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 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.

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.

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.

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

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.

Objective To explore the changes in muscle activity patterns in the lower leg during ankle dorsiflexion and plantarflexion in stroke patients. Methods Ten recovering stroke patients with hemiparesis(Pa- tient group)and ten age-and sex-matched healthy volunteers(Healthy control group)were studied.The subjects performed ankle dorsiflexion and plantarflexion synchronized with a visual cue while supine.Surface electrodes were applied over the anterior tibialis(TA),caput laterale musculi gastrocnemius(IGM),caput mediale musculi gas-troenemius(mGM)and soleus muscles(SOL)for integrated electromyography(iEMG).Results During ankle dorsiflexion,the TA,lGM,mGM and SOL of the affected side showed a significantly lower iEMG signal than the unaffected side.Activity of the lGM,mGM and SOL of the affected side were significantly lower than in the healthy controls.During ankle plantaflexion,the TA,lGM and mGM on the affected side had significantly lower activity than those of the healthy controls.The mGM of the affected side showed significantly lower muscle activity than the unaffeeted side.The SOL contraction ratio on the affected side was significantly higher than on the unaffected side and in the healthy control group. Conclusion Except for the soleus,there is an obvious decline in muscle activi-ty in the affected lower extremities of stoke patients during ankle dorsiflexion and plantaflexion.The soleus on the affected side becomes the primary plantarflexor in patients with stroke,rather than the caput laterale musculi gas-trocnemius or caput mediale musculi gastroenemius as in healthy subjects.

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 review the clinical presentation of patients with hepatobiliary stones (HS).Method 2 359 patients with HS were divided into group A and B according to the presentation of these patients before or after 2002.Their clinical data were retrospectively analyzed.Results The age,the percentage of patients with a case history ＞ 10 years,the admission rate for relapse,the intrahepatic to extrahepatic stone ratio,the number of patients complicated with liver cirrhosis/portal hypertension,the elective operation rate,the ratio of biliary drainage operation,or the ratio of biliary drainage combined with hepatic resection in group B were 54.02 ± 13.54 years,68.99％,53.07％,73.18％,13.41％,80.80％,83.81％,44.74％,respectively.The corresponding figures for group A were 48.65 ± 14.47 years,46.25％,32.0％,62.02％,4.63％,63.92％,41.45％,19.05％,all P ＜0.01.However,the rates of biliary ascariasis,acute cholangitis of severe type (ACST),hepatic abscess,bleeding or perforation of the biliary tract,non-operative mortality,emergency operation rate and stone residual rate in group B were 6.56％,6.15％,0.84％,0,0,1.71％,5.18％,18.70％,respectively.All these were significantly lower than those in group A (12.11％,33.72％,1.95％,0.37％,0.67％,25.62％,respectively,all P ＜ 0.01).Conclusions The popularization of medical insurance and the increase in hospital admission rate,but not the actual increase in HS,led to the increase in hospitalization of patients.There was a tendency of less patients presenting with severe disease due to delay in treatment.Routine choledochoscopic stone extraction intraoperatively or postoperatively and the increased liver resection rate had decreased the residual stone rate.There should be a strict restriction on the use of choledochojejunostomy.