OBJECTIVE:To develop a method for concentration determination of voriconazole in human plasma and apply it in the clinic. METHODS:UPLC-MS/MS method was adopted. Using ketoconazole as internal standard,the determination was per-formed on Shim-pack VP-ODS column with mobile phase consisted of water(containing 1‰ formic acid and 2 mmol/L ammonium acetate)-acetonitrile(gradient elution)at flow rate of 0.3 ml/min and column temperature of 40℃.The electrospray ion source,pos-itive ionizing pattern and multiple reaction monitoring were used;the mass transition ion-pairs of voriconazole and internal standard were m/z 351.2→282.2 and m/z 532.1→490.2. RESULTS:The linear range of voriconazole were 1-10 000 ng/ml (r=0.999 5,n=5),and the limit of quantitation was 1 ng/ml;RSDs of inter-day and intra-day were all lower than 10%;method recovery was higher than 90%(RSD<8%),and extraction recovery was higher than 70%(RSD<8%). The plasma concentrations of voriconazole in 10 patients with invasive fungal infection determined by this method were 507.33-7 011.24 ng/ml,and those of 3 patients were outside the recommended treatment concentration range. CONCLUSIONS:The established method is fast,accurate and sensitive,and can be applied for the therapeutic drug monitoring of voriconazole.

This article describes a method totransfer physiological data through carrier-current communication.The microcontroller measures the data of heartrate and body temperature and sends them through the serial port tothe carrier-current module implementing carrier-current communication.This method can be used totransfer physiological data through short distance less than200meters.

Objective To study the impact of respiratory frequency and amplitude of patients with the thoracic or abdomen tumor on 4DCT' s reconstructed image.Methods 75 thoracic or abdomen tumor patients who performed a scanning with belly belt-type respiratory gating on 4DCT between November 2012 to March 2013 in our hospital were retrieved.Reviewed their respiratory frequency,amplitude and fault distance of 4DCT' s reconstructed image and analyzed the correlation fault distance of the reconstructed image.The correlation analysis was used by bivariate Spearman method.Results Among these reconstructed images,fault distance more than 6 mm could be seen in 11 cases,fault distance ranging from 3 mm to 6 mm could be found in 46 cases,and distance less than 3 mm could be detected in 18 case.Respiratory frequency correlated significantly with the amplitude (rs =0.369,P =0.000);the respiratory rate had a tight association with the fault distance of the reconstructed image (r,=0.273,P=0.018);and respiratory amplitude was associated obviously with the fault distance of the reconstructed image (r,=0.696,P=0.000).Conclusions Both 4DCT reconstructed image and respiratory amplitude are significantly correlated to the continuity of the respiratory frequency.The smaller the respiratory frequence and amplitude change are,the better continuity will be.

Objective: To observe the changes of perfusion index (PI), bispectral index (BIS), heart rate (HR), systolic blood pressure (SBP) and respiratory rate (RR) under pulling stimuli in children undergoing open inguinal hernia repairs with spontaneous ventilation, so as to evaluate the clinical value of PI in monitoring the stress response. Methods: Thirty children undergoing selective open inguinal hernia repairs with American Society of Anesthesiologists (ASA) physical status I or II were recruited. Anesthesia was induced with fentanyl and propofol, and was maintained with sevoflurane after the insertion of laryngeal mask. The PI, BIS, HR, SBP and RR were observed at the following time points: before induction of anesthesia (T0), before pulling hernia sac (T1), at the time point of pulling hernia sac (T2), 1 min after pulling hernia sac (T3) and 5 min after pulling hernia sac (T4). Results: Compared with the baseline level at T0, the PI value at T1, T3 and T4 increased significantly (P=0.000, P=0.033 and P=0.000, respectively). The BIS, HR and SBP values at T1-T4 were significantly lower than baseline levels at T0 (all P=0.000). The PI values at T2 and T3 reduced significantly compared with T1. The HR value at T2 was significantly higher than that of T1 (P=0.033). Compared with the SBP values at T1, the SBP values at T3 and T4 were significantly higher (P=0.000 and P=0.011, respectively). And the RR values at T2 and T3 were higher than that at T1 (both P=0.000). The proportion of children with positive stress response based on PI was significantly higher than that based on other variables (all P=0.000). Conclusion: Perfusion index can reflect the noxious stimuli of the pulling hernia sac effectively and immediately.

Objective To evaluate the short and long-term effect and explore the potential influential factors of focused ultrasound in the treatment of nonneoplastic epithelial disorders of vulva (NNEDV). Methods Clinical data of 583 patients suffering from NNEDV which was treated with focused ultrasound admitted from Jan. 2004 to Jun. 2014 to the hospital the authors served were collected. The treatment effects, complication rate, and potential influential factors were retrospectively analyzed. Results The total effective rate of focused ultrasound in treating NNEDV was 97.43%, the recurrence rate was 28.65%, and the complication rate was 9.09%. The effective rate was significantly increased after a course of strengthened treatment (P<0.05). The incidence of complications of CZF300 (high-power and short term model) treatment was significantly higher than that with CZF- 1(low-power and long term model, P<0.001). Conclusions A good clinical effect is predictable with focused ultrasound in the treatment of NNEDV. More promising results could be attained with multiple strengthened treatment, and a lower complication rate can be obtained with a low-power and long term treatment strategy.

Objective: To explore the clinical rescue, clinical outcomes and complications in neonates with extremely low birth weight (ELBW, < 1 000 g) and very low birth weight (VLBW, < 1 500 g) in a single center in Shanghai. Methods: Clinical data of neonates with birth weight less than 1 500 g admitted to Shanghai Children's Hospital between Jan. 2008 and Dec. 2017 were retrospectively analyzed. Results: A total of 690 neonates were enrolled in this study. The overall survival rate was 72.7% (502/690) and in-hospital mortality rate was 13.9% (96/690). There was 13.3% (92/690) discharge against medical advice and the outcome was uncertain. The survival rate of VLBW neonates in 2013-2017 was significantly lower than that in 2008-2012 (45.2% [33/73] vs 64.7% [11/17], P<0.05). The most common complication was hypothermia, but there was no significant difference in the incidence of hypothermia between the latest 5 years and the frst 5 years (81.0% [363/448] vs 82.6% [200/242], P>0.05). In 2013-2017, there was a significant increase in the occurrence of neonatal respiratory distress syndrome (NRDS) (70.1% [314/448] vs 26.9% [65/242], P<0.01), bronchopulmonary dysplasia (BPD) (19.4% [87/448] vs 9.5% [23/242], P<0.01), necrotizing enterocolitis (NEC) (16.3% [73/448] vs 6.2% [15/242], P<0.01) and infection (50.4% [226/448] vs 29.8% [72/242], P<0.01), while asphyxia (36.6% [164/448] vs 41.7% [101/242], P<0.01), retinopathy of prematurity (ROP) (1.3% [6/448] vs 5.0% [12/242], P<0.01) and hypoglycemia (11.2% [50/448] vs 17.8% [43/242], P<0.05) were decreased as compared with those in 2008-2012. Conclusion: The overall survival rate is still low in neonates with ELBW and VLBW. Asphyxia and infection are still poorly controlled. The cooperation between institutions of obstetrics and neonatalogy is needed to improve the outcome of neonates with ELBW and VLBW.

Objective • To investigate the expression of interleukin-27 (IL-27) in cisplatin-induced acute kidney injury (AKI) and explore its inhibitory effect on apoptosis in AKI. Methods • C57BL/6 mice were randomly divided to control group and cisplatin group, in which mice were sacrificed at 24, 48 and 72 h after cisplatin administration. Blood urea nitrogen (BUN) and serum creatinine (Scr) levels were estimated. And the levels of mRNA for the IL-27 subunits, i.e. p28 and EBI3 in kidneys were determined by real-time PCR. As for in vitro experiments, after cisplatin incubation for 0.5, 1, 6, 12 and 24 h, HK-2 cells, a line of proximal tubular epithelial cells, were collected to assess the expression of IL-27 receptors (GP130 and WSX-1) at mRNA level. After that, HK-2 cells were treated with phosphate buffer saline or recombinant human IL-27 protein after cisplatin treatment, cell viability was detected by CCK-8, nuclear morphology was observed by Hoechst staining, and apoptosis related proteins including Bax, Bcl-2, and cleaved poly ADP-ribose polymerase (PARP) were estimated by Western blotting. Results • Compared with control group, BUN and Scr in cisplatin group significantly increased in a time-dependent manner after cisplatin injection. The mRNA levels of p28 and Ebi3 grew in injured kidneys, and their highest expressions were exhibited at 48 h after cisplatin injection. In HK-2 cells, GP130 and WSX-1 mRNA significantly increased at 1 h after cisplatin treatment but reduced to the basal level at 6, 12 and 24 h. IL-27 treatment significantly up-regulated cell viability and alleviated apoptosis and necrosis in cisplatin-treated HK-2 cells. In addition, IL-27 treatment inhibited the cleaved PARP and pro-apoptotic protein Bax, and upregulated antiapoptotic protein Bcl-2 in cisplatin-treated HK-2 cells. Conclusion • The expression of IL-27 increases in cisplatin-induced AKI, and it may protect against AKI by reducing cell apoptosis.

Objective To investigate the correlation between carotid intima-media thickness (CIMT) and glucose fluctuation in patients with type 2 diabetes mellitus (T2DM).Methods Sixty-eight T2DM patients admitted to Beijing Military General Hospital from March to August 2012 were enrolled in the study,including 32 cases with CIMT thickening (CIMT ≥ 0.9 mm) and 32 cases with normal CIMT (CIMT ＜0.9 mm).The 72 h continuous blood glucose levels were monitored from the day of admission.Results There were no significant differences in the gender,age,body mass index (BMI),systolic and diastolic blood pressure,HDL-C,LDL-C,CHO,TG,glycosylate hemoglobin (HbA1c),fasting blood glucose(FBG) and postprandial average blood glucose (MPBG) between two groups (P ＞ 0.05).The atherosclerosis (AS) score and mean amplitude of glycemic excursion (MAGE),glucose standard deviation,frequency of glycemic excursion (FGE) and absolute mean of daily differences (MODD) in patients with thickening CIMT were (11 ± 7) years,(6.9 ± 3.0) mmol/L,(2.8 ± 1.2) mmol/L,(3.4 ± 1.5) times/d,(2.8 ± 1.3) mmol/L,(4.5 ± 1.0) score,respectively ; while those in patients with normal CIMT were (8 ±6) years,(4.2 ± 1.1) mmol/L,(1.6 ± 0.5) mmol/L,(2.2 ± 0.8) times/d,(2.0 ± 1.0) mmol/L,(3.3 ±0.6) score,respectively.There were significant differences between two groups (all P ＜ 0.05).Pearson correlation showed that CIMT was positively correlated with MAGE,FGE,MODD,course of disease,diastolic blood pressure,LDL-C,MPBG and AS score (P ＜ 0.05).Multiple stepwise regression analysis showed that MAGE,MBPG were the influencing factors of CIMT.Conclusions The CIMT of patients with T2DM is closely correlated with glucose fluctuation,indicating that reduction of blood glucose fluctuation and MAGE,MPBG levels may delay the occurrence of diabetic macroangiopathy.

The classification system of diabetic foot not only helps to assess the wound, but it also can be used to predict the outcome of diabetic foot ulcer in the early stage, dynamically monitor the changes in the wound, and rationally direct the therapeutic schedule. At present, there are diverse systems for classifying the diabetic foot, but none has been internationally recognized. The classification systems can be categorized by time sequence, research objective, or structure type. When one of the classification systems is chosen, it is still very important to take the population, facility, and research type into consideration.
Diabetic Foot ; classification ; pathology ; Humans ; Severity of Illness Index ; Wound Healing

Objective:Colorectal cancer is one of the common gastrointestinal tumors.Recent studies have shown that, the expression of PDEF can promote the differentiation of Secretory progenitor cells to goblet cells in the intestinal tissue.Therefore the oc-currence of colorectal cancer may be related to expression of PDEF.In this study,we tried to investigate the effects of proliferation and invasion after interference targeting prostate-derived ETS factor in colorectal cell lines HT29.Methods: HT29 cells were transiently transfected with PDEF shRNA plasmids and blank control plasmid via cathodolyte liposome transfection method.By fluorescence microscopy,RT-PCR,Western blot technique to detect the expression of PDEF mRNA and protein in normal control group,blank control group,shRNA group.The proliferation and invasion ability of HT29 cells after transfection were assessed by MTT assay and Transwell invasion assay respectively.Results: Green fluorescent protein was observed in blank control plasmid group and shRNA plasmid group.Western blot showed the reduced PDEF protein expression compared with normal control group and blank control group.Interference PDEF gene expression can significantly promote the proliferation of HT29 cells (P<0.05).The ability of cell invasion in interference group was significantly higher than the normal control group and blank control group after 48h ( P<0.05).Conclusion:Interference PDEF in HT29 cells can promote cell proliferation and invasion.