High intensity focused ultrasound(HIFU)can non-invasively and safely focus sound waves on target region to ablate tumors.Using acoustic sensitizer combined with ultrasound to ablate tumors,Sonodynamic therapy(SDT)can ablate tumors at deep region with high precision.The progresses of HIFU combined with SDT for treating tumors were reviewed in this article.

Delirium is an acute brain dysfunction syndrome characterized by confusion and difficulty concentrating,which mainly affects intensive care unit patients and elderly inpatients.Treatment is expensive and may also lead to increased risks of serious complications and death.The complex etiology and unknown pathological mechanisms of delirium mean that clinical drug treatment is largely ineffective.Animal models therefore provide a powerful tool to help understand the mechanism of delirium,screen new drugs,and study potential intervention measures.We review experimental research related to delirium animal models worldwide,and summarize the latest progress in the construction and evaluation of these models from the aspects of animal selection,model construction method,and model evaluation,to provide a reference for further experimental research based on delirium animal models.

Severe infection is a significant threat to patient safety and survival.As the main treat-ment for hospital acquired infections,meropenem is limited in its effectiveness due to the emergence of drug resistance,especially after long-term use of antibiotics.Therefore,optimizing the efficacy of an-tibiotics such as meropenem and avoiding microbi-al resistance has become an urgent issue to be ad-dressed.Therapeutic drug monitoring(TDM),as an important tool for achieving personalized drug ad-ministration,is increasingly recognized as an impor-tant strategy for optimizing antibiotic concentra-tion,avoiding treatment failure and toxicity in criti-cally ill patients and patients with renal insufficien-cy.By reviewing the current application status,pharmacokinetics,and TDM guidance of meropen-em,clinical references are provided for the treat-ment of critically ill patients and patients with renal insufficiency,and guidance and support are provid-ed for optimizing antibiotic treatment.

Severe infection is a significant threat to patient safety and survival.As the main treat-ment for hospital acquired infections,meropenem is limited in its effectiveness due to the emergence of drug resistance,especially after long-term use of antibiotics.Therefore,optimizing the efficacy of an-tibiotics such as meropenem and avoiding microbi-al resistance has become an urgent issue to be ad-dressed.Therapeutic drug monitoring(TDM),as an important tool for achieving personalized drug ad-ministration,is increasingly recognized as an impor-tant strategy for optimizing antibiotic concentra-tion,avoiding treatment failure and toxicity in criti-cally ill patients and patients with renal insufficien-cy.By reviewing the current application status,pharmacokinetics,and TDM guidance of meropen-em,clinical references are provided for the treat-ment of critically ill patients and patients with renal insufficiency,and guidance and support are provid-ed for optimizing antibiotic treatment.

Objective:To explore the safety of pamidronate disodium as adjuvant therapy in children with congenital pseudarthrosis of tibia (CPT).Methods:Medical record data of children with CPT who received pamidronate disodium for the first time and completed 3 doses of treatment during hospitalization in Department of Orthopedics, Hunan Children′s Hospital from July 1, 2019 to June 30, 2020 were collected and analyzed retrospectively. The regimen of medication was slow IV infusion of pamidronate disodium 0.5 mg/kg on day 1 and 1.0 mg/kg on days 2 and 3, dissolved in 0.9% sodium chloride injection 250 ml (the infusion time was >3 hours). Adverse reactions were monitored during and after the IV infusion. Peripheral venous blood was collected 2-3 hours after finishing the 3rd dose of treatment and blood calcium and phosphorus levels were detected. The children were divided into ≤1 year old group, >1-3 years old group, and >3 years old group, and the occurrence of adverse reactions in different age groups were compared.Results:A total of 81 children were enrolled in the analysis, including 54 males and 27 females, aged 0.4 to 15.4 years, with 10 cases in the ≤1 year old group, 46 in the >1 to 3 years old group, and 25 in the >3 years old group. After medication in the 81 children, fever with temperature ≥38.0 ℃ occurred 53 times in 34 children (42.0%), of which 39 times were grade 1 (38.0-39.0 ℃) and 14 times were grade 2 (>39.0-40.0 ℃). The incidence of fever on the day after the 2nd dose was significantly higher than that after the 1st and 3rd doses (all P<0.05). The differences in the incidence of fever and the degree of fever among the 3 groups were not statistically significant (all P>0.05). The temperature of children with fever decreased to below 38.0 ℃ within 1-16 hours after drug-therapy or physical cooling. After the 3rd dose of treatment, the levels of serum calcium and phosphorus were significantly lower than those before administration [(2.06±0.17) mmol/L vs. (2.42±0.12) mmol/L, (1.01±0.23)mmol/L vs. (1.71±0.18)mmol/L, all P<0.001]. The incidences of hypocalcemia and hypophosphatemia were 56.8% (46/81) and 19.8% (16/81) respectively, but none of patients with hypocalcemia and hypophosphatemia had obvious related symptoms. Conclusions:Pamidronate disodium is safe as adjunctive therapy in children with CPT. The main adverse reactions are fever, asymptomatic hypocalcemia, and hypophosphatemia. Fever can be recovered quickly after intervention, and the levels of serum calcium and phosphorus can return to within the normal range after drug withdrawal.

Objective:To explore the safety of pamidronate disodium as adjuvant therapy in children with congenital pseudarthrosis of tibia (CPT).Methods:Medical record data of children with CPT who received pamidronate disodium for the first time and completed 3 doses of treatment during hospitalization in Department of Orthopedics, Hunan Children′s Hospital from July 1, 2019 to June 30, 2020 were collected and analyzed retrospectively. The regimen of medication was slow IV infusion of pamidronate disodium 0.5 mg/kg on day 1 and 1.0 mg/kg on days 2 and 3, dissolved in 0.9% sodium chloride injection 250 ml (the infusion time was >3 hours). Adverse reactions were monitored during and after the IV infusion. Peripheral venous blood was collected 2-3 hours after finishing the 3rd dose of treatment and blood calcium and phosphorus levels were detected. The children were divided into ≤1 year old group, >1-3 years old group, and >3 years old group, and the occurrence of adverse reactions in different age groups were compared.Results:A total of 81 children were enrolled in the analysis, including 54 males and 27 females, aged 0.4 to 15.4 years, with 10 cases in the ≤1 year old group, 46 in the >1 to 3 years old group, and 25 in the >3 years old group. After medication in the 81 children, fever with temperature ≥38.0 ℃ occurred 53 times in 34 children (42.0%), of which 39 times were grade 1 (38.0-39.0 ℃) and 14 times were grade 2 (>39.0-40.0 ℃). The incidence of fever on the day after the 2nd dose was significantly higher than that after the 1st and 3rd doses (all P<0.05). The differences in the incidence of fever and the degree of fever among the 3 groups were not statistically significant (all P>0.05). The temperature of children with fever decreased to below 38.0 ℃ within 1-16 hours after drug-therapy or physical cooling. After the 3rd dose of treatment, the levels of serum calcium and phosphorus were significantly lower than those before administration [(2.06±0.17) mmol/L vs. (2.42±0.12) mmol/L, (1.01±0.23)mmol/L vs. (1.71±0.18)mmol/L, all P<0.001]. The incidences of hypocalcemia and hypophosphatemia were 56.8% (46/81) and 19.8% (16/81) respectively, but none of patients with hypocalcemia and hypophosphatemia had obvious related symptoms. Conclusions:Pamidronate disodium is safe as adjunctive therapy in children with CPT. The main adverse reactions are fever, asymptomatic hypocalcemia, and hypophosphatemia. Fever can be recovered quickly after intervention, and the levels of serum calcium and phosphorus can return to within the normal range after drug withdrawal.

Objective To investigate the clinical effects of levosimmentan combined with freeze-dried recombinant human brain natriuretic peptide in elderly patients with heart failure. Methods Eighty patients with heart failure diagnosed in our hospital from January 2015 to January 2018 were selected as subjects. According to the random number table prepared in Excel 2007,40 patients in the experimental group and the control group were given. For basic treatments such as diuresis,the experimental group was treated with levosimtan combined with lyophilized recombinant human brain natriuretic peptide,and the control group was treated with levosimtan and dobutamine. The left ventricle of the two groups before and after treatment was compared. End-diastolic period (LVEDD),left ventricular ejection fraction(LVEF),cardiac index(CI),stroke volume(SV),serum cystatin C (Cys-C),amino terminal brain natriuretic peptide precursor(NT-proBNP),mean arterial pressure(MAP), pulmonary capillary pressure(PCWP). Results Before treatment,the differences of LVEDD,LVEF,CI and SV levels between the experimental group and the control group were not statistically significant(P > 0.05). After treatment,the LVEDD of the experimental group was significantly lower than that of the control group(P < 0.05).The LVEF,CI and SV values in the experimental group were significantly higher than those in the control group (P < 0.05). There was no significant difference in serum Cys-C and NT-proBNP levels between the experimental group and the control group before treatment(P > 0.05). After treatment,the serum levels of Cys-C and NT-proB-NP in the experimental group were significantly lower than those in the control group(P < 0.05). Before treatment,the difference of MAP and PCWP levels between the experimental group and the control group was not statistically significant(P > 0.05). After treatment,the MAP and PCWP levels in the experimental group were significantly lower than those in the control group(P < 0.05). The incidence of adverse reactions in the experimental group was 10.00％ and the difference between the control group and the control group was not statistically significant(P > 0.05). Conclusions Levosimmentan combined with freeze-dried recombinant human brain natriuretic peptide in patients with senile heart failure can significantly improve cardiac function,reduce Cys-C,NT-proBNP levels,and improve hemodynamic parameters.

Objective To investigate the expression and significance of Histidine decarboxylase (HDC) in liver and intestinal tissue for early diagnosis of strangulated intestinal obstruction.Methods Ten male Wistar rats for the control group and 20 ones for the test group which was divided into A,B groups.Group A (n =10) was made by using ligating ileum for 1 h and group B (n =10) was for 3 h.When intestinal ob struction models were built,the changes of pathology in liver and intestine tissue were observed by light microscope.Real time quantitative PCR was used to detect the expression of HDC in liver and intestinal tissue.Results Under light microscopic level,the injury score of intestine in test group was increased in comparison with that in control group.At 3 h after strangulated intestinal obstruction,RT-PCR showed that brightness of HDC band in intestine tissue was significantly higher than the control.Real time quantitative PCR also showed that the expression of HDC in liver tissue in group A and group B increased 1.34 fold(P ＞0.05) and 2.21 fold (P ＜ 0.05) respectively,when compared with the control group.The expression of HDC in intestine tissue in group A and group B increased 1.81 fold(P ＞ 0.05) and 8.02 fold (P ＜ 0.01) respectively,when compared with the control group.Conclusion Expression of HDC can be used for early diagnosis of strangulated intestinal obstruction.

OBJECTIVE:To establish a method for simultaneous determination of ethinylestradiol and norelgestromin in hor-monal patches. METHODS:RP-HPLC method was performed on column of WondaCract ODS-2 with mobile phase of metha-nol-0.5% phosphoric acid(68∶32,V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 220 nm,the detection tempera-ture was 25 ℃,and sample volume was 20 μl. RESULTS:The linear relationship was 0.872-130.8 μg/ml for ethinylestradiol(r=0.999 6) and 0.880-132.0 μg/ml for norelgestromin (r=0.999 7);RSDs of precision,reproducibility and stability tests were no more than 1.03%,average recoveries were resectively 101.50%(RSD=0.99%,n=9) and 101.68%(RSD=0.95%,n=9). CON-CLUSIONS:The established method is simple and accurate,and can be used for the content determination of ethinylestradiol and norelgestromin in hormonal patches.

Early diagnosis is one of the difficulties in strangulated intestinal obstruction.Serological markers for the early diagnosis of intestinal obstruction has become a hot spot resently.Studies have shown that histidine decarboxylase had a high sensitivity and specificity in the diagnosis of gastric mucosal injury of intestinal obstruction,which would be expected to become an effective serological marker for the early diagnosis of strangulated intestinal obstruction.In this review,the author will describe the advance of serum histidine decarboxylase level for diagnosis of strangulated intestinal obstruction.