Objective To compare the difference in pharmacokinetics characteristics of vancomycin in cerebrospinal fluid between administration by continuous infusion and interim infusion.Methods Twenty postoperative patients in the Department of Neurosurgery of Beijing Tiantan Hospital, Capital Medical University admitted into intensive care unit (ICU) to receive vancomycin for prophylaxis of intracranial infection were enrolled, and they were randomly distributed to a continuous intravenous infusion group and a interim intravenous infusion group, each group 10 cases. In continuous intravenous infusion group, the patients received a loading dose of vancomycin (15 mg/kg) by continuous intravenous pump infusion for 1 - 2 hours followed by 30 mg/kg vancomycin in a constant pump infusion rate for 24 hours; while in interim intravenous infusion group, the patients received 15 mg/kg vancomycin administered by intravenous pump infusion for 1 - 2 hours, once every 12 hours. The concentration of vancomycin in the cerebrospinal fluid at different time points was measured by two-dimensional liquid chromatography (2D-LC) method, the parameters of pharmacokinetics were calculated in the two groups, and the adverse reaction was observed.Results The comparison between the ratio of areas under the concentration-time curves (AUC) and minimum inhibitory concentration (MIC) of the continuous and interim groups showed no significant difference (19.7±14.0 vs. 16.1±6.4,P > 0.05). However, in the continuous intravenous infusion group, the drug concentration reached the peak value (0.96± 0.77)μg/mL at 12 hours, and later revealed a plateau concentration 0.91-0.93μg/mL for 12 hours; while in the intravenous infusion interim group, the drug concentration reached the peak value (0.92±0.47)μg/mL at 16 hours, in the later 2 hours declined to (0.84±0.45)μg/mL, and afterwards still had a tendency of persistent declination. In all the patients, no any adverse reaction related to the drug occurred.Conclusion Continuous intravenous infusion and interim intravenous infusion of vancomycin for the postoperative neurosurgical patients without intracranial infection have the similar efficacy of medication, but the former can achieve the peak concentration faster and later the fluctuation of drug concentration in cerebrospinal fluid is smaller than those in the latter.

Objective To demonstrate the clinical outcome of bilateral gluteus maximus musculocutaneous flap in conjunction with continuous postoperative negative pressure wound therapy in reconstruction of sacral soft tissue defects.Methods From January, 2008 to April, 2013, 18 patients (8 males and 10 females, aged from 34 to 78 years old) with full-thickness sacral soft tissue defects were treated.The size of the defects after initial debridement ranged from 3.0 cm × 2.0 cm to 18.0 cm × 14.0 cm, with the exposure of sacrum or ligament.Bilateral gluteus maximus musculocutaneous flap were applied in all the patients.Two drainage tubes were placed on each side of the flaps during the surgery and suck for 10 to 12 consecutive days after the operation.Results The size of the harvested flaps ranged from 12.0 cm × 8.0 cm to 18.0 cm × 12.0 cm, and all the donor sites of the flaps were closed with primary suture.Thirty-five flaps in 17 patients survived without any complication.Partial necrosis of one flap was found in 1 patient and managed successfully with conservative dressing change.Fourteen patients were followed-up ranged from 8 months to 2.5 years (mean follow-up was 18 months).Color and texture of the flaps were satisfactory and no recurrence of sacral defect was noted.Conclusion Bilateral gluteus maximus musculocutaneous flap in conjunction with continuous postoperative negative pressure wound therapy may serve as a useful option for fullthickness sacral soft tissue defects.

Objective Through the analysis of cases,to improve the cognition of clinicians on extracranial vas-cular embolism diseases(VED)in children.Methods The clinical information included incidence trend,thrombophi-lia,clinical features,treatment and prognosis of 29 children with VED,who were admitted from January 201 1 to Decem-ber 201 5 in Nanjing Children′s Hospital Affiliated to Nanjing Medical University,and retrospectively analyzed.Results The annual rate of VED increased from 0 to 1 .49 per 1 0 000 hospital admissions from January 201 1 to December 201 5.In 29 cases,there were 20 male and 9 female,with an average age of 6.03 years old (2 h -1 3.83 years old).In-fants accounted for >20%(6 /29 cases).The average age of the female,non infected group,rheumatic disease group and venous thrombosis group was higher than that of the male,the infection group,the non rheumatic disease group and the arterial embolization group,but there was no significant difference(all P >0.05).Thrombophilia were as follows:in-fection disease,heart disease,kidney disease syndrome,rheumatoid disease,tumor,and twins embolization syndrome. Risk factors included central venous line,immobility,dehydration,glucocorticoids use,etc.Heart disease was the leading cause of non thrombotic embolism,while other thrombophilic diseases resulted in thrombotic embolism.Pulmonary em-bolism was mainly seen in patients with severe pneumonia,especially mycoplasma pneumoniae pneumonia (MPP ).The older the age,the more typical clinical manifestations,and significantly elevated D dimer,fibrin/fibrinogen degradation products tips VED.Treatment depends on the degree of risk.Thirty -seven point five percent(3 /8 cases)of children with arterial embolism were less than 1 year old,and the mortality 25.00% (2 /8 cases)was significantly higher than that of venous thrombosis 1 7.65%(3 /1 7 cases)and 1 1 .76% (2 /1 7 cases).Conclusion Heart disease mainly cause arterial embolism and infection,while nephritic syndrome and rheumatic disease mainly cause venous embolism.Pulmona-ry embolism is mainly seen in children with severe pneumonia,especially MPP.The risk of arterial embolization is higher than that of venous embolism.

Objective Motility is an important physiological characteristic of a mature sperm.Nerve growth factor(NGF) is a protein essential for the development,maintenance and survival of the peripheral and central nervous systems.NGF and its receptors TrkA and p75 are widely expressed in the testis,accessory reproductive organ,and the epididymal sperms.In the present study,we investigated the role of NGF on human sperm motility.Methods Use 0.1,1 and 10 μmol/L concentrations of NGF,on sperm motility study to investigate the optimal concentration.Use CASA to detect Sperm motility changes every 10 minutes in an hour after 10 μmol/L NGF was added to the semen.Results The parameters of sperm motility increased after NGF incubation had significant difference, in particular,VAP,VSL,VCL,BCF and LIN mean were significantly increased more than 32%.MAD,STR,ALH and WOB mean had no notable difference.Furthermore,NGF promotes the sperm motility in a time- and dose- dependent manner.In addition,the enhancement of NGF on sperm motility was more stronger than those of sperm culture medium.Conclusion Our findings suggest that NGF plays a promoted role in human sperm motility.

Abstract: Objective The purpose of this study is to find out the epidemiological and clinical characteristics of male patients with condyloma acuminatum (CA) in Liaocheng area, as well as to improve the understanding of human papillomavirus (HPV) infection and put forward targeted prevention and treatment measures. Methods The clinical data of 159 male CA patients who admitted to Liaocheng People's Hospital from January 2021 to January 2022 were collected, and the epidemiological characteristics, clinical manifestations, infection sites, HPV gene subtypes and other information were analyzed retrospectively. Results Most of the 159 CA patients (range from 15 to 77 years old) were 31-40 years old (31.45%, 50/159), more than half of them had smoking history, and more than 60% had low income (<5 000 yuan/month), multiple sexual partners (≥2) and no condom use habit, 70.44% of the patients had prepuce long combined with prepuce balanitis. 91 cases (57.23%) were single infection, 102 cases (64.15%) were simple low-risk HPV infection. The analysis of risk factors between mixed infection and simple low-risk infection found statistically significant differences in age≤ 40 years old, unmarried, or less affected by education duration of 15 years or less, engaged in the business or service industry, the number of sexual partners or 2, knew not to clean and not to use condoms, while differences in smoking history, alcohol history, monthly income level, and age at first sexual intercourse were not statistically significant. Low-risk HPV6 and/or HPV11 were detected in 139 cases (87.42%). Fifty-seven patients (35.85%) were infected with at least one high-risk HPV. 72.33% of the patients had multiple warts, and the most common sites were around the coronal sulcus and frenulum of the penis Conclusions The incidence of multiple infections and high-risk subtypes is high in male CA patients in Liaocheng area, and most of the patients have low income, low education level and multiple sexual partners. Strengthening the treatment and education follow-up of this population may contribute to the treatment and prognosis of male CA in this area.

Structure of a recombinant chimeric anti-CD20 IgG1 monoclonal antibody was verified by the application of high-performance liquid chromatography-mass spectrometry (HPLC-MS)and N-terminal sequencer. Molecular masses, N-terminal sequences and peptide maps of the antibody treated with different reagents and enzymes were measured. Results indicate that the amino acid sequences of light and heavy chains and 10 disulfide bonds were consistent with theoretical structure. By comparison of molecular masses and peptide maps for the fully glycosylated and deglycosylated samples, the N-linked glycosylation site was identified. The method is simple, rapid, precise, and could be referred to the quality control and structure determination of other IgG1 products.

Objective To evaluate the efficacy and safety of wuling capsule compared with deanxit in treatment of patients with depression or anxiety status. Methods A total of 139 patients with depression or anxiety status were enrolled in a multi-center double blind clinical trial. All patients were randomized into two groups, 67 patients in wuling capsule group and 73 patients in deanxit group. Efficacy and adverse effects were evaluated with Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD),Pittsburgh Sleep Quality Index (PSQI) and Treatment Emergent Symptoms Scale (TESS) before treatment and 1, 2, 4, 6 weeks after treatment to verify the noninferiority of wuling capsule. Results There was no significant difference in score decline of HAMA and HAMD between the two groups (HAMA: wuling vs deanxit group: 9.0 ± 5.4 vs 10.3 ± 5.4, F = 2.11, P =0.148 ; HAMD: wuling vs deanxit: 9.1±5.6 vs 10.5±5.7, F = 1.61, P=0.207). There was no significant difference in response rate and remission rate between the two groups. No significant difference was found in score decline of PSQI between the two groups (wuling vs deanxit group: 4.1±4.5 vs 5.0 ± 4.2, F = 0.72, P=0.192). The incidence of adverse events was 41% in the wuling group and 55% in the deanxit group respectively. The main adverse effects were symptoms of gastrointestinal and neurology system. Conclusion Safe and well tolerated, wuling capsule improves the anxiety, depression and insomnia symptoms of patients with depression or anxiety status.

Syndrome, a very important concept in traditional Chinese medicine (TCM), is the essence and characteristics of TCM theory. Progress of related studies on syndrome will drive the development of TCM. Therefore, clinical and basic researches on syndrome have focused on the hotspot of TCM. In recent 60 years, many scholars have discussed the concept, essence and the establishment of standardization of syndrome from different angles and layers. Although many results have been obtained, there is still a certain one sidedness and dispute. Therefore, looking for a new theoretical tool to reveal the scientific connotation of TCM syndrome is imperative. TCM syndrome and biological entropy belong to two different subject concepts, but can also reveal the physiological and pathological state in the changes of life body growth. This article discussed isomorphism of TCM syndrome and biological entropy from the concept, theoretical background and characteristics, with a purpose to provide certain guiding significance to study and promote standardized researches on TCM syndrome.

Resident standardization training is an important part of postgraduate medical educa-tion and anesthesiology rotation is an important part in resident standardization training. Anesthesiology rotation is an effective way to improve the efficiency of hospital operation and is an important starting point to promote 'comfortable medical' and hospital upgrades. To improving the quality of training , anes-thesiology department should establish training and supervision system clearly , organize teacher training regularly. Continuous improvements in institutional mechanism can be achieved by detailed theoretical studies, technical operations and departmental rotation examination requirements as well as by exchanging ideas between teachers and students.

Objective To evaluate the effect of three diamension-digital subtraction angiography (3D-DSA) or computed tomography angiography (CTA) on the patients with ruptured multiple intmcranial aneurysm (MIA). Methods A retrospective study on 21 patients with MIA was performed.After scanning with 3D-DSA or 3D-CTA, three-dimensional reconstruction of MIA was carried out by 3D workstation,then the diagnosis was decided and the treatment plan (endovascular treatment or microsurgery) was selected according to stereoscopic image of MIA. Results (1) 3D-DSA or CTA was performed in 21 patients with subarachnoid hemorrhage (SAH),it was revealed these patients carried with 48 aneurysms,including 35 small aneurysms (25 mm).Not only miero-aneurysms and small aneurysms could be precisely showed,also the size of aneurysmal neck,the relationship of the aneurysm and the parent vessel and contiguous branches by stereoscopic image.(2) According to the standard of classification,9 patients with MIA for gradeⅠ(42.9%),10 for gradeⅡ(47.6%),2 for gradeⅢ(9.5%),0 for gradeⅣ.Endovascular treatment was selected prior to microsargery for those high grade patients.In this group,17 patients with 40 aneurysms underwent endovascular embolotherapy with GDC coils.Twenty four anemysms were completely occlusioned,12 beyond 90%,4 were left without treatment because of their small size.In microsurgery group,3 aneurysrus were totally clipped,1 could not be found during operation.No any treatment was accepted in 2 patients with 4 aneurysms. Conclusions 3D-DSA or CTA,which is very useful for the diagnosis and treatment of MIA,could improve the accuracy of diagnosis of MIA and clearly show the stereoscopic image of MIA,also the relation of sac and parent artery.For those patients with high grade MIA,endovascular treatment was selected prior to microsurgery,pro re nata,used to combine with mierosurgery.