AIM To study the effects of cyclophosphamide (CTX) on the pharmacokinetics of buthionine sulfoximine (BSO)in Walker 256 tumor bearing rats. METHODS Walker 256 tumor bearing rats were treated ip for 4 days with saline or CTX in saline (20 mg?kg -1 ), then received iv BSO 200 mg?kg -1 . BSO concentration in rat plasma was determined by a reverse phase HPLC with fluorescence detection after precolumn derivatization with o phthaldialdehyde. Compartment model and pharmacokinetic parameters were determined by 3P87 software processed on a computer. RESULTS A single intravenous dose of BSO 200 mg?kg -1 was eliminated from plasma in a two compartment manner in tumor bearing rats. The pharmacokinetic parameters of BSO were as follows: In tumor bearing control rats, T 1/2? =(11 1?2 4) min, T 1/2? =(65?14) min, CLs=(12 8?1 3) ml?min -1 ?kg -1 , AUC=(262?26) mg?L -1 ?h; in tumor bearing CTX treated rats, T 1/2? =(8 2?1 8) min, T 1/2? =(42?3) min, CLs=(13 4?1 9) ml?min -1 ?kg -1 ,AUC=(252?35) mg ?L -1 ?h. CONCLUSION There is no significant difference between the parameters of tumor bearing control and CTX treated rats except T 1/2? .

Prostaglandin F2? ( PGF2? ) in the brain cortex was measured in mice which were devided into 3 groups, ie sham operation group, cerebral ischemia group and reperfusion after cerebral ischemia group, treated with saline or clonidine ( 0 .15~1 .Omg/kg ) , respectively. The results showed that the PGF2? level in the ischemia group treated with saline was higher than sham operation group, but the PGF2? level in reperfusion group was the highest in all groups. Compared with saline, clonidine decreased the PGF2? levels either in the ischemia group or the reperfusion group significantly . This may be useful to attenuate the brain lesion caused by PGF2? .

Buthionine salfoximine (BSO) is a chemotherapeutic sensitizor under clinical trial. BSO can reverse multidrug resistance in vitro and in vivo. The author reviewed the mechanism, pharmacodynamics, pharmacokinetics and the progress in clinical research of BSO. BSO is a selective inhibitor of 7-glutamylcysteine synthetase, the rate-limiting enzyme in gluthionine synthesis. Depletion of intracellular gluthionine by BSO can reverse tumor resistance to chemotherapeutic a-gents such as platinating and alkylating agents. In tumor-bearing animals BSO enhanced the therapeutic index of chemotherapeutic agents. Animals treated with BSO had a longer life span. Pharmacokinetics of BSO was a two-compartment manner in mice, dogs and huamn beings. The efficacy of BSO in cancer patients is being investigated in clinical trial.

Asymptomatic bacteriuria is common in diabetic patients. This article reviews several aspects of asymptomatic bacteriuria in diabetes mellitus, including prevalence, mechanisms, coexisting risk factors, bacteriology, treatment and prognosis.

Objective To summarize the previous work experience and loss of function in the development process of hospital modernization of sterile supply room,and discuss the model of centralized treatment and unified supply.Methods Through investigation in the clinical departments,various roles and regulations of sterile supply room were established,especially the various job responsibilities,operating procedures,disinfection and isolation system,the quality management system,testing system,equipment and apparatus management systems,traceability systems,continuous quality improvement process and goods recall system.The system had performance appraisal,workilow management and other methods to enhance the staff's self-discipline,to strengthen humanities education for sterile supply room staff,strict execution of the standards and norms of Health Ministry,to enhance the legal awareness,establish and improve the sterile supply room management systems and service system.Results Implementation of centralized treatment can effectively prevent nosocomial infection,reduce the spread of pollution to ensure medical safety,reduce staff input that help ensure the professional quality and reduce the economic costs,and promote the professional development of sterile supply.Conclusions Centralized treatment of multiplexing medical apparatus and instruments promotes the all-dimensional development of sterile supply room,which is worthy of wide application.

Objective:To determine whether lornoxicam has a preemptive analgesic effect to the patients who undergo modified radical mastectomy.To study the effect of lonoxicam on platelet function and investigate the surface expression of p-selectin on platelet by a flow-cytometric assay.Methods:After obtaining a written informed consent from patients,sixty ASAⅠ-Ⅱpatients,aged 40-60 yr,weighted 40-60 Kg,who were scheduled for modified radical mastectomy were included in the study.All patients were randomly divided into two groups.Patients underwent breast surgery under general anesthesia,Group I was administered 16mgof lornoxicam iv.30 minutes prior to surgery,Group Ⅱ was administered 4 mL placebo.Two mL blood was drawn from a peripheral vein to analyze the surface expression of p-selectin on platelet,blood sample was collected at three time points:30 minutes prior to surgery,6h and 24h after surgery.Introoperative blood loss and the volume of drainage fluid 24h,48h,and 72h after surgery was documented;PONV and other side effects was recorded.The rescue analgesics was recorded.Result:Group I demonstrated reduced pain scores compared to Group Ⅱ at three specific time points;Great difference for the expression of p-selectin on platelet at certain time point in each group was noted,the postoperative express was higer than that of the preoperation;there were no difference for the expression of p-selectin on platelet between two groups.There were no difference in introoperative blood loss and the volume of drainage fluid between two groups;Great difference for the rescue analgesics was recorded,GroupⅡdemends more analgesics than GroupⅠ.The rate of PONV was similar between two groups,no other side effects were recorded.Conclusion:Lornoxicam administered preemptively appears to reduce pain scores after surgery,which can improve the quality of postoperative analgesia.Lornoxicam has no significant effect on platelet activation and aggregation with only one dose before surgery,there is no effect in the quality of blood coagulation.Lornoxicam may be safely used in perioperative period.

Objective To analyze the correlation of C -reactive protein level and acute cerebral hemorrhage prognosis,provide the evidence for determining the condition and prognosis.Methods 163 patients with acute spon-taneous intracerebral hemorrhage met selection criteria in Yantai Economic and Technology Development Area Hospi-tal were selected as the study objects,the CRP were detected by immunoturbidimetry in the 1 day,3 days,7 days, 14 days after admission,the NIHSS were calculated,48 cases of healthy people were selected as the control group,the CRP between hemorrhage group and the healthy control group,patients with different brain hemorrhage,patients with different neurological deficit were compared.Results (1 )The C -reactive protein of cerebral hemorrhage group when admission were (8.92 ±1.0)mg/L,the control group were (4.25 ±0.23)mg/L,the C -reactive protein of cer-ebral hemorrhage group were significantly higher than that of the control group,the difference was statistically signifi-cant,t =-3.683,P <0.01.(2)The mean serum CRP after admission admission 1,3,7,14d were (9.34 ±1.65) mg/L,(9.56 ±1.58)mg/L,(6.58 ±1.17)mg/L,(4.98 ±1.26)mg/L,the CRP was a large rise in the course of the disease 1d,3d peak,F =7.487,P <0.05,the CRP had difference between large amount of brain hemorrhage,moder-ate amount of brain hemorrhage,and small amount of brain hemorrhage,a large amount of patients with cerebral hem-orrhage CRP levels were higher than a moderate amount of patients with cerebral hemorrhage and a small amount of patients with cerebral hemorrhage 1,3 and 7d,during which the difference was statistically significant(F =3.31, 4.62,4.21,P <0.01 or P <0.05).(3)The CRP peak levels of different degrees of neurological deficits in patients with acute cerebral hemorrhage decreased in 3d,7d,14d,the CRP of 3d were higher than that in 1d,the CRP of 7,14d were lower than that in 1d,CRP levels between different neurological deficits degree of acute cerebral hemorrhage were also significantly different (F =4.29,5.32,3.62,3.21,P <0.05 or P <0.01),the CRP levels of Severe neurological deficit in 1d,3d,7d,14d were significantly higher in mild and moderate neurological deficit (t =6.567,4.241, 4.010,3.511 and 4.965,3.031,3.104,3.009,P <0.05 or P <0.01 ).Conclusion The serum CRP levels of patients with acute cerebral hemorrhage significantly increased,the serum CRP level shows dynamic changes in the first three days of the onset of peak,the CRP levels significantly correlated with the prognosis of cerebral hemorrhage, the more severe neurological deficit,the greater the amount of cerebral hemorrhage,higher serum CRP levels.

To analyze and research the transformation of teaching thoughts,adjustment of professional teachers,renewal of teaching contents and so on,and establish the foundation for the revolution of professional English teaching in medical university under the new situation.

Objective:To use the perineum four-dimensional pelvic ultrasound stereo imaging for detecting injury situation of pelvic diaphragm hiatus and anal levator ani muscle. Understand abnormal classification of pelvic floor muscle. investigate the application of four-dimensional pelvic ultrasound stereo imaging in pelvic floor dysfunction (PFD) for primipara in order to provide more accurate data for clinical practice.Methods: 270 primiparas with pelvic floor dysfunction were divided into the vaginal delivery group (135 cases) and selective cesarean group (135 cases) as random number table; pelvic floor muscle strength, longitudinal diameter, transverse diameter, area of pelvic diaphragm hiatus and thickness of the anus levator were detected by the perineum four-dimensional pelvic ultrasound stereo imaging, respectively, and then to compare differences between the two groups. Results: In 270 cases, 162 cases (60%) were abnormalities in pelvic floor muscle strength, and 189 cases (70%) were abnormalities in vaginal pressure; the results of pelvic floor muscles fatigue grade situation revealed: 127 cases were abnormal muscle fiber strength ofⅠtype (47%), 30 patients were abnormal muscle fiber strength ofⅡ type (11%). There were no significant differences between the two groups in the abnormal rate of pelvic floor muscle strength, vaginal pressure and muscle fiber strength. Longitudinal diameter, transverse diameter and area of pelvic diaphragm hiatus in the vaginal delivery group were higher than that in the selective cesarean group, while thickness of anal levator were thinner than that in the selective cesarean group with significant differences (t=3.730,t=3.467, t=3.826,t=1.809;P<0.05).Conclusions: The perineum four-dimensional ultrasound diagnosis can intuitively and clearly show morphological characteristics of female pelvic diaphragm hiatus, therefore, it can quickly finish diagnosis, and provide the basis for clinical diagnosis and treatment evaluation of postpartum PFD.

Objective To assess whether mTOR was activated in peripheral T lymphocytes of acute coronary syndrome (ACS)patients and to investigate the relationship among mTOR,regulatory T cells and cytokins. Methods Patients with acute coronary syndrome (n=32) were selected in ACS group. Meanwhile, patients who complainted of chest pain but were proven to be normal in ECG and in coronary arteriography, were excluded as ACS patients but were diagnosed as Chest Pain Syndrome (CPS) and selected in CPS group (n=28). The expression levels of mTOR, phospho-p70S6KT389 (indicative of mTORC1 activity) and phospho-AKTS473(indicative of mTORC2 activity) were investigated in T cells, which were isolated from peripheral blood of patients in ACS group or CPS group, using Western blot. The proportion of CD4+CD25+Foxp3+Tregs over CD4+cells were evaluated by FACS. And T cell subset related cytokines such as IFN-γ, IL-4, IL-17 and TGF-β1 were exam?ined by ELISA. Then we investigated the relationship among mTOR,regulatory T cells and cytokins by Spearman analysis. Results mTOR and p-p70S6KT389 expression were significantly enhanced in ACS group as compared with those in patients from CPS group (P<0.01). Higher levels of IFN-γ, IL-17 but lower level of TGF-β1 cytokines as well as decreased propor?tion of Tregs were observed in ACS group than those in CPS group (P<0.05). There was no significant difference in the level of IL-4 and p-AKTS473 between the two groups (P>0.05). By correlation analysis, p-p70S6KT389 expression level positively correlated with IFN-γ, IL-17(rs=0.91,092,P<0.01)and negatively correlated with Tregs and TGF-β1(rs=-0.85,-0.80, re?spectively, P<0.01). Conclusion mTORC1 pathway was activated in peripheral T lymphocytes of ACS patients, and Tregs insufficiency and cytokins imbalance both contribute to the activation of mTORC1 pathway and pathological process of ACS.