BACKGROUND: D-dimer is the specific marker of cross-link fibers degraded by fibrinolysin. During cerebral hemorrhage, D-dimer is significantly increased; its decrease may reflect the absorption process of hematoma and be closely related with the substantial injuries of brain. Endothelin is remarkably increased during cerebral hemorrhage, which may result in ischemic necrosis of neural histiocytes. The endothelin volume in cerebral hemorrhagic patients can reflect the severity of illness and the function prognosis.OBJECTIVE: To observe the effect of xingnaojing he shengmai injection (compound injection) on D-dimer and endothelin in patients at acute stage of cerebral hemorrhage.DESIGN: A randomized and controlled trial.SETTING: Emergent Internal Department of the Affiliated Hospital of Medical College of Qingdao University and Department of Pathology of Jinan Military General Hospital.PARTICIPANTS: A total of 44 patients of inspected patients at acute stage of cerebral hemorrhage were collected in Emergent Internal Department of affiliated Hospital of Medical College of Qingdao University from September 1999 to May 2001, which were randomized into two groups, named as xingnaojing he shengmai injection(compound injection) group(23 patients) and xingnaojing group(21 patients).METHODS: ELISA method was applied to determine the level of D-dimer and endothelin of peripheral blood before and after treatment. SPSS 8.0 statistical software was applied to analyze the data.MAIN OUTCOME MEASURES: Effects of xingnaojing he shengmai injection(compound injection) on level of D-dimer and endothelin in patients at acute stage of cerebral hemorrhage, compare with xingnaojing group.RESULTS: Xingnaojing he shengmai injection(compound injection) significantly reduced the level of both D-dimer[ (0. 67 ± 0. 21), (0.34 ± 0.18) mg/L,P ＜ 0.01 ] and endothelin[ (94.52 ±30. 23), (51.30 ± 21.62) ng/L, P＜ 0.01 ] before and after treatment respectively. The improvement of which was obviously superior to those in xingnaojing group[ (0. 33 ±0. 11),(0.20±0.08)mg/L, P ＜0.01; (43.22±12.06), (26.52±8.13)ng/L respectively, concerning to the improvements in two groups, P ＜ 0. 01 ].CONCLUSION: To improve the fibrinolytic state in patients with cerebral hemorrhage may protect the substantial injuries of brain and prevent the secondary damage after cerebral hemorrhage. To inhibit cerebral vascular spasm after hemorrhage may improve ischemic oxygen deficiency in brain tissue and probably be taken as one of the ways for xingnaojing he shengmai injection giving play to its therapeutic effects.

OBJECTIVE:To determine the titer of main component in kitasamycin tablets and acetylkitasamycin dry suspension.METHODS:Staphylococcus aureus was used as test organism and which were cultured at (37?0.5) ℃ for about 4～5 hours by adding 1.0%～1.5% kitasamycin and 2.0%～2.5% acetylkitasamycin,then the absorbance was determined at a wavelength of 530 nm.RESULTS:The linear range of kitasamycin was 0.5～4.0 IU?mL-1 and that of acetylkitasamycin was 0.45～6.3 IU?mL-1,and their recovery rates were 101.7%(RSD=1.9%,n=9) and 101.1%(RSD=2.1%,n=9),respectively.CONCLUSION:The established turbidimetry is sensitive,rapid yet with few influencing factors,thus it is applicable for the titer determination of main component in kitasamycin tablets and acetylkitasamycin dry suspension.

OBJECTIVE: To develop a rapid, accurate and sensitive method for the determination of nifedipine, nitrendipine and nimodipine which were added into traditional patent medicine illegally. METHODS: The LC-MS method was used to detect the extractive of Chinese patent medicine for antihypertension in respects of relative molecular mass, tandem mass spectrometry fragment, retention time, UV spectrum. The compounds added into the Chinese patent medicine were identified by comparing with standard sample in terms of spectrum, chromatographic and mass spectrometric behavior. RESULTS: According to four aspects of determination, nifedipine, nitrendipine and nimodipine were found in three kinds of Chinese patent medicine for antihypertension. CONCLUSION: The method is selective and sensitive for the detection of nifedipine, nitrendipine and nimodipine which were added into traditional patent medicine illegally.

OBJECTIVE:To establish a turbidimetric method for the determination of the potency of the crude drugs and tablets of oxytetracycline. METHODS: By turbidimetric method in which Staphylococcus aureus was used as the test organism with biomass concentration of 1.0%～1.5% (V/V). The culture temperature was 37 ℃ and the culture time was about 4 h. The method was compared with the cup-plate method in potency. RESULTS: The linear range of oxytetracycline was 0.05～0.4 IU?mL-1. The average recovery of the crude drug of oxytetracycline was 99.59% (RSD=2.0%) and that of oxytetracycline tablets was 99.51% (RSD=1.91%), showing no significant difference as compared with the cup-plate method in contents. CONCLUSIONS: The method was sensitive and rapid yet with few influencing factors thus applicable for the determination of the potencies of oxytetracycline and its tablets.

0.05).Patients with mucitis of the study group and the control group were 0 and 7.The difference in statistics analysis was significant(P

Purpose To explore the role of cell blocks combined with immunohistochemical examination in the diagnosis and differential diagnosis of malignant pleural effusion,and to explore the role of pleural effusion cell blocks in lung adenocarcinoma molecular pathology examination.Methods 142 cases of malignant pleural effusion based cytology,cell blocks of HE staining and immunohistochemical staining by EnVision twostep were retrospectively analysed,the tumor classification was made through analyzing the characteristics of the cells combined with antibody expression.The detection of epidermal growth factor receptor (EGFR) gene mutation of 40 cases of lung adenocarcinoma diagnosed after immunohistochemical staining were used by ARMS-PCR method.Results Among 142 cases of malignant pleural effusion,there were 99 cases caused by lung adenocarcinoma,4 cases of lung small cell carcinoma,3 cases of lung squamous cell carcinoma,13 cases of breast carcinoma,9 cases of ovarian carcinoma,2 cases of gastric carcinoma,1 case of thyroid carcinoma,1 case of endometrial carcinoma,5 cases of mesothelioma,3 cases of lymphoma,1 case of malignant melanoma,1 case of synovial sarcoma.In 40 cases of lung adenocarcinoma pleural effusion cell block,there were 20 cases with EGFR mutations,9 cases of 19del mutations and 11 cases L858R mutations.Conclusion The pleural effusion cell blocks combined immunohistochemistry are useful to improve the accuracy of diagnosis of patients with pleural effusion,and helpful for the determination of classification and the primary site of tumor,assessment of prognosis.Pleural dffusion cell block may used to detect EGFR mutations of lung adenocarcinoma,which provide new source of specimen for the gene detection of lung adenocarcinoma.

Objective To detect steroidogenic acute regulatory protein (StAR) expression in apolipoprotein E-deficient mice at different ages and serum lipid levels. Methods Nighty-six C57BL/6J and apoE-/- mice were enrolled, which were divided into 16 groups with 6 mice per group according to age (1 day, 1, 3, 5 months), sex and genotype (C57BL/6J and apoE-/-). The serum lipid levels in C57BL/6J and apoE-/- mice were detected by commercial kits. StAR mRNA and protein expressions in liver were detected by Real-time PCR and Western blot respectively. Results ApoE-/- mice had higher LDL-cholesterol and lower HDL-cholesterol compared with C57BL/6J mice of the same age and sex. StAR mRNA and protein expressions were decreased following with aging in C57BL/6J mice. However, in apoE-/- mice with higher lipid levels, StAR mRNA and protein expressions were changed with the lipid levels other than ages. StAR mRNA and protein increased in the early stage, and then decreased with the increasement of lipids levels. Conclusions StAR could affect lipids levels and may be an effective regulator for atherosclerosis and other cardiovascular diseases.

Objective To evaluate the value of the periportal free air(PPFA) sign at computed tomography(CT) in distinguishing between upper and lower gastrointestinal(GI) tract perforation. Methods CT images of 62 patients with surgically proven GI tract perforation were retrospectively analyzed. 62 cases included upper and lower GI tract perforation in 35 cases and 27 cases,respective-ly. When there was free air in the periportal area,it was defined as positive periportal free air(PPFA) sign. The difference of PPFA sign in upper and lower GI tract perforation, and the sensitivity, specificity, positive predictive value, negative predictive value and ac-curacy of PPFA sign in diagnosing gastrointestinal perforation were analysed respectively. Results The PPFA sign was seen in 33 of 35(94%) patients with upper GI tract perforation,but only in 10 of 27 (37%) patients with lower GI tract perforation,there was sig-nificant difference between them(P<0.05). For diagnosis of super GI perforation with PPFA sign, the sensitivity, specificity, positive predictive value,negative predictive value and accuracy were 94% (33/35), 63%(17/27), 770%(33/43), 89%(17/19) and 81% (50/ 62), respectively. Conclusion The PPFA sign is a useful finding in distinguishing between upper and lower GI tract perforation.

Objective To investigate the clinical effect of the blood transfusion with equal ratio component in severe multiple in‐juries with acute traumatic coagulopathy(ATC) .Methods Thirty‐eight patients who had severe multiple injuries with ATC were divided randomly into control group and treatment group .Control group was treated with the different ratio packed red blood cells (PRBC)and fresh frozen plasma(FFP) ,while treatment group received the equal ratio PRBC and FFP .Hemoglobin(HB) ,pro‐thrombin time(PT) ,international normalized ratio(INR) ,fibrinogen(FIB)were measured on the 1st ,2nd ,3rd day after admission . The total amount of PRBC during these 3 days ,the days of hospitalization in ICU ,the corrected rate of shock ,the 28‐day mortality were compared between groups .Results Compared with the control group ,the levels of PT ,INR and FIB of treatment group on the 2nd ,3rd day after admission were better(P<0 .05) .The total amount of PRBC[(18 .5 ± 6 .3)U]during these 3 days ,the days of hospitalization in ICU [(5 .9 ± 4 .3)d] in treatment group were less than those in the control group [(25 .9 ± 7 .8)U ,(10 .5 ± 7 .6)d] (P<0 .05) ,while the corrected rate of shock(85 .0% )in treatment group was higher than that of the control group(44 .4% ) .The 28‐day mortality(10 .0% )in treatment group was lower than that of the control group(27 .8% )(P<0 .05) .Conclusion The blood transfusion with equal ratio component in severe multiple injuries with ATC could not only improve blood clotting index ,reduce the total amount of PRBC and the time in ICU ,but also increase the corrected rate of shock and decrease the 28‐day mortality .

Objective Nutrition becomes a focus to professionals as an important factor during the development of pressure ulcers.However, there is no evidence for the effectiveness of eternal nutrition support for pressure ulcer prevention .This research aimed to evaluate the effectiveness of eternal nutrition support for pressure ulcer prevention and provide evidence for patients with the risk of pressure ulcer . Methods Key words such as pressure ulcer prevention,eternal nutritional supportwere used to search information in the Cochrane Library , JBI Database of Systematic Reviews , MEDLINE, Web of Science, EMbase, CBMdisc, CNKI and Wanfang Database to collect randomized controlled trials (RCTs).The quality of RCTs was critically appraised and data were extracted by 3 reviewers independently .Meta-analyses were conducted for the eligible RCTs using RevMan 5.0 software, and Stata12.0 software was applied to detect bias or sensitivity analysis to determine the source of heterogeneity if necessary . Results 7 RCTs were includ-ed, among which 1 RCT was excluded by sensitivity analysis .6 RCTs ( n=1553 ) were finally included for meta analysis ( n=728 in trail group, n=825 in control group), and all the patients were given oral nutrition support for 7days to 26 weeks.The results showed that the ulcer incidence in the intervention group reduced by 16%in comparison to the control group (P=0.006).The protein and energy intake in intervention group were higher than those in control group , and the length of stay in hospital was shortened by 16 days. No significant difference was found in the albumin values . Conclusion The enteric nutrition support can reduce the incidence of pressure ulcer obviously with the highest level of evidence , IA .