Objective: To investigate whether post-treatment of cultured astrocytes with 14,15-epoxyeicosatrienoic acids（14,15-EET）would increase the brain derived neurotrophic factor（BDNF）secretion after oxygen-glucose deprivation and reperfusion（OGD/R）, and if this effect would subsequently protect neurons during reperfusion after OGD in the co-cultured system. Methods: Astrocytes and neurons were subjected to OGD/R. Exogenous 14,15-EET were applied to astrocytes in the reperfusion period and ELISA was then performed to measure BDNF secretion from astrocytes at different time points following OGD/R. After that，the OGD neurons were co-cultured with the astrocytes that were previously incubated with DMSO or 14,15-EET.Tunnel staining was used to detect neuronal apoptosis. Results: BDNF secretion was significantly promoted by application of 14,15-EET on astrocytes in the reperfusion stage after OGD. Exposure of OGD neurons to astrocyte media previously conditioned with 14,15-EET reduced the neuronal apoptosis，but the pro-survival effect could be partly reversed by TrkB inhibitor k252a. Conclusion Exogenous administration of 14,15-EET augments BDNF secretion from astrocytes，which increases TrkB receptor occupancy on neurons and promotes neuronal survival after OGD/R.

Trigeminal neuralgia (TN) is a common facial pain disease. Recently, TN has been divided into three categories, including classic TN, secondary TN and idiopathic TN by the International Association for the Study of Pain.This article mainly discusses the progress of trigeminal neuralgia from the classification, diagnosis and treatment.

BACKGROUND:Cdh1 has been shown to express in rat hippocampus and cortex in a large number. Moreover, in vitro test demonstrated that Cdh1 expression was higher in neurons than in neural stem cel s, which possibly associated with the differentiation of neural stem cel s into neurons. However, the effects of anaphase promoting complex Cdh1 on ischemic neuronal damage remain unclear.
OBJECTIVE:To investigate the expression of Cdh1 and its downstream substrate in primary cultured neurons with oxygen-glucose deprivation. METHODS:Primary neurons from cortex of postnatal 24-hour rat pups were cultured in vitro, and identified by immunofluorescence staining. The oxygen-and glucose-deprived models were established by three gas incubator fil ed with nitrogen in sugar-free Earle’s solution. After 1 hour of hypoxia, reoxygenation was conducted. Real-time fluorescent quantitative PCR was used to detect the mRNA expression of Cdh1 and its downstream substrates Skp2, Cyclin B1 before hypoxia, 6 hours, 1, 3, 7 days after oxygen glucose deprivation. RESULTS AND CONCLUSION:After oxygen glucose deprivation, the expression of Cdh1 and Cyclin B1 in primary neurons was increased (P<0.05), while Skp2 expression was decreased (P<0.05). Above data indicated that Cdh1 expression in neurons increased after oxygen-glucose deprivation. It may degrade Skp2 and participate in hypoxic neuronal apoptosis by ubiquitination.

Objective To investigate the effects of pentobarbital sodium on compound muscle action potentials (CMAPs) in rats.Methods Ten adult Sprague-Dawley rats (5 males,5 females),aged 8 weeks,weighing 240-260 g,were anesthetized with intraperitoneal 1％ pentobarbital sodium 40 mg/kg.The sciatic nerve was stimulated (intensity 0.50,0.55 and 0.60 V,wave length 0.05 ms,frequency 10 Hz) starting from 8 min after administration.Each intensity was repeated three times at 1 s interval.The stimulation mentioned above was repeated every 5 min.CMAPs from the gastrocnemius muscle were recorded starting from 8 min after administration (T1) and then were recorded every 5 min for 9 times (T2-10),Results The peak value of CMAP was significantly decreased at T3-5 when the intensity was 0.50,0.55 and 0.60 V,and CMAP latency was significantly prolonged at T3-6 when the intensity was 0.50 V,and at T4,5 when the intensity was 0.55 and 0.60 V as compared with those at T1 ( P ＜ 0.05 or 0.01 ).Conclusion Pentobarbital sodium can inhibit CMAPs in rats.

Objective To evaluate the role of ATP-sensitive potassium (KATP) channel in spinal dorsal horn neurons in hyperalgesia after thoracotomy in rats.Methods Twenty-eight Sprague-Dawley rats,aged 7-9 weeks,weighing 250-350 g,in which intrathecal catheters were successfully implanted without complications on 14th day after chronic post-thoracotomy pain was induced,were randomly divided into 4 groups (n =7 each):control group,the solvent dimethyl sulfoxide (DMSO) group,KATP channel opener pinacidil group (group P) and KATP channel blocker glibenclamide group (group G).10％ DMSO 10 μl,pinacidil 10 μg/10 μl and glibenclamide 50μg/10μ1 were injected intrathecally in groups DMSO,P and G at 5 day after the intrathecal catheter was implanted,respectively.Paw withdrawal threshold to von Frey filament stimulation was measured before intrathecal administration and at 10,30 and 60 min after intrathecal administration and the acetone test was performed.Coldinduced pain threshold was measured.Results There was no significant difference in paw withdrawal threshold to yon Frey filament stimulation at each time point among the four groups (P ＞ 0.05).Compared with C and DMSO groups,cold-induced pain threshold was significantly increased in group P and decreased in group G (P ＜ 0.05).There was no significant difference in cold-induced pain threshold between C and DMSO groups (P ＞ 0.05).Conclusion KATP channel in spinal dorsal horn neurons is involved in the maintenance of hyperalgesia after thoracotomy in rats.

Objective To compare the effects of subgluteal(SG) and sub-subgluteal-fold(SSGF)approach for ultrasound-guided siatic nerve block. Methods One hundred forty-eight patients undergoing lower limb surgery were randomly divided into two groups to receive SG approaches and SSGF approaches to sciatic nerve block under real time ultrasound guidance. A combined posterior lumbar plexus block under ultrasound guidance was performed for sufficient surgery anesthesia. 20 ml of 0. 5% ropivacaine was used for sciatic nerve and lumbar plexus block separately. Measurements included skin-to-nerve distance,reorientation of the needle during block and execution time,rates of sensory and motor blockade after 15 min and 30 min of injection, quality of surgery blockade, duration of the sensory and motor block, and postoperative complications related to sciatic nerve block. Results In SSGF group, execution time and reorientation of needle for sciatic nerve block was significantly less than those of the SG group( P ＜0.01).But motor blockade in the SG group was quicker when compared with SSGF group ( P ＜0.01). There were no significant differences in the quality and duration of blockade between the two groups. Conclusions Both SG and SSGF approach can be used for sciatic nerve block with equal sensory and motor block rate,whereas sciatic nerve block via SSGF approach was faster and easy to perform than the SG one.

ObjectiveTo summarize and analyse the perioperative management especially theanesthesia of 20 kidney transplant recipients in non-transplant surgery. MethodThe anesthesia management of 20 kidney transplant recipients in non-transplant surgery was analyzed retrospectively. ResultsIn 20 cases, 1 case (5％) was performed under local anesthesia,4 cases (20％) were performed under intravertebral anesthesia and 15 cases (75％) were performed under general anesthesia. The operation time was 30-260 min, all cases were managed successfully. ConclusionIt is still a clinical challenge to deal with the surgical patients after kidney transplantation, and it needs fully understanding of the pathophysiological status of the patient and closely collaboration of transplant physicians, anesthesiologists and the surgeons.

Objective To determine the relationship between early postoperative delirium (EPD) and prognosis in patients undergoing non-cardiac surgery. Methods This was a prospective cohort study consisted of 698 patients admitted to postanesthesia care unit, undergoing non-cardiac surgery under general anesthesia, between June and December 2009. The risk factors affecting prognosis were collected. All the patients were assessed for the development of delirium by experienced research staff using Confusion Assessment Method for Intensive Care Unit. The patients were divided into 2 groups according to the occurrence of EPD: EPD group and no EPD (NEPD) group. The postoperative hospital length of stay was made as a major prognostic indicator. Cox proportional hazard regression model was used to analyze the risk factors affecting prognosis. Results Of the 698 patients, 197 (28.2%) developed EPD. The postoperative hospital length of stay was prolonged in group EPD compared with group NEPD. The Cox proportional hazard regression model analysis indicated that EPD was an independent risk factor affecting prognosis. Conclusion EPD is an independent risk factor affecting prognosis in patients undergoing non-cardiac surgery.

Objective To evaluate the effects of intravenous anesthesia with propofol and fentanyl on flexible fiberoptic bronchoscopy (FFB).Methods Forty ASA Ⅰ - Ⅱ patients undergoing elective FFB were randomly divided into two groups (20 cases in each group): control group and intravenous anesthesia group.All patients received airway local topical anesthesia with 2% lidocaine before the procedure.The patients in intravenous anesthesia group received propofol 1.5 mg/kg and fentanyl 1 μ g/kg intravenous injection for induction while in control group normal saline was given instead.Supplemental oxygen was administered by the endoscopy face mask.The mean arterial pressure (MAP),heart rate (HR)and pulse oxygen saturation (SpO_2) were continuously monitored and recorded before induction of anesthesia (T_1, baseline), 1 min after intravenous injection (T_2) ,immediately and 3 min after intubation (T_3,T_4),after FFB (T_5).The persistence time of the procedure was noted.When the patients responded to commands exactly, the recovery time was recorded.All patients were interviewed for the global tolerance to the procedure, the acceptance of another fiberoptic bronchoscopy and the degree of amnesia.Results All of the 40 patients finished FFB successfully.VAS postoperation and dependence scores were lower in intravenous anesthesia group than those in contrel group[(1±2),(2±3) scores and (7±1),(7±3) scores](P< 0.05).MAP and HR at T_3, T_4 and T_5 were significantly increased compared with baseline values at T_1 in control group (P <0.05).MAP and HR at T_2 was lower than those at T_1,HR at T_3 was higher than that at T_1 in intravenous anesthesia group (P < 0.05 ).Compared with control group, MAP and HR at T_3, T_4 and Ts were lower, HB at T_2 was lower in intravenous anesthesia group (P < 0.05).There was no awareness during the FFB in intravenous anesthesia group.Conclusion Intravenous anesthesia with propofol and fentanyl is safe and effective for FFB.

Objective To investigate the role of NF-κB in apoptosis of immortalized neural progenitor cells (INPCs) . Methods INPCs were cultured in 6-well plates and were randomly divided into 5 groups ( n = 6 each) : group I was not transfected with any plasmid (group INPC); group Ⅱ was transfected with control plasmid (group INPC/CMV); group Ⅲ was transfected with plasmid RcCMV-p50 (group INPC/p50); group Ⅳ was transfected with plasmid RcCMV-p65 (group INPC/p65) and group V was transfected with plasmid RcCMV-p50 and RcCMV-p65 (group INPC/p50p65). Group INPC/CMV ( H ), INPC/p50 (Ⅲ) and INPC/p65 (Ⅳ) were screened by G418, and the positive clones were then cultured for 3-4 weeks. The transcription of p50 mRNA or p6S mRNA was detected by RT-PCR. The NF-κB activity was measured by luciferase reporter gene assay. The cell apoptosis was measured by annexin V/PI staining. In group INPC/p50p65 and group INPC/p65, the cultured positive clone was transiently transfected with plasmid RcCMV-p50. Two days after transfection, the same measurement was performed in group INPC/pS0p65 and the other groups. Results The expression of p50 mRNA was significantly increased in group INPC/p50 and INPC/p50p65 as compared with the other groups ( P < 0.05) . The expression of p65 mRNA, the NF-κB activity and the apoptotic rate were significantly increased in group INPC/p65 and INPC/p50p65 as compared with the other groups ( P < 0.05). Conclusion Enhanced NF-κB activity can increase immortalized neural progenitor cell apoptosis.