Objective To investigate the effect of Shenfu injection (SFI) on hypoxia and reoxygenation (H/R)-induced apoptosis and the expression of Bcl-2 and Caspase-3 in cultured neonatal rat cardiomyocytes and to explore the possible molecular protective mechanisms of SFI from hypoxia and reoxygenation injury in cardiacmy-ocytes in vitro. Method The experiment was performed in Research Center for Cardiovascular Regenerative Medicine, Cardiovascular Institute and Fuwai Hospital in Beijing. Ventricular myocytes from the hearts of neonatal Sprague-Dawley rats (1- to 2-day old) were cultured. The model of hypoxia and reoxygenation injury was devel-oped in primary cultured neonatal rat cardiacmyocytes. The cultured cells were randomly divided into four groups: (1) Control group (Con group), without any treatment; (2) Hypoxia and Reoxygenation group (H/R group),4 h hypoxia followed by 16 h reoxygenation; (3) Low-dose SFI group (L-SFI group),cardiacmyocytes were pretreated with a low dose (50 μL/mL) of SFI for 30 min followed by H/R; (4) High-dose SFI group (H-SFI group),car-diacmyocytes were pretreated with a high dose (100 μL/mL) of SFI for 30 min followed by H/R. Apoptosis was quantified by fluoreacence-activated cell sorter (FACS) analysis after staining with Fluorescein isothiocyanate (FITC)-labled Annexin-V (Annexin V-FITC) and propidine iodide (PI). The expressions of Bcl-2 and Caspase-3 were detected by ECL-Western blot analysis. All data are expressed as mean±S.E.M. One-way analysis of vari-ance (ANOVA) was performed followed by Student-Newman-Keul test using SSPS 11.5 software. A p value less than 0.05 were considered as statistically significant. Results The results of FACS analysis indicated that the rate of different apoptotic process in cardiomyocytes was significantly increased after H/R, while after SFI treatment the occurrence of cell apoptosis induced by H/R was decreased significantly. The results of ECL-Western blot analysis showed that cells' exposure to H/R induced proteolytic cleavage of caspases,as revealed by the appearance of the characteristic fragment at 17 000 of Caspase-3 and this proteolytic activation was nearly completed with difference concentration SFI incubation. The anti-apoptotic protein Bcl-2 in cardiomyocytes was decreased after H/R insult and was increased in cells with SFI pretreatment. Conclusions SFI has protective effects on cardiacmyocytes a-gainst apoptosis that could be induced by H/R injury, the mechanisms of which probably involve the inhibition of down-regulation of Bcl-2 protein level and sequential activation of Caspase-3.

Objective To investigate the effects of adenosine postconditioning (AP) on serum IL-10 and TNF-α concentrations following myocardial ischemia-reperfusion(VR)in rats.Methods Twenty-four SD ratsweighing 180-250 g were randomly divided into 4 groups(n=6 each):group I sham operation (group S);group Ⅱ myocardial I/R;group Ⅲ ischemic postconditioning(group IP)and group Ⅳ AP.Myocardial I/R was induced by 30 rain occlusion of anterior descending branch of left coronary artery followed by 120 min reperfnsion.IP was induced by 3 cycles of 30 s myocardial ischemia followed by 30 s reperfusion at the end of ischemia.In AP group adenosine 1.5 mg/kg was infused at 40μg·kg-1·min-1 before the onset of reperfusion.SP,DP and HR were recorded before ischemia (baseline) at 30 min of ischemia and 30 and 120 min of reperfusion.Arterial bloodsarnples were collected at 120 min of repednsion for determination of serum TNF-α and IL-10 concentrations.Theanimals were then killed.Their hearts were removed for microscopic examination.Myocardial infarct size wasmeasured and myocardial MDA content was determined.Results BP and HR were signilicandy decreased duringreperfusion while myocardial infarct size.MDA content and serum concentrations of IL-10 and TNF-α weresignificantly increased in I/R group compared with group S.Ischemic and adenosine postconditioning significantlyattenuated hypotension,reduced infarct size,myocardial MDA content and serum TNF-α concentration and increased serum IL-10 concentration in group AP and IP as compared with I/R group.There was no significant difference in the above changes between group AP and IP. Myocardial injury was ameliorated in group AP and IP as compared with I/R group. Conclusion Adenosine postconditioning can protect myocardium from I/R injury by increasing IL-10 production and inhibiting TNF-a release.

Objective To evaluate the role of the complement 1 q (C1 q) in hepatic ischemia-reperfusion (I/R) injury in rats.Methods Sixty healthy male Sprague-Dawley rats,aged 3-4 months,weighing 180-200 g,were randomized into 2 groups:sham operation group (S group,n =12) and hepatic I/R group (I/R group,n =48).Hepatic specimens were obtained at 1,3,6 and 24 h of reperfusion and were then cut and stained with haematoxylin and eosin for examination of histological changes of the liver (with light microscope) and for determination of superoxide dismutase (SOD) activity and malondialdehyde (MDA) content (by colorimetric method),expression of Clq mRNA (using real-time PCR) and expression of Clq (by using Western blot).Results Compared with S group,the activity of SOD was gradually decreased,the content of MDA was gradually increased,and the expression of Clq and Clq mRNA was gradually up-regulated and peaked at 3 h of reperfusion with the prolongation of reperfusion time in I/R group (P ＜ 0.05).The pathological changes of the liver were aggravated with the prolongation of reperfusion time in I/R group.Conclusion Activation of C1 q is involved in hepatic I/R injury in rats.

Objective To investigate the effect of integrin β4 expression on the metastasis potential of human thyroid follicular cancer cells. Methods Metastasis potential was observed and grouped in human thyroid follicular cancer cell line, CGTHW-1 cells, depending on the cells' penetrating ability in artificial matrigel. The expression of integrin β4 mRNA and protein were determined by immunocytochemistry, Western blot, and semiquantitative RT-PCR. Results The mRNA and protein expressions of integrin β4 were significantly higher in cells with high metastasis potential [0.277 5 ±0.034 0 vs 0. 187 5 ±0.022 2 ( Immunohistochemistry ), 0. 099 7 ± 0.0185 vs 0.039 0±0.010 2(Western blot), 0.555 0±0. 101 2 vs 0.270 0±0.029 9(RT-PCR), all P＜0.01]. Conclusion Integrin β4 may play an important role in human thyroid cancer invasion. It seems probably to be a potential target for human thyroid cancer treatment.

Objective To investigate the effect of different doses of dexmedetomidine (DEX) on myocardial ischemia-reperfusion injury (MIRI) in rats.Methods Seventy-five SD male rats weighing between 250 and 300g were divided into sham group,MIRI group,small-dose DEX group,medium-dose DEX group and high-dose group according to the random number table,with 15 rats per group.Threading the left anterior descending coronary artery was done only in sham group,but the MIRI model was produced in the rest groups by ligation of the artery for 30 minutes followed by 120 minutes of reperfusion.Fifteen minutes before the ligation,small-,medium-and high-dose DEX groups were injected 2.5,5 and 10 μg · kg-1 · h-1 of DEX respectively until the end of reperfusion.Instead,an equal volume of normal saline was given in sham and MIRI groups.At the end of reperfusion,five rats in each group were used to determine the myocardial infarct size,and arterial blood samples and myocardial tissues from ten rats in each group were used to measure serum levels of interleukin-1β (IL-β) and serum tumor necrosis factor-α (TNF-α),expression of myocardial nuclear factor kappa B p65 (NF-κB p65) and change of myocardial pathomorphology.Results Myocardial infract size,degree of myocardial pathomorphology structure damage,serum levels of IL-1 β and TNF-αt and expression of myocardial NF-κB p65 in sham group were significantly lower in sham group than other groups (P ＜ 0.05).Above mentioned parameters in small-,medium-and high-dose DEX groups were all significantly decreased compared to MIRI group (P ＜ 0.05),and the decrease was most significant in medium-dose DEX group (P ＜ 0.05).Conclusions DEX can attenuate the MIRI in rats and the possible mechanism is suppressing the release of NF-κB p65,which can reduce serum pro-inflammatory cytokines like TNF-α and IL-1β.And mediumdose DEX exhibits better protective effect.

Objective To evaluate the efficacy of adductor canal block combined with infiltration anesthesia for postoperative analgesia in the patients undergoing total knee arthroplasty. Methods Sixty pa?tients of both sexes, aged 65-80 yr, weighing 40-80 kg, of American Society of Anesthesiologists physi?cal statusⅠ or Ⅱ, scheduled for elective unilateral total knee arthroplasty, were divided into 3 groups ( n=20 each) using a random number table: single?injection adductor canal block + infiltration anesthesia group ( group A) , single?injection femoral nerve block+infiltration anesthesia group ( group F) , and infil?tration anesthesia group ( group I) . Ultrasound?guided adductor canal block and femoral nerve block were performed with 0.5% ropivacaine 20 ml before induction of anesthesia in A and F groups, respectively. Af?ter completion of the block, all the patients were ventilated through the laryngeal mask airway under general anesthesia. After installation of the knee prosthesis, local infiltration anesthesia was conducted with 0.2%ropivacaine 50 ml around the knee joint. Acetaminophen oxycodone capsule was taken orally one pill every 6 h starting from the morning on 1st day after surgery. When visual analogue scale ( VAS) score > 5, tram?adol 100 mg was injected intramuscularly as rescue analgesic. At 4, 8, 24, 48 and 72 h after surgery, VAS scores at rest and during activity were recorded, the quadriceps strength was measured, and the re?quirement for analgesic drugs and development of adverse reactions were recorded. Results Compared with
group I, VAS scores at rest and during activity were significantly decreased at 4, 8, and 24 h after surger?y, and the consumption of tramadol was significantly decreased after surgery in A and F groups ( P<0.05) . The quadriceps strength at 4 and 8 h after surgery was significantly higher in A and I groups than in group F ( P<0.05) . No patients developed serious adverse reactions in the three groups. Conclusion Adductor ca?nal block combined with infiltration anesthesia provides reliable efficacy for postoperative analgesia with little influence on the quadriceps strength in the patients undergoing total knee arthroplasty.

Objective To evaluate the efficacy of different doses of dexmedetomidine for prevention of postoperative cognitive dysfunction (POCD) in the elderly patients undergoing hyperthermic intraperitoneal chemotherapy.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged over 65 yr,weighing 50-70kg,undergoing elective hyperthermic intraperitoneal chemotherapy,were equally and randomly assigned into 4 groups using a random number table:control group (group C),different doses of dexmedetomidine groups (groups D1-D3).In D1-3 groups,a loading dose of dexmedetomidine 0.2,0.4 and 0.8 μg/kg was infused over 30 min before induction of anesthesia,respectively,followed by infusion at a rate of 0.5 μg· kg-1 · h-1 until the end of surgery,while the equal volume of normal saline was given in group C.After induction of anesthesia,the patients were endotracheally intubated and mechanically ventilated.Venous blood samples were collected at 30 min before induction of anesthesia (T0),immediately after intubation (T1),at 0 and 1 h after skin incision (T2,3),at 1 min after abdomen closure (T4) and immediately after onset of extubation (T5) for determination of serum concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) by ELISA.The development of POCD was recorded within 7 days after surgery.Results Compared with group C,the serum concentrations of TNF-α and IL6 and incidence of POCD were significantly decreased in D1-D3 groups (P ＜ 0.05).Conclusion Dexmedetomidine pretreatment can decrease the development of POCD in elderly patients undergoing hyperthermic intraperitoneal chemotherapy and inhibition of inflammatory responses may be involved in the mechanism.

Objective To evaluate the effect of quercetin pretreatment on the permeability of blood-brain barrier in a rat model of global cerebral ischemia-reperfusion ( I∕R). Methods Sixty-three clean-grade healthy male Sprague-Dawley rats, weighing 300-350 g, aged 4-5 months, were divided into 3 groups (n＝21 each) using a random number table method: sham operation group ( group S), group I∕R and quercetin pretreatment group ( group Q). Global cerebral I∕R was induced by occlusion of bilateral common carotid arteries combined with hypotension ( mean arterial pressure was maintained at 35-45 mmHg) in chloral hydrate-anesthetized rats. Quercetin 25 μmol∕kg was injected intraperitoneally twice a day for 3 consecutive days starting from 3 days before establishment of the model in group Q, while the e-qual volume of normal saline was given instead at the corresponding time points in group S and group I∕R, respectively. The animals were sacrificed at 24 h of reperfusion and brains were removed to determine the brain water content, Evans blue ( EB) content and expression of occludin protein in cerebral cortex ( by Western blot) and to observe the ultrastructure of blood-brain barrier. Results Compared with group S, the brain water content and EB content were significantly increased, the expression of occludin protein was down-regulated (P＜0. 05), and the injury to ultrastructure of blood-brain barrier was accentuated in I∕R and Q groups. Compared with group I∕R, the brain water content and EB content were significantly de-creased, the expression of occludin protein was up-regulated (P＜0. 05), and the injury to ultrastructure of blood-brain barrier was significantly attenuated in group Q. Conclusion Quercetin pretreatment can de-crease the permeability of blood-brain barrier and attenuate brain edema, and the mechanism may be related to up-regulated expression of occludin protein in a rat model of global cerebral I∕R.

Objective To evaluate the advantages of sevoflurane inhalation anesthesia combined with lumbosacral plexus block for hip replacement in elderly patients. Methods Sixty patients of both se-xes, aged 65-85 yr, with body mass index of 18-25 kg∕m2, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, scheduled for elective unilateral hip replacement, were divided into 2 groups(n=30 each)using a random number table: total intravenous anesthesia group(TIVA group)and GasMan software-guided sevoflurane inhalation anesthesia combined with lumbosacral plexus block group(SEV-B group). After the laryngeal mask airway was inserted, the patients were mechanically ventilated in both groups. Heart rate and mean arterial pressure(MAP)were recorded before anesthesia(T0), immediate-ly after insertion of laryngeal mask airway(T1), immediately after skin incision(T2), immediately after intramedullary reaming(T3), immediately after prosthesis implanting(T4), at the end of surgery(T5) and at 5 min after removal of the laryngeal mask airway(T6). The end-tidal concentration of sevoflurane at T2-5was also recorded in group SEV-B. The time for removal of the laryngeal mask airway, duration of stay in post-anesthesia care unit and first ambulation time were recorded. The consumption of anesthetics used during patient-controlled intravenous analgesia(PCIA), effective pressing times of PCIA, requirement for rescue analgesic and adverse reactions were also recorded at 24 h after surgery. The patient′s cognitive func-tion was assessed using Mini-Mental State Examination at 1 day before surgery and 1 and 3 days after surger-y, and the occurrence of postoperative cognitive dysfunction was recorded. Results Compared with group TIVA, heart rate at T1-6and MAP at T2-6were significantly decreased, and MAP at T1was increased in group SEV-B, and the time for removal of the laryngeal mask airway, duration of stay in post-anesthesia care unit and first ambulation time were significantly shortened, the consumption of anesthetics used during PCIA, effective pressing times of PCIA, requirement for rescue analgesic and incidence of adverse reac-tions were reduced at 24 h after surgery, the Mini-Mental State Examination scores were increased at 1 day after surgery, and the incidence of postoperative cognitive dysfunction was decreased at 1 day after surgery in group SEV-B(P<005). Conclusion GasMan software-guided sevoflurane inhalation anesthesia com-bined with lumbosacral plexus block can provide more accurate anesthesia management for hip replacement and promote rapid rehabilitation after surgery in elderly patients.

Objective To evaluate the effect of continuous low-to medium-flow oxygen administration in non-ventilated lung on the oxidative stress response of lung tissues during one-lung ventilation (OLV).Methods Fifty-seven American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 50-64 yr,weighing 40-74 kg,scheduled for elective pulmonary tumorectomy,were divided into 2 groups using a random number table:control group (group C,n=29) and continuous oxygen administration group (group O,n =28).The patients were intubated with the double-lumen tube after induction of anesthesia.Correct position of the tube was verified with the fiberoptic bronchoscope.In group O,the F14 tube was placed at 2-3 cm beyond the carina of trachea in the non-ventilated lung at the beginning of OLV,and low-to medium-flow oxygen was continuously administered at 1-4 L/min with the fractional concentration of inspired oxygen set at 25％-37％.Blood samples were taken from the radial artery and internal jugular bulb at the beginning of anesthesia induction (T1) and 30 min,1 h and 2 h of OLV (T2-4) for blood gas analysis.Lung tissues at the site 5 cm lateral to the tumor were taken immediately after resection of diseased tissues for determination of superoxide dismutase and malondialdehyde levels (by chemical colorimetry) and heme oxygenase-1 expression (by Western blot).Results Compared with group C,the partial pressure of arterial oxygen was significantly increased at T2-4,the partial pressure of arterial carbon dioxide was decreased at T2,3,the partial pressure of venous oxygen was increased at T2,3,the partial pressure of venous carbon dioxide was decreased at T2-4,the malondialdehyde level was decreased,and the expression of heme oxygenase-1 was up-regulated (P＜0.05),and no significant change was found in superoxide dismutase level in group O (P＞0.05).Conclusion The mechanism by which continuous low-to medium-flow oxygen administration in non-ventilated lung exerts pulmonary protection is related to inhibiting oxidative stress responses of lung tissues during OLV.