Objective: To study the technological parameters of the enrichment purification process of Baohe Pills with macroporous resin. Methods: With the enriched degree of hesperidin of Pericarpium Citri Reticulatae of Baohe Pills as a marker, the optimum technological parameters of the enrichment process were studied. Results: The optimum process is that 5mL of the extract of BaoHe Pills (500mg/mL) was adsorbed for 30min with a column of macroporous resin (R15mm?H100mm) and the resin was washed with 100mL of distilled water, then the hesperidin was eluted from the macroporous resin with 100mL of 50% ethanol. Conclusion: The elutive rate of hesperidin was above 95% by means of the macroporous resin. So this process enriching the active components of Baohe Pills is feasible.

OBJECTIVE:To study the feasibility of overflow dissolution method for evaluating the drug in vitro sustained re-lease performance. METHODS:Overflow dissolution method was established by simulating the drugs elimination in vivo. Using Nifedipine sustained-elease tablets(Ⅰ)from 2 different manufacturers as model drug A,B,concentration-time curve,cumulative release rate- time curve,release velocity-time curve of model drugs in release pool at 3 different overflow speed (0,1.50,3.00 mL/min)were investigated. RESULTS:When overflow speed was 0,the cumulative dissolution was consistent with that of the con-ventional dissolution method. As the overflow speed increased,cmax of drug A,B was decreased [A:(8.89±0.20),(5.21±0.04), (3.51±0.03)μg/mL;B:(7.62±0.05),(4.80±0.09),(2.89±0.04)μg/mL];cumulative release rate was increased [A:(85.47± 2.45)%,(94.29 ± 2.44)%,(96.04 ± 2.56)%;B:(73.28 ± 1.13)%,(78.46 ± 1.94)%,(82.50 ± 1.69)%] ;tmax was ahead (A:1.5,1.0,0.5 h;B:2.0,1.0,0.5 h). CONCLUSIONS:Overflow dissolution method has avoided the inhibition of too large drug concentration on drug release,making complete drug release and more accurate evaluation of in vivo sustained release performance of the preparation.

Objective To explore the application of high-frequency color Doppler in the diagnosis of infant intussusception and the selection of reduction mode according tO the hemodynamic situations of intussusception intestine tube and blood vessel in mesentery.Methods A total of 377 cases of doubtful intussusception infants wete checked by high-frequency color Doppler.After they had been diagnosed,the hemodynamic situations of intussuscepiton intestine tube and blood vessel in mesentery were carefully observed and the ultra-sound had 3 types and then the hydrostatic enema reduction was chosen as treatment method.Results A total of 263 cases was diagnosed by highfrequency colot Doppler with rate of coincidence of 100%.Among them are 253 successful cases reduced by hydrostatic enema.The successful rate of reduction was 96.2%and the 10 failed cases were changed to be treated bv operation.The intestinal wall of intussusception tube in failure group had serious dropsy without blood flow shown.Conclusions It is accurate that the infant intussusception is diagnosed by high-frequency color Doppler.According to the hemodynamic situations of intussusceptin intestine tube and blood vessel in mesentery,the infant intussusception can be divided into 3 types as follows:type Ⅰ:the blood signal of intestinal tube and wall is up or normal,which shall be reduced by hydrostatic enema;type Ⅱ:the blood signal of intestinal tube and wall is small with high obstruction index,which shall be reduced by hydrostatic enema as possible as it can;type Ⅲ:the intestinal wall has serious dropsy with rather high obstruction index and without blood flow shown,in which the hydrostatic enema redHetion shall bebanned and the operation shall be carried out as soon as possible.

Objective:In investigate the status quo of current physician-patient relationship.Method:A self-designed questionnaire is conducted among the medical staff and patients in 40 hospitals(20 grade 3 hospitals and 20 grade 2 hospitals) located in 10 cities of China.Result:9.3% of the total patient responders consider the current physician-patient relationship dissatisfying,with a counterpart ratio of 31.2% in responders of medical staff.Conclusion:Currently in China,main-stream of physician-patient relationship is harmonious,but it can not be denied that medical staff are suffering tremendous stress from the ever tenser physician-patient contradictions.

Objective To compare the diagnostic significance of pleural SLPI,IFN-γ and ADA for differenti-ating TPE from pleural effusions with the other etiologies. Methods Pleural effusion samples were obtained from 93 patients who were divided into the following groups: tuberculous pleural effusion,malignant pleural effusion, bacterial pleural effusion and transudative pleural effusion. The pleural effusion and/or serum levels of SLPI , IFN-γand ADA were determined. Results 1.The concentrations of SLPI, IFN-γand ADA in tuberculous pleural effusion was higher than that in malignant group, bacterial group and transudative group. 2. The diagnostic value of SLPI, IFN-γor ADA for the diagnosis of tuberculous PE is high respectively. The combinations of SLPI, IFN-γand/or ADA gained the more valuable diagnostic performance. Conclusion Pleural SLPI, IFN-γand ADA may be helpful for the differential diagnosis of tuberculous pleural effusion and the other pleural effusion. The combinations of SLPI or/and IFN-γor/and ADA further increased diagnostic value.

Objective To explore the ultrasonographical characteristics of placental abruption, especially the light placental abruption that was diagnosed by color Doppler ultrasonic combining with enhancement Doppler E-flow imaging, providing diagnosis data for clinical treatment. Methods With color Doppler ultrasonic and enhancement Doppler E-flow imaging, an analysis was made on the ultrasonography and clinical result of 50 patients with heavy placental abruption and 23 patients with light placental abruption. Results The diagnosis and clinical treatment of 50 patients with heavy placental abruption who had been diagnosed by color Doppler ultrasonic combining with enhancement Doppler E-flow imaging were in conformity with the postnatal pathological diagnosis. The coincidence rate in diagnosis was 100%. Of 23 patients with light placental abruption who had been diagnosed by color Doppler ultrasonic combining with enhancement E-flow Doppler imaging, 19 cases' diagnosis and clinical treatment were in accordance with their postnatal pathological diagnosis and the coincidence rate was 83%, 4 cases were misdiagnosis and missed diagnosis. Of 73 patients with placental abruption, 60 cases were carried out caesarean birth and 13 cases performed natural labor. Conclusion The enhancement Doppler E-flow imaging combining with color Doppler ultrasonic can accurately diagnose the heavy placental abruption and also provide a new method for the diagnosis of light placental abruption and perform a dynamic monitoring for the treatment transfer result of it.

Objective To investigate the clinical pathologic characters of colorectal cancer with simultaneous hepatic metastasis and the prognosis. Methods From Aug. 1994 to Dec. 2006, 2019 cases of colorectal carcinoma were admitted, among them there were 166 patients of colorectal cancer with synchronous liver metastases receiving surgical therapy. Results were analyzed retrospectively using the software of SPSS. Results These 166 patients with synchronous liver metastases from colorectal cancer accounted for 8.1% of all 2019 patients of colorectal cancer admitted. Multivariate analysis demonstrated that CEA level before surgery、depth of invasion、 pathological type and Ducks' stage were the key risk factors predicting simultaneous liver metastasis from colorectal cancer. The survival rates at 1, 3 and 5 years were 69%, 21%, and 9% respectively. There was significant difference among the different liver metastasis group of H1, H2 and H3(X2=23.35, P<0.01). The survival rates of patients undergoing radical resection was higher than those undergoing palliative resection (PR)and by-pass operation or feeding neostomy(BP/ FN)(X2= 21.18,P<0.01). PR improved short-term prognosis but did not improve long-term survival compared with BP/FN group(P=0.13). Conclusion Colorectal cancer with synchronous liver metastases has poor clinic pathological characters. Different degree of liver metastasis result in different prognosis.Radical resection leads to a better prognosis. Palliative resection can improve short-term prognosis and life quality but can't improve long-term survival.

Objective To explore the significance of the plasma procalcitonin (PCT) level for directing antibiotic therapy in elderly patients with ventilator-associated pneumonia (VAP).Methods The 50 elderly patients with VAP were randomly separated into the regular therapy group and the PCT-directed therapy group. The regular therapy group was given regular antibiotic therapy, while the antibiotic therapy was decided according to the plasma level of PCT in the PCT-directed therapy group. The used time and utilization rate of antibiotics, as well as inflammatory indicators including white blood cells, neutrophils, C-reactive protein (CRP) and clinical pulmonary infection score (CPIS) were compared between the two groups. Results After treatment, there were no significant differences in white blood cells, neutrophils and CRP between the PCT-directed therapy group and regular therapy group [(8.9 ± 3.5 ) × 109/L vs. (9.4 ± 3.7) × 109/L, 0.62 ± 0.04 vs.0.60±0.04, (18.7±8.5) mg/Lvs. (21.6±6.0) mg/L, t=0.47, 1.84 and 1.37, allP＞0.05],but the CPIS was markedly lower in PCT-directed therapy group than in regular therapy group [(4.0± 1.4) scores vs. (4.7± 1.0) scores, t= 2. 18, P＜0.05]. The neutrophils, CRP and CPIS were significantly lower after treatment than before in the both groups. The concentration of PCT was decreased after treatment than before [(0.5 ± 0.9) mg/L vs. (1.7 ± 0.7) mg/L]. Meanwhile, the time using antibiotics was longer in regular treatment group than in PCT-directed therapy group [(8.72±1.32) d vs. (5.17±0.72) d, t=11.96, P＜0.01], the utilization rate of antibiotics was higher (95.2 % vs. 55.2 %, χ2 = 12.41, P＜0.01) in regular treatment group. Conclusions Using PCT levels for directing treatment in elderly patients with VAP can achieve better curative effect and reduce the use of antibiotics.

Objective To investigate the state of endemic fluorosis, running status of water improvement project to reduce fluoride in Jiangsu province, and to provide a scientific basis for prevention and control of endemic fluorosis. Methods In 2008, in the ten key counties of endemic fluorosis (zone), in Xuzhou,Lianyungang and Suqian, a stratified sampling method was employed to select 40 diseased villages according to their past water fluoride survey data. All children aged 8 to 12 were examined dental fluorosis, and all adults over 16 years were examined clinical skeletal fluorosis. Thirty per cent of the 40 diseased villages were selected, and 20 adults over the age of 16 in each selected village were examined by X-ray, respectively;50% of the 40 diseased villages were selected, and 30 any time urine samples of children aged 8 to 12 in each diseased village were tested urine fluoride. In each city, select a county, the status of water improvement project to reduce fluoride, water supply capacity and coverage in the county were investigated. Results A total of 3560 children aged 8 to 12 were examined, the detection rate of dental fluorosis was 38.51% (1371/3560), tooth defect rate was 5.34% (190/3560), and dental fluorosis index was 0.8. Seven hundred and eight urine samples were tested, the median urinary fluoride was 1.47 mg/L and the range was 0.08 ~ 10.08 mg/L. Clinical detection of skeletal fluorosis was 21.3% among adults over the age of 16, and X-ray detection rate of skeletal fluorosis was 39.2% (123/314).Investigated a total of 248 facilities of centralized water improvement projects, no funds to run or damaged 49, the water fluoride > 1.0 mg/L was 18. Conclusions Endemic fluorosis in Northern Jiangsu province has not been controlled completely, but has a rising trend, we should further strengthen the supervision of water fluoride reduction.

Objective To analyze the changes of the frequency of staphylococcus aureus (SAU) and methicillin resistant staphylococcus aureus (MRSA) isolated from hospitalized children from 2003 to 2006,and investigate the 21 antimicrobial susceptibility against SAU strains for providing reference for clinical rational use of drug.Methods The SAU strains were isolated from 207 children who were hospitalized in department of pediatrics of the sixth people′s hospital affiliated to Shanghai jiaotong university from Jan.2003 to Dec.2006 during the first 48 h of hospital stay.Strains were isolated from cotton-tipped swab of throat culture 75 strains,sputum culture 57 strains,secretion of bellybutton culture 25 strains,liquor puris culture 23 strains,hemoculture 20 strains,tube thoracostomy culture 3 strains,middle piece urnary culture 3 strains,cerebrospinal fluid culture 1 strain.The strains were identified by latex agglutination test,the in vitro activities of the 21 antimicrobial agents against 207 SAU isolates was tested by disc diffusion test (K-B method) according to the guidelines of the clinical and laboratory standards institute.MRSA was screened by oxacillin disc diffusion test.The data were analyzed by WHONET 5 software,Cochran-Mantel-Haenszel was used to analyze the tendency of SAU isolating rate and MRSA detectable rate.Results Of these SAU,30 strains(14.5 %) isolates were MRSA and 177 strains(85.5 %) were methicillin sensitive staphylococcus aureus.The sensitive rates of SAU to Penicilin,Oxacillin,Cefuroxime Sodium,Cefotaxime,Ceftriaxone,Erythromycin,Clindamycin,Trimethoprim/Sulfamethoxazole,Ciprofloxacin,Fosfomycin and Rifampin were 4.8%,85.5%,84.9%,90.0%,88.3%,37.5%,46.3%,92.7%,74.2%,97.2%,94.0%,respectively.All the strains were sensitive to peptide antibiotic(for instance,vacomycin and teicoplanin) and Levofloxacin.The SAU isolated rate and MRSA detectable rate were 9.6%,19.8%,25.0%,39.5% and 5.0%,5.9%,12.7%,24.7% in 2003-2006,respectively.Conclusions SAU has strong resis-tance to Penicilin and Erythromycin,but relative sensitive to Oxacillin and Cephalosporin.The SAU isolatating rate and MRSA resistant rate is increased in our area,pediatrics should to strengthen the monitoring of SAU is important in pediatrics.