OBJECTIVE: To establish an HPLC method for the determination of 8-O-acetyl-shanzhiside methylester in Tibet medicinal Lamiophlomis rotata.METHODS: HPLC analysis was performed on Symmetry C18(150 mm?4.6 mm,5 ?m) column with the mixture of acetonitrile-water(15∶85) served as the mobile phase.The detection wavelength was set at 234 nm.RESULTS:The linear range of 8-O-acetyl-shanzhiside methylester was 1.97～19.68 ?g?mL-1(r=0.999 6) and its average recovery was 99.53%(RSD=1.73%,n=9).CONCLUSION: The method is simple,accurate and specific,and it applies reference for quality evaluation and utilization of Tibet medicinal L.rotata.

Objective Orthotopic liver transplantation (OLT) without bypass is technically simpler butimposes additional stress and strain on already compromised ciroulatory function and milieu interieur. The purposeof this study was to investigate the changes in arterial blood concentrations of glucose and lactate during OLTwithout bypass. Methods Eighty patients (66 male, 14 female) aged 12-67 yr weighing 40-130 kg undergoingOLT without veno-venous bypass for terminal liver cirrhosis (40 patients), liver cancer (28 patients), hepato-lenticular degeneration (5 patients), polycystic liver (3 patients) and severe hepatitis (4 patients). Nine patientswere classified as ASA physical status Ⅱ, thirty-nine patients as ASA Ⅲ, thirty patients ASA Ⅳ and two patientsASAV. Anesthesia was induced with midazolam 2 mg, fentanyl 10-15?g?kg~(-1), propofol 1 .0 - 1 .5 mg?kg~(-1) andpancuronium 0. 15 mg?kg~(-1) and maintained with isoflurane inhalation and intermittent i. v. boluses of fentanyl,midazolam and pipecuronium. The patients were mechanically ventilated after intubation, P_(ET) CO_2 was maintained at32-35 mm Hg. No fluid containing glucose was infused during operation. Radial artery and internal jugular veinwere cannulated for BP and CVP monitoring. ECG, MAP, CVP, SpO_2, P_(ET)CO_2, temperature and urine outputwere continuously monitored during operation. Blood samples were taken from artery before anesthesia (T_0 ), beforecross-clamping of portal vein (T_1), 30 and 60 min during anhepatic phase (T_2, T_3), 5 and 30 min afterunclamping of vena cava before the unclamping of portal vein (T_4, T_5 ) and at the end of surgery (T_6 ) fordetermination of blood glucose and lactate concentrations. Blood lactate was determined only in 50 patients whoreceived no lactated but acetated Ringer's solution during operation. In 70 patients blood samples were obtainedfrom hepatic vein after unclamping of portal vein and before the end of exsanguination from the hepatic vein fordetermination of blood glucose and lactate. Results No patient developed hypoglycemia during operation. Bloodglucose increased slightly before cross-clamping of portal vein (T_1) and during anhepatic phase (T_2, T_3) comparedwith the baseline value before anesthesia (T_0 ) (P

Objective To compare the effects of three different crystalloid solutions on arterial blood lactate concentration and acid-base balance during orthotopic liver transplantation (OLT) without veno-venous bypass. Methods Ninety ASA Ⅱ-Ⅳ patients with end-stage liver disease of both sexes (78 males, 12 females) aged 16-67 yrs weighing 45-87 kg undergoing OLT were randomly allocated to one of 3 groups ( n = 30 each): group Ⅰ received normal saline (NS); group Ⅱ received lactated Ringer's solution (LR) and group Ⅲ acetated Ringer's solution (Plasma A, Baxter) (PA). The crystalloid was infused at a rate of 6-8 ml?kg-1?h-1. Colloid, albumin, RBC and whole blood were infused based on BP, CVP and Hb concentration. The arterial pH, BE and lactate concentration were measured before anesthesia (T0 baseline) , before cross-clamping of the portal vein (T1) at 30 min and the end of anhepatic phase (T2,T3) , 5 and 30 min after unclamping of the portal vein (T4,T5) and at the end of surgery (T6). Results There was no significant difference in the amount of crystalloid, colloid and blood products infused during operation among the 3 groups. Arterial pH decreased significantly at T1 (immediately before anhepatic phase) as compared to the baseline value at T0 and the low pH was maintained until the end of operation. BE was significantly decreased during anhepatic phase (at T2 and T3 ) . The blood lactate was increasing during operation and was 3 times that of baseline value at the end of operation. However there was no significant difference in arterial pH, BE and lactate concentration among the 3 groups.Conclusion In OLT without venovenous bypass, blood lactate increases progressively but the lactated Ringer's solution does not have any effect on the blood lactate concentration.

Objective To investigate the incidence,etiology,diagnosis,treatment and outcome of uterus rupture.Methods From January 1999 to May 2013,clinical data of 67 cases with uterine rupture in Woman's Hospital,School of Medicine,Zhejiang University were studied retrospectively.Results A total of 67 cases of uterine rupture with 21 +2--39 +2 gestational weeks out of 128 599 deliveries were recorded giving an incidence of uterine rupture was 0.052 1 ％ (67/128 599).Cesarean scar rupture were found in 59 cases (88％,59/67) and noncesarean scar rupture were found in 8 cases (12％,8/67).The causes of uterine rupture include 60 cases of scar uterus (59 cesarean scar cases and 1 myomyectomy scar case),2 cases of assisted delivery operation trauma,2 cases of malformed uterus,3 cases of unknown causes (all with artificial abortion history).Non obstructive dystocia and improper oxytocin use were found to be related with uterine rupture.Fifty-two cases of cesarean scar spontaneous incomplete rupture were found and repaired during repeated cesarean delivery without maternal and fetal complications.The remaining 15 cases need emergency rescue operation for fetal distress or dead fetus,severe acute abdomen,prepartum or postpartum vaginal bleeding even maternal hypovolemia; 6/15 uterine rupture cases were diagnosed with the history,clinical symptoms and signs,3/15 cases with ultrasonic found dead fetus in the peritoneal cavity before exploratory laparotomy and 6 cases were diagnosed just during laparotomy.Hysterectomy was done in 10/15 cases and uterine repair in 5/15 cases; there was no maternal death and 12 perinatal fetal death (5 cases of mid-late pregnancy termination for deformed fetus) of the 15 uterine rupture cases.One case with hysterectomy was complicated with stress pancreatitis and dysfunction of liver and kidney and discharged 20 days after operation,the remaining 14 cases were discharged 5-7 days postpartum.One case with repaired malformed uterus got pregnancy 4 years later and delivered a 2 000 g healthy baby by cesarean section at gestational age of 33 +4 weeks.Conclusion Uterine scar caused by caesarean section or other operations became the leading cause of uterine rupture,assisted delivery operations,history of intrauterine manipulation and uterine malformations were the predisposing risk factors of uterine rupture.

OBJECTIVE:To explore the mechanism of procyanidins on mitochondrion injury caused by cerebral ischemia reperfusion(IR) in rats.METHODS:Forty-eight Wistar rats were randomly separated into 4 groups including sham operation group,IR model group,procyanidins pretreatment high and low doses groups(400,40 mg?kg-1).After medication for 30 days,the reperfusion model following focal cerebral ischemia in rats was made by thread embolish of MCA,and the rats were put to death 2 h later for sampling of brain tissues.The expression of cytochrome C protein was detected by immunofluorescence method and that of caspase-9 mRNA was detected by RT-PCR technique.RESULTS:There were significantly more cytochrome C and less caspase-9 mRNA in procyanidins pretreatment group than in IR model group(P

0.05 ) . The patients in both groups all recovered from CABG and discharged from hospital without serious complication such as brain infarct. The MMSE scores after operation were significandy lower than that before operation in both groups ( P

Objective To explore the characteristics of fetal movement and FHR variation elicited by acoustic stimulation and whether acoustic stimulation can replace vibroacoustic stimulation. Methods Ninety-four and seventy-six normal pregnant women for antenatal visit were recruited from the Woman's Hospital, School of Medicine, Zhejiang University from April 2002 to February 2003. All subjects were divided into 5 groups to be exposed to five different intensities of acoustic stimulations at 95,100,105,110,115 dB respectively and self-control of blank and vibroacoustic stimulation were designed. The fetal movements and FHR were recorded during the study. Results (1) The percentage of fetal movement evoked by 95,100,105,110,115 dB airborne sound was 15% , 89%, 83% , 83% , 95% respectively. The total percentage of fetal movement evoked by vibroacoustic stimulation was 99% for all subjects. The percentages of evoked fetal movement by 100,105,110,115 dB airborne sound were not significantly different from those by vibroacoustic stimulation. (2)The percentages of FHR acceleration ≥15 bpm in 100,105,110 and 115 dB airborne sound groups were 39%, 61%, 56% and 85%, respectively, while 92% for all cases evoked by vibroacoustic stimulation was significantly higher than those evoked by 100,105 and 110 dB airborne sound group but with no significant difference to 115 dB airborne sound group. (3)The peak value in FHR evoked by 95,100,105, 110 and 115 dB airborne sound were -4. 5 bpm, 12 bpm, 17 bpm, 14 bpm and 20. 5 bpm, respectively. The peak FHR acceleration evoked by vibroacoustic stimulation was 23 bpm which was significantly higher than those by 100,105,110 dB airborne sound and no significant difference was detected between 115 dB airborne sound and vibroacoustic stimulation group. (4)Compared with 115 dB airborne sound, vibroacoustic stimulation evoked significantly longer duration of FHR tachycardia (42. 5 s vs 5 s, P = 0. 011) and fetal movement (270 s vs 100 s, P = 0. 000). Conclusions Acoustic stimulation at 115 dB is able to elicit efficient fetal movement and FHR acceleration without prolonged tachycardia, fetal behavioral disorganization or excessive fetal movement and is reasonable to replace vibroacoustic stimulation for awaking fetuses combined with NST.

Objective To investigate the significance of the changes in heart rate variability (HRV) in patients undergoing coronary artery bypass graft procedure Methods Thirty six patients scheduled for elective coronary artery bypass were studied HRV was monitored by HXD I monitoring system one day prior to surgery (as baseline values), before anesthesia, at the end of surgery and on the 3rd day and 6th day after surgery Results The baseline logical values for total power(TP), low frequency (LF), high frequency (HF), LF/HF ratio were 3 07?0 35, 2 38?0 47, 2 37?0 54 and 1 34?0 93 respectively There were no significant changes in all these parameters before anesthesia as compared to baseline values LF,HF and TP decreased significantly on the 3rd day after surgery as compared with baseline values, and were kept at the level on the 6th postoperative day Conclusions The decrease in HRV power can last over 6 days after coronary bypass graft surgery, signifying reduced autonomous regulation of heart in the early postoperative days

OBJECTIVE To explore the affection of protective constraint on infection among psychiatric inpatients and it′s preventive methods.METHODS A retrospective study of infection among psychiatric patients was carried by medical records investigation.Inpatients in states of protective constraint and non-constraint in confining units of psychiatric department were divided into study group and control group.Case-control study was carried up on rate of hospital infection and rate of infection of parts of body between groups.RESULTS The infective rate of study group was significantly higher than control one,in which,infective rates of lower respiratory tract,urinary tract,dermatological and mucous parts of study group were significantly higher than control group.CONCLUSIONS Protective constraint for psychiatric patients is one of risk factors of hospital infection,to which should be pay attention,and preventive methods might be taken.

Objective:To study the diagnosis values in severe acute pancreatitis (SAP) by means of the detection of C-reactive protein (CRP) and coagulation function in the early period of acute pancreatitis (AP). Methods:Seventy-two patients with AP accepted early detection of C-reactive protein (CRP),prothrombin time (PT),international normalized ratio(INR),activated partial thromboplastin time (APTT),fibrinogen (FIB ),CT scan and enhanced CT,and the evaluation on the CT severity index (CTSI). Results:There were significant differences in the levels of CRP,PT,INR,APTT,FIB and the CTSI scores between severe AP (SAP) and mild AP (MAP) (P