Objective To investigate the role of Rho/Rock signaling pathways in ventilator-in-duced lung injury in rats.Methods Ninety-six male SD rats,weighing 300-350 g,were equally and randomly divided into four groups using a random number table (n =24 each):control group (group C),fasudil group (group F),high tidal volume group (group H)and high tidal volume + fasudil group (group HF).Rats in group C and group F received no mechanical ventilation,rats in group H and group HF were intubated and mechanically ventilated (VT = 40 ml/kg,RR = 40 beats per minutes,FiO 2 =40%)for 4 h.The animals in group F and group HF were given intraperitoneal in-jection of fasudil 10 mg/kg at the time 1 h before mechanically ventilated.Six rats were chosen in each group at the time before ventilation (T0 )and at 4,8,24 h after ventilation (T1-T3 ),and blood sam-ples were taken for determination of the levels of serum tumor necrosis factor-α (TNF-α),IL-6 and IL-10,lungs were removed,bronchoalveolar lavage fluid (BALF)was collected to examine protein content,wet/drying (W/D)ratio was determined,which were then stained with haematoxylin and e-osin and examined under microscope,the pathological changes of lungs were scored.Myeloperoxidase (MPO)activity in lung tissue was determined by spectrophptometry.Protein and gene expression of RhoA and Rock2 in the lung tissue were detected by Western blot and reverse transcription PCR (RT-PCR).Results Compared with group C,the serum TNF-α,IL-6 and IL-10,BALF protein content, W/D ratio,the pathological scores,MPO activity,the expression of RhoA,Rock2 protein and mR-NA were significantly increased in group H and HF at T1-T3 (P <0.05 ).Compared with group H, the serum TNF-αand IL-6,BALF protein content,W/D ratio,the pathological scores,MPO activi-ty,the expression of RhoA,Rock2 protein and mRNA were significantly decreased,and the serum IL-10 was significantly increased in group HF at T1-T3 (P <0.05).Conclusion Fasudil can attenuate ventilator-induced lung injury in rats,and the mechanism may be associated with inhibition of the Rho/Rock signaling pathways reducing the inflammatory response.

Objective To observe the effects of ketamine on the behavior and indoleamine 2,3-dioxygenase (IDO ) signaling pathway in the rats with pain and depression comorbidity. Methods Twenty-four male adult SD rats,aged 2 months,weighing 200-250 g,were randomized into three groups:control group (group S),saline group (group N)and ketamine group (group K), eight in each group.CFA (50 μl)was injected into the right tibiotarsal joint cavity to establish the model of pain and depression comorbidity in the groups N and K,whereas saline (50 μl)was injected in the group S.The mechanical withdrawal threshold (MWT)and the immobility time were measured 1,7,and 14 days after the CFA injection.After the behavioral tests 14 days after the CFA injection, saline (1 ml)was intraperitoneal administrated in the group N and ketamine 20 mg/kg (1 ml)was in-traperitoneal administrated in the group K 14 days after CFA injection.The MWT and immobility time were measured 1 h after administration in the three groups to evaluate the behavioral changes. Then,the hippocampus,prefrontal cortex,cingulated gyrus and plasma were harvested to determine the levels of IL-6 and IDO using an enzyme-linked immunosorbent assay after the behavioral tests. Results Compared with the group S,the MWT was decreased and the immobility time was signifi-cantly increased in the group N and group K (P <0.05).Compared with the group N,the MWT was increased (P <0.05),the immobility time was decreased (P <0.05),and the levels of IL-6 and IDO in the hippocampus,prefrontal cortex and cingulated gyrus were significantly decreased in the group K (P < 0.05 ).Conclusion Ketamine can effectively treat pain and depression comorbidity,which may be attributed to the inhibition of IDO signaling pathway in different brain regions of rats.

Objective To observe the expression of neuroglobin in brain of rat with septic shock,and study the protective effect of neuroglobin.Methods Sixty male SD rats were randomly di-vided into two groups,30 rats in each.The rats in group M were injected LPS 10 mg/kg through tail vein to establish septic shock model,the success standard of septic shock was systolic blood pressure dropping to 60% of the basic values;the control group were given equal volume of NS.The levels of rat TNF-α,IL-6 and NGB in serum at the time points of before LPS injection (T0 ),1 h (T1 ),2 h (T2 ),4 h (T3 )and 6 h(T4 )after LPS injection were measured using ELISA kits.NGB and caspase-3 protein expression in brain were determined using Western blotting.Results Compared with group C and T0 ,the TNF-α,IL-6 concentrations in serum and caspase-3 in brain were increased significantly at T1-T4 (P <0.05),NGB protein content in serum and brain at T3 and T4 were increased significantly (P <0.05).Conclusion Cell apoptosis and inflammatory response are discovered in the brain during septic shock.NGB is over-expressed in brain of rats with septic shock,which may play a role of pro-tective function.

Objective To investigate the correlation between posterior neck pain and lumbar epidural pressure (LEP)during percutaneous endoscopic lumbar discectomy (PELD).Methods A prospective study was performed on 86 patients undergoing PELD,46 males,40 females,aged 1 9-71 years,with ASA physical status of Ⅰ or Ⅱ.Each patient received lumbar epidural anesthesia.Lum-bar epidural pressure (LEP)was monitored continuously through a lumbar epidural catheter which was connected to a pressure transducer.LEP before the operation (LEPbase ),LEP at the time of pos-terior neck pain (LEPpain )and maximal LEP (LEPmax )were recorded.Results Thirty patients (34.9%)complained of posterior neck pain during the procedure.The lowest LEPmax was 31.0 mm Hg,and the highest LEPmax was 77.0 mm Hg.The LEPmax in patients with neck pain [(60.6± 8.8)mm Hg]was significantly higher than LEPmax in patients without neck pain [(50.7 ± 9.5 ) mm Hg](P <0.01 ).Patients with higher LEPmax had higher probabilities of having posterior neck pain (P <0.01).Conclusion Patients with higher LEPmax had higher probabilities of having posterior neck pain.

Objective To evaluate the efficacy and influencing factors analysis of doxorubicin treatment for herpes zoster neuralgia postherpetic neuralgia (PHN).Methods From January 2010 to January 2014 in the Second Hospital of Tianjin Medical University,209 cases of herpes zoster neural-gia patients (94 males,1 1 5 females,aged 45-86 years)received doxorubicin non-vascular interven-tional treatment,using visual analogue scale (visual analogue scale,VAS score)to evaluate curative effect,then recorded the related factors of patients (gender,age,location,duration,and degree of pain,whether to have hypoimmunity disease,early antiviral treatment,the presence of hyperalgesia, and outbreak pain,drug concentration,guiding method,the recent curative effect).Using single-fac-tor analysis of variance procedure and multiple factors of logistic regression analysis.Results The to-tal effective rate was 82.76% (1 73/209)after one month,the total effective rate was 86.12% (180/209)after twelve months.Single factor analysis showed that age≤65 years,duration of diseases<3 months,severe pain(VAS≥ 7 )or with low immunity disease was significantly associated with the curative effect of treatment of PHN (P <0.05).Multi-factor analysis showed that with low immunity diseases such as malignant tumor (OR =1.418,95%CI 1.347-8.563),the course of the disease more than 3 months (OR = 2.408,95% CI 3.325-18.643 ) were independent prognostic factors of influencing curative effects.Conclusion With low immunity diseases such as malignant tumor and the duration of more than 3 months,curative effect of doxorubicin non-vascular interventional treatment may be poor,patients should be treated as early as possible.

Objective To observe the clinical effect of modified laryngeal mask airway combining fiberoptic bronchoscope intubation in difficult airways.Methods Forty patients,21 males and 1 9 females,aged 30-55 years,ASA physical status Ⅰ or Ⅱ,scheduled for elective general anes-thesia surgery after failure to direct laryngoscope two attempts were randomly divided into two groups,20 cases in each group.Patients in group LMA-FOB underwent intubation with modified la-ryngeal mask airway combining fiberoptic bronchoscope,and patients in group FOB underwent intu-bation with fiberoptic bronchoscope.The fiberoptic bronchoscope score,the intubation time and the rate of successful intubation at first attempt were recorded.All the patients were followed up postop-eratively for adverse effects.Results The fiberoptic bronchoscope scores (Ⅰ/Ⅱ/Ⅲ/Ⅳ:1 5/4/1/0 vs. 8/4/5/3,P <0.05)and the rate of once successful intubation (90% vs.60%,P <0.05)was signifi-cantly higher,and the intubation time [(75 ± 20)s vs.(105 ± 25 )s,P < 0.05 ]was significantly shorter in group LMA-FOB than that in group FOB.In group LMA-FOB,one patient had blood stain in the LMA and one patient felt slight sore throat.There were no significant adverse effects in the two groups.Conclusion Modified Laryngeal mask airway combining fiberoptic bronchoscope intubation in difficult airways was effective to improve the grade of the view of the larynn and the success rate of intubation and shorten the intubation time.No significant adverse effect postoperatively was reported. It is relatively safe,effective and promising in patients with difficult airway.

Objective To observe the efficacy of oxycodone or fentanyl combined with flurbi-profen esters (FA)for postoperative analgesic after thoracic surgery.Methods Eighty patients,53 males and 24 females,aged 40-65 years,ASA physical status Ⅰ-Ⅲ,undergoing elective thoracotomy surgery,randomly divided into two groups (n =40 each).Oxycodone 0.1 mg/kg (group O)or fenta-nyl 1 μg/kg (group F)were intravenously injected 1 5 minutes before the end of surgery.Each patient was given PCIA,with solution including oxycodone 0.8 mg/kg plus FA 4 mg/kg plus ondansetron 8 mg plus 0.9% NaCl (1 50 ml)in group O and fentanyl 8 μg/kg plus FA 4 mg/kg plus ondansetron 8 mg plus 0.9% NaCl (1 50 ml)in group F.The coughing and resting visual analogue scale (VAS), Ramsay score at 2,6,12,24,36 and 48 hours after operation,complications,the times of patient controlled pressing and requirement for rescue analgesic were evaluated.Results Compared with group F, the resting and coughing VAS at 2, 6, 12, 24, 36 and 48 hours after operation, requirement for rescue analgesic,the incidence of nausea and vomiting and the times of patient con-trolled pressing were significantly lower in group O (P <0.05).There was no significantly difference in the Ramsay score.Conclusion It is effective that the patients undergoing thoracic surgery used the PCIA of oxycodone combined FA to control the postoperative pain, and analgesic effect more excellent than fentanyl combined FA,and with fewer side effects.

Objective To compare the effect and safety between lightwand and general-laryngo-scope application of trachea cannula in cervical spine fracture patients undergoing general anesthesia. Methods Forty cervical spine fracture patients with tracheal intubation anesthesia were selected,including twenty-eight males and twelve females,aged 18-65 years,ASA physical statusⅡor Ⅲ.These patients were randomly divided into two groups,twenty cases in each group.After anesthesia induction,group L was giv-en general laryngoscope intubation,whereas group C was taken lightwand guided tracheal intubation.The success case of intubation at first,intubation time,adverse reaction of intubation,changes of MAP and HR at intubation and 5 minutes after intubation were observed.Results Compared with group L,success rate of intubation at first was higher (90% vs.60%),intubation time was shorter [(31.3±11.1)s vs.(46.6 ±15.2)s]in group C (P <0.05).The changes of MAP and HR were more stable during intubation in group C compared with group L.Four cases of arrhythmia (20%)occurred in group C,while none in group L.Conclusion Compared with intubation by general laryngoscope,application of tracheal intubation led by lightwand in cervical fracture patients is more effective and safer.

Objective To investigate the effects of target-controlled confusion of propofol with different concentrations on ventricular repolarization after prophylactic infusion of cefuroxime sodium. Methods Sixty ASA physical status Ⅰ or Ⅱ female patients,aged 18-65 years,undergoing elective gynecological surgery were randomly divided into three groups:group P2 (n =20)with TCI 2 μg/ml, group P3 (n =1 9)with TCI 3 μg/ml and group P4 (n =20)with TCI 4 μg/ml.Firstly,they were re-hydrated;secondly,the patients in groups P2,P3 and P4 were intravenous infused with cefuroxime sodium 2.5 g (in 100 ml normal saline)and then target-controlled infused of propofol 2 μg/ml,3μg/ml and 4 μg/ml in target plasma concentration,respectively.At three pionts of time:after rehy-dration before intravenous antibiotics (T0 ),after intravenous antibiotics before TCI of propofol (T1 ), after TCI of propofol (T2 ),QT interval,QTc interval,Tp-e interval were measured and recorded, respectively.Results Compared with T0 ,QTc [(469.9 ± 34.0)ms vs.(451.2 ± 24.9)ms],Tp-e [(107±25)ms vs.(94±20)ms]and Tp-e/QT (0.260±0.058 vs.0.236±0.043)in group P4 were sig-nificantly prolonged at T1 (P < 0.05 ).Compared with T1 ,QTc of groups P2 [(437.4 ± 24.4)ms vs. (453.3±28.0)ms]and P4 [(438.8±29.9)ms vs.(469.9±34.0)ms]were shortened significantly at T2 (P <0.05).Conclusion Propofol could improve ventricular reporlarization heterogeneity caused by cefu-roxime sodium.

Objective To investigate the effect of ultrasound-guided serratus plane block on ef-ficacy of postoperative analgesia in patients undergoing radical mastectomy.Methods Forty ASA physical status Ⅰ or Ⅱ patients aged 45-65 years scheduled for radical mastectomy under general an-esthesia were randomly divided into two groups (n = 20 each):SP block group (group SP)and control group (group C).After induction of anesthesia,ultrasound-guided homolateral SP block were performed,and 0.375% ropivacaine 20 ml was injected in group SP,while the equal volume of normal saline was used instead in group C.The patients received patient-controlled intravenous analgesia (PCIA)with sufentanil after operation in the two groups.The scores of prince henry pain scale (PHPS)were evaluated at 2,4,8,12 and 24 h after operation.The consumption of sufentanil, propofol and remifentanil were recorded,meantime the times of successfully delivered doses (D1)and attempts (D2 )within 24 h after operation were added up,calculating D1/D2.The adverse effects were also recorded.Results The scores of PHPS at postoperative 2 h [(1.3±0.4)scores vs.(3.0±0.5) scores],4 h [(1.4 ± 0.5 )scores vs.(2.9 ± 0.7 )scores],8 h [(1.7 ± 0.6 )scores vs.(2.7 ± 0.6 ) scores],and the consumption of sufentanil [(54±17)μg vs.(88±25)μg],remifentanil [(287±41)μg vs.(375±66)μg]were significantly lower in group SP than in group C,while D1/D2 (0.88 ±0.11 vs. 0.56±0.17)was higher (P <0.05).There were no adverse reactions in both groups.Conclusion Ultra-sound-guided SP block reduces the perioperative opioids consumption and enhances the efficacy of postopera-tive analgesia in patients undergoing radical mastectomy.