ObjectiveTo investigate the clinical effect,suitable dose,and its safety of dezocine combined with propofol used in painless artificial abortion.MethodsWith a completely randomized double blind method,200 cases of ASA Ⅰ or Ⅱ early intrauterine pregnancy patients were divided into A,B,C,and D four groups ( n =50).Each patient in A,B,and C groups was infused dezocine in 0.10,0.15,and 0.20 mg/Kg,respectively.D group was administrated with intravenous fentanyl 1.5 μ g/kg,then 3min later,slowly intravenous injection of 1％ of propofol.MAP,HR,RR,and SpO2 were recorded at the before anesthesia induction (T0 ),loss of eyelash reflex time (T1 ),recovery time (T2),and recovery 10 -min time (T3 ).Meanwhile,the parameters including the anesthesia induction time,anesthesia recovery time,directional force recovery time,induction dosage and total dosage of propofol,and the intraoperative and postoperative analgesic efficacy and adverse reaction were compared among different groups.Results For the A and D groups,MAP,HR,RR,and SpO2 at the T1 were all lower than that at the T0 ( P ＜0.05).For the B group,MAP and HR at the T1 were lower than that at the T0 ( P ＜ 0.05).The anesthesia recovery time and orientation recovery time in the B and C groups were significantly shorter than A and D groups ( P ＜ 0.05 ),and significantly statistical difference was found between A and D groups,no statistical difference between B and C groups ( P ＞ 0.05).The propofol induction dosage and total dosage were different among groups ( groups C ＜ B ＜ D ＜ A) with a statistical significance ( P ＜ 0.05 ).The intraoperarive analgesia effect,postoperative pain score grading,and intraoperative body dynamic reaction rates in the B and C groups were significantly different from the A and D groups ( P ＜ 0.05 ),and no statistical significance was found between B and C groups ( P ＞ 0.05 ).The respiratory inhibition,postoperative nausea,vomiting and other adverse reaction rates in the B and C groups were significantly lower than those in A and D groups ( P ＜ 0.05),and those parameters in B group were lower than C group.ConclusionsDezocine combined with propofol is definitely effective and very safe in painless induced abortion with very less respiratory inhibition,nausea,vomiting,and other adverse reactions; and their optimal dosage is 0.15 mg/kg.

Objective To investigate the clinical application of remifentanil in awake state for removal of tumors in functional brain area. Methods Twenty-four patients with tumors in functional brain area were divided into two groups by random digits table with 12 cases each:control group and remifentanil group. Infiltration anesthesia was used in all patients with 0.2% ropivacaine. Remifentanil was injected intravenously with micropump in 0.05-0.10 μg/ (kg·min) in remifentanil group and 0.9% sodium chloride was instead of remifentanil in control group. Patients remained awake during surgery in both groups. The hemodynamic changes and complications during operation were monitored. The satisfaction for surgical procedure was evaluated. Results The patients in two groups could be completed in awake state with surgery;mean artery pressure, heart rate in remifentanil group during opening or closing skull or intracranial period were significantly higher than those in control group(P< 0.05). There were no conspicuous complication in two groups such as respiratory depression, nausea, vomitting and dysphoria. The satisfaction score in remifentanil group[(3.3 ?0.6) scores] was higher than that in control group[(2.4 ?0.5) scores],there was significant difference between two groups (P<0.05). Conclusion Awake brain tumor surgery could be completed in rational use of remifentanil on the base of good local anesthesia, and hemodynamics are stable and the patients are well tolerated.

Objective To study the protective effects of propofol pretreatment on ischemia-reperfusion injury in rabbit heart. Methods Forty New Zealand white rabbits (40 male, weighting 2. 5 ± 0. 36kg) were randomly assigned to 4 groups, including sham operation group, ischemia reperfusion (IR)group, IR + ischemia preconditioning (IP) group and IR + Propofol preconditioning (PP) group (n =10 each). The myocardial ischemia-reperfusion model of rabbits was established by coronary artery ligation.The levels of high energy phosphates (ATP, ADP and AMP) in myocardial tissue were measured by HPLC.The activities of serum lactate dehydrogenase (LDH), serum creatine kinase-MB (CK-MB) superoxide dismutase (SOD) and malondiadehyd (MDA) in myocardial tissue were assayed. Results The content of ATP, ADP, AMP, and the activity of SOD in PP group and IP group were higher than that of IR group, and the content of LDH, MDA and CK-MB in injured myocardial tissue in PP group and IP group were obviously lower than that of IR group (P ＜0. 05, P ＜0. 01). No difference was found in PP group and IP group(P＞0. 05). Conclusion Propofol preconditioning as well as ischemia preconditioning protected the myocardial tissues from the ischemia-reperfusion injury by improving the myocardial energy metabolism, the debasement of the oxyradical level and the antagonism the reaction of lipid peroxides.

Objective To compare the diagnostic efficacy of the V/Q scan and CT pulmonary angiography (CTPA) for the detection of acute pulmonary embolism (PE) in elderly patients.Methods Fortyfour patients (age ≥60 years old) with suspected acute PE underwent V/Q scan and CTPA.The diagnosis of PE by V/Q scan was based on the criteria of prospective investigation of PE diagnosis (PIOPED) Ⅱ and the prospective investigative study of acute PE diagnosis (PISA-PED).The final diagnosis was made clinically.The sensitivities,specificities and accuracies of PIOPED Ⅱ,PISA-PED,CTPA and Wills score were calculated and compared using x2 and Fisher's exact tests.Kappa analysis was used to analyze the diagnostic accordance rate of PIOPED Ⅱ and PISA-PED.Results The sensitivities of PIOPED Ⅱ,PISA-PED and CTPA in the diagnosis of PE were 70.00％ (14/20),84.62％ (22/26) and 65.22％ (15/23),respectively (x2 =0.069-1.545,all P＞0.05).The sensitivity of Wills score was significantly lower (23.08％,3/13).The specificity of CTPA (93.75％,15/16) was significantly higher than those of PIOPED lⅡ and PISAPED (80.00％,12/15 and 61.11％,11/18,both P＜0.05).The accuracies of PIOPED Ⅱ,PISA-PED and CTPA were 74.29％ (26/35),75.00％ (33/44) and 76.92％ (30/39),respectively (x2 =0.005-0.070,all P＞0.05).The accuracy of Wills score was significantly lower (52.17％,12/23).The diagnostic accordance rate of PIOPED Ⅱ and PISA-PED criteria was 77.14％(27/35),Kappa=0.547,P＜0.05.Conclusion V/Q scan and CTPA have no significant difference for the diagnosis of PE in the elderly patients.

Objective To investigate the expression of Fas antigen (Fas) and ligand (FasL), placental growth factor (PlGF) in placenta of pregnant women with pre-eclampsia. Methods Expressions of Fas, FasL and PlGF of placenta were determined by immunohistological streptavidin-peroxidase-biotin (SP) method and compared between normal late pregnancy (24 cases) and mild pre-eclampsia (24 cases) and severe pre-eclampsia (24 cases) groups. Results Different expression of levels Fas, FasL and PlGF were observed in the trophoblasts of most placentae. Positive immunostain of Fas, FasL and PlGF was mainly located in the cytoplasm and membrane of syncytiotrophoblast. FasL and PlGF expressions (63?4, 81?6 and 42?6, 65?6) were significantly less (P

Objective:To investigate the effects of chronic exposure to low concentration sevoflurance on hippocampus in SD fetal rats.Methods:Totally sixty female SD rats at clean grade weighing 240-260 g were randomly divided into four groups , the control group and sevoflurane groups (n=15).The three experimental groups were respectively treated with 30 mg· L-1(parts permillion1 × 10 -6), 100 mg· L-1 and 300 mg· L-1 sevoflurane with 6-hour inhalation, qd for 2 weeks, while the control group breathed fresh air with the same volume .After mating conception , the rats inhaled the same concentration sevoflurane or air till scarification on the 19 th day.Half of brain in the fetal rats was withdrawn to prepare the paraffin specimens , and immunohistochemistry was used to detect the apoptosis in hippocampal CA 1 region associated with protein Bcl-2 and Bax.The hippocampus was stripped from the other half of brain and 10%homogenate was prepared, and the activity level of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) were detected.Results:Bcl-2 in hippocampus CA1 region in 300 mg· L-1 group was lower than that in the control group , while Bax was higher than that in the control group (P<0.05);SOD was lower in 300mg· L-1 group than that in the control group , and MDA was higher than that in control group (P <0.05) .The other two sevoflurane groups had no differences when compared with the con-trol group (P >0.05).Conclusion:Low concentration inhalation of sevoflurane above 300mg· L-1 can enhance the cell apoptosis in hippocampus through increasing the oxidative stress reaction in embryonic brain of SD rat resulting in excessive MDA and reduced SOD.

Objective:To evaluate the effects of stellate ganglion block (SGB) on the activation of M1 microglia during cerebral ischemia-reperfusion (I/R) in rats.Methods:Fifty-four SPF healthy male Sprague-Dawley rats, aged 8-10 weeks, weighing 240-270 g, were divided into 3 groups ( n=18 each) using a random number table method: sham operation group (group Sham), cerebral I/R group (group IR) and SGB group.Blood vessels were only exposed, without occlusion in group Sham.Cerebral I/R was induced by occlusion of the middle cerebral artery for 90 min followed by reperfusion in group IR.Cervical sympathetic trunk transaction was performed to induce left SGB immediately after onset of reperfusion in group SGB.Blood samples were collected from the apex of the heart at 6, 12 and 24 h of reperfusion for determination of the concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β in the serum (using enzyme-linked immunosorbent assay). The animals were sacrificed after the neurological function was evaluated at 24 of reperfusion, and brain tissues were removed for microscopic examination of the pathological changes in cortex, for determination of percentage of cerebral infarct size (by TTC staining), for assessment of cell apoptosis and apoptosis rate in cortex (by TUNEL), and for determination of the expression of microglial biomarker Iba-1 and activated M1 microglia biomarker CD68 (by Western blot). Results:Compared with group Sham, the neurological function score, percentage cerebral infarct size, apoptosis rate in cortex, concentrations of TNF-α, IL-6 and IL-1β in the serum, and the expression of Iba-1 and CD68 were significantly increased in IR and SGB groups ( P<0.05). Compared with group IR, the neurological function score, percentage cerebral infarct size, apoptosis rate in cortex, concentrations of TNF-α, IL-6 and IL-1β in the serum, and the expression of Iba-1 and CD68 were significantly decreased in group SGB ( P<0.05), and the pathological changes of brain tissues were significantly attenuated in group SGB. Conclusion:The mechanism by which SGB reduces cerebral I/R injury is related to inhibiting activation of M1 microglia in rats.

Objective To evaluate the effect of dexmedetomidine on acute lung injury induced by scalds in rats.Methods Seventy-five male Sprague-Dawley rats,weighing 200-220 g,were randomly divided into 5 groups (n =15 each) using a random number table:control group (group C),scald group (group S),dexmedetomidine group (group D),α-bungarotoxin (α-BGT) group,and dexmedetomidine+ α-BGT group (group D+α-BGT).About 30％ of the total body surface was shaved and then exposed to 98 ℃ water for 12 s in S,D,α-BGT and D+α-BGT groups.The back of rats was exposed to 37 ℃ water for 12 s in group C.Rats were resuscitated with lactated Ringer's solution injected intraperitoneally according to Parkland formula within 24 h after establishment of the model.In D,α-BGT,and D+α-BGT groups,dexrnedetomidine 40 μg/kg,α7 nicotinic acetylcholine receptor antagonist α-BGT 1 μg/kg,and α-BGT 1 μg/kg plus dexmedetomidine 40 μg/kg were injected intraperitoneally,respectively,at 15 min before establishnent of the model.At 24 h after establishment of the model,the rats were sacrificed,and lungs were removed for examination of the pathological changes and for determination of myeloperoxidase (MPO) activity,in terleukin-1beta (IL-1β),tumor necrosis factor-alpha (TNF-α),and IL-6 contents (by enzyme-linked immunosorbent assay),and nucleoprotein factor kappa B (NF-κB) (by Western blot).The lung water content [(wet weight-dry weight)÷wet weight× 100％] was calculated.Results Compared with group C,the lung water content,MPO activities,and contents of IL-1β,TNF-α and IL-6 were significantly increased,and the expression of NF-κB was up-regulated in S,α-BGT and D groups (P＜0.05).Compared with group S,the lung water content,MPO activities,and contents of IL-1β,TNF-α and IL-6 were significantly decreased,and the expression of NF-κB was down-regulated in D and D+α-BGT groups (P＜0.05),and no significant change was found in the parameters mentioned above (P＞0.05),and the pathological changes were significantly attenuated in group α-BGT.Compared with group D,the lung water content,MPO activities,and contents of IL-1β,TNF-α and IL-6 were significantly increased,the expression of NF-κB was up-regulated (P＜0.05),and the pathological changes were aggravated in group D + α-BGT.Conclusion Dexmedetomidine can mitigate scalds-induced acute lung injury in rats.

Objective To evaluate the role of α7 nicotinic acetylcholine receptor (α7nAChR) in reduction of endotoxin-induced acute lung injury (ALI) by limb ischemic preconditioning in mice.Methods Eighty healthy male C57BL/6 mice,aged 8-10 weeks,weighing 22-26 g,were randomly divided into 5 groups (n =16 each) using a random number table:control group (group C),ALI group,limb ischemic preconditioning group (group P),α-bungarotoxin (α-BGT) group,and limb ischemic preconditioning +α-BGT group (group P+α-BGT).Normal saline 100 μl was intratracheally instilled in group C.In group ALI,lipopolysaccharide 5 mg/kg was intratracheally instilled (in normal saline) to establish the model of endotoxin-induced ALI.In group P,the mice were subjected to 6 cycles of 5-min ischemia of the right hindlimb followed by 5-min reperfusion,and then the model of ALI was established.In group α-BGT,α-BGT 1 μg/kg was injected intraperitoneally before establishment of the model.In group P+α-BGT,limb ischemic preconditioning was performed,α-BGT 1 μg/kg was then injected intraperitoneally,and the model of ALI was established.At 24 h after LPS instillation,6 mice were selected from each group and sacrificed,and lungs were removed for microscopic examination and for determination of wet and dry lung weight,myeloperoxidase (MPO) activities,contents of interleukin-lbeta (IL-1β),tumor necrosis factoralpha (TNF-α) and IL-6,and expression of α7nAChR and high mobility group box-1 (HMGB1) in lung tissues.The lung water content was calculated.The survival of the left 10 mice in each group was observed at 7 days after establishment of the model,and the survival rate was calculated.Results Compared with group C,the lung water content,MPO activities,contents of IL-1β,TNF-α and IL-6,and HMGB1 expression were significantly increased,α7nAChR expression was significantly down-regulated,and the 7-day survival rate was significantly decreased in group ALI(P＜0.05).Compared with group ALI,the lung water content,MPO activities,contents of IL-1β,TNF-α and IL-6,and HMGB1 expression were significantly decreased,α7nAChR expression was significantly up-regulated,and the 7-day survival rate was significantly increased in group P (P＜0.05).Compared with group P,the lung water content,MPO activities,contents of IL-1β,TNF-α and IL-6,and HMGB1 expression were significantly increased,α7nAChR expression was significantly down-regulated,and the 7-day survival rate was significantly decreased in group P+α-BGT (P＜0.05).Conclusion The mechanism by which limb ischemic preconditioning inhibits inflammatory responses and reduces endotoxin-induced ALI is related to activation of α7nAChR in mice.

Objective To investigate the left ventricular synchrony under different ischemic statuses using phase analysis of 99Tem-MIBI gated SPECT MPI (GSMPI).Methods The data of 129 patients (65 males,64 females,age:48-88 (68.6±10.2) years) who underwent 2-d stress-rest GSMPI were retrospectively analyzed.Perfusion images were scored by a 5-grade criteria (0-4) based on 17 coronary artery segments.Patients were divided into normal perfusion group (G1) and abnormal perfusion group (G2) according to the summed stress scores.G2 was divided into reversible perfusion defect subgroup (G2a) and irreversible perfusion defect subgroup (G2b) by the summed difference scores.The difference of PSD and PHB between groups and the difference between stress and rest GSMPI within each subgroup were compared using two-sample t test and paired t test,respectively.Results The numbers of patients in G1,G2,G2a and G2b were 66,63,39 and 24,respectively.The PSD (18.3±7.8) and PHB (68.6±30.9) of G2 were significantly higher than those (14.3±6.6 and 50.2±20.0) of G1 (t =-3.110,-3.989,both P＜0.05).The PSD and PHB of G2b were higher than those of G2a,but the difference was not statistically significant (t:-1.554 to-0.408,all P＞0.05),and the differences of PSD and PHB between rest and stress MPI within each subgroup were not significantly different (t:-0.961 to-0.114,all P＞0.05).The PSD (20.4±8.1 and 20.8±6.4) and PHB (77.8±53.5 and 78.4±26.7) of rest and stress GSMPI in patients with LVEF ≤60％were significantly higher than those in patients with LVEF＞60％(15.0±6.8 and 15.3±7.0,53.5±23.0 and 55.9±24.5;t:3.642 to 4.567,all P＜0.05).Conclusions 99Tcm-MIBI GSMPI phase analysis can show damage effect of abnormal myocardial perfusion on left ventricular synchrony,which influencing global left ventricular function,and it can show different left ventricular synchrony due to different degrees of myocardial ischemia.There is nearly same value of stress GSMPI and rest GSMPI in assessment of left ventricular synchrony.