Objective To study the effects of different doses of propofol on the changes in lung Ca content and pulmonary ultrastructure caused by intestinal ischemia-reperfusion (IIR) induced lung injury. Methods Forty male SD rats weighing 200-250g were randomly divided into 5 groups of 8 rats each: group I sham operation (control group): group II small intestinal ischemia-reperfusion; group III propofol 4 mg-kg-1-h-1; group IV propofol 8mg-kg-h-1; group V propofol 10 mg-kg-1-h-1. The rats were anesthetized with 3% pentobarbital 40mg-kg-1 ip. Right carotid artery and left internal jugular vein were cannulated for BP and pulmonary arteral pressure (PAP) monitoring and fluid and drug administration. The animals were tracheotomized and mechanically ventilated. PETCO2 was maintained at 4 .67- 5.60 kPa. Abdomen was opened. Superior mesenteric artery (SMA) was isolated and clamped for 60 min followed by 120min reperfusion. In group III , IV and V 10min before SMA occlusion was released different doses of propofol was continuously infused until the end of experiment. In group I and II isovolemic normal saline was infused instead of propofol. Lung Ca2+ content was measured and ultrastructure of the lung examined. Results The lung tissue Ca2+ content increased significantly after IIR in group II and III as compared with group I , IV and V ( P

Objective To investigate the effects of desflurane inhalation on pulmonary alveolar-capillary membrane permeability and the inflammatory cell counts in broncho-alveolar lavage fluid (BALF) during endotoxin-induced acute lung injury in rats. Methods Forty-eight Wistar rats weighing 200-290 g were anesthetized with intraperitoneal pentobarbital 100mg?kg-1 , tracheotomized and mechanically ventilated. PETCO2 was maintained at 35-45 mm Hg (VT 8 ml?kg-1 , RR 65-70 bpm). Right carotid artery and left femoral vein were cannulated for BP monitoring and fluid and drug administration. The animals were randomly divided into four group with 12 animals in each group : (1) control group received normal saline (NS) 1.2 ml i.v. followed by 4 h mechanical ventilation; (2) LPS group received LPS (055:B5, Sigma) 5 mg?kg-1 followed by 4h mechanical ventilation; (3)Desflurane group A and B received LPS 5 mg? kg-1 followed by desflurane inhalation for 4 h at 1 MAC (desflurane group A) or 1.5 MAC (desflurane group B) . Six animals in each group received Evans blue 50 mg?kg-1 at the beginning of the experiment for determination of pulmonary alveolar-capillary membrane permeability at the end of the experiment. The animals were sacrificed by exsanguinations at the end of 4h mechanical ventilation. Blood was collected for determination of total plasma protein concentration. Lungs were removed. The right lung was lavaged and BALF was collected for determination of protein content, and differential inflammatory cell counts. The left lung was used for microscopic examination. The morphologic changes were scored 0-3 (0 = normal, 3 = severe morphologic changes). In addition wet/dry lung weight ratio, pulmonary permeability index (BALF protein concentration /total plasma protein concentration?10-3 ) and mortality rate were also determined. Results In group 3 (desflurane 1 MAC) W/D lung weight ratio and lung water content significantly increased compared with those in LPS group. In group 4 ( desflurane 1.5 MAC) W/D lung weight ratio, lung water content, pulmonary permeability index, Evans blue content in lung tissue, morphological change scores and mortality rate were all significantly increased compared with LPS group (group 2). There was no significant difference in total and differential inflammatory cell counts in BALF between group 2 and 4.Conclusion Desflurane inhalation is detrimental to the lungs acutely injured by endotoxin in a dose-dependent manner.

Objective To investigate the effect of sufentanil postconditioning on cardiomyocyte apoptosis during myocardial ischemia-reperfusion (I/R) in rats.Methods Thirty-six male Sprague-Dawley rats weighing 250-280 g were randomly divided into 3 groups ( n =12 each):sham operation group (group S),I/R group and sufentanil postconditioning group (group SP).Myocardial I/R was induced by occlusion of the left coronary artery for 30 min followed by 120 min reperfusion.Sufentanil 3.0μg/kg was injected iv at the beginning of reperfusion in group SP.HR and MAP were recorded during I/R.The rats were sacrificed at 120 min of reperfusion and their hearts were removed for determination of infarct size,number of apoptotic cardiomyocytes,and the expression of Bax mRNA and Bcl-2 mRNA,and apoptotic index was caculated.Results There was no significant difference in HR among the 3 groups ( P ＞ 0.05 ).Compared with group S,MAP and Bcl-2 mRNA expression were significantly decreased,apoptotic index and Bax mRNA expression increased in group I/R,and apoptotic index,and the expression of Bax mRNA and Bcl-2 mRNA were increased in group SP (P ＜ 0.05).Compared with group I/R,the infarct size,apoptotic index and Bax mRNA expression were decreased,and Bcl-2 mRNA expression was increased in group SP (P ＜ 0.05).Conclusion Sufentanil postconditioning can attenuate myocardial I/R injury in rats by up-regulating Bcl-2 expression,down-regulating Bax expression and inhibitting cardiomyocyte apoptosis.

Objective:To investigate the relation between the angiotensinⅡ(AngⅡ)levels in thoracic aorta and plasma and atherosclerosis(AS).Methods:Totally40healthy male Wistar rats were randomly divided into4groups(n=10).Four different feeding methods,including normal diet,high lipid,high lipid+vitamin D overload,and high lipid+vitamin D over-load+endothelium injury,were used for inducing AS in rats.The thickness of intima was taken as the index of AS severity, radio-immunity analysis was used to assay AngⅡin each group in thoracic aorta and plasma.Results:Only rats in high lipid diet group did not develop AS plaque;high lipid+vitamin D only resulted in AS fibrous plaque with VSMC proliferation;high lipid+vitamin D+endothelium injury formed ripe AS plaque.The thickness of intima and AngⅡof thoracic aorta in-creased gradually compared with control group(P

Aim To investigate a possible role for nitric oxide and neurogenic pathway in the protective effect of the limb preconditioning on the ischemic-reperfusion myocardium.Methods 64 Wistar rats were randomly divided into one of the four experimental groups.In Group Ⅰ,the rats underwent 30 min occlusion of the left anterior descending coronary artery,and 120 min reperfusion.In Group PL,the rats underwent four cycles of 5 min occlusion and reperfusion of both hind limbs using a tourniquet before the experiment was continued as in Group Ⅰ.In Group PL-N and Group PL-H,rats were administered with L-Nitro-Arginine Methyl Ester(L-NAME)10 mg?kg-1 or hexamethonium chloride 20 mg?kg-1,intravenously,20 min before IPC.Infarct size,as a percentage of the area at risk,was determined by triphenyltetrazolium chloride staining.And other 8 rats in each group,at the end of the experiment,all rats were killed and myocardium were stored in liquid nitrogen for the measurement of NO,NOS,iNOS and iNOS mRNA.Results The myocardial infarct size(IS)was decreased significantly in Group PL and Group PL-H compared with Group Ⅰ(P

OBJECTIVE: To provide reference for China to comprehensively promote and perfect the "two-vote system" for drug purchase. METHODS: The effects of "two-vote system" on interested parties, the existing problems of drug purchase and its financial reasons were analyzed; the finance strategies were put forward to deal with the existing problems of drug purchase. RESULTS & CONCLUSIONS: "Two-vote system" has certain impact on drug production enterprises, drug circulation enterprises, public medical institutions and government drug supervision departments. At present, the existing problems of drug purchase mainly include that the mechanism of "drug to support hospital" has promoted the virtual-high price of drugs; drug enterprises pull drug sales by the way of rebate; hidden rules disrupt the circulation of drugs as "be subordinate to" "amateur performance". Financial reasons mainly include that the mode of "drug to support hospital" pursuit the maximization of its own interests unilaterally and ignore the drug cost burden of patients; some enterprises have poor investment, lack of R&D investment, have weak internal financial control measures, lack of social responsibility consciousness, rely on "be subordinate to" "amateur performance" profit, underestimate financial risk, etc. The drug production enterprises should adjust marketing model and reduce cost; drug circulation enterprises should predict positioning scientifically and expand profit space; public medical institutions should reform financial supply and reduce drug cost; government drug supervision departments should reduce the supervision cost and improve the comprehensive efficiency. Only by deepening the reform of the medical and health care system, improving the supporting measures for the "two-vote system" in drug purchase can the problems existing in the circulation of drugs be solved gradually.

Objective To investigate the effect of different extraction methods on anti-inflammatory and analgesic activity of Anemone hupehensis.Methods The different abstracts were prepared from the whole herb of Anemone hupehensis.The analgesic effect was observed by adopting the mouse torsion and electric heating plate method,and the anti-inflammatory activity was comprehensively evaluated by using the mouse ear tumefaction,toe tumefaction and tampon granulation tumefaction exprements.Results Compared with the blank model group,the anti-inflammatory action difference of low dose in the water layer parts of mouse ear tumefaction,toe tumefaction and tampon granulation tumefaction had no statistical significance(P＞0.05),and the extracting parts of rest doses all had significant anti-inflammatory and analgesic effect (P＜0.05).Ethyl acetate part had strongest activity in the electric heating plate experiment.N-butanol part had strongest activity in the ear tumefaction,toe tumefaction,tampon granulation tumefaction experiments and torsion method.Conclusion The whole herb of Anemone hupehensis has prominent anti-inflammatory and analgesic effect,and the ethyl acetate part E and N-butanol part are main effective parts.

Objective:To compare the efficacy of HES 130/0.4 and acetate Ringer′s solution (A-HES) and HES 130/0.4 and normal saline (NS-HES) for volume therapy in the patients undergoing non-cardiac surgery with general anesthesia.Methods:Two hundred and fifty American Society of Anesthesiologist physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18-32 kg/m 2, undergoing noncardiac surgery with general anesthesia, were divided into group A-HES and group NS-HES using the stratified block randomization technique.A-HES and NS-HES 15 ml/kg were intravenously infused over 1 h immediately after induction of anesthesia in A-HES and NS-HES groups, respectively.Mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP) were recorded before and after infusion, and the maximum changing rate of MAP and HR and the maximum change in CVP were calculated.The pH value, BE and HCO 3- were recorded before infusion and at 15 min after the end of infusion, and Hb, Hct, electrolytes, blood glucose, blood biochemical parameters and parameters of coagulation function were measured.The occurrence of abnormal blood biochemical parameters, blood glucose, and parameters of coagulation function, intraoperative requirement for vasoactive drugs, occurrence of HES-related adverse events, and intraoperative fluid intake and output were recorded. Results:A total of 251 cases were actually enrolled in this study, with 125 cases in group A-HES, and 126 cases in group NS-HES.Compared with group NS-HES, no significant change was found in the maximum changing rate of MAP and HR and the maximum change in CVP ( P>0.05) in group A-HES, and non-inferiority analysis showed that group A-HES was not inferior to group NS-HES.Compared with group NS-HES, the concentrations of BE and HCO 3-, K + , Ca 2+ and Mg 2+ were significantly increased, the concentrations of Na + and Cl - were decreased, the PT was shortened, the incidence of abnormal PT was decreased at 15 min after the end of infusion ( P< 0.05), and no significant change was found in the other parameters mentioned above in group A-HES ( P>0.05). Conclusion:The volume expanding effect of A-HES and its effect on liver and kidney function are not significantly different from those of NS-HES, however, A-HES has certain advantages in maintaining acid-base balance, electrolyte stability and coagulation function.

BACKGROUNDTo summarize the clinical results of bronchoplastic procedures and pulmonary artery reconstruction or combined with other resection and plasty of heart, great vessels in the treatment of 304 patients with locally advanced lung cancer.

METHODSFrom February, 1983 to December, 2001, double sleeve resection and reconstruction of bronchus and pulmonary artery, or combined with other resection of heart, great vessels were carried out in 304 patients with locally advanced lung cancer. The operations included double sleeve left upper lobectomy in 199 cases; double sleeve right upper lobectomy in 21 cases; double sleeve right upper middle lobectomy in 14 cases; double sleeve left upper lobectomy combined with resection of left atrium in 8 cases; double sleeve right upper lobectomy combined with superior vena cava (SVC) resection and reconstruction with Gortex graft in 29 cases; double sleeve right upper middle lobectomy combined with SVC resection and reconstruction in 21 cases; double sleeve right upper middle lobectomy, carinal and SVC resection and reconstruction in 11 cases; left pneumonectomy combined right main pulmonary artery and pulmonary artery trunk resection and reconstruction with Gortex graft in 1 case.

RESULTSThere were 3 operative deaths. The operative mortality was 1% in this series. Sixty four patients had operative complications. The operative complication rate was 21.05% (64/304). The 1-, 3-, 5- and 10 year survival rates were 81.75%, 60.14%, 37.21% and 24.39% respectively.

CONCLUSIONSDouble sleeve lobectomy or comblined with other resection and reconstruction of heart, great vessels can significantly improve the prognosis and increase the curative rate and long term survival in patients with locally advanced lung cancer.

Objective To summarize the experience of perioperative treatment of lung transplantation for end-stage lung disease. Methods Perioperative clinical data of 7 recipients undergoing lung transplantation were retrospectively analyzed, including 3 cases with bilateral lung transplantation and 4 cases with unilateral lung transplantation. The perioperative status and clinical prognosis of lung transplantation recipients were observed. Results The operation time of 7 lung transplantation recipients was (344±133) min. Cold ischemia time was (236±74) min in 4 cases of single-lung transplantation and (480±120) min in 3 cases of bilateral-lung transplantation. The length of Intensive care unit(ICU) stay was 21 (13-25) d and the length of hospital stay was 101 (64-117) d. In the first 3 d after surgery, the daily fluid output was significantly larger than the fluid input (all P < 0.05). The arterial oxygen partial pressure (PaO₂) of lung transplantation recipients in the first 3 d after surgery was significantly elevated than preoperative level (all P < 0.05), whereas the arterial carbon dioxide pressure (PaCO₂) did not significantly change (all P > 0.05). All recipients had pulmonary bacterial infection after lung transplantation, including 3 cases complicated with fungal infection. One recipient underwent exploratory thoracotomy for hemostasis due to active thoracic bleeding after operation, 1 recipient suffered from primary graft dysfunction (PGD) and 4 recipients received secondary endotracheal intubation. Two cases died after operation, 1 case died of septicemia caused by multidrug-resistant acinetobacter baumannii, the other case died of rejection reaction after self-terminating use of immunosuppressive agents. The remaining 5 cases were successfully discharged and recovered well. The longest survival period was 3.1 years. Conclusions In the perioperative management of lung transplantation, it has great significance to hold the surgical indications, monitor and manage postoperative refined fluid and hemodynamics, implement the strategy of protective pulmonary ventilation, and early diagnose and treat severe postoperative complications for the recipients of lung transplantation to safety through the perioperative period.