OBJECTIVE: To establish a RP - HPLC method for simultaneous determination of the concentrations of phe-nobarbital, phenytoin and carbamazepine in serum.METHODS: Phenobarbital, phenytoin and carbamazepine were extracted from serum with CH2Cl2 and analysed using C18 column with mobile phase consisting of methanol - water(57 : 43); the column temperature was 30℃ ; the detecting wavelength was 254nm and the flow rate was 0.8ml/ min.RESULTS: The calibrating curves of phanobarbital, phenytoin and carbamazepine were linear in the ranges of 2.5 - 40, 2.5-40 and 1.25-20?g/ ml respectively .The within- day and between- day RSDs were less than 10% (n = 5) .CONCLUSION : This method is simple and reliable and suitable for phenobarbital,phanytoin and carbamazepine monitoring.

Objective To explore the extent and severity of cognitive dysfunction in patients with schizophrenia and in order to offer more credible evidence to the treatment of schizophrenia. Methods Eighty-eight patients with schizophrenia and Fifty healthy controls in Shaoxing city were measured with Wechsler Memory Scale (WMS-RC), Wechsler Adult Intelligence Scale (WAIS-RC), Cancellation Test (CT) and Wisconsin Card Sorting Test (WCST). Results There was statistically significant difference between the two groups in visual recognition, visual reproduction, 1→100, 100→1, accumulation, picture remember, associative learning, touch test, logical memory, reciting figure and memory quotient of WMS-RC (t=2.40, 4.66, 2.90, 3.48, 4.03, 4.40, 2.13, 3.01, 3.97, 2.29, 4.87, respectively; P

OBJECTIVE:To evaluate the efficacy and adverse effects of paroxetine alone or in combination with small dose of doxepin for somatization disorder.METHODS:280 patients with somatization disorder were randomly assigned to receive paroxetine alone or in combination with small dose of doxepin for 8 weeks.Clinical global impression scale(CGI)and symptom check list(SCL-90)were used to assess the efficacy,and treatment emergent symptom scale(TESS)was used to assess the adverse effects.RESULTS:After treatment for 8 weeks,CGI score showed the total effective rate was 87.5% in the patients treated with paroxetine alone versus 93.8% in those treated with paroxetine in combination with small dose of doxepin(P0.05).CONCLUSION:Paroxetine in combination with small dose doxepin showed better efficacy for somatization disorder yet without increasing adverse effects as compared with paroxetine alone.

Objective To research the radiodiagnosis of fat embolism sydrome in the chest.Methods The clinic and X-ray manifestation of 12 cases fat embolism after long bone fracture were analysed.Results After wounded 19 to 70 hours later,all of the patients showed dyspneic respiration,symptoms of central nervous system,dermorrhagia,partly thrombocy topenia,fat drop in the urine or blood.There were diffuse maculate and tablet shadow of the pulmones on the chest X-ray film.Conclusion The X-ray character of fat embolism is difuse maculate and tablet consolidation shadow in the pulmones.

Fourly adult healthy patients were separately anesthetlzed with (1 )0. 95% isoflurane; (2) fentanyl 5g/kg and thiopentone 4 mg/kg; (3) upper thoracic epidural blockage and (4 ) lumbar epidural blockage,Continuous 5 min ECG were recorded before and a fier anesthesia with spectral analysis of heart rate varlability (HRV) performed by computer program. For power spectral measurement,three frequency band of HRV were evaluated and the effects of each anesthesia were compared. HRV reduced markedly in patients using 0. 95 % isoflurane. with decreases of frequency by 91. 7% (low frequency ), 84. 4% (mid frequency ). and 82% (high-frequency) respectively. In patients after administration of fentanyl 5g/kg, mid and high-frequency components declined 63. 4 % and 65. 4 %. Upper thoracic epidural block restrained the mid and low frequency components by 66 % and 65 % respectively, Following lumbar epidural block the pattern of HRV components did not change. It is concluded that different anesthesia techniques may have significant different effects on autonomic reflexes as presented by HRV.

Objective Using accurate monitoring,and high precision anesthetic machine and vapourizer,and guided with a simple mathematics formula to implement low-flow inhaled anesthetic techniques.Methods Ten healthy patients under going craniotomy,thoracotomy or laparotomy were assigned to receive isoflurane by low-flor of fresh gas and high vapourizer output.After intubation,the vapourizer dial was set at 5% and the patients were delivered with 1L/min total fresh gas flow of oxygen.The expiratory(F E) and inspired(F 1) concentration of isoflurane were monitored continuously.The data were recorded with computer once every 10. The concentrations were plotted against the time and the predicted regression equation were calculated.Results The F E reached 1.05% 10 min after inhalation of isoflurane ,which could be predicted by curvilinear(y=0 4092(1nx)+0 0172) and lineal (y=0 083x+0 1385) regression equations from 1 to 10 min,The predicted concentration by curvilinear regression equation appeared to estimate the measured value more accurately than linear regression equation.However segmental lineal regression equation cluld predict the measured value as accurately as curvilinear regression equation.Conclusions The inhalation anesthetic induction can be completed within 10 min with low-flow of fresh gas flow and high output of vapourizer dial setting.The measured value of anesthetic can be predicted accurately.

[ ABSTRACT] AIM:To illustrate the effect of methylene blue ( MB) on T-lymphocyte subsets and oxidative stress of the thymus in rats with paraquat ( PQ) poisoning.METHODS: Male SD rats ( n=40) were randomly assigned to 4 groups:normal group, control group, low-dose (2 mg? kg-1? d-1 ) MB group and high-dose (4 mg? kg-1? d-1 ) MB group.After 72 h, the pathological morphological changes of the thymus were observed under microscope with HE staining. The SOD activity and MDA content were measured by colorimetry method.The expression of Bcl-2, Bax, CD4 and CD8 was determined by immunohistochemical method.RESULTS:In MB group, the thymus tissue showed good corticomedul-lary demarcation.MDA content decreased and SOD activity increased, indicating that the ability of antioxidation enhanced. Bcl-2 and Bax expression was down-regulated, Bcl-2/Bax ratio increased, and CD4 positive cells increased.CONCLU-SION:MB protects against oxidative damage induced by PQ, and regulates the distribution of T-lymphocyte subsets in the cortex and medulla, thus relieving the persistent body damage.

Objective To investigate the incidence and trend of colorectal cancer in Wenling City of zhejiang Province from 2006 to 2011.Methods The date of colorectal cancer cases were collected from the tumor registersystem.The incidence rates,time trend and regional distributionof colorectal cancer were analyzed.Results The overall incidence of colorectal cancer in Wenling City was rising.The annual average incidence was 22.67/105.The incidence of colorectal cancer both in man and woman were increased with age,especially in ages between 55 and 75.The incidence of colorectal cancer was highest in city,followed in fringe area and lowest in rural.But the average annual growth rate was highest in rural.Conclusion The incidence trend of colorectal cancer is rising in Wenling City.Control measures of colorectal cancer according to the risk factors should be given,especially in rural area.

Objective To investigate cognitive functions in first-episode schizophrenia and unaffected first-degree relatives of different patients.Methods A total of 52 patients with first-episode schizophrenia (patient group),48 unaffected first-degree relatives of different patients (relatives group) and 50 healthy normal controls (control group) was recruited in the study.The attention,memory,and executive functions of all the subjects were assessed by a battery of neuropsychological tests,including cancellation test (CT),trail making test (TMT),digit span (DS),visual reproduction (VR),verbal fluency task (VFK),Wisconsin card sorting test (WCST) and HANOI tower.Results There were statistically significant difference among three groups in net scores of CT,TMTA,TMT-B,backward and total scores of DS,scores of VR,VFK,total errors and perseverate errors of WCST and all indicators of HANOI Tower (P ＜0.05 or P ＜ 0.01).Post Hoc multiple comparisons showed that,compared with the control group,the patient group had worse scores in all tests above except TMT-A in the relatives group (P ＜0.05 orP ＜0.01).However,compared with the patient group,the relatives group had better scores in net scores of CT,TMT-A,TMT-B,scores of VR,VFK,total errors and perseverate errors of WCST (P ＜ 0.05 or P ＜ 0.01).Conclusions Patients with first-episode schizophrenia have global cognitive functions deficits.Unaffected first-degree relatives of different patients also have cognitive deficits to a certain extent.Our study indicates that cognitive functions deficits may be viewed as a biomarker for candidates reflecting genetic liability for schizophrenia.

Objective To investigate the high risk factors of persistent pulmonary hypertension (PPHN) in preterm and full-term neonates.Methods Fifty-six newborns with PPHN were divided into preterm neonates group and the full-term neonates group according to their gestational ages.The relationship between PPHN and high risk factors such as the primary diseases,mother's complications during pregnancy,and the prognosis were analyzed retrospectively in each group.A retrospective review of lung samples of 3 neonates who died of respiratory failure were carried out.Results Thirty-one (55.36％) out of 56 neonates with PPHN including 27 preterm and 29 full-term newborns had parenchyma diseases.The first and the second primary diseases were meconium aspiration syndrome (MAS,9/29 cases,31.03％) and congenital heart diseases (8/29 cases,27.59％) in the full-term group,and respiratory distress syndrome (RDS,16/27 cases,59.26％) and infection (8/27 cases,29.63％) in preterm group,respectively.There were 15 cases (55.56％) whose mothers had complications during pregnancy among the 27 preterm neonates,and 8 ca ses (27.59％) among the 29 full-term neonates.The morbidity of mothers' complications during pregnancy in preterm neonates was higher than that in full-term neonates (x2 =4.519,P =0.034).The mortality rate was 33.33％ (9/27cases) in the preterm neonates group while 27.59％ (8/29 cases) in the full-term neonates group.There was no significant difference in mortality rate between each group (x2 =0.218,P =0.640).The primary diseases were RDS (9/9cases,100％) and MAS (4/8 cases,50％) in preterm and full-term neonates who died of PPHN,respectively.One case of pulmonary hypertensive vascular remodeling,1 case of alveolar capillary dysplasia (ACD) and 1 case of interstitial pneumonia were found in 3 lung samples of neonates died of PPHN.Conclusions The ratio of preterm increased in neonates with PPHN.RDS and infection were the first two primary diseases in preterm neonates with PPHN.MAS was the first primary disease in full-term neonates with PPHN.Primary pulmonary hypertension should be considered for neonates with severe PPHN.