Objectives To investigate the parmacokinetic characteristics of Meropenem used during the shock phase of severely burned patients. Methods The concentration of Meropenem in the plasma, blister and urine of 11 burn patients during the shock phase (S group) were determined by high performance liquid chromatography after the iv injection of Meropenem. Pharmacokinetic parameters were thus produced by 3P97 software. 6 healthy volunteers served as control group (C group). The t test was used to analyze difference between pharmacokinetic parameters of burned patients and healthy volunteers. Results Compared to those in control group, pharmacokinetic parameters of Meropenem in S group showed significant difference, such as prolonged elimination half-life (t1/2?):[(2 29?0 54)h vs (1 34?0 16)h] and decreased clearance(CLs): [(11 34?3 08)L? h-1 vs (18 76?4 60)L?h -1 ], and enlarged area under the serum concentration versus time curve(AUC):[(47 85?16 15)?g?h?ml -1 vs (27 54?10 76)?g?h?ml -1 ]. Conclusions Meropenem at the dose 500mg iv 3/d can show good activity (both in plasma and wound tissues)against most of pathogens which are common in burn clinic. The intervals should be prolonged when maximum dosage of Meropenem was administered in burn patients during the shock phases.

Animals ; Neurotransmitter Agents ; metabolism ; Rabbits ; Syncope, Vasovagal ; metabolism ; physiopathology

Objective To compare the influence of different doses of dexmedetomidine on the haemodynamic response caused by tracheal intubation during general anesthesia induction in senile hypertension patients .Methods Sixty patients with essential hy‐pertension(EH) undergoing general anesthesia operation ,60-75 years old ,ASAⅠorⅡ ,were randomly divided into the group D1 , D2 and control group(C) ,20 cases in each group .4μg /mL dexmedetomidine in the group D1 and D2 was intravenously pumped at 15 min before anesthesia induction with the doses of 0 .2 ,0 .6 μg/kg respectively and completed within 10 min;while the group C was pumped with sodium chloride injection by the same method .Mean artery pressure (MAP) ,heart rate (HR) and O2 saturation (SpO2 ) were monitored at before medication(T0) ,before induction(T1) ,before intubation(T2) ,at 1 min(T3) ,5 min(T4) after tra‐cheal intubation .Meanwhile plasma norepinephrine(NE) and epinephrine(E) values were detected .Results Compared with before medication ,MAP before induction in the group D2 was significantly decreased (P<0 .05) ,however which in the group D1 and C had no obvious change(P>0.05);HR at 1 min after tracheal intubation in the group D2 was significantly decreased (P<0.05) , while which in the group C and D1 was significantly increased(P<0 .05) .Compared with the group C ,MAP and HR before induc‐tion and tracheal intubation ,at 1 ,5 min after tracheal intubation in the group D2 were significantly decreased(P<0.05) ,SpO2 was significantly decreased only before induction (P<0.01);MAP ,HR and SpO2 at each time points in the group D1 had no significant differences compared with the group C(P>0.05) .Compared with T0 ,the plasma levels of NE and E at T1 in the group D2 were decreased (P<0.01);the plasma levels of NE and E at T3 in the group C and D1 were increased ,while which in the group D2 were decreased (P<0.01) .The plasma levels of NE and E at T1 and T3 in the group D2 were decreased compared with the group C(P<0.01) .Conclusion Intravenous injection of dexmedetomidine can safely inhibit the tracheal intubation caused hemodynamic changes and keep the hemodynamic stabilization during general anaesthesia induction and tracheal intubation period in senile hyper‐tension patients .Furthermore dexmedetomidine 0.6μg/kg can more effectively inhibit the tracheal intubation caused stress reac‐tions than dexmedetomidine 0.2μg/kg .

Objective To explore the application value in primary hospitals using conventional ultrasound and ultrasonic elastography in the diagnosis and surgery of breast cancer both in the diagnosis of joint.Methods One hundred and sixteen patients with breast disease confirmed by surgical pathology were studied retrospectively .All the patients were examined by acoustic elastogra-phy and conventional ultrasonography before surgery.Results Pathological results of 116cases were:74 malignanies and 42 benigni-ties.①Preoperative routine ultrasonography in diagnosis of benign breast lesions in 41 cases, 65 cases of malignant lesions.Ultra-sonography showed that benign lesions were round or oval, smooth edge, no obvious signs of malignant microcalcifications, breast cancer spiculation (87.84%, 65/74), intralesional calcification (62.16%, 46/74).With the pathology of routine preoperative ul-trasound diagnosis coincidence rate was 91.38%(106/116).②Ultrasonic elastography in diagnosis of breast benign lesions in 39 ca-ses, 66 cases of malignant lesions, benign lesions of ultrasound elastography score of 1-2 (92.86%, 39/42); malignant lesions of ultrasound elastography score of 3-5 (89.19%, 66/74);and the pathology of preoperative ultrasound elastography diagnosis coinci-dence rate was 90.51% (105/116).③Preoperative ultrasound elastography and conventional ultrasound diagnosis of 42 cases of be-nign lesions, 68 cases of malignant lesions, and pathological diagnosis coincidence rate was 94.82% (110/116).Conclusion Ul-trasound elastography and conventional ultrasound examination can improve the resection of benign and malignant breast lesions diag-nosis in primary hospital diagnosis, as an effective method for the detection of breast cancer before operation .

Objective To explore a kind of comfortable medical for ervical plexus anesthesia auxiliary anesthesia .Methods 80 thyroidectomy female patients were randomly divided into normal saline group (group A) ,droperidol-fentanyl group (group B) ,bu-torphanol group (group C) ,dex group (group D) ,20 cases in each group .The change of systolic blood pressure (SBP) ,diastolic blood pressure (DBP) ,heart rate (HR) ,blood oxygen saturation (SpO2 ) ,narcotrend index (NTI) were monitored .The above pa-rameters were recorded at 10 min before cervical plexus(T0 ) ,cervical plexus operation(T1 ) ,skin incision(T2 ) ,separation of thyroid upper extreme(T3 )and suture(T4 ) .Results There was no significant difference between the groups A and B at the same time point (P>0 .05) .In group C ,the SBP、DBP、HR at T3 and T4 were significant higher than at T0 ,and at the same point the A and B group decreased statistically significant (P<0 .05) .In group D ,the SBP、DBP、HR at T2 、T3 、T4 were significant lower than at T1 ,espe-cially at T4 compared to at T0 (P<0 .05) .Compared to group A ,B ,C ,the SBP、DBP、HR in group D were lower at T3 and T4(P<0 .05) .NTI in group D at T1 、T2 had significant difference compared with group A and B (P<0 .05) ,especially at T3 、T4 were sta-tistically significant than the other three groups(P<0 .05) ,sedation was better than the other groups .Conclusion Cervical plexus block supplemented by dex can reduce the patient′s stress response and reach moderate sedation analgesia to comfortable medical purposes .

AIM: To evaluate the efficacy of phacoemulsification and intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis.
●METHODS:Retrospective study. A total of 57 cases (57 eyes ) with complicated cataract with uveitis were involved in the study from Jan. 2015 to Dec. 2015. All cases underwent phacoemulsification and intraocular lens implantation surgery successfully. The postoperative reaction, effect, complications and so on were retrospectively analyzed after phacoemulsification and intraocular lens implantation surgery. The date of visual outcome was analyzed using Non - parametric Wilcoxon test.
●RESULTS: lris were bleed in 21 eyes ( 37%) , 4 eyes ( 7%) with posterior capsule rapture and posterior chamber intraocular lens was not implanted in 4 eyes ( 7%) . The uncorrected visual acuity ( UCVA ) was significantly increased after surgery. The UCVA of 8 eyes (14%) were 0. 1 or better before surgery, and the UCVA of 42 eyes (74%) were 0. 1 or better 3mo after surgery, the difference was statistically significant ( Z=23. 42, P<0. 001). The corneal edema (17 eyes, 30%), uveitis (2 eyes, 4%) and intraocular hypertension ( 1 eyes, 2%) were appeared in postoperative 1d. The corneal edema (3 eyes, 5%) was appeared in postoperative 1wk. The uveitis ( 1 eyes, 2%) was appeared in postoperative 1mo. The corneal edema (1 eyes, 2%), uveitis (2 eyes, 4%) , intraocular hypertension ( 1 eyes, 2%) and after-cataract ( 3 eyes, 5%) were appeared in postoperative 3mo.
● CONCLUSION: The phacoemulsification combined intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis has good effect and fewer complications.

BACKGROUND: Studies have showed that Chengzai pill is of distinct significance in the treatment of steroid-induced osteonecrosis of femoral head through increasing bone mineral density, bone weight, bone strength and rigidity, it also reverses the low levels of estrogen. OBJECTIVE: To explore the effect of Chengzai pill on the genes of cell adhesion molecules on bone cells of steroid-induced ostaonecrotic rats, and to understand the role to resume normal blood transport in femoral head of steroid-induced osteonecrosis. DESIGN, TIME AND SETTING: Grouping controlled observation was performed in the Pharmacological Laboratory of Wangjing Hospital of China Academy of Chinese Medical Sciences and laboratory of CapitalBio Corporation between March and August in 2006. MATERIALS: Six male SD rats of 6 months old and weighing (280:1:20) g were used in this study. Chengzai pill was consisted of 22 Chinese medicines, such as Chinese Angelica, Eucommia Bark, Milkvetch Root, Barbary Wolfberry Fruit, Degelatined Deer-hom, Desertliving Cistanche, Eupolyphaga seu Steleophaga, Leech, Danshen Root and Himalayan Teasel Root, which were offered by Beijing Boran Pharmaceutical Co., Ltd. METHODS: The lipopolysaccharide and methylprednisolone were applied to prepare a rat model of steroid-induced osteonecrosis of femoral head. Six rats were divided into model group and Chengzai pill group at random with 3 rats in each group. The rats in the Chengzai pill group were administrated with methylprednisolone for the first time and then 1.5 g/kg Chengzai pill solution, once a day, totally for 6 weeks. The total RNA was extracted from femoral head in all rata 6 weeks later and then gene expression profiling was analyzed. MAIN OUTCOME MEASURES: Gene action pathway of cell adhesion molecules in gene expression profile. RESULTS: Compared with model rats, there were totally 8 downregulated genes of cell adhesion molecules which changed by a minimum of 1.5 folds in cell adhesion molecules pathway of Chengzai pill group, three rats were present with 633 genes (506 down-regulated and 127 up-regulated), 883 genes (640 down-regulated and 243 up-regulated) and 593 genes (408 down-regulated and 185 up-regulated), respectively. MAS software classification analysis showed 79 action pathways were involved in 297 genes.CONCLUSION: Following Chengzai pill administration, those downregulated genes recover the cognitive functions of macrophage and target cell in rats, also renew the normal survival condition of epithelial cells including vascular endothelial cells. Cell adhesion molecules action pathway returns to normal levels. This is the key to resume normal blood transport in femoral head of steroid-induced osteonecrosis.

AIM: To investigate the alterations of tear film after sutureless large incision manual cataract extraction (SLIMCE). METHODS: Sixty-eight SLIMCE operation eyes were studied with slit-limp microscope, break- up time (BUT), SchirmmerⅠtest (SⅠt),and fluorescence(FL) to observe the alterations of tear film at different time points in postoperation. Impression cytology and microphoto-analyses technique were also applied to observe the goblet cells at different time points postoperation(7,14,30,60,90 days). RESULTS: Subjective complaint of dry eye within 90 days after the operations were significantly increased compare with preoperations(5-27,23,19,16,13; 2-16,14,8,6,3). The schirmmer Ⅰ test were greatly increased in 14 days postoperation(10.1±4.5;15.0±4.7,13.8±5.7),the mean scores of fluorescence increased (0-17,9,5;0-8,3,1) and the mean break-up time decreased in 30 days post-operation(10.3±2.2;5.5±2.3,7.0±2.4,7.9±2.2) (P<0.05). CONCLUSION: SLIMCE operation have effect on the stability of tear film.

· AIM: To investigate the expression and the possible implication of CD40/CD40L costimulatory molecules in erythema nodosum of patients with Beh(c)et's disease.· METHODS: Sampling was done from erythema nodosum of 5 patients with Beh(c)et's disease and normal skin of 2 healthy individuals. Immunohistochemical staining was performed to examine the expression of CD4, CD8, CD19, CD68, HLA-DR,CD40 and CD40L molecules in the obtained tissues.· RESULTS: Approximately 90% of epidermic cells in erythema nodosum expressed CD40 molecule. In the dermis and subcutaneous tissue, a significantly increased number of CD4+Tcells, CD8+Tcells, CD19+cells, CD68+cells, HLA-DR+cells,CD40L+cells, and CD40+cells were observed in the erythema nodosum as compared with that in normal skin. Double staining showed that CD40L molecules were expressed on 45% of CD4+T cells. CD40 molecules were expressed on 100% CD68+ cells and 59.2% of HLA-DR+cells respectively.· CONCLUSION: A number of CD40/CD40L costimulatory molecules are upreguiated in the erythema nodosum of patients with Behcet's disease.

Objective To evaluate engraftment status of patients after allogeneic hematopoietic stem cell transplantation(Allo-HSCT) and prompt relapse of disease based on DNA polymorphism analysis technique.Methods Sixty-six cases were detected by DNA polymorphism analysis technique and 25 cases were monitored and analyzed dynamically during this period.Results After Allo-HSCT,48 patients obtained type of donors,but 13 patients did not; 5 patients showed mixed chimerism.Two cases of type of donors converted into mixed chimerism and 4 cases of mixed chimerism converted into type of donors after some time. The others' engraftment status did not change.Conclusion DNA polymorphism analysis technique can detect engraftment status of patients exactly, rapidly, which provides effective evidences of constitution for more clinical therapy projects.