Remimazolam, a novel ultrashort-acting benzodiazepine, has been successfully used for the induction and maintenance of procedural sedation and general anesthesia. It may provide effective general anesthesia for elderly patients undergoing bronchoscopy. To evaluate the safety and efficacy of remimazolam tosilate versus propofol in elderly patients undergoing general anesthesia for bronchoscopy. Prospective, single-blind, randomized clinical trial. Single-center study conducted from November 2023 to April 2024. 118 elderly patients (≥ 65 years) undergoing general anesthesia for bronchoscopy. Patients were randomly assigned 1:1 to receive propofol or remimazolam. The primary outcome was anesthesia success rate, defined as successful bronchoscopy completion with a Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score of 0 without rescue anesthesia. Secondary outcomes included vital signs, anesthesia characteristics, and adverse events. There was no significant difference in the anesthesia success rate between the two groups (P = 0.559). The onset time, MOAA/S score at extubation, hypertension, hypoxemia, tachycardia, and bradycardia were similar between the groups (P > 0.05), as were emergence agitation, nausea/vomiting, and intraoperative awareness (P > 0.05). Compared to propofol, remimazolam was associated with significantly shorter durations of hypotension, reduced injection pain, and faster awakening time (P < 0.01). Remimazolam tosilate demonstrated non-inferior safety and efficacy to propofol for general anesthesia during bronchoscopy in elderly patients. Remimazolam was associated with a lower incidence of injection pain and hypotension. Additionally, when reversed with flumazenil, remimazolam provided significantly faster recovery times compared to propofol, potentially enhancing bronchoscopy efficiency. Clinical trial number and registry URL: ChiCTR2300076845, registration date: October 22, 2023; http://www.chictr.org.cn .

Massive haemoptysis due to central pulmonary artery (CPA) rupture in patients with advanced lung cancer is a fatal complication with limited early diagnostic tools. This study aimed to identify risk factors associated with pulmonary artery rupture and to propose a grading model to facilitate early diagnosis and timely endovascular intervention. This retrospective study included patients with advanced lung cancer who experienced in-hospital sudden haemoptysis-related death and received endovascular treatment for CPA abnormalities. Propensity score matching (PSM; 1:2) balanced covariates between haemoptysis-related and other in-hospital deaths. Following PSM, multivariable logistic regression was performed to identify independent risk factors. Patients were categorised into two cohorts: Group A (2012–2018) and Group B (2019–2024), the latter reflecting the implementation of early detection and endovascular management. Overall survival (OS) was compared using Kaplan–Meier analysis and log-rank testing. Among 886 in-hospital deaths, sudden haemoptysis accounted for 4.63

Objective Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are associated with significant mortality rates. The role of Fcgr2b in the pathogenesis of ALI/ARDS is not fully elucidated. This study aimed to investigate the functions of Fcgr2b in ALI/ARDS and explore its underlying mechanisms. Methods Methods: In this study, rat models of ARDS and pulmonary microvascular endothelial cell (PMVEC) injury models were established through the administration of lipopolysaccharide (LPS). The expression levels of Fcgr2b and Elk1 were quantified in both LPS-induced ARDS rats and PMVECs. Subsequent gain- and loss-of-function experiments were conducted, followed by comprehensive assessments of lung tissue for pathomorphological changes, edema, glycogen storage, fibrosis, and infiltration of inflammatory cells. Additionally, bronchoalveolar lavage fluid was analyzed for T-helper 17 (Th17) cell infiltration, inflammatory response, and microvascular permeability to evaluate lung injury severity in ARDS models. Furthermore, the activity, cytotoxicity, apoptosis, and angiogenic potential of PMVECs were assessed to gauge cell injury. The interaction between Elk1 and Fcgr2b was also examined to confirm their regulatory relationship. Results In the context of LPS-induced ARDS and PMVEC injury, Fcgr2b expression was markedly reduced, whereas Elk1 expression was elevated. Overexpression of Fcgr2b led to a decrease in Th17 cell infiltration and mitigated lung tissue damage in ARDS models, in addition to reducing LPS-induced injury in PMVECs. Elk1 was found to suppress Fcgr2b transcription through the recruitment of histone 3 lysine 9 trimethylation (H3K9me3). Knockdown of Elk1 diminished Th17 cell infiltration and lung tissue damage in ARDS models, and alleviated LPS-induced injury in PMVECs, effects that were reversed upon Fcgr2b upregulation. Conclusion Elk1 negatively regulates Fcgr2b transcription, thereby augmenting the inflammatory response and exacerbating lung injury in LPS-induced ALI/ARDS.

Background and Importance: Postoperative cough is a common complication of general anesthesia after bronchoscopy. The aim of the present study was to determine the safety profile and efficacy of piriform recess instillation with lidocaine in reducing the incidence of coughing. Objective: To what extent could piriform recess instillation with lidocaine decrease the incidence of cough at 10min after extubation? Outcome Measures and Analysis: Eighty-eight consecutive patients were equally randomized to a lidocaine group receiving piriform recess instillation with 2mL 2% lidocaine, and a normal saline group receiving piriform recess instillation with 2mL saline. The primary outcome was the incidence of cough after extubation, and the secondary outcomes were throat score at 10 min and 6 h after extubation assessed by the numerical rating scale, cough severity at 10 min and 6 h after extubation assessed by the Visual Analog Scale (VAS), 24 h 40-item Quality of Recovery Score (QoR-40), and subject-rated satisfaction score on a VAS. Main Results: Compared with saline group, the incidence of cough in lidocaine group was significantly lower (63.6% vs 86.4%, P=0.014). The sore throat score at 10 min after extubation was significantly lower (0[0,0] vs 1[0,2], P< 0.001). The subject-rated overall anesthesia satisfaction score was significantly higher (84.8[+/- 6.2] vs 76.6[+/- 8.6], P< 0.001). The severity of cough at 10 min after extubation was significantly lower (Mild: 36.4% vs 11.4%, P=0.006; Severe: 9.1% vs 43.2%, P< 0.001). There was no significant difference in the sore throat score at 6 h after extubation, severity of cough at 6 h after extubation, or QoR-40 at 24 h after extubation between the two groups. Conclusion: Piriform recess instillation with lidocaine before bronchoscopy is a simple and effective method for reducing early cough intensity and alleviating early sore throat. At 6 hours, there were no differences observed between the groups. Clinical Trial Registration: Chinese Clinical Trial Registry (identifier: ChiCTR2200067087).

Pericytes are the main cellular components of tiny arteries and capillaries. Studies have found that pericytes can undergo morphological contraction or relaxation under stimulation by cytokines, thus affecting the contraction and relaxation of microvessels and playing an essential role in regulating vascular microcirculation. Moreover, due to the characteristics of stem cells, pericytes can differentiate into a variety of inflammatory cell phenotypes, which then affect the immune function. Additionally, pericytes can also participate in angiogenesis and wound healing by interacting with endothelial cells in vascular microcirculation disorders. Here we review the origin, biological phenotype and function of pericytes, and discuss the potential mechanisms of pericytes in vascular microcirculation disorders, especially in pulmonary hypertension, so as to provide a sound basis and direction for the prevention and treatment of vascular microcirculation diseases.

BackgroundCircular RNAs (circRNAs) have been recognized as significant regulators of pulmonary hypertension (PH); however, the differential expression and function of circRNAs in different vascular cells under hypoxia remain unknown. Here, we identified co-differentially expressed circRNAs and determined their putative roles in the proliferation of pulmonary artery smooth muscle cells (PASMCs), pulmonary microvascular endothelial cells (PMECs), and pericytes (PCs) under hypoxia. MethodsWhole transcriptome sequencing was performed to analyze the differential expression of circRNAs in three different vascular cell types. Bioinformatic analysis was used to predict their putative biological function. Quantitative real-time polymerase chain reaction, Cell Counting Kit-8, and EdU Cell Proliferation assays were carried out to determine the role of circular postmeiotic segregation 1 (circPMS1) as well as its potential sponge mechanism in PASMCs, PMECs, and PCs. ResultsPASMCs, PMECs, and PCs exhibited 16, 99, and 31 differentially expressed circRNAs under hypoxia, respectively. CircPMS1 was upregulated in PASMCs, PMECs, and PCs under hypoxia and enhanced the proliferation of vascular cells. CircPMS1 may upregulate DEP domain containing 1 (DEPDC1) and RNA polymerase II subunit D expression by targeting microRNA-432-5p (miR-432-5p) in PASMCs, upregulate MAX interactor 1 (MXI1) expression by targeting miR-433-3p in PMECs, and upregulate zinc finger AN1-type containing 5 (ZFAND5) expression by targeting miR-3613-5p in PCs. ConclusionsOur results suggest that circPMS1 promotes cell proliferation through the miR-432-5p/DEPDC1 or miR-432-5p/POL2D axis in PASMCs, through the miR-433-3p/MXI1 axis in PMECs, and through the miR-3613-5p/ZFAND5 axis in PCs, which provides putative targets for the early diagnosis and treatment of PH.

Background Iatrogenic tracheoesophageal fistula (TEF) is a rare but life-threatening condition. No consensus has been reached regarding TEF treatment, though, stenting has been gaining popularity for less invasiveness than thoracic surgery. The airway management during stent placement for TEF could be challenging. Case presentations We report a patient who suffered from TEF after cardiac surgery with symptoms of persistent coughing and aspiration. He who was admitted for stent placement but ended up in failure and referred to our institution for further treatment. We successfully took advantage of the supraglottic jet oxygenation and ventilation (SJOV) during stent placement. Conclusion This is the first case so far describing SJOV in complicated stenting treatment. This demonstrates that SJOV can be applied for stent placement in TEF patients with restricted airways.

MicroRNAs (miRNAs) are versatile regulators of pulmonary arterial remodeling in idiopathic pulmonary arterial hypertension (IPAH). We herein aimed to characterize miRNAs in peripheral blood mononuclear cell (PBMC) and plasma exosomes, and investigate specific miRNA expression in pulmonary artery cells and lung tissues in IPAH. A co-dysregulated miRNA was identified from the miRNA expression profiles of PBMC and plasma exosomes in IPAH. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed the potential function of differentially expressed miRNAs. Real-time quantitative reverse transcription polymerase chain reaction was used to validate the expression of specific miRNAs in hypoxia-induced pulmonary microvascular endothelial cells (PMECs), pulmonary artery smooth muscle cells (PASMCs), pericyte cells (PCs), and lung tissues of patients with IPAH and rats. Finally, the miRNA-mRNA mechanisms of miR-122-5p were predicted. MiR-122-5p was the only co-upregulated miRNA in PBMC and plasma exosomes in patients with IPAH. Functional analysis of differentially expressed miRNAs revealed associations with the GO terms “transcription, DNA-templated,” “cytoplasm,” and “metal ion binding” in both PBMC and plasma exosomes, KEGG pathway MAPK signaling in PBMC, and KEGG-pathway human papillomavirus infection in plasma exosomes. Hypoxic PMECs and PCs, lung tissue of patients with IPAH, and rats showed increased expression of miR-122-5p, but hypoxic PASMCs showed decreased expression. And miR-122-5p mimics and inhibitor affected cell proliferation. Finally, miR-122-5p was found to potentially target DLAT (in lung tissue) and RIMS1 (in PMECs) in IPAH. According to the dual-luciferase assay, miR-122-5p bound to DLAT or RIMS1. In studies, DLAT imbalance was associated with cell proliferation and migration, RIMS1 is differentially expressed in cancer and correlated with cancer prognosis. Our findings suggest that the miR-122-5p is involved in various biological functions in the adjacent vascular wall cells in IPAH.

Background Extracorporeal membrane oxygenation (ECMO) is a versatile tool associated with favorable outcomes in the field of lung transplantation (LTx). Here, the clinical outcomes and complications of patients who underwent LTx with ECMO support, mainly prophylactically both intraoperatively and post-operatively, in a single center in China are reviewed. Methods The study cohort included all consecutive patients who underwent LTx between January 2020 and January 2022. Demographics and LTx data were retrospectively reviewed. Perioperative results, including complications and survival outcomes, were assessed. Results Of 86 patients included in the study, 32 received ECMO support, including 21 who received prophylactic intraoperative use of ECMO with or without prolonged post-operative use (pro-ECMO group), while the remaining 54 (62.8%) received no external support (non-ECMO group). There were no significant differences in the incidence of grade 3 primary graft dysfunction (PGD), short-term survival, or perioperative outcomes and complications between the non-ECMO and pro-ECMO groups. However, the estimated 1- and 2-year survival were superior in the pro-ECMO group, although this difference was not statistically significant (64.1% vs. 82.4%, log-rank P = 0.152; 46.5% vs. 72.1%, log-rank P = 0.182, respectively). After regrouping based on the reason for ECMO support, 30-day survival was satisfactory, while 90-day survival was poor in patients who received ECMO as a bridge to transplantation. However, prophylactic intraoperative use of ECMO and post-operative ECMO prolongation demonstrated promising survival and acceptable complication rates. In particular, patients who initially received venovenous (VV) ECMO intraoperatively with the same configuration post-operatively achieved excellent outcomes. The use of ECMO to salvage a graft affected by severe PGD also achieved acceptable survival in the rescue group. Conclusions Prophylactic intraoperative ECMO support and post-operative ECMO prolongation demonstrated promising survival outcomes and acceptable complications in LTx patients. Particularly, VV ECMO provided safe and effective support intraoperatively and prophylactic prolongation reduced the incidence of PGD in selected patients. However, since this study was conducted in a relatively low-volume transplant center, further studies are needed to validate the results.

患者,男,53岁,160 cm,60 kg,ASAⅡ级,因"呼吸困难半年余,气促加重"入院.患者于9个月前因全身多处火焰烧伤后出现气管狭窄,曾行气管切开术.3个月前在外院行颈部瘢痕松解术.患者可平卧,RR 18次/分,HR 85次/分, BP 132/88 mmHg.头颈部、上肢、胸背部烧伤后植皮状态,头颈活动度良好, MallampatiⅡ级.术前胸部CT示:气管上段狭窄,管壁不均匀增厚(图1).支气管检查发现:声门下4 cm见气管狭窄,范围约2 cm.术前诊断为"气管狭窄",拟在全身麻醉下行"正中劈开气管节段切除术".

Background Lung resection after previous contralateral pneumonectomy is rare. We present a case of right anterior segmentectomy despite previous left pneumonectomy, demanding special ventilation strategy. Case presentation A 48-year-old woman was going to have the right anterior segmentectomy through uniportal video-assisted thoracoscopy (VATS) who had left pneumonectomy two years ago. A 32-French left-sided double-lumen endobronchial tube (DLT) was chosen and adapted. The DLT was intubated into the bronchus intermedius. And the upper lobe can be isolated from the ventilation in the middle and lower lobes when the bronchial cuff’s inflated. The perioperative period was uneventful and the pathological diagnosis was adenocarcinoma. Conclusion Lung cancer radical resection was discouraged after previous contralateral pneumonectomy partly due to the challenging ventilation and isolation. With this new DLT adapting and intubation technique showed in this case, the challenging ventilation and isolation that deter the promotion of the operation could be solved.

The objective of this work was to develop a simple, selective, and sensitive LC-MS/MS method for the quantitation of the mepivacaine in Chinese biological matrix. The calibration curve of mepivacaine ranged from 0.5 to 2000ng/mL with the lower limit of quantitation being 0.5ng/mL. This sensitivity was high enough to describe the profile of blood mepivacaine level versus time. Thereby it was very desirable for the pharmacokinetic study because of its high sensitivity and accuracy. The study used a single-dose two-period crossover design principle. For the pharmacokinetic analysis of plasma, the mean (SD) values obtained were as follows: t(1/2), 1.63 (0.43) h; C-max, 435.3 (67.4) ng/ml; AUC(0-t), 1546.9 (339.7) ng/mlh; AUC(0-), 1982.3 (421.4) ng/mlh; T-max, 0.62 (0.31) h. The validated method has been successfully applied to assess the pharmacokinetic study of mepivacaine after a single administration to Chinese volunteers.

Objective To evaluate the application and effect of three kinds of non-depolarizing muscle relaxant in painless fiberoptic bronchoscopy.Methods One hundred and twenty ASA Ⅰ orⅡ patients undergoing painless fiberoptic bronchoscopy were randomly divided into 4groups(n=30):rocuronium group(group R),vecuronium group(group V),cisatracurium group(group CIS)and control group(group N).After being induced by general anesthetics,neuromuscular blocking effects on the patients(groups R,V and CIS)were monitored by TOF-guard accelerogragh,after which the patients of the three groups received a single bolus of corresponding muscle relaxant(rocuronium 0.3mg/kg,vecuronium 0.05mg/kg,cisatracurium 0.05 mg/kg)in five seconds,and the group N received 5ml normal saline solution.Three-way laryngeal mask airway was inserted when the maximum depression of T1 came,and all groups were maintained with target controlled infusion of propofol.The onset time,the recovery index(time of T1 recover from 25% to 75%)and TOF ratio to 90%were recorded.MAP,HR were also noted at following time points:before anesthesia(T0),the time of unconsciousness(T1),the time of inserting laryngeal mask airway(T2),when operating fiberoptic bronchoscopy(T3)and the time of waking up(T4).fiberoptic bronchoscopy operate time and laryngeal mask airway condition classification were recorded,too.Results compared with group N,the laryngeal mask airway condition classification of the muscle relaxants had obvious advantage(P 0.05),and at T2-T4,the MAP,HR of the groups R,V and CIS were lower than group N(P0.05).The onset time and the recovery index of group R were shorter than groups V and CIS.Conclusion Rocuronium was more available in painless fiberoptic bronchoscopy.

【Objective】To explore the advantage of three-way laryngeal mask in balloon dilatation for the patients of airway stenosis under general anesthesia.【Methods】Sixty,ASAⅠorⅡpatients of both sexes(17 male,43 female) aged 16~68 yr,weighing 38~82 kg underwent balloon dilatation under general anesthesia from February to May 2011 in shanghai pulmonary hospital.The three-way laryngeal mask was inserted after induction of anesthesia which was maintained with propofol and vecuronium,the patients were mechanically ventilated.The fiberoptic bronchoscope was inserted into the operation hole of three-way laryngeal mask for balloon dilatation.HR,SBP,DBP and SPO2 were recorded respectively before anesthesia(T0),the time when inserting laryngeal mask(T1),before dilatation(T2),the time of dilatation(T3),after dilatation(T4) and after operation(T5).VT,Ppeak and PETCO2 were recorded at T1~T5.【Results】As compared with T0,HR,SBP,DBP lowed lightly when inserting laryngeal mask(P <0.05) and SPO2 was improved significantly when ventilated with the three-way laryngeal mask(P <0.05).Ppeak of all patients increased lightly at the time of dilatation,below 25 cmH2 O.All the patients emerged from anesthesia and the laryngeal mask were removed within 8min after operation.The operation time was 21~40 min,no aspiration,obvious gastrointestinal inflation,and laryngeal injury occurred.【Conclusions】The effect of airway management in balloon dilatation using three-way laryngeal mask under general anesthesia is profitable.

Objective To evaluate the effect of appliation of three-way laryngeal mask in airway management of balloon dilatation bronchoplasty under general anesthesia. Methods Thirty-eight ASA ⅠorⅡpatients of both sexes(9 male, 29 female) aged 16-65 years, weighing 38-74 kg, underwent balloon dilatation bronchoplasty under general anesthesia in shanghai pulmonary hospital, were divided into 2 groups according to the location of stenosis: tracheal stenosis (group A, n =13) and bronchial stenosis (group B, n =25). The three-way laryngeal mask was inserted after induction of anesthesia which was maintained with propofol and vecuronium. HR, SBP, DBP and SpO2 were recorded respectively before anesthesia(T0 ), the time when inserting laryngeal mask(T1 ), before dilatation(T2 ), the time of dilatation(T3 ), after dilatation(T4 ) and after operation(T5 ). VT , Ppeak and PETCO2 were recorded at T1 -T5 . Radial artery was cannulated for blood gas analysis at T0 , T2 -T5 . Results As compared with T0 , SpO2 was improved significantly in all patients ventilated with the three-way laryngeal mask except at T3 in group A( P <0.01), PaCO2 decreased and PaO2 , SaO2 incresed significantly at T2 -T5 in both groups( P <0.05或 P <0.01). Compared with T1 , VT and PETCO2 at T3 was obviously lower in group B( P <0.01), while VT , RR, Ppeak and PETCO2 at T4 , T5 showed no statistical significance. Conclusion The three-way laryngeal mask could be effectively and safely used in airway management of balloon dilatation bronchoplasty under general anesthesia.

Objective: To investigate the application of modified laryngeal mask airway in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Methods 70 patients underwent bronchoscopy from March 2012 to June 2012. 46 patients under intravenous anesthesia with sufentanyl and propofol and then received modified laryngeal mask airway for EBUSTBNA, while 24 patients with local anesthesia received only 2% lidocaine for EBUS-TBNA. Systolic blood (SBP), diastolic blood pressure (DBP), heart rate (HR) and pulse oxygen saturation (SpO2) were recorded before examination (T1), at the endobronchial ultrasound probe insertion point (T2), and at 5 min (T3) and 10 min (T4) during examination, and at the end of examination (T5). Results: SpO2 was significantly higher in the general anesthesia group than in the local anesthesia group. In the general anesthesia group, SpO2 was also significantly higher in T2 than T1. There were significant differences in SBP, DBP and HR between two groups. Vital signs were more stable in the general anesthesia group than in the local anesthesia group. No patient in the general anesthesia group had memory of suffering after EBUS-TBNA. Conclusions: Modified laryngeal mask airway in EBUS-TBNA successfully solves the problem of breath management difficulties accompanying inspection and anesthesia sharing a common channel. It appears more comfortable for the patients.

Objective To evaluate the anaesthesia methods and the managements of ventilation in the micro-operations of the respiratory tract under video-assisted rigid bronchoscope.Methods After general induction,27 patients(ASA Ⅱ-Ⅳ) needing air tube operation,were inserted the rigid bronchoscope with a homemade cuff,using IPPV with hand.HR,MAP,PaO2 and PaCO2 were recorded before anaesthesia(T1) ,inserting rigid bronchoscope(T2) ,15 min(T3) ,30 min(T4) ,60 min(T5) after operation and 30 min(T6) after extubation.In addition,the degree of satisfactory and the rate of the side effects in perioperation and postoperation of patients(including ASA grade Ⅱ-Ⅳ) should be recorded.Results The rigid bronchoscopes were placed satisfactorily in 24 patients(occupied 89%) ,and the another 3 patients(occupied 11%) had the same result after the rigid bronchoscope adjusted.The average time for inserting rigid bronchoscope was(37±9) seconds.Compared with T1,HR descended at T3-T5,MAP ascended at T2 and T6,but descended at T4,PaO2 was highed at T2-T6,and PaCO2 ascended at T5(P0.05 or P0.01) .The patients ASA Ⅲ or Ⅳ had higher incidence of hypoxemia,hypertension,hypotension and arrhythmia than those of patients ASA Ⅱ(P0.05) ,and the incidence of sore throat had no sense in statistics between two groups.Conclusion In total intravenous anaesthesia,using the rigid bronchoscope with a homemade cuff to control the ventilation in the micro-operations of the airtube is safe.

Objective To investigate the effects of different blood pH of the recipients on ischemiareperfusion (I/R) injury to the transplanted lungs in rats. Methods Sixty-four pure bred male SD rats weighing 250-350 g were randomly divided into equal numbers of donors and recipients and the recipient rats were randomly divided into 4 groups(n = 8 each). Both donor and recipient rats were anesthetized with intraperitoneal (IP)ketamine 15 mg/kg and diazepam 6 mg/kg, tracheostomized and mechanically ventilated. In donor rats heparin 1 ml was injected via inferior vena cava and 4 ℃ LDP solution 40 ml was injected via pulmonary artery . The left lung was then removed and placed in 4℃ LDP solution and kept for 4 h. The left lung transplantation was performed using two-cuff-one-stent anastomosis technique. Before the transplanted lung was reperfused, the recipients' blood pH was adjusted to 7.4 (group Ⅰ), 7.2 (group Ⅱ), 7.3 (group Ⅲ) and 7.5 (group Ⅳ) by HCI and NaHCO3 solutions infused via femoral vein. After 2 h reperfusion, the transplants were removed for microscopic examination and determination of W/D lung weight ratio, MPO and SOD activities and MDA, TNF-α and IL-8 contents. Results SOD activity was significantly higher while MPO activity, and MDA, TNF-α and IL-8 contents in the lung tissue were significantly lower in group Ⅲ than in group Ⅰ . There was no significant difference in SOD and MPO activities and MDA, TNF-α, and IL-8 contents in the lung tissue among group Ⅰ , Ⅱ and Ⅳ. There was no significant difference in W/D lung weight ratio among the 4 groups. Microscopic examination showed that the histological damage was attenuated in group Ⅲ compared with the other 3 groups. Conclusion The I/R injury to the transplanted rat lungs can be effectively alleviated by reducing blood pH of the recipients to 7.3.

Objective To investigate the effect of etomidate on the expression of activation makers of platelet CD62p and CD41/ 61 in peripheral venous blood in patients with lung cancer. Methods Peripheral venous blood samples were taken from 10 healthy volunteers (group E) and 40 patients with lung cancer. The 40 patients with lung cancer were randomly divided into 4 groups (n=10 each): groups A, B, C and D. The blood samples in groups E and A were incubated without etomidate, while the blood samples in groups B, C and D were incubated with etomidate 0.2, 2 and 20 mg/L, respectively. The inhibitory effects of etomidate on expression of activation makers of platelet CD62p and CD41/61 were determined by flow cytometry. Results The five groups were comparable with respect to age, body weight, platelet count and coagulation time. The expression of C D62p (37.1±20.3) %、 CD41/61 (97.2±1.4) % on the platelet surface was significantly increased in patients with lung cancer than the expression of CD62p (3.3±1.9)%, CD41/61 (93.1±3.4)% in healthy adults (P<0.01).Compare with group A, the expression of activation makers of platelet CD62p (20.9±9.2)%on the platelet surface in group C was decreased (P<0.05)and the expression of activation makers of platelet CD62p (17.9±15.6)% in group D was significantly decreased(P<0.01),whereas etomidate 0.2 mg/L had no significantly effect on CD62p and CD41/61. Conclusion The expression of activation makers of plateleta significantly increased in patients with lung cancer compared with healthy adults. In vitro,etomidate 2 and 20 mg/L can inhibit the expression of CD62p.

舒芬太尼是一种新合成的强效拟吗啡类镇痛药,镇痛效价是芬太尼的5～10倍,并具有起效快、心血管系统功能稳定、无组胺释放等特点[1].本研究拟比较芬太尼和舒芬太尼用于无痛纤维支气管镜(简称纤支镜)检查的安全性和有效性.