OBJECTIVE:To establish a method for simultaneous determination of sodium valproate(VPA)and its metabo-lite 2-propyl-2-pentenoic acid (2-ene-VPA) in human plasma. METHODS:Plasma sample was extracted with cyclohexane and experienced derivatization with 2,4′-dibromoacetophenone using n-octanoic acid as an internal standard. RP-HPLC method was adopted. The determination was performed on Zorbax SB-C18 column with mobile phase consisted of acetonitrile-water(65∶35,V/V)at the flow rate of 1 mL/min. The column temperature was set at 35 ℃,and UV dectection wavelenth was set at 258 nm. The sample size was 20 μL. RESULTS:The linear range of VPA and 2-ene-VPA were 5.0-200.0,0.5-20.0 μg/mL(r=0.999 9, n=5). The limits of quantification were 5.0,0.5 μg/mL. RSDs of inter-day and intra-day were all lower than 5%. Method recov-eries were 95.99%-98.80%and 97.40%-98.17%,and extraction recoveries were 80.46%-86.23%and 80.45%-85.61%. The plas-ma concentrations of VPA in 10 epileptic children were 27.4-93.2 μg/mL,and those of 2-ene-VPA were 0.85-3.94 μg/mL,respec-tively. CONCLUSIONS:The method is simple,specific and suitable for plasma concentration determination and pharmacokinet-ic study of VPA.

Objective To analyze whether there are any gender differences in clinical features of acute type 1 diabetes mellitus.Methods Clinical data of 193 patients with acute type 1 diabetes mellitus were collected in our hospital from 2002 to 2007,and subjected to statistical analysis by SPSS.Results The ratio of male to female in all the subjects was 1.6:1.There was no significant gender difference in such clinical aspects as age,fasting blood glucose level,HbAlc concentration,positive percentage of serum autoantibodies against pancreatic islet or morbidity of diabetic neuropathy.In contrast to the males,the onset age was significantly younger,the diabetic duration longer,fasting serum C peptide level lower and the incidence of ketotic acidosis higher in female patients.The patients with onset age less than 14 years (puberty) did not show any significant gender differences in the above-mentioned clinical aspects.Among those with onset age more than 14 years,the females had significantly longer duration and lower fasting serum C peptide level than males.The male patients with onset age more than 14 years had significantly higher fasting serum C peptide level than those less than 14,whereas it was the same for total positive percentages of pancreatic islet autoantibodies and morbidity of diabetic neuropathy in females.Conclusion Gender differences may exist in some clinical features of type 1 diabetic patients with acute onset after puberty, which may partially result from the effects of sex hormones.

Objective To investigate the mechanism of venous reverse-flow flap in the differentperiod after operation.Methods The rabbits wero randomly allocated into 3 groups.In group A,including saphenous artery and venae commutante.In group B,saphenous artery without venae commutante.In group C,surface seeping and saphenous artery and venae commutante.Flap appearance,intravenous pressure,vessel diameter,mierocircular and histological examination were mea8ured.Results The difference of introvenous pressure between group A.B and C was obvious.Reverse flow WaS found in group A and C group through microcirculation observation 2 hours post-operation.Venous valve lose efficacy while the vessel diameter wes at maximum just after the pressure peak.Conclusion Venous retrograde return in reverse-flow island flaps can be achieved more easily through"incompetent valves route"than through "communicating and collaterall by pass route".By pass route is a supplementary way.Surface seeping Can slighfly relieve the venous pressure but can cause infection.

Objective To explore the status of healthcare-associated infection(HAI)in hospitals in Buyi autono-mous prefecture of Guizhou Povince,and provide basis for formulating HAI control measures.Methods A survey was conducted by combined methods of bed-side survey and medical record reviewing,prevalence rates of secondary and above hospitals in Buyi autonomous prefecture in Guizhou Province between September 10 and October 5,2014 were surveyed.Results 6 577 hospitalized patients should be investigated,6 541(99.45%)were actually investiga-ted.The prevalence rate and case prevalence rate of HAI were 1 .83% (n=120)and 1 .94%(n=127)respectively. The top three departments of HAI distribution were intensive care unit (26.32%),neurosurgery (6.10%),and neonatal intensive care unit(5.13%);the main infection site was lower respiratory tract(n=39,30.71 %),followed by skin-soft tissue (n=24,18.90%)and superficial incision (n=23,18.11 %).58 pathogenic isolates were detec-ted,gram-negative bacteria were the major pathogens (n=44),gram-positive bacteria and fungi were 10 and 3 iso-lates respectively.Antimicrobial usage rate at survey day was 42.12%,64.75% of which were for therapeutic, 26.83% for prophylactic,and 8.42% for therapeutic+prophylactic use;the percentage of mono-drug,two drugs combination,and three or more drugs combination use were 79.53%,19.89%,and 0.58% respectively;bacterial detection rate in patients receiving therapeutic as well as therapeutic+prophylactic antimicrobial use was 13.76%. Conclusion Survey on prevalence of HAI is helpful for understanding the current status of HAI,monitoring on HAI in key departments of hospital and key sites of patients should be strengthened to reduce the occurrence HAI effectively.

Objective To investigate the current situation of healthcare-associated infection(HAI)in hospitals of Miao and Dong Autonomous Prefecture of Guizhou Province,and provide basis for formulating prevention and con-trol measures of HAI.Methods According to the unified plan of the National HAI Surveillance Network,26 hospi-tals in Miao and Dong Autonomous Prefecture of Guizhou Province were performed cross-sectional survey on HAI prevalence rate,antimicrobial use,and specimen bacterial culture rate.Results A total of 3 tertiary and 23 seconda-ry hospitals were investigated,7 799 inpatients were included,the prevalence rate of HAI was 2.54%(n =198), and case prevalence rate was 2.65% (n=205).HAI mainly distributed in intensive care unit (29.63%);the main infection site was lower respiratory tract (44.44%);HAI mainly caused by gram-negative bacteria,the major pathogens were Escherichia coli ,Pseudomonas aeruginosa ,and Klebsiella pneumoniae .The usage rate of antimi-crobial agents was 45.66%,secondary hospitals was higher than tertiary hospitals (53.65% vs 31 .14%,χ2 =148.53,P <0.001 ).74.02% of antimicrobial agents were for therapeutic purpose,19.77% for prophylaxis,and 6.21 % for both prophylactic and therapeutic application;81 .02% of patients received one agent,17.21 % received two,and 1 .77% received three and more agents;among patients who received antimicrobials for therapeutic as well as for both therapeutic and prophylactic purpose,only 29.37% were sent specimens for pathogenic detection.Conclusion The prevalence rate in this region is lower than national average level,antimicrobial usage rate is lower than national standard,management of key departments and key sites should be strengthened,antimicrobial agents,especially used in secondary hospitals should be used rationally.