Objective: To investigate effects of different frash gas flow of oxygen ventila-tion on emergence time and delirium undergoing Enflurane general anesthesia. Methods: Forty- eight patients, ASA Ⅰ- Ⅱ, aged 33- 68yr, mean 50.5yr, underwent elective abdominal op-eration were randomly divided into three groups according to the different frash gas flow at the end of operation: GroupⅠ, the flow of oxygen maintained at 2 L/min, GroupⅡ 4 L/min, GroupⅢ 10 L/min. Anesthesia was induced with intravenous midazolam 0.08- 0.1mg/kg, etomidate 15- 20mg,fentanyl 3- 4 ?g/kg, pipecuronium 0.08- 0.1mg/kg and maintained with Enflurane(1.5- 2.0vol%), supplemented with intermittent iv pipecuronium and fentanyl. The concentration of Enflurane was monitored continuous which involved Fi, Fa and Fao, originated from inspiration, expiration and the moment expiration when stopped inhalation. Accounted Fao and after this detailed every one minute Fa until the patients recovery and calculated Fa/Fao ratio. Emergence time was recorded. Mini- Mental State Examination (MMSE) was performed before anesthesia and after surgery. Results: Fa/Fao ratio in GroupⅠ was significantly defferent from GroupⅡ and Ⅲ. MMSE scores in GroupⅠwere higher compare with GroupⅡand Ⅲ after surgery. Emergence time was no signif-icantly difference among three groups. Conclusion : The frash gas low flow of oxygen ventila-tion might reduce the incidence of delirium,but does not influnce the time of emergence from general anesthesia.

Objective To investigate the effectiveness of cis-diamminedichloroplatinum (DDP) combined with hyperthennia in killing liver tumor cells and its influence on erythrocytes in vitro. Methods Cultured liver tumor cells (2 ml) were mixed with erythrocyte suspension (10 ml) and then the mixture was separated into 6 centrifuge tubes with 2 ml in each one. The centrifuge tubes were randomly divided into A-F groups and the experiment was repeated for 30 times. Normal saline 2 ml was added in A and D groups. DDP 2 ml (200 μg/ml) was added in B and E groups. DDP 2 ml (400 μg/ml) was added in C and F groups. The cells were then incubated in warm bath of 37 ℃ for 30 min in A, B and C groups and in warm bath of 42 ℃ for 30 min in the other three groups.After hyperthermic treatment, tumor cells were isolated from erythrocytes using density gradient centrifugation, the inhibition rate of tumor cells was determined by MTT method and the clone formation of tumor cells was checked.The erythrocyte osmotic fragility and content of 2,3-diphosphoglyceric acid in erythrocytes were measured. Results The inhibition rate of tumor cells was gradually increased, while the rate of tumor cell clone formation decreased with the increase in the temperature and DDP concentrations ( P < 0.01) . The rate of tumor cell clone formation was more than 98% and no clone formation was tested in group F. There was no significant difference in the content of 2,3-diphosphoglyceric acid in erythrocytes between before and after hyperthermic treatment in group F ( P >0.05 ) . The rate of hemolysis of erythrocytes was less than 1 % in the 0.68 % sodium chloride solution in group F.Conclusion DDP 200 μg/ml combined with hyperthermic treatment with temperature of 42 ℃ for 30 min can make the liver tumor cells lose the capability of proliferation, however, it exerts slight effect on erythrocyte membrane and no influence on the oxygen-carrying capacity of erythrocytes.

Objective To investigate the effectiveness of hyperthermia of different degrees in killing tumor cells and its influence on Na+ -K+ -ATPase activities in erythrocytes. Methods Cultured low differentiated stomach gland tumor cells (SGC-170) and large intestine gland tumor cells (LOVO) (1?106?ml-1 each) were mixed with concentrated RBCs respectively and incubated in warm bath of 37℃ , 42℃, 43℃ , 45℃ or 47℃ for 40 min respectively. After hyperthermic treatment tumor cells were isolated from RBCs using density gradient centrifugation and the live tumor cells were counted by typan staining. The isolated tumor cells were then cultured and the clone formation of tumor cells was checked. The cultured tumor cells were marked with 5-bromo deoxyuridine and DNA metabolism was examined. The Na+ -K+ -ATPase activities in RBC after hyperthermic treatment were also determined. Results The amount of tumor cells was significantly decreased by 40 min hyperthermic treatment in a temperature-dependent manner from 42-471 as compared with the control group (37℃) (P

Objective To compare the postoperative cognition function after propofol intravenous versus isoflurane inhalation anesthesia in off-pump coronary artery bypass grafting (CABG) patients. Methods 30 ASA Ⅱ - Ⅲ patients undergoing off-pump CABG were randomly assigned to two groups. Following induction of anesthesia,isoflurane inhalation( group A ) or propofol intravenous (group B ) were adjusted to maintain comparable depth of anesthesia state. The mini-mental state examination (MMSE) was used to assess the cognitive function 1 day before and 4 days after the operation. Results There were 5 patients suffered postoperative cognitive dysfunction in group A, and 3 cases in group B . But compared with the preoperative( group A (29.13 ± 0. 83 ), group B (29.13 ±1. 13 ) ) ,the MMSE score at 4 days in group A ( 28.73 ± 1.03 ) were lower( t = 2.45, P ＜ 0.05 ), there was no difference in group B( 28.93 ± 1.16)at 4 days( t = 1.87, P ＞ 0. 05 ). Conclusion Both propofol intravenous anesthesia and isoflurane inhalation anesthesia in off-pump CABG may contribute to postoperative cognitive dysfunction, propofol intravenous anesthesia is advantageous over isoflurane inhalation anesthesia.

Objective To investigate the effect of different doses of lidocaine on expression of the high mobility group box 1 protein (HMGB1) in small intestine in septic rats.Methods Fifty adult male Wistar rats weighing 200-250 g were randomly divided into 5 groups ( n =10 each):sham operation group (group S),sepsis group( group Sep ) and different doses of lidocaine group (group L1～3 ).Group S were not applied cecal ligation and puncture (CLP).Sepsis intestinal damage model was performed in group Sep by CLP.Group L1～3 were given intraperitoneally lidocaine in a dose ofS,10 and 20 mg/kg at immediately,1 and 2 h after CLP,respectively.Isometric normal saline was given intraperitoneally in group S and group Sep.The small intestine tissues were taken at 24 and 48 h after CLP.The small intestine morphology was observed with optical microscope.The expression of the HMGB1 mRNA were examined by PCR and the activity of diamine oxidase (DAO) were determined by ELISA.Results Compared with group S,the expression of HMGB1 mRNA was increased and the activity of DAO decreased in group Sep and groups L1～3 at 24 and 48 h after CLP ( P ＜ 0.05 ).Compared with group Sep,the expression of HMGB1 mRNA was decreased and the activity of DAO increased in a dose-dependent manner in groups L1～3 ( P ＜0.05),The injury of pathology of small intestine was slighter in groups L1～3 than in group Sep.Conclusion Lidocaine can reduce samll intestine injury through inhibiting HMGB1 expression in septic rats by a dose-dependent manner.

Objective To investigate the effect of lidocaine on the LPS-induced NF-κB activity in rat peritoneal macrophages. Methods The peritoneal macrophages obtained from male Wistar rats were placed in 12-well plates at 2 × 106 cell/ml after being cultured for 3 days. Each well contained 1 ml of cell suspension. The cells were randomized into control group (group C), LPS group and 3 LPS + lidocaine group S (group LL1.2.3)(n = 10 wells each). In group LPS and LL1,2,3, the cells were exposed to LPS 100 ng/ml. In group LL1,2,3 the cells were exposed to lidocaine 2, 20 200 kg/ml respectively in addition to LPS 100 ng/ml. After being incubated for 24 h, the HMGB1 concentration in the supernatant (by ElISA) and HMGB1 mRNA expression (by RT-PCR)and NF-κB activity in the cells were measured. Results LPS signiticantly increased HMGB1 concentration,HMGB1 mRNA expression and NF-κB activity in the supernatant. Lidocaine treatment significantly attenuated the LPS-induced increase in HMGB1 concentration HMGB1 mRNA expression and NF-κB activity in a dose-dependent manner. Conclusion Lidocaine can inhibit NF-κB activity in the rat peritoneal macrophages and in turn inhibit the synthesis and release of HMGB1.

Objective To investigate the role of high mobility group protein box 1 (HMGB1) in pulmonary vascular remodeling in a rat model of acute lung injury (ALI).Methods Thirty healthy pathogen free male Wistar rats weighing 220-250 g were randomly divided into 3 groups (n =10 each) ∶ group control (group C) ;group LPS (group M) and group LPS + HMGB1 antibody (group H).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 7 ml/kg.ALI was induced with LPS 1 mg/kg infused iv over 30 min in groups M and H.In group H HMGB1 antibody 2 mg/kg was injected iv at 12,24 and 36 h after LPS administration respectively.The animals were sacrificed at 72 h after LPS administration.The left lung was removed for microscopic examination,measurement of the thickness of the medial layer (tunica media) of pulmonary arterioles and determination of the expression of PCNA (by immune-histochemistry) and HMGB1 protein (by Western blotting).Results The medial layer of pulmonary arterioles was significantly thicker and the expression of PCNA and HMGB1 higher in group M than in group C.LPS also induced significant inflammatory cell infiltration within the alveoli and damage to the septa.In group H HMGB1 antibody significantly attenuated the above-mentioned LPS-induced changes.Conclusion HMGB1 may play an important role in the LPS-induced pulmonary vascular remodeling.

Objective To investigate the effects of different doses of lidocaine on acute liver injury in septic rats.Methods Fifty male Wistar rats,weighing 200-250 g,aged 8-10 weeks,were randomly divided into 5 groups(n =10 each):sham operation group(group S),sepsis group(group CLP),and different doses of lidocaine groups(groups L1-3).Sepsis was induced by cecal ligation and puncture(CLP)in anesthetized rats.At 0,1 and 2 h after CLP,lidocaine 5,10 and 20 mg/kg(in normal saline 0.5 ml)were injected intraperitoneally in groups L1-3 respectively,while normal saline 0.5 ml was given in groups S and CLP.At 24 h after CLP,blood samples were taken for determination of the plasma alanine aminotran sferase(ALT)concenlralion.The rats were then sacrificed,and the liver was removed for microscopic examination and determination of the hepatic high-mobility group box 1 protein(HMGBI)mRNA expression.Results Compared with group S,the plasma ALT concentration was significandy increased and hepatic HMGBI mRNA expression was up-regulated in groups CLP and L1-3(P ＜ 0.05).Compared with group CLP,HMGBI mRNA expression was down-regulated in groups 14-3,while the plasma ALT concentration was decreased in groups L2 and L3(P ＜ 0.05),The plasma ALT concentration was significantly decreased and HMGBI mRNA expression was down-regulated in groups L2 and L3 com pared with group L1,and in group L3 compared with group L2(P ＜ 0.05).The microscopic examination showed that the pathologic changes were attenuated in groups L1-3,and the changes were least severe in group L3.Concluslon Lidocaine can reduce acute liver injury in septic rats,this effect is dose-related,and inhibition of hepatic HMGBI mRNA expression is involved in the mechanism.

Objective: To estimate the blood concentration of isoflurane with the inspired andexpired concentrations during laparoscopic surgery. Methods: 2 sections were divided in this experiment: section 1:23 adult patients (ASA I～II)were received abdominal surgeries,of whom,12 patients for non-laparoscopic surgeries and the others for laparoscopic surgeries. Central venous blood samples were collected for gas chromatography determination 20, 40, 60, 80 min after inhalating isoflurane . We could receive two different F value (the fraction of uptake of isoflurane)through the formula. Section 2: 27 patients were recruited for abdominal surgeries, 13 for laparoscopic surgeries and the others for non-laparoscopic surgeries. All of the processes were the same as the former. Then we confirm the results obtained from section1. Results: The F was 0.52 in the laparoscopic surgeries and 0.44 in the nonlaparoscopic surgeries. In the laparoscopic surgeries, the bias (MDPE) was 17% , accuracy (MDAPE)was 22.88% and the wobble was 11.7% .The correlation coefficient (r)was 0.83. In the nonlaparoscopic surgeries, the MDPE was 5.37% , the MDAPE was 16.02% , the wobble was 15.86% .The correlation coefficient was 0.90. Conclusion: The formula could be used in abdominal surgeries to evaluate the concentration of isoflurane according to the clinical standard of MDPE

Objective To discuss the effects of lidocaine infusion on perioperative immune function by evaluating the levels of stress hormone and natural killer (NK) cell cytotoxicity.Methods Thirty-five patients of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 35-65 yr,undergoing elective radical hysterectomy,were randomized into lidocaine group (group L)and control group (group C).Fifteen minutes before anesthesia induction,a bolus of 1.5 mg/kg of lidocaine was administered iv.to each patient in group L and followed by a continuous infusion at 1.5 mg·kg-1 ·h-1 lasting to the end of surgery.Meanwhile,the patients in group C received the same volume of saline.Venous blood samples were collected individually 24 h before the operation,the end of the operation and 48 h after the operation.Levels of prostaglandin,epinephrine and norepinephrine were assayed by ELISA kits.NK Cells were obtained by CD56 antibody magnetic isolation.The cytotoxicity of NK cell was detected by LDH releasing assay,and phosphor-protein kinase A (p-PKA)and protein kinase A (PKA) were detected by Western blotting.Results There were no significantly different in the plasm levels of PGF2,EP1 and NE.The plasm levels of prostaglandin (562.5±98.2 vs.663.2±119.0) pg/ml,epinephrine (24.9±4.8 vs.29.7±3.5) pg/ml and norepinephrine (408.3 ±47.2 vs.499.6±45.6) pg/ml in patients of group L were lower than those in group C (P＜0.05)48 h after the surgery.The cytotoxicity of NK cell was higher in group L than that in group C (44.1 ±5.0 vs.37.1±5.5)％ (P＜0.05) 48 h after the surgery.The ratio of p-PKA/PKA was lower in group L than that in guoup C (0.060±0.008 vs.0.099±0.011) (P＜0.05) at the end of the surgery.Conclusion Perioperative intravenous lidocaine infusion can reduce the level of plasma catecholamine and PGE2,and protect the cytotoxicity of NK cell,possibly via inhibiting of cAMP-PKA signaling pathway.