Macrolide antibiotics are broad-spectrum, with activity against a range of Gram-positive, Gram-negative organisms and some anaerobes. The components of macrolide antibiotics are generally complicated. Therefore, it is very important to establish impurity profiles of these antibiotics to ensure their safety and process control. Compared with classical methods, the liquid chromatography-mass spectrometry method is particularly advantageous to characterize minor components at trace levels in terms of sensitivity, efficiency and selectivity, thus more and more widely used in establishments of impurity profiles. In this study, the general approaches to characterize minor components in complex pharmaceutical matrix, fragmentation pathways of 14- and 16-membered macrolide antibiotics and the establishment of the impurity profile of acetylspiramycin were given to provide valuable enlightenments to establish the impurity profiles of pharmaceutical products.

A near infrared (NIR) method for the detection of illegal addition of sildenafil citrate in capsules of Chinese traditional medicine was constructed. The diffuse reflectance near infrared spectra were recorded using integrated sphere and fiber optics respectively. Using the spectra of the sildenafil citrate standard as Reference spectra, the threshold of the correlation coefficient was set up based on the minimum effective concentration of the sildenafil citrate. By comparing the threshold with the correlation coefficient between the tested spectra and the Reference spectra in the selected spectral range, the tested sample contains sildenafil citrate is determined. For the integrated sphere method, the spectral range of 6070-5800 cm~(-1) and 4170-4070 cm~(-1) were selected, and 70% was set as threshold. For the fiber method, 6070-5800 cm~(-1) and 65% were used. 79 and 247 batches of the Chinese traditional medicines contained sildenafil citrate collected from the Chinese market were used to validate the two methods separately. The accuracy of the integrated sphere method was 91.14%, and that of f iber method was 87.45%.

To study retrospectively on extracorporeal circulation (ECC) in pediatric patients with congenital heart diseases. 1286 cases were divided into two groups. In groupⅠ( n =883) ECC were performed with nonpatterned tubing system, and in group Ⅱ( n =403) patterned tubing system was used. GroupⅠandⅡwere both primed with Ringer′s solastion and colloid. There were no stastistically significant difference in age or body weight between groupⅠand Ⅱ. The crystalloid priming volume in group Ⅱ was less than that in groupⅠ( P

Objective To evaluate the protective effects of ulinastatin on renal function in rabbits with traumatic hemorrhagic shock. Methods Thirty rabbits were randomly allocated to three groups: control group, traumatic hemorrhagic shock group and ulinastatin treatment group. Blood was sampled at two time points: pre-shock and 4h after blood volume replenishment, and the plasma levels of NE, BUN and Cr were measured. 4h after blood volume replenishment, the rabbits were sacrificed, and the activity of MPO in renal tissue and urine NAG were measured. Results In all the three groups, the plasma concentrations of BUN and Cr were somewhat elevated but showed no statistical significance in comparison with each other. The activity of NE in blood, MPO in renal tissue and NAG in urine were increased significantly in the traumatic hemorrhagic shock group compared with those of ulinastatin-treated group (P

Objective To determine the safety and clinical value of secondary ERCP to a failed intubation procedure.Methods A total of 212 patients with difficult intubation during ERCP procedures were enrolled.Patients with failed conventional intubation accepted precut sphincterotomy.The operation stopped after one hour of effort.A secondary selective ERCP was performed at a appropriate time.The operation success rate and complication rate of first ERCP and secondary ERCP were compared.Results The success rate of first ERCP was 67.0％ (142/212),and the total success rate was 90.6％ (192/212).The total success rate is significantly higher than that of first ERCP operation(x2 =35.263,P ＜0.05).The complication rate of first ERCP,secondary ERCP and total complication rate was 8.96％ (19/212),4.29％ (3/70),10.38％ (22/212),respectively.Complication rates of total ERCP and secondary ERCP were not significantly different from the first ERCP (P ＞ 0.05).Conclusion It is safe and effective for patients with failed ERCP intubations after precut to receive a secondary ERCP at a appropriate time.

Objective To investigate effective methodology for preventing infectious diseases from spreading within general hospitals at all levels. Methods Six hospitals at three levels in the city were made into two groups and investigated for their treatment of infectious diseases. The group of A1, A2 and A3 hospitals employs the five pre-triage, while the group of B2, B2 and B3 employs the routine pretriage. Results Comparison of undetected infectious cases between group A1, A2, A3 and group B1,B2,B3 identified significant difference with x2 testing, P＜0. 005. Conclusion Five pre-triage method can screen, identify and pinpoint confirmed or suspected infectious disease patients from all outpatients in the first time, thus preventing and controlling the nosocornial transmission of epidemic or even an outbreak of nosocomial infection effectively.

Objective To study the curative effect of limited-acupotomy therapy on chronic lumbosacral osteo-fascial compartment syndrome. Methods 59 patients were randomly recruited into a control group (with 29 patients) and a treatment group (with 30 patients). The control group was treated with general-acupotomy therapy, and treatment group was treated with limited-acupotomy therapy. Evaluate the curative effects before the first and the second therapy, and 3 months after the therapy respectively, as well as VAS pain, JOA and CODI scores. Results The curative effect was 96.56% and 100% respectively in the control group and the treatment group 3 months after the treatment. The difference between the two groups was not statistically significant(χ2＝0.19,P＞ 0.05). As to VAS pain scores, JOA and CODI scores, the difference among the three stages of the treatment were significant (in control group F＝165.70, 99.90, 106.60 respectively, in treatment group F＝279.76, 154.34, 67.36 respectively, P＜0.01)in both groups respectively, but the difference between the two groups were not significant(P＞0.05) in each stage. Conclusion Limited-acupotomy therapy was safe and effective in treating chronic lumbosacral osteo-fascial compartment syndrome.

Objective To evaluate the clinical utility of SpyGlass single-operator ERCP-guided cholangiopancreatoscopy system for the diagnosis and treatment of bile duct disorders.Methods A total of 9 patients with biliary diseases were treated with SpyGlass single-operator ERCP-guided cholangiopancreatoscopy system.Four patients with large bile duct stones accepted laser lithotripsy,and stones were removed by ERCP.Five patients with indeterminate bile duct stricture accepted cholangioscopy-guided sampling.All patients underwent ENBD,routine blood test,blood amylase test,oral food and water restriction,acid suppression and prophylactic antibiotics.Results SpyGlass was successful in all patients with a manipulating time of 21.2min and total procedure time of 46.2min.Complete stone clearance was achieved in all 4 patients with large biliary stones.Sample quality was adequate in all patients with bile duct stricture with 2 patients diagnosed as having malignant biliary tumor and 3 as inflammatory bile duct stenosis.Post-ERCP complications including mild pancreatitis in 2 patients,and the patients recovered gradually after corresponding treatment.Conclusion ERCP-guided cholangiopancreatoscopy with the SpyGlass system is technically feasible and can be successfully and safely performed in patients with biliary disorders.

Objective To analyze the radiological findings of dedifferentiated chondrosarcoma, and to explore the imaging features of dedifferentiated tissue. Methods The X-ray and CT findings of 13 cases with dedifferentiated chondrosarcoma of bone were analyzed retrospectively, and studied with clinic and corresponding histological changes. Results The dedifferentiated chondrosarcoma not only had the radiological findings of typical chondrosarcoma but also had the imaging features of dedifferentiated tissues. In 13 patients, periosteal reactions were found in 11 cases, ossifications in 8 cases, soft tissue masses in 12 cases, calcifications in 10 cases, and the site of calcifications in 8 cases was in the center of the focus. Conclusion The dedifferentiated chondrosarcoma showed special imaging features, which includes ossification, calcification, periosteal reaction, and soft tissue mass. These features were not found in typical chondrosarcoma. Recognizing these specific features is helpful to the diagnosis of dedifferentiated chondrosarcoma.

The molecular descriptors of impurities with known structure in cefdinir were calculated, selected and associated with the chromatographic retention behavior to establish a model. This quantitative structure retention relationships (QSRR) model for the related substances of cefdinir was established under specific chromatographic condition and verified by other impurities. 12 molecular descriptors were used to establish the QSRR model, F_AFRBWF, Blbn_J, SsCH3, SssCH2, SsNH2, SssNH, SssS, SHdCH2, EEM_AFc, EEM_AFpl, EEM_XFpl and Pi_MaxQ. The relativity between true values and predictions in QSRR of cefdinir is R2 = 0.9836 (n = 18), ΔRRT is no more than 0.154, as 10.17% in RRT. The results indicate that the QSRR model for the related substances of cefdinir can be used to evaluate the analysis methods for related substances and predict the chromatographic behavior of new impurities, which will provide a new way for the evaluation of the effectiveness for drug quality control.