OBJECTIVE:To study the pharmacokinetics of lidocaine and bupivacaine in children undergoing epidural anesthesia so as to evaluate the safety and efficacy of this anesthetic method.METHODS:A total of 30 children who were expected to undergo surgery for undescended testis,hernia or high ligature for hydrocele were assigned to receive 2% lidocaine(5 mg?kg-1) plus 0.75% bupivacaine(1.875 mg?kg-1)(single epidural dose) by epidural anesthesia.Plasma concentrations of lidocaine and bupivacaine were determined by HPLC.Pharmacokinetics parameters were calculated and fitted by using DAS ver 2.0 pharmacokinetic program.RESULTS:The plasma concentration-time curves of lidocaine and bupivacaine were in line with a two-compartment model.The main pharmacokinetic parameters of lidocaine vs.bupivacaine were as follows:tmax 27.0 vs.33.0 min;t1/2? 43.97 min vs.73.52 min;Cmax 2.411 mg?L-1 vs.1.475 mg?L-1;AUC0～∞ 144.714 mg?min?L-1 vs.168.541 mg?min?L-1.CONCLUSION:The dosages of the local anesthetics injected into the epidural cavity of children are proven to be safe and effective.

Objective To study chronic nephrotoxicity of Penthorum chinense. To provide a scientific evidence for the development and application of Penthorum chinense in food and drug. Methods 48 SD rats were randomly divided into 4 groups (n=12), 0. 9% sodium chloride solution saline group and three Penthorum chinense treat groups. The Penthorum chinense groups were treated by intragastric administration with 5,10,20 g·kg-1 crude drug once a day for 3 months. The levels of Urea, UA, Cre in serum were detected, and the HE dyeing was chosen to observe the kidney morphology. Results The body weight, nephritic organ quotiety, and the level of Urea, UA, and Cre in each exposure group have no statistically significant difference compared with 0. 9% sodium chloride solution group (P>0. 05). There were no obvious kidney morphology changes in the Penthorum chinense group(F=1. 37,P=0. 268). Conclusion The kidney morphology and function of rat shows no apparente injury after long-term intragastric administration of Penthorum chinense.

Difficult cases are frequently found at the department of internal medicine of large hospitals.Better quality of ward-rounds by these department heads is key to medical safety,to better operations,and to reducing medical disputes incurred by malpractice.Focusing on standardizing wardround behavior and medical records,the People's Liberation Army General Hospital established and applied the Quality Standards of Ward-rounds on difficulty cases,which scored expected outcomes of better quality of care and better patient satisfaction.

To preliminarily determine the appropriate dosage of carboplatin (CBP) at AUC of 5 mg.Ml(-1).min(-1) in the combination chemotherapy for Chinese senile patients with non-small cell lung cancer (NSCLC). Thirty-five Chinese senile patients with NSCLC in advanced stage (III/IV) were given 96 cycles of combination chemotherapy. Chemotherapy schedules included Taxol+CBP, Gemzar+CBP and NVB+CBP. The dose of CBP was at 5 mg.mL(-1).min(-1) of area under the concentration-time curve (AUC). Side effects and quality of life were observed before and after the chemotherapy. Myelosuppression was severe and commonly observed. Grade 3/4 of granulocytopenia was found in 47.9% (46/96) of the patients and grade 3/4 of thrombocytopenia was noted in 28.1% (27/96) of the subjects. However, other side effects were slight. The mean score of quality of life (QOL), according to the criteria of QOL for Chinese cancer patients had reduced 6.8. At 5 mg.mL(-1).min(-1) by AUC, the hematological toxicity of CBP was severe and it had some negative effects on the QOL. The administration of CBP at 5 mg.mL(-1).min(-1) by AUC may be too high for Chinese senile patients with non-small cell lung cancer.
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Area Under Curve ; Carboplatin/*administration & dosage ; Carboplatin/adverse effects ; Carcinoma, Non-Small-Cell Lung/*drug therapy ; Lung Neoplasms/*drug therapy

BACKGROUND:Stem cell transplantation can, in theory, rebuild the immune system and regulate immunologic function. In addition, the transplanted stem cells may differentiate into tissues or cells we want. Therefore, this intervention may restore gastrointestinal inflammatory lesion and exert therapeutic effect on inflammatory bowel diseases (IBD). OBJECTIVE:To review the application of different kinds of stem cells in IBD treatment. METHODS:A computer-based search of CNKI, PubMed and FMJS was performed for articles concerning stem cel transplantation and IBD published after January 2002. The key words were stem cells, inflammatory bowel diseases, Crohn's diseases, ulcerative colitis, cell therapy in Chinese and English respectively. At last, 49 articles were included in result analysis. RESULTS AND CONCLUSION: Embryonic stem cells and adult stem cells both have certain therapeutic benefits in IBD. But which kind of stem cell is the safest and most efficacious cannot be confirmed, and at the same time the most effective and the optimal dose and way of transplantation of such cells are still unclear. All in all, there is still a lot of work to do to remove the obstacles.

OBJECTIVE:To observe the effects of epalrestat combined with lipoic acid on nerve function,oxidative stress and inflammatory reaction in patients with diabetic peripheral neuropathy(DPN). METHODS:From Jan. 2013 to Jan. 2016,150 pa-tients were selected from our hospital and then divided into group A,B,C according to random number table,with 50 cases in each group. Group A was given Lipoic acid injection 600 mg,ivgtt,qd;group B was given Epalrestat tablet 50 mg,po,tid;group C was given lipoic acid+epalrestat,same usage and dosage as above. TSS score,MNCV,SNCV,oxidative stress indexes (SOD and MDA)and inflammatory indexes(TNF-α and IL-6),as well as blood pressure,blood lipid and blood glucose indexes were compared among 3 groups before and after treatment. The occurrence of ADR were observed. RESULTS:Before treatment, there was no statistical significance in above indexes among 3 groups (P>0.05). Compared to before treatment,TSS score, MDA,TNF-α and IL-6 levels of 3 groups were decreased significantly after treatment;MNCV and SNCV were speeded up signifi-cantly,and SOD level was increased significantly;each index of group C was better than that of group A and B,with statistical significance(P<0.05),but there was no statistical significance between group A and B(P>0.05). SBP and FPG after treatment of 3 groups were decreased significantly than before treatment,while HDL-C was increased significantly,with statistical signifi-cance(P<0.05);there was no statistical significance among 3 groups(P>0.05). No obvious ADR was found in 3 groups. CON-CLUSIONS:Epalrestat combined with lipoic acid can effectively improve nerve function in DPN patients by inhibiting oxidant stress and inflammatory reaction with good safety. The effect of drug combination is better than single drug.

OBJECTIVE:To investigate the effect of total saponins of Man medicine Thladiantha dubia root(TSTR)on the ex-pressions of CD3+,CD4+and CD8+ in spleen tissue of rats with type Ⅱ collagen-induced arthritis (CIA),and explore its mecha-nism in the treatment of rheumatoid arthritis(RA). METHODS:8 rats were taken as normal control group(NC group),the others 72 rats were injected mixture of bovine type Ⅱ collagen and Freund's complete adjuvant in tail and back to induce CIA model. The 50 modeled rats were randomly divided into model group(MC group),tripterygium polyglycoside(TG)group(12 mg/kg,posi-tive control),TSTR low-dose,medium-dose,high-dose groups (20,40,80 mg/kg),10 in each group. Rats in medicine groups were intragastrically administrated for 35 d,once a day;rats in NC group and MC group were intragastrically administrated equal volume of distilled water. Ankle swelling degree of rats was determined,arthritis indexes were calculated,HE staining was used to observe the lesions in synovial tissue,and immunohistochemistry was used to detect the expressions of CD3+,CD4+,CD8+ in spleen tissue of rats. RESULTS:After 35 d of administration,ankle swelling degree,arthritis indexes,CD4+ expression in spleen tissue,and CD4+/CD8+ ratio in MC group were significantly higher than NC group (P<0.05 or P<0.01),expressions of CD3+, CD8+were significantly lower than NC group(P<0.05);and there was congestion and massive inflammatory cell infiltration in sy-novial tissue. The ankle swelling degree,arthritis indexes,expression of CD4+ in spleen tissue,and CD4+/CD8+ ratio in administra-tion groups were significantly lower than MC group(P<0.05);the expressions of CD3+,CD8+ in spleen tissue in administration groups were significantly higher than MC group (P<0.05);TG group,TSTR medium-dose and high-dose groups showed mild congestion and a small amount of inflammatory cell infiltration in synovial tissue of rats,and TSTR low-dose group showed no ob-vious congestion or inflammatory cell infiltration. CONCLUSIONS:Up-regulating the expressions of CD3+,CD8+ and down-regu-lating the expression of CD4+ may be one of the mechanisms of TSTR in the treatment of RA;and with best efficacy when the TSTR dose of 20 mg/kg.

Reference materials are one of the major approaches to achieve measurement accuracy and metrological comparability. Different functions of reference materials should also be distinguished when applied to mass spectrometry as an emerging technology in clinical laboratory. Proper reference materials for validation, calibration and quality control of measurement method can ensure the accuracy and comparability of test results. Based on the problems of reference materials in clinical mass spectrometry, the precautions for the use of reference materials are summarized in the aspects of measurement method validation, calibrator usage and quality control.

Objective To discuss the application of Germany Cooperation for Transparency and Quality in Health Care (KTQ) quality certification system in the field of nursing management. Methods The Plan-Do-Check-Act (PDCA) from KTQ was used in the management of ward nursing quality. The post-interventional quality of basic nursing, critical nursing, health education, ward management, nursing safety and disinfection and isolation were compared and contrasted with the pre-interventional one. Result The quality of basic nursing, critical nursing, health education, ward management, nursing safety and disinfection and isolation were significantly improved after intervention with PDCA from KTQ (P<0.01). Conclusion The KTQ quality certification system can be applied to improve the nursing quality in the process of nursing management.

Objective To explore and analyze the related factors of nosocomial infection in patients after total laparoscopic hysterectomy.Methods A total of 231 patients undergoing total laparoscopic hysterectomy were enrolled in this study and their data were retrospectively analyzed.The related factors such as uterus size,operation duration,intraoperative blood loss,type of disease,drainage tube,hospital duration before surgery,and history of pelvic surgery were analyzed.Results Among the 231 cases undergoing total laparoscopic hysterectomy,23 cases had infection and the infection rate was 9.96％.Univariate analysis showed uterus size,operation duration,intraoperative blood loss,hospital duration before surgery,and history of pelvic surgery had influence on postoperative infection and the difference had statistical significance (P＜0.05),while the difference of age and drainage tube had no statistical significance on postoperative infection (P＞0.05).Conclusion The incidence of infection after laparoscopic hysterectomy is related to uterus size,operation duration,intaoperative blood loss,hospital duration before surgery,and history of pelvic surgery.