Objective To systematically review the efficacy of glutamine enriched nutrition support for patients with severe acute pancreatitis (SAP).Methods Database including PubMed,Embase,HighWire,Cochrane Central Register of Controlled Trials,Wanfang Database,CJFD and CBM were searched with glutamine,severe acute pancreatitis,SAP,谷氨酰胺,重症急性胰腺炎.Literatures published before March 2014 were searched.Randomized controlled trials containing the comparison of conventional treatment and glutamine enriched nutrition support were enrolled in the study,and then the literatures were screened and the data were extracted by 2 independent reviewers.The quality of the literatures was assessed,and the data were analyzed using the RevMan 5.2 software.SAP was diagnosed according to The revised Atlanta classificantion for acute pancreatitis or guideline for the diagnosis and treatment of SAP which was composed by the pancreatic surgery Branch of Chinese Medical Association.The count data were analyzed using the relative risk (RR) and 95％ confidence interval (95％ CI),and the measurement data were analyzed using standard mean difference (SMD) and 95 ％ CI.The heterogeneity of the data was analyzed using the I2 test.Results Ten literatures including 433 cases were enrolled in the study,and all of them were prospective randomized controlled studies.There were 218 patients treated by conventional methods (control group) and 215 patients received glutamine enriched nutrition support (experimental group).Compared with the control group,glutamine enriched nutrition support could elevate the albumin level,decrease the C-reaction protein level and shorten the hospital stay in the experimental group (SMD=1.00,-0.93,-0.71,95％CI:0.50-1.50,-1.25--0.61,-1.10--0.32,P＜0.05),glutamine enriched nutrition support could decrease the morbidity and mortality (RR =0.56,0.34,95％ CI:0.41-0.77,0.15-0.76,P ＜ 0.05) without increasing the expenses (SMD =0.03,95％ CI:-0.88-0.95,P ＞ 0.05).Conclusion Glutamine enriched nutrition support is superior to conventional methods for the treatment of SAP.

Objective To compare the application of debridement combined with vacuum sealing drainage (VSD) versus debridement combined with conventional dressing change in patients with subscalp infection following surgical treatment of traumatic brain injury (TBI) and investigate the effect of VSD in treatment of wound infection associated with surgery for TBI.Methods A retrospective review was conducted on clinical data of 60 TBI patients with combined wound infection after decompressive craniotomy between August 2005 and January 2012.According to the treatment modalities after admission,the patients were divided into debridement combined with VSD group (Group A) and debridement combined with conventional dressing change group (Group B),with 30 patients per group.Then wound healing,infection relapse rate and length of hospital stay were compared between the two groups.Results All 60 patients were followed up for 12-36 months (mean 21.6 months).The wound infection did not recur after surgery in Group A and sutures were removed in time.Seven patients (23％) in Group B presented with recurrent wound infection after the removal of wound drainage tube,which was healed after an additional debridement and drainage as well as the delay of suture removal.Wound healing time (13 d vs 22 d),dressing change frequency (3 times vs 8 times),length of hospital stay (17 d vs 26 d),antibiotic use duration (7 d vs 14 d),and time to drop the body temperature to normal after operation (2 d vs 4 d) in Group A and B respectively showed significant difference (P ＜ 0.05).Conclusion In treatment of wound infection associated with decompressive craniotomy for TBI,VSD is beneficial for rapid healing of the infected wound and is worthy of wide clinical use.

0.01). The new caries did not occur in the test group. DMF index was higher in the controls than that in the tested subjects(P

Cardiomyopathy, Hypertrophic ; Humans ; Pulmonary Edema

Objective:To evaluate the uncertainty in carbamazepine ( CBZ) determination in human plasma by HPLC-MS/MS. Methods:The whole process of CBZ determination was analyzed and the uncertainty sources were established, and then the uncertainty was evaluated and combined, and the expanded uncertainty was also calculated. Results: The expanded uncertainty of CBZ with low (7.46 ng·ml-1) and high (745 ng·ml-1) levels was 0.410 ng·ml-1 and 33.400 ng·ml-1, respectively (P=95%, k=2). Conclusion:The uncertainty in CBZ determination in human plasma by HPLC-MS/MS is mainly caused by recovery, sample prepara-tion and matrix effect for low concentration, and by sample preparation and repeatability for high concentration.

OBJECTIVE:To establish and validate the method for the determination of carbamazepine (CBZ) in human plas-ma,and to apply the method for external quality assessment. METHODS:After precipitated with acetonitrile,the plasma sample was determined by LC-MS/MS. Using loratadine as internal standard,the determination was performed on Kromasil C18 column with mobile phase consisted of water (containing 0.1% formic acid)-acetonitrile (gradient elution) at flow rate of 0.6 ml/min and column temperature of 40 ℃. The ion transitions under MRM mode by ESI+ ionization were performed at m/z 237.1→194.0 and m/z 383.1→267.0 for CBZ and internal standard,respectively. RESULTS:The linear range of CBZ were 5-1 000 ng/ml (r>0.998). The limit of quantitation was 5 ng/ml. RSDs of inter-day and intra-day were 1.00%-6.42%;relative deviation were -6.93%-0.32%. The external quality assessment of 5 samples were 679.0,475.0,104.0,29.2 and 26.2 ng/ml,respectively. The pass rate of assess-ment result was 100%. CONCLUSIONS:The method is sensitive,accurate and specific. The method is applicable for the plasma concentration determination and external quality assessment of CBZ.

Objective:To evaluate the uncertainty in the determination of lamotrigine(LTG)in human plasma by LC-MS/ MS. Methods:The uncertainty sources in the determination of LTG were analyzed and the uncertainty was evaluated and combined. Re-sults:The expanded uncertainty of LTG at low(0. 050 4 μg· ml - 1 )and high(1. 27 μg· ml - 1 )concentrations was 0. 005 18 μg· ml - 1 and 0. 066 4 μg· ml - 1 ,respectively(P = 95% ,k = 2). Conclusion:The uncertainty in the determination of LTG in human plasma by LC-MS/ MS is mainly caused by the protein precipitation recovery,matrix effect and sample preparation at low concentration, and by the matrix effect,sample preparation and repeatability at high concentration.

Objective To explore the effect of argatroban injection on serum copeptin, NT-proBNP levels and clinical efficacy in patients with acute cerebral infarction.Methods 120 patients with acute cerebral infarction were selected neural department of internal medicine in our hospital .They were randomly divided into two groups, 60 patients in control group, treated with bed rest, oxygen, nutrition support treatment, giving control of blood pressure, blood glucose, lipid symptomatic disposal according to the disease, anti platelet aggregation, nourishing brain cells and other conventional treatment, 7 days for a course of treatment two course of treatment;the experimental group in the control group based on routine treatment, the first days with argatroban 60 mg,500 mL diluted with normal saline, 60 mg/d, 24 hcontinuous intravenous infusion for second days was given argatroban 20 mg, 200 mL diluted with normal saline,continuous intravenous pumping, total treatment 14 d.After the end of treatment, compared before and after treatment in patients with NIHSS (America National Institutes of Health Stroke), Barthel score (ADL) index score, serum copeptin, NT-proBNP levels and clinical efficacy.Results The two groups after treatment in patients with neurological functions were improved, compared with the control group, patients in the experimental group the NIHSS score was significantly lower , the difference was statistically significant (P<0.05).7 days after treatment, two groups of patients with self-care ability were improved, compared with the control group, patients in the experimental group significantly increased Barthel index score, the difference was statistically significant ( P <0.05 ); 14 days after treatment, compared with control group, patients in the experimental group significantly increased Barthel index score, the difference was statistically significant (P<0.05);14 days after treatment, compared with the same group 7days after treatment, patients in the experimental group significantly increased Barthel index score, the difference was statistically significant (P<0.05).After the treatment two groups of patients with serum copeptin, NT-proBNP levels were decreased, the experimental group patients serum copeptin, NT-proBNP levels were significantly lower than the control group, the difference was statistically significant (P <0.05). Efficiency of total the experiment group (96.7%) was significantly higher than the control group (80%), the difference was statistically significant (P<0.05).Conclusion Argatroban can significantly reduce the levels of serum copeptin, NT-proBNP levels in patients with, improve self-care ability recovery of nerve function and life, has a good clinical effect.

Objective To establish the chromatographic fingerprint of Curcuma wenyujin by HPLC.Methods The chromatographic fingerprint of C.wenyujin was established by HPLC with Shimadzu VP-ODS C18 column(250 mm?4.6 mm,5 ?m),acetonitrile-water(0.1 phosphoric acid) gradient elution,the flow rate of 1.0 mL/min,column temperatures of 30 ℃,and detective wavelength at 210 nm.ResultsTaking germacrone as the reference peak,14 common-peaks were selected as the fingerprint peaks.The similarities among samples of C.wenyujin among 19 approved samples and their standard chromatographic fingerprints were calculated with a software "Similarity Evaluation System for Chromatographic Fingerprint of Chinese Materia Medica" published by GPC(Version 2004A) and cluster analysis.ConclusionThis method with better accuracy and reproducibility could be used in the quality control of C.wenyujin.

Objective To evaluate the uncertainty for the determination of salicylic acid in human plasma by ultra performance liquid chromatography(UPLC).Methods All sources of uncertainty in the whole process of salicylic acid determination were analyzed,then the combined and expanded uncertainty were evaluated.Results The expanded uncertainty at concentrations of the lowest limit of quantitation(0.23 μg·mL-1) and a high level(39.43 μg·mL-1) of salicylic acid(P=95%,k=2) was 0.014 and 7.34 μg·mL-1,respectively.Conclusion The uncertainty of salicylic acid determination in human plasma by UPLC was mainly caused by recovery,repeatability and sample preparation at the lowest limit of quantitation and high qulity control concentration.