OBJECTIVE:To establish TLC scanner method for the determination of stachydrine hydrochloride in xue?niaokang granule.METHODS:Silica gel G thin layer plate was adopted in the determination with n-butanol-hydrochloric acid-ethyl acetate(8∶3∶1)used as developer and thin potassium heptaiodobismuthate test solution used as color-developing agent,the detection wavelength was515nm,the reference wavelength was700nm and the slit size was6.00mm?0.45mm.RESULTS:Good linear correlation with the peak area score of spots achieved when the concentration range of stachydrine hydrochloride was within5.06?g～25.32?g(r=0.9978),the average recovery was96.67%(RSD=2.01%).CONCLUSION:The method was accurate,simple,reliable,sensitive and reproducible,and it can be used for the determination of xueniaokang granule and its quality control.

Chromatography, Gas ; methods ; Triazoles ; blood

Objective To investigate the mutation characteristics and genotype of hepatitis B virus resistance gene in Nantong area,and provide scientific basis for clinical rational drug.Methods A total of 158 cases of chronic hepatitis B (CHB)pa-tients who were received with nucleos (T)ide analogues therapy for at least 2 years as the research object,and 30 cases of CHB patients who were not received nucleos (T)ide analogues for the treatment as the control group.PCR-sequencing method was used to detect the HBV P resistant gene and genotype,meanwhile,observe the relationship between three main mutation model and the levels of ALT and HBV DNA was also investigated.Results B genotype was detected in 42 (26.58%)out of 158 CHB patients,and 116 cases (73.42%)were C genotype.A total of 131 patients with different site mutations in P region,the mutation rate were 82.91%.There were totally 11 HBV mutation sites,including the main muta-tion site:M204I,L180M,M204V,A181V and A181T,the frequency of drug resistance were 41.14%,37.34%,22.15%, 11.39% and 10.13%,respectively.Moreover,11 mutation sites had 21 mutation patterns.In lamivudine (LAM)resistance associated mutations,the L180M and M204V sites were mainly co-occurrence,followed by M204I alone.In adefovir dipivoxil (ADV)resistance associated mutations,A181V was the main mutation site.Whereas,the drug resistance rate of entecavir (ETV)was low.Conclusion The main genotypes of HBV were type B and C in Nantong area,and C type was the dominant genotype.The resistance mutations mainly concentrated in LAM and ADV resistance associated mutations,while the resist-ance rate of ETV was low.Multi-locus drug-resistant mutation detection may help to detect viral resistance and guide clinical treatment better.

Objective To compare the effect of parenteral nutrition and enteral nutrition with different start time on acute pancreatitic patients.Methods Randomized controlled trials comparing enteral and parenteral nutrition in acute pancreatitic patients published from January 1996 to January 2011 were searched in MEDLINE,EMBASE,Cochrane databases,Wanfang science library,and China National Knowledge Infrastructure.The information about study design,patient characteristics,and outcomes were extracted by two independent analysers before processed with RevMan 4.2 software.Results Altogether 14 trials were included.When started after 24 hours of admission,enteral nutrition,in comparison with total parenteral nutrition,resulted in a statistically significant reduction in the risks of infections (P =0.0004),surgical intervention (P =0.0200),organ failure (P =0.0400),and morality (P =0.0002) in acute pancreatitic patient.When started within 48 hours of admission,enteral nutrition,in comparison with total parenteral nutrition,resulted in a statistically significant reduction in the risks of infections (P =0.0000),surgical intervention (P =0.0001),organ failure (P =0.0006),and mortality (P =0.0300) in acute pancreatitic patients.Conclusions The time of the commencement of nutriton has an influence on the benefits of enteral nutrition.Enteral nutrition started between 24 hours and 48 hours of admission is more effective than within 24 hours or after 48 hours of admission.

Objective To understand whether it had differences in bile culture and drug susceptibility test between patients with community-acquired acute cholecystitis and patients with community-acquired acute cholangitis at present.Methods 169 patients with community-acquired acute cholecystitis and the 97 patients with community-acquired acute cholangitis in our department were selected prospectively,in which 16 patients suffered from both community-acquired acute cholecystitis and community-acquired acute cholangitis.Bile sample was extracted in operations and delivered to perform aerobic culture and drug sensitivity test.The bile samples coming from cholecyst were divided into group A,while the bile samples coming from bile duct were divided into group B.Results The positive rates of bile culture in group A and group B were separately 24.9% and 64.9%(P<0.05).The result of the sample coming from cholecyst and the result of the sample coming from bile duct were not the same in 4 patients of the 16 patients who suffered from both community-acquired acute cholecystitis and community-acquired acute cholangitis simultaneously.The main bacteria of acute cholecystitis included Escherichia coli(28.0%),Klebsiella pneumonia(24.0%)and Enterococcus faecium(16.0%).The main bacteria of acute cholangitis included Escherichia coli(39.7%),Klebsiella pneumonia(19.2%)and Enterobacter cloacae(12.3%).The antibiotics which were lowly resistant to gram negative bacteria in the two groups(A and B) included amikacin(0%/0%),ertapenem(0%/0%),imipenem(0%/7.0%)and piperacillin/tazobactam(0%/7.0%).The antibiotics which had lower resistant rates to gram positive bacteria in the two groups included tigecycline(0%/0%)and linezolid(0%/0%).The proportions of the multidrug-resistant strains in the two groups were separately 24.0% and 35.6%(P>0.05).Conclusion Some difference exist in the results of bile culture between patients with community-acquired acutecholecystitis and patients with community-acquired acute cholangitis,but the main bacteria of the both two types of biliary tract infection are Escherichia coli and Klebsiella pneumonia.The drug resistance is serious in the both infections,and the most sensitive antibiotics to gram negative bacteria include amikacin,ertapenem,imipenem,piperacillin/tazobactam,and the most sensitive antibiotics to gram positive bacteria include tigecycline,linezolid in the both infections.

Objective To study multi-slice spiral CT(MSCT) features of cardiogenic hepatohemia.Methods MSCT features of cardiogenic hepatohemia were retrospectively analysed.Results All cases were showed having reflux of contrast into the inferior vena cava(IVC)during arterial phase,of them,10 cases were accompanied with abnormal hepatic perfusion and 7 cases with intrahepatic lymphostasis sign.Conclusion The features including the reflux of IVC and abnormal hepatic perfusion during arterial phase in contrast-enhanced CT scan may suggest hepatohemia caused by higher pressure level of right heart from the cardiovascular diseases.

Objective To study the blood pressure changing patterns in normal pregnancy and pregnancy induced hypertension(PIH). Methods 24 hour ambulatory blood pressure monitoring (ABPM) were performed in 38 cases of normal pregnancy and 36 cases of PIH during 18～20,28～30 and 38～40 gestational week. Results The 24 hour mean blood pressure were increased with pregnancy advanced. In normal pregnancy, a typical circadian rhythm of blood pressure pattern was shown that it increases during the day and decreased during the night with the disparity of (16.3? 4.1)%, (14.1?3.2)% and (15.7?2.0)% in three different gestational week respectively. In moderate and severe PIH, the 24 hour mean blood pressure,blood pressure load and the frequence of abnormal rhythm were significantly higher than those in mild PIH and normal pregnancy, while the disparity between day and night blood pressure was lower. Conclusion The blood pressure patterns show a typical circadian rhythm in most normal pregnancy. The more severe the PIH is, the higher rate of abnormal blood pressure rhythm occured.

Objective To investigate and compare the effect of cyclosporine A (CsA) vs. tacrolimus (TAC)-based immunosuppressive regimen on chronic allograft nephropathy. Methods Ninety-six patients who received a cadeveric kidney transplantation in our unit during Jan. 1995 to Jan. 2004 more than 12 months prior to study enrollment and who were being treated with CsA-based immunosuppressive treatment were included. All patients received allograft biopsy and were diagnosed as CAN. Patients were differentiated according to following regimen. Patients were either converted to tacrolimus (TAC group, n=58) or remained on their initial CsA-based immunosuppression (CsA group, n=39). The clinical data at study entry and after 3, 6 and 12 months including serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), blood urea nitrogen (BUN), creatinine (SCr), albumin were recorded during a follow-up of over 12 months. Results Though TC, TG and LDL levels remained unchanged in CsA group, while statistically reduced in TAC group respectively ( 6.60? 1.34 mmol/L vs. 5.20? 0.75 mmol/L, 3.00? 1.40 mmol/L vs. 1.90? 0.86 mmol/L, and 3.70? 0.93 mmol/L vs. 3.00? 0.72 mmol/L, P

Six five renal graft biopsies were performed routinely in 36 renal transplantation patients with normal renal function 1 and 3 months after transplantation. All the patients were given the immunosuppressive regimen of cyclosporine A (CsA), prednisone (Pred), azathioprine (Aza) and Tripterygium Wilfordii Hook (TW). The histological diagnosis of allograft biopsy was made according to the Banff schema. In 18 45% of the biopsies (12/65), early subclinical rejection or borderline changes were found. There was a significant difference for different dosages of TW, but no difference for the dosages of CsA, Pred and Aza intravenous between patients with pathological changes and those without. The patients with early subclinical rejection or borderline changes, methylpredisolone was given in bolus, followed by the adjustment of immunosuppressive regimens. With this treatment, there was no difference in 5 year survival rate between them and those with normal renal allograft biopsy findings. The routine allograft biopsy helps discover early subclinical rejection and borderline changes in patients with renal transplantation, and beneficial for adjustment of immunosuppressive therapy.

Objective To investigate the effect of anti-inflammation-analgesic injection (AIAI) combined with extract from rabbit skin inflamed by vaccinia virus (ERSVV) on repair of the damaged sciatic nerve in rats.Methods Fifty adult SD rats of both sexes weighing 260-300 g were randomly divided into 5 gronps ( n = 10each): sham operation group (group S); sciatic nerve chronic constriction injury group (group CCI); CCI + AIAI group (group A); CCI + ERSVV group (group E) and CCI + AIAI + ERSVV group (group A + E). Right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4/0 catgut in CCI,A,E and A + E groups. A catheter was placed around sciatic nerve, and fixed to the nearby muscle and kept unclogged by injecting 0.2 nl distilled water daily. AIAI and/or ERSVV 0.2 ml were injected via the catheter starting from the 14th day after operation. AIAI 0.2 ml contained dexamethasone palmitate (4 mg/ml) 0.05 ml, 2% lidocaine 0.05 ml and vitamin B12 (0.5 mg/ml) 0.05 ml in distilled water. Dexamethasone palmitate was omitted in AIAI starting from the 2nd of drug administration in group A and A + E. Paw withdrawal threshold to mechanical stimulation (MWT) was measured before (baseline) and at 1, 5, 7, 14, 21 and 28 days after operation. Sciatic nerves were exposed at 14 and 28 days after operation in 5 rats in each group. Conduction velocity of motor nerve (NCV) and action potential (AP) of gastrocnemius muscle were measured. Sciatic nerve at the site of CCI was examined for pathologic changes, the number of axons (NA) and thickness of myelin sheath (TMS) with light microscope. Results CCI significantly decreased MWT, AP, NA, TMS and NCV in group CCI as compared with group S (P ＜0.01). AIAI and/or ERSVV significantly attenuated CCI-induced decrease in MWT, AP, NA, TMS and NCV in A,E and A + E groups as compared with CCI group ( P ＜ 0.05). Their curative effects were potentiated by combined use. Conclusions Both AIAI and ERSVV have curative effects against CCI-induced sciatic nerve injury and their actions are potentiated by combined used.