Objective The aim of this study was to explore possible pharmacokinetic factors and develop a population pharmacokinetic model for remifentanil in adult patients.Methods Eleven healthy patients,undergoing elective major abdominal surgery,aged 25 to 86 years,received random-ly remifentanil 0.3μg·kg-1 ·min-1 (group R3),or 0.6μg·kg-1 ·min-1 (group R6).Frequent ar-terial blood samples were drawn according to predetermined time and assayed for remifentanil concen-tration.Nonlinear mixed-effects modeling (NONMEM)was used to evaluate the time courses of the measured concentrations.The covariates include age,bodyweight (WT),gender,lean body mass (LBM),body mass index (BMI)and body surface area (BSA).Results The pharmacokinetic data of remifentanil were well described using a three-compartment linear model with first-order elimination from the central compartment.Forward analysis showed that age,height and body mass index (BMI) does not affect the pharmacokinetic parameters,which are contrast with body weight,lean body mass (LBM),body surface area (BSA)and gender;further analysis demonstrated only a significant effect of body weight on remifentanil systemic clearance (CL)and volume of the central compartment (V). For typical 60 years patients,PK parameters were:V1 =7.64 L,V2 =4.81 L,V3 =4.34 L,CL1 =2.74 L/min,CL2 = 0.738 L/min,CL3 = 0.0905 L/min.Conclusion The pharmacokinetics of remifentanil is consistent with its rapid elimination by blood and tissue esterase in Chinese patients. The systemic clearance and volume of distribution of central compartment increases with body weight in the population and the range of covariates studied,which suggests that a patient with greater body weight needs a greater initial dose and maintenance infusion rate higher to obtain a stable plasma con-centrations and clinical effects.

Objective To study prognosis of patients with fulminant hepatitis after plasma ex- change treatment using model for end-stage liver disease(MELD)scoring system.Methods 160 pa- tients were randomly divided into plasma exchange group and control group,and MELD score was calculated according to the original formula for each patient.The efficacy of plasma exchange was as- sessed by mortality and improvement in biochemical parameters and MELD score.Results The levels of total bilirubin(TBIL),INR and MELD score of patients whose MELD scores were between 30 and 40[TBIL,(379.4?40.4)?mol/L; INR,2.5?0.2; MELD,30.8?3.8]were lower than before PE treatment[TBIL,(509.7?64.6)?mol/L;INR,3.5?0.3;MELD,37.3?3.5].The levels of TBIL and INR and MELD score of patients whose MELD scores were higher than 40 [TBIL,(595.6?61.5)?mol/L;INR,3.8?0.4;MELD,39.8?3.5]were lower than before PE treatmem [TBIL, (650.4?66.3)?mol/L;INR,4.4?0.6;MELD,45.2?4.2].The mortality of patients in PE group with MELD score from 30 and 40 was 50.0%,while it was 86.7% in control group,showing significant differ- ence between PE group and control group(P＜0.01).The mortality of patients with MELD scores higher than 40 was 91.2% in PE group and 100% in control group,showing no significant difference between these two groups(P＞0.05).Conclusions Plasma exchange treatment can decrease the serum TBIL level, INR and MELD score of patients with fulminant hepatitis and improve liver function.Compared with the control group,plasma exchange can significantly decrease the mortality of patients in PE group with MELD score from 30 to 40,but no effect on patients with MELD score higher than 40.

Objective To explore the efficacy of postoperative transarterial chemoembolization (TACE) and portal vein chemotherapy (PVC) for hepatocellular carcinoma (HCC) patients complicated with portal vein tumor thrombus (PVTT). Methods One hundred and eleven HCC patients with PVTT were randomly divided into three groups receiving respectively tumor resection only ( group A) , resection plus TACE ( group B) , and resection plus TACE and PVC ( group C). Results (1) Group B had significantly lower recurrence rates at 0. 5- and 1-year, and higher survival rates at 0. 5-year compared with group A (P

Bone Cysts, Aneurysmal ; diagnostic imaging ; pathology ; surgery ; Cartilage Diseases ; diagnostic imaging ; pathology ; surgery ; Female ; Hamartoma ; diagnostic imaging ; pathology ; surgery ; Humans ; Infant ; Mesoderm ; diagnostic imaging ; pathology ; surgery ; Nasal Cavity ; diagnostic imaging ; pathology ; surgery ; Neoplasm Recurrence, Local ; Nose Diseases ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed

Objective To investigate the effect ofYindanxinnaotong (YDXNT) capsule on learning and memory abilities, super oxide dismutase (SOD) activity and malondialdehyde (MDA) content in the hippocampus of rat models of vascular dementia (VD). Methods Animals were randomly divided into sham-operated group,VD vehicle group (Group VD) and YDXNT treatment group (Group VD+YDXNT); the 4-vessel occlusion was employed to establish the VD rat models in the Group VD and Group VD+YDXNT,while rats in the sham-operated group were not performed occlusion of the bilateral common carotid artery.Rats of the Group VD+YDXNT were given 1 mL liquid (9 granules of YDXNT into 360 mL normal saline) through intragastric administration 3 times daily for a consecutive 4 weeks; and rats of the other 2 groups were given the same volume of saline.The changes of learning and memory abilities were observed by Morris water maze test; the activity of SOD and the content of MDA in the hippocampus were measured. Results As compared with those in rats of the Group VD, the learning and memory abilities in rats of the Group VD+YDXNT were significantly improved (P＜0.05):time in finding the platform was obviously decreased and swimming distance in finding the platform was obviously shortened in rats of Group VD+YDXNT.As compared with those in rats of the Group VD,the activity of SOD in the hippocampus was significantly increased and the content of MDA was obviously decreased in rats of the Group VD+YDXNT (P＜0.05). Conclusion YDXNT could increase oxygen radical metabolism to improve the learning and memory abilities of rats with VD.

Background The domestic and international researches discovered that many proteins and enzymes of the extracellular matrix (ECM) participate in the sclera remodeling by affecting the collagen typeⅠand fibronectin.Objective This study was to investigate the effect of matrixmetalloproteinase-2 (TIMP-2) on expression of collagen typeⅠand fibronectin of ECM in the posterior sclera by injecting liposomes containing tissue inhibitor of TIMP-2 gene into suprachoroidal space of the form-deprivation myopia in guinea pig.Methods Form-deprivation myopia was induced by translucent goggles in 36 clean guinea pig for 2 weeks.Then the animals were randomly assigned to TIMP-2 group,empty plasmid group,saline group and 12 for each group.Liposomes of 5μl containing TIMP-2 gene,empty plasmid and saline were suprachoroidally injected in the right eye respectively,and the left eyes without any treatment were used as self-control group.Other 12 matched guinea pigs only covered the right eyes through out the experimental duration as model control group.The guinea pigs were sacrificed and the posterior sclera tissue of the eyeballs were collected at 2,7 and 14 days after injection of drug.The expressions of collagen typeⅠmRNA and fibronectin mRNA were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR).This study followed the Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The expression level of collagen type Ⅰ mRNA in the posterior sclera of guinea pig was lower but that of fibronectin mRNA was higher in TIMP-2 group than self-control group,showing significant differences between them (P＜0.05).The expression level of collagen type Ⅰ mRNA in the posterior scleral tissue began to increase from the 2nd day after drug injection and was obviously elevated at the 7th day and then gradually decreased at the 14th day.However,the expression level of fibronectin mRNA in the posterior scleral tissue showed the opposite pattern.The expression levels of collagen typeⅠmRNA and fibronectin mRNA at the 7th after drug injection were significantly lower than that at the 2nd day or 14th day (P＜0.01).Conclusion Suprachoroidal injection of TIMP-2 in form-deprivation myopia could up-regulate the expression of collagen typeⅠmRNA and down-regulate the expression of fibronectin mRNA in the posterior scleral tissue.It may slow down the sclera remodeling of form-deprivation myopia in guinea pig in the early stage.

Objective To compare the therapeutic effect of the combination of ~(99m)Tc-methnetium methylene diphosphunate and colloidal chromic,phosphate ~(32)p with the monotherapies in rats with adjuvant arthritis(AA).Methods In this study,50 Sprague-Dawley rats were randomly divided into five groups with 10 rats in each:normal control group(arthritis induced and treated with the same volume of normal saline via the same administration route),AA control group(arthritis induced with adjuvant and treated with normal sa- line),~(32)p colloid group(arthritis induced with adjuvant and treated with single intra-articular injection of col- luidal chromic phosphate ~(32)p 0.74 MBq and intra-peritoneal injection of normal saline every other clay),~(99m)Tc- MDP group(arthritis induced with adjuvant and treated with intra-peritoneal injection of ~(99m)Tc-MDP 2.5?10~(-3)?g/kg every other day and single intra-articular injection of normal saline),combination group(arthritis in- duced with adjuvant and treated with the combination of the two drugs).The diameter of the left hind ankle, serum levels of turnout necrosis factor(TNF)and interleukin-1?(IL-1?),and the pathological changes of an- kle joints were tested at different time points.Results The diameter of the left hind ankle at week 4 was smaller in the combination group than that of the ~(32)p colloid treatment alone group [(7.11?0.34)mm vs(7.57?0.29)mm,P

Objective:To explore clinical and histopathological characteristics of primary biliary cirrho-sis-autoimmune hepatitis overlap syndrome.Methods:Clinical data and pathological findings of 10 pa-tients were reviewed.Results:Serum glutamine transpeptidase,alkaline phosphatase levels,alaninetransaminase,aspartate transaminase,serum IgG and IgM were elevated in all the patients.They were allpositive for anti-mitochondrial antibody and AMA-M2.Nine patients were positive for anti-nuclear anti-body and one patient was positive for anti liver-kidney microsome antibody.Liver biopsies in these pa-tients revealed:ten patients had bile duct lesion,hepatitis activities ranged from moderate to severe,andfibrosis ranged from S1 to S3.Conclusion:PBC-AIH overlap syndrome is mostly found in middle-agedwomen.It has the clinical and histopathological characteristics of both PBC and AIH.Accurate andprompt diagnosis of overlap syndrome patients should be based on the clinical presentation,biochemicaland immune indexes,and hepalic pathological changes.

Objective To investigate the impact of fatty liver and its related factors on the effi- cacy of antiviral therapy in patients with chronic hepatitis C.Methods ninety-eight patients with chronic hepatitis C were treated with 180?g peginterferon?-2a plus ribavirin.Hepatitis C virus (HCV) genotypes were measured by enzyme-linked immunosorbent assay (ELISA) and fatty liver were detected by ultra sonography.The body mass index (BMI),waist to hip ratio (WHR) and ho- meostasis model assessment of insulin resistance (HOMA-IR) were calculated.The serum HCV RNA level was determined by polymerase chain reaction (PCR) and serum insulin level was detected by chemiluminescence analysis.The impact of fatty liver and its related factors on the efficacy of antiviral therapy were analyzed by multivariate Logistic regression analysis.Results Of 98 patients with chro- nic hepatitis C,35 (35.7%) were genotype 1,41 (41.8%) were genotype 2,13 (13.3%) were gen- otype 3,9 (9.1%) were undetermined genotype.The incidence of fatty liver in HCV infection of genotype 1,2,3 and undetermined genotype was 11.4%,9.8%,38.5% and 11.1%,respectively (X~2=7.83,P

Objective To explore the effects of smoking and alcohol drinking on arsenic metabolism of people exposed to different concentrations of arsenic in drinking water.Methods Residents in Shanxi exposed to different concentrations of arsenic in drinking water and age ≥ 18 years old adults were chosen as the subjects for this study in 2008,the subjects were divided into three groups according to the concentrations of arsenic in drinking water: high-arsenic exposure group (more than 0.05 mg/L),low-arsenic exposure group (between 0.01 and 0.05 mg/L) and control group(less than 0.01 mg/L),excluded recently had eaten seafood and had poisoning symptoms of chronic arsenic in drinking water in the crowd.Smoking and alcohol drinking habits were investigated by questionnaire.Arsenic species in the urine samples were detected with hydride generation atomic absorption spectroscopy.Total arsenic(tAs) was the sum of iAs％,MMA％ and DMA％.iAs％,MMA％ and DMA％ were calculated as iAs/tAs,MMA/tAs and DMA/tAs,respectively.The first methylation ratio(FMR) and the secondary methylation ratio(SMR) were calculated as (MMA + DMA)/tAs and DMA/(MMA + DMA),respectively.Results Three hundred and ninety-five adults were chosen in this study.In the high exposure group the alcohol drinking and smoking subjects had higher MMA％(16.24％) but lower SMR(82.19％ ) than the non-drinking and non-smoking subjects (12.16％ and 86.13％,respectively).The differences of both MMA％ and SMR were significant(P ＜ 0.05 ).No significant difference was observed between the non-smoking/non-drinking subjects and the smoking or the drinking subjects(all P ＞ 0.05 ).In the low exposure group there were higher MMA％( 13.86％,13.99％) lower DMA％(72.87％,77.76％)and lower SMR (83.48％,83.90％ ) in those with smoking or drinking/smoking compared with the non-drinking and non-smoking subjects (11.83％,80.35％ and 86.54％,respectively,all P ＜0.05 ).No significant difference was observed between drinkers and non-drinking/non-smoking subjects(P ＞ 0.05).In the control group there were a higher MMA％( 17.27％,17.06％) lower DMA％ (73.89％,72.29％) and lower SMR (81.48％,82.58％ ) in those with smoking or drinking/smoking compared with the non-drinking and nonsmoking subjects( 11.52％,79.68％ and 87.19％,respectively,all P ＜ 0.05).No significant difference was observed between drinkers and the non-drinking/non-smoking subjects (all P ＞ 0.05).ConclusionThe arsenic methylation capacity of people with drinking and smoking is poorer than that of non-drinking and non-smoking subjects after arsenic exposure.