AIMTo study the NMR phenomena of cetirizine hydrochloride and assign all proton and carbon signals in NMR spectra.

METHODSTo record the 1D and 2D NMR spectra of cetirizine hydrochloride while changing the experimental temperature and adding D2O into the solution.

RESULTSMore than one NMR signal or broad peak resulting from piperazine and the attached groups with N atom were given in DMSO-d6 solution at room temperature. "Coalescence" or narrowing had occurred for the proton and carbon signals when the experimental temperature was increased or D2O was added into the solution.

CONCLUSIONCompared with the NMR "time scale", there are more than one conformation of cetirizine hydrochloride in DMSO-d6 solution at room temperature. The different conformation will be exchanged fast while temperature rise and the stable conformation will be existed while D2O was added into the solution.

Cetirizine ; chemistry ; Deuterium ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Protein Conformation ; Temperature

OBJECTIVETo explore the possible factors causing the increase of rabies cases and to provide references for the development of related prevention and control strategy in Hunan.

METHODSData was collected and analyzed on epidemic situation of rabies in the past ten years, and studies were carried in some counties.

RESULTSFrom 1994 to 1999, the annual cases sustained between 17 and 78. However, the number of cases has continued to increase since 2000. The annual reported cases in 2001 and 2002 were 311 and 313, and accounted for 34.8% and 30.0% of the total cases in the whole country respectively. The epidemic areas were mainly located in the south and middle parts of Hunan. Furthermore, the epidemic areas had been expanding. In 1997, human rabies cases were only reported in 7 cities but increased to 12 cities in 2004.

CONCLUSIONFactors as increasing number but low inoculating rate to dogs, and incorrect treatment on the wounds etc. might have served important roles for the recurrence of rabies. Hence, it is necessary to take comprehensive preventive measures to control and prevent the epidemics of rabies in Hunan.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Rabies ; epidemiology

OBJECTIVETo investigate the efficacy of the procedure for prolapse and hemorrhoids (PPH) combined with external hemorrhoids excision in the treatment of III or IV mixed hemorrhoids.

METHODSOne hundred and twelve patients with III or IV mixed hemorrhoids admitted for surgical treatment were randomly divided into three groups: PPH 1 group (34 cases), PPH2 group (36 cases), and Milligan-Morgan group (42 cases). PPH1 group received the standard PPH operation, PPH2 received PPH and external hemorrhoids excision, and Milligan-Morgan group received Milligan-Morgan hemorrhoidectomy. Postoperative 24 h-pain index, pain index when defecating, bleeding, anal discomfort feeling , wound edema, the ability of controlling feces, operating time, hospitalization time and charges were recorded. The change of anal dynamics was detected by anorectal manometry. All the patients were followed-up for 0.5-1 year.

RESULTSThere were no significant differences among the three groups in bleeding, anal discomfort feeling, the ability of controlling feces (P>0.05). The postoperative 24 h-pain index of PPH1 group was lower than those of the other two groups (P<0.05). PPH1 group and PPH2 group were better than Milligan-Morgan group in pain index when defecating, wound edema, operating time, and hospitalization time (P<0.05). Milligan-Morgan group was better than the other two groups in postoperative urinary retention and hospital charges (P<0.05). The change of anal duct pressure of Milligan-Morgan group was less than those of the other two groups (P<0.05). Within 0.5-1.0 year follow-up, 3 patients got thrombosed external hemorrhoid in PPH1 group, 2 patients recurred and 1 patient got thrombosed external hemorrhoid in Milligan-Morgan group, no recurred patients in PPH2 group.

CONCLUSIONPPH combined with external hemorrhoid excision is a safe and effective treatment for mixed hemorrhoids, which is suitable for mixed hemorrhoids with severe external hemorrhoids.

Adult ; Aged ; Anal Canal ; surgery ; Female ; Follow-Up Studies ; Hemorrhoids ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Prolapse ; Surgical Stapling

Objective To evaluate the combined antibacterial effect of fosfomycin and imipenem against 60 carbapenem-resistant Enterobacteri-aceae ( CRE ) in vitro.Methods Experiment was designed by the checkerboard method , the minimal inhibition concentrations of single antibacterial drug or the combination of fosfomycin and imipenem at dif-ferent concentrations against 60 CRE isolated from inpatients were evalua-ted through agar double dilution method synergy effect of combination was assessed by fractional inhibitory concentration index ( FIC ) .Results Compared with single-use, the minimal inhibitory concentra-tion of thecombination of fosfomycin and imipenem decreased ( P<0.01).The combination of fosfomycin and imipenem demonstrated 23.3%( 14/60 ) synergism , 35.0%( 21/60 ) partial synergism , 1.7%(1/60) additive, 40.0%( 24/60 ) indifference, no antagonism in our study.Conclusion Combination of fosfomycin and imipenem showed synergism or partial synergism against most CRE isolates.

OBJECTIVETo evaluate the oncologic safety, indications and aesthetic results for skin-sparing mastectomy (SSM) and immediate breast reconstruction (IBR).

METHODOne hundred and twenty-nine breast cancer patients treated by SSM + IBR from October 1999 to May 2007 were reviewed. Reconstructive techniques included latissimus dorsi flaps (38 patients), implants only (2 patients), latissimus dorsi flaps plus implants (61 patients), pedicled transverse rectus abdominis myocutaneous (TRAM) flaps (25 patients) and deep inferior epigastric artery perforator (DIEP) flaps (3 patients). Aesthetic results were judged by patients' self-evaluation.

RESULTSMean duration of hospitalization was 18.6 days. Time of first chemotherapy was 5.2 days after operation. Eleven patients (11/63, 17.5%) developed capsular contracture and 24 patients (24/99, 24.2%) developed seroma in the donor site. Nine patients (9/28, 32.1%) developed partial fat necrosis in TRAM and DIEP flaps. The satisfaction with the aesthetic results of the reconstructive breast was significantly lower in irradiated patients than non-irradiated ones. Median follow-up time was 11 months. Five patients developed local recurrence and 7 patients with metastasis.

CONCLUSIONSSSM with IBR can be used for the 0 to II a stage breast cancer patients, with surgical oncologic and aesthetic satisfaction. Radiotherapy has an adverse effect on the reconstructive breast. Delayed or delayed-immediate reconstructions are recommended for patients indicated to postoperative radiotherapy.

Adult ; Breast Neoplasms ; surgery ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; methods ; Mastectomy, Subcutaneous ; Middle Aged ; Retrospective Studies ; Surgical Flaps ; Treatment Outcome

Renal angiomyolipoma is a type of benign tumor that occurs sporadically in addition to being associated with tuberous sclerosis. Preoperative embolization of large tumors is important to avoid excessive blood loss during surgery. We reported a patient with a 5505-g giant renal angiomyolipoma in a solitary kidney. The patient was treated with preoperative embolization and radical nephrectomy without complications. This type of treatment for an enormous angiomyolipoma can reduce the risk of uncontrolled hemorrhage caused by rupture of the tumor during the operation and should be considered for the treatment of similar tumors.
Adult ; Angiomyolipoma ; surgery ; Arteries ; surgery ; Embolization, Therapeutic ; methods ; Humans ; Kidney Neoplasms ; surgery ; Male

Renal angiomyolipoma is a type of benign tumor that occurs sporadically in addition to being associated with tuberous sclerosis. Preoperative embolization of large tumors is important to avoid excessive blood loss during surgery. We reported a patient with a 5505-g giant renal angiomyolipoma in a solitary kidney. The patient was treated with preoperative embolization and radical nephrectomy without complications. This type of treatment for an enormous angiomyolipoma can reduce the risk of uncontrolled hemorrhage caused by rupture of the tumor during the operation and should be considered for the treatment of similar tumors.

OBJECTIVETo investigate the prevalence of CHEK2 c.1100delC mutation among non-BRCA1/BRCA2 familial/early-onset breast cancer patients in Shanghai.

METHODSOne hundred and fourteen non-BRCA1/BRCA2 hereditary breast cancer patients were analyzed, among whom 76 cases had at least one first-degree relative affected with breast cancer and 38 cases were diagnosed as breast cancer below the age of 40 years without family history. The mutation genotyping of CHEK2 c.1100delC were carried out through long-range PCR amplifying of exons 10-14, and followed by amplification of exon 10 and then DNA direct sequencing.

RESULTSNo c.1100delC frame-shift mutation was identified in our studied population. One novel missense mutation 1111C>T (p.His371Tyr), located in kinase catalytic domain, was found in 3 familial breast cancer cases but no one in control group.

CONCLUSIONCHEK2 c.1100delC is rare variant for Chinese population and may not contribute to predisposition for hereditary breast cancer in Shanghai. Novel variant -1111C>T could be in association with genetic susceptibility to breast cancer. A further study is needed to confirm the results.

Adult ; Aged ; Apoptosis Regulatory Proteins ; Asian Continental Ancestry Group ; genetics ; BRCA1 Protein ; genetics ; BRCA2 Protein ; genetics ; Base Sequence ; Breast Neoplasms ; ethnology ; genetics ; Checkpoint Kinase 2 ; China ; DNA Mutational Analysis ; Female ; Frameshift Mutation ; Genetic Predisposition to Disease ; genetics ; Humans ; Middle Aged ; Mutation, Missense ; Protein-Serine-Threonine Kinases ; genetics ; Sequence Deletion ; Young Adult

OBJECTIVETo evaluate the factors for the conversion of transurethral resection of the prostate (TURP) to open prostatectomy and to provide clinical evidence for surgical options.

METHODSFrom January 1997 to March 2005, we performed 1 086 TURP and made retrospective analyses of 11 risk factors concerning the demographics, clinical history, laboratory data, ultrasound results, and intraoperative complications of the patients. In addition, multivariate logistic regression was used to determine those variables predicting the conversion of TURP.

RESULTSThirty-nine (3.59%) of the TURP cases required conversion, mostly because of uncontrollable hemorrhage (71.79%). Multivariate analyses showed that a prostate volume > 85.2 ml (OR = 2.568, P < 0.01), intraoperative slit of capsula prostatic (OR = 1.916, P < 0.01) and a second midstream bladder specimen (VB2) white blood cell count of the urine > 13.5/HP (OR = 1.486, P < 0.01) predicted the conversion to open prostatectomy.

CONCLUSIONBenign prostatic hyperplasia (BPH) patients with a huge prostate and those with intraoperative slit of capsula prostatic undergoing TURP are more likely to be converted. And uncontrollable hemorrhage, huge prostate and poor endoscopic vision are the major reasons for the conversion.

Aged ; Aged, 80 and over ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Hemorrhage ; etiology ; Prostatectomy ; methods ; Prostatic Hyperplasia ; surgery ; Retrospective Studies ; Risk Factors ; Transurethral Resection of Prostate ; adverse effects ; methods ; Treatment Outcome

Adolescent ; Bronchial Neoplasms ; complications ; diagnosis ; Female ; Humans ; Intubation, Intratracheal ; Lymphoma, Non-Hodgkin ; complications ; diagnosis ; Respiration, Artificial ; Respiratory Insufficiency ; etiology