Objective:To prepare nevirapine nanosuspensions ( Nev-NS) and study the pharmacokinetics in rats. Methods:Nev-NS was prepared by a high pressure homogenization technology. The particle size, PDI and Zeta potential of the nanosuspensions were used as the indices to determine the influencing factors in the preparation process. Nevirapine plasma concentration was detected by HPLC and the pharmacokinetic parameters were calculated by 3P97 software. Results: The particle size, PDI and Zeta potential of Nev-NS was (456. 1 ± 72. 1) nm, 0. 441 ± 0. 072 and ( -24. 4 ± 4. 7) mV, respectively. AUC0-12 of Nev and Nev-NS was (7. 57 ± 0.52) and (11.72 ±1.83) mg·h·L-1, t1/2 was (2.45 ±0.31) and (3.16 ±0.39) h, Tmax was (1.43 ±0.38) and (1.61 ± 0. 32) h and Cmax was (1. 62 ± 0. 42) and (3. 15 ± 0. 52) mg·L-1 , respectively. Conclusion:Nev-NS can improve the pharmacoki-netic behavior of Nev in rats significantly, and obviously enhance the bioavailability when compared with nevirapine suspensions.

Objective To establish a RP-HPLC method for determination of aconitine in Shenhailong capsules.Methods Zorbax SB-C18column(4.6 mm?250 mm,5 ?m)was used,with(methanol∶water∶triethyl amine)60∶40∶0.1,as the mobile phase.The flow rate was 1.0mL?min-1and the column temperature was at 30℃.The detection wavelength was 240nm.Results Aconitine concentration presented a good linear range of 0.04?10-3～4?10-3g?L-1(r = 0.9999).with the average recovery of 98.4%,and RSD :1.0%.ConclusionThe method was accurate,nice in reproducibility and with few interference.It could be used for quality control of Shenhailong capsules.

Objective To explore the clinical efficacy of proximal femoral locking compression plate (LCP)fixation in elderly intertrochanteric fractures patients. Methods 30 cases of intertrochanteric fracture fixed with LCP were collected,and the functional recovery of all hip joints was observed. Results The average follow-up and healing time of all cases was 10 months(6 to 14 months)and 3.5 months respectively. Hip joint function of 27 cases was excellent( Harris scoring≥90) ,that of the other 3 cases was good ( Harris scoring:80 ～ 89). Conclusion The proximal femoral LCP fixation had a good clinical value in treatment of elderly intertrochanteric fracture patients. It had many advantages, such as simplicity, rigid fixation, less trauma and bleeding, shorter operative time, less complications, high heal rate, etc.

Objective To evaluate effect of en bloc resection of malignant sacral tumor involving partial sacrum and ipsilateral sacroiliac joint with reservation of contralateral sacral foramina.Methods Between February 2005 and July 2010,16 patients with malignant sacral tumor involving partial sacrum and ipsilateral sacroiliac joint underwent hemi-sacrectomy and functional reconstruction.The operation achieved en bloc resection of tumor with reservation of contralateral sacral foramina.There were 10 males and 6 females,aged from 17 to 70 years (average,37.9 years).There were 5 cases of chondrosarcoma,3 cases of Ewing's sarcoma,2 cases of malignant schwannoma,2 cases of osteosarcoma,1 case of malignant giant cell tumor of bone,1 case of lymphoma and 2 cases of metastatic tumor.Results The surgical time ranged from 4 to 11.5 hours (average,6.5 hours).The average blood loss was 3600 ml (range,1500 to 5500 ml).Five patients underwent type Ⅰ resection,while 11 patients underwent type Ⅱ resection.All patients were followed up for 21 to 59 months (average,34.4 months).Three months after operation,13 patients had difficulty with ankle plantar flexion,while sphincter function was more or less reserved in 16 patients.Four patients (25％)had wound healing complications,which was cured after debridement and drainage.Local recurrence occurred in 7 patients.There were 5 cases of local recurrence among 6 patients who had intralesional margin;4 recurrence lesions located in the sacrum and 1 in soft tissue.Eight patients (50.0％) survived without tumor,2 patients (12.5％)survived with tumor,and 6 patients (37.5％) died of tumor.Conclusion The en bloc resection of tumor involving partial sacrum and ipsilateral sacroiliac joint with reservation of contralateral sacral foramina was feasible and had better outcome compared with total sacrectomy.

OBJECTIVE:To observe therapeutic efficacy and safety of dexrazoxane combined with Shenmai injection in the treatment of anthracycline-induced cardiotoxicity in patients with breast cancer. METHODS:120 female breast cancer patients were randomly divided into group A,B,C and D with 30 cases in each group. Group A was given CAF chemotherapy plan(cyclophos-phamide 75 mg/m2+fluorouracil 500 mg/m2 + doxorubicin 60 mg/m2),ivgtt;group B was additionally given Shenmai injection 50 ml,qd,ivgtt,on the basis of CAF plan;group C was additionally given rapid intravenous of dexrazoxane 60 mg/m2 30 min before chemotherapy,on the basis of CAF;group D was additionally given constant dose of dexrazoxane combine with Shenmai injection on the basis of CAF plan. A treatment course lasted for 3 weeks,they were given 4 courses in total. The change of ECG,LVEF, cTnT and BNP and the incidence of bone marrow suppression were observed before and after chemotherapy. RESULTS:After treat-ment,the rate of abnormal ECG,LVEF value,cTnT value and BNP value of groups B,C and D were all decreased significant-ly,with statistical significance(P<0.05). Compared with group D,above index of groups B and C were decreased significantly, with statistical significance(P<0.05). The incidence of bone marrow suppression was in ascending order,group D

OBJECTIVETo compare clinical effects of spinal leveraging manipulation and medicine for the treatment of degenerative scoliosis in pain and function.

METHODSFrom July 2010 to June 2013, 38 patients with degenerative scoliosis were randomly divided into spinal leveraging manipulation group and medicine group by coin tossing. In manipulation group, there were 9 males and 11 females aged from 58 to 74 years old with an average of (66.63±7.73), the courses of diseases ranged from 3 to 8 months with an average of (5.65±2.58), spinal leveraging manipulation(following meridian to straighten tendon,relieving spasm, osteopathy and massage, clearing and activating the channels and collaterals) were performed for 30 min, once a day, 4 days for a period treatment, totally 9 courses. In medicine group, there were 8 males and 10 females aged from 57 to 70 years old with an average of (63.51±6.61) the courses of diseases ranged from 3 to 5 months with an average of (4.82±1.43), celecoxib with eperisone hydrochloride were orally taken, 4 days for a period treatment, totally 9 courses. VAS score, Cobb angle and ODI score were measured.

RESULTSAfter treatment, VAS score in manipulation group was (5.38±0.99), (6.36±1.31) in medicine group,and had significant meaning (t=2.618, P<0.05); there was significant differences in Cobb angle between manipulation group (16.51±4.89)° and medicine group (19.85±5.03) °(t=2.074,P<0.05); and had obviously meaning in ODI score between manipulation group (20.20±2.93) and medicine group (26.01±3.11) (t=5.592, P<0.05).

CONCLUSIONSpinal leveraging manipulation for degenerative scoliosis could regulate muscle balance on both side of spine, correct coronal imbalances in spine, recover normal sequence of spine, reduce and remove opperssion and stimulation of nerve root, relieve pain in leg and waist and further improve quality of life.

Aged ; Case-Control Studies ; Celecoxib ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Manipulation, Spinal ; Middle Aged ; Propiophenones ; administration & dosage ; Pyrazoles ; administration & dosage ; Scoliosis ; drug therapy ; therapy ; Sulfonamides ; administration & dosage ; Treatment Outcome

Objective To identify the pathogen distribution and antibiotics resistance of blood stream infection(BSI) in the pediatric surgery intensive care unit(PSICU).Methods The clinical data of 138 pediatric patients diagnosed with BSI from January 2011 to December 2015 were collected in PSICU,and the distribution of pathogens and drug resistance were retrospectively analyzed.Results The incidence of BSI was 3.88‰(138/35.524)in the five years,the majority of the BSI cases occurred under one year old,and the mortality was 13.77%(19/138).A total of 179 strains were isolated from blood samples of 138 patients,of which gram-positive bacteria,gram-negative bacteria and fungi accounted for 60.89%(109/179),22.91%(41/179)and 16.20%(29/179)respectively.The most common gram-positive bacteria was coagulase-negative staphylococcus (84/179,46.93%).The predominant gram-negative bacteria were Acinetobacter baumannii(15/179,8.38%),Klebsiella pneumonia(12/179,6.70%) and Escherichia coli(6/179,3.35%).The rate of carbapenems-resistant Acinetobacter baumannii increased continuously in the study period.Non-albicans Candida was the most common fungi (14/179,7.82%).The resistance rate of multi-drug resistant strains to carbapenems significantly increased.Conclusion The incidence of BSI in PSICU increases,and the mortality in children younger than one year is high.Better understanding of distribution of BSI pathogen could provide more effective antibiotic prescription.

Objective To investigate the effect of folic acid intervention on plasma homocysteine (Hcy) metabolic changes and pulse wave velocity(PWV)in patients with type H hypertension. Methods Patients(hos-pitalized from March 2014 to December in our hospital)with H type hypertension were randomly divided into treat-ment group and control group randomly ,and were given routine antihypertensive drug therapy. Treatment group was given oral folic acid 0.8 mg,1 times a day,the control group was given placebo,1 times a day. All patient were treated for 12 months. Changes of plasma Hcy and PWV levels were observed. Results 432 patients(Han nationality)with type H hypertension were enrolled in this study with the age of 61.7 ± 13.6 years old and the ratio of men and women is 1.3:1. The most common diseases were coronary heart disease and type 2 diabetes mellitus. 2 groups were treated for a period of 12 months,with follow-up time from 6 to 10 months(average duration in 8 months). After treatment,the difference between plasma Hcy(Z=-7.63,P=0.000)and PWV(Z=-3.16,P=0.002)levels of the two groups were statistically significant. Conclusion Folic acid intervention can significantly reduce the level of plasma Hcy in patients with type H hypertension ,slow down the progression of atherosclerosis and reduce the risk factors of cardiovascular disease.

The acute phase of ischemic stroke patients are often treated with both Chinese patent medicine:and western medicine therapies in clinical practice. This research included 27,678 cases of the acute phase of ischemic stroke came from 14 3A level hospitals. We collected data from patients with ischemic stroke who used both Chinese patent medicine and western medicine and were hopitalized within 14 days from hospital information system (HIS). Constructing complex network of Chinese patent medicine and western medicine were found to show scale-free network. Hierarchical structure of the core algorithm was used to analyze the characteristics of combined core Chinese patent medicine and western medicine in admission condition of "acute", "critically", and "general" of ischemic stroke acute phase patient within one day, 2-3 days, 4-7 days and 8-14 days. We found that the core Chinese patent medicine mainly used for activate blood and resolve stasis medicine, and phlegm eliminating brain refreshing medicine in all kinds of patients, but the phlegm eliminating brain refreshing medicine were used to reduce with time elapsing. The core western medicine mainly used for anti-platelet medicine, improve circulation medicine, neuroprotective medicine, anticoagulants medicine and dehydration medicine. The dehydration medicine as the core western medicine for critically patients within 14 days, but the patients for general admission as core western medicine within 3 days. The neuroprotective medicine was used to decreases after 7 days in hospital. Combination of Chinese patent medicine and western medicine were mainly for neuroprotective medicine + activate blood and resolve stasis medicine, and anti-platelet medicine + activate blood and resolve stasis medicine, and improve circulation medicine + activate blood and resolve stasis medicine. The phlegm eliminating brain refreshing medicine was mainly combined with neuroprotective medicine by urgent and general admission condition patients, and it was more combined with dehydration medicine by critically admission condition patients. This research found that the dynamic characteristics for the combination of Chinese patent medicine and western medicine of acute phase of ischemic stroke patients by big data analytics and complex networks modeling, and provide basis for acute phase of ischemic stroke patients, it provide basis for ischemic stroke treatment strategy making.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Brain Ischemia ; drug therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Stroke ; drug therapy

OBJECTIVETo study clinical effects of a new internal fixation by using a cable through the bone and Kirschner with a hole in the tail, for the treatment of patellar fractures.

METHODSFrom May 2012 to July 2013, thirty-four patients with patellar fractures were treated with cable through the bone and Kirschner with a hole in the tail. All the patients had close fracture,including 12 transverse fractures and 22 comminuted fractures. There were 18 males and 16 females, ranging in age from 26 to 81 years old, with an average of (46.0 ± 3.0) years old. After open reduction, two appropriate length of Kirschner with a hole in the tail were driven into the patella as perpendicular to the fracture line or the major fragments as possible. A transverse bone tunnel was then drilled with a Kirschner at one side of the patella. Then the cable, which was successively pulled through the bone tunnel and the hole of Kirschner, was crossed in a figure-eight over the anterior of the patella, tightened and fixated by special instruments. The Kirschner was clipped off on the edge of the hole. If it was a comminuted fracture, another cable was used to fasten the patella with cerclage. Postoperative evaluation was based on Bostman.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 26 months, with a mean of (16.0 ± 2.0) months. Fractures healed in all the cases without such complications as infection, loosening of Kirschner and cable loop, and skin irritation. According to the Böstman score system, 33 cases got an excellent result, and 1 good.

CONCLUSIONThe cable through the bone and Kirschner with a hole in the tail is a simple, stable and effective method for the treatment of patellar fractures, especially the transverse fractures, with earlier knee exercise and fewer complications.

Adult ; Aged ; Aged, 80 and over ; Bone Wires ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Patella ; injuries ; surgery ; Treatment Outcome ; Young Adult