Objective To determine the minimum alveolar concentration(MAC) of sevoflurane without body movement during laryngeal mask airway(LMA)intubation in premature infants less than 37 weeks of corrected gestational age undergoing total inhalation general anesthesia induction.Methods Twenty-one ASA Ⅰ or Ⅱ premature infants less than 37 weeks of corrected gestational age undergoing elective inhalation general anesthesia were enrolled in this study.At first,the general anesthesia induction was started by inhaling 6 ％ sevoflurane.After the premature infant lost consciousness,the end tidal sevoflurane concentration(ET-sev)was adjusted to the predetermined concentration and maintained stable for 15 min.After that,LMA was inserted.The up-anddown sequential allocation was used to determine MAC.The initial ETsev was 2 ％,which was increased or decreased by 1 gradient concentration in the next case according to the LMA insertion body movement response.The adjacent concentration gradient was 0.2％.The midpoint from th body movement response to non-body movement response was set as the balance point and the mean value of the concentrations of sevoflurane at all the balance points were calculated as MAC.Results The end tidal sevoflurane con centration without the body movement responses to LMA insertion was 1.71％.Conclusion The MAC of sevoflurane without the body movement responses to LMA insertion in premature infants less than 37 weeks of corrected gestational age is 1.71％,which is lower than that in the normal children and probably because imperfect central nervous system development in premature infants.

369 patients with hypertension living in Xietu community were randomized into 2 groups:intervention group receiving the group-interference-management and control group receiving routine hypertension management services.We found that patients in the intervention group had better self-management behaviors,self-efficacy and health status in comparison with the control group (P＜0.05).The systolic and diastolic blood pressure in the intervention group decreased more remarkably than that in the control group (P＜0.05).Our result suggested that the community-based hypertension group-interference-management model is more effective to control hypertension than the routine hypertension management services.

ObjectiveTo provide evidence for the development of national norm of coping style for petrol station employee.MethodsStratified random sampling surveys and individual interview were performed in 13 269 in-service petroleum employees.Taking gender,age,education level and marriage as independent variables and coping factors as dependent variables,t test or analysis of variance was completed.Results Our data indicated that coping style was significantly changed in different gender ( P＜0.05),age (F=4.596,P＜0.05),education (F=14.723,P＜0.05) and marriage groups (P＜0.05).Conclusion Specified working environment results in corresponding coping style,and the development of national norm may be important and necessary.

AlM: To evaluate the application of phacoemulsification of different nucleus density using ozil and traditional mode.METHODS: A total of 89 eyes (72 patients ) ( visual acuity was of 0. 6 and above after 1mo follow - up) of different nucleus density level (LOCS Ⅱ criteria grade Ⅲ 46 eyes, grade Ⅳ and more 43 eyes ) were randomly assigned into 2 groups: ozil group (group A), grade Ⅲ 22 eyes (torsional energy 80% lP on);grade Ⅳ and more 17 eyes (torsional energy 100% lP on); Traditional mode group(group B), grade Ⅲ 24 eyes (energy 50% ), grade Ⅳ and more 26 eyes (energy 60% ~ 70% ) . All surgeries were performed by the same experienced surgeon,who use the chop to split the nucleus in the application of phacoemulsification. lntraoperative parameters were total equivalent pawer ( TEP ), cumulative dissipated energy ( CDE ) and effective phaco time ( EPT ) and surgical complications. The effectiveness of the two modes in dealing with hard - core cataract phacoemulsification were compared.RESULTS: GradeⅢ nucleus dealing: TEP of ozil group was significantly higher than that of the traditional mode group [(24.58±7.78)% vs (13.84±1.97) %]and EPT of ozil group was significantly lower than that of the traditional mode group (50. 59±14. 73 s vs 60. 19±9. 04 s, P<0. 05). CDE showed no difference between two groups [(13.12±6.03)% vs (13.38±2.85)]. Grade Ⅳ and more nucleus dealing: CDE [( 34. 10 ± 13. 48 )%] and EPT (104. 64±32. 4s) of the ozil group was higher than CDE [(30. 31 ± 13. 48)%] and EPT (93. 01 ± 41. 01s) of the traditional mode group, but there were no difference between two groups. Obstacles in the needle of phacoemulsification surgery: ozil group 4/17, traditional mode group 2/26 (χ2=2. 16, P=0. 14).CONCLUSlON: Bothozil and traditional mode can deal with all kinds of nucleus effectively and safely. Ozil mode is more efficacy and quick deal in gradeⅢnucleus. With the increase of nucleus hardness, the traditional mode still have the advantage of high efficiency and no obstacle to dealing patients with grade Ⅳ and more nucleus. Choose according to different nuclear hardness ultrasonic model can improve the operation efficiency and security.

Objective To observe the changes of inflammatory factors and clinical parameters on septic patients with hemoperfusion,and to discuss the application of hemoperfusion on sepsis. Methods 43 patients with sepsis were divided into treatment group and control group randomly. In the treatment group,the patients received conventional treatment and hemoperfusion together,which performed every 24 hours,continuously for 3 times when they arrived in ICU in the first hour. The concentrations of TNF-α,IL-6,IL-10 and PAF were dynamically detected before hemoperfusion,after 24 hours,48 hours and 72 hours in treatment group. The concentrations of TNF-α,IL-6,IL-10 and PAF were compared between the two groups after 72 hours. So did the clinical parameters as WBC count,CRP,PCT and blood lactate acid. Results The concentrations of TNF-α,IL-6, IL-10 and PAF were increased significantly in the early stage of sepsis,and were decreased obviously after hemoperfusion(P < 0.01). After 72 hours treatment,the concentrations of TNF-α,IL-6 and PAF were decreased rapidly,so did the level of CRP,PCT and blood lactate acid. There were significant differences between the two groups(P < 0.05). ConclusionHemoperfusion could remove the inflammatory factor of septic patients and improve the clinical symptoms of them.

The biological activity of ADCC by anti-CD20 monoclonal antibody was determined by BioGlo™ Luciferase Assay System using Jurkat/NFAT-luc+FcγRIIIa cell line as effector cell and WIL2-S cell line as target cell. The developed method was verified for specificity, precision and accuracy. Anti-CD20 monoclonal antibody showed a dose-response mode by the developed method, and the determination result complied with the following four-parameter equation: y = (A-D)/[1 + (X/C)(B)] + D. The optimized parameters of the method were determined including the antibodies diluted concentration (18,000 ng·mL(-1)), dilution rate (1:5), the ratio of effector cell and target cell (6:1), and induction time (6 h). The values of eight independent tests have passed a statistical test for curve regression analysis, linear or parallelism, which showed the method possessed good specificity. Four different dilute groups of recovery rates sample were determined for 3 times, and the result showed mean relative potencies of (44.39±3.93)%, (72.74±2.78)%, (128.28±7.01)% and (168.19±2.70)% respectively, with a variation coefficient of less than 10%, and the recoveries of (88.78±7.85)%, (96.99±3.70)%, (102.63±5.61)% and (112.12±1.80)% respectively. A novel reporter gene method for determination of biological activity of ADCC by anti-CD20 monoclonal antibody was successfully developed, which showed strong specificity, good reproducibility and high accuracy, and might be used routinely.

OBJECTIVETo explore the imaging characteristics and operation outcomes of intramedullary schwannoma in thoracolumbar spine.

METHODSFrom June 2005 to December 2012,17 patients with intramedullary schwannoma in thoracolumbar spine were operated through posterior approach, including 11 males and 6 females with an average age of 53 years old ranging from 46 to 67 years old. The courses of disease ranged from 3 to 5 years (averaged 3.3 years). Thoracic patients manifested chest and back pain,numbness and inability on lower limb gradually, unsteady gait. Lumbar patients manifested low back pain,radiating pain and numbness on lower limb, intermittent claudication. Preoperative VAS score was 5 to 8 with an average of 6.12. Eleven patients suffered from never injury, 4 cases were grade C, 5 cases were grade D and 2 cases were grade E according to Frankel classification. Three patients were injured on thoracic segments, 5 patients were on thoracolumbar segments, 3 patients on lumbar segments and 6 patients on lumbosacral segment confirmed by CT and MRI. Five patients were epidural, 12 were intradural extramedullary. Six patients underwent spinal decompression and tumor resection simply, eleven patients underwent spinal decompression, tumor resection, internal fixation and bone graft fusion.

RESULTSNo injury of blood vessel or spinal cord occurred during operation, cutting healed well. All patients were followed up from 12 to 60 months with an average of 32 months. Chest and back pain, low back pain, radiating pain and numbness on lower limb were improved significantly. VAS score at final follow-up was 0 to 3 (averaged 1.5). According to Frankel classification, 5 cases were grade D, and 6 cases were grade E at final follow-up.

CONCLUSIONMRI is an effective method in diagnosis of intramedullary schwannoma in thoracolumbar spine. Operative method is choosed by imaging expression, and the aim is effectively decompression of spine, reconstruction of stability of spine.

Aged ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemmoma ; pathology ; surgery ; Spinal Neoplasms ; pathology ; surgery ; Thoracic Vertebrae ; surgery

Objective To analyze the differences of size and charge heterogeneities between origi-nal humanized anti-TNF-αantibody and four similar biotherapeutic products ( SBP ) .Methods The size exclusion chromatography ( SEC-HPLC ) and weak cation exchange chromatography ( WCX-HPLC ) were used to analyze the size and charge heterogeneities , respectively.Carboxypeptidase B (CpB) treatment was employed to analyze the source of charge heterogeneity of the antibody products .Results Four SBPs showed the same pattern with the originator in SEC-HPLC, and no significant difference with the percentage of mono-mer was observed .The percentages of the aggregates of SBP-3 and SBP-4 were a little higher than those of the originator .The charge distribution of SBPs was significantly different from the originator ′s, especially in the basic region .The results from the samples treated with CpB indicated that the difference of charge distri -bution in the basic region might be caused by the C-terminal lysine variants .Conclusion Four SBPs showed similar size heterogeneity with the originator , but significant differences with charge heterogeneity were observed among them .The study suggested that more attention should be paid to the charge heterogene -ity analysis of the biosimilar products .

Objective To compare the capability of capillary electrophoresis-sodium dodecyl sul-fate ( CE-SDS) and size exclusion-high performance liquid chromatography ( SE-HPLC) for analysis of size heterogeneity of monoclonal antibody products .Methods The size heterogeneity of one humanized anti-VEGF monoclonal antibody was analyzed by using non-reduced and reduced CE-SDS, and conventional , de-natured and denatured reduced SE-HPLC.Results The percentage of aggregates detected by non-reduced CE-SDS (0.82%±0.01%) was equal to that by using denatured SE-HPLC (1.05%±0.02%), but it was significantly lower than that by using conventional SE-HPLC analysis (5.08%±0.10%).With regard to fragments analyzed with non-reduced antibodies, its percentage was (7.12±0.04)% measured by non-re-duced CE-SDS analysis that was significantly higher than that by conventional SE -HPLC analysis (0.02%± 0.01%) and denatured SE-HPLC analysis (0.62%±0.01%).Using reduced antibodies , the percentage of fragments was (3.19±0.50)%tested by reduced CE-SDS analysis that was significantly higher than that by using denatured reduced SE-HPLC analysis (0.07%±0.01%).Conclusion Conventional SE-HPLC was more objective than CE-SDS for content analysis of aggregates , as both the covalent and non-covalent forms of aggregates could be detected .Non-reduced CE-SDS could demonstrate the content of clips , while reduced CE-SDS showed the degraded fragments .Therefore, CE-SDS had an advantage over conventional SE-HPLC for content analysis of fragments .The use of the two analytical methods in combination provided solid techni-cal supports for the quality control of size heterogeneity of monoclonal antibodies .

Here we discuss whether N terminal sequencing is appropriate as one of the conventional control methods for monoclonal antibody products. We determined the N terminal sequences of two monoclonal antibody products targeting two antigens separately with both Edman degradation and mass peptide spectrometry. We also identified the characteristic peptide fragments with mass spectrometry. Furthermore, we analyzed their heterogeneity with ion exchange chromatography, capillary zone electrophoresis and Imaged Capillary Isoelectric Focusing. Edman degradation method showed that the N terminal 15 amino acids of heavy and light chains of the two monoclonal antibodies were identical. Peptide mass spectrometry demonstrated that T1 peptide fragments of heavy and light chains of the two antibodies were also the same. But in contrast, peptide mapping and the three analytical methods for heterogeneity analysis could effectively identify and differentiate the two antibodies. The N terminal sequences of two monoclonal antibodies are identical because the number of framework sequences of humanized or human monoclonal antibodies is relatively limited, so whether N terminal sequencing analysis could be regulated as one of the practical control methods should be carefully discussed. Our work also proves that the above analytical methods could combinatorially applied to the identification of monoclonal antibody products, and are more objective compared to N terminal sequencing.
Amino Acid Sequence ; Antibodies, Monoclonal ; isolation & purification ; Chromatography, Ion Exchange ; Humans ; Isoelectric Focusing ; Mass Spectrometry ; Peptide Mapping ; Peptides ; Sequence Analysis, Protein ; methods