OBJECTIVE：To study the effects of rat intestinal flora on the pharmacokinetic parameters of pyrazinamide and its active metabolite pyrazinoic acid. METHODS ：Totally 16 SD rats were randomly divided into trial group and control group ，with 8 rats in each group. Trial group was given mixed antibiotics （streptomycin sulfate+neomycin sulfate ）intragastrically to construct pseudoaseptic rat model. After modeling ，both groups were given pyrazinamide intragastrically （150 mg/kg）. Before and 0.167， 0.333，0.667，1，1.5，2，3，4，6，9 h after administration ，0.1 mL blood sample was collected from orbital venous plexus ，and 0.3 mL blood sample was collected from orbital venous plexus 12，24 h after administration. Using phenacetin as internal standard ， LC-MS/MS method was adopted to determine the plasma concentration of pyrazinamide and pyrazinoic acid. The determination was performed on Agilent ZORBAX SB-Aq column with mobile phase consisted of 0.2％ formic acid （containing 8 mmol/L ammonium acetate）-methanol（gradient elution ）at the flow rate of 1 mL/min. The column temperature was set at 30 ℃，and sample size was 10 μL. The ion source was ESI and the temperature of ion source was 500 ℃. The collision gas was nitrogen and the pressure was 10 psi. The temperature of mass transfer interface was 100 ℃. The mass spectrum monitoring mode was multi reaction monitoring ， and the collection mode was positive ion mode. The monitoring transition ion-pairs were m/z 124.0→79.0（pyrazinamide），m/z 125.1→79.1（pyrazinic acid ）and m/z 180.0→110.2（internal standard ）. The de-clustering potential and collision voltage were 55， 26 and 85 V，24，23 and 28 V，respectively. The pharmacokinetic parameters were calculated and compared by using DAS 2.1.1 software. RESULTS ：The linear ranges of pyrazinamide and pyrazinoic acid were 25-5 000 ng/mL（r＝0.997 6）and 100-12 500 ng/mL（r＝0.999 0）. The lower limits of quantification were 25 and 100 ng/mL，respectively. Intra-batch and inter-batch accuracy were 92.93％-100.50％，and RSDs of intra-batch and inter-batch precision and matrix effect tests were all lower than or equal to 8.42％（n＝6 or n＝3）. Compared with control group ，tmax of pyrazinamide in trial group was prolonged significantly （P＜0.01）； there was no statistical significance in other pharmacokinetic parameters between 2 groups（P＞0.05）. CONCLUSIONS ：The absorption of single dose pyrazinamide is delayed with the change of intestinal flora in rats.

Objective To compare internal fixation with hallow compression screws combined vascularized bone graft(observation group) with only three hallow compression screws(control group) in young patients' Garden III and IV femoral neck fractures. Methods The patients with femoral neck fracture were treated from January, 2004 to December, 2013 were retrospectively reviewed. A total of 417 displaced femoral neck fractures in young and mid-dle-aged patients were long term followed-up. One hundred and thirty-seven patients were underwent open reduction and internal fixation with 3 hallow compression screws combined with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery;280 patients were treated by closed reduction with 3 hallow com-pression screws. Results Patients had been followed-up for 5-12 years. At the last follow-up point, the Harris score of flap in observation group(93.68±5.12) were higher than that in control group(92.53±6.12), while it was no sta-tistical difference(P>0.05). It was 0.7％of nonunion incidence rate in the observation group, and incidence of avascular necrosis of femoral head was 6.6％, and incidence of femoral neck shortening was 8.8％. In the control group, inci-dence of avascular necrosis of femoral head was 14.6％, nonunion incidence rate was 4.6％, and incidence of femoral neck shortening was 22.5％. The differences between two groups was statistically significance( P<0.05). Conclusion The open reduction and internal fixation which is hallow compression screws in combination with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery is an optimal treatment for young adults with Garden III and IV femoral neck fractures.

Humans ; Torsades de Pointes

Objective To observe the effect of yin-yang acupuncture in association with respiratory reducing-reinforcing needling manipulations on the gait cycle in patients with post-stroke hemiplegia. Methods Sixty patients with ischemic stroke were randomized into a treatment group and a control group, 30 each. The control group was intervened by conventional medication, while based on which the treatment group was additionally given yin-yang acupuncture in association with respiratory reducing-reinforcing needling manipulations. The kinematic time parameters were evaluated before intervention and after 28-day treatment. Results After intervention, the stance phase of the affected side and the healthy side, ambulation cycle, swinging phase of the affected side and the healthy side, and the stance phase of both limbs in the treatment group were significantly different from that in the control group(P＜0.05). Conclusion Yin-yang acupuncture in association with respiration reducing-reinforcing needling manipulations can effectively improve the gait cycle and ambulation function of the patients with post-stroke hemiplegia.

Objective: To observe the effect of reinforcing and reducing manipulation by breathing on yin and yang meridian points for motor function of knee joints in patients with ischemic stroke. ＜br> Methods: A total of 60 ischemic stroke cases were randomly allocated into an observation group and a control group, 30 in each group. Other than basic and conventional rehabilitation therapies, cases in the observation group were treated with reinforcing and reducing manipulation on yin and yang meridians points for a period of 8 weeks; whereas cases in the control group only received the same basic and conventional rehabilitation therapy as that in the observation group. Then the knee joint energy, support moment and shaking moment were compared between the two groups before treatment, and after 4-week and 8-week treatment respectively. ＜br> Results: Before treatment, there were no between-group significant differences in knee joint energy, support moment and shaking moment (all P>0.05). After treatment, the knee joint energy, support moment and shaking moment in both groups were significantly improved (P＜0.05). After 8 weeks of treatment, the knee joint energy, support moment and shaking moment in both groups were significantly improved than that of 4-week treatment (P＜0.05). In addition, there were between-group statistical significances in comparing knee joint energy, support moment and shaking moment after 4 and 8 weeks of treatment (P＜0.05). ＜br> Conclusion: Reinforcing and reducing manipulation by breathing on yin and yang meridian points can increase the knee joint support and shaking force and moment in stroke patients and improve their walking ability.

Objective To observe the change of extension-flexion arc of ankle in hemiplegia due to ischemic stroke after yin-yang acupuncture associated with respiration needling manipulations.Method Sixty ischemic stroke patients were divided into a control group and a treatment group by random number table, 30 in each group. The control group was intervened by basic treatment, while the treatment group was by yin-yang acupuncture associated with respiration needling manipulations in addition to the basic treatment. Before intervention and 28 d after intervention, the Lokomat gait analysis system was adopted to observe the change of the extension-flexion arc of ankle respectively under motorial and stationary states.Result When heel was grounded, the flexion angle, the maximum extension-flexion arc value, and motility of ankle joint of the treatment group were statistically different from those of the control group (P＜0.05).Conclusion Yin-yang acupuncture associated with respiration needling manipulations can effectively improve the movement and the walk function of hemiplegia due to ischemic stroke.

This study was aimed to investigate the therapeutic effect of yin-yang meridian acupuncture by reinforc-ing-reducing with patient's respiration on lower limb function among post-stroke patients. A total of 100 stroke pa-tients were enrolled and randomly divided into two groups, which were the control group and the treatment group, with 50 cases in each group. Basic treatment was given in the control group with no related rehabilitation treatment. Basic treatment was given in the treatment group combined with yin-yang meridian acupuncture by reinforcing-re-ducing with patient's respiration. All patients were assessed with kinematics time parameters at the beginning of the treatment and 28 days after the treatment on muscle strength, muscular tension and the change of joint movement of hip joint and knee joint among patients. The results showed that compared with the control group, there was significant difference in treatment group on muscle strength, muscular tension and the change of joint movement of the hip joint and knee joint 28 days after the treatment (P < 0.01). It was concluded that yin-yang meridian acupuncture by reinforcing-reducing with patient's respiration can effectively increase the muscle strength, reduce muscular tension, and improve the change of joint movement, in order to increase the lower limb movement func-tion among stroke patients.

Objective To investigate the mRNA expression of β‐catenin and PTEN in hepatocellular carcinoma exposed to hepa‐titis B virus(HBV) and aflatoxin B1(AFB1) .Methods 108 HCCs came from different districts of Guangxi province were labeled as four categories based on their biomarkers of HBV and AFB1 exposure .Group A :HBV(+ )/AFB1(+ ) ,48 cases ,group B :HBV (+ )/AFB1(-) ,27 cases ,group C :HBV(-)/AFB1(+ ) ,19 cases ,group D :HBV(-)/AFB1(-) ,14 cases .And normal hepatic tissue from 20 cases of hepatic hemangioma ,liver resection and liver transplant donor were chosen as normal control group .And the mRNA expression of β‐catenin and PTEN were detected by RT‐PCR .Results The mean expression level of β‐catenin gene mRNA in group A ,B ,C ,D and control group were(1 .13 ± 0 .14) ,(1 .06 ± 0 .12) ,(1 .16 ± 0 .18) ,(1 .01 ± 0 .13) and(0 .085 ± 0 .13) respec‐tively .There were significant differences between group A and C ,A and D .And there were significant differences between these four groups and control group(all P<0 .05) .The mean expression level of PTEN gene mRNA in four subgroup A ,B ,C ,D and con‐trol group were(0 .54 ± 0 .13) ,(0 .59 ± 0 .16) ,(0 .97 ± 0 .16) ,(0 .92 ± 0 .13) and(1 .10 ± 0 .16) respectively .There were significant differences between group A and D ,C and D .And there were significant differences between group A and C (P=0 .002) ,A and D(P=0 .032) ,B and C(P<0 .001) and B and D(P=0 .011) .And there were significant differences between subgroup A ,B and D and control group(all P<0 .05) .Conclusion The over expression β‐catenin of HCC cases may be associated with the exposure to AFB1 while the loss of gene PTEN may relate to the exposure to HBV .

Objective To explore the change of Brain natriuretic peptide(BNP) and endothelin-1 (ET-1) levels in artial septal defect(ASD) patients and the relationship among BNP,ET-1 and pulmonary pressure.Methods 105 final diagnosed ASD patients were divide into non-pulmonary hypertension group (nPH group) and pulmonary hypertension group(PH group),and the PH group were divided into two subgroup:slight PH group,moderate and sever PH group.According to the altitude of habitation,105 ASD patients also were divided into 3 groups:＜ 2 500 m group,2 501-3 500 m group and ＞ 3 500 m group.Plasma BNP were measured by radioimmunity method and ET-1 were measured by ELISA.The data analysis used single factor analysis and Fisher least singnificant difference t test.Results Both the plasma BNP levels (152.34 ± 40.61) pg/ml and ET-1 level (137.69 ± 37.17) pg/ml of the ASD-PH group were significantly higher than those [BNP (126.70 ± 32.27) pg/ml,ET-1 (92.92 ± 32.3) pg/ml] of ASD-nPH group.There were strong difference in plasma BNP levels and ET-1 levels among different degree PH groups(F =6.782,P ＜ 0.05 ; F =8.475,P ＜ 0.05).Statistical difference were also shown in BNP(F =6.846,P ＜ 0.05) and ET-1 (F =9.327,P ＜ 0.05) levels by compared difference altitude groups.The BNP levels are positively correlated with mean pulmonary artery pressure (r =0.326,P ＜ 0.05),size of defect (r=0.301,P＜0.05) and the altitude of habitation (r =0.252,P＜0.05).Conclusion Plasma BNPand ET-1 levelsof ASD-PH group significantly higher than those of ASD-nPH group.By the increasing of the altitude and PH degree,the plasma BNP and ET-1 levels are increasing,which suggest that BNP and ET-1 play an important role on the proceeding and development of the PH and hypoxia promoted secretion of BNP and ET-1.

Objective To investigate the choice of methods and time on the treatment of Gustilo type Ⅲ B and type ⅢC open tibia fractures by bone fixation and tissue flap repairing.Methods The clinic data of 136 cases of Gustilo Ⅲ B and Ⅲ C open tibia fractures were retrospectively studied.There were 102 males and 34 females,with average age of 34 years(range 14 to 68 years).Ninety-eight cases were classified as Gustilo type Ⅲ B and 38 cases were type Ⅲ C in degree.In all cases,one hundred and thirteen were treated with onestage external fixation,ninteen cases were treated with secondary bone fixation.Sixty-seven cases of all wounds were repaired by one-stage vascular pedicle skin flap.Seven wounds were repaired by one-stage free flaps with vascular anastomosis.Sixty-two cases were secondary repaired by different flaps after defect tissue under VSD (vacuum-sealing-drainage) treatment by 1 to several weeks,which contains 9 free skin graft,eleven muscle flaps based on posterior tibial artery perforator,thirteen flaps based on fibial artery perforator,fourteen gastrocnemius falps and 15 cross-leg flaps.Results Wound of all cases were healed wholly.Primary union occurred in 121 cases,twelve,cases healed after bone grafting for segmental bone defect.Three cases with delayed union healed after reoperation for infection that caused osteomyelitis and sinus tract.The period of bone healing was form 5 to 12 months.Conclusion The treatment of Gustilo Ⅲ B and Ⅲ C open tibia fractures by onestage or secondary bone fixation and tissue flap repairing get their advantages and disadvantages,but one-stage bone fixation and tissue flap repairing was better where appropriate.