Objective To systematically review articles about therapeutic drug monitoring of vancomycin in Chinese adults, so as to provide a reference of vancomycin trough concentrations for clinical evidence-based medicine.Methods Literature concerning vancomycin therapeutic drug monitoring were electronically retrieved in, CBM, Wanfang data, CNKI and Vip.Furthermore, the articles written in English by Chinese author in PubMed, EMbase were included.All the data were searched from inception of the database or network to Aug.2014.Two reviews independently screened literature according to the inclusion and exclusion criteria, and assessed the quality of literature using the Combieg and NOS.Analyzing the types of studies, the number of therapeutic monitoring of vancomycin, trough serum concentration, clinical outcome and renal function.Results A total of 35 studies including 32 cross-sectional studies and 3 cohort studies were included, all studies were observational studies.3099 patients with 5206 blood concentrations monitoring results were eligible for final analyses in all 32 cross-sectional studies.The rates of trough serum concentration in 5-15 mg/L was 53.6%.Compared with the trough concentrations between 5 and 15 mg/L, clinical cure rate was no significant difference in the trough concentrations of over 15μg/mL.However, the incidence rate was significantly reduced in renal toxicity in 5-15 mg/L trough serum concentration.Conclusions For adults, trough serum concentration of vancomycin should adopt the 5-15 mg/L in China.However, considering lack of high-level evidence, so it needs to be studied further.

Objective To evaluate the effect of mouse nerve growth factor on fracture healing.Methods Cochrane library, Pubmed, EMbase, CNKI,VIP,Wanfang Data and CBM were searched for the randomized controlled trials(RCTs)of mouse nerve growth factor on fracture healing from the date of establishment of the databases to May 2014.Three independent rese archers evaluated the included studies using GRADE,according to recommend classification method of GRADE system by three researchers,crtical evaluated and data extracted of the quality of the included studies,which conform to the quality standard of RCT was analyzed by Meta analysis.The extracted data were analyzed by RevMan 5.0 and GRAED proiler.Results A total 5 trials were discovered and all of these were in Chinese.Compared with conventional treatment was improved a lot[MD =-8.74,95%CI( -9.79,-7.68),P<0.0001].However, adverse drug reaction in patients with mouse nerve growth factor were increased[OR =14.66,95%CI(1.89, 113.99),P=0.01].The both outcomes were low quality in the GRADE system.Conclusion Mouse nerve growth factor can improve fracture healing and the side effects will also increase.

BACKGROUND:Recombinant bovine basic fibroblast growth factor is a manifold effect cytokine which can promote angiogenesis, wound healing, tissue repair and bone regeneration. Recombinant bovine basic fibroblast growth factor with good histocompatibility is easy to operate and has been widely used in oral and maxil ary surgery.
OBJECTIVE:To evaluate the effect of recombinant bovine basic fibroblast growth factor against dry socket syndrome after tooth extraction.
METHODS:A total of 160 patients who had been extracted mandibular third molar were selected and randomly divided into two groups. In the experimental group, recombinant bovine basic fibroblast growth factor was put into the sockets after mandibular third molars were extracted, while in the control group, we let the wounds to be healed natural y without any materials. The incidence of dry socket syndrome was observed and compared between two groups at 3 days, 5 days and 1 week after tooth extraction.
RESULTS AND CONCLUSION:One patient had dry socket after operation in the experimental group, and the incidence was 1.25%. In the control group, 10 patients suffered from dry socket, and the incidence was 12.5%. There was a significant difference in the incidence of dry socket between the two groups (P<0.01). There was visible granulation tissue within the tooth socket after tooth extraction in the experimental group, and extraction sockets narrowed and were fil ed with granulation tissues, which was 1-2 days earlier than the control group. No al ergies, tissue hyperplasia and other local and systemic reactions occurred in patients receiving implantation of recombinant bovine basic fibroblast growth factor gel. These findings indicate that local implantation of recombinant bovine basic fibroblast growth factor gel after mandibular tooth extractions can speed up the healing of dental extraction wounds.

Objective To evaluate the role of calcium channel in the mechanism of the generation and maintenance of bursting firing of substantia nigra pars compacta (SNc) dopaminergic neurons in rats.Methods Using the patch clamp technique,we observed the firing pattern switching features after adding 10 μmol/L N-methyl-D-aspartic acid (NMDA),compared the changes of whole-calcium current and L-type calcium current with or without NMDA,and analyzed the correlation between the generation of burst firing and L-type calcium channel activation.Results After NMDA treatment,the firing pattern of SNc dopaminergic neurons changed to burst firing,which was compromised by a charastistic high plateau potential and series of action potential on it.The current density of L-type calcium current increased significantly after adding NMDA,which,from (2.86 ±0.26) pA/pF (n =28),significantly increased to (3.75 ± 0.18) pA/pF (n =34 ; t =7.52,P =0.002 8).The high plateau potential was almost abolished with the application of verapamil,a specific antagonist of L-type calcium channel.Consiusion NMDA could induce the firing pattern changed to burst firing in SNc dopaminergic neurons,while L-type calcium channel contributes to the process of generation and maintenance of burst firing.

Objective? To understand the situation of urinary incontinence and quality of life among patients with post-laparoscopic radical prostatectomy and to analyze the correlation between them. Methods? From September 2015 to October 2016, we selected 115 patients with post-laparoscopic radical prostatectomy at a ClassⅢ Grade A hospital in Beijing for survey by questionnaire with the method of convenience sampling. We collected patients' general information as well as disease information, and evaluated the situation of urinary incontinence (incidence and severity of urinary incontinence) with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and influence of urinary incontinence on quality of life with the Incontinence Impact Questionnaire (IIQ-7) to analyze the correlation between severity of urinary incontinence and quality of life. Results? Among 115 patients with post-laparoscopic radical prostatectomy, there were 95 (82.6%) urinary incontinence patients including 41 cases (43.1%) with mild urinary incontinence, 47 cases (49.5%) with medium urinary incontinence and 7 cases (7.4%) with severe urinary incontinence. The score of severity of urinary incontinence ranged from 0 to 19.0 with 8.0 for the median and 5.0 for the interquartile range. Spearman correlation analysis showed that the score of IIQ-7 had a positive correlation with the severity of urinary incontinence (r=0.674, P＜0.01), and had a negative correlation with the postoperative time (r=-0.215, P＜0.05). Multiple linear regression analysis showed that the main influencing factor of quality of life was severity of urinary incontinence (P＜0.01). Conclusions? Urinary incontinence is common among patients with post-laparoscopic radical prostatectomy mainly in mild and medium urinary incontinence. The more serious the urinary incontinence is,the greater the influence on quality of life is which points out that the scientific and effective management by medical staff for urinary incontinence can improve patients' quality of life.

Objective To study the differences of UVB damage among yong,intermediate and aged human dermal fibroblasts (HDFs),the recovery effect of adipose-derived stem cell conditioned medium (ADSC-CM) on UVB damage and the relationship between the recovery effect and ADSC-CM concentration as well as its treating period.Methods HDFs were cultured at different senescent degrees in vitro to establish UVB damage model of HDFs,and then the HDFs were cultured in different concentration ADSC-CM and cellular proliferation was detected.Results The optimal treating period and concentration of ADSC-CM were 48h and 100％ respectively.As to HDFs in different senescent degrees,ADSC-CM was able to accelerate cellular proliferation in both UVB group and control group.Conclusions Independently or simultaneously,the intrinsic and extrinsic factors can cause ageing damages on HDFs.To some extent,ADSC-CM has recovery effect on the damages through secretomes from ADSC.

During the process of dairy farming,various factors such as physical injury and bacterial infection act upon body tissues or organs,leading to the disruption of skin or mucous tissue integ-rity and subsequent tissue injury and trauma.The healing of these injuries is a complex process that necessitates the coordinated efforts of different cells and involvement of diverse cytokines.A-mong them,the interaction between macrophages and myofibroblasts is indispensable for efficient tissue repair.Nod-like receptor protein 3(NLRP3),a pattern recognition receptor in the innate im-mune system,may play a regulatory role in modulating this intricate process.In this study,cow myofibroblasts and M1 type bone marrow-derived macrophages were cultured in vitro,followed by collection of cell culture supernatant for co-culture analysis.Both cytokine secretion levels in M1 type bone marrow-derived macrophages as well as expression patterns levels of myofibroblast growth factor protein and mRNA were detected.The regulatory mechanism underlying NLRP3 in-volvement in mediating interactions between these two cell types was investigated using NLRP3 inhibitor MCC950.The results showed that an effective method for culturing cow muscle fibroblasts in vitro was successfully established and myofibroblast conditioned medium(MFbCM)could regulate M1 macrophage secretion profiles.Moreover,M1 macrophage conditioned medium(M1?CM)was found to influence myofibroblast growth factor expression levels.Our findings sug-gest that NLRP3 plays a significant regulatory role during crosstalk between myofibroblasts and M1-type pro-inflammatory macrophages.

Objective:To explore the potential relationship of urethral pressure profilometry and the complications of artificial urethral sphincter (AUS) implantation.Methods:The clinical data of patients who underwent AUS implantation in Beijing Hospital from March 2019 to March 2022 were retrospectively analyzed. All the patients were male. The average course of disease was 43.1 months(ranging 11-120 months). The average age was (68.6±13.2) years. The median number of pads used was 4.5 (3.0, 6.0). The preoperative maximum urethral pressure (MUP) was (84.6±25.5) cmH 2O, and the maximum urethral closure pressure (MUCP) was 51.0 (41.0, 74.0) cmH 2O. AUS implantation was performed through a single perineal incision in all patients. The sleeve size was mainly determined by the measured urethral circumference of the patient. After installation of all components, the urethral pressure profilometry was performed under the state of device inactivation and activation. The pump was activated 6 weeks after the operation, and telephone follow-up was performed 3 months after the activation of the device. The urinary control and complications were recorded. The results of follow-up were compared with the results of urethral pressure profilometry, and the preliminary conclusions were drawn. Results:In this study, 3 patients (20%) received 4.0cm cuffs, 10 patients (66.7%) received 4.5cm cuffs, and 2 patients (13.3%) received 5.0cm cuffs. The MUP and MUCP of AUS device in inactivated state were (82.5±30.2) cmH 2O and 51.0(48.0, 77.0) cmH 2O. In the activated state, MUP was (138.9±21.7) cmH 2O and MUCP was 109.0(94.0, 133.0) cmH 2O. Compared with that before operation, the urethral pressure in the inactivated state did not increase significantly (all P > 0.05), while the urethral pressure in the activated state increased significantly (all P < 0.001). The patients were followed-up for 3-33 months. Thirteen patients (86.7%) used the initial installation device, and all of them met the standard of social continence. One patient died of cerebrovascular accident. One patient took out the device due to urethral erosion. The incidence of complications was 26.7% (4/15), including painless hematuria in 2 cases, scrotum and penis infection in 1 case, and urethral erosion in 1 case. The MUP and MUCP of these patients were (100.0 ± 40.7) cmH 2O and (80.8 ± 39.7) cmH 2O respectively. In the intraoperative active state, the MUP was (151.5 ± 15.3) cmH 2O and the MUCP was (123.0 ± 17.2) cmH 2O. The MUP of the other 3 patients in the device activation state was significantly higher than the average value, and all of them were above 150 cm H 2O, except one patient who was infected due to cognitive problems and chronic urinary retention. In 11 patients without complications, the MUP and MUCP were (76.1±24.7) cmH 2O and (55.1±20.0) cmH 2O respectively. In the intraoperative active state, the MUP was (134.4±22.5) cmH 2O and the MUCP was (108.5±29.8) cmH 2O. Conclusions:AUS implantation has a definite curative effect. Poor comprehension, and MUP higher than 150 cmH 2O in the activated state of the device may be risk factors for complications.

Objective:To evaluate the efficacy and safety of robotic arm assisted laparoscopic hysterosacral fixation in patients with pelvic organ prolapse(POP), and its impact on lower urinary tract function.Methods:This study retrospectively analyzed the clinical data of POP patients who had undergone robotic arm assisted laparoscopic hysterosacral fixation at our center from June 2019 to October 2020, and conducted exploratory research.Results:A total of 6 patients were included in the study, with POP quantitative staging above stage Ⅲ.The ages ranged from 70 to 82 years.The number of births each patient had given ranged from 1 to 3, & all were via vaginal deliveries.There were no significant changes in urodynamic parameter scores in any patients before and after surgery, but half of the patients had detrusor overactivity before surgery, which all disappeared after surgery.In addition, synchronous X-ray images showed that the postoperative pelvic organs were closer to the normal anatomical position.At the same time, quantitative staging of POP had achieved clear improvement, and related scale scores also significantly improved.One patient complained of occasional lumbar and back discomfort with postoperative over-stretching during outpatient review, which improved after symptomatic treatment.Conclusions:robotic arm assisted Laparoscopic hysterosacral fixation is satisfactory in efficacy and safety for POP patients, with good postoperative restoration of the uterus to the anatomical position and has insignificant influence on the function of the lower urinary tract.It is worth further assessment for wide application.

Objective:To explore the efficacy and safety of robot assisted laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse.Methods:The data of 16 patients who underwent robot assisted laparoscopic sacrocolpopexy in Beijing Hospital from September 2019 to May 2022 were collected. The average age was (73.5±9.3) years, the preoperative course was 4-240 months, the body mass index was (24.2±1.7) kg/m 2, the number of births was (1.7±0.8), and the quantitative index of pelvic organ prolapse (POP-Q) was grade Ⅲ -Ⅳ. The maximum urine flow rate before operation was (9.6±3.4) ml/s, the maximum detrusor pressure during urination was 26 (20, 32) cmH 2O, the first sense urine volume of the bladder was (119.1±39.4) ml, the first sense urine urgency volume of the bladder was (253.6±75.7) ml, the maximum bladder pressure capacity was (406.0±79.8) ml, and the residual urine volume was 10 (10, 28) ml. The preoperative PFDI-20 score was 100 (70, 122) and the PFIQ-7 score was 107 (90, 160). During the robot assisted laparoscopic sacrocolpopexy, the right area of the sacral promontory was exposed, the anterior and posterior walls of the uterus were separated, and the 2 cm small hole was separated from the right broad ligament of the uterus. The mesh was cut into a "Y" shape and passed through the small hole. The anterior and posterior leaves of the Y-shaped mesh were sutured to fix the cervix, and the other end was fixed to the anterior longitudinal ligament of the sacrum. The operation time and intraoperative bleeding were observed. The effect of surgery was evaluated by preoperative and postoperative urodynamic imaging, POP-Q stage, PFDI-20 score and PFIQ -7 score. Results:All the 16 operations were successfully completed. No injury of urethra, bladder, rectum, important blood vessels and nerves occurred during the operation. The average operation time was (255.6±56.0) min, and the average amount of bleeding was (28.8±18.2) ml. There was no inhibitory contraction wave in 7 patients (44%) before operation, suggesting that there was detrusor overactivity. After operation, the detrusor overactivity disappeared or significantly decreased in 7 patients. The postoperative follow-up period was 3-36 months. During the follow-up period, one patient had recurrence, and the rest had no prolapse and urination problems. The POP-Q stage was reduced to grade 0-Ⅰ after the operation. The subjective satisfaction rate of patients was 94%. The PFDI-20 score [13(8, 24)] and PFIQ -7 score [11(6, 15)] after operation were significantly reduced ( P<0.001), the initial urgent volume of bladder (272.5±88.5) ml was significantly increased compared with that before operation ( P=0.038), and the maximum volume of bladder (427.2±79.2) ml was significantly increased compared with that before operation ( P=0.006). Image urodynamics showed that the patient basically recovered the pelvic floor anatomy and achieved functional reduction. Conclusions:Robot assisted laparoscopic sacrocolpopexy has good subjective and objective effects in POP, low recurrence rate and less complications. It needs a larger sample size study for confirming the improvement of bladder function.