OBJECTIVE:To explore the general patterns and characteristics of the adverse drug reactions(ADR)induced by acyclovir.METHODS:52 acyclovir-induced ADR reports(60 cases)published in China Hospital Knowledge Database from 1994 to 2006 was analyzed statistically.RESULTS:The ADR induced by acyclovir were more often occurred in patietns aged from 31 to 60,with 41.67% appearing within 10～60 min after drug use.The clinical presentation was complex and diverse,which involved different systems and organs,predominantly the lesion of renal function.CONCLUSION:Clinician and pharmacists should attach great importance to Acyclovir-induced ADR in clinical practice and stick to rational drug use.

Eight batches of raw material of pollen preparation——pollen mass have heen investigated in their character,specific pollen rate, abnormal toxicity test and residue of pesticide. These data will avail the quality control of pollen mass and assurance of safety and effect of pollen preparation.

AIM: To establish the determination of ? eudesmol in atractylis oil from Rhizomes of Atractylodes Lancea (THUNB.) DC. by gas chromatography. METHODS: Pentadecanol had been used as the internal standard substance in internal standard method. The GC system consisted of capillary column, 10%SF 30 as the stationary phase, nitrogen as the carrier gas, and FID as the detector. RESULTS: Both ? eudesmol in essential oil and pentadecanol had got satisfactory separation under the chromatographic condition. The mean recovery of ? eudesmol was 99.60%, and RSD was 1.30%. CONCLUSIONS: The method is sensitive, accurate and reproducible, and it can be used to control the quality of the essential oil from Rhizomes of Atractylodes Lancea (THUNB.) DC.

Objective To explore the indications of conservative treatment and to explore the laparotomy for children with abdominal trauma,so as to improve the diagnosis and treatment of abdominal injury in children.Methods This retrospective review included 89 children who had an abdominal trauma which was classified according to the injury situation.Results (1)Of 25 patients with hepatic injury,1 underwent surgery.Among the 48 patients with splenic injury,46 cases were treated successfully by conservative treatment,only 1 underwent splenectomy and another adopted splenic neoplasty.Fourteen patients suffered from gastrointestinal injury,and 4 of them underwent emergency laparotomy,however a delayed perforation of digestive tract occurred in 1 child when he was in hospital 4 days later.Eight cases of pancreatic trauma were treated successfully by conservative treatment,the same as 6 cases of renal and adrenal contusion.One child with uterus and bladder injury was atopted emergency surgical treatment.(2) Unlike adults,conservative management of hepatic and splenic injuries was successfully applied to the vast majority of children.Operative treatment ought to be carried out when hemodynamic stability could not be maintained despite a continuous intravenous fluids and blood transfusion,or when the total amount of blood transfusion exceeds 40 ml/kg.(3)CT was very useful for children with gastrointestinal injury,especially for one cannot stand for abdominal X-ray examination.Operative treatment ought to be carried out timely in those with pneumoperitoneum or abdominal distension.We should pay particular attention to the possibility of delayed perforation.(4)In general,pancreatic injury could be treated conservatively except the ones with pancreatic rupture.(5)Children with bladder and uterine injury often suffered from severe trauma,and needed to be operated timely.Conclusion Children with abdominal injury should be highly valued in primary hospital.Internal bleeding caused by substantial organ injury is the leading cause of death in children,and the delayed diagnosis and treatment of the injured cavity organs is another important cause of the death.Therefore,early accurate diagnosis,active treatment,comprehensive treatment of severe combined injuries and complications are the key to successful treatment of such patients.

Objective To evaluate free or pedicled perforator flaps for repairing chronic osteemylitis with soft-tissue defect in the distal lower extremity. Methods From May of 2006 to October of 2007, 28 consecutive patients of chronic osteomylitis with soft-tissue defect in the distal lower extremity underwent surgical debridement and reconstruction with free or pedicled perforator flaps. There were 13 free flaps. The free anterolateral thigh flaps were used in 2 cases to repair the soft defects in the front of leg, 3 cases in the front of the malleolus, 2 cases in the dorsum of foot, 2 cases in the heel. The free lateral crural flaps nourished by perone al artery were used in 4 cases to repair the soft defects in the dorsum of foot. There were 15 pedicled flaps. Posterior tibial artery perforator flaps were used in 4 cases to repair the soft defects in the front of leg, and 2 cases in the medial malleolus. Lateral retromalleolar perforator flaps nourished by peroneal artery were used in 6 cases to repair the soft-defects in the heel, 1 case in the lateral malleolus and 1 case in the dorsum of foot, the first dorsal metatarsal artery perforator flap was used to repair the proximal dorsum of hallux. The wound was closed with irrigation-suction in 7 cases and with vancomycin-impregnated gelatin in 8 cases. Results All 27 flaps were successfully survived except insuffcient vein refluence in 1 posterior tibial artery perforator flap, which resulted in a superficial necrosis and healed spontaneously. The follow-up period from 6 months to 2 years revealed that recurrence developed in two diffuse type patients and both were treated once and twice with success, respectively. The others healed without any signs of recurrences. No debulking procedure was necessary in any case. Secondary bone graft was performed in 3 cases. All patients were ambulatory and fully weight-bearing with normal clinical parameters at the time of last review. According to the evaluating criteria for the treatment of foot disease, the mean score was 84.5. Conclusion Free or pedicled perforator flap has been shown to be well vascularised, and it is feasible for the treatment of chronic osteomyelitis with soft-tissue defect in the distal lower extremity.

Objective The controlled release BMP-2 and implantation into the acoustic bulla of the guineapig and the effects on the cochlea were observed.Methods The acellular cancellous bone was prepared,accompanied with BMP-2.The material accompanied with BMP-2 was implanted into one acoustic bulla of the animal,and the opposite side of the acoustic bulla was implanted with acellular cancellous bone without BMP-2.A total of 20 guinea-pigs were undergone this procedure.The ABR was tested on the animals before and after the operation immediately and 3 month after operation,respectively.3 month after operation,the animals were sacrificed.The osteogenesis induced by BMP-2,the acoustic bulla and the cochlea affected by BMP-2 were observed.The structures of hair cells were observed after being treated with silver nitrate.Results The animals recovered soon after surgery.The hearing thresholds of the animals reduced slightly after the operation,and recovered completely 3 month after.The bulla and the cochlea were normal in shape.The osteogenesis occurred in the pore of the acellular cancellous bone with BMP-2.No abnormal hyperplasia of bone in the hulla and the cochlea was found.The articulation between the stapes and oval window was not merged.The shape of the hair cells was normal and no obvious deletion of the hair cells was noted when compared with control group.Conclusion The controlled release BMP-2 could induce osteogenesis in the bulla of the animals.This material did not affect the shape of the bulla and the hearing thresholds.They did not induce any abnormal hyperplasia of bone in the bulla and might be used to reconstruct the affected ossicles.

Objective To provide an anatomical basis for repairing the medial malleolus with bone-severed vascularized fibular head epiphysis, and to explore the effect of clinical application with this method. Methods Figures of fibular head and medial malleolus were measured on 20 fresh lower limbs specimens of child age from 2 to 12 years old, then bone-severed formula was deduced. The bone-severed composite fibular head epiphysis to repair the defect of medial malleolus were carried for 6 child patients of emergency or post-poned cases on one stage. Obersved the clinical effect by following-up. Results The angle between fibular head and stem (M) was(170±8)°, angle of fibular head sadacc(N) was (145 ±6)°, length(1.5±0.2)cm and width (1.4±0.2)cm; angle between medial malleolus and stem(1) was(152±8)°, length of the articular surface of medial malholus was(1.25 ± 0.2)cm and width (1.25 ± 0.2)cm. Angle between defect surface and tibia was(Q). Formula: angle of bone-severing X = L-N-Q, and apex at the upper 1/6 of the reversed articular surface of fibular. 6 cases with this method was completed, all healed at stage one, following-up 1 to 3 years, medial malleolos developed well and no epiphysis ossification anticipation, and the ankle joint has no inversion with its loadind and walking function good. Conclusion The fibular head epiphysis and the medial malleolus differ in shape to some extent, but good donor can be got by bone-severing, can repair the epiphysis and soft tissue defect of the medial malleolus at one stage with additional flap, developing with the child at the same time, it is a perfect method to reconstruct the traumatic defect of child medial malleohs.

Objective To observe the clinical effects of ultra-sound guided lumbar plexus and sciatic plexus nerve block combined with general anesthesia on elderly patients undergoing hip replace-ment surgery.Methods Eighty elderly patients scheduled for unilateral hip replacement surgery were randomly divided to lumbar plexus and sciatic plexus nerve block combined with general anesthesia group (group N)and general anesthesia group (group G).The airways of all the patients were con-trolled by laryngeal mask airway (LMA)in both groups.The bispectral index (BIS)of patients in both groups was maintained in the range of 45-55.The dosage of sulfentanyl,visual analogue scale (VAS)at 2,4,8 and 24 h after surgery,and the dosage of patient controlled analgesia (PCA)drugs were recorded.The period from end of surgery to extubation,off-bed activity and discharged from hospital,mortality in 30 days after surgery were recorded.Meanwhile,postoperative delirium (POD) and postoperative cognitive dysfunction (POCD),and severe cardiovascular and pulmonary complica-tions were evaluated.Results No patient died in 30 days after surgery in both two groups.One patient suffered from severe pulmonary infection in group G.The dosage of sulfentanyl of group N was less than the value of group G (P <0.05),the periods from end of surgery to extubation,off-bed activity and discharged from hospital of group N were shorter than those in group G (P <0.05 ).The VAS scores and incidence of POD and POCD in group N were lower than those in group G (P < 0.01 ). Conclusion In elderly patients undergoing hip replacement surgery,ultrasound-guided lumbar plexus and sciatic plexus nerve block combined with general anesthesia could help reduce usage of opioids during operation,offer better analgesia effect,shorten the period of off-bed activity and discharged from hospital and reduce incidence of POD and POCD in elderly patients.

Objective To investigate the relationship between maintaining concentration and loss of consciousness (LOC) concentration of propofol target controlled infusion (TCI) in patients undergoing heart valve replacement.Methods Thirty patients undergoing elective heart valve replacement were enrolled to receive propofol by ladder plasma TCI for anesthesia induction,8 males and 22 females.The initial plasma concentration (Cp) of propofol was set to 1.0 μg/ml,0.3 μg/ml Cp was increased every 1 min until LOC when the prediction effect-cite concentration (Ce) reached 0.5 μg/ml,then sufentanil 0.8-1.0 μg/kg and rocuronium 0.6-0.9 mg/kg were given for intubation.When BIS reached 50,Cp was decreased to the level of Ce.All the surgeries were performed under hypothermia CPB.MAP,HR,CVP,CO,SV,SVR,BIS,propofol Cp and Ce values were recorded at baseline (T0),LOC (T1),BIS reached 50 (T2),and other time points during operation (T3-T9).The correlation analysis between propofol Ce at LOC and perioperative variables were completed.Results In correlation analysis,there was a significant positive correlation between propofol Ce at LOC and baseline CO,SV (P<0.01),there was a significant negative correlation between propofol Ce at LOC and age (P<0.05),there was a significant positive correlation between propofol Ce at LOC and propofol Ce at T2-T9(P<0.01).Conclusion In patients undergoing valvular replacement,the Ce of propofol at maintenance are related to the concentration of propofol at LOC,which is helpful for adjusting the Ce of propofol at maintenance according to the Ce of propofol at LOC.

Objective To analyze the occurrence of traumatic carotid cavemons fistula (TCCF) resulted from the fracture of basilaris cranii, in order to find out the related factors to outcomes and to discuss the approaches to improving prognosis.Method Data of 312 patients with the fracture of skull base complicatcd with TCCF con-firmed angiography from 1999 to 2005 were analyzed. These patients were classified into patients with disable and patients without disabed. The factors potentially impacting on outcomes were analyzed. Results The overall inci-dence of TCCF in 312 patients with fracture of basilaris cranii was 3.8% .The incideucs of TCCF occurred in pa-tients with the fracture of anterior fossa, middle fossa and posterior fossa accounted for 2.4%, 8.3 % and 1.7 %, respectively. Between two cohorts of patients, there were no difference in age, gender, number of embelization proce-dares performed and the time from injury to appearence of the first symptom except the differencc in time from ap-pearence of the first symptom to the intravascular embohzation performed (P>0.05). Conclusions A relatively high incidence of TCCF occurs in patients with middle fossa fractures, especially those with transverse or oblique fractures. Prompt diagnosis and intervention can not be emphasized in case of patients with TCCF, and non inva-sive techniques for the early detection of TCCF under certain circumstance after brain or facial trauma should be considered so as to avoid a miss in the early diagnosis of middle fossa fracture to ensure favourable outcomes.