Objective The article was to speed up the dissolution rate of poorly soluble drugs, reduce the configuration time and improve the allocative efficiency by analysis on factors influencing dissolution and adoption of proper allocative approaches accord-ing to different characteristics of insaluble drugs. Methods 5 insaluable drugs were chosen for the study, which were ornithine as-partate, mezlocillin sodium and sulbactam sodium, teicoplanin, omeprazole sodium injection and imipenem and cilastatin sodium.The control group were allocated by routine configuration approach, while the experiment group were improved by increasing the amount of solvent, loosing the powder inside the bottle before configuration, reducing the bubble, adopting special solvent and increasing the dis-solution temperature.Observation and comparative experiment were made on two groups along with the timing from configuration to com-plete dissolution into clear transparent liquid. Results As to the average complete dissolution time of 5 drugs, significant difference was found between two groups([42±5]s vs [246±35]s, [3±1]min vs [30±3]min, [5±1]min vs [10±3]min, [5±3]min vs [10± 5]min, [2±1]min vs [10±1]min, P<0.05).Compared with the control group, the dissolution time of 5 drugs was cut down by 83%, 90%, 50%, 50%, 80%in experiment group. Conclusion Appropriate increase of solvent, loose powder, bubble reduction, special solvent and increased solution temperature contribute to shortening the dissolution time of insoluble drugs and improving the configura-tion efficiency of pharmacy intravenous admixture.

Objective To observe the effect of angiotensin-converting enzyme inhibitor(ACEI) on insulin sensiti-(vity) in dogs with acute myocardial infarction(AMI) after thrombolytic treatment. Methods Twenty dogs were made as AMI models and then underwent thrombolytic treatment.The dogs were divided into the control group(n=10) and the captopril group(n=10) randomly.Insulin,plasma glucose,erythrocyte insulin receptor(EIR),nitrogen(NO) and angiotensin Ⅱ(AT Ⅱ) were(detected) and insulin sensitivity index(ISI) was calculated.The changes of these values in the two groups were contrasted. Results After reperfusion for 120 min,in the control group,ISI and AT Ⅱgot much more rise while EIR and NO fell much more(P

Background Oxidative damage plays an important role in pathogenesis of age-related macular degeneration( AMD ),and its mechanism is the destroy of blood-retinal barrier.Müller cells is a primary component to stabilize the inner barrier of the blood-retina.Researches showed that epidermal growth factor(EGF) can promote the proliferation and migration of animal Müller cells,but less study was found in the effect of EGF on human Müller cells. Objective The present study was to investigate the effects of EGF on the proliferation and migration of human Müller cells and its molecular mechanism. Methods Human Müller cell line MIO-M1 cells were cultured and incubated,and cultured cells were identified using glial fibrillory acidic protein (GFAP),factor Ⅷ,α-smooth muscle actin( α-SMA ),keratin and S-100.Different concentrations of EGF( 0,1,10,30,100 mg/L)was added in freeserum DMEM,and the positive rate of the cells was calculated using 5-bromo-2-deoxyuridine(BrdU) method.The cells were divided into EGF group,H2 O2 group,EGF + H2 O2 group,glucose oxidase ( GO ) group,GO + EGF group,EGF + LY294002+H2O2 group according to the different intervention,and the effects of LY294002 on the proliferation of Müller cells (A590 )were detected by colorimetric assay for cellular growth and survival( MTT assay).The scratch test of Müller cells was used to assess the influence of EGF(0,1,10,30,100 mg/L)on H2 O2-induced damage of human Müller cell.Western blot was used to detect the cell proliferation under the protection of EGF on co-cultured cells using LY294002 and H2O2 and the activation of Akt signal pathways. Results The proliferative rates of the cells were 28.0％,32.9％,39.0％ in 10,30,100 mg/L EGF groups respectively and obviously higher than those in 0,1 mg/L EGF groups (24.5 ％,26.2 ％ ).Under the H2O2 culture,GO culture,respectively,the A570 value of the Müller cell in high concentrations of EGF groups was significantly increased in comparison with lower concentrations EGF groups with the statistical significance among the groups( F=23.582,P=0.000).Compared with EGF+H2O2 group,the A570value of the Müller cells was lowed in EGF+LY294002+H2O2 group.The maximum migration rate of Müller cells was found in 10 mg/L EGF group.Western blot revealed that the presence of H2O2 reinforced the expression of Akt in Müller cells,however,pretreatment with 100 mg/L EGF antagonized the harmful effect of H2O2 on Müller cells.Meanwhile,pretreatment with EGF and LY294002 reduced the expression of Akt in Müller cells. Conclusions EGF can induce the proliferation and migration of human Müller cells with the strongest effect in 10 mg/L.100 mg/L exogenous EGF has a stronger protection to the Müiller cells against H2O2-induced cell damage by activating the PI3KAkt cell survival pathway.

Objective: To analyze the semen quality parameters of sperm donor volunteers, so as to provide insights into male infertility control and related research. Methods: A total of 155 sperm donors were recruited from the Human Sperm Bank of Zhejiang Province using the convenience sampling method from January to March 2021. Demographic information were collected through questionnaire surveys. Semen were collected, and parameters including semen volume, sperm concentration, total number of sperm, forward motility rate and total sperm viability were measured. Semen quality was evaluated according to the WHO Laboratory Manual for the Examination and Processing of Human Semen. : Results Conclusion There were 20.65% of the 155 sperm donors with unqualified semen, and the unqualified rates of forward motility rate and total sperm viability were relatively high.

Objective To investigate the prevalence and pattern of androgenetic alopecia (AGA) in Shanghai through a community-based survey. Methods A cluster sampling survey was done among the residents in Beixinjing Community, Changning District, Shanghai. All the subjects were asked to fill a questionnaire to provide their general information, including sex, age, native place, physical status, life habit, family history, etc. The diagnosis of AGA was made by dermatologists. To determine the pattern of hair loss,Norwood-Hamilton classification system and Ludwig classification system were used for male AGA and female AGA, respectively. All the data were statistically analyzed by EpiData and SPSS11.5 software. Results Totally, 7056 subjects completed the questionnaire, including 3519 males and 3537 females, and the response rate was 72.5%. AGA was diagnosed in 809 patients, consisting of 701 males aging from 19 to 91 years (mean 64.16±11.9 years) and 108 females aging from 35 to 91 years (mean 70.46±18.89 years). The standardized prevalence (SP) was 9.47% in total, 15.73% in males and 2.73% in females; the difference was significant between males and females (χ2=356.00, P<0.001). A family history of AGA was observed in 52.7% of all subjects including 391 (55.78%) males and 35 (32.41%) females. Type Ⅲ vertex involvement was the most common type in men aging from 20 to 70 years old, and type Ⅵ in those over 70 years old. Grade Ⅰ and Ⅱ predominated in female AGA. Conclusions The results of this survey indicate that the prevalence of AGA is remarkably higher in men than that in women. Furthermore, the prevalence is steadily increased with advancing age in Shanghai.

Objective　To observe the changes of glucocorticoi d receptor (GR) in hepatic cytoplasm in rats after scalding-induced pathologic al stress and its regulation. Methods　The receptor binding capa city (R0) and the apparent dissociation constant (Kd) of GR in hepatic cytopla sm of normal, low-degree and heavy-degree scalded rats were measured with rad io-ligand binding assay, with ［3H］ dexamethasone as ligand. The changes of R0 and Kd of GR were regulated by injections of anti-rat TNFα, IL-1β a ntibodies, α-melanocyte-stimulating hormone (α-MSH), and KPV peptide( Ac- D-Lys-L-Pro-D-Val) respectively in vivo. Results　The R 0 of GR in hepatic cytoplasm in rats 12 h after heavy-degree scalding ［Mass action robust: （205.52±30.14） fmol/mg; Scatchard: （208.45±30.78） fmol/mg ］were significantly lower than that of control group ［Mass action robust:（307 .86±24.22） fmol/mg;Scatchard:（306.71±27.96） fmol/mg］(P<0.01), but no s ignificant difference was found in the R0 of GR between the control and the ra ts 12 h after low-degree scalding ［Mass action robust: （285.19±16.62） fmol/ mg ; Scatchard: （296.64±16.06） fmol/mg］. The injection of anti-rat TNFα, IL-1β antibodies, α-MSH and KVP all prevented the decline of R0 of GR in h epatic cytoplasm in rats with severe scalding. Conclusion　The injections of anti-rat TNFα, IL-1β antibodies, α-MSH or KPV can attenuate the reduction of GR in rat hepatic cytoplasm caused by severe scalding-induced pathological stress to some extent.

Objective: To summarize the peri-operative management experience of pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods: A total of 56 CTEPH patients received PEA in our hospital from 2015-01 to 2016-11 were retrospectively analyzed. Our study was focused on the medication in respiratory and circulatory system during ICU stay, peri-operative application of vasoactive drug and target drug to pulmonary hypertension (HP), usage of ventilators, mechanical assisted devices and other management experiences. Results: No peri-operative death occurred. There were 2/56 (3.6%) patients with lung reperfusion, 2 (3.6%) with PH crisis. Compared with pre-operation, the post-operative pulmonary artery hemodynamics parameters were improved as right heart catheter measured pulmonary artery systolic pressure (PASP) decreased from (85.05±22.40) mmHg to (36.83 ±17.21) mmHg and pulmonary vascular resistance decreased from (773.84±342.95) dyn·s·cm-5 to (293.59±214.95) dyn·s·cm-5. Post-operative oxygen saturation was maintained at (95-100) % in all patients. Echocardiography found that PASP from pre-operation (85.03±25.78) mmHg decreased to (39.44±19.24) mmHg at follow-up period, P<0.01.Conclusion: A comprehensive peri-operative management of PEA was helpful to improve pulmonary hemodynamics in CTEPH patients; meanwhile, effective prevention and treatment of severe complication could obviously reduce peri-operative mortality.

OBJECTIVETo compared the efficacy of drug-coated balloon and common balloon for treatment of superficial femoral artery and popliteal artery occlusive disease.

METHODSForty-six patients were admitted for ipsilateral single or multiple superficial femoral artery and/or popliteal artery lesions (between 3 and 15 cm stenosis or occlusion), Rutherford grades 2 to 5, with or without other accompanying diseases in the Department of Interventional Vascular Therapy of the First Hospital of Nanjing between September, 2015 and December, 2016. The patients were randomly assigned into drug-coated balloon (DCB) group (n=23) and common balloon (CB) group (n=23). None of the patients had stent restenosis, aneurysms, acute thrombosis, pregnancy, life expectancy less than 1 year, or below-the-knee artery occlusion. The late lumen loss (LLL), improvement of the ankle brachial index (ABI), improvement of Rutherford grade, incidence of restenosis, thrombosis rate and amputation rate were compared between the two groups at 6 months after treatment.

RESULTSThe two groups of patients were comparable for general conditions, risk factors, and characteristics of the compromised vessels (P>0.05). Six months after treatment, the patients in DCB group showed significantly smaller LLL, more obvious improvement of the ABI and Rutherford grade, and lower restenosis rate and thrombosis rate than those in CB group (P<0.05). The amputation rates were similar between the two groups (P>0.05).

CONCLUSIONSDCB shows obvious advantages over common balloon for treatment of superficial artery and popliteal artery arteriosclerosis obliterans in that it more effectively reduces LLL, restenosis rate and thrombosis rate and improves the ABI and Rutherford grade at 6 months after the treatment.

OBJECTIVETo investigate the limiting effect of pelvic diameters on the technical difficulty of total mesorectal excision(TME) for rectal cancer by computed tomography pelvimetry.

METHODSFrom January 2009 to January 2011, 69 patients with rectal cancer underwent TME in the Department of Proctology at the Changhai Hospital in Shanghai. There were 55 males and 14 females. Using three dimensional reconstruction software, pelvic dimensions of rectal cancer patients were measured based on pelvic MDCT thin-slice computed tomography. All the patients were measured for 15 pelvic parameters, including the length of pelvic inlet, the length of pubic symphysis, the interspinous distance, the distance from sacral promontory to tip of coccyx, etc. All the procedures were open surgery, including anterior resection(n=19), low anterior resection and ileostomy(n=29) and abdominal perineal resection(n=21). Duration of the operation and blood loss at surgery were recorded as evaluation indicators of the technical difficulty of total mesorectal excision. By univariate analysis significant pelvic parameters were selected. Multiple regression analysis was used to investigate the relationship between pelvic parameters and blood loss or duration of operation.

RESULTSThe mean operative time was(139.9±32.4) min and the mean intraoperative blood loss was (228.8±150.6) ml. Multivariate analysis showed that the interspinous distance, the length of pelvic inlet, the distance from sacral promontory to the tip of coccyx were the main factors affecting the operation time, and that the length of pubic symphysis and the distance from sacral promontory to the tip of coccyx were the main factors affecting the amount of blood loss (all P<0.05). Among the 3 procedures, the multivariate analysis for low anterior resection appeared to be most valuable, in which operative time was associated with the distance from sacral promontory to the tip of coccyx and the interspinous distance (adjusted coefficient of determination of the regression equation, Rc(2)=0.460, P=0.003). Factors associated with intraoperative blood loss were the length of pelvic inlet, the distance from sacral promontory to the tip of coccyx, and the sacrum-pubis angle(Rc(2)=0.358, P=0.022). Comprehensive analysis of the measurement parameters showed that the ratio between the length of pelvic inlet and the distance from sacral promontory to the tip of coccyx was associated with the operative time and blood loss. This ratio was significantly higher in female patients than that in males. In females with a ratio greater than 1, the operative time was significantly shorter(P=0.050), and the intraoperative blood loss was significantly less in males with a ratio greater than 0.9(P=0.021).

CONCLUSIONSOperative time and intraoperative blood loss for total mesorectal excision are more favorable in patients with a wide and shadow pelvis. Surgical difficulty is increased in deep and narrow pelvis or those with major sacrum curvature. The difficulty of total mesorectal excision procedure can be predicted by measuring the length of pelvic inlet and the distance from sacral promontory to the tip of coccyx.

Adult ; Aged ; Aged, 80 and over ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Mesentery ; diagnostic imaging ; surgery ; Middle Aged ; Pelvis ; diagnostic imaging ; Rectal Neoplasms ; diagnostic imaging ; surgery ; Tomography, Spiral Computed ; methods

OBJECTIVE: To evaluate the value of early identification and endovascular treatment of iliac vein compression syndrome (IVCS), with or without deep vein thrombosis (DVT). MATERIALS AND METHODS: Three groups of patients, IVCS without DVT (group 1, n = 39), IVCS with fresh thrombosis (group 2, n = 52) and IVCS with non-fresh thrombosis (group 3, n = 34) were detected by Doppler ultrasonography, magnetic resonance venography, computed tomography or venography. The fresh venous thrombosis were treated by aspiration and thrombectomy, whereas the iliac vein compression per se were treated with a self-expandable stent. In cases with fresh thrombus, the inferior vena cava filter was inserted before the thrombosis suction, mechanical thrombus ablation, percutaneous transluminal angioplasty, stenting or transcatheter thrombolysis. RESULTS: Stenting was performed in 111 patients (38 of 39 group 1 patients and 73 of 86 group 2 or 3 patients). The stenting was tried in one of group 1 and in three of group 2 or 3 patients only to fail. The initial patency rates were 95% (group 1), 89% (group 2) and 65% (group 3), respectively and were significantly different (p = 0.001). Further, the six month patency rates were 93% (group 1), 83% (group 2) and 50% (group 3), respectively, and were similarly significantly different (p = 0.001). Both the initial and six month patency rates in the IVCS patients (without thrombosis or with fresh thrombosis), were significantly greater than the patency rates of IVCS patients with non-fresh thrombosis. CONCLUSION: From the cases examined, the study suggests that endovascular treatment of IVCS, with or without thrombosis, is effective.
Adolescent ; Adult ; Aged ; *Angioplasty, Balloon ; *Balloon Dilatation ; Constriction, Pathologic/therapy ; Diagnostic Imaging ; Female ; Humans ; Iliac Vein/*pathology/surgery ; Male ; Middle Aged ; Peripheral Vascular Diseases/complications/diagnosis/*therapy ; Retrospective Studies ; *Stents ; Thrombectomy ; Vascular Patency ; Vena Cava Filters ; Venous Thrombosis/complications/diagnosis/*therapy