Objective To explore the cause and effective management and prevention of septic shock after minimally invasive percutaneous nephrolithotomy (MPCNL) in the elderly.Methods Clinical data of 13 patients with septic shock after MPCNL in our hospital were retrospectively analyzed,and the cause,prevention and treatment of septic shock were investigated.Results The incidence of septic shock in patients undergoing MPCNL was 3.54％ in this study.Single-factor analysis and logistic regression analysis showed that the risk factors for post-MPCNL septic shock were female and the history of diabetes (both P＜0.05).Conclusions Septic shock is a serious complication after MPCNL.Intensive perioperative prevention measures can reduce the incidence of septic shock.Early diagnosis and proper treatment are the keys to successful treatment of septic shock.

Objective To estimate fairness in the financial contributions of suburban households of Shanghai to the health system and the situation throughout the country. Methods A household survey was conducted to obtain data on health expenditure and government health input, which was then analyzed by means of the index for and methodology of fairness in the financial contributions of households in the performance assessment of the health system as introduced by the WHO. Results The coefficient of fairness in the financial contributions of households to the health system was estimated to be 0.735 and the rate of cooperative medical care coverage was positively related to the fairness. Conclusion The fairness level of the financial contributions of suburban households of Shanghai to the health system tallies with the level estimated by the WHO for China while the national level is lower. The calculations of government subsidy for household health, as recommended by the WHO in estimating fairness in the financial contributions to the health system, do not conform to the actual situation in China.

Objective To analyze and investigate clinical characteristics, pathogenesis and treatment of urinary tract infection and aseptic meningitis. Methods Clinical features and laboratory tests of a two-month-old baby girl with urinary tract infection and aseptic meningitis were reported. Results The patient complained of fever, neck stiffness and a bulging fontanel, accompanied by congestion and abnormal secretion of urethra. The cerebrospinal lfuid (CSF) white blood cell count was 30×106/L. The blood culture and the CSF culture were both negative. And the urine culture was positive for Enterococcus faecium. The patient received a 10-day course of intravenous antibiotic therapy. The prognosis is good with no recurrence of the disease. Conclusions Aseptic meningitis can be concomitant with urinary tract infection, The probable hypothesis may be that sterile CSF pleocytosis is mediated by urinary tract infection. Knowledge of this may prevent unnecessary antibiotics therapy for presumed bacterial meningitis.

Objective To investigate the protective mechanism of hydrogen sulfide(H2S) on inflammatory and oxidative damage of myocardium due to stress after amputation,and explore the relationship between H2S signal pathway and inflammatory and oxidative damage.Methods Twenty-eight adult male Wistar rats(weighing 260-300g) were randomly divided into 4 groups(7 each):control group,trauma group,NaHS group and PPG group.Rat model of traumatic stress was established in the rats in the 3 latter groups,and the animals were sacrificed 6 hours after modeling.The rats in control group were also sacrificed at the same time point.Rats in NaHS and PPG group respectively received intraperitoneal injection of NaHS(28?mol/kg) or PPG(50mg/kg).The level of H2S in plasma was measured by sensitive sulphur electrode,the activity of CSE in myocardium was determined by methylene blue method,myeloperoxidase(MPO) in plasma and myocardium was measured with ultraviolet spectrophotometry,and malondialdehyde(MDA) in plasma and myocardium was measured by TBA method.Results Compared with the control group,the content of H2S in plasma decreased,MPO and MDA in plasma and myocardium increased 6 hours after amputation(trauma group).Compared with the trauma group,the contents of H2S and MPO in plasma and the activity of CSE in myocardium increased,MDA in plasma and MPO and MDA in myocardium decreased in NaHS group,while the contents of H2S and MPO in plasma and the activity of CSE in myocardium decreased,MDA in plasma and MPO and MDA in myocardium increased in PPG group.Conclusion Inflammatory and oxidation injuries may occur in rat's myocardium after amputation,and H2S can offer a protective effect on myocardium by decreasing inflammatory and oxidative damage.

Objective:To study the effects of soybean phospholipids on learning and memory abilities and contents of fatty acids in hippocampus of mice and its mechanism. Method:Mice were randomly divided into four groups:low dose(2.5g/kg) ,middle dose(5.0g/kg) and high dose(10.0g/kg) groups of soybean phospholipids and control group. The treatment groups were fed with soybean phospholipids every day while the control group with distilled water for 30 d.After learning and memory abilities were measured,the mice were killed and contents of fatty acids in hippocampus of mice were determined by high performance liquid chromatography(HPLC) . Results:(1) The learning and memory abilities of mice in middle and high dose groups were significantly improved,but only memory abilities in low dose groups were stronger than control group.(2) The contents of protein in hippocampus in middle and high dose groups were increased extremely.(3) The contents of oleic acid(C18:1) and docosahexaenoic acid(DHA,C22:6 ) were obviously enhanced in hippocampus of high dose group;but decreased in eicosapentaenoic acid(EPA,C20:5) and linoleic acid(C18:2) . The content of DHA was increased and EPA decreased significantly in middle dose group.The increase of arachidonic acid(C20:4) was not significant.Conclusion:Soybean phospholipids may improve learning and memory abilities,which might contribute to change of fatty acids contents in hippocampus of mice.

AIM:To establish a HPLC fingerprint of Stellera chamaejasme L. from Inner Mongolia Region. METHODS: The RP-HPLC method was used with Akzonobel Kromasil C_ 18 (250 mm?4.6 mm, 5 ?m) the acetonitrile-0.5% phosphoric acid (gradient elution) was used as mobile phase, analytic time was 60 min, and detective wavelength was at 297 nm, the column temperature of 15℃ were adopted. RESULTS: The HPLC fingerprint of Stellera chamaejasme L. set up showed that 14 peaks were co-possessing in different sources. The results of method validation met technical standard of fingerprint, the similarities of Stellera chamaejasme L. were 0.9 to 1.0. CONCLUSION: The method is stable and reliable with a good reproducibility and provides a reference standard for the quality control of Stellera chamaejasme L. from Inner Mongolia Region.

Based on the results of oral glucose tolerance test( OGTT )and the levels of 1-h plasma glucose ( 1 hPG),793 subjects were classified into three groups:583 with NGTN ( normal 1 hPG in OGTT),127 with NGT1 H( higher 1 hPG in OGTT) and 83 with IGT( impaired glucose tolerance).NGT1H group had large waist circumference,higher body mass index,fasting plasma glucose( FPG),triglyceride,and lower high density lipoprotein-cholesterol than those of NGTN group.NGT1 H group had higher homeostasis model assessment insulin index ( 1.2 ± 0.6),lower homeostasis model assessment β3 ( HOMA-β ) (4.5 ± 0.7 ) and insulinogenic index (2.1 ±0.7) than those of NGTN group(0.5 ±0.6,4.8 ±0.7,2.7 ±0.9,respectively,all P ＜0.05 ).HOMA-β of NGT1 H group was higher than that of IGT group(4.5 ±0.7 vs.4.4 ±0.6,P ＜0.05 ).The results indicate that 1 hPG in OGTT may identify a condition of glucose metabolic abnormalities characterized by insulin resistance and reduced β-cell function.

BACKGROUND:Amputation is a special type of trauma. Mechanism of trauma-induced damage to the liver and the effects of hydrogen sulfide (H 2 S) on the liver remain unclear.
OBJECTIVE:To explore the mechanism of hepatic damage in rats of postoperative amputation, and how H 2 S exerts effects on liver function.
METHODS:Wistar rats and Sprague-Dawley rats were equal y and randomly divided into normal group, postoperative 6-, 12-, 24-and 72-hour groups, sodium hydrosulfide (NaHS) group, and propargyl glycine group, as wel as normal group, postoperative 6-hour group, HaHS group, and propargyl glycine group. Except the normal group, the structure 1.2-1.4 cm above the left knee was completely transected in rats of other groups. Blood vessels were ligated, and then left femoral vein and femoral artery were cut to establish rat models of amputation in the left hind limb. In the NaHS and propargyl glycine groups, 28 μmol/kg NaHS and 50 mg/kg propargyl glycine were intraperitoneal y injected immediately after amputation.
RESULTS AND CONCLUSION:Compared with the normal group, traumatic changes in rat liver cel s and mitochondrial structure were seen, and plasma and liver myeloperoxidase, malondialdehyde, H 2 S/cystathionineγ-lyase levels, liver mitochondrial respiratory control rate, membrane potential and ATP activity were significantly lower in the postoperative 6-hour groups (P<0.05). After NaHS intervention, H 2 S/cystathionineγ-lyase level and above indicators were significantly higher in the postoperative 6-hour groups (P<0.05), but plasma transaminase did not significantly alter (P>0.05). After treatment with propargyl glycine, above indicators except mitochondrial indexes were further decreased, and transaminase was significantly reduced (P<0.05). These findings suggest that H 2 S can reduce lipid peroxidation, inflammatory reaction, and make the mitochondrial function improved significantly, but did not reduce the damage of liver function in rat models after amputation.

OBJECTIVE:To select a technique for preparation of fluconazole for injection and to establish a method for determination of its content.METHODS:The formula was selected on the basis of pH value and species of solution adjuvant.The content was determined by HPLC.RESULTS:The preparation was stable when pH value was between6.5～8.5,and its clarity could be increased by propylene glycol.The detectable concentration of fluconazole showed a good linear correlation in the range of40～200?g/ml.The average recovery was100.37%,RSD=1.37%(n=3).CONCLUSION:The fluconazole for injection prepared by the present technique is stable in quality and the method for content determination is accurate and practicable.

OBJECTIVE To understand the urinary tract infections after cesarean section,the distribution of pathogenic strains,and drug resistance analysis in order to provide clinical treatment. METHODS The routine urine cultures of the 2652 case were identified and drug resistance was analyzed by K-B method. RESULTS From 458 isolated bacteria,Gram-negative bacilli were main,pathogen accounting for 80.13%,Escherichia coli and Klebsiella,accounted for 71.62% and 4.8% respectively;Gram-positive bacteria accounted for 14.41%,and fungi accounted for 3.71%. CONCLUSIONS G-bacteria in the urinary tract infection are in the absolute superiority;rational use of antibiotics to effectively control the urinary tract infections and avoid drug-resistant strains produceing is especially critical.