Efficacy of different doses of ulinastatin for prevention of insulin resistance in patients undergoing partialhepatectomy / 中华麻醉学杂志

Objective To evaluate the efficacy of different doses of ulinastatin for prevention of insulin resistance in the patients undergoing partial hepatectomy.Methods Sixty patients of both sexes,aged 33-71 yr,weighing 44-70 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for electivepartial hepatectomy,were randomly assigned into 3 groups (n =20 each) using a random number table:control group (group C),low dose of ulinastatin group (group UL) and high dose of ulinastatin group (group UH).Before induction of anesthesia and at the beginning of operation,ulinastatin 2 500 U/kg and 5 000 U/kg (in 20 ml of normal saline) were injected intravenously in UL and UH groups,respectively.The equal volume of normalsaline was given instead of ulinastatin in group C.Before skin incision,before removal of the liver,after removal of the liver,and after closure of the abdominal cavity,blood samples were taken from the right internal jugular vein for determination of plasma glucose,insulin and glucagon concentrations.Insulin sensitivity index was calculated.Results Compared with group C,insulin sensitivity index was significantly increased,and the plasma glucose and insulin concentrations were decreased in UL and UH groups.Conclusion Ulinastatin 2 500 U/kg injected intravenously before induction of anesthesia and at beginning of operation can effectively prevent insulin resistance in the patients undergoing partial hepatectomy.

Effect of acute hemorrhage on cognitive function of aged spontaneously hypertensive rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of acute blood loss on postoperative cognitive function of aged spontaneously hypertensive rats (SHRs).</p><p><b>METHODS</b>Forty aged male SHRs were randomized into sham hemorrhage group (group A, n=13), 20% hemorrhage group (group B, n=13) and 40% hemorrhage group (group C, n=14). The rats were subjected to acute loss from the femoral artery and subsequent fluid replacement with lactated Ringer's Solution (3 folds of the blood loss volume). All the rats underwent Morris water maze test to assess the visuospatial memory and learning ability, and were then decapitated to observe the pathological changes of the hippocampus.</p><p><b>RESULTS</b>The latency of reference memory in group C was significantly prolonged after the operation (P=0.002), but the working memory and learning capacity showed no significant differences between the 3 groups. Immunochemistry did not reveal significant differences in p-CREB expressions in the hippocampal CA1 region among the groups, but volume reduction of some neurons was noted in the CA1 region in group C.</p><p><b>CONCLUSION</b>Varying degrees of acute hemorrhage can result in different effect on postoperative cognition in aged SHR. Acute hemodilutional anemia to 40% of baseline can cause reference memory impairment with cell volume reduction of the neurons in the hippocampal CA1 region but does not affect the working memory and learning capacity or p-CREB expression.</p>

Effect of target-controlled infusion of propofol on global and regional, cerebral glucose metabolism in healthy volunteers / 中华麻醉学杂志

Objective To investigate the effect of target-controlled infusion(TCI) of propofol on global and regional eerobral glueose metabolism in humans studied with positron emission tomography(PET).Methods Five healthy right-handed male volunteers aged 22-30yrs, weighing 58-72 kg underwent PET sean to assess glucose metabolism when they were awake and unconseions. The interval between the two PET seans was longer than 1 week. The unconseious state was induced by TCI of propofol. The initial effeet-site concentration(ESC) of propofol was set at 2.5?g?ml~(-1) and was modulated in ?0.2?g?ml~(-1) increments until OAA/S score roached 1(no response to prodding). Then the ESC was maintained during PET scanning. The dynamic scans were performed at 0-4.5 min(T_1), 4.5-9.5 min(T_2), 9.5-29.5 min(T_3), 29.5-44.5 min(T_4), 44.5-59.5min(T_5) and 59.5-74.5 min(T_6) after the end of FDG 10 mci injection. After the data were reconstructed we used the stereotactic method to select the following regions of interest(ROI): the whole brain, frontal lobe, temporal lobe, parietal lobe, occipital lobe, putamen, caudate nucleus, thalamus and cerebellum ets. The ROI data were then transformed into standard uptake value(SUV). The difference and percentage decrease in SUV of the different ROI between eonscious and unconscious state at different intervals were compared. Results The SUVs of the whole brain and all ROIs were significantly decreased in unconscious state during T_(3-6) compared with those in conscious state. In unconscious state at T_6 the percentage decrease in SUV of different ROIs was different-42.38% (occipital lobe), 35.52%(frontal lobe) and 21.40%(putamen). The percentage decrease in SUV of thalamus was similar to that of occipital lobe, temporal lobe and parietal lobe but higher than that of frontal lobe. The sequence of SUVs of cortex and subcortioal centers in conscious state during T_(4-6) and in unconscious state during T_(3-5) were the same: temporal lobe