Humans ; Nose ; anatomy & histology ; surgery ; Petrous Bone ; anatomy & histology ; surgery

Endoscopy ; education ; Humans ; Skull Base ; surgery

Objective To investigate the status of hold vaccination contraindication knowledge by Zhengzhou Municipal vaccination staff for improving the vaccination service.Methods To sample 54 vaccination clinics with Stratified random samping 216 Expanded Program on Immunigation (EPI) staff were suvveyed by questionnaire and analyse the data with descriprive method.Results The knowledge rate on contraindications was 56.9%,knowledge was mainly come from vaccine manual,professional books and tranining.Conclusion The EPI staff's contraindications knowledge was weak,and vaccination contraindication rules should be developed to guide actual work as soon as possible.

Under physiological conditions, many vital functions of the body are controlled by transient release of bioactive substances at a specific time and site. Based on the circadian rhythm character of disease and chronotherapeutic conceptions, pulsatile delivery system has been designed to achieve optimal therapeutic effect and reduce the toxic and side-effect. In recent years, more and more studies are focused on the pulsatile multiparticulate drug delivery system. Pulsatile multiparticulate system possesses many benefits, such as no risk of dose dumping, predictable gastric emptying, flexible release patterns and increased bioavailability. Based on these premises, the aim of this review is to summarize the major design methods of pulsatile multiparticulate and the research progress.

Aim: To investigate the chemical components in Zhizidahuang decoction( ZZDHD) to reveal the possible material therapeutic basis. Methods: High performance liquid chromatography coupled with photodiode array detector and tandem mass spectrometry ( HPLC-PDA-MS/MS) was applied to simultaneously characterize the chemical components and their structures in ZZDHD. The analysis was preformed on a Lichrospher C_(18) column using a binary eluent of 0. 1% acetic acid( A) and methanol( B) mixed under the gradient mode; UV spectra were scaned from 210 nm to 480 nm; negative ESI experiments in data-dependent scan mode were performed. Results: HPLC-PDA-MS/MS chromatogram of ZZDHD was achieved. Based on UV spectral data, information of molecular weight and mass fragmentation behaviors connected with extracted ion current( EIC) chromatogram, twenty kinds of components were detected and identified, including flavonoids, anthraquinones, iridoids and other constituents. Conclusion: The method presented in this study, which combined HPLC with UV and MS, allowes the characterization of compounds in the complex herbal system even without the reference standards.

Objective To develop a rapid specific method to detect HBV gene mutation by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Methords The patients of YMDD and YIDD mutation were detected by DNA sequencing.Results the DNA sequencing demonstrated that not only YMDD and YIDD/YVDD mutation, but LLLL,LMLL,DLHD,DMHD,LLAQ and LMAQ mutation were also detected in different hepatitis B patients. The results of PCR-RFLP indicated that there were different restricted sites in the distinct mutation.Conclusion The results above indicated that all these mutants exist in the initiator codon of ATG(Met). The mutation of LMLL DMHD LMAQ was associated with Lamivordin treatment. Whether mutation of Met links with the second replicating of HBV needs to be further studied.

Objective To learn the clinicians'attitude towards the “Drug and Medical Service Separation” reform in Beijing.Methods A number of pilot hospitals of “Drug and Medical Service Separation” reform in Beijing were pinpointed,for a random questionnaires survey among 800 clinicians,to learn their awareness,evaluation and attitudes to the reform.Results The clinicians were found with good awareness and understanding of the reform,with an awareness rate of 99.5％ ; 72.0％ of them hold that the pricing of “medical service charge” of the reform as reasonable; most of them believe that the reform plays a positive role in relieving the difficulties of seeing doctors and affordability of medical treatment; their approval rate for the reform pilot project is 97.3％; their satisfaction for the reform implementation is 90.8％,and their support for full implementation of the reform is 94.0％.Conclusion The clinicians from those pilot hospitals are sufficiently aware of and understand this policy,and are supportive of the pilot with useful suggestions.The recommended strengthened publicity and training,higher medical service charges,better pay for medical workers,improved incentive mechanism and evaluation mechanism,and better clinicians' satisfaction.

Objective The correlation and agreement of mycophenolic acid (MPA) plasma concentrations that detected by enzyme extended immunoassay (EMIT) and high performance liquid chromatography (HPLC) were studied using Pearson's correlation and Bland-Altman plots.METHODS 435 plasma samples were collected from 95 renal transplant patients who were treated with MPA from October 2014 to December 2015.The MPA plasma concentrations were simultaneously measured by EMIT and HPLC respectively,and the results were divided into two levels.Paired t test and Pearson's correlation were performed using SPSS13.0 to evaluate the relationships between the results in each level.The Bland-Altman plot was used to assess the agreement of the results of two methods.Results Higher concentrations were obtained with EMIT,there was a significant positive bias of EMIT for MPA(20.94％ ±14.42 ％,P＜0.001).Pearson's correlation analysis and Bland-Altman analysis showed that the results from different methods presented good correlation (r＞0.98) and agreement.Conclusion The results of EMIT were higher than that of HPLC.There were good correlation and agreement between the two methods.The differences between EMIT and HPLC suggest that different therapeutic window should be set up when the two methods are used for MPA therapeutic drug monitoring.

Objective To compare different dose of remifentanil combined with propofol for painless abortion and approach to an appropriate dose of remifentanil.Methods Ninety pregnant women with ASA 1 were randomly divided into three groups(n=30)before administrating remifetanil,a bolus midazolam 1 mg was injected inminutes later.These two drugs did not stop administration until three minutes before the end of negative suction.MAP,HR,SpO2,BIS,RR,VT,PET CO2 were monitored.The onset,operation and recovery time,sedation score and adverse reaction were recorded.Results Sedation scores were significantly different between group A and C [(3.90±0.97)and(4.90±0.85),t=4.24,P＜0.01].Three cases in group A were found moving.MAP,HR,BIS decreased as compared witll baseline.HR reduced significantly in group C(P＜0.05,P＜0.01).Respiratory movement was lower and shallower.RR,VT decreased compared to preoperative one.PET C02 increased gradually (P＜0.05,P＜0.01).There were two cases of respiratory depressing in group A,four cases in group B and ten cases in group C(five cases apnea more than three minutes).All patients used oxygen mask to maintain SpO2＞95%.Incidence of adverse reactions such as chest titanic,nausea and vomiting,itching were of no difference among three groups(P＞0.05).All patients were satisfied with anesthesia.Conclusion The appropriate infusing dose of remifetory devices such as oxygen mask and monitoring life signs are very important to prevent respiratory depress and bradycardia during operation.

Objective To investigate the effect of exogenous apelin-13 on oxidative stress, myocardial inflammatory cytokines and apoptosis in diabetic model rats.Methods A total of 40 male Wistar rats were randomly divided into 2 groups: normal control group (NC, n=8) and experimental group (EX, n=32).Diabetes was induced by feeding with high-sugary and high-fat diet for 8 weeks and a single intraperitoneal injection of streptozotocin (STZ) (30 mg/kg).The wellestablished 28 diabetic model rats were then randomly divided into 2 subgroups: model group (DM, n =14) and apelin-13 administration group (AP, n =14).The rats in AP group were given intraperitoneal administration of apelin-13 at a single dose of 0.1 μtmol · kg-1 · d-1 for 10 weeks, while NC group and DM group were given 0.9％ NaCl in the same way.All rats were sacrificed at the end of the week 10.Blood hydrogen peroxide (H2O2), nitric oxide (NO) and malonaldehyde (MDA) were measured by colorimetry, and superoxide dismutase (SOD) was measured by enzyme-linked immunosorbent assay (ELISA).The expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in rat myocardium were detected by immunohistochemistry.Masson staining was used to observe the myocardial fibrosis in rats of different groups.Cardiomyocyte apoptosis was determined by TUNEL.Results (1) Compared with NC groups, DM group showed that MDA, H2O2 and NO were significantly increased, while SOD was significantly decreased (F=22.400, 6.230, 4.267 and 8.901, all P＜0.0167).There was a statistically significant difference in the levels of MDA, H2O2,SOD between DM group and AP group.(2) The expression of TNF-α and IL-6 was significantly higher inDMgroup than inNCgroup (0.0599±0.0208 vs.0.0076±0.0031, F=35.139;0.0503±0.0243 vs.0.0071± 0.0024, F=15.946, both P＜0.0167).After 10 weeks of apelin-13 administration, the levels of inflammatory cytokines were significantly decreased in AP group than in DM group.(3) The myocardial apoptosis and fibrosis were significantly increased in DM group than in NCgroup [0.0293±0.0061 vs.0.0030-t-0.0013 and 0.0708±0.0420 vs.0.0013±0.0003, F=84.930 and 19.420, both P＜0.0167].The myocardial apoptosis and fibrosis were significantly decreased in AP group than in DM group (both P＜0.0167).Conclusions To some extent, apelin13 reduces the levels of oxidative stress and myocardial inflammation reaction in type 2 diabetes.Moreover, it may play a vital role in the improvement of myocardial apoptosis and fibrosis.