Objective To investigate the diagnosis, prenatal treatment and prognosis of pregnancy with idiopathic thrombocytopenic purpura(ITP).Methods The clinical data of 92 cases of pregnancy with ITP in Beijing Obstetrics and Gy necology Hospital during Oct.1994 to Oct.2003 were analysed, including the ch anges of platelet counts, bleeding improvement, and the outcome of mothers and i nfants after treatment by using glucocorticoids, gamma globulin and transfusio n of platelets. Results The incidence of pregnancy with ITP was 2.4‰. Thirty-four cases(40%) were ac companied with other complications, such as hypertensive disorders complicating pregnancy (7), postpartum hemorrhage (6), premature labor (9), impaired glucose tolerance (19) and fetal macrosomia (10). Among the 92 cases, vaginal delivery and cesarean section were performed in 20(22%) and 72(78%) cases, respectively. Twenty-six, 18 and 24 cases were treated by glucocorticoids, glucocorticoids p lus gamma globulin, and glucocorticoids plus gamma globulin plus transfusion of platelets, respectively. Significant effects were achieved in 42 cases(62%), g eneral effects in 16 cases(24%),and improvement in 8 cases(12%),respectively. T he incidence of postpartum hemorrhage was 8%(6/72 cases). There was no maternal death.The infantile death ratio was 2/94 during perinatal period. The platele t count of peripheral blood in all the newborns was higher than 100?109/L.Th ere were no intracranial hemorrhage and other diseases related to platelet decre ase. Conclusion Glucocorticoids, gamma globulin and transfusion of platelets are effective m ethods for the treatment of ITP in mid-late pregnancy. They can increase the platelet counts and decrease the postpartum hemorrhage of the patients, and have no side effects to mother or infant.\ \

Endoscopic drainage was practised in 23 patients with acute or chronic pancreatitis. Among them 13 cases with acute pancreatits (AP) including 5 serious ones were treated with endoscopic sphincterotomy (EST) and naso biliary drainage (ENBD).Following successful drainage ( n =11) all the patients were cured with an average of 10 4 days (5-18 days). Among 11 patients with chronic pancreatitis, there were 7 cases treated by endoscopic pancreatic sphinterotomy (EPS), 2 cases by extraction of pancreatic duct stones with balloon, 5 cases by dilatation of pancreatic duct with bougienage, 6 cases by endoscopic naso pancreatic drainage(ENPD), and 7 cases by pancreatic duct drainage(PDE). After the operation, abdominal pain was eliminated in 5/7 cases. Pancreatic duct stones were extracted out in 2 patients and pancreatic cyst disappeared in 4 patients. It is concluded that endoscopic drainage is safe and useful in management of acute or chronic pancreatitis.

Objective To investigate the application value of CEUS combined with biopsy in qualitative diagnosis of pe ripheral pulmonary lesions.Methods A total of 158 patients with peripheral pulmonary lesions underwent percutaneous puncture biopsy.Among them,97 cases underwent CEUS before biopsy (experiment group),and 61 cases underwent conventional ultrasound (control group).Puncture times,positive rate of samples pathological diagnosis and occurrence rate of complications were compared between the two groups.The time intensity curve (TIC) was used to obtain the rise time (RT),time to peak (TTP),wash-in slope (WIS) and peak intensity (PI).The parameters of TIC between the two groups were compared.The enhanced morphology of lesions was also observed and recorded.Results The positive rate of samples pathological diagnosis was 94.85 ％ (92/97) in experiment group and 83.61％ (51/61) in control group.The difference of the positive rate was significant between the two groups (P=0.02).In experiment and control group,the average puncture times were 2.11±0.48 and 2.20±0.44;While the occurrence rate of complications were 2.06％ (2/97) and 4.91％ (3/61).No significant difference was found of the average puncture times and the occurrence rate of complications between the two groups (both P＞0.05).While the statistical differences of RT,PI and WIS were found between benign and malignant lesions (all P＜0.05) in experiment group.And no statistical difference of TTP was found (P =0.08).Totally 77.50％ (31/40) of the benign lesions showed inhomogeneous enhancement,while the proportion was 88.46％ (46/52) in malignant lesions.There was no statistical difference of enhanced morphology between benign and malignant lesions (P=0.16).Conclusion CEUS is helpful in distinguishing benign and malignant peripheral pulmonary lesions.And it has great value in guiding percutaneous biopsy in peripheral pulmonary lesions.

Objective To evaluate the effects of different doses of dexmedetomidine administered intranasally on the median effective target plasma concentration (EC50) of propofol inhibiting responses to laryngeal mask airway (LMA) insertion in the pediatric patients.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ pediatric patients of both sexes,aged 1-3 yr,with body mass index of 20-26 kg/m2,scheduled for elective surgery under general anesthesia,were divided into 3 groups using a random number table:control group (group C),dexmedetomidine 1 μg/kg group (group D1) and dexmnedetomidine 2 μg/kg group (group D2).At 20 min before induction of anesthesia,dexmedetomidine 1 and 2 μg/kg (diluted to 1 ml in normal saline) were intranasally administered in D1 and D2 groups,respectively,and the equal volume of normal saline was intranasally administered in group C.Children were separated from their parents at 20 min after intranasal administration and admitted to the operating room.The target plasma concentration of propofol was determined by modified Dixon's up-and-down method.The initial target plasma concentration of propofol was set at 5.4 μg/ml.The target plasma concentration of propofol was increased/decreased by 10％ in the next patient according to the response to LMA insertion,and the ratio between the two successive concentrations was 1.1.Patients' sedation status and LMA acceptance were evaluated when patients were separated from their parents.Patient's satisfaction with sedation and with LMA acceptance was recorded.Probit analysis was used to calculate the EC50 of propofol inhibiting responses to LMA insertion.Results Compared with group C,the satisfactory rates of sedation and LMA acceptance were significantly increased,and EC50 of propofol inhibiting responses to LMA insertion was decreased in D1 and D2 groups (P＜0.05).Compared with group D1,the satisfactory rates of sedation and LMA acceptance were significantly increased,and the EC50 of propofol inhibiting responses to LMA insertion was decreased in group D2 (P＜0.05).Conclusion Dexmedetomidine 1 and 2 μg/kg administered intranasally both can decrease the EC50 of propofol inhibiting responses to LMA insertion in the pediatric patients,and 2 μg/kg produces better efficacy.

Objective To evaluate the clinical toxicity and efficacy of S-1 combined with γ-ray body stereotactic radiation therapy in treatment of locally advanced pancreatic cancer.Methods Forty-five patients with locally advanced pancreatic cancer were randomly divided into two groups.The combination group received γ-ray stereotactic body radiation therapy which was given isodose curve of 50 ％-60 ％,tumor encircling dose of 3.0-4.5 Gy per fraction depended on dimension of tumors,9-12 fractions.Combined with S-1 40 mg/m2,2 times/d,for consecutive twenty-one days for four courses.The control group was given γ-ray stereotactic body radiation therapy only.Toxicities and effects were evaluated according to the criteria of WHO and RTOG.Results The CR rates in combination group and control group were 30.4 ％ (7/23) and 13.6 ％ (3/22),the response rates were 91.3 ％ (21/23) and 63.6 ％ (14/22) (x2 =4.980,P =0.026).The rates of gastrointestinal tract side reaction in combination group and control group were 82.6 ％ and 68.2 ％ (x2 =1.267,P =0.260),myelosuppression in combination group and control group were 78.3 ％ and 63.6 ％ (x2 =1.171,P =0.279).The rate of Ⅲ-Ⅳ grade myelosuppression in combination group were higher than that in control group (x2 =4.874,P =0.027).The median progression-free survival (PFS) rates of two groups were 8 months and 6 months respectively (x2 =1.357,P ＞ 0.05),the median survival period were 17 months and 14 months (x2 =1.017,P ＞ 0.05),1 year survival rates were 60.9 ％ and 54.5 ％ respectively (x2 =0.184,P ＞ 0.05).Conclusions S-1 combined with body gamma system treatment can improve local control rate and effective rate for inoperable patients with local advanced pancreatic carcinoma,and the adverse reactions are well tolerated.This method can be used as locally advanced pancreatic cancer chemoradiation safe and effective choice.

Obiective To elaborate the application of PCT/CT orientation Gamma Knife in the body.Methods From May, 2007 to May, 2008, PET/CT equipment was used on 120 cases with gamma knife body positioning and image fusion, Re-sults The PET/CT scan may not have iodine in the contrast agent to enhance the effective conduct of tumor imaging and CT position provides more simple and more accurate image information to guide target(GTV) of the outline. Conclusion The PET/CT in the gamma knife treatment can improve in the positioning accuracy of GIN, and improve treatment opportunity for iodine allergy patients.

OBJECTIVE:To establish mathematical model of liquid volume added of TCM medicinal broth decoction machine to accurately calculate liquid volume added in the process of medicinal herb decocting,so as to guarantee the quality of medicinal herb decocting. METHODS:The water absorption rate of representative TCM decoction piece with high use frequency were deter-mined,and cluster analysis of water absorption rate of TCM decoction piece was conducted according to closely related index as density,size,shape,moisture. TCM decoction piece with similar water absorption rate were bracketed together,so that of single ingredient TCM decoction piece can be estimated by water absorption of representative TCM decoction piece;the quantity of water evaporation and liquid extrusion were determined among different types of decoction machine (powered by electric and gas);ac-cording to the above parameters,mathematical model of liquid volume of TCM medicinal broth prepared by different types of de-coction machine had been established,and validated with TCM formula. RESULTS:Factors that affected the liquid volume added included the water absorption of each ingredient,the quantity of water evaporation and extrusion function. The mathematical model was liquid volume added=water absorption of each ingredient × quality of decoction piece+the quantity of water evaporation+re-quired amount of liquid-parameters of extrusion function×total weight of decoction piece;in validation test,the percentage of the practical amount of liquid to required amount was within ±5%. CONCLUSIONS:Established model can promote the accuracy li-quid volume added and guarantee the quality of TCM decoction when using TCM decoction machine.

To develop an ophthalmic preparation of Shedan, an in situ forming gel was prepared with the formulation containing 18% of poloxamer 407 and 5% of poloxamer 188 by response surface designs plus central composite designs. The rheology results showed that LVE range gamma should limited within 0.5%, Shedan high-frequency region, and the thixotropy recovery time is less than 5 seconds. The phase transition temperature was 33.25 °C according to curve of storage modulus and loss modulus determined by temperature scanning. Surface tension and osmometer of it determined by surface tension meter and dew point osmometer were 36.43 mN · m(-1), and 320.6 mOsm · kg(-1), respectively. Fluorescein sodium was selected as the marker to monitor the corneal residence time, and the results showed that Shedan gel could prolong drug residence for 180 min. In line with zero-order kinetics, releases of muscone and salvianolic acid B in vitro depends on gels erosion. The results of rabbit ocular irritation experiments suggested that Shedan in situ forming gel was biocompatible and nonirritant. In conclusion, a novel Shedan in situ forming gel was developed and characterized for potential drug treatment of retinal vein occlusion.
Animals ; Benzofurans ; chemistry ; Cycloparaffins ; chemistry ; Female ; Gels ; chemistry ; Male ; Ophthalmic Solutions ; Poloxamer ; chemistry ; Rabbits ; Retinal Vein Occlusion ; drug therapy ; Viscosity

Objective To investigate the effects of intratumoral implantation of ~(32)P-CP-PLLA seeds on the normal canine liver tissue and to exolore the metabolism of ~(32)P-CP-PLLA seeds implanted in the liver of experimental dogs.Methods Twelve beagles were enrolled in this study.The dogs were randomly and equally divided into four groups:group A(185 MBq),group B(370 MBq),group C(740 MBq)and group D(0 MBq).By using laparotomy procedure ~(32)P-CP-PLLA seeds were implanted into dog's liver.CT scan was performed before operation as well as before the dog was sacrificed.All dogs were sacrificed three months after the implantation.Before the procedure and 1,2,4,8 and 12 weeks after the procedure the blood tests and serum biochemical tests were conducted.One dog from group B and group C was selected respectively and was fed in a metabolic cage.Within one month after the procedure the cpm in feces and in urine was determined every 24 hours.One dog was picked out from each of the three groups and was punctured to get its liver tissue for pathologic exam each time at 1,2,4,8 and 12 weeks after the implantation,and SPECT imaging was also performed at the same time.Pathologic study,both macroscopic and microscopic(including optical and electronic microscopy)was made to observe the liver damage after the dog was sacrificed.The statistical analysis was processed by using SPSS 13.0 software and the measuring data were expressed with mean±standard deviation((x)±s).Results Two months after the procedure,serological examination found that the serum alkaline phosphatase(BKP)in both group Band group C was significantly higher than that in other groups,the difference was statistically significant (P ＜0.05),and the BKP levels returned to normal in three months.The postoperative 30-day inspection of the urine showed that the radioactive particles slowly released into the body and eliminated from the body with the urine and feces,mainly through the renal excretion.The 30-day cumulative percentage of eliminated radioactive dose in the urine and in the feces was 6.34% and 11.64% respectively.No sign of particle displacement was found on SPECT imaging.On autopsy three months after the implantation,the size of the radioactive seeds became smaller and fragile.With the radioactive dose used increasing,the area of liver damage at the site of seed implantation became bigger,which was demonstrated on CT scan,macroscopic exam and pathologic study.The local damaged focus of the liver caused by ~(32)P-CP-PLLA seeds was manifested as a spherical lesion which was encysted by a layer of fibrous tissue with an edematous zone peripherally.Conclusion The implantation of ~(32)P-CP-PLLA seeds in dog's liver causes only localized hepatic damage with no general adverse effects.The implanted seeds can slowly release the radioactive dose and will not immigrate to other organs in the body.Besides,the seeds possess excellent stability,targeted orientation and safety.

Objective To compare endovenous laser therapy (EVLT) with endovenous microwave coagulation (EMC) in the treatment of varicose vein in the lower extremities. Methods Sixty-five (male 30, female 35) patients with 70 lower extremities (35 legs in each treatment group) were pair matched according to age, gender and CEAP classification to receive endovenous laser therapy (EVLT) or endovenous microwave coagulation (EMC). The same surgeon performed all procedures. Patients were monitored on 72 hours, 4 weeks and 6 months after the procedure (by procedural site scored for bruising, skin burn, painful induration or trabes as well as a pain score), the cured extremities were examined via Duplex uhrasonography to evaluate the effects of the procedure. Results All these 65 patients (mean age, 47.52 years) completed treatment and were followed-up. The mean operation time of EMC group was less than that of EVLT (71±25 vs. 59±15, P=0.01). At 72 hour after the procedure, bruising scores and skin buring were significantly different (P<0.05): patients in the EMC group showed less bruising (17.14% vs. 54.29%) but more burn (48.57% vs. 20%) on the procedure site than the patients in the EVLT group. At 4 weeks and 6 months after the procedure, no significant differences were found between patient outcomes, physical conditions, and symptoms and or possible adverse events. In 20/28 patients the pigmentation faded away, Edema were relieved in all the 25 extremities. 4 patients with ankle ulcer were healed. No major complications were found. Conclusions Both EMC and EVLT were effective in treating lower extremities varicose veins, with no major complications.