Objective To optimize the extraction process of Xuanfei Zhike Mixture. Methods The preparation process was investigated by L9(34) orthogonal design with content of ephedrine hydrochloride, the extraction rate of n-butanol and total extraction as indexes. The main factors influencing the extraction efficiency such as the amount of added water, the time of extraction and times of boiling were investigated. Results The optimum technical condition was as follows:8 times amount of water, extract 2 times and 60 min for each time. Conclusion The result is reliable. It can be used for mass production.

Objective To evaluate the effect of fast track surgery nursing on percutaneous lumbar diskectomy. Methods A total of 126 patients were randomly divided into the control group and the experimental group,the control group received traditional nursing plan, the experimental group was given fast track surgery nursing plan. The nursing effect was observed. Results Postoperative anal exhaust time, feeding time, walking time, length of hospital stay ofthe experimental group were (1.61±0.71) days, (2.01±0.71) days, (4.70±2.12) days, (12.72±2.07) days, whichwere significantly shorter than those of the control group, which were (3.37±0.93) days, (2.27±0.63) days, (8.40±3.21) days, (15.81±2.14) days, the difference between two groups were statistically significant (t=4.012-6.068, P<0.05). The incidence of complications was 11.1%(7/63) in the experimental group, which was lowercompared with the control group, 23.8% (15/63), the difference between two groups was statistically significant(χ2=6.639, P < 0.05). Curative effect of the experimental group was 90.4% (57/63), which was significantly higher than that of the control group, 85.7% (54/63), the difference between two groups was not statistically significant (χ2=1.460,P>0.05). The Rdand Morris Questionnaire score of the experimental group was 21.67±3.48, which was higher than that of the control group(14.43 ± 2.01), the difference between two groups was statistically significant(χ2=6.077, P <0.05). Conclusion Fast track surgery nursing can promote the patient's postoperative rehabilitation ,reduce the postoperative complications, shorten the length of hospital stay and improve the quality of life.

BACKGROUND: The key point in the treatment of acute cerebral infarction lies in inproving the blood supply of brain effectively as soon as possible as well as rescue ischemic and half diazonal nerve cells, so as to contract the local of infarction as great as possible.OBJECTIVE: To observe the effect of traditional treatment of cerebral piamatral microcirculation in gerbil with cerebral ischemic reperfusion injury by supplementing qi and activating blood circulation.DESIGN: Contrast animal experiment at random.SETTING: Zhabei Branch of Shanghai Changzheng Hospital.MATERIALS: The experiment was performed in the Institute of Naval Medicine (key laboratory of the whole army). Twenty-two healthy Monglian gerbils of clean grade (six months old) were selected and randomly divided into medicine group and control group with 11 gerbils in each group.METHODS: Animals were routinely anaesthetized and fixed in prone position to open the cranium window in median line and expose the pia mater. The cranium window was protected by being covered with a cotton ball containing artificial cerebrospinal fluid (ACSF) after operation. Gerbils were fixed in dorsal position with an median incision made in the lateral cervical nucleus to isolate and expose bilateral common carotid artery (CCA). The bilateral CCA were occluded by atraumatic micro-bulldog clamp, and the occluded blood flow in the distal end was observed under the microscope. Thirty minutes after occlusion of bilateral CCA, the vascular clamp was unclamped to recover the cerebral blood reperfusion. Gerbils in the medicine group were abdominally injected with 0.4 mL of Huangqi injection (containing 0.8 g of crude drug), 0.3 mL of compound Danggui injection (containing Danggui, Chuanqiong and Honghua, 0.09 g for each)and 0.3 mL of Danshen injection (containing 0.45 g of Shengyao). Animals in the control group were abdominally injected with same-volume of normal saline. The changes of pial microcirculation were quantitatively observed in two groups through cranium window respectively before blockage, at the reperfusion after blockage as well as in 120 minutes after injection by laser microcirculation microscope and the TV video system.MAIN OUTCOME MEASURES: The changes of piamatral microcirculation as well as comparison in venous blood flow velocity in gerbils of each group before and after ischemic reperfusion.RESULTS: All gerbils were involved in the analysis of results with no animal died in the experiment.①When the CCA of animals in the two groups were blocked, obvious contraction of piamatral microcirculation was seen and partial blood vessels were blocked up. Platelet and red blood cells etc.adhered to the arteriolae of grade Ⅰ and veinules below grade Ⅲ with microthrombus formed and large ischemic area appeared. The blood flow rate was obviously slowed down. Moderate and severe aggregations were found in red blood cells, and the white blood cells were significantly increased.There was obvious exudation in the periphery of microvessels. After CCA reperfusion, the arteriolae and veinule were in different thickness, and the thrombus in veinule of grade Ⅰ and Ⅱ formed in the cerebral ischemia were difficult to be removed by blood flow. Red blood cell moderately aggregated, and the number of white blood cells greatly increased. White small thrombus could be seen sometimes, while the exsudation in the periphery of microvessel was not significantly ameliorated. Great changes were found in gerbils of the medicine group after abnormal injection of supplementing qi and activating blood circulation medicine: almost all arteriolae and venulae were opened, and the rate of blood flow was accelerated with the blood flow rate remarkably increased. Deposit in the venulae began to decreased, and the thrombus was gradually dissolved. Red blood cells were moderately aggregated or normal. Blood flow in ischemic spot was improved significantly than that after reperfusion. The exudation in the periphery of microvessels was gradually lessened even dissolved. However,no obvious change was found in gerbils of the control group. ②The blood flow rate of arteriole in the medicine group was 1.04-1.50 mm, which was obviously higher than that in the control group with significant differences (P ＜ 0.5-0.01).③The blood flow rate of veinule in the medicine group was 0.96-1.12 mm/s, which was remarkably higher than that in the control group with marked differences (P ＜ 0.05-0.01).CONCLUSION: The effect on piamatral microcirculation of gerbil with cerebral ischemic reperfusion by supplementing qi and activating blood is exact, which is directly related with accelerated blood flow rate, expanded veinule and arteriolae as well as ameliorated blood-supply of brain.

Objective To analyze the association between mtDNA mutations and photodamagc after ultraviolet B (UVB) irradiation. Methods Primary human skin fibroblasts (HSF) and primary human epi- dermal keratinocytes of adult (HEKa) were irradiated by sub-lethal doses of UVB thrice a day for 4-5 days. Thereafter, genomic DNA was extracted from irradiated cells and conventional PCR was applied to detect the frequency rates of 4977 bp and 3895 bp mtDNA deletion. To quantitatively analyze the mutation levels, SYBR Green real-time PCR method was performed. Results In both cell lines, the frequency rates and relative copy number of deletions increased with the cumulative doses of UVB exposure (P<0.05). The prevalence rate of 3895 bp deletion peaked 53.3% and and relative copy number reached (49.63±4.38)×10-5, showing a more intense response to the accumulation of UVB radiation than 4977 bp deletion. In HSF, the minimum cumu- lative dose of UVB radiation was 150 mJ/cm2 for the induction of 3895 bp deletion, and 200 mJ/cm2 for the induction of 4977 bp deletion. It seemed that mtDNA deletion was more readily to be induced by UVB radia- tion in HSF than in HEKa. Conclusions The development and accumulation of mtDNA mutation are intimately related with cumulated UVB dose received by skin cells, and the 3895 bp deletion is more reliable in moni- toring the photodamage caused by UV than 4977 bp deletion. Therefore, the 3895 bp deletion may serve as a biomarker for the detection of photodamagc in skin cells. HSF appear to have an increased susceptibility to UVB radiation, which results in a higher frequency and level of mtDNA mutations compared with HEKa.

Objective To observe the aging,apoptosis,cell cycle arrest and oxidative stress in human skin fibroblast(HSF)induced by UVB,and to detect the expression profiles of p66Shc,a determinant of oxidative stress response and life span,in this process.Methods HSF cells were exposed to UVB at a subcytotoxic dosage twice a day for three days.The cells without exposure served as control.After another 24-hour culture,SA-β-Gal staining was performed to evaluate the senescence state of the cells,flow cytometry to observe cell apoptosis;cell cycle arrest was detected by serum starvation and flow cytometry:ELISA was applied to detect intracellular levels of superoxide dismutase(SOD)and malondialdehvde(MDA),and Western blotting to analyze the expression of p66Shc protein.Results The percentage of cells positive for SA-β-Gal staining increased from 0 to 98.3% after UVB radiation,which strongly suggested an aging state of HSF cells.The percentage of apoptotic cells increased from 0.96% to 37%.and 80.07% of the HSF cells were arrested in G0/G1 phase following the irradiation.Intracellular SOD activity decreased from(52.35±4.97)ng/g to(7.81±0.68)ng/g(P＜0.01).while intracellular MDA was found to increase from(3.52±0.34)ng/g to(33.91±3.20)ng/g(P＜0.05).The p66Shc protein was found to be weakly expressed in HSF in 24 hours following the exposure to UVB,and a stronger expression was noted 48 hours later.Conclusions HSF cells are induced into a state of senescence associated with oxidative stress after UVB irradiation,which may be applied as an in vitro model in aging research.The expression of p66Shc is increased in HSF during this process,and further studies are needed to explore the relation between p66Shc and oxidative stress as well as cellular aging.

The management for qualification documents of medical instruments is very important work to management department of medical instruments. Because the number of qualification documents of medical instruments is very large and they have an expiry date, it is difficult to manage them. This article discussed how to manage qualification documents of medical instruments, and an information management system that has a function of traceability management has been developed. This information management system standardizes management for qualification documents of medical instruments, and ensures that qualification documents of medical instruments are available and can be traced. Besides, it can reduce the amount of work for medical instruments management.
Documentation ; standards ; Equipment and Supplies ; standards ; Information Systems

BACKGROUND:The hidden blood loss, accounted for a fairly large proportion of perioperative blood loss in total hip replacement, can seriously affect the recovery of postoperative joint function, but the specific influential factors and mechanisms remain unknown at present. OBJECTIVE:To evaluate the relative influential factors for hidden blood loss after primary total hip arthroplasty by the blood loss condition, and to analyze the association between hidden blood loss and prognosis. METHODS:Clinical data of 110 patients who underwent primary total hip arthroplasty in the Liuzhou Worker’s Hospital between April 2011 and April 2013 were retrospectively analyzed. The hidden blood loss was calculated according to Ward and Gross formula. The effects of patient’s gender, age, body mass index, type of prosthesis, presence of internal diseases, and different causes of a disease on hidden blood loss after arthroplasty were analyzed. The patients were divided into the high blood loss group (≥ 480 mL) and the low blood loss group (<480 mL) according to the hidden blood loss. Al the patients were fol owed up for 1 year. The Harris hip score system was used to assess the recovery of hip joint function between the two groups. The correlation between hidden blood loss and the recovery of joint function was analyzed using Pearson’s correlation analysis RESULTS AND CONCLUSION:The total blood loss of primary total hip arthroplasty was (1 340±367) mL, and the hidden blood loss was (748±324) mL, and the percentage of hidden blood loss was 53.7%. The type of prosthesis, presence of internal diseases, and different causes of a disease were significantly associated with hidden blood loss after total hip arthroplasty (P<0.05). Gender, age, body mass index, and operation time were not significantly associated with hidden blood loss after total hip arthroplasty (P>0.05). The hidden blood loss was correlated with postoperative functional recovery (P=0.046). Results indicated that type of prosthesis, presence of internal diseases, and different causes of a disease are main influential factors for hidden blood loss after total hip arthroplasty. The hidden blood loss has some influence on the recovery of postoperative joint function.

Objective To evaluate the MRI value in changes of mid-urethral ligament injury offemale stress urinary incontinence (SUI).MethodsComparison of MRI changes of mid-urethral ligament on 30 healthy female volunteers and 20 female SUI patients.Chi-square test was used to compare the form of SUI patient's mid-urethral support ligaments Results The female nid-urethral support ligaments were composed of 4 groups of ligaments,including the periurethral ligament and pubourethral ligaments (1 pair),and at both sides of the urethra's paraurethral ligaments (1 pair) and suburethral ligament lying dorsal urethra,connecting the urethra and pelvic arcus tendinous fasciae.In normal MRI,ligament was a thin strip and showed low signal on both T1WI and T2WI,T2WI sagittal and cross-section scan was the best combination to show the middle urethral support ligaments changes,with tension;6 patients (20％) in the 30 patients normal control group could be seen tortuously and slack like around the urethra ligaments.Twenty SUI patients mid-urethral support ligaments were performance laxity or rupture,rates were 39％ (47/120) and 42％ (50/120) (x2 =43.191,P ＜ 0.05 ).On T2WI,the ligamentous laxity was floating,and losstension,also could performance one side extension and thinner than the other side.The ligament rupture was performance of the signal interruption,ligament contracture and one end of liganent attachment points separation.ConclusionMRIcanobjectiveeffectiveevaluatethemid-urethralsupportligaments' pathological changes in stress urinary incontinence patients.

ObjectiveTo discuss the diagnostic value of MRI in female patients with stress urinary incontinence (SUI).Methods All SUI patients underwent pelvic MRI examination.The 16 patients mean age was 58 years (range,48 -66 years),disease course was 6 years (range,2 -15 years).All patients underwent transobturator tension-free tape (TOT) procedures.The 28 volunteers with no pelvic diseases were set as control,Mean age was 45 years (range,30 -55 years).Results28 Volunteers' urethral support ligaments appeared as low signal intensity broad linear structures in both T1 WI and T2WI images.Display rate:periurethral ligament was 89％ (25 cases) ; paraurethral ligament was 75％ (21 cases),unilateral 25％ (7 cases) ; pubourethral ligament,in each distal 100％ (near,28 cases),10％(medium,3 cases),7％ (distal,2 cases); suburethral ligament was 100％(28 cases). Levator ani muscle in T1WI,T2WI showed Moderate- intensity signal and the display rate was 100％.16 SUI patients showed varyious degrees of laxity and rupture of urethral supporting ligaments which occurred in one group (4 cases) or multi-group (12 cases) ligaments.The ligament laxity showed that periurethral ligament 14 cases,paraurethral ligament 2 cases and proximal pubourethral ligament 10 cases.The ligament rupture was seen in periurethral ligament 2 cases,paraurethral ligament 5 cases,pubourethral ligament 6 cases and suburethral ligament 7 cases.16 patients showed a relaxation of the levator ani muscle changes,including 4 cases with cervical and vaginal wall prolapsed.Conclusions MRI could clearly show the weak of support structures around the urethra in female SUI patients,and showed the cervical and vaginal prolapsed.Therefore,MRI may provide imaging evidence for clinical diagnosis and treatment.

Chemical and Drug Induced Liver Injury ; Dimethylformamide ; Humans ; Occupational Exposure