Adolescent ; Attention Deficit Disorder with Hyperactivity ; classification ; diagnosis ; epidemiology ; Child ; Comorbidity ; Female ; Humans ; Male ; Prevalence ; Prognosis

Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional

Objective To detect fat emboli in cardiac chamber of the patients undergoing total knee arthroplasty(TKA) by transesophageal echocardiography(TEE), and to discuss the relevant clinical value.Methods Eleven female patients with 12 osteoarthritis(OA) knees were underwent TKA. According to whether using tourniquet or not,12 knees were divided into 2 groups at random:tourniquet-related group (6 knees) and control group(6 knees). Echo intensity and ultrasonic characteristics of fat emboli in cardiac chamber were studied dynamically by multiplane TEE in various periods of the whole operation. Results All of the patients were implanted knee prostheses successfully. In different periods of TKA, fat emboli appeared as isoechoic or hyperechoic particles, which were found in right atrium, but nothing could be found in left heart. The imaging of the particles was flowing with duration time of 10～600s, like dots, lines, "moving star" or "shower". While femur expanding(0～3mins),the particles in right atrium and ventricle became more and more, and the echo intensity became significantly higher than those in other periods. After releasing tourniquet(0～5mins),most particles with highest echo intensity were observed in right heart,showing like "snowstorm" in tourniquet-related group, and more emboli were still detected at the end of monitoring (10 min after releasing tourniquet) by TEE,compared to the control group. No patient suffered from fat embolism syndrome(FES) with clinical manifestation. Conclusions Fat emboli in cardiac chamber can be observed sensitively by real-time TEE dynamically during TKA. It should be encouraged and promoted to analyze ultrasonic characteristics to facilitate the early detection, early diagnosis and early clinical intervention for the subclinical type of FES.

The work aims to study the drug metabolizing enzymes involved in the metabolism of butylphthalide and evaluate the induction and inhibition activities of butylphthalide on CYP450 isoenzymes by using in vitro (liver microsome incubation system of rats and human) and in vivo (CYP induced model of rats) method. Butylphthalide was incubated with selective inhibitors of CYP450, and its metabolic rate was determined to identify the metabolizing isoenzymes of NBP in rat (normal and induced rats) and human liver microsomes. The in vitro inhibition effect of butylphthalide on 6 main liver microsomal CYP450 isoenzymes was evaluated by using probe drugs; the induction and inhibition activities in vivo of butylphthalide on CYP450 isoenzymes were evaluated by NBP ig dosing (160 mg x kg(-1)) and iv dosing (20 mg x kg(-1)) in rats. After adding the specific inhibitors of CYP2C11, 2E1 and 3A 1/2 for rat, CYP2C19, 2E1 and 3A4/5 for human, the metabolism of NBP in rat and human liver microsomes were reduced 38.8%, 86.2%, 78.4% and 51.0%, 92.0%, 58.9% of control, respectively. The metabolic rates of NBP in CYP2E1 and 3A 1/2 induced rat liver microsomes were increased 25.5% and 68.9%. High concentration of NBP (≥ 200 μmol x L(-1), in vitro) could inhibit the activities of CYP1A2, 2C6, 2C11 and 2D2 in rats, and high concentration of NBP ( ≥ 15 μmol x L(-1), in vitro) could inhibit the activity of CYP2C19 in human. All the results indicated that NBP should be mainly metabolized by CYP2E1, 2C11 and 3A 1/2 in rats and CYP2E1, 2C19 and 3A4/5 in human. High concentration of NBP could inhibit human CYP2C19 in vitro. No significant induction/inhibition effects of NBP were observed on rat liver CYP450 isoforms after ig 160 mg x kg(-1) NBP or iv 20 mg x kg(-1) NBP.

AIM: To establish a method for detecting the residual solvents in protopanaxdiol. METHODS: Capillary GC with HP-PLOT-Q column (30 m ? 0. 53 mm ? 1. 0 ?m) was used to determine residual in protopanaxdiol. N,N-dimethyl-acetamide as solvent media,FID detector and nitrogen as the carrier gas. RESULTS: There was a good linearity at the experimental concentration (r = 0. 999 96-0. 999 99),the RSD of precision was less than 6. 0 % . The spotting recovery of the 3 residul,including methol,ethyl acetate and n-butanol,was in the range of 98. 2%-102. 2% ,and its’RSD was 1. 1%-2. 4% . CONCLUSION: The method is simple,accurate and of high sensitivity,can be used for the determination of residual solvents in protopanaxdiol.

Objective: To explore the efficacy of esmolol on cardiac ischemia in patients with serious coronary lesions who are not candidates for coronary revascularizations. Methods: Fifty seven aged patients (34 male) with serious coronary artery disease not candidates for coronary revascularizations were included. All patients had classical angina involved in cardiac ischemia, and definitely ischemic ST-segment depressions in surface electrocardiogram, however which were not relieved by routine treatment including intravenous nitrate or even morphine. All patients received loading dose injection and continuously intravenous infusion of Esmolol, and the baseline characteristics before treatment and the effects at 4 hours after infusion of Esmolol were carefully recorded. Results: After infusion of Esmolol, the ischemia-related symptoms of 41 patients completely relieved, and their ST depressions recovered to the baseline accompanied with significant reduction in blood pressure and heart rate (P＜0.0001 all) within (66±23) min. Moreover, nine patients were observed that their ischemia-related symptoms were relieved and ST alteration recovered partially (P＜0.0001 both) at four h after continuous infusion of esmolol. Conclusion: Esmolol is effective to relieve the serious cardiac ischemia-related symptoms and ST-T alteration of ECG in patients with serious coronary lesions.

To clone the differential genes in antibiotic resistence Neisseria gonorrhoeae,the library that contains the fragments of differential genes between antibiotic resistance strain and standard reference strain of Neisseria gonorrhoeae was constructed which used suppression subtractive hybridization technique. Then the antibiotic resistance relational genes fragments were cloned and analyzed. Antibiotic resistance Neisseria gonorrhoeae subtractive library that has high subtractive efficiency was set up successfully. The amplified library contained 2500 positive clones. Sequence analysis was performed to find the fragments of antibiotic resistance relational genes. Five sequences were unknown previously. The fragments of antibiotic resistance genes may provide an important clue for studying the mechanism of occurrence and development of antibiotic resistance Neisseria gonorrhoeae.

Objective To probe the correlation between the short-axis diameter(SD) of microwave coagulation and the time(T) and/or power(P) using a new type of internally cooled microwave antenna. Methods A MTC-3 microwave apparatus with a new type of internally-cooled microwave antenna was used to coagulate a fresh porcine liver in vitro. The correlation was analyzed between the SD of coagulation necrosis and the time and/or power. Results ①Under the same power, there was high linear relationship(r= 0.94- 0.98,P

Objective To investigate the correlation between the distribution of lesions on MRI and the findings of computerized tomography angiography (CTA) in patients with posterior circulation infarction.Methods Patients with acute posterior circulation infarction were enrolled in the study.The sites of the infarcts were divided into proximal,middle and distal infarctions according to the results of MRI.All the patients received head and neck CTA.The correlation between the distribution of posterior circulation infarcts and the sites of vertebrobasilar system lesions was analyzed.Results A total of 203 patients with acute posterior circulation infarction were enrolled.Their primary clinical symptoms and signs were unilateral limb weakness (n =77,37.93％),dizziness (n =129,63.55％),dysarthria (n =31,15.27％),nausea and vomiting (n =61,30.05％),headache (n =79,38.92％),gait abnormal (n =50,24.63％),nystagmus (n=34,16.75％),and ataxia (n=21,10.34％).Proximal infarction (n=35,17.24％):medullary infarction (n =28,13.79％),posterior inferior cerebellar artery infarction (n =7,3.45％); middle infarction (n =95,46.79％):pontine infarction (n =80,39.4％),anterior inferior cerebellar infarction (n =15,7.39％); distal infarction (n=73,35.96％):middle cerebral infarction (n=6,2.96％),superior cerebellar infarction (n =16,7.88％),thalamic infarction (n =34,(16.75％),occipital lobe infarction (n =10,4.93％),temporal lobe infarction (n =7,3.44％).Extracranial vertebral artery lesions were most common in the distal infarction group.It reached 53.42％,and was significantly higher than 22.86％ in the proximal infarction group (P =0.003) and 33.68％ in the middle infarction group (P =0.010).Intracranlal vertebral artery lesions were most common in the proximal infarction group.It reached 57.14％,and then followed by the middle infarction (41.05％).They were all significantly higher than 15.07％ in the distal infarction group (all P =0.000).Basilar artery lesions were most common in the middle infarction group.It reached 20.00％ and was significantly higher than 4.11％ in the distal infarction group (P=0.002).Posterior cerebral artery lesions were most common in the distal infarction group.It reached 27.40％ and was significantly higher than 5.71％ in the proximal infarction group (P =0.009) and 5.26％ in the middle infarction group (P=0.000).Conclusions The range of vascular lesions of the distribution of lesions shown on MRI and the findings of CTA on vertebrobasilar artery system in patients with posterior circulation infarction had some connection.During the proximal and middle infarctions,the possibility of having intracranial vertebral artery lesions was greater; during the distal infarction,the possibility of having extracranial vertebral artery and posterior cerebral artery lesions was greater.

Objective:To evaluate the efficacy and safety of combined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with lobaplatin and docetaxel for treatment of synchronous peritoneal carcinomatosis (PC) from gastric cancer. Methods:Fifty patients with synchronous PC from gastric cancer were treated by 52 CRS+HIPEC procedures with 100 mg of lobaplatin and 120 mg of docetaxel in 12000 mL of normal saline at (43 ± 0.5)℃for 60 min. The primary and secondary endpoints were overall survival (OS) and perioperative safety profiles, respectively. Results:At a median follow-up of 22.5 months, the median OS rate was 14.3 (95%CI:7.6-21.0) months, and the 1-, 2-, and 3-year survival rates were 58%, 40%, and 32%, respectively. No perioperative deaths or serious adverse events occurred in 12 cases (23.1%). Multivariate analysis indicated that completeness of cytoreduction, nor-mality of perioperative tumor markers, and adjuvant chemotherapy of more than six cycles were independent predictors for improved survival. Conclusions:CRS+HIPEC with lobaplatin and docetaxel could improve the OS and ensure perioperative safety of patients with synchronous PC from gastric cancer.