A new method for the determination of peptide antibiotics in sediment from aquaculture environment by high performance liquid chromatography-tandem mass spectrometry was developed. The target analytes in sediments were ultrasonically extracted twice with citrate buffer solution and methol mixture (3∶ 4, V/ V), followed by complexation with 0. 5 g of Na2 EDTA, purification with 5 mL of methyl isobutyl ketone, and clean-up with HLB-SPE column. The analytes were separated on a MGII C18 column by gradient elution with 0. 1% formaic acid-0. 1% formaic acid acetonitrile as mobile phase, detected in multiple reaction monitoring (MRM) with electrospray ionization (ESI) under positive ion mode, and quantified by external standard method. The calibration curves were linear (R2 >0. 999) over a concentration range of 10 -10000μg / L for colistin and bacitracin and 4-4000 μg / L for virginiamycin M1 . The limits of detection (S / N = 3) were 5 μg / kg for colistin and bacitracin and 2 μg / kg for virginiamycin M1 . The limits of quantification (S / N=10) was 10 μg / kg for colistin and bacitracin and 4 μg / kg for virginiamycin M1 . At three spiked levels, the recoveries ranged from 79. 7% to 91. 6% (RSD=1. 9% -10. 8% ), showing high sensitivity, good reproducibility and wide applicability.

Objective: To construct a prediction model for preterm birth risk among pregnant women, so as to provide the reference for screening high-risk population and preventing preterm birth. Methods: Pregnant women who received antenatal examination and delivered at the Women's Hospital, School of Medicine, Zhejiang University from January 1 to December 31, 2019 were selected as the study subjects, among them, 80% were included in the modeling group, and 20% were included in the validation group. Demographic and clinical information were collected. A multivariable logistic regression model was used to analyze the predictive factors of preterm birth risk in the modeling group, and a preterm birth risk prediction model was established based on the OR values of predictive factors. The model was validated with the data from the validation group. The Youden index was used to determine the critical score for predicting preterm birth risk. The prediction performance of the model was evaluated using the receiver operating characteristic (ROC) curve. Results: A total of 15 197 pregnant women were surveyed, including 12 131 pregnant women in the observation group and 3 066 pregnant women in the validation group. There was no statistically significant difference in age, education level and gravidity between the two groups of pregnant women (all P<0.05). Multivariable logistic regression analysis identified the number of pregnancies, education level, place of residence, hypertension, diabetes, history of preterm birth, twin-pregnancy, placenta praevia, and gestational hypertension as risk prediction factors for preterm birth risk among pregnant women. The risk score system for preterm birth was established as follows: >2 pregnancies (2 points), high school education or below (4 points), college degree or above (-4 points), rural residence (5 points), hypertension (7 points), diabetes (11 points), history of preterm birth (11 points), twin-pregnancy (28 points), placenta previa (19 points), and gestational hypertension (12 points). The total score of the preterm birth risk scoring system ranged from -4 to 99 points. When the critical score was 8 points, the Youden index was the highest at 0.480, with an area under the ROC curve of 0.749 (95%CI: 0.732-0.767), a sensitivity of 0.610, and a specificity of 0.886, indicating good prediction performance of the model. Conclusion The preterm birth risk prediction model established in this study based on demographic and clinical characteristics of pregnant women can effectively predict the risk of preterm birth among pregnant women.

Objective To explore the gender difference in clinical features and outcomes of elderly patients with coronary true bifurcation lesions after percutaneous coronary intervention (PCI).Methods A total of 169 consecutive patients were included in the study, who were diagnosed coronary true bifurcation lesions by coronary angiography (CAG)and received PCI in our hospital from December 2013 to December 2015.All patients were divided into 2 groups according to their gender (71 femals and 98 males).Angiographic characteristics of the coronary lesions and clinical data were analyzed in both groups.Clinical outcomes during follow up were recorded and studied.Results The levels of total cholesterol (TC), triglyceride (TG),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) in the female group were significantly higher than in the male group (all P<0.05).The levels of BUN,Cr,UA,CyC and TBIL in the female group were significantly lower than in the male group (all P<0.05).Comorbidity rates of hypertension and diabetes were higher in female patients without significant differences (P>0.05).The median follow-up time was 17 months and the incidence rate of overall adverse events in women was higher than that of men (25.4% vs.11.2%, P<0.05).Conclusions The clinical outcomes of elderly patients with coronary true bifurcation lesions after PCI had gender differences.The rates of adverse events in female patients was found significantly higher than male patients.

Objective:To explore the curative effect of Buyang Huanwu Decoction combined with suspension exercise training for the patients with cerebral infarction combined and lower limb hemiplegia.Methods:According to random number table method, 94 patients with cerebral infarction and lower limb hemiplegia meeting the inclusion criteria were divided into the control group and the observation group between January 2017 and February 2021, 47 in each group. The control group was treated with suspension exercise training, while observation group was additionally treated with Buyang Huanwu Decoction on the basis of the control group treatment. All were treated for 6 weeks and then followed up for 3 months. Before and after treatment, the Traditional Chinese Medicine (TCM) syndromes scores were recorded. The severity of nerve function injury was evaluated by National Institutes of Health Stroke Scale (NIHSS). The lower limb function was evaluated by Fugl-Meyer Assessment (FMA). The balance function was evaluated by Berg Balance Scale (BBS). The activities of daily life were assessed by Barthel Index (BI). The whole blood high shear viscosity, plasma viscosity and hematocrit were detected by full-automatic hemorheology analyzer. The levels of plasma total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were detected by full-automatic analyzer. All were followed up for 3 months. The prognosis of patients was assessed by modified Rankin scale (mRS). The adverse reactions during treatment were recorded.Results:After treatment, scores of TCM syndromes and NIHSS in observation group were significantly lower than those in control group ( t=5.35, 4.54, P<0.01), while scores of FMA, BBS and BI were significantly higher than those in control group ( t=3.40, 3.10, 7.57, P<0.01). The whole blood high-shear viscosity, plasma viscosity and hematocrit in observation group were significantly lower than those in control group ( t=2.94, 3.81, 4.23, P<0.05 or P<0.01), and levels of TC, TG and LDL-C were significantly lower than those in control group ( t=4.10, 4.27, 3.61, P<0.01). The differences in good prognosis rate between observation group and control group were statistically significant [74.47% (35/47) vs. 51.06% (24/47); χ2=5.51, P=0.019]. Conclusion:The Buyang Huanwu Decoction combined with suspension exercise training can relieve clinical symptoms, recover lower limb function, improve activities of daily life and prognosis in cerebral infarction combined with lower limb hemiplegia.

Objective:To explore the effects of long non-coding RNA SATB2-AS1 in the proliferation and apoptosis of cervical cancer cells as an endogenous competitive RNA to regulate miR-373-5p/BTG3 axis.Methods:qRT-PCR was used to detect the expression of LncRNA SATB2-AS1, miR-373-5p and BTG3 in paracancerous tissue and cancerous tissue of patients with CC. The interaction between LncRNA SATB2/miR-373-5p/BTG3 was then predicted and verified. The expression of SATB2-AS1 and miR-373-5p in cells was intervened, subsequently the CC cells were divided into different groups. The proliferation activity of cells in each group was detected by MTT, and the apoptosis of cells in each group was detected by flow cytometry.Results:qRT-PCR showed that the expression of SATB2-AS1 and BTG3 in cancer tissue and CC cells was significantly decreased, while the expression of miR-373-5p was significantly increased in cancer tissue and CC cells compared with paracancerous tissue and normal cervical cells.The targeting relationship between SATB2-AS1 and miR-373-5p was confirmed. Compared with NC group, overexpression of SATB2-AS1 inhibited cell proliferation butinduced apoptosis. Overexpression of miR-373-5p promoted cell proliferation, inhibited apoptosis, but this effect was partially saved by SATB2-AS1.Conclusion:Up-regulation of LncRNA SATB2-AS1 expression regulated the miR-373-5p/BTG3 axis and participated in the progression of cervical cancer, subsequently inhibited cancer cell proliferation but induced apoptosis.

Objective To evaluate the effect of the LEMON method in predicting difficult air-way.Methods A total of 1 528 patients scheduled for elective surgery requiring tracheal intubation under general anaesthesia,680 males and 848 females,aged 18-83 years,ASA physical status Ⅰ orⅡ,were enrolled in the study.We used the LEMON method to assess airway conditions before an-aesthesia and recorded the scores.The primary end point was difficult tracheal intubation.The sec-ondary end point was difficult laryngoscopy.Receiver operating characteristic (ROC)curve analysis and the area under the curve (AUC)were used to evaluate the clinical effect of the LEMON mothod. Results There were 37 cases with difficult tracheal intubation and 106 cases with difficult laryngosco-py.The incidence of difficult tracheal intubation and difficult laryngoscopy were 2.4% and 6.9%,re-spectively.The area under the curve of the LEMON method for predicting difficult laryngoscopy and difficult tracheal intubation were 0.884 (95% CI 0.867-0.899)and 0.934 (95% CI 0.921-0.946), respectively.Conclusion The LEMON method has good clinical effect in predicting difficult airway.

Objective To study the impact of aspirin resistance(AR)on the recurrence of artery athero-sclerotic cerebral infarction,and analyze the risk factors of AR. Methods According to TOSAT classification, newly diagnosed cerebral infarction patients with artery atherosclerotic cerebral infarction were selected into groups,and aspirin enteric-coated tables(ASP)was used to prevent platelet aggregation.One week later,the inhi-bition rate of platelet was detected by thrombelastogram(TEG),and the patients were divided into aspirin sensi-tive(AS)group and AR group,and were followed-up for at least 6 months.According to whether they were recur-rent cerebral infarction,the patients were divided into recurrent group and non-recurrent group. Then,statistical analysis was conducted.Results The incidence rate of AR in recurrent group was significantly higher than that in non-recurrence group(P < 0.05);the recurrence rate of cerebral infarction in AR group was significantly higher than that in AS group(P<0.05).When compare the clinical indexes between the recurrence group and non-recur-rence group,age,diabetes,TC,Hcy,Apo-a in the two groups were different(P<0.05).In recurrent group,the distribution of diabetes,LDL-C and Hs-CRP were different between AR and AS group(P<0.05).Age,gender, hypertension,diabetes,Hs-CRP and TC were risk factors for AR.Conclusions AR plays an important role in the relapse of artery atherosclerotic cerebral infarction and it is more likely to occur especially accompanied by adverse factors such as underlying diseases. TEG can be used to detect AR rapidly and conveniently,which has practical significance in preventing recurrent cerebral infarction.

Objective: To explore the availability and safety of fecal microbiota transplantation for patients with refractory diarrhea after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: Four acute leukemia patients suffered from refractory diarrhea after allo-HSCT. One of them was refractory intestinal infection, the others were intestinal graft versus host disease. One or two doses of fecal microbiota, 3.4-6.0 U for one dose, were infused via nasal-jejunal tube. The curative effect and side effects were reviewed. Results: Three cases achieved complete remission while 1 was stable disease. The side effects included fever, abdominal pain and diarrhea, which all were Ⅰ grade. Conclusion Fecal microbiota transplantation was effective and safe for refractory diarrhea after allo-HSCT.

Objective: To analyze the efficacy and safety of asparaginase based chemotherapy bridging autologous hematopoietic stem cell transplantation (auto-HSCT) in the treatment of 16 patients with nasal type extranodal NK/T-cell lymphoma (ENKTL). Methods: From January 2012 to June 2017, 16 patients with nasal type extranodal NK/T-cell lymphoma reached complete remission by L-asparaginase based regimens, and then received auto-HSCT. Results: ①Of the 16 patients, 12 were males and 4 females, with a median age of 35.5 (14-61) years. There were 11 patients in the first complete remission (CR1) and 5 in the second CR (CR2) before transplantation, respectively. EB virus (EBV) DNA (EBV-DNA) was negative and positive in 13 and 3 cases respectively before transplantation. ②Hematopoietic reconstitution was achieved in all 16 cases. The median time for neutrophils implantation was 12 (8-17) days, and that of platelet implantation was 15.5 (12-24) days. ③To the last follow-up, there were no transplant related deaths, 3 patients died of disease progression. The median overall survival (OS) time and progression-free survival time (PFS) were not reached. Seven patients lived with no disease progression more than 2 years. ④The OS and PFS of patients at CR₁ before auto-HSCT are better than that of patients at CR₂, but there was no statistically significant difference (P=0.162, P=0.123). There was no significant difference in OS and PFS between EBV-DNA negative and positive patients before transplantation (P=0.280, P=0.244). Conclusions L-asparaginase based regimens bridging auto-HSCT is a safe and highly effective for advanced-stage and relapsed ENKTL treatment.

Objective To compare the renal toxicity of vancomycin with continuous infusion vs intermittent infusion. Methods The databases of EMBASE,PUBMED,the Cochrane Register of Controlled Trials,CBM,CNKI and WanFang were searched.The Cochrane Revman5.2 software was used for Meta-analysis.Results Two RCTs and eight observational studies were included in the systematic literature search with total of 1 764 patients.1 037 patients received vancomycin with continuous infusion while 727 patients with intermittent infusion.The Meta-analysis indicated that there was no significant difference in renal toxicity between continuous infusion group and intermittent infusion group(P>0.05).Conclusion Vanco-mycin continuous infusion cannot effectively reduce the incidence of renal toxicity.