Objective To analyze if the increasing the dose and time of vancomycin will increase the renal toxicity risk in patients with resistance to toluene penicillin Staphylococcus aureus (methicillin-resistant Staphylococcus aureus, MRSA) and blood drug concentration significance in the course of treatment.Methods We enrolled 105 patients, mean age (58.0 ±5.8) years;59 males (61.9%) treated in our hospital with MRSA.Patients’ age, sex, serum creatinine (SCr), creatinine clearance rate (CrCl), serum vancomycin concentrations, duration of treatment, acute physiology and chronic health evaluation II score were analysed.The definition of renal toxicity is that SCr is higher than the baseline 0.5 mg/dL, or according to the measurement results of a series SCr:SCr elevation≥50%.The relevant data in patients with renal toxicity and non toxicity were compared.Results 45 (42.9%) had renal toxicity.Vancomycin concentration was significantly higher in renal toxicity patients than non toxicity [(20.9 ±9.8)μg/mL vs. (14.2 ±6.6)μg/mL, P<0.001), serum drug concentration≥15μg/mL (67.8% vs 40.3%; P =0.01) and vancomycin treatment duration (14 days) ( 46.0% vs 21.4%; P =0.011 ) has obvious different scale between two groups. Regression analysis showed that: vancomycin serum concentration≥15μg/mL and prolonged treatment were independent predictors of renal toxicity ( adjusted likelihood ratio =2.83; 95%CI, 1.03 ~7.72, P=0.045).Conclusion The increase of vancomycin dosage and treatment time was the risk of nephrotoxicity.

In order to locate the level of nitroquine action on the folate metabolism, ni-troquine was given to the mice infected with P. berghei or P. yoelii. To the first group of mice, different doses of nitroquine were given to its five subgroups. The second group of mice received the same doses of nitroquine as the first group but calcium leucovorin (folinic acid) 6 mg/kg/day intramuscularly, folic acid 20 mg/kg/day intramuscularly, or PABA 20 mg/kg/day orally were given to different subgroups respectively at the same time. It was found that the dose-effective curve of nitroquine was shifted to the right when PABA was administered simultaneously and the CD50 of nitroquine at that time was larger than that of nitroquine used singly. Both calcium leucovorin and folic acid essentially showed no antigonistic effects.From the antigonistic action of PABA against nitroquine) it is suggested that nitroquine is likely to achieve its antimalarial effect through its competition for dihydropteric acid synthetase with PABA. Other chains on the folic acid metabolism were also discussed.

Objective To study the nursing of bedsore prevention in patients with unstable pelvic fracture. Methods Bedsore forewarning risk assessment went on in 39 patients with unstable pelvic fracture by Braden scoring method. Results No bedsore was observed in these 39 patients with unstable pelvic fracture.The nursing result turned out to be satisfactory. Conclusions The incidence rate of bed-sore can be degraded in patients with unstable pelvic fracture by forewarning risk assessment with Braden scoring method and early nursing intervention.

Objective To investigate the reliability and effect of using the chimeric flap retrieved by laparoscopic surgery to cover the large defect of the extremities.Methods The debridement and vacuum sealing drainage (VSD) were performed on 18 patients, who were admitted due to the defects of the extremities.The free chimeric peritoneal-deep inferior epigastric artery perforator (DIEP) flap assisted by laparoscopic surgery was transplanted to cover the defect with exposed tendons and/or skeleton.Results The remaining defects of the extremities were 12 cm × 8 cm-30 cm × 17 cm.The peritoneal component of the chimeric flaps measuring 8 cm × 6 cm -14 cm × 10 cm retrieved by laparoscopic surgery was used to cover the tendons, bones and joints.The deep inferior epigastric artery perforator (DIEP) flaps measuring 13 cm × 10 cm-32 cm × 18 cm allowed the cutaneous coverage of wounds.The chimeric flaps survived completely excepting two patients.The two patients experienced partial necrosis of the chimeric flaps and received skin grafting to achieve the wound closure.The function of the injured extremities recovered partially after 6-18 months of follow-up.No abdominal pain, distension, herniation,bulging and intestinal obstruction were recorded.Conclusion The chimeric flap assisted by laparoscopy is a helpful, safe and effective method for reconstruction of large wounds in extremities with exposed tendons and bones.

In order To evaluate whether the parameters of spiral artery blood flow, as measured by transvaginal color Doppler, may be used to assess endometrium receptivity prior to embryo transfer (ET), a retrospective study of 94 infertile women who had undergone ART treatments with different outcomes (pregnant or nonpregnant) was done. Subendometrial blood flow was evaluated. The resistance index (RI), systolic/diastolic ratio (S/D) and pulsatility index (PI) were significantly lower in those who achieved pregnancy as compared with those who did not: 0.62+/-0.04 vs 0.68+/-0.04 (P<0.001), 2.66+/-0.33 vs 3.19+/-0.39 (P<0.01) and 1.15+/-0.17 vs 1.34+/-0.22 (P<0. 05), respectively. Furthermore, when RI>0. 2, PI>1. , and S/D>3. , no pregnancy occurred. These data suggest that the parameters of spiral artery blood flow could be used as a new assay in predicting endometrial receptivity before ET.
Arteries/ultrasonography ; Embryo Implantation/*physiology ; Embryo Transfer ; Endometrium/*blood supply ; Endometrium/*physiology ; Endometrium/ultrasonography ; Fertilization in Vitro ; Infertility, Female/physiopathology ; Regional Blood Flow ; Sperm Injections, Intracytoplasmic ; Treatment Outcome ; Ultrasonography, Doppler, Color

Objective To investigate the clinical efficacy of using the tissue engineering bone loaded with adipose derived stem cells (ADSCs)and perforator flap in the treatment of composite tissue defects.Methods From April,2013 to June,2015,there were 9 cases of traumatic bone and skin composite tissue defects,including 7 males and 2 females,with an averaged age of 43 years old.The ADSCs were isolated,induced and co-cultured with demineralized bone scaffold.The tissue engineering bone and deep inferior epigastric artery perforator (DIEP) flap were adopted for reconstruction of composite tissue defects.Results All 9 patients were followed up for 12-36 months,averaged of 18 months.The bone growth was obviously for 5 cases with bone defects at the middle and lower part of the tibia.They tolerated full weight bearing walking.One case of middle humeral bone defect demonstrated normal bone tissue growth,and the 2/3 of cross section had been restored.One case of humeral bone defect and 1 case of radial bone defect reached bone union.The remaining 1 with skull defect showed new bone growth,but it had not yet achieved complete bone healing.Conclusion The combination of tissue engineering bone and perforator flap is a minimally invasive,easy accessible and effective method for reconstruction of composite tissue defects.

Objective To observe and classify endometrial wavelike activities in controlled ovarian hyperstimulation (COH) cycles,and to study their effect on assisted reproductive techniques(ART) outcomes in COH cycles.Methods Patterns of endometrium wavelike movements were described,then their percentages of the total endometrium movements were calculated and compared retrospectively in 57 infertile women who had undergone ART treatments with different outcomes.Results Five types of endometrial wavelike movements could be distinguished:No activity, random,positive,negative,and opposing endometrium movements.The frequencies and types of endometrial movements varied in COH cycles.Endometrium movements,especially negative movements more frequently appeared in non-conception group than in conception group.Conclusions Abnormal endometrium activity could be seemed as underlying mechanisms in some cases of unexplained infertility or ART failure.

Objective To discuss the clinical effect of Da Vinci robot-assisted free fibula flap for the management of mandibular and mouth segmental defect.Methods There was a patient with malignant neoplasm of lower gum,which underwent robot-assisted free fibula flap for the management of mandibular and mouth segmental defect,was analyzed.The surgery was divided into two groups:a group resected the primary tumors,another group cut fibula free flap.Use of Da Vinci robotic surgical system for vascular anastomosis and suture of the oral mucosa.Results Four weeks after surgery,the free fibula flap survived completely.There was no infection in the mouth.The patient can walk freely and eating semifluid.Conclusion The Da Vinci robotic surgical system is a stable,minimally invasive,clear and safe method for microsurgery.

0.05).But aripiprazole produced fewer side effects than risperidone,such as extrapyramidal symptom,gain weight,disorder of menstruation.Conclusion:Aripiprazole is as effective as risperidone for the treatment of the initial schizophrenia and has fewer side effects.

Objective To evaluate the clinical value of ~(99m)Tc-MAA imaging in patients with lower extremital posttraumatosis and postoperation(LEPP).Methods 21 LEPP patients with clinical highly suspected acute pulmonary embolism(APE) underwent ~(99m)Tc-MAA veins imaging and pulmonary perfusion imaging(PPI).Vena caval filters were inserted and thrombolysis were given in patients with big area APE and/or iliofemoral vein thrombosis indicated by ~(99m)Tc-MAA imaging.Thrombolysis was given in patients with small area APE and/or subpopliteal vein thrombosis.PPI was reexamined after 2～4weeks` treatment.The lung segments with 100% lack of perfusion were marked 3,those with 25%～75% were marked 2,those with less than 25% were marked 1 and normal was marked 0.The therapeutic results were assessed using this marking system.Results There were 13 patients with big area APE,8 with small area APE,14 with iliofemoral vein thrombosis,and 7 with subpopliteal vein thrombosis.2 cases(9.5%) died before thromobolytic therapy.The marks were significant different before(10.2?3.8) and after(2.8?1.4) treatment(t=7.75,P