An untargeted urinary metabonomics method based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry ( UPLC-Q-TOF-MS ) has been established to investigate the mechanism of Schisandra chinensis in treating diabetes and its complications. The urinary biomarkers related to the therapeutic effects of Schisandra chinensis on the diabetes rats were analyzed. In urine, 28 kinds of endogenous metabolites were identified as potential biomarkers, including 13 endogenous metabolites in positive ion mode, 15 endogenous metabolites in negative ion mode, and hippuric acid detected both in positive and negative ion modes. The results revealed that Schisandra chinensis mainly affected the pathways of pentose and glucuronate interconversions, riboflavin metabolism, pantothenate and CoA biosynthesis, arginine and proline metabolism, intestinal bacteria metabolism, ascorbate and aldarate metabolism and tryptophan metabolism in diabetic rats. Combined with biological analysis of these pathways, the therapeutic mechanism of Schisandra chinensis on diabetes and its complications was verified. Based on the biological function of each pathway, the effect of Schisandra chinensis on diabetic nephropathy is stronger. Moreover, it also has the effects of protecting liver, decreasing fat and antioxidant activity.

Objective To investigate the clinical utility of keyhole craniotomy for Cholesteatmas in the cerebello-pontine angle region presenting as Trigeminal neuralgia by using keyhole craniotomy. Methods Clinical data of 35 pa-tients with Cholesteatmas in the cerebellopontine angle region presenting as Trigeminal neuralgia was analyzed retrospec-tively. All patients received suboccipital retrosigmoid keyhole craniotomy. Thirty cases who received conventional craniot-omy group were served as control group. A comparative analysis was conducted to assess the difference between these two groups in microsurgical methods, effects and complications. Results All patients were confirmed with MR diagnosis. In keyhole group, all patients had no pain symptoms of trigeminal neuralgia after surgical operation. The symptoms disap-peared immediately in 33 cases and gradually disappeared in 2 cases within one month following keyhole craniotomy. The tumors were totally removed in 25 cases and almost completely in 10 cases. The surgical duration was shorten in key-hole group than in conventional group (126±48 vs. 216±66 min;t=2.536, P<0.05). The amount of bleeding was smaller in keyhole group than in conventional group (91.3±52.2 vs. 186.3±65.4 mL;t=2.163, P<0.05). Postoperative neurologi-cal function was assessed in House-Brackmann. In keyhole group, there were 32 cases in class Ⅰ and 3 in grade Ⅱ. Two patients had hearing loss which was improved gradually in three months. In conventional group, there were 25 cases in class Ⅰ and 5 in grade Ⅱ (χ2=4.158, P<0.05). Postoperative hearing evaluation (AAO-HNS) revealed that there were 33 cases in grade A , and 2 in grade B in the keyhole group, whereas there were 27 cases in grade A and 3 in grade B in the conventional group(χ2=5.167, P<0.05). There were no relapse of tumors and death during 3 month to 5 years follow-up. Conclusions The suboccipital retrosigmoid keyhole craniotomy is a valid choice for Cholesteatmas in the cerebellopontine angle region presenting as Trigeminal neuralgia.

Objective To explore specimen sampling for microbial culture in ICU patients with documented infections in order to offer clinical evidence for improving the rational use of antibiotics.Methods Patients with documented infection on the first day after admission into ICU and discharged from ICU from July to December 2012 and from July to December 2013 were enrolled in the study.Clinical data including presence or absence of infection,initial antimicrobial therapy,microorganism specimen sampling and culture were retrospectively analyzed.Results Of 841 patients discharged from ICU,443 had evidence of infections and received antimicrobial therapy on the admission day,and only 30 (6.8％) of them had microbiological detection results prior to treatment.There were microbial specimens available at infection sites on the admission day in 369 cases,and 360 cases (97.6％) of them were sampled in the first three days after ICU admission,while only 119 cases (33.1％) were sampled before the first dose of antimicrobial therapy.Specimens sampled were sputum (56.4％) in the majority,followed by the blood (17.4％).Further analysis of 269 infected patients receiving initial broad-spectrum antimicrobial therapy also showed that only 33.5％ cases were sampled before the first dose of broad-spectrum antimicrobial administration.The positive isolation rate of multi-drug resistant isolates including A.baumannii,S.maltophilia and B.cepacia from specimens sampled after first dose of initial broad-spectrum antimicrobial therapy were significantly higher than those sampled before antimicrobial therapy,P ＜ 0.05.There was no significant difference in isolation rate of Staph.aureus and Enterobacteriaceae between samples obtained before and after first dose of initial broad-spectrum antimicrobial therapy.Conclusions Few evidence of pathogenic microorganisms was available before initial antimicrobial therapy in ICU patients.Although sampling rate of microbial specimens is high,the most of them are sampled after the first dose of antimicrobial administration,and the patentially contaminated specimens such as sputum in predominance,obviously decrease the reliability of authentic results obtained from microorganism culture.

OBJECTIVE: To study the situation and the related factors of ADR occurred in our hospital and to provide references for rational use of drug. METHODS: A total of 246 ADR case reports collected in our hospital from Nov. 2007 to Oct. 2008 were analyzed statistically. RESULTS: Of the 246 ADR cases, 120 kinds of drugs were involved. 64.63% of ADR were induced by intravenous drip infusion; 42.28% were antimicrobial,13.01% were drugs for central nervous system, 10.57% were for circulation system, 7.32% were TCM preparation; ADR-inducing TCM injection accounted for 50.00% in TCM preparations. The main clinical manifestation represented as lesion of skin and its appendants (51.63%). 11 severe cases accounted for 4.47% and 1 new cases only 0.41%. CONCLUSION: ADR may be caused by many factors. The most attention should be paid to monitoring ADR in the clinic so as reduce or avoid occurrence of ADR.