Objective To investigate the related factors of encephalopathy following orthotopic liver transplantation (OLT).Methods The clinical data of 128 patients who underwent liver transplantation consecutively between October 2001 and October 2003 were analyzed retrospectively by SPSS 10.0 . All clinical factors were analyzed by Crosstabs or independent-samples t test. A mutivariative analysis of these significant factors was done by using the Binary Logistic Regression.Results Encephalopathy occurred in 21 cases within the first week after operation, including 19 cases of Child-pugh C and 2 cases of Child-pugh B. There was a higher occurrence in the patients with chronic severe hepatitis or undergoing re-transplantation ( P 0.05 ). In the encephalopathy group the incidence of renal failure after transplantation and infection pre- or postoperation was higher than in control group ( P

Objective To improve the rate of early diagnosis and prolong the survival of patients with gallbladder carcinoma.Method Clinical data of 111 cases of primary carcinoma of the gallbladder undergoing surgery from Jan 2002 to Dec 2010 were analyzed retrospectively.Result The preoperative diagnositic rate was 61.3％.Among the 111 cases of primary carcinoma of the gallbladder,22 patients received simple cholecystectomy,47 patients received radical resection,18 patients received extended radical resection,12 patients received palliative operation while the other 12 patients only got biopsy due to widespread intraabdominal metastasis.The 3 years survival rate of the patients was 29.7％ (33/111) while the 5 years survival rate was 9.9％ ( 11/111 ).Conclusions B-ultrasonography and CT are the mainstay for the diagnosis of primary carcinoma of the gallbladder.For those suspected of having the carcinoma,an exploration is recommended.

Desmoid tumor also known as aggressive fibromatosis,are rare fibroblastic tumors which are derived from deep fascia planes or muscuofascia structures.Resectable extra-abdominal and abdominal desmoid tumor should always be treated with the aim of achieving a negative margin through wide radical resection with margins above 2 cm.Ifthis is not feasible,function-sparing surgical resection is suggested.Adjuvant radiation should be considered for patients with positive margins,recirrent tumors or unresectable diseases.Intra-abdominal desmoid tumor is common in patients with familial adenomatous polyposis.It has a high recurring rate after surgical resection and therefore a high dosage of tamoxifen and sulindac are recommended as first-line treatment.Due to the variable nature of the outcome and vague reaction to drug therapy,individualized treatments,including the wait and see policy,has been widely investigated and thought to be a promising strategy for the future.

OBJECTIVE The status and risk factors of nosocomial infections in intensive care unit(ICU) were investigated to make the intervention strategy. METHODS Use prospective monitoring and retrospective investigation to analyze the 198 nosocomial infections patients. RESULTS The lower respiratory tract infection was the main infection in ICU,about 69.4%.The risk factors were old ages,long hospitalization time,the use of many antibiotics,severe underlying illness,invasive operation manipulation and so on. CONCLUSIONS General intervention strategy should be adopt in the control of ICU nosocomial infections to low the infection rate and raise the rate of rescue.

Objective:To compare the preventive effects of dezocine or parecoxib used alone or combination on emergence pain and agitation in the patients undergoing radical hysterectomy. Methods: Sixty ASA Ⅰ~Ⅱ patients undergoing radical hysterectomy were randomly divided into three groups. At the time of sewing incision, the dezocine group (group D, n=20) received dezocine in-travenous injection at the dosage of 0. 1 mg·kg-1, the parecoxib group (group P, n=20) received parecoxib intravenous injection at the dosage of 0.8 mg·kg-1, and the combination group (group DP, n=20) received 0.1 mg·kg-1dezocine and 0.8 mg·kg-1 parecoxib. When the operation was finished, the patients were transferred to the recovery room with endotracheal tubes, and recovered and extubated without the administration of reversal agents. Visual analogue scale ( VAS) for pain and Aono' s four-point scale for e-mergence agitation ( EA) were measured. The recovery time, extubation time, VAS, degree of EA and side effects such as nausea, vomiting, respiratory depression and hypersomnia during the emergence were also evaluated and recorded. Results:There were no sig-nificant differences in recovery time and extubation time among the three groups (P >0. 05). The VAS score and degree of EA in group DP were lower than that in group D (4. 65 ± 1. 69) and group P (5. 95 ± 1. 82) (P<0. 05), and the VAS score in group D was lower than that in group P (P<0. 05). The incidence of moderate and severe pain during the emergence in group DP (20%) was low-er than that in group D and group P (75% and 85%, respectively, P<0. 05), and that was lower in group D when compared with that in group P(P<0. 05). There were no significant differences in the incidence of degree of EA higher than 3 among the three groups (P>0. 05), and no side effects such as nausea, vomiting, respiratory depression and hypersomnia were detected during the emergence. Conclusion:Intravenous injection of 0. 1 mg·kg-1 dezocine combined with 0. 8 mg·kg-1 parecoxib at the time of sewing incision shows effective analgesia and emergence agitation reduction without obvious complications in the patients undergoing radical hysterecto-my.

OBJECTIVE:To explore the role and breakthrough point of clinical pharmacist in the anti-infective therapy for a patient with purulent meningitis. METHODS:Clinical pharmacists provided pharmaceutical care for a patient with purulent meningi-tis,assisted physicians to adjust therapy plan of antibiotics,i.e. anti-infective therapy of vancomycin+ceftriaxone sodium,meropen-em+vancomycin,levofloxacin+vancomycin successively;disposed ADR induced by meropenem and levofloxacin. RESULTS:The physicians adopted the suggestions of clinical pharmacists,the infection symptom had been controlled,and ADR disappeared;and then the patient was discharged from hospital. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care for patient with purulent meningitis,assist the physicians to develop safe and effective anti-infective therapy plan,and dispose ADR timely so as to promote rational drug use in the clinic.

OBJECTIVE: To establish an HPLC method for the determination of Matrine in Baishan tablets. METHODS: The analytical column was Aminopropyl (200 mm?4.6 mm, 10 ?m) with mobile phase consisted of acetonitrile-0.5% phosphate solution - ethanol(100∶8∶10) at a flow rate of 1.0 mL?min-1. The column temperature was set at 30 ℃ and the detection wavelength was set at 220 nm. RESULTS: The linear range of Matrine was 0.27～ 8.66 ?g(r=0.999 8) and the average recovery of Matrine was 99.52 %(RSD=0.91%,n=6). CONCLUSION: The method is simple, accurate and reproducible, and it is applicable for the quality control of Baishan tablets.

OBJECTIVE:To prepare temperature sensitive hydrogel which is of strength.METHODS:The hygrogel was prepared using CS,PVA and GP as matrix with concentration of CS(A),weight ratio of CS to PVA(B) and pH value(C) as factors and with initial gelatination temperature,strength and dehydration as indexes.The formula was optimized by orthogonal experiment and verified.RESULTS:The optimal formula was as follows:A 20 mg?mL-1,B 1 :1,C 7.2.The prepared hydrogel was fluid at 4 ℃ or room temperature while gelatinized at 37 ℃ within 10 min with strength of about 1.4 kPa.Gelatination time reduced along with the increase of temperature.The pH value had hardly changed during degradation in vitro within 28 d.CONCLUSION:The CS/PVA/GP hydrogel is simple and practical in preparation technique and is temperature sensitive and of strength.

AIM To investigate the protective effects and mechanisms of TMP on accelerated anti-glomerulus basement membrane(GBM) antibody nephritis of rats. METHODS Model of accelerated anti-GBM nephritis was established in rats and TMP was administrated 120 mg?kg -1 ?d -1 by ip since the day before the model established, consecutively for 15 days. Content of 24h urine protein was detected after model established and rats were killed on d 7 and d 14. Contents of blood urine nitrogen (BUN) and serum creatinine (SCr) were detected. Renal cortex cytoplasm and mitochondria were produced and change of content of lipid peroxidation products malondialdehyde(MDA), activities of glutathione peroxidase(GSH-Px) and catalase(CAT) and superoxide dismutase(SOD) were investigated. RESULTS Compared with model group, TMP group showed significant inhibition in changes of proteinuria and BUN, SCr(P

Prostaglandin (PG) D_2 is one of unsaturated fatty acids with 20 carbon atoms, which is synthesized by PGD synthase (PGDS) in the brain. PGD_2 has been identified to be a sleep-inducing substance that becomes bound to the DP receptor (DPR) exclusively localized on the surface of the basal forebrain, leading to an increase in extracellular adenosine levels there. Through A_ 2A receptors (A_ 2A R), the adenosine activates neurons in the ventrolateral preoptic area (VLPO), a putative sleep center, and inhibits neurons in the histaminergic tuberomammillary nucleus (TMN), a putative wake center, via GABA to induce sleep. Studying the effect and the molecular mechanisms of sleep-induced by PGD_2 would be helpful in the development of novel sleeping drugs for more rational treatment of sleep disorders.