Objective: To make a system evaluation on the therapeutic effect and safety of Mailuoning Injection(MI) in treating acute stage of ischemic brain infarction apoplexy(IBIA).Methods: Literatures about randomized controlled trial (RTC) on MI in treating acute stage of IBIA were collected,and the qualified researches were filtrated.Then made a quality evaluation by Jadad scoring method, and took statistics of the correlated data with the methods of heterogeneity test,Meta-analysis,filler-graph analysis and sensitivity analysis etc.Results: There were eight items accorded with bringing into standard.Then the methodology quality of each articles were evaluated adopting Jadad scoring standard,and the trials each get one score,belonging to low-quality literatures.The analytic results of Meta-analysis showed that compared with blank control group,the total effective rate comparison relative risk(RR) to merge equaled 1.19,99% confidence interval(CI) was(1.09,1.30),the case-fatality rate(CFR) comparison relative risk(RR) equaled 0.93,99% confidence interval(CI) was(0.02,36.07). Conclusion: This system evaluation demonstrated that MI was good for treating acute stage of IBIA,and no serious adverse reactions.

Objective To prepare the national reference panel of hepatitis B virus(HBV) for nucleic acid testing(NAT)donor screening.Methods A number of plasma samples from donors positive for HBV antibody and patients with HBV infection collected from blood centers,plasma stations and biological products companies in Shanghai,Gansu,Henan,Hunan,Hubei and other regions were tested for HBV DNA viral load agent,and negative and positive reference candidates were screened;The HBV DNA national standard was diluted to 10~3 IU/ml with human negative plasma,as a candidate for limit of detection(LOD).National negative and positive reference candidates of HBV for NAT donor screening and LOD reference to be calibrated were distributed to 8 enterprise laboratories for joint detection of HBVHCVHIV NAT donor screening.The homogeneity and stability of the national reference panel were investigated.Results A total of 8 negative samples with HBV viral load of 0 were screened as negative references and 9 positive samples with viral load of 10~3～10~4 IU/mL were used as positive references;One LOD reference was calibrated with WHO HBV DNA standard,and the virus content was 1.0 × 10~3 IU/ml.The national reference panel showed good stability and the homogeneity inspection met the requirements.Conclusion The national reference panel of HBV DNA for NAT donor screening was prepared,which provided a basis for the quality control and standardization of HBV DNA reagents for donor screening.

Objective: To study the effect of Carisolv in caries removal on dentin bonding surface.Methods:24 extracted third molars with moderate carious were randomly divided into four groups. Each cavity was split into two parts, one part was prepared by Carisolv and the other by high-speed bur. Then samples were processed as follows: samples in group A were not treated, those in group B were treated with 320 ml/L phosphoric acid, SEM was used to observe the morphology of dentin surface of the samples in group A and B. Samples in group C were restored with Dyract AP and those in group D with resin for the observation of the microstructure of dentin-filling bonding interfaces.Results:In group A, rough surface without obvious smear layer was exhibited and dentinal tubules were clearly open after Carisolv preparation; after bur preparation, dentin surfaces were covered with a thick smear layer and no opening of tubules was visible. In group B, after treatment with 320 ml/L phosphoric acid, the smear layer was removed and dentinal tubules were exposed after either Carisolv or bur preparation, but tube stoppers were visible in the samples prepared by bur. In group C, resin tags were observed only in the samples after Carisolv preparation. In group D,dentin surfaces and lengths of the resin tags did not show remarkable difference after Carisolv or bur preparation, but more lateral branch connection between resin tags appeared in the samples prepared by Carisolv than by bur.Conclusion:The dentin prepared by Carisolv favors bonding between dentin and resin/compomer and has the advantage of restoring with compomer.

Objective To analyze retrospectively the results of closed reduction and static transarticular fixation with unilateral external fixators in the treatment of severely comminuted distal radius fractures caused by high-energy injuries. Methods From June 2000 to June 2003, 20 patients with 24 severely comminuted distal radius fractures were treated with closed reduction and static transarticular fixation with unilateral external fixator. The injuries involved 16 males and 4 females, the age of the patients was from 15 to 48 years (average 33.4 years). All fractures were classified as Frykman's type Ⅷ or AO type C3. The operative technique consisted of reduction of the fractures by manipulation or assisted with the external fixator, then fixed them statically. The mean duration of the union was 7.4 weeks (ranged from 6-8 weeks). After the fixator removal, the patients were encouraged to proceed for the rehabilitations, such as the elbow flexion-extension, radial abduction, ulnar adduction, and the pronation as well as the supination of the forearm. Results All patients were available at the final follow-up, the mean duration was 16 months (range, 6-42 months). At the last examination, the radiological manifestations revealed excellent in 21 fractures (17 patients) and good in 3 (3 patients) according to the Sarmiento scoring system (modified by Stewart); and the functional results displaied excellent in 16 (13 patients), good in 6 (5 patients) and fair in 2 (2 patients) according to Gartland-Werley functional assessment system. There were only 2 cases of superficial pin site infection cured with oral antibiotics and local care with mild disinfectants. 7 obvious defect of mataphysis occurred in 5 patients, but the fractures united simultaneously without any additional treatment. And there was no any complication, such as pin tract infection, fixator loosening, iatrogenic fracture and injury of the superficial radial nerve. Conclusion The technique of closed reduction by manipulations or external fixators combined with static transarticular fixation plus unilateral external fixators is an effective method for the treatment of severely comminuted distal radius fracture caused by high-energy injuries, such as falling from the height. It is unnecessary to apply supplementary bone grafts to promote bone healing. The complications can be avoided by selecting the right sites for the insertion of the pins, which is beneficial for the hand to mobilize earlier after operation.

Objective To retrospectively analyze the results of closed reduction and static trans-articular fixation with unilateral external fixators in the treatment of unstable distal radius fractures.Methods From June 2000 to March 2005,45 patients with 50 unstable distal radius fractures were treated with closed reduction and static transarticular fixation by unilateral external fixators.Their average age was 44.8 years(15 to 78 years).All the fractures were classified with AO-scheme.There were five A3-fractures,four B3-fractures,three C1-fractures,nine C2-fractures and 29 C3-fractures in 24 cases.Follow-ups lasted from 8 to 48 months(averaging 20 months).Results The time of bone healing was 6 to 8 weeks(averaging 7.6 weeks).At the latest follow-up,the radiological outcomes were excellent in 42 fractures(39 patients)and good in eight fractures(six patients)according to the Sarmiento rating system modified by Ste wart et al.The functional results included 37 excellent cases(34 patients),nine good ones(eight patients)and four fair ones(three patients)according to the Gartland-Werley assessment.There were only four cases of superficial pin site infection settled with oral antibiotics and mild disinfectants.Conclusions Closed reduction by manipulation and static transarticular fixation with unilateral external fixators is an effective method to treat severely comminuted distal radius fractures caused by high-energy injury.Radial nerve injury and iatrogenic fracture of the 2nd metacarpal bone can be avoided,pin tract infection and pin loosening can be decreased,and early postoperative mobilization of hand can be facilitated by insertion of external pins at appropriate sites.It is unnecessary to apply supplementary bone grafting to promote bone healing.

Objective To investigate the risk factors of anastomotic leakage after laparoscopic anterior resection of rectal cancer.Methods Literatures on the risk factors of laparoscopic anterior resection of rectal cancer were retrieved from August 2003 to August 2013,and then a Meta analysis was carried out based on the data.Data were expressed by odds ratio (OR) and 95％ confidence interval (95％ CI).The heterogeneity of the data was analyzed using the chi-square test or I2 test.Data were pooled using the fixed or random model.Results Eight literatures including 3 289 patients with rectal cancer were retrieved.The incidence of anastomotic leakage was 6.050％ (199/3 289).The incidence of anastomotic leakage after laparoscopic anterior resection of rectal cancer in males was significantly higher than females (OR =2.17,95％ CI:1.54-3.06,P ＜0.05).Neo-adjuvant chemotherapy might increase the risk of postoperative anastomotic leakage (OR =1.53,95％ CI:1.00-2.32,P ＜ 0.05).Interoperative blood transfusion might increase the risk of postoperative anastomotic leakage (OR =4.80,95％CI:2.98-7.73,P ＜0.05).Patients with low rectal cancer had greater risk of anastomotic leakage than those with high rectal cancer (OR =1.60,95％ CI:1.14-2.23,P ＜ 0.05).Number of linear stapler firings greater than 3 increased the risk of postoperative anastomotic leakage (OR =0.46,95％ CI:0.27-0.78,P ＜ 0.05).The ASA classification of anethesia risk,depth of tumor infiltration,lymph node metastasis,preventive colostomy were not correlated with the incidence of postoperative anastomotic leakage (OR =0.66,0.91,1.25,0.78,95％CI:0.36-1.20,0.55-1.51,0.75-2.09,0.50-1.23,P＞0.05).Conclusion Male,neo-adjuvant chemotherapy,interoperative blood transfusion,low rectal cancer,number of linear stapler firings greater than 3 are the main risk factors for anastomotic leakage after laparoscopic anterior resection of rectal cancer.

BACKGROUND:After peripheral nerve injury, to inhibit scar formation by drugs is the key to functional recovery. To reduce the amount of scar formation we designed a prednisolone-loaded film which can sustain drug release and good achievement in in vitro drug release test.
OBJECTIVE:To prepare the prednisolone implantable film and investigate its in vivo biocompatibility and safety.
METHODS:Prednisolone-loaded nanoparticles were first prepared with reverse micellar emulsion-solvent evaporation method, and the composite film and drug-loaded film were further prepared. Then, we investigated the in vivo biocompatibility of drug-loaded film through celltoxicity test, hemolysis test, acute systemic toxicity test, chronic systemic toxicity test.
RESULTS AND CONCLUSION:After cultured for 7 days, the relative growth rate of L929 mouse fibroblasts was 92.6%, showing no cytotoxicity. The hemolysis rate of the film was 0.59%, indicating that the material had no hemolysis action. No abnormal biological behaviors were seen in mice after intraperitoneal injection of film extracts, and there were no changes in liver and renal functions in rats. As il ustrated above, we can safely come to a conclusion that prednisolone-loaded film possesses good biocompatibility and can be safely used in the experiment of reducing the scar at sites of peripheral nerve repair.

Aim To study the pharmacokinetics of faropenem sodium for injection after a single and multiple intravenous dose in 12 healthy volunteers.Methods Multiple-dose regiments used 12-hour dosing intervals for 5 doses.Plasma and urine faropenem sodium concentrations were measured using high-performance liquid chromatography.The concentration-time curves of faropenem sodium were fitted to a two-compartment open model.The excretion data in urine were disposed by the method of excretion rate in urine.Results The pharmacokinetic parameters obtained from the single-dose study were as follows: C_(max) =(45.20±8.73) mg·L ~(-1); T_(1/2α) =(0.401±0.096) h; T_(1/2β) =(1.419±0.267) h;AUC_(0-12) =(59.216±11.886) mg·h·L~(-1) .The steady-state pharmacokinetic parameters were: C ss min =(0.03±0.02) mg·L~(-1) ; C ss max =(44.60±9.08) mg·L~(-1) ; C_(av)=(4.939±1.048) mg·L~(-1) ; T_(1/2α) =(0.340±0.105) h; T_(1/2β) =(1.257±0.173) h;AUC~(ss)_(0-12) =(59.268±12.571) mg·h·L~(-1) .The amount of cumulative recovery of faropenem sodium in urine for single and multiple dose within 12 h was(30.48±12.77)% and (40.55±17.53)%, respectively.The pharmacokinetic parameters in urine of the single-dose study were: T_(1/2) =(0.993±0.088) h, K_e=(0.227±0.097) h~(-1) .The steady-state pharmacokinetic parameters in urine were: T_(1/2) =(1.085±0.069) h, K_e=(0.296±0.136) h~(-1) .Conclusions The distribution and elimination rates of faropenem sodium for injection are not changed after multiple intravenous administrations.Effective concentrations in vivo can be achieved after the repeated administration with 400 mg twice a day regiment.The dosing schedule can be recommended.

Formative evaluation is a medical education evaluation form used to correct its own track in the course of activities so as to get better effect. In the medical education, it can significantly improve the medical students' ability such as active learning ability, relearning ability, ability to master and apply know l edge, ability of scientific thinking and debating, ability of innovation and analysis, ability of association and communication, and so on.