Neonates are undergoing the transition period from fetal circulation to adult circulation, and the hemodynamic changes are complex.For premature infants(especially very low birth weight infants and extremely low birth weight infants), the cardiovascular systems are immature.Therefore, they are prone to hypotension at early postnatal stage.Hypotension may lead to multiple organ perfusion insufficience, cerebral lesion, and even death.However, it is not always accompanied by hypoperfusion.Before treatment, clinicians should evaluate the hemodynamics comprehensively.At present, there is no consensus on the definition and intervention threshold about hypotension in premature infants.This review summarizes the definitions and hemodynamic monitoring methods of hypotension in premature infants at early postnatal stage to provide references for diagnosis and treatments.

ObjectiveTo investigate the common pathogenic bacteria and antimicrobial resistance status in neonatal ward to provide guidance for rational clinical medication. MethodsData of 2306 cases in neonatal ward from July 2008 to June 2010 whose body fluid were cultured with positive results of common bacteria were collected. The change of the bacteria and drug resistance was analyzed. Results Among 10 017 body fluid samples, 80 species consisted of 2306 strains of bacteria were found. Enterobacteria accounted for about 53.8％ (1241/2306), Klebsiella pneumoniae subsp. pneumoniae (430/1241, 34.6％) and Escherichia coli (341/1241, 27.5％) were the most common ones,and among which 68.1％(293/430)strains of Klebsiella pneumoniaesubsp.pneumoniae and 59.5 ％ (203/341 ) strains of Escherichia coli were extended-spectrum β-lactamases (ESBLs) producing strains, which were significantly lower than those[78.1％ (118/151) and 82.6％(76/92) respectively]during 2003 to 2005 (U=-2.32 and -4.11, P＜0.05 respectively).Methicillin-resistant Staphylococcus aureus(MRSA)detectionrate was 8. 5％(23/272)in Staphylococcus, which was lower than that (17.7％, 15/85) in year 2004 to 2006 (U= -2.4, P＜0. 05). Methicillin-resistant coagulase-negative Staphulococcus (MRCNS) detection rate was 63.5％(157/247), which was higher than that (32.6％, 97/298) in year 2004 to 2006(U=7.54,P＜0.05).The common pathogens of nosocomial infection were Klebsiella pneumoniae subsp.pneumoniae,Escherichia coli , Acinetobacter baumannii and Pseudomonas aeruginosa ; while common pathogens of community infection were Staphylococcus aureus, Klebsiella pneumoniae subsp.pneumoniae and Escherichia coli. Multiple drug-resistant infections in hospital were significantly higher than those in community. Drug susceptibility results showed that the resistance of Staphylococcus haemolyticus,Acinetobacter baumannii and Klebsiella pneumoniae subsp.pneumoniae were especially severe.ConclusionsOpportunistic infections and drug resistant strains increased. The increasing of MRCNS and drug-resistant of Acinetobacter baumanniishouldbepaidmore attention.Comprehensive measures might reduce the production of ESBLs bacteria. The choice of antibiotics should be based on drug susceptibility test.

Objective To analyze the imaging features of endometrial carcinoma derived from multimodal MRI.Methods MRI scan was performed in 45 patients with biopsy-proved endometrial carcinoma,including conventional MRI,diffusion weighted imaging(DWI),dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI),and time-signal curve (TIC).Results The diagnosis rate of DCE-MRI combined with DWI was 93.3%, and that of conventional MRI was 77.8%.Tumor differentiation was negatively correlated with ADC and rADC, and significant difference was found between G2 and G3 as well as G1 and G3 (both P<0.05).There was no significant difference between G1 and G2 (P>0.05).Of the 45 cases, 43 showed TIC type Ⅰ and type Ⅱ, and 2 showed TIC type Ⅲ, while the normal myometrium was mainly type Ⅲ curve.The difference of signal intensity of each phase (D), and enhancement rate (ER) of the lesions were lower than those of the normal myometrium.The difference was statistically significant at the phase of >30 s(P<0.05),the peak time of the former was (50±10) s.Conclusion Multimodal MRI is of great value in preoperative staging and grading of endometrial carcinoma.

Objective To summarize and discuss the characters of intracranial ring-enhanced metastatic tumors enhancedly scanned by MRI with ultra-low field.Methods Retrospective study was made of enhanced MRI characters of intracranial ring-enhanced foci in 19 cases diagnosed by clinics and operative pathology.Results Of all 19 cases there were altogether 60 foci,including 15 cases of metastatic tumor with 52 foci,among which there were 39 ring-enhancement,13 even nodular enhancement accompanied by 2 soft mater emhancement,1 cerebral abscess case with ring-enhancement in all 3 foci,1 case cysticercosis of brain with 3 ring enhanced foci accompanied by intraparietal cephalomere enhaucement.In 2 cases of ostrocytoma,mild ring-enhancement could be seen in 1 case of Ⅱ astrocytic tumors,petaling ring enhancement in 1 case of Ⅲ anaplastic astrocytoma.Conclusions The specific shape showed by MRI provides important information for diagnosing intracranial ring-enhanced metastatic tumors.Correct diagnosis can be made in most cases with medical history,age of patient and location of focus.

AIM: To study the linear relationship between pharmacokinetic parameters and doses about potassium clavulanic acid (CAV) and amoxicillin (AMX). METHODS: 15 healthy male volunteers were randomly divided into 5 dose groups. The plasma concentration of CAV and AMX was determined by high performance liquid chromatography (HPLC) method. The pharmacokinetic parameters obtained with 3p97 soft were regressed to corresponding dose. RESULTS: The regression equations of AUC and c max to dose about CAV were Y= 2.0895 X+ 0.4438 (r= 0.9915 ) and Y= 0.9397 X+ 0.1796 (r= 0.9922 ), respectively. The regression equations of AUC and c max to dose about AMX were Y= 4.8795 X+ 2.4794 (r= 0.9988 ) and Y= 1.7276 X+ 1.4832 (r= 0.9935 ), respectively. CONCLUSION: There is good linear relationship between pharmacokinetic parameters and doses about CAV and AMX.

Objective To investigate the association between nonalcoholic fatty liver disease (NAFLD) and metabolism or carotid intima-media thickness (CIMT) in Type 2 diabetic(T2DM). Methods According to the liver B-ultrasonography, a total of 321 T2DM patients were divided into two groups, with or without NAFLD. Metabolic indexes such as BMI, BP, blood glucose, blood lipid, uric acid ( UA ), insulin, C-peptipe,insulin resistance index(HOMA-IR) between the two groups were compared, and the relationships between alanine aminotransferase (ALT) and the above indexes were analyzed. Furthermore,the CIMT of the two groups were compared, and the relationships between NAFLD, ALT and CIMT were investigated by correlation and regression analysis. Results Compared with the group without NAFLD, the patients with NAFLD had higher level of BMI, triglyceride ( TG ), UA, fasting blood glucose ( FBG ), fasting insulin ( FIns ), fasting C peptide (FCP) ,HOMA-IR,and lower level of high density lipoprotein ( HDL-C ) significantly; BMI ( OR = 1.25, P ＜0. 001 ), TG ( OR = 1.74, P = 0. 008 ) and HOMA-IR ( OR = 2. 33, P = 0.010) were independent risk factors of NAFLD while H DL-C was independent protective factor; ALT was positively correlated with BMI (r = 0. 255, P ＜0. 001 ) ,TG(r =0. 156,P ＜0. 018) ,UA(r =0. 239,P ＜0. 001 ) ,FIns(r =0. 213,P =0. 001) ,FCP(r =0. 199,P ＜0. 003), HOMA-IR ( r = 0. 247, P ＜ 0. 001 ) and negatively correlated with HDL-C ( r = - 0. 199, P =0. 002) ,and BMI (β =0. 456,P =0. 048) ,UA (β =0. 021 ,P =0. 025) and HOMA-IR(β =3.634 ,P =0. 004)were independent associated facrors. The difference of CIMT between the two groups didn't reach statistical significance, while mutiple regression analysis revealed that ALT was independently associated with CIMT(β =0. 002,P = 0. 013). Conclusion T2DM patients with NAFLD show more serious disorder of metabolism and insulin resistance. ALT is an independent risk factor of CIMT in T2DM patients.

Cytochrome P450 enzymes are composed of many isozymes and involved in the biotransformation of both exogenous and endogenous substances. A growing number of studies have found that the P450 enzymes do not always follow the classical Michaelis-Menten kinetics, but show atypical kinetic behavior, which is also the current research hotspot. In this paper, the category and mechanisms of atypical kinetics of the P450 enzyme were reviewed, providing theoretical basis for the research of enzyme kinetics.

Objective To investigate the effects of different doses of dexmedetomidine on cerebral oxygen saturation and pulmonary shunt fraction in patients undergoing one-lung ventilation (OLV). Methods Sixty ASAⅠ-Ⅱpatients, aged 46-71 years, with body mass index (BMI)18-24 kg/m2 and scheduled for thoracotomy were randomly divided into three groups (n=20 each):high dose dexmedetomidine group (group D1), low dose dexmedetomidine group (group D2) and control group (group C). Dexmedetomidine 1μg/kg was infused in group D1 after anesthesia induction, and then a rate of 0.5μg·kg-1·h-1 was continuously infused. Dexmedetomidine 0.5μg/kg was infused in group D2 after anesthesia induction, and then a rate of 0.3μg · kg-1 · h-1 was continuously infused. Group C was received the equal volume of normal saline. Anesthesia was main?tained with propofol-remifentanil and intermittent iv boluses of rocuronium. Arterial and jugular venous blood samples were collected before anesthesia induction (T0), at 15 min after two-lung ventilation (T1), at 5 min (T2) and 30 min (T3) of OLV for blood gas analysis. Value of Qs/Qt was calculated and SctO2 was recorded at the same time. Results Compared with group C and group D2, Qs/Qt was decreased at T2 in group D1 (P<0.05). Qs/Qt was lower at T3 in group D1 and D2 than that of group C, and which was lower in group D1 than that of group D2 (P<0.05). In group C and group D1 a significant de?crease in SctO2 was observed at T2 and T3 compared to that at T0 and T1 (P<0.05). SctO2 was significantly higher at T2 and T3 in group D2 than that in group C and group D1 (P<0.05). Conclusion Dexmedetomidine given during OLV undergoing thoracotomy can improve oxygenation, decrease pulmonary shunt fraction and reduce the occurrence of low SctO2.

Objective To analyze the effects of the mumps virus on testicular function and evaluate the value of blood testosterone in acute orchitis condition and prognosis by observing the testosterone levels of peripheral blood in the mumps orchitis patients.Methods Thirty patients with acute mumps orchitis (mumps orchitis group)and 28 patients with mumps only without any major complications (mumps group)were enrolled in the study.At the same time,we selected 20 healthy males in our hospital as healthy controls.All cases were treated by ribavirin (10mg/kg). The testosterone was tested by chemiluminescence method,in 0,7,14 days respectively.The variance analysis and LSD -t test were used to compare differences of blood testosterone in each group,and Pearson method was used to analyze the correlation of blood testosterone and testicular swelling day times,blood amylase,level of neutrophils,IL -6 and CRP.Results The testosterone of acute orchitis [(1.51 ±0.26)ng/mL]was lower than mumps group and healthy controls.The difference was significant(F =99.36,P <0.01).The level of blood testosterone was significantly increased in the treatment for 14 days (t =13.03,P <0.01),and there was no significant difference compared with healthy controls (t =1.23,P =1.23).Pearson correlation analysis found that blood testosterone levels were negatively correlated with the days of testicular swelling,the levels of IL -6 and CRP(r =0.678,P <0.01 and r =0.528,P =0.000;r =0.442,P =0.000).Conclusion This study showed that MuV infection inhibited testosterone synthesis in Leydig cells.In other words,the level of blood testosterone is related to the severity of the orchitis,which can be widely used in clinical.

Aim An HPLC method was established for the study on pharmacokinetics and bioequivalence of oxaprozin enteric tablet in healthy volunteers.Methods The oxaprozin in plasma was determined using HPLC method following a single oral dose of 400 mg of oxaprozin given respectively to 18 healthy male volunteers in an open randomized crossover design.The pharmacokinetic parameters and relative bioavailability were calculated to evaluate the bioequivalence of 2 preparations.Results AUC_(0-240 h) of oxaprozin tested tablet and reference tablet were(2852.86?871.00)and (2992.84?854.02)?g?L~(-1)?h,C_(max) were(33.48?11.36)and (32.70?7.30)?g?L~(-1),T_(max) were(12.1?5.7)and(13.8?5.8)h,T_(1[]2ke) were(57.11?8.51)and(60.98?7.97)h,respectively.These main pharmacokinetic parameters obtained showed no statistically significant difference between the 2 products.Conclusion The method is simple and sensitive.Both preparations are bioequivalent.