OBJECTIVE:To develop a method for the concentration determination of olanzapine,risperidone and paliperidone in human plasma.METHODS:After liquid-liquid extraction,using buspirone hydrochloride as internal standard,the concentration of plasma sample was determined by UPLC-MS/MS.The determination was performed on ACQUITY UPLCTM BEH C18 column with mobile phase consisted of methanol-0.01 mol/L ammonium formate solution (gradient elution) at flow rate of 0.2 mL/min.The column temperature was 45 ℃,and sample size was 5 μL.The electrospray ionization source was adopted for positive ion scanning under MRM mode.Ion-pairs for quantitative analysis were as follows:m/z 313.29→256.25 (olanzapine),m/z 411.42→191.19 (ris peridone),m/z 427.45→207.18 (paliperidone) and m/z 386.43→122.37 (internal standard).RESULTS:The linear ranges of olanzapine,risperidone and paliperidone were 0.426-108.954,0.213-54.476,0.213-54.476 ng/mL,respectively.RSDs of inter-day and intra-day were all lower than 20％.The recoveries of them ranged 83.3％-112.9％,90.0％-109.8％ and 95.2％-114.9％,respective ly.Extraction recoveries ranged 65.5％-95.0％,73.9％-98.5％ and 73.6％-99.4％,respectively.Both plasma matrix effect and dilute effect didn't influence the determination of plasma concentration.The plasma concentrations of olanzapine,risperidone and paliperidone in 100 schizophrenia patients were (103.3 ± 73.6),(13.1 ± 13.1) and (23.2 ± 20.0) ng/mL,respectively.CONCLU SIONS:The method is simple,rapid,sensitive and specific.It can be used for the determination of plasma concentration and pharmacodynamic study of olanzapine,risperidone and paliperidone.

Objective To investigate the operational timing and manner for the digestive tract reconstruction after Hartmann procedure and the prevention for the postoperative complications in the patients with left colorectal cancer.Methods The data of twenty-four cases with digestive tract reconstruction were analysed retrospectively containing the cause of Hartmann procedure for left colorectal cancer,preoperative evaluation of the digestive tract reconstruction,operation timing,operation manner,postoperative complications and length of hospital stay and so on.Results Three of 24 patients gave up the digestive tract reconstruction due to the results of their distant metastasis detection in the preoperative evaluation.As a commonly manner of digestive tract reconstruction,rectum-sigmoid colon or sigmoid-descending colon end-end anastomosis was used for 17 patients.Meanwhile,ascending colon-sigmoid colon end-side anastomosis was used for 4 patients.The incidence of postoperative complications was 14.29 ％ (3/21),and the mean time of postoperative hospital stay was 10.5 days.Conclusions In patients undergoing Hartmann procedure for left colorectal cancer,adequate assessment of the tumor recurrence and metastasis is necessary.In addition,the optimal timing of surgery should be selected after completion of chemotherapy,and operational manner should be determined by the situation of intraoperative exploration.

0.05). Regarding to the grade of irradiation mucositis, the majority of patients in the treatment group were at stage Ⅰ-Ⅱ,while those in the control at stage Ⅲ-Ⅳ(P0.05).No adverse drug reaction was observed in both groups during irradiation process.Conclusion:Actovegin can postpone the development of irradiation oropharyngeal mucositis and decrease the incidence of gradeⅢ and Ⅳmucositis.

Objective To study the application of negative pressure drainage on nasal septum reconstructomy by endoscopy.Methods Totally 80 patientswith nasal septum deviation in our hospital from May 2014 to March 2015 were randomly divided into the observation group and the control group.All patients were given nasal septum reconstructomy by endoscopy,and patients of the observation group were given negative pressure drainage after surgery while the patients in control group were given traditional nasal cavity filling postoperatively.Observed the subjective symptoms,degree of disease and complications of patients 12 hours and 24 hours after surgery.And the clinical curative effect of the two groups were compared and analyzed 1 week after the surgery.Results The subjective symptoms of the observation group was obvi-ously better than the control group 24 hours after the surgery with statistically significant difference (P <0.05).And the degree of disease in observation group had significantly improved,and the nasal mucosa edema ratio of level 0 was 40%,which was significantly higher than 10% in the control group (P <0.05).The total effective rate was 97.50% in the observation group 1 week after surgery and it was 80% in the control group,and there were significant difference between the two groups (P <0.05).The incidence of complications in the observation group was 2.50%,which was significantly less than 20% in the control group (P <0.05).Conclusion The application of negative pres-sure drainage on nasal septum reconstructomy by endoscopy could effectively relieve the pain of patients and reduce complications,and its prognosis effect is better.

Objective To investigate the cause,therapeutic strategy,methods of treatment and clinical results for the rectovaginal fistulas(RVF)after rectal cancer operations.Methods The clinical data of 14 female patients with RVF after rectal cancer operations were examined retrospectively.According to therapeutic strategy,all patients were divided into two groups,A group and B group,which were seperately performed traditional treatment,and progynova in combination with non-operative treatment.Results Among 10 patients in A group,8 patients were performed feacal diversion stoma,and 7 patients with RVF cured naturally,then performued colostomy reversal and restoration of bowel continuity,the other 2 cases were performed non-operative treatment for refusing feacal diversion stoma.Among 4 patients in B group,3 cases with RVF healed naturally during 1.5 to 2 months,one case secondary to rectal anastomosis was performed feacal diversion stoma for rectovaginal fistula without signs of healing.Conclusion RVF is a rare but serious complication after resection of rectal carcinoma,which is taken by the treatment strategy of progynova in combination with non-operative treatment,not only can promote the natural healing of RVF obviously,but also can shorten the healing time greatly.Feacal diversion stoma can be used while the treatment is failure.

Objective: To investigate the clinical efficacy of acupuncture combined with tuina in treating patients with cervical vertigo. ＜br> Methods: According to the principle of randomization, 258 cases with cervical vertigo who met the inclusion criteria for the study were randomly divided into an observation group and a control group, with 129 cases in each. The patients in the observation group received acupuncture combined with tuina therapy, while those in the control group were just treated by the same acupuncture therapy as in the observation group. After 10-day continuous treatments, the clinical efficacies of the two groups were analyzed and compared. ＜br> Results: The total effective rate of the observation group was 100%, versus 86.0% of the control group, and the difference was significant (P＜0.05). After treatment, cervical range of motion (ROM) scores in both groups were statistically significantly different from those before treatment (allP＜0.05); in addition, there was a statistically significant difference in inter-group comparison of ROM score (P＜0.05). ＜br> Conclusion: Compared with simple acupuncture treatment, acupuncture combined with tuina therapy has a better effect in improving the ROM of cervical vertigo patients, with higher clinical efficacy.

Objective To observe the efficacy and safety ofYiqi Huatan Granules combined with carbocisteine to reduce the acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Totally 108 patients in the stationary phase of COPD with qi deficiency or merging phlegm blockage/blood stasis syndrome were randomly divided into two groups. Patients in the control group were treated with carbocisteine and inhaled bronchodilators on-demand, while patients in the treatment group were treated withYiqi Huatan Granules combined with carbocisteine and bronchodilators for 24 weeks. Times and severity of acute exacerbations of COPD, TCM syndrome scores, lung function, and 6-minute walking distances of the two groups during the treatment period were observed.Results The average times of acute exacerbations of COPD in the treatment group (0.33 ± 0.55) were fewer than the control group (0.62 ± 0.71);the average times of severe acute exacerbations of COPD in the treatment group (0.12 ± 0.33) were fewer than the control group (0.28 ± 0.45), with statistical significance (P<0.05). Comparison between the TCM syndrome scores before and after treatment, TCM total syndrome scores, breathless/dyspnea score, breath shortness and fatigue score, and 6-minute walking distance in the treatment group were better than the control group (P<0.05), with better safety.Conclusion The treatment ofYiqi Huatan Granules combined with carbocisteine for COPD patients can effectively decrease times and severity of acute exacerbations of COPD, and improve TCM syndrome scores and 6-minute walking distance.

Objective To investigate the correlation between dose volume histogram(DVH)of tumor targets and organs at risk(OAR)at CT-image based 192Ir brachytherapy and effects and complications for patients with locally advanced cervical cancer. Methods Ten patients with FIGO stage ⅢB cervical cancer received CT image-based 192Ir intracavitary brachytherapy after 54 Gy of three-dimentional four-field pelvic external beam radiotherapy and concurrent weekly cisplatin chemotherapy. Before each brachytherapy,CT images were acquired with applicators in place. Gross tumor volume(GTV), clinical target volume (CTV)and OAR were contoured and inverse treatment planning was designed and optimized by using PLATO treatment planning system. Conventional two-dimensional plans were also designed for comparison.The total intracavitary brachytherapy dose was 30 -42 Gy in 5 -7 fractions. The patients were followed, and the local control and complications were analyzed. The biologically equivalent dose(BED)and biologically equivalent dose in 2 Gy fractions(BED2)for GTV, CTV and OAR were calculated. The minimum dose in the most irradiated tissue volume 2 cm3(D2 cm3)adjacent to the applicator of the sigmoid colon, rectum,bladder and small bowel was determined from the DVH. Results The 1-year local pelvic control rate was 90% and grade 1-2 late complication of sigmoid colon and rectum was 50%. No grade 3 or more complications developed. On CT-image based planning, the BED and BED2 to 90% of the CTV(D90)were 95.50 Gy ± 7. 81 Gy and 79. 73 Gy ± 6. 57 Gy. The BED and BED2 to 90% of the GTV(D90)were 101.86 Gy ± 7.27 Gy and 84. 95 Gy ± 6. 1 Gy. The volume enclosed by 90% of prescribed dose(V90)for GTV and CTV were 92% ±4% and 87% ±7% respectively. The D2cm3 for rectum and sigmoid colon were 74. 97 Gy ±1.64 Gy and 67. 93 Gy ± 4. 30 Gy(EQD2, α/β = 3). Comparing with 2D brachytherapy plans , CT - image based planning has improved D90 and V90 for GTV and CTV with similar dose at point A and rectum reference point. Conclusions Computer tomography-image based 192Ir brachytherapy has resulted in the better dose distribution to the tumor targets with excellent tumor control and acceptable toxicity.

AIM: To study the reactions of human platelet to active complement and the effects of anti-CD59 on human platelet activation induced by complement. METHODS: By applying CVF to activate complement, the platelet aggregation and release reactions induced by activated complement with or without appling anti-CD59 with different doses to block the complement modulative protein CD59 in healthy individuals, were observed. RESULTS: CVF induced platelet release and significant and lasting metamorphosis in healthy individuals, but platelet aggregation was not observed. CVF-induced platelet metamorphosis showed positive linear correlation to lg concentration of CVF (r=0 970. P

Objective To investigate the diagnosis,the treatment methods and the prognosis of rectal cancer patients after renal transplantation.Methods Four patients with rectal cancer were found in 1035 renal transplantation recipients.Three of four patients were treated with anterior resection (AR) or abdomenoperineal resection (APR) with total mesorectal excision (TME).The two patients accepted regular adjuvant chemotherapy for six months period after surgery,but one patient rejected to accept any chemotherapy after surgery.Otherwise,one patient was only treated with chemotherapy and best support therapy for diagnosed as rectal cancer with multiple liver metastases.Results Two patients were fine to be followed up,8 months and 21 months after rectal resection respectively.Two other patients eventually died of metastasized cancer 5 months and 31 months respectively after therapy had been initiated.Conclusion Transplantation patients should receive standard oncology treatment,including operation and adjuvant treatment,so long as their general condition and organ graft functions allow to do so,although a higher degree of morbidity might be encountered,and periodical colorectal screening should be performed before and after renal transplantation.