OBJECTIVE:To establish a HPLC method for simultaneous determination of chlorogenic acid and cefazolin in rat plasma.METHODS: Chromatographic determination was performed on spherisorb C18 column with methyl alcohol- 0. 1mol/L potassium ethydrogen phosphate(30: 70v/v, pH 3.0)as the mobile phase and a flow rate of 1.2ml/min.Detection wavelengthes were UV 275nm for chlorogenic acid and 326nm for cefazolin.The concentrations of chlorogenic acid and cefazolin in rat plasma were detected.RESULTS: The calibration curves were linear with the correlation coefficients of 0.997 and 0.998, repectively.The RSDs for the between- day and within- day were both lower than 4% for chlorogenic acid and 6% for cefazolin, respective.The mean recoveries were 93.30%, 93.35% and 96.40% for chlorogenic acid, and 93.41%, 96.60% and 92.36% for cefazolin at large, middle and low dosages, respectively.The concentrations of cefazolin in rat plasma were decreased in coadministration with chlorogenic acid.CONCLUSION: The study provides a simple method for simultaneous determination of the plasma levels of chlorogenic acid and cefazolin.

ObjectiveTo identify the differential expressed proteins,and to investigate the relationship between altered expression of annexin A4 during window of implantation [ WOI ( at day-6 after ovulatory day )] in infertile patients with endometriosis and endometrial receptivity.MethodsTwo-dimensional fluorescence differential in-gel electrophoresis (2D-DIGE) and matrix-assist laser desorption ionization-time of flight-mass spectrometry (MALDI-TOF-MS) were used to detect protein expression in endometrial WOI in 10 infertile cases with endometriosis as endometriosis group and 10 infertile cases with tubal factors as control group.The semi-quantitative validation of annexin A4 in the eutopic endometrial tissue during WOI was analyzed by western blot.Results By comparing protein profiles,there were 7 meaningful differential proteins during WOI in infertile patients with endometriosis.One protein with an isoelectric point of 5.84 and relative molecular weight of 36 100 were down regulated 348％ in samples of endometriosis group.It was identified as annexin A4 by mass spectrometry.By western blot,relative intensity of annexin A4 in endometriosis group was 7.2 ±0.9,which was lower than 17.8 ± 2.6 in control group significantly (t =7.654,P =0.002 ).ConclusionLower expresssion of annexin A4 during WOI in infertile patients with endometriosis might be associated with the decrease of endometrial receptivity.

Objective To investigate whether there is exists optimal effective connections of prefrontal-amygdala in patients with major depressive disorder when they recognize dynamic positive face expressions with the technology of magnetoencephalograph (MEG),and discuss the possible aberrant mechanism of emotion processing.Methods Twenty major depressive patients and 20 well-matched healthy volunteer controls participated in the experiment.The regions of interested brain area included the primary visual cortex (V1),the precuneus (PQ),the dorsolateral prefrontal cortex (DLPFC),the anterior cingulate cortex (ACC),the amygdala (AMYG).After constructing three putative models,dynamic causal model was used to select an optimal model,then extracted all the effective connection parameters and conducted t-test under the overall optimal model between-group comparison.Results The bayesian model selection (BMS) indicated that model with top-down modulate connections between DLPFC-ACC,DLPFC-AMYG and ACC-AMYG was the most superior model,whose exceedance probability was 0.41.In the fight hemisphere of patient group,the endogenous connectivity from AMYG to ACC significantly decreased compared to healthy controls (t=-2.21,P=0.033),while the endogenous connectivity from ACC to DLPFC was enhanced significandy (t=2.50,P=0.017),which was the same with the endogenous connectivity from AMYG to DLPFC (t=2.10,P=0.040).Conclusion The effective connections of prefrontal-amygdala in major depressive disorder are exactly impaired,which may indicate that major depressive disorder have a bias toward negative.While depressed patients don' t show abnormality in the modulate connectivity under happy stimulus.

Objective:To explore clinical application value of immediate breast reconstruction with silicone prosthesis after nipple areolar sparing mastectomy for breast cancer.Methods:The clinical data of 30 breast cancer patients underwent immediate breast reconstruction with the silicone prosthesis after nipple areolar sparing mastectomy from January 2016 to January 2018 were collected. In the observation group, 15 patients underwent immediate breast reconstruction with the silicone prosthesis after nipple areolar sparing mastectomy. In the control group, 15 patients underwent conventional modified radical mastectomy only. The differences of operation indicator and postoperative complications between the two groups were compared, and the postoperative cosmetic effects were evaluated.Results:The patients successfully completed prosthetic breast reconstruction in the observation group. The surgical time and indwelling time of the drainage tube in the observation group were both increased compared with the control group, and the difference was statistically significant ( t=118.8 and t=23.9, P<0.05). There were no statistically significant differences between the two groups in the complications of postoperative flap necrosis, subcutaneous hematoma, intraoperative infection and incision dehiscence ( P>0.05). The total complications rate of the observation group was 40%, compared with the control group (20%), there were not statistically significant differences ( P>0.05). The postoperative aesthetic effect evaluation showed that the reconstructed breast was full in shape and basically symmetrical to the contralateral side, with an excellent and good rate of 83.3%. The patients were satisfied with the appearance of the breast. All patients were followed up for 12 to 36 months with the average time of 24 months, and local recurrence and distant metastasis were not observed. Conclusions:In the modified radical mastectomy for breast cancer with preserved nipple and areola, the immediate application of silicone prosthesis for breast reconstruction has the advantages of less trauma, faster postoperative recovery and better cosmetic effect, which is worthy of clinical application.

Objective:To evaluate the effect of tutorial system for medical undergraduates in a non-affiliated hospital of a medical university in Jiangsu.Methods:32 senior medical undergraduates in non-affiliated hospitals were divided into two groups. The experimental group adopted tutor-guided teaching, and the control group adopted traditional teaching. Professional theoretical knowledge, clinical ability, operational ability, foreign language level, basic research ability and participation of scientific research activities of students in the two groups were evaluated. SPSS 19.0 was used for t test, chi-square test and U test. Results:The results of operational ability ( t=3.537, P=0.000), the number of papers that had been read ( t=6.961, P=0.000), quality of these ( U=68.000, P=0.017), the number of literature reviews that had been written and reading notes ( χ2=4.747, P=0.000), participation in scientific research activities ( t=6.788, P=0.009) of students in the experimental group were better and higher than those in the control group. In the same period, there was no significant difference between the two groups in the scores of theoretical exam, clinical competence and foreign language tests. Conclusion:The implementation of tutorial system for medical students in non-affiliated hospitals is an effective measure to improve the quality of training. We should make full use of the short intership, to improve the comprehensive quality of students by establishing perfect rules, regulations and teaching evaluation system, and educate students in accordance with their own ability.

Objective:To explore the clinical application of lateral thoracic artery perforator flap in repairing local defect after breast conserving surgery.Methods:The clinical data of 48 breast cancer patients planned to finish breast conserving surgery were retrospectively analyzed. The patients were divided into plastic breast-conserving group and routine breast conserving group. In the plastic breast-conserving group, 24 patients local defect repaired with the lateral thoracic artery perforator flap. In the routine breast conserving group, 24 patients local defect repaired with the fascial flap around the cutting edge. The operation related indexes and cosmetic effect from two groups were compared.Results:Both groups of patients successfully completed breast conserving surgery. The plastic breast-conserving group patients had significantly increased in operation time, operative blood loss, incision length and drainage tube indwelling time compared with the routine breast conserving group; the differences were statistically significant ( t=6.99, 9.37, 21.74, 8.80, P<0.05). The rate of secondary surgery enlarged was lower than fhat in the routine breast conserving group, and the difference was statistically significant (χ 2=4.76, P<0.05). There were 3 cases in the plastic breast conserving group and 1 case in the conventional breast conserving group. The skin at the edge of the flap was ischemic necrosis in the 4 cases, which healed after dressing change and drainage, and there was no significant difference ( P>0.05). The evaluation of postoperative cosmetic effect showed that the excellent and good rate of the observation group was 91.7%, compared with the routine breast conserving group (58.3%); the difference was statistically significant (χ 2=7.11, P<0.05). All patients were followed up for average 24 months, and local recurrence and distant metastasis were not observed. Conclusions:The lateral thoracic artery perforator flap for filling local defects in the lateral quadrant or central region of breast cancer is feasible, easy to operate, hides incision scar, better cosmetic effect and worthy of clinical promotion.