Objective:To establish a method for the determination of residual 5 heavy metal elements in single use and gravity feed infusion sets and intravenous infusion needles, including Cd, Cr, Cu, Sn and Pb. Methods:After the pre-preparation,the sample was dissolved in 1% nitrate. The 5 heavy metal elements in the sample solution were determined by inductively coupled plasma mass spec-trometry (ICP-MS). Results:Under the ICP-MS assay conditions, each element showed good linearity within the range of 0-50 ng· ml-1(r>0. 999 0). The average recoveries were within the range of 92%-116% and 1. 6%-2. 9%, respectively (RSD<3,n=9). Conclusion:The operation is simple and can meet the demand for the analysis of heavy metal elements in single use and gravity feed infusion sets and intravenous infusion needles.

Objective Establishment of HPLC to determine the content of Baicalin in different processing varieties of traditional Chinese Medicine.Methods The HPLC method was used to determine the content of Baicalin in different processing varieties of Radix. The analytical column was thermo- C18 (150 mm × 4.6 mm, 5μm). The mobile phase consisted of methanol-water- phosphoric acid solution (47:53:0.2). The column temperature was 35℃,and the UV detection wavelenghth was 280 nm.Results The contents of Baicalin in different processed products were different. The lowest content of Radix. It was considered that the content of Baicalin in Radix decreased with the time of processing and the degree of heating.Conclusions It's known that the difference of baicalin content in different processed products ofscutellaria baicalensis Georgi was conducive tothe rational and scientific process of products.

Objective Design the "Nursing Obstetrics and Gynecology" network courses, and then observe the teaching effect of it. Methods The rational design of technical solutions, development and application of information resources and modem educational technology. Results The "Nursing Obstetrics and Gynecology" network courses prompt satisfaction teaching more than 90%. Conclusions "Nursing Ob-stetrics and Gynecology" network courses make our teaching program is brand new, as "Nursing Obstetrics and Gynecology" network courses of discipline and quality building a solid foundation, especially for the cultivation of young teachers to provide direct help.

Objective To investigate the functional esophageal dismotility in patients with gastroesophageal reflux disease(GERD) by simultaneous high frequency intraluminal ultrasonography(HFIUS) and esophageal manometry,and evaluate the correlation between the peak pressure and the peak muscle thickness of the esophagus.Besides,to identify the potential efficacy and feasibility of the HFIUS for evaluating the functional gastrointestinal diseases(FGIDs).Methods Ten GERD patients and 5 healthy controls were enrolled into this study.High-frequency ultrasonic probe and esophageal manometry catheter were simultaneous administrated.The cross sectional image of esophageal motion was recorded by HFIUS and was analyzed by the contractility index (CI)of the longitudinal smooth muscle(LSM)and circular smooth muscle(CSM),the duration of the contraction (DC)and the maximum cross section area(CSA)during distension;In addition,esophageal peak pressure during wet-swaltow was measured by manometry.Results Tile contractility index of the LSM and CSM of esophagus at 5 cm,10 cm,1 5 cm and 20 em proximal to the LES was significantly lower in patients with GERD than that of controls(P＜0.05).The duration of the contraction was longer in patients with GERD.But there was no siginificant difference of the maximum CSA during distension between GERD patients and normal controls(P＞0.05).However,the simultaneous manometry only demonstrated nonspecific esophageal motility disorder on 6 of 10 GERD patients.And there was positive correlation between the peak pressure and the peak muscle thickness at all sites along the axis of the esophagus,revealed the pressure was increasing along with the thickening of the esophageal muscle layers(r=0.552-0.736).Conclusions Functional esophageal dismotility played an important role in the pathogenesis of GERD.Meanwhile,there was positive correlation between the esophageal pressure and the muscle layer thickness of the esophagus.HFIUS can detect the minor changes of the layer structure of the esophagus and is a potentially useful imaging modality for evaluating esophageal dismotility as well as FGIDs.

An analytical method for the simultaneous determination of four quinolones in soil was developed. Soil samples were extracted by a mixture of 50% magnesium nitrate and 10% ammonia(96∶ 4, V/V)with an ultrasonic-assisted extraction, then purified and concentrated by HLB cartridge, and eluted with acetonitrile and 0.067 mol/L phosphoric acid(5∶ 1, V/V). Using acetonitrile and 0.067 mol/L phosphoric acid(pH=2.5) as the mobile phase, these analytes were quantificated by HPLC(fluorimetric detector) at excitation and emission wavelength of 280 nm and 450 nm respectively. The detective limits for four quinolones in soil were from 0.58 to 0.03 g/kg. The recoveries were 60.4% to 99.3% for soil samples. The method was successfully applied to determine the quinolones in soil samples from vegetable fields. Four quinolone compounds were detected to a different extent with total amounts of quinolones ranged from 27.84 to 129.26 μg/kg.

Objective To evaluate the effects of isokinetic quadriceps training with different ranges of motion for improving mal-patellar tracking after total knee replacement (TKR). Methods Isokinetic quadriceps training was administered to 52 TKR cases, involving 66 knee joints with poor patellar tracking. The subjects were randomly allocated into 3 groups for isokinetic training with ranges of 0-30°, 30-60° or 60-90°, with 22 knee joints in each group. The angular velocity was set at 30°/second. X-rays with loading and with 45° knee flexion were taken before and after the training. The lateral patello-femoral angle,the patella index and the patello-femoral index were recorded along with the maximum torque ( MT), the total work ( TW ), and the average work(AW) in the three different ranges of motion. Hospital for Special Surgery (HSS) scores were also recorded. Results After 3 months of training, the average lateral patello-femoral angle, patella index, and patello-femoral index in the 0-30° training group were all significantly better than before the training. However, there was no significant difference in these measures for the 30-60° and 60-90° groups. After training average MT, TW and AW increased significantly in all groups, but the improvements were significantly correlated with the differences in lateral patello-femoral angles, patella indices and patello-femoral indices only for the 0-30°group. When compared with the baseline values, a statistically significant difference in HSS score after training was observed only in the 0-30° training group. Conclusions Isokinetic quadriceps training with a 0-30° range of motion can best realign patellar tracking after TKR, and best improve knee function.

Objective To explore the mechanism of cell apoptosis of immortalized human keratinocytes (HaCaT cells) and protein expression related to this process after long term exposure to sodium arsenite (NaAsO2,1.0 μmol/L).Methods Malignant transformation model was set up through long-term exposure of HaCaT cells to 1.0 μmol/L NaAsO2.Cell passage for 0,1,7,14,21,28 and 35 generations in the process of malignant transformation were collected for measurement of cell apoptosis rate by flow cytometry,and apoptosis related proteins by Western blotting,including activation of cysteine protease 3,8 (cleaved-caspase-3,8),C/EBP homologous protein (CHOP),B-cell leukemia/lymphoma 2 (Bcl-2),and Bcl-2 associated X protein (Bax).Results Along with the arsenite treatment,the apoptosis levels were significantly decreased (F =26.770,all P ＜ 0.05),the apoptosis levels (0.307 ± 0.049,0.213 ± 0.055,0.163 ± 0.057,0.147 ± 0.035,0.053 ± 0.012) of the 7th,14th,21st,28th and 35thgenerations of cells after arsenite treatment were lower than that of control group of the 0th generation (0.393 ±0.021,all P ＜ 0.05).Compared between generations,there were statistical differences of the protein expression levels of cleaved-caspase-3,Chop,Bax and Bcl-2 in arsenite group (cleaved-caspase-3:1.000 ± 0.000,1.030 ± 0.027,1.104 ± 0.069,1.016 ± 0.087,0.838 ± 0.075,0.753 ± 0.082,0.677 ± 0.073;Chop:1.000 ± 0.000,1.059 ± 0.018,0.934 ± 0.095,0.976 ± 0.216,0.793 ± 0.136,0.651 ± 0.042,0.564 ± 0.056;Bax:1.000 ± 0.000,1.069 ± 0.037,1.028 ± 0.042,0.954 ± 0.118,0.641 ± 0.135,0.531 ± 0.132,0.429 ± 0.085;Bcl-2:1.000 ± 0.000,1.072 ± 0.023,1.249 ± 0.134,1.334 ± 0.143,1.633 ± 0.221,1.507 ± 0.152,1.461 ± 0.145,F =7.730,7.355,27.802,12.438,all P ＜ 0.05),compared with control group of the 0th generation (1.000 ± 0.000) and the same generation control group (1.000 ± 0.000),after the 21st generation,the differences were statistically significant (all P ＜ 0.05),while there was no difference of the protein expression levels of cleaved-caspase-8 (F =0.832,P ＞ 0.05).Conclusion In the process of malignant transformation,the apoptosis levels of HaCaT cells are inhibited after long term sodium arsenite exposure through mitochondria and endoplasmic reticulum (ER) stress signaling pathways.

A large size tertiary comprehensive hospital designed the performance reform program not only based on RBRVS and DRGs but also combined with cost control and medical quality and safety. The hospital have implemented performance reform at 2016, with achieving the public welfare and fairness by "combination" and exploring a set of performance management methods which suit the hospital's actual condition and boost its development.

Objective To analyze the clinical and biochemical,as well as genetic characteristics of a patient with Wiedemann-Steiner syndrome (WDSTS).Methods The clinical data of a patient with WDSTS were collected.The patient was treated with recombinant human growth hormone (rhGH) combined with gonadotrophine-releasing hormone agonist (GnRHa).Blood samples of the patient and her parents were taken for whole-Exome Sequencing (WES).Relevant literatures about KMT2A mutations were reviewed.Results The 5-year old girl presented with growth retardation,with height 100 cm (-2.4 SD),torpid reaction,and facial anomalies including low hairline,thick eyebrow and hair,hypertelorism,a wide nasal bridge.She had small and puffy hands and feet,excessive hair around back of neck,bilateral forearm and lower limbs.Her GH peak level was 26.6 ng/ml during GH stimulation test.She was re-examined at the age of 10.4 years,with severe short stature (120 cm/-3.58 SD) and a Tanner stage 2 of breast development.Her bone age was found to be approximately 11.4 years.Height increased from 120 cm at the age of 10.4 years to 147.3 cm after rhGH treatment combined with GnRHa for 2.5 years.rhGH therapy alone continued for 1.1 years and a height of 150 cm was reached at the age of 14.9 years,with bone age 14 years.Gene sequencing revealed a de novo frameshift mutation (c.10051 delA,p.Thr3351 Leufs * 17) of exon 27 in KMT2A gene of the patient,but without any mutation in her parents.Through a literature review,seventy-one patients with WDSTS (including present case) presented with intellectual disability (70/71),facial anomalies (70/71),short stature (50/71),and hypertrichosis (39/71).Conclusion Patients presented with short stature,typical facial dysmorphism,intellectual disability,and hypertrichosis should be considered for WDSTS.The mutation p.Thr3351Leufs * 17 in the KMT2A gene detected in our patient is a novel mutation.This is so far the first report of WDSTS patient who was successfully treated with a combination of GH and GnRHa at the onset of puberty to improve her adult height.

Objective To observe the safety and efficacy of oncolytic adenovirus (H101) implantation under EUS guidance combined with gemcitabine in patients of non-operative pancreatic cancer.Methods From May 2007 to December 2007,6 patients with non-operative pancreatic cancer were enrolled in the study.H101 were implanted into 3 sites of the tumor under EUS guidance.Gemcitabine Was siren systemicly on d2,d9 and d16 after implantation, and repeated 1 month later.Tumor size and perfusion were assessed by computed reconstruction and perfusion imaging.Changes of clinical indices,adverse effects and complications were also recorded.Results All patients completed the two periods of treatment as planned.Tumor size decreased in 5 cases(18.21%-38.65%),but without statistical difference (P=0.078).The area of liver metastasis Was found decreased in 1 ease.Perfusion imaging showed significant increase of mean transit time(P=0.049) and improvement in blood flow,blood volume and permeability surface at 2 weeks after the treatment. KPS increased in 2 patients and pain score decreased in 3 patients.Three patients died 2.5,2.5 and 3 months respectively after the procedure.while 3 other patients are still alive with the survival time of 3,5 and 10 months. Major adverse effects associated with H101 implantation were fever and flu-like symptoms.Mild acute pancreatitis occurred in 1 cage.Conclusion EUS guided oncolytic adenovirus implantation in advanced pancreatic cancer is feasible and safe.With the combination of gemcitabine,it is capable of shrinking the tumor size,destroying the angiogenesis of the tumor and improving the patients'living quality.