Objective To investigate the pharmacokinetics of propofol when combined with remifentanil in patients with liver cirrhosis.Methods Ten patients (5 males, 5 females) with liver cirrhosis scheduled for endoscopic esophageal varix ligation (test group) and 10 cases (5 males, 5 females) with normal liver function scheduled for gastroscopy (control group), aged 18-55 yr, weighing 40-75 kg, were studied. The patients were unpremedicated. All the patients received iv injection of propofol 1.5 mg/kg and remifentanil 0.5 μg/kg, and 5 min later propofol 0.5 mg/kg and remifentanil 0.2 μg/kg was given again. Blood samples were taken from radial artery before administration and at 2, 5, 10, 15, 20, 30, 45, 60, 80 and 120 min after administration for determination of the plasma propofol concentration using gas chromatography-mass spectrography. The pharmacokinetic parameters were calculated using DAS 2.0 software.Results The pharmacokinetics of propofol was best described by a three-compartment open model. There was no significant difference in the distribution half-life, elimination halflife , terminal half-life, area under the curve and transfer rate constant between the two groups ( P ＞ 0.05) . The apparent volume of distribution of propofol and clearance were significantly increased in test group compared with control group (P ＜0.01) .Conclusion When propofol combined with remifentanil is used in patients with liver cirrhosis, the apparent volume of distribution of propofol and clearance are significantly increased, while no changes in the other pharmacokinetic parameters are found.

Objective To determine the levels of plasma histamine and oxidative status in patients with dermatographism before and after the treatment with anti-histamine drugs. Methods Totally, 85 patients with dermatographism were randomly divided into two groups to receive oral desloratadine and cetirizine respectively for 4 weeks. Enzyme linked immunosorbent assay (ELISA) was performed to detect the plasma level of histamine, superoxide dismutases (SOD), glutathion peroxidase (GSH-PX) and malondialdehyde (MDA) in all the patients before and after the treatment and in 15 normal human controls. The efficacy of desloratadine and cetirizine for dermatographism was estimated. Results The response rate was 83.72% and 78.57% in patients treated with desloratadine and those with cetirizine, respectively (x2 = 0.369, P> 0.05). The untreated patients with dermatographism showed an elevation in the plasma level of histamine (3.87 ± 1.21 ng/ml vs. 1.76 ± 0.56 ng/ml, P< 0.05) and MDA (3.86 ± 1.03 nmol/ml vs. 2.19 ± 0.82 nmol/ml, P< 0.05), but a decline in the activity of SOD (86.29 ± 19.9 U/ml vs. 112.12 ± 27.88 U/ml, P< 0.05) and GSH-PX (74.52 ± 47.67 vs.915.06 ± 115.96, P< 0.05) compared with the normal human controls. The treatment with antihistamine induced a reduction in the plasma level of histamine (1.61 ± 0.47 ng/ml vs. 3.87 ± 1.21 ng/ml, P< 0.05) and MDA (2.65 ± 0.77 nmol/ml vs. 3.86 ± 1.03 nmol/ml, P< 0.05), but an increment in the activity of GSH-PX (921.46 ± 157.37 vs.74.52 ± 47.67, P < 0.05) with no changes of SOD in patients with dermatographism. Conclusions In patients with dermatographism, plasma histamine is increased and there is an imbalance of oxidation-antioxidation.Desloratadine and cetirizine are effective for the treatment of dermatographism.

Objective To investigate α-interferon (α-IFN) and cyclooxygenase-2 (COX-2)inhibitor celecoxib synergistically inhibit the growth of human liver cancer SMMC-7721 cells xenografts and tumor angiogenesis in a nude mouse model.Methods The effects of celecoxib and α-interferon on tumor volumes and weight were observed.The expressions of VEGF and Cox-2 were determined by immunohistochemistry and RT-PCR,and the effect of α-interferon on MVD also was observed by immunohisto chemistry.Results During the period of observation tumor volume increased progressively in control group,while it was suppressed obviously in other drug treatment groups.The average tumor volume was significantly smaller in celecoxib + α-IFN group than that in IFN group,celecoxib group and control group (P ＜ 0.01,respectively),its inhibitory rate was 61.84％.Immunohistochemistry showes that the VEGF and MVD was significantly smaller in celecoxib + IFN group than that in α-IFN group,celecoxib group and control group (P ＜ 0.01,respectively).RT-PCR shows that the COX-2mRNA and VEGF mRNA pression was lower in the celecoxib + α-IFN group than in α-IFN group,celecoxib group and control group (P ＜ 0.01).Conclusions The COX-2 inhibitor celecoxib and α-interferon synergistically reduces xenografts growth of human liver cancer SMMC-7721 cells effectively via suppressing tumor growth and angiogenesis.

Objective To evaluate the efficacy of high performance liquid chromatography (HPLC) for simultaneous determination of propofol and remifentanil concentrations in human plasma.Methods Methods Eighteen healthy volunteers of both sexes,aged 18-45 yr,weighing 52-81 kg,were enrolled in the study.Venous blood samples were collected,and the concentrations of propofol and remifentanil in human plasma were detected simultaneously by HPLC.The internal standard was thymol.Potassium dihydrogen phosphate 0.1 mol/L was added to the plasma and then the plasma samples were extracted with extract liquor (ethyl acetate ∶ hexane =4 ∶ 1,V/V).The analytical column was ZORBAX Eclipse XDB-C18 (4.6 mm×250 mm,5 μm).The mobile phase was methano ∶ 0.02 mol/L NaH2PO4 ∶ acetonitrile,the flow rate was 1.0 ml/min,the detection wavelength was 210 nm within 1-7 min,and 266 nm within 7-16 min,and the sample size was 20 μl.Linear regression analysis was performed by using the least-squares method.The specimens of the blood with the final concentration of remifentanil 1.00,5.00 and 20.00 ng/ml and propofol 0.50,2.00 and 10.00 μg/ml were obtained to determine the recovery,precision and stability.Results Linear regression equation of remifentanil was C=12.853 5Ai/As+0.084 8 (R2 =0.999 4),and this system showed a good linear relationship with the concentration of remifentanil ranged 0.5-40.0 ng/ml.Linear regression equation of propofol was C=8.554 3 Ai/As+0.029 1 (R2=0.998 6),and this system showed a good linear relationship with the concentration of propofol ranged 0.2-20.0 μg/ml.For both propofol and remifentanil concentrations,the relative recovery was within the range of 85％-115％,the absolute recovery was larger than 75％,and the relative standard deviation of intra-and inter-day precision and stability was less than 5％.The method was proved to meet the requirements of biological sample analysis.Conclusion For HPLC method established in this trial,the determination is sensitive,reproducible,rapid and simple,and it can be used for simultaneous determination of propofol and remifentanil concentrations in human plasma and for clinical pharmacokinetic research.

ObjectiveTo investigate clinical application of intraoperative intraperitoneal hyperthermic chemotherapy using sustained-release fluorouracil in radical gastrectomy for advanced gastric cancer.MethodsThe clinical data of 280 advanced gastric cancer patients admitted from September,2002 to September,2010 were analyzed retrospectively.They were divided into three groups randomly and followed up.The postoperative morbidity,the mortality and the overall survival rates were evaluated.ResultsThere were no significant differences in these three groups with respect to postoperative morbidity ( P ＞ 0.05 ).The incidence of recurrence in intraperitoneal chemotherapy using sustained-release fluorouracil ( treatment group) was significantly lower than those of intraperitoneal chemotherapy and operative treatment( 16.18％,37.61％ and 41.28％,P ＜0.05).The 1,3- and 5-year overall survival rates of treatment group were 85.51％,61.28％ and 53.67％,respectively,and the 1-,3- and 5-year overall survival rates were 84.11％,39.98％ and 28.12％,and 81.28％,29.88％ and 25.21％ respectively in intrapeitoneal chemotherapy group and operative group.1-year overall survival rate had no significant differences among three groups with respect to ( P＞0.05).3-and 5-year overall survival rates in treatment group were higher signfficantly than those of intraperitoneal chemotherapy and operative treatment( P＜0.05).Conclusions Intraoperative intrapeitoneal hyperthermic chemotherapy using sustained-release fluorouracil is a kind of convenient,safe,and highly effective comprehensive treatment method,and it can kill isolated intraperitoneal cancer cells.It may reduce postoperative recurrence and improve survival rates.

Objective To compare the effect of three-point positioning method and traditional puncture method in patients with arteriovenous fistula in hemodialysis.Methods A total of 800 hemodialysis patients with malignant tumor of urinary system in our hospital were divided into three-point positioning method group (observation group) and traditional puncture method group (control group), with 400 cases in each group.All the puncture was performed by the senior nurses with color Doppler, and vein intima thickness of artery fistula before puncture and 60 times after puncture were observed, puncture failure rate, incidence of venous fistula aneurysm, arteriovenous fistula stenosis and satisfaction were compared.Results There was no significant difference in vein intima thickness of artery fistula(P<0.05);The effect degree of vein intima thickness of artery fistula in the observation group after treatment was significantly lower than that of the control group, and the difference was statistically significant(P<0.05);The puncture failure rate, incidence of arteriovenous fistula aneurysm, and arteriovenous fistula stenosis rate in the observation group after 60 times puncture were significantly lower than that in the control group, and the differences were statistically significant(P<0.05);The satisfaction in the observation group was significantly higher than that in the control group, the difference was statistically significant (P<0.05).Conclusion Three-point positioning puncture combined with losartan has significant effect for arteriovenous fistula patients with the malignant tumor of urinary system, and it can effectively prolong longevity of vascular puncture, and reduce complications of vascular with fistula.

Objective To compare the effect of three-point positioning method and traditional puncture method in patients with arteriovenous fistula in hemodialysis.Methods A total of 800 hemodialysis patients with malignant tumor of urinary system in our hospital were divided into three-point positioning method group (observation group) and traditional puncture method group (control group), with 400 cases in each group.All the puncture was performed by the senior nurses with color Doppler, and vein intima thickness of artery fistula before puncture and 60 times after puncture were observed, puncture failure rate, incidence of venous fistula aneurysm, arteriovenous fistula stenosis and satisfaction were compared.Results There was no significant difference in vein intima thickness of artery fistula(P<0.05);The effect degree of vein intima thickness of artery fistula in the observation group after treatment was significantly lower than that of the control group, and the difference was statistically significant(P<0.05);The puncture failure rate, incidence of arteriovenous fistula aneurysm, and arteriovenous fistula stenosis rate in the observation group after 60 times puncture were significantly lower than that in the control group, and the differences were statistically significant(P<0.05);The satisfaction in the observation group was significantly higher than that in the control group, the difference was statistically significant (P<0.05).Conclusion Three-point positioning puncture combined with losartan has significant effect for arteriovenous fistula patients with the malignant tumor of urinary system, and it can effectively prolong longevity of vascular puncture, and reduce complications of vascular with fistula.

Objective To generate and identify the Itgbl1(integrin beta-like)promoter-driven Cre knock-in mouse line.Methods Itgbll-Cre knock-in mice were generated using clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated protein 9(Cas9)gene editing.The Itgbl1-Cre mice were crossed with the Cre reporter ROSALSL-tdTomato)mice to detect the expression profile of Cre activity.The tdTomato expression pattern across tissues and cell-specific markers were used to identify the cell types of Itgbl1-expressing cells and their progeny.Results and Conclusion tdTomato was specifically expressed in mucous acinar cells of the sublingual gland,pancreatic islet cells,and gastric endocrine cells.In addition,tdTomato expression was also found in some of the neurons of the retina and brain,as well as in a few cells in the serosal layer of the intestine,articular cartilage,periosteum,and bone marrow.The first Itgbl1-Cre recombinase transgenic mouse line was established,which can specifically label the mucous acinar cells of the sublingual gland.

Purpose/Significance To construct a specialized database for inflammatory demyelinating disease of the central nervous system(CNS),so as to contribute to clinical research and improve the diagnostic and treatment capabilities of primary healthcare institu-tions.Method/Process Using the internet to collect medical data,after processing and analysis,the CNS inflammatory demyelinating disease database is constructed.Using statistical analysis,natural language processing(NLP),artificial intelligence(AI)image recog-nition and data visualization and other technologies,the database information is integrated and analyzed.Result/Conclusion A standard-ized big database for CNS inflammatory demyelinating diseases is constructed,which enables visualization of clinical research data,pro-vides patient education and specialist training,and facilitates multi-center teleconsultations.The establishment of a specialized database for the CNS inflammatory demyelinating disease can promote the transformation of medical research achievements,provide references for future real-world clinical research,optimize the process of diagnosis and treatment,and improve the clinical capability of primary healthcare institutions.