OBJECTIVE:To evaluate the status quo and tendency of the use of Chinese material medical injection(CMMI) in Nanjing area.METHOD:Chinese material medica injection used in 22 hospital of Nanjing from 2004 to 2006 was analyzed statistically in terms of variety,consumption sum,defined daily dose(DDDs) etc. RESULTS: The consumption sum of CMMI increased year by year,with annual incremental rates of 19.80% and 11.82% respectively.The cardio-cerebral vascular CMMI dominated the first place in terms of consumption sum and DDDs over the 3 years.Lentinan,Shengmai,Shenmai,Puerarin took the lead in consumption sum of single variety.The variety and specification and the number of manufacturers of CMMI increased year by year.CONCLUSION:CMMI plays a key role in clinical treatment,its consumption sum and consumption quantity kept increasing rapidly.

OBJECTIVE: To study the etiological factors of knee osteoarthritis and to provide the anatomical basis of corrective therapy for knee joint deformity by comparing the biomechanical differences of the knee joints between the osteoarthritis patients and the normal people. METHODS: The sexes, ages, heights, weights, painful characters and accompanied symptoms were recorded, and the femoral angle, tibial angle, femorotibial angle, joint space angle, and the height and width of condylus medialis and lateralis were measured for 29 selected knee osteoarthritis patients. And the biomechanical data of the patients were compared with those of the 19 normal people. RESULTS: The femoral angle of the osteoarthritis patients was smaller and the joint space angle was greater statistically than that of the normal people, and the ratios of height and width of condylus medialis and condylus lateralis of the osteoarthritis patients were greater than those of the normal people. CONCLUSION: In the patients, the gravity line of the lower limb inclines to the condylus medialis, so the condylus medialis is more vulnerable. And the configuration of the condylus of the patients, which is narrower and longer, is different from that of the normal people. It may be one of the etiological factors of knee osteoarthritis.

Objective To investigate the clinical efficacy of Sanqi Decoction in the treatment of early diabetic nephropathy (Diabetic, Nephropathy, DN) and its influence on the metabolism of lipid and glucose and renal function. Methods 96 patients with DN in our hospital were randomly divided into two groups. 48 cases in control group were treated with Enalapril, and 48 cases in observation group were treated with Sanqi decoction. Results The total effective rate of the observation group was 95.65%, which was significantly higher than that of the control group (81.25%) (P<0.05). Lipid, glucose metabolism and renal function improvement were better than those in the control group (P<0.05). Conclusion Sanqi Decoction is effective in the treatment of early DN, it can effectively improve the metabolism of lipid and sugar, reduce the excretion rate of urinary albumin, and have the effect of renal protection.

Objective To introduce the experience of applying horns percutaneous tracheostomy in critically ill neurosurgical patients. Methods The size of operative incision, operation time, amount of blood loss, incision healing time , and incidence of complications were analyzed retrospectively in 95 patients with GWCH and 83 with ST. Results There were smaller size of operation incision [(1.6 ± 0.4) cm vs. (3.8 ± 0.9) cm], shorter operation time [(4.4 ± 2.8) min vs. (20.5 ± 5.2) min], less blood loss [(4.5 ± 0.8) mL vs. (8.5 ± 4.5) mL] and shorter incision healing time [(3 ± 0.5) d vs. (5 ± 1.5) d] in GWCH group than that in ST group and the difference was statistical significant (P < 0.01). The incidence of incision blood leaking after operation was lower in GWCH group (2.1%) than that in ST group (16.9%) and the incidence of incision sputum leaking was lower in GWCH group (1.1%) than that in ST group (14.5%), but no difference was found in terms of the incidence of other complications (P > 0.05). Conclusions When compared with traditional ST, horns percutaneous tracheostomy is with smaller incisions , shorter operation time , less blood loss , faster healing and lower incision sputum leaking and is worthy of popularization in critically ill neurosurgical patients.

OBJECTIVE To investigate antimicrobial resistance of Enterobacter cloacae in our hospital,for guiding the treatment of these infections in clinical practice.METHODS Bacterial susceptibility testing was done by Kirby-Bauer method and bacteria were identified by VITEK-32.Retrospective analysis of the drug resistance was done to the E.cloacae isolated from our hospital in the recent 3 years.RESULTS A total of 364 E.cloacae strains were isolated,which mainly isolated from sputum.They were resistant to 13 types of antibacterial agents but the resistance rate to imipenem was 3.30%.The resistant rate to third and fourth generation cepholosporins(excepting cefoperazone/sulbactam) and quinolones was more than 30% and to ampicillin and cefazolin was more than 94.00%.CONCLUSIONS E.cloacae is severely resistant to cepholosporins and quinolones.More attention should be paid to the surveillance of such strains.Imipenem may be considered for use in critical patients.

Objective To establish the method for simultaneous determination of epimedium glycoside and other 4 kinds of active ingredients in Xianling Gubao Capsules by three wavelength switching method. Methods An Waters Atlantis T3 C18 column (4.6 mm × 250 mm, 5 μm) was used with the mixture of acetonitrile-0.05％ formic acid solution as the mobile phase in gradient elution (0–5 min, 12％–20％ A; 5–15 min, 20％–55％ A; 15–35 min, 55％ A;35–55 min, 55％–76％ A; 55.1 min, 12％ A; 55.1–60 min, 12％ A). Detection wavelength was as follow: 0–30 min, 212 nm; 30–42 min, 246 nm; 42–60 min, 270 nm. The flow rate was 1.0 mL/min. The column temperature was 30 ℃. Results The calibration curves of asperosaponin Ⅵ, psoralen, angelicin, epimedin C, and icariin were in good linearity among the ranges of 101.6–3048 ng, 8.7–261 ng, 7.9–237 ng, 117.2–3516 ng, 78–2340 ng, respectively. In the instrument precision test, stability test, repeatability test, the RSD was less than 3％. The average recoveries were 99.83％, 100.35％, 100.59％, 100.60％, 99.72％, respectively, and all the RSD were less than 3％. Conclusion The method is sensitive, accurate, and separation effect is good, which can provide a basis for quality evaluation standard of Xianling Gubao Capsules.

Objective To investigate the clinical manifestations and treatment regiment of children with juvenile dermatomyositis(JDM).Methods The clinical manifestation,changes of serum muscale enzyme,myopathic laboratory examination,treatment and prognosis of 15 children with JDM retrospectively admitted from Jan.1990 to Jan.2004 were analyzed.Results All of the children had symmetrical weakness of the proximal muscles.The most frequent features were heliotrope and Gottron's papules.Elevated muscle enzymes were noted in all cases.Electromyography revealed typical change of myopathic type and muscle biopsy was compalible with myositis in all cases.Most of patients achieved normal muscle enzymes within 1 month and had improved muscle strength with 2.5 monthes of the initiation of corticosteroid therapy.Conclusion It is very important to know the clinical features of JDM,and prompt diagnosis and treatment will result in an improved prognosis.

Objective To analyze the correlation of intervertebral disc degeneration with the blood perfusion of its adjacent border of vertebral body by dynamic contrast‐enhanced MRI (DCE‐MRI) .Methods 3 .0T DCE‐MRI examinations were performed in 15 patients (50 discs) .Intervertebral discs from L1 to L5 were classified to normal group(17 discs) and degeneration group(33 discs) based on the Pfirrmann grading system .The DCE‐MRI pharmaeokinetic parameters of the region of interest(ROI):volume transfer constant (Ktrans ) ,blood volume(BV) and blood flow (BF) were obtained .Independent sample t test was used to compare normal group and de‐generation group .Results In normal group (n=17) ,the mean Ktrans ,BV and BF were (0 .036 2 ± 0 .011 2)min-1 ,(4 .81 ± 1 .17) mL/100 mL ,(5 .68 ± 1 .55) mL · min-1 · 100 mL -1 for the superior border of vertebral body ,and (0 .042 ± 0 .012 9)min-1 ,(5 .03 ± 0 .797) mL/100 mL ,(6 .02 ± 1 .28) mL · min-1 · 100 mL -1 for the inferior border of vertebral body .In degeneration group (n=33) ,the mean Ktrans ,BVand BF were (0 .030 4 ± 0 .011 2)min-1 ,(4 .22 ± 1 .03) mL/100 mL ,(4 .73 ± 1 .38) mL · min-1 · 100 mL-1 for the superior border of vertebral body ,and (0 .033 8 ± 0 .012 5) min-1 ,(4 .07 ± 0 .940) mL/100 mL ,(4 .72 ± 1 .43) mL · min-1 · 100 mL -1 for the inferior border of vertebral body .By statistical analysis :(1)There were no significant differences between superior border and inferior border of vertebral body in Ktrans ,BV and BF in normal group(t= -0 .98 ,-0 .479 ,0 .533 respectively ,P>0 .05 ) .(2)There were no significant differences between superior border and inferior border of vertebral body in K trans ,BV and BF in degeneration group(t= -0 .906 ,0 .497 ,0 .013 respectively ,P>0 .05) .(3)There were significant differences between normal group and degeneration group in Ktrans ,BV and BF(t= -2 .26 ,-3 .01 ,-2 .99 respectively ,P<0 .05) .Conclusion The bone marrow per‐fusion in degeneration group is decreased when compared to normal group with dynamic contrast‐enhanced MRI .Intervertebral disc degeneration correlates with the loss of its blood supply .

Objective To evaluate the effect of dexmedetomidine on acute kidney injury after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods One hundred patients of both sexes with rheumatic heart disease,aged 32-64 yr,weighing 46-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association class Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were divided into 2 groups (n =50 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine was intravenously infused in a loading dose of 1 μg/kg over 10 min before induction of anesthesia followed by an infusion of 0.4 μg · kg-1 · h-1 until 24 h after operation in group D,while the equal volume of normal saline was given in group C.The urine output per hour during the postoperative 48 h period was recorded.At 6,12,24,36 and 48 h after operation,blood samples were collected from the median cubital vein for determination of serum creatinine levels.The development and severity of acute kidney injury were determined according to the urine output and serum creatinine level.Results Compared with group C,the incidence and severity of acute kidney injury were significantly decreased in the postoperative 48 h period in group D (P＜0.05).Conclusion Dexmedetomidine infused in a loading dose of 1 μg/kg over 10 min before induction of anesthesia followed by an infusion of 0.4 μg · kg-1 · h-1 until 24 h after operation can reduce the development and severity of acute kidney injury after cardiac valve replacement with CPB in patients.

OBJECTIVE:To provide references for the quality assessment of traditional Chinese liquid medicine-Fructus Polygoni Orientalis.METHODS:The description and the physicochemical identification of Fructus Polygoni Orientalis were carried out;the contents of the extractives were determined and the chemical composition of which was studied.The quality of commercial Fructus Polygoni Orientalis medicinal substances from15nationwide areas was investigated.RESULTS:The results showed that the content of the preparation was higher than that of the raw material in the water soluble extractive assaying;the content of the alcohol-soluble extractive was the opposite.Meletin was found to be contained in the Fructus Polygoni Orien?talis acetic ether extraction liquid by the TLC identification.There was only half maturing rate for most of the commercial Fructus Polygoni Orientalis.CONCLUSION:This method can be used as a reference for the quality assessment of Fructus Polygoni Orientalis.