OBJECTIVE:To modify the HPLC method for determining the contents of cefpodoxime proxetil and cefpodoxime proxetil capsules or suspension,and to compare it with the method of UV determination.METHODS:Column:ODS-C18,mobile phase:methanol-water(50∶50),flow rate :1.5mL?min-1,column temperature:40℃,detection wavelength:235nm.RESULTS:The standard curve was rectilinear when cefpodoxime proxetil was within the range of 25～150?g?mL-1(r=0.999 9).The average recovery rate was 98.56%(RSD=1.79%)and the average content of the samples was 101.54%.CONCLUSIONS:The method is simple,rapid,accurate and sensitive for determination of cefpodoxime proxetil and cefpodoxime proxetil capsules or suspension.

Objective To investigate the effect of Xuefuzhuyu granule combined Irbesartan in reversing the carotid vascular remodeling of essential hypertension(EH) patients. Methods 61 EH patients were enrolled in this study. 29 cases of EH were treated with Irbesartan, 32 cases were treated with Xuefuzhuyu granule and Irbesartan, and 28 normotensive subjects served as control. Color dopplor ultrasound were adopted to measure IMT and LD of carotid. Results After treated for 9～12 months, the IMT and IMT/LD in EH patietns treated by Xuefuzhuyu granule and Irbesartan significantly decreased than those in EH patients treated only by Irbesartan. Conclusion Xuefuzhuyu granule was beneficial to reversing the carotid vascular remodeling in EH patients.

Objective To evaluate the efficacy of 0.1% tacrolimus ointment and 0.1% mometasone furoate cream in the treatment of chronic actinic dermatitis (CAD). Methods Forty male patients with CAD were recruited and divided into two groups randomly.Twenty cases were treated with 0.1%tacrolimus ointment (Group A), and the other 20 cases were treated with 0.1% mometasone furoate cream (Group B) . The medications mentioned were applied topically to the lesions on the face twice a day and mizolastine tablet 10 mg per day given orally for 4 weeks. The therapeutic efficacy and side effects of medications were observed. The enzyme linked immunosorbent assay (ELISA) method was used to measure the serum levels of IFN-γ, IL-2 and IL12 in CAD patients before and after treatment with topical tacrolimus ointment and mometasone furoate cream. Results (1) Both groups had overall response rates of 100%, with no statistically significant difference ( > 0.05) . (2) Serum levels of IFN-γ,IL-2 and IL-12 were down-regulated after treatment in both treatment groups respectively ( < 0.01) . No statistically significant difference was found between the two treatment groups ( > 0.05) . Conclusion 0.1%tacrolimus ointment is effective in the treatment of CAD. Its therapeutic efficacy is equivalent to that of 0.1%mometasone furoate cream. It can be used as a possible steroid sparing equivalent.

Objective To evaluate the efficacy and safety of itraconazole injection in treatment of invasive fungal infection in the patients with multiple organ dysfunction syndrome.Methods Invasive fungal infection in 15 patients with multiple organ dysfunction syndrome was treated with 200 mg itraconazole injection,twice a day on the first two days,then once a day,for 8 to 14 days.During the treatment,the symptoms and signs,the results of chemical detection were recorded.Everyday fungus,sputum,stool smear or culture were performed.Results The recovery rate,effective rate,and fungal clearance in this trial with itraconazole injection were 80%(12/15),86.7%(13/15),and 86.7%(13/15) respectively.The side effect was not found.Conclusion Itraconazole injection is an effective and safe drug against invasive fungal infection in patients with multiple organ dysfunction syndrome.

Objective To investigate the clinic-pathological significance of von Willebrand factor (vWF) and P-selectin expression in patients with lupus nephritis (LN).Methods Biopsy specimens from 71patients with LN whose disease course ranged from 2 months to 10 years were examined and scored according to a standardized method.SLE activity was evaluated by the SLE disease activity index (SLEDAI) and the British Isles Lupus Assessment Group index.Immunohistochemistry was used to detect the expressions of vWF and P-selectin in the renal tissue of LN patients and 10 normal controls.Of all the patients,7 had World Health Organization type Ⅱ,10 had type Ⅲ and 36 had WHO type Ⅳ,18 had type Ⅴ lupus nephritis.At the same time,the 24-h urine protein (UP) excretion level,the serum creatinine,the serum C3,C4,album level,antinuclear antibody (ANA),anti-double stranded DNA and disease activity scores of all patients were detected.The relationship of their expressions with the clinicopathological parameters of lupus nephritis was analyzed.ANOVA,Nemenyi test and Pearson's analysis were used for statistical analysis.Results Compared with the control group,the in situ expressions of vWF and P-selectin in the lupus nephritis patients were significantly higher.Among these patients,renal expressions of vWF were higher in type Ⅳ (0.30±0.10) than those with type Ⅱ and Ⅲ (0.12±0.05,0.22±0.14)(x2=9.273,x2=8.712,P＜0.05),while the expressions of P-selectin were higher in type Ⅳ and Ⅴ (0.29±0.05,0.36.±0.10)than those in type Ⅱ and Ⅲ (0.27±0.09,0.29±0.05 )(P＜0.05).Correlation analysis indicated that vWF was correlated significantly with AI and 24-h UP (r=0.403,0.332,P＜0.05 ),while P-selectin was correlated significantly with the scores of activity index (AI),24-h UP excretion rate and SLEDAI (r=0.283,0.453,0.297,P＜0.05 ).The expression of vWF was also closely related to P-selectin expressions (r=0.371,P=0.001).Conclusion These results indicate that vWF and P-selectin play a critical role in the pathogenesis of LN.The detection of these two factors will provide a valuable clinical reference for renal damage.These information provide valuable clues for making better treatment regimen plan and achieving more favorable prognosis.

This article analyzes and summaries the problems and difficulties existing in the first-aid medicine's clinical teaching.Combined with his own teaching experience,the author has made some exploration on the teaching time,the way of teaching and inspection form,which has got a good teaching effect.It provids the reference and development for the clinical teaching of first-aid medicine.

Objective To investigate the effects of sustained inflation (SI) combined with small tidal volume ventilation on lung recruitment and hemodynamics in patients with acute lung injury (ALI). Methods Patients with severe trauma followed by ALI were selected for this study. Patients underwent small tidal volume ventilation (baseline) for 1 h and then SI with 20 cm H 2O?30 s(SI 1), 30 cm H 2O?30 s(SI 2), 40 cm H 2O?30 s(SI 3) and 50 cm H 2O?30 s(SI 4) for 1 h, respectively. Parameters of pulmonary mechanics and hemodynamics were measured at 1 h after baseline, SI and returning baseline, respectively. Results Compared with those of the baseline, no changes of parameters were found after SI 1 and SI 2, but EELV and Cst increased significantly after SI 3 and SI 4. Paw, PAP and PVRI decreased significantly after SI 3 and SI 4. After SI interruption, all the physiological variables returned to baseline. SI had no significant effect on HR, AP and CI. Conclusion Treatment with SI combined with small tidal volume ventilation in patients with ALI can provide lung recruitment and improve lung compliance, but it has no significant side effect on hemodynamics.

Objective To compare and study the value of multiple antigens dot immunogold filtration assay (DIGFA ) and ima-ging diagnosis for rapid diagnosis of two kinds of echinococcosises .Methods 167 cases of hydatid patients diagnosied by pathologi-cal examination were divided into the DIGFA group for diagnosis of DIGFA and the control group for imaging diagnosis .Results The diagnosis rate of cystic echinococcosis (CE) in the DIGFA group was 74 .60% and control group was 90 .48% (P<0 .01);the diagnosis of alveolar echinococcosis(AE) in the DIGFA group was 92 .68% and the control group was 73 .17% (P<0 .05);when the cystica<5 cm ,the diagnosis rate of AE and CE in the DIGFA group was 91 .67% and 61 .11% (P<0 .05) ,when the cystica 5- <10 cm ,the detection rate of AE and CE in the DIGFA group was 94 .12% and 71 .43% (P<0 .05) .When the cystica≥10 cm ,<5 cm or between 5 - < 10 cm ,the detection rate of CE in DIGFA group was 94 .12% ,61 .11% ,71 .43 ,respectively (P<0 .05);The totle detection rates of the AE and CE in DIGFA group were 92 .68% and 74 .60% (P<0 .05) .Conclusion Imaging di-agnosis for the CE was higher and the DIGFA diagnosis for the AE was higher and the DIGFA also had clinical significance espe-cially applicated to the early diagnosis of AE .With the help of the imaging diagnosis ,the DIGFA could diagnose two kinds of echi-nococcosises correctly and it provided the benefits of specificity and sensitivity and performed easily .

Objective To investigate the features of epileptic seizures and eletroencepalogram (EEG) in patients with mitochondrial myopathy encephalopathy,lactic acidosis and stroke-like episodes (MELAS).Methods Forty-four patients with MELAS were diagnosed at the First Hospital of Peking University from November 2007 to August 2013.EEG and head MRI were performed on all patients.The types of epileptic seizure and EEG changes were compared between patients in and outside stroke-like episodes.Results Epileptic seizures occurred in 39 of 44 patients (88.6％) with MELAS,while multitype epileptic seizures were presented in 26 cases (66.7％).In stroke-like episodes,22 patients presented with partial seizures,30 with generalized seizures and 17 with status epilepticus.In nonstroke-like episodes,7 patients presented with partial seizures,14 with generalized seizures and 2 with status epilepticus.The frequency of partial seizures,generalized tonic-clonic seizures,status epilepticus were 47.7％ (21/44),68.2％ (30/44),38.6％ (17/44) in stroke-like episodes and 13.6％ (6/44),27.3％ (12/44),4.5％ (2/44) in nonstroke-like episodes,which have statistical significance (x2 =12.022,14.758,15.103;P =0.001,0.000,0.000,respectively).Abnormal EEGs appeared in all patients.The rates of slow alpha frequency,diffuse δ or θ wave,epileptic discharges were 6.8％ (3/44),43.2％ (19/44),25.0％(11/44) in stroke-like episodes and 31.8％ (14/44),59.1％ (26/44),22.7％ (10/44) in nonstroke-like episodes,respectively.Slow alpha frequency were significantly different between patients in and outside stroke-like episodes (x2 =8.822,P =0.003).Conclusions Epileptic seizures with different types are more common during stroke-like episodes in patients with MELAS.While the rates of epileptic discharges are also common outside the stroke-like episodes.

PURPOSE: We investigated the effects of different stimulation frequencies on the inhibition of bladder overactivity by sacral neuromodulation (SNM) in pigs. METHODS: Implant-driven stimulators were used to stimulate the S3 spinal nerve in 13 pigs. Cystometry was performed by infusing normal saline (NS) or acetic acid (AA). SNM (pulse width, 210 µsec) at frequencies ranging from 5 to 50 Hz was conducted at the intensity threshold at which observable perianal and/or tail movement was induced. Multiple cystometrograms were performed to determine the effects of different frequencies on the micturition reflex. RESULTS: AA-induced bladder overactivity significantly reduced the bladder capacity (BC) to 34.4%±4.7% of the NS control level (354.4±35.9 mL) (P<0.05). During AA infusion, SNM at 5 Hz did not significantly change the BC (48.1%±6.9% of the NS control level) (P>0.05), but SNM at 15, 30, and 50 Hz significantly increased the BC to 54.5%±7.1%, 55.2%±6.5%, and 57.2%±6.1% of the NS control level (P<0.05), respectively. No significant differences were found among the results obtained using frequencies of 15, 30, and 50 Hz (P>0.05). CONCLUSIONS: This study demonstrated that 15 Hz was an appropriate frequency for SNM and that frequencies higher than 15 Hz did not lead to better surgical outcomes.
Acetic Acid ; Reflex ; Spinal Nerves ; Swine* ; Tail ; Urinary Bladder* ; Urinary Bladder, Overactive ; Urination