异氟醚保护离体大鼠肺缺血再灌注损伤

Objective To study the effects of isoflurane on ischemia-reperfusion (IR)-induced injury in isolated rat lungs. Methods This study was performed on an isolated buffer-perfused rat lung model. There were four groups: CON group ( n = 6): perfusion for 60 min without ischemia; IR group (n = 6): after perfusion for 30 min, then interruption of perfusion and ventilation for 45 min followed by reperfusion for 30 min; ISO1 group (n = 6 ): 1.38% isoflurane was administered for 30 min before 45 min ischemia, then followed by 30 min reperfusion; ISO2 group (n= 6): 1.38% isoflurane was administered during the period of reperfusion. The Myeloperoxidase (MPO) activity of lung, neutrophils counts, tumor necrosis factor-α(TNF-α), superoxide dismutase (SOD) activity, malondialdehyde (MDA) in perfusate, and the Wet-to-Dry lung weight ratios were measured. Results IR caused significant increases in the wet-to-dry lung weight ratios, the activity of lung MPO, the contents of MDA and TNF-α in perfusate, but decreasess in the SOD activity and neutrophils counts. Administration of isoflurane (both ISO1 and ISO2 groups) significantly protected against IR-induced injury the via inhibiting increases of MPO activity and contents of MDA and TNF-α in perfusate. Isoflurane significantly increased the SOD activity and neutrophils counts in perfusate. No difference was found between ISO1 and ISO2 groups. Conclusion Our results suggest that isoflurane protects the lungs against IR-induced injury in isolated rat lung model.

坐骨神经结扎对大鼠背根神经节和脊髓背角神经元磷酸化环酸腺苷反应元件结合蛋白表达的影响

Objective To investigate whether chronic constriction injury (CCI) of the sciatic nerve of rats could produce alterations in the phosphorylation of cyclic AMP response element binding(CREB) protein in dorsal root ganglia (DRG) and superficial dorsal horn neurons of the spinal cord. Methods Chronic constriction injury (CCI) of the sciatic nerve was employed as a model of neuropathic pain. Thirty-two Sprague-Dawley rats were randomly divided into Naive, Sham, CCI 2w(received CCI for 2 weeks) and CCI 4w(received CCI for 4 weeks)groups. Hind paw withdrawal threshold to mechanical stimuli and withdrawal latency to thermal stimuli were used to determine the mechanical and thermal hyperalgesia. Then all the rats were deeply anesthetized and perfused intracardially with paraformaldehyde. The fixed L4-5 spinal cord and the L5 DRG ipsilateral to CCI were harvested for fixation. The pCREB-immunoreactive(pCREB-IR) cells in both DRG and superficial dorsal horn neurons were quantified for analysis using immunohistochemistry methods. Results On the 14th day after sciatic nerve injury, all the rats exhibited significant mechanical and thermal hyperalgesia. The mechanical withdrawal thresholds to yon Frey filament from CCI 2w group decreased significantly compared to both baseline values and those of Sham group( P ＜ 0.01); Thermal withdwal latencies from CCI 2w group decreased significantly compared to both baseline values and those of Sham group( P ＜0.01). Some rats from Sham group also showed mechanical hyperalgesia compared to hoth baseline values and those of Naive group( P ＜ 0.01 ). 28 days after CCI, both mechanical and thermal hypersensitivity were significantly alleviated, with no statistical significance compared to those of Sham group. On the 14th day after CCI, the number of pCREB-IR cells significantly increased in ipsilateral L5 DRGs and superficial dorsal horns( P ＜0.01) compared to Sham group. The number of phosphorylated CREB-IR cells in the ipsilateral DRGs from Sham group also increased compared to that of Naive rats( P ＜ 0.05). There were no significant statistical differences of numbers of CREB-IR neuron between Sham group and CCI 4w group. Conclusion CCI increases CREB phosphorylation both in DRG and superficial dorsal horn neurons of the lumbar spinal cord, and may be one of the key molecular mechanisms of central and peripheral sensitization following peripheral nerve injury.

肾上腺髓质素研究进展

肾上腺髓质素(ADM)是一种体内分布广泛的活性多肽,其受体多样且调控复杂.ADM具有多种生理调节功能,参与兴奋丘脑-腺垂体-肾上腺轴,影响糖及水盐代谢,舒张血管与气道平滑肌并抑制心肌构形重建及气道的重塑,抑制血小板聚集,参与炎症反应,还可调节子宫和胎盘的血流,在缺血再灌注损伤及脑保护中起重要作用.

围术期β肾上腺素受体阻滞剂的应用

β肾上腺素受体阻滞剂为临床上常用的心血管药物,在围术期可用于防治高血压、控制心律失常、治疗慢性心衰、保护和改善心肌功能,从而增强手术耐受力,提高术后生存率.现就β肾上腺素受体阻滞剂在围术期的应用作一探讨.

脑膜瘤围手术期出血的原因及防治

脑膜瘤多数为良性肿瘤,手术切除是主要治疗措施之一,手术中易出血,术后易再次出血形成血肿,需行血肿清除术.现就脑膜瘤的特性、开颅手术对凝血纤溶的影响及减少脑膜瘤手术出血的措施几方面展开综述,认为应加强对脑膜瘤围手术期凝血纤溶功能的监测.

蛋白质芯片与全身麻醉机制

探寻全身麻醉的确切机制已成为麻醉学的一个研究热点,采用何种有效的研究手段是探寻机制的关键所在.蛋白质芯片是一种高通量的蛋白功能分析技术.它可以用于构建蛋白质表达谱,进行抗原-抗体筛选,药物靶点筛选,蛋白质-蛋白质交互作用筛选等,在全身麻醉机制的研究中可能成为一项新的高效分析技术.

脑电非线性分析参数近似熵对麻醉深度的监测

脑电(EEG)数字化分析已广泛用于麻醉中大脑皮层的功能监测,应用单一的数字化EEG参数分析麻醉药的中枢效应更为直观、方便.已知EEG信号起源于高度非线性系统,近年来EEG的非线性分析对围术期脑功能监测发展很快.以下就脑电非线性参数之一近似熵,对麻醉深度的监测基础和临床研究作一综述.

体能评估与围手术期心血管意外事件的预测

体能是机体有氧代谢所允许的活动能力,受心、肺功能及活动器官氧供等因素影响.体能相关指标被临床广泛用于指导心血管疾病诊治.现就体能评估的手段和方法及其在预测心血管疾病尤其围术期心血管事件的可行性和临床意义作一介绍.

载脂蛋白E基因多态性与认知损害

研究发现载脂蛋白E基因多态性与认知损害有良好的相关性,可能成为认知损害发生的预测或诊断指标,与术后认知功能障碍的关系值得进一步探讨.

神经源性炎症与器官损伤

当组织或器官受到伤害性刺激时,感觉神经末梢释放SP和CGRP等神经肽引起神经源性炎症,并进而激发瀑布式炎症反应,造成组织或器官损伤.大量研究表明,神经源性炎症反应已成为某些器官疾病的病理生理学基础.现就神经源性炎症反应机制、参与的多肽及其生物学作用以及神经源性炎症与器官损伤等方面加以综述.

心肌缺血再灌注损伤心肌细胞凋亡的分子调节机制

心肌缺血再灌注损伤中凋亡的发生可能与缺血再灌注损伤活性氧大量产生、钙超载等直接或间接激活细胞凋亡的信号途径,启动凋亡相关基因的表达有关.现就近年来心肌缺血再灌注损伤心肌细胞凋亡的分子调节机制的有关研究内容作简要综述.

基因芯片技术在心肌缺血再灌注损伤研究中的应用

心肌缺血再灌注损伤是受多基因调控的病理过程.基因芯片技术具有高通量、多样化、微量化和集成化等优点,为系统研究心肌缺血再灌注损伤提供了强有力的手段.基因芯片技术已在心肌缺血再灌注损伤及防治的分子机制研究中得到应用并取得了一定的进展.

经食管超声引导和监测先心病封堵治疗

经食管超声心动图(TEE)对心脏及其周围大血管成像清晰,并可持续监测,在引导封堵先心病过程以及监测封堵并发症等方面有重要作用,正被广泛应用于各类先天性心脏病的封堵治疗.

机器人辅助心脏手术的麻醉

机器人辅助心脏手术本身的特点与要求,使其麻醉具有一定的特殊性.现将机器人辅助心脏手术的特点、麻醉方法及其麻醉管理要点作一介绍.

肝移植术中容量管理

肝移植术是目前终末期肝病确切、根本的治疗手段.由于此类患者的病理生理学特征和肝移植手术的特殊性,术中容量管理十分重要,其基本原则是根据终末期肝病患者术前容量状态及手术过程,选择合适的液体,合理进行术中补液,并尽可能避免发生与容量相关的并发症.

过敏性休克--一种没有抑制氧耗的分布性休克

背景:麻醉中发生过敏性休克的病理生理尚未完全阐明.它被认为是一种具有分布性的类似于感染性休克(无氧代谢,高组织氧压[PtiO2])的一种休克形式.过敏性反应中组织氧压的情况及其结果至今尚未知晓.

七氟醚抑制脑干吸气前运动神经元的作用机制

研究背景:位于延髓尾部腹侧髓质的神经元是与吸气相关的前运动神经元,它们是支配呼吸肌如膈肌、肋间外肌、肋间内肌等运动神经元的上一级神经元.这些神经元的兴奋状态由NMDA受体,AM-PA受体调控,也受抑制性AGBAA能神经调节.作者在去大脑狗的模型上探讨七氟醚对这些突触机制的影响.

初级神经元损伤后触诱发痛的机制

Tactile allodynia, defined as a pain or a nociceptive response provoked by an innocuous mechanical stimulus,in addition to hyperalgesia and spontaneous pain, is one of the common features of peripheral neuropathy in humans following peripheral nerve injury.

第二届淮海国际麻醉学论坛通知