ObjectiveTo investigate the changes of serum myocardial enzymes and high density lipoprotein cholesterol(HDL-C) in children with septic shock.MethodsFifty-two children with septic shock in our hospital from Jan 2006 to Mar 2011 were divided into severe septic shock group( n =27 ) and mild septic shock group ( n =25 ).The serum creatine kinase-MB ( CK-MB ),α-hydroxybutyrate dehydrogenase (α-HBDH),lactic dehydrogenase(LDH) and HDL-C were analysed in both two groups on 1,2,4,7,10,15 d,and compared with 32 normal children as control group.Meanwhile,the children's condition,death cases and cured time were recorded.ResultsThe levels of serum CK-MB [ ( 32.084 ± 4.595 ) U/L,( 61.481 ±5.639) U/L],α-HBDH/LDH(0.694 ±0.080,0.884 ±0.079) in mild and severe septic shock groups were higher than those of normal control group[ (21.675 ± 3.453) U/L ] and (0.443 ± 0.065 ) ( P ＜ 0.01 ) ;the levels of serum HDL-C[ (0.646 ±0.067) mmol/L,(0.310 ± 0.124) mmol/L ] in the two septic shock groups were decreased significantly than that of control group[ ( 1.012 ±0.156) mmol/L] (P ＜0.01 ).Five cases died in the severe septic shock group while no cases died in mild septic shock group.The times of CK-MB recovered[ (9.82 ±1.76) d vs (4.68 ± 1.22) d],α-HBDH/LDH recovered[ (7.23 ± 1.38) d vs (3.76 ± 0.83 ) d] and HDL recovered[ ( 12.14 ± 2.21 ) d vs ( 6.48 ± 1.33 ) d ] were more slowly in severe septic shock group than those of mild septic shock group( P ＜ 0.01 ).ConclusionThe higher of the serum CK-MB and α-HBDH/LDH,and the lower of HDL-C in septic shock children,the disease is more severe,the recovery time is longer and a worse prognosis may occur.

Objective To study the preventive effect of small-dose fluconazol adiministered in low frequency on nosocomial fungal infectoin.Methods The condition of nosocomial fungal infection among 200 patients in pediatric intensive care unit (PICU)were observed,who were suffered with serious infection or basic diseases and underwent broad-spectrum or ultra-broad spectrum antibiotic and steroid hormones treatment.These patients were divided imto treatment and control group.And the patients in treatment group received fluconazol[5 mg/(kg?time)once every 2 days,total 3 times,after that,twice 1 week till improved] to prevent fungal infection .The control group were treated with fluconazol [6-10 mg/(kg?time),once everyday for 10-14 days] after fungal infection.Results The incidence rate of nosocomial fungal infectoin of control group was 58.3%(56 out of 96 cases,which were 44 cases of mouth,5 cases of respiratory tract ,5 cases of digestive tract and 2 cases of urethra ) and that of treatment group was 1.9%(2 out of 104 cases, which were 2 cases of mouth).In control group,37 cases were cured,17 cases improved and 2 cases were not effective.Mouth fungal infection in treatment group was gently and cured with 1 or 2 times of local treatment .The treatment group didn′t occured liver function damage or aggravation.Conclusion For PICU patients, adiministration of small-dose flucomazol in low frequency is an effective and relatively safety method to prevent against nosocomial fungal infectoin.

Objective To investigate the feasibility and efficacy of tunica vaginalis flap cover in treatment of recurrent urethrocutaneous fistula (UCF).Methods We reviewed the clinical datas of 25 cases of UCF after urethroplasty of hypospadias from January 2011 to January 2015.The mean age of the patients was 6.2 years(range 1.6-14.0 years).All patients had undergone previous hypospadias repair and at least one previous failed attempt to close the urethrocutaneous fistulae.There were 5 cases of fistula in the coronary sulcus,6 cases of fistula in the penile body and 14 cases of fistula at the junction of penis and scrotum.The diameter of urethrocutaneous fistulae were 3-10 mm.Single fistula was present in all patients.16 cases had undergone UCF repair for two times, 9 cases had undergone UCF repair for more than two times.After closing the fistula with inverting running stitch, a tunica vaginalis flap was mobilized to cover the repair site through a subcutaneous tunnel and the skin closed.Results The mean follow-up time was 2.1 years(range 0.5-4 years).The overall success rate was 96％ (24/25).Penile cosmesis was excellent.There was no evidence of recurrent fistulas or urethral strictures.All parents reported a straight penis when erected, and one patient in whom there was leak from the fistula site because of local wound infection.No postoperative complication was encountered in the testis.The testis was of normal size and position, and the ultrasound findings were normal.Conclusions Repairment of recurrent urethrocutaneous fistulas with a tunica vaginalis flap could be effective regardless of fistula location.The technique is simple to improve the success rate of the repair of UCF effectively and reduce the occurrence of postoperative complications.

AIM: To observe the effect of stellate ganglion interruption combined with Xuefu Zhuyu Capsules on the residual post-herpetic neuralgia (PHN) in the old. METHODS: 74 aged patients (55-87 years) suffering from residual PHN were selected and divided into two groups. and received stellate ganglion interruption (control group) and received stellate ganglion interruption combined with Xuefu Zhuyu Capsules (treatment group). The clinic effect was evaluated before and after treatment by visual analogue scale (VAS) and quality of sleep (QS). RESULTS: VAS and QS were 8.84?0.66 and 3.78?0.31, respectively, before treatment and there was significant reduction in VAS and QS after treatment in treatment group. CONCLUSION: The clinic effect of stellate ganglion interruption combined with Xuefu Zhuyu Capsules is efficient on relief from PHN and improvement of sleep quality.

Objective To investigate the dynamic changes of lymphocyte subsets (lymphocyte count, CD3 +T,CD4 +T,CD8 +T,CD19 +B,CD56 +NK)in children with septic shock.Methods Peripheral blood lymphocyte subsets were analysed in 25 cases with severe septic shock and 24 cases with mild septic shock on day 1 ,3,8,and compared with those of 25 healthy volunteers.Children with severe septic shock were divided in-to survival group and dying group according to the outcome.The detection data were compared.Results In the first day of admission,peripheral blood lymphocyte subsets in children with septic shock decreased significantly compared with the normal children,and there was significant difference in the three groups(P <0.05 ).In the third day of admission,children with mild septic shock had statistical increase of CD4 +T,CD3 +T and lympho-cyte count(P <0.05),and children with severe septic shock had statistical decrease of lymphocyte subsets ex-cept CD56 +NK.In the eighth day of admission,children with mild septic shock had no significant difference in CD4 +T lymphocyte count compared with control group(P >0.05),but children with severe septic shock had statistical increase of CD4 +T,CD3 +T and lymphocyte count(P <0.05).There were 5 cases died who had se-vere septic shock in day 2 to day 5 after admission.The count of lymphocyte subsets were detected significantly lower in dying group than survival group in the third day of admission(P <0.05).Conclusion The continuous low level of lymphocyte subsets indicates bad outcome.The patientˊs condition improved with increase of CD4 +T,CD3 +T,lymphocyte count.CD4 +T is the most sensitive.Dynamic detection of lymphocyte subsets in the pe-ripheral blood of children with septic shock is of great clinical significance in judging the severity of disease and cura-tive effect.

Idiosyncratic adverse drug reactions (IDR) induce severe medical complications or even death in patients. Alert structure in drugs can be metabolized as reactive metabolite (RM) in the bodies, which is one of the major factors to induce IDR. Structure modification and avoidance of alert structure in the drug candidates is an efficient method for reducing toxicity risks in drug design. This review briefly summarized the recent development of the methodologies for structure optimization strategy to reduce the toxicity risks of drug candidates. These methods include blocking metabolic site, altering metabolic pathway, reducing activity, bioisosterism, and prodrug.
Binding Sites ; Cytochrome P-450 Enzyme System ; metabolism ; Drug Design ; Drug Discovery ; methods ; Drug Recalls ; Drug-Related Side Effects and Adverse Reactions ; prevention & control ; Humans ; Structure-Activity Relationship

Objective To probe into the feasibility of establishing a uniform reimbursement plan for hospitalization expenses under NRCMS in Nanjing city. Methods Hospitalization expenses in 2005 for peasants under NRCMS from the sour suburb districts and county in Nanjing were sampled. Based on this study, a reimbursement ratio was designed for such peasants as classified by "grades, sections and accumulated reimbursement". Results A uniform NVRMS reimbursement plan for hospitalization expenses may not be practical for all peasants in Nanjing. Yet such a plan of relative uniformity is worthy of experimenting as follows: no minimum for reimbursement;within the same expense range, reimbursement ratio may be measured and fixed accordingly among districts and county in the city, ranging 20%-70%;a uniform ceiling and reimbursement range are recommended. Conclusions A uniform city-wide plan requires by-step and planned implementations. With support from government finance, fund-raising gaps among these areas can be narrowed gradually, cutting back differences in their reimbursement plans in the end.

BACKGROUND: Consummate innervation plays an important role in bone formation. Nerve injury can impact normal bone metabolism, whereas bone regeneration depends on nerve regeneration in the innervation site to some degrees. Modified implant surface structure or usage of growth factors in local region can promote osseointegretion.OBJECTIVE: To retrospectively analyze effects of nervous system dominance bone metabolism and denervation on bone remodeling, innervated establishment and osseoperception during osseointegration following implantation.METHODS: The first author retrieved Pubmed database (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang database (http://www.wanfangdata.com.cn) (1990/2008) for publications of effects of nervous system dominance bone metabolism and denervation on bone remodeling, innervated establishment and osseoperception during osseointegration following implantation,with the key words of "bone metabolism, innervation, osseointegrationosseoperception" . Articles of repetitive contents were excluded. A total of 54 literatures were primarily obtained. According to inclusion criteria, 28 literatures were selected for summary.RESULTS AND CONCLUSION: Signals derived from the nervous system exert potent effects on osteoclast and osteoblast function. A ubiquitous innervation of all periosteal surfaces exists and its disruption affects bone remodeling. Several neuropeptides, neurohormones, nerotransmitters and their receptors are detectable in bone, and make it clear that nervous system is involved in bone metabolism and regeneration. Establishment of innervation of soft and hard tissue around implants may play an important role in osseointegration and osseoperception. Further studies will be required to explore the basic of anatomy,neurophysiology and neuropathology, which forms osseoperception.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Melanosis ; drug therapy ; therapy ; Middle Aged ; Young Adult

Abstract?AlM: To evaluate the efficacy of intravitreal injection with Ranibizumab combined with sub-Tenon injection with Triamcinolone acetonide ( TA ) for macular edema ( ME) due to central retinal venous occlusions ( CRVO) .?METHODS:Forty-six patients (46 eyes) were diagnosed ischemic CRVO with significant macular edema by fundus fluorescence-angiography ( FFA ) and optical coherence tomography ( OCT ) . All the patients had panretinal photocoagulation ( PRP ) , a week after the four times therapies. Twenty-three patients ( 23 eyes ) in group A were randomly chosen to receive intravitreal injection with ranibizumab ( lVR ) , another 23 patients ( 23 eyes ) in group B to treat with both lVR and sub-Tenon injection with TA ( PSTT ) . There was no significant difference on macular edema and best corrected visual activity ( BCVA) between the two groups. The changes in BCVA and central macular thickness ( CMT) before and 1wk; 1, 3, 6mo after treatments were analyzed.?RESULTS: One week after the treatment: the BCVA increased while the CMT decreased compared with that of pretreatment in groups A and B (P<0. 05). BCVA and CMT changes between two groups were statistically significant differences (P<0. 05). One month and three months after the treatment:the BCVA increased while the CMT decreased compared with that of pretreatment in group A and B (P<0. 05), the difference was significant between two groups ( P< 0. 05 ). Six month after the treatment:the BCVA increased while the CMT decreased compared with that of pretreatment in groups A and B. Compare BCVA difference between the groups was statistically significant change (P<0. 05), CMT difference was not statistically significant (P>0. 05).?CONCLUSlON:Not only lVR can decrease ME caused by CRVO and increase the BCVA, but also lVR combined with PSTT can. But combined therapies can be more rapidly and have more positive effect on decreasing the ME and protecting the visual function.