Objective To investigate the clinical application value of real‐time PCR in the detection of bloodstream infection pathogens .Methods A total of 92 blood samples from 80 patients in our hospital were collected for conducting real time PCR de‐tection and conventional blood culture .The sensitivity and specificity were compared between the two methods .Results Among 92 samples ,66 samples (71 .7% ) were negative in both assays .Ten different pathogens were detected by either blood culture system or real‐time PCR or by both methods .Seven positive samples were detected by both assays .The consistence of the two methods was 79 .3% .The negative predictive value of real‐time PCR was 0 .94 ,the sensitivity was 0 .64 and the specificity was 0 .82 .Among them ,15 samples were positive in real‐time PCR ,while negative in blood culture system ,4 samples were positive in the blood cul‐ture ,whereas were negative in the real‐time PCR .The pathogens cultured in 2 samples were not in the detection range of real time PCR ,moreover real time pCR could not detect Candida glabrata .Conclusion Real time PCR is a valuable method for rapidly detec‐tion the sample of bloodstream infection ,but cannot completely replace the blood culture test .

Objective To analysis the effect of salbutamol combined with noninvasive ventilator on TNF-α,IL-6,IL-8 and serum CK-MB activity in patients with chronic obstructive pulmonary disease with respiratory failure.Methods 60 patients who were diagnosed with chronic obstructive pulmonary disease with respiratory failure were collected.All patients were randomly divided into experimental group and control group,30 cases in each group. Patients in the control group received noninvasive ventilator treatment, patients in the experimental group were given salbutamol treatment on the basis of control group treatment, after the treatment, the serum levels of TNF-α,IL-6,IL-8 and serum CK-MB activity were detected in all patients.Results After treatment, compared with control group, the serum level of TNFαwas lower in the experimental group,and the difference was statistically significant(P<0.05); the serum level of IL-6 and IL-8 were lower in the experimental group(P<0.05); the serum CK-MB activity was lower in the experimental group(P<0.05).Conclusion The salbutamol combined with noninvasive ventilator can significantly reduce the serum levels of TNF-α, IL-6, IL-8 and serum CK-MB activity in patients with chronic obstructive pulmonary disease with respiratory failure, reduce the inflammatory reaction and reduce the myocardial damage,and have a guiding significance for clinica.

Objective To explore the improving way to repair the lower one-third of leg soft tissue defect transferred the adjacent flap with non-main vessel pedicle. Methods Analyzing 42 cases.using 4 kinds flaps with nonmain vessel pedicle.If it is fine the skin around soft tissue defect of the lower one-third shank,choosing adjacent adversed sural neurotaneous vascular flap or sapheenous nerve vascular flap.If the skin damaged,chosing gastrocnemius flap.If the soft tissue defect was large,combined adversed sural neurotaneous vascular flap with gastrocnemius flap.Osteomyelitis and peroneus previs musculocutaneous flaps were choosed for small soft tissue defect. Results All case observed 6 to 12 months,37 cases were survived completely,5 cases distal part necrsis partly,among them,2 cases transferred flap repaired;1 case musculocutaneous flap transferred, 2 cases after granulation tissue grown,skin grafted. Conclusion The flap transferred adjacent non-main vessel pedicle is the best way to repaire soft tissue defect of one-third lower leg.Different flap can fit with kinds of soft tissue defect.

OBJECTIVE: To study the antibacterial activity of meropenem in vitro and the pharmacokinetics of which in patients with burn injury. METHODS: The minimal inhibition concentration (MIC) of meropenem against 136 clinical isolates was determined with double agar dilution method. 28 patients with burn injury were given 0.5g of meropenem by iv gtt, with the blood concentration of meropenem and the recovery of meropenem in urine were determined at different time. The pharmacokinetics parameters were computed with 3p97 software. RESULTS: Meropenem showed a strong antibacterial activity against K.peneumoniae, pneumonococcus and Enterobacter cloacae. MIC90 was below 0.0 075～0.25?g/ml. Pharmacokinetics parameters of meropenem were the following: t1/2? was (0.35?0.12) h,t1/2? was (2.10?0.71) h,AUC was (44.62?12.95) ?g/ml,Vc was (10.60?3.93) L; CLs was (12.00?3.04) L/h. 6.5 hours later, the mean blood concentration was (1.01?0.53)?g/ml; and the recovery of meropenem in 0h～12h urine was (58.06?16.83) %. CONCLUSIONS: Meropenem showed a very strong antibacterial activity in this study,there were significant differences regarding the in vivo pharmacokinetics parameters between the healthy volunteers and the patients with burn injury.

Objective To prepare the flurbiprofen orally disintegrating tablets and establish the procedures of controlling the quality.Methods Flurbiprofen orally disintegrating tablets was prepared by wet granulation and it content was determined by HPLC.Results The obtained tablets were fine in the shape and smooth in the surface.Their hardness was 2 kg,the disintegrating time was about 30 s.The linear correlation was in a range of 1.0-10.0 ?g/ml,r=0.999 9.The average recovery was 99.32%,RSD=1.09%(n=7).Conclusion Our methods of flurbiprofen orally disintegrating tablets are simple and feasible in preparation and quality control.

OBJECTIVE:To determine the content of ceftazidime in renal dialysate effluent in burn patients.METHODS:HPLC was used.The sample was separated on Bondapak-C18 analysis column with a mobile phase of mixture of methanol-ammonium acetate(17∶83,V/V).The flow rate was 1.0ml/min.The UV detector wavelength was set at 254nm.RESULTS:A linearity was obtained from 0.5～100?g/ml with a good correlation(r=0.9 999).The RSDs of inter-day and intra-day precision were not more than 3.The average recovery was 100.30%.CONCLUSION:The method is simple,rapid and accurate.

ObjectiveTo investigate anatomical characteristics of the medial foot vessels and effects of different vascular pedicle skin flaps in repair of foot and ankle trauma.MethodsThirty adult cadaveric lower limbs were injected with red latex through the popliteal artery and posterior tibial artery to anatomically observe the cutaneous arterial origin,branches,distribution and anastomosis of the medial foot.Then,anterior medial malleolar artery perforator flaps and distally-based medial foot flaps were harvested and used for repairing foot and ankle trauma of 16 patients.Results The origin of cutaneous blood vessels of the medial foot was diversified and mainly included the anterior medial malleolar artery,medial tarsal artery,and arterial arcades anastomosing with anterior posterior branches of the two former arteries and the superficial branches of plantar digital artery and the medial plantar artery.According to distribution area of the anterior medial malleolar artery and the medial tarsal artery,the vascular anatomy of the medial foot skin was classified into three types.Clinically,all the flaps survived.Follow-up ranged from 2 weeks to 20 months,which showed normal color,good shape and good pain and warm sensation of the flaps.ConclusionThe anterior medial malleolar artery perforator flaps present good reconstruction of soft tissue defects around the ankle,whereas the distally-based medial foot flaps present good reconstruction of soft tissue defects of the mid-forefoot.

Objective:To establish an HPLC method for the determination of the content of magnolol and honokiol in Cortex mag-noliae Officinalis formula granules and compare the content of the formula granules from different manufacturers. Methods:An HPLC was used to determine the content of magnolol and honokiol in Cortex magnoliae Officinalis formula granules. The analysis was carried out on a Hypersil C18 (250 mm × 4. 6 mm, 5 μm) chromatographic column. Acetonitrile-water was used as the mobile phase with gra-dient elution and the flow rate was 1. 0 ml·min-1 . The detection wavelength was set at 294 nm, the sample size was 20 μl and the column temperature was 25℃. Results:The linear range was 0. 873-26. 190μg·ml-1(r=0. 999 5) for magnolol, the average recov-ery was 99. 24% with RSD of 2. 00%(n=6) and that was 0. 732-21. 980μg·ml-1(r=0. 999 0) for honokiol,and the average recov-ery was 99. 89% with RSD of 1. 33%(n=6). The difference in the content of magnolol and honokiol in Cortex magnoliae Officinalis formula granules from different manufacturers was notable. Conclusion: The method is simple, repeatable and feasible, and can be used for the quality control of magnolol and honokiol in Cortex magnoliae Officinalis formula granules. The content difference in magno-lol and honokiol in Cortex magnoliae Officinalis formula granules from different manufacturers suggests that it is necessary to standardize the planting and selecting of Chinese medicine, and develop scientific and unified production technology and quality standard for the formula granules.

BACKGROUND: Distally based flap pedicled with the distal nutritional vessels in forearm is especially suitable for reconstructing the tissue defects in the distal end of hands, while high rotation point cannot satisfy the requirements of reconstructing the distal injuries or defects in hands, and severer lesion may even be caused in the donor site.OBJECTIVE: To study the anatomic proceeding of artery perforators in distal radial margin of forearms, so as to provide anatomic basis for the design of distally based compound flap pedicled with the nutrient vessel of cephalic vein in distal radial margin of forearms.DESIGN: Single sample experiment.SETTING: Center for Clinical Anatomy of the Department of Orthopedics,Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command.MATERIALS: The experiment was conducted in the Laboratory of Center for Clinical Anatomy of Department of Orthopedics, Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command between August and December 2004. The upper extremities of 30 cadavers injected with a mixture of red gelatin into the artery (provided by the Center for Clinical Anatomy of Department of Orthopedics, Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command) were adopted.METHODS: The vascular external diameter and distance were measured with sliding caliper and ruler with radial styloid process as the marker.MAIN OUTCOME MEASURES: ① The perforator artery in distal radial margin of forearms. ② The nutrient vessels of cephalic vein. ③ The relationship of blood supply between the nutrient vessels and vicinal bone and skin as well as the lateral antebrachial cutaneous nerve. ④ The superficial and deep communicating branches of cephalic vein.RESULTS: The perforator artery in distal radial margin of forearms derived from: 6-11 cutaneous branches of radial artery with external diameter of (0.7±0.3) mm; 2-6 cutaneous branches of superficial palma with the external diameter of (0.5±0.3) mm; 1-2 recurrent cutaneous branches of the styloid process of radius with the external diameter of (0.5±0.1) mm; 1-2 cutaneous branches of snuff tobacco with the external diameter of (0.6±0.2) mm. At 8.0-15.0 cm above radius styloid process there were 1-3 intermuscular cutaneous branches of radial artery with an initial external diameter of (1.1±0.2) mm, distributing in the exposureregion and corresponding skin of middle and inferior segments in radius. The above-mentioned perforator arteries all developed into cutaneous branch, fascia branch, periosteum branch, cephalic vein and nutrient vessel branch of distal cutaneous nerve,and constituted the vascular chain, the by-pass of cephalic vein, vascular chain of cutaneous nerve stem as well as superficial, deep fascias and periosteal vascular net.CONCLUSION: The perforator artery in distal radial margin of forearms is the source of nutrient vessels in cephalic vein, while the nutrient vessels share an isogeny with the nutrient vessels derived from vicinal bone, skin and lateral antebrachial cutaneous nerve, which provide an anatomic basis for designing the distally based compound flap pedicled with the nutrient vessels of cephalic vein. The rotation point of compound flap pedicled with the recurrent branch of radius styloid process (or branch of snuff tobacco) can reach the surface of rotation joint, which can be adopted in the transposition and reconstruction of distal tissue defects in hands.

OBJECTIVE:To study the absorption features of Silymarin enteric coated-polyllactic-co-glycolic acid (PLGA) nanoparticles in rat in situ intestine perfusion model and colonic adenoma Caco-2 cell model. METHODS:HPLC method was used to determine the content of silymarin. The absorption rate constant(Ka)and apparent absorption coefficient(Kapp)of Silymarin sus-pension,Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles were investigated in duodenum,jejunum, ileum and colon of rat in situ intestine perfusion model;the apparent permeability coefficient (Papp) of those drugs containing low-concentration,medium-concentration and high-concentration(20,40,60 μg/mL)of silymarin in Caco-2 cell model were also investigated. RESULTS:Compared with Silymarin suspension,Ka and Kapp of Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles were all increased in duodenum,jejunum,ileum and colon(P<0.05);compared with the correspond-ing concentration Silymarin suspension,two-way Papp of Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanopar-ticles containing low-concentration,medium-concentration and high-concentration of silymarin were all increased in Caco-2 cell model (P<0.05);there was no statistical significance between Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles (P>0.05). CONCLUSIONS:Silymarin enteric coated-PLGA nanoparticles can effectively increase the intestinal ab-sorption,cellular uptake and transmembrane transport rate of silymarin.