Objective To explore the security of spinal anesthesia by observing the pefioperation serum troponin T in the elderly patients with coronary heart disease who underwent spinal anesthesia.Methods 40 case8 were divided into two groups according to the elderly patients with or without the history of coronary heart disease.Group Ⅰ 0f 20 cases were the patients with the history of coronary heart disease.Group Ⅱ of 20 cases were the patients without the history of coronary heart disease.Both groups were undertaken single spinal anesthesia combined with epidural anesthesia.The blood samples were collected at the time of perioperation,the end of the operation and 24 hours after surgery.The serum troponin T Was tested by Roche fully automated ehemiluminescent analyzer E170.The symptoms and signs of the coronary heart disease in the patient were observed.And the age,operation time,anesthesia lever,the amount of bleeding and transfusion were recorded,and at the same time,electrocardiogram,heart rate,pulse,cerebral oxygen saturation were monitored.Results There was no significant difference between two groups in age,operation time,anesthesia lever,the amount of bleeding and transfusion,heart rate,pulse,cerebral oxygen saturation.There was no significant difference between two groups in seram troponin T.No symptoms and signs of the coronary heart disease were observed in two groups.There Was no significant difference between two groups in constituent ratio of positive rate of serum troponin T.There was one case in each group that serum lroponin T was more than reference value (0.010μg/L)during the perioperation while the patient was no discomfort.Conclusion Spinal anesthesia has no impact on the change of perioperative 8ertlm troponin T in the elderly patients with coronary heart disease.

Objective To evaluate the sufentanil-sparing effect of ketorolac tromethamine for postoperative analgesia in the elderly patients.Methods Sixty ASA Ⅱ or Ⅲ patients,aged ≥ 65 yr,with a body mass index of 18-24 kg/m2,undergoing elective gynecological operations,were randomly divided into 2 groups(n =30 each):sufentanil group(group S)and ketorolac tromethamine plus sufentanil group(group T).Both groups received combined intravenous-inhalational anesthesia and patient-controlled intravenous analgesia(PCIA)after operation.PCIA solution contained ketorolac tromethamine 180 mg and sufentanil 100 μg in 100 ml of normal saline in group T.After a loading dose of ketorolac tromethamine 30 mg was injected intravenously at 15 min before the end of operation,the PCA pump was set up with a 1.6 ml bolus dose,a 20 rain lockout interval and background infusion at a rate of 1.5 ml/h in group T.PCIA solution contained sufentanil 100 μg in 100 ml of normal saline in group S.After a loading dose of sufentanil 5 μg was injected intravenously at 15 min before the end of operation,the PCA pump was set up with a 1.6 ml bolus dose,a 20 min lockout interval and background infusion at a rate of 1.5 ml/h in group S.The effective analgesia(postoperative VAS scores at rest and during activity ＜ 3)was maintained within 48 h after operation.The amount of sufentanil consumed within 48 h after operation and adverse effects were recorded.Results Compared with group S,the amount of sufentanil consumed within 48 h after operation was significantly reduced,and the incidence of nausea and vomiting,urinary retention and pruritus was significantly decreased in group T(P ＜ 0.05).Conclusion Ketorolac tromethamine used with PCIA with sufenlanil has a significant sufentanil-sparing effecl for posloperative analgesia and improves the safety of analgesia in the elderly patients.

Objective To investigate the physical and magnetic properties and cytotoxity of 5-FAM-dextran-coated superparamagnetic iron oxide nanoparticles ( 5-FAM-dextran-Fe3 O4 ) , and to observe the cell-labeling character of these nanoparticles. Methods 5-FAM-dextran-Fe3 O4 were prepared by ultra-sonic and chemical coprecipitation method and the characteristics were evaluated. The size and distribution of 5-FAM-dextran-Fe3 O4 were measured by transmission electron microscope ( TEM) and Malvern Zetasizer. The organic structure of the coating was characterized by fourier translation infrared spectroscopy. The optical imaging ability was measured by ultraviolet visible spectrometer and the susceptibility was measured by vi-brating sample magnetometer. In vitro cytotoxities of 5-FAM-dextran-Fe3 O4 , dextran-Fe3 O4 and Fe3 O4 were detected by MTT assay. The area of labeled neuronal cells was observed by confocal microscopy after incuba-ted with nanoparticles under different magnetic intensities. One-way analysis of variance was used. Results The size of 5-FAM-dextran-Fe3 O4 was homogeneous under TEM, and the diameter ranged from 15 to 25 nm ( average=22 nm) by Malvern Zetasizer. The organic structure of the coating of Fe3 O4 was confirmed by fou-rier translation infrared spectroscopy. Ultraviolet visible spectrometer observation showed that the nanoparti-cles expressed unanimous green fluorescence under ultraviolet activation. The saturation magnetization, residu-al magnetization and coercivity of the nanoparticles by magnetometer detection were 86. 02 A · m2 · kg-1 , 15. 05 A·m2 ·kg-1 and 5414.01 A/m respectively, showing superparamagnetic character. MTT assay re-sults showed that 5-FAM-dextran-Fe3 O4 had no obvious cytotoxicity. The confocal microscopy observation in-dicated that the cell-labeled area reached the maximum under the magnetic field intensity of 500 mT ((0. 880±0.146) mm2, F=320.298, P<0.05). Conclusions 5-FAM-dextran-Fe3O4 prepared by ultra-sonic coprecipitation method have the advantages of small size, good homogeneity and magnetic property. Therefore, they might be used as the fluorescent magnetic bio-probe in laboratory and clinical studies.