Objective To investigate the effects of limb ischemia-reperfusion injury(I-RI) on blood coagulation.Methods Eighteen patients scheduled for unilateral knee arthroscopy surgery under epidural anesthesia were treated with an inflatable tourniquet to ptoduce ischemia for (42 ± 6) min.Venous blood was taken before tourniquet inflation,at 30 min during ischemia,3 min and 30 min during reperfusion for measuring blood coagulation by thrombelastography(TEG).Results TEG showed the decreases in reaction time(R value) and coagulation time(K value),and the increases in alpha angle(α) and maximal amplitude(MA),which were all within the normal limits and had no significant differences among four time points of testing.Conclusion I-RI of the limbs has no significant effects on blood coagulation.

Objective To investigate the effect of continuous hemofiltration in patients with acute renal injury induced by rhabdomyolysis and summarize the nursing experience.Methods Ten patients with acute kidney injury induced by rhabdomyolysis were managed with continuous hemofiltration,corresponding nursing care performed.Results After treatment,the renal function of 7 patients resumed normal,the function of 2 were improved,and only 1 needed long-term hemodialysis.After treatment,the levels of serum creatine phosphokinase(CPK),myoglobin(Mb),blood urea nitrogen(BUN),creatinine(Scr),aspartate aminotransferase(AST) were gradually decreased,K+resumed normal and urine volume increased to normal level,with significant difference as compared to those before treatment(P<0.05).Conclusions Continuous hemofiltration together with pertinent nursing measures can ensure the curative effect.It is of great significance for improving the prognosis of rhabdomyolysis.

OBJECTIVE:To explore the method for promoting drug circulation management of online pharmacies. METH-ODS:Hazard analysis and critical control point (HACCP) was applied to identify the critical control points (CCPs) and explore the effective method for drug circulation management of online pharmacies. RESULTS & CONCLUSIONS:According to the HAC-CP principle,four CCPs of drug circulation management of online pharmacies are supplier qualification,acceptance method,main-tenance and storage scheme and distribution system. It is suggested to adopt correct measures of drug circulation quality manage-ment of online pharmacy. Firstly,the supplier’s legal qualification should be determined and the quality of the drug should be regu-larly checked;secondly,drug retailers should improve the acceptance method of drugs and improve the sampling rate of drug;then,the three three four scientific conservation which required the medicine to be divided into three parts according to the pro-portion of 30%,30%,40% and checked monthly should be implemented to improve the storage and maintenance program;finally, the independent distribution system should be established to ensure the full process of the appearance inspection.

Objective To investigate the effects of two different dosages of dexmedetomidine on short-latency somatosensory evoked potentials (SLSEP)in intracranial surgery.Methods Forty pa-tients,ASA Ⅰor Ⅱ,aged 20-65 years old,selected for intracranial surgery were randomly divided in-to two groups,20 patients in each group.Bolus dose of 0.5 μg/kg dexmedetomidine was infused within first 10 min and followed by continuous infusion of 0.5 μg·kg-1·h-1 for 10 min in group A;Bolus dose of 1.0 μg/kg dexmedetomidine was infused within first 10 mins and followed by continu-ous infusion of 1.0 μg·kg-1·h-1 for 10 min in group B.SLSEP indications include N20-P25 amplitute and N20 latent period were observed.MAP,HR,N20-P25 amplitute and N20 latent period were re-corded respectively before dexmedetomidine adminstraition (T0 )and 20 mins after dexmedetomidine adminstraition (T1 ).Results Compared with T0 ,MAP and HR at T1 significantly decreased in both groups(P <0.05).N20-P25 amplitude had no statistically significant difference in both groups,while N20 latent period significantly prolonged (P <0.05).Conclusion Both doses of 0.5 μg/kg and 1.0μg/kg dexmedetomidine can significantly prolong the latent period of N20.

BACKGROUND:Extraction of a wel fixed cementless femoral stem or a cemented stem is difficult during revision of total hip arthroplasty. The extended trochanteric osteotomy provides excellent methods, and combining with long-stem cementless prosthesis can better reduce postoperative complications.
OBJECTIVE:To retrospectively analyze the recent clinical curative effect after extended trochanteric osteotomy combined with long-stem cementless prosthesis in hip revision.
METHODA total of 25 patients undergoing hip revision were selected from the Department of Osteoarthrosis, Pingdingshan First People’s Hospital, China from May 2008 to May 2013. Of them, 17 patients were subjected to the extended trochanteric osteotomy combined with single-incision and double-approaches. The femurs were reconstructed with long-stem cementless prosthesis. Al patients were fol owed-up for 12 to 60 months. Pre-operative and post-operative Harris hip scores, the post-operative complications, the bone cutting length, the length of stem in contact with cortical bone, the length of the end of bone cutting to the end of the prosthesis were recorded.
RESULTS AND CONCLUSION:17 patients were fol owed-up. The mean length of bone was 17 cm (15-23 cm). The mean length of stem in contact with cortical bone was 6.4 cm (4-11 cm). The mean length of the end of bone to the end of the prosthesis was 11.5 cm (8-18.5 cm). After fol ow-up, the mean Harris hip scores were improved from (39.0 ± 13.6) scores preoperatively to (75.0 ± 14.9) scores postoperatively (P<0.01). Subsidence occurred in two hips. The cutting sites of 17 cases of extended trochanteric osteotomy were fixed wel . These data suggested that the operation through single-incision and double-approach to the hip, while preserving the attachment of the external rotators and posterior capsule, wil strength rear hip stability and prevent postoperative dislocations. Recent effects were satisfactory, but the long-term outcomes should be further investigated.

Objective To evaluate the efficacy of vitreoretinal surgery for the treatment of complicated rhegmatogenous retinal detachment and to study the correlated factors affecting the surgical outcomes. Methods Complete follow up data from 103 patients (eyes) with complicated rhegmatogenous retinal detachment treated with vitreoretinal surgery were analyzed retrospectively. Conditions of the eyes included macular hole in 21 eyes [with proliferative vitreoretinopathy (PVR) stage C2 or more serious in 12 eyes], giant hole in 11 eyes, and PVR stage C2 to D3 in 71 eyes. Filling with C3F8 was performed in 82 eyes, and silicone oil in 21 eyes. A follow up for 3-18 months was conducted. Results The reattachment of retina was achieved in 99 eyes (96.1%) and functional success in 68 eyes (66.0%). In eyes with functional success, visual acuity of 0.02-0.08 was achieved in 18 eyes, 0 1-0 4 in 39 eyes, 0.5-0.9 in 10 eyes, and 1.0 in 1 eye. Conclusion Vitreoretinal surgery is an effective way for the management of complicated rhegmatogenous retinal detachment. Early surgery may result in satisfactory surgical outcomes.

OBJECTIVE:To provide reference for further promoting the implementation ofseparation of prescribing and dis-pensingpolicy which fit China's national conditions. METHODS:Based on literature review,informant interview,and filed in-vestigation the development ofseparation of prescribing and dispensingwere compared between typical eastern and western coun-tries. Constraints ofseparation of prescribing and dispensingin China were explored,international successful experiences were summarized to inspire appropriate implementation of this policy in China. RESULTS & CONCLUSIONS:There are four con-straints in the implementation ofseparation of prescribing and dispensingin China. Firstly,the legal foundation is yet established for the professional development of pharmacists. Secondly,the medicine pricing and hospital financing systems are unreasonable. Thirdly,patients'ownership of prescriptions and right of dispensing options are monopolized by hospitals. Fourthly,safety of medi-cines use is yet ensured.Separation of prescribing and dispensingshould follow the rules of social and economic development and should be adjusted to adapt local conditions.Separation of prescribing and dispensingpolicy itself may not help to achieve the objectives of cost containment and rational use of medicines. To achieve the intended objectives,legislation of Pharmacist Law should also be accelerated to clearly define the role of pharmacist and guide the behavior of prescribers with economic levers.

Chromosomal integration enables stable phenotype and therefore has become an important strategy for breeding of industrial Saccharomyces cerevisiae strains. pAUR135 is a plasmid that enables recycling use of antibiotic selection marker, and once attached with designated homologous sequences, integration vector for stable expression can be constructed. Development of S. cerevisiae strains by metabolic engineering normally demands overexpression of multiple genes, and employing pAUR135 plasmid, it is possible to construct S. cerevisiae strains by combinational integration of multiple genes in multiple sites, which results in different ratios of expressions of these genes. Xylose utilization pathway was taken as an example, with three pAUR135-based plasmids carrying three xylose assimilation genes constructed in this study. The three genes were sequentially integrated on the chromosome of S. cerevisiae by combinational integration. Xylose utilization rate was improved 24.4%-35.5% in the combinational integration strain comparing with that of the control strain with all the three genes integrated in one location. Strain improvement achieved by combinational integration is a novel method to manipulate multiple genes for genetic engineering of S. cerevisiae, and the recombinant strains are free of foreign sequences and selection markers. In addition, stable phenotype can be maintained, which is important for breeding of industrial strains. Therefore, combinational integration employing pAUR135 is a novel method for metabolic engineering of industrial S. cerevisiae strains.
Genetic Engineering ; methods ; Genetic Vectors ; Metabolic Engineering ; Plasmids ; genetics ; Saccharomyces cerevisiae ; genetics ; Xylose ; metabolism

Objective To investigate the resistance status of different integrons of Shigella sonnei (S.sonnei) and to analyze the distribution of resistant genes in integrons in Jiangsu Province.Methods A total of 32 strains of S.sonnei isolated from six cities of Jiangsu Province in 2011 were collected.The antibiotic susceptibility was tested by disk diffusion method.The molecular homology was analyzed by pulsed field gel electrophoresis (PFGE).The detection and classification of integrons were achieved by analyzing the positive polymerase chain reaction (PCR) products using restriction fragment length polymorphism (RFLP).RFLP and DNA sequencing were used to analyze the resistance genes in integrons.Results Multi-drug resistance (MDR) was detected in 28 (87.5％) S.sonnei strains.The resistant rates to ampicillin,nalidixic acid and tetracycline were highest (87.5％,respectively).However,it was sensitive to norfloxacin.PFGE analysis showed that there were 3 kinds of homologous clones involving 31 strains of the 32 S.sonnei strains.Among them,2,5 and 24 strains had the same clones,respectively.Accordingly,they spread within one,two and five different cities.The detection rates of class 1,class 2 and the atypical class 1 integrons in S.sonnei were 62.5％ (20/32),81.3％ (26/32) and 21.9％ (7/32),respectively,and no class 3 integron was detected.Sequence analysis of class 1 integron variable area revealed that it contained multiple resistant genes (aacA4-cmlA1 and dfrA1-aadA 1) ; dfrA1-sat 1-aadA 1 from class 2 integron and blara-30-aadA 1 from atypical class 1 integron were also identified.Conclusions In 2011,homologous S.sonnei strains spread among different cities in Jiangsu Province.MDR strains are prevalent and integrons are widespread which mediated the emergence of MDR strains.

This article was aimed to determine effects of Jia-Shen prescription (JSP) on infarct size (IS), cardiac function and myocardial cytokine in the early phase of myocardial infarction (MI) in rats. Acute MI models were induced by the ligation of left anterior descending coronary artery in Sprague-Dawley (SD) rats. The rats were ran-domly divided into five groups, which were the sham-operated group, model group, JSP-3 g (3 g·kg-1·day-1) group, JSP-6 g (6 g·kg-1·day-1) group, and the losartan (10 mg·kg-1·day-1) group. IS was determined by Evans blue and 2,3,5-Triphenyltetrazolium chloride (TTC) 3 days after MI. The left ventricular structure and contractility were measured by echocardiography performed 7 days after MI. And contents of myocardial inflammatory mediators in-cluding tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), and monocyte chemoattractant protein-1 (MCP-1) were measured by ELISA. The results showed that compared with the model group, treatment with JSP at the dose of 6 g significantly reduced myocardial IS (P<0.05);left ventricular end diastolic diameter (LVEDD) and left ventricu-lar end systolic diameter (LVESD) were significantly decreased (P<0.05); left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were significantly increased (P<0.05).The results were similar as the losartan group. Compared with the model group, JSP can significantly reduce the production of TNF-α, IL-1βand MCP-1 in cardiac tissues (P<0.05). Except TNF-α, these effects of JSP were in a dose-dependent manner. JSP (6 g) had equal effectiveness with losartan. It was concluded that consistent with losartan-induced cardioprotection, JSP administered after MI reduced myocardial IS, improved cardiac function, and decreased inflammatory mediators in ischemic myocardium. The data indicated that JSP exerted its cardioprotection possibly via inhibiting inflammatory response.