OBJECTIVE:To establish a method for separation and determination of ethanol,dichloromethane and N,N-dimethylformamide in pidotimod tablets.METHODS:The residual organic solvents were quantitatively determined by GC on DB-624 capillary column with FID detector,using nitrogen as the carries gas.Temperature programming was carried out in which the column temperature was initially maintained at 40 ℃ for 5 minutes,then increased at a rate of 50 ℃ per minute to 200 ℃,and maintained at 200 ℃ for at least 10 minutes.The temperature at injection mouth was maintained at 160 ℃;the detector temperature was maintained at 280 ℃.The split ratio was 5∶1.RESULTS:3 residual organic solvents were completely separated and their determination was free of inference from hidden foreign substances.The linear ranges of the ethanol,dichloromethane and N,N-dimethylformamide were 10.036～802.88 (r=0.999 9),26.44～105.76 (r=0.999 6),and 1.76～140.8 (r=0.999 5) ?g?mL-1,respectively,and their average recovery rates were 102.4%,99.0%,and 99.2%,respectively,with RSD at 1.99%,3.34%,and 0.55%,respectively.CONCLUSION:The method is sensitive,accurate and rapid,and it is suitable for determination of residual organic solvents in pidotimod tablets.

Objective To investigate the factors associated with hospital infection in old inpatients with Alzheimer's disease. Methods 368 old inpatients with Alzheimer's disease were reviewed and analyzed with Logistic regression. Results There were 95 cases (25.81%) suffered in hospital infection to 116 case-times. As multivariate regression analysis, activities of daily living (OR=8.398, 95% CI: 5.343~12.098), invasive intervention (OR=2.842, 95%CI: 1.445~3.365), no insight (OR=4.457, 95%CI: 2.789~8.853), long-term use of antibiotics (OR=3.348, 95%CI: 1.693~6.336), chronic in bed (OR=3.258, 95%CI: 1.583~6.154), and antipsychotic drug (OR=2.243, 95%CI: 1.427~5.583) increased the risk of hospital infection independently, and ventilated timely (OR=0.546, 95%CI: 0.334~0.867) reduced the risk. Conclusion Good performance of basic and living nursing, less invasive intervention, reasonable use of antibiotics, antipsychotic monitoring,and intensive sterilization may reduce the incidence of hospital infection in inpatients with Alzheimer's disease.

Transforming growth factor-? (TGF-?) is a multifunctional peptide growth factor with a wide range of effects. TGF-? signals are conveyed through cell-surface serine/threonine kinase receptors to the downstream cytoplasmic mediators, known as Smads proteins. Receptor-regulated Smads become phosphorylated by activated type Ⅰ receptors and form heteromeric complexes with a common Smad-Smad4, which translocates into the nucleus to regulate gene transcription. Inhibitory Smads inhibit the activation of receptor-regulated Smads. There are positive, negative and feedback regulations in the Smads mediated TGF-? signaling pathway.

Sixty five stroke patients undergoing rehabilitation training in our hospital from May 2010 to May 2013 were randomly divided into study group (n =32) and control group (n =33).Patients in study group received intramuscular injection of botulinum toxin A (BTX-A) in the affected limbs before rehabilitation training started.The F wave amplitude and F/M value,muscle tension and TUG test and 10 m free walking test results of patients in two groups were observed before and 4 weeks after treatment.Compared to the results before treatment,the amplitude of F wave and F/M value after 2 and 4 weeks of treatment in study group decreased significantly (P ＜ 0.05).Compared to control group,the indexes at each time point after treatment in study group were significantly different (P ＜ 0.05).The muscle tension score in study group after 4 weeks of treatment decreased significantly (P ＜ 0.05),and also lower than that in control group (P ＜ 0.05).Before treatment there were no significant differences in TUG test and 10 m free walk test between two groups (P ＞0.05) ; while TUG test and 10 m free walk test in study group were better than those in control group after 4 weeks of treatment (P ＜ 0.05).The TUG test and 10 m free walk test had little improvement in control group after treatment (P ＞ 0.05).The results indicate that botulinum toxin A injection can reduce amplitude of F wave in the corresponding segment of spinal cord motor neurons and improve the walking ability of stroke patients.

Objective To study the correlation with ketamine and its metabolite norketamine concentration in plasma and saliva in acute toxic rabbits.Methods Experimental rabbits were given intragastric(i.g.group,n=6)and intravenous(i.v.group,n=6)administration of ketamine respectively,and control tabbits(n=6)were given a same volume of physiologic saline.The plasma and saliva were collected before and after ketamine administration.Ketamine and norketamine in plasma and saliva were determined using GC/MS and GC.The correlation with ketamine(norketamine)concentration in plasma and saliva were artalyzed by a double variable Pearson correlation analysis.Results The correlation coefficients(r)of ketamine (norketamine)concentrations in plasma and saliva were from 0.80 to 0.95 in ketamine i.g.group and i. v.group.Conclusion There is a good relativity between the concentration of ketamine(norketamine)in plasma and in saliva.The ketamine(norketamine)concentration in saliva can be used to estimate the plasma concentration in the forensic identification of ketamine abuse.

Objective To study high resolution CT (HRCT) and MRI findings of temporal bone anomaly in patients with tinnitus and identify the optimal examination method in the detection of the anomaly. Methods The HRCT and MRI data were analyzed retrospectively in 1015 patients including 145 patients with pulsatile tinnitus (PT) and 870 patients with nonpulsatile tinnitus (NPT). The positive rates of HRCT and MRI in the identification of temporal bone anomaly were analyzed and the efficiency of various examination methods was compared in revealing the anomaly. Data were tested by Chi-square test analysis. Results Among 1015 patients, anomaly was seen in 767 cases (75.57%). High jugular bulb was found in 414 patients, accounting for 40. 79%. Sigmoid sinus anomaly was detected in 387 patients (38. 13%), while otitis media was found in 148 cases (14. 58%), and low middle cranial fossa in 70 cases (6. 90%). The positive rate of HRCT in the detection of high jugular bulb was 54. 89% (365/665), which was significantly higher than those of other methods (P ＜ 0. 05). The positive rate of enhanced HRCT in showing sigmoid sinus anomaly was 73.68% (56/76), which was significantly higher than those of other methods(P ＜0. 05). Sigmoid sinus anomaly was the most frequent finding in patients with PT, accounting for 66. 21% (96/145). The incidence of sigmoid sinus anomaly was higher in PT than in NPT (291/870,33.45% ;χ2 =56. 537 ,P ＜0. 01). The fast imaging employing steady-state acquisition (FIESTA) sequence was the best examination method in displaying the vessel within the internal auditory canal (42/42,100%).Conclusions High jugular bulb and sigmoid sinus anomaly were the most frequent abnormal findings of temporal bone in patients with tinnitus. Enhanced HRCT was the choice of modality in patients with PT.Plain HRCT was recommended for NPT. FIESTA sequence was the best in the evaluation of the vessel within the internal auditory canal.

Objective To investigate the effects of Tirofiban on the expression of matrix metalloproteinase(MMP-9)and sCD40L in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI)and to explore the potential mechanism of anti-artherosclerosis and stabilize plaque by Tirofiban.Methods Eighty-six patients with ACS were enrolled and were randomly divided into the control group and the Tirofiban group with different time periods after PCI.The expression of MMP-9 and sCD40L were tested by ELISA at 6 h,12 h,24 h,36 h after PCI.Results After application of Tirofiban 6 h,12 h,24 h,36 h,the expression of MMP-9 decreased from(228.25 ±0.015)ug/L to(53.56 ±0.02)μg/L and the expression of sCD40L decreased from(321.12 ±0.02)ng/L to(123.32 ±0.02)ng/L,compared with the control group,the difference was significant(P ＜ 0.05).Conclusions Tirofiban can inhibite the expression of sCD40L and MMP-9,the inhibition of the expression of MMP-9 may be related to the CD40/CD40L pathway.This effect may be one of the mechanism of reducing atherosclerotic plaque inflammation and preventing plaque rupture by Tirofiban.

Objective To analyze the resistant profile and genotypes ,as well as susceptibility to tigecycline in carbapenemase‐producing K lebsiella pneumoniae for better clinical management of such infections .Methods Nine strains of carbapenemase‐producing K .pneumoniae were isolated from clinical specimens during the period from February 2012 to May 2013 in our hospital .Bacterial identification and antimicrobial susceptibility testing were carried out with VITEK 2 Compact automatic microbiological assay systems .The phenotype of carbapenemase‐producing K . pneumoniae was detected by modified Hodges test .The genotype of carbapenemase was identified by PCR method .The susceptibility to tigecycline was tested by E‐test . Results All the 9 strains of carbapenemase‐producing K . pneumoniae were resistant to the 19 antibiotics tested .Modified Hodges test was positive for 7 strains (77 .8% ) .Target band of carbapenemase gene was identified in all the 9 strains of K . pneumoniae ,and all were confirmed as KPC‐2 gene .All the 9 strains were susceptible to tigecycline .Conclusions The resistance of carbapenemase‐producing K .pneumoniae is still serious .Tigecycline has shown good in vitro activity against such strains .

OBJECTIVE To analyze the incidence of anatomic variations of the temporal bone to provide valuable reference for clinical otology. METHODS Sev-enty six healthy adults (152 ears) and 66 patients(96 ears) with chronic suppurative otitis media confirmed by clinical examination underwent axial and coronal High-resolution Computed Tomography(HRCT) scan. The incidence of high jugular bulb, dehiscent jugu-lar bulb, anterior location of sigmoid sinus, low-lying middle cranial fossa, dehiscent tegmen tympani, mas-toid antrum dysplasia, aberrant internal carotid artery, and large sinus tympani were recorded. RESULTS In normal, abnormal, well and poorly pneumatized groups, the incidence of highly positioned jugular bulb on the right was higher than that on the left. The total inci-dence of high jugular bulb on the left and right was 26.2 % and 46.0 % respectively. The incidence of ante-rior location of sigmoid sinus in the abnormal group (32.3 %) was higher than that in normal group(15.8 %), which was higher in poorly pneumatized group(43.5 %) than that in well pneumatized group(11.3 %). The inci-dence of dehiscent tegmen tympani in well pneuma-tized group(18.0 %) was higher than that in poor pneu-matized group(8.7 %). There was no significant differ-ence in dehiscent jugular bulb, low-lying middle cranial fossa, mastoid antrum dysplasia, aberrant internal ca-rotid artery, and large sinus tympani between the left and right within and among groups. The incidence of these varia-tions was 2.0 %,21.8 %,1.2 %,0.4 %,0.8 %respectively. CONCLUSION HRCT can show ana-tomic variances of temporal bone clearly before opera-tion and has great clinical value for reducing the inci-dence of complications caused by middle ear operation.

Objective To study angiography features and clinical significance of "multiple tumor feeding embolization".Methods Twelve patients with pelvic tumor were reviewed retrospectively.The lesions included fibrosarcoma(n=1),chondrosarcoma(n=2),osteosarcoma(n=2) and metastatic tumor(n=7).Results Angiography features were:(1)multiple origin and branch of tumor-feeding vessels.(2)large vascular mass with dense tumor stain.(3)larger size of tumor stain comparing with that of bone destraction.After treatment,symptom relief and tumor shrink were obviously using"the multiple tumor-feeding embolization".Conclusion Angiography features of pelvic tumor are great value in guiding the clinical therapy.