Objective To study the inlfuence factors on detection of activity of four coagulation factors in prothrombin complex concentrates (PCC) by several factors. Methods Using Pharmacopoeia of the People’s Republic of China (2010) as reference, the activity of four coagulation factors in PCC were investigated by choosing different pre-treatments, different diluents, different salt concentration, different standard human plasma and different company reagents. Results The activity of FII, FVII, FX were decreased and FIX was increased in the condition of adding protamine sulfate, and there were no differences of four coagulation factors whether warm bath in 37 for 15 min or not. However, the differences of four coagulation factors were significant by using deficient plasma, saline, distilled water and commercial dilution buffer(P<0.05). The activity of coagulation factor II, X in 1 mol/L salt concentration of PCC were significantly lower than in 0.25 mol/L(P<0.05), while coagulation factor VII, IX were not. The activity of FII, FVII, FIX, and FX were different by using different standard human plasma to make standard curve. The activity of four coagulation factors existed significant difference(P=0.00) by using SIEMENS company reagents and domestic reagents. Conclusion Choosing different pre-treatments, different dilution buffers, salt concentration, standard human plasma and commercial kits will inlfuence the detection result of coagulation factors.

Objective To investigate the value of screening bridge vessels before coronary artery bypass graft(CABG) by ultrasonic examination. Methods To analyze the ultrasonic result of internal mammary arteries,carotid arteries,and radial arteries before CABG. Results Among the 140 cases,11 internal mammary arteries were not qualified,14 of 74 radial arteries were not qualified. And the stenosis of carotid arteries were present in 28 cases. Conclusions It is valuable to examine the bridge vessels before CABG.

OBJECTIVE: To establish the fingerprints of Lonicera similis from Sichuan and Chongqing.METHODS: Chlorogenic acid was taken as the reference substance.The separation was carried out on Dikma Kromasil C18(250 mm?4.6 mm,10 ?m) column with methanol-0.1% phosphoric acid solution as mobile phase(in gradient elution) under a detection wavelength of 326 nm.RESULTS: A total of 11 common peaks appeared in the 10 batches of L.similis samples,and the parameters of the common peaks were up to the standard of the specification for fingerprints of Chinese medicine injections.CONCLUSION: The established HPLC fingerprints can be used as a reference for the quality evaluation and variety discrimination of L.similis.

Objective:To discuss what impact prone position ventilation (PPV) plays in treatment of acute respiratory distress syndrom (ARDS)originating from pulmonary disease(ARDSp) and extra-pulmonary disease(ARDSexp).Methods: Retrospective case-control cohorts study. Sixty patients with ARDS were included, were classified two groups which were originated from pulmonary disease(n=30) and extra-pulmonary disease(n=30), they were ventilated in PPV. And oxygenation of 0,2,4, and 6 hours in PPV, static compliance(Cst), airway resistance(Raw) of were evaluated. The Ultrasonic Cardiac Output Monitor was applied to monitor the cardiac function.Results:At 2 hours after ventilation in ARDSexp group, PaO2/FiO2 have been improved significantly. The longer duration of PPV seemed to be associated with continuous improvement and peaks at 4 hours. In ARDSexp group PaO2/FiO2 after ventilation at 3 hours exceeds the other groups. At 4 hours after ventilation, PaO2/FiO2 of both ARDSp and ARDSexp groups of PPV have been improved than that of supine position. After ventilation for 4 hours, the RAW of ARDSp decreases dramatically and considerably below the other groups.Conclusion: PPV was a safe and effective maneuver for improving oxygenation in patients with ARDSp and ARDSexp. Both ARDSp and ARDSexp clearly appear to benefit from PPV, particularly in ARDSexp group. PPV aslo influenced haemodynamics in patients rarely.

Objective To study the clinical effect of minimally invasive percutaneous nephrolithotomy in patients with diabetes mellitus and non-diabetic patients. Methods A retrospective analysis was performed to look into the clinical data of 2,796 patients undergoing downward F18minimally invasive percutaneous nephrolithotomy during May 2007 to June 2016 under X-ray guidance Among them,582 diabetic patients were assigned as the diatetes group,aged 26-82 years,279 male,303 female, 174 with pelvic stones,255 with multiple calculi,153 with staghorn calculi,fasting blood glucose 5.4~20.3 mmol/L,postprandial and 2 hours blood glucose 9.1~28.9 mmol/L. In the group,the results of preoperative fasting blood glucose,glycosylated hemoglobin,meal 2 hours blood glucose,diabetes mellitus immune and two others,were in line with diabetes diagnosis and typing standard, and the stones were tested by infrared spectrum analyzer for determination of chemical composition(P<0.05). The rest 2,214 diabetic patients were set as non-diabetic group. The two groups were compared in terms of the operation duration,the rate of stone removal,surgical complications and hospital stay. Results There were no significant differenices in the operation duration,rate of stone removal and operative complications between the two groups(P>0.05),but the hospital stay in the diabetic group was significantly longer than that of the control group. In comparison of the stone compositions,therate of uric acid stones in the diabetic group was significantly higher than that of the control group (P < 0.05). Conclusion Minimally invasive percutaneous nephrolithotomy is safe and effective for the treatment of renal calculi in patients with diabetes mellitus. Diabetic patients are susceptive to uric acid stones and those patients at the poor control of blood glucose suffer from a higher recurrence of renal stones , which reminds the importance of doctors to educate the patients on the prevention of kidney stones.

BACKGROUND:In recent years, minimal y invasive percutaneous plate fixation has been a selectable method to repair fracture of lower limbs, especial y complex fracture of lower limbs. Its advantages are to reduce the damage to soft tissues, and do not destroy bone nutrient supply vessels. However, there is no unified criterion to select which method in the repair of distal tibial fractures. OBJECTIVE:To observe clinical effects of minimal y invasive percutaneous plate fixation versus open reduction and plate fixation in the repair of distal tibial fractures. METHODS:A total of 60 cases of distal tibial fractures treated with minimal y invasive percutaneous plate osteosynthesis (n=35) and open reduction and plate fixation (n=25) were selected. The time of surgery was identified by evaluating soft tissue. We should pay attention to the protection of soft tissue in surgery and reasonable fixation method should be selected. After fixation, we guided patients to do active early functional exercise. They were fol owed up and regularly received X-ray reexamination. Operation time, weight loading time, healing time and functional recovery were observed and the clinical therapeutic effects of the two methods were compared. RESULTS AND CONCLUSION:Al patients were fol owed-up after surgery. They were fol owed up for 3 to 15 months. No significant difference in healing time of type A fracture was detected between minimal y invasive percutaneous plate fixation and open reduction and plate fixation. The healing time of types B and C fracture was better in minimal y invasive percutaneous plate fixation group than in open reduction and plate fixation group. These results indicated that minimal y invasive percutaneous plate fixation in repair of tibial fractures, especial y distal complex tibial fractures, is an effective method. The healing rate of fracture was high, but postoperative complications were less.

Objective To access the left internal thoracic artery (LITA) graft late postoperative patency after coronary artery bypass grafting (CABG) by peripheral blood vessel ultrasound combined with color Doppler coronary flow imaging (CDCFI).In contrast with angiography,try to find available flow parameter to access graft patency.MethodsForty-six patients with CABG more than 1 year postoperatively followed-by angiography were detected by ultrasound.The LITA graft and left anterior descending artery were examined.Systolic and diastolic peak velocity(Smax,Dmax),velocity time integral(VTIs,VTId)of each segment were measured separately.The ratio of diastolic and systolic peak velocity (D/S),and diastolic velocity time integral fraction(DVTIF) were calculated.All patients were divided into groups according to angiography results.ResultsThirty -one LITA grafts were patent,11 were dysfunctional,4 were occlusive.According to the angiography results,the flow parameters of the proximal segment of LITA graft were significant.The D/S and DVTIF of patent group was higher than that of dysfunctional group.The diastolic peak velocity of distal segment of LAD of patent group was higher than that of dysfunctional group.ConclusionsPeripheral blood vessel ultrasound combined with CDCFI could provide the evidence to access the patency of the graft.It was an effective method for the clinical follow-up.

Objective To compare different susceptibility testing methods of tigecycline against Acinetobacter baumannii and Klebsiella pneumoniae.Methods Fifty carbapenem-resietant A.baumannii (CRAB) strains and 49 K.pneumoniae strains were collected from Tianjin Medical University General Hospital during January and March 2012.Minimum inhibitory concentration (MIC) and inhibitory zone diameters for tigecycline were determined by broth microdilution,Vitek-2,MTS and disk diffusion methods.The results of Vitek-2,MTS and disk diffusion methods were compared with those of broth microdilution method.Results According to FDA standards,the susceptibilities of CRAB and K.pneumoniae to tigecycline determined by broth microdilution,Vitek-2 and MTS were 94.0％/91.8％,68.0％/91.8％ and 90.0％/91.8％,respectively.For CRAB isolates,the essential agreement (EA) and categorical agreement (CA) produced by Vitek-2 and MTS were 94.0％/72.0％ and 92.0％/90.0％.MICs determined by Vitek-2 were 1-2 dilutions higher than the reference method in 33 (66.0％) strains,and those determined by MTS were higher in 16 (32.0％) strains and lower in 11 (22.0％) strains.For K.pneumoniae isolates,the EA/CA produced by Vitek-2 and MTS were 95.9％/98.0％ and 83.7％/91.8％,respectively.MICs determined by Vitek-2 were 1-3 dilutions lower than the reference method in 17 (34.7％) strains,and those determined by MTS were 1-3 dilutions lower than the reference method in 39 (79.6％) strains.None of thetwo methods produced very major error (VME) and major error (ME) against two kinds of isolates.The results were determined by disk diffusion method using different breakpoints according different isolates.For CRAB,using ≥14 mm/≤ 10 mm as breakpoint,CA was 94.0％,which was higher than the breakpoint recommended by Jones et al (≥16 mm/≤12 mm,CA was 82.0％) ; and for K.pneumoniae,using the ≥ 14 mm/≤ 10 mm as breakpoint,CA was 93.9％,higher than the FDA Enterobacteriaceae breakpoint (≥ 19 mm/≤ 14 mm,CA was 67.3％).Conclusion For CRAB strains,MTS produces better consistence with broth microdilution,with several higher or lower MIC results.For K.pneumoniae strains,Vitek-2 has better correlation with reference method,with several lower MIC results.The consistence between disk diffusion method and broth microdilution is comparatively lower,and the breakpoint should be adjusted according to different bacteria.

Objective To establish an HPLC method for the simultaneous determination of hydroxysafflor yellow A, rutin, quercetin, and kaempferol in Carthamus tinctorius L..Methods The Agilent ZORBAX SB-C18 column (4.6 mm × 250 mm, 5 μm) was used with diode array detection. The mobile phase was 0.5% phosphoric acid (A) and methanol (B) to separate the four components by gradient elution at 30℃; the flow rate was 0.8 mL/min; the injection Volume was 10 μL; the detection wavelength was at 360 nm.Results The linear ranges of hydroxysafflor yellow A, rutin, quercetin, and kaempferol were 0.0776–0.7760 μg (r=0.9999), 0.0460–0.4600 μg (r=0.9996), 0.0064–0.0640 μg (r=0.9999) and 0.0128–0.1280 μg (r=0.9997), respectively. The average recoveries of four components were 99.68% with RSD=2.29% (n=6), 99.78% with RSD=1.52% (n=6), 102.03% with RSD=1.02% (n=6), 97.03% with RSD=2.05% (n=6), respectively.Conclusion The method is convenient, accurate, sensitive, stable and repeatable, which can be a method for quality control of Carthamus tinctorius L..

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Female ; Gout ; therapy ; Humans ; Male ; Middle Aged