Objective To observe therapeutic effect of naoxintong on the patients with cerebral infarction.Methods 69 patients with cerebral infarction were randomly allocated to naoxintong group or control group. All patients were treated with 20ml shuxuening injection into veins and aspirin 100mg once a day, and those in naoxintong group were treated with naoxinting moreover. Neurological deficit scores (NDS) were evaluated before and after 1 month and 2 months of treatment Results Effective rate and notable effective rate of naoxintong group after 2 months of treatment were 97% and 88% ,obviously higher than those of control group 79% and 52%. Conclusion Nongxintong treatment for cerebral infarction was effective.

The orientational projections of the sensory fibres of axillary nerve to the substantia gelationsa (SG) of the spinal cord in rats were studied in accordance with the principle of transgangionic degeneration by using acid phosphatase technique. It was found that the afferent fibers of the axillary nerve projected chiefly to SG from the upper part of C_6 to the lower part of C_8 longitudinally. In a few rats, projections extended to the lower part of C_5 and upper part of T_1. In comparison with the available studies, a tendency of backward localization was noted. As to their transverse projections, the afferent fibres of the axillary nerve were found outside of the midline of SG, and mainly located in the lateral half of SG, at the 1/3 of median and the 1/3 of interior region. In the segments of C_7C_8 of some rats, the medial. 1/2 of the lateral half of SG was projected. It was found that the projection column from up downward had a tendency of extension toward lateral portion.

The orientational projections of sensory fibres of median nerve to the Substantia Gelatinosa (SG) of the spinal cord in rats were studied in accordance with the principle of transganglion degeneration by using the acid phosphatase technique. It was found longitudinally that the afferent fibres of the median nerve projected chiefly to SG from the upper part of C_5 to middle part of T_1. In a few rats, projections extended to middle and lower part of C_4 and lower part of T_1. In comparison with the records in anatomy literature and data from researches with HRP technique, a tendency of pre-positioning was noted. The regional projections of the afferent fibres of median nerve were found within the centre line of SG, and mainly in the region of the medial 1/4-1/2 of the medial half. In the segments of C_7-T_1 of a few rats, the whole area of the medial half of SG was projected. In observing the projections of the afferent fibres of median nerve, it was found that they have a tendency of lateralward increase from cranial portion to caudal portion.

The orientational projections of sensory fibres of radial nerve and ulnar nerve to the substantia gelatinosa(SG) of the spinal cord in rats were studied in accordance with the principle of transganglion degeneration by using the acid phosphatase technique.It was found that the affeernt fibers of the radial nerve projected chiefly to SG, from the upper part of C_6 to the middle part of T_1 longitudinally; the ulnar nerves projected chiefly to SG from the middle part of C_6 to the middle part of T_1.In their transverse projections,the afferent fibres of the radial nerve were mainly found in the region of the whole area of the middle 1/3 of SG; and the afferent fibres of ulnar nerve were found within the centre line of SG, and mainly in the region of the lateral 1/2～3/4 at medial half. In summary, radial nerve projected to the lateral region and ulnar nerve to the medial region of SG.

Objective:To establish a method for the determination of organic residues ( hexane, benzene, toluene, xylene and sty-rene) in macroporous adsorption resins. Methods:Headspace-GC with a DB-624 column was used to determine the residues in macro-porous resins. The inlet temperature was 200℃ and the FID detector temperature was 240℃. The column temperature programming was as follows:the initial temperature was 40℃, maintained for 3 min, and then raised to 200℃ with the rate of 14℃/min and kept for 2 min. The solvent was methyl alcohol and the carrier gas was nitrogen. HPLC was applied to determine the contents of the five resi-dues. Results:The contents of the five organic residues were all below 20‰ in five macroporous resins in common use including D101, HPD100, AB-8, DM301 and NKA-9. Conclusion:The method is simple,accurate and reproducible. It can be used in the res-idue determination of macroporous resins.

Objective:To study the optimal water extraction method for Shugan Xiaocuo granules. Methods: The study was car-ried out according to the orthogonal tablet. The water amount, extraction time,extraction times and soak time as the influencing factors, and the extractive yield and baicalin content as the indices in a comprehensive evaluation, the optimal extraction technology was screened. Results:The optimal extraction technology was as follows:soaked 30 minutes before cooking, 8-fold water,extracted for 3 times with 1h for every time. Conclusion:The verification test showed that the optimum extraction process was stable,reasonable and feasible.

ObjectiveTo investigate the diagnosis of acute superior mesenteric venous thrombosis(MVT) by ultrasonography. MethodsSeventeen patients with MVT were confirmed by operation or CT scanning and followed-up, whose ultrasonographic features were analyzed retrospectively. ResultsUltrasonographic features of seventeen patients with MVT were enlarged superior mesenteric vein filled with hypoecho without flow signals( n =9) ,portal vein and(or) splenic vein filled with hypoecho without flow signals (n =4), intestine wall thickening and intestine distension( n =2) and ascites( n =2). The accuracy of ultrasonographic examination for SMV was 65％ (11/17). According to MVT with or without splenic or portal vein involvement,MVT were been classified as two type:large vessel type(n =10) and small vessel type(n =7). The accuracy of ultrasonographic examination for large vessel type and small vessel type were 90％ (9/10) and 29％ (2/7) ,respectively. Patient with large vessel type of MVT were easy to be diagnosed by ultrasonography than those with small vessel type( x2 =3.41, P ＜ 0. 05 ). ConclusionUltrasonography was valuable in diagnosis of MVT, and it played more important role in diagnosis of large vessel type of MVT.

Objective To evaluate the excursion of the diaphragm and analyze the value in predicting weaning from mechanical ventilation in intensive care unit patients.Methods The patients with mechanical ventilation (＞48 hours) in ICU at Hebei Forth Medical University Hospital from June 2014 to December were classified into a success group or a failure group according to the weaning outcome.T-piece spontaneous breathing (SBT),airway occlusion pressure at 0.1 sec (P0.1) and maximal inspiratory pressure (MIP),rapid shallow breathing index (RSBI) and P0.1/MIP were measured or calculated.During the period of the 1 st hour SBT,the excursion of diaphragm was measured with ultrasonography.The predictive value of each parameter to weaning was evaluated with ROC curve.Results A total of 98 patients were enrolled in this study,including 74 successfully weaning and 24 failed.There were significant differences between two groups (success group and failure group) in P0.1 [(2.00 ± 2.00) cmH2O (1 cmH2O =0.098 kPa) vs (3.00 ±2.75)cmH2O,P ＜0.05],RSBI (39.14 ± 16.81 vs 52.00 ± 19.18,P ＜0.05),left diaphragmatic excursion [(1.12 ± 0.97) cm vs (0.69 ± 1.00) cm,P ＜ 0.001],right diaphragmatic excursion(1.87 ± 0.75) cm vs (1.17 ± 0.76) cm,P ＜ 0.001] and mean value of left and right diaphragmatic excursion [(1.57 ± 0.52) cm vs (0.83 ± 0.53) cm,and P ＜ 0.001].The ventilation time [2.00 (2.00-4.00) d vs 4.00 (2.00-5.00) d],ICU hospital lengths of stay [4.50 (3.00-7.25) d vs 8.50 (6.25-15.25) d] and total hospital lengths of stay [20.00 (15.00-25.25) d vs 25.00 (20.25-37.25)d] were also statistically significant in success group and failure group respectively (all P ＜ 0.05).The cutoff value of diaphragmatic excursion for predicting successful extubation was determined to be 1.14 cm by ROC curve analysis.The sensitivity of diaphragmatic excursion to predict successful weaning was 89.2％ and the specificity was 75.0％,the AUCROC was 0.849.Conclusion As an early predictor of diaphragmatic dysfunction,diaphragmatic excursion is probably superior to the traditional parameters in predicting weaning from ventilator in ICU patients.

ObjectiveTo investigate the extracorporeal clearance rate of imipenem in severe infection patients in the mode of continuous vena-venous hemofiltration (CVVH) during continuous renal replacement therapy (CRRT), in order to approach if the concentration of imipenem in plasma could achieve effective levels of anti-infection, and to explore the effect of time and anticoagulation measure on imipenem clearance during CRRT treatment.Methods A prospective observational study was conducted. All adult severe infection patients complicating acute kidney injury (AKI) in the Department of Critical Care Medicine of the Fourth Hospital of Hebei Medical University from March 2013 to September 2014, who were prescribed imipenem as part of their required medical care, and CRRT for treatment of AKI were enrolled. 0.5 g doses of imipenem was administered intravenously every 6 hours or 8 hours according to random number table, and infused over 0.5 hour. The unfractionated heparin was used for anticoagulation in the patients without contraindications, and no anticoagulation strategy was used in the patients with high risk of bleeding. At 24 hours after first time of administration, postfilter venous blood and ultrafiltrate samples were collected at 0, 0.25, 0.5, 0.75, 1, 2, 5, 6, and 8 hours after imipenem administration. The concentration of imipenem in above samples was determined with liquid chromatography-mass spectrometer/mass spectrometer (LC-MS/MS).Results A total of 25 patients were enrolled. Thirteen patients received imipenem intravenously every 6 hours, and 12 patients, every 8 hours. The anticoagulation was conducted with heparin in 13 cases, and 12 cases without anticoagulation. The intra-day precision, inter-day precision, matrix effect, and recovery rate in low, medium, and high concentration of plasma and ultrafiltrate, and the stability of samples under different conditions showed a good result, the error of accuracy was controlled in the range of±15%. With the application of Prismaflex blood filtration system and AN69-M100 filter, under the mode with CVVH, the total clearance rate of imipenem was (8.874±2.828) L/h when the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1, the total CRRT clearance rate of imipenem in vitro was (2.211±0.539) L/h, which accounting for (30.1±15.7)% of the total drug clearance. In 6 hours interval dosage regimen, the percentages of the time> 4×minimum inhibitory concentration (MIC) at specific 4×MIC of 2, 4, 6, and 8μg/mL of imipenem were more than 40% of the dosing interval. But in the 8 hours interval dosage regimen, when the level was above the 4×MIC of 4μg/mL, maintaining time would drop below 40% of the dosing interval, with significant differences compared with that in 6 hours interval dosage regimen [4×MIC = 2μg/mL: (60.84±20.25)%vs. (94.01±12.46)%,t = 4.977,P = 0.001; 4×MIC = 4μg/mL: (39.85±15.88)% vs. (68.74±9.57)%,t = 5.562, P = 0.000; 4×MIC = 6μg/mL: (27.58±13.70)% vs. (53.97±8.36)%,t = 5.867,P = 0.000; 4×MIC = 8μg/mL:(18.87±12.43)% vs. (43.48±7.83)%,t = 5.976,P = 0.000]. No significant change in sieving coefficient of imipenem was found within a short time (6 hours), which indicated that there was no effect of anticoagulation on clearance of imipenem by AN69-M100 filter, and no statistical significance was found with repeated measure analysis (F = 0.186, P> 0.05).ConclusionsThe clearance rate of imipenem is increased significantly in vitro under the mode of CVVH with the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1 in severe infective patients with severe sepsis complicating AKI, affecting the level of plasma drug concentration, need to adjust the dosage regimen. When the time of the dosing interval was shortened, the concentration of imipenem in patients' plasma could be increased significantly. In a short period of time, the sieving coefficient of imipenem through AN69 filter is not affected by anticoagulation measures and time cleaning efficiency will not decline.

Objective To analysis clinical effect of Diyu Shengbai tablets combined with granulocyte colony stimulating factor on cancer related fatigue syndrome.Methods II-VI primary cancer 60 patients from January 2011 to December 2013 were admitted to department of internal medicine, Fourth Hospital of Hebei Medical University,and randomly divided into two groups.Control goup(n=30)were treated with granulocyte colony stimulating factor(G-CSF).Experimental group(n=30)were treated with Diyu Shengbai tablets and G-CSF.Results After chemotherapy, ratio of patients in the experimental group appeared fatigue syndrome and changes in leukocyte was significantly lower than that of control group, the difference was statistically significant ( P <0.05 ) . Conclusion Diyu Shengbai tablets combined with G-CSF have better clinical efficacy for leukopenia caused by tumor chemotherapy, the symptom of fatigue also can improve significantly.