OBJECTIVE:To explore the necessity of developing therapeutic drug monitoring of vancomycin in our hospital and its existing problems,and provide a reasonable basis for the clinical rational use of vancomycin. METHODS:The cross-sectional survey was designed to collect the clinical data of 92 patients with therapeutic drug monitoring of vancomycin and statistically ana-lyze 192 cases of plasma concentration monitoring data. RESULTS:The average plasma trough concentration was (15.96 ± 8.06) mg/L;with the increase of age,the plasma trough concentration was increasing,there was no significant difference in the plasma trough concentration among different age groups (P=0.000);there were only 13 cases (6.77%) that obtained the plasma trough concentration within 30 min before the fourth dose;after using wancomycin,clearance rates of Cr and the endogenous creatinine were slightly higher than before,but there was no significant difference(P=0.722);36 cases(39.13%)showed vancomycin sus-ceptible gram positive cocci;after using wancomycin,the body temperature,white blood cell count and neutrophil percentage were lower than before,the differences were statistically significant (P=0.006,P=0.000,P=0.000);48 cases (52.17%) in treatment received initial loading dose,and only 15 cases (16.30%) did not use in combination with other anti infective drugs. CONCLU-SIONS:The results showed there are still a lot of problems in the treatment of vancomycin in our hospital,for example,the stan-dard rate of the plasma trough concentration is about 50%;most of the time of blood sampling is not reasonable;the detection rate of the pathogen is low;only about half of the cases are given the loading dose,etc. Therefore clinical pharmacists’intervention for blood sampling is an important part to promote rational drug therapy monitoring. Meanwhile,data interpretation of the monitoring results of serum drug concentration of vancomycin is a basic method for clinical pharmacists in clinical monitoring to correct the un-reasonable operations,and also the necessary measures for preventing the drug renal toxicity,it is a very important significance for the medication safety and effectiveness especially in severe infection patients,the elderly,the children and the people with renal function insufficiency.

Objective To study the design and fabricating method, biomechanical effect and practicablity of the orthosis for patients suffering from large femoral bone defect and leg length discrepancy and study the effect of the orthosis on patients' equilibrium, walking function and gait. Methods By four stages we finally made ischial weight bearing orthosis with prosthetic feet, and then analysed its biomechanical effect and efficiency, evaluated balance and walking function of patients.Results The orthosis, according with principle of biomechanics, realized patients' wish of walking without crutch. The energy consumption and balanced capacity of patients wearing orthosis were much better while walking distance parameters came close to normal. Conclusion Ischial weight bearing orthosis with prosthetic feet can help patients reconstruct walking function, therefore can be recommended.

By reverse transcription-polymerase chain reaction (RT-PCR), an open reading frame of pathogenesis-related protein 1 (PR1) was isolated from Panax notoginseng and named as PnPR1. Molecular and bioinformatic analyses of PnPR1 revealed that an open reading frame of 501 bp was predicted to encode a 166-amino acid protein with a deduced molecular mass of 18.1 kD. Homology analysis showed that the deduced amino acid sequence of PR1 protein of Panax notoginseng had a high similarity with other higher plants had the same conservative structure domain of cysteine-rich secretory protein (CAP). The recombinant expressed plasmid pET28a(+)-PnPR1 was expressed in Escherichia coli BL21. The expression conditions were optimized by induction at different times, different temperatures, different IPTG concentrations and different giving times. The optimum expression condition was 0.4 mmol.L-1 IPTG at 28 degrees C for 20 h. The successful expression of PnPR1 provides some basis for protein purification and preparation of the monoclonal antibody.
Amino Acid Sequence ; Cloning, Molecular ; Escherichia coli ; metabolism ; Molecular Weight ; Open Reading Frames ; genetics ; Panax notoginseng ; chemistry ; Phylogeny ; Plant Proteins ; genetics ; metabolism ; Plants, Medicinal ; chemistry ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Alignment

Objective To compare the effectiveness of nano-hydroxyapatite/collagen (nHAC)and autologous mesenchymal stem cells (AMSCs) for the repair of femoral defect in a rabbit model with femoral defect under the monitoring of the synchrotron radiation hard X-ray. Methods The rabbit models of traumatic bone defect were established and completely randomized into three groups. The femoral defects filled with nothing were used as control group (Group A) , the femoral defects filled with nHAC as Group B and the femoral defects filled with nHAC + AMSCs as Group C. Phase-contrast imaging with synchrotron radiation hard X-ray was applied to detect the degradation and repair process of each group at postoperative weeks 4, 8 and 12, respectively. Results Phase-contrast imaging with synchrotron radiation hard X-ray could display the reparative process. Four weeks after operation, there was collapse in some defect areas in Group A, and the degradation of nHAC and new bone formation were observed in Groups B and C. Eight weeks after operation, fibrous tissues were observed in the defect area in Group A, while osteogenesis and nHAC degradation were more obvious in Groups B and C. Twelve weeks after operation, the defect areas were still unhealed and were substituted by fibrous tissues in Group A, tissue densities of defect areas in Group C were identical with periphery areas, and trabecular bones were formed in Group C. There were statistical differences in the osteogenesis between Group A and Groups B and C,with Group C the best. Conclusion Phase-contrast imaging with synchrotron X-ray can detect the reparative process at a micro-level and plays an important role in the development of tissue engineering.

Objective:To evaluate the clinical outcome of botulinum A toxin(BTX-A)injection into external sphincter combined with oral baclofen in treatment of detrusor-external sphincter dyssynergia(DESD)after spinal cord injury(SCI). Methods:A total of 38 urodynamic examination-confirmed DESD patients,male 31 and female 7,with an average age of (36.5?17.8)years old,were included in this study.200 U of BTX-A toxin was dissolved in 8 ml of normal saline and the solution was injected at 8 different sites(1 ml per site)of the external sphincter via a 5F flexible cystoscopic needle.On the second day,9 patients(BTX-A+baclofen group)were randomly selected for baclofen oral administration,3/d for 3 months; the other 26 patients were taken as control.Urodynamic examination was repeated in all patients 4 weeks later;the voiding diary and urodynamic outcomes were compared before and after treatment.The adverse and toxic effects were observed in the patients who were followed up for 2-9 months.Results:One month after treatment the voiding and storing functions of bladder were improved to different degrees,with the mean maximum uroflow rate(Qmax),the mean urine volume,the mean maximal cystometric capacity and the bladder compliance increased significantly and the mean postvoid residual urine volume and the mean maximal voiding pressure decreased significantly(all P

OBJECTIVETo study the occupational exposure limit of dimethoxymethane (DMM) in workplace air.

METHODSLiterature research was conducted on DMM; information on its physicochemical properties, toxicology, and occupational epidemiology was collected. Upon analyzing these data, an occupational exposure limit of DMM in workplace air was proposed according to the guidelines and principles of developing occupational exposure limits for harmful factors in workplaces.

RESULTSA total of 165 air samples were collected from DMM manufacturers, 14 of which had a DMM concentration over 3000 mg/m(3), accounting for 8.48% of all samples. Compared with the control group, the exposed employees had a significantly increased incidence of discomfort symptoms when exposed to more than 6000 mg/m(3) DMN (P < 0.01).No significant differences in the constituent ratios of abnormal results in physical examinations were found between the exposure groups and control group (P > 0.05).

CONCLUSIONWe recommend to set the permissible concentration-time weighed average to 3100 mg/m(3) as the occupational exposure limit of DMM in workplace air in China. This occupational exposure limit standard meets the relevant requirements of toxicology and occupational epidemiology, as well as fits well with our country's current economical and technological levels. This standard has high applicability in China's domestic settings.

Air Pollutants, Occupational ; analysis ; China ; Humans ; Inhalation Exposure ; Methyl Ethers ; analysis ; Occupational Exposure ; analysis ; Threshold Limit Values ; Workplace

OBJECTIVETo investigate the stability of curcumin, demethoxycurcumin and bisdemethoxycurcumin in different buffer solution.

METHODTo determine concentration of curcumin by HPLC when added curcumin, demethoxycurcumin and bisdemethoxycurcumin into the buffer solution the equation of degradation was established.

RESULTThe sequence of stability are bisdemethoxycurcumin > or = demethoxycurcumin > or =curcumin at the same condition.

CONCLUSIONThe demethoxycurcumin can stabilize curcumin more strong than the others. The demethoxycurcumin is a nature stabilizing agent for curcumin.

Chromatography, High Pressure Liquid ; Curcumin ; analogs & derivatives ; chemistry ; Drug Stability ; Hydrogen-Ion Concentration

OBJECTIVETo summarize the experiences of ligating left subclavian artery (LSA) in total arch replacement and stented elephant trunk implantation for Stanford type A aortic dissection patients with difficulty in exposing the LSA.

METHODSTotal arch replacement and stented elephant trunk implantation were performed on 79 consecutive patients from January 2008 to June 2010. Twenty-nine cases of the cohort undertook LSA ligation due to bad exposure. There were 21 males and 8 females patients, aged from 19 to 55 years with a mean of (44 ± 12) years. There were 12 acute dissections, 4 sub-acute dissections and 13 chronic dissections. Based on thoroughly evaluation of the Willis' circle and bilateral vertebral arteries through pre-operative imaging and intra-operative circulative parameters, if the collateral circulation was considered sufficient, LSA was ligated directly and only the innominate artery and carotid artery were reconstructed; if considered insufficient, an additional bypass from ascending aorta to left axillary artery was performed.

RESULTSAll the 29 operations were completed successfully. There was one patient died from pulmonary infection and the others recovered well.Blood pressure of left arms were lower than right postoperatively [(78 ± 17) mmHg vs. (126 ± 24) mmHg, 1 mmHg = 0.133 kPa, P < 0.01], but oxygen saturation, skin temperature and strength of the left hand were normal compared to the right. All the survived patients have been followed 1 - 27 months and none of them presented with any symptoms of left subclavian artery steal syndrome and ischemia of left arms.

CONCLUSIONSLigation of LSA under strict evaluation of collateral circulation could be safe in Type A dissection patients with bad exposure due to big ascending aortic aneurysm and will simplify the procedure significantly.

Adult ; Aneurysm, Dissecting ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Follow-Up Studies ; Humans ; Ligation ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Subclavian Artery ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo study the possibility and mechanism of construction of tissue engineered bone with human bone marrow mesenchymal stem cells (hBMSCs) as seeding cells and partially demineralized bone matrix (pDBM) as scaffold.

METHODShBMSCs are cultured and mutiplified. The 4th grade hBMSCs are seeded on the pDBM, the growth and adhesion of hBMSCs on pDBM are observed under scanning electro microscope. The adhesion efficiency is assessed. The complexes are implanted in the nude mice subcutaneously, the pDBM without cells as control. The grafts are taken out on the 8th and 12th week.

RESULTSThere is new bone formation on the 8th and 12th week in complex group. There is a layer of osteoblast like cells adhered on the surface of most of the new bone, which suggest the possibility of intramembranous ossification. There is no bone formation in control group.

CONCLUSIONSTissue engineered bone can be constructed with hBMScs and pDBM in vivo, and the mechanism of which could be intramembranous ossification.

Animals ; Bone Marrow Cells ; cytology ; Bone and Bones ; Cell Adhesion ; Cell Differentiation ; Humans ; Mesenchymal Stromal Cells ; cytology ; Mice ; Mice, Nude ; Tissue Engineering ; methods

OBJECTIVETo discuss the changes of lymphocyte subsets in HCV children with different genotypes during treatment with pegylated interferon alfa-2b and ribavirin.

METHODSThe genotype of 45 HCV infected children were identified by real time PCR. The lymphocyte subsets were dynamically detected by BD FACSCalibur flow cytometer with four color MultiTEST IMK Kit during the treatment.

RESULTSFor the children with 1b genotype, after 24 weeks, the CD4+ T cells were higher than pre-treatment (P < 0.05). For the children with 2a genotype, after 12 weeks and after 24 weeks, the CD3+ T cells and CD4+ T cells significantly increased while the NK cells decreased than pre-treatment (P < 0.05).

CONCLUSIONSThe lymphocyte subsets of HCV children with 2a genotype were different from 1b genotype during trentment with pegylated interferon alfa-2b and ribavirin.

Child ; Child, Preschool ; Female ; Genotype ; Hepacivirus ; classification ; genetics ; Hepatitis C, Chronic ; drug therapy ; immunology ; virology ; Humans ; Lymphocyte Subsets ; immunology ; Male ; RNA, Viral ; analysis ; Retrospective Studies