OBJECTIVE:To develop a method to assay the content of tinidazole in tinidazole tablets METHODS:RP-HPL_C:mobile phase,acetonitrile-water-glacilal acetic acid(20∶80∶0 1);detection wavelength,317nm RESULTS:The linear range of concentration of tinidazole in calibration curve was 10～90?g/ml,r=0 9 996 The recovery of the added sample was 99 68%,RSD was 0 72% CONCLUSION:The method is simple,sensitive,accurrate and can be used as one of method for quality control of this tablet

BACKGROUND: Both animal experiments and clinical practice have confirmed that mild or moderate hypothermia is effective in reducing secondary brain injury, but its effect on homeostasis is not very clear.OBJECTIVE: To investigate the effect of a combined therapy of mild hypothermia and hibernation on the homeostasis of patients with severe brain injury.DESIGN: A randomized controlled study.SETTING: Neurosurgical Institute of Beijing; Neurosurgical Department of the First Clinical Medical College Affiliated to Harbin Medical University;and Neurological Department of the Second Clinical Medical College Affiliated to Harbin Medical University.PARTICIPANTS: The study was conducted at the Department of Neurosurgery, the First Affiliated Hospital of Harbin Medical University, from June to December 2002. Totally 24 patients (aged 35-60 years) with severe cerebral hemorrhage or brain injury were randomly divided into combined therapy group and normothermia group. Their Glasgow Coma Scale scores ranged from 3 to 8. The subjects signed the informed consent.METHODS: Within 10 hours of their injury, patients in hypothermia and hibernation combination group were given half dosage of No. 1 hibernation cocktail (chlorpromazine 25 mg, pethidine hydrochloride 50 mg, and promethazine 25 mg), and were cooled by cooling blankets to make their body temperature dropped to 32-34 ℃ (rectal temperature). Their temperature was kept within this range for 5 days, at 35 ℃ for 24 hours, and then was slowly increased to their normal level. The body temperature of patients in normothermia group was maintained at 37-38 ℃. The mean arterial pressure and heart rate of all patients were measured continuously by HP monitor. On the 3"d and 7th days of hospitalization, intracranial pressure and creatine phosphate kinase were measured via lumbar puncture.Femoral artery puncture was performed to check the partial pressure of arterial O2 and CO2. Platelets count and blood electrolytes K+ and Na+ concentration of each patient were measured, too. On the 7th day Glasgow Outcome Scale scores of each patient and mortality of each group were recorded.activity of creatine phosphokinase, platelets count, blood K+ and Na+ conand CO2 of patients in combined therapy group on the 3rd and 7th days of hospitalization.intracranial pressure, creatine phosphokinase and platelets count: The decreased values of intracranial pressure, creatine phosphokinase and platelet number in combined therapy group were all significantly higher than those in normothermia group [(104.09±54.90), (58.75±25.33) mm H2O; (26.95±19.22), (10.17±7.18) μkat/L; (89.82±46.36)×109/L, (48.83±44.59)×109/L,the mean arterial pressure, blood electrolytes, and partial pressure of artewas significantly lower than that of normothermia group (25.0%, 66.6%,P ＜0.05).CONCLUSION: This combined therapy of hypothermia and hibernation can effectively decrease intracranial pressure and creatine phosphokinase,but has no significant effects on the mean arterial pressure, blood electrolytes concentration, and partial pressure of arterial O2 and CO2. It has the risk of disturbing the patients' hematopoiesis.

Objective Toinvestigatethecorrelationsofthelevelsofplasmasolublereceptorfor advanced glycation end product (sRAGE )with the National Institutes of Health Stroke Scale (NIHSS ), grade of white matter lesions,and risk factors for cerebral vascular disease in patients with acute cerebral infarction.Methods Atotalof120patientswithacutecerebralinfarctionwereenrolledretrospectively. They all underwent head MRI. The plasma sRAGE levels of the acute cerebral infarction group and 120 healthy subjects were detected with enzyme-linked immunosorbent assay (ELISA)and were compared. According to the interquartile range (P25 =540 ng/L,P50 =1030 ng/L,P75 =1400 ng/L ),the plasma sRAGE levels were divided into 4 quartiles (Q1 to Q4). Q1:sRAGE<540 ng/L (n=29),Q2:540 ng/L≤sRAGE≤1030 ng/L (n=31),Q3:1030 ng/L < sRAGE≤1400 ng/L (n =30),and Q4:sRAGE >1400 ng/L (n =30 ). The plasma sRAGE levels in the acute cerebral infarction group and the healthy control group were compared using the Wilcoxon rank sum test. Multiple linear regression analysis was used to analyze the correlations of the sRAGE levels with NIHSS scores,grade of cerebral white matter lesions,and cerebrovascular risk factors. Results (1 )The median level of plasma sRAGE was 870 (540.0,1403. 8)ng/L in the acute cerebral infarction group,which was lower than 1032 (727. 5,1721. 5) ng/L in the healthy control group. There was significant difference (P<0. 05). (2)Single factor analysis showed that the smoking rate,NIHSS scores,the types of deep white matter hyperintensity (DWMH),and the estimated glomerular filtration rate(eGFR)among Q1,Q2,Q3 and Q4 quartiles were significant different (all P<0.05). The smoking rate,ratio of patients with high NIHSS score,incidence of severe DWMH and percentage of the patients with normal eGFR in Q1 (n=29)were 62. 1%(n=18), 44. 8%(n=13),55.2%(n=16)and 51. 7%(n=15),respectively,and they had a higher trend than other quartiles. (3)Multiple linear regression analysis showed that the smoking,NIHSS score,eGFR,and severity of DWMH were the influence factors of the levels of plasma sRAGE in patients with acute cerebral infarction.Thereweresignificantdifferences(allP<0.05).Conclusion Theexpressionlevelsofthe plasma sRAGE in patients with acute cerebral infarction group is significantly lower than those in the healthy subjects,and smoking,neurological defect,eGFR,and severity of DWMH are associated the low level of sRAGE. sRAGE may be used as a reference index for predicting the conditions of acute cerebral infarction.

Objective To investigate the effect of lacosamide on expression of Nav1 .8 in dorsal root ganglia (DRG) in a rat model of chronic neuropathic pain.Methods Thirty-six female specific-pathogen-free (SPF)SD rats were randomly assigned into 3 groups ( n = 12 each): sham operation group (group S), model group (group M) and lacosamide group (group L) . Chronic neuropathic pain was produced by insertion of a small stainless steel rod (4.00 mm in length and 0.63 mm in diameter) into the L, intervertebral foramen in the rat, producing a chronic steady compression of the DRG in M and L groups. The mechanical threshold was measured 2 days before operation and on the 2, 4, 6, 7, 8, 9 and 10 days after operation (T0-7 ) . Intraperitoneal lacosamide 20mg/kg (in normal saline 0.5 ml) was injected at T4-7, twice a day in S and L groups. In group M, normal saline 0.5 ml was injected at T4-7 twice a day and the mechanical threshold was measured after the last administration everyday . The L, DRG on the operated side was removed after measurement of pain threshold to detect the expression of Na, 1.8 mRNA and protein by RT-PCR and immuno-histochemistry respectively. Results Compared with group S, the mechanical pain threshold was significantly decreased at T1-7 and the expression of Navl .8 mRNA and protein was up-regulated in M and L groups ( P < 0.05) . Compared with group M, the mechanical pain threshold was significantly increased at T4-7 and the expression of Nav 1.8 mRNA and protein was down-regulated in group L ( P < 0.05) . Conclusion The mechanism by which lacosamide reduces chronic neuropathic pain is related to the down-regulation of the expression of Nav 1.8 in rat DRG.

Objective To investigate the clinical effect of proximal femoral nail anti rotation intramedullary nail (PFNA)in the treatment of intertrochanteric osteoporotic fractures in elderly patients.Methods 42 cases of femoral intertrochanteric fracture were treated with proximal femoral nail anti rotation intramedullary nail (PFNA)in cases (AO type,A1 type 13 cases,A2 type 24 cases,type A3 5 cases).Results The group of 42 patients after 12 -36 months of follow -up,the average follow -up time of 18 months,all the patients were healed,1 case of deep venous thrombosis,1 case of mild coxa vara.According to the Harris evaluation standard:excellent 32 cases,good in 9 cases,fair in 1 case,the excellent rate was 97.6%.Conclusion The proximal femoral nail anti rotation (PFNA) anti tensile,anti sliding and anti rotation function is good,and has the advantages of simple operation,small trauma,for osteoporotic intertrochanteric fracture patients can be applied.

Objective To investigate the distribution of pathogens in adult patients with community-acquired pneumonia (CAP) in Tangshan area. Methods The clinical data of 530 hospitalized patients with CAP were retrospectively collected in department of respiratory medicine from 6 hospitals in Tangshan area from October 2011 to September 2012. The sputum samples were isolated and cultured. Results A total of 195 strains were isolated from 530 patients with CAP. The most common types of pathogens included Klebsiella pneumoniae (64 strains,12.08%), Streptococcus pneumoniae (24 strains, 4.53%) and Bauman Acinetobacter (19 strain, 3.58%). The detective rates of Klebsiella pneumoniae and Pseudomonas aeruginosa were significantly higher in patients with basic diseases than those of patients without basic diseases (P<0.05). The detective rates of Klebsiella pneumoniae and Streptococcus pneumoniae were significantly higher in patients not taking antibiotics than those of patients taking antibiotics (P<0.05). The detective rates of Klebsiella pneumoniae, Bauman Acinetobacter and Pseudomonas aeruginosa were significantly higher in the age group≥60 years than those in the age group<60 years (P<0.05). The detective rates of Klebsiella pneumoniae were significantly increased with increased levels of PORT (P<0.05). There were no significant differences in the detective rates of pathogens between different regions and different seasons (P>0.05). Conclusion The gram-negative bacterial pathogens were the majority isolated from patients with CAP in Tangshan area. And Klebsiella pneumoniae was the primary bacteria. Patients with serious illness, above 60 years old, without antibiotic treatment before hospitalization, with basic diseases and above PORTⅢlevels should be given treatment of anti-gram-negative bacteria.

ObjectiveTo observe the effect on repairing facial nerve injury of rabbits by neural stem cells and autologous fasia. Methods22 rabbits with transected facial nerve were divided into 2 groups randomly, control group (8 rabbits,15 sides totally), which transected facial nerve were wrapped by autologous fasia, and treament group (14 rabbits, 20 sides totally), which were wrapped by neural stem cells and autologous fasia. Six weeks after transplantation, neuro-electrophysiological test, immunohistochemical examination were done. The number and thickness of myelin in the re-connected area of transected facial nerve were observed. ResultsThe transplanted animals recovered much better than that in control group (P<0.05). Immunohistochemical examination showed a great deal of BrdU positive cells around the re-connected area of transected facial nerve. Immunohistochemical staining also found plenty of regenerative myelins in this area in the treatment group. While in control group, there were no BrdU positive cells and only a few of regenerative myelins in the same area. ConclusionTransplantation of neural stem cells combined with autologous fasia might become the new method to treat facial nerve injury.

Objective To identify critical genes in evolution of Staphylococcus aureus (S.aureus).Methods A total of 2457 genes from two whole genomes of S.aureus strains were amplified for fabricating whole genome microarray,which was employed for comparative genome hybridization (CGH) analysis of 23 strains of divergent MRSA clones,including ST239-spa t037 and ST239-spa t030.Representatives of differential genes were confirmed by PCR.Results Four gene clusters were identified to be associated with evolution of major epidemic MRSA clones.The four gene clusters were specific to ST239-spa t030,and belonged to three known genomic islands (vSa4,prophage ΦSa1 and ΦSa3).Eight genes were variable expressed in ST239-spa t030 MRSA from different coutries.Conclusion The acquisition of genomic islands vSa4,prophage ΦSa1 and ΦSa3 enhanced the virulence and resistance of ST239-spa t030 MRSA,and contributed to its rapid replacement of ST239-spa t037 MRSA in China.

Objective To analyze the molecular epidemiology and resistant mechanisms ofmacrolide-nonsusceptible Moraxella catarrhalis.Methods A total of 383 strains of Moraxella camrrhaliswere collected from nasopharynx of children under 2 years old.The minimum inhibition concentration (MIC)values were determined by Etest method,and the production of β-lactamase was examined by using anitrocefin-based test.The pulsed-field gel electrophoresis (PFGE) method was used to analyze the type ofdifferent isolates.Polymerase chain reaction (PCR) and sequencing were performed for the resistancemechanism of macrolide resistance in Moraxella catarrhalis.The non-susceptibility rates of six cities( Beijing,Shanghai,Jinan,Nanjing,Wuhan and Dongguan) were compared byx2 test.ResultsAccording to Clinicaland Laboratory Standards Institute (CLSI) breakpoints,the non-susceptibility rates for erythromycin andazithromycin in 383 strdns of Moraxella catarrhalis were 40％ and 23％,respectively.Whereas,the non-susceptibility rates were 59％and 60％based on pharmacokinetics/pharmacodynamics(PK/PD)breakpoints.Significant differences in non-susceptibility rates to macrolide were observed in different cities,and the higher non-susceptibility rates were determined in relatively northern cities,such as Beijing andJinan.Among the 383 strains of Moraxella catarrhalis,92％ (353/383) of isolates produced β-lactamase.Atotal of 14 patterns of groups were generated by PFGE in 37 high-level macrolide resistant Moraxella catarrhalis,and 43％ ( 16/37 ) of isolates could be considered to be related or indistinguishable to group A.In this study,the ermA,ermB,mefA,and merE genes were not detected,while the A2982T,A2796T,A2983T mutations in 23S rRNA gene may be related to macrolide resistance in Moraxella catarrhalis.The A2982T and A2796T mutations conferred high-level macrolide resistance,while the A2983T mutation conferred low-level resistance.ConclusionsA large number of macrolide-nonsusceptible Moraxella catarrhalis isolates are detected in the study.The macrolide resistance is probably related to the mutations in 23S rRNA gene,and the relationship between MIC values of macrolide and mutations has been determined.

Objective To investigate the factors affecting the susceptibility of tigecycline and assess the testing methods.Methods The 116 isolates of Acinetobacter baumanaii and Klebsiella pneumoniae were collected in 13 hospitals from January to December,2010,to evaluate the effects on the tigecycline susceptibility of the overnight medium,medium brand and lot number,respectively.The 56 isolates of Acinetobacter baumannii and the 47 isolates of Klebsiella pneumoniae were selected randomly according to the MIC distribution proportion in 2010 and 2012.The broth microdilution was taken as the reference method to evaluate the effects of the agar dilution,disk diffusion,MIC Test Strip (MTS) and Vitek2 (GN16) on the susceptibility of tigecycline.Results The essential agreement (EA) of Acinetobacter baumannii and Klebsiella pneumoniae is 89.7％ (52/58)and 87.9％ (51/58) using overnight medium and fresh medium respectively.Both EA and categorical agreement (CA) of the different brands (BBL and Oxoid) and lot numbers are 100％ using agar dilution.According to the FDA break point criteria,the CA/EA is 77.7％ (80/103)/99.0％ (102/103),87.4％ (90/103)/98.1％ (101/103),64.1％ (66/103)/76.7％ (79/103) using agar dilution,MTS,Vitek (GN16) with respect to broth microdilution.The CA is 79.6％ (82/ 103,S≥14 mm,R≤10 mm),69.9％ (72/103,S≥ 16 mm,R≤ 12 mm),34.0％ (35/103,S≥19 mm,R≤14 mm)using disk diffusion method compared with broth microdilution (FDA break point criteria).Conclusions The susceptibility of tigecycline must be tested using fresh medium.The medium brands and lot numbers used in this test have no effects on the tigecycline susceptibility to Acinetobacter baumannii and Klebsiella pneumoniae.There exist the better correlations on MIC using agar dilution and MTS than the disk diffusion and Vitek(GN16) compared with broth microdilution.It is expected that the consistency can be improved by adjusting the break point of disk diffusion.