BACKGROUND: Alendronate has been recently used for treating osteoporosis by inhibiting the activity of osteoclasts, but further clinical observation is necessary to compare its therapeutic effect with exclusive use of calcium supplement.OBJECTIVE: To observe the therapeutic effect of oral alendronate (tianke tablet) on the clinical symptoms and bone mineral density (BMD) of middle-aged and elderly patients for comparison with calcium gluconate.DESIGN: A self-controlled study and controlled trial with concurrent patients.SETTING: Department of Orthopedics, Shenzhen Hospital, Peking UniversityPARTICIPANTS: Sixty-eight middle-aged and elderly patients with osteoporosis were admitted in the Department of Orthopedics, Shenzhen Hospital of Peking University between July 1999 and July 2000. From these patients 62 at the age over 45 years without secondary osteoporosis were selected for this study, who were randomly divided into oral alendronate group (n=32) and oral calcium gluconate group (n=30).INTERVENTIONS: On the basis of comprehensive therapies, the patients in the alendronate group were given 10 mg alendronate daily and those in calcium gluconate group had 20 mL oral calcium gluconate solution (containing 100 mg calcium gluconate, equivalent to 9 mg calcium in every 10 mL) three times daily for three months. According to bodily pain relief, occurrence of new fracture and improvement in BMD, the therapeutic effect was assessed in three grades.RESULTS: Thirty patients in the alendronate group and 26 in the calcium gluconate group completed the study. Alendronate treatment for 3months significantly increased BMD of the patients [(0.716±0.082) g/cm2in comparison with that before treatment [(0.667±0.083) g/cm2, t= 2.473,P ＜ 0.01], whereas the BMD underwent no obvious changes after treatment with calcium gluconate [(0.671±0.081) g/cm2 before vs (0.680±0.073) g/cm2after treatment, t=1.812, P ＞ 0.05]. Significant difference in BMD after treatment was noted between the two groups (t=2.384, P ＜ 0.01). The effective rate was significantly higher in alendronate group than in calcium gluconate group (X2=14.9, P=0.005), but 7 patients complained of abdominal discomfort in the former group and the patients in calcium gluconate group reported no adverse effects.CONCLUSION: Alendronate can inhibit bone absorption, promote the recovery of bone matrix, and increase the bone mass, producing better effect than exclusive use of calcium gluconate oral solution in treatment of the osteoporosis in the middle-aged and the elderly.

Objective:To establish the drug release determination conditions and method for phencynonate hydrochloride extended release tablets. Methods:The drug release of the tablets was determined by HPLC using a Diamonsil C18 (250 mm × 4. 6 mm, 5 μm) column with the mobile phase of acetonitrile-water-phosphoric acid-triethylamine (270∶400∶1. 3∶2), the detection wavelength was 220 nm, the flow rate was 1. 0 ml·min-1 , the column temperature was 30 ℃ and the injection volume was 20 μl. The effects of different release apparatus, release media and rotation speeds on the release of phencynonate hydrochloride extended-release tablets were studied as well. Results:The established drug release determination method had a good linear relationship within the range of 0. 3-5. 0 μg· ml-1(r=0. 999 8), and the average recovery was 100. 6%(RSD=1. 16%, n=15). Under the conditions of 900ml pH 3. 0 phos-phate buffer solution as the release medium, rotation speed of 50 r·min-1 and the settlement basket as the apparatus, the release be-havior of the product was complied with a zero-level model in vitro, and the release equation was as follows:Q=6. 141 2t-9. 328 7(r=0. 996). Conclusion:The method is simple, accurate and reliable, and suitable for the quality control of phencynonate hydrochlo-ride extended-release tablets.

Cardiac Tamponade ; Coronary Artery Bypass ; Humans ; Postoperative Complications

Objective To evaluate the role of a new non-image based surgical navigation system in improving the accuracy of acetabular component in total hip arthroplasty. Methods Within the prospective study in 12 human cadavers,acetabular component implantations in total hip arthroplasty were performed. For every case,one randomly chosen side was operated on by the non-image based hip navigation system,and the other side by a conventional mechanically guided procedure. According to the design of the study,the acetabular component was placed in beat inclination of 45? and beat anteversion of 20?. Postoperative cup position was determined in both groups by using a mechanical digitizing arm (MicroScribe-3DX). Results In the navigated group,inclination and anteversion reached (45.5? 2.3)? and (21.8?2.5)? respectively. In the control group,inclination and anteversion were (42.5? 6.3)? and (24.8?7.7)?respectively. The difference of inclination was considered statistically significant ( P

Objective To establish the reference range of serum human serum insulin levels in our laboratory and investigate measurement stability, Methods The automated Architect i2000 chemiluminescence immunoassay, calibrator and quality control materials were used to measure concentration of serum insulin. Totally 413 cases of healthy adults were enrolled. The physiologic characteristics and the influence of laboratory markers on insulin levels were analyzed. Then the reference range in our laboratory was established. The thermal stability of insulin at different temperatures was investigated. Results Within-run imprecision and between-day imprecision of the automated Architect i2000 insulin assay were 1.67% and 2. 6%, which indicated that this system had good analytical performance. The subjects were classified into 4 groups according to age range ( 10 years). There was no significant difference among four age groups (the median is 5. 6, 5.2, 5.3 and 5. 7 mU/L) (X<'2> = 1. 929,P >0.05). However, the insulin levels were higher in female ( median = 5.7 mU/L) than male ( median = 5.0 mU/L) ( Z = 3.696, P < 0.01 ). The reference range was established based on the 2. 5 and 97.5 percentile values. The reference range of insulin for female was 2. 6-11.8 mU/L and 2. 3-11.6 mU/L for men, which differed from that of other insulin assay. Insulin had a positive correlation with BMI (r =0. 115 ,P =0. 019) and triglyeeride (r =0.143 ,P = 0. 004), and a negative correlation with high density lipoprotein (r = -0.179, P = 0.000). Insulin was stable at 25 ℃ for at least 4 hours or 4 ℃ for 24 hours or could be extended to at least 7 days when stored at -20 ℃. Conclusion Gender is an important physiologic characteristic which has an impact on human serum insuhn level. Insulin reference range should be established according to gender. Insulin immunoreactivity was not very stable at different temperatures.

Objective To make a summary of radiation-induced changes in ocular lens and retinal lesions based on dynamic follow-up of a patient exposed to a radiation exposure from 192 Ir source accident,in order to provide the information and experience for the clinical diagnosis and treatment of such injury in emergency of a nuclear or radiation accident.Methods The examination methods included eye lens and visual acuity,slit-lamp examination,fundus examination,automated perimetry,optical coherence tomography (OCT) examination,fundus photography,and fundus fluorescein angiography (FFA).The patient was followed-up for 20 months.Comparative analyses were made of the follow-up results.Results One month after 192Ir radiation exposure,the visual acuities in both eyes were 1.0.Mild age-related opacities were observed in peripheral cortex,but the fundus looked normal.Twenty months later,the patient was followed-up.The visual acuities reduced to about 0.6,evident powder-and punctuate-like opacities could be observed in the cortex of the right lens,and mild turbid foci in the posterior polar and capsule.Multiple scotomata appeared in the superior temporal and inferior nasal in the right eye.The macular fovea thickness was not changed significantly in the right eye.Examination with fundus photography demonstrated mild optical nerve atrophy,drusens,and pale optic discs,while FFA examination showed punctuate or flocculent leakages in both eyes.Conclusions The lens opacity could be induced or accelerated by radiation exposure.In addition to the posterior capsule and pole cataracts,punctuate opacity within cortical layer may also occur.It also suggests that cataract and fundus injuries may occur later during long-term follow-up,even though the eyes may look normal during early examination after the patient exposed to the radiation.

ObjectiveTo assess the safety and clinical values of video-laryngoscope in spontaneous respiration tracheal intubation for emergency patients. Methods Seventy-nine patients,who needed the endotracheal intubation,were recruited in our department between January 2010 and December 2010,and were randomly ( random number) divided into two groups according to consultative sequence.Forty patients (group A ) were operated with traditional laryngoscope and thirty-nine patients (group B ) with videolaryngoscope.The operative time and success rate of tracheal intubation,Cormack-Lehane classification,as well as adverse events,were recorded.The heart rate ( HR ),mean arterial blood pressure ( MAP),respiratory rate ( RR ),and saturation of pulse oxygen ( SpO2 ) were observed pre-operation,during operation and 2 min post-operation.Results( 1 ) The Cormack-Lehane classification in group A were significantly lower than in group B. (2) The operative time of tracheal intubation in group B was significantly less than that in group A [(35.6+12.7) svs. (58.3 ± 13.5) s; P＜0.05] ; and one-time success rate of tracheal intubation in group B was higher than that in group A ( 84.6％ vs.52.5％ ; P ＜0.05).(3) Compared to group B,the HR and MAP in Group A were significantly increased at t2 and t3 ( P ＜ 0.05 ). ( 4 ) The adverse events,including restlessness,bucking and injury,were significantly decreased in group B than those in group A ( P ＜ 0.05 ).ConclusionsThe video-laryngoscope used in spontaneous respiration tracheal intubation,could improve Cormack-Lehane classification,short operative time,enhance one-time success rate and reduce adverse evevnts.

Objective To observe the effect of resveratrol on cognitive impairment in rats after chronic cerebral hypoperfusion,and to explore the underlying antioxidant mechanism of resveratrol.Methods The chronic cerebral hypoperfusion model was induced by permanent occlusion of bilateral common carotid arteries (2VO) in rats.Healthy male Wistar rats were randomly divided into 3 groups:sham-operated group,2VO group and 2VO+resveratrol group.Spatial learning and memory were assessed using the Morris water maze at 4 weeks after the occlusion.The levels of 4-Hydroxynonenal (4-HNE) and 8-Hydroxy-2′-deoxyguanosine (8-OHdG) in the cortex and hippocampal CA1 areas were detected using immunohistochemistry staining,for reflecting the lipid peroxidation and oxidative DNA damage.Results The escape latencies from the third day to the fifth day were longer in 2VO group than in sham-operated group[(42.1+5.4)s vs.(25.1±3.3)s,(36.4±4.4)s vs.(12.4±3.3) s,(30.4±4.0)s vs.(8.1±3.4)s,q=10.91、14.54 and 14.07,all P ＜0.01],while the time spent in the object square was shorter in 2VO group than in sham-operated group[(12.9+2.5)s vs.(18.9+2.2)s,q=6.47,P＜0.01].Compared with 2VO group,the escape latencies in 2VO+resveratrol group from the third day to the fifth day were shorter[(29.5+4.0)s,(25.6±4.3)s and (19.8±4.2)s,q=7.71,6.22 and 6.37,all P＜0.01],while the time spent in the object square was longer[(16.5±1.8)s,q=3.83,P＜0.05].Compared with the shamoperated group,the mean integral optical density (IOD) of 4-HNE and 8-OHdG in the cortex and hippocampus CA1 area were increased in 2VO group (265.1 + 9.0 vs.168.2 + 6.0,37.8 + 5.0 vs.24.0+4.0,q=31.89 and 7.48,both P＜0.01).And in the 2VO+resveratrol group,the mean IOD of 4-HNE and 8-OHdG in the cortex and 8-OHdG in hippocampus CA1 area were lower than in 2VO group (195.1±7.0,26.0±4.3,q=23.03 and 6.49,both P＜0.01).Conclusions Resveratrol can improve the cognitive impairment in rats after chronic cerebral hypoperfusion,which may be related to preventing oxidative damage.

Objective To investigate the relationship between adhesion molecule CD44v6,intercellular adhesion molecule-1 (ICAM-1) and lymph node metastasis in early stage of cervical squamous cell carcinoma.Methods Seventy-four specimens of cervical cancer stage Ⅰ b1,20 specimens of normal cervical tissue and 20 specimens of cervical squamous cell in situ carcinoma were collected from Jiangxi Provincial Maternal and Child Health Care Hospital.The expression of CD44v6 and ICAM-1 in cervical tissue was detected by real-time PCR and immunohistochemistry.The lymphatic vessel density (LVD) labeled by D2-40 was detected by immunohistochemistry.The relationship of CD44v6,ICAM-1 and LVD with the differentiation degree and lymph mode metastasis was investigated.Results The positive expression rate of CD44v6 and ICAM-1 in normal cervix,cervical squamous cell carcinoma in situ,and cervical carcinoma tissues was gradually increased,which were 0,75.00％,87.84％ and 10.00％,45.00％,81.08％ respectively.Their mRNA expression amount was gradually increased,which were 0,0.24±0.02,1.02±0.11 and 0.10 ± 0.00,0.19±0.02,1.03 ± 0.10 respectively,the differences were statistically significant (P＜0.01).LVD was gradually increased in normal cervix,cervical squamous cell carcinoma in situ,and cervical carcinoma (P＜0.01).The expression of CD44v6,ICAM-1 and LVD in low differentiated cervical carcinoma tissue was higher than that in high and middle differentiated cervical carcinoma (P＜0.01).The expression of CD44v6,ICAM-1and LVD in lymph node metastasis was higher than that in non-lymph node metastasis (P＜0.01).The expression of CD44v6,ICAM-1 and LVD in cervical cancer tissue had each two positive correlation (P＜0.01).Conclusion CD44v6 plays a promoting role in the progression of cervical cancer,which with ICAM-1 and LVD synergically promote the cervical cancer development,and could be used as an effective indicator for judging lymph node metastasis and diagnosis of cervical cancer.

OBJECTIVE:To determine the plasma concentration of Phencynonate hydrochloride(PCH)in dogs,and to calcu-late pharmacokinetic parameters. METHODS:6 Beagle dogs were given PCH tablets(2 mg and 4 mg)intragastrically. The blood samples were collected 5 min before medication and 0.17,0.25,0.5,0.75,1.0,1.25,1.5,2,3,4,6,8,10,12,14,16,18, 24 and 36 h after medication,2 ml each time. Using penehyclidine hydrochloride as internal standard,HPLC-MS/MS method was adopted to determine the plasma concentration of PCH. The medication plans were interchanged 2 weeks later. The pharmacokinetic parameters were calculated using DAS 2.0 software. RESULTS:The linear range of PCH was 0.1-15 ng/ml(r=0.999 6);the low-est limit of quantification was 0.1 ng/ml;the methodology recovery were 97.30%-103.20%;the extraction recovery were 52.30%-60.11%(RSD<11%,n=5). The main pharmacokinetic parameters of low and high doses were as follows as t1/2α of (0.678±0.525)and(0.405±0.465)h,tmax of(1.042±0.401)and(0.900±0.418)h,cmax of(14.063±6.29)and(31.580±9.673) mg/L,AUC0-36 h of(48.186±14.776)and(79.269±34.649)mg·h/L. CONCLUSIONS:The method is simple,sensitive and speci-fic,and can be used for pharmacokinetic study of PCH in dogs.