20(S)-9-nitrocamptothecin was synthesized from camptothecin by nitration reaction using mixed nitrate salts in sulfuric acid medium.The yield was raised from 31% to 40% after chromatographic purification treatment.The best reaction conditions was as follows:0.5 g of camptothecin;30ml of sulfuric acid;0.007mol of nitrate salts(NH4NO3/CaNO3=1/1).The reaction was completed in 24h at 20℃.The advantage of this method is high yield and easily purification.

Objective To evaluate the application of health education in patients with cholecystectomy. Methods From October 2009 to July 2010, 93 patients in our hospital with cholecystectomy were randomly divided into the control group (45 cases) and the observation group(48 cases). The control group was given routine nursing care, the observation group received perioperative health education in addition to the routine nursing care, then compared the nursing effect of two groups. Results In the observation group, the patients' knowledge and awareness rate of their own disease was 95.8%, and the control group was 80.0%, the difference was statistically significant between two groups. The recovery of gastrointestinal function in the observation group was significantly better than the control group, the difference was statistically significant between two groups. Conclusions Health education can enable patients with cholecystectomy correct understanding of their disease, eliminate negative emotions, and help the recovery of gastrointestinal function in patients, which is worthy of attention.

Objective To investigate the mechanism of venous reverse-flow flap in the differentperiod after operation.Methods The rabbits wero randomly allocated into 3 groups.In group A,including saphenous artery and venae commutante.In group B,saphenous artery without venae commutante.In group C,surface seeping and saphenous artery and venae commutante.Flap appearance,intravenous pressure,vessel diameter,mierocircular and histological examination were mea8ured.Results The difference of introvenous pressure between group A.B and C was obvious.Reverse flow WaS found in group A and C group through microcirculation observation 2 hours post-operation.Venous valve lose efficacy while the vessel diameter wes at maximum just after the pressure peak.Conclusion Venous retrograde return in reverse-flow island flaps can be achieved more easily through"incompetent valves route"than through "communicating and collaterall by pass route".By pass route is a supplementary way.Surface seeping Can slighfly relieve the venous pressure but can cause infection.

Objective This paper aims at establishing a inductively coupled plasma mass spectrometry ( ICP-MS) method for quantification and evaluation of iodine in human urine and serum in routine clinical laboratory .Methods This study was methodology validation research on iodine evaluation using ICP-MS.Ammonia, isopropanol and ultrapure water were mixed at certain ratio to dilute samples in the ratio of 1:10, and then the diluted samples were analyzed by ICP -MS.Re was used as the internal standard.And linearity, lower limit of detection, recovery, precision, accuracy, carryover and stability was evaluated thoroughly .Results of iodine of pregnant women who required iodine tests were retrospectively analyzed to evaluate the status of iodine .Results The method only needs 30s for analysis of one sample .It was sensitive with a lower limit detection of 0.87μg/L, the correlation coefficient was higher than 0.999 9 in ten measurements.The recovery in both serum and urine was approximately 100% (95.3% -109.9%). Based on the NIST standard reference material 3668 comparison, the bias was less than 4%( -0.9% -3.9%).The inter-coefficient variation (CV) for serum iodine and urine iodine was 1.2%-3.0%, 2. 0%-2.9%, respectively;and total CV for serum iodine and urine iodine were 3.0%-3.8%, 4.1%-4.9%, respectively.The mean carryover of this method was 0.03% and iodine was stable for at least one month at -20℃ and 4℃.The urine and serum iodine for pregnant women was (154.8 ±89.7) μg/L (mean ±SD),(75.8 ±21.4) μg/L, respectively.The correlation between urine and serum iodine was 0.21. Conclusion Establishe a rapid and simple ICP -MS method for urine and serum iodine measurement with high accurate and precise in routine clinical laboratory .

Objective: To explore the effectiveness of healthy school canteen intervention on nutritional literacy, food consumption, as well as attitude towards school canteen. Methods: A primary school in Taizhou City was selected as the intervention school, and another comparable primary school was selected as the control one. A total of 320 students (163 in the intervention group and 157 in the control group) received a comprehensive intervention based on the construction of a healthy school canteen in the school,incluling healthy dining environment,food impravement,chef training,nutrition and health education, while the control group did not receive any intervention. Questionnaires survey was administered to both groups before and after the intervention. Results: Before the intervention, no significant differences were found in the total scores of skills and nutrition literacy, frequency of food intake, behaviors and attitudes related to canteen construction between the two groups( P >0.05). Daily intake of vegetables, dairy products, fish/poultry/eggs/lean meat increased by 19.63, 15.95 and 19.63 percentage point respectively ( χ 2=15.25，9.14，13.93， P <0.01). The proportion of students reporting have read related intervention materials in the intervention group(95.71%) was higher than the control group(84.71%) ( χ 2= 11.04, P < 0.01 ). The students in favor of low salt, low oil and low sugar dishes in the intervention group (74.85%) was higher than in the control group(48.41%) ( χ 2=23.73, P <0.01). Conclusion Based on the comprehensive intervention of nutrition and health canteens can improve students nutrition literacy and dietary structure. It is recommended to adopt the form of "home school linkage" to carry out the construction of large sample, multi regional and long term nutrition and health canteens.

Clinical application of mass spectrometry technology has attracted the attention of clinical laboratory experts due to its high sensitivity, high specificity, and capacities of simultaneous detection of multiple compounds. In recent years, mass spectrometry technology has made significant achievements in the fields of identification of pathogenic microorganism, detection of trace elements and heavy metals, small molecule hormones, vitamins, amino acids, peptides and proteins, as well as therapeutic drug monitoring (TDM) and poisoning drugs screening. In order to further clarify the opportunities and challenges brought by this complex mass spectrometry technology in the field of clinical laboratory, the Chinese Journal of Laboratory Medicine invited experts and scholars of laboratory medicine to share their experience and opinions on related items focusing on the positioning of mass spectrometry technology in the clinical laboratory, the development and improvement of the clinical laboratory by mass spectrometry technology, the challenges of interpreting mass spectrometry test results, the challenges of operating and managing clinical mass spectrometry laboratories, and ways of improving the application of clinical mass spectrometry laboratories with this technology. Agreement was achieved in that the introduction of mass spectrometry technology into the clinical laboratory could bring new directions and opportunities for clinical testing and research, and also is associated with a series of challenges such as the difficulty of sample pretreatment, the high cost and complexity of mass spectrometry technology, the complexity of data processing and interpretation, the lack of standards and norms, and the issue of determining the price of mass spectrometry examinations.

BACKGROUND: Accurate serum total thyroxine (TT4) measurement is important for thyroid disorder diagnosis and management. We compared the performance of six automated immunoassays with that of isotope-diluted liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS) as the reference method. We also evaluated the correlation of thyroid stimulating hormone (TSH) with TT4 measured by ID-LC-MS/MS and immunoassays. METHODS: Serum was collected from 156 patients between October 2015 and January 2016. TT4 was measured by immunoassays from Abbott (Architect), Siemens (ADVIA Centaur XP), Roche (E601), Beckman-Coulter (Dxi800), Autobio (Autolumo A2000), and Mindray (CL-1000i), and by ID-LC-MS/MS. Results were analyzed using Passing-Bablok regression and Bland-Altman plots. Minimum requirements based on biological variation were as follows: a mean bias of ≤4.5% and total imprecision (CV) of ≤3.7%. RESULTS: All immunoassays showed a correlation >0.945 with ID-LC-MS/MS; however, the slope of the Passing-Bablok regression line varied from 0.886 (Mindray) to 1.23 (Siemens) and the intercept from −12.8 (Siemens) to 4.61 (Mindray). Only Autobio, Beckman-Coulter, and Roche included the value of one in the 95% confidence interval for slope. The mean bias ranged from −10.8% (Abbott) to 9.0% (Siemens), with the lowest value noted for Roche (3.5%) and the highest for Abbott (−10.8%). Only Abbott and Roche showed within-run and total CV ≤3.7%. CONCLUSIONS: Though all immunoassays correlated strongly with ID-LC-MS/MS, most did not meet the minimum clinical requirement. Laboratories and immunoassay manufacturers must be aware of these limitations.
Bias (Epidemiology) ; Diagnosis ; Humans ; Immunoassay ; Mass Spectrometry ; Methods ; Thyroid Gland ; Thyrotropin ; Thyroxine

Objective:Analysis of the oxidative products of DNA and RNA in patients with hypertension by determination of 8-oxo Gsn and 8-oxo dGsn, respectively.Methods:This is an observational study. During August and December, 2018, 139 hypertension patients without other chronic diseases with an average age of (49.6±12.4) years old, and 139 apparently healthy volunteers without hypertension with an average age of (48.5±11.7) years old were recruited. Fasting morning urine were collected. The oxidative products of DNA: 8-oxo Gsn and the products of RNA: 8-oxo dGsn were analyzed using liquid chromatography tandem mass spectrometry. Urine Cr(U-Cr), and other serum biomarkers such as ALT, Cr, UA, Glu, TG, TC were analyzed using automatic biochemical analyzers.Results:of 8-oxo Gsn and 8-oxo dGsn were presented as median(quartile). Statistical analysis was performed using SPSS 22.0 and GraphPad Prism 5. Nonparametric test was used to compare the difference of 8-oxo Gsn and 8-oxo dGsn between the hypertension patients and the healthy controls. Results The DNA and RNA oxidative products of 8-oxo Gsn and 8-oxo dGsn in patients with hypertension and their U-Cr-corrected 8-oxo Gsn/U-Cr and 8-oxo dGsn/U-Cr were 14.38(10.39-19.91)ng/ml, 12.97(7.92-18.96)ng/ml, 1.10(0.88-1.38)μg/μmol and 0.96(0.75-1.30) μg/μmol, respectively, which were significantly higher than those in the healthy controls: 11.95(7.52-18.01) ng/ml, 10.12(6.42-15.04) ng/ml, 0.86(0.59-1.21) μg/μmol and 0.72(0.50-1.02) μg/μmol, respectively. After grouped by sex, 8-oxo Gsn in males, 8-oxo Gsn and 8-oxo dGsn in females showed no significant difference between patients with hypertension and healthy controls, however, after U-Cr correction, both males′ and females′ 8-oxo Gsn/U-Cr and 8-oxo dGsn/U-Cr in patients with hypertension were higher than that in the healthy controls.Conclusion:The oxidative products of DNA and RNA in patients with hypertension were significantly higher than that in healthy controls.