Objective To investigate the preventive effects of midazolam and propofol on liver against hypoxia/reoxgenation(H/R) injury in rats.Methods Twenty-four Wistar rats of both sexes weighing 200-250g were randomized into four groups:control group(group A),hypoxia/reoxygenation(group B),H/R + midazolam(group C) and H/R + propofol(group D).The 8-iso-prostaglandin F2?(8-iso-PGF2?) levels in the hepatic tissue were determined by enzyme-linked immunosorbent assay(ELISA).The contents of nitric oxide(NO) and the activity of nitric-oxide synthase(NOS) in hepatic tissue were determined by biochemistry methods.Results After hypoxia and reoxgenation injury in rats,the 8-iso-PGF2? level of hepatic tissue in group B was significantly higher than that in group A(P

Objective To investigate the protective effects of propofol on liver against hypoxia/reoxgenation (H/R) injury in rats. Methods Twenty-four Wistar rats of both sexet weighing 200-250g were randomized into control group (group A), hypoxia/reoxygenation group (group B) and H/R + propofol group (group C). The 8-iso-prostaglandin F 2? (8-iso-PGF 2? ) level in the hepatic tissue was determined by enzyme-linked immunosorbent assay (ELISA). The content of NO and the activity of NOS were assessed by biochemical methods. Results In group B, the 8-iso-PGF 2? level in hepatic tissue was significantly higher than that in group A (P

ObjectiveTo investigate the sequelae and relative factors of sensation disorders of lateral skin of the incision after total knee arthroplasty (TKA) and to explore its effect on knee function.MethodsThirty-six patients (53 knees) who underwent TKA were continuously selected in this study.The length of the incision and the area of sensation disorders of skin around the incision were measured 1 week postoperatively.The area of sensation disorders of skin around the incision was measured again 1.5 years postoperatively,and the range of motion of the knee and the knee society score (KSS) were recorded.ResultsAll of the patients presented with objective hypesthesia of lateral skin of the incision.Twenty-six (72％) patients existed subjective numbness,whose areas of hypesthesia were larger than those of patients without subjective numbness.The average area of hypopselaphesia and average area of hypalgesia were(36.43±14.71) cm2 and (69.62±23.48) cm2,respectively.Both of them had positive correlation with the length of the incision (r=0.303,P=0.04; r=0.318,P=0.03).One and a half years postoperatively,besides 5 patients recovered completely,all other patients existed no hypopselaphesia,and the average area of hypalgesia was(8.55±4.56)cm2,which was statistically different with that 1 week postoperatively(t=2.553,P=0.012).The KSS score was lower in patients with subjective numbness than that in patients without subjective numbness (t=2.066,P=0.044).ConclusionThe hypesthesia of lateral skin of the incision is common after TKA,which can recover partially or completely over time.All patients should be advised of this complication as part of their informed consent before TKA.

Objective To evaluate the effects of different sedation depths of propofol on brain injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-five ASA physical status Ⅲ or Ⅳ patients of both sexes,aged 26-64 yr,weighing 50-85 kg,scheduled for elective cardiac valve replacement with CPB,were divided into 3 groups according to intraoperative sedation depths (n =15each):30 ≤ bispectral index (BIS) value ＜ 40 (group A) ; 40 ≤ BIS value ≤ 50 (group B) ; 50 ＜ BIS value ≤ 60(group C).Anesthesia was induced with iv injection of lidocaine,midazolam,sulfentanil,etomidate and vecuronium.The patients were tracheally intubated and mechanically ventilated.PET CO2 was maintained at 35-45 mm Hg.Anesthesia was maintained with iv infusion of propofol at a rate of 7,5 and 3 mg· kg-1 · h-1 in A,B and C groups,respectively,intermittent iv boluses of sulfentanil and pipecuronium,and intermittent inhalation of sevoflurane.The infusion rate of propofol was adjusted to maintain the corresponding anesthesic depth in each group.Before CPB (T1),at 30 min of CPB (T2),immediately after termination of CPB (T3) and at 1 h after the end of CPB (T4),blood samples were obtained from the jugular bulb vein and radial artery for determination of plasma S-100β protein concentration and for blood gas analysis,and the arterial to venous blood oxygen content difference (Dj-aO2),cerebral O2 extraction rate (CERO2) and jugular bulb venous to arterial blood lactic acid content difference (Dj-aL) were calculated.Results Compared with group C,the plasma S-100β protein concentrations were significantly decreased,SjvO2 was increased,and Dj-aO2 and CERO2 were decreased at T3-4,and Da-jL was decreased at T3 in groups A and B (P ＜ 0.05).Compared with group B,the plasma S-100β protein concentrations were significantly decreased at T3-4,SjvO2 was increased at T2,Da-jO2 and CERO2 were decreased at T2,and DajL was decreased at T3 in group A (P ＜ 0.05).Conclusion Moderately deepened anesthetic depth of propofol (30≤ BIS value ＜ 40) is helpful in attenuating the brain injury in patients undergoing cardiac valve replacement with CPB.

Objective To investigate the effect of probiotics preconditioning on intestinal mucosal barrier function in a rat model of cardiopulmonary bypass (CPB) . Methods Twenty-four adult male SD rats weighing 350-450 g were randomly divided into 3 groups ( n = 8 each) : group Ⅰ sham operation ( group S); group Ⅱ CPB and group Ⅲ probiotics + CPB. CPB was established between left carotid artery and right jugular vein and maintained for 60 min. Croup Ⅲ received intragastric instillation of probiotics 2 ml once a day for 7 consecutive days before CPB. Blood samples were collected at 2 h after CPB was terminated for determination of plasma D-lactate, TNF-and IL-6 concentrations and diamine oxidase (DAO) activity. Venous blood was obtained from portal vein for determination of LPS concentration and cultured. Liver, pancreas, spleen, kidney and mesenteric lymphnode (MLN) specimens were obtained under sterile condition and cultured for bacterial growth. The mucous membrane of small intestine was examined with electron microscope. Results CPB significantly increased plasma DAO activity, and D-lactate, IPS, TNF-α and IL-6 concentrations and the rate of bacteria-positive culture of portal venous blood, liver, MLN, lung and kidney in group Ⅱ as compared with group S. Probiotics preconditioning significantly attenuated the above-mentioned CPB-induced changes. Microscopic examination showed that probiotics preconditioning significantly ameliorated CPB-induced damage to the epithelium of the small intestine. Conclusion Probiotics preconditioning can significantly attenuate CPB-induced inflammatory response and protect the intestinal mucosal barrier function.

Objective To evaluate the changes in the expression of aquaporin-8 (AQP8) in intestinal mucosa in pigs with hemorrhagic shock.Methods Sixteen Bama miniature pigs,weighing 22-25 kg,were equally and randomly divided into sham operation group (group S) and hemorrhagic shock group (group HS).The animals were fasted for 8 h before operation.The animals were anesthetized with propofol 3 mg/kg injected via the auricular vein,and tracheostomized and mechanically ventilated.In group S,the femoral artery and internal jugular vein were only cannulated.In group HS,the femoral artery and internal jugular vein were cannulated for blood pressure and mean arterial pressure monitoring and blood sampling.Hemorrhagic shock was then induced by removing 40 percent of blood volume over 15 min.Before anesthesia (T0),and at 30 min and 1.0,1.5,2.0,3.0 and 4.0 h after the end of blood-letting (T1.6),blood samples were collected for determination of serum D-lactate and intestinal fatty acid binding protein (I-FABP) concentrations.After blood sampling at T6,the pigs were sacrificed,and intestinal specimens were obtained for microscopic examination and for determination of AQP8 cotent in intestinal mucosa (by ELISA).The water content of intestines was calculated by wet/dry weight ratio.Results Compared with group S,the serum D-lactate concentrations at T2-6,I-FABP concentrations at T1-6,and water content of intestines were significantly increased,and the cotent of AQP8 was up-regulated at T6 in group HS.No changes were found in the intestinal mucosa in group S.In group HS,severe damage to the intestinal mucosa was found,and bleeding,inflammatory cell infiltration,and epithelial cell necrosis were observed.Conclusion The mechanism of hemorrhagic shock-caused damage to intestines is related to up-regulated expression of AQP8 in intestinal mucosa in pigs.

Objective To evaluate the effect of sevoflurane on liver injury in a pig model of hemorrhagic shock.Methods Twenty-four Bama miniature pigs of both sexes,weighing 20-25 kg,aged 3-5 months,were equally randomized into 3 groups using a random number table:sham operation group (group S);hemorrhagic shock group (group HS);sevoflurane group (group Sev).Hemorrhagic shock was induced by withdrawing 40％ of blood volume from the right femoral artery within 15 min (30 ml/kg) in HS and Sev groups.The animals inhaled 2％ sevoflurane for 30 min after establishment of the model in group Sev.Before hemorrhagic shock (T0),and at 30,60,90,120,180 and 240 min after hemorrhagic shock (T1-6),blood samples were collected from the femoral artery for determination of plasma alaninc aminotransferase (ALT) and betaine-homocysteine S-methyltransferase (BHMT) concentrations (by enzymelinked immunosorbent assay).After blood sampling at T6,the animals were sacrificed,and the right lobes of livers were removed for examination of the pathological changes with light microscope.Results Compared with group S,the plasma ALT concentrations were significantly increased at T4-6,the plasma BHMT concentrations were significantly increased at T3-6 (P＜0.05),and significant liver pathological changes were observed in HS and Sev groups.Compared with group HS,the plasma ALT concentrations were significantly decreased at T4-6,the plasma BHMT concentrations were significantly decreased at T3-6 (P＜0.05),and the liver pathological changes were significantly attenuated in group Sev.Conclusion Sevoflurane can mitigate liver injury in a pig model of hemorrhagic shock.

Objective To investigate the effects of probiotics on the plasma diamine oxidase (DAO) activity and D-lactate, IL-6 and IL-10 levels in patients undergoing open heart surgery under cardiopulmonary bypass (CPB) , trying to elucidate the mechanism of protective effect of probiotics against CPB- induced injury to intestinal mucosal barrier. Methods Forty ASA Ⅱ - Ⅲ patients of both sexes aged 30-64 yr weighing 40-80 kg undergoing open heart operation under CPB were randomized into 2 groups ( n = 20 each) : control group (group C) and probiotics group (group Y) . Group Y received Jinshuangqi (Bifid Triple Viable containing bifido-bacterium, lacto-bacillus, streptococcus thermophiles) 4 pills 3 times a day for 7 days before operation. Venous blood samples were taken from CVP line before operation (T1 ), at 10 min after aortic unclamping (T2 ) and at the end of CPB (T3 ) and at 2, 6, 18 h (T4,5,6) after operation for determination of plasma DAO activity and D-lactate, IL-6 and IL-10 levels.Results Plasma DAO activity, D-lactate, IL-6 and IL-10 levels were significantly increased after CPB was started at T2-6 as compared with the baseline values at T1 in both groups. Plasma DAO activity and D-lactate level were significantly lower at T2-5 , the plasma IL-6 level was significantly lower and plasma IL-10 level higher at T4,5 in group Y than in group C. Conclusion Probiotics can protect intestinal mucosal barrier in patients undergoing open heart surgery under CPB and attenuate inflammatory response.

Objective To investigate the effects of penehyclidine hydrochloride on blood-brain barrier in a rat model of cardiopulmonary bypass ( CPB) . Methods Sixty adult male SD rats, aged 4-6 months, weighing 320- 370 g, were randomly divided into 5 groups ( n = 12 each) : sham operation group (group S), CPB group, and low-, median- and high-dose penehyclidine hydrochloride groups (groups LP, MP and HP). The animals were anesthetized with intraperitoneal 10% chloral hydrate 350 mg/kg, intubated and mechanically ventilated. The femoral and jugular arteries and jugular vein were cannulated. CPB was performed for 60 min. Penehyclidine hydrochloride 0.2, 0.6 and 2.0 mg/kg were added to the priming solution in groups LP, MP and HP respectively, while the equal volume of normal saline was added in group CPB. Evans blue was injected via femoral vein at 1 h before the animals were sacrificed. Six rats in each group were sacrificed, their brains immediately removed and the hippocampi isolated for determination of Evans blue content. The other rats were sacrificed and the hippocampi isolated to determine the water content and observe the ultrastructure of blood-brain barrier. Results Compared with group S, the Evans blue content and water content were significantly increased in the other groups ( P ＜ 0.05) . Compared with groups CPB and LP, the Evans blue content and water content were significantly decreased in groups MP and HP ( P ＜ 0.05) . The Evans blue content was significantly lower in group HP than in group MP ( P ＜ 0.05). The CPB-induced changes were significantly attenuated in groups MP and HP compared with groups CPB and LP. Conclusion Penehyclidine hydrochloride can protect blood-brain barrier against the CPB-induced injury and the effect is related to the dose.

ObjectiveTo investigate the effect of penehyclidine hydrochloride on acute lung injury induced by cardiopulmonary bypass (CPB) in rats.MethodsForty adult male SD rats aged 4-6 months weighing 330-420 g were randomly divided into4 groups ( n =10 each): sham operation group (group S),acute lung injury group (group ALI) and low and high dose of penehyclidine hydrochloride groups (groups PL and PH ).Penehyclidine hydrochloride 0.6 and 2.0 mg/kg were added to the priming solution in groups PL and PH,while the equal volume of normal saline was added in group ALI instead.The rats of groups ALI,PL and PH were underwent 1 h of CPB.Arterial blood samples were collected before CPB and at 2 h after CPB for blood gas analysis.The superior vera cava blood samples and lung tissues were collected at 2 h after CPB for determination of concentrations of TNF-α and IL-6,lung tissue contents of water and malondialdehyde (MDA) and activity of glutathione peroxidase (GSH-px).The pathological change of lung tissue was also examined.ResultsCompared with group S,PaO2 was significantly decreased at 2 h after CPB,plasma concentrations of TNF-α and IL-6 and contents of water and MDA in lung tissues were increased,while activity of GSH-px in lung tissues was decreased in groups ALI,PL and PH ( R ＜ 0.05).Compared with group ALI,PaO2 was significantly increased at 2 h after CPB,plasma concentrations of TNF-α and IL-6 and contents of water and MDA in lung tissues were decreased,activity of GSH-px in lung tissues was increased (P ＜ 0.05),and the pathological change was reduced in groups PL and PH.Compared with group PL,PaO2 was significantly increased at 2 h after CPB,plasma concentrations of TNF-α and IL-6 and contents of water and MDA in lung tissues were decreased,activity of GSH-px in lung tissues was increased ( P ＜0.05),and the pathological change was reduced more obviously in group PH.ConclusionPenehyclidine hydrochloride 0.6 or 2.0 mg/kg can reduce the CPB-induced lung injury in a dose-dependent manner by antioxidant and anti-inflammatory mechanism in rats.