Objective To evaluate the safety and efficacy of intravenous dalteparin compared with unfractionated heparin in patients underwent coronary angiogram with or without percutaneous coronary intervention(PCI).Methods A total of 87 patients who underwent one-stage elective PCI were randomized to intravenously unfractionated heparin(UFH,10 000 IU) group or dalteparin group.The dalteparin group was further divided into low dose dalteparin(5 000 IU) group or high dose dalteparin(10 000 IU) group according to whether the patients underwent PCI procedure.Blood samples for anti-Xa levels and ACTs were assayed at baseline and at 10 min,20 min,1 hour,2 hours and 4 hours after all dalteparin or UFH doses were administered.Results Baseline characteristics were similar across the three groups.In all groups,ACTs reached the maximum at 10 min after the total doses given,with the highest value in the UFH group and lowest in the low dose dalteparin group(524.68 ?278.32 s vs 191.26?39.35 s vs 304.20?42.71 s,P0.05).Conclusion Both 5 000 IU and 10 000 IU dalteparin injected through sheath before PCI or coronary angiography could reach an anti-Xa levels similar to that achieved by 10 000 IU UFH.

Objective Microdialysis technique is a technology which can continuous monitoring of a substance′s metabolism level in specific tissues or organs,it can provide a series of substances monitoring of the liver transplantation,especially monitoring of glucose,lactate,glycerol,pyruvate and some amino acids. By the range of these substances, we can anticipate complications and ischemia?reperfusion injury after liver transplantation. In this paper we reviewed the principle, characteristics of the microdialysis technique and its applications of monitoring the ischemia?reperfusion and complications after liver transplantation,then pointed out the main problems and trends of the technology to provide a reference for further research in the field.

The HPLC-ELSD method was used in the content determination of astragaloside, astragalosideⅠ, astragalosideⅡand astragalosideⅢ in Mongolia Radix Astragali (Astragalus membranaceus(Fisch.) Bge. var. mongholicus(Bge.) Hsiao) among 16 batches from various habitats. The DIKMA Diamonsil C18 (150 mm× 4.6 mm, 5μm) was adopted with acetonitrile and water as the mobile phase at a gradient mode program. The flow rate was 1.0 mL·min-1. And the column temperature was 30℃. The ELSD detector parameters were the drift tube temperature at 90℃, and the air flow rate of 2.8 L·min-1. The SPSS 16.0 software was used in the cluster analysis of content determination. The results showed that when the injection volume was within the range of 0.093 2-1.02μg (r = 0.999 5), 0.789-8.78μg (r = 0.999 7), 0.506-3.13μg (r = 0.999 6), and 0.016 1-1.38μg (r = 0.999 2) for astragaloside, astragalosideⅠ, astragalosideⅡ and astragalosideⅢ, respectively, the average recoveries were 97.55%, 98.61%, 99.68%, 98.58%with RSD of 1.2%, 1.3%, 1.3%, 1.2%, respectively. The results of cluster analysis showed that the single using of astragaloside as index was unable to differentiate Mongolia Radix Astragali from various habitats. However, the simultaneous determination of 4 types of astragalosides as indexes can differentiate Mongolia Radix Astragali from various habitats. It was concluded that the method was simple, quick and accurate, which can directly reflect the quality status of Mongolia Radix Astragali from different origins. It also provided new ideas for the quality control of Mongolia Radix Astragali.

Aim To evaluate whether the combination of polypeptide AP25 and docetaxel is more efficient in treating experimental breast cancer,than either reagent used alone,and to offer suggestions for clinical use. Methods An experimental breast carcinoma model was set up to investigate the anti-tumor effects of AP25 and docetaxel combination.The Q value was caluculat-ed by Guinness rules and the anti-tumor effects of the combination of polypeptide AP25 and docetaxel were e-valuated.Results The treatment by the combination of polypeptide AP25 and docetaxel showed a better tumor inhibition rate.The combination of AP25 20 mg ·kg -1 and docetaxel 10 mg·kg -1 significantly inhibi-ted the tumor growth with 0.85 1.15,showing a synergistic effect.Conclusions The combination of AP25 and docetaxel can significantly in-hibit the tumor growth with a synergistic effect and de-crease the dose of chemotherapy.

Sepsis should be defined as life-threatening organ dysfunction caused by a dys-regulated host response to infection. Continuous renal replacement therapy (CRRT) is one of the methods for the clinical treatment of sepsis. For patients undergoing CRRT, rational antimicrobial therapy is very important for the control of patient's infection. However, during CRRT, there is no clear guideline for the dose adjustment of antibiotics. In this paper, we analyzed the effect of CRRT combined with antibiotics on sepsis treatment in China and abroad, and discussed its effect on antibiotic clearance, and provided reference for clinical work.

objective To study the pharmacokinetics of lignans components in Shengmai granule in volunteers and in mice. Methods After oral administration of Shengmai granule (3.6 g/person) for the volunteers and ig administration of the drug (4.7 g/kg) for the mice, the plasma was collected at different time points. The lignans components in Shengmai granule and in the plasma were analyzed by HPLC to monitor the changes of plasma concentration of schisandrind. Pharmacokinetic parameters were calculated from the plasma concentration- time data with the 3P97 software package. Results After oral administration of Shengmai granule by volunteers and mice, schisandrin and some new components in plasma were detected. The new components may be the metabolites of schisandrin. The main pharmacokinetic parameters of schisandrin in mice and in volunteers were as follows: T1/2ka was 0.03 and 0.04 hour, T1/2ke 0.88 and 0.86 hour, Vd 19.12 and 1.73 L? kg- 1, CL 15.06 and 1.46 L? h- 1? kg- 1, Cmax 1.196 and 0.098 mg? L- 1, Tpeak0.21 and 0.50 h, AUC0- ∞ 1.096 and 0.137 mg? h? L- 1, respectively. Conclusion Schisandrin in Shengmai granule can be absorbed in the volunteers and mice after oral administration. It can be absorbed and eliminated rapidly, and can be transformed into the metabolite. The pharmacokinetics of plasma Schizandrin complies with linear kinetic course.

Third-class medical metrology station is being established in hospital for implementing national and military medical metrology law and regulations. The goal, significance and main functions are elaborated. It is suggested that the leader should take the initiative to grasp not only the overall design and the supplementary equipment construction, but the civil engineering technological design and the layout of metrology standard equipment. The general steps of establishing third-class medical metrology station are discussed.

Objective To compare the changes in postoperative pain, complications and clinical effect between gastrodin and remifentanil for controlled hypotension in endoscopic sinus surgery.Methods Eighty patients undergoing endoscopic sinus surgery were enrolled in the study.Patients were randomized into two groups of 40 to receive gastrodin (Group G) or remifentanil (Group R) infusion.Two groups were administered with propofol of 2 mg/kg to induce anaesthesia, which was maintained using sevoflurane.Group R received a continuous infusion of remifentanil titrated between 3 and 4 ng/mL using target-controlled infusion, whereas Group G received an i.v.gastrodin bolus of 2 mg/kg followed by a 20 mg/kg continuous infusion to maintain a mean arterial pressure ( MAP) between 60 and 70 mmHg.Haemodynamic variables, surgical conditions, postoperative pain, and adverse effects, such as postoperative nausea and vomiting ( PONV) and shivering were recorded.Results Controlled hypotension was well maintained in both groups.MAP and heart rate were higher in Group R than Group G after operation(P<0.05).Surgical conditions scores were not different between two groups.Postoperative pain scores were significantly lower in Group G than Group R (P<0.05).Shivering and the use of antiemetic and analgesic drugs were also less frequent in Group G than Group R (P<0.05).Conclusions Both gastrodin and remifentanil when combined with sevoflurane provides adequate controlled hypotension and proper surgical conditions for endoscopic sinus surgery.However, patient administered gastrodin has a more favourable postoperative course with better analgesia and less shivering and PONV.

Objective To evaluate the diagnostic value of cerebrospinal lactate for the diagnosis of bacterial meningitis in patients post-neurosurgical operation (PNBM) with blood-contaminated cerebrospinal fluid (CSF). Methods A prospective observational study was conducted. 101 patients underwent neurosurgical operation and clinically suspected PNBM admitted to neurosurgical intensive care unit (NSICU) of the First Affiliated Hospital of Sun Yat-sen University from October 2015 to December 2016 were enrolled. Based on red blood cell quantitative test in CSF, the patients were divided into blood-contaminated and non blood-contaminated CSF groups. According to the PNBM diagnostic criteria of 2008 Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN), all patients were divided into PNBM group and non-PNBM group. The biochemical indexes levels in CSF were compared among the groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic power of CSF lactate for PNBM in blood-contaminated patients.Results A total of 101 suspected PNBM patients were enrolled. In 77 blood-contaminated CSF patients, 39 patients were diagnosed as PNBM (account for 50.6%); in 24 non-blood-contaminated patients, 12 patients were diagnosed as PNBM (account for 50.0%). ① In non-PNBM patients, the lactate level in blood-contaminated CSF was significantly higher than that of non-blood-contaminated CSF (mmol/L: 3.5±1.3 vs. 2.3±1.1,P < 0.01). In PNBM patients, there was no significant difference in lactate level between blood-contaminated CSF and non blood-contaminated CSF (mmol/L: 6.8±2.1 vs. 6.9±2.5,P > 0.05). ② In both blood-contaminated and non blood-contaminated CSF, white blood cell (WBC), protein and lactate levels in PNBM group were significantly higher than those in non-PNBM group [WBC (×106/L): 660.0 (67.5, 1105.0) vs. 41.0 (15.0, 142.5) in blood-contaminated CSF,168.0 (86.5, 269.5) vs. 34.5 (7.0, 83.5) in non-blood-contaminated CSF; protein (mg/L): 4757.8 (2995.2, 10219.8) vs. 1292.8 (924.2, 1936.2) in blood-contaminated CSF, 39247.3 (14900.6, 62552.2) vs. 1441.6 (977.3, 2963.9) in non blood-contaminated CSF; lactate (mmol/L): 6.8±2.1 vs. 3.5±1.3 in blood-contaminated CSF, 6.9±2.5 vs. 2.3±1.1 in non blood-contaminated CSF, allP < 0.05], and glucose and CSF glucose/blood glucose ratio in PNBM group were significantly lower than those in non-PNBM group [glucose (mmol/L): 2.5±1.2 vs. 4.4±1.6 in blood-contaminated CSF, 1.9±1.4 vs. 3.4±0.9 in non blood-contaminated CSF; CSF glucose/blood glucose ratio: 0.28±0.15 vs. 0.46±0.16 in blood-contaminated CSF, 0.24±0.16 vs. 0.45±0.11 in non blood-contaminated CSF, allP < 0.01]. ③ It was shown by ROC curve analysis that CSF lactate level was a good diagnostic parameter for PNBM both in blood-contaminated and non blood-contaminated CSF, and the area under ROC curve (AUC) was 0.91 and 0.97, respectively. When the cutoff value of lactate in non blood-contaminated CSF was 3.35 mmol/L, the sensitivity was 100%, and the specificity was 91.7%. When the cutoff value of lactate in blood-contaminated CSF was 4.15 mmol/L, the sensitivity was 92.3%, and the specificity was 71.1%, and the combination of CSF lactate and glucose achieved better diagnostic specificity (AUC = 0.96, sensitivity was 97.4%, specificity was 84.2%).Conclusions Blood in CSF led to the elevation of CSF lactate as compared with that in non-blood-contaminated CSF of patients with PNBM. CSF lactate was still a good diagnostic parameter for PNBM both in blood-contaminated patients, and the combination of CSF lactate and glucose achieved better diagnostic specificity.

Objective To explore clinical effect of double-tube continuous negative pressure drainage in the treatment of Morel-Lavallée leision.Methods We retrospectively analyzed the clinical data of 13 patients with Morel-Lavallée leision,which were diagnosed and treated in our hospital from May 2009 to July 2010.They were 11 women and 2 men,aged from 19 to 57 years (average,32.5 years).All patients underwent operations within 3 days after injury,except for 2 patients whose diagnosis was postponed.The operation was performed with small incision and double-tubes were placed for continuous negative pressure drainage.Double-tubes were not removed until effusion was less than 30 ml/24 hours.The heal was defined as no skin necrosis and subcutaneous hydrops at lesion site,no skin floating and sliding at palpation.Results Double-tubes were removed 4 to 12 days postoperatively (average,6.3 day).All of 13 patients were followed up for an average of 13.7 months (range,10 to 18 months).Skin necrosis occurred in 1 patient.Lesions were healed 4 to 10 weeks postoperatively(average,7.2 weeks).No deep infection or delayed hematogenous infection was found.There were no general systematic complications.Superficial infection at wound site occurred in one patient and healed after wound management.Conclusion Application of double-tube continuous negative pressure drainage is a safe,less invasive,low-cost and effective treatment for Morel-Lavallée leision.