Objective:To establish a method to determine the content of morphine and codeine phosphate in compound liquorice tablets. Methods:The analysis was performed by HPLC-ESI-MSMS. The acquisition was MRM ( multi-reaction monitor) , the column wasAgilentZorbaxEclipseSBC18(2.1mm×100mm,3.5 μm),themobilephasewasacetonitrileand15mmol·L-1ammoniumac-etate with gradient elution. Results:The precursor (m/z) of morphine and codeine was 286. 0 and 300. 0, respectively, and the quan-titative ion was 165. 0 and 165. 0, respectively. The linearity of morphine was excellent between 25 and 500ng·ml-1 , and the average recovery was 103. 1%. The linearity of codeine was good between 0. 75 ng and 150 ng·ml-1 , and the average recovery was 101. 5%with RSD of 1. 7(n=6). Conclusion:The method is simple and accurate, which can be used for the quality control of compound ligu-orice tablets.

Objective To investigate the effect of EDTA combined with ciprofloxacin on Pseudomonas aeruginose biofilm in vivo.Methods Pseudomonas aeruginosa was inhaled into the lung of guinea pigs and colonized,formed biofilm.After 7 days,the model was treated with ciprofloxacin,EDTA alone,or a combination of both for 7 days.The number of colony in the lungs is measured by agar plate.The pathological change of the lung is observed by hematoxylin and eosin (HE) staining and scanning electron microscope.Results EDTA combined with ciprofloxacin make the number of bacteria in the lungs reduced from l05 CFU/g to 10 CFU/g(t =24.67,P＜0.05),the lung lesion was less-sever histophathologically.Conclusion The combination of EDTA with ciprofloxacin has significant activity to remove mucoid PA biofilm in vivo.

Objective To investigate the effect of persistent hypoglycemia on the cerebral oxidative stress and matrix metalloproteinase-2 (MMP-2) activity of newborn rats and to explore the potential mechanism of hypoglycemia-induced brain injury of newborn.MethodsSeven-day-old rats were injected insulin subcutaneously to induce persistent hypoglycemia.Cerebral cortex,hippocampus and thalamus were collected after 36 hours' observation and stored in -80 ℃.Glutathione (GSH)and glutathione disulfide (GSSG) were detected by commercial kit and GSSG/GSH was calculated.MMP-2 activity was detected by gelatin zymography. The data were analyzed by t test,one or two-wayanalysis of variance and Pearson correlation analysis.Six rats were set as the normal glucose group. ResultsThirty-six hours after induction of hypoglycemia, the cerebral GSSG and GSSG/GSH of hypoglycemic pups elevated about 1.5 times higher than those of control group [GSSG:(15.89 ± 5.46) vs (6.15 ± 3.42) mg/g protein,t =3.704,P =0.004; GSSG/GSH:(5.58± 1.79) ％ vs (2.79±1.76) ％,t =2.712,P=0.022].The GSSG and GSSG/GSH in thalamus of hypoglycemia were significantly higher than those of control [GSSG:(15.93 ± 5.75) mg/g protein vs (5.03±5.14)mg/g protein,P＜0.05; GSSG/GSH:(6.50±3.25) ％ vs (2.41±3.12) ％,P＜0.05],whereas there were no significant differences in the cortex ard hippocampus.The total MMP-2 activity of hypoglycemic animals (2.22±0.59) was significantly higher than that of control (1.21± 0.17)(t=4.064,P=0.002),and significant differences were found between the two groups in cortex (2.14 ± 0.5 vs 1.17± 0.27),hippocampus (2.31± 0.72 vs 1.22 ± 0.37) and thalamus (2.22±0.68 vs 1.24±0.18) with all P＜0.01].The activity of MMP-2 was positively related to GSSG (r=0.575,P=0.0002) and GSSG/GSH (r=0.484,P=0.0003).ConclusionsOxidative stress might play an important role in the persistent hypoglycemia induced brain injury of 7-day-old rat pups and thalamus might be most vulnerable to hypoglycemia.Hypoglycemia might also elevate MMP-2 activity which is positively related to GSSG level and GSSG/GSH of the brain.

Objective To investigate the relationship between retinal vessel diameters and cerebral infarction of carotid artery stenosis patients.Methods Eighty seven patients (174 eyes) with carotid stenosis were included in this study.There were 49 males and 38 females,with an average age of (65.25±7.85) years.Thirty-four patients were suffered from cerebral infarction (cerebral infarction group),and the other 53 patients had no cerebral infarction (control group).There was no significant difference in age (t=1.916),male rate (x2=0.142) and carotid stenosis extent (x2=0.785) between the two groups (P=0.059,0.706,0.675).All patients underwent color fundus photography after mydriasis.Retinal vascular caliber measurements were performed using IVAN software.The main parameters were central retinal artery diameter (central retinal artery equivalent,CRAE),the diameter of the central retinal vein (central retinal vein equivalent,CRVE) and the retinal arteriole to venular ratio (AVR).The relationship between retinal vessel diameter and cerebral vascular disease were analyzed with logistic regression analysis.Results In cerebral infarction group,CRVE,CRAE and AVR ratios were (132.90 ± 20.67) μm,(243.47 ±43.92) μm and 0.56±0.10,while the control group was (145.26±21.59) μm,(224.99±32.35) μm and 0.68±0.13 respectively.There were significant differences between the two groups (t=-2.648,2.257,-4.631;P＜0.05).After correction for risk factors,such as age,smoking history,CRAE reduction and CRVE increases were significantly correlated with cerebral infarction.Conclusion CRAE reduction and CRVE increases are risk factors of cerebral infarction in patients with carotid stenosis,and it is useful in the prediction.

Objective: To observe the efficacy and safety of analgesic drugs in the standardized treatment of cancer pain patients at the pain clinic. Methods: The data of 787 cancer pain patients and their corresponding prescriptions for cancer pain were collected from April, 2012 to April, 2013 at the pain clinic. The obtained information comprise of diseases that lead to cancer pain, cause of pain, pain intensity, and efficacy and side effects of medications. Diseases that caused cancer pain include 658 cases with primary malignant lung cancer. Results: Pain was mainly caused by primary lung cancer in 787 cancer-related patients. An analgesic drug, namely, oxycodone hydrochloride, was administered in 54.6% via single drug therapy. The daily dosage range of this drug was 20 to 90 mg/d in 280 cases. About 35.6% of the studied patients with a daily dosage of 90 mg/d or lower had their pain effectively managed. After the treatment, the number of cases with moderate to severe pain was reduced from 437 (55.5%) to 248 (31.5%). The oral administration of opioid oxycodone hydrochloride tablets ranked first among the prescribed drugs for cancer pain, and single-drug therapy was the choice of medication. The majority of patients had satisfactory pain-relief with a daily dosage of less than 90 mg/d upon the administration of oxycodone hydrochloride sustained-release tablets and morphine sulfate controlled-release tablets. Side effects included mild constipation, nausea, vomiting, dizziness, loss of appetite, urinary retention, somnolence, and so on. Intervention treatment was needed in most of the patients. Conclusion: Pain clinic is critical in the administration of standardized treatment for cancer pain in hospitals. The establishment of pain clinic ensures the standardized treatment of cancer pain.

Participating in the National Oral Medical Skills Competition can push forward the teaching reform and curriculum construction,and promote the standardized development of teaching.According to the changes of competition level,rules and content of the National Oral Medical Skills Competition,the selection and training methods have been reformed.By designing the training programs,quantifying the scoring standards,strengthening the oral physician guidance and strengthening the psychological counseling and other trainings,satisfactory results have been achieved.

Objective To retrospectively assess the clinical manifestations and treatment of secondary syphilis with ocular impairment as the initial symptom. Methods Clinical data were retrospectively analyzed on secondary syphilis with ocular impairment as the initial symptom collected from September 1998 to October 2008. Results There were 11 syphilitic patients presenting acute ocular impairment as their initial manifestation. Skin eruptions developed simultaneously with ocular impairment in 2 patients, following ocular impairment in 9 patients. All patients were positive for rapid plasma reagent test (RPR) and treponema pallidum haemagglutination assay (TPHA), but negative for HIV. Of these patients, 9 suffered from uveitis (iridocyclitis, choroiditis or panuveitis), 2 from optic neuritis; 3 had unilateral ocular involvement, 8 had bilateral ocular involvement. After treatment with injected penicillin or ceftriaxone sodium, 9 patients experienced complete visual recovery, 2 partial visual recovery. Conclusions Ocular impairment occurs in patients with secondary syphilis at a low incidence, with no characteristic clinical manifestations. For patients who have no response to conventional ocular therapy, ocular syphilis should be considered and serological examination for syphilis is recommended.

Objective To investigate the characteristics of intestinal microbiota in neonates on the first and third day after birth.Methods A total of 50 healthy singleton neonates who were born between June 15,2016 and August 3,2016 in Shanghai First Maternity and Infant Hospital were enrolled.Their stool samples were collected on the first and third day after birth and the samples were labeled according to the time of collection (D1 and D3 groups,n=50 each).Illumina NexSeq high-throughput sequencing platform was used to sequence the variable region 4 and 5 of all bacterial 16S rRNA genes in the samples.The composition of intestinal microbial communities was determined and the differences between the two groups were compared by Metastats analysis.Results (1) A total of 100 stool samples were sequenced and the retrieved sequences were from 25 bacterial phyla,119 families,227 genera and 159 species.(2) Major phyla in the two groups were the same,namely,Proteobacteria,Frimicutes,Bacteroidetes and Actinobacteria.The relative abundances of Frimicutes (0.27 ± 0.03 vs 0.41 ± 0.05) and Bacteroidetes (0.07 ± 0.01 vs 0.09 ± 0.03) increased over time,while that of Actinobacteria (0.10±0.01 vs 0.01 ±0.00) decreased on day 3.No significant difference in the relative abundance of Proteobacteria (0.51 ±0.03 vs 0.49± 0.05) was observed between D1 and D3 groups.There were significant difference in relative abundances of Frimicutes and Actinobacteria between the two groups (both q=-0.01,both P＜0.05).(3) Among the top ten most abundant families,Enterobacteriaceae,Staphylococcaceae,Enterococcaceae,Streptococcaceae and Lachnospiraceae were detected in both of the two groups.The relative abundances of Enterobacteriaceae (0.25 ± 0.02 vs 0.46 ± 0.06),Staphylococcaceae (0.07 ± 0.02 vs 0.12 ± 0.03),Enterococcaceae (0.04±0.02 vs 0.10±0.04),Streptococcaceae (0.03 ±0.02 vs 0.06±0.01) increased over time,while that of Lachnospiraceae (0.03 ± 0.01 vs 0.02 ± 0.02) decreased on day 3.Only the relative abundance of Enterobacteriaceae had statistical difference between the two groups (q=0.00,P＜0.05).(4) Among the top ten most abundant genera,Staphylococcus,Enterococcus,Streptococcus,Bacteroides and Pseudomonas were detected in both groups.The relative abundances of aerobic and facultative anaerobic bacteria which belonged to genera of Stenotrophomonas,Propionibacterium,Acinetobacter,Bacillus,Sphingomonas and so on decreased on day 3 as compared with those on day 1 (0.00±0.00 vs 0.07±0.02,0.00±0.00 vs 0.06±0.01,0.00±0.00 vs 0.03±0.01,0.00±0.00 vs 0.02±0.01,0.00±0.00 vs 0.02±0.00,all q=0.00,all P＜0.05).However,the relative abundances of anaerobic bacteria which belonged to Bacteroides,Veillonella,Parabacteroides and so on increased on day 3 (0.01 ±0.00 vs 0.08±0.03,0.00±0.00 vs 0.03±0.02,0.00±0.00 vs 0.01 ±0.00,q=0.01,0.01 and 0.00,all P＜0.05).(5) The most abundant species in intestinal microbiota was escherichia coli in both groups.Three less abundant species including lactobacillus gasseri,lactobacillus animalis and bifidobacterium bifidum were detected in both groups.(6) Regardless of the mode of delivery,Staphylococcus,was the highest predominant genera in meconium samples,followed by stenotrophomonas.Stool samples collected on the third day after birth were divided into four groups based on deliver modes and feeding patterns.Neonates who were born abdominally with exclusive breastfed thereafter were different from those of the other three groups in predominant intestinal bacteria,but the difference was not statistically significant.Bifidobacterium and Subdoligranulum were only detected in the vaginally born neonates.Conclusions Meconium is not sterile.Although the intestinal microbiota on the first day of life is different from that on the third day of life,the dominant bacteria are common.During the first three days of life,the relative abundances of aerobic and facultative anaerobic bacteria decreased significantly over time,while the relative abundance of anaerobic bacteria increased.

Objective To explore the relationship between CD34 expression or microvessel density and hepatic fibrosis degree in advanced schistosomiasis patients.MethodsThirty-five advanced schistosomiasis patients and 5 control patients were included in this study.CD34 expression in liver tissue was measured with immunohistochemistry while microvessel density(MVD)of liver tissue was evaluated under a light microscope.ResultsCD34 expression and MVD value were significantly correlated with hepatic fibrosis degree in liver tissue from the advanced schistosomiasis patients.ConclusionsCD34 expression and MVD value are two histological parameters representing the liver sinusoid changes during fibrogenesis in advanced schistosomiasis patients.

Objective:To investigate the clinical manifestations, laboratory and imaging features, treatment and prognosis of systemic lupus erythematosus (SLE) with primary sclerosing cholangitis (PSC).Methods:This is a retrospective case series study describing the clinical, laboratory and imaging manife-stations, treatment and prognosis of 3 SLE patients with PSC. The related literatures were reviewed.Results:In total, 10 patients were included. SLE with PSC, with an average age of (43±17) years old, was more common with hematological and renal involvement, jaundice and arthralgia, positive anti-double-stranded DNA (anti-dsDNA) antibody, hypocomplementemia, elevated erythrocyte sedimentation rate (ESR) and abnormal liver function with predominately elevated alkaline phosphatase (ALP). The classic magnetic resonance cholangio-pancreatography (MRCP) features of PSC include multifocal strictures, beading and areas of dilatation involving the intra- and/or extrahepatic bile ducts. The treatment included glucocorticosteroids, immunosup-pressants and ursodeoxycholic acid (UDCA), and some patients required biliary drainage. Most patients had a good prognosis.Conclusion:Although PSC is rare, attention should be paid to SLE patients with abnormal liver function, especially with elevated ALP, in order to differentiate from PSC.