ObjectiveTo investigate the effect of intensive dose atorvastatin on preventive contrast-induced nephropathy (CIN) in elder with coronary heart disease (CHD) after elective percutaneous coronary intervention (PCI).Methods110 subjects older than 60 who received elective PCI,were randomly divided into intensive dose atorvastatin group (the study group,n =50) and conventional treatment group (the control group,n =50).On the ba sis of the hydration therapy,the study group received atorvastatin and the control group received atorvastatin.Scr、β2- MG and liver function were checked for evidence of tubular or glomemlar damage before and after elective PCI were compared between the two groups.Ccr was calculated according to Cockcroft-Gault formula;The incidence of the major adverse cardiovascular events (MACE) and cytotoxicity and hepatotoxicity of rosuvastation were respectively recorded in 30 days follow-up period.ResultsCcr in the study group was significantly higher than that in the control group at day 1 [( 73.12 ± 16.89 ) ml/min vs ( 63.89 ± 18.42 ) ml/min,P =0.036],day 2 [( 65.32 ± 13.46 ) ml/min vs (55.63 ± 15.47 )mL/min,P =0.021] ;Blood β2-M in the study group was significantly lower than that in the control group at day 1 [( 2.44 ± 0.42 ) ml/min vs ( 2.69 ± 0.63 ) mL/min,P =0.009],day 3 ( 2.52 ± 0.46 ) mL/min vs (2.81 ±0.63) ml/min,P =0.011],day 3[(2.37 ±0.43) ml/min vs (2.54 ±0.65 ) ml/min,P =0.021].The incidence of CIN was lower in the study group than that in the control group(6％ vs 24％,P =0.012).During 30days clinical follow-up,the incidence of the MACE in the control group was more than the study group ( x2 =5.316,P =0.021).There was no significant difference between the two groups for the cytotoxicity and hepatotoxicity.ConclusionHigh dose atorvastatin may be more efficient in prevention CIN in elder before elective PCI and this higher dose may be safe to the elder.

Objective To analyze and summarize the features of children's facial wound and to share the emergency treatment experiences.Methods An retrospective study was conducted on the pathogenesis,age distribution,emergency treatment methods and complications in 1407 children (under 15 years of age) during recent 8 years (from January 2004 to December 2011).Results In this study the major facial wound type was simply lacerations (1196/1407,85.0 ％),and the most common wound cause was trumbling injury (1154/1407,82.0 ％).The T area was the easiest injured,successively,forehead (562/1407,39.9％),chin (211/1407,15.0％),lips (196/1407,13.9％) and nose (95/1407,6.8％).Here were 2 peaks in age distribution which were 2 and 5 years of age,respectively.Pleased outcome would be found while normalized plastic means were taken.After 3 to 6 months following up,there were 5 infection cases,27 cases healed with hypertrophic scars,and 7 cases with traumatic tattoos in wound location.Conclusions The most common wound type is simply laceration.2 and 5 years of age are two of the highest risk stages.It is necessary to act up to plastic surgery principles and take children's particularity into account when emergency treatment,and to do our best to minimize the scar in the first operation time.

OBJECTIVE:To develop a method for simultaneous determination of 6 alkaloids in Coptis teeta.METHODS:The determination was performed on XtimateTM C18 with mobile phase consisted of 30 mmol/L ammonium bicarbonate [containing 0.1％ triethylamine and 0.7％ ammonia-acetonitrile (gradient elution)] at the flow rate of 1.0 mL/min.The detection wavelength was set at 270 nm,the column temperature was 30 ℃,and the sample size was 10 μL.RESULTS:The linear ranges of jateorrhizine,columbamine,epiberberine,coptisine,palmatine hydrochloride and berberine hydrochloride were 0.85-16.96 mg/L (r=0.999 9),1.25-24.96 mg/L(r=0.999 8),2.05-40.96 mg/L(r=0.999 9),3.65-72.96 mg/L(r=0.999 9),2.88-57.60 mg/L(r=0.999 9) and 13.25-264.96 mg/L(r=0.999 9),respectively.RSDs of precision,stability and reproducibility tests were all lower than 3.0％.Recoveries were 97.14％-102.14％ (RSD=1.93％,n=6),97.00％-102.00％ (RSD=2.06％,n=6),98.18％-101.82 ％ (RSD=1.79％,n=6),96.15％-101.28％ (RSD=2.06％,n=6),96.88％-101.88％ (RSD=1.87％,n=6),99.31％-103.76％ (RSD=1.89％,n=6),respectively.CONCLUSIONS:The method is simple,accurate,stability and reproducible,and can be used for simultaneous determination of 6 alkaloids in Coptis teeta.

Objective To illustrate and analyze the clinical feature and treatment of botulism introduced by illegal injection of botulinum neurotoxins (BoNT),in order to provide some evidence for early diagnosis and treatment strategy.Methods Retrospective analysis of 13 botulism patients was performed in this article.All of the patients were suffered from illegal injection of botulinum neurotox in products.Support treatments were carried out according to their severe grade,and the courses of disease and the curative effects were observed.Results A new category was first identified as injection induced botulism to describe such a situation of cosmetic injection out of the hospital with neither the prescribed botulinum toxin product nor a doctor.One in 13 patients graded mild botulism,the other 12 patients graded middle level.The processes of the new botulism had 4 stages:preclinical stage (4 days),progressive stage (9.8 days),apical stage (9.1 days) and restoration stage (5.2 months).The relationships of a positive correlation in injection dose and the length of progressive stage were identified,while a negative correlation with the length of preclinical stage was revealed.Conclusions The earlier2-3 weeks after illegal injection are crucial for intense care because of the acceleration in this period.Absolute rest and active treatments as well as antitoxinum are benefit for the recovery of patients.

Congenital pulmonary hypoplasia is a rare developmental abnormality of the lung with an incidence rate of around 1/5000 000. As a fatal condition associated with respiratory insufficiency after birth, this disease is rare in adults. We treated a 29-year-old female patient with congenital pulmonary hypoplasia and concurrent of cystic duct calculus in May, 2011 using single-port transumbilical laparoscopic cholecystectomy, which resulted in a good therapeutic effect comparable to that by routine laparoscopic cholecystectomy.
Abnormalities, Multiple ; Adult ; Cholecystectomy, Laparoscopic ; methods ; Female ; Gallstones ; complications ; surgery ; Humans ; Lung ; abnormalities ; Lung Diseases ; complications

OBJECTIVETo explore the technique and therapeutic effect of bridge wire splint fixation with ankle dorsiflexion for the treatment of femoral shaft fractures in young children. Methods:From June 2006 to June 2012,45 young children with femoral shaft fractures were treated by bridge wire splint fixation with ankle dorsiflexion,which was designed according to arch bridge mechanical principle and structure. There were 31 males and 14 females with an average age of 3.2 years old ranging from 8 months to 5.5 years old; 14 cases were upper 1/3 femoral fractures,26 cases were middle 1/3 femoral fractures,5 cases were lower 1/3 femoral fractures; 20 cases were transverse fractures, 14 cases were oblique fractures,6 cases were spiral frac- tures, and 5 cases were comminuted fractures. X-ray, follow-up imaging changes,clinical curative effect and complications were assessed.

RESULTSForty-five patients were followed up for 6 to 21 months (averaged 12 months). All fractures were reached clinical bone healing after 5 to 7 weeks (averaged 6 weeks) fixation. Seven cases appearred limb soft tissue complications, including buttocks bedsore,dorsal foot and Achilles tendon epidermal necrosis, and healed after dressing and removal of external fixation. During follow-up,the original overlap angle and lateral displacement were remodeled, and limbs were restored to the normal line of force and bone structure. According to Flynn standard, 35 cases got excellent results, 8 cases good, 2 cases fair.

CONCLUSIONThe bridge wire splint fixation with ankle dorsiflexion for the treatment of femoral. shaft fractures in young children (less than 6 years old) is safe,feasible, simple,and has raliable effect, which can be applied in primary hospitals.

Ankle ; surgery ; Bone Wires ; Child ; Child, Preschool ; Female ; Femoral Fractures ; surgery ; Femur ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; Humans ; Infant ; Male ; Treatment Outcome

OBJECTIVEThe study the patterns of rDNA ITS sequence variation of 9 medicinal species of genus Bupleurum in China to find the DNA molecular markers for identification of these crude drugs.

METHODThe ITS regions of these species were amplified by PCR and sequenced, and their sequences were analyzed by DNAssist Version 2.2.

RESULTSHomologous alignment indicated that the consanguinity of the ITS sequences between genus Bupleurum and outgroups was lower than 75%, and that within genus Bupleurum was higher than 88%. For the same species, the consanguinity was higher than 99%.

CONCLUSIONThe ITS sequences may serve as reliable molecular markers for identification of Radix Bupleuri.

Bupleurum ; classification ; genetics ; DNA, Plant ; chemistry ; genetics ; DNA, Ribosomal Spacer ; chemistry ; genetics ; Molecular Sequence Data ; Phylogeny ; Plant Roots ; genetics ; Sequence Analysis, DNA ; Species Specificity

Objective To evaluate the efficacy and safety of oxycodone hydrochloride for postoperative analgesia in patients who received spin surgery.Methods Sixty -nine patients treated with spin surgery were included in this study and randomly divided into treatment group ( n=34 ) and control group ( n=35).Half an hour before the end of operation ,the patients of the two group were given oxycodone hydrochloride and morphine 0.07 mg · kg-1 , respectively.After extubation , patient -controlled analgesia pump was given with the background dosage of 0.5 mg · h -1 and one time push 1 mg of oxycodone hydrochloride or morphine.The mean arterial pressure ( MAP) , and heart rate were com-pared in the time points of entering the operation room ( T0 ) ,tracheal in-tubation ( T1 ) , 5 min after tracheal intubation ( T2 ) , and 15 min after tra-cheal intubation(T3) between the two groups.The recovery time, extu-bation time ,visual analogue scale ( VAS) ,observer assessment of sedation ( OAA/S ) score and safety were compared between the two groups . Results The MAP and heart rate were not statistically different between the two groups and among the time points ( P>0.05 ).The recovery time , extubation time , VAS, OAA/S score in treatment group were significant lower than those of control group( P<0.05 ).The adverse drug reaction rates were 17.14%and 8.82% in the control group and treatment group respectively with statistical difference ( P<0.05 ).Conclusion Compared with morphine , oxycodone hydrochloride is more effective and safe for postoperative analgesia in patients who received spin surgery.

Objective To investigate the bacterial distribution and resist-ance to antibiotic of bone and joint infection in China, 2012.Methods The bacteria isolated from bone and joint in the tertiary hospitals were routinely identified.Disc diffusion test, minimum inhibitory concentra-tion ( MIC) test and E-test were used to detect the antimicrobial sensi-tivity.Results All the clinical stains isolated from 557 tertiary hospi-tals.2636 pathogenic strains were collected from bone and joint speci-men, which included Klebsiella pneumonia 370 strains (14.0%), Esche-richia coli 348 strains ( 13.2%) , Acinetobacter baumannii 319 strains (12.1%), Staphylococcus aureus 252 strains (9.6%) and Pseudomonas aeruginosa 167 strains ( 6.3%).The resistant rate of Staphylococcus aureus strains to oxacillin were 36.0%, no vancomycin and linezolid re-sistant isolate were found.The resistant rate of Escherichia coli, Klebsiella pneumonia and Enterobacter cloaecae strains to ceftriaxone were 64.6%, 33.0%and 37.4%, respectively, the resistant rate to imipenem were<2%.The resistant rate of Pseudomonas aeruginosa to carbapenem, ceftazidime and cefepime were <20%, the resistant rate to quinolone were <10%.The resistant of Acinetobacter buamannii to cabarpenem were <40%, the resistant rate to amikacin were 18.8%.The resistant rate of Acinetobacter lwoffii to cabarpenem were <1%, and the resistant rate to pipercillin and cefepime were <10%.Conclusion Gram negative bacteria were predominant organism in bone and joint infections in China, it may be related to the initial em-piric therapy always cover Staphylococcus.There were some difference in bacterial resistance to different antibiotics.These data present information for the proper treatment of bone and joint infections.

Objective To investigate the prognostic factors affecting the postoperative survival of patients with invasive bladder cancer,and to predict the survival time of the patients.Methods We retro- spectively analyzed the clinical and follow-up data of 178 patients with invasive bladder cancer treated by radical cystectomy and urinary diversion from 1991 to 2004.A multivariate analysis was performed in these patients by the Cox proportional hazard model.A prognostic index(PI)based on the Cox regression was con- structed.According to the individualized PI,the patients were classified into different hazard groups and the expected survival curve of each patient was calculated.Results Cox regression analysis showed that the factors which influenced the postoperative survival included tumor stage(RR=1.982,P=0.000),grade (RR=1.978,P =0.042),lymph node metastasis(RR=2.142,P=0.048),Tis(RR=6.177,P= 0.000),tumor shape(RR=0.416,P=0.003),number of tumors( RR=1.820,P=0.035),pathological type(RR=2.228,P=0.032),patient age(RR=0.672,P=0.025)and neoadjuvant chemotherapy (RR=0.257,P=0.016).Based on the percentile of PI,patients were classified into 3 prognostic groups; the median survival time of 3 groups were 42.5,22.5 and 7.0 months,respectively.There were significant differences between each 2 among the 3 groups(P＜0.01).Conclusions Neoadjuvant chemotherapy, tumor stage,grade,lymph node metastasis,Tis,shape and number of tumors,pathological type,patient age were important prognostic factors.PI value can be used to predict the prognosis of patients with invasive blad- der cancer.