OBJECTIVE:To evaluate the rationality of vancomysin use in the hospital where the authors work.METH-ODS:50patients taking vancomysin between May.2005and Nov.2005were studied.The pathogenic examination,monitoring of drug concentration in blood,indices of renal function,combined use of drugs as well as adverse effects in these patients were reviewed and analyzed statistically.RESULTS:On the whole vancomysin use in our hospital was safe.CONCLUSION:Vancomysin use will be made safer by monitoring drug concentration in blood,individualizing drug administration,and timely correcting the aggravating factors of kidney injury.

AlM: To study the therapeutic effect of external-route microsurgery forrhegmatogenous retinal detachment.
METHODS: ln 55 patients ( 55 eyes ) with rhegmatogenous retinal detachment, drainage of subretinal fluid, examination of locating the holes, sclera cryotherapy, scleral buckling, and vitreous cavity injection of filtrated air were performed under surgical microscope.
RESULTS:The retinal reattachment occurred in 50 cases after the primary surgery. The final rate of reattachment was 91% during 6 - 12mo follow - up. The retinal reattachment occurred in 1 case ( recurrent retinal detachment) after the secondary surgery and in 4 cases ( recurrent retinal detachment ) after vitrectomy. The eyesight was improved with different degrees in 55 cases.CONCLUSlON: The external- route microsurgery for rhegmatogenous retinal detachment is simple, safe and effective.

Objective To determine the median effective target effect-site concentration (EC50) of sufentanil inhibiting responses to insertion of laryngeal mask airway (LMA) when combined with propofol in the elderly patients.Methods ASA physical status Ⅰ or Ⅱ patients,aged 66-75 yr,with body mass index of 19-30 kg/m2,scheduled for elective transurethral resection of prostate under general anesthesia,were included in this study.Anesthesia was induced with propofol given by target-controlled infusion.The initial target effect-site concentration (Ce) of propofol was 1 μg/ml,and the Ce was increased by 0.5 μg/ml every 1 min until it was increased to 2 μg/ml and maintained at this level for 5 min.Sufentanil was simultaneously administered by target-controlled infusion.The target Ce of sufentanil was 0.3 ng/ml in the first patient.The concentration of sufentanil was determined using the modified Dixon's up-and-down method.After the patients lost consciousness,LMA was inserted after the target effect-site and plasma concentrations were balanced.The insertion response was defined as positive when MAP and HR increased by 20％ of the baseline value within 5 min after insertion of LMA.The Ce of sufentanil was increased/decreased in the next patient if the insertion response was positive or negative.The ratio between the two successive concentrations was 1.2.The EC50 and 95 ％ confidence interval of sufentanil blunting responses to insertion of LMA was calculated using Probit analysis.Results When combined with propofol,the EC50 (95％ confidence interval) of sufentanil blunting responses to insertion of LMA was 0.160 (0.130-0.188) ng/ml.Conclusion The EC50 of sufentanil inhibiting responses to insertion of LMA is 0.160 ng/ml when combined with propofol in the elderly patients.

Objective To evaluate development of gastro-esophageal reflux (GER) during laparoscopic surgery in lateral jack-knife position under general anesthesia through comparing with reverse Trendelenburg/ Trendelenburg position in the patients lying supine.Methods Ninety patients of both sexes,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 18-30 kg/m2,scheduled for elective laparoscopic surgery under general anesthesia,were randomly divided into 3 groups (n =30 each):lateral jack-knife position group (group L),Trendelenburg position group (group T) and reverse Trendelenburg position group (group Tre).Anesthesia was induced with midazolam,sufentanil,propofol and cisatracurium besylate and maintained with propofol and remifentanil given by target-controlled infusion.A pH-sensitive probe was inserted through nose into the lower esophagus and pH value was continuously recorded until 1 min after extubation.GER was defined as pH value ≤ 4 lasting for ≥ 1 min in the lower esophagus during surgery.The development of GER during surgery and the lowest pH value in the lower esophagus when GER developed were recorded.Results Compared with group Tre,the incidence of GER (27％) and total number of times GER had occurred were significantly increased in group L,and no significant changes were found in the indices mentioned above in L and T groups.When GER developed,the lowest pH value in the lower esophagus was 2.1 ± 1.3,2.6 ± 1.2 and 3.5 in L,T and Tre groups,respectively.Conclusion The incidence of GER is 27 ％ during laparoscopic surgery when the patients are in lateral jack-knife position and it is higher than that obtained with reverse Trendelenburg position in the patients lying supine.

Objective To explore the changes and clinical significance of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen time(FGB)and platelet(PLT)on Kawasaki disease(KD)in children with acute and convalescent 10 d,which aimed at early diagnosis,prediction and prognosis of coronary artery lesions.Methods Thirty-eight cases who were diagnosed KD were selected as KD group,30 cases age-matched acute respiratory infections in children with fever as fever group,moreover,30 cases of a class of elective surgery preoperative children admitted to surgical departments were put as control group.The plasma PT,APTT,TT,FGB,PLT of all cases and plasma APTT,FGB,PLT in recovery 10 d in children with KD disease were detected,and then the results were compared between the 3 groups;and the results of APTT,FGB,PLT in KD children with acute and convalescent 10 d to coronary artery dilatation groups or not were compared.Results 1.APTT prolonged and FGB,PLT increased in KD children with acute stage,which had a significant difference compared with other groups(Pa0.05).2.When comparing the results of APTT,FGB,PLT in KD children with acute and convalescent 10 d,the difference was significant(Pa

ObjectiveTo investigate the effect of Puerarin on expression of inductible nitric oxide synthase (iNOS) in RAW264.7 macrophage cells induced by lipopolysaccharide （LPS）. MethodsThe protein and mRNA levels of lipopolysaccharide (LPS)-induced iNOS was determined in RAW264.7 macrophage cells using Western blotting and RT-PCR respectively. ResultsPuerarin inhibited expression of iNOS concentration dependently (P<0.01). ConclusionPuerarin may reduce iNOS level, result in prevention of inflammation.

Objective To investigate the effects of glycyrrhizin on gene expression of transforming growth factor(TGF)-?signaling pathway of hepatic stellate cell(HSC)in mice by gene microarray tech- nique.Methods The HSCs were isolated from mice and cultured in vitro.Then the mice were divided into control group,TGF-?_1 group(5 ng/ml) or TGF-?_1(5 ng/ml)combined with glycyrrhizin(100?mol/L) group.The cells were collected after 10 hours to extract RNA.A cDNA microarray(GEArray~(TM) Q) targeting TGF-?/BMP signal transduction was used to screen the genes which showed significant changes in expression of TGF-?pathway of HSC by glycyrrhizin.Results The microarray analysis showed that 16 genes(16.7%),such as Smad2,Smad3,Smad7,CoL3A1,CoL1A2,and PAI-1,were upregulated by TGF-?_1 and then down-regulated by glycyrrhizin.Five genes(5.2%)(including BMP7,IGFbp3 and etc.)downregulated by TGF-?_1,were then up-regulated by glycyrrhizin.Finally,2 genes upregulated by TGF-?_1 were then up-regulated predominantly by glycyrrhizin in HSC(T?R2,betaglycan).Changes in some genes,such as Smad2 Smad3,Smad7,were further confirmed to be coincided with cDNA microarray by semi-quantitative RT-PCR.Conclusions The anti-fibrosis mechanisms of glycyrrhizin may be through to interference of TGF-?signaling pathway,decrease the synthesis and increase the degradation of collagen.

ObjectiveTo investigate the effects of infrared radiation and magnetic fields on the synovitis of rabbit with experimental knee osteoarthritis (OA).MethodsTwenty-four New Zealand grown rabbits were duplicated for OA model of the knee by extended fixation technique, and after 6 weeks, all rabbits were unchained from fixation. The rabbits were randomly divided into four groups: control group (no treatment), infrared group (treated with infrared radiation ), magnet-therapy group (treated with magnetic fields ) and the combined therapy group (treated with infrared radiation and magnetic fields). At the ends of the first, second and third week after treatment, 2 rabbits in each group were taken to measure the general change and histopathology of their synovium.ResultsCompared with other groups, the severity of synovitis (include the synovium line cells proliferation, the invading of granulation and blood vessels in the underlayer of synovium, the infiltration of inflammatory cells) declined significantly in combined therapy group. Scores of Ayral's index of combined group were significantly lower than other groups ( P<0.05), and there was no significant difference between infrared group and magnet-therapy group ( P>0.05).ConclusionThe combination of infrared radiation and magnetic fields can efficiently suppress the synovitis of OA and alleviate the tissue's destructions.

Objective To study the MRI manitestation of juvemle acute pure cartilage fracture of the knee joint.Methods The MRI changes of cartilage,subcartilage low signal line and subcartilage bone were analysed retrospectively in 26 juvenile patients with acute pure cartilage fracture confirmed by arthroscopy.Sagittal and coronal MRI scanning were performed in 26 patients.Using fast low angle shot fat saturation T_1-weighted image(FLASH-FS-T_1WI)sequences,spin echo T_1-weighted image(SE-T_1WI)and fast imaging with steady-state precession three dimensional fat saturation T_2-weighted image(FISP-3D-FS- T_2WI)sequences in sagittal plane,SE-T_1WI and multi echo data image combination T_2-weighted imaging (MEDIC or ME-T_2WI)in coronal plane.Using ME-T_2WI sequence,axial plane MRI scanning in 5 patients.Results Twenty-seven sites of 26 patients include 8 patella,7 femoral medial condyle, 11 femoral lateral condyle and 1 tibial plateau.Three types pure cartilage fracture were observed,totally defect of the cartilage in 7 sites(include 3 patella,2 femoral medial condyle,1 femoral lateral condyle and 1 tibial plateau),fissuring fracture in 3 sites(include 2 femoral medial and 1 femoral lateral condyles), superficial defect of the cartilage in 17 sites(include 5 patella,3 femoral medial and 9 femoral lateral condyle).Corpus liberum was found in 21 patients'knee joints by arthroscopy,but only 3 cases by MRI. Bone bruise was detected,and subcartilage low signal lines were normal.Conclusion Using FLASH-FS- T_1WI,SE-T_1WI,FISP-3D-FS-T_2WI and ME-T_2WI sequences,sagittal and coronal MRI scanning in femoral and tibial plateau pure cartilage fractures,and using ME-T_2WI sequence axial scanning in patella r cartilage fractures may show the position,extension and types of the acute pure cartilage fracture of the knee joint. MRI is the hest non-invasive method for studying cartilage fracture.

Objective: To investigate the seroprevalence and influencing factors of serum neutralizing antibodies among SARS-CoV-2 infected individuals, so as to provide the evidence for developing the health management and COVID-19 vaccination strategy among SARS-CoV-2 infected individuals. Methods: Recovered SARS-CoV-2 infected individuals from January 1st, 2020 to February 10th, 2021 in Zhejiang Province were recruited in March 2021. Participants' demographics, underlying diseases, date of definitive diagnosis and severity of clinical symptoms were collected using questionnaire surveys, and serum neutralizing antibody against SARS-CoV-2 was detected using a fluorescent immunoassay. In addition, factors affecting the seropositivity of neutralizing antibody against SARS-CoV-2 were identified using a multivariable logistic regression model. Results: A total of 559 SARS-CoV-2 infected individuals were enrolled, including 480 confirmed cases and 79 asymptomatic carriers, with an median (interquartile range) age of 47.00 (22.00) years, and all participants had never received COVID-19 vaccination. The median (interquartile range) duration from diagnosis to serum sampling was 387.00 (11.00) days, and the seroprevalence of neutralizing antibody against SARS-CoV-2 was 83.90%. The serum neutralizing antibody against SARS-CoV-2 was all positive 9 months after diagnosis, and the seroprevalence of neutralizing antibody against SARS-CoV-2 appeared no tendency towards a decline with time within 14 months after diagnosis (P>0.05). Multivariable logistic regression analysis showed that women were 1.892 times (95%CI: 1.169-3.064) more likely to produce serum neutralizing antibodies against SARS-CoV-2 than men, and mild, common and severe/critically ill SARS-CoV-2 infected cases were 2.438 (95%CI: 1.305-4.557), 4.481 (95%CI: 2.318-8.663), and 23.525 (95%CI: 2.990-185.068) times more likely to produce serum neutralizing antibodies against SARS-CoV-2 than asymptomatic carrier, respectively. Conclusions The seroprevalence of neutralizing antibody was 100.00% among SARS-CoV-2 infected individuals within 9 months after diagnosis. Individuals' gender and severity of clinical symptoms correlate with the seroprevalence of neutralizing antibody against SARS-CoV-2.