OBJECTIVE:To establish a method for simultaneous determination of the contents of three components in synthesis and actual satongfeng injection.METHODS:A flexible tolerance simplex method was used for multi-wavelength spectrophotometry with interval of 1nm in 258～290nm wavelenth,33 wavelenths were selected.RESULTS:The linear range and average recoveries rate of sodium salicylate,phenazone and caffeine were 0～42,0～12,0～6?g?mL-1 and(99.93?0.22)%,(99.85?0.24)% and(100.19?0.40)% respectively.All were agreed with those by standard method.CONCLUSIONS:This method is easy in operation,fast and reproducible,applicable to automatic analysis,and therefore can be used for the quality control of the preparation.

Objective To survey village doctors'knowledge,demand and behavior of health management,to provide scientific evidence for village people's health self-management.Methods Prepared a self-designed question-naire and make it completed by 106 village doctors chosen at random from 106 different villages in the eight towns in Guangzhou's two mountainous districts.Results The average age of the village doctors was(50.9 1 ±7.84)years, 36.79% of them had the ultimate diploma of a health technical school,and the average knowledge rate of health man-agement was 30.09%.There was remarkable difference among the 3 age groups which disclosed statistic value(χ2 =112.900,P =0.000).The 35-44 age group was the highest in the knowledge rate of health management (52.61%). The doctors with a ultimate technical diploma vary in the knowledge rate (the highest was 47.44%),which also had statistic value(χ2 =112.900,P =0.000).Only 2.83% of the village doctors believed that their health management skill can completely meetthe current demand and 3.77% can.18.87% believed that training about health management was very meaningfuland 25.47% meaningful.63.21% (most required by the health bureau) expected to receive training.16.98% didn't receive such training in the recent year because they thought it was un-necessary or not available.11.32% of the village doctors were willing to pay for the health management training,while 97.17% had never taken such training on their own expenses.Conclusion Village doctors are mostly elderly,low-educated,and insufficient in the professional knowledge of health management.Without the corresponding motivations and regulations,they are not enthusiastic about the training.It is suggested that the local authorities pay more attention to the buildup of the village health stations and improve the structure,knowledge,and earning of the village doctor group so as to ensure the effective health management service for the masses in villages.

Objectives To investigate preparation of gemcitabine albumin nanoparticles, and its property of slow-release, the cytotoxic effect on pancreatic cancer cells (PANC1) in vitro, for improving the effect of regional intra-arterial infusion chemotherapy in pancreatic cancer with new medicament in the future. Methods The gemcitabine albumin nanoparticles were prepared with bovine serum albumin and gemcitabine with the desolvation-crosslink method, the concentration of gemcitabine was detected by high performance liquid chromatography (HPLC). The cytotoxic effect on pancreatic cancer cells in vitro were detected with MTT colorimetric assay. Results The mean diameter of gemcitabine albumin nanoparticles was (156.2±2.2) nm, and Zeta potential was (-20.4±1.41)mV, drug loading was 10.8%, drug release time in virto was 3 hours respectively. Gemcitabine albumin nanoparticles (0.01～50 μg/ml) had a 31%～44% inhibitory rate on PANC1 cell, which was similar to the inhibitory rate of same concentration of gemcitabine (26%～47%). Conclusions The new preparation of gemcitabine albumin nanoparticles had obvious drug slow-release effect, which may help improve the effect of regional intra-arterial infusion chemotherapy for pancreatic cancer.

OBJECTIVE To investigate the genetic abnormalities of FHIT gene in nasal and paranasal sinus carcinoma, and to explore its relationship between genetic abnormalities of FHIT gene and etiology of nasal and paranasal sinus carcinoma(NPSC). METHODS The clinical data of 48 patients with NPSC treated with radical operations from 1991 to 2000 were studied retrospectively. Patients included 23 female and 25 male ranging in age from 20 to 71 years. Immunohistochemistry with SP method was used to assess the expression of FHIT in the carcinoma specimens of the patients. Microdissection and denaturating high-performance liquid chromatography (DHPLC) were used to analyze the loss of hereteozygosity (LOH) of DS1234 in exon 8 of FHIT gene. RESULTS The loss of expression of FHIT was found in 5 patients(10.4 %, 5/48). Comparing with adjacent non-neoplastic tissue, reduced expression of HFIT was found in 16 (55.17 %, 16/29) patients. The adenoid cystic carcinoma showed stronger expression of FHIT than squamous cell carcinoma(P

Objective To observe the acute toxicity of local achyranthes aspera, and its injury to major internal organs. Methods Estimated the dose before the experiment, then selected 40 mice and divided them into five groups randomly, namely 4 dose-groups and one control group. The doses used in the dose-groups were 400 g/kg, 300 g/kg, 225 g/kg and 169 g/kg respectively. Observed the symptoms and the death for successive 7 days and calculated LD (50)with statistic methods. Dissected the dead mice and observed the lesion of organs. Results The LD50 of acute toxicity test of achyranthes aspera was 309.21 g/kg, Sx=0.0359 g/kg. 95% of the limit of trust was 309.14～309.28 g/kg. According to the acute toxic standard, it belonged to non-toxicity. The specimen revealed that large dose administration caused coagulation of blood in both liver and spleen. Conclusion Local achyranthes aspera had little toxicity. Large dose administration affected heart function of mice.

Objective:To analyze the effectiveness and annual cost-effectiveness of extracorporeal cardiopulmonary resuscitation, ECPR) in adults.Methods:Totally 60 patients received ECPR from April 2015 to March 2020 in Emergency Medicine Department of the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. The patients were grouped by discharge survival/hospital death and shockable/unshockable initial rhythm. Age, gender, initial rhythm, survival rate, ECMO treatment time, time-to-death, length of stay and hospitalization costs were analyzed. All discharged survivors were followed up for 1 year, then cost-effectiveness analysis was performed using total cost of ECPR as the cost and 1-year survival rate as the effect.Results:Fifty-four adult patients with ECPR were enrolled, and 17 (31.5%) patients survived and discharged, of whom 15 (88.2%) patients had good neurological outcomes and survived at 1-year follow-up. The median ECMO time was 5 ( IQR 1-8) d, time-to-death was 4 ( IQR 1-9) d, length of stay was 10 ( IQR 3-18) d, total hospitalization cost was 209 122 ( IQR 121 431-303 822) RMB, and the daily cost was 23 587 ( IQR 13 439-38 217) RMB. The rate of shockable initial rhythm was significantly higher in the discharge survival group than the hospital death group. The survival rate of ECPR patients with shockable initial rhythm was significantly higher than that of patients with unshockable initial rhythm, and there was no difference in cost. Conclusions:ECPR is a resource-intensive treatment with a total cost of about 200 000 RMB. Moreover, the effectiveness and annual cost-effectiveness are superior for patients with shockable initial rhythm.

Objective: To analyze the causes of preoperative miscarriage of pancreatic serous cystadenoma (SCN) and find the ways to improve it. Methods: Clinical data of 425 pancreatic cystic neoplasm patients who underwent surgical resection from January 2006 to December 2016 in Department of Pancreatic Surgery in Huashan Hospital were retrospectively analyzed.Excel database was created which covered 128 fields of 7 fields: general information of patients, preoperative blood biochemical indexes, tumor markers, surgical related data, postoperative complications, imaging findings and pathology.One hundred and sixty-one cases of SCN were analyzed in depth, mainly in three aspects: surgical benefit, preoperative imaging diagnostic value and interference factors in preoperative judgement.The classification data were analyzed by χ² test and the quantitative data were analyzed by t test.The Logistic regression model was used for multiple factor analysis. Results: Of the 425 PCN cases surgically removed, 161 cases (37.9%) were SCN, the incidence of operative complications was 40.4%(65/161), the hospitalization days was (20.7±12.1)days and the medical cost was (75 267±37 866) yuan.Only 3 of 161 cases of SCN were accurately diagnosed by preoperative imaging methods, 61 cases were diagnosed as "cystic lesions of pancreas" (37.9%) and 52 cases were diagnosed as "pancreatic cystadenoma" (32.3%). SCN was misdiagnosed as MCN(32.3%) and IPMN(28%) before operation.25.5% of them were diagnosed as SCN before operation, but still underwent radical operation.The rate of preoperative imaging diagnosis for identifying SCN was 62.8%.The lack of preoperative endoscopy and the lack of understanding of the image characteristics and biological behavior of SCN were the most important factors affecting the accuracy of preoperative judgment.Statistics found that gender, age, CA125 and tumor location can be used as independent factors contribute to the clinical identification(χ²=8.995, P=0.003; χ²=10.019, P=0.007; t=3.157, P=0.002; χ²=6.790, P=0.009). Logistic analysis showed that women, older than 60 years old, the tumors located in the pancreatic body and tail were the independent factors of SCN classification and diagnosis (OR=0.481, 0.376, 0.577, 0.666, 95% CI: 0.305-0.759, 0.199-0.710, 0.361-0.924, 0.433-1.024, P=0.002, 0.003, 0.022, 0.064). Conclusions SCN has more benign biological behavior.Although surgical excision is acceptable for clinical safety, the corresponding benefit is very limited.It is possible to improve the rationality of SCN clinical operation decisions to some extent by performing endoscopic examination, imaging doctors to improve the SCN feature recognition and surgeons to enhance the awareness of SCN.

Objective:To investigate the prognostic value of early lactate in patients with extracorporeal cardiopulmonary resuscitation (ECPR).Methods:A retrospective analysis was performed on the clinical data of patients with ECPR in the Emergency Medicine Department of The First Affiliated Hospital of Nanjing Medical University from March 2015 to August 2021. The age, sex, etiology, initial rhythm, prognosis, blood lactate and pH of patients with ECPR were collected, and their difference between the deceased and survived patients was compared.Results:Totally 95 patients were enrolled, with an average age of 47 years; male accounted for 69.5%, and the survival rate was 29.5%. There was no significant difference in age and sex ratio between the deceased and survived patients. However, the deceased patients had a significant lower rate of shockable rhythms (31.3% vs. 60.8%), a higher level of lactate [16.4 (11.2, 19.1) vs. 9.2 (3.2, 15.0), mmol/L], and a lower pH [7.01 (6.88, 7.23) vs. 7.37 (7.10, 7.43)] than the survived patients. Multivariate binary logistic regression analysis showed that shockable rhythm [odds ratio ( OR) = 0.295, 95% confidence interval ( CI): 0.118-0.739), lactate ( OR=1.159, 95% CI: 1.068-1.258) and pH ( OR= 0.017, 95% CI: 0.002-0.157) were independent risk factors for poor prognosis. Furthermore, a lactate level >24 mmol/L was the best threshold to predict mortality with a specificity of 100%. Combined application, the cutoff point was lactate level>16 mmol/L and pH <6.828. Conclusions:Shockable rhythm, higher early lactate and lower pH value are independent risk factors for prognosis in patients with ECPR. Early lactate > 24 mmol/L or lactate > 16 mmol/L companied with pH < 6.828 are novel indicators of the termination of ECPR.

Objective:To investigate the predictive value of platelet dynamics on the prognosis of 28-day in patients with extracorporeal membrane oxygenation (ECMO).Methods:From January 2017 to December 2020, 60 patients from the Emergency Medicine Center of the First Affiliated Hospital of Nanjing Medical University received ECMO for life support. The baseline data of the patients were collected, the minimum value of platelets on day 1-7 of the machine was calculated, and the platelet change value and change rate were calculated. The patients were divided into the survival group and death group according to the 28-day survival status after ECMO was installed, and the receiver operating curve (ROC) was drawn based on the platelet change value and change rate to evaluate its predictive value for prognosis.Results:Among patients receiving VV-ECMO, the platelet change value and change rate on day 7 had the best prediction effect on the patient's 28-day outcome ( AUCΔPLT7=0.772, P=0.016; AUCΔPLT7%=0.764, P=0.020), when the platelet change value was 4×10 9/L as the critical value, the sensitivity was 0.857, the specificity was 0.615, and when the platelet change rate was -28.99% as the critical value, the sensitivity was 0.857, the specificity was 0.615, and when the platelet change rate was -28.99%. The sensitivity was 0.643 with a specificity of 0.846. In patients receiving VA-ECMO, the platelet change rate on day 6 predicted the best effect on the patient's 28-day outcome ( AUCΔPLT6%= 0.707, P = 0.045). When the platelet change rate was -26.19% as the critical value, the sensitivity was 0.842 and the specificity was 0.643. Conclusions:Platelet dynamic changes of platelets are correlated with the 28-day prognosis of patients receiving ECMO, and the combination of platelet change value and the critical value of change rate can better predict the poor prognosis of patients in both ECMO modes.

Objective:To summarize the experience and effect of extracorporeal cardiopulmonary resuscitation (ECPR) in the treatment of out-of-hospital cardiac arrest (OHCA) in adults.Methods:The data of 40 adults with OHCA-ECPR in Emergency Department of the First Affiliated Hospital of Nanjing Medical University from April 2015 to April 2022 were retrospectively analyzed. The patients were grouped by discharge survival/in-hospital death, with/without bystander resuscitation, and with/without interhospital transport. Age, sex, Charlson comorbidity index, initial rhythm, no-flow time, time from cardiac arrest to extracorporeal membrane oxygenation (ECMO) initiation (CA-Pump On time), ECMO evacuation success rate, survival rate, ECMO treatment time, time-to-death, and length of hospital stay were analyzed.Results:①Among the 40 patients with OHCA-ECPR, 9 patients (22.5%) survived upon discharge, 7 (77.8%) of whom had good neurological outcomes.②The no-flow time in the survival group was significantly shorter than that in the death group, and the proportion of shockable initial rhythm was higher.③Bystander resuscitation greatly shortened the no-flow time.④The regional OHCA-ECPR interhospital transport extended the CA-Pump On time, without affecting patients’ prognosis.Conclusions:ECPR improves the prognosis of patients with OHCA. Bystander resuscitation greatly shortens the no-flow time. ECPR is significantly effective in patients with short no-flow time and shockable initial rhythm. Regional interhospital transport ECPR is recommended to benefit more patients with OHCA.