Objective To assess the anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing video-assisted thoracoscopic surgery(VATS).Methods Forty ASA Ⅰ-Ⅱpatients. undergoing VATS were randomly divided into remifentanil-propofol group(group P,n=20)and remifentanil-desflurance group (group D,n=20).MAP and HR were monitered during the entire procedures. Conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score were recorded and compared between two groups. Results During the operation, MAP was decreased significantly in group D (P＜0.05).There was no significant difference in conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score between two groups. Conclusions The anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing VATS were both with quick recovery, but the fronter has more stable hemodynamics.

Objective To evaluate the effect of dexmedetomidine on lung injury induced by extremity ischemia-reperfusion.Methods Forty patients,aged 18-60 yr,with body mass index of 20-25 kg/m2,of ASA physical status Ⅰ or Ⅱ,with 1 h ≤ predicted duration of surgery ≤ 1.5 h,were randomly divided into 2 groups (n =20 each) using a random number table:control group (group C) and dexmedetomidine group (group D).In groupD,dexmedetomidine 1 (g/kg was infused intravenously for 10 min,followed by continuous infusion of dexmedetomidine at 0.5 μg· kg-1 · h-1 until the end of the surgery,while in group C the equal volume of normal saline was given instead.Immediately before induction of anesthesia (T1,baseline),at 60 min after tourniquet was inflated (T2) and at 30 min,2 h and 6 h after tourniquet release (T3-5),blood samples were collected from the radial artery for blood gas analysis and for measurement of the levels of plasma interleukin-6 (IL-6),IL-8,tumor necrosis factor-α (TNF-α),malondialdehyde (MDA) and superoxide dismutase (SOD),and arterial partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) were recorded.Alveolar-arterial oxygen difference (A-aDO2) and respiratory index (RI) were calculated.Results Compared with group C,PaO2 was significantly increased at T5,and A-aDO2 and RI at T5,the levels of plasma IL-6 and IL-8 were decreased at T4,5 and the levels of plasma TNF-α,MDA and SOD were decreased at T3-5 in group D.Conclusion Dexmedetomidine can attenuate lung injury induced by extremity ischemia/reperfusion via inhibiting inflammatory responses and lipid peroxidation.

Objective To investigate the therapeutic effects of cFLIP-siRNA tail venous injection on acute necrotizing pancre.atitis (ANP) rats,and explore the related mechanism.Methods Three pairs of cFLIP siRNAs (cFLIP-siRNA) and negative control(siRNA-NC) were designed and synthesized.The most effective siRNA to inhibit the expression of cFLIP gene was selected for the experiment.Thirty SD rats were treated with retrograde pancreaticobiliary duct injection of 5％ taurocholic acid sodium salt solution to establish ANP rat model.They were randomly divided into ANP group,siRNA-NC group and cFLIP-siRNA group with l0 rats in each group using random number method.The same volume of normal saline,siRNA-NC and cFLIP-siRNA were injected into tail vein,respectively.The rats were sacrificed after 24 h and the blood samples were colelcted.The levels of serum amylase and endotoxin were measured.The pancreatic tissues were collected and routine pathological examination was performed.The expressions of cFLIP-S and caspase-8 protein in pancreatic tissues were detected by immunohistochemistry and Western blotting.Results The levels of serum amylase in ANP group,siRNA-NC group and cFLIP-siRNA group were (1 286 ± 209),(1 297 ± 305) and (552± 256)U/L,the level of serum endotoxin were (136± 32),(128± 56) and (46± 23)ng/L,respectively.The pancreatic pathological scores were (4.97 ± 1.16),(4.92 ± 2.03) and (1.67 ± 1.98).The expression level of cFLIP-S protein were (8.56 ± 2.72),(9.12 ± 2.45) and (3.82 ± 1.46),respectively,which were significantly lower in cFLIP-siRNA group than in ANP group and siRNA-NC group (P ＜ 0.05),and the difference was statistically significant (P ＜ 0.05).The expression level of caspase-8 protein in the three groups were (2.25 ± 1.24),(2.41 ± 1.14) and (5.56 ± 1.79),respectively,which were significantly higher in cFLIP-siRNA group than in ANP group and siRNA-NC group,and the difference was statistically significant (P ＜0.05).However,there was no significant difference between ANP group and siRNA-NC group.Conclusions Inhibition of cFLIP gene expression can reduce pancreatic injury in ANP rats.The possible mechanism was that the up-regulation of caspase-8 can inhibit pancreatic cell necrosis and promote apoptosis.