Objective: To establish the method for determination of taurocholic acid in the Traditional Chinese Medicine Shedanchuanbei Oral Liquid and snake bile. Methods: The sample was prepared as mixed solution containing methanol and KH 2PO 4. The mixed solution was injected into Sep Pak C 18 cartridge for the purpose of sample purity. In this processing, the substances which having strong retain action and could harm analytic column were hold in the Sep Pak C 18 cartridge. The eluting solution that the Sep Pak C 18 cartridge had be over loading for taurocholic acid was used as the test solution. The test solution was measured by RP HPLC. The chromatographic conditions were as followed: Supelcosil LC 8 column(150mm?4.6nm,5?m) as analytic column, detect wavelength at 203nm, and MeOH 0.4%KH 2PO 4 mixed solution(56∶44, V/V ) as mobile phase. The inject volume was 50?L. Results: The linear response range of sodium taurocholate was from 0.0253mg?mL -1 to 0.253mg?mL -1 , and the correlation coefficient was 0.9999. The average recovery rate was 101.3%, RSD was 0.40%( n =6). Conclusion: This method was simple, efficient and suitable to the quality control for Shedanchuanbei Oral Liquid and snake bile.

A method for the determination of methylmercury in seafood has been developed using dispersive liquid-liquid microextraction followed by direct mercury analyzer. Total mercury was detected by direct mercury analyzer, and inorganic mercury was calculated by the difference. The parameters affecting the extraction efficiency, including the selection of extractant and dispersant, their volume ratio, concentration of HCl and NaCl have been optimized in this study. The results showed that CH2 Cl2 as extractant, ethanol as dispersant, Volume ration of 1:5, 1 mol/L HCl and 120 g/L NaCl were chosen. The detection limit and the dynamic liner range were 0. 10 μg/L and 0. 2-20 μg/L, respectively. The relative standard deviation was 6. 0% for eleven replicates at the spiked level of 2. 0 μg/L. The enrichment factor was 8. For total Hg determination, the detection limit and the dynamic liner range for methylmercury were 0. 10 μg/kg and 0. 2-50 μg/kg, respectively. The relative standard deviation was 2. 4%. The method was simple, fast and a little solvent needed. Some certified reference materials were analyzed to validate the accuracy of the proposed method, and the results were in good agreement with the reference value. Besides, the method was applied to the real samples with satisfactory results.

Objective To investigate the characteristics of postoperative complications and related risk factors in neurosurgery patients. Methods A retrospective study was carried out in neurosurgery patients during anesthesia recovery period from March, 2009 to November, 2013. The recorded complications included respiratory and circulatory system complications, pain, shivering, nausea and vomiting, agitation and delaying recovery. Multivariate logistic regression analysis was performed to screen the risk factors for these complications. Results Da-ta of 13,495 patients were available for analysis. The general incidence was 48.8%. Post-operative complications included post-operative nausea and vomiting (PONV) (14.5%), agitation (13.5%), hypertension (13.4%), arrhythmia (9.3%), shivering (8.9%), pain (5.9%), hypox-emia (2.5%), delayed recovery (1.9%), airway obstruction (1.7%) and hypotension (0.3%). Regression analysis showed that the risk factors for hypoxemia included male,<59 years old and infratentorial tumor (P<0.05);the risk factors for PONV included male, supratentorial tu-mor, infratentorial tumor, cerebrovascular disease, inhalation anesthesia, the use of muscle relaxants antagonism and tramadol (P<0.05);and the risk factors for postoperative restlessness included male, infratentorial tumor and cerebrovascular disease, inhalation anesthesia, the use of muscle relaxants antagonism and no use of patient-controlled analgesia (PCA) pump (P<0.05). Conclusion Patients with different neuro-logical diseases showed different post-operative complications and exhibited different risk factors for these complications. Anesthesiologists should closely monitor patients receiving various neurosurgery and provide timely treatment.

Objective To investigate the common complications during anesthesia recovery period after deep brain stimulation in patients with Parkinson disease. Methods The complications during anesthesia recovery period after deep brain stimulation in 869 patients with Parkinson disease were retrospectively analyzed. Results The median recovery time during anesthesia recovery period was 15 (0 - 30) min. The complications of 869 patients with Parkinson disease were hypertension in 133 cases (15.3%), arrhythmia in 99 cases (11.4%), agitation in recovery period in 76 cases (8.7%), respiratory obstruction in 24 cases (2.8%), postoperative nausea and vomiting (PONV) in 18 cases (2.1%), hypoxemia in 17 cases (2.0%), pain in 10 cases (1.2%), delayed emergence in 10 cases (1.2%), shivering in 3 cases (0.3%), and hypotension in 1 case (0.1%). The incidence of 1 complication was 26.8%(233/869), the incidence of ≥ 2 complications was 9.9% (86/869), and the total incidence of complications was 36. 7% (319/869). In the 869 patients, the modified Aldrete score ≥ 9 scores when patients were removed away from the anesthesia recovery room was in 849 cases (97.7%), and≤8 scores was in 20 cases (2.3%). Conclusions The common complications during anesthesia recovery period after deep brain stimulation in patients with Parkinson disease are special. To maintain a stable circulation, preventing respiratory complications and aspiration are important to reduce the incidence and improve the prognosis.

Objective To evaluate the value of diagnosis in fallopian tube patency by using four dimensional transvaginal hysterosalpingo-contrast sonography (4D-HyCoSy) and two-dimensional transvaginal hysterosalpingo-contrast sonography(2D-HyCoSy) with SonoVue in infertile women.Methods First,fifty seven infertile women(113 fallopian tubes) were examined by 4D-HyCoSy,then examined by 2D-HyCoSy,and the results of examination were respectively recorded.Results By 4D-HyCoSy,54 fallopian tubes were patency,42 were unobstructed but unsmooth flow,17 were obstructed.By 2D-HyCoSy,48 of them were patency,40 of them were unobstructed but unsmooth flow,25 of them were obstructed.Three fallopian tubes were obstructed by 4D-HyCoSy,but by 2D-HyCoSy they were patency.Eleven fallopian tubes were patency by 4D-HyCoSy,but obstructed by 2D-HyCoSy.Nine fallopian tubes were patency by 4D-HyCoSy,but fimbriated extremity of these fallopian tubes were far awary from homolateral overys.They were unuseful.Eighteen patients underwent laparoscopy,30 fallopian tubes (91.4％) were concordant with laparoscopy using combination of 4D-HyCoSy and 2D-HyCoSy,the sensitivity,specificity,positive predictive value and negative predictive value were 86.7 ％,90.5 ％,86.7 ％ and 90.5 ％.The concidence rate,sensitivity,specificity,positive predictive value and negative predictive value were 85.7％,84.6％,90.5％,84.6％ and 86.4％ by 4D-HyCoSy and 71.4％,64.7％,70.0％,64.7％ and 77.8％ by 2D-HyCoSy,respectively.Accuraty of combination of 4D-HyCoSy and 2D-HyCoSy was similar with laparoscopy.Five patients appeared moderate pelvic pain,three patients appeared mild pelvic pain,two patients appeared nausea and vomiting.None need resuscitation.Conclusions Combination of 4D-HyCoSy and 2D-HyCoSy can more accurately diagnose fallopian tube patency,it can judge if fallopian tube is valuable or not and reduce misdiagnosing.It is a simple,safe,accurate,efficient method for evaluating the fallopian tube patency.

Objective To investigate the metabolite features of chronic pancreatitis in rats in vitro by high resolution magic angle spinning nuclear magnetic resonance spectroscopy. Methods A total of 30 Spraque-Dawley rats were randomized into experimental group (n =20) and control group (n = 10). All the animals in experimental group were intravenously injected with 8 mg/kg body weight DBTC, and the animals in the control group received same amount of solvent. Pancreatic tissues were examined by histology and Van Gieson staining. Metabolic changes of chronic pancreatitis in vitro in rats were studied by high resolution magic angle spinning nuclear magnetic resonance spectroscopy. Results 60 days after DBTC application, the pancreatic tissue was characterized by an extended interstitial fibrosis with infiltrating mononuclear cells. Compared with the control group, the signal intensities of phosphocholine (Pc) and glycerophosphocholine (Gpc), taurine (Tau), lactate (Lac) of chronic pancreatitis group increased. Oppositely, the signal intensities of betine (Bet), glutamic acid ( Glu ), alanine (Ala), ileucine (He), leucine ( Leu ) and valine (Val) decreased. The signal intensities of acetic acid (Ace) and choline (Cho) were not changed. Conclusions There were obvious metabolic features of chronic pancreatitis in rats, and it is helpful for the application of magnetic resonance spectroscopy in chronic pancreatitis in human studies.

Objective To investigate the clinical, laboratory and genetic features of glycogen storage disease(GSD)IXc. Methods Five patients suspected as liver GSD were included in our study. DNA was extracted from peripheral blood of all the patients and diagnoses were made after target sequencing to nearly 2700 disease causing genes. All detected mutations were confirmed in the probands and their parents. Further analysis was based on clinical features, routine laboratory examinations and treatment. Results All the 5 patients manifested with severe hepatomegaly, hypoglycemia, moderately to severely elevated liver enzyme levels, hypertriglyceridemia and growth retardation. Four cases showed poor exercise tolerance but with normal creatine kinase (CK) levels. None of the patients showed liver cirrhosis. Growth velocity and hepatomegaly was improved after the uncooked corn starch treatment was initiated. In the 5 patients, 6 different pathogenic or likely pathogenic mutations in the PHKG2 gene were identified, including one reported mutation (p.E157K) and five novel mutations (p.E56X, p.R185X, c.79_88delinsTCTGGTCG, c.761delC,p.R279C). The p.E157K was the most frequently mutation identified (6/12, 50%). Conclusions The p.E157K mutation is the hot mutation in our small cohort. Main clinical features of our patients include fasting hypoglycemia, impaired liver function,short statures and poor exercise tolerance, without developing liver cirrhosis.

To discuss clinical diagnosis and treatment of cow’s milk protein allergy and cow’s milk protein-induced FPIES (food protein induced enterocolitis syndrome). Methods We retrospectively analyzed clinical data of one infant with milk protein allergy-induced FPIES. Results A 67 days old female on mixed breast and formula feeding developed recurrent diarrhea, abdominal distension, vomiting, mucousy and bloody stools, feeding dififculty, anemia, and failure to thrive since 2 weeks after birth. Laboratory studies showed anemia, increased CRP level and elevation of peripheral white blood count and eosinophil proportion. Milk-speciifc IgE was negative. She was previously hospitalized 4 times, all with admitting diagnosis of“necrotizing enterocolitis”. We treated her with milk protein elimination for 4 weeks and all symptoms were resolved. Milk protein re-challenge test was positive, consistent with clinical features of cow’s milk protein allergy-induced infant FPIES. Conclusions Cow’s milk protein allergy and cow’s milk protein-induced FPIES can present with non-speciifc and variable clinical symptoms and signs, and should be considered in the differential diagnosis.

OBJECTIVETo analyze the efficacy of percutaneous endoscopic gastrostomy (PEG) in pediatric patients.

METHODFrom October 2011 to October 2014, children in the gastrointestinal ward of Guangzhou Women and Children's Medical Center received PEG or jejunal tube PEG(JET-PEG). The success rate, operation time were recorded. The changes of their weight, enteral nutrition calories and the incidence of pneumonia before and after the first 6 months of operation were compared. Follow-up was conducted until October 2014, the recent and long term complications, the length of indwelling time, the replacement or removal of the tube were recorded, the patients swallowing function or the primary disease's outcomes were observed.

RESULTOf the 13 cases, 10 were male, 3 were female, their average age was 2 years (range 1.8 months-9 years). We performed PEG for 12 of the patients who had congenital craniofacial problems that led to feeding difficulties or recurrent cough and pneumonia (6/12), or neurological disorders (6/12) with inability to swallow, and in one case JET-PEG was performed, this child suffered from chronic intestinal pseudo-obstruction with vomiting and abdominal distension. The gastrostomy was successful in all the patients through one operation, the average operation time of PEG was (25 ± 3) minutes, JET-PEG was 60 minutes. One local skin infection was noted, no long-term complication occurred. In the first 6 months after operation, all the patients gained weight((5.5-30.5) kg postoperation vs. (3.0-30.0) kg preoperation), and 12 cases' enteral nutrition calories increased (from (209-502) to(272-543) kJ/(kg·d)), the incidence of pneumonia decreased in the children who had recurrent pneumonia before the operation (from (0-1.5) to (0-0.16) per month). Until October 2014, their average length of gastric tube indwelling time was 17.8 months (range 4-36 months). In 4 cases PEG tube was removed when they could eat completely independently, the other 9 needed enteral vein nutrition via PEG tube or jejunal tube, in 3 of them balloon type gastric fistula tube was applied. Two of the 13 cases who had cleft palate received stomatological operations when their weight grew to meet the standard.

CONCLUSIONPEG and JET-PEG are safe and effective method for enteric nutrition feeding in pediatrics, the technique causes minimal trauma and has rapid postoperative recovery, few complications, good aesthetic appearances and simple nursing, it can significantly improve their nutritional status and quality of life.

Child ; Child, Preschool ; Enteral Nutrition ; methods ; Female ; Gastrostomy ; adverse effects ; Humans ; Incidence ; Infant ; Male ; Nervous System Diseases ; therapy ; Pneumonia ; therapy

Radiation enteritis is a kind of intestinal radiation injury in patients with pelvic and retroperitoneal malignancies after radiotherapy, and its occurrence and development process are very complicated. At present, studies have confirmed that intestinal microecological imbalance is an important factor in the formation of this disease. Abdominal radiation causes changes in the composition of the flora and a decrease in its diversity, which is mainly manifested by a decrease in beneficial bacterial species such as Lactobacilli and Bifidobacteria. Intestinal dysbacteriosis aggravates radiation enteritis, weakens the function of the intestinal epithelial barrier, and promotes the expression of inflammatory factors, thereby aggravating the occurrence of enteritis. Given the role of the microbiome in radiation enteritis, we suggest that the gut microbiota may be a potential biomarker for the disease. Treatment methods such as probiotics, antibiotics, and fecal microbiota transplantation are ways to correct the microbiota and may be an effective way to prevent and treat radiation enteritis. Based on a review of the relevant literature, this paper reviews the mechanism and treatment of intestinal microbes in radiation enteritis.