New process reported the synthesis of telavancin using decyl alcohol as the starting material.After methanesulfonylation,nucleophilic substitution with ethanolamine,Fmoc protection,and Parikh-Doering oxidation,the intermdiate N-(9-fluorenyl-9-methoxycarbonyl) decylaminoethyl acetaldehyde (5) was obtained.Vancomycin hydrochloride and intermediate 5 were then subject to reductive amination reaction,Fmoc deprotection,and Mannich reaction to give the telavancin product.The process have been deeply studied on the two key reactions of reductive amination and Mannich reaction,and the reaction conditions have been optimized.The overall yield is 46％ based on starting material vancomycin.

Objective To determine ED50 and ED9 5 of etomidate for combined remifentanil used in elderly patients in gastroscope.Methods Twenty-three patients were scheduled to receive gastros-copy aged 65-78 years old including males 13 and females 10,weighting 45-76 kg and ASA Ⅰ-Ⅲ. They were slowly injected remifentanil 0.3 μg/kg,and then etomidate 0.20 mg/kg,gastroscopy was performed after their eyelash reflex disappeared.The dosage of etomidate were determined by modified up-and-down methods,0.20 mg/kg was initial dosage.During the gastroscope,restlessness, frowning,swallowing,choking cough could be seen.The adjacent experimental interval dosage was 0.05 mg/kg,the trial was ended when there was the seventh cross-sectional,and determined the ED50 and ED9 5 of etomidate and (95%confidence interval)of them for gastroscope with probability a-nalysis methods.Results The ED50 of etomidate was 0.1 7 mg/kg and 95%CI 0.14-0.21 mg/kg,and the ED9 5 was 0.23 mg/kg,95%CI 0.20-0.42 mg/kg respectively.Conclusion The ED50 and ED9 5 of etomidate combined with remifentanil used for elderly patients for gastroscope respectively are 0.1 7 mg/kg and 0.23 mg/kg.

Objective:To establish the ISSR fingerprint of Chrysanthemum morifolium cultivated in Futianhe area of Macheng county to guide the breeding of C. morifolium. Methods:Using the technology of ISSR molecular markers and the software of SPSS 15. 0, the coefficient matrix of Jaccard was established and the tree graph of the genetic relationship of the breeds of C. morifolium cultivated in Fu-tianhe area was built to analyze the respective genetic relationship and features. Results:By ISSR analysis, it confirmed that C. morifoli-um in Futianhe area had long genetic distance with the other white chrysanthemum breeds, and it could be considered as an individual breed. Conclusion:The ISSR map can be used to identify the breed of C. morifolium cultivated in Futianhe area.

OBJECTIVETo explore the effect of a self-made guiding needle of steel wire in guiding the wire through the tibial tunnel for the treatment of avulsion fractures of tibial posterior cruciate ligament with open reduction and wire fixation.

METHODSFrom February 2011 to June 2014, a total of 22 patients with avulsion fractures of tibial posterior cruciate ligament underwent surgical treatments were analyzed, including 14 males and 8 females with an average age of 35.6 years old (ranged, 17 to 63 years old). According to Meyers classification, 9 patients were classified as type II, 13 patients were classified as type III. All the patients underwent open reduction and wire fixation with medial knee "L" shape approach. A wire guiding needle was used to guide the wire through the tibial tunnel during operation.

RESULTSWith the assistance of wire guidance needles, wires passed through the tibial tunnel rapidly during the operation in all the 22 patients. All the patients were followed up, X-ray imagings 6 months after operation showed the fractures healed well. The average follow-up time in all patients was 6 months (ranged, 6 to 12 months). The averaged Lysholm knee score in 22 knee was 92.7 +/- 3.4. All patients' posterior drawer test were negative.

CONCLUSIONSelf-made wire guiding needle can simplify the operation procedures in which the wires pass through the tibial tunnel, shorten the operation time, reduce the surgical trauma and complications, and be worthy of clinical application.

Adolescent ; Adult ; Bone Wires ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Young Adult

In the article,a plan of network construction which satisfies the demand of applications for a telemedical information sharing platform is proposed. We choice network access plans in view of user actual situation, through the analysis of the service demand and many kinds of network access technologies. Hospital servers that locate in LAN link sharing platform with node servers, should separate from the broadband network of sharing platform in order to ensure the security of the internal hospital network and the administration management. We use the VPN technology to realize the safe transmission of information in the platform network. Preliminary experiments have proved the plan is practicable.
Computer Communication Networks ; Computer Security ; standards ; Hospital Information Systems ; Humans ; Information Storage and Retrieval ; methods ; Internet ; Radiology Information Systems ; Telemedicine ; methods ; standards ; User-Computer Interface

This article introduces the development of a middleware based on HL7, which solves the problem of data integration and sharing effectively and successfully, among the hospital internal subsystems and different hospitals' information systems.
Computer Communication Networks ; standards ; Computer Systems ; Hospital Information Systems ; standards ; Humans ; Information Services ; Information Systems ; Medical Records Systems, Computerized ; Software ; Systems Integration

Objective To investigate the plasma level change of myeloperoxidase(MPO)in patients suffering from stable angina pectoris.Methods Five hundred and seventy three patients underwent elective coronary angiography in a bi-racial cohort study,which included 295 patients with stable angina peetoris(SAP)and 278 subjects served as control.Plasma level of MPO and traditional risk factors of coronary artery disease(CAD)were measured.Results MPO levels did not differ significantly between control group and SAP group[126.3(95.8-160.2)mg/L vs 123.6(97.4-150.0) mg/L P＞0.05].MPO levels were similar across ethnicity and gender[black male 119.6(94.8-146.9) mg/L,white male 124.6(99.9～154.6)mg/L,black female 124.0(93.3～152.3)mg/L and white female 127.5(95.3～159.8)mg/L],and were correlated positively with the levels ofⅦfactor(r= 0.251,P＜0.01),fasting plasma glucose(r=0.095,P＜0.05),triglyceride(r=0.186,P＜0.01), total cholesterol(r=0.081,P＜0.05),high-sensitivity C-reactive protein(r=0.123,P＜0.01) and fibrinogen levels(r=0.077,P＜0.01),negatively correlated with adiponectin level(r=-0.115, P＜0.01).Conclusions Plasma MPO level is not elevated in patients with SAP.This suggests that MPO is not a characteristic feature of SAP.There are also no significant relationships between different genders and between different ethnicities.

In this article, based on the analysis on the regional information system's development background and its applications, the construction of the regional medical information system through creating the electronic medical record and the medicine image data centers is proposed, for information resource sharing. And then, the system's software construction and various subsystems functions are mainly introduced. Standardization and the middleware platform are suggested as the effective way of constructing these two data centers in the present situation in our country.
Computer Security ; Computer Systems ; Hospital Information Systems ; Humans ; Medical Records Systems, Computerized ; Radiology Information Systems ; Software

OBJECTIVETo evaluate the incidence of postoperative hemorrhage in children undergoing adenoidectomy, and to discuss its possible causes.

METHODSIncluded in this study were children who underwent adenoid and/or tonsil surgery at Shenzhen Children's Hospital between January 2004 and November 2009. The change of hemoglobin (Hb) and hematocrit (Hct) were retrospectively analysed. The blood loss was estimated by the change of Hct.

RESULTSThere were 2078 cases that accomplished the inclusion criteria in the period of study. Ten children bled 0.5 - 4.0 hours after surgery, without superfluous hemorrhage during the operation and post-tonsillectomy. This represented an incidence of 0.48%of immediate postoperative haemorrhage among the 2078 procedures analyzed. Statistical differences were found between boys (0.21%) and girls (1.10%, χ² = 5.597, P < 0.05). The change of Hb and Hct was positively correlated (r = 0.95, P < 0.01), the blood loss was positively correlated with the bleeding time (r = 0.66, P < 0.05). The causes of postoperative hemorrhage were coagulation system deficits, chronic nasopharyngitis, deficient hemostasis and immoderate ravage. To control the postoperative hemorrhage, 2 postnasal packing under topical anaesthesia and 8 electrocautery under general anaesthesia were applied.

CONCLUSIONSPoor operative technique and deficient hemostasis are the major causes of primary hemorrhage. Prompt operation to control the postoperative bleeding should be done 2 hours after bleeding under general anesthesia in order to avoid severe complications.

Adenoidectomy ; adverse effects ; Adolescent ; Child ; Child, Preschool ; Female ; Hematocrit ; Hemoglobins ; analysis ; Humans ; Infant ; Male ; Postoperative Hemorrhage ; etiology ; Retrospective Studies ; Tonsillectomy ; adverse effects

Objective:To explore the effects of protoporphyrin Ⅸ (PpⅨ)-mediated photodynamic therapy (PDT) on induction of apoptosis and death in colon cancer cell and the underlying mechanisms.Methods:The cell killing effect of PDT on HCT116 cell was determined by cell counting kit (CCK).The cells were divided into a control group,a single light group,a single PpⅨ group,and a PDT group.Hoechst 33342 and flow cytometry was used to assess the cell apoptosis.Western blot was employed to analyze the expressions ofbd-2,bax,and caspase-3.Reactive oxygen species (ROS) was detected by flow cytometry.Results:The viability of HCT116 cell was decreased gradually with the increase of irradiation dose (P<0.05).Compared to the other 3 groups,ROS production,the number of apoptotic cells and the protein expressions ofbax and caspase-3 in PDT group increased,while bcl-2 expression was decreased (P<0.05).Conclusion:PpⅨ-mediated PDT can enhance the apoptosis in HCT116 cell,which may be related to mitochondrial apoptosis pathway.