Objective To examine the distribution of flurbiprofen axetil in cerebral-spinal fluid (CSF) by determining the CSF concentration of flurbiprofen after iv administration. Methods Seventy-two ASA Ⅰ or Ⅱ patients of both sexes aged 18-75 yr weighing 54-82 kg undergoing spinal or combined spinal-epidural anesthesia for lower extremity or lower abdominal surgery were studied. Flurbiprofen axetil 1 mg/kg was injected intravenously.CSF 2 ml and venous blood 3 ml were obtained simultaneously every 5 min after iv injection for 45 min (T1-9 ) for determination of flurbiprofen concentration using high performance liquid chromatography, and the CSF/blood flurbiprofen concentration ratio was caculated. Results Flurbiprofen was not detected in CSF at T1,2 after iv injection in 3 and 4 patients. The CSF flurbiprofen concentration was significantly higher at T4-9, and CSF/blood flubiprofen concentration ratio higher at T5-9 than at T3 ( P ＜ 0.05). There was no significant difference in CSF flurbiprofen concentrations among T4-9 ( P ＞ 0.05 ) Conclusion Flurbiprofen is detected in CSF after iv injection, the CSF flurbiprofen concentration peaks at 20 min after iv injection and it lasts until 45 min after iv injection.

Adolescent ; Antimetabolites, Antineoplastic ; administration & dosage ; Child ; Child, Preschool ; Female ; Humans ; Infusions, Intravenous ; Leucovorin ; administration & dosage ; Lymphoma, Non-Hodgkin ; drug therapy ; Male ; Methotrexate ; administration & dosage ; adverse effects ; blood ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

[Objective] To analyze the frequency,type of chromosome 1 clonal abnormalities in hematologic malignancies,and to understand the clinical and biological significance of its occurrence.[Methods] Retrospectively analyzed of 256 cases of patients with hematologic malignancies cytogenetic R banding karyotype analysis [Results].Summarized the abnormal chromosomel karyotype and clinical data summary and combined with literature review.Results There were 25 samples with clonal disorder of chromosome 1 in 256 cases of patients with malignant hematologic disease,accounting for 9.8 percent of the total samples,including ALL-L2,ANLL-M2,MDS,MM,lymphoma with bone marrow involvement,CML with accelerated phase and blast crisis,plasma cell leukemia and chronic myelogenous monocytic leukemia.The types of the clonal disorder included chromosome 1 translocation with other chromosomes[including 3cases with t(1;19),and 2 cases with t(1;4)],there were 7 cases with chromosome 1 the increase or missing partly, and 7cases with increasing a full or partial deletion of chromosome 1,and also 3 cases with isochromosome of 1q.t(1 ; 19) can be found in B lymphocyte proliferative diseases,while t(1;14) was found in T-ALL.The clinical efficacy and short survival were found in 20 patients with chromosome 1 clonal abnormalities. [Conclusion] Chromosome I clonal abnormalities in hematologic malignancies is common in acute leukemia,MDS,MM,and atypical abnormality is more than typical abnormality.It is common in chromosome 1 translocation with other chromosomes,lq-trisomy.The recurrent chromosome abnormalities is t (1;19) and t (1;14),which is related with the leukemia immune phenotype.lq-trisoiny and amplification of 1q21 is effective in the therapy and guide the prognosis of MDS and MM.

OBJECTIVE: To investigate the effects of arsenic trioxide (ATO) on the expressions of vascular endothelial growth factor (VEGF) and P-glycoprotein (P-gp) in K562/A02 cells and to explore the correlation between VEGF and P-gp. METHODS: The inhibition rate of K562/A02 cell proliferation was detected by using methyl thiazolyl tetrazolium assay (MTT); the level of VEGF was detected by enzyme-linked immunosorbent assay (ELISA) and the expression rate of P-gp was determined by flow cytometry (FCM). RESULTS: 0.05 micromol/L ATO had no influences on the cell proliferation and the expression of VEGF in K562/A02 cells; 0.4 and 3.2 micromol/L ATO could significantly inhibit the K562/A02 cell proliferation and down-regulate the expression of VEGF in K562/A02 cells (P<0.05). The expression of P-gp did not changed after being exposed to 0.05 and 0.4 micromol/L ATO for 24, 48 and 72 hours (P>0.05). 3.2 micromol/L ATO could remarkably reduce the expression of P-gp in K562/A02 cells after 48- and 72-hour incubation with ATO (P<0.05). CONCLUSIONS: The down-regulation of P-gp and VEGF after being exposed to ATO probably contributes to the reversion of multidrug resistance in K562/A02 cells. The level of VEGF may be related to the expression rate of P-gp in K562/A02 cells.

Objective To observe the therapeutic response of liver tumors by arterial embolization hyperthermia with Nano Superparamagnetic Iodized Oil(NSIO)using rabbit VX2 liver tumor model.Methods A total 24 rabbits containing experimental hepatic tumors were randomly assigned to one of four groups as follows:NSIO embolization hyperthermia group(group A),Lipidol embolization group(group B),NSIO embolization group(group C),and contronl group(group D),each groups contain 6 VX2 rabbits.Fourteen days after implantation of the experimental hepatic tumor,VX2 rabbits were treated.In group A group B and group C,the rabbits hepatic proper artery were selectively catheterized by 3 Fr microcatheters via right femoral artery under fluoroscopic guidance.10% NSIO 0.5 ml(group A and group C)or Lipidol 0.5 ml(group B)infused into proper hepatic artery.Three days after embolization,the rabbits in group A and group B were exposed to gap-type alternating magnetic field for 30 minutes,while rabbits in group C and group D have not been exposed to alternating magnetic field.The liver tumor size were measured by CT scanning before and 14 days after treatment then the animals were sacrificed,the liver,lung,heart spleen and kidney were harvested for histopathology examination,the liver tumor size were detected directly. Results All subjects experienced uneventful 14 days surivials,on the biochemical examination,there were no changes about the function of liver and renal in each group 14 days after treatment compare to pre- treatment.Fourteen days after treatment,the tumor size decreased by 8.09% in group A,but increased by 9.72% and 13.00%(P＜0.05)in group B and group C respectively,in group D,the tumor size increased by 57.50%(P＜0.01).In histopathology examination,the tumor necrosis in three treatment groups were manifest,particular in group A.Conclusion Arterial embolization hyperthermia with NSIO has obvious therapeutic response to experimental hepatic tumors,it encourages further development of this technology for the treatment of liver cancer in humans.

OBJECTIVETo prepare Form A and Form B of benazepril hydrochloride and to compare the differences in spectrums, thermodynamics and crystal structure between two polymorphic forms.

METHODSForm A and Form B of benazepril hydrochloride were characterized by Fourier transform infrared spectroscopy (IR), thermal gravimetric analysis (TG), differential scanning calorimetry (DSC), powder x-ray diffraction (PXRD) and single crystal x-ray diffraction (SCXRD).

RESULTSPreparation method, crystal structure and polymorphic stability of Form A and Form B of benazepril hydrochloride were obtained. Based on the analysis of crystal structure of both polymorphs, Form A belonged to monoclone space group P2(1) with a=7.8655(4)Å, b= 11.7700(6)Å, c= 13.5560(7)Å, β= 102.9470(10)°, V=1223.07 (11)Å(3) and Z=2, while Form B belonged to orthorhombic space group P212121, with a=7.9353(8)Å, b=11.6654(11)Å, c=26.6453(16)Å, V=2466.5(4)Å(3) and Z=4. From the DSC and XRD results, Form B of benazepril hydrochloride could be transformed into Form A after heating treatment.

CONCLUSIONForm A and Form B of benazepril hydrochloride are both anhydrous and displayed different polymorphs due to different molecular configuration. Furthermore, Form A exhibits more stable than Form B at high temperatures.

Benzazepines ; chemistry ; Crystallization ; Drug Stability ; Molecular Conformation

Objective To analyze the risk factors of hospital acquired pneumonia (HAP) caused by nonfermentative bacteria in ICU.Methods Using binary logistic regression analysis,we reviewed the related risk factors of hospital acquired pneumonia caused by nonfermentative bacteria from January,2002 to May,2006 in ICU of our hospital.Results Univariate regression ana- lysis identified 22 variables associated with HAP,including age,diabetes mellitus,malignant tumor,chronic obstructive pul- monary disease (COPD),smoking,Glasgow Coma Scale (GCS) score,Acute Physiology and Chronic Healthy EvaluationⅡ(APACHEⅡ) score.Multivariate regression analysis confirmed 6 high risk factors:aspiration,COPD,use of antacids,seda- tive agents,mechanical ventilation and tracheal intubation or tracheostomy.Conclusions Aspiration,COPD,use of antacids, sedative agents,mechanical ventilation,tracheal intubation or tracheostomy are high risk factors associated with HAP.

Objective To evaluate the clinical significance of CT angiography(CTA)in the diagnosis of arterioportal shunts(APS)associated with hepatocellular carcinoma(HCC).Methods One hundred and twenty-seven consecutive HCC patients accepted both dynamic enhancement CT and DSA examinations.The interval between CT and DSA exam was from 3 to 15 days.Based on transverse CT images in hepatic artery phase,CTA was performed for all the patients.By contrast with DSA results,the capabilities of transverse CT and transverse images combined with CTA in APS diagnosis were analyzed. Results In all 127 HCC cases,52 cases with APS were confirmed by DSA(40.94%),33 with central type of APS and 19 with peripheral type.Diagnostic sensitivity of APS based on transverse CT and combined CTA with transverse CT images were both 94.23%(49/52).However,specificity was 84.00%(63/75) and 97.33%(73/75),respectively,accuracy was 88.19%(112/127)and 96.06%(122/127),the predictive value of positive cases was 80.33%(49/61)and 96.08%(49/51),and the predictive value of negative cases was 95.45%(63/66)and 96.05%(73/76).Combined with CTA,false positive cases of 4 central type of APS and 6 peripheral type of APS were excluded which were demonstrated by transverse CT images.By contrast with DSA,the coincidence rate of the type of APS diagnosed by transverse images combined with CTA was 88.46%(46/52),including 90.91%(30/33)of central type of APS and 84.21%(16/19)of peripheral type.The supplying arteries of central type of APS were intuitively displayed by CTA in 23 cases,19 from proper hepatic artery and 4 from gastro-duodenal artery.Conclusion CTA techniques based on the dynamic enhancement CT exams could effectively promote the specificity and the accuracy of APS diagnosis.

Objective To understand status and influencing factors for cervical discomfort in medical staff and to provide evidence for cervical spondylosis control. Methods We made a cervical discomfort questionnaire for medical personnel, including information about demography, life style, occupational hazard and symptoms of cervical discomfort. Then we carried out a survey from May to July 2017 in a hospital and used logistic regression model to analyze the influencing factors for cervical discomfort in medical staff. Results There were 965 medical staff participated in the survey, the response rate was 79.88% (965/1 208) . A total of 454 cases reported to have cervical discomfort, the prevalence was 47.05%. The results of multiple logistic regression analysis showed that years of service (OR4-10=2.551, 95% CI: 1.683-3.861; OR ＞10=1.767, 95% CI:1.325-2.358), air pollution in the workplace (ORgeneral=0.612, 95%CI: 0.418-0.898; ORno=0.684, 95%CI: 0.469-0.997), new business adaptability (OR=1.749, 95%CI: 1.325-2.309) were the influencing factors for cervical discomfort in medical staff. Conclusion The prevalence of cervical discomfort is high in medical staff. Years of service, working environment and new business adaptability are associated with cervical discomfort in medical staff.

OBJECTIVETo evaluate clinical results of early total care (ETC) treatment for elderly patients with intertrochanteric femur fractures.

METHODSClinical data of 106 elderly patients with intertrochanteric fracture treated from January 2012 and February 2015 were retrospectively studied. According to whether receiving the early total care mode, the patients were divided into 2 groups, 34 cases were diagnosed and treated with early total care pattern (ETC group), including 14 males and 20 females with an average age of (74.88 ± 4.38) years old ranging from 70 to 86. According to Evans types, 4 cases were type I, 5 cases were type II, 13 cases were type III, 11 cases were type IV, 1 case was type V. Seventy-two patients were treated with conventional trauma method (conventional group), including 35 males and 37 females with an average age of (74.46 ± 3.63) years old ranging from 70 to 85. According to Evans type, 8 cases were type I ,13 cases were type II, 25 cases were type III, 25 cases were type IV, and 1 case was type V. All fractures were treated with proximal femoral nails anti-rotation (PFNA). Operative time, hospital stays, leaving bed time, complications, cases of death at 1 year after operation, postoperative Harris score at 12 months were observed and compared.

RESULTSAll patients were followed up, the time of ETC group ranged from 9 to 18 months with an average of 13.29 ± 1.51, and the time in conventional group ranged from 12 to 16 months with an average 12.93 ± 1.15, while there was no significant difference between two groups in time of following-up (t = 1.368, P = 0.174). There was no significant meaning in cases of death between ETC group (2 cases) and conventional group (8 cases). Three cases occurred complications in ETC group, and 20 cases in conventional group,there was obvious meaning between two groups (χ² = 0.739, P = 0.318). Operative time,hospital stays,leaving bed time in ETC group respectively was (2.03 ± 0.67) d, (15.41 ± 2.87) d and (3.62 ± 0.74) d; while in conventional group respectively was (4.17 ± 1.59) d, (20.11 ± 4.24) d and (5.35 ± 1.22) d; there were significant differences between two groups in operative time, hospital stays, leaving bed time. Postoperative Harris scores at 12 months in ETC group was (82.32 ± 4.56), and (79.24 ± 5.52) in conventional group, there was obvious meaning between two groups (t = 2.833, P = 0.006).

CONCLUSIONETC pattern is a novel method for diagnosis and treatment of intertrochanteric femur fractures in elderly, it could shorten operative time, hospital stays, leaving bed time, decrease complications and promote recovery of function.

Aged ; Aged, 80 and over ; Female ; Femur ; injuries ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; surgery ; Hip Joint ; surgery ; Hospitalization ; Humans ; Male ; Operative Time ; Postoperative Care ; Retrospective Studies