Objective To evaluate the treatment of acute cerebral infarction of 4 kinds of drug cost-effective-ness.Methods A retrospective analysis was performed on 207 patients with acute cerebral infarction,according to the drug formulation of patients treatment,they were divided into four groups: group A (alprostadil),group B(Oza-grel),group C(Dan red injection),group D(Xuesaitong),the curative effects and adverse reactions were observed and analyzed by using pharmacoeconomic cost-effectiveness method.Results The costs of groups A,B,C and D were 5 248.6,4 253.7,4 475.8,3 501.2 yuan,respectively;The effective rates were 92.2%,83.7%,87.5%,76.9%, respectively;The cost effectiveness ratio(C/E) were 56.93,50.82,51.15,45.53,respectively;A,B,C group compared with the incremental cost-D group,the effect of ratio(△C/△E) were 107.2,110.7,91.9;The incidence of adverse reactions were 3.9%,6.1%,12.5%,11.5%.Conclusion Alprostadil group scheme was the best treatment scheme.

Objectives Pancreatic ischemia is a pathogeny of acute pancreatitis(AP), and systemic blood rheologic changes have close relationship with AP. The aim of this study was to investigate the potential role of the systemic blood rheologic and pancreatic hemodynamic changes in rats with AP, and to reveal their relationship. Methods Acute edematous pancreatitis(AEP, n =20) and acute necrotizing pancreatits(ANP, n =20) models were induced by injection of sodium taurocholate into the pancreatic duct of rats, another 10 normal rats were used as control group. The pancreatic blood flow(PBF) was measured by Doppler ultrasound before and after the operation. At 12 h after the induction of AP, 10 rats in each group were sacrificed, the blood rheologic indexes were detected, and the pathological study of pancreas was performed. The survival rate in 3 days of the rest 10 rats in AEP and ANP group was also observed. Results Compared with the control group, only the hemagglatination index increased in AEP group and all the blood rheologic indexes increased in ANP group distinctly with the elevation of blood viscosity curve. The velocity of PBF was decreased in AEP and ANP groups, reducing to 79% and 30% of theirs levels before the induction of AP. Compared with the control group, the pathological scores of pancreatic edema, inflammation, hemorrhage and necrosis of AEP rats significantly increased, and compared with AEP group, these four indexes increased significantly in ANP rats. The survival rate in 3 days of AEP group was 90%, but that of ANP group was 0. Conclusions Systemic blood rheologic and pancreatic hemodynamic changes happen synchronously in rats with AP. The injury of pancreatic microcirculation due to ischemia is one of the initial pathogeneses of AP. The change of blood rheology is not a contributing factor causing AP, it could aggravate pancreatic ischemia and accelerate the pancreatic injury after onset.

Aseptic loosening of the prosthesis due to periprosthetic osteolysis is one of the main causes that affect the service life following artificial joint replacement. The patient should undergo revision of artificial joints,but the surgery is of high difficulty,high risk and excessive cost,etc. Therefore,using nonsurgical technique to control artificial prosthesis osteolysis is an urgent and realistic task. Currently,the drug prevents osteolysis through inhibiting osteoclast bone resorption,responding to cytokines,and promoting bone formation. In addition,gene therapy and other treatments for osteolysis are under exploration.

To observe the effects pf propofol combined with fentanyl on metabolic rate of energy cxpen diture in anesthesia. Method: Thirty-one elective neurosurgical adult patients, ASA class Ⅰ-Ⅱ, received tolal intravenous anesthesia with propofol combined with fentanyh Oxygen consumption (VO_2), carbon dioxide production (VCO_2), respiratory quotient(RQ), metabolic rate(MR)were measured. Resuh: VO_2 and MR increased when patients' posture changed or there existed strong operative stimulation. VO_2 and MR during post induction were 91.09% and 91.29% of the level before anesthesia respectively(P

Objective To develop a method for simultaneous determination of benzodiazepines in human whole blood by SPE-Micellar electrokinetic capillary chromatography.Methods With the Clenbuterol as internal standard,Oasis column was used to extract the drugs from whole blood.The separation was performed on a fused-silica capillary of 75?m ID?50.2cm(40cm of effect length).The running buffers were sequentially used as 15mmol/L phosphates→15mmol/L sodium borate(pH8.2)→30 mmol/L SDS,and 18% methanol served as an organic modifier.Sample solution was injected with pressure mode,and the running voltage was 25kV.The detection wavelength was set at 230nm.Results The linear ranges of the calibration curves were from 0.02 to 1.6?g/ml,and the limits of detection ranged between 5 ng/ml and 50 ng/ml.The within-day and between-day precision was less than 12%.Conclusion The method developed for determination of benzodiazepines in human whole blood is effective,simple and reliable,with which 9 benzodiazepines may be simultaneously separated.

Objective To evaluate the effects of mild-hypothermia therapy on coagulation and prognosis in patients with severe traumatic brain injury(sTBI). Methods Forty sTBI patients with Glasgow coma score(GCS) 3-8 were randomly divided into normal temperature-treatment control group(NT group)and hypothermia-treatment group(HT group),each 20 cases. Both groups were given conventional therapy,and HT group was additionally given mild-hypothermia therapy. The values of prothrombin time(PT),activated partial thromboplastin time(APTT), thrombin time(TT) and concentrations of plasma fibrinogen(Fg),D-dimer(DD)in two groups were monitored dynamically. The incidences of frequently seen blood coagulation related complications,such as delayed hematoma, hyper-fibrinolysis,cerebral infarction were counted,and 3 months after injury,the standard glasgow outcome scale (GOS)was applied to assess the prognosis. Results The values of PT,APTT and TT were significantly shorter and reached their valley values after 12 hours in NT group〔PT(s):10.6±0.8 vs. 11.6±1.2,APTT(s):16.7±1.2 vs. 20.8±1.4,TT(s):9.8±0.8 vs. 13.6±0.8〕,the concentrations of plasma Fg,DD were obviously increased and reached their peak values after 12 hours〔Fg(g/L):3.2±0.9 vs. 2.5±0.8,DD(μg/L):4 126.7±1 170.3 vs. 873.5±140.2〕,which showed that hypercoagulability appeared in the first 12 hours after injury in NT group,and after 12 hours turned into hyper-fibrinolysis. However,the values of PT,APTT,TT extended slowly until 12 hours reaching to their peak values〔PT(s):14.4±0.9 vs. 10.9±1.0,APTT(s):45.4±1.0 vs. 20.2±1.0,TT(s):25.3±1.2 vs. 13.0±0.6〕,the concentration of plasma Fg declined gradually until 12 hours to its valley value(g/L:1.8±0.7 vs. 2.3±0.6)and then back to normal,the concentration of DD rose gradually until 12 hours reaching to its peak value(μg/L:3 079.8±947.6 vs. 795.6±120.7)and then back to normal at 72 hours in HT group. The time of recovery for above indexes in HT group was earlyer than that in NT group. The incidence of delayed hematoma in NT group was higher than that of HT group(10%vs. 5%),but there was no statistical significant difference between the two groups(P>0.05),and the incidences of hyper-fibrinolysis(5% vs. 35%,P<0.05)and cerebral infarction (0 vs. 25%,P<0.05)in HT group were obviously lower than those in NT group. The rate of good therapeutic effect was higher(30% vs. 5%,P<0.05),and mortality lower(10% vs. 25%,P<0.05)in HT group than that of NT group. Conclusion Mild-hypothermia therapy can ameliorate coagulation dysfunction, reduce morbidity of coagulation related complications,and can improve the prognoses of patients with sTBI.

Objective To discuss the significance of acoustic rhinometry(AR) and rhinomanometry(RM) in the evaluation of surgical treatment of nasal septal deviation.Methods Fifty-one patients of nasal septal deviation were recruited,and seventy-two nasal cavities were tested(twenty-one patients with narrowing of double sides).Visual analogue scale(VAS) was used to estimate the degree of nasal obstruction.AR and RM were used to obtain the data of nasal airway resistance(NAR),nasal cavity 0-5cm volume(NCV0-5) and nasal minimal cross-sectional area(NMCA).The data were used to assess the airflow function of nasal cavity.Each patient was tested at the time both before surgery and 12 weeks after surgery.The pre-and post operative data were used to calculate paired t-test by SPSS 16.0,and to disclose the correlation among ?NCV,?NMCA,?NAR and ?VAS.Results The preoperative data showed that NCV0-5 was 4.07?0.91cm3,NMCA 0.33?0.08cm2,NAR 1.14?0.34kPa?s?L-1,and VAS 7.36?1.23;and the postoperative data showed that NCV0-5 was 7.29?0.68cm3,NMCA 0.56?0.08cm2,NAR 0.35?0.12kPa?s?L-1,and VAS 1.14?0.91.Significant differences existed in NCV0-5,NMCA,NAR and VAS(P

BACKGROUND: Environment pollution due to lead is severe day by day,and the lead-induced developmental toxicity of central nervous system is prominent.OBJECTIVE: To observe the effect of lead at low exposure level on neurobehavioral function of preschool children and provide basis for preventing childhood behavior disorders.DESIGN: Sampling survey.SETTING: Department of Children and Adolescent Health, Public Health College, Sun Yat-sen University.PARTICIPANTS: Totally 211 children of 4-6 years (109 boys and 102girls) were enrolled from a kindergarten of a populated area of Zhuhai City by randomized cluster sampling from September to October 2004.METHODS: 20 mL peripheral blood of finger tip was collected. Blood lead was determined with graphite stove atomic absorption spectrometry.According to the amount of blood lead, the children were divided into high blood lead exposure group (＞100μg/L) and low blood lead exposure group (＜100μg/L). Furthermore, they were also assigned into ＜50 μg/L group, 50μg/L- group, 100μg/L- group, 150 μg/L- group, 250- μg/L group. Achenbach's Child Behavior Checklist (CBCL) and self-designed questionnaire (composed of possibly effective factor on children's neurobehavioral function, such as age, sex, cultivation, family background and so on) were applied, filled by their parents under the instruction of professional staffs. Results and blood lead value were analyzed with first order correlation and multiple factors stepwise regressive analysis.MAIN OUTCOME MEASURES: ①Blood lead level and each factor scores of CBCL, ②correlation analysis between blood lead value and behavioral factor score.RESULTS: A total of 211 questionnaires were sent out, and 211 were retrieved with 211 effective questionnaires. The effective rate was 100%. ①Score on externalizing and behavioral disorder rate in the high blood lead exposure group (13.28±6.26,18.26%) was significantly higher than those in the low blood lead exposure group (9.98±5.46,7.29%)( t=4.067 7,χ2=5.470, P＜0.05). There was insignificant difference in score on internalizing and total score of CBCL between the low and high blood lead exposure groups. ②The behavioral disorder rate of different blood lead level had significance (χ2=13.695,P＜0.01). The behavioral disorder rate in blood lead ≥ 150 μg/L was obviously higher than that of the former 3groups after further pairwise comparison (χ2 were 4.727, 6.261, 5.168;4.503, 5.911, 4.928, P＜0.05), which revealed that the child behavioral disorder rate markedly increased when the blood lead was ≥ 150 μg/L.③Blood lead logarithm value had positive correlation with the scores on hyperactivity, aggression and defiance (r=0.316 4,0.282 8,0.188 6,P ＜0.05), and had no correlation with obesity, desintegration, truculence and sexual questionnaire (r=0.102 4,0.094 2,0.118 3,0.092 6,P ＞ 0.05). ④After the stepwise regression analysis, the scores on hyperactivity, aggression and defiance factors were included in the regression equation. The results suggested that the effect of lead on child externalizing behavior still remained, and kept statistical meaning after confounding factors, such as controlling family and society, etc.CONCLUSION: Low-level lead exposure has adverse effects on externalizing behavior in preschool children.

Objective To evaluate the clinical value of gasless video-assisted endoscopic thyroidectomy by infraclavicular wall.Methods 15 cases received gasless video-assisted endoscopic thyroidectomy by infraclavicular wall.13 cases underwent total thyroidectomy,2 cases underwent subtotal thyroidectomy.All 15 cases were protected recurrent laryngeal nerve and parathyroid by inspecting during the operation.Results All 15 patients were cured without hoarse and tetany,and the flaps without hematomas and extravasated blood.Conclusion Gasless video-assisted endoscopic thyroidectomy by infraclavicular also can reach the principle demand by the tradional opening way.As the supremacy way of aesthetic and hidden,it can be used to the patients who want high request on faces.

Objective To detect the excision repair cross-complementing gene 1 (ERCC1) and thymidylate of the acid synthase (TS) in non-small cell lung cancer (NSCLC) and its adjacent tissue,and investigate the relationship of the expression of ERCC1 and TS with the clinical characteristics of NSCLC and prognosis for NSCLC individual therapy to provide experimental basis.Methods The protein expression levels of ERCC1 and TS in 50 cases of postoperative NSCLC cancer and adjacent tissue were detected by immunohistochemical method and the relationship among the expression of ERCC1,TS,and overall survival of patients with NSCLC Phase (OS),disease progression time (TTP),the median OS,and median TTP was analyzed.Results (1)There was an obvious difference between the expression of ERCC1,TS in cancer and paraneoplastic tissue of NSCLC,which had statistically significance (64.00％ vs 20.00％,x2 =19.87,P ＜ 0.01 ;48.00％ vs 24.00％,x2 =6.25,P ＜ 0.05) ; (2)The continued investigation in the patients who received postoperative cisplatin or carboplatin chemotherapy showed that the 0S of negative expression of ERCC1 was significantly longer than the positive one (19.10 vs 10.00 months;x2 =8.133,P =0.002),so was median TTP (15.30 vs 9.00 months; x2 =7.410,P =0.003).The median 0S of the negative expression of TS,was significantly longer than the positive one (17.80 vs 11.00 months,x2 =7.001,P =0.008),so was median TTP (11.40 vs 6.80 months; x2 =5.884,P =0.026).Conclusions ERCC1 and TS protein may become sensitive predictors of platinum chemosensitivity for NSCLC patients ; the detection of combined with ERCC1 and TS would contribute to the selection of individualized treatment programs for NSCLC.