New oral anticoagulants,including direct thrombin inhibitors and factor Xa inhibitors.They have overcome several shortcomings of warfarin.The efficacy of preventing stroke and systemic embolism is superior to or not inferior to warfarin in patients with non-valvular atrial fibrilhtion,and they can decrease the risk of bleeding (especially intracranial hemorrhage).However,no agent can efficiently reverse its anticoagulant effect now.This article reviews the pharmacological characteristics,clinical efficacy,complications,and its management of the commonly used new oral anticoagulants at present.

Animals ; Asthma ; drug therapy ; immunology ; metabolism ; physiopathology ; Child, Preschool ; Humans ; Infant ; Leukotrienes ; immunology ; metabolism ; pharmacology ; Respiratory Sounds ; drug effects ; immunology ; physiopathology

Objective To evaluate the efficacy of the nasopharyngeal airway for airway management during anesthesia recovery in obese patients. Methods Eighty ASA Ⅰ-Ⅲ patients, aged 48-72 yr, body mass index > 30 kg/m~2 , were randomly divided into 2 groups (n=40 each) : nasopharyngeal airway group (group Ⅰ) and oropharyngeal airway group (group Ⅱ). The extubation was performed after recovery of breathing (RR ≥ 10 bpm, V_T≥5 ml/kg). The nasopharyngeal airway was inserted though the nasal cavity immediately after extnhation in group Ⅰ, and the oropharyngeal airway was inserted though the oral cavity after extubation in group Ⅱ. Oxygen (3 L/min) was then inhaled by mask until recovery of consciousness in both groups, and if SpO_2 < 90%, the rescue medication was given. The changes in RR, SpO_2 , HR, SP and DP were observed at 1 min (T_1), 5 min (T_2), 10 min (T_3) and 20 min (T_4) after insertion of the airway and complications were recorded in 20 min after insertion of the airway. Results The RR, SpO_2, HR, SP and DP were all maintained in the normal range after insertion of the airway in both groups. The RR,HR, SP and DP at T_(3,4) and incidence of resdessness, nausea and vomiting, and laryngospasm were significantly lower in group Ⅰ than in group Ⅱ (P<0.05), while there was no significant difference in SpO_2 at each time point between group Ⅰ and group Ⅱ(P>0.05). Conclusion The efficacy of the nasopharyngeal airway is similar to that of the oropharyngeal airway for the relief of the upper respiratory tract obstruction during anesthesia recovery in obese patients, but the stress response induced is lower and complications are fewer.

Objective To introduce dimethyl on 4-position of 4-ene-3-one steroids. Methods Seven 4-ene-3-one steroids were treated with methyl iodide (CH3I) and potassium tert-butoxide (t-BuOK) in tert-butanol (t-BuOH). Results Four substrates were smoothly converted to 4,4-dimethyl products, while other three substrates afforded 3-O-methylation products with high yields. Conclusions The different reaction results revealed a high remote effect of D ring moiety on the selectivity between 3-O-methylation and 4-dimethylation.

Objective To develop a method to determine trace Pb and Cd in mineral water, tap water and sea water. Methods Pb and Cd in the samples were enriched in the sulphydryl cotton column under the conditions that the pH of the samples was adjusted to 7 and collected by washing the column with 4 ml of 0.2 mol/L HCl solution. The concentration of Pb and Cd was determined by flame atomic absorption spectrophotometry. Results Pb and Cd were not detected in four kinds of mineral water samples, but in tap water and sea water, Pb was 1.56 ?g/L and 0.43 ?g/L, Cd was 0.62 ?g/L and 0.07 ?g/L respectively. The rates of recovery were 96.6%-104.0% and RSD was

Objective To study the effect of oral Cefradine on pharmacokinetics of baicalin in rats in vivo. Methods The rats were divided into two groups: one was supplied with baicalin individually and the other was supplied with the combination of Cefradine and baicalin. Plasma concentrations of two groups were detected by HPLC with electrochemical detection (ECD). The pharmacokinetic parameters were calculated by statistical analysis and compared. Results The pharmacokinetic parameters of combination administration group were C_ max (782.63?469.37) ng/mL, AUC_ 0-24 h (8 407.86?3 476.14) ng/mL?h; while the individual administration group of baicalin was C_ max (2 645.62?601.42) ng/mL, AUC_ 0-24 h (28 952.90 ?5 731.42) ng/mL?h. Conclusion The main pharmacokinetic parameters show significant difference between the two groups (P

Objective To study the effect of oxygen therapy combined with recombinant epidermal growth factor on cervical cancer radioactive dermatitis. Methods From October 2013 to October 2015 in Guangxi tumor hospital, 70 stage IIIB cervical cancer patients with radioactive dermatitis from intensity modulated radiation therapy (IMRT) were enrolled in the study, 35 cases with dermatitis occurring on odd date as the study group and another 35 with dermatitis occurring on even date as the control group. The former were treated with oxygen therapy combined with epidermal growth factor and the latter with recombinant epidermal growth factor alone. The two groups were compared in terms of curative effect, wound healing time and pain. Results The total effective rate of the research group was significantly higher than that of the control group (P<0.01). The healing time of the research group was significantly shorter than that of the control group (P < 0.001). Conclusion The oxygen therapy combined with recombinant epidermal growth factor is more effective in improving the cure rate, shorten healing time of dermatitis, reduce the pains from radiotherapy and help them through the radiotherapy process.

Objective To detect the expression of T cell immunoglobulin mucin 3 (Tim-3) and its relationship with Th17/Treg cytokine isolated from peripheral blood mononuclear cells (PBMCs) and broncho-alveolar lavage fluids (BALF) cells in the asthmatic murine model and to investigate the role of Tim-3 in the occurrence and development of the asthmatic inflammation. Methods The asthmatic murine model was established by the method of ovalbumin (OVA) injection and inhalation. The mice were randomly divided into 2 groups: the normal control and the asthma group. PBMCs and BALF cells in each group were collected. Expression of Tim-3 mRNA was detected by the real-time PCR assay. Levels of CD4+IL-17+ and CD4+CD25+FoxP3+, reflecting expressions of Th17 and Treg respectively , were detected by flow cytometry. The correlationbetween Tim-3 and Th17/Treg level was analyzed. Results Contrast with the normal control group, the expression of Tim-3 mRNA in PBMCs and BALF cells in the asthma group increased significantly (P < 0.01). OVA sensitization and challenges resulted in the increased CD4+IL-17 production and the decreased CD4+CD25+Foxp3+in PBMCs and BALF cells compared with those in the normal control group (both P < 0.05). The ratio of Th17/Treg significantly increased in asthma group (P < 0.05). Tim-3 mRNA expression in PBMCs and BALF cells was positively correlated with CD4+IL-17+ level and Th17/Treg ratio , respectively , and was negatively correlated with CD4+CD25+Foxp3+ level. Conclusions Tim-3 mRNA level in PBMCs and BALF cells in the asthma group was increased , indicating that Tim-3 might take part in the occurrence and development of asthmatic inflammation and has a very close relationship with the Th17/Treg imbalance.

Objective To evaluate the ability of contrast-enhanced ultrasonography (CEUS ) compared to enhanced MRI scan in differential diagnosis of benign and malign tumor of orbit.Methods CEUS and enhanced MRI was performed in 74 patients with tumor of orbit.These patients were divided into two groups:benign and malignant tumor depended on histological diagnosis.The results were analysed with SonoLiver software.The coincidence rate of diagnosis and enhancement intensity among CEUS,MRI and CEUS+ MRI were compared and the quantitative parameters of CEUS were analysed.Results (1 )The diagnostic accordance rate of benign group by three methods were 90.0%,80.0% and 96.0% respectively, there was statistical difference for diagnostic coincidence rate between the MRI and CEUS+ MRI(P <0.05).The diagnostic accordance rate of malignant group by the above three methods were 75.0%,79.2%and 95.8% respectively,there was no statistical difference for diagnostic coincidence rate between the three methods(all P > 0.05 ).(2 )The enhancement intensity of CEUS was different between benign and malignant groups (P <0.05).There was no statistical difference between benign and malignant groups by MRI method (P >0.05).(3)The parameters of tumor imaging obtained time intensity curve(TIC):rise time (RT),half elution time and time to peaking (TTP)were significantly different between benign and malignant groups(P <0.05).While there was no significant difference of parameters as mean transit time (mTT)and arrived time (AT)(P >0.05).Conclusions CEUS had higher diagnostic accuracy than MRI in benign orbital tumor.The contrast enhancement intensity and time-intensity curves provide valuable diagnostic information for differential diagnosis of benign and malignant orbital tumor.

Objective To investigate the clinical characteristics and mutations of guanosine triphosphate eyclohydrolase (GCH) Ⅰ gene in patients with dopa-responsive dystonia (DRD). Methods Five families with 18 affected family members and 17 patients with sporadic DRD were examined. Patients were allocated into 3 groups according to onset time, either in childhood, or in adolescence or adult. Interview, physical examination, psychologic testings and CT/MR scan were performed. Mutation screening was performed on 26 patients and 1 normal family nember. Thirty-five healthy control subjects were matched for age and sex. Statistical analysis were conducted with the use of SPSS 13.0 computer software. Results(1)Most of patients started with dystonia. The main clinical manifestation was dystonia too. There was no difference among 3 groups.(2) There were significant differences in diurnal fluctuation among 3 groups(15/15,6/6,7/14, χ2=13.125,P=0.001). Diurnal fluctuation negatively correlated with age (r=-0.720, P<0.01).(3)The differences in postural tremor were also found among 3 groups (7/15,5/6,1/14, χ2=8.073, P=0.018). Postural tremor positively correlated with age (r=0.399, P=0.018).(4)There were differences in exaggeration of tendon among three groups(11/15,1/6,4/14, χ2=8.309, P=0.016). Exaggeration of tendon reflexes negatively correlated with age (r=-0.429, P=0.010).(5)The scores of Hamilton Depression Scale and Hamilton Anxiety Scale in patients were higher than those in controls.(6)DNA sequencing revealed a heterozygous A224G missense mutation(Tyr75Cys)located within exon 1 in one autosomal dominant inheritance family. Conclusions The manifestations of DRD varies. The clinical course is closely correlated with age. A missense mutation(A224G)in coding region of the GCH 1 gene probablyleads to the occurrence of DRD.