Objective To investigate the effects of acute hypervolemic hemodilution (AHH) on cerebral O2 supply/consumption and energy metabolism in patients undergoing elective surgery under general anesthesia combined with continuous epidural block. Methods Fourteen ASA Ⅰ or Ⅱ patients of both sexes (9 male, 5 female) aged 44-62 yrs weighing 55-70 kg undergoing elective surgery under general anesthesia combined with epidural block were enrolled in this study. Lactated Ringer's solution 6-8 ml?kg-1 was infused before anesthesia. After correct placement of epidural catheter was confirmed radial artery was cannulated for BP monitoring and blood sampling. BP, EGG, SpO2 and PET CO2 were continuously monitored during anesthesia. General anesthesia was induced with fentanyl, midazolam, propofol and rocuronium and maintained with iaoflurane and intermittent i. v. boluses of vecuronium. The patients were intubated and mechanically ventilated. PET CO2 was maintained at 30-35 mm Hg. Epidural block was produced by a mixture of 1.33 % lidocaine + 0.167 % dicaine. Right internal jugular vein was retrogradely cannulated and advanced cephalad until jugular bulb for blood sampling. AHH was conducted by infusing 6% HES 20 ml?kg-1 at 50 ml?min-1 after induction of general anesthesia. Blood samples were taken from artery (a) and jugular venous bulb (jv) simultaneously before AHH (T0) at 15 min (T1) and 120 min (T2) after AHH was accomplished for blood gas analysis and determination of Hb, glucose and lactate concentrations. Cerebral O2 extraction rate (CERO2), glucose extraction rate (CMRglu) , arterial-jugular bulb venous O2 content difference (D a-jvO2) and arterial-jugular bulb venous lactate difference (VADL) were calculated. Results At the end of AHH Hct and Hb decreased by 20% as compared to the baseline values before AHH. S jvO2 was significantly higher, D a-jvO2 smaller and CERO2 lower at T1 than at T0. There were no significant differences in BP, HR, CMRglu and VADL at all time points. Conclusion AHH can increase cerebral O2 supply and has no significant effect on cerebral glucose metabolism during operation performed under general anesthesia combined with epidural block.

Neuronal damage is associated with the excessive stimulation of N-Methyl-D- Aspartate (NMDA) receptors by glutamate during cerebral ischemia.Because of non-selective NMDA receptor antagonist can influence all NMDA receptors and produce adverse effects,and its clinical application has been restricted significantly,an increasing attention has been paid to the selective NMDA receptor in recent years.NR2B subunit antagonists are mainly divided into piperidine derivatives,amide derivatives,amidine derivatives,and aminoquinoline derivatives,etc. The representative drugs include ifenprodil and eliprodil.These drugs can selectively act on NMDA receptor NR2B subunit,and they are expected to become safe and effective neuropro- tective agents in clinical practice.

Animals ; Disease Models, Animal ; Heart Rate ; Hypertension ; physiopathology ; Rats ; Rats, Wistar

Objective To explore the effect of combined application of Pathfile in the VDW-Mtwo nickel titanium file in the elderly narrow canals.Methods 35 teeth with 101 root canals were divided into the two groups by drawing lots.In group A,root canals were prepared with VDW-Mtwo and Pathfile.In group B,root canals were prepared with VDW-Mtwo.All root canals were filled with continuous wave thermoplasticized gutta-percha technique.The operating time for each root canal,the number of broken instruments and postoperative pain were recorded.The efficacy of reparation was analyzed with radiography.Results The root canal preparation time of group A was (5.14 ± 1.25) min,which was significantly shorter than (6.82 ± 1.76) min of group B (t =5.539,P ＜ 0.05) ; The difference was not statistically significant in step formation and just fill rate between the two groups (P =1.00,1.74) ; The instrument intact of group A was 100.00％,which was significantly higher than 79.17％ of group B (x2 =4.279,P =0.039) ;The difference was not statistically significant in pain after operation between the two groups (P =0.20).Conclusion For narrow root canals preparation in the elderly treated with Mtwo and Pathfile would be shorten the preparation time and reduce broken instruments.

Objective: To observe the preventive effect of taurine on alcoholic liver damage in rat.Methods: The model was induced by filling stomach with alcohol, and the treatment groups were given two different concentrations of taurine, and the control group was given 0.9%NS, then we measured the blood triglycerides (TG), and the pathological changes of liver quantitatively.Results: Two different le-vels of taurine can significantly decrease the level of TG and ameliorate the liver damage of rats (P0.05), and the 5% taurine group can also decrease the mean arterial pressure (P

Objective To study the effect of total nutrient admixture (TNA) on lipid metabolism in rats with acute hepatic failure (AHF). Methods Fifty-six male Wistar rats were randomly divided into four groups: normal diet group, nitrogen-free diet group, fat-free nutrient admixture group, and TNA group. All rats were injected with D-galac- tosamine to induce AHF model Meanwhile, 6 healthy Wistar rats were used as control group. TNA provided energy 221.75 kJ (1 kcal=4.184 kJ), nitrogen 0.365 g, nitrogen to energy ratio 1:145, amino acids 2.28 g (including branched-chain amino acid 0.70 g), glucose 7.85 g, and fat 1.25 g on a daily basis. After 10 days of the operation of Jugular vein puncture tube, blood glucose, blood lipid, liver and renal function were determined. Results The blood glucose level was significantly higher in TNA group than that in fat-free nutrient admixture group (P < 0.05). The levels of serum triglyceride and cholesterol were highest in fat-free nutrition admixture group, and triglyceride level was signif- icantly higher than that in normal diet group and nitrogen-free diet group (P <0.05). The levels of serum triglyceride and cholesterol were significantly higher in TNA group than those in normal diet group (P <0.05). The levels of ala- nine aminotransferase, alkaline phosphatase, total bilirubin and blood urea nitrogen were lower in TNA group than those in fat-free nutrient admixture group (P < 0.05). Conclusion The nutritional proportion of TNA is suitable for the metabolism disorder of hepatic failure, and therefore TNA can reasonably promote the anabolism and reverse the deteri- oration of hepatic failure in rats.

Objective To explore the clinical modalities and diagnosis of respiratory failure due to laryngotracheal disorders in children,in order to reduce the misdiagnosis.Methods Fifteen patients(11 cases were male,4 cases were female) with respiratory failure in Intensive Care Unit, Tianjin Children′s Hospital from Jul.2006 to Jul.2009 were selected.Data including history,characteristics and results of spiral computerized tomography(CT) and reconstruction and magnetic resonance imaging(MRI) were reviewed.Results The major clinical manifestations indicated that 7 cases had laryngeal stridor,6 cases had recurrent pneumonia,5 cases had cyanosis after crying,and 12 patients were complicated with respiratory failure in 12 hours.Nine cases were recovered,3 cases were given up,and 3 cases died.All patients were performed with CT about laryngohypopharynx,and the results were cyst of root of tongue in 3 cases,trachea pressed by cyst of parapharyngeal space in 1 case.There were 11 cases examined by spiral CT and reconstruction,in which 6 cases were confirmed as tracheal stenosis,2 cases were left bifid tracheostoma,2 cases were pulmonary artery sling,and 1 case was diagnosed as tracheomalacia.Chest X-ray radiograph indicated that bronchopneumonia in 8 cases,bronchitis in 3 cases and negative in 4 cases.Echocardiograph examination was performed among 11 cases,in which 2 cases were pulmonary artery sling,2 cases were atrial septal defect,1 case was patent ductus arteriosus, and 6 cases were negative.Conclusions There is high morbidity of respiratory failure caused by laryngotracheal disorders in infants,but misdiagnosis ccures usually because of non-specific symptoms.If the infant must depend on mechanic ventilation for a long time and has airway obstruction,he should be examined early by using spiral CT.

Objective To investigate the molecular mechanism of bone marrow mesenchymal stem cells (BM-MSCs) in repairing cisplatin-induced acute renal injury.Methods The rats were injected 6 mg/kg of cisplatin intraperitoneally,and bone marrow mesenchymal stem cells (BM-MSCs group) or PBS (PBS group) were injected respectively via tail vein after 24 hours.The rats without injecting cisplatin were selected as a normal control group.The repair effect of BM-MSCs on renal injury was observed by HE staining and immunohistochemistry.In addition,NRK-52E cells were cultured in vitro and treated with cisplatin for 6 hours.Then,NRK-52E cells were continued to culture for 48 hours or co-cultured with BM-MSCs for 48 hours,and NRK-52E cells untreated with cisplatin were used as a control.The expression levels of miR-92b and its target gene PTEN were detected by qRT-PCR,and the expression level of p-Akt by western blot.Results HE staining showed that the tubular protein casts in BM-MSCs group were significantly less than that in PBS group,and that the renal tubular structure was significantly improved in BM-MSCs group.Immunohistochemical staining indicated that the number of cells expressing proliferating cell nuclear antigen (PCNA) in BM-MSCs group (131.0 ± 14.4) was significantly higher than that in PBS group (42.2 ±6.1,t =11.28,P ＜0.01).qRT-PCR results showed that in the vivo experiment,compared with the expression level of miR-92b and PTEN in the normal control group (1.11 ± 0.78,1.01 ± 0.21),PBS group were (4.64 ± 1.06) and (0.61 ± 0.2),respectively (all P ＜ 0.05);BM-MSCs group were (2.27 ± 0.81) and (1.1 ± 0.1),respectively (all P ＜ 0.05).In vitro experiment,compared with the expression level of miR-92b and PTEN in the negative control group (1.12 ± 0.77,1.02 ± 0.13),cisplatin group were (7.64 ± 0.72) and (0.58 ± 0.2),respectively (all P ＜ 0.05),cell group were (4.38 ± 0.50) and (1.15 ± 0.23),respectively (all P ＜ 0.05).Western blot results showed that compared with the expression level of p-Akt in cisplatin group (0.96 ± 0.18),p-Akt expression in cell group was (2.11 ± 0.11,P ＜ 0.01).Conclusion BM-MSCs may repair the cisplatin-induced acute renal injury via down-regulating the expression level of miR-92b.

Objective To investigate the serum superoxide dismutase( SOD) ,malondialdehyde ( MDA) , and nitric oxide( NO) level in generalized anxiety disorder ( GAD) patients for exploring the importance of oxida?tive stress in etiology of GAD. Methods 42 cases of first episode patients with GAD ( GAD group) and 42 cases of health ( control group) matched with age and gender were included . Serum levels of SOD,MDA ,and NO were tested to analyze for a control study.Results GAD patients had significantly higher levels of SOD,MAD and NO than health controls ((858.09±137.32)×102 U/L vs (745.40±119.19) ×102 U/L;(10.92±3.42)mmol/L vs (7.52±2.32)mmol/L;(74.32±12.34) μmol/L vs(65.22±14.29) μmol/L), t=4.036,5.368,3.297;P=0.000, 0.000,0.003) . A positive relationship between SOD and total score of Hamilton Anxiety Scale( HAMA ) ,psychotic anxiety factor of HAMA,or somatic anxiety factor of HAMA was found in GAD group ( r=0.331,0.370,0.318;P=0.029,0.016,0.040).The level of MAD correlated with total score or psychotic anxiety factor of HAMA( r=0.311, 0.320;P=0.042,0.039).Conclusion It is suggested that the dysfunction of oxidative stress may play a role in pathogenesis of generalized anxiety disorder.