Objective:To compare the ocular tissue concentrations and pharmacokinetic parameters in rabbit's eyes after topically and subconjunctivally administrated with levofloxacin (LVFX).Methods:The concentrations of LVFX in the cornea,aqueous humor,iris-ciliary body,lens and vitreous at different times were measured by high performance liquid chromatography after 0.3% LVFX were topically and subconjunctivally administrated into rabbits.Results:The penetration of LVFX into the cornea,iris-ciliary body,lens and vitreous after subconjunctival injection was significantly higher than that of topically applied one( P

Objective To investigate the safety of inhalation of isoflurane (ISO) or sevoflurane (SEVO) mixed with nitric oxide (NO) during mechanical ventilation.Methods Thirty-six healthy piglets of both sexes weighing 7-11 kg were randomly allocated to one of 6 groups ( n = 6 each): (1) control group was mechanically ventilated with O2; (2) NO group inhaled 20 ppm NO; (3) ISO group inhaled 1.3 MAC isoflurane; (4) ISO + NO group 1.3 MAC isoflurane + 20 ppm NO; (5) SEVO group inhaled 1.3 MAC sevoflurane and (6) SEVO + NO group inhaled 1.3 MAC sevoflurane + 20 ppm NO. The animals were mechanically ventilated with IPPV (VT 10 ml?kg-1 , RR 30-40 bpm, I: E 1:2) for 4 h in the all 6 groups. The animals were premedicated with atropine 0.02 mg?kg-1 i.m. . The Ⅳ line was established for fluid and drug administration. An additional dose of ketamine 10 mg?kg-1 was given i.v. before tracheostomy. 4F S-G catheter was placed in pulmonary artery via right internal jugular vein for hemodynamic monitoring. Femoral artery was cannulated for BP monitoring and collection of artrerial blood samples. MAP, HR, CVP, right ventricular pressure (RVP), PCWP, MPAP and total compliance of respiratory system (Crs), Paw, VT and PET CO2 were recorded before (T0 ) and at 1, 2, 3, 4 h of ventilation (T1-4). Blood samples were taken at T0 , T2 and T4 for determination of Met Hb and NO2- /NO3- . The animals were killed at the end of 4 h mechanical ventilation and the lungs were removed for determination of wet/dry(W/D) lung weight ratio, broncho-alveolar lavage fluid (BALF) and microscopic examination. BALF was collected for determination of surface tension and concentrations of saturated phosphate (DSPC) , total phosphate (TPL) total protein (TP) and white cell count. Results Crs was significantly decreased at the end of ventilation (T4 ) as compared with the baseline (T0) in group 3,4,5 and 6, while there was no significant change in Crs in group 1 and 2. DSPC/TP was significantly lower in group 3,4,5 and 6 than in group 1 ( P 0.05 ) . Conclusion 1.3 MAC isoflurane or sevoflurane mixed with 20 ppm NO can be used safely during mechanical ventilation.

Objective To investigate the efficacy of bilevel positive airway pressure mechanical ventilation (BiPAP) in the patients of acute organophosphorus pesticides poisoning (AOPP) with respiratory failure. Methods 44 AOPP patients with respiratort failure were randomly divided into experimental group (n = 22) and control group (n = 22). The routine trentment was given to both groups, additional BiPAP assisted ventilation was given to the treatment group. Blood gas,heart rate and respiratory rate were detected before and 2 h,24 h,48 h after treatment, and the rote of intubatinn,mortality,duration and cost of hospitalization were compared between two groups. Results Heart rate,PaO2 was significantly increased and PaCO2 decreased in BiPAP ventilation (P <0. 05). The mortality,intubatien rate and cost of hospitalization were significantly decreased in BiPAP treatment group (P < 0. 05). Conclusion The BiPAP ventilation is certainly effective to acute organophosphorus pesticides poisoning with respiratory failure. It could obviously improve the clinical symptoms and arterial blood gas analysis, and could reduce the mortaiity, rate of intubotion,cost of hospitalization of patients of acute organophosphoms pesticides poisoning with respiratory failure.

OBJECTIVE: To introduce material science characteristics and clinical application of bone plate. METHODS: The first author retrieved PubMed Database (http://www.ncbi.nlm.nih.gov/), China National Knowledge Infrastructure (http://www.cnki.net/) and Wanfang Database (http://www.wanfangdata.com.cn) for articles addressing material science characteristics and clinical application of bone plate published from 2000 to 2009. The key words included "bone plate, material science characteristics, biocompatibility, clinical application". Testing articles with reliable argument and evidence as well as close topic were included, and simultaneously, non-original articles were excluded. Ultimately, 25 articles were included. We arranged and analyzed material science characteristics, clinical application, advantages and disadvantages of bone plate. RESULTS: From the material science characteristics, the elastic modulus of bone plate should be close to skeleton so as to reduce stress occlusion effects. In clinical application, we should pad attention to the bonding of biological fixation and mechanical fixation to improve plate structure, resulting in decrease in contacting area of plate and skeleton to diminish or prevent osteoporosis in local regions. CONCLUSION: Presently, bone plate materials mainly contain stainless steel, cobalt alloy and titanium alloy in clinic with their advantages and disadvantages. Among them, medical titanium alloy is an ideal in vivo implant. In clinical application, less invasive stabilization plate provides a powerful technique security for early recovery of motor function following fracture, and shows a spacious application prospect.

Objective: To compare cumulative dose technique with single dose technique for determining dose-re sponse relationship of rocuronium during balanced anesthesia. Method: Thirty-four ASA grade Ⅰ-Ⅱ patients, aged 23- 65 years, undergoing elective surgery,were randomly allocated to single dose group(n=24) or cumulative dose group (n=10). Single dose group was further divided into 4 subgroups receiving 150,200,250 or 300?g/kg of rocuronium re spectively. In cumulative dose group, the initial dose of 150 or 200 ?g/kg rocuronium was followed by a second dose de termined individually to produce about 90% neuromuscular block. The ulnar nerve was stimulated at the wrist to mea sure the accelography of thumb adduction. The relationship between probit-transformed depression of first twitch height of TOF and the logarithm dose of rocuronium was analysed using linear regression. Result: ED_50 and ED_95 of rocuronium were 193.6?69.1 and 367.2?72. 7?g/kg respectively in single dose group, and 213.0?55.1 and 418.5? 61.7?g/kg respectively in cumulative dose group. No statistically significant differences were found in the slope,inter cept,ED_50 and ED_95 values between two groups. Conclusion: The two-dose cumulative technique can be used as effec tively as traditional single dose technique in determining the dose-response relationship of rocuronium.

Objective To analyze the relationship between complement key component C3,C4 and the severity of sepsis in children,in order to explore the role of complement activation in the progression of sepsis and provide a reference for diagnosis and treatment of severe sepsis.Methods Four hundred and twenty-four children diagnosed as sepsis from December 2012 to December 2015 in Children's Hospital of Nanjing Medical University were enrolled in this study,among whom 347 children with sepsis were eligible for the following research including 169 cases of common sepsis and 178 cases of severe sepsis.Blood specimens were collected in 24 hours after their admission into pediatric intensive care unit(PICU) for the analysis of lymphocyte subsets,humoral immunity,blood routine analysis,coagulation,liver and renal function analysis.General information was collected by consulting their medical records,laboratory analysis and clinical treatment.The relationship between complement C3,C4 and the severity of sepsis was analyzed,and the correlation between C3 and coagulation,liver,renal,myocardium damage was also studied.Logistic regression was used to analyze the relationship between C3 and the progression to severe sepsis and multiple organ dysfunction syndrome(MODS),while Cox regression was used for survival analysis.Results Natural killer(NK) cell percentage was lower in severe sepsis group than that in common sepsis group [6.6％ (3.7％,10.7％) vs.8.5％ (4.7％,13.3％),Z =2.635,P =0.008],while C3 decreased in severe sepsis group compared with common sepsis group [0.653 (0.462,0.985) g/L vs.0.991 (0.678,1.265) g/L,Z =5.684,P ＜ 0.001],and C4 decreased in severe sepsis group compared with common sepsis group [0.160(0.102,0.244) g/L vs.0.190(0.121,0.265) g/L,Z =2.513,P =0.012].The proportion of severe pneumonia was higher in severe sepsis group than that in common sepsis group (34.3％ vs.19.5％,x2 =9.540,P =0.002),and liver function damage proportion was increased in severe sepsis group than that in common sepsis group (48.3％ vs.16.0％,x2 =41.28,P ＜0.001),and the duration of PICU treatment was longer in severe sepsis group than that in common sepsis group[10.7(6.5,17.4) d vs.7.5(4.0,12.4) d,Z =-4.039,P ＜0.001].C3 was significantly decreased in children with single organ dysfunction,multiple organ dysfunction and death group compared with common sepsis group (K =33.04,P =0.001),and the median of each group decreased with the severity of sepsis,but C4 had no difference among 4 groups (K =7.36,P =0.061).C3 was positively correlated with coagulation marker platelet (p =0.31,P ＜ 0.001) and fibrinogen (ρ =0.53,P ＜ 0.001),but negatively correlated with international normalized ratio (INR) (ρ =-0.39,P ＜ 0.001) and activated partial thromboplastin time (p =-0.34,P ＜ 0.001).C3 was also negatively correlated with liver damage marker alanine transaminase (ρ =-0.30,P ＜ 0.001) and total bilirubin (ρ =-0.28,P ＜ 0.001),and had a negative correlation with renal function marker creatinine (p =-0.24,P ＜ 0.001) and myocardial damage marker creatine kinase-MB (p =-0.27,P ＜ 0.001).The depletion of C3 was a risk factor of severe sepsis(OR =3.45,P ＜ 0.001) and MODS(OR =3.03,P =0.005) after being adjusted for confounding factors by using Logistic regression.In stratification analysis,C3 depletion was still a risk factor of severe sepsis (OR =2.78,P =0.019) and MODS (OR =3.57,P =0.015) among children less than 1 year old,and was also a risk factor of severe sepsis(OR =4.76,P =0.008) among children more than 1 year old as well.In children without liver function damage,C3 depletion was still a risk factor of severe sepsis(OR =4.17,P =0.002) and MODS(OR =9.09,P =0.002).Cox regression showed that C3 depletion was a hazard in 28-day mortality (HR =3.57,P =0.026) in children with sepsis.Conclusion The decrease of C3 is correlated with coagulation dysfunction and organ damage marker,while C3 depletion was a risk factor of severe sepsis,MODS and 28-day mortality,and could be a potential prognostic marker of children with sepsis.

Objective To explore the relationship between the severity of coronary artery lesion and the level of serum bilirubin, uric acid in elder people. Methods 192 elder patients underwent coronary angiography were divided into 5 groups according to the severity of coronary lesion: normal(group A), vessel stenosis

Objective To explore and analyze the clinical characteristics and treatment strategy of severe complications caused by childrenˊs foreign bodies in esophagus.Methods The clinical data of 71 ca-ses of esophageal foreign bodies in children with ENT admitted to our hospital were analyzed retrospectively from Jan 2009 to Dec 2014.Results Esophageal foreign bodies in children with 71 cases,of whom 42 males and 29 females;aged from 2 months to 14 years old,highest incidence of 1 to 3 years old.Foreign bodies in esophagus lasted 2 h to 15 d.Ingestion of metallic foreign bodies in 43 cases,12 cases of plant-based foreign body,9 cases of animal foreign bodies,7 cases of chemical foreign bodies.Foreign bodies located in the upper esophageal was 51 cases,9 cases of the middle and 7 cases of the under section,3 cases of esophageal en-trance,1 case of falling into the stomach.In children with 71 cases,9 cases had complications,69 cases were cured,improved in two cases,and the cure rate was 97.2%,the average healing time was 4 d.Conclusion Early diagnosis and treatment,avoid esophageal perforation are the key to avoid the emergence of the compli-cations in children with esophageal foreign bodies,timely and accurate treatment of esophageal perforation and other complications are the effective measures to improve the cure rate.

The pharmacodynamics and its circulatory effects of alcuronium and atracurium were investigated in cardiac and noncardiac surgical patients.The results demonstrated that:l Compared with atracurium group,the duration of action of alcuronium is longer in cardiac patients than that of non-cardiac patients, but there is no difference in the onset of action between these two groups; 2. Half of the patients which received alcuronium need reversal with neostigminel 3. The effects on the circulation of these two drugs were nor remarkable;Therefore,alcuronium is also suitable for cardiac and non-cardiac surgical patients