Aim To develop a sensitive, rapid and ac-curate LC-MSn method for determination of midazolam/1′-hydroxymidazolam and their pharmacokinetic char-acteristics in rat brain. Methods SD rats received in-travenous injection of midazolam ( 5 mg · kg-1 ) via femoral vein, a probe drug of cytochrome P450 3A. The microdialysis ( MD ) samples in situ brain were collected every 8 mins at 2. 0μl·min-1 in 2. 4 hours. Analytes in brain dialysate were quantified by the pro-posed LC-MSn method. Gradient elution was performed on an Agilent Eclipse Plus-C18 column ( 2 . 1 × 50 mm, 3. 5 μm). The mobile phase consisted of 2 mmol ·L-1 ammonium acetate and acetonitrile. The analyte was detected using electrospray ionization ( ESI ) in multiple reaction monitoring ( MRM) modes. The reac-tion selected ions were 326 . 1/291 . 1 m/z for midazo-lam, 342. 1/324. 1 m/z for 1′-hydroxymidazolam and 285. 1/154. 0 m/z for diazepam as internal standard. Result The linear ranges of midazolam and 1′-hydroxymidazolam were 0 . 78~100 and 0 . 195 ~12 . 5μg·L-1 respectively. The lower limit of quantification was 0 . 2 μg · L-1 . The RSD of intra- and inter-batch precisions was less than 7 %. The RSD of accuracy was from -1 . 34 to -8 %. Conclusion This sensi-tive and rapid LC-MSn method is suitable for determi-nation of midazolam/1′-hydroxymidazolam in rat brain dialysate. MD combined with LC-MSn method may give assistance to deep and further studies of drug metabo-lism and CYP3A enzyme in brain.

Objective To define the prognostic factors and local failure in late course accelerated hyperfractionation radiotherapy(LCAHR) for esophageal carcinoma.Methods A retrospective study was conducted in 201 esophageal squamous cell carcinoma patients treated by LCAHR during the period between August 1994 to January 2000.The radiotherapeutic portals were set and based on CT scan and esophagograms. All patients received a mean dose of 41.4 Gy /23 F/4～5 WK. With conventional fractionation regimen during the first two thirds of the course,and followed by LCAHR with reduced fields, at dose of 27 Gy/18 d,1.5 Gy per fraction,twice daily. The total dose varied up to 67～70 Gy/40～43 F/40～49 d. Results The 1 ,3 and 5 year actuarial survivals were 72.5% ,35.6% and 31.1%. The 1 ,3 and 5 year local control rates were 82.2%, 71.3% and 71.3%,respectively. Of the 95 patients who died, 34(35.8%) did so from local failure , 32(33.7%) from distant metastasis(33.7 %), 13(3.7%) from lymphatic metastasis, 4(4.2%) frome both local and distant metastasis and 12(12.7%) from complications.Conclusions It is showed that significant improvement in local control and survival are observed after LCAHR for esophageal carcinoma in comparison to conventional fractionated regimen. The prevention and management of distant metastasis and lymphatic spread have become the major problems in the future.

Objective To improve the diagnosis and treatment of renal inflammatory pseudotumor (RIP). Methods 10 cases of RIP treated from 1970 to 1999 were reviewed and the diagnosis and treatment were discussed. Results The main clinical manifestation of RIP were fever,lumbago and hematuria.6 of 10 underwent nephrectomy because of the suspicion of kidney cancer whereas the other 4 were cured by antibiotics without recurrence on following up for 1～5 years. Conclusions RIP is rare,the diagnosis being based on clinical symptoms together with dynamic B ultrasound and CT scan.Needle biopsy is indicated to establish the diagnosis if necessary.Antibiotics is usually effective.

Objective To study the clinical results and prognostic factors of late course accelerated hyperfractionation radiotherapy (LCAHR) in the treatment of esophageal carcinoma in the elderly. Methods 105 over 60 year-old patients with esophageal carcinoma who received radical LCAHR, were retrospectively analysed. Radical tumoricidal dose of 67.9～72.0?Gy was delivered in 39～43 fractions over 42～53 days. Results The 5-year local control rate was 63.7%. The 5-year disease-free survival and overall survival rate were 22.6% and 34.4%. Acute esophagitis and bronchitis were the most common but acceptable radioreactions Grade 1～2. No significant differences were found either in the clinical response or complication, between the 60～69 year and 70～80 year groups. By multivariate analysis, T stage and KPS score were two independent prognostic factors. Of 67 death cases, 31 died of local relapse, 23 of distant metastases, 8 of both and 5 of other causes. Conclusions LCAHR toxicity ,being tolerable for the older esophageal carcinoma patients,may improve their survival and quality of life.

The aim of this study was to investigate the expression of basic fibroblast growth factor (b FGF) and its relationship with tumor microvasogenesis and biological behavior of human renal carcinoma. Gene expression of b FGF was assayed in 20 cases of renal carcinoma tissue using RNA dot blot hybridization. Meanwhile, the protein expression of b FGF and microvasular density (MVD) was assayed in 35 cases of renal carcinoma tissue with immunohistochemical assay. It was found that the expression of b FGF was significantly higher in renal cancer tissue than in normal renal tissue or normal tissue adjacent to the tumor, There was significant correlation between b FGF expression in cancer tissue and clinical stages as well as clinical grades.Similar results were also observed between MVD and b FGF expression in renal cancer tissue. It seemed that b FGF played an important role in angiogenesis in renal carcinoma. Taken together, the results suggest that MVD and the expression of b FGF in renal cancer tissue might be related to the prognosis of renal carcinoma patients.

Objective To compare the differences of atria and atrial myocyte structure in patients with atrial fibrillation (AF) and sinus rhythm(SR) .To evaluate the influence of AF on cardiac function .Methods 79 patients without heart failure undergoing car-diopulmonary bypass surgery were divided into the AF group (n=39) and the SR group(n=40) .Echocardiography was performed for analysis of left ventricular end diastolic dimension(LVDd) ,left ventricular end-systolic dimension(LVDs) ,left ventricular poste-rior wall(LVPW) ,interventricular septum(IVS) and left atrial diameter(LAD) .Part of left atrial appendages was taken freshly for HE staining in order to observe atrial tissue structure .Results LVDd ,LVDs ,LVPW and IVS of the AF group were lower than that of the SR group .But LAD of the AF group was higher than the SR group .There was statistical significance in IVS and LAD between the two groups(P<0 .05) ,and there were no significant differences in other aspects (P>0 .05) .Compared with the SR group ,the AF group had thinner myocardial atrophy ,more obvious fibrosis ,smaller nucleus and darker HE staining .Conclusion The incidence of AF was mainly in rheumatic heart disease .The development of AF was mostly accompanied with the enlargement of LAD and the change of atrial tissue structure which showed that AF can reduce cardiac function .

BACKGROUND: Recently, Chinese herb and comprehensive therapy are widely adopted for the treatment of chronic atrophic gastritis (CAG), while infrared ray is widely used in the fields of physical therapy and scientific research. Therefore, some scholars suggest whether the physical characteristics of infrared ray have effects on the treatment of chronic atrophic gastritis.OBJECTIVE: To observe the effect of infrared ray on the changes of gastric mucosa tissue in rat models with chronic atrophic gastritis.DESIGN: Randomized controlled observation.SETTING: Hebei North University.MATERIALS: Thirty-five adult Wistar male rats weighing from 180 to 230 g were purchased from Hebei Experimental Animal Center [SCXK (ji) 2003-1-003]. The experiment was disposed with the ethical standard. Sodium salicylate powder produced by Beijing Fangcao Chemical Company (batch number: 890720). The drug was prepared with distilled water. Infrared lamp (220 V, 200 W) was bought by Equipment Division of our college.METHODS: The experiment was carried out in the Experimental Center of Hebei Beifang College from June 2005 to January 2006. ① Experimental intervention: Rats were fed with conventional standard granules for one week. Among them, 8 rats were selected as the normal control group, and other rats underwent model establishment. Rats were perfused with sodium salicylate and alcohol to stimulate gastric mucosa, and then chronic CAG models were established for 8 weeks based on exertion, irregular diet and other factors. Five rats were randomly selected for the check of histopathology before the end of model confirmedly making, and then the model rats were randomly divided into model group and infrared group with 11 in each group. Infrared lamp (220 V, 200 W, 0.76–1.5 μm in wavelength) was used to vertically radiate at the gastric projective area of rats in the infrared group, once a day, ten minutes once for twenty days. The rats in normal group and model group were regularly breed. ② Experimental evaluation: The body mass was weighed every week in 1, 4, 9 and 12 weeks after modeling. The infiltration of inflammatory cells and thickness of gastric mucosa were observed under optic microscope.MAIN OUTCOME MEASURES: ① Changes of body mass; ② pathohistological changes of gastric mucosa.RESULTS: All 30 rats were involved in the final analysis. ① Changes of body mass: From the end of the 4th week, increasing percentage of body mass in the model group and infrared group was decreased gradually as compared with that in the normal group, and there was significant difference (P < 0.05). ② Pathohistological changes of gastric mucosa: Gastric mucosa of rats in the model group was thinner, and atrophic glands, notable inflammatory infiltration and partial intestinal metaplasia were observed under optic microscope. The thickness of gastric mucosa in the infrared group was significantly thicker than that in model control group, and there was significant difference (P < 0.01); the inflammatory cells in the infrared group were less than those in the model group, and there was significant difference (P < 0.05). Morphologic structure and volume of the parietal cells were all recuperated or closed to normal.CONCLUSION: Infrared ray can decrease thickness of gastric mucosa and reduce inflammatory cells of rats with chronic atrophic gastritis, and it has greatly therapeutic achievements.

Objective To study the effects of He-Ne laser irradiation dosage on the expression of heat shock protein ( HSP70) and CyclinD_1 in rats with chronic atrophic gastritis ( CAG). Method Fifty-two adult male Wistar rats were randomly divided into five groups: a normal control group, model group and three groups receiving different doses of He-Ne laser irradiation. CAC was induced using an enema of 2% sodium salicylate and 30% alcohol combined with irregular fasting and forced exercise as pathogenic factors. Laser irradiation was applied for 20 days (large dose 6.24 J/cm~2 , medium dose 4. 80 J/cm~2, small dose 3. 36 J/cm~2). The changes in HSP70 and CyclinD_1 expression were observed. Results The expression of HSP70 and CylinD_1 were highest in the normal control group and the small dose laser group. Compared with the model group, the average expression of HSP70 and CyclinD_1 increased significantly in the small dose group. Conclusions Irradiation with a He-Ne laser at 3. 36 J/cm~2 provides good adjuvant therapeutic effect for CAG in rats. After irradiation, the expression of HSP 70 and CyclinD_1 increased. HSP is important in improving mucosal defenses and promoting cell proliferation in CAG, and it can be promoted through small doses of He-Ne laser irradiation.

Objective To study the effects of He-Ne laser irradiation on histological changes and the expression of proliferating cell nuclear antigen ( PCNA ) and B-cell lymphoma/leukemia-2 ( Bcl-2 ) in the gastric mucosa of rats with chronic atrophic gastritis (CAG) so as to elucidate the relationship of He-Ne laser irradiation with precancerous lesions and apoptosis in the gastric mucosa. Methods The rats were divided into a normal group,a model group and a laser group.A model of CAG was established by gastric perfusion with a mixture of sodium salicylate and alcohol combined with irregular fasting and forced exercise.A He-Ne laser was used to irradiate the rats at 3.36 J/cm2 for 7 min daily for 20 d.Histopathological changes including the severity of inflammation in the gastric mucosa and the morphology and structure of the parietal cells were observed with a light microscope,and the expression of PCNA and Bcl-2 was detected with immunohistochemical methods. Results The pathologic morphological changes in the gastric mucosa of the model group were atrophy of the glands of the gastric mucosa and notable inflammatory infiltration.But in the laser group inflamed cells decreased,and the morphology,structure and volume of the cells all recovered close to normal.The immunohistochemistry results showed that during the atrophy of the gastric mucosa the expression of PCNA and Bcl-2 was elevated,and it was significantly higher in the model group than in the normal group.After irradiation the expression of PCNA and Bcl-2 was significantly lower. Conclusions There was hyper-proliferation in the gastric mucosa of the CAG model rats,with high expression of apoptosis suppressor PCNA and Bcl-2 proteins.Laser irradiation can reduce the expression of PCNA and Bcl-2,enhance cell proliferation and induce apoptosis,preventing the development of cancer.Laser irradiation has a good adjuvant therapeutic effect for all the pathological changes observed.

Objective To investigate the ability of decision-making under risk condition in benign epilepsy children with centrotemporal spikes (BECT).Method Seventy-eight BECT patients and seventyfive healthycontrols were studied by Iowa Gambling Task (IGT) with inexplicit probability and Game of Dice Test (GDT) with explicit probability.Results (1) There was a significant difference in IGT task scores between the two group (t=-2.56,P＜0.05).The total number of advantageous choices in IGT were lower in BECT group (49.35±5.38) than that in healthy control group (52.24±6.23).BECT group (-1.41 ± 10.60) performed worse on task than healthy control group (4.43±11.88),and the difference was statistically significant (t=-3.21,P＜0.05).The control group scored higher on Blockl,Block4 and Block5 than that of BECT group (P＜0.05).(2) There was no significant difference between the BECT group (4.42±7.74) and the control group(5.49±6.81) in the GDT test scores (t=-0.91,P=0.37).(3) Pearson correlation analysis showed that there was no significant correlation between the age,age of onset,education,seizure frequency and onset duration and the score of IGT and GDT (r =-0.091-0.274,all P ＞ 0.05).Conclusion There is no significant decision-making disability in children with BECT under the condition of certain risk probability,while there is significant impairment under the condition of uncertain risk probability.The decision-making disability may be associated with impaired frontal lobe function.