OBJECTIVE: To review the efficacy and safety of ambroxol hydrochloride in the treatment of meconium aspiration syndrome by evidence based medicine methods. METHODS: Databases of Medline, EMBase, the Cochrane library, ISI database, CBM, VIP, wanfang, and CNKI were searched. Studies of randomized controlled trials (RCT) of ambroxol hydrochloride in the treatment of meconium aspiration syndrome were included for quality analysis and meta-analysis. RESULTS: Eleven RCTs were included.Meta-analysis indicated that there was significant difference between ambroxol hydrochloride and conventional treatment in cure rates, oxygen therapy, hospital stay with RR values (MD values) and 95% CIs of 1.29 (1.11, 1.48), -10.71 (-15.87, -5.55), and -3.12 (-4.81, -1.43), respectively. The death rates had no significant difference. CONCLUSION: Based on the recent evidence, ambroxol hydrochloride treatment can achieve better prognosis in patients with meconium aspiration syndrome. Due to its safety and reliable efficacy, this drug can be recommended for treating patients with meconium aspiration syndrome. Copyright 2012 by the Chinese Pharmaceutical Association.

Objective To study the feasibility of transumbilical single-incision laparoscopic surgery ( SILS) in the treatment of tubal pregnancy, as compared with conventional multi-port laparoscopic surgery. Methods Sixty-two patients diagnosed as tubal pregnancy undergoing laparoscopic surgery at this hospital between September 2013 and June 2014 were selected for investigation. There were 29 cases of transumbilical SILS ( SILS group) and 33 cases of conventional multi-port laparoscopic surgery ( MPLS group) . We retrospectively reviewed the medical records of all patients and analyzed the surgical outcomes, including operative time, blood loss, surgical complications and hospital stay. Results In both groups, all procedures were performed without failure.No conversion to open surgery or additional skin incision was needed.There were no differences between the SILS and MPLS groups in the operation time [(51.5 ±10.8) min vs.(47.3 ±9.4) min, t=1.637, P=0.107], the mean estimated blood loss [(15.5 ±10.5) ml vs.(18.4 ±12.2) ml, t=-0.996, P=0.323], the absolute decrease of hemoglobin from preoperative to postoperative [(14 ± 5) g/L vs.(13 ±4) g/L, t=0.874, P=0.386], the postoperative hospital stay [(3.5 ±0.9) d vs.(3.8 ±0.8) d, t=-1.390, P=0.170], and the incidence of postoperative fever (2 cases vs.3 cases, χ2 =0.000, P=1.000).Follow-up for 1-3 months ( mean, 1.8 months) in all the cases showed smooth recovery and no postoperative complications. Conclusion SILS is a feasible and safe approach in the treatment of tubal pregnancy.

Objective To compare the manipulation of two different methods of percutaneous dilatational tracheostomy (PDT),the guidewire dilating forceps (Portex method) and the modified onestep dilation technique (Ciaglia Blue Rhino method,CBR method).Methods From March 2013 to February 2014,48 patients eligible to meet the criteria of tracheostomy in ICU were collected and were divided into two groups at random.The length of time consumed for operation,amount of blood lost during operation and the operation complications were compared between two groups.The participant surgeons were asked which method they preferred,Portex or CBR.Results Of them,the mean age was 76.7 ± 11.6 years old,and 25 patients (52.1％) were male.The reasons for tracheotomy were the length of time needed for mechanical ventilation support expected to be longer than 2 weeks (n =30),severe disturbance of consciousness (n =17),and upper airway obstruction (n =1).The patients enrolled in the study were randomly divided into Portex and CBR groups.There were no significant differences in age,gender,APACHE Ⅱ score,the reason of tracheotomy,the length of time for mechanical ventilation support before tracheotomy,and the preoperative coagulation function between two groups.CBR method can easily be done with less operation time required than Portex [(5.9 ±4.3) min vs.(9.9 ± 1.5) min,P ＜0.01],and had obviously fewer operation complications and less amount of blood lost than Portex method (P ＜ 0.05).The male surgeons with a slew of surgical practice were in preference to Portex,whereas female doctors with less work experience and without surgical practice preferred CBR.Conclusions The CBR method can easier be done and was better than the Portex method in minimizing operative trauma and reducing the complications,especially it can easily be accepted by female doctors with less work experience and without surgical practice and it is worth using widely in clinic.

The generation and activity of serum neuralizing antibody in cynomolgus monkeys and SD rats undergoing long-term toxicity study with antitumor peptides HM-3 were investigated.The rats were administered intravenously with HM-3 at doses of 4.5 mg/kg,13.5 mg/kg,and 40.5 mg/kg for 6 months,and the cynomolgus monkeys were administrated intravenously with HM-3 at doses of 3 mg/kg,9 mg/kg and 27 mg/kg for 6 months,respectively.Anti-HM-3 antibodies and their neutralizing activities in serum samples taken every month after the administrations were determined by ELISA and cell migration assay,respectively.During the long-term administrations,anti-HM-3 antibodies were generated in some SD rats at high and moderate dose groups,and the antibody-neutralizing activities could be detected in a number of these samples (P ＜0.05).However,activity could be detected in very few monkeys (P ＜ 0.05),and the antibody titers were not correlated with the neutralizing activities.Therefore,we conclude that the antigenicity of HM-3 was low,but after long-term administration at high dose,low affinity neutralizing antibody could be generated in small number of samples.

Objective To explore the effects of lactational maternal stress on neurobehavioral development of offsprings.Methods Maternal mice were divided into normal control,maternal deprivation and maternal stress group.A 5-min/day cold water swimming was used as maternal stress for continuously of 14 day since the 7th postnatal day.The increasing bodyweight and neurobehavior of adolescent offspring mice were assessed by forced swimming test,tail suspension test and locomotor activity in the 35th postnatal day.Results Maternal chronic stress in lactational stage significantly increased the vulnerability of offspring to acute stress,which was reflected by significantly increased immobility time of adolescent offspring in forced swimming test (female:(139±6) s,(138±9) s,(96±9) s respectively; male:(139±9) s,(112±9) s,(96±9) s respectively) and in tail suspension test (femal:(127±8) s,(123±8) s,(98±6) s respectively ; male:(141 ±7) s,(105±5) s,(92±6) s respectively).Meanwhile,sexual difference occurred for adolescent offspring to acute stress,and the female offspring were more vulnerable to acute stress.Conclusion Lactational maternal stress may be important factors for development of adolescent depression.Our findings highlight the area of early prevention and intervention for adolescent depression.

Objective To investigate whether the biochemical function and morphology of stored outdated erythrocytes were able to be restored to normal levels.Methods The experiments were carried out with 4 groups of erythrocytes. Group 1 consists of post-rejuvenated erythrocytes, which were harvested by incubating twice washed stored erythrocytes on the 3 rd day after outdate at 37℃ for 1h, with a rejuvenating solution containing adenine 5mmol/L, inosine 100mmol/L, pyruvate 100mmol/L, phosphate 103mmol/L. Group 2 was pre-rejuvenate erythrocytes, obtained by washing stored erythrocytes on the 3rd day after outdate. Group 3 was saline control erythrocytes, which were incubated with 0.9% saline. Group 4 was freshly collected erythrocytes used as normal controls. ATP, 2, 3-DPG, morphology scores, MCV, osmotic fragility, and hemoglobin content of RBC in four groups were measured.Results The post-rejuvenate RBC ATP [(3.41?0.52)?mol/gHb] was significantly higher(P0.05) compared with fresh RBC [(3.45?0.51)?mol/gHb].The post-rejuvenate RBC 2,3-DPG [(14.08?3.10)?mol/gHb] was significantly higher(P0.05) compared with fresh RBC [(14.87?3.10)?mol/gHb].The post-rejuvenation morphology score(130.00?10.80) was significantly greater (P0.05) compared with fresh RBC (120.00?5.00). The post-rejuvenate mean corpuscular volume [(89.30? 7.20)fl] was significantly lower (P0.05). The hemoglobin shed in vesicles during rejuvenation was significantly greater than that in the saline control [(0.51?0.33)vs(0.20?0.18)mg/dl RBCs;P

Objective To study the diagnostic value of spectral CT in atypical tuberculosis ball and lung cancer.Methods 45 cases of pulmonary nodule or mass received unenhanced and two phase enhanced scan in gemstone spectral imaging mode,and all pulmonary nodule or mass were confirmed by pathology.Selecting unenhanced,arterial phase and venous phases of spectrum image,atypical tuberculosis ball group and lung cancer group were analyzed.Normalized iodine concentration (NIC), the spectral curve slope (λHU),CT value of unenhanced and two phase enhanced spectrum image were measured and calculated.Two independent samples t-test was used for the statistic analysis of each spectrum parameters between the two groups.The receiver operating characteristic (ROC) curve was obtained for comparing the sensitivity and specificity of each spectral parameter.Results Among the 45 patients,11 were atypical tuberculosis ball, and 34 were lung cancer.Comparison NIC,two phase enhanced λHU and the net enhanced CT values of 70 keV monoenergetic image of the two groups, lung cancer group was higher than atypical tuberculosis ball group,and the difference was statistically significant(P<0.05);However, the unenhanced CT value of 70 keV monoenergetic image of the two groups was not statistically significant (P>0.05).When the NIC diagnostic threshold was 0.105, the maximum Youden index (0.733), the area under the ROC curve was 0.89, and sensitivity and specificity was 82.4% and 90.9%, respectively.Conclusion The quantitative parameters of spectral CT is helpful in the diagnosis of atypical tuberculosis ball and lung cancer,especially the NIC with high value.

Environmental Monitoring ; instrumentation

Chinese herbal pieces are a key factor to protecting the quality of the clinical efficacy of traditional Chinese medicine (TCM), and it is one of the basic elements of ensuring the quality of TCM and people's usage safety. However, Chinese herbal pieces has massive problem such as adulteration and counterfeit, dyeing and weighting, pesticide residues, heavy metals in excess of the standards, and all the issues are repeated excessive in the clinic treatment. These issues impacted sound development of production, management and use of TCM, but also brings common people hidden trouble for the clinical safety of medication. Protect and improve the quality of the Chinese herbal pieces demand that continue improve quality system, in-depth scientific research, and strengthen self-discipline and other factors. So it is fundamentally to ensure good quality of Chinese herbal pieces with the color, taste and shape by systematic supervision to it from the source, production, management and research, with strengthened implementation and en- forcement of the "3G".
Drug Contamination ; prevention & control ; Drugs, Chinese Herbal ; adverse effects ; Medicine, Chinese Traditional ; adverse effects ; Total Quality Management ; methods

Objective To investigate in knowledge rate of 120 first aid and satisfaction rate with emergency services among Nanchong citizens. Methods 360 patients who received prehospital first aid from three hospitals and their accompanies were selected from January to June 2010. The investigation content included knowledge rate of 120 first aid and satisfaction rate with emergency services. Results Results showed that about half of those surveyed still did not know the emergency phone"120" and its function, lacked self-help and self-protection knowledge, some respondents felt quite helpless upon daily life of electric shock, gas poisoning, coma and traumatic accidents. The attitude of the majority of emergency personnel was good or better, but still very stiff or irresponsible attitude existed in those few. This undermined the "120" and the image of credibility and emergency personnel. Conclusions There is an urgent need for universal coverage of on-site first aid knowledge and enhance awareness of first aid. Full-time staff in emergency department must pay close attention to the knowledge of first aid training, mastering the technique of bleeding control and bandaging, fixing, handling and CPR, as well as the use of instruments and equipment equipped in vehicles. Only in this way can we continuously improve the treatment of critically ill patients and increase survival rate.