Objective To investigate the effects of mild hypothermic cardiopulmonary bypass(CPB) on bax and bcl-2 protein expression and neuronal apoptosis in hippooampus CA1 region in rats. Methods Healthy male SD rats weighing 380-420g were randomly divided into 3 groups: (1)post-CPB 1h group (n=6); (2) post-CPB 6h group (n=6) and (3) sham CPB group(n=5). The animals were anesthetized with intraperitoneal fentanyl 150?g?kg~(-1), midazolam 1 mg?kg~(-1) and vecurunium 0.1 mg?kg~(-1), intubated and mechanically ventilated. Left femoral artery was cannulated for heparinizafion, BP monitoring and blood sampling. Artery in the tail and right jugular vein were cannulated for CPB. The animals in group 1 and 2 underwent 2 h mild hypothermic (26-28℃) CPB at a flow of 160 ml?kg~(-1)?min~(-1). 1h(group 1) and 6h(group 2) after CPB 4% polymerized formaldehyde was injected via the artery in the tail. Brains were immediately removed. Bax and bcl-2 protein expression in hippocampus CA1 region was determined by immuno-histochemistry method and neuronal apoptosis by TUNEL technique. Ultrastructural changes were examined with electron microscope. Results (1)Bax and Bcl-2 protein expressions were significantly higher in group 1(1h after CPB)than in sham CPB group. Bax protein expression was significantly higher but bcl-2 protein expression was significantly lower in group 2 than in group 1. bax/bcl-2 ratio in group 2(at 6h after CPB)was significantly higher than that in group 1(at 1h after CPB). (2) Neuronal apoptosis was significantly increased in group 1 and 2 compared to sham CPB group. (3) Electron microscopy showed that some mitochondria were moderately or severely swollen with vacuolizafion and decreased number of mitochondrial at 1h after CPB and at 6h after CPB there was shrinkage of neuronal cells with irregular shape of nucleus, notches in nuclear membrane and margination of nucleoli. Conclusion CPB induces upregulation of both bax and bcl-2 protein expression with predominance of the pro-apoptotic gene Bax leading to increased neuronal apoptosis, indicating that CPB can cause brain injury.

Objective To investigate the safety of inhalation of isoflurane (ISO) or sevoflurane (SEVO) mixed with nitric oxide (NO) during mechanical ventilation.Methods Thirty-six healthy piglets of both sexes weighing 7-11 kg were randomly allocated to one of 6 groups ( n = 6 each): (1) control group was mechanically ventilated with O2; (2) NO group inhaled 20 ppm NO; (3) ISO group inhaled 1.3 MAC isoflurane; (4) ISO + NO group 1.3 MAC isoflurane + 20 ppm NO; (5) SEVO group inhaled 1.3 MAC sevoflurane and (6) SEVO + NO group inhaled 1.3 MAC sevoflurane + 20 ppm NO. The animals were mechanically ventilated with IPPV (VT 10 ml?kg-1 , RR 30-40 bpm, I: E 1:2) for 4 h in the all 6 groups. The animals were premedicated with atropine 0.02 mg?kg-1 i.m. . The Ⅳ line was established for fluid and drug administration. An additional dose of ketamine 10 mg?kg-1 was given i.v. before tracheostomy. 4F S-G catheter was placed in pulmonary artery via right internal jugular vein for hemodynamic monitoring. Femoral artery was cannulated for BP monitoring and collection of artrerial blood samples. MAP, HR, CVP, right ventricular pressure (RVP), PCWP, MPAP and total compliance of respiratory system (Crs), Paw, VT and PET CO2 were recorded before (T0 ) and at 1, 2, 3, 4 h of ventilation (T1-4). Blood samples were taken at T0 , T2 and T4 for determination of Met Hb and NO2- /NO3- . The animals were killed at the end of 4 h mechanical ventilation and the lungs were removed for determination of wet/dry(W/D) lung weight ratio, broncho-alveolar lavage fluid (BALF) and microscopic examination. BALF was collected for determination of surface tension and concentrations of saturated phosphate (DSPC) , total phosphate (TPL) total protein (TP) and white cell count. Results Crs was significantly decreased at the end of ventilation (T4 ) as compared with the baseline (T0) in group 3,4,5 and 6, while there was no significant change in Crs in group 1 and 2. DSPC/TP was significantly lower in group 3,4,5 and 6 than in group 1 ( P 0.05 ) . Conclusion 1.3 MAC isoflurane or sevoflurane mixed with 20 ppm NO can be used safely during mechanical ventilation.

OBJECTIVE:To build up a method of determining the concentration of midazolam in plasma by RPHPLC-UV detection.METHODS:The separation was carried out by a reversed-phase Hypersil ODS column(250mm?4.0mm,5?m) with a mobile phase consisting of methanol-acetonitrile-0.02mol/L potassium phosphate buffer(pH 7.4) (65∶25∶10,V/V).Mida_zolam was extracted from alkalinizing plasma and soluted in the mobile phase then detected at 221nm.RESULTS:The calibration curve had the fine linearity in the concentration range 50～1 600ng/ml(r=0.9 999).The detection limit was 2ng/ml.The absolute recovery was 90.8%～95.4%,the relative recovery was 99.3%～101.3%.The within-day and between-day precision(CV%) was 1.94%～5.16%,3.00%～6.39% respectively.CONCLUSION:The method is simple,stable and highly sensitive and could meet with the research of clinical pharmacokinetics.

0.05) . AEP index increased sharply from 42 to 67 when the patients regained consciousness (OAA/S increased from 2 to 3) but BIS increased gradually from 64 to 72 indicating that AEP index had better discriminatory performance. OAA/S correlated fairly well with BIS , AEP index and target-controlled concentration of propofol and r was 0.781, 0.684 and - 0.580 respectively. Conclusions Both AEP index and BIS can predict fairly well the level of sedation but AEP index prooes to be better in distinguishing conscious from unconscious.

ve To compare the effects of coronary-artery-bypass (CAB) surgery with and without cardiopulmonary bypass(CPB) on hemodynamics and the function of the grafts. Methods Thirty-five patients undergoing elective CAB surgery were studied. CAB was performed either with hypothermic CPB (n = 15) or without CPB(off-pump, n = 20) . The patients were premedicated with intramuscular pethidine 50 mg and scopolamine O.3mg. Anesthesia was induced with intravenous midazolam 5-15mg, fentanyl 5-20?g?kg and pancuronium 0.1 mg?kg-1 or pipecuronium 0.1 mg?kg-1 and maintained with iv infusion of fentanyl 6-10?g?kg-1, propofol 2-4mg?kg-1?h-1 and intermittent boluses of pancuronium, midazolam supplemented with 1%-1.5% isoflurane inhalation. In off-pump group naso-pharyngeal T?was maintained at 37.2℃ during operation. The amount of heparin used was equal to about one-third of amount used during CPB and ACT was maintained above 250 seconds. MAP was maintained at 70-90 mm Hg. While blood vessel was being grafted onto the coronary arteries heart rate was maintained at 60-80 bpm, otherwise esmolol 10-20mg was given iv every 5 min until it was satisfactorily controlled. In CPB group, during CPB naso-pharyngeal T?was maintained at 32℃-34℃, MAP at 50-70 mm Hg and blood gases and electrolytes within normal range. Right radial artery was cannulated and 7.5F Swan-Ganz catheter was inserted via internal jugular vein into pulmonary artery for hemodynamic monitoring and blood gas analysis. ECG, SpO2 were continuously monitored during operation. At the end of operation in patients with internal mammary artery used as graft, the flow rate of grafts was measured with 3mm Doppler probe.Results (1) After CAB cardiac index (CT) increased significantly in off-pump group(P0.05) . (3) There was no significant difference in the blood flow of artery graft and myocardial oxygen delivery (MDO2), and consumption ( MVO2) as well as MDO2/MVO2 between the two groups. Conclusions Off-pump CAB surgery has less effects on hemodynamics but systemic and myocardial oxygen delivery and consumption are similar between the two groups.

Objective To compare the neuromuscular blocking effects of rocuronium given by intermittent bolus injection, continuous infusion and target-controlled infusion during liver transplantation. Methods Thirty-six patients with hepatic failure of both sexes aged 21-63 yr weighing 48-80 kg undergoing liver transplantation were studied. The donor livers were obtained from living donors. The patients were divided into 3 groups according to the mode of rocuronium administration ( n = 12 each): group Ⅰ intermittent bolus injection (group Ⅳ); group Ⅱ continuous infusion (group CI) and group Ⅲ target-controlled infusion (group TCI). Neuromuscular block was assessed by TOF stimulation of ulnar nerve (TOF-Watch SX). Anesthesia was induced with midazolam 5 mg,fentanyl 4-6 μg/kg and propofol 1.0-1.5 mg/kg, and rocuronium was administered using different modes of administration. A bolus of rocuronium 0.6 mg/kg was given during induction and supplemental rocuronium 0.15 mg/kg was given when T1 was returned to 25% in preanhepatic stage and T4/T1 (TOFR) returned to 25% in anhepatic and neohepatic stages in group Ⅳ. TCI at an initial target effect-site concentration of 3 μg/ml was started during induction, the concentration was adjusted to maintain T1 at 5%-10% , TCI was temporarily suspended at the beginning of anhepatic and neohepatic stages, and then TCI at a target effect-site concentration of 0.1 μg/ml was started again and the concentration was adjusted to maintain T1 at 5%-10% in group TCI. A bolus of rocuronium 0.6 mg/kg was given during induction, the initial infusion rate was set at 30 μg· kg-1 ·min-1 and then adjusted to maintain T1 at 5%-10% in preanhepatic stage, CI was temporarily suspended at the beginning of anhepatic and neohepatic stages, and then it was started again at 1 μg· kg-1 · min-1 in preanhepatic stage and the infusion rate was adjusted to maintain T1 at 5%-10% in group CI. Tracheal intubation was performed when the maximal effect was achieved. The administration was stopped after suture of the peritoneum. The onset time, the maximal depression of T1 , intubation condition, recovery time and the total amount of rocuronium consumed were recorded.Results There was no significant difference in onset time, the maximal depression of T1, intubation condition,ecovery time and the total amount of rocuronium consumed among the 3 groups ( P ＞ 0.05). Conclusion There is no significant difference in the onset and recovery when neuromuscular blocade was induced by rocuronium via Ⅳ, CI and TCI, but neuromuscular blockade induced by rocuronium via TCI and CI is more stable than that induced by rocuronium via Ⅳ during liver transplantation.

The pharmacodynamics and its circulatory effects of alcuronium and atracurium were investigated in cardiac and noncardiac surgical patients.The results demonstrated that:l Compared with atracurium group,the duration of action of alcuronium is longer in cardiac patients than that of non-cardiac patients, but there is no difference in the onset of action between these two groups; 2. Half of the patients which received alcuronium need reversal with neostigminel 3. The effects on the circulation of these two drugs were nor remarkable;Therefore,alcuronium is also suitable for cardiac and non-cardiac surgical patients

The aim of this study was to evaluate the accuracy of transtracheal doppler (TTD) cardiac output monitoring. Eleven mongrel dogs (weight: 8～15kg) were anesthetized with intravenous thiopental 20mg?kg~(-1), and the doppler tube was inserted into trachea and fixed at a proper position where clear signal was received, and the catheter with thermistor was passed into pulmonary artery via femoral vein. CO were measured simultanously by thermodilution (TD) and TTD in the basic state, during 10 mins after intravenous administration of propofol 2mg?kg~(-1), in 30 mins following intravenous dopamine 100?g?kg~(-1) or under condition of isovolumic hemodilution in sequence. The results demonstrated that the CO measured by TTD correlated positively with that by TD (r=0.88, P

Gelofusine is a plasma substitute made from modified fluid gelatin,it's hemodynamic and biochemical effects on organism were studied in 6 anesthetized dogs and 20 patients scheduled for undergoing open heart surgery(OHS). Different degree of isovolemic acute hemodilution was achieved by supplying the gelofusion at the same amount of blood withdrawn. The results showed,in patients group, after hemodilution, no significant changs were observed in HR, MAP, DO_2 and CaO_2, wherease, CO, CI, and VO_2 increased. In dog group, HR and MAP remained, CaO_2 and SVRI decreased, CO, CI, DO_2 and VO_2 increased at the degree of isovolemic hemodilution less than 20 ml/kg, DO_2 began to decrease at the degree of hemodilution greater than 20ml/kg. In both groups, there's no significant changes in the concentration of K~+, Na~+ ,CI~- and pH value after hemodilution. Our findings supports previous observation about gelofusion's effect to maintain the blood volume and reserve the hemostasis,in addition,it has no deterious effect on coagulation

objective: The aim of this study was to investigate effects of desflurane and sevoflurane on coronary circulation in dogs and to compare its effects with those of isoflurane. Method:Eighteen mongrel dogs were anesthetized with sodium pentothal 20mg/kg and atracurium 0.8mg/kg. After intubation, thoracotomy was performed and a 3.0 or 3.5mm pulsed Doppler flow probe was placed around the left anterior descending coronary artery. The dogs were randomly assigned to receive desflurane,sevoflurane or isoflurane with the values of MAC being 7.2%, 2.3% and 1.28%,respectively. Coronary blood flow(CBF)were recorded 20 min after the period of equilibration at the desired endtidal concentration. Result:CBF was significantly increased in desflurane and isoflurane group at giving concentrations. Unlike isoflurane,CBF in sevoflurane group decreased slightly at low concentration,but increased significantly at high concentration. Conclusion: The effects of desflurane and isoflurane on coronary circulation are similar, but those of sevoflurane and isoflurane are different.