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To explore the correlation between gene polymorphism and opioid efficacy in patients with gastric or intestinal cancer.Fifty-nine patients who underwent laparoscopic surgery for gastric or intestinal cancer under general anesthesia were included and randomly divided into oxycodone (n=30) and sufentanil groups (n=29) by reproducible random number generation method. Single nucleotide polymorphisms (SNPs) of four alleles: μ-opioid receptor gene OPRM1 A118G, cytochrome P450 (CPY450) enzyme system: CPY3A4*1G, CYP3A5*3, and CYP2D6*10 were detected by PCR-pyrosequencing. Patients in sufentanil group received intravenous sufentanil injection during anesthesia induction, intraoperative maintenance, and postoperative analgesia, while those in oxycodone group received oxycodone. Patients' postoperative VAS score, opioid use, and prevalence of adverse reactions were recorded.The genotype distribution of OPRM1 A118G, CYP3A4*1G, CYP3A5*3, and CYP2D6*10 in Chinese gastric cancer/intestinal cancer patients accorded with the Hardy-Weinberg law (p0.05). OPRM1 A118G polymorphism correlated with postoperative VAS score and medication dosage, in oxycodone group (p0.05), while it didn't with those of sufentanil group. The VAS scores in GG group were higher than that in AA group and AG group at T6-T9, (p0.05); the postoperative pain remedies times in GG group were more than that in the AA and AG groups (p=0.002). CYP3A4*1G polymorphism related to postoperative VAS score, medication dosage and prevalence of adverse reactions in sufentanil group (p0.05), while it didn't with those of oxycodone group (p0.05). The total intraoperative medication in AA group was less than that in GG and GA groups (p0.01), with a higher prevalence of respiratory depression (p=0.01). Nor was there any correlation of CYP3A5*3 and CYP2D6*10 polymorphisms with the efficacy, postoperative VAS score, pain remedies times, postoperative 24 h medication dosage, or prevalence of adverse reactions in oxycodone and sufentanil groups.Gene polymorphism affects the efficacy and adverse reactions of opioids in patients undergoing laparoscopic gastric or intestinal cancer surgery.

We showed that hypothermic preconditioning (HPC) increased survival of Purkinje neurons in rat cerebellar slices after oxygen-glucose deprivation (OGD). HPC also reduced the OGD-increased expression of high mobility group I (Y) proteins, a transcription factor that can enhance inducible nitric oxide synthase (iNOS) expression. iNOS is a putatively damaging protein that contributes to ischemic brain injury. Heat shock proteins (HSPs) can be induced by various stimuli to protect cells. We hypothesize that HPC induces neuroprotection by reducing the expression of putatively damaging proteins such as iNOS and/or by increasing the expression of putatively protective proteins such as HSPs. Cerebellar slices were prepared from adult male Sprague-Dawley rats and incubated in circulating artificial cerebrospinal fluid. OGD was for 20 min at 37 degrees C and was followed by a 5-h recovery at 37 degrees C before slices were used for morphological, immunohistochemical and Western analyses. HPC was performed by incubating slices at 33 degrees C for 20 min at 1 h before the OGD. HPC and aminoguanidine, an iNOS inhibitor, prevented OGD-induced Purkinje cell death/injury. OGD increased the expression of iNOS and nitrosylated proteins. These increases were abolished by aminoguanidine and HPC. Interestingly, the expression of HSP70 was increased by OGD but not by HPC. Our results suggest that an increased iNOS expression contributes to the pathophysiology of OGD-induced Purkinje neuronal death in our model. Our results also suggest the involvement of inhibiting the expression of the putatively damaging iNOS proteins in the HPC-induced neuroprotection. HSP70 may not contribute to the HPC-induced neuroprotection.

Injury of the cervical spine may cause serious complications and neurological sequelae. Recently, a patient with C1-2 spinal cord compression developed pulmonary edema postoperatively associated with unstable hemodynamics, which might result from overzealous fluid administration in order to correct neurogenic shock during anesthesia. Therefore, early recognition and timely use of vasoconstrictors, together with judicious fluid replacement are important in the anesthetic management of patients with cervical spine injury undergoing surgery. In addition, the placement of pulmonary artery catheter is crucial for assessing the cardiac function and fluid status.

Quantitative sensory testing has gained popularity as a tool in the diagnosis of peripheral neuropathies. This study aims to establish normative data of quantitative thermal and vibratory thresholds in normal subjects in Taiwan. In addition, we also examined the effect of age and gender differences on these thresholds.The study included 100 healthy subjects (50 males and 50 females) who were admitted for regular physical examination. The quantitative testing of thermal, cold and vibratory sensations were performed having recourse to a Thermotest instrument applied on the right hand and foot of these subjects. Measurements included perception thresholds of warm (WT), cold (CT), heat pain, cold pain and vibration as well as a visual analog pain scale.Age was comparable between the sexes, but the male subjects were taller than the female subjects. A higher WT and CT in the hand, but not in the foot, were found in the male subjects in comparison with the female subjects. Heat pain threshold and cold pain threshold of both sites did not significantly differ between genders. Moreover, the groups did not differ in vibration threshold and visual analog pain scale. Young subjects (age30 years) showed a higher CT in the foot than the older subjects (age50 years). None of the above parameters were different between these two age groups. Overall, the age or height bore no significant relation to the difference between WT and CT (DDWT-CT).The female subjects were found to be more sensitive to warm and cold stimulation in the hand than their counterparts. These results have provided valuable normative data on sensory perceptive thresholds in Taiwanese, which are useful as a tool in the diagnosis of peripheral neuropathy.

Transurethral incision (TUI) is a simple and safe procedure. We, herein, present a case undergoing transurethral incision procedure during which he developed transurethral resection of prostate syndrome (TURP syndrome) and hypothermia precipitating an acute perioperative myocardial infarction attack. The potential risk of development of TURP syndrome in settings other than TURP surgery as well as its prevention are reviewed and discussed.

Background: It has been speculated that epidural anaesthesia may induce bronchoconstriction via the mechanism of a sympathetic blockade. However, this hypothesis has not been confirmed by any experimental evidence. Therefore, we investigated the effects of high thoracic epidural anaesthesia with neural sympathetic blockade on basal airway resistance and airway reactivity in response to bronchoconstrictive stimuli in a canine periphery lung model. Methods: Acetylcholine (Ach, 8 μg kg-1 i.v.) or histamine (His, 3 μg kg-1 i.v.) was administered to 7 anaesthetized mongrel dogs before and after thoracic epidural anaesthesia. Successful neuronal sympathectomy was confirmed by nitroglycerin test. The changes of peripheral airway resistance (Rp), haemodynamics, cardiac output (CO), and the recovery time for Rp from peak returning to baseline in each challenge were studied. Results: Thoracic epidural anaesthesia altered neither the baseline Rp nor the peak Rp evoked by Ach or His. However, the recovery time of the Rp was prolonged significantly after epidural anaesthesia (P