Clinical data of 14 patients with iatrogenic duodenal injuries treated in hospital from January 2000 and January 2010 were retrospectively reviewed.Iatrogenic duodenal injuries were found intraoperatively in 9 cases,in whom repair or additional jejunostomy was performed and all were cured and discharged.In 2 patients the duodenal injuries were found within 24 hours postoperatively,1 was cured,another had low flow duodenal fistula and cured with conservative treatment.Duodenal bypass and extraoral drainage were performed in 2 patients whose duodenal injuries was found 72 hours after surgery and died from severe infection of retroperitoneal space and multiple organ failure respectively.One patient whose duodenal injury was found 7 d postoperatively suffered from septic shock and died in 4 h after admission.The results suggest that early detection and early management would result in satisfied outcome for patients with iatrogenic duodenal injuries,the first 24 hours are crucial.

AIM: To investigate the effects of external counterpulsation (ECP) on nitric oxide (NO) and nitric oxide synthase (NOS) and the expression of NOS gene in myocardial infarction canines. METHODS: Nineteen healthy dogs were randomly divided into three groups ie. controls, ischemia group, ischemia and ECP group. Serum NO concentrations and myocardium NO levels and NOS specific activity were determined by modified nitrate reductase method. The protein synthesis of sub-type NOS including inducible NOS (iNOS) and endothelial NOS (eNOS) of myocardial tissue were also determined by immunohistochemical method. The constitutive NOS (cNOS) mRNA was measured via in situ hybridization. RESULTS: 120 and 180 minutes after the ligating of LAD, serum NO concentration in ECP groups were higher than those in ischemic groups (P

Objective To evaluate the clinical value and the early therapeutic efficacy of hysteromyomas treated with the radiofrequency ablation (RFA) by two-dimensional contrast-enhanced ultrasound(2D-CEUS) and three-dimensional contrast-enhanced ultrasound(3D-CEUS). Methods A total of 90 patients with 150 hysteromyomas were treated with RFA, including 138 intramural myomas and 12 submucous myomas (in which 5 had micr-pedicles). 2D-CEUS and 3D-CEUS were performed within one day before and after RFA treatment, respectively. The blood supply of focal zone(FZ) was observed by 2D-CEUS and 3D-CEUS. The volume of hysteromyomas and the coagulation necrosis range were measured by 3D-CEUS. The average necrotic rates of hysteromyoma were calculated. Results The 5 submucous myomas with micr-pedicles were removed completely after the RFA treatment. The 2D-CEUS appearances of other 145 hysteromyomas were diverse after the RFA treatment, in which 137 FZs had no contrast infusion,indicating complete ablation, 8 FZs appeared peripheral linear or small flaky enhancement, considering incomplete treatment. The 3D-CEUS performances were variant too, in which 132 FZs vascular network displayed as a "cavity", indicating complete tumor necrosis, the other 7 FZs appeared "branch shape" low enhancement and another 6 FZs showed nonuniform low enhancement, considering residual tumor tissue. The average necrotic rate of the 139 hysteromyomas was (97.1 ± 12. 9)% ,another 6 hysteromyomas was only (46. 4 ± 7. 0) %. Conclusions 3D-CEUS can display vascular structure and spatial relationship of the hysteromyomas, which can be used as the complement of 2D-CEUS. The combination of the two techniques can evaluate the earlier therapeutic efficacy of hysteromyomas by RFA more timely, intuitively and accurately.

OBJECTIVETo assess the association of T190C polymorphism of β3 adrenergic receptor gene (β3-AR) with chronic heart failure (CHF), and to evaluate the effect of this polymorphism on clinical response to β-AR blockade among patients with CHF.

METHODSThree hundred and thirty patients with stable CHF receiving basic therapy for heart failure were included. Before initiation and 5 months after the maximal tolerated dose of carvedilol was reached, all indices including heart rate (HR), blood pressure (BP), left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP) level, 6 min walk distance were measured and compared with the indices of those with a T190C genotype. Distribution of the T190C polymorphisms in the control group and CHF group was compared.

RESULTSThe frequencies of T190C genotypes of the β3-AR gene have fit with the Hardy-Weinberg equilibrium. No significant difference was found between the frequencies of T190C alleles and genotypes between the two groups (P > 0.05). Compared with CC-homozygotes, TT-homozygous patients showed substantially greater improvement in LVEF and BNP (all P < 0.01).

CONCLUSIONNo difference has been detected in the prevalence of the three genotypes between healthy and CHF subjects. The T190C variation of the β3-AR gene was not associated with increased risk for CHF. CHF patients with a T allele have greater response to carvedilol than those carrying a C allele in ethnic Han Chinese.

Adult ; Carbazoles ; therapeutic use ; Chronic Disease ; Female ; Heart Failure ; drug therapy ; genetics ; physiopathology ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Propanolamines ; therapeutic use ; Receptors, Adrenergic, beta-3 ; genetics ; Ventricular Function, Left

ObjectiveTo establish a non-targeted screening method for emerging contaminants in drinking water based on high-resolution mass spectrometry and apply it to actual water samples. MethodsA total of 9 drinking water samples collected from 3 reservoirs in Shanghai were purified and concentrated by HLB solid phase extraction column， then separated and analyzed by liquid chromatography high-resolution mass spectrometer and gas chromatography high⁃resolution mass spectrometer. The acquired data were analyzed by Thermo Tracefinder， Excel and other software combined with mzCloud and NIST databases. The methodology was verified with representative compound standards. Pesticide and perfluorinated compounds were taken as examples to analyze their pollution status. ResultsA non-targeted analysis strategy based on liquid chromatography and gas chromatography tandem high-resolution mass spectrometry was established. The pollution level of 20 kinds of pesticides and 4 kinds of perfluorinated compounds identified in 9 drinking water samples were higher in the Huangpu River than in the Yangtze River estuary. ConclusionThe established non-targeted screening method by high-resolution mass spectrometry can detect potential emerging contaminants in drinking water without relying on the standards， which provides a powerful technical means for water quality monitoring and risk assessment.

Background The production and consumption of high polar pesticides in China are the largest in the world. Therefore, it is urgent to develop a method with fast analysis, large flux, and high accuracy to determine the residues of these pesticides in food. Objective To establish a method for the determination of eight highly polar pesticides [chlormequat, paraquat, difenzoquat, cyromazine, propamocarb, glyphosate, (aminomethyl)-phosphonic acid, and glufosinate] in vegetables and fruits by ultra-performance liquid chromatography-tandem mass spectrometry. Methods After comparing various types of hydrophilic interaction liquid chromatography (HILIC) columns, and optimizing pH value and buffer concentration of mobile phase, effective chromatographic retention and separation of selected eight pesticides were achieved. Based on the optimization of mass spectrometry under chromatographic conditions, a multiple reaction monitoring (MRM) channel of target compounds was established. In the sample pretreatment, through optimization of water content, extraction solvent, and purification method, a final MRM mode of ultra-performance liquid chromatography-tandem mass spectrometry was used for detection, and the isotope internal standard method was used for quantification. The accuracy and the precision of the method were evaluated using recovery and relative standard deviation. The established method was applied to detect 57 samples of retail vegetables and fruits to investigate the adaptability of the proposed method and the residual levels of selected high polar pesticides. Results For positive ion electrospray ionization (ESI⁺) detection, we chose Sielc Obelisc R as chromatographic column, and 20 mmol·L⁻¹ ammonium formate solution (pH=3±0.05) and acetonitrile as mobile phase; for negative ion electrospray ionization (ESI⁻) detection, we chose Shodex Asahipak NH2P-50 2D as chromatographic column, and 5 mmol·L⁻¹ ammonium acetate solution (pH=11±0.05) and acetonitrile as mobile phase to obtain good chromatographic separation and peak shape. Under the optimal conditions of sample water content standardization, using 2% acidified methanol as extraction solvent, and C18 dispersed solid phase extraction purification, the linearity ranges of five analytes (chlormequat, paraquat, difenzoquat, cyromazine, and propamocarb) and three analytes [glyphosate, (aminomethyl)phosphonic acid, and glufosinate] were 1.00-100 μg·L⁻¹ and 5.00-500 μg·L⁻¹ (both correlation coefficients>0.999) respectively, the detection limits were 0.002-0.010 mg·kg⁻¹, and the limits of quantification (LOQ) were 0.005-0.025 mg·kg⁻¹. At three spiked levels (LOQ, 2LOQ, and 5LOQ), the recoveries were in the range of 85.3%–113.2%, and the relative standard deviations were 1.5%–9.5% (n=6). Three target pesticides (chlormequat, cyromazine, and propamocarb) were detected in 57 samples of retail vegetables and fruits, and the residue of chlormequat in cowpea exceeded the maximum residue limit. Conclusion The established method of HILIC combined with ultra-performance liquid chromatography-tandem mass spectrometry and isotopic internal standard quantification has the characteristics of simplicity, stability, and easy operation, which is suitable for rapid screening and quantitative detection of selected eight high polar pesticide residues in large quantities of vegetables and fruits, and provides technical support for monitoring and risk assessment of high polar pesticide residues.