OBJECTIVE:To establish a HPLC method for the determination of stavudine and related substances METHODS:The Hypersil C18(4 6mm?150mm,5?m)was used as analysis column The mobile phase was methanol-water(13∶87,V/V) Detection wavelength was 264nm The flow rate was 1ml/min The column temperature was 20℃ RESULTS:The calibration curves was linear in the concentration range of 0 025～0 3mg/ml(r=0 9 999,n=6) The average recovery was 99 26%(RSD=0 76%) The contents of stavudine in 3 batches of semifinished materials and stavudine capsules(imported and domestic)were 99 48%,99 55%,99 32%(materials);97 21%,101 54%,98 92%(imported stavudine capsule);100 57%,97 86%,102 33%(domestic stavudine capsule)respectively CONCLUSION:The method is simple,accurate,sensitive and repeatable and it is suitable for the determination of stavudine and its preparations

Objective To investigate the role of endoscopic nasobiliary drainage ( ENBD) of bile duct instead of T tube drainage during laparoscopic common bile duct exploration (LCBDE). Methods All the patients accepted ENBD before LCBDE / laparoscopic cholecystectomy (LC) + LCBDE. During the operation the stones were extracted by choledochoscopy or crashed with electrohydraulic lithotripsy. After removing all of the biliary stones, the nasobiliary tube still remained in the common bile duct, then primary closure of the exploration wound on the duct wall was made, and with routine abdominal drainage. After operation , radiography of the nasobiliary tube was taken to investigate if there were any residual stones or leakage in the bile duct remained. Subsequently the drainage tube and nasobiliary tube were respectively removed as indicated. Results Totally 43 cases accepted ENBD preoperatively, after 6. 1 days LCBDE was performed, in 36 cases (83. 7% ) the operation was successfully using nasobiliary drainage and primary closure of the duct wound. Postoperative radiography of the duct system through the nasobiliary tube showed only in one case (2. 6% ) a small stone left which was then extracted under ERCP. There were no bile duct stricture and bile leakage, so the nasobiliary tube was removed smoothly. Seven cases ( 18. 6% ) were transferred to open abdominal exploration, 2 of them still kept the nasobiliary tube and the choledochal incisions were primary closed. Totally 38 patients (88.4% ) were successfully drained by ENBD. The abdominal drainage and nasobiliary tubes were removed in average of 3.2 and 6.7 days respectively without complications. Conclusion ENBD is an effective and safe procedure for bile duct drainage in LCBDE. It has the advantage of minimal trauma, short drainage period and rare complications. It suggested that this procedure should be a new satisfied way in treatment of bile duct stones.

Objective To evaluate the changes of platelet aggregation rate and short-term prognosis after the application of colopidgrel with booster doses or replaced by ticagrelor for ACS patients with CYP2C19 medium-metabolized genotype). Method A total of 302 patients with medium-metabolized genotype were randomly divided into colopidgrel group (75 mg/bid) and ticagrelor group (90 mg/bid). Patients in both groups accepted other conventional treatments of coronary heart disease and accompanied diseases. The platelet aggregation rates and platelet inhibition rates were observed before and after the treatment. The incidence of adverse events was followed up within 1 m. Results After one-week treatment, the platelet aggregation rates of the inducement with 5 μmol/L ADP had statistical significance between colopidgrel group and ticagrelor group ( P = 0 . 019 ) and the platelet inhibition rates had statistical significance difference between the two groups (P = 0.000). No severe adverse events occurred within one-month follow-up and 10 dyspnea patients were all in ticagrelor group. Conclusions Compared with booster doses of clopidogrel, ticagrelor presents obvious inhibitory effect on platelet of patients with medium-metabolized of ACS but it increases the incidence of dyspnea.

Objective To investigate the clinical application and effect of micro-planting nail anchorage in orthodontics.Methods Fifty-six patients with oral orthodontic were randomly divided into two groups.29 patients in the observation group were used micro-planting nail anchorage,27 patients in the control group were used the strong non-implant anchorage.Results The reduction of upper incisor inclination and distance in observation group was significantly higher than control group.In another hand,displacement of molars in observation group was significantly lower than control group,the difference was significant(t =9.714,4.491,17.172,all P ＜0.05).Conclusion Micro planting nail can provide the ideal anchorage and orthodontic treatment,and it has the advantages of easy and flexible operation,and it can be instantly afterburner,reliable quality,worthy of clinical application and promotion.

B ased on Chinese medicine pharmacological literature data , the property , flavor , toxicity , meridian tropism, efficacy, and clinical application of Chinese herbal medicine were used as a set of attributes. The sup-port vector machine ( SVM ) was used in the establishment of predictive models of 187 pharmacological effects of Chinese herbal medicine respectively. And the cross-validation method was used to determine the accuracy of predictive models . After that , the predictive models with the predictive accuracy rate greater than 90% were used to predicate pharmacological effects of 624 herbals recorded in the Chinese Pharmacopoeia(2010 edition). It was found that the accuracy rate of 108 models was greater than 90%, and the accuracy rate of antibacterial effect predictive model was 99.76%. The highest predictive value of Chinese herbal medicine was the anti-oxi-dation effect of Menispermi Rhizoma.

Successful pain management of perioperative shoulder arthroscopy may allow patients to go home earlier, improve the quality of life in perioperative period, and facilitate rehabilitation. A comprehensive method to perioperative pain control has three stages including preoperative, intraoperative and postoperative phase. Successful pain reduction should begin preoperatively because of an excellent communication between patient and physician, moreover, preoperative analgesia also should be administered. Intraoperative efforts should include local wound infiltration and the administration of anesthetic medication intra-articularly. Postoperative management should include oral analgesics, constant infusion devices, Patient Controlled Analgesia (PCA), sedative-hypnotic drug, continuous cryotherapy and vicarious treatment.
Acupuncture Analgesia ; Analgesia ; methods ; Analgesia, Patient-Controlled ; Arthroscopy ; Humans ; Pain, Postoperative ; therapy ; Perioperative Period ; Shoulder Joint ; surgery ; Transcutaneous Electric Nerve Stimulation

Objective To investigate the diagnostic value and the efficacy of magnetic resonance tomographic angiography(MRTA) in identifying the relationship between nerves and blood vessels of the patients with idiopathic trigeminal neuralgia.Methods Clinical and MR data of 280 ITN patients were analyzed retrospectively,and then were compared with operation results by using blind con-trol trials.Results Of the 280 ITN patients,there were a total of 267 patients with neurovascular contact,dubious contact or com-pression in affected sides (positive rate:95.3%),and 66 patients in normal sides (false positive rate:23.6%).And of 120 surgical patients,1 18 were found to have neurovascular contact or compression during the operation.There was significant statistical differ-ence between the neurovascular contact or compression in affected sides and that in normal sides (P <0.05).Using operation results as the gold standard,the specificity,sensitivity and the diagnostic accordance rate of MRTA in diagnosing neurovascular contact or compression were 100%,96.6% and 96.7% respectively.Conclusion MRTA can reliably display the relationship between nerves and blood vessels with higher diagnostic sensitivity and accuracy,thus providing the objective basis for the etiological diagnosis of and surgical treatment for ITN.

Objective To investigate relationship between insulin sensitivity and beta-cell function with body mass index (BMI) and age in patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods Totally, 304 patients with T2DM newly-diagnosed at admission to the first hospital affiliated to Nanjing Medical University, Jiangsu province, during 2006 to 2007 were recruited in the study. The patients were divided into three groups based on WHO criteria of obesity in Asia Pacific Region in 2003, 68 cases with normal weight ( 18. 5≤ BMI ＜ 23.0), 69 in overweight (23.0 ≤ BMI ＜ 25.0), and 167 in obesity (BMI≥25.0). Fasting serum glucose, glycesylated hemoglobin Alc (HbAlc) and lipids were measured for all the subjects, as well as oral glucose tolerance test (OGTr), C-peptide releasing tests and determination of serum insulin performed. Homeostasis model assessment of insulin resistance index (HOMA-IR), insulinogenic index (AI30/AG30) and modified beta-cell function index (MBCI) werecalculated to evaluate their insulin sensitivity and beta-cell function of the islets. All these parameters werecompared between the three groups and subgroups. Results HOMA-IR and MBCI were significantly higherin T2DM patients with obesity than those in the groups with normal weight and over-weight ( P < 0. 05 ).AI30/AG30 in obesity group was significantly higher than that in the group with normal weight (P <0. 05).Multiple linear regression analysis showed that BMI independently correlated with HOMA-IR ( P < O. 05 ).Sub-group analysis showed that △I30/△G30 and MBCI were significantly higher in those aged 60 years and over with obesity than those in the groups aged less than 60 years ( P ＜ 0. 05 ). Conclusions Non-obese patients with newly diagnosed T2DM have more severe impaired insulin secretion than that in obese ones,and their insulin resistance increases with BMI. Age has no significant correlation with pancreatic beta-cell function or insulin sensitivity.

Female ; Foreign Bodies ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Pharynx ; Tomography, Spiral Computed

Objective To evaluate the methods of diagnosis and treatment of thyroid disease with concomitant focal lymphocytic thyroiditis(FLT), and explore the reasons for its confused with Hashimoto′s disease(HD).Methods During the recent 25 years, 207 patients underwent surgical trearment for pathologically diagnosed HD.Among this group, 143 cases of HD with other concomitant thyroid disease were retrospectively analysed.Results Of the 143 cases, 57 cases were found to have thyroid disease with concomitant FLT, and this was 27.5%(57/207) of the total HD group, or 39.9%(57/143) of the group with thyroid disease and concomitant HD.Intraoperative pathologic section revealed that focal lymphocytic infiltration was positive in 87.7%(50/57) of cases. The postoperative hypothyroidism occurrence rate was 19.3%(11/57), of which, 7 cases(7/57, 12.3%) were subclinical hypothyroidism.Conclusions The character of pathologic changes of thyroid disease with FLT and with HD was different. Intraoperative pathologic section can be helpful in the diagnosis of this condition and can have important significance as a guide to the scope of (surgical) resection of the thyroid gland.