Because of their physiological and anatomical immaturity, premature infants are prone to disorders of glucose metabolism. In the ifrst week after birth, infants have the greater risk of abnormal glucose metabolism. Compared with term infants, the glucose/insulin homeostasis of preterm infants is very different. This article reviewed the characteristics of glycometabolism in premature infant and the methods of glucose test.

Objective To study the pain relief effectiveness of the combined spinal epidural analgesia(CSEA) and the inhalation of nitrous oxide, and the influences on the mothers and infants Methods The 300 cases of pregnant women were randomly divided into 3 groups: CSEA group,nitrous oxide group and control group The nitrous oxide group was that pregnant women inhaled nitrous oxide premixed with oxygen (50%∶50%),the pregnant women of the CSEA group were injected fentanyl and bupivacaine in the subarachnoid and epidural space,analgesic was not used in the control group The degree of labor pain, duration of the labor,way of delivery, bleeding volume, rate of anoxia of newborn,blood gas analysis to maternal radius artery and fetal umbilical blood among 3 groups were observed Results The effect for analgesia labor of the CSEA group was much better than that of the nitrous oxide group ( P 0 05) In the second stage of labor,the 3 groups were alike to each other The bleeding volume of caesarean section (373?77) ml in the nitrous oxide group was much more than the other 2 groups, there was no difference between the CSEA group (259?78) ml and the control group (239?89) ml The rate of obstetric forceps of CSEA group was higher than the control group ( P

OBJECTIVE:To establish a method for simultaneous determination of valsartan and hydrochlorothiazide in Valsar-tan hydrochlorothiazide tablets. METHODS:UPLC was adopted. The determination was performed on Phenomenex C18 column with mobile phase consisted of [0.1% phosphoric acid solution-acetonitrile(95 : 5,V/V)]-[0.1% phosphoric acid solution-acetonitrile (5 : 95,V/V)](gradient elution)at the flow rate of 0.25 mL/min. The detection wavelength was set at 272 nm,and the column tem-perature was 35 ℃. The sample size was 1.5 μL. RESULTS:The linear range were 8.1-324.2 μg/mL for valsartan(r=0.9999)and 1.2-50.1 μg/mL for hydrochlorothiazide(r=0.9999). The limits of quantitation were 0.24,0.04 ng,and the limits of detection were 0.06,0.01 ng. RSDs of precision,stability and reproducibility tests were less than 2.0%;recoveries were 97.69%-100.35%for valsartan(RSD=1.03%,n=9)and 98.27%-100.60% for hydrochlorothiazide(RSD=0.83%,n=9). CONCLUSIONS:The method is simple,rapid and accurate,and can be used for the simultaneous determination of valsartan and hydrochlorothiazide in Valsartan hydrochlorothiazide tablets.

Objective To evaluate the efficacy of hydromorphone for patient-controlled intravenous analgesia (PCIA) after hip replacement in elderly patients.Methods Seventy patients, aged 65-75 yr, weighing 40-70 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective unilateral hip replacement, were randomly divided into either analgesia with hydromorphone group (group H, n =35) or analgesia with fentanyl group (group F, n=35).After a loading dose of 20 μg/kg of hydromorphone was injected at the beginning of skin closure, a PCA pump was connected, and the PCIA solution contained hydromorphone 0.25 mg/kg and tropisetron 10 mg in 120 ml of normal saline in group H.After a loading dose of 1 μg/kg of hydromorphone was injected at the beginning of skin closure, a PCA pump was connected, and the PCIA solution contained fentanyl 25 μg/kg and tropisetron 10 mg in 120 ml of normal saline in group F.The PCA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and the background infusion at a rate of 2 ml/h in both groups.Tramadol 0.5 mg/kg was injects intravenously as rescue analgesic, and visual analogue scale score was maintained ≤ 3.The Ramsay sedation score,the number of attempts and the number of tramadol administration were recorded at 24 and 48 h after operation.The adverse effects within 48 h after operation and patient's satisfaction with analgesia were recorded.Results There was no significant difference in the Ramsay sedation score, the number of attempts and the number of Tramadol administration between H and F groups.Compared with group F, the incidence of adverse effects such as postoperative nausea, vomiting, respiratory depression, drowsiness, urinary retention, was significantly decreased, and the level of satisfaction with analgesia was increased in group H.Conclusion Hydromorphone provides accurate efficacy for PCIA after hip replacement in elderly patients, with fewer adverse effects and higher level of patient' s satisfaction.

Objective:To establish a headspace capillary gas chromatography method for the determination of residual solvents in erlotinib hydrochloride .Methods:A DB-624 capillary column (30 m ×0.53 mm, 3.0 μm) was used and the carrier gas was nitro-gen.The flow rate was 2.0 ml· min-1 and the inlet temperature was 190℃.The FID detector temperature was 230 ℃.The column temperature program was with the initial temperature of 35℃( maitaining 8 min) , risen to 170℃with the rate of 28℃· min-1 ( main-taining 8 min) , and then risen to 200℃with the rate of 32℃· min-1 ( maintaining 7 min) .The headspace vial temperature was 100℃and the time was 30 min.Results:Ethanol, isopropanol, methylene chloride and n-butanol had a good linear relationship within the range of 0.68-409.14 μg· ml-1 (r=0.999 8),0.67-404.88 μg· ml-1 (r=0.999 8),1.71-51.31μg· ml-1 (r=0.999 7) and 0.72-431.12 μg· ml-1(r=0.999 8), respectively.The average recovery was 99.0% (RSD=0.41%, n=9), 100.2%(RSD=0.52%, n=9),97.1%(RSD=1.75%, n =9) and 102.5% (RSD=1.08%, n=9), respectively.Conclusion: The method is simple and accurate , which can be used for the determination of four residual organic solvents in erlotinib hydrochloride .

Objective To study the risk factors of MRI for the prediction of collapse in patients with avascular necrosis of the femoral head.Methods Twenty-two patients (39 hips) diagnosed avascular necrosis of femoral head by MR were enrolled in our study.The following MR appearances were evaluated:bone marrow edema,joint fluids,signal intensity and location of the lesion.The volume and surface area of the necrosis zone were calculated.The time of follow-up was 18-84 months (median,25 months).Logistic regression analysis was used to predict the risk factors by SPSS 13.0.The maximum value of Youden index was selected as the critical point to predict the collapse of femoral head and to define the sensitivity,specificity and accuracy.Results In the 39 hips with femoral head necrosis,21 hips had collapse.Bilateral collapse occurred in 5 cases.In 25 hips with the necrosis surface larger than 25％,collapse occurred in 21 (84％); In 8 hips with the volume of femoral head necrosis larger than 30％,collapse occurred in all cases; 1n 33 hips with the necrosis locating at the superolateral quadrant,collapse occurred in 21 (63.6％); In 22 hips with necrotic areas showing heterogeneous signal intensity,collapse occurred in 18(81.8％) ;In 25 hips with large amount of joint effusion,collapse occurred in 16 (64％) ;in 18 hips with bone marrow edema,collapse occurred in 13 (65％).Joint fluid,heterogeneous signal intensity and lesions in the superolateral quadrant,volume ratio,and area ratio were the high risk factors,while bone marrow edema was a relatively low risk factor.The area under ROC curves for area ratio of NASA was greater than that for volume ratio (0.987 vs 0.902).When the critical value for area ratio was 26.7％,the true positive rate was 95.2％,true negative rate was 94.4％,and Youden's index was 0.896.Conclusions The collapse of necrosis of femoral head may result from many factors.The femoral head was easy to collapse when it had large enough area of necrosis and mixed signal intensity,a large amount of joint effusion,bone marrow edema,and superolateral quadrant location.The critical value for area ratio to predict the collapse of femoral head was about 26.7％.The area ratio is more accurate than volume ratio in predicting the collapse of necrosis of femoral head.

Objective To evaluate the value of cholangiography for early diagnosis of ischemic-type biliary lasions(ITBL) after liver transplantation. Methods Two hundred and fifty-three patients with liver transplantaion between Jan 2004 and Oct 2006 were recruited. Initial cholangiography was compared with terminal cholangiography to evaluate the value of initial cholangiography of ITBL. The t test, Chi-square test, sum rank test were used for statistics. Results Based on initial cholangiography, 189 patients were diagnosed with normal appearance, while 64 patients were diagnosed with abnormal appearance. The abnormal initial cholangiography appearances included poor filling in 33 patients and irregularity in 31 patients. Based on terminal cholangiogruphy, 199 patients were diagnosed with normal appearance and 54 patients with ITBL In patients with abnormal initial cholangiography, ITBL was occurred in 39 of 64 patients including 10 of 33 poor frlling patients and 29 of 31 irregularity patients. In patients with normal initial appearance, ITBL was only occurred in 15 of 189 patients. The abnormal initial cholangiography was associated with ITBL significantly (X2 = 79.999, P = 0.000, r = 0.490). Initial cholangiography had an overall sensitivity of 72.22%, and specificity of 87.44%, with positive and negative predictive values of 60.94% and 92.06%, respectively. The abnormal initial cholangiogruphy was a risk factor of ITBL by logistic regression analyses(OR=15.193, P=0.000). Conclusion The abnormal initial cholangiography is associated with ITBL Initial cholangiography, especially minimal irregular of intrabepatic biliary tract, is a sensitive and specific method for the detection of ITBL after liver transplantation.

Objective To detect content of 4-hydroxy-3-methoxy benzoic acid by RP-HPLC and observe the inhibitory effect of phloroglucinol on catecholamine-O-methyl transferase (COMT). Methods This study used the principle of 3,4-dihydroxy benzoic acid transforming to 4-hydroxy-3-methoxy benzoic acid under COMT’ s catalytic action. COMT (20 μL) was extracted from mouse liver homogenate. In a reaction system,10 μL catecol (1í10-3 mol·L-1 ) and 10 μL phloroglucinol (5í10-3 , 1í10-3 and 2í10-4 mol·L-1 ,respectively) were added. Products were determined by RP-HPLC to analyze effects of 4-hydroxy-3-methoxy benzoic acid on COMT. Results Phloroglucinol had inhibitory effect on COMT activity at concentrations of 5í10-3 mol·L-1 ,1í10-3 mol·L-1 and 2 í10-4 mol ·L-1 ,with the inhibition rate being 25. 3% ,17. 6% and 8. 9% ,respectively. Conclusion Phloroglucinol has an inhibitory effect on COMT activity,which is weaker than the effect of catechol of the same concentration.

Objective To evaluate the impact of multiple lacunar infarction (MLI) on the outcomes of mild cognitive impairment (MCI). Methods MCI patients were selected in outpatients and hospitalized patients using a common international standard MCI screen. Magnetic resonance imaging (MRI) and computer tomography (CT) were used to determine the presence of MLI. MCI patients were followed up for 6～24 months and their cognitive status and the impact of MLI on MCI were evaluated using Kaplan-Meier survival analysis. Results One hundred twenty patients were diagnosed as having MCI based on clinical evaluation and neuropsychological assessment. Among them, 43 (35.8%) patients had MLI and the rest 77 (64.1%) patients did not have. Twenty-seven MCI patients with MLI (62.8%) developed dementia, while 15 MCI patients without MLI (19.4%) developed dementia during 6～24 months follow-up. Kaplan-Meier analysis indicated that the incidence of dementia was significantly higher in patients with MLI than in patients without MLI did (P＜0.05). Conclusions MCI patients with MLI are more prone to dementia. These results suggest that early interventions aimed at controlling the modifiable risks are warranted for dementia prevention in MCI patients with MLI.

AIM To determine the antagonistic activities of new endothelin receptor antagonist CPU0214 on the left ventricle membranes and the aorta ring contraction in normal rat and its reduction effect on the mean arterial pressure in conscious DOCA salt hypertensive rats. METHODS Left ventricle membranes of normal rat hearts achieved for competition binding assay was used to investigate the antagonistic effects of CPU0214. Aorta ring contraction induced by ET 1 in normal rat was used to investigate the antagonistic activity of CPU0214. DOCA salt hypertensive rats were induced by injection of deoxycorticosterone acetate (DOCA, sc) following with 1% NaCl as drinking for 4 wk. A multiple physiological recorder was used to record the mean arterial pressure of femoral artery. The endothelin receptor change in the left ventricle membranes of DOCA salt hypertensive rat was measured by binding assays. Intraperitoneal injection of CPU0214 was used to investigate its effect on reduction of mean arterial pressure. RESULTS In the left ventricle the IC 50 of endothelin receptor antagonist CPU0214 is 16 nmol?L -1 and CPU0214 (10 ?mol?L -1 ) inhibited the ET 1 induced isolated aorta rings contraction in normal rats. Mean arterial pressure as well as B max and K d of left ventricle were increased significantly in DOCA salt hypertensive rat. CPU0214 (60 mg?kg -1 ip) significantly reduced the mean arterial pressure of conscious DOCA salt hypertensive rats especially during 60～90 min after administration. CONCLUSIONS CPU0214 has significantly antagonistic effects on the left ventricle membrane and the isolated aorta ring contraction in normal rat, which is verified by CPU0214 as a strong endothelin receptor antagonist. Furthermore its effect on the mean blood pressure reduction in conscious DOCA salt hypertensive rats, which is manifested as an abnormal endothelin system, shows its prosperity of drug development value as a new endothelin receptor antagonist.