Objective:To prepare a novel slow-releasing ketoconazole spraying membrane and to observe its effect on eczema and tinea corporis in guinea pigs.Methods: A novel ketoconazole spraying membrane was prepared with chitosan chlorhydrate as the membrane material.The contents of ketoconazole and desamethasone in the spraying membrane were assayed by HPLC.The separation was performed on Waters Symttry C_(18) column(250 mm?4.6 mm,5 ?m),with the mobile phase consisting methanol-potassium dihydrogen phosphate buffer(4∶1),at a flow rate of 0.6 ml/min.The dectection was carried out with a UV detector at 239 nm,at(22?2)℃.The quality criteria for the novel ketoconazole spraying membrane was established.The curative effect of the ketoconazole spraying membrane on eczema and tinea corporis was observed in guinea pigs and was compared with those of spraying membrane matrix,desamethasone antipruritics cream and compound ketoconazole cream.Results: The calibration curves of ketoconazole and desamethasone were linear between 0.2-2.0 mg?ml~(-1)and 0.02-0.20 mg?ml~(-1),respectively;the recoveries for ketoconazole and desamethasone were 98.41% and 97.84%,respectively.The intra-day and extra-day RSDs for ketoconazole were(1.17%) and 1.26%,respectively,and for desamethasone were 1.57% and 1.40%,respectively.Stimulation test showed that the spraying membrane had no irritative effect on the skin of guinea pig.The novel ketoconazole spraying membrane had similar effect on eczema and tinea corporis as those of desamethasone antipruritics cream and compound ketoconazole cream.Conclusion: This novel ketoconazole spraying membrane is easy to prepare and has obvious therapeutic effects on eczema and tinea corporis in guinea pigs,making it favourable for containing combined agents.

OBJECTIVE: To prepare double-layer sustained release ornidazole films and investigate its release rate in vitro.METHODS: The double-layer sustained release ornidazole films film were prepared by the method of homogenate.The formula of the films were optimized by orthogonal experiment with the mass ratio of polyviol to CMC-Na(factor A),the total amount of polyviol and CMC-Na(B) and the amount of glycerol(C) as factors.The concentration of ornidazole was determined by ultraviolet spectrophotometry and its release rate was also computed.RESULTS: The double-layer sustained release film was well-shaped.The optimized formula of the film was as follows: factor A=1∶1,B=4.5 g,C=4.0 g.The standard curve of ornidazole was linear within a range of 1～20 ?g?mL-1(r=0.999 5,n=6),with an average recovery of 100.3%(RSD=1.3%,n=5).A continuous releasing of 11.0 hours was achieved for the prepared films and its cumulative release amount in vitro within 8 hours reached 81.50%.CONCLUSIONS: The preparative method of the films was simple,and the film had a slow-release property.

Objective To study the value of color Doppler ultrasound in diagnosis of deep vein thrombosis (DVT) of lower extremity and pulmonary embolism (PE) in spinal cord injury (SCI). Methods 60 PE patients (PE group) and 35 SCI patients without PE (control group) received color Doppler ultrasound examination for DVT of lower extremity. Results PE group included 36 SCI patients (PE-SCI group) and 24 no-SCI patients (PE-no-SCI group). There were 15 cases with lower extremity thrombosis in PE-SCI group, and 9 cases in PE-no-SCI group (P>0.05), while there were 5 cases in the control group. There was significantly different in lower extremity thrombosis between PE group and the control group (P<0.01). In PE group, the detection rate was not significantly different between acute PE (detected 11 cases out of 37 cases) and chronic PE (detected 10 cases out of 23 cases) (P>0.05). 31 cases were rechecked as lower extremity venous valve regurgitation and calf muscle vein dilation (51.7%) in PE group while 8 cases in the control group (22.9%) (P<0.01). Conclusion There is not significantly different in the detection rate of DVT of lower extremity in PE patients with and without spinal cord injury, which are higher than in the patients without PE. Color Doppler ultrasound is necessary to check DVT in acute and chronic PE patients.

Objective To primarily investigate the clinical value of analgesia/nociception index (ANI) in evaluating the analgesic effect during lobectomy performed via video-assisted thoracoscope.Methods Forty ASA physical status Ⅰ or Ⅱ patients,aged 25-64 yr,weighing 45-80 kg,undergoing elective lobectomy performed via video-assisted thoracoscope,were enrolled in this study.After induction of anesthesia with propofol,sufentanil and cisatracurium,patients received double lumen endotracheal intubation.Anesthesia was maintained with targetcontrolled infusion of propofol,and iv infusion of remifentanil and cisatracurium.The concentration of propofol was adjusted to maintain the bispectral index (BIS) value in the range of 40-60.ANI,HR,systolic blood pressure (SBP),diastolic blood pressure (DBP) and BIS value were recorded within 5 min before and after the predefined time points including posture change between lateral and supine position,ventilatory pattern change between onelung and double-lung ventilation,skin incision and trocars insertion,lymph node dissection and pleural lavage.At skin incision and during trocars insertion,lymph node dissection and pleural lavage,the development of hemodynamic responses (increase in HR and SBP ＞ 20％ of baseline value) were recorded.Results The incidence of hemodynamic responses was 100％ at skin incision and trocars insertion,and 84 ％ during No.4,7,10 groups of lymph node dissection and after pleural lavage and difference was found in ANI during these stimuli.ANI was significantly decreased within 5 min after skin incision,trocars insertion,No.4,7,10 groups of lymph node dissection and pleural lavage than that before the procedures (P ＜ 0.05).The BIS value was maintained at 40-60,and no significant changes were found between before and after the procedures (P ＞ 0.05).No significant changes were found in ANI,HR,SBP,and DBP between before and after the changes of posture and respiratory pattern (P ＞ 0.05).Conclusion ANI can be used to evaluate the analgesic effect during lobectomy performed via video-assisted thoracoscope in patients and is unaffected by the changes of posture and ventilatory pattern.

Objective To explore effect of Simotang on gastrointestinal motility and expression of vasoactive intestinal peptide(VIP) in the hypothalamus, spinal cord and duodenum of chronical stressed mice. Methods Mice were randomly divided into normal, stress and Simotang group( n= 10 in each group), and given a variety of unpredictable chronic mild stress. After 21 days gastric emptying and intestinal propulsion function were measured,the expression of VIP was detected by immunohistochemistry and RT-PCR. Results Compared with mice in normal group( (49.81 ± 8.56)%; (51.02 ± 5.11 )% ), chronic stress increased gastric residual rate( (61.53 ±8.71 ) %; P ＜ 0.05 ) and reduced small intestine propulsion rate ( ( 31.79 ± 2.38 ) %; P ＜ 0. 05 ). There were differences in expressions of VIP positive cells and mRNA in duodenum( (8.8 ± 1.1 )/mm2 and(0. 58 ±0.03) ),hypothalamus ( ( 12.9 ± 1.5 )/mm2 and (0.81 ± 0. 07 ) ) and spinal cord ( ( 12.1 ± 1. 2)/mm2 and (0.76 ± 0.02) )in chronic stress group compared with normal group( (6.5 ± 0. 9)/mm2 and (0.43 ± 0. 04);( 10.8 ± 1.3 )/mm2and (0.57 ± 0.03 ); (9.3 ± 1.5 )/mm2 and (0.53 ± 0. 02 ) respectively). There was not difference in gastric residual rate (52.93 ± 9.15 )%, small intestine rate(48.98 ± 4.38 )% and expressions of VIP positive cells and mRNA in duodenum ( (6.7 ± 0.9)/mm2 and (0.48 ± 0. 05 ) ), hypothalamus ( ( 10. 6 ± 1.4 )/mm2 and ( 0. 61 ± 0. 05 ) )and spinal cord ( (9. 1 ± 1.3)/mm2 and(0.55 ± 0.05 ) ) in Simotang group compared with those in normal group (P ＞ 0.05 ), but there were decreased compared with those in chronic stress group (P ＜ 0.05 ). Conclusion Simotang can regulate expressions of VIP in duodenum, hypothalamusand spinal cord in chronically stressed mice.

ObjectiveTo study the value of quantitive scoring methodby ultrasound in differential diagnosis of thyroid nodule.MethodsTotally 1 360 patients with thyroid carcinoma or nodular goiter were given preoperative ultrasound examination of thyroid. The features of thyroid nodule and their signiifcances in diagnosing thyroid carcinoma were evaluated by logistic regression analysis. Surgical pathology was taken as golden standard. Signiifcant feature was scored as 1 point, and insigniifcant feature was scored as 0 point. In two groups, the data were analyzed statistically.ResultsLow echo, obscure boundary, incomplete or no capsule, incomplete or no halo, aspect ratio≥1, internal lfow, posterior acoustic attenuation, no cystic echo, microcalciifcation and background Hashimoto′s thyroiditis showed correlation with malignancy. There were statistically significant difference between thyroid cancer and nodular goiter in thyroid nodules scores (χ2=802.08,P<0.05). Of 768 thyroid nodules with<6 points, 742 were benign and 24 were malignant. Of 60 thyroid nodules≥10 points, 2 were benign and 58 were malignant. Of 314 thyroid nodules with 8-9 points, 60 were benign and 254 were malignant. Of 368 thyroid nodules with 6-7 points, 155 benign and 213 were malignant.ConclusionsQuantitive scoring of thyroid nodule had clinic signiifcance in differential diagnosis. Thyroid nodule with>8 points accounted for the majority of malignancy and should be considered for surgery.

The prescription of antibiotics for children with upper respiratory infections (URIs) in outpatient department of our hospital from November to December 2010 and from July to August 2011 were retrospectively analyzed.In 37 211 patient visits (prescriptions) with suppurative tonsillitis,laryngitis and other URIs,the antibiotic prescription rates were 90.45％ (3 626/4 009),78.77％ (2 642/3 354)and 52.25％ (15 596/29 848),respectively;the intravenous antibiotics rates were 78.22％ (3 136/4 009),60.58％ (2 032/3 354) and 16.47％ (4 915/29 848),respectively for above three conditions.For suppurative tonsillitis,the 3rd generation cephalosporins were the most commonly prescribed antibiotics (orally:51.07％,715/1 400) and(intravenously:54.88％,1 721/3 136),followed by the 2nd and first generation cephalosporins and macrolides.For laryngitis and other URIs,the 2nd generation cephalosporins were most frequently prescribed(orally:48.78％,538/1 103 and 39.16％,4 433/11 320,respectively) and (intravenously:54.38％,1 105/2 032 and 42.75％,2 101/4 915,respectively),followed by macrolides,3rd generation cephalosporins and first generation cephalosporins.No intravenous penicillin were prescribed.Oral penicillin were prescribed for 0-0.22％ of these children.The results indicate that antibiotics prescription rates are high for children with upper respiratory infections,particularly the prescription of broad spectrum antibiotics and intravenous antibiotics,while penicillin is seldom prescribed.

Objective To evaluate the intraoperative opioid?sparing effect of different duration transcutaneous electrical acupoint stimulation ( TEAS ) in video?assisted thoracoscopic lobectomy. Methods Seventy?five patients, aged 18-64 yr, weighing 40-96 kg, of ASA physical status Ⅰ or Ⅱ, scheduled for elective video?assisted thoracoscopic lobectomy under general anesthesia, were randomly divided into 3 groups (n=25 each) using a random number table: control group (group C), 30 min of stimulation before induction of anesthesia group ( group B) , and stimulation throughout surgery ( group T) . In group B, the patients received TEAS ( frequency 2∕100 Hz ) on acupoints Xinshu ( BL15 ) , Feishu (BL13), Neiguan (PC6), Hegu (LI4) on the operated side starting from 30 min before induction of anesthesia until the beginning of induction, and the intensity was the maximum current that could be tolerated. The intensity for Neiguan ( PC6) and Hegu ( LI4) was 6-12 mA, and for Xinshu ( BL15) and Feishu ( BL13 ) was 9-18 mA. In group T, the patients received TEAS on the four acupoints mentioned above starting from 30 min before induction of anesthesia until the end of surgery. The patients had the electrodes applied, but received no stimulation in group C. After anesthesia was induced with propofol?sufentanil?cisatracurium, double lumen endotracheal tube was inserted. Propofol was given by target?controlled infusion to maintain BIS value within the range of 40-60. Cisatracurium was infused continuously to facilitate muscle relaxation. The infusion rate of remifentanil was adjusted to maintain analgesia nociception index value within the range of 50-70. The intraoperative consumption of remifentanil ( the intraoperative consumption of sufentanil was converted to the consumption of remifentanil producing the equivalent effect by 1∶ 10) was recorded. Results Compared with group C, the intraoperative consumption of remifentanil was significantly decreased in B and T groups. The intraoperative consumption of remifentanil was significantly lower in group T than in group B. Conclusion TEAS on Xinshu ( BL15 ) , Feishu (BL13), Neiguan ( PC6) and Hegu acupoints throughout surgery and for 30 min before induction of anesthesia significantly reduces intraoperative opioid consumption in the patients undergoing video?assisted thoracoscopic lobectomy, while TEAS throughout surgery provides better effect.

Objective To investigate the current treatment of childhood bronchiolitis and wheezy bronchitis in the outpatient clinic.Methods The medication treatments of the children under 2 years old with bronchiolitis were retrospectively analyzed in the outpatient department of the Children's Hospital Affiliated to the Capital Institute of Pediatrics,during the 2 periods from November to December 2010 and July to August 2011.These children were divided into 3 groups according to age,1-6 months old group,＞ 6 months to 1 year old group and ＞ 1-2 year old group.The medications prescribed,including antibiotics,steroid,β2 agonists and anticholinergic drugs were analyzed.Results Altogether 6 198 patient visits were included.Among them,4 764 (76.86％) visits received antibiotics,4 078 (65.80％) visits received intravenous antibiotics,3 018 (48.69％) visits received systemic glucocorticoids,2 980 (48.08％) visits received intravenous steroid,3 400 (54.86％) visits received nebulization treatment,3 381 (54.55％) visits received nebulized steroid,3 417 (55.13％) visits received inhaled bronchodilators,among them,3 384 (99.03％) visits received combined nebulization of β2 agonists and anticholinergic drugs;and 826 (13.33％)visits received oral bronchodilators.In the 3 age groups,the older the age group the higher the oral bronchodilators prescription rate (6.77％,11.50％ and 18.77％,respectively).While the prescription rate of intravenous steroid,inhaled steroid and inhaled bronchodilators were lowest in the oldest(＞ 1-2 year old) group (43.65％,49.64％ and 50.00％,respectively).The average cost was 166.08 Yuan per visit,and 69.06％ was spend on drug cost.Conclusions There is a wide spread use of antibiotics,glucosteroids and bronchodilators in the treatment of bronchiolitis and wheezy bronchitis.There is a need for national guideline of bronchiolitis to standardize the management of childhood bronchiolitis in outpatient clinic.