Objective:To research the difference of the effects of anesthesia and postoperative pain relief between propofol combined with sufentanil and propofol combined with fentanyl in painless abortion.Methods:208 cases with voluntarily painless abortion were selected in our hospital.They were randomly divided into experimental group (n=104) and control group (n=104).The control group was given propofol combined with fentanyl and the experimental group was given propofol combined with sufentanil intravenously.Recording MAP,SpO2,RR and HR at the time of premedication(T0),preoperation(T1),expanding cervix uterus(T2) and postoperation(T3).Recording the dosage ofpropofol,recovery time and VAS score of uterine pain after the operation.Adverse reactions were also recorded in both groups of patients.Results:Compared with those at T0,the MAP,SpO2,RR,HR were all statistically decreased at the time ofT1 and T2 in both groups (P＜0.05),but the difference were not significant between both groups (P＞0.05).The dosage ofpropofol in the experimental group was lower than in the control group (P＜0.05).The average recovery time was shorter and the VAS score of uterine pain and propofol injection pain were lower in the experimental group than in the control group (P＜0.05).The incidence of nausea and vomiting and respiratory depression were lower in the experimental group than in the control group,but the difference was not statistically significant (P＞0.05).Conclusion:Propofol combined with sufentanil was more effective than propofol combined with fentanyl,with better postoperative recovery.It is worth promoting application in painless abortion operation.

目的观察食管癌根治术患者麻醉单肺通气期间应用帕瑞昔布钠、乌司他丁对肺内分流的影响。方法择期行食管癌根治术患者50例,年龄在36～46岁,ASA分级I～Ⅱ级,随机分为乌司他丁组(A组)和帕瑞昔布钠组(B组),每组25例。单肺通气时A组应用乌司他丁50 U,B组应用帕瑞昔布钠40 mg,分别加于100 mL生理盐水中滴注。测定麻醉诱导后(T1)、30 min(T2)、60 min(T3)及恢复双肺通气30 min(T4)时CVP、HR、MAP和气道平均压(M ean),同时采集颈内静脉和桡动脉血样,进行血气分析,计算肺内分流率(Qs/Qt)。结果与T1时比较,两组T2～5时P mean和Qs/Qt均升高(P<0.05);两组间各时点P mean、Qs/Qt、CVP、HR和MAP比较差异无统计学意义(P>0.05)。结论食管癌根治术患者单肺通气过程中应用乌司他丁与帕瑞昔布钠对肺内分流影响几乎相同。

Objective To investigate the effects of parecoxib pretreatment on the intrapulmonary shunt during one-lung ventilation in patients undergoing esophageal cancer resection.Methods Forty ASA Ⅰ or Ⅱ patients of both sexes,aged 25-64 yr,weighing 45-70 kg,with body height 156-178 cm,undergoing elective esophageal surgery,were randomly divided into 2 groups (n =20 each):normal saline group (group NS) and parecoxib group (group P).Parecoxib 40 mg (in normal saline 10 ml) was injected intravenously 30 min before anesthesia in group P,while the equal volume of normal saline was given instead of parecoxib in group NS.Anesthesia was induced with iv injection of propofol,fentanyl and rocuronium.Bronchial blocker was inserted after tracheal intubation and the correct position was confirmed by bronchoscopy.Anesthesia was maintained with iv infusion of propofol and remifentanil and intermittent iv boluses of atracurium.HR,MAP,SpO2 and mean airway pressure (Pmean)were determined at 5 min of two-lung ventilation,at 40 min of one-lung ventilation,and at 30 min after re-expansion of the collapsed lung (T0-2).Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis.Intrapulmonary shunt (Qs/Qt) was calculated.Results There were no significant differences in hemodynamic parameters and Pmean between the two groups (P ＞ 0.05).PaO2 was significantly lower,while Qs/Qt was significantly higher at T1,2 than at T0 in groups NS and P (P ＜ 0.05).PaO2 was significantly higher,while Qs/Qt was significantly lower at T2 than at T1 in groups NS and P (P ＜ 0.05).Qs/Qt was significantly lower at T1,2 and PaO2 was significantly higher at T2 in group P than in group NS (P ＜ 0.05).Conclusion Parecoxib 40 mg injected intravenously at 30 min before anesthesia can reduce the intrapulmonary shunt during one lung ventilation in patients undergoing esophageal cancer resection.

Objective To investigate the efficacy and related adverse events of butorphanol for multinodal analgesia after thoracic surgery.Methods Forty patients,ASAⅠandⅡ,undergoing thoracic surgery were randomly allocated into 2 groups.Experimental group(group M,n=20)received 1 mg and postoperative patient-controlled intravenous analgesia(PCIA)with butorphanol,and the control group(group C,n=20)received PCIA with butorphanol.VAS scores for postoperative pain and Ramsay scores for postoperative sedation were recorded and compared at 2,4,8,12,24,48 h after the operation.The effective times of pressing and the incidence of adverse effects were observed.The recovery of the patients and patient satisfaction were compared between the two groups.Results VAS scores and Ramsay scores at different time-points after operation and effectively PCA pressure scores were significantly higher in control group than those of multimodal group(P0.05).The adverse reactions of losartan were mild and respiratory depression had not appeared.The rehabilitation of post-surgery and satistaction of patients were better in multimodal group than those of control group(P0.05).Conclusion The use of multimodal analgesia is more effective than routine analgesia method in the control of postoperative pain after thoracic surgery.Moreover,it can minimize the related adverse events.

目的比较SLIPA喉罩与气管内全麻复合连续硬膜外麻醉在腹腔镜胆囊切除术的麻醉效果。方法 200例单纯胆囊切除手术,随机分为2组,SLIPA喉罩复合连续硬膜外麻醉组(S组)和气管内全麻复合连续硬膜外麻醉组(E组)。通过对两组患者插管(喉罩)时的循环变化、麻醉期间的气道压力和拔管(喉罩)时间、苏醒时间以及术后不良反应等进行评估。结果与S组相比,E组患者在插管前后的HR、SBP、DBP明显升高(P<0.05),但两组患者术中气道压(Pmean)、气道峰压(Pmax)、SpO2、PETCO2相比差异无统计学意义(P>0.05);CO2气腹前后患者的Pmean、Pmax、SpO2、PETCO2对比差异有统计学意义(P<0.05);与E组比较,S组患者拔管时间、苏醒时间明显缩短(P<0.01)、术后咽部疼痛、声音嘶哑的发生率明显减低(P<0.05,P<0.01)。结论 SLIPA喉罩复合连续硬膜外麻醉较气管内全麻复合连续硬膜外麻醉在腹腔镜胆囊手术中具有苏醒快、血流动力学稳定、呼吸管理安全、术后不良反应少等优点。

AIM To study whether store-operated Ca2+ channel (SOC) is present in rat colonic smooth muscle cells. METHODS Intracellular Ca2+ ([Ca2+]i) changes induced by thapsigargin- or caffeine-activated SOC channel were measured in enzymatically dissociated rat colonic smooth muscle cells with the fluorescent indicator Fura-2/AM. RESULTS In the absence of external Ca2+ , the sarco-endoplasmic reticulum Ca2+ pump inhibitor thapsigargin (1 micromol/L) and ryanodine receptor (RyR) activator caffeine both transiently elevated [Ca2+]i from (68.32 +/- 3.43) nmol/L to (240.85 +/- 12.65 ) nmol/L, (481.25 +/- 34.77) nmol/L. A subsequent reintroduction of Ca2+ into the extracellular solution resulted in [Ca2+]i further elevated to (457.55 +/- 19.80) nmol/L, (1005.93 +/- 54.62) nmol/L; (643.88 +/- 34.65) nmol/L, (920.16 +/- 43.25) nmol/L, respectively. And the elevated response was blocked by lanthanum (1 mmol/L), but was insensitive to L-type voltage calcium channels blocker verapamil and membrane depolarization. CONCLUSION SOC activated by store depletion are present in rat colonic smooth muscle cells. And we further prove the existence of such Ca2+ channels in excitable cells.

Objective To investigate the effect and mechanism of total ginkgo flavonoids(FG) on myocardial injury in diabetic rats. Methods Rats were given streptozotocin(STZ) to induce the diabetic rats model. The maleic dialdehyde (MDA), creatine phosphokinase(CK), nitric oxide(NO) contents and the activity of superoxide dismutase (SOD), lactate dehydrogenase (LDH) and nitric oxide synthase (NOS) in myocardium were measured by spectrophotometric method with different dose of FG. The ultrastucture of myocardial cells was detected with eletronmicroscope. Results FG 100, 200 mg/(kg·d) markedly inhibited the increases of the content of MDA and the decreases of the content of CK in mice myocardial tissue. FG 50, 100, 200 mg/(kg·d) increased the activity of SOD and markedly inhibited the reduction of NO content and the activity of NOS in rats myocardium, FG 200 mg/(kg·d) increased the activity of LDH. Electron microscopic observation of myocardial muscle of the DM rats revaled typical alterations consisting of cutaneous or interruption of the myocardial muscle fiber, absence of the normal structure of the sarcomere, swell of the mitochondria and disappearance in some transverse striation. FG 200 mg/(kg·d) treatment group could greatly improve the above changes. Conclusion FG treatment has a protective effect on myocardial injury in diabetic rats, and the mechanism may be via attenuating oxygen free radicals and increasing NO production and decreasing the ultrastucture of myocardial cells.

Objective To study the expression of the apoptosis-related genes(Bax,Bcl-2) in retinas of diabetic rats before and after treatment with total Ginkgo flavonoids(FG), and evaluate the functions of FG on the expression. Methods Forty-eight SD rats were randomly divided into six groups of normal control(NC), diabetic control(DC), FG treatment(L-FG_1, L-FG_2, M-FG, H-FG) group. Diabetic models were induced by streptozotocin(STZ). After giving FG at 20,50,100,200 mg/(kg·d) to the treatment groups for 8 weeks, immunohistochemical(ABC) method was applied to monitor the expression, and then the results were analyzed using organism picture analysis system. Results The positive reaction intensity of both Bax and Bcl-2 was stronger in DC, L-FG_1, L-FG_2 than that in NC, while weaker in M-FG, H-FG than in DC. Conclusion FG can affect the expression of Bax and Bcl-2 in retinas, which may be related to apoptosis of retinal cell in diabetic rats.

Contraction of smooth muscle cells is triggered by an increase in cytosolic Ca(2+) upon agonist stimulation. Ca(2+) influx across the plasma membrane constitutes a major component of the agonist-induced response in smooth muscle cells. Traditionally, voltage-operated Ca(2+) channel (VOCC) is considered as the channel mediating the Ca(2+) entry. However, this view has been challenged by recent discoveries, which demonstrated that other types of ion channels, such as store-operated and/or receptor-operated Ca(2+) channels (SOCC and/or ROCC), also participate in Ca(2+) response induced by agonists in smooth muscle cells. SOCC is defined as the channel activated in response to the depletion of the internal Ca(2+) stores, an event secondary to G protein coupled receptor or receptor tyrosine kinase stimulation. The Ca(2+) flow mediated by SOCC is termed as capacitative Ca(2+) entry (CCE). Previous study from other group has demonstrated that VOCC played a predominant role in ACh-induced contraction of distal colon smooth muscle in guinea pig. However, whether SOCC participates in the agonist-induced contractile response in this particular tissue is unknown. The present study was performed to investigate the role of CCE in ACh-induced mechanical activity of distal colon smooth muscle in rats. The contractile function of the smooth muscle was assessed by measuring isometric force of isolated rat distal colon rings. We showed that both high extracellular K(+) (40 mmol/L) and ACh (5 mumol/L) evoked striking contraction of the smooth muscle. The contractile responses were almost abolished by removal of extracellular Ca(2+) with ethylene glycol-bis(2-aminoethylether)-N,N,N',N' tetraacetic acid (EGTA), suggesting a critical contribution of extracellular source of Ca(2+) to the contraction. Verapamil (5 mumol/L), an L-type VOCC blocker, significantly attenuated, but didn't completely eliminate the high K(+)- and ACh-induced contraction (74% and 41% for high K(+) and ACh, respectively), indicating that additional channels might be involved in the contractile mechanism. Furthermore, ACh only induced transient contractions in the absence of extracellular Ca(2+). Readmission of Ca(2+) into the extracellular compartment resulted in a significant and sustained increase in the tension of the smooth muscle. This response was not affected by verapamil (5 mumol/L) and Cd(2+) (5 mumol/L), both of which efficiently block VOCC at the doses. However, La(3+), a known inhibitor of SOCC, significantly suppressed the Ca(2+) readdition-induced contraction in a dose-dependent manner. On the basis of these results, we conclude that contraction of smooth muscle in the distal colon is regulated by multiple Ca(2+) channels. In addition to VOCC-mediated Ca(2+) influx, SOCC-mediated CCE participates in agonist-induced contractile response of distal colon smooth muscle in rats.

目的应用计算机信号采集和处理技术系统地研究豚鼠离体腹腔神经节细胞电生理特性.方法离体神经节灌流,细胞内微电极记录技术.结果豚鼠CG细胞静息电位(RP)为(-62.26±11.27) mV (n=110),膜电阻(Rm)为(79.17±27.16) MΩ,膜电导(G) 为(14.40±5.60) nS (n=63),膜电容(Cm)为(231.53±105.24) pF,膜时间常数(τ) 为(2.01±1.07) ms (n=36);直接胞内刺激引起的锋电位幅度(APA)和时程(APD)分别为(63.41±12.18) mV和(2.12±0.46) ms,锋电位后超极化电位幅度(AHPA) 和时程(AHPD)分别为(16.37±3.72) mV和(16.1±5.24) ms (n=75);刺激内脏大神经引起的快兴奋性突触后电位(f-EPSP)幅度和时程分别为(13.26±6.74) mV和(45.20±10.6) ms (n=34),刺激内脏大神经引起的APA 和APD分别为(69.71±15.38) mV和(2.13±0.55) ms (n=54),AHPA和 AHPD分别为(8.58±2.77) mV和(12.8±0.85) ms (n=48).结论计算机信号采集和处理技术在细胞电生理研究方面的应用,为全面地分析细胞生物电的变化及其形成机制,亦为深入研究递质、调质以及某些药物对细胞生物电的影响提供真实客观的数据.