Objective To develop a HPLC-MS/MS methodfor determination of cyclosporin A(CSA)and AM1 in bone marrow transplant patient,and explore the relationship of CSA and its main metabolite AM1 within individual and between individuals,and provide reliable basis for clinical rational use of monitoring in CSA blood drug concentration.Methods CSD was used as internal standard,and whole blood samples were treated with internal standard methanol precipitated protein.The column was Ultimate XB-C18 with a column temperature of 65 ℃ and the mobile phase was eluted with 0.1％ of formic acid and 2 mmol/L ammonium acetate in water and methanol containing 0.1％ formic acid.The mass spectrometry was detected by electrospray ion trap positive ion mode,MRM scanning,monitoring CSA 1219.9 to 1203.1 m/z,AM1 1236.1 to 1219.1 m/z,CSD 1234.0 to 1217.0 m/z.Results The concentration of CSA was linear in the range of 16 to 1600 ng/mL,Y=0.0143X+0.0213(r=0.9976).The concentration of AM1 was linear in the range of 10～1000 ng/mL,Y=0.00363X-0.00528(r=0.9973).The ratio of CSA to AM1 (AM1/CSA) between individual ranged from 32％ to 356％.The ratio of CSA to AM1 within indiviolual(AM1/CSA) ranged from 27 ％ to 147 ％.Conclusion HPLC-MS/MS method for the simultaneous detection of CSA and AM1 was established.The variation of CSA exists in the bone marrow transplant patient between individuals and within individual;the HPLC-MS/MS method can be used for monitoring of whole blood concentration of CSA in bone marrow transplant patients.

Objective To develop a HPLC-MS/MS method for determination of Tacrolimus(FK506) in bone marrow trans plant patient,and explore the relationship of HPLC-MS/MS with CMIA and Elecsys in the measurement of FK506 blood drug concentration,and provide reliable basis for clinical rational use of monitoring method in FK506 blood drug concentra tion.Methods The separation was performed on a Ultimate xB-C18 column with a mobile phase of water (containing 2 mmol/L ammonium acetate and 0.1 ml/dl formic acid) and methanol (containing 0.1 ml/dl formic acid).The way of eluting was gradient.Mass spectrum detection method was ESI positive ion mode and the MRM transitions of FK506 m/z 821.5～ 768.5 and Ascomycin m/z 809.4～756.4.Selected part of the whole blood samples of FK506 in bone marrow transplant patient and respectively were tested by HPLC/MS/MS method,CMIA method and Elecsys method.Then,three methods for the detection of FK506 density were compared.Results The standard curve of FK506 was linear over the range of 0.5～50 ng/ml,Y=0.228X-0.003 08 (r=0.999 0).FK506 blood concentrations were not significantly different in HPLC/MS/MS method,CMIA method and Elecsys method.Conclusion The HPLC-MS/MS method in the detection of FK506 was established and can be used for monitoring of whole blood concentration of FK506 in bone marrow transplant patients.

Objective:To explore the clinical effect of hyperbaric oxygen plus magnetic stimulation and Xingnaojing injection on the coma patients with severe brain injury.Methods:120 coma patients with severe brain injury who were treated in our hospital from September 2011 to March,2016 were enrolled in the present study.According to different therapies,they were divided into the observation group (55 cases) and control group (65 cases).Both groups received conventional therapy and Xingnaojing injection,on the the basis of which,the control group received the Hyperbaric Oxygen therapy,while the observation group received Magnetic Stimulation on the basis of control group.The GCS,level of inflammatory factors,clinical prognosis as well as memory function were compared between the two groups.Results:After the therapy,the GCS score of both groups were obviously increased and that of observation group was significantly higher than control group (P＜0.05);the serum level ofCRP,TNF-oα,IL-6 levels were significantly decreased compared with those before therapy,and those of observation group were obviously lower than the control group (P＜0.05);the total effective rate of ob servation group was 94.55％ (52/55),which was equivalent to the control group (89.23％,P＞0.05);the long term memory,short term memory,instantaneous memory and memory quotient of observation group were significantly higher than those of the control group.Conclusion:Hyperbaric oxygen plus magnetic stimulation and Xingnaojing injectionon was effective on the coma patients with severe brain injury,it could down-regulate the inflammatory response,promote awake and recovery of memory function.

ObJective To evaluate the multi-slice spiral CT (MSCT) in the diagnosis of early small renal cell carcinoma (RCC). Methods 32 cases of small RCC proved by pathology were retrospectively analyzed. The relationship of imaging features MSCT with pathology was compared. Results Of the 32 RCC in this study, 19 patients were with low density, 6 medium density, and 5 minimal high density. In 24 patients, the lesion were seen as a mixed enhancement pattern, 8 were with the homogeneous enhancement pattern.In cortical phase, clear cell RCC (25/32) tended to be marked enhancement or mixed enhancement pattern; 2 chromophobe lesions and 2 angsarcomakoid renal cell carcinoma (2/32, 2/32 respectively) tended to enhance moderately, papillary lesions (3/32) were mostly hypovascular and homogeneous enhancement pattern. The detection and characterization as well as accuracy of staging in 32 small RCC on MSCT were 100%, 93.75%, and 84.38%, respectively. Conclusion Muhiphase enhanced MSCT scan was a reliable technique in the dectection and clinical predicting subtype of small RCC.

Objective To investigate the levels and distribution of radon in dwellings in Shenzhen cities of China.Methods A total of 108 low-,multi-,middle-and high-rise buildings were selected.Indoor radon concentrations were measured by using solid track detector.Results The arithmetic mean of indoor radon concentrations in Shenzhen was 64 Bq/m3,and geometric mean was 58 Bq/m3,in range of 15 to 155 Bq/m3.The average indoor radon concentration in Bao'an district was 50 Bq/m3 with the lowest value,and that in Pingshan new district was 87 Bq/m3 with the highest value.There were 12 measuring points where indoor radon concentrations were higher than 100 Bq/m3 in Shenzhen,accounting for 11.1％ of the total number.Shapiro-Wilk test showed that the frequency distribution of indoor radon concentration in Shenzhen follows lognormal distribution (P ＞ 0.05).The indoor radon concentrations showed a downward trend from 1990 to 2015.The indoor radon concentration decreases with the elevated floors except 10th and above floors.Conclusions The indoor radon concentrations in Shenzhen increased by 35％,compared to the previous investigations.It is recommended that efforts continue to improve radioactive materials standards about building material and to enhance the natural ventilation in high-rise buildings in order to lower the radiation hazards from radon.

Objective To investigate the clinical and radiologic features of posterior reversible encephalopathy syndrome (PRES) associated with preeclampsia-eclampsia.Methods Twenty-one cases of PRES associated with preeclampsia-eclampsia were retrospectively studied on some aspects of clinical and radiologic features.Results The most common clinical presentations were seizures( 18 cases ),headache (16 cases),altered mentation (15 cases) and vision change (12 cases). Vasogenic edema lesions distributed in the parietal or occipital lobe (20 cases),the frontal lobes (14 cases),temporal lobes ( 11 cases), and basal ganglia (11 cases). The splenium involvement occurred in 4 cases,cerebellar hemispheres and brain stem involvement was prcscnted in 3 cases and 1 case separately. Three major patterns of PRES included dominant parietal-occipital (7 cases),the holohemispheric watershed (7 cases),and superior frontal sulcal (6 cases).Partial and asymmetric expression of PRES only occurred in 1 case.Conclusions The clinical features of PRES associated with preeclampsia-eclampsia are typical.Except the parietal or occipital lobe,involvement of the frontal lobe,temporal lobe and basal ganglia is common,followed by the occasional presence of the splenium,cerebellar hemispheres and brain stem.Three primary PRES patterns are noted,occasional with partial and asymmetric expression of PRES. Awareness of these typical and variable characteristics is important to recognize the PRES ncurotoxicity morc accurately when PRES present.

ObjectiveTo evaluate the effect and safety d sorafenib in treatment of patients with metastatic renal cell carcinoma.Methods40 patients with metastatic renal cell carcinoma,were given sorafenib tablets methanesulfonate treatment,the initial dose of 800mg/d,bid,continuous administration of 21d,stopping 7d,The adverse reactions,efficacy and immunohistochemistry results were observed.Results40 cases with metastatic renal cell carcinoma were not found complete remission (CR) and partial remission (PR) ; The 32 cases in stable disease (SD)(80.0％ ) and 8 cases ( 20.0％ ) in PD; The incidence of 28 cases ( 70.0％ ) in digestive system; The expression of positive rate 30.5％ of local in connexin 32,Cx32 was significantly lower than that 1.2％ in metastatic renal cell carcinoma( x2 =8.123,P ＜0.01 ),The expression of Cx32 was negatively correlated with the clinical stage( r =-0.419,P ＜0.05 ) ;The expression positive rate of vascular endothelial growth factor(VEGF) in renal cell carcinoma was significantly higher than 18.5％ in normal renal tissue( x2 =8.723,P ＜ 0.01 ) ; The expression positive rate 72.0％ in the limitations of renal cell carcinoma and metastatic renal cell carcinoma 89.1％ was not statistically significant( x2 =1.978,P ＞ 0.05 ).ConclusionSorafenibin for advanced kidney cancer had better disease control effect,and was new choice for treatment of metastatic renal cell carcinoma.

Objective:To explore the spatio-temporal dynamics of brain mechanisms in visual change detection by 256-channel event-related potential (ERP) and low-resolution electromagnetic tomography (LORETA) analyses.Methods：ERP were recorded in 12 healthy participants during performing an S1-S2 matching task.Visual stimuli defined by color and shape.Each trial consisted of two sequentially presented stimuli (S1 and S2),where S2 was either the same as S1,different from S1 in shape only,different in color only,or different in both color and shape.Subjects matched the stimuli according to task demands：attending to color and attending to shape.Result：Change condition elicited change-related positivity (CRP) ranging 135～165 ms.The estimated source regions contributing to CRP were lingual gyrus and cuneus of occipital lobe.N200 was elicited in no change and task-irrelevant change condition ranging 235～275 ms.The source for N200 was in the right temporal fusiform gyrus,middle temporal gyrus and parahippocampal gyrus.In the time window of 240～320 ms,N270 was elicited in all change conditions.The N270 source was localizable to the anterior cingulated cortex and amygdala.Conclusion：In the early stage,CRP reflects the preattentive processing of visual changes.The LORETA result confirms that CRP is generated in the early visual areas.N200 may be related to the active ignored processing of task-irrelevant change.The source for N200 is in the right temporal fusiform gyrus,middle temporal gyrus and parahippocampal gyrus.In the late stage,N270 reflects the advanced processing of visual change in the human brain.The N270 source may be in anterior cingulate cortex (ACC) and amygdala.

Objective To explore the effect of radon released from water on the indoor radon activity concentration in groundwater supplies.Methods Two groundwater supplies in a city were chosen.Radon concentrations in three kinds of water samples were determined by using a continuous radon monitor with air-water exchanger,including source water,finished water and tap water.The solid track detector was used to analyze the indoor radon concentration in water supplies.Results The concentrations of radon in source water,finished water and tap water were (7.59 ± 1.36),(3.56 ±0.86),(3.68 ±0.81)Bq/L and (12.19 ±0.57),(7.87 ± 1.12),(9.50 t 1.12) Bq/L,respectively.The concentration of radon was the highest in source water and at less varying level in finished water and tap water.Aeration and filtration tank process significantly decreased radon activity in water.Radon concentrations in aeration and filtration rooms were 4 218 Bq/m3 and 1 937 Bq/m3,respectively,which exceeded the limit in work place (1 000 Bq/m3).Conclusions Aeration and filtration workplaces for groundwater supplies were found to contain elevated radon concentrations in air,which was released from groundwater.Radon issues in groundwater supplies in China should be paid more attention.

Objective To compare the therapeutic effect of Pilates and conventional training after total hip arthroplasty (THA).Methods Fifty-eight patients who had undergone minimally invasive total hip replacement surgery were divided into an observation group (n =29) and a control group (n =29) using a random number table.The observation group was given Pilates rehabilitation training,including a series of exercises especially designed for this condition,for 6 months after the operation.The control group was provided with conventional postoperative rehabilitation training including passive range of motion exercise,balance training,etc.,lasting for 1 to 2 months in hospital,followed by self-training after discharge.At 1 month,3 months and 6 months after the operation hip joint function was evaluated in both groups using the Harris hip score and the modified Barthel index (MBI).The time for first out-of-bed activity after the operation,length of hospital stay and postoperative complications of the two groups were also recorded.Results At 1 month after the operation,the average Harris hip score and MBI score of the observation group were significantly better than those of the control group [(59.78 ± 6.22) vs (51.26 ± 3.42) and (52.56 ± 16.67) vs (45.63 ± 15.24),respectively].Two and 4 months later,in the observation group the average Harris hip score had improved significantly to (82.12 ± 3.32) and further to (91.42 ± 5.91),while the MBI score increased significantly to (58.39 ± 13.32) and (81.17 ± 13.87).The same tendency was observed in the control group and at those two time points no significant difference was observed between the observation group and the control group.The patients in the observation group had their first out-of-bed ambulation significantly earlier,a significantly shorter average hospital stay and significantly fewer postoperative complications.Conclusion Pilates training after minimally invasive THA can promote earlier and quicker functional recovery than conventional rehabilitation training.