Calomel is a common traditional Chinese medicine (TCM) containing mercury in clinical external application. Although the toxicity of calomel has attracted concern, there is no unified standard yet in clinical external application. Risk assessment is used for evaluating the potential health effects of hazardous substances. The purpose of this article was to evaluate the health risk of calomel in clinical external application on the basis of toxicity data, to ensure safe and rational application of TCM containing calomel. The toxicity data of transdermal administration of calomel or mercurous chloride were collected by searching the literature. The daily maximum exposure dosage of calomel in clinical external application was estimated by following the four procedures of risk assessment, and Margin of Safety (MOS) as an evaluation indicator was then calculated to evaluate the safety of calomel on clinical application. It has been reported that the adult in single transdermal administration of calomel at 1. 5 g was lethal. Based on the LOAEL of calomel for long-term transdermal exposure (1 month) in rats was 0.096 g · kg(-1) · d(-1), the NOAEL of calomel for patients (about 60 kg) by external application within 2 weeks was estimated to be 1.46 mg · kg(-1) · d(-1). When MOS value equals to 1, the daily maximum exposure of calomel in clinical external application within 2 weeks was calculated to be 1.1 g. The results suggest that daily single dose of calomel in clinical external application should be lower than 1.5 g for adults, and more attention should be paid to changes in hepatic and renal function of patients when repeated dose more than 1.1 g within 2 weeks. The approach of risk assessment could be helpful in rational application of TCM containing mercury.
Animals ; Humans ; Medicine, Chinese Traditional ; Mercury Compounds ; toxicity ; No-Observed-Adverse-Effect Level ; Rats ; Risk Assessment

Objective To explore the etiology of patients with chief complaint of vertigo in the department of neurology in order to reduce thc rate of misdiagnosis.MethodsA total of 367 patients with chief complaint of vertigo in our department of neurology were followed up.The associated medical history,symptoms and physical examination were obtained.ResultsThe main diagnoses for the 367 patients were benign paroxysmal positional vertigo (BPPV) ( 219,59.7％ ),posterior circulation ischemia (PCI) ( 65,17.7％ ),migraine ( 31,8.4％ ),hypertension ( 18,4.9％ ) and psychogcnic vertigo ( 17,4.6％ ).Conclusions Presentation of vertigo can be clinically diagnosed in most discases,with the most common causc of BPPV.Combination of the prominent clinical features,physical examinations and especially Dix- Hallpike maneuver may guide the general physicians to a most proper cause of vertigo.

The origin of northern Artemisia argyi recorded in Compendium of Materia Medica(Bencao gangmu) is Fudao(Chinese characters) in Tangyin county, While there is only Fudao(Chinese characters) instead of Fudao(Chinese characters). Whether indeed Fudao(Chinese characters) is Fudao(Chinese characters)? By reviewing the genuine evolution of A. argyi, doing textual research on Fudao(Chinese characters) and combing with field survey data of national census of Chinese Materia Medica resources, this paper concluded that the word Fudao(Chinese characters) firstly emerged in Figure Canon of Chinese Materia Medica(Bencao tujing) of Susong in Song dynasty and was applied in later generations, but the implication was not clear, then emerged both Tangyin and Fudao(Chinese characters) in Compendium of Materia Medica(Bencao gangmu). The place Fudao(Chinese characters) is one of the graves of Bianque, that existed from Shang and Zhou dynasty and never changed until now, the A. argyi of Tangyin was famous from the grave of Bianque in Fudao(Chinese characters), which could infer that Lishizhen considered Fudao (Chinese characters) was Fudao(Chinese characters) indeed, and the origin of northern A. argyi was Fudao(Chinese characters) in Tangyin county.
Artemisia ; China ; Drugs, Chinese Herbal ; history ; History, 16th Century ; History, 17th Century ; History, 18th Century ; History, 20th Century ; History, Medieval ; Humans ; Materia Medica ; history ; Plants, Medicinal ; Terminology as Topic

By using cup culture, influence of different strains (ammonium-resistant N2-fixing type, wild type, none N2-fixing type) of Klebsiella oxytoca on the growth of rice seedling was compared. It was discovered that ammonium-resistant N2 -fixing bacteria could excrete some plant growth promoting substance, which could be adsorbed by cation resin. It' s activity wouldn't be affected at 80℃. At optimal concentration, the weight of rice root and seedling were increased by

Recurrent spontaneous abortion (RSA),which affects 1% to 5% of women of reproductive age,is difficult to treat in the clinical setting. In the investigations of immunopathogenesis,diagnosis and treatment of RSA since the late 1980s,it was found that RSA was associated with abnormal maternal local or systemic immune response,the pathogenesis of autoimmune RSA was mainly associated with antiphosphlipid antibody (APA),while that of alloimmune RSA was due to the disturbance of maternofetal immunological tolerance. Systemic etiological screening process and diagnosis systems of RSA with immune type were developed,and anticardiolipin (ACL)+? 2-GP1 combining multiple assay for effective diagnosis of RSA with immune type was initially established. According to dynamic monitoring clinical parameters before and during gestation,low-dose,short-course and individual immunosuppressive therapy and lymphocyte immunotherapy for RSA with immune type were initiated. The outcomes of the offsprings of patients with RSA were followed up,and the safety and validity of the therapies were confirmed. The research achievement leads to great progress in the diagnosis and treatment of RSA in China.

Objective To evaluate clinical and procedural characteristics and outcomes of patients with ST-elevation myocardial infarction(STEMI) caused by drug-eluting stent(DES) thrombosis undergoing primary percutaneous coronary intervention(PCI).Methods From October 2004 to June 2007,31 patients with STEMI due to definite DES thrombosis who received primary PCI were retrospectively studied(ST group).Baseline clinical,angiographic,PCI procedural features and 1-year outcomes were recorded.Another consecutive 93 patients with STEMI due to de novo coronary thrombosis were served as control group.The primary endpoint was cumulative rate of major adverse cardiac events(MACE),including death,reoccurrence of myocardial infarction and target vessel revascularization(TVR),during hospitalization and at 1-year follow-up.Results Compared with the control group,patients in ST group were older(69.9?11.4 y and 63.7?13.6 y,P=0.01) and higher comorbidity rates of diabetes(41.9% and 22.6%,P=0.04)and previous history of myocardial infarction(29.0% and 11.8%,P=0.02).The occurrence of TIMI 3 flow immediately after primary PCI was reduced(45.2% and 92.5%,P

[Objective]A prospective comparative evaluation of fulcrum bending radiographs(fulcrum)to determine curve flexibility and predict surgical correction in adolescent idiopathic scoliosis(AIS).[Method]A total of 64 consecutive patients with AlS according to inclusion and exclusion criterias who underwent surgical treatment were studied.All curve types were single-curve and the PUMC classification were Ia/Ib/Ic.All patients were divided into 4 groups according to the magnitude of Cobbs angle in preoperative standing anteroposterior radiograph:moderate thoracic curve(20 cases,40?60?),moderate lumbar curve(21cases,35?60?).The Cobbs angles were measured and the flexibility ratio was determined on fulcrum radiograph.The amount of correction obtained by fulcrum radiograph was compared with the amount of surgical correction by evaluating the differences from surgery as absolute values.The correlation of Cobbs angles between postoperative standing anteroposterior radiograph and fulcrum radiograph were analyzed.[Result]For the moderate thoracic curves,curve flexibility provided by fulcrum radiograph has no significant difference(P=0.141)from surgical curve correction,there was no significant difference(P=0.094)between the mean Cobbs angle on fulcrum bending and that on postoperative standing anteroposterior radiograph.The postoperative Cobbs angle was positively correlated with the preoperative Cobbs angle on fulcrum radiograph and the correlation degree in the moderate lumbar curve was relatively weak.[Conclusion]Fulcrum radiograph can only be used to assess the flexibility and correction of moderate thoracic curves in AIS.Pedicle screw instrumentation provides even more correction.

Objective To investigate the indications and results of combined liver-kidney transplantation.Methods From Jan. 2001 to Dec. 2003, 15 patients were subjected to combined liver-kidney transplantation in our department. The underlying diseases included hepatitis B viral cirrhosis complicated by HRS ( n= 8), hepatitis B viral cirrhosis complicated by uremia ( n =2), hepatitis B viral cirrhosis complicated by diabetic nephropathy ( n =1), polycystic liver and kidney disease ( n =2), Caroli's disease and polycystic kidney ( n =1), alcoholic liver cirrhosis complicated by uremia ( n =1). The surgical procedure, perioperative complications, acute and chronic rejection, the recurrence of hepatic viral B hepatitis, and the result of follow-up were analyzed.Results The graft function in 15 cases of combined liver-kidney transplantation was restored well after operation. The 6-month and one-year survival rate was 100%. One patient was supported by respiration machine for 48 days. The complications occurred in 3 patients after operation, including one case of gastroenternal bleeding repeatedly and one case of postoperative wound bleeding subject to non-surgical treatment, and one case of stenosis of biliary anastomosis subject to ERCP. Only one patient experienced a rejection episode of the liver. No acute rejection of the kidney graft occurred. One patient was died from liver graft function failure by recurrence of hepatitis B after 30 months.Conclusions Combined liver-kidney transplantation is only radical treatment method for patients with end-stage liver disease with chronic renal dysfunction or chronic renal failure. In the patients with hepatitis B,lamividine and hepatitis B immunoglobin can prevent the recurrence of hepatitis B.

Objective To explore the effect s of nimodipine therapy and prognosis in patients with traumatic subarachnoid hemorrhage.Methods 138 patients were randomly divided into treatment group and control group.The treatment group(70 cases)received early nimodipine therapy and the control group(68 cases)was supported with common method.At the same time,the complications with cerebral infarction and hydrocephalus during treatment were observed and the prognosis were judged.All data were statistily analyse.Results The incidence rate of cerebral infarction and hydrocephalus in nimodipine treatment group was lower obviously than control group.And prognosis in treatment gruoup were better than those of control group.Conclusions It is useful that the cases of cerebral injury with traumatic subarachoid hemorrhage receive the treatment of nimodipine.The early nimodipine therapy can be beneficial to depress the occurrence of cerebral infarction and hydrocephalus and improve the prognosis.