OBJECTIVE： To determine the gentamycin sulphate,ephedrine hydrochloride and dexamethasone sodium phosphate in nasal drops without need of separation.METHODS： Gentamycin was determined via the dihydrolutidine derivatives produced by Hantzsh reaction using UV-spectrophotometry.The detecting wavelengths was 330nm.A dual-wavelength spectrophotometry was used for determination of ephedrine hydrochloride and dexamethasone sodium phosphate.The detecting wavelengths were 256.5nm and 241.6nm and the reference wavelengths were 228.4nm and 266.4nm for ephedrine hydrochloride and dexamethasone sodium phosphate,respectively.RESULTS： The average recovery rates of gentamycin sulphate,ephedrine hydrochloride and dexamethasone sodium phosphate were 100.74％ (CV=0.2％ ,r=0.9 999,n=5),100.15％ (CV=0.66％ ,r=0.9 997,n=5)and 99.46％ (CV=0.35,r=0.9 996,n=5)respectively.CONCLUSION： This method is simple,rapid,accurate and stable and suitable for rapid quality control of compound gentamycin sulphate nasal drops.

Objective To investigate the value of Helicobacter pylori (HP),blood carcinoembryonic antigen (CEA),carbohydrate antigens 72-4 (CA72-4) and CA24-2 in the screening of gastric cancer.Methods The contents of HP,blood CEA,CA72-4 and CA24-2 in 50 healthy controls,45 patients with benign gastric lesions mnd 70 patients with gastric cancer were detected.According to the number of positive cases,the positive rate of single detection and the positive rate of combined detection were calculated.Sensitivity,specificity,and accuracy of serum tumor markers were calculated according to HP single and combined detection.Results The positive rate of each individual detection and 4 joint detection in gastric cancer group was significantly different from that in the benign lesion group and the normal control group (P ＜0.01).The positive rate of 4 joint detection in gastric cancer group was 89.25％,and the difference was statistically significant (P ＜0.01).There was no significant difference in the positive rate of the single test and the 4 joint detection in benign stomach group and normal control group (P ＞ 0.05).The sensitivity,specificity and accuracy of HP,blood CEA,CA72-4,CA24-2 joint detection were significantly higher than single detection (P ＜ 0.05).Conclusions Joint detection was significandy better than single detection,and can significantly improve the detection rate of gastric cancer.

Objective To investigate the clinical and pathological features of colonic polyp canceration and related risk factors of colon polyps,and explore clinicopathologic features and major risk factors of the canceration of polyps of colon polyps.Methods Totally 80 patients with colon polyps including 6 cases of cancerations and 20 patients with colon cancers were selected from Xuzhou Tumor Hospital Admissions.Those patients were divided into 74 cases of non cancer group and 26 cases of cancer group.The clinical data,the detection index and the statistical analysis were performed.Results The clinical features of patients included 51 cases of multiple polyps,30 cases of fatty liver,13 cases of fecal occult blood positive,and 30 patients with colonoscopy.There were 218 polyps,191 data intact,and 6 cases showed cancer (3.14％).Inflammatory polyps mainly occurred in rectum,cecum,and significant risk other than the colon.Tubular adenoma occurred mainly in the transverse colon.Sigmoid colon cancer colon polyps of the highest risk showed OR =2.30 (P ＜ 0.05).The cancer risk from high to low was from tubular villous adenoma to villous adenoma hair (P ＜0.01),and no difference in tubular adenoma cancer risk (P ＞0.05).There was no difference between the indexes of the canceration group and the non cancerous group (P ＞ 0.05).The single factor analysis showed pathological type,and the lesion were the main risk factors of malignant colonic polyps (P ＜ 0.05).Multi-factor regression analysis showed WBC,pathological type,and the lesion were the main risk factors of malignant colonic polyps (P ＜ 0.05).Conclusions The colonic polyps in male have higher incidence with fatty liver,hypertension and other pathological features,and are mainly tubular adenomas,inflammatory and hyperplastic polyps,with different lesions,pathological types occur and different cancer risk.

The brain—type creatine kinase isoenzyme (CK—BB)in the cerebrospinal fluid(CSF) within 24 hs following trauma was measured in 62 cases with acute head injuries by chromatography and fluorometry, and the comparative analysis was made between CSF-CK-BB activities and the outcome of the patients in 6 months after trauma according to Glasgow Outcome Scale(GOS),The results showed that the determinations of CSF-CKBB activities,in combination with Glasgow coma Scale (GCS) can be used as an early objective diagnostic index for assessing the prognosis ,and there was a reference value for improving accuracy of evaluating recovery of neurological disfunction in the patients with acute head injuries.

The levels of platelet-activating factor (PAF) in cerebrospmal fluid (CSF) of patients with acute cerebral infarction were measured by the method of PAF-induced platelet aggregation quantitative analysis. The results indicated that the levels of PAF in CSF of patients with acute cerebral infarction were significantly increased (P

Objective To investigate the dynamic changes in the fibrinolytic system during and after open heart surgery performed with cardiopulmonary bypass (CPB) and the effect of epsilon-aminocaproic acid (EACA) on fibrinolysis, postoperative blood loss and transfusion requirements.Methods Forty patients (24 males, 16 females) aged 17-43 yr undergoing valve replacement with CPB were randomized to receive EACA 200 mg?kg-1 (group A) or normal saline (group B) added to the priming solution. The patients were premedicated with intramuscular morphine 0.2 mg?kg-1 and scopolamine 0.3 mg. Anesthesia was induced with midazolam 0.2 mg ? kg, fentanyl 10 ?g?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with isoflurane inhalation and intermittent i.v. boluses of fentanyl and vecuronium. The patients were mechanically ventilated (VT = 10 ml?kg-1 , RR = 10-12 bpm, I:E = 1:2) after tracheal intubation. Blood samples were taken before skin incision (baseline) , 8 and 30 min on CPB, 10 min after protamine administration and 2 h after operation for determination of tissue type plasminogen activator (t-PA) activity, plasminogen activator inhibitor (PAI) activity, plasmin (Plm) activity and D-dimer. The amount of blood drained from chest and bank blood infused within 24 h after operation were recorded.Results (1) Group B (control group): PAI activity was maintained stable perioperatively. The t-PA activity and t-PA/PAI ratio increased significantly during operation but returned to the baseline value 2 h after operation. D-dimer level also significantly increased during and after operation. The Plm activity increased significantly at 8h on CPB and 10 min after protamine administration compared to the baseline value. (2) The t-PA activity and t-PA /PAI ratio were significantly lower in group A than in group B. The D-dimer level and Plm activity were also significantly lower in group A than in group B during and after operation. The amount of blood loss and bank blood infused within 24 h after operation was 40% and 37% less than that in group B.Conclusion Fibrinolytic system is activated during CPB as shown by the increase in plasminogen and t-PA/PAI ratio. EACA is effective in reducing postoperative blood loss and blood transfusion through inhibition of the activation of fibrinolytic system.

Objective To assess the long-term efficacy and safety of mid-dosage (13～15 mg?kg-1?g-1) ursodeoxycholic acid (UDCA) treatment for primary biliary cirrhosis (PBC). Methods A systematic review of all randomized controlled trials (RCT) comparing UDCA with placebo was performed. Results Seven trials including 1038 patients were assessed. UDCA could significantly improve liver biochemistry, but had no effect on pruritus and fatigue. In the patients with initial stage Ⅰ-Ⅱ, there was a significant decrease in the histologic progression after treatment with UDCA for 2 years compared with the placcebo group(P=0.03), but there was no significant difference between the two groups when considering overall patients with initial stage Ⅰ-Ⅳ (P=0.08). Meta-analysis showed no significant difference in the incidence of death (odds ratio 0.99, 95% confidence interval 0.62-1.58), liver related death (1.05, 0.53-2.05), liver trans-plantation (0.87, 0.53-1.41), death and/or liver transplantation (0.92, 0.64-1.31) and liver decompensation (0.94, 0.60-1.49) between the UDCA and placebo groups. Conclusions The analysis of RCTs of UDCA versus placebo shows improvement of liver biochemistry, but not improvement of clinical symptoms and survival. UDCA may slow down liver histologic progression in the early-stage patients with PBC.

Objective To explore the role of CGRP and progesterone along with it on the etiopathology of PIH. Methods 8 specimens of umbilical vein endothelial cells from women with PIH were cultured. Four groups were divided when cultured cells were confluent: the sera of normal pregnancy women (group 1), the sera of women with PIH (group2), the mixture of the sera of women with PIH and the injection of progesterone (group3), and the same amount of media (group 4). The cultured cell were added respectively into the four different kinds of media. After 24h of incubation, the concentration of endothelin (ET) and CGRP in media were measured by radioimmunoassay. Results 1. Comparing with group1, the concentration of CGRP in group 2 decreased and ET increased significantly. Statistic difference of ET/CGRP was found between the two groups. 2. Comparing with group 1, the concentration of CGRP in group 3 was unchanged and ET increased obviously. No difference of ET/CGRP was shown between them. 3. Comparing with group 3, in group 2, the concentration of CGRP decreased obviously and that of ET unchanged. Significant difference of ET/CGRP was found. Conclusions Progesterone, along with CGRP, might delay the onset and progressing of PIH.

Objective To explore the effect of comprehensive rehabilitation on patients with knee ankylosis and contracture of popliteal fossa after severe burn. Methods 35 patients with severe burn on lower limb (containing the around skin of popliteal fossa) accepted exercise therapy, hydrotherapy, occupation therapy (including pressure therapy), electrotherapy, etc. They were assessed with Functional Independence Measure (FIM), range of motion and muscle strength of knee before and after treatment. Results The scores of FIM, range of motion and muscle strength of knee improved after treatment (P<0.01). Conclusion Comprehensive rehabilitation can improve activities of daily living and function of knee after severe burn.

Objective To predict the risk of neonatal hyperbilirubinemia by transcutaneous bilirubin (TcB) nomograms and clinical risk factors.Methods Healthy term and late-preterm newborns (≥ 35 gestational weeks,and birth weight ≥ 2 000 g) born in Guizhou Maternal and Child Care Hospital between January 1,2013 and December 31,2013,were included.TcB levels were continuously recorded within 168 hours after birth.The value of hour-specific TcB nomogram combined with receiver operating characteristic (ROC)curves and Logistic regression model for predicting risk of hyperbilirubinemia was evaluated.Pearson's Chisquare test was also used for statistical analysis.Results A total of 5 250 cases were enrolled.TcB increased rapidly in the first 40 hours after birth,slowly increased between 40 to 96 hours,and reached a high level after 96 hours.Among them,the 95th percentile TcB stablized at 96 hours after birth.The 40th,75th and 95th percentile TcB peak levels were 173,217 and 248 μmol/L.Among the 5 250 neonates,there were 277 cases (5.3％) in the high-risk zone within 72 hours.The positive predictive value (PPV) was 22.02％;1 087 cases (20.7％) and 1 854 cases (35.3％) were in the medium-high risk and medium-low risk zones along with the PPV of 10.58％and 3.72％,respectively.There were 2 032 cases (38.7％) in the low-risk zone with the PPV of 1.38％.Multivariate analysis showed that the TcB high-risk zone after 72 hours was associated with gestational age,delivery mode,feeding mode and TcB level of risk zones within 72 hours.Compared to those born at ≥ 40 gestational weeks,those born at ≥ 37-＜40 gestational weeks were more likely in the TcB high-risk zone after 72 hours (OR=1.80,95％CI:1.29-2.51).The likelihood was reduced by 42％ among neonates born with cesarean section compared to those delivered vaginally in term of the TcB high-risk zone after 72 hours.Infants who received mixed feeding were less likely to be in the TcB high-risk zone after 72 hours when compared to breastfed infants (OR=0.51,95％CI:0.29-0.88).With the reduction of the high-risk zone level within 72 hours,the likelihood in the TcB high-risk zone after 72 hours was also decreased.ROC curve showed that the area under the curve (AUC) for predicting hyperbilirubinemia was 0.75 and its 95％CI was 0.72-0.78,with a sensitivity of 90.00％ and specificity of 40.00％.The AUC of a combination of predictive results obtained by the Logistic regression model with significant variables in univariate analysis and high-risk zone after 72 hours was 0.66,and its 95％CI was 0.62-0.69.AUC estimated by Logistic regression model according to the TcB levels of risk zones within 72 hours combining with clinical risk factors was 0.79,and its 95％CI was 0.76-0.82 (P＜0.01).Conclusions Hour-specific TcB nomograms of newborns in our hospital have been obtained,which facilitates the prediction and early intervention of neonatal hyperbilirubinemia.