Objective To investigate the effects of different doses of ketamine on spatial cognitive function and the expression of mRNA and protein of N-methyl-D-uspartate (NMDA) receptor subunits NR1 and NR2B in the hippocampus of aged rats.Methods Forty SD rats of both sexes aged 15 months weighing 470-570 g were randomly divided into 4 groups (n=10 each) : one control group (C) and three ketomine groups (K1 ,K2 ,K3).The animals in group K1 ,K2 and K3 received intraperiteneal(IP) ketaminc 10,20 and 100 mg/kg respectively once a day for 3 days,whereas the animals in control group received IP normal saline instead of ketamine.One day after the last drug administration,the animals underwent Morris water maze test 4 times a day for 3 consecutive days.The animals were killed within 1 h after the last test for determination of the expression of NR1 mRNA and NR2B mRNA (using RT-PCR) and protein (using immuno-histochemistry) in the hippocampus.Results The latency period and swimming distance of water maze test were significantly longer on the 2nd and 3rd days in group K3 than in control group.The NR2B mRNA and protein expression was significantly lower in group K3 than in control group.Conclusion Anesthetic dose of ketamine decreases spatial cognitive function and the expression of NR2B mRNA and protein in aged rats whereas subanesthetic doses of ketamine do not.

Objective The purpose of this study was to examine the effect of preoperative glucose infusion on glucose transport-4 mRNA ( Glut-4 mRNA) expression in skeletal muscle before and after thoracic operation. Methods Twelve male ASA Ⅰ - Ⅱ patients undergoing elective radical surgery for esophagus cancer were randomly divided into 2 groups : (Ⅰ ) control group; (Ⅱ) glucose infusion group. Patients with hypertension, hyperlipidemia or diabetes mellitus were excluded. The patients in both groups were premedicated with phenobarbitol and atropine. Anesthesia was induced with midazolam 0.1 mg ? kg-1 , propofol 1.5 mg ?kg-1 , fentanyl 4?g?kg-1 and vecuronium 0.15 mg?kg-1 . The patients were mechanically ventilated after trachea! intubatioa Anesthesia was maintained with continuous iv infusion of propofol (80?g ? kg-1? min-1 ) and vecuronium (1.0 ?g?kg-1?min-1) supplemented with droperidol 0.1 mg?kg-1 and fentanyl 6 ?g ?kg-1 given in several boluses. In group Ⅱ 5 % glucose (0.25 g?kg-1) was infused 2 h before operation. Blood samples and 1 g of skeletal muscle were obtained while chest was being opened and closed for determination of plasma glucose and insulin levels and Glut-4 mRNA expression in muscle. The total RNA of the muscle cells was extracted by trizol one-step template. The Glut-4 mRNA amplification products were determined using RT-PCR with ?-action mRNA as an internal control. The Glut-4 mRNA expression was expressed by desired gene/ ?-action? 100% .Results Glut-4 mRNA expression was significantly decreased ( P

Objective To investigate the effect of intraperitoneal local anesthetic on patients undergone laparoscopic cholecysteetomy (LC).Methods Thirty-six patients (ASAⅠ-Ⅱ),who were undergoing selective LC were randomly divided into there groups.GroupⅠreceived preoperational anesthetic spary with 30 ml of 0.5% ropivacaine.GroupⅡwas given the anesthetic at a same dosage after the operation.While groupⅢwas set as a control by using 0.9% NaCl instead of ropivacaine.The LC was completed under general anesthesia.After the operation,visual analog scale (VAS) was recorded at 6,24,and 48 hours to evaluate the degree of postoperative pain.Meanwhile,the number of the patients who received anesthetics after the surgery,as well as the incidence rates shoulder or back pain and nausea or vomiting were recorded.Results Postoperative VAS of the groupⅠwas significantly lower than that of the other two groups,while the VAS of groupⅡwas significantly lower than that in groupⅢ(both P0.05). Conclusions Intraperitoneal local anesthetic can significantly reduce postoperative pain after LC.It is more effective to give local anesthetic at the end of the procedure than using it before operation.

Objective To investigate the effect of continuous positive airway pressure(CPAP)during one lung ventilation on pulmonary function in patients undergoing video-assisted thoracoscopic repair of atrial septal defect.Methods Twenty ASA Ⅱ patients of both sexes,aged 16-30 yr,weighing 41-64 kg,scheduled for video-assisted thoracoscopic repair of atrial septal defect,were randomly divided into 2 groups(n = 10 each): control group and CPAP group.One lung ventilation(VT 8 ml/kg,RR 12-16 bpm,I:E 1:2,PETCO2 35-40 mm Hg)was perform in both groups.CPAP(6 cm H2O)was perform during one lung ventilation in group CPAP.The oxygenation index,pulmonary compliance and airway pressure were recorded during operation.The cardiovascular events,hyoxemia and extubation time were recorded.Results The oxygenation index and pulmonary compliance were significantly higher,extubation time was shorter,and the incidence of hyoxemia was lower in CPAP group than in control group(P ＜ 0.01).The airway pressure was in the normal range in both groups.No cardiovascular events was found in both groups.Conclusion CPAP(6cm H2O)during one lung ventilation can improve the pulmonary function in patients undergoing video-assisted thoracoscopic repair of atrial septal defect.

Objective To study the expression of clock genes in Parkinson's disease(PD) and also the molecular clock machinery of PD.Methods Seventeen PD patients(nine men,eight women)and sixteen agematched controls(nine men,seven women) were investigated in this study.Bload samples were collected over a 12h span at 21:00,00:00,06:00 and 09:00.Using a real-time PCR assay,the peripheral molecular clock was examined by measuring Bmall and Bmal2 expression in total leukocytes during the dark span(from 21:00 to 09:00)in PD patients and age-matched healthy controls.Results At PD,the relative abundance of Bmall was significantly lower at 21:00,00:00 and 06:00(21:00:(22.17±4.09)vs(51.14±8.31),P=0.003,00:00:(30.30±5.45)vs(100.00±24.71),P=0.008,06:00:(19.02±3.33)vs(65.61±14.11),P=0.002).The relative Bmal2 levels in PD patients were significantly less abundant than controls at 21:00 and 00:00(21:00:(48.09±7.40)vs(84.96±9.34),P=0.005;00:00:((65.85±7.88)vs(100.00±11.78),P=0.025).Conclusion These results suggest that a peripheral molecular clock is altered in PD patients.In addition,the relative abundance of Bmall and Bmal2 was significantly lower in PD patients versus control subjects,which can provide a molecular basis to help monitor disease progression and response to investigational drugs.

Objective To observe the effect of creatine phosphate sodium on BIS and recovery quality during general anesthesia emergence period in elderly patients.Methods Sixty ASA Ⅰ or Ⅱpatients,31 males,29 females,aged 65-80 yr undergoing transabdominal cholecystectomy by general anesthesia were randomly allocated into two groups(n=30 each):group creatine phosphate (P)and group control(C)according to random numbers generated by computer.Patients were intravenously infused with 1.0 g creatine phosphate sodium melted in 100 ml normal saline or only 100 ml normal saline in group P or C respectively in thirty minutes at the same time of surgical incision.The heart rate(HR)and bispectral index(BIS)were recorded before anesthesia induction (T0 ),during sputum aspiration (T0 ),during extubation (T2 )and 1(T3 ),5(T4 ),10(T5 ),15 minutes (T6 )after extubation. The dosage of propofol,remifentanil and cisatracurium,anesthesia duration,operation time,awake time,extubation time,recovery time of consciousness and Steward recovery scores on T3-T6 were also recorded,and the occurrence of tachycardia during the operation was observed at the same time. Results Compared with T0 ,the BIS value were lower significantly and HR were significantly in-creased on T1-T4 in the two groups(P <0.05).Compared with group C,the BIS value were signifi-cantly higher in group P on T1-T4 (P <0.05).Compared with group C,awake time,extubation time, recovery time of consciousness significantly shortened in group P (P <0.05).There were six cases of tachycardia occurring in group C which were significantly higher than two cases in group P (P <0.05).Steward recovery scores on T3 and T4 were also higher in group P (P <0.05).Conclusion Not only can 1.0 g creatine phosphate sodium administered during transabdominal cholecystectomy im-prove the BIS value of general anesthesia recovery period and recovery quality,but also effectively re-duce the incidence rate of tachycardia during operation in elderly patients.

Objective To evaluate the efficacy and safety of a collagen dressing for healing of wounds induced by fractional CO2 laser in patients with atrophic facial acne scars.Methods Seventy patients with atrophic facial acne scars were recruited to this study,and randomly divided into a treatment group and a control group.Both the two groups were treated by two sessions of fractional CO2 laser with an interval of one month.After each session of laser therapy,the treatment group were topically treated with a collagen dressing for 20 minutes once a day for 10 consecutive days,while the control group did not apply any collagen dressing.All the patients were followed for 6 months.Efficacy was evaluated by the degree of acute inflammatory reaction,time needed for crust shedding and patient comfort level.The length of downtime as well as incidence of post-inflammatory hyperpigmentation and other adverse reactions were also assessed.Results Compared with the control group,the treatment group showed a decrease in the score for acute inflammatory response (W =312,P ＜ 0.01),time needed for crust shedding (t =2.08,P ＜ 0.05),incidence rate of post-inflammatory hyperpigmentation (x2 =6.06,P ＜ 0.05),length of downtime (t =3.14,P ＜ 0.05),but an increase in self-reported comfort level (W =172,P ＜ 0.01).No new scar formed in any of these patients.Conclusion The collagen dressing is effective in reducing incidence of adverse reactions and improving satisfaction degree of patients with atrophic facial acne scars after fractional CO2 laser therapy.

BACKGROUND:Healthy human umbilical cord jel y is a mucous connective tissue without vessels and has been used in eye plastic operation because of its elasticity and toughness. It contains lysozyme, placental globulin, hyaluronic acid enzyme, AMP antibody and complement, and also contains a lot of mesenchymal stem cells, so it is not prone to infection and rejection. OBJECTIVE:To observe the histocompatibility and histopathological changes of human umbilical cord jel y as a tarsal substitute transplanted for eyelid reconstruction in guinea pigs. METHODS:The mucous connective tissue of healthy neonate umbilical cord jel y was made into tissue blocks at even thickness. Models of tarsal defects were established in guinea pigs, and then the mucous connective tissue of healthy neonate umbilical cord jel y was implanted. Samples of implanted materials were col ected for histological examination at 1, 2, 3 weeks postoperation under light microscope. RESULTS AND CONCLUSION:There were no obvious rejection, infection and eyelid deformation observed, the corneas of al the animals were clear, corneal epithelial shedding did not occur, and the eyelid could move normal y. One week after implantation, there was no infection and rejection on the conjunctiva and the incision of the eyelid, the eyelid could move normal y, and partial inflammatory cells were observed between the human umbilical cord jel y and the muscle of the eyelid with microscopy. Two weeks after implantation, there was no infection and rejection on the conjunctiva and the incision of the eyelid, the cornea was clear, the eyelid and eye could move normal y, and no symblepharon occurred;umbilical cord jel y showed the tendency of absorption, and the inflammatory cells were reduced at 2 weeks after implantation. Three weeks after implantation, the incision of the conjunctiva healed wel , the cornea was clear;there was no difference in the eyelid form and movement between the two eyes;the umbilical cord jel y was absorbed partial y, normal fibrous tissues formed and there were no inflammatory cells. With low immunogenicity, human umbilical cord jel y can guide the growth of new col agen and serve as an ideal tarsal substitute.

A 36-year-old woman presented with a 3-year history of pruritic erythema and scaling on the trunk and extremities.Dermatological examination revealed ill-defined light pink macules with white lamellar scales on the chest,abdomen and buttocks.Histologically,there was a focal mononuclear cell infiltrate in the superficial dermis,with the epidermotropism of some cells and mild atypia of epidermotropic cells,as well as an interstitial mononuclear cell infiltrate and mild deposition of mucin between the collagen fibers in the middle dermis.CD3 and CD4 were expressed by scattered mononuclear cells infiltrating the upper and middle dermis.Based on these data,the patient was diagnosed with interstitial granuloma fungoides.

A case of benign follicular neoplasm-trichogerminoma-is reported.A 48-year-old man presented with a 10-year history of asymptomatic subcutaneous nodule in the chest.Histological examination revealed a well-circumscribed lesion composed of variously sized lobuli and cysts in the deep dermis and separated from the surrounding tissue by a fibrous capsule.Most lobuli consisted of concentrically arranged clear cells in the central area and basophilic cells in a palisade arrangement in the peripheral area.The tumor cells displayed a multi-directional differentiation toward hair bulb,inner root sheath,outer root sheath and infundibulum of hair follicles.Immunohistochemically,the tumor cells expressed AE1/AE3,CK5/6 and CK17,but were negative for CK20 or CK7.There was a sharp contrast in immunohistochemical findings between the central clear cells and peripheral basophilic cells.Based on the histological and immunohistochemical features,a diagnosis of trichogerminoma was made.