Aim To elucidate the relationship between IgG antibodies and penicillin allergy.Methods Enzyme-linked immunosorbent assay was used to examine 8 kinds of specific IgG antibodies,including major antigenic determinants:benzylpenicilloyl(BPO),ampicilloyl(APO),amoxicilloyl(AXO)and phenoxomethylpenicilloyl(PVO),and minor antigenic determinants:benzyl-penicillanyl(BPA),amoxicillanyl(AXA),ampicillanyl(APA)and phenoxomethylpenicillany(PVA),in the sera of 241 patients with penicillin allergy.Results Except BPA-IgG,levels of 7 kinds of antigenic determinants IgG antibodies were significantly higher than those of control group(P

OBJECTlVE To elucidate the sensitization mechanism of baicalin in guinea pigs. METHODS Baicalin antigens were prepared by activated ester method. A guinea pig model of allergic shock induced by the coupling was established. Passive cutaneous anaphylaxis ( PCA) was used to ana-lyze the regularity of the specific antibody. The lgG antibodies of baicalin in serum among 19 sensitized guinea pigs were determined by ELlSA. RESULTS UV scanning spectrum couplings occurred between baicalin and protein ( bovine serum albumin and human serum albumin) . The conjugation ratio was 9∶1 and 5∶1, respectively. The guinea pig model of allergic shock was successfully established and suggested that the antigen induced a typical immediate hypersensitivity response. The antibody could be determined on the 19th day and reached the maximum on the 31st day and then degraded gradually. Both specific lgE and lgG existed in the sensitized serum, but there was no correlation between lgG and lgE. The pos-itive rate of specific lgG antibody to baicalin was 84%. The degranulation rate of peritoneal mast cells was (72.6±11.4)%and higher than that incubated with plasma from control (26.8±6.9)%(P<0.05). lsolated ileum from sensitized guinea pigs contracted conspicuously after being challenged by baicalin-human serum albumin. CONCLUSlON Baicalin can induce allergic reaction in guinea pigs and the reaction is correlated with lgE and lgG production.

Objective To observe the clinical therapeutic effect of nucha electroacupuncture on patients with adult hypoxic ischemic encephalopathy(HIE)and to approach its mechanism. Methods After exclusion of cases with incomplete historical data from 80 adult HIE patients admitted in the Department of Critical Care Medicine of 401st Hospital of Jinan Military Region of PLA,finally 74 cases were randomly divided into a nucha electroacupuncture treatment group(38 cases)and a conventional therapy control group(36 cases)by random number table. The patients in the control group were treated with conventional medical therapies,including dehydration,intracranial pressure reduction,brain protection with head hypothermia,and so on. In nucha electroacupuncture group,based on the conventional treatment in the control group,additionally nucha electroacupuncture was performed for the patients. Before and after therapy,the changes of Glasgow coma scale score(GCS score)and Glasgow-Pittsburgh coma score (G-PCS score)in all the patients were assessed and compared between the two groups,and according to the standard criteria of GCS and G-PCS scores for evaluation of efficacy,the clinical therapeutic effective rates in the two groups were assessed. Results ①There were no statistically significant differences between the two groups in GCS score and G-PCS score before treatment(both P>0.05),after treatment,the GCS and G-PCS scores in nucha electrical acupuncture group were obviously higher than those before treatment(GCS score:6.22±2.66 vs. 4.33±1.35,G-PCS score:22.96±6.22 vs. 17.53±4.68,both P<0.05),and the GCS and G-PCS scores of nucha electroacupuncture group were markedly higher than those of control group after treatment(GCS score:6.22±2.66 vs. 5.17±3.01,G-PCS score:22.96±6.22 vs. 16.78±7.96,both P<0.05).②The total effective rate of nucha electroacupuncture group was significantly higher than that of control group when assessed by both the standard criteria of GCS score(73.7%vs. 50.0%,P<0.05)and G-PCS score(84.2%vs. 61.1%,P<0.05). Conclusion The nucha electroacupuncture has definite clinical therapeutic value in treatment of patients with adult HIE and it can improve their neurological function and outcome.

Objective To investigate CT features of solitary fibrous tumor of the mediastinum(SFTM),and to analyze the causes of misdiagnosis of this disease.Methods CT features of 5 patients of SFTM confirmed operatively and pathologically were retrospec-tively analyzed.All patients underwent before operation but were misdiagnosed.Results 3 cases were located in right mediastinum with oval-shap,well-defined margin,and “pleural tail sign”,2 cases were located in right thoracis cavity with unwell-defined margin, and in the adjacent lung were oppressed.In all 5 patients,the mean median of tumors was 1 1.5 cm(8.6-1 5 cm),non-homogeneous density of tumors were seen on plain CT scans,and obvious non-homogeneous enhancement with“geographic pattern”on contrast-en-hanced CT.Conclusion CT can clearly reveal the size and the appearance of SFTM,adjacent architectures,the final diagnosis de-pends on histopathological and immunohistochemical findings of the tumors.To un-know is the main caused of misdiagnosis of medi-astinal SFT.

Objective:To establish a real time dissolution determination method for furosemide tablets and compare the similarity of dissolution curves of furosemide tablets from 11 generic drug manufacturers and the original research drug manufacturer in four kinds of dissolution media to evaluate the overall situation of dissolution process of furosemide tablets in our country. Methods:A fiber-optic medicine dissolution process real time test system was used to monitor the dissolution process of furosemide tablets from 11 generic drug manufacturers and the original research drug manufacturer. A paddle method was applied and the rotation speed was 50 r·min-1 . The dissolution medium was pH 1. 2 hydrochloric acid solution, pH 4. 0 acetate buffer, pH 6. 8 phosphate buffer and water, respectively with volume of 900 ml. The absorbance wavelength was 277 nm. The dissolution profile was drawn and f 2 factor was used to evaluate the similarity. Results:The dissolution tests were not influenced by the excipients and the dissolution media. The liner range of furose-mide was 4. 44-26. 66 μg·ml-1(r=0. 9997). The average recovery of furosemide was 101. 26% and RSD was 1. 84%(n=9). Ee-spect to 11 manufactures, there was only one of the dissolution similarity can meet the requirements. Conclusion:A simple, fast and accurate fiber-optic method for medicine dissolution process real time test is established. The method can reflect the real dissolution and provide the information on how to improve the preparation technology and monitor the stability of the preparation technology.

Objectives To implement the guideline-based clinical practice program for identification and manage-ment of dysphagia in stroke patients,and to create a good evidence-based practice culture,and to improve the quality of clinical care. Methods In this study,we use the Iowa model of evidence-based practice as a guide, reference guide issued by RNAO to implement the corresponding implementation strategy tool,and gradually apply the program to the pilot ward. Results The implementation of the program had a positive impact on the patient level (quality of life,satisfaction and hospitalization),the nurse level(satisfaction and knowledge),and the level of eachau-ditcriteria. Conclusion It is possible to improve the clinical nursing quality by adapting the high quality guide-lines for the identification and management of dysphagia in foreign countries and this study can provide reference for the research of future guideline implementation.

Objective To analyze the effect of high and low dose radiation on the expressions of Th1,Th2 and Th3 /Tr1 related-genes in mice thymocytes and investigate the possible underlying molecular mechanism.Methods ICR mice were randomly divided into low-dose group (0.075 Gy),high-dose group (2.0 Gy) and sham-control group.The mouse thymus tissue was extracted at 16 hours after irradiation and the expressions of Th1-Th2-Th3 related genes were measured by PCR array.Results Eight genes were up-regulated and five genes were down-regulated after low dose radiation (0.075 Gy);while 54 genes were up-regulated and three genes were down-regulated after high dose (2.0 Gy) radiation.These genes included Th1 cell related genes,Th2 cell related genes,Th3/Tr1 cell related genes,Th1/Th2 immune response genes and transcription factor related genes.Low dose radiation induced up-regulation of Stat4 and Socs1 of genes related to the Th1 cells,and it induced down-regulation of IL-4ra,Cebpb,Gata3 and Tgfb3 associated with Th2 and Th3 cells,which lead to Sftpd genes up-regulation of Th1 immune response eventually.The high dose radiation up-regulated all of Th1,Th2 and Th3/Tr related genes and also enhanced the expressions of Cd86,IL-18,IL-10 and Irf4 genes related to Th2 immune response,but it did not alter the gene expression of Th1 immune response.Conclusions Low-dose radiation induces Th1-type immune response,while high doses radiation triggers Th2 type immune response.

AIM: To develop a simple and sensitive high-performance liquid chromatography (HPLC) for the quantification of zidovudine and to study the pharmacokinetics of two kinds of zidovudine capsules in Chinese healthy volunteers. METHODS :The concentrations of zidovudine in plasma were determined by a validated HPLC method with UV detection. A randomized two-way crossover study was conducted in 18 fasting volunteers to compare plasma pharmacokinetic profile and single-dose tolerability of a new zidovudine capsules. RESULTS: The main pharmacokinetic parameters of two formulations, reference and test capsules, were as follows: cmax were (2 252±s 837) μg·L-1 and (2 300±1 099) μg·L-1; tmax were (0.49±0.19) h and (0.5±0.3) h;t1/2 ke were (0.93±0.19) h and (0.99±0.24) h; AUC0-t were (2 530±452) μg·h·L-1 and (2 467±605) μg·h·L-1;AUC0-∞ were(2 689 ± 414) μg·h·L-1 and (2 583±575) μg·h·L-1. The results of ANOVA and two one-side t test statistical analysis for lg AUC0-t, lg AUC0-∞ and lg cmax showed that two formulations were bioequivalent. CONCLUSION:The method is convenient, sensitive, accurate and reproducible, and could be applied to determining the plasma zidovudine concentration and studying on pharmacokinetics. Two zidovudine capsules are bioequivalent in Chinese healthy volunteers.

Objective To investigate the rehabilitation prognoses of children with traumatic brain injury (TBI).MethodsA retrospective analysis was made in 64 children who had been admitted for rehabilitation.Their clinical information,rehabilitation protocols,recovery of consciousness and ability in the activities of daily living (ADL) were analyzed. ResultsThe children's injuries were severe-42.19％ had consciousness disorders,but 80％ of them recovered consciousness after rehabilitation.Their limb motor dysfunction was dominated by hemiplegia (51.67％).For 65.63％ of the patients rehabilitation was initiated within one month after injury.The average length of stay in rehabilitation was 33.09 ± 25.96 days.Those with consciousness disorders stayed significantly longer than those without.The main treatments were hyperbaric oxygen therapy,exercise and neurotrophic drugs (the ratios were 95.31％,89.06％ and 82.81％ respectively).After the first course of inpatient rehabilitation,the conscious ness recovery rate was 81.48％ and ADL ability improved significantly.The total effectiveness rate was 90.63％.Univariate and multivariate analyses showed that the factors most strongly correlated with effective rehabilitation were age at injury and the rehabilitation intervention time.ConclusionThe results suggest that a general hospital should focus on early (acute and subacute phase) rehabilitation.So developing the rehabilitation network system is necessary and urgent.Rehabilitative therapy is very helpful in TBI cases.Being older at the time of injury and earlier rehabilitation intervention predict better short term outcomes.It is necessary to build and improve on a more standardized and systemic rehabilitation and assessment system for pediatric TBI.

AIM: To establish a method to determine the concentration of indinavir in human plasma and study indinavir bioavailability in Chinese healthy people. METHODS: In a random two-period crossover study, 18 healthy male volunteers received a single dose of indinavir capsules 800 mg of two formulations respectively.A sensitive and specific reversed phase HPLC method was developed to quantitate plasma levels of indinavir. The drug was extracted from plasma with acetonitrile. Analysis was performed on a Hy persil C18 column with a mobile phase of acetonitrile:0.01 mol · L -1 phosphate buffer(pH 5.5 ) (43: 57).The UV detector was set at 210 nm. The standard curve covered the concentration ranged from 0. 03 to 16.38 mg · L-1. RESULTS: The concentration-time curves of reference and tested formulations both fitted to a one-compartment open model. The main pharmacokinetic rameters of tested and reference formulations were (10.6 ±s 2.4) mg· L-1 and (9.8 ±2.2)mg· L-1 for cmax, (0. 71 ± 0. 19) h and (0. 8 ±0.3) h for tmax, (1.30±0.24) h and (1.31 ±0.23) h for t1/2ke, (23±6) mg·h· L-1 and (22±5) mg·h · L-1 forAUC0-10, (24±6) mg · h · L-1 and (22±5) mg · h · L-1 for AUC0-∞, respectively. Two one-sidet test and variance analysis were performed in bioequivalent assessment. No statistically significant difference was found in AUC0-10, AUC0-∞ and cmax values between the tested and reference formulations. CONCLUSION:The reversed phase HPLC is a reliable method to determine the concentration of indinavir in human plasma and the two formulations of indinavir are bioequivalent.