Objective To assess the advantages and disadvantages of urine drainage by double-J ureteral stent or by percutaneous indwelling stent for pyeloplasty. Methods A total of 62 patients who had undergone pyeloplasty (6 patients had undergone operation on both sides) were reviewed.These patients had 68 sides of drainage during operation.The therapeutic effects,relevant complications and recoveries of 31 sides with internal stent and 37 with external stent for pyeloplasty were analyzed retrospectively. Results The rate of total postoperative complications such as hematuria,urinary tract infection,anastomotic leakage of urine or stenosis and urinary salt deposit in the internal drainage group (7/31,22.6%) was remarkably lower than that of the external drainage group (17/37,45.9%), P

Objective To evaluate the changes of GRP78 expression in the Spinal Cord of Ischemia/Reperfusion Injuried Rat.Methods Fifty five adult Wistar rats(250～300 g)were randomly divided into 2 groups as control group(n=5)and operation group(n=50).The spinal cord SCII model was established.The expression of GRP78 was detected in spinal cord tissue through immunohistochemistry(IHC)and Western blot analysis,and the neuronal apoptosis was detected through terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)methods.Results The GRP78 expression was increased at 30 min of reperfusion,and peaked at 7 h,but began to decline at 11 h post-reperfusion,and reduced significantly at 23 h.The number of GRP78 positive neurons at 0.5,3,7,11 and 23 h groups was(19.4?1.34),(42.6?2.30),(82.4?2.07),(40.0?1.58)and(18.8?0.83),respectively and significantly higher than that of control group(P

OBJECTIVE:To provide reference for the optimization of automatic system in outpatient pharmacy of the hospital. METHODS:Based on PDCA(Plan,Do,Check and Action)cycle management,the modules for adding and dispensing drugs of the automatic system in the outpatient pharmacy were optimized and the work records and quality indexes before (July-September in 2013) and after (May-July in 2014) the optimization were compared. RESULTS:By the optimization of the software system, hardware equipment and staff training,the error rate of adding drugs was reduced by 95%,daily box number of added drugs was increased by 30.9%,monthly box number of drugs damaged by the machine was decreased by 80%,the error rate of dropping drugs was decreased by 96.6%,and the frequency of machine fault was decreased by 87.5%,compared with before. CONCLU-SIONS:By PDCA cycle management,the work efficiency of automatic outpatient pharmacy can be improved,and the errors of prescription dispensing are reduced.

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.

Objective To observe the effects of electro-acupuncture on the expression and inhibition of DNA binding protein 2 (Id2) and myelin basic protein (MBP),and to explore the mechanism of remyelinization after compressive spinal cord injury (CSCI) in rats.Methods Fifty-four SD rats were randomly divided into a control group and a treatment group,and each was further subdivided into 3 time point subgroups:3,7 and 14 days.There were 9 rats in each subgroup.The CSCI models were made with a self-designed method.The acupuncture points Jiaji (EX-B2),bilateral Zusanli (ST36) and Taixi (KI3) were selected for treatment.Electro-acupuncture (continuous wave,2 Hz,1.5 V)was applied to the bilateral Zusanli (ST36) and Taixi (KI3) points.The control group received the injury but no treatment.The changes in the ultrastucture of the nerve fibers＇ white matter were de-termined by transmission electron microscopy (TEM).The alterations in the expression of MBP and Id2 were observed by double labeled immunofluorescence and Western blotting on the 3rd,7th and 14th day after the injury.Results TEM showed that the myelin sheaths in the control group had degenerated,swollen,and even broken down after CSCI.Changes to the myelin sheaths in the treatment group were milder than those in the control group.The immunofluorescence results showed the amount of Id2-immunoreactive oligodendrocytes in the control group to be (20 ±2) on the 3rd day after CSCI,becoming (16 ± 1) on the 14th day.The differences among the 3 control subgroups were not statistically significant.The amount of Id2-immunoreactive oligodendrocytes in the treatment group was (13 ± 1) on the 3rd day,reaching a minimum the 14th day.The differences among the 3 treatment groups were statistically significant.The differences compared with the control group at the same time points were also statistically significant.Western blotting showed that the expression of Id2 in the contrast and treatment groups was (1.12 ±0.12) and (0.67 ±0.01) respectively on the 3rd day after CSCI,and both decreased with time.The expression of Id2 in both groups reached their minima ((0.86 ±0.02) and (0.25 ±0.01) respectively) on the 14th day.The difference between the treatment groups and the contrast group was statistically significant at each time point.The expression of MBP in the contrast and treatment groups at day 3 was (0.44 ± 0.02) and (0.67 ± 0.04) respectively,and these increased with time.The expression of MBP in both groups peaked at the 14th day (at (0.95 ± 0.04) and (1.74 ± 0.09) respectively).These differences were again statistically significant.Conclusion Electro-acupuncture can regulate the expression of Id2 and MBP after CSCI.The down-regulation of Id2 which controls MBP negatively and the up-regulation of MBP may contribute to remyelination in the injured spinal cord.

AIM:To develop a high performance liquid chromatography -mass spectrometry method for the determination of ?-Lipoic acid in plasma,to study the pharmacokinetics of ?-Lipoic acid and evaluate the bioequivalence of two preparations in healthy subjects. METHODS:A single oral dose of 200 mg ?-Lipoic acid capsules and tablets was given to 22 healthy male volunteers according to an open randomized 2 way crossover design. Plasma concentrations of ?-Lipoic acid were determined by HPLC-MS method. The pharmacokinetic parameters and relative bioavailability were calculated to evaluate the bioequivalence of the two preparations. RESULTS:The pharmacokinetic parameters of the two products were as follows:tmax were (16?4) and (20?20) min,?max were (1490?359) and (1537?290) ng/mL,AUC0-t were (59559?18456) and (58210?15080) ng?mL-1?min,AUC0-∞ were (60068?18556) and (58634?15126) ng?mL-1?min,respectively. The relative bioavailability of AUC0-t and AUC0-∞ were (102.97?18.28)% and (103.09?18.26)%. CONCLUSION:The result demonstrated that two formations are bioequivalent by statistical analysis of variant,two one-side t-test and 90% confidential interval.

Objective To investigate the changes of dopamine-?-hydroxylase(DBH) and activator protein 2-?(AP-2?) expression in spinal cord under the condition of stress or pain stimulation,so as to explore the mechanism for changes of noradrenergic(NA) neurons in the spinal cord of rat pain model.Methods Immunohistochemical staining,double immunofluorescent staining,Western blotting and computing-image analysis system were used to detect the changes of DBH/AP-2? expression in the spinal cord of formalin-induced rat pain model.Results A small number of DBH-positive neurons were sparsely distributed in the ventral horn of the normal spinal cord,while in the formalin-treated group,much more darkly-stained DBH-positive neurons appeared primarily in the ventral horn,intermediate zone,and the dorsal horn,which reached the highest level on day 3 after formalin-injection.The grey value and number of DBH-positive neurons on day 7 after injection began to decrease,but still higher than that in the control group.Compared with control group,the number of noradrenergic neurons in spinal cord of formalin-treated rat was increased significantly,which was also confirmed by Western blotting.Double immunofluorescent staining showed that DBH and AP-2? co-existed in the cells of the spinal cord.The changes of AP-2? expression were similarly to that of DBH in the spinal cord of rat pain model.Conclusion Our results indicated that some non-noradrenergic neurons with different chemical properties might convert into noradrenergic neurons under pain stimulation;noradrenaline may be involved in the formalin-induced pain and behavior regulation;As one of transcription factors,AP-2? may promote the DBH synthesis.

Objective To systematically evaluate the comprehensive effect of subglottic secretion drainage (SSD) on patients with mechanical ventilation (MV) in intensive care unit (ICU). Methods The randomized controlled clinical trials (RCTs) comparing SSD (intervention group) versus non-SSD (control group) in adult patients with MV in ICU was collected through the databases such as the PubMed database of the National Library of Medicine, CNKI, Wanfang database and the Chinese journal of science and technology database (VIP). The subjects were ICU patients with MV, and the retrieval time ranged from January 2006 to December 2016. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, and assessed the quality. Then RevMan 5.3 software was used for Meta-analysis. Sensitivity analysis was performed using Stata 11.0 software. Funnel plot was used to analyze publication bias. Results In the 1004 documents obtained from preliminary screening, a total of 13 studies involving 2052 patients were enrolled after excluding duplicated documents and literature did not meet the inclusion criteria, with 1021 patients in intervention group, and 1031 in control group. Meta-analysis showed that compared with control group, the application of SSD in patients with MV could contribute to the reduction of the incidence of ventilator-associated pneumonia [VAP; risk ratio (RR) = 0.54, 95% confidence interval (95% CI) = 0.46-0.64, P < 0.00001], the duration of MV [mean difference (MD) = -3.29, 95%CI = -4.53 to -2.05, P < 0.00001] and length of hospital stay (MD = -4.27, 95% CI = -7.36 to -1.18, P = 0.007) were shortened, while there was no significant difference in ICU or hospital mortality rate between the intervention group and control group (RR = 0.89, 95%CI = 0.73-1.09, P = 0.25). The sensitivity analysis for studies enrolled in Meta-analysis of MV duration showed that individual research results were stable through step remove of the included literatures and combined calculation of the remaining literature value, suggesting that individual research results were stable, and would not have a significant impact on the overall results. The results of the funnel analysis showed that there was a symmetry in the inclusion studies, and no significant publication bias was found. Conclusions SSD did have effect in reducing the incidence of VAP, shortening the duration of MV and length of hospital stay, while there was no significant effect on reducing mortality rate. Effective use of SSD is an important measure to prevent VAP. It is necessary to objectively evaluate the clinical effect of SSD.

This paper proposed the idea of building the applied anatomical experiment and research platform for surgical postgraduates with professional degree,establishing double-tutorial system and applying applied anatomical teaching in basis course learning,clinical skill training and research capacity cultivating after analyzing the reasons of poor applied anatomical background of surgical postgraduates with professional degree.These ideas were intended to improve the cultivation quality.

OBJECTIVE:To establish the method for simultaneous determination of gallic acid,rosmarinic acid,liquiritin and ammonium glycyrrhetate in Regan saibisitan granules. METHODS:RP-HPLC method was adopted. The determination was per-formed on Waters RP-C18 column with mobile phase consisted of acetonitrile-0.2% phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min. The detection wavelengths were 210 nm(gallic acid,rosmarinic acid and liquiritin),230 nm(ammonium glyc-yrrhetate). The column temperature was 28 ℃,and sample size was 20 μL. RESULTS:The linear ranges were 0.2744-7.546 μg for gallic acid(r=0.9998),0.1870-5.143 μg for rosmarinic acid(r=0.9996),0.1300-3.575 μg for liquiritin(r=0.9999)and 0.2540-6.985μg for ammonium glycyrrhetate(r=0.9998),respectively. The LOQ were 2.67,1.36,1.09 and 2.11 ng,respective-ly. The LOD were 1.03,0.62,0.87 and 0.91 ng,respectively. RSDs of precision,stability and repeatability tests were all less than 2.0%. The average recoveries were 97.26%-101.00%(RSD=1.1%,n=9),97.66%-101.80%(RSD=1.3%,n=9),97.45%-101.70%(RSD=1.4%,n=9),97.74%-101.70%(RSD=1.4%,n=9). CONCLUSIONS:The method is simple,accurate and reproducible, and can be applied for simultaneous determination of gallic acid,rosmarinic acid,liquiritin and ammonium glycyrrhetate in Regan saibisitan granules.