Objective To investigate the effect of different doses of dexmedetomidine(Dex)on sevoflurane consumption in patients undergoing laparoscopic oophorocystectomy.Methods Eighty ASA Ⅰ or Ⅱ patients aged 25-50 yr with body mass index 18-25 kg/m2 undergoing laparoscopic oophorocystectomy were randomly divided into 4 groups (n =20): control group (group C),low dose Dex group(group DL),medium dose Dex group(group DM) and high dose Dex group(group DH).Normal saline 20 ml and Dex 0.3,0.6,0.9μg/kg was infused iv over 10 min at 10 min before skin incision in groups C,DL,DM and DH,respectively.End-tidal sevoflurane concentration (ETsev) was recorded before Dex administration(T1 ),skin incision(T2 ),immediately after pneumoperitoneum (T3 ),10 min of pneumoperitoneum(T4 ) and the end of surgery (T5 ).Duration of anesthesia,consumption of sevoflurane,emergence time,extubation time were recorded and restlessness at 10 min after extubation was also recorded.The concentrations of blood glucose and corticosteroid were measured by quickly by glucose analyzer and radio-immunity gefore anethesia induction (T0) and at T3,T4,T5 respectively.Results The consumption of sevoflurane per hour,ETsev at T2-5,concentrations of blood glucose and corticosteroid at T3-5 were decreased gradually in groups C,DL,DM and DH ( P ＜ 0.05).The emergence time and extubation time were shorter and the incidence of restlessness was lower in groups DL,DM and DH than in group C ( P ＜ 0.05 ).Conclusion Dexmedetomidine can reduce the consumption of sevoflurane in a dose-dependent manner in patients undergoing laparoscopic oophorocystectomy.

Objective To investigate the effect of intrathecal (IT) dexmedetomidine on the expression of cAMP response element-binding protein phosphorylation (p-CREB) in spinal dorsal horn in a rat model of bone cancer pain. Methods Sixty-four adult female Wistar rats weighing 200-240 g were randomly divided into 4 groups (n = 16 each): sham operation group (group S); bone cancer pain group (group BP); normal saline group ( group NS) ; dexmedetomidine group (group D) . Bone cancer pain was induced by injecting Walker 2S6 mammary gland carcinoma cell suspension (2 ×106 cells/ml) 10μl into the medullary cavity of the tibia in BP, NS and D groups. Groups S and BP received no IT injection. Croups NS and D received IT injection of NS 10 μl and dexme detomidine 5 μg/kg respectively 7 days after successful establishment of the model. Ten animals were selected from each group at 1 day before IT administration (T0), immediately before IT administration (T1 ) and at 1, 6, 12 and 24 h after IT administration (T2-5 ) and paw withdrawal threshold (PWT) to mechanical stimuli was measured with von Frey filaments. The other 6 rats in each group were sacrificed at T4 and the spinal cord was removed for determination of p-CREB expression in the spinal dorsal horn.Results PWT was significantly decreased at T1-5 and pCREB expression up-regulated at T4 in BP, NS and D groups compared with group S ( P ＜ 0.05) . Compared with group BP, PWT was significantly decreased at T2-5 and p-CREB expression down-regulated at T4 in group D ( P ＜0.03), while no significant change in PWT and p-CREB expression was found in group NS (P ＞ 0.05) .Conclusion IT dexmedetomidine can reduce the bone cancer pain through inhibiting the phosphorylation of CREB in rat spinal dorsal horn.

ObjectiveTo explore the effect of glucocorticoid inhaled on bone metabolism, bone density and adrenal function in children with asthma.Methods60 children were randomly divided into the treatment group and control group with 30 cases in each group, and having 30 pneumonia children as another control. Children of the treatment group were treated with budesonide (200～600 μg/d) inhaled, asthma cases in the control group without budesonide inhaled. Bone metabolism, bone density and adrenal function of children in three groups were compared.ResultsAfter 18 months treatment, there were no significantly differences of bone metabolism, bone density and adrenal function among children of three groups (P>0.05).ConclusionThe treatment of glucocorticoid inhaled is safe to asthma children.

Objective To evaluate the accuracy of ultrasound-measured inferior vena cava (IVC) diameter in assessment of the preoperative blood volume in elderly patients.Methods Sixty patients,aged 60-75 yr,with body mass index 20-25 kg/m2,of ASA physical status Ⅰ-Ⅲ,scheduled for elective transurethral resection of prostate,were randomly divided into 3 groups (n =20 each):control group (group C),lactated Ringer's solution group (group RL),and hydroxyethyl starch group (group H).Lactated Ringer's solution 8 ml/kg was infused intravenously in group RL.Hydroxyethyl starch 130/0.4 8 ml/kg was infused intravenously in group H.SpO2,mean arterial pressure (MAP),HR and central venous pressure (CVP) were monitored before and after fluid therapy.The IVC diameters,both during expiration (IVCe) and inspiration (IVCi),were measured using ultrasound.IVC collapsibility index (IVC-CI) was calculated.Results The IVCeand IVCi were significantly increased,and IVC-CI was decreased after fluid therapy as compared with those before fluid therapy in RL and H groups.Compared with group C,the IVCe and IVCi were significantly increased,and IVC-CI was decreased after fluid therapy in RL and H groups.IVCe and IVCi were positively correlatedwith CVP (r=0.746 and 0.697,respectively).IVC-CI was negatively correlated with CVP (r =-0.547).Conclusion Ultrasoundmeasured IVC diameter provides better accuracy in assessing the preoperative blood volume in elderly patients.

Objective To evaluate the role of T?type calcium channels in up?regulation of spinal Ca2+∕calmodulin?dependent protein kinase Ⅱ ( CaMKⅡ) expression in rats with neuropathic pain. Meth?ods Forty?eight male Sprague?Dawley rats, weighing 230-270 g, in which intrathecal catheters were suc?cessfully implanted, were divided into 4 groups ( n=12 each) using a random number table: sham opera?tion group (group S), neuropathic pain group (group NP), normal saline group (group NS), and T?type calcium channel blocker mibefradil group ( group M ) . The model of neuropathic pain was established by chronic compression of the dorsal root ganglion ( DRG) . Normal saline 20μl and mibefradil 200μg ( dilu?ted to 20μl in normal saline) were injected intrathecally at 5 days after compression of the DRG in NS and M groups, respectively. Before intrathecal catheter implantation ( T1 ) , before compression of the DRG ( T2 ) , at 5 days after compression of the DRG and before intrathecal administration ( T3 ) , and at 30, 60, 120 and 240 min after intrathecal administration ( T4?7 ) , the mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured. The rats were sacrificed after the last measure?ment of the pain threshold at T7 , and the lumbar enlargement segments of the spinal cord were harvested for determination of CaMKⅡ expression by Western blot. Results Compared with group S, the MWT was significantly decreased, and TWL was significantly shortened at T3?7 , and the expression of spinal CaMKⅡ was significantly up?regulated in NP and M groups (P<0.05). Compared with group NP, the MWT wassignificantly increased, and TWL was significantly prolonged at T4?6, and the expression of spinal CaMKⅡwas significantly down?regulated in group M (P<0.05), and no significant change was found in the parame?ters mentioned above in group NS (P>0.05). Conclusion T?type calcium channels are opened, the intra?cellular free calcium ion concentrations are increased, and activated spinal CaMKⅡ is involved in the de?velopment of neuropathic pain in rats.

Aim To investigate the effect of intrathecal injection of fluorocitrate(Fc)on mechanical and thermal hyperalgesia induced by complete Freund's adjuvant(CFA)injection in rats.Methods The mechanical withdrawal threshold(MWT)and thermal withdrawal latency(TWL)were measured before and after CFA or Fc treatment.The changes of glial fibrillary acidic protein(GFAP)and OX-42(a microglial marker)expression in the spinal cord dorsal horn were evaluated by immunohistochemistry analysis.Results Rats with CFA-induced arthritis showed mechanical allodynia and thermal hyperalgesia,which was correlated with the increased GFAP and OX-42 expression in the spinal cord dorsal horn.Intrathecal injection of Fc markedly suppressed CFA-induced thermal hyperalgesia and mechanical allodynia.Fc significantly attenuated the activation of GFAP and OX-42 in the spinal cord dorsal horn.Conclusions The glia activation in spinal cord is closely related to the progress of CFA-induced peripheral hyperalgesia.Fc may exert antihyperalgesic effect by inhibiting the activation of astrocyte and microglia.

Objective To investigate the effect of propentofylline on nerve growth factor (NGF) and IL-1βrelease from rat cerebral cortical astrocytes. Methods Primary cultured rat astrocytes from SD rats (1-3 d,weighing 6-8 g) after 4 passages were randomly divided into 8 groups ( n = 6 wells each): group Ⅰ control (group C); group Ⅱ , Ⅲ, Ⅳ the astrocytes were exposed to propentofylline 10, 100 and 1000 μmol/L respectively (group P1, P2, P3 ); group Ⅴ the astrocytes were exposed to LPS 1 μg/ml and group Ⅵ, Ⅶ, Ⅷ the astrocytes were exposed to propentofylline 10, 100 and 1000 μmol/L in addition to LPS 1 μg/ml (group P1 + LPS, P2 + LPS,P3 + LPS). The astrocytes were then incubated for 3 days in all 8 groups. The concentrations of IL-1β and NGF in the supernatant were detected at 1 and 3 days of incubation using ELISA. Results LPS activated astrocytes resulting in decrease in NGF release and increase in IL-1β release. Propentofylline significantly increased NGF release and decreased IL-1β release from astrocytes incubated alone or with LPS by suppressing activation of astrocytes. Conclusion Propentofylline can enhance NGF release and inhibit IL-1β release from rat cerebral cortical astrocytes.

Objective To analyze the epidemiology,clinical and imageological characteristics,diagnosis,misdiagnosis,treatment and prognosis of pulmonary alveolar proteinosis (PAP) reported in China in recent 20 years,in an attempt to provide important clues for prompt and accurate diagnosis of PAP.Methods Clinical data of PAP from 1988 to 2008 in China were retrospectively analyzed and the clinical data of 126 patients with PAP which were misdiagnozed were summarized.Results There were 19 cases misdiagnozed with pneumonia,24 cases with pulmonary cancer,18 cases with bronchitis,19 cases with idiopathic pulmonary fibrosis,15 cases with pulmonary tuberculosis,10 cases with eosinophilic pneumonia,9 cases with sarcoidosis,5 cases with fungus pneumonia.The clinical manifestations of PAP had no specificity and the imageology manifestation was various.Its final diagnosis mainly depended on the examination of brochoalveolar lavage fluid and/or lung biopsy,and pathologic examination.Conclusions The diversity of clinical manifestations of PAP has resulted in higher clinical misdiagnosis rate.WhoLe lung irrigation is the safest and the most effective way to treat PAP.

Objective To evaluate the role of gliocytes in the spinal cord in the development of inflammatory pain (IP) in rats. Methods Adult male SD rats weighing 180-220 g were used in this experiment. A catheter was implanted in the subarachnoid space according to the method described by Yang. Animals with abnormal motor function of the hindlimb after intrathecal (IT) catheter implantation were excluded. IP was induced by subcutaneous (sc) injection of complete Freund's adjuvant (CFA) 50 μl at the lateral side of the ankle joint of the right hindpaw. Sixty-five rats were randomly divided into 5 groups ( n = 13 each): group I IP control normal saline (NS) 50μl was injected sc instead of CFA; group II IP; group IE PC (IT) + IP control fluorinated citric acid (FC, a gliocyte metabolism inhibitor) 1 nmol/10μl was injected IT at 15 min before NS 50 μl sc injection; group IV NS (IT) + IP and group V FC (IT) + IP. The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured 2 d before induction of IP (T_0, baseline) .before and at 2, 4, 6, 8, 10, 12, 24 and 26 h (T_(1-9)) after sc NS or CFA injection. Five enimals in each group were killed at T_5 (8 h after sc NS/CFA injection) and the lumbar segment (L_(4,5)) was removed for determination of glial fibrillary acidic protein ( CFAP) and OX-42 expression by immuno-histochemistry. Results In group Ⅱ and Ⅳ sc CFA significantly decreased MWT and TWL. Mechanical and thermal hyperalgegia induced by sc CFA was significantly suppressed by intrathecal FC in group V . IP significantly increased GFAP and OX-42 expression in the spinal cord. Intrathecal FC significantly attenuated IP-induced up-regulation of GFAP and OX-42 expression in the spinal cord. Conclusion The activation of gliocytes in the spinal cord is involved in the development of CFA-induced hyperalgesia in rats.

Objective To detect the expressions and clinical significance of Nanog and CD44 protein in lung cancer. Methods The expressions of Nanog and CD44 were detected by immunohistochemistry in 50 cases of lung cancer, 32 cases of benign lesion lung tissue and 18 cases of paraneoplastic normal lung tissue. Then their relationships with clinicopathological factors were analyzed. Results The expression of Nanog in lung cancer was significantly higher than those in benign lesion lung tissue and paraneoplastic normal lung tissue (P < 0.05). There was no significant difference of the expression of CD44 among the three groups (P > 0.05). The expressions of Nanog and CD44 in squamous cell carcinomas were higher than those in adenocarcinomas and small cell lung carcinomas (P < 0.05). The expressions of Nanog and CD44 were significantly correlated with lymph node metastasis (P < 0.05), but were not correlated with age, gender, tumour size, TNM stage and differentiation of lung cancer (P>0.05). The positive correlation was also noted between the expressions of Nanog and CD44 in lung cancer (r = 0.564, P < 0.05). Conclusion Nanog and CD44 proteins may participate in the genesis and progression of lung cancer. Nanog protein is a potential diagnostic marker and therapeutic target for lung cancer.