Through investigating the hospital admission and hospital discharge of vagrant mental patients in Xi-aoshan Hospital from January 2011 to December 2015 , the present study found that there existed some ethical di-lemmas including the risk ofdiagnosing mental disorder but actually not, lack of the guarantee of patients' rights and interests and supervision mechanism without guardian, long-term retention in the wards, and so on. It is sug-gested to establish right protection and supervision committee for vagrant mental patients, reduce the misdiagnosis ofdiagnosing mental disorder but actually not through the error correction mechanism, ensure proper treatment and care, create retention way, protect the basic rights of the vagrant mental patients, reduce mental disability, avoid to stray again, so as to perfect the social management system.

Objective To establish a rapid and precise continuous flow-injection chemiluminescence method for the determination of tetracycline and oxytetracycline. Methods In NaOH solution, tetracycline and oxytetracycline can sensitize obviously the chemiluminesence (CL) intensity of the reaction of luminol with KIO4, the sensitized CL intensity is proportional to the concentration of tetracycline and oxytetracycline. So, a new flow-injection CL method has been developed. The optimum chemical conditions for the CL reaction were investigated. Results Under the optimized conditions (KIO4 concentration: 1.0×10-5 mol/L; NaOH concentration: 0.1mol/L; luminol concentration: 1.0×10-4mol/L), tetracycline and oxytetracycline were determined. The linear range of the working curves was 1.0×10-7 -1.0×10-4g/mL, the detection limits was 1.0×10-8g/mL and 1.1×10-8g/mL, and the relative standard deviation was 2.6% (CS=1.0×10-6g/mL; n=11) and 2.0% (CS=1.0×10-6g/mL; n=11) respectively. Conclusion The method is simple, rapid, and sensitive, and it has been successfully applied to the the determination of tetracycline and oxytetracycline tablets, the mean recoveries being 99.7% and 98.8% respectively.

Objective To establish a rapid and precise continuous flow-injection chemiluminescence (CL) method for the determination of perphenazine. Methods In HNO_3 medium, perphenazine could be oxidated by ceriuim (IV) and CL was proportional to the perphenazine concentration without any sensitizers. Thus, a new flow-injection CL method was developed. Results Under the optimized conditions, the proposed method allowed the determination range within 1.0?10~ -7 -7.0?10~ -5 g/mL with the detection limit of 8.0?10~ -8 g/mL. Eleven parallel assays were conducted on perphenazine of 1.0?10~ -6 g/mL, with the relative standard deviation of 1.8%. Conclusion The method is simple, rapid, precise, and sensitive, and has broad linear range; therefore, it has been applied to the the determination of the perphenazine in tablets with satisfactory results.

Objective Toobservetheeffectofperioperativeuseoflowmolecularheparin(LMH)forpreventinglowerlimbdeep vein thrombosis(DVT ) in elderly hip peripheral fracture .Methods 105 cases of elderly hip peripheral fracture from July 2007 to July 2011 were divided into the LMH group(65 cases) and the conventional treatment group(40 cases) .The two groups were per-formed the physical therapy for preventing lower limb DVT .The LM H group was added with LM H for preventing DVT .The sta-tuses of DVT occurrence and the coagulation related indicators were compared between the two groups .Results In the LM H group ,the thrombus events happened in 4 cases ,accounting for 6 .15% .In the conventional treatment group ,thrombosis occurred in 13 cases ,accounting for 32 .5% .The difference between the two groups had statistical significance (P<0 .05) .Hemoglobin on post-operative 1 ,10 d was obviously improved ,the difference had statistical significance(P<0 .05) .Conclusion Using LMH has rela-tively ideal effect for preventing lower limb DVT in elderly hip peripheral fracture .

Objective To establish a rapid, accurate and sensitive chemiluminescence method for determining sulfydryl-containing drugs. Methods In sulfuric acid solution, glyoxal could be oxidized by potassium permanganate, and weak chemiluminescence could be observed. Chemiluminescence signal could be enhanced in the presence of sulfydryl-containing drugs. Thus, on this basis we established a new method of determining the concentration of sulfydryl-containing drugs with flow injection chemiluminescence analysis. Results Under the optimized conditions, the linear range of methimazole, captopril and acetylcysteine was 1.0×10~(-8)- 5.0×10~(-6), 7.0×10~(-8)-1.0×10~(-6) and 3.0×10~(-8)-1.0×10~(-6)g/mL, respectively. The limit of detection of methimazole, captopril and acetylcysteine was 1.0, 3.9 and 3.7ng/mL, respectively. Conclusion The method was successfully applied to determine the three drugs that contain sulfydryl. Compared with the results of pharmacopeia methods, the results we obtained were satisfactory.

Objective To investigate the efficacy and toxicity of neoadjuvant regional arterial chemotherapy in the treatment of advanced gastric cancer. Methods The clinical data of 158 patients with advanced gastric cancer and with the same clinical stages who were admitted to Renji Hospital of Shanghai Jiaotong University from February 2002 to May 2005 were retrospectively analysed. Preoperative regional arterial chemotherapy was applied to 76 patients (test group) and the remaining 82 patients only received surgical treatment (control group). The chemotherapy regimen was epirubicin (50 mg/m2) + cisplatin (60 mg/m2) + 5-fluorouracil (1000 mg/m2).This regimen was modified to oxaliplatin (130 mg/m2) + 5-fluorouracil (1000 mg/m2) since 2003, and surgery was performed 6-11 days after the chemotherapy. All patients received postoperative intravenous chemotherapy.The clinical effects, radical resection rate, operative complications and long-term survival of the two treatment methods were evaluated. All data were analysed using the chi-square test and Kaplan-Meier analysis. Results The radical resection rate was significantly higher at 86% (65/76) in the test group compared with 71% (58/82)in the control group ( x2 = 5.01, P ＜ 0. 05 ). The toxicity of the chemotherapy in the test group was mild. The postoperative complication rate was 20% (15/76) in the test group and 16% (13/82) in the control group, with no significant difference between the two groups (x2 = 0.41, P＞0.05). The median survival time was 41 months in the test group and 23 months in the control group. The 5-year overall survival rate was higher in the test group (44.6%) than that in the control group (29.1%) (x2 =3.95, P＜0. 05). Conclusions Neoadjuvant regional arterial chemotherapy is well tolerated by patients with advanced gastric cancer. It is also effective for increasing the radical resection rate and improving the long-term survival.

BACKGROUND: It is often found in the clinic that apart from oppression and instability, there is much difference in sensibility and motion function recovery in patients who have similar imageological changes. Studies show that adhesion in the dura mater of spinal cord, traction of fibrous strip,traumatic scar, malacosis and cyst are the main causes.OBJECTIVE: To investigate the clinical effects of spinal decompression and nerve tissue implantation for obsolete incomplete paralysis.DESIGN: Self-control observation.SETTING: Department of Orthopaedics, Changhai Hospital of Second Military Medical University of Chinese PLA.PARTICIPANTS: We selected 28 patients with traumatic obsolete incom plete paralysis from the Department of Orthopaedics, Changhai Hospital of Second Military Medical University of Chinese PLA, from June 1994 to August 2002. Injured vertebral segments were T7-T9 (5 cases), T10-T12 (12 cases), and L1-2(11 cases). Sixteen patients had undergone decompression, fusion and internal fixation. Thirteen cases of them had undergone posterior decompression and pedicle screw internal fixation. The internal fixation devices had been removed in 7 patients before this procedure. Six cases of traumatic obsolete incomplete paralysis had been treated by hyperbaric oxygen. According to the classification of Frankel, 16 cases were degree B and 12 cases were degree C.METHODS: The dura mater of spinal cord was opened, and the fibrous bands adhering to the spinal cord from arachnoid, pia mater spinalis, ligamenta denticulatum, initial part of nerve root were complete relieved. Then the spinal cord with scar fibers contracted was opened by 3-6 incisions,which were 0.1-0.2 mm deep and longer than the scar part. Cyst found in the spinal cord in 6 cases was opened and the liquid in it was sucked. After that, we denuded spineurium and perineurium of the autogenous sural nerve graft, making the texture and appearance of the nerve look like cauda equine. The nerve was lined in several strips and longitudinally implanted into the incised spinal cord and cyst, and then it was sutured with pia mater spinalis with 9-0 scatheless wire. Finally the endorachis was sutured or covered by sacrospinal muscle.RESULTS: Sixteen cases were followed up for an average of 2.5 years, and all the patients entered the result analysis. The sensibility and motion func tion increased above one grade. Eleven patients who had suffered gatism had obvious progress. The strength of main muscle was increased by 2 grades and reached grade 4 in 16 cases, and walking capability was recovered. In 10 cases it was increased by 1 grade Only sensation had progress in 2 cases.CONCLUSION: Relieving adhesion in the endorhachis, incising the cicatricial spinal cord and bridging the autogenous peripheral nerve have good therapeutic results for gatism and recovering the muscle power of the ex-tremities for the patients with traumatic obsolete incomplete paralysis.

Objective:To explore the clinical effect of the second toenail flap with the dorsal bone of the phalange in repairing the defect of fingernail bed.Methods:From January, 2012 to June, 2019, 10 patients with large area of fingernail bed defect were treated by the second toenail flap with bone on the back of the phalanx. The survival of the flap was observed after the operation, and the fracture healing, the shape of the nail and the flexion and extension function of the finger joint were observed in the outpatient follow-up.Results:All flaps of the second toenail survived. The average follow-up period was 8 (4-12) months. The fractured ends of 10 patients' phalanges healed well without nonunion, good appearance of toenail and deformity of toenail. The recovery of hand function was evaluated according to the evaluation standard of upper limb function of Hand Surgery Society of Chinese Medical Association, 9 cases were excellent, and 1 case was good.Conclusion:The second toenail flap with dorsal bone of the phalanx preserved is easy to cut, simple to operate, and has good clinical effect. It is a good method to repair the defect of the fingernail bed.

OBJECTIVETo observe the therapeutic efficacy of Qingxue Granules (QX) in treating postnephrotransplant erythrocytosis (PNTE).

METHODSTwenty patients were randomly divided into two groups according to the randomized table. QX was given to patients in the TCM treated group (QX group) and Enalapril given to patients in the Western medicine treated group (WM group), and the clinical efficacy in the two groups was observed. Results In the QX group, 3 patients got markedly effective, 2 effective, 2 improved, 1 ineffective, 1 dropped from the treatment, 1 absconded, with the total effective rate of 77.78%. The corresponding numbers in the WM group were 4, 2, 2, 1, 1 and 66.67%. There was no significant difference in comparison of the efficacies between the two groups (P > 0.05). There was no difference between the Intent-to-Treat population and Per-protocol Pouplation after statistical management of lost cases.

CONCLUSIONIt has proved that QX has the same therapeutic effects as classic Western medical treatment in treating PNTE. The reliability and scientificity of QX was proved by Intent-to-Treat analysis.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Phytotherapy ; Polycythemia ; drug therapy ; etiology

Objective:To analyze the clinical features and SCN4A gentic background of a family with hypokalemic periodic paralysis.Methods:Peripheral blood samples and clinical data were collected from the proband, his brother and parents, and genomic DNA was extracted from these blood samples. Genome-wide exome sequencing was conducted to determine the mutation site in the proband and then allele-specific oligonucleotide primers were designed based on the mutation site. Polymerase chain reaction (PCR) was performed to detect the mutation site to further identify the causative gene in the family.Results:The patient was a 19-years-old male, Han nationality. The patient presented with periodic paralysis while hypokalemia at the same time. His father and grandpa have a similar medical history in the family. A hybrid missense variation (p.R672H) was identified in exon 12 of SCN4A gene in the proband. The same mutation was also detect in the proband's father.Conclusions:The heterozygous missense variation of SCN4A gene (p.R672H) found in this study resulted in familial hypokalemic periodic paralysis. Our research provided reference for the future genetic counseling of this patient and enriched the research data on the relationship between genotype and clinical manifestations.