Object To develop a method for the determination of palmatine hydrochloride and berberine hydrochloride in Chinese Mahonia Stem from different habitats Methods HPLC method was set up, using Intersil ODS 3 C 18 column, the mobile phase was acetontrile water sodium laurylsulfonate (470∶ 530∶1 g), the UV detection wavelength was 265 nm, with a flow rate of 1 0 mL/min at 40 ℃ Results A good linearity was obtained in the range of 4 368 52 416 ?g/mL(r=0 999 9) for palmatine hydrochloride and 4 532 54 384 ?g/mL (r=0 999 9) for berberine hydrochloride The average recovery of palmatine hydrochloride and berberine hydrochloride was 98 97% and 98 98%, respectively Conclusion The method is simple, rapid and with better reproducibility for the determination of palmatine hydrochloride and berberine hydrochloride in Chinese Mahonia Stem

Objective To study the epidemiological characteristics of Hand-Foot-Mouth Disease of chil-dren in Zhongshancity from 2011 to 2015 and provide etiological evident for the prevention and control of Hand -Foot -Mouth Disease of children in Zhongshan city. Methods We analyzed the data of children with Hand-Foot-Mouth Disease in Zhongshan Boai 's Hospital from 2011 to 2015. The enterovirus nucleic acid of Hand-Foot-Mouth Diseaseof children were detected. Results Atotal of 31164 cases of Hand-Foot-Mouth Disease were diagnosed in Zhongshan Boai′s Hospital during 2011-2015,the ratio of male to female was 1.62:1. Every year,the peak inci-dence of the disease is not the same. During 2011-2015,there were 10147 cases of Hand-Foot-Mouth Diseaseof children,among which,through viral nucleic acid EV71and CoxA16testing,2062 cases were positive and the positve rate was 20.32%. Pathogen of Hand-Foot-Mouth Diseasewas mainly based on EV71 in 2011,2012, 2013and2015,accounting for the total positive rate of 79.04%,72.46%,81.60%,73.73%respectively;Pathogen of Hand -Foot -Mouth Diseasewas mainly based on Cox16 in 2014,accounted for 54.47% of the total positive. In different years EV71 and CoxA16 positive rate was significant different.There were 1982 cases repeated Hand-Foot-MouthDiseaseinfectioins .Conclusion The incidence of Hand-Foot-Mouth Disease of children is related to age , sex and season in Zhongshan city. It is mainly based on clinical diagnosis ,the preventive measures and the clinical recognition in time to provide help for the treatment and control of Hand-Foot-Mouth Disease of children.

Objective A 23-year-old female patient who had a past history of sexual - precocity and fracture developed hyperhyroidism 8 months ago. Radiological examination revealed enlargement of sella turcica and a adrenal gland nodule. The patient was diagnosed to have McCune -Albright syndrome and scheduled for resection of left subtotal adrenalectomy under general anesthesia. The patient was taking (1) thiamazole 5 mg t. i. d. and propranolol 10 mg q. d. for hyperthyroidism; (2) adalat 10 mg t. i. d. and potassium citrate 20 ml t. i. d. for Cushing syndrome and (3) calcium tablets for osteoporosis. Anesthesia was induced with intravenous midazolam 1 mg, fentanyl 50 ?g and vecuronium 1 mg followed by propofol 150 mg and succinyl choline 100 mg. The patient was intubated and mechanically ventilated (VT = 500 ml, RR =10 bpm, I: E = 1 :2) . PET CO2 was maintained between 35 - 45 mm Hg. Anesthesia was maintained with inhalation of isoflurane and N2O - O2 (1:2) and intermittent i.v. boluses of fentanyl and vecuronium. The BP was increased to 180/110 mm Hg after induction of anesthesia. Urapidil 10 mg was given intermittently i.v. During the exploration of adrenal gland BP was again increased to 200/140 mm Hg. Nitroglycerin was infused i.v. and BP was decreased to 120-130/80-90 mm Hg and was kept at this level till the end of operation. Hydrocortisone succinate 100 mg was infused i.v. slowly after operation. The operation went smoothly. The patient was extubated and the postoperative course was uneventful.

Objective To investigate the relationship between the C161T polymorphisms in peroxisome proliferators-activated receptor γ (PPARγ) gene and atherothrombotic infarction (ATI) in a Chinese Han population.Methods The patients with atherothrombotic infarction and controls,who without histories of stroke,transient ischemic attack and myocardial infarction were enrolled.Genotypes of the PPARγ C161T polymorphisms were determined using the polymerase chain reaction-restriction fragment length polymorphism.The frequencies of genotype and allele in patients with ATI and controls were compared.Results A total of 112 ATI patients and 112 controls were enrolled.There were no significant differences in the age (67.9± 11.73 years vs.66.5 ± 10.35 years; t =0.386,P =0.701) and the proportion of male (61.61％ vs.58.04％ ;x2 =0.297,P =0.586) in the ATI group and the control group.The proportions of hypertension (59.82％ vs.44.62％ ;x2 =5.171,P =0.023),type 2 diabetes mellitus (26.79％ vs.9.82％;x2 =10.778,P =0.001) in the ATI group were significantly higher than those in the control group.Body mass index (25.13±1.86 kg/m2 vs.24.11 ± 1.81 kg/m2; t =3.543,P=0.001),systolic pressure (158.84 ± 20.15 mm Hg vs.135.82 ± 19.58 mm Hg; t =7.350,P =0.000),diastolic pressure (76.90 ± 13.64 mm Hg vs.68.90 ± 8.52 mm Hg; t =4.374,P =0.000) and the level of fasting blood glucose (6.523 ± 2.831 mmol/L vs.5.706 ± 2.177 mmol/L; t =2.026,P =0.044) in the ATI group were significantly higher than those in the control group.The genotype frequencies of CC,CT and TT in the ATI group were 77.7％,17.0％ and 5.4％,respectively,and in the control group were 69.6％,22.3％ and 8.0％,respectively.There were no significant difference between the two groups (x2 =1.909,P =0.385).The allele frequencies of C and T in the ATI group were 86.2％ and 13.8％,respectively,and in the control group were 80.8％ and 19.2％,respectively.There were no significant difference between the two groups (x2 =2.331,P =0.127).Conclusions PPARγ C161T polymorphisms may be not associated with the onset of ATI in a Chinese Han population.

Objective Anti-N-methyl-D-Aspartate (NMDA) receptor encephalitis is a rare disease,recently described as autoimmune disorder of paraneoplastic limbic encephalitis,which is related to the NMDA receptor antibodies and frequently develops in young women with ovarian teratoma.The disease is usually accompanied by symptoms of psychosis and abnormal behaviors,autonomic nervous system dysfunction,central hypoventilation,and hyperthermia.During induction and maintenance of general anesthesia,we should be aware of adverse reactions such as cardiovascular events,hyperthermia and respiratory insufficiency.In order to maintain vital signs stable,pharmacological agents including vasopressors,β-blockers,antihypertensives,and anticholinergics should be prepared before the surgery.Invasive monitoring for blood pressure can be set if necessary.This study described the method for anesthetic management of 3 patients with anti-NMDA receptor encephalitis undergoing resection of ovarian teratoma under general anesthesia.Preoperative treatment included antipsychotic,anti-infective and immune therapy.General anesthesia was induced with propofol,rocuronium,fentanyl and midazolam to facilitate tracheal intubation and was maintained with inhalation of sevoflurane (mixed with oxygen and air) and intermittent iv boluses of fentanyl and rocuronium during the surgery.All the drugs mentioned above had no interaction or had slight indirect action on anti-NMDA receptors to avoid NMDA-related adverse reactions.In conclusion,the adequate preparation for the surgery should be done in this kind of patients,we should avoid using anesthetics having NMDA receptor antagonism (such as ketamine,N2O,methadone,dextromethorphan,phencyclidine) or other anesthetics acting indirectly (such as pentobarbital) on the NMDA receptors during anesthetic management in the patients with anti-NMDA receptor encephalitis.

Objective To investigate the predictive values of the pulsatility index detected by transcranial Doppler (TCD) and serum neuron-specific enolase (NES) in patients achieved return of spontaneous circulation after cardiopulmonary resuscitation (CPR). Methods The patients with CPR restoration of spontaneous circulation who were still in coma were divided into survival group and death group. TCD monitoring and serum NSE detection were performed at 48 hours after CPR restoration of spontaneous circulation. Receiver operating characteristic (ROC) curves were used to evaluate the predictive values of the pulsatility index detected by TCD and serum NES in patients after successful CPR. Results Seventy patients were collected, 32 patients (19 males and 13 females) in the survival group, age 54. 63 ± 13. 28 years; 38 patients (22 males and 16 females) in the death group, age 58. 00 ± 13. 15 years. There were no significant differences in age and gender between the survival and death groups. The pulsatility index was 1. 217 + 0. 352 in the death group, and it was significantly higher than 0.841 +0. 163 in the survival group; the serum NSE content was 130. 968±59.634 ng/ml in the death group, and it was signiflcantly higher than 49. 465 ± 26. 864 ng/ml in the survival gronp (P＜0. 01). When the pulsatility index was used to predict the death of patients, the ROC area under the curve was 0. 794 (P=0. 000,95% confidence interval [CI] O. 679-0. 908);when the cutoff value was 1. 110, the sensitivity was 68.4%, the specificity was 100%,positive predictive value was 100%, and negative predictive value was 72. 7%. When serum NSE level was used to predict the death of the patients, the ROC area under the curve was 0. 756 (P= 0. 000, 95% CI 0. 672-0. 885); when the cutoff value was 56. 502 ng/ml, the sensitivity was 80. 8%, the specificity was 65. 4%, positive predictive value was 82. 5%, and negative predictive value was 76. 6%. Conclusions The pulsatility index detected by TCD and serum NSE content can be used as predictors in patients achieved return of spontaneous circulation after CPR.

Objective:To assess the effects of Herbst two phase treatment on temporomandibular joint(TMJ) position analyzed by CBCT.Methods:15 patients of permanent dentition with class Ⅱ malocclusion combined with mandibular retrusion were treated by Herbst appliance as the 1st phase,then the 4 1st premolars of each patient were extracted,the fixed appliance of edgewise was applied as the 2nd phase of treatment.CBCT examination was carried out at the following stages:2 weeks before Herbst treatment(T1),at the start of the treatment when Herbst appliance was placed(T2),immediately after Herbst appliance was removed(T3) and immediately after the edgewise appliance was removed(T4).The InvivoDental software was used to calculate the joint space of TMJ from the three -dimensional CBCT images.The acquired data were then statistically analyzed.Results:During T1-T2-T3 stages,the anterior joint space was decreased and then increased,superior joint space and posterior joint space were increased and then decreased.During T3-T4 stages,the superior joint space and posterior joint space decreased further,but anterior joint space did not change.No significant difference was found in the anterior joint space,superior joint space and posterior joint space between T1 and T4 stage.Conclusion:At the start of treatment with Herbst appliance,the condyle is displaced in an anterior and inferior direction.At the end of functional treatment,especially the end of two phase treatment,the condyle is drawed back nearly to the original position.

Objective: To evaluate the effects of functional appliance and multi-bracket appliance on Angle Class II malocclusions coupled with vertical and transversal problems. Methods:Headgear-activator, Herbst appliance and multi-bracket appliance were used to treat 20 patients with Class II malocclusions coupled with vertical and transversal problems aged from 10 to 15 years. The lateral cephalograms were measured with Winceph 8. 0 software and statistical analysis was carried by SPSS 13. 0 software. Results:The sagi-tal, vertical, transversal problems had mainly been resolved at the end of functional appliance treatment. The SNB were increased( P<0. 05), ANB were decreased(P<0. 05), upper posterior teeth were intruded and distally moved(P<0. 05), lower posterior teeth were extruded and mesialy moved(P<0. 05). After multi-bracket appliance treatment, the anterior teeth achieved normal overbite and over-jet. The molar relationship changed from class II to class I. Mandibular plane angle was not clockwise rotated(P>0. 05). The upper and lower dentition were harmony in sagital, vertical and transversal. Conclusion: Functional appliance combined with multi-bracket appliance can be used effectively and conveniently for the treatment of Class II malocclusions coupled with vertical and transversal prob-lems.

Objective To investigate the relationship of radiation dose with the volume and late toxicity of the sternocleidomastoid muscle ( SM) in patients with nasopharyngeal carcinoma. Methods SM was divided into upper part and lower part based on the lower edge of cricoid cartilage. Patients were divided into three groups according to the prescribed dose for clinical target volume at the lower neck ( CTV2 ) ( 0, 54,60 Gy) . The dosimetric parameters included Dmean , V66 , and V60 for the upper, lower, and whole SM. SM was delineated and the volume was calculated on computed tomography images in the treatment planning system before and at 6, 12, and 18 months after treatment. The anteroposterior and transversal diameters of SM at C3?C4 , C4?C5 , C5?C6 , and C6?C7 levels were measured and recorded. Late toxicity of neck skin and SM was evaluated according to the Common Terminology Criteria for Adverse Events V4 .0 criteria. Between?group comparison was made by t?test or Kruskal?Wallis non?parametric test. Between?group comparison of the sample rate was made by one?way analysis of variance. The correlation analysis was made by Spearman correlation. Results There were significant difference in SM volume between the three time points after treatment ( P=0. 000) . At 12 or 18 months after treatment, the volume of SM wasignificantly reduced ( P=0. 000,0. 000);the reduction in SM volume was significantly correlated with V66 of the SM and the upper SM ( P=0. 015,0. 020) . At 18 months after treatment, SM fibrosis was significantly correlated with V60 of the upper SM ( P=0. 030);the fibrosis of neck skin was significantly correlated with the Dmean and V60 of the upper SM ( P=0. 029,0. 005) . Conclusions In order to prevent the incidence of the fibrosis of neck skin and SM, the dose homogeneity should be as high as possible, while the number of hot spots should be as small as possible.

Objective To evaluate the topical anesthetic effects of compound lidocaine cream ( CLC) coated endo-tracheal tube on the prevention of cough/agitation during extubation in thyroidectomy under general anesthesia . Methods 42 patients scheduled for thyroidectomy in Peking Union Medical College Hospital were continuously en -rolled in this prospective double-blinded randomized controlled trial .Patients were randomized into two groups . Group L were intubated with endotracheal tube coated with CLC , while the control group , group C with liquid par-affin .The end point of study was spontaneous or induced cough /agitation during extubation .Hemodynamic parame-ters and the consumption of opioids were recorded .Patients were followed for major complications during their stay in hospital .Results Spontaneous cough/agitation rate was lower in group L than group C ( 15% vs 65%, P<0.01 );so was induced cough/agitation (35%vs 90%, P<0.001 );the value of SBP ×HR was lower in group L at 1 min after extubation ( P<0.05 ) .Conclusions The topical anesthetic effects of CLC coated endotracheal tube could prevent cough and agitation during extubation in thyroidectomy under general anesthesia .