Objective To evaluate the effects of different rates of remifentanil infusion on cardiovascular response to tracheal intubation in older patients. Methods Thirty ASA Ⅰ-Ⅲ patients aged 65-75 yrs weighing 50-80 kg scheduled for elective abdominal operation were randomly divided into 3 groups (n = 10 each) according to the remifentanil infusion rate: group A 0.05 ?g?kg-1?min-1; group B 0.1 ?g?kg-1?min-1 and group C 0.15 ?g ?kg-1?min-1. The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg. Radial artery and subclavian vein were cannulated for BP and CVP monitoring and blood sampling. ECG, BP, HR and SpO2 were monitored during anesthesia. After 10 min stabilization induction of anesthesia was commenced with remifentanil infusion for 10 min. Midazolam 0.1 mg?kg-1 was then given Ⅳ. Succinylcholine 1.5 mg?kg-1 was given to facilitate intubation after the patients lost consciousness. BP and HR were recorded immediately before induction of anesthesia (T0, baseline), immediately after intubation (T1 ) and at 2, 5 and 10 min after intubation (T2 ,T3 ,T4 ) . Cardiovascular intubation response was defined as increase in SP or HR by 15% of the baseline value within 2 min after intubation. Blood samples were taken at T0-4 for determination of plasma concentration of norepinephrine (NE) and epinephrine (E) by HPLC. Side effects such as chest wall rigidity and hypotension were also recorded. Results The cardiovascular intubation response rate was significantly higher in group A (80%) than in group B (10% ) and C (10% ) . The incidence of side effects was significantly higher in group C (70% ) than in group B (20%) and A. Plasma NE and E concentrations were significantly increased after intubation in group A (at T2-4) and B (at T2,3) as compared with baseline values at T0; while in group C only plasma NE concentration was significantly increased at T2 and T3 and there was no significant change in plasma E concentration after intubation. The plasma NE and E concentrations were significantly higher in group A (T2-4) and B (T2,3) than in group C. Conclusion The appropriate infusion rate of remifentanil for tracheal intubation is 0.10 ?g?kg-1 ?min-1 in older patients.

Whether transforming growth factor-beta2 (TGF-beta2) induces apoptosis of human trabecular meshwork cells was investigated in vitro. Cultured 3-5 passage human trabecular meshwork cells were treated with 0 (control), 0.32, 1, 3.2 ng/ml TGF-beta2 for 48 h and divided into control group and experimental group. The apoptosis of human trabecular meshwork cells was examined by transmission electron microscopy, TUNEL technique and flow cytometry. The results showed characteristic morphologic changes of apoptotic cells were observed under transmission electron microscopy. DNA fragmentation of human trabecular meshwork cells was found by TUNEL technique. Quantitative analysis of flow cytometry showed that percentages of apoptotic human trabecular meshwork cells were (2.79 +/- 0.44)%, (4.43 +/- 1.17)% and (9.60 +/- 2.05)% respectively with different concentrations [1 ng/ml (P<0.05), 3.2 ng/ml (P<0.01)] of TGF-beta2 with the difference being significant between experimental group and control group [(1.41 +/- 0.34)%]. It was concluded that TGF-beta2 can induce apoptosis of human trabecular meshwork cells in vitro and may be involved in the decrease of trabecular meshwork cells in the patients with primary open angle glaucoma and aging of normal people.
Apoptosis/*drug effects ; Cells, Cultured ; Trabecular Meshwork/*cytology ; Transforming Growth Factor beta/*pharmacology ; Transforming Growth Factor beta2

To explore the effect of coriaria lactone (CL)-activated astrocyte-conditioned medium on the cerebral TNF-alpha of normal rats, the CL-activated astrocyte-conditioned medium (ACM) was injected into the lateral ventricle of SD rats. The rats were observed for behavioral changes, and the changes of the expression of TNF-alpha in the cerebral cortex and hippocampus were immunohistochemically examined by employing SP method. TNF-alpha level was assessed by means of radioimmunoassay in homogenate of cerebral cortex and hippocampus as well as cerebrospinal fluid. Seizure episodes were observed in ACM group 30 min after the ACM injection, but they were not observed in the control group. Immunohistochemical detection showed that the immunoreaction of TNF-alpha in hippocampus and cerebral cortex of rats were stronger than that of the control group 4 h after the ACM injection (P<0. 05). In this group, the concentrations of TNF-alpha in homogenate of cerebral cortex and hippocampus and cerebrospinal fluid were higher than those of the control group (P<0.05). It is suggested that the ACM activated by CL can enhance the expression of TNF-alpha in normal rats, and is related to epileptogenesis.

Whether cultured bovine trabecular meshwork cells and trabecular tissue ex vivo express insulin-like growth factor-I (IGF-I) messenger RNA (mRNA) and protein was investigated. Total RNA of cultured bovine trabecular meshwork cells as well as trabecular meshwork tissue freshly excised from bovine eyes was extracted, and reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect IGF-I mRNA. RT-PCR product was verified by sequencing. Immunohistochemical stain was used to detect IGF-I protein. The results showed that a single PCR amplified product was obtained, and the sequence was homologous to the known sequence.. IGF-I immunostain was positive in the cytoplasm of trabecular meshwork cells. It was concluded that trabecular meshwork cells produce IGF-I and contribute to the presence of IGF-I in trabecular meshwork microenvironment as well as aqueous humor. Trabecular meshwork cells were affected by IGF-I not only through paracrine, but also autocrine action. Whether abnormal down-regulations in IGF-I production may contribute to the pathogenesis of primary open-angle glaucoma and the possibility of promoting the autocrine action of IGF-I by trabecular meshwork cells to treat the disease is worth further investigation.
Cells, Cultured ; Cloning, Molecular ; Glaucoma, Open-Angle/etiology ; Glaucoma, Open-Angle/metabolism ; Insulin-Like Growth Factor I/biosynthesis ; Insulin-Like Growth Factor I/*genetics ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, DNA ; Trabecular Meshwork/cytology ; Trabecular Meshwork/*metabolism

Objective To investigate the expression of eukaryotic initiation factor 4E(eIF4E) ,vascular endothelial growth factor (VEGF)‐A and VEGF‐C in gastric cancer tissues and their correlation with invasion and metastasis of gastric carcinoma .Methods The expressions of eIF4E ,VEGF‐A and VEGF‐C were detected in tissues of 58 gastric carcinomas and 25 normal gastric mucosa by using immunohistochemical method .Results The positive rate of eIF4E、VEGF‐A and VEGF‐C protein expression were 89 .7%(52/58) ,65 .5% (38/58) ,60 .3% (35/58) in gastric carcinoma ,which were higher than those in normal gastric mucosa tissues which were 4 .0% (1/25) ,12 .0% (3/25) ,8 .0% (2/25) respectively .Expressions of eIF4E ,VEGF‐A and VEGF‐C were significantly correlated with the depth of invasion and lymph node metastasis(P<0 .05) ,but not with the age ,sex of patients(P>0 .05) .Ex‐pressions of eIF4E and VEGF‐C were significantly correlated with tumor differentiation .The expression of eIF4E was being found positively correlated with VEGF‐A and VEGF‐C .Conclusion eIF4E may play certain roles in the oncogenesis and progression of gastric carcinoma .VEGF‐A and VEGF‐C may be helpful in lymph metastasis .Combined detection of eIF4E ,VEGF‐A and VEGF‐C may be helpful to assess the malignant degree and prognosis of gastric carcinoma .

Objective To evaluate the effect of dexmedetomidine on cognitive dysfunction after thoracic surgery in patients undergoing one-lung ventilation.Methods Sixty-two patients,aged 45-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index ranged from 17.5 to 25.5 kg/m2,scheduled for elective thoracic surgery,were randomly allocated into 2 groups (n =31 each) using a random number table:dexmedetomidine group (Dex group) and control group (C group).Dexmedetomidine 0.5 μg/kg was infused for 10 min starting from the time point before induction of anesthesia,followed by continuous infusion at a rate of 0.5 μg · kg-1 · h-1 until 30 min before the end of surgery in Dex group.The equal volume of normal saline was administered instead in group C.Before induction and at 24,48 and 72 h after surgery,venous blood samples were collected for determination of levels of S-100 beta protein and neuronspecific enolase in serum by ELISA.Cognitive function was assessed by Mini-Mental State Examination at 72 h after surgery.Results The levels of S-100 beta protein and neuron-specific enolase in serum were significantly increased after surgery than before induction in the two groups.Compared to C group,the levels of S-100 beta protein and neuron-specific enolase in serum were significantly decreased after surgery,and the incidence of postoperative cognitive dysfunction was decreased in Dex group (26％ vs 6％).Conclusion Dexmedetomidine can effectively reduce the nerve damage during one-lung ventilation and significantly inhibit the development of postoperative cognitive dysfunction in patients undergoing thoracic surgery,indicating that dexmedetomidine is suitable for thoracic surgery.

Objective To observe the clinical efficacy of acupoint thread embedding on the peripheral serum leptin and insulin levels in simple obesity patients, and to further explore the mechanism of acupoint thread embedding in treating simple obesity.Method A total of 120 patients with simple obesity were randomized into a control group, an eletroacupuncture (EA) group and a thread embedding group, 40 cases in each group. The control group was intervened by diet plus exercise intervention, the EA group by EA treatment in addition to the intervention given to the control group and the thread embedding group by acupoint thread embedding treatment in addition to the intervention given to the control group. The levels of blood serum leptin and insulin in the three groups were observed before and after 2 treatment courses and the clinical efficacies were compared among the three groups.Result The total effective rate was 87.5% in the thread embedding group, 85.0% in the EA group, and 47.5% in the control group. The total effective rates in the thread embedding group and EA group were significantly different from the rate in the control group (P<0.05). The levels of the fasting serum leptin and insulin were significantly changed in the thread embedding group and EA group after the treatment (P<0.01). After the treatment, the levels of the fasting serum leptin and insulin in the thread embedding group and EA group were significantly different from those in the control group (P<0.01,P<0.05). The insulin level in the thread embedding group was better than that in the EA group, and the difference was statistically significant (P<0.05).Conclusion Acupoint thread embedding is an effective approach for simple obesity, and it can down-regulate the fasting peripheral serum leptin and insulin levels.

Objective To explore the effects of astrocytes on the N-ethylmaleimide-sensitive fusion protin,(NSF) and AMPA receptor of the neurons as well as their function in epileptogenesis. Methods ACM was injected into lateral ventricle of SD rats and the behaviour changes were observed; Immunohistochemical method was used to assess the changes of the expression of NSF in the cerebral cortex and hippocampus; The cultured neurons were divided into control group, ACM group and CNQX+ACM group at random, immunocytochemistry was used to assess the changes of the expression of NSF, Western blotting was used to assess the changes of the content of NSF of the cultured neurons. Results Seizure was observed in ACM group 30 min after injecting ACM. the immunoreaction of NSF in hippocampus and cerebral cortex of rats were depressed than those of the control group 2h, 4h after injecting ACM (P

Objective To evaluate the changes in mRNA expressions of Toll-like receptor 4 (TLR4) and its down-stream cytokines IL-1β,IL-6 and TNF-a in incisional tissues from a rat with postoperative pain.Methods Incisional pain was induced in 74 male adult SD rats weighing 200-250 g.Paw mechanical withdrawal threshold (PMWT) around the wound on the operated and nonoperated sides was measured at 1 day before operation and at 0.5,1,2,6 and 12 hours as well as 1,2,3,5 and 7 days after operation.Skin incisional tissues were removed for determination of mRNA expressions of TLR4,IL-1β,IL-6 and TNF-a using real-time quantitative PCR at 1 day before operation and at 2 and 8 hours as well as 1,2,3,5 and 7 days after operation.Results Compared with the baseline value before operation,PMWT on the operated side was significantly decreased at 0.5 hours-5 days after operation,mRNA expression of TLR4 around the wounds on the operated side was down-regulated at 2 hours after operation followed by a gradual increase,mRNA expressions of IL-1β,IL-6 and TNF-α on the operative side were up-regulated at 2 and 8 hours as well as 1,2,3 and 5 days after operation (P ＜ 0.05),but no significant changes were found in PMWT and mRNA expressions of TLR4,IL-1β,IL-6 and TNF-α on the non-operated side(P ＞ 0.05).PMWT on the operated side was lowest at 6 hours after operation followed by the gradual increase,mRNA expression of TLR4 on the operated side peaked at 2 days after operation,and mRNA expressions of IL-1β,IL-6 and TNF-a respectively peaked at 2 hours,1 day and 3 days after operation (P ＜ 0.05).mRNA expressions of TLR4,IL-1β,IL-6 and TNF-a were negatively correlated with PMWT on the operative side (r =-0.501,-0.743,-0.893,-0.657,P ＜ 0.05),and mRNA expressions of IL-1 β,IL-6 and TNF-a were positively correlated with the level of TLR4 mRNA(r=0.764,0.283,0.667,P＜0.05).Conclusion mRNA expressions of TLR4 and its down-stream cytokines IL-1 β,IL-6 and TNF-a in skin incisional tissues are up-regulated,which may be involved in the development and maintenance of postoperative pain.

Objective To evaluate the reliability of autologous blood withdrawal during cesarean section. Methods Fifteen patients preoperatively diagnosed with pernicious placenta previa and∕or accrete by using ultrasound and magnetic resonance imaging, aged 20-35 yr, weighing 55-75 kg, at≥36 weeks of gestation, were enrolled in the study. Blood containing amniotic fluid from the surgical field was collected, and the washed blood was processed using cell?salvage machine and then filtered using a leukocyte depletion filter during cesarean section. The 20 ml blood samples collected included maternal central venous blood after delivery of fetus, unwashed blood, washed blood and filtered blood. The fetal squamous cells were counted using papanicolaou staining. The concentrations of a?fetoprotein, tissue factor, endothelin?1 and histamine were measured by enzyme linked immunosorbent assay. The fetal red blood cells were counted using the acid elution method and HE staining. Results Compared with unwashed samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count, concentrations of a?fetoprotein and endothelial?1, and fetal red blood cells were decreased in the washed samples. Compared with washed samples, the fetal squamous cell count, concentrations of a?fetoprotein and fetal red blood cells were significantly decreased in filtered samples. Compared with maternal venous blood samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count and concentrations of a?fetoprotein and endothelial?1 were decreased in filtered samples. Conclusion Autologous blood withdrawn during cesarean section can be used for reinfusion in cesarean section.