Objective To observe oxygenation status when different modes of mechanical ventilation were actualized during laparoscopic operations in obese patients. Methods Sixty obese patients for laparoscopy were divided into three groups with 20 patients in each group, receiving volume controlled ventilation (VCV Group), or pressure controlled ventilation (PCV Group), or pressure controlled ventilation with positive end-expiratory pressure (PCV+PEEP Group). Levels of pH value, PCO_2, PO_2/FiO_2, and Qs/Qt were measured at 30 min after pneumoperitoneum (T1), 60 min after pneumoperitoneum (T2), 30 min after extubation (T3), and 60 min after extubation (T4), respectively. Results The oxygenation index was significantly higher in the PCV+PEEP Group at T1 (429.35?51.88) and T4 (231.87?20.47) than in the VCV Group at T1 (346.15?54.48; q=6.771, P

Objective To investigate effects of three types of mechanical ventilation on oxygenation status in laparoscopic gastric banding for the treatment of morbid obesity.Methods Twenty-four morbidly obese patients scheduled for laparoscopic gastric banding were divided into three groups.The Group A was given a tidal volume of 12 ml/kg and a respiratory rate of 10 times/min,the Group B,a tidal volume of 20 ml/kg and a respiratory rate of 10 times/min,and the Group C,a tidal volume of 12 ml/kg and a respiratory rate of 20 times/min,respectively.The measurement of arterial blood for pH value,PO2,PCO2,Plat Pressure,Peak Pressure,and AaDO2 was conducted before(T1) and after pneumoperitoneum(T2). Results After pneumoperitoneum,the Group B had significantly higher Plat Pressure(33.2?1.8 cm H2O) and Peak Pressure(36.3?1.6 cm H2O) than the Group A(Plat Pressure: 29.5?3.9 cm H2O,q=3.053,P

Objective To investigate the sinusoidal endothelia) cell (SEC) apoptosis induced by hepatic ischemia-reperfusion (I/R) and the effect of propofol on the hepatic cell apoptosis in vivo. Methods For hepatic I/R study we utilized a rat model of 70% liver ischemia according to Kohli, et al . Twenty-four male SD rats weighing 250-350 g were randomly assigned to 3 equal groups of eight animals : group A was subjected to 30 min of liver ischemia followed by 6 h of reperfusion and normal saline was infused iv at the onset of reperfusion, at a rate 10 ml ? kg-1 ? h -1 for 60 min; group B was subjected to the same J/ R as in group A but instead of NS propofol 20 mg " kg was given iv followed by continuous infusion of 0.5% propofol at 50 mg? kg-1 ? h-1 for 60 min; group C underwent sham operation followed by intravenous NS infusion at 10 ml kg h for 60 min. Blood samples and liver biopsies were obtained at the end of 6h of reperfusion, for determination of plasma alanine aminotransferase (ALT) activity and hepatic malondialdehyde (MDA) content, apoptosis and microscopic examination (light and electron microscopy) . Apoptosis was determined both qualitatively and quantitatively by DNA laddering and TUNEL methods. Results In group A there was a significant increase in apoptotic hepatocytes and SEC after I/R as compared with group C ( P

Objective To evaluate the predictive performance of the target controlled infusion (TCI) system for propofol using Marsh pharmacokinetic parameters in the elderly patients. Methods Sixteen ASA grade I - Ⅱ patients of both sexes (9 male, 7 female) aged 65-75 yr weighing 49-76 kg scheduled for elective lower abdominal surgery were enrolled in this study. The patients were unpremedicated. Right internal jugular vein was cannulated for drug and fluid administration and left radial artery was cannulated for BP monitoring and blood sampling. Anesthesia was induced with TCI propofol (target plasma concentration was set at 3 ?g?ml-1 ) and TCI fentanyl (target plasma concentration set at 2 ng?ml-1 ) . Tracheal intubation was facilitated with succinyl choline 1.5mg?kg-1 . The patients were mechanically ventilated ( VT 8 ml?kg-1 , RR 10 bpm) . Anesthesia was maintained with TCI propofol and fenlanyl and intermittent i.v. boluses of vecuronium. The target plasma concentration of propofol and fentanyl were the same as that for induction. MAP, HR, SpO2 and BIS were continuously monitored during operation. Blood samples were taken at 5, 10, 15, 20, 30, 45, 60, 90, 120 min during TCI of propofol for determination of plasma propofol concentration with HPLC. The predictive performance was evaluated by PE% [measured concentration (Cm) - predicted concentration (Cp)] /Cp ? 100% , MDPE, MDAPE and wobble. Results BIS was maintained between 38-55. The MDPE was 6%, MDAPE 14% and wobble 18 % with this TCI system incorporating Marsh pharmacokinetic parameters for propofol. Conclusion The TCI system incorporating Marsh pharmacokinetic parameters for propofol is acceptable for elderly patients.

Objective To determine the feasibility of achieving local transgenic expression in the rat lung using bone marrow mesenchymal stem cells ( MSCs) transfected with Lac-Z gene. Methods Primary cultures of bone marrow MSCs from Lewis rats were transfected with the pSV-?-galactosidase control vector and labelled with a fluorescent, membrane impermeable dye DAPI. The transfected and labelled MSCs (5?105 cells/animal) were injected into the jugular vein of syngenetic recipient rats. The animals were killed at 48 h and 8 wk after injection respectively. The lungs, spleens, livers, kidneys and skeletal muscle were then excised and examined under fluorescene microscope. The transgenic expression of Lac-Z gene was detected by incubating with the X-gal chromogen.Results Only a few DAPI labelled MSCs could be identified in the spleen, liver, kidney and skeletal muscle, whereas a large amount of DAPI labelled MSCs could be identified in the lung and most of them lodged in the lung parenchyma and air sac at 48h and 8wk after intravenous injection of transfected MSCs. After incubation with the X-gal chromogen, microscopic examination showed that a large number of MSCs with multiple intense blue staining were scattered throughout the lung. On the contrary only a few cells with blue staining could be identified in the spleen and kidney and no MSCs with blue staining could be seen in the liver pancreas and skeletal muscle. Conclusion Genetically modified MSCs injected into the jugular vein can target the lung effectively and achieve local transgenic expression for a long time.

Objective　To investigate the different expression of actin, myosin Ⅱ in hypertrophic scars, keloids and normal skins, and to understand the relationship of actin, myosin Ⅱ and the scar contracture. Methods Fifteen cases with hypertrophic scars, 10 cases with keloids and 15 cases with normal skins were chosen randomly. The expression of actin and myosin Ⅱ were detected by immunohistochemical method in the hypertrophic scars, keloids and normal skins. The fibroblasts isolated from three types of tissue were cultured in vitro, then actin and myosin Ⅱ in three different fibroblasts were measured using flow cytometry. Results　The immunohistochemical staining of myosin Ⅱ in hypertrophic scars was positive, while the staining in keloids and normal skins were negative. The positive rate of myosin Ⅱ expression in hypertrophic scars, keloids and normal skins were (95.11±2.78)%， (16.86±7.11)%, and (5.31±1.79)% respectively. There were significant difference between keloids and the two others(P＜0.01). The actin expression in three difference tissues were positive, there were no significant difference in hypertrophic scars, keloids and normal skins(P>0.05). The positive rate of actin expression in hypertrophic scars, keoids and normal skins were(77.77±15.43)%, (88.89±10.29)%, and (82.92±13.48)% respectively, and there were no significant difference(P>0.05). Conclusion　Myosin Ⅱ may play an important role in the scar contracture. Actin is the contractile protein of cell, it plays important role in cellular movement. Actin is necessary protein in the cell.

Objective To analyze effects of different anesthesia procedures on heart rate variability(HRV) as an index of autonomic nervous activity and hemodynamics during CO2 pneumoperitoneum pressure in laparoscopic cholecystectomy(LC).Methods 45 patients of ASA I or II phage scheduled for LC were divided into general anesthesia group(Group I,Control Group),general anesthesia combined with esmolol group(Group II) and general anesthesia combined with epidural block group(Group III) according to operation date.HRV,HR and MAP were measured before anesthesia(T1),before pneumoperitoneum(T2) and at 5 min(T3),10 min(T4),20 min(T5),30 min(T6) after pneumoperitoneum.Results As compared with pre-pneumoperitoneum(T2),low frequency(LF),low frequency/high frequency(LF/HF) in the Group I increased significantly(P0.05).Comparisons among the three groups,LF,LF/HF in the Group I at all time points after pneumoperitoneum were significantly higher than those in the II and III Group(P0.05).Conclusions Esmolol can relieve stress reaction induced by pneumoperitoneum,but it can't completely block increasing of sympathetic nerve activity;using general anesthesia combined with epidural block in LC can inhibit sympathetic nerve excitation,sustain automatic never stability.

Objective To evaluate if expression of serum retinol-binding protein 4 (RBP4) concentrations in cholesterol gallstone disease.Methods Serum RBP4 levels of 100 cholesterol gallstone disease patients (cholesterol gallstone disease group) and 147 healthy controls (healthy control group) were measured by enzyme-linked immunosorbent assay and further correlated with clinical and biochemical characteristics,including insulin resistance and renal function.The chemical composition of gallstones was determined by postoperative pathology.Results The level of RBP4 in cholesterol gallstone disease group was significantly lower than that in healthy control group [(30.57 ± 13.64 ) mg/L vs.(41.52 ± 20.25 ) mg/L](P＜ 0.01 ).The level of RBP4 was also associated with gallstone occurrence (OR =0.93,95％ CI:0.88 -0.96,P =0.004).Serum RBP4 levels of all subjects were positively correlated with total cholesterol,triglyceride,creatinine,insulin resistance and albumin ( P ＜ 0.05 or ＜ 0.01 ),and negatively correlated with aspartate aminotransferase (P ＜0.01).In multivariate analysis,cholesterol gallstone formation was significantly associated with a lower serum RBP4 level (OR =2.97,95％ CI:1.15 -7.68,P =0.025 ).Both gallstone patients and controls were subdivided into two groups according to ceatinine:≥ 88.40 μ mol/L group and ＜ 88.40 μ mol/L group.Patients with gallstones were found to have significantly lower serum RBP4 levels than controls in both subgroups (P =0.012,0.045 ).According to GFR,both gallstone patients and controls were subdivided into ≥ 90 ml/(min· 1.73 m2) group,60 - 89 ml/(min· 1.73 m2) group and ＜60 ml/ (min· 1.73 m2) group.It showed that a lower GFR was associated with greater serum RBP4 level in healthy control group.This trend was not noted in cholesterol gallstone disease group.Conclusions Serum RBP4 decreases in cholesterol gallstone disease independent of renal function.The relationship between liver function and RBP4 level in these patients deserves further investigation.

Objective To discuss the mechanism of Liuwei Dihuang Decoction against renal interstitial fibrosis. Methods The rat models of renal interstitial fibrosis were induced by 5/6 nephrectomy, and were randomly divided into sham-operation group, model group, Liuwei Dihuang Decoction group and enalapril group. Liuwei Dihuang Decoction group was given 6.25 g/(kg?d) of Liuwei Dihuang Decoction for gavage, enalapril group was given 10 mg/(kg?d) enalapril for gavage, sham-operation group and model group were given 10 mL/(kg?d) of distilled water for gavage, 1 time per day for 12 weeks. Expressions of HIF-1α, CollI, and CollIII in kidney tissue were detected by immunohistochemistry. Results Compared with the sham-operation group, the expressions of HIF-1α, CollI, and CollIII of renal tissue in the model group significantly increased (P<0.05). Compared with the model group, Liuwei Dihuang Decoction group and enalapril group can inhibit the expressions of HIF-1α, CollI, and CollIII (P<0.05), and Liuwei Dihuang Decoction group was better than enalapril group (P<0.05). Conclusion The mechanism of Liuwei Dihuang Decoction against renal interstitial fibrosis may improve the renal tissue of chronic hypoxia to play the role of preventing renal interstitial fibrosis by decreasing the expressions of HIF-1α, CollI, and CollIII.