Objective To investigate the role of spinal cord opioid receptors in the antinocieeptive effect of propefol in rats. Methods Male SD rats weighing 220-280 g were anesthetized with intraperitoneal chloral hydrate 300 mg/kg. Intratbecal (IT) catheter was placed at L5～6 interspace. Correct placement was confirmed by lower extremity motor block after injection of 2% lidocaine 15 μl via the iv catheter. Animals which were lame or paralyzed were excluded. Ninety SD rats in which IT catheters were successfully placed were randomly divided into 9 groups (n = 10 each): group Ⅰ propofol 10μg IT (P);group Ⅱ dimethyl suipbexide (DMSO-solvent for propofol) 5 μl IT (D);group Ⅲ artificial cerebral spinal fluid (ACSF) 5 μl IT;group Ⅳ propoful 10 μl + naloxone 15 μg IT (PN);group Ⅴ DMSO 5 μl IT + naloxone 15 μg IT (DN);group Ⅳ propofol 10μg IT + CTOP Ⅰμg IT (PC);group Ⅶ DMSO 5 μl IT + CTOP 1μg IT (DC);group Ⅷ propofol 10 μg IT + ICI 174, 864 1 μg IT (PI) and group ⅨDMSO 5 μl 1T + ICI 174, 864 1 μg IT (DI). In group Ⅳ-Ⅸ naloxone or CTOP (μ-receptor antagonist) or ICI 174, 864 (δ-receptor antagonist) was injected 5 min after propofol/DMSO. Pain threshold was measured before the first drug administration (T0) and at 10 min (T1), 20 min (T2) and 40 min (T3) after the first drug administration using hot water tail-withdrawal test. The latency for withdrawal of the tail from hot water was recorded. Results The pain threshold was significantly higher in group P, PN, PC and PI than in group D, DN, DC and DI respectively. The pain threshold was significantly increased at T1.2 compared with the baseline value at T0 in group P, PN, PC and PI. The pain threshold was significantly lower at T3 than at T1 and T2 in group P, PN, PC and PI. The pain threshold was significantly lower after drug administration in group PN and PI than in group P and PC. Conclusion Spinal cord δ-oploid receptors are involved in the anfinocicepfive effect of propofol.

Objective To evaluate the effect of curcumin pretreatment on c-Jun N-terminal kinase (JNK) signaling pathway during one-lung ventilation (OLV)-induced acute lung injury in mice.Methods Ninety SPF male C57BL/6J mice,aged 6-9 weeks,weighing 18-24 g,were randomly divided into 6 groups (n=15 each) using a random number table:two-lung ventilation (TLV) group;OLV group;curcumin 100,150,200 and 250 mg/kg groups (C100,C150,C200 and C250 groups).The corresponding doses of curcumin were administered intraperitoneally at 2 h before one-lung ventilation in C100,C150,C200 and C250 groups.The animals were tracheally intubated and mechanically ventilated in volume-controlled mode.The ventilator settings were adjusted to maintain the end-tidal pressure of carbon dioxide at 35-45 mmHg.In OLV,C100,C150,C200 and C250 groups,unilateral lung was ventilated for 1.5 h followed by 0.5 h of TLV.Bilateral lungs were ventilated for 2.0 h in group TLV.Peak airway pressure and airway pressure were recorded at 1.5 h of OLV and 0.5 h of TLV.At the end of mechanical ventilation,left lungs were removed for microscopic examination of the pathologic changes,and the index of quantitative assessment for alveolar damage (IQA) was recorded.Wet/dry lung weight ratio (W/D ratio) was determined,and the cell apoptosis in lung tissues was detected using TUNEL.The apoptosis index (AI) was calculated.The expression of JNK mRNA was determined using real-time polymerase chain reaction.The expression of JNK and phosphorylated JNK was determined by Western blot.The phosphorylation of JNK was calculated.Results Compared with group TLV,the IQA,W/D ratio,AI,expression of JNK mRNA and phosphorylation of JNK were significantly increased in group OLV (P＜0.05).Compared with group OLV,the IQA,W/D ratio,AI,expression ofJNK mRNA and phosphorylation of JNK were significantly decreased in C150,C200 and C250 groups,the parameters mentioned above were significantly decreased in sequence in C100,C150,C200 and C250 groups (P＜0.05),and no significant change was found in the parameters mentioned above in group C100 (P＞ 0.05).Compared with group OLV,the pathological changes were significantly attenuated in sequence in C150,C200 and C250 groups.Conclusion The mechanism by which curcumin pretreatment reduces cell apoptosis during OLV-induced acute lung injury is related to inhibition of JNK signaling pathway activation in mice.

Objective To evaluate the effects of dexmedetomidine on the expression of spinal matrix metalloproteinase-9 (MMP-9) in a rat model of neuropathic pain (NP).Methods Eighty-one adult male SpragueDawley rats,weighing 190-230 g,were randomly divided into 3 groups (n =27 each) using a random number table:sham operation group (group S); group NP; dexmedetomidine group (group Dex).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread in NP and Dex groups.In group Dex,dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.The equal volume of normal saline was given instead of dexmedetomidine in S and NP groups.Paw withdrawal threshold to von Frey filament stimulation (MWT) and paw withdrawal latency to thermal stimulation (TWL) were measured at 1 day before operation (To,baseline) and 5,9 and 16 days after operation (T1-3).Nine animals were sacrificed after measurement of pain threshold at T1-3 and their lumbar segments (L4,5) of the spinal cord were removed for detection of MMP-9 expression (by immuno-histochemistry) and tumor necrosis factor-alpha (TNF-α) content (by ELISA).Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the levels of MMP-9 and TNF-α were increased at T1-3 in NP and Dex groups.Compared with NP group,MWT was significantly increased,TWL was prolonged,and the levels of MMP-9 and TNF-α were decreased at T1-3 in Dex group.Conclusion Dexmedetomidine can inhibit up-regulation of MMP-9 expression,and decrease inflammatory responses,thus attenuating NP in rats.

Objective To evaluate the effects of propofol on the expression of hippocampal γ-aminobutyric acid (GABAA) and NMDA receptor in a rat model of inflammatory pain (IP).Methods A total of 32 female Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 4 groups (n =8 each):control group (group C),group IP,and different doses of propofol groups (P1,2 groups).IP was induced by injection of formalin.In group C,normal saline and dimethyl sulfoxide (DMSO) 0.1 ml/kg were injected intraperitoneally.In group IP,normal saline and DMSO 0.1 ml/kg were injected intraperitoneally,and 5 min later formalin was injected.In P1,2 groups,propofol 30 and 100 mg/kg were intraperitoneally injected,respectively,and 5 min later formalin was injected.The pain behavior of rats was observed within 1 h after injection of formalin and pain intensity scoring (PIS) value was calculated.The animals were sacrificed at 1 h after injection of formalin and the hippocampi were isolated for determination of GABAA and NMDA receptor expression by immunohistochemisty.Results Compared with group C,PIS value was significantly increased,GABAA and NMDA receptor expression was up-regulated in IP and P1.2 groups.Compared with group IP,PIS value was significantly decreased,GABAA receptor expression was up-regulated,and NMDA receptor expression was down-regulated in P1,2 groups.PIS value was significantly lower,GABAA receptor expression was higher,and NMDA receptor expression was lower in group P2 than in group P1.Conclusion Intraperitoneal propofol can down-regulate NMDA receptor expression in hippocampi of rats with IP,thus inhibiting responses to pain sensitivity; intraperitoneal propofol can up-regulate hippocampal GABAA receptor expression,thus enhancing endogenous mechanism of analgesia.

Objective To evaluate the blood-saving effect of tranexamic acid in pediatric patients undergoing radical correction of tetralogy of Fallot with cardiopulmonary bypass (CPB).Methods A total of 56 children of both sexes,aged 11 months-14 yr,with body mass index of 9.8-21.4 kg/m2,of ASA physical status Ⅱ or Ⅲ,with left ventricular ejection fraction ＞50％,scheduled for elective radical correction of tetralogy of Fallot with CPB,were randomly divided into 2 groups using a random number table:tranexamic acid group (TA group,n =30) and normal saline group (NS group,n =26).Anesthesia was induced with iv midazolam,sufentanil,vecuronium and propofol.The children were endotracheally intubated and mechanically ventilated.Anesthesia was maintained with inhalation of 1％-2％ sevoflurane and infusion of propofol,sufentanil and vecuronium.After induction of anesthesia,a loading dose of tranexamic acid l0 mg/kg was intravenously infused over 20 min before skin incision,followed by infusion at a rate of 10 mg · kg-1 · h 1 until the end of surgery in TA group,while the equal volume of normal saline was given instead in NS group.The volume of chest tube drainage at 24 h after surgery and volume of allogeneic red blood cells,fresh frozen plasma,platelet and cryoprecipitate transfused were recorded.The requirement for re-thoracotomy for bleeding,and the incidence of hepatic artery and portal vein thrombosis were also recorded.Results Compared to NS group,the volume of chest tube drainage at 24 h after surgery and volume of allogeneic red blood cells,fresh frozen plasma,platelet and cryoprecipitate transfused were significantly reduced in TA group.No re-thoracotomy was required in TA group,and the rate of re-thoracotomy was 15％ in NS group.No hepatic artery and portal vein thrombosis were detected in group TA.Conclusion Tranexamic acid (loading dose 10 mg/kg,maintenance dose 10 mg· kg-1 · h-1) can provide blood-saving effect and has high security in pediatric patients undergoing radical correction of tetralogy of Fallot with CPB.

OBJECTIVE To investigate characters of molecular epidemiology of meticillin-resistant Staphylococcus aureus(MRSA) outbreak strains in an emergency intensive care unit(EICU),to follow-up the possible sources,understand transmission for infection,and determine preventive strategies.METHODS Pulsed-field gel electrophoresis(PFGE) was used to analyze the homology of MRSA strains,isolated from clinical patients′ infection sites and environment,and carried by patients and healthcare workers in EICU of our hospital in December,2004.RESULTS Six of 17 patients were infected by MRSA,and 7 strains were isolated((including) 2 strains from different sites of the same patient).Surveillance cultures of ward′s environments,(patients)′ nares and healthcare workers′ nares and hands were performed in the outbreak period.Five MRSA strains were isolated,including a strain from nares of a patient,a strain from a table-board of a procedure room,a strain from hand of a nurse,a strain from a bed bar,and a strain from ward′s air.PFGE typing of the 12 MRSA strains showed that all 7 strains isolated from patients′ infection sites and two strains from nares of a patient and hand of a nurse were of type A.Strains from a procedure room,bed bar and air were of types B,C and D,respectively.CONCLUSIONS MRSA′s source and its transmission route are elucidated by genotyping.MRSA appears to come from a patient′s nares and has been transferred in ward by hand of healthcare workers.

OBJECTIVE To investigate the profile of pathogen of infection in kidney disease patients. METHODS Pathogen of infection in kidney disease patients in our hospital from Jan 2004 to Feb 2006 was retrospectively investigated. RESULTS A total of 240 pathogen strains were isolated from 223 cases.Of the 240 isolated strains the rate of strains of Gram-negative bacilli was 55.4%,that of the Gram-positive cocci was 26.3%,the rate of fungi was 10.0% and that of the Gram-positive bacilli was 8.3%.The positive rate of Escherichia coli was the highest followed by Haemophilus influenzae.54.2% Of isolates were from urine,21.3% from sputum.The isolated pathogens resisted at different degrees to antibiotics which were used frequently in clinic.The rate of polyinfection was not high. CONCLUSIONS Pathogen of infection in kidney disease patients is mainly Enterobacteriaceae.The isolates mainly are E.coli which is multi-resistant.It mainly causes the urinary infections.

By using the image processing function and programming tomography,the following functions are realized: the contour line,edge line and gradation histogram of medical images are displayed;the selected regions of medical images are freely zoomed;the gray level of discretional regions is displayed using medical image processing tool and the distance of the given points is freely measured.

Objective To determine the median effective dose (ED50) of hemocoagulase agkistrodon (HCA) inhibiting the bleeding after trans-bronchial lung biopsy (TBLB).Methods ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 45-75 yr,body mass index 19-24 kg/m2,scheduled for elective TBLB,were enrolled in this study.TBLB was performed after routine anesthesia.HCA diluted in normal saline 5 ml was locally injected into the biopsy site at 2 min before surgery.The initial dose of HCA was 1.4 U.The dose of HCA was determined by up and down sequential method.Each time the dose of HCA increased/decreased in the next patient depending on whether nor not the bleeding was observed in the biopsy wound under fiberoptic bronchoscope.The ratio between the two successive concentrations was 1.2.The ED50 and 95 ％ confidence interval of HCA were calculated by Dixon's up-and-down method.Results ED50 of HCA inhibiting the bleeding after TBLB was 0.9 U,and 95 ％ confidence interval was 0.7-1.1 U.Conclusion ED50 of HCA inhibiting the bleeding after TBLB is 0.9 U.

Objective To investigate the effect of postoperative analgesia with difference methods on immunity in patients after thoracic tumour surgery. Methods Forty ASA Ⅰ-Ⅱ patients aged 35-65 years old undergoing thoracic tumour surgery were randomized to receive either postoperative patient- controlled intravenous analgesia (PCIA) (group Ⅰ, 20 cases) or patient-controlled epidural analgesia (PCEA) (group E, 20 cases) for 48 h. Medicine compatibility in group Ⅰ: sulfentanyl 1μg/ml, tropisetron 0.05 mg/ml, the PCIA pump was set up to deliver a 5 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h. Epidual catheter was placed at T4-5interspace before induction of anesthesia in group E. The PCEA solution contained 2 mg/ml ropivacaine. The PCEA pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h after a loading dose of 0.33% ropivacame 6 ml. The VAS score, Ramsay sedation score and complications were reeorded. Blood samples were taken before induction (baseline) and at 2 h and 1st, 3rd and 7th day after surgery for determination of plasma concentrations of cortisol, interleukin 2 (IL-2) and the level of natural killer (NK) cells and eytokine-induced killer (CIK) cells. Results There was no significant difference in VAS score at 2 h after operation between two groups [(1.8±0.3) scores in group Ⅰ and (1.8±0.5)scores in group E].Ramsay sedation score at Ist, 3rd and 7th day after operation in group E were significantly lower than those in group Ⅰ (P<0.05), The plasma concentration of cortisol at 2 h and Ist, 3rd, 7th day after operation in group Ewere significantly lower than those in group Ⅰ (P<0.05), the levels of IL-2, NK cells and CIK cells in group E were significantly higher than those in group Ⅰ (P<0.05). Conclusions The efficacy of postoperative PCEA in improving immunity after thoracic tumour surgery is better than that of postoperative PCIA.