Objective To investigate the effect of ketamine injected via the radicular arteries on spinal cord. Methods Twenty healthy mongrel dogs of both sexes weighing 12-18 kg were randomly divided into 2 groups ( n = 10 each): control group (group C) and ketamine group (group K). The animals were anesthetized with intravenous pentobarbital 30-35 mg/kg, fentanyl 50-100 μg and vecuronium 0.2 mg/kg and maintained with propofol ically ventilated after tracheal intubation. A catheter was inserted into T8 poster intercostal artery and advanced toward the opening of radicular artery which supplies the spinal cord. Ketamine 100 mg (in 2 ml of normal saline)was injected via the catheter in group K. Three hours after ketamine administration, the animals were sacrificed. A 1.5 cm long segment of spinal cord at the level of T8 was removed for microscopic examination and determination of the expression of NSE, S100β and Tau protein by immuno-histochemistry. Results There was no significant difference in the number of Nissl' s staining-negative neuronal cells and the expression of NSE, S100β and Tau protein in the spinal cord between the 2 groups ( P ＞ 0.05 ). Conclusion Ketamine injected via the radicular arteries does not induce spinal cord injury.

Purpose:To investigate the effectiveness of intralymphatic infusion of anti- cancer agents and cytokines in the treatmrnt of malignancy.Materials anti methods:23 patients suffering from advanced metastatic cancers anti 2 primary lymphomas,unresponsble to the standard therapies or intra-arterial chemotherapy,were treated with lymphatic injections of an- ticancer ddrugs or combiation with biochemotherapy.Results:Follow-up study about one month after the therapy,comparing with findings on lymthatic radiographies anti computed tomographic scans,revealed decrease of lymphnodes in size in 23 cases.Conclusion:This therapeutic ap- proach proved to be an effective and safe method for the palliative treatment of advanced lym- phatic metastases and lymphomas.The procedure was feasible without serious compllications.

Objective To investigate the efficacy and safety of the combined therapy of cyclophosphamide and thalidomide in the treatment of refractory Crohn's disease (CD).Methods This study was a prospective and open study.A total of 15 patients with refractory CD were enrolled.All patients received intravenous cyclophosphamide 200 mg every other day for two weeks,then followed by intravenous 400 mg once a week until the cumulative dose reached 6 to 8 g.when the cyclophosphamide treatment started,at the same time thalidomide was taken 25 to 75 mg every night according to the tolerance of patients.Before the treatment,two weeks' after the treatment and at the time when the cumulative dose of cyclophosphamide reached 6 to 8 g,Crohn's disease activity index (CDAI),hemoglobin (Hb),white blood cell (WBC) count,erythrocyte sedimentation rate (ESR) and high-sensitivity C-reactive protein (hs-CRP) were recorded.Endoscopy examination was conducted before the treatment and at the time when the cumulative dose of cyclophosphamide reached 6 to 8 g.The condition of mucosa healing was observed and scored by simple endoscopic score for crohn's disease (SES-CD).Adverse effects of all patients were monitored.Paired t test was performed for statistical analysis.Results Before the treatment,the CDAI of 15 patients with refractory CD was 235.87±59.87,two weeks after the treatment the CDAI declined to 135.33 ± 29.23,and the difference was statistically significant (t=7.50,P＜0.01).Before the treatment,ESR and hs-CRP was (42.13±22.80) mm/1 h and (13.73± 2.18) mg/L.Two weeks after treatment they declined to (23.80±16.63) mm/1 h and (5.77±4.77) mg/L,and the differences were statistically significant (t=2.43 and 6.17,both P＜0.05).After two-week treatment,10 patients achieved clinical remission.After the cumulative dose of cyclophosphamide reached 6 to 8 g combined therapy,CDAI of patients was 108.14 ± 47.10,which decreased significantly compared with that before treatment (t=6.30,P＜0.01).ESR,hs-CRP and WBC count was (19.35± 19.18) mm/1 h,(6.16± 5.02) mg/L and (6.28 ± 3.42) × 109/L,respectively,which decreased compared with those before treatment,and the differences were statistically significant (t=5.90,5.40 and 3.71,all P＜0.01).Twelve patients achieved clinical remission.And the lesions of 12 patients improved under endoscope,furthermore,the mucosa of four patients healed.Before the treatment,SES-CD was 9.14 ± 5.39,which declined to 5.07 ± 4.58 after the treatment,and the difference was statistically significant (t =3.14,P ＜ 0.01).During the treatment,five patients had adverse effects.Alanine aminotransferases (ALT) increased in three patients,WBC count decreased in one patient and one patient got a severe urinary infection.Conclusions Patients with refractory CD could achieve clinical remission,mucosa healing under endoscopy and better efficacy with the combined therapy of cyclophosphamide and thalidomide.However,adverse effects should be monitored during the treatment.

Background/Aims: Data on the natural course of Chinese patients with ulcerative colitis (UC) was lacking. This study aimed to evaluate the natural history and prognosis of patients with UC in the past 15 years in China. Methods: This cohort study included patients with UC in a tertiary hospital in southern China from 2007 to 2021 (cohort I: 2007–2011, cohort II: 2012–2016, cohort III: 2017–2021). Patients’ clinical characteristics and natural history were analyzed retrospectively. Results: Of 1,139 included patients, 683 patients presented with proctitis or left-sided colitis at diagnosis and 38.5% of them (263/683) developed proximal disease extension. Fifty-eight percent of patients experienced relapse, chronic continuous and intermittent active course. Five patients (0.4%) developed colorectal tumors/dysplasia. The overall surgery rate was 8.6%, and the rates were 14.2%, 7.8%, and 8.0% in the 3 cohorts, respectively (P= 0.059). Average time from diagnosis to surgery decreased from cohorts I to III (144 months vs. 36 months, P< 0.001), so did the use of glucocorticoids (58.2% vs. 43.5%, P< 0.001) and immunosuppressants (14.1% vs. 13.4%, P= 0.016), and days of hospitalization (13 days vs. 9 days, P< 0.001). Biologics were used more frequently during the first year (0.8%, 2.1%, and 13.7% for cohorts I to III, respectively; P< 0.001). The rate of mucosal healing increased over time. Conclusions In Chinese UC patients, one-third of patients experienced proximal disease extension. The rates of malignancy and mortality were low. More biologics were used, while use of immunosuppressants and glucocorticoids were reduced over time. Early biologics use seemed to promote mucosal healing, but the rate of colectomy has not dramatically decreased.

OBJECTIVE To explore the effects of the expression of serum Sirtuin-1 （SIRT1） on therapeutic efficacy of sodium valproate （VPA） in the treatment of epilepsy patients. METHODS Fifty-four epileptic patients were collected from the Affiliated Baiyun Hospital of Guizhou Medical University from Mar. to Oct. 2021 as the research objects， and fifty healthy people were also collected during corresponding period as baseline reference samples. The patients whose relative mRNA expression of SIRT1 was lower than the baseline were selected as SIRT1 low-expression treatment group， and the patients whose that expression was higher than the baseline as SIRT1 high-expression treatment group.All patients were treated with low dose （12 mg/kg or about 600 mg/day） of VPA for 3 months， and the clinical efficacy was evaluated. The dosage of VPA in patients with ineffective gzwkj2021-468） epilepsy control should be increased to 15 mg/kg or about 800 mg/day for another 3 months as SIRT1 high-expression intensive treatment group and SIRT1 low-expression intensive treatment group. Clinical efficacies were evaluated. The blood concentration and liver function indexes of the patients were detected after 3 months of treatment and 3 months of intensive treatment. RESULTS Before treatment， among 54 epileptic patients， 31 epileptic patients had low expression of SIRT1， and 23 had high expression of SIRT1. After 3 months of low-dose VPA treatment， within effective blood concentration of VPA， effective control rate of patients in SIRT1 high-expression treatment group was significantly lower than SIRT1 low-expression treatment group （P＜0.05）. After 3 months of intensive treatment， the effective control rate of patients SIRT1 high-expression intensive treatment group was significantly higher than SIRT1 high expression treatment group （P＜0.05）. No abnormality was found in liver function indexes during VPA treatment. CONCLUSIONS Epilepsy in patients with high expression of serum SIRT1 may be more difficult to control when VPA is within the effective blood concentration range； when the VPA dose is effectively increased， the effective control rate of epilepsy can be improved.