Objective To observe the protective effects of hypoxic preconditioning(HPC) on the improvement of the cognitive dysfunction(learning and memory) and the damage in hippocampus induced by global cerebral ischemia/reperfusion(I/R) in CA1 and CA3 for 5 days in rats,and on the regulation of expression of erythropoietin(EPO) protein to approach the mechanism of the protection.Methods One hundred and twenty adult male Sprague-Dawley(SD) rats were divided into four groups randomly: sham group,I/R group,HPC24 group(hypoxia for 24 hours before I/R) and HPC48 group(hypoxia for 48 hours before I/R).Hang(motor function),passive avoidance and Morris water maze tests were carried out on the 5th day after I/R to measure the motor and cognition functions;hematoxylin-eosin(HE) staining was used to detected histopathological changes in hippocampus tissues;and the contents of EPO were tested by immunohistochemistry at 1 hour and 4 hours after I/R from hippocampus CA1 and CA3 regions.Results Hang,passive avoidance and Morris water maze tests showed that I/R can injure rat cognition;the improvement of cognition was marked in HPC groups, and it was shown that the effects were more significant in HPC48 group than those in the HPC24 group(P

The fluid status variate sharply in patients after operation. Appropriate fluid therapy is essential to reduce perioperative complications, shorten hospitalization days and improve prognosis of postoperative patients. In this article, we reviewed the relevant issues about fluid therapy strategy for postoperative patients such as the variation of body fluid in patients after operation, the assessment of fluid status, the establishment of the goal of fluid therapy and the selection of strategy or fluid for fluid therapy in patients after operation.

Objective To observe the therapeutic effect of irradiation of the lumbar sympathetic ganglia by linear polarized light for the lower-limb neuropathie pain.Methods The lumbar sympathetic ganglia was irradiated by super liar therapeutic equipment focused on L_2 as the center,once a day,20 min each time for 30 days.Skin temperature on the lower limb,VAS score and pain threshold were evaluated.Results Compared to before,the skin temperature increased (P<0.01),VAS decreased (P<0.01),and pain threshold incresed(P<0.01).Conclusion The super lizer irradiation has a good therapeutic effect on lower extremity neuropathic pain

OBJECTIVE: To sum up the advantages and disadvantages as well as application prospects of several kinds of new devices in airway management, including the laryngeal mask airway (LMA), esophageal-tracheal combitubes (ETC),fribreoptic stylet laryngoscope (FOS), video Macintosh intubating laryngoscope system (VMS) and GlideScope(R) videolaryngoscope(GSVL).DATA SOURCES: Using the terms "airway management", we searched Medline for airway management device-related articles, which were published during January 1990 to February 2006 in English.STUDY SELECTION: The materials were firstly selected. Successful rate of intubation, intubation-related complications and incidence in studying tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen. Inclusive .criteria: ① Randomized and controlled study of adult cases. ② Clinical studies or case report. ③ Including the studies of general airway or difficult airway. Exclusive criteria: ① Study of intubation in children. ② Repetitive study.DATA EXTRACTION: Eighty-six articles about tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen, among which, 36 were included in this study, and 50 were excluded due to study on intubation in children or repetitive study.DATA SYNTHESIS: Correct placement does not affect vocal cord movement, so patients may vocalize while an LMA is in place. Its successful rate is over 90%. Its most attractive advantages are increased speed and ease of placement by both inexperienced personal and experienced anesthesiologists, low frequency of cough and low incidence. The esophageal tracheal combrtube is a supraglottic airway device that functions as an effective alternative to ventilization via mask and tracheal intubation in both the esophageal and tracheal position. It is successful when emergency occurs, but it is only suitable for adults. The flexibility of FOS allows for intubation of patients, without the need for head and neck manipulation. The main disadvantages of FOS are their limited field of view and the high cost of purchase and maintenance. Observation and manipulation in using VMS can be performed in one axis. GSVL provides a clear view of larynx on the monitor instead of directly viewed by the operator.CONCLUSION: These new devices of airway management can relatively decrease the intubation difficulty, increase the successful rate and lead to lower complication incidence. The skills of these new airway management devices should be included in the modern anesthesia residency program.

Objective To investigate the pharmacodynamics of cis-atracurium after a single bolus injection in adults and children undergoing live donor liver transplantation during preanhepatic,anhepatic and neohepatic phase.Methods Twenty-six ASA Ⅲ or Ⅳ patients aged 7 months-64 yr,werghing 6-80 kg of beth sexes undergoing live donor liver transplantation were assigned to one of 2 groups:group A adults (n=16) and group B children(n=10).Anesthesia was induced with midazolam 0.05 mg/kg and fentanyl 3-5 μg/kg in both groups and propofol TCI (Cp 3μg/ml) in adults.As soon as the patients lost consciousness,tracheal intubation was facilitated with 2×ES95 of cis-atracurium (0.1 mg/kg).The intubation condition wag recorded.The response of the adductor pollicis to TOF stimulation of the ulnar nerve was recorded (TOF-Guard).An increment of cis-atracurium 0.03 mg/kg was given when T1 returned to 25% of baseline value or the four twitches appeared.Cis-atracurium administration and sevoflurane inhalation were stopped before the three phases and resumed when T1 reached 75% of baseline value.The onset time,mterval between the 2 cis-atracurium administrations,duration of clinical action and recovery of neuromuscular block were recorded.The intubation condition was evaluated.Results The onset time was significantly shorter in adults than in children.There was no significant difference in intubation condition between the 2 groups.The interval between the 2 cis-atracurium administrations and duration of clinical action were similar during the 3 phases in adults and significantly shorter during neohepatic phase than during anhepatic phase in children.The recovery was faster in children than in adults.Conclusion Cis-atracurium 2×ED95 (0.1 mg/kg)can be used for both adults and children undergoing live donor liver transplantation.The onset time is longer and recovery is faster in children than in adults.Cis-atracurium is suitable for patients of different ages and liver function.

Objective To investigate the preventive effect of midazolam pretreatment against neurotoxicity of ropivacaine and the underlying mechanism. Methods Thirty male SD rats aged 4-6 months weighing 250-300 g were randomly divided into 3 groups with 10 animals in each group: group Ⅰ blank control; group Ⅱ ropivacaine (R) and group Ⅲ midazolam-ropivacaine (M-R). In group R and M-R 0.75% ropivacaine was infused i.v. at a rate of 0.5 ml?min-1 until the animal developed convulsion. The animals were killed and brains were immediately removed for detennination of glutamate, aspartate, glycine and GABA content in the brain. Venous blood samples were taken for determination of pH and plasma concentration of lactate. The total amount of ropivacaine infused was calculated.Results The plasma lactate concentration was significantly higher and pH was significantly lower in group R than in blank control group. The concentrations of the 4 amino acids in the brain were significantly increased in group R and M-R as compared with the blank control group. The aspartate, glycine and GABA contents in the brain were significantly lower in M-R group than in R group. The total amount of ropivacaine infused i.v. was significant larger in group M-R than in group R.Conclusion Midazolam pretreatment can prevent the neurotoxicity of ropivacaine by modulating the balance between excitatory and inhibitory amino acids.

Objective To investigate the changes in the dose requirements of rocuronium after right hemihepatectomy in donor of living donor liver transplantation. Methods Sixteen ASA Ⅰ patients of living donor liver transplantation, aged 21-49 yr, weighing 51-86 kg, scheduled for right hemihepatectomy, were enrolled in this study. Anesthesia was induced with iv midazolam and fentanyl, and TCI of propofol and rocuronium. Changes in adductor pollicis muscle were monitored by the train of four (TOF) stimulation. The patients were mechaincally ventilated after tracheal intubation when T1/Tc = 0. The target plasma concentration of rocuroniurn was reduced to 1.0 μg/ml after tracheal intubation and the concentration was regulated to maintain 0 < T1 ≤ 10%. Anesthesia was maintained with sevoflurane inhalation, TCI of propofol, intermittent iv injection of fentanyl. The infusion of rocuronium and inhalation of sevoflurane were stopped before the second time of cholangiography, the total time and amount of rocuronium administered and the recovery of muscle relaxation were recorded at this time (before hemihepatectomy). The infusion of rocuronium and inhalation of sevoflurune were rests-ted after right hemibepatectomy. After the peritoneum was closed, the infusion of rocuroniurn and inhalation of sevoflurane were stopped again, the total time and amount of rocuronium administered and the recovery of muscle relaxation were also recorded at this time (after hemihepatectomy). Results The amount of rocuronium administered was significantly reduced after hemihepatectomy compared with that before hernihepatectomy (P < 0.05). The amount of rocurunium administered after hemihepatectomy was (67 ± 13) % of that before hemihepatectomy. Conclusion Right hemihepatectomy can affect the metabolism of rocuronium in the donor of living donor liver transplantation.

Objective To observe the effects of desflurane, sevoflurane and isoflurane on hepatic oxygen balance and hepatic blood flow Methods Fifteen pigs were randomly divided into three groups: A desflurane group(n=5), B sevoflurane group(n=5), C isoflurane group(n=5) This study observed the effects of desflurane, sevoflurane and isoflurane on systemic and hepatic blood flow and oxygen balance with different concentrations using continuous thermodilution cardiac output monitor and ultrasonic Doppler blood flow monitorResults ①Hepatic blood flow: total hepatic blood flow(THBF) decreased dose-dependently in three groups without significant differences between groups The effects of desflurnae and sevoflurane on THBF were same as those on cardiac output(CO), while the effect of sevoflurane on THBF was larger than that on CO ②Oxygen balance: both systemic oxygen delivery(DO_2) and hepatic oxygen delivery(HDO_2) decreased significantly with the increasing of inhalation concentrations, systemic oxygen delivery(VO_2) and hepatic oxygen consumption(HVO_2) decreased significantly only at high concentration The effects of desflurnae and sevoflurane on HVO_2 and HDO_2 were same as those on VO_2 and DO_2, while the effect of sevoflurane on HDO_2 was larger than that on DO_2, but the effect of sevoflurane on HVO_2 was still same as that on VO_2Conclusions Because of the dose-dependently decreased hepatic blood flow, hepatic oxygen delivery decreases significantly, but hepatic oxygen consumption can be maintained well by self-regulation of hepatic oxygen extraction ratio,indicating that there is almost no influence on hepatic intracellular respiration and metabolism

0 05), while the difference between RBco and TDco was significant before CPB was started and 60min after termination of CPB (P

Objective To evaluate the accuracy of a new generation bioimpedance cardiac output monitor as compared with thermodilution and end expiratory CO 2 techniques Methods Sixteen patients (14 males, 2 females) aged (58?12) years undergoing elective coronary artery bypass (CAB) surgery were studied Cardiac output was measured after CAB surgery in ICU using a new generation bioimpedance cardiac output monitor(Rheo Bioimpedance Hemodynamic monitor) and conventional thermodilution technique in 16 patients and end expiratory CO 2 technique in 10 patients Cardiac output was also measured with Rheo Bioimpedance Hemodynamic monitor in 200 healthy volunteers consisting of equal numbers of male and female The volunteers of each sex were further divided into 5 equal groups of 20 each: (1)20 29 years, (2)30 39 years, (3)40 49 years, (4)50 59 years and (5)60 70 years Results Cardiac outputs measured by bioimpedance and thermodilution techniques were well correlated (r=0 83) and there was also a good correlation between cardiac outputs measured by bioimpedance and end expiratory CO 2 techniques(r=0 88) Cardiac out measured with Rheo Bioimpedance Hemodynamic monitor in 200 healthy volunteers showed that there was a significant difference in cardiac output between 60 70 years age group and the other age groups in both male and female Conclusions Cardiac output and other hemodynamic parameters measured with the new generation bioimpedance hemodynamic monitor are accurate and can be used for preoperative cardiovascular function evaluation and postoperative monitoring of dynamic changes in circulatory function