Objective To identify the independent risk factors of surgical site infections (SSIs) for patients with cholelithiasis after biliary tract surgery.Methods 712 patients were enrolled from April 2010 to April 2015 in this study and their clinical data were retrospectively analyzed.There were 106 patients who developed SSIs.The risk factors of SSIs and their three subtypes (superficial incisional SSIs,deep incisional SSIs,and organ/space SSIs) were analyzed.The total hospitalization cost,length of hospitalization and patients who stayed over 30 days in hospital were compared between the group of patients with and without SSIs.Results Univariate analysis showed that SSIs were associated with diabetes,emergency operation,bile duct re-exploration,hepatectomy,positive bile bacteria culture,porta hepatis clamping,Ⅱ-Ⅳ grades of cholelithiasis,ASA Grade 3,BMI ＞ 30,hepatic function Grade B and protein level ＜ 30 g/L on hospital admission (all P ＜ 0.05).The results also indicated that superficial incisional SSIs,deep incisional SSIs and organ/space SSIs were correlated with emergency operation,bile duct re-exploration,hepatectomy,operation time,porta hepatis clamping,smoking,ASA score and protein level on hospital admission (all P ＜ 0.05).The total hospitalization expense,length of hospital stay and the number of patients hospitalized for over 30 days in the SSIs Group were significantly more than the non-SSIs Group (all P ＜ 0.05).Bile duct re-exploration,hepatectomy,positive bile bacteria culture and Ⅱ-Ⅳ grades of cholelithiasis were independent risk factors of SSIs on multivariate unconditional logistical regression analysis (all P ＜ 0.05).Conclusions Multiple factors in the perioperative period were involved in SSIs after bile duct surgery.Bile duct te-exploration,hepatectomy,positive bile bacteria culture and Ⅱ-Ⅳ grades of cholelithiasis were independent risk factors of SSIs.

OBJECTIVETo establish a method for the determination of gypsum and magnesium in decoction by capillary zone electrophoresis and study the influence of different compatibility on the contents of calcium and magnesium dissolution.

METHODNine decoctions with gypsum were prepared and analysed by L9 (3(4)) orthogonal design and the contents of calcium and magnesium ions were determined by the set method. The conditions of the experiment were a running buffer of 6.4 mmol x L(-1) imidazole solution (glacial acetic acid ajusted pH to 3.50) and an applied voltage of 10 kV (room temperature). Samples were introduced by hydrodynamic injection (8 cm x 7 s) and determined with on-column UV monitoring at 214 nm. Copper sulphate was chosen as the internal standard.

RESULTSThe linear responses covered the range from 0.009 68 mg x L(-1) to 9.68 mg x L(-1) (r = 0.998 1) for calcium, the detection limits (S/N = 3) and the quantitation limits (S/N = 10) of calcium were shown to be 0.002 1 mg x L(-1) and 0.007 1 mg x L(-1), respectively. The average recovery for calcium was 100.4%. The linear response covered the range from 0.01 mg x L(-1) to 10 mg x L(-1) (r = 0.995 9) for magnesium. The detection limits (S/N = 3) and the quantitation limits (S/N = 10) of magnesium showed to be 0.002 8 mg x L(-1) and 0.008 9 mg x L(-1), respectively. The average recovery for magnesium was 96.4%.

CONCLUSIONThe method is simple, rapid, cost-effective and precise with satisfactory results. The influence of Ephedra and Semen Armeniacae Amarum on the contents of gypsum dissolution are significant, while that of Radix Glycyrrhizae on the contents of gypsum dissolution is insignificant. The influence of Ephedra on the contents of magnesium dissolution are significant, while that of Semen Armeniacae Amarum and Radix Glycyrrhizae on the contents of magnesium dissolution are insignificant.

Calcium ; analysis ; Calcium Sulfate ; chemistry ; Drugs, Chinese Herbal ; analysis ; Electrophoresis, Capillary ; methods ; Magnesium ; analysis

OBJECTIVETo establish a method for the determination of ephedrine and pseudoephedrine in Herba Ephedrae and Maxing Shigan Tang by capillary zone electrophoresis.

METHODThe conditions of the experiment were optimized with a fused-silica capillary of 60 cm x 50 microm (50 cm effective length) in a running buffer of 50 mmol x L(-1) borax-20 mmol x L(-1) threonine (pH 9.27) and an applied voltage of 15 kV (room temperature). Samples were introduced by hydrodynamic injections (10 cm x 20 s)and determined with on-column UV monitoring at 210 nm. Phenobarbital was chosen as the internal standard.

RESULTEphedrine and pseudoephedrine are separated successfully within 8 min. The linear responses covered the ranges from 21.3 to 213 mg x L(-1) (r = 0.9996) for ephedrine and from 8.4 to 84 mg x L(-1) (r = 0.9995) for pseudoephedrine. The detection limits (S/N = 3) of ephedrine and pseudoephedrine were shown to be 1.45 and 1.48 microg x mL(-1), respectively, The quantitation limits (S/N = 10) of ephedrine and pseudoephedrine were shown to be 4.81 and 4.93 mg x L(-1), respectively. The average recoveries for ephedrine and pseudoephedrine were 97.5% and 98.6% with RSD less than 5.0%.

CONCLUSIONThe method is simple, rapid, cost-effective and precise with satisfactory results.

Drugs, Chinese Herbal ; Electrophoresis, Capillary ; methods ; Ephedra sinica ; chemistry ; Ephedrine ; analysis ; Plants, Medicinal ; chemistry ; Pseudoephedrine ; analysis ; Reproducibility of Results

Objective: To evaluate the using value of FibroTouch and six serological models in detecting the degree of liver fibrosis in patients with chronic hepatitis B, in an attempt to provide reference for accurate diagnosis. Methods: Two hundred and fifty-eight cases with chronic hepatitis B admitted to Xixi Hospital of Hangzhou from September 1, 2015 to September 1, 2017 were selected. All patients underwent liver histopathological examination and FibroTouch measurement to determine liver stiffness (LSM). Serum biochemical parameters were detected and the scoring values of six serological models were calculated. SAS 9.4 statistical software was used for statistical analysis, and the correlation between FibroTouch and the six serological models was analyzed by Spearman correlation. The diagnostic value of FibroTouch and six serological models was analyzed by receiver operating characteristic curve (ROC) based on liver histopathological findings. Results: The median LSM of 258 cases with chronic hepatitis B was 9.4 (6.5-13.8) kPa. In the six serological models, the median value of aspartate transaminase to platelet ratio index (APRI), FIB-4 index, S-index, Forn’s index, PRPindex, and FIB-5 were 0.42 (0.28-0.62), 1.27 (0.78-2.03), 0.11 (0.07-0.20), 6.95 (5.89-8.51), 0.000 8 (0.000 6-0.000 9),and 38.59 (36.28-40.97). FibroTouch had positive correlation with APRI, FIB-4, S-index, Forn’s index, PRP, fibrosis stage (r= 0.73,P< 0.001) and inflammation grade, and had negative correlation with FIB-5, and both had statistical significance. The area under curve (AUC) of FT-LSM at S≥2, S≥3, S = 4 were 0.89, 0.90 and 0.85, respectively, which was significantly higher than serological models (P< 0.001). The AUC of S-index model at S≥2, S≥3, S = 4 were higher than other five serological models. Conclusion The diagnostic performance of FibroTouch is significantly better than serological model. S-index model has the best diagnostic performance in the six serological models, and the combination of S-index and FT-LSM may better diagnose the grading of liver fibrosis, and thus can be applied and promoted in clinic.

Adding biological passivation agent during composting is one of the most effective ways to reduce the toxicity of heavy metals in contaminated livestock manure. To further improve biological passivation, we obtained a strain with high-heavy metal compounds tolerance to passivate heavy-metal contaminated manure and to characterize heavy-metal biosorption. High-tolerance microorganisms for lead and cadmium were isolated and screened from swine manure composting samples. The strain was identified by its morphology and molecular biology. After the influence of different pH, temperature and salt concentrations on growth of the strain were investigated, the optimal growth conditions were obtained for further analysis of its biosorption characteristics of lead and cadmium. The bacterium with tolerance to lead and cadmium termed SC19 was obtained, whose lead resistance was 600 mg/L and cadmium resistance was 120 mg/L. The isolate was further identified as Cedecea sp., and then its optimum pH was 7.0, temperature was 37 °C, and salt concentration was 0.5%. Lead removal was highest after 30 min of adsorption by the SC19 strain cultured for the stationary phase 36 h, and the maximum removal rate and biosorption capacity of lead were 60.7% and 329.13 mg/g, respectively. Meanwhile, cadmium removal was highest after 30 min of adsorption by the strain cultured for the logarithmic phase 8 h, and the maximum removal rate and biosorption capacity of cadmium were 51.0% and 126.19 mg/g, respectively. Fourier Transform InfraRed (FT-IR) results revealed that the biosorption process mainly happened on the surface of SC19 cell and many active groups on the cell surface could chelate the Pb²⁺ and Cd²⁺. By comprehensive comparison, it was showed that strain SC19 shared a certain capacity of Pb²⁺ and Cd²⁺ biosorption, and the bacterium provided precious microbial germplasm resources for biological passivation of heavy metal contaminated manure.