Aged ; Amiodarone ; adverse effects ; Chemical and Drug Induced Liver Injury ; etiology ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Male

Objective: To study the difference in tooth profile among Chinese,Caucasian and Japanese with normal occlusion.Methods: The data of the measurments of Chinese,Caucasian and Japanese with normal occlusion were collected from published studies.Crown angulation,crown inclination and crown convex were used in the comparation among the peoples. Results: Tooth profile in Chinese was significantly different from that of Caucasian but was similar to that of Japanese. Conclusion: The orthodontic appliances should be modified when we use the straight wire appliances that is suitable for Caucasian and Japanese.

Objective To discuss the impact of nursing intervention on self- care ability and health behavior of cancer patients with indwelling PICC in order to improve their life. Methods 218 cases of cancer patients with PICC catheter were randomly divided into the intervention group (107 patients)and the control group (111 patients),the control group were treated with conventional care, the intervention group was treated with targeted cognitive intervention by the PICC nurse specialists on the basis of conventional care. Interventions included improving health knowledge, self-concept, self-care responsibility and self-care skills in four areas, the intervention lasted 3 months. A questionnaire survey was conducted before and after intervention. Self-care skills and health behavior levels were compared between the two groups. Results Self-care skills and health behavior levels of the intervention group were significantly higher thanthose of the control group after intervention. Conclusions Targeted interventions can effectively improve the self-care capacity of outpatient oncology patients with PICC catheter and improve their health behaviors.

Objective To analyze the reasons of abnormal extubation for the chemotherapy patients with PICC,and put forward preventive measures. Methods A retrospective investigation was carried out about the reasons for abnormal extubation in 583 chemotherapy patients with PICC in our hospital from December 2007 to September 2009. Results There were 63 cases of abnormal extubation in 583 patients, accounted for 10.8% of the total number. The reasons of abnormal extubation included: catheter-related infection, misplacement,prolapse, dilapidation and fracture, catheter occlusion,thrombosis and abandoning treatment. Conclusions Complications caused by PICC are the main reasons for abnormal extubation. Important care measures to prevent and deal with kinds of complications timely can reduce the incidence of abnormal extubation.

BACKGROUND: The initial stability of implantable distractor depends on the stress distribution of bone-distractor interface. The understanding of the biomechanical change in initial stage can improve the clinical success ratio of implantable distractor used in alveolar crest.OBJECTIVE: To evaluate the influence of bone quality on stress distribution and deformation in initial distraction stage.METHODS: Four three-dimensional models with 10 079-11 456 cells and 17 299-20 101 nodes were prepared by finite element methods (11 mm in length and 3.7-4.1 mm diameter). Implantable distractor was embedded in a segment of mandible. The elastic modulus of cancellous bone and the thickness of cortical bone, stress and deformation of bones and distractor were calculated.RESULTS AND CONCLUSION: The highest stress in the bone was concentrated in transportable section and the maximum deformation of transportable section was observed at the edge of the cortical bone, both of which were increased with bone quality decreased. The subsidence of distractor was observed with bone quality decreased. Bone quality influenced the initial stability and the result of the implantal distraction. The decrease of bone elastic modulus would increase the failure risk of distraction osteogenisis.

In order to study the chemical constituents in the water extract of the stem of Nauclea officinalis, column chromatography over D101 macroporous resin and silica gel and an automatic purification system were used to isolate and purify the chemical constituents from the extract. Nine compounds were obtained. By analysis of the physicochemical properties and spectral data, their structures were identified as naucleamide G (1), 3, 4-dimethoxyphenol-beta-D-apiofuranosyl (1-->6)-beta-D-glucopyranoside (2), kelampayoside A (3), 3alpha, 5alpha-tetrahydrodeoxycordifoline lactam (4), naucleamide A-10-O-beta-D-glucopyranoside (5), pumiloside (6), 3-epi-pumiloside (7), strictosamide (8) and vincosamide (9), separately. Among them, compound 1 is a new compound, compound 2 was found in plants of the genus Nauclea for the first time, and compounds 3 and 4 were isolated from this plant for the first time.

Objective To explore the impacts of intensive nutritional intervention on maternal and infant outcomes in women with gestational diabetes mellitus(GDM). Methods From January 2014 to ecember 2014, a total of 518 women with GDM were stratified by age, height, body mass index (BMI), and were divided into treatment group (n=258) and control group (n=260) according to the random number generated by the computer software. Women in control group underwent conservative treatment while those in treatment group were given intensive nutritional intervention including keeping records of eating habits, measurement of blood glucose and regular follow-up. The incidence of pregnancy-related complications and newborn outcomes in both groups were compared. Results Women of the two groups were similar in basic clinical data. The range of gestational weight gain (GWG) [(12.2 ± 4.7) vs. (13.9 ± 5.0)kg] and birth weight of infants [(3 406.4±495.4) vs. (3 494.9±484.7)g] in the intervention group was significantly lower than those in the control group (P<0.01). The rate of reaching recommended target of GWG was significantly higher in the intervention group (60.9%) than in the control group (51.9%, χ2=4.2, P<0.05). There was a significant reduction in glucose-related parameters in both groups (P<0.01). In the intervention group, fasting blood glucose and postprandial blood glucose were reduced from (5.21 ± 0.71) mmol/L, (6.68 ± 0.90) mmol/L to (4.71 ± 0.73) mmol/L,(6.21 ± 0.71) mmol/L (P<0.01), respectively in comparison with the control group, the intervention group had lower incidence of cesarean section (44.6% vs. 53.8%), postpartum hemorrhage (2.3%vs. 6.2%), polyhydramnios (7.8%vs. 13.5%), neonatal hypoglycemia (3.1%vs. 6.5%) and macrosomia (8.1%vs. 13.8%, P<0.05). Conclusions Strengthening nutritional intervention in women with GDM could increase the rate of reaching recommended target of GWG, improve the glucose-related parameters and reduce the incidence rate of pregnancy complications.

Background Keratoconus is a progressive corneal thinning and protrusion disease that develop in the age of puberty,resulting in a certain extent impairment of visual function.Corneal collagen cross-linking (CXL) increases the stiffness of the cornea through the photooxidation of ultraviolet A (UVA) and riboflavin,with the aim to postpone and prevent the progression of keratoectasia.Objective This study was to evaluate the safety and efficacy of transepithelial CXL in the treatment of pediatric keratoconus.Methods Ten eyes of 9 pediatric patients with keratoconus undergoing transepithelial CXL were enrolled from February 2010 to March 2013 in Affiliated Eye Hospital of Wenzhou Medical University,with the mean age was (15± 1) years (range from 13 years to 17 years).After topical anesthesia (0.1％ tetracaine) for 15 minutes,0.5％ riboflavin was applied until it was saturated in the anterior chamber,then UVA with the intensity of 3 mW/cm2 was performed on the cornea for 30 minutes.The uncorrected distance visual acuity (UDVA),corrected distance visual acuity (CDVA),refractive error,topography,corneal thinnest thickness were measured 7 days,1 month,3 months,6 months and 1 year after operation.Endothelium cell density (ECD) was measured 7 days afier operative.Results The mean corneal reepithelization time was (1.4±0.8) days.The UDVA and CDVA were significantly improved from preoperative 1.02±0.16 and 0.34±0.20 to postoperative 0.77±0.18 and 0.25 ±0.15,respectively (t =4.251,3.750;both at P＜0.05).The refractive sphere and spherical equivalent significantly changed from preoperative (-7.15±3.00)D and (-9.26±3.23)D to postoperative (-5.28±2.05) D and (-7.05±2.08) D 1 year,respectively (t =-2.515,-2.597;both at P＜0.05).Maximum Kvalue (Kmax) was significantly decreased from preoperative (64.1 ± 11.9) D to postoperative (61.8 ± 10.4) D (t =2.304,P＜0.05).The refractive cylinder,corneal thinnest thickness and ECD showed no significant differences between preoperation and postoperation (t =-1.331,0.328,1.205;all at P＞0.05).Stromal opacity was observed in 2 eyes 3 months and 6 months after operation,respectively.Conclusions Transepithelial CXL is safe and effective in prolonging or halting progression in adolescent keratoconus.

OBJECTIVE:To study the pharmacokinetic characteristics of triflusal capsule in healthy volunteers. METHODS:In ran-domized test,36 healthy volunteers were randomly divided into 3 groups. They were given low-dose,medium-dose and high-dose of Triflusal capsule(300 mg,600 mg and 900 mg),qd,for one day,and then pharmacokinetic study of single dose of Triflusal capsule was conducted;Triflusal capsule medium-dose group was continuously given medicine for 13 days,and then pharmacokinetic study of multiple dose of Triflusal capsule was conducted. The plasma concentration of triflusal was determined by LC-MS/MS,and Zorbax SB-C18 column was used with methanol-0.2% formic acid (80:20,V/V) at the flow rate of 0.2 ml/min. ESI was adopted in MRM mode,negative ion detection was carried out,quantitative analysis m/z 247.1→161.1(triflusal),m/z 294.0→250.0(internal standard, diclofenac sodium). Pharmacokinetic parameters were calculated by using WinNonlin 6.2 software,and the difference of them were compared. RESULTS:The linear range of triflusal were 0.05-20 μg/ml. The main pharmacokinetic parameters of triflusal capsules high-dose,medium-dose and low-dose groups were as follows:t1/2 were (0.45 ± 0.20),(0.47 ± 0.10),(0.43 ± 0.20) h;tmax were (0.56±0.20),(0.60±0.20),(0.47±0.40)h;cmax were(3.30±0.98),(10.65±3.26),(13.96±4.88)μg/ml;AUC0-8 h were(3.99±0.93), (13.29±1.72),(19.62±6.78)μg·h/ml;within dose of 300-900 mg,linear relationship was found between cmax,AUC0-8 h and dose(R2=0.954,0.986). When reaching stable state of multiple dose,average blood concentration was(0.71±0.20)μg/ml;main pharmacokinetic parameters were as follows:AUCs(17.10±4.82)μg·h/ml,t1/2(0.49±0.10)h,tmax(0.85±0.62)h,cmax(11.58±3.99)μg/ml,AUC0-8 h (16.99±4.84)μg·h/ml,AUC0-∞(17.08±4.81)μg·h/ml;accumulation factor(1.28±0.40). tmax and t1/2 of single dose were similar to those of multiple dose. CONCLUSIONS:LC-MS/MS can determine the content of triflusal in human plasma rapidly and accurately, and accumulation phenomena exist in healthy Chinese volunteers,which shows linear pharmacokinetic characteristics.

Background:Intestinal metaplasia(IM)and dysplasia in Barrett’s esophagus(BE)can be detected by endoscopic biopsy combined with pathological examination. Aims:To evaluate the efficacy of acetic acid stain-guided biopsies in detection of IM and dysplasia in BE under standard endoscopy. Methods:One hundred patients found to have columnar-lined esophagus by endoscopy from January 2012 to November 2014 at Shanghai Jing’an District Central Hospital were enrolled. Under standard endoscopy,acetic acid was sprayed and multi-point biopsies were performed in visible abnormal regions. This was followed by four-quadrant biopsies at every 1 to 2 cm of the remaining BE segments. Detection rates of columnar epithelium,IM and dysplasia were compared between acetic acid stain-guided biopsies and four-quadrant biopsies. Results:A total of 96 patients were diagnosed as BE. Detection rates of columnar epithelium by acetic acid stain-guided biopsies and four-quadrant biopsies were 96. 9%(93 / 96)and 90. 6% (87 / 96),respectively,no significant difference was found between the two methods(McNemar test,P = 0. 146),however,consistency of the two methods was poor(κ = 0. 340). A total of 32 patients were diagnosed as BE with IM. Detection rates of IM by acetic acid stain-guided biopsies and four-quadrant biopsies were 84. 4%(27 / 32)and 40. 6%(13 / 32),respectively,difference in detection rate between the two methods was significant(McNemar test,P = 0. 007),and consistency of the two methods was poor(κ =0. 266). Five cases of low-grade dysplasia were detected by acetic acid stain-guided biopsies only. Conclusions:Acetic acid stain-guided biopsies can detect BE with IM and dysplasia better than four-quadrant biopsies.