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Objective To investigate the effect of different concentrations of morphine on the viability of cortical neurons and synaptic plasticity in newborn mice.Methods Cortical neurons isolated from male C57/BL/6 mice within 24 h after birth were seeded in 60-mm cultured dish (10 ml),24-well plates (500 ml) and 96-well plates (100 ml) at a density of 2×106,1×105 and 1.5×104 cells per plate/well,respectively,and cultured for 7 days.Neurons were then divided into 4 groups (n =6 each) using a random number table method:control group (group C),morphine 1.0 mmol/L group (group M1),morphine 10.0 mmol/L group (group M2),and morphine 100.0 mmol/L group (group M3).Neurons were incubated for 48 h with morphine 1.0,10.0 and 100.0 mmol/L in M1,M2 and M3 groups,respectively.MTT assay was used to measure the cell viability,immunofluorescence to measure the length of microtube-associated protein-2-labeled dendrites,and Western blot to detect the expression of caveolin-1 (Cav-1),growth-associated protein-43 (GAP-43),synapsin,synaptophysin Ⅰ and vesicle-associated membrane protein.Results Compared with group C,the length of dendrites was significantly prolonged,and the expression of Cav-1,GAP-43,synapsin,synaptophysin Ⅰ and vesicle-associated membrane protein was up-regulated in group M2,and the cell viability was significantly decreased,and the expression of Cav-1,GAP-43 and vesicle-associated membrane protein was up-regulated in group M3 (P＜ 0.05).Conclusion Morphine 10.0 mmol/L causes no damage to cortical neurons and enhances synaptic plasticity of neurons in newborn mice.
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Objective To investigate the role of calcium/calmodulin-dependent protein kinase Ⅱ (CaMK Ⅱ) in the primary somatosensory area (S1 area) and hippocampi in reduction of remifentanil-induced hyperalgesia by lidocaine in rats.Methods One hundred fifty-six male Sprague-Dawley rats,aged 8-10 weeks,weighing 240-260 g,were randomly allocated into 4 groups using a radom number table:control group (group C,n=6),remifentanil group (group R,n=50),lidocaine group (group L,n=50),and remifentanil+lidocaine group (group RL,n =50).Remifentanil was given as a bolus of 6 mg/kg followed by an 2 h infusion of 2.4 μg · kg-1 · min-1 in group R.Lidocaine was given as a bolus of 6 mg/kg followed by an infusion of 200 μg · kg-1 · min-1 for 2 h in group L.In group RL,drug administration was similar to those previously described in R and L groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured before administration and at 0.5,2,5 and 24 h after the end of administration.The rats were then sacrificed immediately after administration and at 0.5,2,5 and 24 h after the end of administration in R,L and RL groups,or at the corresponding time point in group C.The S1 area and hippocampi were isolated for determination of phosphorylated CaMK Ⅱ (p-CaMK Ⅱ) expression by Western blot.Results Compared with the value before administration,the MWT was significantly decreased at 0.5 and 2 h after the end of administration (P＜0.05),and no significant change was found in TWL at each time point after the end of administration in R,L and RL groups (P＞0.05).Compared with group C,p-CaMK Ⅱ expression in the S1 area and hippocampi was significantly up-regulated immediately after administration and at 0.5 and 2 h after the end of administration in group R (P＜0.05).Compared with group R,p-CaMK Ⅱ expression in the S1 area and hippocampi was significantly down-regulated immediately after administration and at 0.5 and 2 h after the end of administration in group RL,and p-CaMK Ⅱ expression in the S1 area was significantly down-regulated immediately after administration,and at 0.5 and 2 h after the end of administration,and p-CaMK Ⅱ expression in the hippocampi was down-regulated immediately after administration,and at 0.5,2 and 24 h after the end of administration in group L,and MWT was increased at 0.5 and 2 h after the end of administration in groups L and RL (P＜0.05).There was no significant difference in TWL at each time point among the three groups (P＞0.05).Conclusion The mechanism by which lidocaine mitigates remifentanil-induced hyperalgesia is associated with inhibited activity of CaMKII in the S1 area and hippocampi of rats.
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Objective To evaluate the effects of sevoflurane-remifentanil anesthesia on the balance between cerebral oxygen supply and demand during cerebral revascularization for ischemic moyamoya disease by monitoring regional cerebral O2 saturation (rSO2) with near infrared spectroscopy.Methods Forty patients of both sexes aged 19-59 yr with a body mass index of 19-25 kg/m2 undergoing superficial temporal artery-middle cerebral artery anastomosis were randomly allocated into 2 groups (n =20 each):propofol-remifentanil group (group PR) and sevoflurane-remifentanil group (group SR).Radial artery was cannulated for direct BP monitoring and blood sampling.Near infrared spectroscopy probe was placed on the forehead.Anesthesia was induced with propofol TCI (Cp =5 μg/ml),fentanyl 3 μg/kg and rocuronium 0.6 mg/kg.The patients were mechanically ventilated after tracheal intubation (VT 8-10 ml/kg,RR 10-12 bpm,I∶ E 1∶2,FiO2 =1.0).PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with sevoflurane (end-tidal concentration 1.0％-1.7 ％) or propofol TCI (Cp =3-4 μg/ml) in combination with remifentanil TCI (Cp =3.5 ng/ml) and intermittent iv boluses of rocuronium 0.3 mg/kg.BIS was maintained at 40-60 during operation.rSO2 was recorded before induction of anesthesia (T0),10 min before and 10 min after blood vessel was clamped (T1,T2) and 10 min after anastomosis was completed (T3).Results rSO2 was significantly increased on the operated side at T3 in PR group while in SR group bilateral rSO2 was significantly increased at T1-3 as compared with the baseline values at T0 (P ＜ 0.05 or 0.01).rSO2 on the operated side was significantly higher at T1 in group SR than in PR group (P ＜ 0.05).Conclusion The efficacy of sevoflurane-remifentanil anesthesia is similar to that of propofol-remifentanil anesthesia for revascularization for moyamoya disease in terms of maintence of the balance between cerebral oxygen supply and demand.
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Objective To compare the accuracy of jugular venous oxygen saturation (SjvO2),somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) in estimation of the occurrence of intraoperative cerebral ischemia in patients undergoing clipping of intracranial aneurysm.Methods Forty-three ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with a body mass index of 20-25 kg/m2,undergoing clipping of intracranial aneurysm,were studied.Anesthesia was induced with sufentanil,rocuronium and propofol.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil and propofol.Blood samples were taken from the jugular bulb for detection of SjvO2 before aneurysm clipping or temporary occlusion of parent artery and at 1,3,10,20 and 30 min after clipping aneurysm or temporary occlusion of parent artery.The amplitude and latency of SSEPs and MEPs were recorded simultaneously.The occurrence of cerebral ischemia estimated by SjvO2,SSEPs and MEPs was recorded.The condition of nerve defect was recorded within 3 days after operation and the gold standard of cerebral ischemia was defined as the occurrence of nerve defect.Results Among 43 patients,14 cases were diagnosed as having brain ischemia.The sensitivity and specificity of SjvO2 in estimation of the occurrence of intraoperative brain ischemia were 71％ and 93％,respectively (P ＜ 0.01).The sensitivity and specificity of SSEPs in estimation of the occurrence of intraoperative brain ischemia were 71％ and 62％,respectively (P ＜ 0.05).When the diagnostic criterion of cerebral ischemia was defincd as a decrease in the amplitude of MEPs or prolongation of the latency MEPs,the sensitivity and specificity of MEPs in estimation of the occurrence of intraoperative brain ischemia were 79 ％ and 52 ％,respectively (P ＞ 0.05).When the diagnostic criterion of cerebral ischemia was defined as a loss of the amplitude of MEPs,the sensitivity and specificity of MEPs in estimation of the occurrence of intraoperative brain ischemia were 57％ and 93％,respectively (P ＜0.05).Conclusion The sensitivity of SjvO2 and SSEPs in estimation of the occurrence of intraoperative brain ischemia is higher,however,the specificity of SjvO2 and MEPs is higher,indicating that SjvO2 is a reliable criteria for estimation of the occurrence of intraoperative brain ischemia in patients undergoing clipping of intracranial aneurysm.
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@#Opioids can activate the pro-nociceptive channel by which the sensitivity to pain has been increased, which is called opioids induced hyperalgesia (OIH). The mechanism of OIH has not been identified, but it is possibly involved in the increased activity of central glutamatergic system, changed function of opioid receptors, roles of peripheral receptors, effects of endogenous neuropeptides, decreased function of inhibitory neurotransmission system, and changed elements in signal transduction pathway, etc.
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Objective To evaluate the effects of 6% hydroxyethyl starch (HES)130/0.4 and 6% HES 200/0.5 on blood coagulation in patients undergoing major operation under general anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 18-64 yr undergoing major operation under general anesthesia during which the blood loss was expected to be＞20%of blood volume were allocated randomly into 3 groups(n=20 each):Ⅰ control group(C);Ⅱ6% HES200/0.5 group (H) and Ⅲ HES130/0.4 group (V).In group H and V the patients Arterial blood samples were taken before(T1),immediately(T2)and 1 h after the end of fluid infusion(T3)for determination of hematocrit(Hct),platelet count(PLT)and prothrombin time(PT),platelet maximum aggregation test induced by 5 μmol/L ADP,and Sonoclot coagulation and platelet function analysis(gbACT,CR,PF,TP).Activated partial thromboplastin time(Am),coagulation factor Ⅷ (FⅧ)activity and von Willebrand factor(vWF)were measured only in group H and V.Results (1) PT and APTT were significantly prolonged after fluid infusion at T2 and T3 as compared with the baseline values at T1 in group H and V.(2)FⅧ activity and platelet maximum aggregation induced by ADP were significantly decreased at the end of fluid infusion at T2 as compared with the baseline at T1 but increased again at T3 in group H and V.(3)There was no significant change in Sonoclot coagulation parameters after fluid infusion as compared with the baseline except clot formation rate (CR)in group H and V.Conclusion Acute hypervolemic hemodilution with 6% HES130/0.4 or 200/0.5 has minimal effect on blood coagulation and there is no significant difference in blood coagulation changes induced by 6%HES130/0.4 and 200/0.5.
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OBJECTIVE:To develop a simple but practical evaluation system of pharmacoeconomics.METHODS:The data base of this system was built up using the SQL Server 2000.Delphi was used as programming tool to develop an evaluation system of pharmacoeconomics.RESULTS:This system has good human-computer interfaces,including the interfaces of data input,cost-effectiveness analysis,cost-benefit analysis and cost-utility analysis.The sensitivity analytic results consisted of the computed results of simple analysis,bootstrap analysis and rank-order stability analysis.CONCLUSION:System testing indicates the system is simple in operation and reliable in analytical results,which thus deserves to be popularized.