ABSTRACT
The unpredictable and unfavorable connection of dose and plasma concentration of valproic acis supports the nescessity to regularly measure its plasma concentration. The present study is drug monitoring of valproic acid and comparative evaluation of therapeutic monitoring results of valproic acid for assessment of clinical response, safety and toxicity in different age and gender groups of Chinese epileptic patients. This knowledge will help the clinicians in adjusting the drug dosages of valproic acid in various sub-groups of epileptic patients for enhancing the safety and minimizing the toxicity of valproic acid. A total of 206 plasma samples [126 males and 80 females] of epileptic patients using valproic acid were requested for therapeutic drug monitoring by neurology department of Qilu Hospital. It was found that 29% of the total samples were found in sub-therapeutic levels. 13% of the samples had toxic levels and 58% of all samples had valproic acid levels in therapeutic range. The difference in plasma concentration of valproiv acid is notably altered in gender and various age groups. However, this requires further investigation. Despite the majority of samples in the therapeutic range, there was an unfavorable clinical response. The outcomes of the current research work exposed that there was a poor correlation between the plasma concentration and clinical response. Careful attention must be applied to specific gender and particular age group on an individual basis in the interpretation of plasma concentration results, in order to facilitate the modification of doses and develop the best approach in treatment and to obtain the desired clinical response because multiple factors can effect the valproic acid plasma concentration. Through these results, it can be concluded that poor correlation exists between valproic acid plasma concentration and clinical response
ABSTRACT
The aim of this study is to establish an HPLC method for simultaneous determinations of mifepristone and its metabolites, mono-demethylated mifepristone, di-demethylated mifepristone and C-hydroxylated mifepristone in plasma and to evaluate the pharmacokinetic characteristics of mifepristone tablet. Twenty healthy female Chinese subjects were recruited and a series of blood samples were collected before and after 0.25, 0.5, 1.0, 1.5, 2.0, 4.0, 8.0, 12.0, 24.0, 48.0, 72.0 and 96.0 hours administration by a single oral dose of 75 mg mifepristone tablet. Mifepristone and its three metabolites were extracted from plasma using ethyl acetate and determined by high performance liquid chromatography. The main pharmacokinetic parameters of mifepristone and its metabolites, including Cmax, tmax, MRT, t(1/2), V, CL, AUC(0-96 h) and AUC(0-infinity), were calculated by Drug and Statistical Software Version 2.0. The simple, accurate and stable method allows the sensitive determinations ofmifepristone and its metabolites in human plasma up to 4 days after oral administration of 75 mg mifepristone tablet and the clinical applications of their pharmacokinetic studies.
ABSTRACT
Objective To compare surgical outcomes between laparoscopic high ligation and conventional procedure in the treatment of inguinal hernia.Methods High ligation of the hernial sac was performed in 94 patients with indirect inguinal hernia and communicating hydrocele between July 2002 and December 2004.Forty-four patients were treated laparoscopically by using a self-made hooked sledge-shaped needle(Laparoscopic Group),whereas conventional open procedure was conducted in 50 patients(Conventional Group).Results As compared with the Conventional Group,the Laparoscopic Group presented shorter operating time(18?5 min vs 27?8 min,t=-6.436,P=0.000),less postoperative analgesic requirement(5 patients vs 14 patient,?2 =4.017,P=0.045),shorter hospitalization length(3.2?1.2 d vs 7.3?1.9 d,t=-12.311,P=0.000),and higher total expenditure(2965.5?516.7 yuan vs 2389.7?372.3 yuan,t=-6.251,P=0.000).Conclusions Compared to conventional procedure,laparoscopic high ligation of hernial sac has advantages of minimal invasion,less pain,quicker recovery,shorter hospitalization,and better cosmetic results.It is an ideal procedure for treating pediatric indirect inguinal hernia and communicating hydrocele.