Objective:To establish an HPLC method for the simultaneous determination of six active constituents ( ferulic acid, chlorogenic acid,ephedrine hydrochloride,protocatechuic acid,protocatechualdehyde and naringin) in Jizhi syrups. Methods:A Zorbax XDB-C18(4.6 mm×250 mm,5 μm)column was used. The mobile phase consisted of acetonitrile (A)-0.9% acetic acid (B) with gradient elution at the flow rate of 1. 0 ml·min-1 . The detection wavelength was changed as follows:257 nm for 0-22. 0 min, 326 nm for 22. 0-30. 0 min, 320 nm for 30. 0-52. 0 min, 210 nm for 52. 0-58. 0 min and 283 nm for 58. 0-60. 0 min. The column temperature was 30 ℃ and the injection volume was 10 μl. Results:The separation of the six active constituents was good. The linear range ( r>0. 9990) was 2. 817-112. 670, 2. 342-93. 670, 0. 710-28. 415, 0. 776-31. 035, 0. 694-27. 755 and 1. 279-51. 175 ng for ferulic acid, chlorogenic acid, ephedrine hydrochloride, protocatechuic acid, protocatechualdehyde and naringin, respectively. The average recover-ies varied from 99.3% to 99.8%(RSD varied from 0.18% to 0.28%). Conclusion: The method is rapid with high sensitivity, promising accuracy and good specificity, which can provide scientific basis for the quality control of Jizhi syrups.

Objective To investigate the efficacy of pancreaticoduodenectomy (PD) combined with vascular resection and reconstruction.Methods The clinical data of 56 patients who received PD combined with vascular resection and reconstruction at the Southwest Hospital of Third Military Medical University from January 2007 to May 2011 were retrospectively analyzed.The incidence of perioperative complications,mortality and postoperative conditions were also analyzed.Results The mean operation time and intraoperative blood transfusion were 473 minutes (range,234-853 minutes) and 781 ml (range,0-900 ml),respectively.Seven patients did not receive blood transfusion.The median period of hospital stay was 25.9 days (range,17-100 days).A total of 43 patients underwent PD combined with vascular reconstruction.The incidence of perioperative complications and mortality rate were 34％ (19/56) and 7％ (4/56),respectively.There were 42 patients with pancreatic ductal adenocarcinoma,5 with ampullary carcinoma,3 with distal bile duct carcinoma,4 with papillary carcinoma of duodenum,1 with pancreatic neuroendocrine carcinoma and 1 with pancreatic serous cystadenoma.All patients were followed up till August 2011,and the 1-year survival rate was 57％ (32/56).The mean survival time was 13.5 months.The weight of 32 surviving patients increased and no abdominal pain occurred.Within 3 months after the operation,5 patients had slight diarrhea and were administered antidiarrheal; thrombosis in the artificial blood vessels and peritoneal effusion were found in 1 patient,while 6 months later,collateral circulation was formed and the peritoneal effusion was diminished.Conclusion PD combined with vascular resection and reconstruction can improve the quality of life for patients with pancreatic cancer and with blood vessels involvement.

Objective We are going to establish a robust liquid chromatography-tandem mass spectrometric(LC-MS/MS) method for plasma aldosterone assay.Methods 324 healthy individuals were enrolled in Zhongshan Hospital from February to April in 2016 for reference interval survey.The signallinearity,lower limits of quantitation,precision and accuracy of LC-MS/MS have been evaluated.Results from LC-MS/MS and RIA methods were compared.Software SPSS17.0 software was used for statistical analysis.Results The performance characteristics for the method in terms of linearity,lowerlimits of quantitation,precision and accuracy were verified.Linear range of ALD were between 25-2000 pg/ml;the LC-MS/MS assay had a limit of quantitation of 20 pg/ml for ALD;the intra-and inter-assay CV of ALD were ＜10％ and ＜6％,respectively;the recovery of ALD from serum samples ranged between 97.3 and 105.8％ The reference value of ALD in health people ranged between 21-211.6 pg/ml The regression equation by LC-MS/MS (X) and RIA (Y) was:Y =0.271X + 138.900(r=0.43;n=322).Conclusion LC-MS/MS method is robust and reliable for the analysis of aldosterone in plasma and suitable for clinical application.

ObjectiveTo evaluate the clinical outcome of new proximal femoral nail antirotation (PFNA) in treatment of subtrochanteric fractures. MethodsThere were 31 patients with traumatic subtrochanteric fractures intramedullarily fixed with PFNA. The patients included 14 males and 17 fe-males at a mean age of 54.6 years (range 34-90 years). According to Seinsheimer classification of sub-trochanteric fractures, 14 patients were with type Ⅱ fractures (including four patients with type ⅡA,seven with type ⅡB and three with type ⅡC), 12 with type Ⅲ fractures (including eight with type ⅢA and four with type ⅢB), two with type Ⅳ fractures and three with type Ⅴ fractures. Close reduction was performed under traction and C-arm fluoroscopy in 26 patients and open reduction through a mini-incision before inserting the nail in five patients due to difficult close reduction. ResultsThe operation lasted for a mean time of 72.5 minutes (range 45-120 minutes), with mean blood loss of 127.5 ml (range 100-350 ml). Of all, 27 patients (87.1%, 27/31) were followed up for a mean duration of 14.3 months (range 8-24 months), which showed fracture union in all patients, with a mean union period of 17.4 weeks (range 10-21 weeks). According to Harris Hip Rate Scale, the results were. excellent in 21 pa-tients, good in two and fair in four, with excellence rate of 85.2% (23/27). ConclusionsPFNA is an effective device for treatment of subtrochanteric fracture, with a high union rate and a low complication rate, for it has advantages of easy use and minor trauma, low bleeding and stable fixation in operation.

Objective To observe and explore the effects of different tidal volume (VT) ventilation on right ventricular (RV) function in patients with critical respiratory failure.Methods Consecutive respiratory failure patients who were treated with invasive ventilator over 24 h in the Department of Critical Care Medicine at the Fourth Hospital of Hebei Medical University from June to December in 2015 were enrolled in this study.Clinical data including patients′ vital signs, ventilator parameters and RV echocardiography were collected within 6 h (D0), day1(D1), day2 (D2) and day3 (D3) after ventilation started.According to the VT, patients with acute respiratory distress syndrome (ARDS) were assigned to low VT group [S6, ≤6 ml/kg predicted body weight (PBW)] and high VT group (L6, >6 ml/kg PBW), while non-ARDS patients were also assigned to low VT group (S8, ≤8 ml/kg PBW) and high VT group (L8, >8 ml/kg PBW).Results A total of 84 patients were enrolled in this study.44.2% ARDS patients and 58.5% non-ARDS patients were in low VT groups.After ventilation, tricuspid annulus plane systolic excursion(TAPSE)decreased progressively in S6 [from 18.30(16.70,20.70) mm to 17.55(15.70,19.50) mm, P=0.001], L6 [from 19.50(17.00,21.00) mm to 16.30(15.00,18.00) mm P=0.001], S8[from 18.00(16.00,21.00) mm to 16.50(15.50,18.00) mm, P=0.001] and L8 [from 19.00(17.50,21.50) mm to 16.35(15.15,17.00) mm, P=0.001] groups.However, TAPSE decreased less in small VT groups (S6 and S8) than those of in large VT groups (S8 and L8) without significant differences.There were not statistical differences between different VT groups in terms of ventilation days, including right ventricle area/left ventricle area (RVarea/LVarea),TAPSE,peak mitral flow velocity of the early rapid filling wave (E),peak mitral flow velocity of the late rapid filling wave (A),early diastolic velocity of the tricuspid annulus (e′),pulmonary artery systolic pressure,inferior vena cava diameter (all P>0.05).Compared to L6 group, low VT (S6 group) resulted in decreased mortality at 28 days [1/19 vs 37.5%(9/24), P=0.014].There were not statistical differences between different VT groups in terms of ventilation days, length of intensive care unit stay, length of hospital stay (all P>0.05).Logistic regression analysis showed that VT could be the independent factor of TAPSE (OR=1.104,95%CI 0.100-1.003,P=0.049).Conclusions Positive pressure mechanical ventilation resulted in RV systolic dysfunction.Lower VT may have the protective effect on RV function.Trial registration Chinese Clinical Trial Registry,ChiCTR-POC-15007563.

There are many limitations in evaluating vaccine efficacy by comparing the incidence of clinical endpoint events (such as morbidity, bacterial colonization) between the vaccine group and the control group. Therefore, the researchers put forward the concept of Surrogate of protection to predict vaccine protection with immunological indicators. In 2012, WHO put forward the immunological substitution endpoint of pneumococcal vaccine, using 0. 35 μg/ml as the protective antibody level of pneumococcal vaccine. But subsequent studies have found that using this threshold to assess all vaccine serotypes may not be accurate.

There are many limitations in evaluating vaccine efficacy by comparing the incidence of clinical endpoint events (such as morbidity, bacterial colonization) between the vaccine group and the control group. Therefore, the researchers put forward the concept of Surrogate of protection to predict vaccine protection with immunological indicators. In 2012, WHO put forward the immunological substitution endpoint of pneumococcal vaccine, using 0. 35 μg/ml as the protective antibody level of pneumococcal vaccine. But subsequent studies have found that using this threshold to assess all vaccine serotypes may not be accurate.

Objective To establish the items framework of transcultural nursing self-management education for patients with chronic heart failure( CHF) . Methods Delphi method was used in this study. The items framework of transcultural nursing self-management education for patients with CHF was developed based on two rounds of consultation among 17 experts. Results The response rates of questionnaires of two rounds of expert consultation were 100%. And the authority coefficient, determine coefficient and degree of familiarity were 0. 895, 0. 850 and 0. 940, respectively. The items framework of transcultural nursing self-management education for patients with CHF consisted of 10 one-levels entries, 29 two-levels entries and 117 three-levels entries. Conclusions The items framework with good scientifically and practicability is based on the transcultural nursing theory, and provides scientific basis for the practice of personalized self-management education.

OBJECTIVETo explore the risk factors associated with the prognosis in poorly differentiated(G3) advanced gastric cancer (AGC) and the effect of number of harvested lymph nodes on the prognosis.

METHODSClinical data of 484 patients with G3 advanced gastric cancer undergoing gastrectomy combined with lymphadenectomy in Zhongshan Hospital from December 2002 to October 2007 were retrospectively analyzed. The χ(2) test or Fisher's exact probability method was used to test measurement data. Survival was calculated using Kaplan-Meier method. Clinicopathological factors such as age, invasion depth, number of harvested lymph nodes, lymph node metastasis, ratio of metastatic lymph node, lymphatic vessels involvement were analyzed using the Cox regression model.

RESULTSNumber of lymph node dissected, lymph node metastasis, ratio of metastatic lymph node and lymphatic vessels involvement were significantly affected by groups of 15 lymph node dissected in G3 AGC patients (P<0.05). Invasion depth, number of lymph node dissected, lymph node metastasis, ratio of metastatic lymph node and lymphatic vessels involvement were significantly independent predictors of survival in G3 AGC patients (all P<0.05). Patients with at least 20 lymph nodes had a better survival rate than those with less than 20(P<0.01).

CONCLUSIONSInvasion depth, number of harvested lymph nodes, lymph node metastasis, ratio of metastatic lymph node and lymphatic vessels involvement are important factors influencing the prognosis of G3 AGC. At least 20 lymph nodes should be recommended to ensure the quality of lymphadenectomy for gastric cancer.

Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; pathology ; surgery ; Survival Rate

Objective:The aim of this study was to develop and validate a new liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay for the quantification of melatonin in human serum.Methods:We describe the performance and validation of melatonin by LC-MS/MS. 182 serum samples from the patients diagnosed with Sleep disturbance who visited the Department of Psychiatry at Zhongshan Hospital affiliated to Fudan University from February 2022 to March 2023(56 males,162 females,mean age [45.51±16.31]years), as well as 182 healthy individuals were included(87 males,95 females,mean age [48.55±11.93]years). The two groups were used to assess the application of serum melatonin levels as a diagnostic indicator for sleep disorders (SDs). The liquid chromatography mass spectrometry (LC-MS) system with an chromatography column (2.1×100 mm, 1.8 μm) was used for separation. The column temperature was set at 35 ℃, as well as the mobile phase consisting of a 0.1% formic acid aqueous solution and pure acetonitrile. The flowing rate was set at 0.4 ml/min for gradient elution. The LC-MS/MS method was validated according to guidance documents, including the following parameters: specificity, selectivity, matrix effect, carryover contamination and reproducibility, lower limit of measuring interval, linearity, precision, recovery rate, dilution consistency, and serum sample stability. Then, it was subsequently employed to profile melatonin changes in Sleep disturbance.Results:The lower limit of quantification for melatonin was 1 pg/ml, and the linear range of detection was 1 pg/ml to 500 pg/ml ( r=0.999). The intra-day and intra-batch precision, expressed as the coefficient of variation ( CV), was within the range from 3.07% to 6.86%, which met the requirement of less than 15%. The recovery rate of the spiked samples ranged from 105.91% to 116.30%. The level of serum melatonin in the sleep disturbance group was significantly lower than that in the healthy control group ([2.00(1.00,3.28)] vs [8.35(4.28,14.80)] pg/ml, P<0.001). Conclusions:The LC-MS/MS method we developed for the quantification of melatonin is clinical practicable.