Objective To evaluate the relationship between subventricular zone(SVZ), the shortest distance from tumor centroid to the edge of the lateral ventricles (TV) and prognosis of patients with glioblastoma multiforme (GBM). Methods The clinical data of 130 patients with GBM in our hospital since 2006 to 2016 were retrospectively reviewed and 45 persons of these patients with SVZ were involved. Chi-square test and survival analysis was performed to identify prognostic factors associated with GBM. Results Chi-square test indicated that there were no significant differences in the distribution of age, gender, tumor location, tumor volume, preoperative epilepsy and the extent of resection in these two groups with involvement of SVZ or not (P>0.05). Similarly, there were no statistically significant differences in the distribution of age and sex, tumor location, tumor size, preoperative epilepsy between TV<30 mm and TV≥30 mm (P>0.05). Univariate analysis showed that adjuvant therapy (HR=0.765, 95%CI:0.557-0.998, P=0.045), SVZ (HR=2.996, 95%CI:1.995-4.500, P<0.01), and extents of resection (HR=0.472, 95%CI:0.313-0.713, P<0.01) were predictors of overall survival of patients with GBM, while the gender, age, tumor size, and preoperative epilepsy did not reach statistic significance (all P>0.05). When the parameters with statistical significance identified by univariate analysis were included in the multivariate analysis, the results showed that adjuvant therapy (HR=0.540, 95%CI:0.333-0.875, P=0.012), SVZ (HR=2.634, 95%CI:1.725-4.022, P<0.01) and extents of resection (HR = 0.563, 95% CI: 0.366- 0.867, P = 0.009) were independent prognostic indicators in patients with GBM. Univariate analysis showed that adjuvant therapy (HR = 0.535, 95% CI: 0.332- 0.863, P<0.01) and TV (HR = 3.297, 95% CI: 1.738- 6.253, P<0.01) were predictors of overall survival of patients of GBM with SVZ involvement, while the gender, age, tumor size, and preoperative epilepsy not reached statistic significance (all P>0.05). When the parameters with statistical significance identified by univariate analysis were included in the multivariate analysis, the results showed that adjuvant therapy (HR=0.726, 95%CI:0.529-0.997, P=0.048) and TV(HR = 3.234, 95%CI: 1.711- 6.112, P<0.01) was independent prognostic indicator in patients of GBM with SVZ involvement (P<0.05). Conclusions Involvements of SVZ and TV less than 30 mm are the risk factors for the prognosis of patients with GBM.

Motor dysfunction is one of the leading problems after stroke. The evidence existed that motor performance is largely affected by the location and volume of white matter especially the pyramidal tract, but not the cortex. The remodeling of contralesional primary motor output tract highly correlated with motor improvement. The unaffected pyramidal tract axons regenerate and cross into the affected side after ischemia can promte motor recovery after ischemia. Exercise and other rehabilitation may play a role on remodeling of pyramidal tract subsequent after cerebral infarction.

Objective To evaluate the barium meal radiography and CT scans in diagnosing malignant gastrointestinal stromal tumors (GIST) of small intestine. Methods The clinical and imaging data of 16 patients with GISTs of small intestine which were diagnosed surgically and pathologically were analyzed and summarized. In this group CT scan and gastrointestinal barium exam(GI) was performed. Results The tumors included 6 low-malignant GISTs of small intestine and 10 high-malignants. The diameter varied from 3.2 cm to 7.2 cm, the average size was 5.6 cm. The main signs of barium meal of malignant GIST of small intestine included flattened or destroyed mucosa runae, partial lumen stenosis, and barium fleck and fistula in the tumor. On CT scans, the main manifestation was an extraluminal mass with multiple necrosis areas of low density. Conclusion Barium examination and helical CT scan are the major imaging techniques in the determination of the location of GIST of small intestine. The appearance of imperfect lumen and the irregular tumor with multiulcerations or low density regions and inhomoneneous enhancement may lead to the correct diagnosis of malignant GIST.

0.05) . AEP index increased sharply from 42 to 67 when the patients regained consciousness (OAA/S increased from 2 to 3) but BIS increased gradually from 64 to 72 indicating that AEP index had better discriminatory performance. OAA/S correlated fairly well with BIS , AEP index and target-controlled concentration of propofol and r was 0.781, 0.684 and - 0.580 respectively. Conclusions Both AEP index and BIS can predict fairly well the level of sedation but AEP index prooes to be better in distinguishing conscious from unconscious.

Objective To evaluate the accuracy of target-controlled infusion (TCI) of propofol using pharmacokinetic parameters reported by Marsh to predict plasma propofol concentration in Chinese. MethodsTwenty-two ASA I - II patients were divided into two groups: group Y aged65 yr ( n = 11). Patients with liver, kidney or cardiovascular diseases were excluded. The patients were premedicated with pethidine 50mg and phenobarhital 0.1 g im. Radial artery and internal jugular vein(IJV) were cannulated. The pharmacokinetic parameters incorporated in the Graseby 3500 pump we used were: V1=228 ml-kg-1 , K10 =0.119 min-1 ,K12=0.112 min-1, K2l=0.055min-1 , K13 =0.0419 min-1 ,K31 =0.0033 min-1. Target concentration was started with 2ug-ml-1 and increased at increment of 1ugml-1 until loss of consciousness. The patient was then intubated. When target concentration of propofol was increased, the concentration of inhalation anesthetic was reduced to maintain hemodynamic stability. When target concentration of propofol was increased, arterial blood sample was taken 1-3 times for determination of plasma propofol concentration measured by HPLC (Agilent 1100) . Then blood samples every 10-15 min. For each sample prediction error(PE) and constancy error(CE) were calculated. For each patient median prediction error(MDPE), median absolute prediction error(MDAPE) . Median absolute constancy error (MDACE) and median constancy error (MDCE) were calculated.ResultsThere was remarkable initial overshot. PE and absolute PE were 63.3 % and 66.2 % in group E and 62.1 % and 62.7% in group Y. CE and absolute CE were -0.3% and 12.7% in group E and 0.6% and 13.5% in group Y. The median value of MDPE ( = the median value of MDAPE) was 78.1 % in group E and 66.1% in group Y. The median value of MDCE was 0.2% (group E) and 0.8% (group Y) and MDACE was 12.5% (group E) and 13.5% (group Y) . The measured concentrations were significantly linearly correlated with the premedicated concentrations. Conclusion TCI system with propofolpharmacokinetic parameters reported by Marsh can lead to initial overshot and underestimate the measured plasma propofol concentration but it can maintain a stable plasma concentration

Objective To determine the population pharmacokinetics of intravenous etomidate infusion in adult patients.Methods Twenty-nine ASA Ⅰ or Ⅱ patients of both sexes aged 25-82 yr weighing 45-80 kg received contant-rate infusion of etomidate at 60 μg· kg-1 · min-1 until BIS value dropped to ≤ 40.Arterial blood samples were obtained from radial artery for determination of plasma etomidate concentration before,at 1,3,5 min of continuous etomidate infusion and at 1,3,5,7,10,20,30,45,75,120,180,240,300 and 360 min after termination of etomidate infusion.Population pharmacokinetic model was established by using the software package NONMEM.Population pharmacokinetic parameters were calculated according to etomidate concentrations and covariates including age,height,bodyweight,sex,liver-kidney function etc.using software package NONMEM.Results Pharmacokinetics of etomidate was best described by a three-compartment pharmacokinetic model with age as a covariate affecting systemic clearance (CL1).The typical parameters were:V1 =4.7 L,V2 =11 L,V3 =123L,CL1 =1.28-0.0119 × (Age (yr)-55) L/min,CL2 =1.25 L/min and CL3 =1.08 L/min respectively.Context-sensitive half-time increased with age and steady-state infusion time.Conclusion Pharmacokinetics of etomidate is best described by a three-compartment pharmacokinetic model with age as a covariate affecting systemic clearance (CL1).

Objective To estimate the value for the plasma-effect site equilibration rate constant(Ke0)of propofol using the time to peak effect(Tpeak)method and two pharmacokinetic models for propofol.Methods The Tpeak after a submaximal bolus dose 1.5 mg?kg~(-1) of propofol was measured with AAI A-line auditory evoked potential monitor in 36 patients scheduled for elective surgery under general anesthesia.Using Tpeak and two sets of pharmacokinetic parameters for propofol reported by Marsh and Shafer,the Ke0 was estimated according to the method described by Minto.Results The mean Tpeak was(142?62)s in 30 patients.The Ke0 was 0.626 min~(-1) with the model by Marsh and 0.914 min~(-1) with the model by Shafer.The corresponding t_(1/2) Ke0 values were 1.107 min and 0.759 min respectively(P＜0.01).Conclusion The Ke0 value of propofol estimated depends on the pharmacokinetic models used.The values we estimated in Chinese patients are significantly different from the values reported by foreign authors

Objective By using primary cultured mouse renal tubular epithelial cells (TECs) to develop an in vitro model of simulated ischemia-reperfusion (IR) injury.Methods The outer medulla of C57BL/6J mouse kidney was flushed and primary cultured after digestion in type Ⅰ collagenase,and then immunocytochemical staining was used to verify TECs.Primary cultured TECs were immersed in mineral oil to simulate the ischemic process,and 60 min later the whole culture medium was added to simulate reperfusion process.The cells were collected and RAN was extracted at indicated time points after medium replacement.The expression of TNF-α,IL-1β and IL-6 was detected by using real-time fluorescence quantitative RT-PCR. The culture supernatants were collected at 24 h after medium replacement for detection of the expression of cytokine protein by using ELISA.Results Primary cultured TECs were identified by cobblestone-shaped morphology and then verified by cytokeratin 18 (CK18) staining.In TECs of IR group after medium replacement the mRNA expression of TNF-α,IL-1β and IL-6 was higher than in control group.The expression of TNF-α after medium replacement was increased to a peak level at 0.5 h,about (24.45 ±6.51) times (P＜0.01 ) higher than the control group,and gradually declined thereafter.The mRNA expression of IL-1β after medium replacement kept an increasing tendency,about ( 15.27 ± 4.29) times (P＜0.05) higher than the control group at 6 h,and that of IL-6 after medium replacement was increased to a peak level at 3 h,about ( 11.19 ±4.55) times (P＜0.01) higher than the control group. In the IR group at 24 h after medium replacement,the protein expression of NF-α,IL-1β and IL-6 in the supernatants was significantly higher than in the control group.Conclusion High purity of primary cultured TECs was achieved from the outer medulla of mouse kidney by separation and digestion.The in vitro model of simulated IR in primary cultured mouse renal TECs was successfully created using paraffin oil.

ObjectiveTo investigate the effect and underling mechanism of water-soluble CO-releasing molecules (CORM-3)on the alleviation of allograft rejectionafter mouse kidney transplantation.Methods A mice kidney transplantation model was established using C.FVB-Tg (Itgax-DTR/GFP)57Lan/J or C57BL/6J (H-2Kb) mice as donors,and Balb/c (H-2Kd) mice as recipients.After donor nephrectomy,kidney was preserved in UW solution which contained CORM-3 or iCORM (inactive CO-releasing molecules) for 24 h in 4℃.Recipient survival after removal of both na? ve kidneys,serum creatinine as well as graft histology was observed.In the C.FVB-Tg(ItgaxDTR/GFP) 57Lan/J donors,rDCs were acquired in vitro and selected by magnetic cell sorting (MACS) after graft nephrectomy.The expression of activation markers,CD80 and CD86,on rDC was assessed by using flow cytometry.ResultsThe graft medium survival time was 40.5 days in the iCORM group and 70 days in the CORM-3 group respectively (P＜0.05).CORM-3 preserved the graft function as shown by significantly lower serum creatinine (P＜0.05; or P＜0.01) and alleviated graft pathology injury.Diffuse infiltration of mononuclear cells in the interstitial tissues,moderate tubulitis and partial glomerular sclerosis were found in the iCORM graft kidney,while the CORM-3 graft kidney displayed almost normal histology.Meanwhile,CORM-3 suppressed the expression of CD80 and CD86 in donor-derived rDC.ConclusionCORM-3 can alleviate allograft rejection,prolong the graft survival,and improve kidney function in mouse kidney transplantation,probably via inhibiting rDC activation.

Background: Mast cell activation is a characteristic of irritable bowel syndrome (IBS).Study on mast cell and the related inflammatory mediators in colonic mucosa is helpful for the evaluation and treatment of IBS.Aims: To assess the effect of mesalazine combined with trimebutine on colonic mucosal mast cell and related inflammatory mediators in patients with IBS.Methods: Forty patients with diarrhea-predominant IBS (IBS-D) and 40 patients with constipation-predominant IBS (IBS-C) from Oct.2014 to June 2016 at Shanghai Jiading District Central Hospital were enrolled, 20 healthy volunteers were served as controls.Forty patients with IBS-D and 40 patients with IBS-C were randomly divided into mesalazine+trimebutine group and trimebutine group, the treatment courses were all 4 weeks.Number of mast cell was counted by modified toluidine blue staining.Score of related inflammatory mediators were evaluated by immunohistochemistry.Clinical efficacy was assessed.Results: Compared with healthy controls, number of mast cell at baseline was significantly increased both in IBS-D and IBS-C patients (P<0.05).After treatment with mesalazine+trimebutine, number of mast cell was significantly decreased (P<0.05).At baseline, immunohistochemical staining score of 5-HT, IL-1, TNF-α, histamine, tryptase were significantly increased in IBS patients than in healthy controls (P<0.000 1).After treatment with mesalazine+trimebutine, above-mentioned inflammatory mediators were significantly decreased (P<0.05).In IBS-D patients, the total efficacy rate in mesalazine+trimebutine group was significantly increased than that in trimebutine group (85.0% vs.45.0%, P=0.008).In IBS-C patients, no significant difference in total efficacy rate was found between mesalazine+trimebutine group and trimebutine group (55.0% vs.25.0%, P=0.053).Conclusions: Mesalazine combined with trimebutine is an effective and safe approach to reduce mast cell infiltration and release of related inflammatory mediators, and is more efficient for patients with IBS-D.