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Objective To analyze the magnetic resonance imaging (MRI) of the spinal cord and clinical characteristics in patients with autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy.Methods A total of 1 040 samples of cerebrospinal fluid (CSF) and sera collected in the Second Affiliated Hospital of Guangzhou Medical University from March 2013 to June 2018 were tested with tissue-and cell-based assays,and 42 patients were found positive for GFAP-IgG.The clinical data and MRI characteristics of the spinal cord of 19 patients who were positive for GFAP-IgG in CSF with autoimmune GFAP astrocytopathy and lesions in the spinal cord were retrospectively reviewed.Results There were 12 females and seven males among the 19 patients,with onset age of (44±17) years.The main manifestations of these patients included limb weakness (14/19),abnormal vision (5/19),headache (4/19),seizure (4/19),dementia (3/19),etc.On MRI of the spinal cord,five patients showed involvement in the cervical cord alone,eight showed involvement in the thoracic cord alone and six had both cervical and thoracic segment involvement.Fifteen patients had longitudinally extensive myelitic abnormalities (≥3 vertebral segments long).Seven enhancement patterns were encountered.Lesions were displayed in the spinal cord and brain in eight patients.Central gray matter involvement in the spinal cord was found in all the 19 patients.Conclusions Autoimmune GFAP astrocytopathy more frequently presents in females than in males.MRI of the spinal cord has complex presentations and longitudinally extensive myelitic abnormalities usually.Patients often show central gray matter involvement in the spinal cord.Myelitic abnormalities present more often in thoracic segment than in cervical segment.Abnormalities in lumbar segment are less encountered.
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Objective To evaluate the effects of remifentanil preconditioning on the renal injury induced by limb ischemia-reperfusion (I/R) in rats.Methods Twenty-seven healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly assigned into 3 groups (n =9 each):sham operation group (Sham group),I/R group and remifentanil preconditioning group (RPC group).Limb ischemia was induced by clamping bilateral femoral arteries and veins for 2 h,followed by 24 h reperfusion in I/R and RPC groups.Remifentanil 1.0 μg· kg-1 · min-1 was infused via the caudal vein for 30 min before ischemia in RPC group,while the equal volume of normal saline was given in Sham and I/R groups.Blood sample was taken from the inferior vena cava at 24 h of reperfusion to measure blood urea nitrogen (BUN) and creatinine (Cr) concentrations in serum.The rats were sacrificed and the left kidney was removed for determination of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) contents,cell apoptosis and microscopic examination of pathological changes.Apoptosis index was calculated.Results Apoptosis index and concentrations of BUN and Cr in serum,TNF-α and IL-6 contents,and apoptosis index were significantly higher,and the pathological changes were more severe in I/R and RPC groups than in Sham group.Compared with group I/R,concentrations of BUN and Cr in serum,TNF-α and IL-6 contents,and apoptosis index were significantly decreased,and the pathological changes were attenuated in RPC group.Conclusion Remifentanil preconditioning can attenuate renal injury induced by limb I/R in rats,and inhibition of inflammatory responses and cell apoptosis in kidney may be involved in the mechanism.
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A simple and efficient method for the determination of organotin compounds ( OTCs) in biota by GC-MS coupling with sodium tetraethylborate ( NaBEt4 ) derivatization was established. The results showed that recoveries for each OTCs spiked in blank freeze-dryed biological samples ( 0 . 1 g ) following extraction (15 mL 0. 035 mol/L methanolic HCl solution for 1 h ) and derivatization (2 mL contained internal standard n-hexane and 0. 5 mL of 2% (m/V) NaBEt4 solution for 30 min) were above 80%. The method is fast and easy to operate for the determination of OTCs in complex biological samples. The minimum limit of detection was about 0. 01 μg/L, and relative standard deviation values were within 10% for three parallel samples.
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Objective To compare the bronchial blocker and double-lumen tube for one-lung ventilation in patients undergoing esophageal cancer resection.Methods Forty ASA physical status Ⅰ-Ⅲ patients of both sexes,aged 42-63 yr,scheduled for elective esophageal cancer resection,were randomly divided into 2 groups (n =20 each):double-lumen endotracheal tube group (group DLT) and bronchial blocker group (group BB).After induction of anesthesia,the patients were intubated with a left-sided double-lumen endotracheal tube and correct positioning was verified by fiberoptic bronchoscopy in group DLT.After induction of anesthesia,the patients were intubated with a conventional single-lumen endotracheal tube,and then the bronchial blocker was inserted under the guidance of fiberoptic bronchoscope in group BB.The intubation time,one-lung ventilation time,time to achieve lung collapse,operation time,extubation time,tube malposition and hypoxemia were recorded.The lung collapse was scored at the end of operation.Hoarseness and throat sore within 2 days after extubation and pulmonary infections within 7 days after operation were recorded.Results Compared with group DLT,intubation time and time to achieve lung collapse were significantly prolonged,and the incidence of hoarseness and throat sore within 2 days after extubation was decreased in group BB (P ＜ 0.05).There was no significant difference in the one-lung ventilation time,operation time,extubation time,lung collapse score,incidence of tube malposition,hypoxemia and pulmonary infections within 7 days after operation between the two groups (P ＞ 0.05).Conclusion The efficacy of bronchial blocker is similar to that of double-lumen tube when used for one-lung ventilation in patients undergoing esophageal cancer resection.
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Objective To investigate the effect of sevoflurane postconditioning on the renal injury induced by hind limb ischemia-reperfusion (I/R) in rats.Methods Twenty-four healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly assigned into 3 groups (n =8 each):sham operation group (group S),group I/R and sevoflurane group (group Spo).Limb ischemia was induced by occlusion of bilateral hind limbs for 4 h followed by 6 h reperfusion.In group Spo,sevoflurane was inhaled for 6 h at the end-tidal concentration of 2.5 ％ before reperfusion,while pure oxygen was inhaled instead of sevoflurane in groups S and I/R.Blood samples were taken from the inferior vena cava at 6 h of reperfusion to determine the serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.The rats were then sacrificed and the kidney was removed for determination of superoxide dismutase (SOD) activity and contents of malondialdehyde (MDA),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and for microscopic examination.Results The levels of BUN,Cr,MDA,TNF-α and IL-6 were significantly higher,the SOD content was significantly lower (P ＜ 0.05),and the pathological damage was severer in groups I/R and Spo than in group S.Compared with group I/R,the levels of BUN,Cr,MDA,TNF-α and IL-6 were significantly decreased,the SOD content was significantly increased (P ＜ 0.05),and the pathological damage was attenuated in group S.Conclusion Sevoflurane postconditioning can reduce the renal injury induced by hind limb I/R in rats,and the reduction of oxygen radical release and inhibition of inflammatory response may be involved in the mechanism.