Objective To study the collision-induced dissociation fragmentation pathways of the jasminoidin and catalpol in ESI-Msn. Methods The samples were studied by using high performance liquid chromatography-electrospray ionization tandem mass spectrometry (HPLC-ESI-Msn) both in positive and negative. Results The collision-induced dissociation fragmentation pathways of both compounds were described. In the spectrum of two compounds, the loss of glucose residue and whole glucose were observed in positive mode, while only the loss of glucose residue could be observed in negative mode. Furthermore, we found that as the effect of the substituting groups, the fragment ions of jasminoidin were more in positive mode and those of catalpol were more in negative mode. Conclusion Conclusion The established method could be used for the sensitive and rapid identification of this kind of iridoid glycosides。

OBJECTIVE To investigate the present situation of hand-washing among medical staff then explore more suitable hand-washing methods and monitoring measure. METHODS By surveying the hand-washing situation of 96 medical staff in our hospital through the method of sampling,the different germ eradication rate between routine soap hand-washing and disinfectant wet towel hand-wiping as well as hand-washing rate in all candidate population during practical work were observed. RESULTS The germ eradication rate after routine soap hand-washing was 86.0%,while by disinfectant wet towel wiping it was increased to 91.3%.The washing rate after above former method was 18.3% and after above two methods combined was increased to 43.6%,and after health propaganding and training was up to 60.6%. CONCLUSIONS Disinfectant wet towel hand-wiping is convenient,practical and effective which would be more suitable for clinical practice when combined with routine soap washing method.

The clinical data of 186 patients with acute gout attack during upper gastrointestinal bleeding were analyzed retrospectively.The ratio of male to female was 1.7∶1, smokers and alcohol drinkers accounted for 66.1% ( 123/186 ) and 62.4% ( 116/186 ) of patients were had underlying diseases.All patients had different degree of joint painful and fever , the blood uric acid levels were higher.Gastroscopic examinations were performed in 166 patients , of whom 88 cases received endoscopic intervention.The symptoms of gout were improved after treatment with dexamethasone and celecoxib ; and the medication did not induce or increase gastrointestinal bleeding.

This report presented a case of 62-year-old woman who was admitted to our hospital for cirrosis, but she had a variety of clinical manifestations,such as abdominal distension,diarrhea,ascites, hepatosplenomegaly,anemia, palpitation, flushing, low blood pressure, arrhythmia and so on. Upper gastrointestinal endoscopy showed thicken mucosa at gastric fundus. Colonoscopy revealed nodular, pseudopolypoid. Ascitic fluid test suggested a transudate. Endoscopic abnormal mucosa biopsy showed chronic inflammation. Many mast cells were seen in bone marrow and liver biopsies,and liver tissue immunophenotype was CD117, and CD68. Thus the patient's diagnosis was systemic mastocytosis. It is rare that a patient only has the gastrointestinal tract symptoms complicated with ascites without skin lesion. The goal for treatment was to reduce hypersecretion of mast cells.

Objective To investigate the relationship between the nerve function and the sorbitol concentrations of erythrocyte and sciatic nerve, and to evaluate the effects and mechanism of a formulae of Chinese medicine, Shen Mai Huo Xue Yin (a decoction, it ingredients including ginseng, tuber of dwarf lilyturf and safflower) on diabetic peripheral neuropathy (DPN). Methods The rats were divided into 3 groups: normal rats, diabetic rats and diabetic rats treated with Shen Mai Huo Xue Yin. The diabetes of rats was induced by streptozotocin intraperitoneally. Motor nerve conduction velocity (MNCV) of sciatic, sensory nerve conduction velocity (SNCV) of caudal nerve and the H reflex were detected with evoked electromyogram; The sorbitol concentrations of erythrocyte and sciatic nerve was measured by spectrophotography. Results The sorbitol concentration of erythrocyte was positively correlated with that in the sciatic nerve, and the sorbitol concentration of erythocyte and sciatic nerve were negatively correlated with SNCV and positively with H reflex. The SNCV reduced significantly and the sorbitol concentration of both erythrocyte and sciatic nerve increased significantly in diabetic group as compared with those in normal group. The SNCV and sorbitol concentrations of sorbitol both erythrocyte and sciatic nerve in diabetic group were significantly improved after treated with Shen Mai Huo Xue Yin. Conclusion The sorbitol concentration in erythrocyte reflects the level of that in sciatic nerve and the lesion degrees of DPN. Shen Mai Huo Xue Yin alleviates the lesion of DPN in the early stage.

Objective To investigate the causes of death and the influencing factors in patients with peripheral arterial disease(PAD) during the perioperative period and reduce the perioperative mortality.Methods A retrospective analysis of the causes of death was performed for PAD during the perioperative period in our hospital from July 2005 to July 2010. Results Nine patients died preoperatively.The causes of death were multible organ failure in 5,heart failure in 2,sudden cardiac death in 1,and respiratory failure in 1.Six patients died postoperatively.The causes of death were acute renal failure in 2,heart failure in 2,cerebral infarction in 1,and hemorrhagic shock in 1.The causes of death which were related to heart,kidney and lung were in 10,6 and 2,respectively.The causes of death which were directly due to heart failure,sudden cardiac death,renal failure,respiratory failure,cerebral infarction and hemorrhagic shock were in 4,1,2,1,1 and 1,respectively.The main causes of death were multible organ failure,heart failure and acute renal failure,which accounted for 73.33％ of all deaths.In this series the overall perioperative mortality was 3.11％ (15/483),Operative mortality was 1.47％ (6/407).Conclusions The influencing factors and the function of organs were closely correlated with the causes of death. To reduce the perioperative mortality of PAD,it is necessary both to intervene in the influencing factors and to monitor and treat the dysfunction of vital organs.

Objective: To observe the clinical efficacy of photodynamic therapy on oral leukoplakia in elderly patients. Methods: In this prospective study, fifteen elderly patients with oral leukoplakia were treated with 5-aminolevulinic acid-based photodynamic therapy(ALA-PDT). After 2 hours of dressing, patients were irradiated using a 635nm semiconductor laser with the power density of 300mW/cm².Each lesion was irradiated for 6 minutes with energy density of 100J/cm².The curative effect was evaluated and the adverse reactions were recorded based on the observation of lesion changes. Results: Of the 15 lesions in 15 patients, 4 lesions were treated once, 3 lesions were treated twice.And 6 lesions were cured after three treatments, and 2 patients were cured after four treatments.The average treatment frequency was(2.4±1.1)treatment.The postoperative adverse reaction was pain.The average visual analogue scale was(2.2±0.8)scores after operation, and the duration of pain was(2.6±1.1)days after operation.There was no recurrence for 3 to 9 months after operation.No abnormalities of oral sensation and function were found in patients. Conclusions ALA-PDT is an effective method for the treatment of oral leukoplakia in elderly patients.

Objective To explore the clinical characters, diagnosis and treatment methods of placenta accreta. Methods A retrospective analysis was made of 47 cases of placenta accreta admitted during May 1997 to May 2007 into Peking Union Medical College Hospital. They included 17 cases in the second trimester and 30 cases in the third. Results Among all the patients, the incidence of placenta accreta was 0. 262% ( 47/17 918 ). Most of these cases ( 81%, 38/47 ) experienced a uterine procedure.30% (14/47) of the cases were found with placenta previa and 11% ( 5/47 ) with myoma in the current pregnancy. 11% (5/47) of all the cases suffered postpartum hemorrhage. In the 17 cases in the second trimester, 12 were diagnosed by uhrasonography and 5 by clinical evidence . While in the 30 cases in the third trimester, 8 were diagnosed by biopsy, 2 by uhrasonography, and 20 by clinical evidence. 45 cases were cured by conservative treatment, which included dilatation and curettage, uterine artery embolization (UAE) with or without methotrexate (MTX), tamping B-lynch suture, singly with MTX, and mifepristone. Only 2 cases received cesarean hysterectomy. Conclusions The incidence of placenta accreta seems on the rise. The incidence in the second trimester is higher than that in the third. In the second trimester, most cases can be diagnosed by uhrasonography after labor, and presently UAE is the best conservative management. While in the third trimester clinical evidence is the most frequent diagnostic approach. A majority of the cases could be cured by conservative therapies, which help them avoid a hysterectomy.

In color flow imaging systems, the ultrasound Doppler signal scattered from blood is heavily corrupted by the strong clutter signal reflected from the slow-moving muscular tissue. Moving target indicator (MTI) is a key technique of rejecting the clutter signal and detecting blood flow. To improve the performance of detecting blood flow, a new MTI scheme is proposed in this paper. It consists of a pre-filter, a clutter weak-rejector and a 2-order AR estimator. After the processing of pre-filtering and clutter weak-rejection, the strong clutter signal is effectively eliminated and its strength is comparable with blood flow. Under such condition, the optimal performance can be attained by the 2-order AR estimator. It is illustrated in the simulation that, compared with the data from traditional methods, the blood flow parameters are estimated with smaller deviation and the lower speed flow is detected.
Blood Flow Velocity ; Equipment Design ; Humans ; Image Interpretation, Computer-Assisted ; instrumentation ; methods ; Ultrasonography, Doppler, Color ; instrumentation ; methods

This study was aimed to establish a method for the rapid content determination of Ixerin Z and 11,13α-dihydroixerin Z in Ku-Die-Zi (KDZ) injection by UPLC-ESI-MS/MS. The separation was performed on a Waters ACQUITY BEH C18 column (2.1 mm × 50 mm, 1.7μm) by using a gradient elution with the mobile phase of acetonitrile-water at the flow rate of 0.4 mL·min-1. The column temperature was set at 40℃. Multi-reaction moni-toring (MRM) scanning was employed for quantification in ESI negative mode. The results showed that two sesquit-erpene lactones in KDZ injection were totally separated within 2 min. The linear range of Ixerin Z was 5.70-182.50 ng·mL-1, and the linear range of 11,13α-dihydroixerin Z was 4.60-131.25 ng·mL-1. The correlation coefficient r was more than 0.999 0. The recovery rates (n = 6) were 98.18% and 97.52%, with RSDs < 1.5%. The established method was successfully applied for simultaneous content determination of Ixerin Z and 11,13α-dihydroixerin Z in 6 batches of KDZ injection from 2 factories, which had some variations on the content determination results. It was concluded that the method was rapid, accurate and sensitive, which can be used for the content determination of two sesquiterpene lactones in KDZ injection.