Fraction absorbed (Fa) is an important parameter to describe the absorption level of oral drugs, and an important basis for the development and optimization of the formulation process. Because it is easily confused with the concept of absolute bioavailability, it has not received enough attention from the industry. There are many complex factors affecting Fa. There are three time-related factors that directly affect the extent of Fa: the release time, the absorption time, and the residence time. The relationship between these three time-related factors determines the extent of Fa. Generally, we are more concerned about the apparent factors that affect the extent of Fa, including independent variables and covariates; The independent variables include administered dose, route, dosage form, etc. The covariates are divided into internal and external factors, and external factors include food factors, drug interactions, etc. Internal causes include age, sex, disease, etc. This paper analyzes and systematically combs how independent variables and covariates directly or indirectly affect the three time-related factors by affecting the body's physiology and internal environment, thus changing the complex process of Fa. Understanding this theoretical framework can better optimize the independent variables to reduce the impact of covariates on Fa. In addition, this paper also introduces the latest progress of prediction and evaluation of Fa, including the progress of complex dissolution device and the status of software prediction.

Objective To develop national norms of nursing soft skills, and provide a basis for the evaluation of the nursing soft skills for new nurses.Methods With the stratified cluster sampling, 2816 new nurses were choosed from across China, and nursing soft skills evaluation scale was used to investigate.The general descriptive statistics, reliability analysis and confirmatory factor analysis of sample data were done.Results Developed the total national norms of nursing soft skills for new nurses ( the total soft skills was 150.31 ± 15.47,interpersonal skills was 28.28 ± 3.75, organizational management was 33.74 ± 4.10, self-management was 37.50 ±4.58 ,career sentiment was 28.10 ±3.52 ,cognitive kills was 22.70 ±3.11 ) and established a T-rough and percentiles-rough score conversion tables.The level of nursing soft skills of new nurses was divided into five levels: T-score ＜ 30 was poor for the soft skill, T-score at the 30 to 39 for the somewhat less, T-score at the 40 to 59 for the general level, T-score at 60 to 69 for good,T-score ≥ 70 for the best.Conclusion These norms can be used as evaluating standards of nursing soft skills for new nurses.

This study was based on live yeast cell derivative (LYCD), which was produced by live yeast cell stressed with high temperature and H 2O 2. The results showed that pretreating of low dose(37℃and 0.2mmol/L H 2O 2) could increase the content of GSH and the activity of SOD and CAT. These pretreatment could induce the resistance to lethal concentration of H 2O 2. LYCD was produced by yeast treated with 37℃ and 0.2mmol/L H 2O 2. And it was found that the survival of yeast treated with lethal concentration of H 2O 2 obviously increased, while LYCD was added in yeast culture. It indicated that LYCD could have resistance to oxidative condition.

Objective To present a method to treat soft tissue defects with bone exposure after the distal tihial fracture.Methods Twenty-six patients who had suffered from the distal tibial fracture complications leading to exposure of the bone or fixation material sought medical help in our department.The internal fixation material was removed and radical revision of dead and infected tissue was carried out in all cases.Five of the 26 cases were treated using a free microvascular muscle flap and the mesh skin graft by one stage.Twenty-one of them were re- paired with the same method by two-stage.Results Follow-ups were 10 to 24 months.The microvascular re- construction was successful in 22 patients.Two of the 26 cases had partial necroses of the skin graft,and the other two cases had delayed wound healing.All the fractures united.Conclusion Microvascular free muscle flap re- construction of the leg is regarded as a reliable method to treat legs with massive soft-tissue defects or defects with bone exposure and chronic infection or fistulation at the distal leg.

Objective To analyze the validity of Caprini venous thrombosis risk assessment model (Caprini RAM) in the tunneled cuffed dialysis catheters (TCCs) dysfunction patients with central venous thrombosis (CVT).Methods A total of 187 maintenance hemodialysis patients with TCCs dysfunction admitted to West China Hospital of Sichuan University from January 2013 to September 2016 were analyzed retrospectively.According to the chest computed tomography venography results,patients were divided into CVT group and non CVT group.Their general clinical data (age,gender,primary diseases,history of dialysis access,etc.),blood biochemical data (hemoglobin,serum albumin,blood lipid,etc.) and 40 risk factors of Caprini RAM were collected.Caprini RAM scores were computed for risk stratification of thrombosis.Two groups were compared to analyze the value of Caprini RAM in these patients by statistics.Results One hundred and twenty CVT patients and sixty-seven non CVT patients were enrolled.In CVT group the duration of dialysis,hemoglobin and hematocrit were higher than those in non CVT group (all P ＜ 0.05).There was no significant difference between the two groups in gender,age,primary diseases,duration of catheter dependence,catheter tip position,usage of urokinase (all P ＞ 0.05).The average score of Caprini RAM in CVT group and non CVT group did not show statistical difference (6.23+ 1.81 vs 6.19+ 1.95,P=0.913).All patients were stratified into higher risk level and highest risk level according to Caprini RAM.Higher risk level patients accounted for 18.18％ and highest risk level patients accounted for 81.82％.As patients with inequable Caprini RAM scores,their incidence of CVT did not differ statistically (x2=0.105,P=0.746).CVT incidence rate of higher risk level patients was 61.76％,and of highest risk level patients was 64.70％.Conclusions Caprini RAM verifies that maintenance hemodialysis patients with TCCs dysfunction have high risk of venous thrombosis,but this model fails to distinguish patients between CVT group and non CVT group.Its clinical diagnosis is relatively limited and needs to be further explored.

Objective To study the diagnostic and prognostic values by magnetic resonance imaging(MRI) and computed tomography(CT) for investigation of infantile spasms(IS).Methods Fourty-two patients with IS were retrospectively reviewed by CT scan and MRI T1W,T2W and inversion recovery (IR) and MRA techniques.Results Fourteen cases were found abnormal in CT,including encephalatrophy,hemorrhage,gross malformation and lesions with underlying calcification;MRI studies of 24/28 cases showed that MRI was the most appropriate imaging technique in diagnosis of the underlying substrate of patients with IS and other epilepsies,particularly in periventricular leuko malacia(PL),delayedmyelination(DM),hypxic-ischemic encephalopathy(HIE),kernicterus,tuberous sclerosis(TS),hippocampal sclerosis(HS),brainstematrophy,heterotopia,corpus callosum and vascular malformation,et al.MRI was also valuable for determining the prognoses of IS,but it should be combined with the clinical symptom and ages. Conclusions MRI and CT are highly important for the investigation and treatment of patients with IS; MRI is much more sensitive to exploration of neuropathology of infatile spasms,such as PL,DM,HIE,kernicteus,HS,heterotopias and focally cortical dysplasia.

Objective To investigate the value of the diagnosis of contrast-enhanced ultrasound(CEUS) in renal tumors. Methods Nineteen patients with hyperechoic renal tumors detected by CEUS underwent resection for suspected renal malignant and benign tumors. The characterization of hyperechoic renal tumors on CEUS was evaluated. Results Histopathologic results of resected lesions showed benign tumors in 11 patients with angiomyolipoma and malignancy in 8 patients with clear cell carcinoma. Six patients with angiomyolipoma showed rapid wash in contrast enhancement and slow wash out on all tumor and focal tumor (6/11). One patient with angiomyolipoma was observed in rapid wash in and wash out (1/11). Four patients with angiomyolipoma showed rapid wash in and negative contrast enhancement after rapid wash out(negative contrast enhancement compared to renal cortex,4/11). Five patients with clear cell carcinoma showed rapid wash in and wash out (5/8). Two patients with clear cell carcinoma showed rapid wash in and delayed wash out (2/8). One patient with showed no enhancement on CEUS (1/8). The pseudocapsule could be seen at 5 patients with clear cell carcinoma. Wash in enhancement and wash out on clear cell carcinoma were significant in comparison to these of angiomyolipoma (P<0.05). Wash in enhancement,delayed wash out and negative contrast enhancement were no significant between clear cell carcinoma and angiomyolipoma (P>0.05). Conclusions CEUS is useful for discriminating between benign and malignant renal tumor.

Objective To explore the value of contrast-enhanced ultrasound(CEUS) in the diagnosis of hematoma and active hemorrhage of renal trauma. Methods Totally 28 patients with renal trauma were examined by conventional ultrasound and CEUS,respectively,including 24 cases caused after renal biopsy,4closed trauma. The detectability of renal hematoma and active hemorrhage with these two methods were compared. All patients were identified by CT or follow-up studies with ultrasound. Results The detectability of renal hematoma with conventional ultrasound and CEUS were 67. 86% (19/28), 92. 86%(26/28), respectively. There was statistically different for detectability in the diagnosis ( P ＜0.05), and the extent of hematoma was more obvious with CEUS. CEUS diagnosed 7 of 26 were renal hematoma with active hemorrhage,which were difficult to be detected with conventional ultrasound. For renal hematoma,the features of CEUS were no enhancement found in every phase; for renal hematoma with active hemorrhage,the contrast agents overflowed from injured blood vessels and formed irregular remarkable enhanced regions. Conclusions CEUS is useful in diagnosing hematoma and identifying the extent and active hemorrhage of renal trauma,in addition,CEUS is valuable in detecting complications after renal biopsy.

Objective:The purpose of this study is to locate and characterize splenic trauma with contrast-enhanced ultrasound(CEUS).Methods:A defined mild intraparenchymal lesion was done in 2 pigs.Ultrasound features after trauma were observed by baseline ultrasound,color Doppler flow images(CDFI) and CEUS with a contrast agent(Sono Vue),respectively.Results:In 2 pigs,focal intraparenchymal lesions on spleen with diameters ranging from 10.0 to 10.0 mm could be identified by CDFI and CEUS but not by the baseline ultrasound.Hyperechoic rift in spleen was visible along trauma area as enhancement in splenic parenchyma disappeared on CEUS.Hyperechoic line could be kept in a long time.The hyperechoic rift also appeared at the sub-capsular region beside a traumatic lesion.Hyperechoic rift in traumatic region could be seen even as CEUS was converted to conventional B-mode.Enhancement in the traumatic lesion was clearly seen in CDFI.Conclusion:Hyperechoic rift in spleen was visible along trauma area as a contrast agent is used.CEUS is useful in identifying the grade,range and location of splenic injury.