To stury the pharmacokinetie of tramadol and aeetaminophen in healthy volunteers. Methods Totally 20 healthy adult male volunteers participated in the study were randomly assigned to 2 treatment groups and were given respectively the dose of one and two pills by oral administration. Serum was separated and the concentrations of tramadol and acetaminophen in human serum were determined by HPLC using fluorescence and UV detector. The values of concentration were directly detected, and AUC was calculated by linear trapezoid method. Results The main pharmacokinetie parameters of tramadol and acetaminophen of 2 dosages groups were as follow: Tramadol: AUC_(0-24h)(ng · h· mL~(-1)) were 2 724. 89 ± 1 016.54 and 1 361.61 + 441. 79; AUC_(0-∞)(ng·h·mL~(-1)) were3 065.49±1 190.66 and 1 555.04±582.51; t_(max)(h) were 1.8±0.75 and 1.9±0.57; t_(t/2)(h) were 7.34±1.39and7.63±2.02; Kel(h~(-1)) were 0. 098±0. 019 and 0. 097± 0.027; Cl_r(mL · min~(-1)) were 31.84±13.65 and 30.03 ± 9.20; MRT(h) were 7.62 ± 1.07 and 7.77 ± 0.75. Acetaminophen. AUC_(0-24h)(μg · h · mL~(-1)) were 40.28 ± 10.36 and 18.37 ± 3.84 ; AUC_(0-∞)(μg · h · mL~(-1)) were 41.63 ± 10. 96 and 18. 81 ± 4.06; t_(max)(h) were 0. 9 ± 0.46 and 0. 9 ± 0. 39; t_(t/2)(h) were5.39 ± 1. 16 and 4. 96 ± 1.03; Kel(h~(-1)) were 0. 13 ± 0. 03 and 0. 15 ± 0. 03; Clr (mL · min~(-1)) were 17.17 ± 4.57 and 18.42 ± 3.89; MRT(h) were 4.86 ± 0.48 and 4.50 ± 0.53. Conclusions No significant difference in pharmacokinetic parameters, such as t_(max), t_(t/2), Ke,Cl, MRT,AUC_(0-t)/dose, AUC_(0-∞)/dose and C_(max)/dose are shown between these two dose groups and a linear pharmacokinetic is featured.

The patient is an 11-year old boy, who was born with universe alopecia as well as dry and coarse skin. When he was 3 months old, photophobia was noticed, and since then, upper respiratory tract infection had occurred twice a month complicated by frequent diarrhea. He had short stature with slight conjunc- rival congestion, corneal vascularization, opacity, coarseness and poor vision. No abnormality was found in the teeth, sweating ability, or hearing. He had universal alopecia; his skin was dry and rough with generalized rhombus- or polygon-shaped scaly patches. Particularly thick brown scales were observed on the upper limbs. Moreover, there were spiny follicular papules on the abdomen and axillae, hyperkeratosis of palm and sole, and dystrophic nails. Hyperextensibility of proximal interphalangeal joints of the third, fourth and fifth fingers was noticed. He also suffered from mental retardation, the verbal intelligence quotient being 52, performance intelligence quotient lower than 40, full intelligence quotient lower than 40, but no abnormality was found in the heart, lung, liver or spleen. Histopathology of skin on the abdomen suggested a change characteristic of ichthyosis. Chromosome analysis revealed a karyotype of 46, XY. This is the first diagnosed case of ichthyosis follicularis with atrichia and photophobia syndrome in China.

Objective To study the clinical significance of changes of plasma nitric oxide (NO) and tumor necrosis factor (TNF) levels in patients with congestive heart failure (CHF).Methods Plasma NO and TNF in 68 CHF cases were tested.30 healthy subjects served as normal controls.Results Plasma NO and TNF levels in CHF patients were obviously higher than those in normal subjects (P

Objective To evaluate the appl ication of CT perfusion in intra-axia l disease. Methods By applying a nuclear medicine data processi ng technique to the time-density data obtained from dynamic CT, cerebral tissue perfusion was p e rformed in 8 cases, 4 with normal findings, 2 with ischemic cerebrovascular dise ase, and 2 with gliomas. Cerebral blood perfusion maps was created and analyzed, absolute regional cerebral blood volume, regional cerebral blood flow, and mean transit time were determined and analyzed as well. Results Wit h regard to var ious degrees of perfusion impairment within the ischemic territory, thus giving rise to a very heterogenous appearance. As a rule, the center of a lesion usuall y representing the core of ischemia showed marked reduction of blood flow. At th e outer margin of a tumor area, the reduction of CBF and CBV was often less pron ounced, indicating some residual flow via collaterals, as was confirmed by the b olus delay on the time to peak time. Conclusion In the near fut ure, functional imaging techniques should have a major impact on therapeutic decision-making i n acute stroke patients, perfusion CT may be recommended even now for emergency applications in daily patient care due to its practicability.

Objective To explore the clinical value of real time contrast-enhanced ultrasound in diagnosis of liver localized fatty deletion and fatty infiltration which couldn't be confirmed by conventional ultrasonography. Methods Contrast-enhanced ultrasound was performed on 94 patients with liver localized diseases confirmed by baseline sonography, among them 34 patients with liver localized fatty deletion and fatty infiltration were enrolled. Results Contrast-enhanced ultrasonography didn't show apparent occupancy nidus in 34 patients. Enhancement mode of lesions was the same as liver parenchyma, which was distinctly different from liver occupancy diseases. Conclusion Real time contrast-enhanced ultrasound can display typical signs of liver localized fatty deletion and fatty infiltration and has significant value in diagnosis and differentiating diagnosis of them.

Objective To explore the effects of formaldehyde (FA) on the contents of CD3, CD4, CD8 and the activity of SOD and the contents of MDA in the spleen and thymus of mice. Methods 30 Kunming mice were randomly divided into 5 groups, 6 in each and treated with FA: the negative control group, 1 mg/m3, 3 mg/m3, 5 mg/m3 and the positive control group (treated with cyclophosphamide, CP). The mice were exposed to FA by static state inhalation in a chamber for 14 days, then the contents of CD3, CD4, CD8, MDA and the activity of SOD in the liver, spleen and thymus were determined. Results The contents of CD3, CD4, CD8 in the spleen and thymus showed a significant decreasing as the exposure dose increasing, an obvious dose-response relation was seen and there were significant differences between FA exposed groups and the control group (P

Objective To observe the clinical efficacy of Zhuang’s tendon manipulations plus fire acupuncture in treating lumbar intervertebral disc herniation (LIDH). Method Sixty patients were randomized into a treatment group and a control group by drawing lots. The treatment group was intervened by Zhuang’s tendon tuina manipulations plus fire acupuncture, while the control group was by tuina manipulations plus acupuncture. The therapeutic efficacies were then observed. Result In the treatment group, 10 subjects were clinically controlled, 11 showed marked effect, 7 were effective, 2 failed, and the total effective rate was 93.3%;in the control group, 5 were clinically controlled, 12 had marked effect, 5 showed effective, 8 failed, and the total effective rate was 73.3%. There was a significant difference in comparing the total effective rate between the two groups (P＜0.05). Conclusion Zhuang’s tendon manipulations plus fire acupuncture can produce a content clinical efficacy in treating LIDH.

BACKGROUND:Posttraumatic osteomyelitis is bone infection after surgery of open fractures or other joint, which leads to more secretions in antrum or bone exposed wounds, long treatment cycle, delayed healing of fracture, even disunion. The key link in the treatment is complete debridement, adequate drainage, and the use of external fixators with low interference and far away from lesions. ＜br> OBJECTIVE:To observe the clinical efficacy of external fixator combined vacuum sealing drainage (VSD) in the treatment of post-traumatic osteomyelitis, and compared with conventional catheter drainage. ＜br> METHODS:Since June 2010 to June 2013, 21 patients of post-traumatic chronic osteomyelitis were included in this study and divided into VSD group (n=11) and conventional catheter drainage group (n=10). Al patients in VSD groups underwent debridement and VSD was used to fil dead space, then the wounds were sutured. Cases appeared nonhealing fractures underwent external fixation, 10 cases using external fixators and 1 case retained original external fixator. Al patients achieved the closed wounds at the second phase, 9 cases were directly sutured, and 2 cases received skin flap transplantation. Among them, 1 case received autologous bone graft at the third phase because of bone defects. In the conventional catheter drainage group, al patients underwent debridement and conventional catheter drainage to rinse the wounds after surgery, 3 cases failing to close the wounds changed to receive ordinary dressing and skin flap transplantation at the second phase. Cases appeared nonhealing fractures underwent external fixation. Local swel ing, pain and fever were observed after treatment. The time of total hospitalization stay and fracture healing was recorded. ＜br> RESULTS AND CONCLUSION:The VSD group quickly control ed preoperative symptoms such as swel ing and pain and fever than the conventional catheter group (P＜0.05). The length of hospital stay showed no significant difference between the two groups (P>0.05). Al patients were obtained through clinic service and fol owed up for 24-36 months. The healing time in the VSD group was shorter than that in conventional catheter group (P＜0.05). Until the end of fol ow-up, no patients in the VSD group appeared infection recurrence, and two cases in the conventional catheter group had recurrent infection. The results suggest that VSD combined with external fixator can repair post-traumatic chronic osteomyelitis due to rapid control of infection, easy care, shortened treatment time, and reduced rate of postoperative recurrence. In addition, external fixator can be used as the final fixation for post-traumatic chronic osteomyelitis.

Objective To investigate tbe pharmacodynamics of different local anesthetics administered intrathecally for caesarean section. Methods Ninety-six parturients with singleton term pregnancies undergoing caesarean section under combined spinal-epidural anesthesia were enrolled in this study. The patients were randomly divided into 3 groups ( n = 32 each ) and received intrathecal (IT) 0.5 % bupivacaine, 0.5 %levobupivacaine and 0.5% ropivacaine respectively. The initial doses was 9 mg in all 3 groups. The ratio of two successive doses was 0.9. If the upper sensory block reached T7 or above and there was no need for additional dose in the 45 min after the initial dose, the IT analgesia was considered to be effective. The median effective dose ( ED50 ), the 95 % effective dose( ED95) and 95 % confidence interval (95 % CI )were calculated by Dixon. Results The ED50 and ED95 and 95%CI of bupivacaine were 6.15 (95%CI 5.48-6.68) mg and 7.62 (95%CI 6.91-11.82) mg; of levobupivacaine were 8.06 (95%CI 7.46-8.62) mg and 9.59 (95%CI 8.86-13.42) mg;of ropivacaine were 10.55 (95%CI 9.73-11.49) mg and 12.80 (95%CI 11.66-21.42) mg. The relative potency potency ratio between bupivacaine, levobupivacaine and rupivacaine is 1.00:0.76:0.58.

Objective To compare the effect of low concentration versus ultra-low concentration of ropivacaine in combination with sufentanil delivered via programmed intermittent epidural bolus (PIEB) with patient-controlled epidural analgesia (PCEA) during labour on obstetric and anesthetic outcomes.Methods Seventy-six ASA Ⅰ or Ⅱ nulliparous parturients who were at full term with a singleton fetus in vertex presentation were randomized to receive 0.1 ％ ropivacaine with 0.5 μg/mL sufentanil (Group L,38 cases) or 0.06％ ropivacaine with 0.5 μg/mL sufentanil (Group UL,38 cases).Another matched 76 cases of primiparas without labor analgesia (Group C) served as controls.For primiparas received analgesia,an epidural catheter was inserted when the cervical dilatation was up to 2-3 cm.The analgesia level was controlled below T8,and VAS score was controlled below 4.Thirty minutes after analgesia started,Group L and UL received PIEB with PCEA regimen including basal infusion of 8 mL/h of ropivacaine with sufentanil,patient-controlled bolus 6 mL and lockout interval 10 minutes.The duration of labor,delivery mode,Apgar score,VAS score and anesthetic drug consumption of each group were recorded.Results The second stage of labor were not statistically different between Group UL and C.The second stage of Group L was longer than that of Group C (P＜0.05).Furthermore,with similar performance in pain score and satisfactory level at each time point,Group UL consumed much less ropivacaine than Group L (P＜0.05).The cesarean section rate,instrumental delivery rate and the Apgar score were not significantly different among the 3 groups.Conclusions While using PIEB with PCEA,0.06％ ropivacaine was capable of providing satisfactory analgesia effects for primipara and has less effects on the obstetric outcome.Therefore,it could be recommended for labour analgesia.