Objective To investigate the role of moderate hypothermia in the lung inflammation of rat acute lung injury induced by lipopolysaccharide( LPS). Methods A rat model of acute lung injury (ALI) was established by intra-tracheal instillation of lipopolysaccharide (1.5 mg/kg, 0.5 ml) at 16 h after LPS (1.0 mg/kg) intraperitoneal administration. Thirty-four male Sprague Dawley rats were randomly divided into four groups: control group, receiving saline only;LPS group, receiving LPS; hypothermia group, treated with hypothermia without LPS; LPS + hypothermia group, treated with LPS and cooled to 32.5℃～ 33.0℃ as PaO2/FiO2 was below 300 mmHg. Hemodynamics and blood gases were recorded every hour throughout the study. Rats were killed 4 h after ALI, and lung lavage was performed to measure the tumor necrosis factor α (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) concentrations in bronchoalveolar lavage fluid (BALF) by using enzyme-linked immunosorbent assay (ELISA). Results PaO2/FiO2 was significantly decreased and PaCO2 was increased in the LPS group as compared to their baseline values( P 《 0.01 ). Treatment with hypothermia inhibited the increase in PaCO2 ( P 《 0.05) but had no effect on PaO2/FiO2 in the presence of LPS. The administration of LPS significantly increased the concentrations of TNF-α, IL-6 and IL-10 in BALE as compared to the control experiment( P 《0.05, P 《 0.01 ). Moderate hypothermia reduced the expressions of TNF-α and IL-6( P 《 0.01 ) but had no effect on the production of IL-10( P 》 0.05). Conclusion Moderate hypothermia significantly inhibits proinflammatory cytokine expressions in lipopolysaccharide-induced acute lung injury.
作者：吴长毅；曾因明；顾卫东；丁浩中；陈肖；张焰 刊期： 2004年第04期
Objective To investigate the effects of a highly selective cAMP-dependant protein kinase(PKA)inhibitor, H-89, on tactile allodynia, as well as cyclic AMP response element binding protein (CREB) phosphorylation in the ipsilateral spinal dorsal horn neurons induced by chronic constriction injury(CCI) of the sciatic nerve in rats. Methods In part one, after CCI model had been successfully established, twenty eight female SD rats weighing (250+ 20)g were randomly allocated to one of four groups( n= 7): control group received solvent; H1, H2 and H4 group received H-89 1,2,and 4 nmol respectively. Drugs were delivered via L5-6 acute puncture after briefly anesthetized with isoflurane. Mechanical withdrawal threshold (MWT) were determined at before and 15, 30, 60 min after drug-delivery. In part two, five groups ( n= 6), including a sham group( sham surgery received solvent), and four CCI groups received drugs( H1, H2, H4group) or solvent(DMSO group) as described above were euthanatized 30 min after drug delivery to investigate the effect of H-89 on CREB phosphorylation in the superficial neurons of the ipsilateral spinal dorsal horn. CREB phosphorylated (pCREB) neurons were detected by immunohistochemistry. Results MWT increased after drug administration, but there were no statistical significance in the 1 nmol group, compared to baseline or control group( P 》0.05). 15 min after drug delivery, MWT significantly increased( P 《 0.01, compared to baseline or control group) in the 4 nmol group. The number of pCREB positive neurons in the L4-5 spinal dorsal horn and their gray level were reduced by H-89 administration( P 《0.01, compared to DMSO group). Conclusion PKA inhibitor H-89 can attenuate tactile allodynia induced by chronic constriction injury of the sciatic nerve in rats, and inhibit CREB phosphorylation in the spinal dorsal horn neurons following CCI, indicating PKA/CREB signaling pathway plays an important role in the maintance of neuropathic pain.
作者：姚永兴；祝继洪；宋学军；张励才；曾因明 刊期： 2004年第04期
变性血红蛋白含量增多,会引起人体的各种不适,甚至危及生命.在麻醉过程中许多药物都可以引起变性血红蛋白含量的增多,只有合理用药,采取针对性的措施和方法,才能避免变性血红蛋白的增多.
作者：郝晓燕；曹定睿 刊期： 2004年第04期
随着胸心外科的发展、胸腔镜的出现、各种疑难手术及微创手术的推广,单肺通气(OLV)得到了广泛的应用.但是OLV中低氧血症的发生至今仍是限制其应用的重要问题.现就OLV中低氧血症的原因、预测以及防治等方面的研究进展作一简要综述.
作者：王楠；李文志 刊期： 2004年第04期
近10年国外对异丙酚舒张气管平滑肌作用的基础与临床研究发现,异丙酚具有很强的舒张气管平滑肌的作用.在临床浓度范围内主要通过抑制迷走神经张力而起作用,在高浓度时具有直接舒张气管平滑肌的作用,对致敏的气管平滑肌,异丙酚可产生更为强烈的舒张作用,焦亚硫酸盐作为保存剂可削弱异丙酚对气管平滑肌的舒张作用.异丙酚中含有大豆油、卵磷脂等,有引起过敏性疾病患者气管阻力增加的可能性.
作者：周钦海；傅诚章；钱燕宁；沈健藩 刊期： 2004年第04期
甘氨酸受体是一种重要的抑制性氨基酸受体,主要参与脑干及脊髓对运动及感觉的调节.近年研究发现多种全身麻醉药也可作用于甘氨酸受体.现就甘氨酸受体与全麻药的关系作一综述.
作者：喻洁；戴体俊 刊期： 2004年第04期
GABAA受体在内源性痛觉下行抑制系统中有广泛的分布,在调节下行抑制和易化作用中有重要作用.现就GABAA受体在内源性痛觉下行抑制系统中的对伤害性刺激信号的调控作一简要综述.
作者：王擒云；戴体俊；曾因明 刊期： 2004年第04期
药物的剂量和剂型是影响麻醉起效的关键因素;生理因素中,心排血量及靶器官的血流分布对麻醉药物的起效时间和效应影响至关重要;肺参与了某些药物的摄取;在靶器官,药物的分布、效价强弱以及药物在受体水平的相互作用均影响麻醉药物的起效.
作者：吴滨；江伟 刊期： 2004年第04期
在中枢神经系统中,NO/cGMP系统具有重要的信息传递作用,与NO/cGMP系统信息传递有关的中枢神经通路有兴奋性NMDA通路和抑制性GABA通路等.有证据表明氯胺酮麻醉作用机制与NO/cGMP系统有密切关系.
作者：马晓旭；戴体俊；曾因明 刊期： 2004年第04期
长效酰胺类局麻药布比卡因为左旋镜像体和右旋镜像体混合而成的消旋体,而其毒性主要来自于右旋镜像体.研究表明,左布比卡因的麻醉效能与消旋体无显著差别,而其毒性显著减小.现就左布比卡因的药代学、药效学和对机体的毒性等作一综述.
作者：王向兵；曾因明 刊期： 2004年第04期
长效酰胺类局麻药左布比卡因保留了消旋布比卡因作用时间长、麻醉效能好的优点,且心脏和神经系统毒性小,目前已用于各种临床麻醉及术后镇痛.现就其药理和临床应用有关的文献进行综述.
作者：张黄丽；刘怀琼；葛衡江 刊期： 2004年第04期
气管-支气管内支架置入技术为治疗气道狭窄提供了有效的治疗手段.该治疗技术的麻醉管理是麻醉医师面临的具有挑战性的临床工作之一.现就气道狭窄病人的支架置入术及麻醉管理等进展作一综述.
作者：韩东吉；罗爱林 刊期： 2004年第04期
新型长效局麻药罗哌卡因在小儿阻滞麻醉中的镇痛效果确切,运动阻滞程度较低.加用可乐定或S(+)-氯胺酮可显著延长其镇痛时间.罗哌卡因用于年长儿持续硬膜外阻滞的推荐剂量为0.4 mg·kg-1·h-1.罗哌卡因在新生儿及婴儿中的清除率降低,持续硬膜阻滞时应适当降低剂量,输注时间不宜超过(36～48)h.
作者：潘守东；马旭波；吴新民 刊期： 2004年第04期
随着神经生理学、分子生物学和PET(正电子发射断层扫描)等新技术的应用,有关异丙酚作用机制的研究已有所进展.现就异丙酚脑摄取、异丙酚对脑血流和脑代谢的影响以及对γ-氨基丁酸受体复合体(GABA receptor complex)、N-甲基-D-天冬氨酸(NMDA)受体的影响等方面,总结异丙酚全麻作用的可能机制.
作者：于冬男；林春水；古妙宁 刊期： 2004年第04期
循证医学是近年来发展起来的一门新兴科学,是对传统经验医学的挑战.现已广泛应用于临床各个领域.现就循证医学的内容、方法及其在麻醉学研究中的应用作一综述.
作者：高亚利；方才 刊期： 2004年第04期
肌松药的残余阻滞作用对呼吸功能的恢复有一定的影响,将呼吸力学监测、肌松监测以及临床征象相结合进行合理的判断,对肌松药残余阻滞作用可能造成的呼吸系统并发症有较好的预防作用.
作者：闻大翔；杭燕南 刊期： 2004年第04期
研究背景:挥发性麻醉药在冠脉手术期间可以保护心肌.本研究旨在和全凭静脉麻醉相比较,说明挥发性麻醉药的应用与ICU住院天数和总住院天数(LOS)减少有关.
作者： 刊期： 2004年第04期
背景:近来研究提示异氟烷的神经保护作用不是持续的.由细胞凋亡介导的神经元的延迟性死亡可导致梗死面积的逐渐增加.这些资料提示异氟醚可能不能抑制延迟性神经元死亡.除了异氟烷外,caspase抑制剂的神经细胞凋亡预防作用可以提供神经保护作用.本研究的开展是决定在非特异性的caspase抑制剂z-VAD-fmk存在下异氟烷的神经保护作用是否更持久.
作者： 刊期： 2004年第04期
