Objective This research examined the effect ofmicrobubble contrast agent plus ultrasound on the permeability of blood-brain barrier,and explored whether it affects the efficacy of chemotherapeutic drugs on cerebral glioblastoma.Methods Wistar rats were divided into three groups to find the optimal concentration of ultrasonic contrast agent.To identify the best ultrasound mode that affected the permeability of blood brain barrier,we employed transmission electron microscopy for study of brain ultrastructure.Western blotting was used to detect the tight junction protein claudin-5.Evans blue staining of brain tissues was utilized to identify the best ultrasonic contrast agent concentration and mode.Rat glioma cells (line 9L) were injected into Wistar rats.After temozolomide chemotherapy,the tumor size was measured and the tumor marker GFAP in serum was detected by ELISA.Results The best contrast agent concentration which increases permeability of BBB in rats was found to be lml/kg and the best ultrasound mode was intermittentlytriggered pulses lasting for 10min (with interval was set at 400ms).More Evans blue passed the blood-brain barrier in ultrasonic cavitation effect group than in control group (P＜0.05).After temozolomide chemotherapy,more tumor marker GFAP was detected in ultrasonic cavitation effect group than in control group (P＜0.05).Conclusion The permeability of BBB was increased and more temozolomide went through BBB when the rats were subjected to intermittently triggered ultrasonic pulses and were injected at contrast agent at lml/kg,which could help to achieve better therapeutic efficacy for glioblastoma.

Objective To investigate the clinical characteristics,diagnosis and treatment of pelvic abscess complicated with septic shock.Methods The clinical symptoms,laboratory tests,surgical procedures,and prognosis were analyzed retrospectively for 9 patients with pelvic abscess complicated with septic shock.All the patients were treated in the Second Affiliated Hospital of Soochow University from August 2009 to March 2017.Results High fever and abdominal pain were reported in all the 9 patients,associated with hypotension,cardiac,pulmonary and renal dysfunction,and other symptoms.Eight patients were referred to ICU after early volume resuscitation,antimicrobial treatment,surgery or puncture.These 8 patients finally survived.The remaining one patient experienced multiple organ failure,disseminated intravascular coagulation,and extensive bleeding during treatment,and died finally.Conclusions Early diagnosis,adequate volume resuscitation,antimicrobial therapy,appropriate vasoactive drugs,and timely surgical removal of abscess are important for improving the survival of patients with pelvic abscess and septic shock.