Prevalence survey of clinical manifestations following COVID-19 / 中华麻醉学杂志

Objective:To investigate the clinical manifestations of population following COVID-19 by using questionnaires.Methods:COVID-19 among anesthesia workers and the surrounding population was investigated between 11 November 2022 and 31 December 2022 in China.The Tencent electronic questionnaire(ID.11492813) was sent to different WeChat groups of the Association of Anesthesiologists or Society of Anesthesiologists via the WeChat platform of the medical personnel in China. The survey was conducted between January 7 and January 15, 2023. Results:A total of 17 000 questionnaires were issued for this survey, 11 060 valid questionnaires from 31 provinces and autonomous regions were collected all over the country, with a recovery rate of 65.059%.There were 10068 (91.037%) participants diagnosed as having COVID-19, and among of them, 47.606% were male and 52.394% were female. The main post-COVID-19 clinical manifestations included fever (85.777%), cough (83.731%), fatigue (75.338%), parasomnia (64.352%), limb soreness (58.890%), dizziness, headache, tinnitus (38.617%), loss or abnormality of taste (37.763%), and loss or abnormality of smell (30.960%); peripheral neuralgia was usually found within 3 days after positive nucleic acid test or positive antigen test; there were 2 963 cases accompanied with sweating, and among of them, 47.25% were male and 52.75% were female, and 37.80% of these participants continued to sweat after the nucleic acid test or antigen test became negative. There were 1 151 cases with premature heart beats among the study population, and the symptoms aggravated following COVID-19 were found in 34.32% of these patients.Conclusions:In addition to the respiratory system, the central and peripheral nerves of patients are also affected following COVID-19, and the peripheral and central nerve disorders last until several days after negative nucleic acid test or antigen test, suggesting that anesthesiologists should pay more attention to monitoring of various nerve function and impact of surgery and anesthetic drugs on the stress response of the body in such patients.

Protective effects of pretreatment with ifenprodil on learning, memory and cognitive dysfunction induced by sevoflurane in neonatal rats / 临床麻醉学杂志

Objective To evaluate the role and mechanism of ifenprodil, which is the selective antagonist of N-methyl-D-aspartic acid subtype receptor NR2B, in soflurane-induced cognitive dysfunction in neonatal rats.Methods Twenty-eight 7-day-old Sprague Dawley rats, weighing 15-18 g, were randomly divided into 4 groups (n=7 each): control group (group C), ifenprodil group (group I), sevoflurane group (group S) and ifenprodil+sevoflurane group (group IS).Normal saline 0.2 ml was injected intraperitoneally in group C.Specific NR2B receptor antagonist ifenprodil 5 mg/kg was injected intraperitoneally at the corresponding time points in group I.Normal saline 0.2 ml was injected intraperitoneally and 2.0% sevoflurane was inhaled for 4 h in group S.Ifenprodil 5 mg/kg was injected intraperitoneally 2 h before sevoflurance inhalation, and 2.0% sevoflurance was inhaled for 4 h in group IS.The rats were then sacrificed 3 weeks after administration, their brains were immediately removed and hippocampal slices were prepared for electrophyisological experiments.The value of population spike amplitude (PSA) and long-term potentiation (LTP) were measured every 10 minutes.Induced LTP was recorded.Results Compared with group C, the values of PSA and rates of induced LTP were significantly decreased in group S (P＜0.01).The values of PSA and rates of induced LTP were significantly increased in group IS than those in group S (P＜0.01).Conclusion NR2B receptor is involved in sevoflurance-induced cognitive dysfunction in the neonatal rats.Pretreatment with ifenprodil 5.0 mg/kg can improve the neurotoxicity and protect the brain.

Relationship between NLRP3 expression and mitochondrial function during mechanical stretch-induced damage to mouse alveolar epithelial cells / 中华麻醉学杂志

Objective To evaluate the relationship between the expression of Nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) in nerve tissues and mitochondrial function during mechanical stretch-induced damage to mouse alveolar epithelial cells.Methods Alveolar epithelial type Ⅱ cell line MLE-12 cells were divided into 3 groups (n=13 each) using a random number table:control group (group C),cyclic stretch group (group CS) and cyclic stretch plus NLRP3 inhibitor TAK-242 group (group CS+T).MLE-12 cells underwent 20％ cyclic stretch at a frequency of 0.5 Hz (stretch ∶ intermittence =1 ∶ 1) for 4 h in group CS.In group CS+T,after being incubated for 1 h with 1 μ mol/L TAK-242,MLE-12 cells underwent 20％ cyclic stretch for 4 h,and the parameters were similar to those previously described in group CS.The reactive oxygen species (ROS) content and mitochondrial membrane potential (△ΨM) were measured using chemiluminescence assay.Enzyme-linked immunosorbent assay was used to determine the concentration of interleukin-1 beta (IL-1β) in the supernatant.The expression of NLRP3 in MLE-12 cells was detected using Western blot.Results Compared with group C,the △ΨM of cells was significantly decreased,the ROS content and IL-1β concentration were increased,and the expression of NLRP3 was up-regulated in group CS,and the △ΨM of cells was significantly decreased,the ROS content was increased,and the expression of NLRP3 was up-regulated in group CS+T (P＜0.05).Compared with group CS,the △ΨM of cells was significantly increased,the ROS content and IL-1β concentration were decreased,and the expression of NLRP3 was down-regulated in group CS+T (P＜ 0.05).Conclusion Mechanical stretch induces damage to mitochondria through up-regulating the expression of NLRP3,thus leading to damage to mouse alveolar epithelial cells.

Role of p120 in mechanical stretch-induced transferring of E-cadherin to cytoplasm in mouse alveolar epithelial cells / 中华麻醉学杂志

Objective To evaluate the role of pl20-catenin protein (p120) in mechanical stretchinduced transferring of E-cadherin to cytoplasm in mouse alveolar epithelial cells.Methods Experiment Ⅰ Mouse alveolar epithelial cells (MLE-12 cells) were seeded in 6-well cell stretch plates at a density of (1.0-1.5) ×106 cells/well and divided into 3 groups (n=12 each) using a random number table:control group (group C),cyclic stretch for 2 h group (group CS2) and cyclic stretch for 4 h group (group CS4).The cells underwent 20％ cyclic stretch at 0.5 Hz (stretch:intermittence =1 ∶ 1) for 2 and 4 h in CS2 and CS4 groups,respectively.The cells underwent no cyclic stretch in group C.The expression of p120,E-cadherin and phosphorylated Src kinase (p-Src) and expression of E-cadherin in cytomembrane and cytoplasma were detected by Western blot.Experiment Ⅱ MLE-12 cells were seeded in 6-well cell stretch plates at a density of (1.0-1.5)× 106 cells/well and divided into 4 groups (n =6 each) using a random number table:control group (group C),cyclic stretch group (group CS),p120 small interfering RNA (siRNA) transfection group (group p120 siRNA),and p120 siRNA transfection plus cyclic stretch group (group p120 siRNA+CS).The cells were transfected with scramble siRNA in C and CS groups,and 24 h later the cells underwent 20％ cyclic stretch for 2 h at 0.5 Hz (stretch:intermittence =1 ∶ 1) in group CS.The cells were transfected with p120 siRNA in p120 siRNA and p120 siRNA+CS groups,and 24 h later the cells underwent 20％ cyclic stretch for 2 h at 0.5 Hz (stretch ∶ intermittence =1 ∶ 1) in group p120 siRNA+CS.The expression of E-cadherin in cytomembrane and cytoplasm was detected by Western blot after the end of treatment in each group.Results Experiment Ⅰ Compared with group C,the expression of p120 and E-cadherin was significantly down-regulated,the expression of p-Src was up-regulated,the expression of E-cadherin in cytomembrane was down-regulated,and the expression of E-cadherin in cytoplasm was up-regulated in CS2 and CS4 groups (P ＜ 0.05).Compared with group CS2,the expression of p120 and E-cadherin was significantly down-regulated,the expression of p-Src was up-regulated,the expression of E-cadherin in cytomembrane was down-regulated,and the expression of E-cadherin in cytoplasm was upregulated in group CS4 (P ＜ O.05).Experiment Ⅱ Compared with group C,the expression of E-cadherin in cytomembrane was significantly down-regulated,and the expression of E-cadherin in cytoplasm was up-regulated in CS,p120 siRNA and p120 siRNA+CS groups (P＜ 0.05).Compared with group CS or group p120 siRNA,the expression of E-cadherin in cytomembrane was significantly down-regulated,and the expression of E-cadherin in cytoplasm was up-regulated in group p120 siRNA+CS (P＜0.05).Conclusion The degradation of p120 can promote mechanical stretch-induced transferring of E-cadherin to cytoplasm in mouse alveolar epithelial cells.

Effect of recombinant human annexin A5 on expression of p-PKCα and p120-catenin during endotoxin-induced damage to cardiomyocytes / 中华麻醉学杂志

Objective To evaluate the effect of recombinant human annexin A5 on the expression of phosphorylated protein kinase C alpha (p-PKCα) and p120-catenin during endotoxin-induced damage to cardiomyocytes.Methods H9c2 cells cultured in vitro were randomly divided into 3 groups (n=18 each) using a random number table:control group (group C),endotoxin group (group L),and recombinant human annexin A5 group (group A).Recombinant human annexin A5 (final concentration 5 ng/ml) was added,and the cells were incubated for 2 h in group A,and then lipopolysaccharide (final concentration 1 μg/ml) was added,and the cells were incubated for 4 h in L and A groups.At 4 h of incubation,cell apoptosis was detected using the cell apoptosis detection kit,the intercellular space was measured using the confocal microscopy,and the expression of p-PKCα and p120-catenin was determined by Western blot.The apoptosis rate was calculated.Results Compared with group C,the apoptosis rate was significantly increased,the intercellular space was significantly widened,the expression of p120-catenin was significantly down-regulated,and the expression of p-PKCα was significantly up-regulated in group L (P＜0.05).Compared with group L,the apoptosis rate and intercellular space were significantly decreased,the expression of p120-catenin was significantly up-regulated,and the expression of p-PKCα was significantly down-regulated in group A (P＜0.05).Conclusion Recombinant human annexin A5 can inhibit phosphorylation of PKCα and up-regulate the expression of p120-catenin,thus attenuating endotoxin-induced damage to cardiomyocytes.

Effects ofpneumoperitoneum on the airway pressure and pulmonary infection of patients with different body mass index in laparoscope / 临床麻醉学杂志

Objective To make clear the patients in minimally invasive surgery through explo-ring effects of pneumoperitoneum and pulmonary infection on the airway pressure of patients with dif-ferent body mass index (BMI)under general anesthesia.Methods A total of 849 cases of patients with trachea cannula in pneumoperitoneum surgery inr general anesthesia under different position were studied.To observe the changes of airway pressure and the ratio of pulmonary infection within one week of patients in general anesthesia.Propofol,Remifentanil and Atracrium were used in general an-esthesia.BIS and TOF were used to detect the degree of muscle relaxation.Results The airway pres-sure was increased obviously in patients of Head-down Tilt under same pneumoperitoneum pressure(P30 kg/m2 (P 30 kg/m2 under same pneumoperitoneum pressure.Therefore,shorten the operation time and decreased pneumoperitoneum pressure could be used to prevent pulmonary infection.

Risk factors for postoperative acute kidney injury in patients undergoing cardiac transplantation / 中华麻醉学杂志

Objective To determine the risk factors for postoperative acute kidney injury (AKI) in the patients undergoing cardiac transplantation.Methods Forty patients with end-stage heart failure (both sexes) , aged 13-66 yr, weighing 45-84 kg, of ASA physical status Ⅳ or Ⅴ (NYHA Ⅲ or Ⅳ), undergoing heart transplantation, with normal kidney function before operation, were selected.According to whether or not AKI occurred within 7 days after operation, the patients were divided into either AKI group or non-AKI group.Factors including age, gender, body weight, complications (including hypertension and diabetes mellitus), preoperative blood glucose, hemoglobin, serum creatinine, cardiac output, ejection fraction, pulmonary arterial systolic pressure, intraoperative cardiopulmonary bypass (CPB) time, transfusion of allogeneic red blood cells, and urine volume within 24 h after operation were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify postoperative AKI-related risk factors for this type of patients.Results A total of 39 patients were enrolled in this study.Of the 39 patients, 14 patients suffered from AKI after operation, and the incidence was 36％.The results of logistic regression analysis showed that preoperative pulmonary hypertension and CPB time ＞ 180 min were the independent risk factors for AKI after cardiac transplantation.Conclusion Preoperative pulmonary hypertension and CPB time＞180 min are the independent risk factors for postoperative AKI in the patients undergoing cardiac transplantation.

Role of Src tyrosine kinase in damage to alveolar epithelial cells caused by mechanical stretch / 中华麻醉学杂志

Objective To evaluate the role of Src tyrosine kinase in damage to alveolar epithelial cells caused by mechanical stretch.Methods MLE-12 cells cultured in vitro were randomly divided into 3 groups using a random number table:mechanical stretch group (group S),dimethyl sulfoxide control group (group D),and Src tyrosine kinase inhibitor PP2 group (group P).In D and P groups,dimethyl sulfoxide 30 μl/ml and PP2 100 μmol/L were added to the culture medium,respectively,and the cells were then cultured for 30 min.The cells underwent mechanical stretch for 8 h with frequency of0.5 Hz and amplitude of 20％ in the three groups.At 0,2,4 and 8 h of mechanical stretch,MLE-12 cells in 3 wells of each group were collected for determination of cell apoptosis with flow cytometry and expression of occludin using Western blot.The apoptosis rate was calculated.Results Compared with S group,no significant changes were found in the apoptosis rate and expression of occludin at each time point in group D,and the apoptosis rate was significantly decreased,and the expression of occludin was up-regulated at 2,4 and 8 h of mechanical stretch in group P.Conclusion The activation of Src tyrosine kinase is involved in damage to alveolar epithelial cells caused by mechanical stretch.

Role of protein kinase C in mechanical ventilation-induced lung injury in rats / 中华麻醉学杂志

Objective To investigate the role of protein kinase C (PKC) in mechanical ventilation-induced lung injury in rats.Methods Thirty healthy male Wistar rats,weighing 250-300 g,were randomly divided into 5 groups (n =6 each):control group (group C),small tidal volume group (group S),small tidal volume and PKC inhibitor group (group S + P),large tidal volume group (group L),and large tidal volume and PKC inhibitor group (group L + P).VT =42 ml/kg,RR =40 bpm,I∶E =1∶ 2,PEEP =0,FiO2 =21％ in groups L and L + P,while VT=7 ml/kg,RR=40 bpm,I∶E=1∶2,PEEP=0,FiO2 =21％ in groups S and S+P.The rats were only tracheostonized in group C,while the rats were mechanically ventilated for 4 h in the other four groups.PKC inhibitor bisindolylmaleinide Ⅰ 0.12 mg/kg was injected intramuscularly 1 h before anesthesia in groups S + P and L + P.The animals were sacrificed immediacy after tracheotomy in group C,and at 4 h of ventilation in the other four groups and lungs were removed for calculation of wet/dry lung weight ratio (W/D ratio) and for microscopic examination.The expression of occludin was determined in the lung tissues by Western blot.Results Compared with group C,W/D ratio was significantly increased and the expression of occludin was down-regulated in the other four groups (P ＜ 0.05).Compared with group S,W/D ratio was significantly increased and the expression of occludin was down-regulated in group L,and W/D ratio was decreased and the expression of occludin was up-regulated in group S + P (P ＜ 0.01).W/D ratio was significantly lower and the expression of occludin was higher in group L + P than in group L (P ＜ 0.01).The pathological changes were attenuated in groups S + P and L + P as compared with groups S and L.Conclusion PKC is involved in mechanical ventilation-induced lung injury in rats.

Characteristics of neutrophils infiltration in ventilation-induced lung injury / 华中科技大学学报（医学）（英德文版）

Neutrophils play a critical role in ventilation-induced lung injury. This study was aimed to investigate the characteristics of neutrophils influx in lungs induced by high tidal volume ventilation. Anaesthetized rats were randomly divided into low tidal volume ventilation group (Vt: 7 mL/kg, LV group) or high tidal volume ventilation group (Vt: 42 mL/kg, HV group) (n=40 in each). Rats in each group were ventilated for 0, 60, 90, 120 and 240 min. The wet/dry lung weight ratio (W/D) was measured. The levels of macrophage inflammatory protein-2 (MIP-2) and tumor necrosis factor-α (TNF-α), and the activity of myeloperoxidase (MPO) were detected by enzyme-linked immunosorbent assay (ELISA). The number of neutrophils in bronchoalveolar lavage fluid (BALF) was counted after Wright's staining, and the percentage of netrophils in lung tissues calculated. Histopatholgical examination was used to observe the changes of lung tissues after different ventilations. The results showed that the W/D weight ratio was increased, and the levels of MIP-2 and TNF-α significantly enhanced in HV group at 90, 120 and 240 min. Neutrophils in BALF and the neutrophil percentage in lung tissues were also elevated at 120 and 240 min, which coincided with the enhanced activity of MPO in HV group. The lung injury was significantly related with the ventilation time and the infiltration of neutrophils in lungs in HV group. In conclusion, in ventilation-induced lung injury, neutrophil infiltration is present in a time-dependent manner and associated with the aggravated lung injury. Pulmonary structural damage may be the main reason for ventilation-induced lung injury.

Characteristics of neutrophils infiltration in ventilation-induced lung injury / 华中科技大学学报（医学）（英德文版）

Neutrophils play a critical role in ventilation-induced lung injury. This study was aimed to investigate the characteristics of neutrophils influx in lungs induced by high tidal volume ventilation. Anaesthetized rats were randomly divided into low tidal volume ventilation group (Vt: 7 mL/kg, LV group) or high tidal volume ventilation group (Vt: 42 mL/kg, HV group) (n=40 in each). Rats in each group were ventilated for 0, 60, 90, 120 and 240 min. The wet/dry lung weight ratio (W/D) was measured. The levels of macrophage inflammatory protein-2 (MIP-2) and tumor necrosis factor-α (TNF-α), and the activity of myeloperoxidase (MPO) were detected by enzyme-linked immunosorbent assay (ELISA). The number of neutrophils in bronchoalveolar lavage fluid (BALF) was counted after Wright's staining, and the percentage of netrophils in lung tissues calculated. Histopatholgical examination was used to observe the changes of lung tissues after different ventilations. The results showed that the W/D weight ratio was increased, and the levels of MIP-2 and TNF-α significantly enhanced in HV group at 90, 120 and 240 min. Neutrophils in BALF and the neutrophil percentage in lung tissues were also elevated at 120 and 240 min, which coincided with the enhanced activity of MPO in HV group. The lung injury was significantly related with the ventilation time and the infiltration of neutrophils in lungs in HV group. In conclusion, in ventilation-induced lung injury, neutrophil infiltration is present in a time-dependent manner and associated with the aggravated lung injury. Pulmonary structural damage may be the main reason for ventilation-induced lung injury.

Accuracy of stroke volume variation in monitoring blood volume in patients undergoing off-pump coronary artery bypass grafting / 中华麻醉学杂志

Objective To evalute the accuracy of stroke volume variation (SVV) in monitoring blood volume in patients undergoing off-pump coronary artery bypass grafting.Methods Twenty-one ASA Ⅱ or Ⅲ patients of both sexes aged 44-77 yr undergoing off-pump coronary artery bypass grafting were enrolled in this study.Anesthesia was induced with midazolam,etomidate,fentanyl,rocuronium and dolicaine and maintained with target-controlled infusion of propofol,infusion of remifentanil,intermittent iv injetion of atracurium and inhalation of sevoflurane.The patients were mechanically ventilated (VT 8 ml/kg,RR 12 bpm,I:E 1:2,PEEP 0,FiO2 80％ ).PEr CO2 was maintained at 35-44 mm Hg.Radial artery was cannulated and connected to FloTrac pressure transducer and Vigileo monitor.6％ hydroxyethyl starch 130/0.4 sodium chloride solution 7 ml/kg was infused at a rate of 0.25 ml· kg- 1 1· min- 1 at 5 min of haemodynamics stabilization after pericardiotomy (T1).HR,MAP,CVP,systemic vascular resistance (SVR),systemic vascular nesistance index (SVRI),SVV,stroke volume index (SVI)and CI were recorded at T1 and at 10 min after loading dose (T2).The change rate of HR(△HR),MAP(△MAP),CVP(△CVP),SVR(△SVR),SVV(△SVV),SVI(△SVI) and CI(△CI) were calculated.△SVI≥25％ was considered effective volume expansion.The ROC curves for HR,MAP,CVP,SVR and SVV in determining the volume expansion efficacy were plotted.The area under the curves and 95 ％ confidence interval were calculated.Results Compared with T1,CVP,SVI,CO and CI were significantly increased,SVRI and SVV decreased at T2 (P ＜ 0.01).There was no significant difference in MAP and HR between T1 and T2(P ＞0.05).△SVI was negatively correlated with △HR and △SVR ( r =- 0.737,r =- 0.480,P ＜ 0.05).△SVI was not correlated with △CVP,△MAP and( P ＞ 0.05).The change in SVI was determined by SVV 8.8％ (sensitivity =52.6％,specificity =100.0％ ).The area under the curve for SVV and 95％ confidence interval were 0.579(0.346-0.812).Conclusion SVV can not be used to accuratelymonitor the changes in blood volume in patients undergoing off-pump coronary artery bypass grafting.

The relationship between serum CC10 protein and ventilator-associated lung injury in rats / 中华麻醉学杂志

Objective To investigate the relationship between serum CC10 protein and lung injury induced by mechanical ventilation.Methods Forty healthy Wistar rats of both sexes weighing 200-250 g were randomly divided into 5 groups(n=8 each):group Ⅰ control;group Ⅱ mild lung injury[VT=7 ml/kg,duration of mechanical ventilation(t):2 h];group Ⅲ moderate lung injury(VT=7 ml/kg,t=4 h);group Ⅳ severe lung injury(VT=40 ml/kg,t=2 h);group Ⅴ extremely severe lung injury(VT=40 ml/kg,t=4 h).The animals were anesthetized with intraperitoneal 10% chloral hyrdrate 3.5 ml/kg and tracheostomized.Group Ⅰ received no mechanical ventilation.The animals in group Ⅱ-Ⅴ were mechanically ventilated with air(FiO2=21%,RR=40 bpm,I:E=1:2).The animals were sacrificed at the end of mechanical ventilation.The lungs were immediately removed for microscopic examination and determination of W/D lung weight ratio.The left lung was lavaged.The CC10 protein level in broncho-alveolar lavage fluid(BALF)and serum were determined by Western blotting.The Clara cells in the bronchiolar epithelium were examined by immno-histochemistry.Results The level of CC10 protein in BALF was significantly lower in group Ⅳ and Ⅴ while the serum CC10 protein level was significantly higher in group Ⅱ-Ⅴ than in group Ⅰ.The serum CC10 protein level was positively correlated while the CC10 protein level in BALF was negatively correlated with the severity of lung injury and W/D ratio.Conclusion The serum CC10 protein is closely related to the severity of lung injury induced by mechanical ventilation.

Efficacy of sufentanil combined with propofol for video-assisted endoscopic transthoracic sympathectom / 中华麻醉学杂志

Objective To evaluate the efficacy of sufentanil combined with propofol for video-assisted endoscopic transthoracic sympathectomy.Methods Twenty ASA I or II patients of both sexes aged 17-40 yr weighing 52-75 kg undergoing video-assisted endoscopic transthoracic sympathectomy were enrolled in this study.Anesthesia was induced with propofol 2.0-2.5 mg/kg and sufentanil 0.5 μg/kg.Tracheal intubation was facilitated with atracurium 0.6 mg/kg.The patients were mechanically ventilated (VT=8-10 ml/kg,RR=10-12 bpm,I:E =1:2,FiO2=80%).Anesthesia was maintained with infusion of propofol 2-4 mg·kg-1·h-1 and sufentsnil 0.2-0.3/.μg·kg-1 h-1 and intermittent iv boluses of atracurium.At the 30 rain before the end of operation propofol infusion was reduced to 1-2 mg.kg-1·h-1 and sufentanil infusion to 0.1 μg·kg-1 h-1 .BP (SP,DP) and HR were recorded and venous blood samples were taken before induction of anesthesia (baseline),at tracheal intubation at the moment of CO2 insnfflation 10 min and 30 min after CO2 insufflation,5 min after deflation and at extubation for determination of plasma corticesteroid,aldosterone and glucose levels.The duration from termination of infusion of the anesthetics to recovery of spontaneous breathing,eye opening at command and tracheal extubation were recorded.Results SP,DP and HR were within the normal range.Plasma levels of comcesteroid,aldosterone and blood glucose were significantly increased during operation as compared with the baseline values.The duration from termination of infusion of the anesthetics to recovery of spontaneous breathing,eye opening at command and tracheal extubation were4.5±1.9,6.4±2.7 and (12.6±1.5)min respectively.Conclusion Sufentanil 0.1-0.3 μ·kg-1·h-1 combined with propofol 1-4 mg·kg-1.h-1 can inhibit stress response during video-assisted endoscopic transthoracic sympathectomy with stable hemodynamics.

The Effect of Urotension Ⅱ in the Myocardium of Acute Myocardial Ischemia Reperfusion Rat by Electro-acupuncture "Neiguan" and "Shenmen" Precondition / 浙江中医药大学学报

[Purposes] To observe the effect of urotension Ⅱ in myocardium on electro-acupuncture "Neiguan" and "Shenmen" precondition acute myocardial ischemia reperfusion rat.[Methods] To select 80 healthy male adult SD rats,divided into four groups randomly: normal group,model group,electro-acupuncture precondition group and special antagonist group.To duplicate model with ligating the left coronary artery and in the progress.After duplicating model successfully,select 10 rats to analysis.[Result] The content of UII in myocardium in model group is obviously decreased than in normal group,and in electro-acupuncture precondition group is also decreased obviously but much better than in model group(P

Combined Action of ACE Gene I/D and GNB3 Gene C825T Polymorphisms on Essential Hypertension in Northern Han Chinese / 生物化学与生物物理进展

Essential hypertension (EH), a complex polygenic disease, is considered to the result of the genetic interaction of multiple gene alterations in concert with environmental factors. Evidences showed that angiotensin-converting enzyme (ACE) gene and G protein beta3 subunit (GNB3) gene are both important susceptibility genes for EH, and that there exists putative biological connection between the two genes in developing hypertension. To investigate whether hypertension was affected by gene-gene interaction between the two genes in the northern Chinese Han population, a case-control association study including 502 hypertensive cases and 490healthy controls was conducted, selecting the ACE gene I/D polymorpinsm and the GNB3 gene C825T polymorphism. Linkage disequilibrium analysis revealed a significant nonrandom distribution only in male hypertensives, indicating that interaction between ACE gene and GNB3 gene may predispose males to the occurrence of hypertension. Multivariate stepwise logistic regression in single locus analysis, with adjustment for common risk factors for hypertension, demonstrated that the OR for DD/ID versus Ⅱ for hypertension among men was significant (OR 1.57; 95% CI, 1.09 ～2.27; P = 0.016) in dominant genetic model. In combination analysis stratified with respect to gender, slightly significant ORs were found after adjustment in males: OR for TT vs CC, 0.11; 95%CI, 0.01 ～0.99; P = 0.049 within ACE DD genotype; OR for DD/ID vs Ⅱ, 1.52; 95% CI, 1.01 ～2.29; P = 0.047 within GNB3 CC+CT genotype. The results suggest that ACE, or a nearby gene, is a male-specific susceptible gene for hypertension, and that there may exist epistatic gene-gene interaction between ACE D allele and GNB3 825C allele.

Effect of electroacupuncture at different segments of heart meridian on the electric discharge activities of the superior sympathetic plexus in rabbits / 中国组织工程研究

BACKGROUND: Correlation between channel and viscera is a core of athemry on acupuncture and meridian, and is also a key entrance for mech anism of acupuncture. This study was designed to discuss theory onacupuncture and meridian through correlation between heart meridian andelectric discharge activities of sympathetic nerve. OBJECTIVE: To investigate the effect of electroacupuncture at differentsegments of heart meridian on the electric discharge activities of the supe rior sympathetic plexus in rabbits. DESIGN: Randomized controlled animal study. SETTING: Central Laboratory of Channel and Viscera Research, AnhuiCollege of Traditional Chinese Medicine. MATERIALS: The experiment was carried out at the Central Laboratoryof Channel and Viscera Research, Anhui College of Traditional ChineseMedicine in March 2004. A total of 36 healthy chinchilla rabbits weighing(2.8±0.3) kg were randomly divided into three groups with 12 in eachgroup, including multi-electro-acupuncturing the wrist (Shenmen region), elbow (Shaohai region) or axils (Jiquan region) sections of heart meridian. METHODS: One rabbit of the same sex whose body mass was less than10% was selected from each group. Superior sympathetic plexus was sepa rated under Olympus anatomic microscope (Japan), and multiple double electrodes materialized as stainless steel sil were embedded. Then, afterfixing with special gelatum (USA), thoracic cavity was closed, temperaturein anus was controlled at (39±0.5) ℃, and 50 mL/L glucose was drippedinto vein for 2 hours before acupuncture. The changes of heart rhythm vari ability (HRV) and electric discharge activities of superior sympatheticplexus were recorded and analyzed. MAIN OUTCOME MEASURES: HRV, ratio between high frequency(HF) and low frequency (LF) of power spectrum. RESULTS: All rabbits were involved in the final analysis. After elec troacupuncture, the total HRV values and electroactivitic frequencies of thesuperior sympathetic plexus were increased, but LF/HF of power spectrumwas decreased. The decrease at the wrist section was superior to others; theaxils section was inferior to elbow section. CONCLUSION: Electroacupuncture at different segments of heart meridi an can improve the electric discharge activities of the superior sympatheticplexus and the leaf-cardiac function. Among the three groups, the relation ship of functions was the closest between the wrist stem of heart meridianand left heart.

Effects of Intrathecally Administerd NaV1.8 Antisense Oligonucleotide on the Expression of Sodium Channel mRNA in Dorsal Root Ganglion / 华中科技大学学报（医学）（英德文版）

Neuropathic pain has been hypothesized to be the result of aberrant expression and function of sodium channels at the site of injury. To investigate the effects of NaV1.8 antisense oligonucleotide on the expression of sodium channel mRNA in dorsal root ganglion (DRG) neurons in chronic neuropathic pain. 24 Sprague-Dawley rats weighing 200-260 g were anesthetized with the in of sciatic nerve trunk by 4-0 chromic gut. The mechanical and thermal pain threshold were measured before operation and 1, 3, 5, 7, 9, 11, 13 days after operation. A PE-10 catheter was implanted in subarachnoid space at lumbar region. On the 7th postoperative day the animals were randomly divided into 4 groups. The drugs were injected intrathecally twice a day for 5 consecutive days in group 2-4. The animals were decapitated 14 days after the surgery. The L4-L6 DRG of the operated side was removed and crushed, and total RNA was extracted with Trizol reagent. The contralateral side was used as control. The change of NaV1.8 sodium channel transcripts was determined by RT-PCR. Pain threshold was significantly lowered after CCI as compared with that in control group and was elevated 3 days after antisense oligonucleotide injection. Sensory neuron specific TTX-R sodium channel NaV1.8 transcript was down-regulated after antisense oligonucleotide injection at the dosage of 45 μg as compared with that in CCI group (P＜0.01), and it was even greater at the dosage of 90 μg. The intrathecally injected NaV1.8 antisense oligonucleotide can reduce the mechanical allodynia and thermal hyperalgesia partially by downregulating the SNS transcript expression.

Expression Changes of Early Response Genes in Lung Due to High Volume Ventilation / 华中科技大学学报（医学）（英德文版）

Summary: The expression changes of early response genes due to ventilation with high volume in adult rats in vivo were observed. Forty SD male rats were randomly divided into control and 30, 60, 90 and 120 min ventilation groups, respectively (n=8 in each group). The animals were ventilated with tidal volume of 42 ml/kg and a PEEP level of 0 cmH2O at a rate of 40 breaths per minute in room air with a ventilator was given to the small animals. The expression of Egr-1, C-jun and IL-1β mRNA and proteins was detected by RT-PCR and immunohistochemical technique, respectively. The pathological changes in lung tissues were examined by HE staining. The results indicated that the expression of Egr-1, C-jun and IL-1β mRNA was detectable at 30th min after overventilation, but there was no significant difference in comparison with that in control group until overventilation for 60 min. However, at 90 and 120 min there was a significent increase as compared with 30 min or control group (P<0.05). The expression of Egr-1, C-jun and IL-1β deteced by immunohistochemical assay also showed a similar tendency of the gradual increase. In the 120 min ventilation group, the expression intensity of Egr-1, C-jun and IL-1β proteins in lung cells was the strongest and the nuclear translocation was increased markedly in comparison with any other groups (P<0.05). HE staining suggested that the degree of lung injury was aggravated gradually with the ventialtion going on and had a similar tendency to the expression of these early response genes and proteins. The current data suggested that overventilation activated and upregulated the expression of early response genes and the expression of these genes may be taken as the early signal to predict the onset and degree of lung injury. These results may demonstrated partially that the expression of early response genes induced by the mechanical stretch is associated with biochamic lung injury.

The expression of Egr-1, C-jun and IL-1? in the lung injured by mechanical ventilation in rats / 中华麻醉学杂志

Objective To investigate the changes in the expression of Egr-1, C-jun and IL-1? mRNA and protein in the lung injured by mechanical ventilation. Methods Forty male SD rats weighing 250-320 g were randomly divided into 5 groups (n = 8 each): group A received no mechanical ventilation; group B-E received mechanical ventilaion for 30 (B), 60 (C), 90 (D) and 120 (E) minutes. The animals were anesthetized with intraperitoneal 3% pentobarbital 35 mg?kg-1 , tracheostomized and mechnically ventilated (VT =42 ml?kg-1 , RR = 40 bpm, I: E = 1:2, FiO2 = 21 % ) . Arterial blood samples were taken for blood gas analysis. The animals were killed at the end of mechanical ventilation in group B-E and after tracheostomy in group A. The lungs were removed for microscopic examination using HE staining. The expression of Egr-1, C-jun and IL-1? mRNA and protein was detected by RT-PCR and immuno-histochemical technique respectively. Results There was no significant difference in PaO2 and SaO2 among the 5 groups while PaCO2 was significantly decreased in group B and C but increased in group E as compared with group A. The expression of Egr-1, C-jun and IL-1? mRNA and protein was significantly increased by mechanical ventilation in a duration - dependent manner. Histological studies demonstrated that the damage to the lung was correlated with the duration of mechanical ventilation in terms of perivascular inflammatouy cell infiltration, exudates and hemorrhage in the alveoli and thickening of alveolar walls. Conclusion The results of our study show that mechanical ventilation activates and upregulates the expression of the early response genes in a duration - dependent manner. The upregulation of the expression of these genes might be involved in the underlying mechanism of lung damage induced by mechanical ventilation.