OBJECTIVE: To establish a simple and rapid HPLC method for the determination of serum concentration of isofosfamide.METHODS: With cyclophosphamide as internal standard,the serum sample was extracted on C18 solid phase extraction column and determined on Zorbox-ODS C18 at room temperature.The mobile phase consisted of acetonitrile-water(25∶75) at a flow rate of 1 mL?min-1 and a detection wavelength of 200 nm.RESULTS: The linear range of ifosfamide was 2.5～200 ?g?mL-1(r=0.999 9),with the lowest detectable limit at 0.5 ?g?mL-1(S/N=3).Both the intraday and interday RSD were less than 5%.The extraction recoveries of ifosfamide at high,middle and low concentrations were ranged between 89.3% and 93.6% versus 77.6%～82.3% in chloroform-treated serum samples.CONCLUSION: The method which uses the C18 solid phase extraction column is of high recovery,and the sample treatment by which is simple,rapid,accurate,and pollution-free,and it is applicable for the monitoring of serum concentration and pharmacokinetic study of isofosfamide.

Objective To analyze the pathogenesis, clinical features, treatment and prognosis of pulmonary hypertension (PHT) in systemic lupus erythematosus (SLE) patients. Methods Thirty-eight patients admitted during Jan 2001 to Aug 2008 were diagnosed as SLE associated with PHT and were analyzed retrospectively. Results All cases were female with the mean age of 35.7 yds. The mean period from PHT to the diagnosis of SLE was 2.3 years. Three cases were severe PHT with remarkable heart failure. Twenty-seven eases demonstrated Raynaund's phenomenon. Antinuclear antibody (ANA) was positive in all 38 cases and the titer was 1:320. Anti-DNA antibody, anti-Sin antibody, anti-U1RNP antibody and anti-SSA, anti-SSB were positive in 21 cases, 16 cases, 15 cases, 8 cases respectively. Antiphospholipid antibody and rheumatoid factor (RF) were elevated in 4 cases and 13 cases respectively. Seven cases were involved in lung fibrosis and pulmonary function test showed mild to moderate restrictive abnormality in these 7 cases. After treated with the combination of steroid and immunosuppressive agents, one case died on the 10th day and 2 cases died in 2 to 3 years after the diagnosis was established. The other 35 cases stayed stable. Conclusion PHT is one of the severe complications of SLE and often accompanied by poor outcome. Therefore early diagnosis and early combined therapy is very important.

Objective To investigate the efficacy and safety of cervical dilatation balloon and Dinoprostone for promoting cervical ripening and induction of labor.Methods 80 maternal who were taken induction of labor were randomly divided into two groups,40 patients in each group,according to the order of admission,the study group and the control group used COOK balloon and Dinoprostone for promoting cervical ripening and induction of labor respec-tively,Bishop score before and after treatment,cervical ripening rate of maternal and neonatal outcomes were compared between the two groups of maternal.Results The study group′s Bishop score was (8.96 ±0.15)points,which was significantly higher than (6.02 ±0.34)points of the control group after treatment,the difference was statistically sig-nificant(t =3.75,P <0.05);The total effective rate of the study group for maternal cervical ripening and induction of labor was 97.5%,which was significantly higher than 67.5% of the control group,the difference was statistically sig-nificant(χ2 =5.31,P <0.05);The study group′s induction to the regularity of contractions time was (6.2 ±1.4)h, which was significantly lower than (11.5 ±2.1)h of the control group(t =13.28,P <0.05),and the study group′s vaginal delivery rate and cesarean section rate were 85.0% and 15.0% respectively,the difference was statistically significant,which compared with 62.5% and 37.5% of the control group (χ2 =3.88,6.49,all P <0.05);The two groups′maternal and neonatal outcomes showed no significant difference(t =0.17,0.43,0.31,0.82,all P >0.05).Conclusion The cervical dilatation balloon has a higher success rate for promoting cervical ripening and induction of labor which is safe and reliable that should be widely applied.

OBJECTIVE: To evaluate the clinical effect of acellular dermal matrix (ADM) on the repair of different tissue defects in pharyngeal and laryngeal cancer. METHOD: Twenty-three cases of pharyngeal and laryngeal cancer were analyzed retrospectively, including 16 patients with pharyngeal cancer, and 7 patients with laryngeal cancer. After surgery, the patients appeared two types of tissue defects respectively: hypopharynx tissue defect and neck skin tissue defect. These defects were repaired with ADM, and the clinical effects were observed. RESULT: Sixteen cases of hypopharynx tissue defect and 7 cases of neck skin tissue defect were repaired with ADM. One case in hypopharynx tissue defect group and 2 cases in neck skin tissue defect group undergone pharyngeal fistula postoperatively. CONCLUSION The repair of tissue defects in pharyngeal and laryngeal cancer with ADM had some advantages, such as good histocompatibility, low immune rejection, wide material sources and simple method. There were some differences in clinical effects between hypopharynx cavity defect and neck skin tissue defects, so the emphasis of the need to pay attention to is different in the clinical.
Acellular Dermis ; Dermatologic Surgical Procedures ; Humans ; Hypopharynx ; surgery ; Laryngeal Neoplasms ; surgery ; Mucous Membrane ; surgery ; Neck ; surgery ; Otorhinolaryngologic Surgical Procedures ; Retrospective Studies

OBJECTIVE: To compare the clinical results between stapled and traditional suture closure total laryngectomy. METHOD: Fifty-three cases of laryngeal cancer with total laryngectomy were divided into 2 groups: 32 cases with traditional suture closure total laryngectomy (group A) and 21 cases with stapled total laryngectomy group (group B). Compare two groups in pharyngeal fistula, postoperative bleeding, dysphagia, and nasal regurgitation. RESULT: There was no difference of postoperative pharyngeal fistula between group A and B (P>0. 05). The incidence of dysphagia, nasal regurgitation, and postoperative bleeding in group B were 23. 8%, 14. 3% and 14. 3% respectively, which were obviously higher than that in group A (P<0. 05). CONCLUSION Stapled total laryngectomy has the advantages of reducing the operative time and simplifying the operation with some disadvantages such as higher standards of operation indications, higher incidence of dysphagia, higher nasal regurgitation, higher postoperative bleeding, and poor medical economic profit. Traditional suture closure total laryngectomy is recommended in clinical practice.
Deglutition Disorders ; Fistula ; pathology ; Humans ; Incidence ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Pharynx ; pathology ; Postoperative Complications ; Suture Techniques ; Sutures

BACKGROUND:The relationship between placing time after stem cel preparation and cel survival is the basis of safety and effectiveness for the clinical application. OBJECTIVE: To observe effects of different preservation solutions and different storage time on survival rate of umbilical cord-derived mesenchymal stem cels, and to provide important evidence for identifying effectiveness of stem cels. METHODS:Umbilical cord-derived mesenchymal stem cels were selected to prepare stem cel preparation, which was preserved in physiological saline, medium, medium+physiological saline, physiological saline containing epidermal growth factor, and medium containing low molecular heparin calcium suspension. Cold closet was selected for imitating celular transport conditions. Samples were obtained at 0, 6, 12, 18, 24, 30, 36, 42 and 48 hours. Total cel number and cel survival rate were detected. RESULTS AND CONCLUSION:The difference in cel number and survival rate was not great within 24 hours in each group. Twenty-four hours later, total cel number and survival rate were better in the medium and medium containing low molecular heparin calcium groups than in the physiological saline containing epidermal growth factor, physiological saline, and medium+physiological saline groups. These findings suggest that after stem cel preparation, the cel survival rate can reach more than 90% within 24 hours under refrigerated transport conditions. Nutritional ingredients and proper pH value of preservation solution can make the cel survival rate increased greatly.

Objective To summarize the clinical efficacy of suture anchors in repairing the delayed Achilles tendon rupture.Methods From January 2010 to December 2013,23 patients with delayed Achilles tendon rupture were treated using the suture anchors.There were 19 males and 4 females,at mean age of 43 years (range,35-53 years).Injury on the left side occurred in 5 patients and right side in 18 patients.Mean time from injury to operation was 26.3 days (range,21-40 days).Ten patients were diaguosed by ultrasound and the other by MRI.All patients underwent suture anchor fixation without external support.Functional training started at the early stage.Incision complications were detected.Ankle flextiou-extension range,American Orthopedic Foot and Ankle Society (AOFAS) score,maximum bilateral leg circumference,tendon rerupture and walking posture were recorded at postoperative 6,12,18 and 24 months.Achilles tendon muscular strength was measured with the Lunsford-Perry heelrise test.Results Follow-up was 24 months.All incisions healed by first intention without sural nerve injury,adherence with skin and deep infection.Six months after operation,the ankle range of motion was dorsiflexion 10.8° (range,9-15°) and plantar flexion 43.8° (range,40-48°),with no significant difference in comparison to the health side (P ＞ 0.05).AOFAS score differed significantly before and after operation (P ＜ 0.01).Maximal leg circumference was 38.2 cm in the health side versus 35.8 cm in the injury side (P ＜ 0.05),but the difference was no more than 3 cm.All patients completed 25 times heel raising without difficulty.Four patients walked with a slight limp and recovered from the limp 12 months after operation.No Achilles tendon ruptured again during the follow-up time.Conclusions Repairing the old Achilles tendon rupture with suture anchors can supply strongly strain between broken ends of the tendon,and the outer cast is not needed after operation.Complications are less and functional practice can be commenced in the early postoperative period for better function restoration.

OBJECTIVE:To establish an HPLC method for the determination of triterpenoid in the roots of Actinidia deliciosa from Guangxi. METHODS: With the content of 2?,3?,24-trihydroxyursa-12-en-28-oic acid used as index. The separation was performed on Thermo Hypersil BDS C18 column (250 mm?4.6 mm,5 ?m) with 2?,3?,24-trihydroxyursa-12-en-28-oic acid as standard substance. The mobile phase consisted of methanol-0.2% phosphoric acid (73 ∶ 27) with column temperature set at 20 ℃. The flow rate was set at 1.0 mL?min-1 and detection wavelength was 210 nm. RESULTS: The linear range of 2?,3?,24-trihydroxyursa-12-en-28-oic acid were 0.025～0.200 mg?mL-1(r=0.999 8). The average recovery was 99.79%(RSD=1.54%,n=6). CONCLUSION: The method is accurate, reliable and reproducible for the quality control of the roots of A. deliciosa from Guangxi.

Objective To assess the prognostic significance of pre-treatment hypercoagulable state in cervical cancer patients. Methods With retrospective analysis, pre-treatment coagulation indicators and platelets from 321 cervical cancer patients from stages I to IV were collected. The pre-treatment coagulation parameters were investigated along with tumor stage and survival data. Result Advanced tumor stage was associated with elevated fibrinogen (Fbg) and platelet (PLT) levels (P < 0.05). Patients with higher levels of Fgb, PTA and PLT suffered from higher risk of recurrence (P<0.05). Multivariate survival analyses showed that tumor stage, Fgb and PTA were independent prognostic factors for disease free survival. Conclusion Coagulation parameters can be served as useful tool for predicting recurrence of cervical cancer.

Objective To explore the probable mechanism of tinnitus and the accompanied symptoms us-ing RS-FMRI. Methods We recruited 10 adults with chronic tinnitus and 10 health adults for fMRI in the resting state. Then we compared the differences of regional homogeneity(REHO)maps and functional connectivity to the whole-brain maps with the auditory cortex as a region of interest between the two groups. Results The REHO maps of tinnitus group showed significant differences in the automated anatomical labeling brain map including the middle frontal_gyrus (right),superior frontal_gyrus (left),entorhinal cortex_(right),middle occipital_gyrus (right),middle occipital gyrus(bilateral),lingual gyrus(left)and cuneate lobe(left). The functional connectivity maps of tinnitus group showed significant differences in lingal_gyrus(left)of AAL brain regions. The p threshold value was<0.001 in all results. Conclusion Tinnitus may cause abnormal neural activity in several non-auditory brain regions,which may be the neurophysiological mechanism of tinnitus accompanied symptoms.