An analysis of the medical risks exposure for resident doctors in their standardized training,and insights into the risk management measures proposed for this stage.These measures include:1) Pre-control of risks;2) Full-length supervisor of such training stage;3) Systematic education for medical risk exposure;4) Timely guidance on risk identification and response;5) Development of the evidence awareness.

A chiral high-performance liquid chromatography method was developed for the simultaneous determination of ibuprofen enantiomers in dog plasma. It was used to study the pharmacokinetics in the Beagle dog after intravenous administration of racemic-ibuprofen, S-ibuprofen and R-ibuprofen. Ketoprofen was chosen as the internal standard. After a simple precipitation using methanol as the precipitating solvent, both analytes and IS were separated on a Kromasil 100-5CHI-TBB chiral column (250 mm x4.6 mm, 5 μm) with isocratic elution using acetonitrile - 20 mmol x L(-1) phosphate buffer (pH 3.0, containing 5% methanol) (6 : 4) as the mobile phase. The detection wavelength was 220 nm. Liner calibration curves for both of the ibuprofen enantiomers were over the concentration range from 0.5 to 50 μg x mL(-1) with a lower limit of quantification of 0.5 μg x mL(-1), the accuracies were all in standard ranges. The intra- and inter- assay precisions were all below 7%. The recovery rate was 93.1% to 100.4%. The experiments proved that the method was simple, rapid and sensitive. It can be used in the quantitative determination of ibuprofen enantiomers in dog plasma. The method was used to determine the concentration of ibuprofen enantiomers in Beagle dog plasma after a single intravenous administration of racemic-ibuprofen, S-ibuprofen and R-ibuprofen (9 mg x kg(-1)) and the pharmacokinetics parameters were calculated based on the concentration-time curves. The C(max) of S-ibuprofen in Beagle dog plasma after a single intravenous administration of racemic-ibuprofen, S-ibuprofen and R-ibuprofen were 30.8 ± 4.7, 46.1 ± 5.9 and 20.0 ± 2.6 μg x mL(-1), respectively. In terms of the exposure of active ingredient, it revealed a significant difference between the administration of S-ibuprofen and the other two groups. The systematical R- to S- chiral inversion was discussed. Comparing the pharmacokinetic parameters at different doses, chiral inversion were 70.1% ± 36.6% and 76.4% ± 36.2%, respectively, after intravenous administration of racemic- and R-ibuprofen. This study provides a theoretical basis for the safety of ibuprofen formula of injection drug.

Objective To analyze effect of balloon embolization therapy for traumatic carotid cavernous fistula (TCCF),so as to provide references for treatment of this disease.Methods A total of 21 patients with TCCF managed with balloon embolization from April 2006 to March 2012 were collected in the study.There were 17 males aged (32.3 ±5.4) years and 4 females aged (40.6 ±5.8)years.Perioperative clinical presentations and imageologic changes were observed as well as operative outcome was evaluated.Results After 3 months of follow-up,20 patients experienced successful detachable balloon embolization,but the other one patient had to have stent angioplasty due to the failure of the procedure.All patients had some improvements on clinical presentations after operation (P ＜ 0.05).Imageologic examination revealed that all patients had complete occlusion of TCCF following operation.In follow-up,one patient had a relapse,with total curative ratio of 95％.Conclusions Detachable balloon embolization is effective in treatment of TCCF.Presently,the technique is an optimal method for such kind of disease and is worthy of wide clinical use.

Objective:To investigate the pharmacokinetics of sugammadex in reversal of postoperative residual neuromuscular blockade in obese patients.Methods:Sixteen patients of both sexes, aged 18-65 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, with body mass index of ≥25 kg/m 2, scheduled for elective laparoscopic bariatric surgery, were selected.The patients were divided into 2 groups ( n=8 each) according to the degree of obesity: group O (25 kg/m 2≤BMI<40 kg/m 2) and group M (BMI≥40 kg/m 2). In group O and group M, vecuronium was administered by closed-loop muscle relaxant injection system to maintain moderate neuromuscular blockade.The administration was stopped at the end of surgery, and sugammadex 2 mg/kg was injected according to corrected body weight (CBW) of patients when the muscle relaxation monitoring T 2 recovered naturally.The recovery time of neuromuscular blockade and the occurrence of residual neuromuscular blockade within 3 h after surgery were recorded.Arterial blood samples were collected at 2, 3, 5, 10, 15, 20, 30, 60, 120, 240, 360 and 480 min after administration of sugammadex.The concentration of sugammadex in plasma was determined by ultra-performance liquid chromatography-mass spectrometry.The pharmacokinetic parameters were calculated with PKSolver software. Results:No residual neuromuscular blockade occurred, and the pharmacokinetics of sugammadex in plasma were consistent with the linear non-compartmental model in the two groups.Compared with group O, apparent clearance was increased ( P<0.05), and no significant change was found in other pharmacokinetic parameters, recovery time of neuromuscular blockade and concentrations of sugammadex in plasma at different time point ( P>0.05) in group M. Conclusion:The pharmacokinetics of sugammadex in reversal of postoperative residual neuromuscular blockade in obese patients are consistent with the linear non-compartmental model, and the clearance of sugammadex is higher in morbidly obese patients.

Objective To investigate the radiation dose to operators in the process of ²⁴¹Am-Be neutron source logging, and discuss neutron source management and protective measures for operators in well logging. Methods Through on-site observation and measurement of ²⁴¹Am-Be neutron source logging in a company, we obtained the surface γ dose rate and neutron dose rate of the neutron source, as well as the operating time and distance of various processes including source taking, transfer, and loading, calculated the radiation dose to operators in various processes, and analyzed the source and proportion of the personal effective dose to operators. Results The effective doses of neutron irradiation and γ irradiation were 94.17 μSv and 2.72 μSv, respectively, for the combined processes of source tank inspection, transfer, and detection; 36.66 μSv and 24.08 μSv, respectively, for source loading and unloading; and 130.83 μSv and 26.80 μSv, respectively, for the whole neutron source logging process. The total annual effective dose of neutron source logging was 15.78 mSv, as estimated by logging 100 times per year. Conclusion In the process of ²⁴¹Am-Be neutron source logging in the company, the effective dose to operators mainly arises from neutron irradiation. Therefore, it is necessary to strengthen neutron source management and take effective protective measures against neutron radiation.