Objective:To determine the clinical pharmacokinetics of cisatracurium besilate,and its effects on hepatic function and renal function in Chinese patients.Methods: Thirty ASA Ⅰ～Ⅲ,patients undergoing elective surgery were enrolled in this study.Anesthesia was induced by a single injection of cisatracurium 0.15mg/kg.The change of heart rate,blood pressure,skin condition and TOF were observed.When T1 reached the maximum block effect,condition of intubation were appraised and recorded.The inhibition and recovery process of adductor pollicis muscle to stimulation of ulnar nerve with TOF pulses was recorded.Times to T4/T1 inhibition and recovery to 25%,75% and 100% were noted.Which were the observing index for muscle relaxation.Hepatic function and renal function were determined after 24 hours.Results: AS the maximum block effect was 100%intubation completed.Grade one was 93.3%(28cases),and grade two was 6.7(% 2cases).No erubescent phenomenon and bronchitis spasm were discovered.After induction of anesthesia,HR and BP decreased significantly(P

Objective:To evaluate the sedative effect and security of propofol on psychotics undergoing modified electroconvulsive treatment(MECT).Methods:Tow hundred and ten psychotics undergoing MECT were treated with propofol for sedation and the treating times for each case were diversely 8 to 15.The changes of HR,MAP,SpO2 were monitored,and respiration and recovery time were observed after propofol was administered.Results:Compared with pre-anesthesia,HR remained the same and MAP significantly decreased after propofol was injected intravenously(P

Objective:To explore the peri-operative change of hemodynamics,electrolytes and biochemistry in patients undergoing allogenic renal transplantation.Methods:MAP,CVP,HR,electrolytes and biochemistry were monitored and analysed in 92 patients undergoing renal transplantation pre-anesthesia(T 1),before opening of renal artery (T 2),15 minutes after opening renal artery(T 3)and the end of surgery(T 4).Results:Comtrast T 1, MAP, CVP, pH,HCO3 - and BE decreased significantly at T 3,k + and GLU increased significantly at T 3,which has significantly different.CVP,GLU,pH,HCO3 - and BE decreased significantly and HR increased significantly at T 2 compared with T3.Conclusion:peri-operative change of hemodynamics,elecyrolytes and biochemistry is different in the different surgery phase and the change is the greatest after the blood recovery of donor kidney.

BACKGROUND:Currently the ultrasound-guided continuous femoral nerve block has been widely used as a postoperative analgesia method after knee replacement surgery, but there are stil some technical and practical details issues to be studied. OBJECTIVE:To evaluate the effect of ultrasound-guided imaging and safety evaluation of different puncture techniques and needle choice in the ultrasound-guided continuous femoral nerve block after total knee arthroplasty.METHODS:One hundred and sixty patients undergoing total knee arthroplasty were randomly divided into four groups, with 40 cases in each group. Continuous femoral nerve block was done after general anesthesia induction. Patients in each group were respectively punctured using 20 G needle (diameter 1.1 mm) out-of-plane approach, 20 G needle (diameter 1.1 mm) in-plane approach, 18 G needle (diameter 1.3 mm) out-of-plane approach, and 18 G needle (diameter 1.3 mm) in-plane approach. Patient-control ed analgesia pump was used 30 minutes before the end of surgery. The operating time of continuous femoral nerve block was recorded. The visual analogue scale scores at rest, active functional exercise and continuous passive movement state on 6, 24, 48, 72 hours after total knee arthroplasty were estimated. The presses of the pump, time of first walk, daily walk times and complication of continuous femoral nerve block were observed. RESULTS AND CONCLUSION:The operating time of continuous femoral nerve block in group D was shorter than that in other groups (P<0.05). There was no difference of visual analogue scale scores, the presses of the pump, time of first walk, and daily walk times among each group. The incidence of puncture site pain in group C was higher than that in other groups (P<0.05). The best ultrasound imaging was obtained by using 18 G needle in-plane approach for ultrasound-guided continuous femoral nerve block after total knee arthroplasty, and the complication incidence was not increased.

Objective To evaluate the clinical effect of different temperature of fluids and blood infusion on postoperative recovery quality in elderly patients undergoing total knee arthroplasty (TKA).Methods One hundred and fifty-six cases of elderly patients (male 42,female 1 14,aged 65-85 years,ASA Ⅰ or Ⅱ)scheduled for selective single TKA were recruited and divided into three groups randomly(n =52 each),normal temperature group (group NT),constant temperature group (group CT)and warming temperature group (group WT).Patients of group NT were infused with blood or fluids of room temperature (22-24 ℃)and surgical area were flushed with fluid of room tem-perature too.Patients of group CT were infused with blood or fluids of 37 ℃ by heating apparatus and temperature of fluids used to flushing was 37 ℃ too.Otherwise,in group WT,the tempreture of blood and fluids for infusion were kept at 37 ℃ and the surgical area were flushed with fluid of 39 ℃. The nasopharyngeal temperature were recorded on time points of before anesthesia (T0 ),30 min (T1 )and 1 h (T2 )after surgery beginning,30 min (T3 )and 1 h (T4 )after surgery.Time of sponta-neous breathing,time of eye opening on call,time of fully conscious,extubation time and Steward scores of patients were recorded too.And the cognitive function were evaluated by Postoperative Quality Recovery Scale (PQRS)on time points of 1 5 min and 40 min after extubation and the 1,3, 30 d after surgery.Results Compared with T0 ,the nasopharyngeal temperature of three groups were significantly decreased at T1-T4 (P <0.05 or P < 0.01 ).The nasopharyngeal temperature of group CT and group WT were significantly higher than in group NT at T1-T4 (P <0.01).And the nasopha-ryngeal temperature of group WT was significantly higher than in group CT at T4 (P <0.05).Com-pared with group NT,time of eye opening on call and spontaneous breathing in groups CT and WT were significantly shorter (P < 0.01 ).Time of fully conscious in group WT was obviously shorter than in group NT (P <0.01),and the Steward score in group WT was significantly higher than in group NT (P <0.05).Compared with before extubation,the cognitive function scores in all patients at 1 5,40 min after extubation and 1,3,30 d after surgery were increased significantly (P <0.01).The cognitive function scores in group CT and group WT at all time points were significantly higher than that in group NT (P <0.05).And the cognitive function scores in group WT was significantly higher than that in group CT at 30 d after surgery (P <0.05).Conclusion The elderly patients undergoing TKA receiving blood transfusion and infusion at 37 ℃ and flushing the area with fluid at 39 ℃ can prevent the occurrence of hypothermia and improve the postoperative recovery quality and cognitive function recovery.

Ultrasound-guided peripheral nerve block is widely used in clinical practice because of its high accuracy and safety. Residents must pass formal training to master this technique. However, residents are not familiar with the related anatomical structure of nerve block, and lack of basic ultrasonic knowledge, operation skills, simulation training, understanding of the corresponding complications, the optimal concentration and dose of local anesthetic drugs. In order to solve the above problems, we have taken measures such as basic theoretical knowledge learning, application of anatomy and ultrasound software, simulation training and grading training so that residents in standardized training of anesthesiology could fully grasp the clinical application of ultrasound-guided peripheral nerve block techniques.

Objective To investigate the blood-saving effect of controlled low central venous pressure (CLCVP) in different types of hepatectomy.Methods Ninety ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 37-76 yr,weighing 40-75 kg,undergoing elective hepatectomy,were divided into 6 groups according to the surgical approach and whether CLCVP was used during surgery (n =15 each):CLCVP1-3 groups and nonCLCVP1-3 groups (NCLCVP1-3 groups).The standard hepatectomy,half liver resection and irregular hepatectomy were performed in CLCVP1-3 groups,respectively,with CLCVP.The standard hepatectomy,half liver resection and irregular hepatectomy were performed in NCLCVP1-3 groups,respectively,without CLCVP.In CLCVP1-3 groups,from skin incision to the end of liver resection,CVP was maintained ≤ 5 cm H2 O through adjustment of the position,fluid restriction and iv infusion of nitroglycerin,and norepinephrine was infused simultaneously to maintain mean arterial pressure ≥ 60 mm Hg.In NCLCVP1-3 groups CVP was maintained at 6-12 cm H2O.Intraoperative blood loss and blood transfusion were recorded.Results Compared with NCLCVP1-3 groups,intraoperative blood loss was significantly decreased in CLCVP1-3 groups (P ＜ 0.05).Compared with NCLCVP3 group,the amount of blood transfusion was significantly decreased,the constituent ratio of intraoperative blood loss ＜ 200 ml was increased,and the constituent ratio of intraoperative blood loss ＞ 1000 ml was decreased in group CLCVP3 (P ＜ 0.05).Conclusion CLCVP can decrease the intraoperative blood loss and blood transfusion in patients undergoing irregular hepatectomy.

Objective To investigate the protective effects and possible mechanisms of polydatin(PD) on hypoxic-ischemia brain damage(HIBD) in neonatal rat by means of the expression of intercellular cell adhesion molecule( ICAM)-1 in cortex. Methods Fifty-four SD rats were divided into 3 groups at random, shame group (no HIBD), HIBD group (no medication) ,and PD treatment group. 7day-old rat's HIBD model was established by Rice's method. ICAM-1 expression in brain after HIBD was measured in different time by Immunohistochemitry technique. Results In sham group, there were less brain microvessel immunostained positively. In HIBD group,the number of ICAM-1 immuno-positive staining blood vessels increased significantly after 6h, 12h reached peak point. ICAM-1 immunoreactive staining of blood vessels levels continued in the peak after 24h. In PD treatment group, ICAM-1 expression on brain microvascular endothelial decreased after HIBD 6h, 12h, 24h, which was significant compared with HIBD group( P < 0. 05 or P < 0. 01 separately). Conclusion The expression of ICAM-1 was involved in the procedure induced by hypoxic-ischemia. After HIBD, polydatin would downregulate ICAM-1 expression in cerebral microvascular endothelial, and inhibite the inflammatory response.

Objective To explore the protective effects and possible mechanisms of Polydatin (PD)on hypoxic-ischemia brain injury(HIBD) in neonatal rat by means of spatial learning memory and the expression of synaptophysin in hippocampal CA1. Methods Thirty-seven neonatal SD rats were divided into 3 groups at random: normal sham-operated group( no hypoxia and ischemia); HIBD group( no medication) ;PD treatment group. 7-old-day rat' s model of HIBD was established by left carotid artery ligation and 2 h hypoxia. Morris water maze test was used to evaluate cognitive function in the rats after 28-day-old( 21-day later after HI). Immunohistochemical method was used to measure the expression of synaptophysin after the end of Morris water maze test. Results Morris water maze results showed that the mean escape latency of the shamgroup (SG) ,HIBD group (HIBD) and PD treatment group (PD) were (39. 55 ±8. 08) s, (52. 37 ±8.03) s and (43.29 ± 7. 63 ) s respectirely. For PD and SG, the mean escape latency was significantly shorter than the HIBD (P ＜0.05). After training,the mean escape latency in the three groups of rats was shortened gradually. The frequency of platform crossings were 5. 29 ±2.62、2. 36 ± 1.80、4. 25 ± 1. 66 in the SG,HIBD and PD respectirely. The frequency of platform crossings in PD was higher than that of HIBD ( P ＜ 0. 05 ). The swimming time in target quadrant were ( 15.74 ± 3.85) s, ( 10. 63 ± 3.66) s and ( 14. 32 ± 2. 52 ) s in SG, HIBD and PD respectirely. For HIBD ,the swimming time in target quadrant was significantly shorter comparing to SG and PD ( P ＜ 0. 05 ). The expression of synaptophys in hippocampal CA1 in PD ( 0. 295 2 ± 0. 044 3 )were evidently higher than that in the HIBD group (0.261 2 ±0.032 3) at 3 week after operation (P ＜0. 05). Conclusion Spatial learning memory deficits and the decrease of synaptophys in hippocampal CA1 could be induced by hypoxic-ischemia. Polydatin could improve the learning and memory ability in neonatal rats following hypoxic-ischemia brain damage. The mechanisms of improvement with Polydatin treatment is associated with the enhancement of expression of synaptophys.

Objetive To investigate a method of collecting lung cancer cells with bronchofibroscopic biopsy for primary culture and to improve the success rate of primary culture. Methods Thirty lung cancer specimens were obtained through bronchoscopic biopsy for primary culture. The correlation of cancer morphology under bronchofi-broscopy and success rate of primary culture was analyzed. Results Among the lung cancer specimens obtained through bronchoscopic biopsy, primary culture was successful in 17 of 30 cases (56.67%) . The success rate of cauliflower-like tumor mass under bronchofibroscopy was 84.62% (11/13) . The success rate of infiltrating tumor mass under bronchial mucosa with luminal stenosis with or without cristate were 66.67% (2/3) and 37.5%(3/8), respectively. The primary culture of a globular and stiff tumor mass was successful only 1 in 6 cases (16.67%) .Conclusions The primary culture of lung cancer cells obtained from bronchofibroscopic biopsy is simple and effective with a total success rate of 56.67%. Furthermore, the success rate of primary culture is signifi-cantly correlated with the cancer morphology under bronchofibroscopy.