Aim To investigate the extent of systemic absorption and uptake of meptazinol (MEP) hydrochloride in cerebrospinal fluid (CSF) after intranasal administration on rats and compare with oral administration. Methods CSF samples were collected by a serial sampling method. The concentration of MEP in the biological samples was measured by HPLC with fluorescence detector. Results Rapid and significant levels of MEP in plasma and CSF can be achieved after nasal administration whereas the oral administration resulted in considerably lower drug concentrations. AUC in plasma and CSF from the nasal route are 7.375 and 15.6 folds compared with those of the oral route, respectively. Conclusion Intranasal MEP is able to show quick absorption and improve the bioavailability, which could be a promising alternative to oral administration.

Objective To improve the technique of pancreatoduodenectomy in order to facilitate the(management) of complications and direct observation on follow up.Methods Pancreatoduodenectomy and Child′s method of digestive tract reconstruction was performed in 42 paltents.A blind loop of jejunum 5 to 6 cm in length was constructed beyond the pancreatojejular anastomosis and it was fixed to the subcutaneous(tissue) of the adjacent abdominal wall.Results Thirty-two cases recovered uneventfully,and 10 cases had complications induding pancreatic and biliary leakage and hemorrhage.These complications were successfully treated under direct vision by choledochoscope passed into the blind jejunal loop.This method of observation was used for long-time follow up in 22 cases,and revealed ercurrent tumor(n=5),bile duct stricture(n=4) and bile duct ascariasis(n=1).Conclusions This operative method did not cause new(complications) and it can be combined with the traditional operation.Postoperatively,direct observation and management of leakage of pancreatojejular anastomosis and biliointestinal anastomosis and hemorrhage can be accomplished,and the anastomoses and pancreatic stump can be directly observed at followup.

Objective To discuss the value of choledochoscopy via subcutaneous jejunal blind loop in the diagnosis and treatment of severe complications after pancreatoduodenectomy. Methods A fiber choledochoscope (FCC) was introduced through a subcutaneous jejunal blind loop. Under direct vision, the pancreatojejunal or choledochojejunal anastomotic leakages were coated with biological glue, or the anastomotic bleedings were stopped with hemostatic drugs. Results Five cases of intestinal leakage, 3 cases of biliary leakage and 2 cases of anastomotic bleeding were all cured. Follow-up for 1～3 years in the 10 cases found no recurrence of tumors. Choledochojejunal anastomotic stricture occurred in 1 case 1 year after the surgery and was cured by dilatation under fiber choledochoscope. In the remaining 9 cases, the pancreatic juice and bile fluid were excreted normally. Conclusions Application of FCC through the subcutaneous jejunal blind loop can be employed in the diagnosis and treatment of complications after pancreatoduodenectomy and in the long-term follow-up of pancreatojejunal or choledochojejunal anastomotic stoma under direct vision.

Objective To evaluate the effectiveness of scanning with labeled autologous leukocytes for the detection of abdominal inflammation in equivocal patients. Methods From July 1998 to April 2000 sixteen patients with equivocal abdominal inflammation were recruited into this study. ResultsThere were 10 cases with positive scanning. The diagnosis of intraabdominal infection was consequently confirned by laparotomy and or good response to antibiotic therapy.The 6 cases with negative result were eventualy proven to have no intraabdominal infection. The average radioactivity of imaging and paired non imaging district was determined ( P

Objective To evaluate the method and result of thyroid artery embolization as a new therapy for hyperthyroidism. Methods Twenty two patients with hyperthyroidism underwent selective thyroid artery embolization. Totally 52 thyroid arteries were embolized with microspheres. The indications to this therapy were following: hyperthyroid patients having indications to surgical and 131 I therapy, clinically being difficult to complete the preparation for subtotal thyroidectomy and having high risk for surgical process because of their huge thyroid gland. Results Serum level of thyroid hormones dropped significantly [median T3 from 8 8 nmol/L(4 3～ 43 0 nmol/L) to 4 0 nmol/L(1 1～9 2 nmol/L), median T4 from 206 4 nmol/L(77 4～748 2 nmol/L) to 144 5 nmol/L(25 8～279 9 nmol/L), P

Adefovir dipivoxil (ADV) is commonly used as an anti-viral agent in the treatment of chronic hepatitis B,with a dose-and time-dependent nephrotoxicity.Clinical analysis was made in 4 patients with chronic hepatitis B who developed Fanconi syndrome and hypophosphatemic osteomalacia after long-term use of ADV (10 mg/d).

Objective To explore the release and percutaneous penetration of cyclovirobuxine D patches at different concentrations in vitro. Methods The release curves of cyclovirobuxine D patch in vitro were fitted by ritger-peppas mathematical model, and the patch release mechanism was discussed according to the fitting parameters. At the same time, compared the percutaneous permeability characteristics of 0.25,0.5,1.0,2.0 mg.( cm2 )-1 of cyclovirobuxine D patch by using a modified Franz diffusion cell, with isolated rat skin serving as transdermal barrier. Results Ritger-Peppas model fitting equation for cyclovirobuxine D patch [1.00 mg.(cm2)-1]was: Mt/M=0.964 6 t1.621 6.And the percutaneous penetration curve was best fitted to Higuchi kinetics equation.The drug release rate from the patch matrix was greater than the rate of penetration through the skin, indicating the patch at the time through rat′s skin was a passive diffusion process, and transdermal process was rate-limited by skin. Conclusion Kinetics equation fitting is an effective method for analyzing drug release and permeation behavior of cyclovirobuxine D patch in vitro.

Objective To evaluate the influence of L-ornithine-L-aspartate (LOLA) on model for end stage liver disease(MELD) score and liver function of patients with chronic liver failure (CLF). Methods Sixty patients consecutively admitted to our hospital from May, 2002 and November, 2008 were enrolled into the study and randomly divided into low dose group (LD group, LOLA:10 g/d) and high dose group (HD group, LOLA :20 g/d)After treatment of LOLA, the clinical data ( serum NH3 , MELD score and liver function ) were compared between the two groups. Results Compared to serum NH3 level before treatment, serum NH3 decreased ( 62.59 + 27.87 )μmoL/L in the HD group and (49.36 + 27.34 ) μmol/L in the LD group, and both decreasements were statistical significant (Ps ＜ 0. 05 ). Compared to MELD before treatment, MELD score decreased ( 8.38 ± 2. 24 ) and ( 14.57 + 7.68), respectively ( Ps ＜ 0.05 ). Compared to LD group, all indices of liver function in the HD group improved more compared to those of the LD group ( Ps ＜ 0.05 ). Conclusions LOLA could significantly decrease serum NH3 and MELD score and improve liver function in CLF patients.

Objective To investigate the relationship between plasma Chemerin and diabetic nephropathy of type 2 diabetes mellitus (T2DM).Methods Totally 195 T2DM patients and 65 healthy controls were enrolled in this study.The T2DM patients were further divivded into three subgroups:normal albuminuria group (n =65),microalbuminuria group (n =65),and clinical albuminuria group (n =65).The plasma Chemerin level was determined by enzyme-linked immunosorbent assay (ELISA).Results The serum Chemerin level was (150.20 ±21.99) μg/L in diabetic patients,which was significantly higher than that in healthy controls (62.13 ± 18.90) μg/L) (P ＜0.01).Inside the T2DM group,the plasma Chemerin level was [(143.63 ± 22.33) μg/L] in the microalbuminuria group and [(173.21 ± 23.91) μg/L] in the clinical albuminuria group (P ＜ 0.001),and both were significantly higher than that in the normal albuminuria group [(100.35 ±20.11) μg/L] (both P ＜0.01).Multivariate regression analysis showed that the plasma Chemerin level was independently associated with glycosylated hemoglobin (β =0.216,P =0.038),total cholesterol (β =1.867,P =0.048),high-sensitivity c-reactive protein (β =12.330,P ＜ 0.001),and urine albumin (β =37.184,P ＜0.001) in T2DM patients.Conclusion Plasema Chemerin level increases in T2DM patients and therefore can be a reliable indicator for detecting early type 2 diabetic nephropathy.