0.05).Neither pruritus nor respiratory depression was noted in both groups.CONCLUSION:At an equivalent dose,Nefopam Hydrochloride showed a similar PCSA efficacy to Fentanyl after surgery but less side effect,therefore,it can be applied in postoperative PCSA.

Bacillus megaterium strains are commonly used in microbial fertilizer(MF) . MF products are often contaminated by other B. cereus group members,which have similar phenotype such as Bacillus cereus,B. thuringiensis,B. mycoide. For quality control and safety of MF,a rapid and accurate method is needed to distinguish the strains of Bacillus megaterium from B. cereus group. Based on specific nucleotide sequences of the spoOA genes,2 pairs of species-specific primers were designed and a multiplex-PCR(mPCR) was developed for this purpose. When the optimized mPCR was used to detect the DNAs of 24 reference strains from three genera of Bacillus,Paenibacillus,and Brevibacillus,all B. megaterium strains showed singlefragment of 443 bp and Bacillus cereus group showed a fragment of 411 bp. However,no any amplified product was from the other bacteria. The sensitivity of mPCR was 105 CFU/mL. The mPCR results of 10 isolates of B. megaterium/B. cereus group and 8 products of MF coincided with the biochemical assay. Taken together,our newly developed mPCR assay was species-specific and effective in application. It can be used to detect and identify the strains of B. megaterium and B. cereus group from microbial fertilizer products.

Posterior reversible encephalopathy syndrome is a clinical imaging syndrome associated with multiple pathogenic factors.The main clinical manifestations were headache,seizures,psychotic symptoms,visual disturbance,disturbance of consciousness,etc.The parieto-occipital reversible white matter lesions are the main manifestations of the imaging.If this disease can be diagnosed and treated in time,the clinical symptoms and imaging changes of most patients can be disappeared.If the diagnosis and treatment cannot be obtained in time,it may happen some irreversible damage,serious and even life-threatening,so it is very important to strengthen the understanding,diagnosis and treatment of this disease.At present,the pathogenesis of the disease is still not clear,now reviewed its pathogenesis and imaging manifestation in order to strengthen the clinician's understanding of the disease's pathophysiological mechanism and improve the level of diagnosis.

Objective To explore the application and clinical effect of bipolar hemiarthroplasty with bipolar prosthesis on unstable intertrochanteric fracture in the elderly patients.Methods The study involved 53 patients aged over 75 years with intertrochanteric fracture treated with bipolar hemiarthroplasty in our hospital from April 2003 to January 2010.According to Evans-Jensen classification,there were 24 patients with type Ⅲ fractures,eight with type Ⅳ and 11 with type Ⅴ.Osteoporosis degree was at Singh degree Ⅰ in 13 patients,degreeⅡ in 18,degree Ⅲ in 12 and degree Ⅳ in 10.Most patients underwent operation within three days after injury.Results The operation duration was(75 ±10)min,with intraoperative blood loss of(350 ± 68)ml.Three patients were lost to follow-up after discharge and one patient was died of respiratory failure caused by chronic bronchitis five months after operation.Forty-nine patients were followed up for 12-93 months(mean 38 months),which showed no joint dislocation,or loosening,subsidence or rupture of the prosthesis.According to the Harris score of hip joint,the result at final follow-up was excellent in 29 patients,good in 13 and fair in seven,with excellence rate of 86％.Conclusions Bipolar hemiarthroplasty is an effective treatment for osteoporotic and unstable intertrochanteric fractures in the elderly patients.However,as the complemented therapeutic method of proximal femoral nail antirotation(PFNA),bipolar hemiarthroplasty has severe secondary trauma and its indications must be strictly mastered.

Objective To prepared the docetaxel nano liposome (L-DOC) for the therapy of liver cancer HepG2 cells in vitro and in vivo. Methods The film-ultrasonic dispersion method was used to prepare the L-DOC.The diameter and Zeta potential of L-DOC were determined by Nanosizer and the encapsulation efficiency was further measured.CCK-8 method was used to determine the cell viability of HepG2 cell after treating with various concentration of DOC and L-DOC respectively and the cell death type was detected by Flow cytometer.Next, we have studied the relative tumor volume change of tumor-bearing mice and the toxicity in vivo.Results The average diameter of L-DOC was 104 nm and the Zeta potential was about -35.1 mV.The Zeta potential of L-DOC was almost unchanged after standing for 96 hours.The encapsulation efficiency of L-DOC was ( 71.2 ±1.6 )%.The CCK-8 results showed that the cell viability was decreased after treating with various concentration of DOC and L-DOC, but the inhibition effect of L-DOC was better than that of DOC after treating with the same dose, especially for 20μg/mL.It was found that the cell death was induced by apoptosis.The in vivo study results showed that 6mg/kg L-DOC could inhibit the tumor volume better than that of same dose of DOC.In addition, 6mg/kg L-DOC and DOC didn’ t induce in vivo toxicity.Conclusion The L-DOC is prepared by film-ultrasonic dispersion method which has small diameter, great biocompatibility.And it could inhibit the HepG2 cells in vitro and in vivo, especially for no in vivo toxicity.

Objective To develop an in vitro method to determine the effects of drugs on tyrosinase(TYR)activity and screen the inhibitory effects on TYR of14extracted components of Chinese medicinal herbs.Methods The activity of TYR was detected by revised Matsuda's method.Effects of14extracted com-ponents on tyrosinase system were observed in vitro.Results Ten of the14components showed dose-depen-dent down-regulation of tyrosinase activity and melanogenesis.The inhibitory activities of eugenol,curcumin and gallic acid were significantly higher than those of arbutin(P

Objective To study the variation of blood concentration of tetramine in human body with acute tetramine intoxication treated with three different protocols and the levels in human body after discharge from the hos-pital. Methods The blood concentration of tetramine was determined by gas chromatography-mass spectrometry (GC-MS). All 101 patients of acute tetramine intoxication were divided into 3 groups (routine comprehensive treat-ment group,hemoperfusion group,blood transfusion group) according to their blood concentration of tetramine and clinical symptoms. The patients were followed up to monitor the tetramine levels in a year. Results The level of tet-famine in blood was decreased from 33.0(1.7～115.0)μg/L to 18.0(0.3～47.6)μg/L in routine comprehensive treatment group. The total decrement was 45.5 %. The level was decreased from 108.0 (54.0～290.0)μg/L to 26.0 μg/L in hemoperfusion group. The total decrement was 75.9%. The decrement was 20.0%～45.0% after each he-moperfusion. The level was slightly high after 24 h of hemoperfusion. The total decrement in blood transfusion group was 33.5%～60.0%. The level was <0.3μg/L in all 25 out-patients 1 year after their intoxication. Conclusion Routine comprehensive treatment,hemoperfusion,blood transfusion are effective in the treatment of acute tetramine intoxication. The degradation of tetramine in human body is slow.

Objective To analyze the sibling relationship and genetic diversity of four certified Radix Gentianae (RG) species by RAPD and ISSR methods. It provided molecular biological proof for species identification and breeding of certified RG. Methods PCR reaction systems of RAPD and ISSR were optimized, and the agarose gel electrophoresis results were analyzed into statistic data. Results Ten RAPD primers and four ISSR primers were selected respectively from 100 RAPD primers and 32 ISSR primers. The statistic data were analyzed to construct cluster analysis dendrogram by genetic distance UPGMA method. Conclusion The PCR reaction systems of this experiment gets ideal RAPD and ISSR results that suit to the analysis of certified RG species in genetic diversity and sibling relationship.

Objective To investigate the clinical effects of large flow-through venous flap for salvaging the limb on the verge of amputation complicated with arterial defect.Methods Between March 2012 and January 2015,large flow-through venous flap was used in 10 patients with upper limb on the verge of amputation to reconstruct artery defect and large-area skin and soft tissue defect,including 6 males and 4 females with a mean age of 27.9 years (range,18 to 41 years).Injury was caused by machine crush in 4 patients,twisting belt pulley in 4,and traffic accident in 2.The dimension of skin defect ranged from 6.5 cm× 10.0 cm to 10.5 cm × 18.0 cm (mean,9.0 cm × 12.0 cm).Vascular defect length ranged from 6.0 to 16.0 cm (mean,12.3 cm).Time from injury to operation was 1.5-5.5 h (mean,3.5 h).After operation,flap survival,appearance,texture and sensation were recorded.Upper limb function was evaluated using the standard set up by hand surgery branch of Chinese Medical Association.Results The flap varied in size from 8.0 cm×12.0 cm-12.0 cm ×20.0 cm (mean,10.0 cm × 13.5 cm).One patient was amputated due to severe postoperative infection,and 9 patients were successfully operated.The flap showed small-area necrosis on the distal end in 2 patients,which was cured after dressing change,while survived completely in 7 patients.The donor wounds healed in one stage.After 12-27 months of follow-up (mean,13.7 months),the thickness,texture and appearance of the flap were close to the surrounding normal tissues and the skin protective sensation was restored.The functional results were excellent in 6 patients,good in 2 and poor in 1,with the excellent and good rate of 89％.Conclusion Large flow-through venous flap can reconstruct upper-limb vascular defect while repairing large-area wound,and has advantages of easy operation,less damage to the donor site and good appearance.

BACKGROUND:From the biological structure, the posterior cruciate ligament is surrounded by the synovial folds of posterior capsule, arising from the inner side of the medial femoral condyle to the posterior part of tibial intercondyloid spine. The main traditional treatment method for posterior cruciate ligament tibial avulsion fracture is open operation, but it is difficult in anatomic reduction, cannot ful y restore knee joint stability and has a great negative impact on the normal function of posterior cruciate ligament. OBJECTIVE:To investigate the effects of arthroscopic implant internal fixation in the treatment of tibial avulsion fracture of the posterior cruciate ligament. METHODS:120 patients with tibial avulsion fracture of the posterior cruciate ligament were randomly assigned into treatment group and control group, with 60 cases in each group. The control group was given the traditional open surgery, and the treatment group was given the arthroscopic surgery. After 3 months, International Knee Documentation Committee (IKDC) scores and Lysholm scores were detected in the two groups;the knee joint range of motion was determined before and 3 months after treatment. RESULTS AND CONCLUSION:Wounds were healed at stage I in al patients with no serious complications. There was no difference in the knee joint range of motion between the two groups before treatment, but the range of motion was increased significantly in both two groups at 3 months after treatment (P<0.05), meanwhile which was higher in the treatment group than the control group (P<0.05). At 3 months after treatment, the excel ent knee function rate was significantly higher in the treatment group (97%) than the control group (88%) according to the Lysholm scores;the IKDC scores were significantly higher in the treatment than the control group in terms of claudication, support, pain, swel ing, and squat (P<0.05). These results indicate that the arthroscopic implant fixation of tibial avulsion fracture of the posterior cruciate ligament has better short-term effects to promote recovery of knee joint function, but no serious complications.