Objective: To observe the controlled hypotension effects of nicardipine in 2 different ways for spinal tumor operalion. Methods: Twenty-four adult patients, scheduled for selective spinal tumor operation, were randomly divided into 2 groups. In groupⅠ(n=12), the nicardipine was infused at a rate of 10 μg*kg-1*min-1 and the infusion continued until MAP was at the level of 7.33-8.66 kPa, and then the rate was decreased to 1 μg*kg-1*min-1. In Group Ⅱ(n=12), nicardipine was given 0.01-0.02 mg/kg as the load dose, then infused at 1-2 μg*kg-1*min-1. Results: During the period of controlled hypotension, cardiac index(CI) increased significantly, other hemodynamic variables were stable and no hypertension rebound occurred in both groups. Reaching time of target blood pressure in groupⅡ was shorter than that in groupⅠ（P＜0.05）. The dose required to obtain target blood pressure in group Ⅱwas less than that in group Ⅰ（P＜0.05）. BP recovery time from discontinuing nicardipine infusion to pre-hypotension level,bleeding volume and transfusion volume were similar between 2 groups（P＞0.05）.During mass bleeding,　serious arrhythmia and oliguria did not occur in any case. Conclusion: Controlled hypotension with nicardipine is rapid, stable and easily controlled without hypertension rebound. Nicardipine has considerable protective effects on heart and kidney during mass bleeding. The method of bolus injection followed with intravenous infusion is more suitable to clinical application.

OBJECTIVE　To develop an HPLC method for the determination of floxuridine in human serum.METHODS　With metronidazole as the internal standard,200 μL of serum was extracted by n-propyl alcohol/methyl t-butyl ether in a two-step extraction.The organic layer was evaporated under nitrogen stream and the residual was reconstituted with the mobile plase.A Shim-Pack CLC-ODS column was selected and the mobile phase was consisted of acetonitrile-phosphate buffer-water (75∶100∶900) at a flow rate of 0.6 mL*min-1.The detection wavelength was 268 nm.RESULTS　A linearitywas obtained from 0.005 to 0.5 mg*L-1 of floxuridine in serum with a good correlation coefficient (r=0.9999,n=8).The intra-run and inter-run coefficients of variation were less than 4.09%.The mean recoveries were 103.00%,107.00% and 100.88% for the low,middle and high concentrations of check samples,respectively.The limit of detection was 0.001 mg*L-1.CONCLUSION　The method was sensitive,specific and simple.It is suitable for clinical pharmacokinetic study.

Objective To investigate the volume of hippocampal formation in normal adult using coronal magnetic resonance imaging. Methods 3D-fSPGR sequence was used to depict the brain in 68 healthy adult. The volume of hippocampus was calculated by drawing the outline of 10 coronal hippocampal formation images acquired equally form posterior border of rostrum corpus callosum to anterior border of the splenium. Data were analysed using the SPSS 17.0 software. Results In the coronal plane images of normal adult brain, the absolute volume of left and right hippocampal formation were 2 319.63-2 610.73 mm3 and 2 447.52-2 749.50 mm3 respectively . The relative volume of left and right hippocampal formation were 2 319 . 87-2 602 . 47 mm 3 and 2 443.96-2 755.89 mm3. There were no correlation between hippocampal volume and age (r = 0.084, P = 0.549. Significant gender differences (t=2.500, P=0.029) were observed between absolute volume of right hippocampal formation in the youth group. There were significant differences in the absolute volume (t = -2.571, P = 0.022), relative volume (t = 2.600, P = 0.021) among the right and left hippocampal formation. Significant absolute volume differences (P = 0.038) were observed between the middle-aged group and the youth group among the hippocampal formation of women. Conclusion No significant differences were observed in age, gender among the hippocampal volume of normal adult, and there was a significant difference between the left and right hippocampal formation volume.

Objective To study the influential factors of tacrolimus'dosage and concentration differences between individuals in morning periods after renal transplantation.Methods The clinical data consisted of 118 receptors in morning periods after renal transplantation,whose immune suppressions were tacrolimus,mycophenolate and hormone.At 3,7,14 and 30 d after operation,all the receptors'weight,dosage of tacrolimus,dosage of hormone,diarrhea,blood fat,liver function,renal function,albumn and erythrocrit were recorded respectively,and at the same time their concentrations of tacrolimus and genetic polymorphisms of CYP3A5,MDRl 3435,MDR1 2677 and MDRl 1236 weredetected.Multiple linear regressions were performed.Results The fitting degrees of stepwise regression equations were low.At 3,7,14 and 30 d after operation,the adjusted R2was 0.284,0.267,0.417 and 0.324,respectively.From the aspect of pharmacogenomics,the main factors rela-ted to the differences of tacrolimus'dosage and concentration included MDR1 2677,MDRl 1236 and MDR13435,which varied intensively.Age,albumn,renal function,blood fat and liver function were important factors too.Conclusions The main reasons of the differences of tacrolimus'dosage and concentration between individuals in morning periods after renal transplantation are medicines and changes of internal environment after operation.The genetic polymorphisms of MDR1,age,albumn,renal runetion.blood fat and liver function are important factors too.

AIMTo prepare the micelles of stearic acid-grafted chitosan oligosaccharide and investigate the drug release from micelles.

METHODSMediated by a 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC), stearic acid (SA) was covalently attached to chitosan oligosaccharide (CSO), and the graft polymer (CSO-SA) was obtained. The critical aggregation concentration (CAC) of the CSO-SA was determined by measuring the fluorescence intensity of pyrene as a fluorescent probe. The effect of various pH dispersed media and concentration of tripolyphosphate sodium (TPP) on the micellar size distribution and zeta-potential measured by light scattering and electrophoretic mobility, was investigated. In buffers of different pH, the release profiles of methotrexate (MTX) from micelles were evaluated.

RESULTSThe CAC value of CSO-SA in deionized water was 0.05 g x L(-1). The mean diameter of CSO-SA micelles was 26.7 nm and the zeta potential was (55.9 +/- 0.1) mV. With the increase of TPP concentration, the size and MTX encapsulation of CSO-SA micelles increased, while the zeta-potential decreased. With the decrease of pH value of dispersed media, the size and zeta-potential of CSO-SA micelles increased, and the MTX encapsulation in CSO-SA micelles decreased. While the enhancement of drug release from the micelles was observed.

CONCLUSIONThe graft polymer of CSO-SA provides polymeric micelles, which possessed a low CAC value in aqueous media. The drug release in vitro from CSO-SA micelles was affected by the pH of delivery media.

Chitosan ; administration & dosage ; chemistry ; Drug Carriers ; Drug Delivery Systems ; Hydrogen-Ion Concentration ; Methotrexate ; administration & dosage ; chemistry ; Micelles ; Oligosaccharides ; administration & dosage ; chemistry ; Particle Size ; Polymers ; Polyphosphates ; Solubility ; Stearic Acids ; administration & dosage ; chemistry

Objective To evaluate the clinical effects of block calculus extraction catheter in the ureteroscopic lasertripsy. Methods Two hundred and thirty patients with ureter calculus were enrolled. Ninety-six patients were treated with block calculus extraction catheter (test group), and 134 patients were treated without block calculus extraction catheter (control group). The patients in 2 groups were treated with holmium laser ureteroscopic lithotripsy of Lumenis PowerSuite60W, and the treatment effectiveness was compared. Results The operation time and primary stone clearance rate in test group were significantly better than those in control group: (23.3 ± 7.4) min vs. (35.6 ± 11.1) min, 98.92%(92/93) vs. 88.89%(112/126), and there were significantly differences (P<0.01). The bleeding amounts and fever rate of 2 groups had no significant difference (P > 0.05). Conclusions The block calculus extraction catheter is very useful and safe in preventing the calculus shift, shortening the operation time and improving the calculus elimination rate .

Objective The present study was designed to investigate whether pulsing DCs with tumor-derived extracts is an ef- fective way to induce CTL. and antitumor immunity, Methods DCs were propagated from bone marrow (BM)of C57BL/6J(H-2Kb. I- Ab)mice in vitro with GM-CSF + IL-4tumor associated antigen (TAA) extracted from actively growing Hepa 1-6 cells was used to activate DCs. The phenotypes of DCs were detected by FACS, the cytotoxicity of CTL was as- sayed by 3H-TdR labbel assay. Result and Conclusion The TAA extract pulsed DCs exhibited much more and longer cell processes and increased expression of MHC- Ⅰ, MHC-Ⅱ, CD80 (B7-1 ) 、 CD86 (B7-2 ). This experiment has shown that DCs pulsed with TAA extracts of C57B/6J cells could stimulate effectively the responsiveness of syngenic splenic T cells to induce specific CTL against C57BL/6J cells.

Objective To evaluate the efficacy of 1-stage urethroplasty using pedicle circular fascioctaneous preputial flap for the treatment of complex anterior urthral strictures.Methods Between January 2006 and January 2013, 37 patients with complex anterior urethral stricture were treated by 1-stage urethroplasty using pedicle circular fascioctaneous preputial flap.The mean age was 41 years ( 22 -71 years) .The etiology of stricture included trauma of 13 cases, iatrogenieity of 13 cases, gonorrhea infection of 2 cases, unknown reason of 9 cases.The penile urethral stricture was found in 22 cases, the bulbourethral stricture in 9 cases, and stricture extending from penile to posterior urethra in 6 cases.The mean length of anterior urethral stricture was 8.1 cm (range 5.0-14.0 cm).A circumferential island of the preputial/distal penile skin was mobilized by the technique of preserving penile fasciocutaneous wide vascular pedicle. The pedicle is composed of two layers of the dartos and the superficial lamella of Buck′s fascia, and the flap was divided in the midventral/middorsal plane back to the penoscrotal junction to convert the circular configuration to a longitudinal trip for urethral reconstruction.The dorsal and ventral inlaid flap urethroplasty was performed in 27 cases and tubularized flap urethroplasty was performed in 10 cases.Results The mean operative duration was 3.1 h (2.5-3.5 h).The mean length of the circular fascioctaneous preputial flap was 10.4 cm (range 9.0 -14.0 cm).All the patients were followed up for mean 22 months (3 -51 months).Thirty-two cases voided well and the mean peak urinary flow rate was 22.3 ml/s (15.0-29.0 ml/s).One-stage healing achieved in 32 cases (86.5%).Recurrent stenosis was noted in 4 cases, and meatal stenosis occurred in 1 patient, who required re-operation.Re-repair succeeded in 4 cases and total success rate was 97.3% (36/37).Conclusions The pedicle circular fascioctaneous preputial flap has advantage of good blood supply and autograft for new meatus.It could be a reliable and durable method for the treatment of complex anterior urthral strictures(≥5 cm) in 1-stage urethroplasty.

Objective To explore the outcomes of kidney transplant recipients who developed urinary and male genital cancers after transplantation. Methods Data of 31 kidney transplant recipients developed de novo urinary and male genital cancer were compared with data of 31 patients in general population with the same age and same tumor stage. Results Compared with the general population, the overall survival was significantly worse in the transplant recipients (P=0. 02) , 5-year survival rates for each group were 50% vs 68%. Multivariate analyses demonstrated cancer stage to be a negative risk factor for survival for transplant recipients with de novo urinary and male genital cancer, and surgery and functioning graft to be the positive survival predictors. Conclusions Transplant recipients experience worse outcomes than the general population from urinary and male genital cancers. Cancers in transplant recipients are more biologically aggressive at the time of diagnosis.

Objective: To observe the controlled hypotension effects of nicardipine in 2 different ways for spinal tumor operalion. Methods: Twenty-four adult patients, scheduled for selective spinal tumor operation, were randomly divided into 2 groups. In groupⅠ(n=12), the nicardipine was infused at a rate of 10 μg*kg-1*min-1 and the infusion continued until MAP was at the level of 7.33-8.66 kPa, and then the rate was decreased to 1 μg*kg-1*min-1. In Group Ⅱ(n=12), nicardipine was given 0.01-0.02 mg/kg as the load dose, then infused at 1-2 μg*kg-1*min-1. Results: During the period of controlled hypotension, cardiac index(CI) increased significantly, other hemodynamic variables were stable and no hypertension rebound occurred in both groups. Reaching time of target blood pressure in groupⅡ was shorter than that in groupⅠ（P＜0.05）. The dose required to obtain target blood pressure in group Ⅱwas less than that in group Ⅰ（P＜0.05）. BP recovery time from discontinuing nicardipine infusion to pre-hypotension level,bleeding volume and transfusion volume were similar between 2 groups（P＞0.05）.During mass bleeding,　serious arrhythmia and oliguria did not occur in any case. Conclusion: Controlled hypotension with nicardipine is rapid, stable and easily controlled without hypertension rebound. Nicardipine has considerable protective effects on heart and kidney during mass bleeding. The method of bolus injection followed with intravenous infusion is more suitable to clinical application.