fiber oscope. METHODS:315 patients undergoing bronch fiber oscope were randomly divided into group A(106 cas-es),group B(104 cases)and group C(105 cases). Group A was treated with traditional bronch fiber oscope lidocaine atomization local anesthesia,group B was treated with modified bronch fiber oscope pethidine combined with lidocaine atomization local anes-thesia and group C was treated with three-limb tube connected with laryngeal mask and target-controlled propofol and remifentanil general anesthesia. SaO2,SBP,DBP,heart rate,breathing rate,excellent anesthesia rate,compliance rate,the rate of bodymove-ment and choking,pain recalling rate were compared among 3 groups before and during examination,and ADR was observed. RE-SULTS:Compared with before examination,SaO2 of group A was decreased significantly during examination,with statistical sig-nificance(P<0.05);that of group B and C had no obvious change before and during examination. Blood pressure,heart rate and breathing rate of 3 groups had no obvious change before and during examination. The excellent anesthesia rate and compliance rate of group A were significantly lower than those of group B and C,but the rate of bodymovement cough and pain recalling rate were significantly higher than group B and C,with statistical significantly(P<0.05). The excellent anesthesia rate and compliance rate of group B were significantly lower than those of group C,but the rate of bodymovement cough and pain recalling rate were signifi-cantly higher than group C,with statistical significance (P<0.05). No ADR was found in 3 groups. CONCLUSIONS:Modified bronchoscope atomization local anesthesia and modified painless bronchoscope are better than traditional bronch fiber oscope atomi-zation local anesthesia in anesthesia effect,safety,degree of comfort and acceptability. Modified bronchoscope atomization local an-esthesia was best but most expensive,so these methods can be chosen according to patient’s condition.

Hepatic myelopathy is one of special category changes of nervous system,which was secondary to the end-stage hepatic diseases and is a syndrome of myeleterosis.It usually occurred after portosystemic shunt surgery or collateral circulation of portosystemic vein.The prognosis of hepatic myelopathy is poor,and the progression of this disease is slow.Surgical approaches such as dissociation of colon and anastomosis of ileum and rectum aimed at reducing the absorption of toxic substance and thus to breakdown the blood ammonia and improve the symptoms of nervous system,but the effects are not satisfactory.The clinical data of 1 patient with hepatic myelopathy who received liver transplantation at the Second Affiliated Hospital of Dalian Medical University in April 2012 were retrospectively analyzed.The clinical symptoms and physical signs were improved,and muscle strength was effectively recovered in the patient.Liver transplantation might be an effective method for the treatment of hepatic myelopathy.

Objective To investigate the role of PI3-kinase-Akt-endothelial nitric oxide synthase (PI3KAkt-eNOS) signaling pathway in the attenuation of myocardial ischemia-reperfusion (I/R) injury by sevoflurane postconditioning in rats.Methods Fifty healthy male Wistar rats weighing 250-280 g aged 2-3 months were randomly divided into 5 groups ( n =10 each):sham operation group (group S),I/R group,sevoflurane postconditioning group (group Spo),sevoflurane postconditioning + dimethyl sulfoxide (DMSO) group (group Spo + D),and sevoflurane postconditioning + LY294002 (a specific PI3K inhibitor) group (group Spo+ L).I/R was produced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 120 min reperfusion in anesthetized rats.In group Spo,sevoflurane was inhaled for 5 min after the end-tidal concentration reached 2.5％-3.0％ at 1 min before reperfusion.In group Spo + L,LY294002 0.3 mg/kg in 0.02％ DMSO was injected intravenously at 5 min before reperfusion,and then sevoflurane postconditioning was performed.In group Spo + D,0.02％ DMSO equal to the volume of LY294002 was injected intravenously at 5 min before reperfusion,and then sevoflurane postconditioning was performed.Arterial blood samples were taken at 120 min of reperfusion for determination of the levels of creatine kinase isoenzyme MB (CK-MB),lactate dehydrogenase (LDH) and cardiac Troponin Ⅰ (cTnI).The myocardial infarct size (IS) and area at risk (AAR) were measured and IS/AAR ratio was calculated.The rats were sacrificed at 120 min of reperfusion and the myocardial tissues in the area at risk were taken for determination of the expression of Akt,phosphorylated Akt (p-Akt),eNOS and phosphorylated eNOS (peNOS) by Western blot.The ratios of p-Akt/Akt and p-eNOS/eNOS were calculated.Results Compared with group S,the levels of CK-MB,LDH and cTnI,IS/AAR ratio,p-Akt/Akt ratio and p-eNOS/eNOS ratio were significantly increased in the other groups ( P ＜ 0.05 or 0.01 ).Compared with group I/R,no significant change was found in the parameters mentioned above in group Spo+ L (P ＞ 0.05),and the levels of CK-MB,LDH and cTnI and IS/AAR ratio were significantly decreased,and the ratios of p-Akt/Akt and p-eNOS/eNOS were significantly increased in groups Spo and Spo + D ( P ＜ 0.05 or 0.01 ).There was no significant difference in the parameters mentioned above between group Spo and group Spo + D (P ＞ 0.05).Conclusion PI3K-Akt-eNOS signaling pathway mediates the attenuation of myocardial I/R injury by sevoflurane postconditioning in rats.