OBJECTIVE:To develop an HPLC-fluorescence method for simultaneous determination of losartan and its major metabolite(E-3174) in human plasma.METHODS:Plasma sample was pretreated by liquid-liquid extraction with aether then determined with valsartan served as internal standard.The determination was performed on Diamonsil C18 with column temperature set at room temperature.The mobile phase consisted of 0.02 mol?L-1 sodium dihydrogen phosphate buffer (adjusted to pH=2.35 with phosphoric acid)-acetonitrile (57∶43) at a flowrate of 0.5 mL?min-1.The excitation wavelength was set at 250 nm and the emission wavelength was set at 370 nm.RESULTS:The linear range of losartan was 10～1 000 ng?mL-1(r=0.999 0) with a lowest limiest of quantification(LLOQ) of 10 ng?mL-1;the linear range of E-3174 was 5～1 000 ng?mL-1(r=0.999 0) with a LLOQ of 5 ng?mL-1.The methodological recoveries of losartan and E-3174 were 94.05%～110.09% and 107.7%～110.94%,respectively,with both intra-day RSD and inter-day RSD at less than 10.0%;the extraction recoveries of losartan and E-3174 were 69.16%～70.85% and 67.50%～70.77%,respectively.CONCLUSION:The developed method is simple,accurate and reproducible,and it is applicable for the concentration determination and pharmacokinetic studies of losartan and its major metabolite (E-3174) in human plasma.

Infantile cholestasis is a syndrome caused by multiple factors with conjugated hyperbilirubinemia for clinical characteristics. The etiologic factors include infection, poisoning, inherited metabolic defects and bile duct abnormalities. Infection, biliary atresia accounts for more than half of cholestasis children. Recently, the new causes have been recognized, for example citrin deficiency, Alagille syndrome,progressive familial cholestasis symptoms caused by different causes are similar to biliary atresia, but the prognosis and treatment are quite different. If misdiagnosed, the condition will exacerbate. Understanding the various causes plays an important role for the early diagnosis and differential diagnosis of infantile cholestasis.

To introduce germfree isolating technologies used in gnotobiology , and to compare the differences with in Cleaning Rooms, Restrictive Access Barrier Systems (RABS) and Isolators.To expect the development of isolators , and to describe the uses of isolators in gnotobioly .

Magnesium participates in many fundamental metabolic processes and plays important roles in maintaining normal body function. Magnesium homeostasis is regulated by a fine balance between gastrointestinal absorption and renal excretion. Several hereditary disorders characterized by hypomagnesemia have been described since 1960s, including familial hypomagnesemia with hypercalciuria and nephrocalcinosis, autosomal dominant hypomagnesemia with hypocalciuria, hypomagnesemia with secondary hypocalcemia, autosomal dominant hypocalcemia and etc. Recent advances in molecular genetics and protein functions contribute to more understanding of magnesium transport. We will review clinical aspects of hereditary disorders of hypomagnesemia and summarize genetic findings related to these disorders.

BACKGROUND:Unicompartment knee replacement is more popular for smal trauma, rapid recovery, low complication and almost normal knee mechanics, and has been more and more used in clinic to repair single compartment knee disease. At present, there is no report about the influence of the angle of the single condyle prosthesis on the survival rate. OBJECTIVE:To evaluate the effectiveness of unicompartmental knee replacement for medial compartmental osteoarthritis of the knee in 4-6 years of fol ow-up. METHODS:Thirty patients with medial compartmental osteoarthritis of the knee were treated by unicompartmental knee replacement with Oxford system. Complication occurrence was observed. Curative effects were evaluated with Hospital for Special Surgery score before and 3 months, 6 months and 1 year after surgery. On anteroposterior view, the varus/valgus alignments of the tibial components were measured relative to the long axis of the tibia. On lateral view, flexion/extension of the femoral component was measured relative to the posterior femoral cortex. RESULTS AND CONCLUSION:(1) Primary healing of incision was obtained in al patients, and no infection or lower limb deep venous thrombosis occurred. (2) Al of the patients were fol owed up for 48-72 months. There was no prosthetic loosening, dislocation or revision for contralateral compartment and patel ofemoral joint symptoms. (3) Hospital for Special Surgery score was significantly increased to (90.47±4.05) (P=0.00). (4) Tibial placement angle of single condyle prosthesis:The axis of the prosthesis was perpendicular to the axis of the tibia in 21 cases. Varus placement:2° in 1 case, 4° in 3 cases, 5° in 2 cases, 6° in 2 cases, and 10° in 1 case. No valgus occurred in the tibial side. (5) Femoral prosthesis placement angle:The axis of the femoral prosthesis was paral el to the posterior edge of the femoral cortex in 22 cases, on the flexed position:4° in 2 cases, 5° in 1 case, 6° in 1 case and 7° in 1 case;in the extension position:3° in 1 case, 4° in 1 case and 5° in 1 case. (6) Results suggested that the unilateral condylar replacement for the repair of medial compartment osteoarthritis of the knee has a good initial effect. The middle-term and long-term efficacy needs longer fol ow-up study.

Objective To discuss the clinical effect and the application value of total mesentery excision to the rectal cancerous patients. Methods The clinical data of 67 rectal cancerous patients who received the radical resection which following the TME principle,and with a 2 ～3 years follow-up were analyzed. Results All the 67 patients received the radical resection,including 1 anastomotic fistula,3 anastomotic stenosis, neither local recurrence nor distant metastasis. Conclusion TME played an important role in preventing the local recurrence of rectal cancer, and it met the standards of surgical treatment of rectal cancer better.

Objective:To estimate the effect of treatment opportunity for severe caries in primary molars on child dental fear and dent-al behavior.Methods:288 children aged 3 -6 years with primary molars caries were included on the first visit.The children in the ex-perimental group(n =144),with obvious clinical symptom,were initiative to see a dentist.Those in control group(n =144)without evident symptom were found with caries in conventional dental examination.The change of the children fear before and after the first treatment was assessed by MCDASf within the first week,the change of children's clinical behavior in their first and return visit was esti-mated by Venham Clinical Anxiety and Cooperation Behavior Measurement Scale.Data was statistically analyzed.Results:After the first treatment and during the return visit,the MCDASf average score of the experimental group was decreased(P <0.05),that of the control group was not(P >0.05).On their return visit,the behavior of the 2 groups was similar (P >0.05),and which was ameliora-ted in the experimental group during their own first and return visit,compared with the control group(P <0.05).Conclusion:Treat-ment of severe caries before acute symptom arising in young children may alleviatie the child dental fear.

Objective To investigate the effects of sevoflurane preconditioning on cardiovascular function in patients with coro -nary heart diseases , and explore its mechanism .Methods Eighty patients with coronary heart disease during 2009 January to 2012 December from our hospital patients were selected and randomly divided into the study group ( 41 cases ) and control group ( 39 ca-ses) .Patients in study group were given sevoflurane preconditioning , while the control group were given propofol .A series of parame-ters were recorded, including the patient's heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), stroke volume (SV), cardiac output (CO), systolic time ratio (STR) and serum cardiac troponin T (cTnT) before induction of anesthesia (T0), 30min (T1) during the operation, incision suture (T2), 6h after operation (T3), 12h after operation (T4), and 24 h after op-eration (T5).Results HR, CO, SV, CVP, MAP, STR, and cTnT of the research group were relatively more stable than the control group in the preoperative, intraoperative, postoperative, and recovery.The study group at CO, T1, SV, STR, and cTnT were (3.48 ±0.40)L/min, (6.4 ±1.9)ml/(min· m2), (0.36 ±0.76), (0.227 ±0.112)ng/ml, CO, SV, STR in T2 and cTnT were (3.58 ±0.52)L/min, (6.6 ±2.3)ml/(min· m2), (0.36 ±0.63), (0.241 ±0.115)ng/ml, control group T1 at CO, SV, STR and cTnT were (3.11 ±0.53)L/min, (5.2 ±2.1)ml/(min· m2), (0.46 ±0.81), (0.351 ±0.106)ng/ml, CO, SV, STR in T2 and cTnT were (3.15 ±0.61)L/min, (5.7 ±1.5)ml/(min· m2), (0.44 ±0.90), (0.311 ±0.112) ng/ml.The patients in study group were in T1 CO, SV CO in T1 , SV, T2 times higher than that in control group .STR in T1 , T2 point was lower than that of the control group, cTnT in T1 , T2 point was lower than that of the control group , and the difference between the groups was statistically significant ( P <0.05 ) .Research group of patients with CO , SV higher than that in control group at in T 1 ,T2 , and STR lower than that at T 1 , T2 , cTnT lower than that of the control group at in T 1 , T2 , and the differences were statistically significant ( P <0.05 ) .Conclusions Sevoflurane preconditioning can make the hemodynamics more stable , more suitable for clinical anesthesia , and its mechanism may be related to the changes of cardiac troponin T .

Malignant biliary obstruction is caused by biliary tract malignant tumors or by extrinsic compression from pancreatic cancer, liver cancer, etc. Clinically, the disease is characterized by jaundice, skin itching, hepatic failure, etc., and the patients endure a poor quality of life with a short survival time. The key point for the treatment of malignant biliary obstruction lies in dredging biliary drainage channel , timely reducing jaundice and protecting liver function. This paper reviews the relevant medical literature , that have been published both at home and abroad in recent years, concerning percutaneous transhepatic endobiliary radiofrequency ablation by using HabibTM EndoHPB catheter to treat malignant biliary obstruction in order to clarify the fact that percutaneous transhepatic endobiliary radiofrequency ablation is a safe and feasible treatment and this technique can effectively reduce the incidence of re-stenosis of implanted biliary metallic stent.