Objective To evaluate the efficacy of bispectral index (BIS) in guiding sevoflurane anesthesia in children. Methods Forty-eight ASA Ⅰ or Ⅱ pediatric patients aged 1-12 yr undergoing elective urological surgery were randomized into 2 groups ( n = 24 each) : group Ⅰ control and group Ⅱ BITS. Each group was further divided into 3 subgroups according to the age (n = 8 each) : subgroup A ( 1 yr≤age < 3 yr) ,subgroup B (3 yr≤ age<6 yr ) and subgroup C (6 yr≤age ≤ 12 yr). The patients were premedicated with IM atropine 0.015-0.02 mg/kg. Anesthesia was induced with 5% sevoflurane and 60% N2O in O2. Tracheal intubation was facilitated with vecuronium 0.1 mg/kg. Anesthesia was maintained with inhalation of sevoflurane and,50% N2O in O2 and intermittent Ⅳ bolnses of vecuronium and fentanyl. In BIS group, BIS was maintained at 40-60 during operation and at 60-75 during the 15 min before the end of surgery. BIS was monitored and recorded but not available to the anesthesiologist in control group and the depth of anesthesia was maintained based on hemodynamic changes and clinical signs. MAP, HR, end-tidal sevoflurane concentration, BIS, emergence time, extubation time and PACU discharge time were recorded. The amount of sevoflurane consumed was calculated. Results There was no significant difference in the demographic data between the cotresponding age groups of BIS and control group. The BIS were maintained at 40-60 in control group. The BIS was significantly higher in BIS group than in control group except the subgroup A. The end-tidal sevoflurane concentration was significantly lower, and the emergence time, extubation time and PACU discharge time were significantly shorter in BIS group than in control group. There was no significant difference in MAP and HR between the 2 groups. Conclusion BIS monitoring can reduce sevoflurane consumption and allow faster emergence from sevoflurane anesthesia in children over 1 yr of age.

Objective: To examine the effects of midazolam-induced sedation on heart rate variability (HRV). Method:Fifteen ASA Ⅰ- Ⅱ adult patients,undergoing elective surgery under lumbar epidural anesthesia were randomly selected. An intravenous bolus dose of midazolam(1.5mg) was administered every 3-5 minutes until patients' sedation levels assessed by observers assessment of alertness sedation(OAA/S) scale had scores of 1. Spectral analysis of HRV was performed at different OAA/S scores and at 3min,5min and 10min following OAA/S score of 1. Result:All frequency components of HRV were significantly reduced as patients' OAA/S scores decreased,especially low frequency (LF) and total power. Midazolam decreased normalized unit power of LF from 33.5%?8.9% to 16.65?9.6% and increased normalized unit power of high frequency(HF) from 11.7%?4.2% to 20.5%?26.5%. LF/HF ratio also reduced. Conclusion:Midazolam shiftes the balance of autonomic nervous activity toward the parasympathotonic.

Objective To evaluate the effects of dantrolene pretreatment on diaphragmatic function in septic rats .Methods Thirty adult male Sprague-Dawley rats , weighing 200-220 g , aged 9-10 weeks , were randomized into 3 groups (n=10 each) using a random number table :sham operation group (group S) ,spesis group (group CLP) and dantrolene group (group D) .The animals were anesthetized with pentobarbital sodium . Dantrolene 6 mg/kg was injected intraperitoneally (in dimethyl sulfoxide 500 μl ) .Sepsis was induced by cecal ligation and puncture 1 h later in CLP and D groups .The left and right diaphragm was rapidly excised at 24 h after cecal ligation and puncture . The left diaphragm was used to detect the systolic function including the single stimulation twitch , dmax/dt , dmin/dt , maximal force of tetanic contraction , force-frequency curves , and fatigue index .Results Compared with group S ,the single twitch myopalmus ,dmax/dt ,dmin/dt ,maximum peak tension and fatigue index were significantly decreased in group CLP ,the single stimulation twitch ,dmax/dt ,dmin/dt and maximal force of tetanic contraction were decreased , fatigue index was increased in group D , and the force-frequency curve was shifted downward in CLP and D groups ( P<0.05 or 0.01) .Compared with group CLP ,the single stimulation twitch ,dmax/dt ,dmin/dt ,maximal force of tetanic contraction and fatigue index were significantly increased in group D ( P< 0.05 or 0.01 ) .Conclusion Dantrolene pretreatment can improve diaphragmatic function in septic rats .

Objective To discuss the efficacy of the modified falling risks for older people-community setting screening tool and the falling risks of the older people.Methods A cross-sectional study was conducted in 4 communities of Chengdu.A total of 408 people aged 65 years and over from 4 residents communities were selected with convenient sampling.To screen out the people who were in high risk of falls with a self-making questionnaire and the modified falling risks for older people-community setting screening tool.Results After the 408 older people were evaluated by modified falling risks for older people-community screening tool,the result showed the area under curve of receiver operating characteristic of the scale was 0.936.Its sensitivity was 77.6％ (66/85),specificity was 93.2％ (301/323),positive predictive value was 75.0％ (66/88) and negative predictive value was 94.1％ (301/320).Conclusions The using of modified falling risks for older people-community setting screening tool is easy and fast,it has higher sensitivity,specificity and evaluation function.It can be used for screening falling risks among community setting elderly people in China.

Objective To evaluate the effect of sevoflurane on the expression of calcium-sensing receptor (CaSR) in the myocardium of rats with high-level spinal cord injury (SCI).Methods Thirty healthy male Wistar rats, weighing 250-300 g, were randomly divided into 3 groups using a random number table: sham operation group (group S, n = 6) , SCI group (n =12) and sevoflurane group (group Sev).SCI was induced in anesthetized rats by dropping a l0-g weight onto C7 spinal cord from 5.0 cm height falling freely inside a vertical hollow glass tube.Group SCI inhaled 2 L/min pure oxygen for 30 min, and group Sev inhaled 2％ sevoflurane for 30 min starting from 30 min after SCI.At 12 and 24 h after SCI (T1,2) , 6 rats were selected randomly, and blood samples from the abdominal aorta were drawn for determination of serum cardiac troponin I (cTnI) concentrations.The rats were then sacrificed, and myocardial specimens were obtained for determination of CaSR protein and mRNA expression (using fluorescent quantitative real-time reverse transcriptase-polymerase chain reaction or Western blot) and for examination of myocardial ultrastructure (with transmission electron microscope).Results Compared with group S, the serum cTnI concentrations and CaSR protein and mRNA expression were significantly increased at T1,2 in SCI and Sev groups.Compared with group SCI, the serum cTnI concentrations and CaSR protein and mRNA expression were significantly decreased at T1,2 in Sev group.The damage to myocardial cells was significantly reduced in group SCI compared with group Sev.Conclusion Sevoflurane reduces myocardial damage through inhibiting CaSR expression in the myocardium of rats with high-level SCI.

Objective Orthotopic liver transplantation (OLT) without bypass is technically simpler butimposes additional stress and strain on already compromised ciroulatory function and milieu interieur. The purposeof this study was to investigate the changes in arterial blood concentrations of glucose and lactate during OLTwithout bypass. Methods Eighty patients (66 male, 14 female) aged 12-67 yr weighing 40-130 kg undergoingOLT without veno-venous bypass for terminal liver cirrhosis (40 patients), liver cancer (28 patients), hepato-lenticular degeneration (5 patients), polycystic liver (3 patients) and severe hepatitis (4 patients). Nine patientswere classified as ASA physical status Ⅱ, thirty-nine patients as ASA Ⅲ, thirty patients ASA Ⅳ and two patientsASAV. Anesthesia was induced with midazolam 2 mg, fentanyl 10-15?g?kg~(-1), propofol 1 .0 - 1 .5 mg?kg~(-1) andpancuronium 0. 15 mg?kg~(-1) and maintained with isoflurane inhalation and intermittent i. v. boluses of fentanyl,midazolam and pipecuronium. The patients were mechanically ventilated after intubation, P_(ET) CO_2 was maintained at32-35 mm Hg. No fluid containing glucose was infused during operation. Radial artery and internal jugular veinwere cannulated for BP and CVP monitoring. ECG, MAP, CVP, SpO_2, P_(ET)CO_2, temperature and urine outputwere continuously monitored during operation. Blood samples were taken from artery before anesthesia (T_0 ), beforecross-clamping of portal vein (T_1), 30 and 60 min during anhepatic phase (T_2, T_3), 5 and 30 min afterunclamping of vena cava before the unclamping of portal vein (T_4, T_5 ) and at the end of surgery (T_6 ) fordetermination of blood glucose and lactate concentrations. Blood lactate was determined only in 50 patients whoreceived no lactated but acetated Ringer's solution during operation. In 70 patients blood samples were obtainedfrom hepatic vein after unclamping of portal vein and before the end of exsanguination from the hepatic vein fordetermination of blood glucose and lactate. Results No patient developed hypoglycemia during operation. Bloodglucose increased slightly before cross-clamping of portal vein (T_1) and during anhepatic phase (T_2, T_3) comparedwith the baseline value before anesthesia (T_0 ) (P

Objective To evaluate the effects of propofol and thiopontal on calcium and potassium channels in rat ventricular myocytes and to elucidate the underlying mechanisms of their inhibitory effect on myocardium. Methods Freshly isolated ventricular myocytes were prepared from hearts of rats by trypsin. The effects of propofol and thiopental on L-type calcium current(Ica) and delayed rectifier potassium current(IK)were compared using whole-cell patch clump technique. Results Propofol and thiopontal produced a concentration-dependent inhibition of Ica. Peak concentration of propofol(50 ?mol?L~(-1)) and thiopental(100 ?mol?L~(-1)) during induction of anesthesia decreased Ica by 28% and 46% and shifted the steady-state inactivation curve to more negative voltage, but had no effect on the steady-state activation curve. Propofol and thiopental also decreased IK in a concentration-dependent manner, but the effects of both anesthetics on IK were smaller compared with their effects on Ica. Conclusion The findings of this study suggest that the negative inotropic of propofol and thiopental are, at least in part, related to decrease in Ca~(2+) trans-sarcolemmal current by accelerating L-type calcium channel inactivation. Both anesthetics decrease delayed rectifier potassium current, thus partially antagonizing the effect of decreased calcium current.

Objective To investigate the effects of propofol on the release of noradrenaline ( NE) from the locus coeruleus in the brain of rabbits trying to elucidate the central mechanism of the cardiovascular inhibition induced by propofol.Methods Nine healthy male New Zealand rabbits weighing 2.0-2.5 kg were used in this study. A trocar (0.8 mm in diameter) was inserted into locus coeruleus using the stereotactic technique and fixed. Four days later push-pull perfusion of the brain was performed. 37℃ artificial cerebrospinal fluid (aCSF) was infused through the trocar at 0.1 ml?min-1 . A loading dose of propofol 2 mg?kg-1 was given i.v. followed by continuous infusion at 150 ?g?kg-1?min-1 for 30 min. The experiment was concluded at 20 min after propofol infusion. The perfusate having passed through the locus coeruleus was collected before and every 10 min during and after infusion. The NE concentration of the perfusate was measured by high performance liquid chromatography. Results The NE concentration of the perfusate from locus coeruleus significantly decreased after the loading dose and during the infusion of propofol and reached its bottom level at 10 min after loading dose. The maximal decrease was 75.5% [from (15.9 ? 3.2) pg??l-1 to (3.9?0.5) pg ? ?l-1]. Conclusion Intravenous propofol decreases the NE concentration in locus coeruleus. The cardiovascular inhibition induced by propofol may partly be explained by this central mechanism.

Objective To examine the effects of propofol, midazolam and pyrrolidine dithiocarbamate (PDTC) on acute lung injury (ALI) induced by normothermic cardiopulmonary bypass (CPB) .Methods Twenty-six adult SD rats of both sexes weighing 350-450 g were randomly divided into 4 groups: group I midazolam (MZ, n = 7); group 11 MZ + PDTC ( n = 7); group III propofol (PROP, n = 7) and group IV sham operation ( n = 5). The animals were premedicated with intraperitoneal (i.p.) atropine 1 mg?kg-1 and anesthetized with i.p. midazolam 4 mg?kg-1 and fentanyl 150?g?kg-1 in group I , II and IV or with i.p. propofol 30mg?kg-1 and fentanyl 150 ?g?kg-1 in group III . CPB was performed at a flow rate of 100 ml?kg-1? min-1 for 60 min. In group II PDTC 100 mg?kg-1 was given i.p. 30 min before CPB. In sham operation group the animals were anesthetized, intubated and mechanically ventilated but underwent no CPB. Arterial blood samples were taken before initiation of CPB (T1 ) , at the end of CPB (T2) and 60 min after CPB (T3) for blood gas analysis and determination of the expression of CD11b on neutrophils by flow cytometry. Respiratory index (RI) was calculated at T1 and T3 . The animals were killed at 60 min after CPB and the lungs were removed for broncho-alveolar lavage. PMN count, protein and IL-8 concentration of broncho-alveolar lavage fluid (BALF) and lung MDA content were determined. The lung histology was also examined. Results RI was significantly increased at T3 as compared to T1 in group MZ ( P

Objective To investigate the inhibitory effects of fentanyl on GABAA receptors in hippocampal pyramidal neurons of rat.Methods Pyramidal neurons were acutely isolated from 3-10 day old SD rats of either sex by enzymatic-mechanic method. GABAA receptor mediated currents ( IGABA) were recorded using voltage clamped whole cell patch clamp technique in gap-free mode at the holding potential (VH) of - 50 mV. Current-voltage relationship of IGABA was obtained in ramp protocol ranging from + 30 mV to - 110 mV and lasting for 1 600 ms. Data were collected by using a system consisting of Axopatch 200B patch-clamp amplifier, Pentium Ⅲ computer and Digidata 1200 interface. All experiments were performed at room temperature (22-25℃). Five to twelve neurons were used for each fentanyl concentration. The effects of fentanyl from 1.0 ? 10-5 ?mol?L-1 to 10. 0 ?mol?L-1 were evaluated by the inhibition rate of the peak amplitude of IGABA, the desensitization time constant (?des) of IGABA and the reversal potential (Ecl- ) of IGABA. A ?-opioid receptor selective antagonist CTAP 1 ?mol?L-1 was applied and its effects on fentanyl were recorded. Results (1) GAB A 1-1 000 ?mol?L-1 induced inward currents (IGABA) dose-dependently with an EC50 of 23.73 ?mol?L-1.IGABA induced by GABA 30 ?mol?L-1 was blocked by bicuculline 1 ?mol?L-1. (2) Fentanyl depressed IGABA dose-dependently with EC50 of 0.011 ?mol?L-1 and shortened the rdes of IGABA.(3) The inhibitory effects of fentanyl on IGABA were antagonized by CTAP. (4) Fentanyl 0.01 ?mol?L-1 and CTAP did not influence the reversal potential of IGABA (Ecl- -3.0 mV) .Conclusion Fentanyl inhibits the function of GABAA receptors through ?-opioid receptors in hippocampal pyramidal neurons. Hippocampus may play a role in the neuroexcitatory effects of opioids.