Objective:To establish a headspace capillary gas chromatography method for the determination of residual solvents in erlotinib hydrochloride .Methods:A DB-624 capillary column (30 m ×0.53 mm, 3.0 μm) was used and the carrier gas was nitro-gen.The flow rate was 2.0 ml· min-1 and the inlet temperature was 190℃.The FID detector temperature was 230 ℃.The column temperature program was with the initial temperature of 35℃( maitaining 8 min) , risen to 170℃with the rate of 28℃· min-1 ( main-taining 8 min) , and then risen to 200℃with the rate of 32℃· min-1 ( maintaining 7 min) .The headspace vial temperature was 100℃and the time was 30 min.Results:Ethanol, isopropanol, methylene chloride and n-butanol had a good linear relationship within the range of 0.68-409.14 μg· ml-1 (r=0.999 8),0.67-404.88 μg· ml-1 (r=0.999 8),1.71-51.31μg· ml-1 (r=0.999 7) and 0.72-431.12 μg· ml-1(r=0.999 8), respectively.The average recovery was 99.0% (RSD=0.41%, n=9), 100.2%(RSD=0.52%, n=9),97.1%(RSD=1.75%, n =9) and 102.5% (RSD=1.08%, n=9), respectively.Conclusion: The method is simple and accurate , which can be used for the determination of four residual organic solvents in erlotinib hydrochloride .

This article selected several typical clinical cases, analyzed many factors affect the doctor-patient relationship of ethical issues and new technology of differentiating the ethical dilemma for clinical application, and put forward some suggestions for the reference of medical staff , hospital ethics committees and health policy makers.

Objective The insulin pathways within ovary are in close relationship with female reproductive ability .The arti-cle was to observe the effects of ovarian insulin resistance on ovarian function and the effects of cryptotanshinone (CRY) on ovarian in-sulin resistance. Methods All mice were randomly divided into saline group (isotonic saline), DEX a group (isotonic saline plus DEX), CRY a group(isotonic saline plus DEX plus cryptotanshinone ), 10 in each group.The degree of insulin resistance was tested on each rat, along with the measurement of disintergrations per minute (DPM), ovulation rate and serum hormone level .After 20 fe-male mice were put to death , their ovaries were randomly divided into 4 groups:blank control group ( blank culture solution ) , DEX b group (DEX), CRY b group(DEX plus cryptotanshinone ), and WT group (DEX plus cryptotanshinone plus wortmannin ), 8 in each group. Murine ovaries in each group were cultured in vitro to test the number of ovarian glucose and the serum hormone level . Results After in-
sulin resistance took place in murine ovaries , significant statistical difference was found between DEX a group and saline group as to 2-deoxy-D-[1,2-3H]-glucose, liver, adipose and ovarian tissues (P<0.05).Ovaries in CRY a group increased significantly compared with DEX a group([2805.2 ±921.5]DMP/mg vs [1183.2 ±382.2]DMP/mg, P<0.01 ).Compared with DEX a group(37.5 ± 7.0, 5.0 ±1.8), the ovulation rate and the average corpus luteum in saline group (26.3 ±5.9, 3.5 ±1.6) and CRY group (27.2 ± 6.3,3.8 ±0.9) decreased (P<0.05).In comparison to DEX a group, the estrogen and progestogen levels in saline group and CRY a group decreased significantly(P<0.05).The expression level of AKT2 protein in DEX a group was much lower than that in saline group([0.39 ±0.01] vs [0.77 ±0.03], P<0.05).The glucose uptake in ovarian tissues cultured in vitro in blank control group , DEX b group, CRY b group and WT group was respectively (3447.2 ±1245.2)DMP/mg, (1183.2 ±382.2) DMP/mg, (2805.2 ± 921.5) DMP/mg, and (1364.2 ±292.3) DMP/mg.DEX b group decreased significantly compared with blank control group , DEX b group and WT group decreased significantly in comparison to CRY b group (P<0.05).In comparison to blank control group, the me-dium testosterone level increased and the protesteron level decreased significantly in DEX b group (P<0.05). Conclusion Tradi-tional Chinese medicine cryptotanshinone can relieve ovarian insulin resistance in vitro and in vivo , and it may exert insulin sensitivza-tion through PI3K pathway.

[ ABSTRACT] AIM:To evaluate the clinical application of single nucleotide polymorphism array ( SNP array) in prenatal diagnosis for screening the abnormality of women with Down’ s syndrome ( DS) .METHODS:The amniotic fluid samples ( n=312) collected by amniocentesis for the DS screening abnormality women were tested by karyotyping and SNP array analysis, respectively.The findings of karyotyping and SNP array analysis were compared.RESULTS:Two cases of trisomy 21 were identified by karyotyping and SNP array analysis, but SNP array analysis failed to identify 6 cases of chro-mosome balanced structural rearrangement.SNP detected 176 cases copy number variants ( CNVs) in 303 cases normal karyotype were detected by SNP, including 106 benign CNVs, 61 variants of unknown significance (VOUS), 9 de novo CNVs, and none of them was pathogenic.The distribution difference of CNVs in DS screening positive group and DS screening positive plus advanced maternal age group was not statistically significant ( P>0.05) .Furthermore, we reported 14 kinds of CNVs for the first time in population.CONCLUSION:SNP array can further assure chromosome microdupli-cation/microdeletion.In normal karyotype fetus of prenatal diagnosis, SNP can detect some clinical significant CNVs.

OBJECTIVE:To investigate the influential factors of adverse drug reaction(ADR)in elderly patients during medi-cation,and to provide reference for reducing the incidence of ADR in geriatrics department. METHODS:The clinical data of elder-ly patients admitted to our hospital from Jan. 2011 to Dec. 2015 were collected and analyzed by single factor and unconditional Loigstic multiple regression analysis. The risk influential factors of ADR were investigated. RESULTS:A total of 1 680 patients re-ceived drug therapy,and the incidence of ADR was 7.92%(133/1 680). Organs/systems involved in ADR were mainly allergic re-action(49 cases,36.84%)and digestive system(48 cases,36.09%). The results of single factor analysis showed that the age of patients,drug dosage,route of administration,treatment course,the type numbers of drug combination and others were the inde-pendent influential factors of ADR. By unconditional Loigstic multiple regression analysis,it was found that the risk of ADR in-creased with the drug dosage,treatment course,intraverous administration and various drugs use,etc. CONCLUSIONS:It is nec-essary to pay attention to ADR monitoring,particularly risk factors monitoring of ADR in the elderly patients,strengthen medica-tion guidance to improve medication compliance,take the necessary preventive measures to reduce the incidence of ADR.

This study aimed at unfolding the therapeutic effects of freeze-dried powder separated from Shuang Xia decoction (SXD) on female senile drosophila melanogaster with fragmented sleep.Taking drosophilas as the model organisms,the locomotor activity was monitored using the autonomic monitoring software to explore the regulation of fragmented sleep in senile drosophilas by the treatment of SXD.As a result,it was found that the optimum concentration of SXD was 2.50％,while the desirable therapeutic duration was 4 days.In comparison with the control group,35-day-old virgin drosophilas'sleep was prolonged in the SXD group and the positive control group.The positive drug mainly affected their sleep in the daytime,while SXD impacted their sleep at night featuring the prolonged fragmented sleep.In conclusion,it was demonstrated that the freeze-dried powder of SXD effectively alleviated intermittent insomnia in the female senile drosophilas.Compared with positive drug,SXD also mitigated intermittent insomnia at night without significant changes in the sleep of the drosophilas in the daytime.Above all,SXD was beneficial in the regulation of sleep-wake rhythm in the drosophilas.

Objectives:To assess bowel function and quality of life in patients with ulcerative colitis (UC)after ileal pouch anal anastomosis (IPAA).Methods:Clinical data of 37 UC patients after IPAA between 2014 and 2017 were retrospectively analyzed at Sir Run Run Shaw Hospital School of Medicine Zhejiang University. The IBDQ and Bowel Function questionnaire were used for analyzing correlation between clinical variables and quality of life or bowel function.Results:Laparoscopic operation was performed in 12 cases at stage 2 and 25 cases at stage 3. Postoperative defecation of stage 3 patients were better than that of stage 2 ( t=6.72, P<0.05). The number of daily defecation in age >45-year-old group was more than that in <45-year-old ( t=3.49, P<0.05), and the rate of evening stool seepage in the older group was higher than in the younger group( t=5.28, P<0.05). The total score of intestinal symptoms of IBDQ in patients of pouchitis was lower than that without pouchitis ( r=0.330, P<0.05). The total score in age >45 in terms of systemic symptoms ( r=0.349, P<0.05) and emotional function ( r=0.379, P<0.05) was higher than age <45. Conclusions:Outcomes of UC patients after IPAA are satisfactory, bowel function and quality of life is related with age, and stage of IPAA affect postoperative defecation.

Objective To explore the effect of infrasound on the expression of glial fibrillary acidic protein (GFAP) after cerebral ischemia/reperfusion in rats. Methods The model of cerebral ischemia/reperfusion in rats was induced with intraluminal middle cerebral artery occlusion (MCAO) with nylon monofilament suture. 36 male adult Sprague-Dawley rats were randomly divided into sham group (n=12),model group (n=12) and infrasound group (n=12), then each group was randomly divided into 3 d and 7 d subgroups, with 6 rats in each subgroup.The infrasound group was treated with infrasound for 2 h every day 12 h after operation, the model group was treated in the same way turning off the power, the sham group received no treatment. They were evaluated with the modified Neurological Severity Score (mNSS) 3 and 7 d after treatment (before being executed), and brain tissue slices were immunohistochemically stained to observe the expression of GFAP around the ischemic sites. Results Compared to the model group, the mNSS score in 7 d infrasound group decreased significantly (P<0.05), the integral optical density (IOD) of GFAP around the focus was significantly higher in the infrasound group than in the model group (P<0.001). Conclusion Infrasound can increase the expression of GFAP after cerebral ischemia/reperfusion in rats.

OBJECTIVETo study the relationship between HLA-DRB1 alleles and idiopathic thrombocytopenic purpura (ITP) in children.

METHODSPCR-SSO was used to identify DRB1 alleles of 42 children with ITP. Among them, anti-GPIIb/IIIa and anti-GPIb/IX autoantibody were detected in 36 cases by modified monoclonal antibody specific immobilization of platelet antigens (MAIPA).

RESULTS(1) Compared with healthy controls, HLA-DRB1 * 17 was significantly increased (relative risk = 2.76, P < 0.05, etiologic factor = 0.106 4) and HLA-DRB1 * 1202 decreased (relative risk = 0.20, P < 0.025, prophylactic factor = 0.761 6) in children with ITP. (2) In comparison with patients with good response to steroids and IgG therapy, HLA-DRB1 * 11 was significantly increased (P < 0.025) in patients with a poor response, furthermore, most (5/6) of HLA-DRB1 * 11-positive patients were female teen-ager. (3) Twenty-seven patients (75%) had anti-GPIIb/IIIa and seventeen (47.22%) had anti-GPIb/IX autoantibodies, the positivity rates of both anti-GPIIb/IIIa (P = 0.02) and anti-GPIb/IX (P = 0.01) were associated with HLA-DRB1 * 02. However, the pos./itivity rates of autoantibodies between refractory and non-refractory patients showed no significant difference.

CONCLUSION(1) The DRB1 * 17 seems to predict susceptibility to ITP in children, while DRB1 * 1202 appears to be protective to against ITP. (2) The DRB1 * 11 plays an important role in resistance to steroid and IgG therapy in children with ITP. (3) It seems that the response to the antigenic epitope of GPIIb/IIIa and GPIb/IX is restricted by DRB1 * 02, while the presence of the autoantibodies couldn't predict prognosis. Our preliminary findings indicate that genetic factors influence the clinical course of ITP, but its exact mechanism needs to be further investigated.

Alleles ; Child ; Female ; Gene Frequency ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Humans ; Male ; Purpura, Thrombocytopenic, Idiopathic ; genetics ; immunology ; therapy

OBJECTIVETo gain an insight into the relations between human leukocyte antigen-DRB1 (HLA-DRB1) alleles and idiopathic thrombocytopenic purpura (ITP) in children.

METHODSPolymerase chain reaction-sequence specific oligonucleotide (PCR-SSO) was used to identify DRB1 alleles of 42 children with ITP. Among them, 36 were identified for anti-GPIIb/IIIa and anti-GPIb/Ix autoantibody by modified monoclonal antibody specific immobilization of platelet antigens.

RESULTSCompared with health controls, the frequency of HLA-DRB1*17 significantly increased (P<0.05, relative risk=2.76, etiologic factor=0.1064) and the frequency of HLA-DRB1*1202 significantly decreased (P<0.025, relative risk=0.20, prophylactic factor=0.7616) in children with ITP. In comparison with patients of good response to steroids and IVIgG therapy, the frequency of HLA DRB1*11 significantly increased (Chi-square=6.091, P<0.025) in patients with a poor response, furthermore, the most of HLA-DRB1*11 positive patients were female teen-agers. Twenty-seven patients (75%) had anti GPIIb/IIIa and seventeen (47.22%) had anti_GPIb/Ix autoantibodies. The positivities of both anti_GP IIb/IIIa (P=0.02) and anti-GPIb/Ix (P=0.01) were associated with HLA-D RB1*02. However, the positivity of autoantibodies between refractory and non-refractory patients showed no significant difference.

CONCLUSIONThe allele of HLA-DRB1*17 seems to predict susceptibility of ITP in children, while HLA-DRB1*1202 appears to be protective to ITP. The allele of HLA DRB1*11 plays an important role in resistance to steroid and IgG therapy in children with ITP. It seems that the response to the antigenic epitope of GPIIb/IIIa and GPIb/Ix is restricted by HLA-DRB1*02, while the presence of the antibodies could not predict prognosis. In conclusion, the above preliminary findings indicate that genetic factors influence the clinical course of ITP, but the exact mechanism needs to be investigated further.

Adolescent ; Alleles ; Autoantibodies ; blood ; Child ; Child, Preschool ; DNA ; genetics ; Drug Resistance ; genetics ; Female ; Gene Frequency ; Genotype ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Humans ; Immunoglobulin G ; therapeutic use ; Male ; Platelet Glycoprotein GPIIb-IIIa Complex ; immunology ; Platelet Glycoprotein GPIb-IX Complex ; immunology ; Platelet Membrane Glycoproteins ; Purpura, Thrombocytopenic, Idiopathic ; blood ; drug therapy ; genetics ; Steroids ; therapeutic use