Aim: To establish a method for the determination of pantoprazole sodium and its related substances. Methods: A column packed with octadecylsiance bonded silica gel (250 mm × 4. 6 mm, 5 pjn) was used. The 0. 01 mol/L monopotassium phosphate solution( adjusted with phosphoric acid to pH 7. 0) -acetonitrile were adopted as the mobile phase, a gradient elution was programmed as follows: 0→30 min(90:10-60:40), 30→45 min(60: 40→15: 85); the detection wavelength was 289 nm; the column temperature was 40 ℃; the flow rate was 1. 0 mL/min. Results: Pantoprazole sodium, the intermediates and its related substances could be well separated. A good linear relationship was obtained over the range of 6. 96-48. 72 μg/mL( r =0. 999 9). The limit detection and quantisation of pantoprazole sodium were 8.51 ng and 17.0 ng, respectively. Conclusion: This method can be applied to control the related substances of pantoprazole sodium and determine pantoprazole sodi-um.

Objective To explore the role of spinal monocyte chemoattractant protein?1 ( MCP?1) ?extracellular signal?regulated protein kinase ( ERK)?kinesin superfamily motor protein 17 ( KIF17)∕N?methyl?D?aspartate receptor subunit 2B ( NR2B) signaling pathway in the maintenance of type 2 diabetic neuropathic pain (DNP) in rats. Methods Type 2 diabetes mellitus was induced by a high?fat and high?sucrose diet and intraperitoneal streptozotocin ( STZ) 35 mg∕kg, and confirmed by fasting blood glucose level≥16?7 mmol∕L 3 days later in male Sprague?Dawley rats aged 6 weeks. Type 2 DNP was confirmed when the mechanical paw withdrawal threshold ( MWT ) and thermal paw withdrawl latency ( TWL ) measured on day 14 after STZ administration decreased to< 80% of the baseline value. The rats with type 2 DNP were randomly divided into 4 groups ( n=36 each) using a random number table: type 2 DNP group (group DNP), type 2 DNP +MCP?1 neutralizing antibody group (group DM), type 2 DNP +ERK inhibi?tor group (group DE) and type 2 DNP + dimethyl sulfoxide group ( group DD). In DM, DE and DD groups, 0?1 ng∕μl MCP?1 neutralizing antibody 10 μl, 0?5 μg∕μl U0126 10 μl and 5 % dimethyl sulfoxide 10 μl were injected intrathecally, respectively, once a day for 14 consecutive days starting from 14 days after administration of STZ. Another 36 normal rats fed a common forage diet were adopted as con?trol group ( group C) . MWT and TWL were measured before STZ injection and at 1, 3, 7 and 14 days after STZ injection ( T0-4 ) . Nine rats were sacrificed after measurement of pain thresholds at T1-4 , and the lumbar segments ( L4-6 ) of the spinal cord were removed for determination of the expression of phosphoryla?ted ERK (p?ERK), KIF17 and phosphorylated NR2B (p?NR2B) by Western blot. Results Compared with group C, the MWT was significantly decreased, the TWL was shortened, and the expression of p?ERK, KIF17 and p?NR2B was up?regulated at T1-4 in DNP, DM, DE and DD groups. Compared with group DNP, the MWT at T3-4 in group DM and at T2-4 in group DE was significantly increased, the TWL at T3-4 in group DM and at T2-4 in group DE was prolonged, and the expression of p?ERK, KIF17 and p?NR2B was down?regulated at T2-4 in DM and DE groups, and no significant changes were found in the pa?rameters mentioned above in group DD. Conclusion Spinal MCP?1?ERK?KIF17∕NR2B signaling pathway is involved in the maintenance of type 2 DNP in rats.

Objective To discuss how to use the core elements of international classification of functioning,disability and health(ICF) as a guide in stroke operation treatment to develop targeted,effective therapy plan and rehabilitation goals,establish individualized treatment of rehabilitation,and to observe the effect of limb movement function in stroke patients. Methods Sixty cases patients with stroke and aged from 40 to 65 years old were selected. The body function and structure of all stroke patients were marked by comprehensive evaluation scores of The National Institutes of Health Stroke Scale ( NIHSS ) and Fugl?Meyer assessment. And then they were randomly divided into two groups,30 cases in each group. The observation group used the Chinese version of brief ICF Core Sets for evaluation, and set individualized treatment according to the results of the assessment;The control group, according to the conventional rehabilitation process, involved in training routine physical therapy. Again 8 weeks after treatment for patients with evaluation,the assessment results was compared with the results of the first assessment. Results Before treatment, the NIHSS, Fugl?Meyer assessment and Chinese version of brief ICF core elements scale scores for the observation group were 7. 95±2. 37,34. 5±4. 0 and 82. 15±17. 96,for the control group were 7. 58±2. 25,34. 8±4. 0 and 81. 55±18. 78. After treatment,the above three rating scale scores, for the observation group were improved to 4. 78 ± 1. 63, 56. 3 ± 4. 2, 60. 45 ±11. 04,for the control group were improved to 5. 13±1. 75,48. 1±3. 8,73. 56±16. 89. The two groups were significantly improved ( observation group:t=4. 94, 15. 51, 18. 59, P<0. 05;control group:t=3. 17, 14. 66, 12. 33,P<0. 05). After treatment,compared with the control group of three rating scale scores(5. 13±1. 75,48. 1
±3. 8 and 73. 56±16. 89),the observation group(4. 78±1. 63,56. 3±4. 2 and 60. 45±11. 04) improved more apparently(t=3. 15,14. 54,15. 45,P<0. 05) . Conclusion Guided by the idea of ICF and scale,with the demand of the patients as the center,to develop personalized physical therapy,can achieve more productive and more targeted rehabilitation goals.

OBJECTIVE: To investigate the treatment for benign tumor of external auditory canal by carbon dioxide laser under microscope. METHOD: Ten cases of benign tumor of external auditory canal were treated by carbon dioxide laser under microscope. The curative effects and complications were observed. RESULT: Ten cases of benign tumor of external auditory canal were satisfied after operation without any complications. There were no recurrences during 3 months to 2 years of follow up. CONCLUSION The operation for benign tumor of external auditory canal by carbon dioxide laser under microscope was easy, safe and effective.
Ear Canal ; pathology ; Ear Neoplasms ; therapy ; Humans ; Laser Therapy ; methods ; Lasers, Gas ; Microscopy ; Neoplasm Recurrence, Local ; Neoplasms

Tumor occurrence is usually recognized as the interplay between genetic variations within the tumor and the environment. During a long time, great effort has been made in killing cancer cells. However, the role of tumor microenvironment has been largely ignored, which plays an important role in tumor generation, growth, invasion and metastasis. Meanwhile, tumor microenvironment not only facilitates the tumor infiltration, but also promotes the exchange of enzymes and cytokines to aid tumor proliferation, differentiation and self-renewal. Thus, better understanding of tumor microenvironment shows great importance. Recent developments in nanotechnology have brought new approaches to cancer diagnosis and therapy. Nanoparticles were suggested to show enhanced efficacy, while simultaneously reducing side effects and promoting bioavailability, owing to properties such as tumor localization and active cellular uptake. Additionally, nanoparticle surface chemistry has evolved from conventional synthetic polymers to more biologically inspired strategies, including cell membrane and self-recognition peptides, to minimize nonspecific uptake of nanoparticles. In the current review, we highlight the targets in tumor microenvironment and the strategies of nano drug delivery system to target tumor microenvironment for the treatment of cancer. We also highlight design considerations to improve nano drug delivery.

OBJECTIVE To assess the association of SLC12A3 and SCNN1B gene polymorphisms (rs11643718 and rs12447134) with essential hypertension among ethnic Koreans from Mudanjiang, China. METHODS For 204 patients with essential hypertension and 186 healthy controls, the genotypes of rs11643718 and rs12447134 loci were determined with an improved multiplex ligase detection reaction (iMLDR) method. RESULTS Allelic and genotypic frequencies of rs11643718 of SLC12A3 gene are associated with the onset of disease hypertension (P <0.05) as well as systolic blood pressure (P < 0.01, under a recessive model). No association was found between rs12447134 of SCNN1B gene with the onset of disease (P > 0.05) but diastolic blood pressure (P < 0.05, under a recessive model). CONCLUSION The polymorphisms of rs11643718 locus is associated with the susceptibility for essential hypertension among ethnic Koreans from Mudanjiang area and can be used as a predictor for the disease.

Objective:To investigate clinical and bronchoscopy characteristics of Mycoplasma pneumoniae pneumonia in children with 23S rRNA resistance gene positive in bronchoalveolar lavage fluid(BALF), and find clinical indicators that can identify Mycoplasma pneumoniae drug resistance early.Methods:The clinical data of 61 hospita-lized children diagnosed with Mycoplasma pneumoniae pneumonia as subjects from October 2017 to June 2018 in the Department of Pediatric Respiratory Medicine of Shengjing Hospital Affiliated to China Medical University were analyzed retrospectively.Bronchoscopy was performed on each subject and the BALF was taken and used to detect the 2063 site mutation of the 23S rRNA V region gene in BALF, and they were divided into drug-resistant gene positive group and drug-resistant gene negative group.The clinical manifestations, relevant laboratory data, imaging data, and bronchoscopy findings in different load groups were compared.Statistical methods such as t test, rank sum test, χ2 test, Fisher′ s exact probability method, and multivariate Logistic regression analysis were used to analyze the data. Results:Among the 61 children, 38 cases (62.30%) were in the drug resistance gene positive group, and 23 cases (37.70%) were in the drug resistance gene negative group.There were no significant differences in gender and age between the two groups (all P>0.05). The days of hospitalization and fever in the children with positive drug resistance genes were longer than those in the negative drug resistance gene groups, and they were more likely to have refractory mycoplasma pneumoniae pneumonia(RMPP) and extra pulmonary complications, with statistically significant differences ( P<0.05), but there were no significant differences in hypoxemia ( P>0.05). There were significant differences in white blood cell(WBC), C-reactive protein(CRP), procalcitonin(PCT), D-Dimer (D-D) and interleukin-6 (IL-6) between the two groups (all P<0.05). Except that the WBC level in the drug-resistant gene-positive group was lower than that in the drug-resistant gene-negative group, the rest of the test results indicated that the drug-resistant gene-positive group was higher than the drug-resistant gene-negative group.There were no significant differences in the concentrations of serum lactate dehydrogenlase(LDH)and IL-6 in BALF ( P>0.05). In this study, Logistic regression analysis was performed on several statistically significant laboratory indicators.It was found that WBC was more sensitive to identify drug resistance genes, and the optimal critical value was 8.55×10 9/L.The specificity of D-D in identifying drug resistance genes was higher, and the optimal cut-off value was 523 μg/L.In the drug resistance gene positive group, 35 cases (92.11%) showed extensive lung consolidation/atelectasis on imaging, and the drug resistance gene negative group was 13 cases (56.52%), with statistically significant differences ( P<0.05). The drug resistance gene-positive group mainly showed mucosal erosion, necrosis, phlegm plug/plastic phlegm plug and bronchitis stenosis, with a total of 19 cases (50.00%). In the drug resistance gene negative group, the main manifestations of mucosal longitudinal wrinkle, flocculent and viscous secretions were 14 cases (60.88%), with statistically significant differences ( P<0.05). Conclusions:The point mutation of 23S rRNA V region gene is closely related to the clinical characteristics of children with Mycoplasma pneumoniae pneumonia.Children with A2063G mutation are more prone to have RMPP and extrapulmonary complications, and their imaging manifestation and bronchoscopy are more severe.The levels of leukocytes and D-D in the blood have significance for the early identification of drug resistance.The systemic excessive immune inflammatory response caused by Mycoplasma pneumoniae pneumonia with drug-resistant gene positive needs to be valued.

Objective Whole brain radiotherapy ( WBRT) remains the primary treatment for patients with multiple brain metastases ( BM). Hippocampal avoidance WBRT ( HA-WBRT) offers the feasibility of less cognitive function impairment than conventional WBRT.WBRT yields better control rate of intracranial distant progression than stereotatic body radiotherapy (SBRT).This study aims to understand the distribution characteristics of BM within the cranial structures by analyzing imaging features and define the safe margin during HA-WBRT. Methods Clinical data of patients diagnosed with BM by enhanced MRI in Ruijin Hospital from July 2011 to July 2016 were retrospectively analyzed. The distance between the intracranial lesion closest to the hippocampus and the hippocampus was measured. Results A total of 146 patients (90 male and 56 female) with 630 BM lesions were reviewed. Sixty-four patients were diagnosed with non-small-cell lung cancer complicated with BM during the initial admission. In the other 82 patients, the average time from the initial diagnosis to the diagnosis of BM was (14.5±14. 3) months. In total,486 (77. 1％) BM lesions were situated beyond the tentorium. The average diameter of the largest intracranial lesion was (12.5± 10. 3) mm (95％CI:10. 8-14. 2). All 630 BM lesions were distributed as follows:138 (21. 9％) in the cerebellum, 182 ( 28. 9％) in the frontal lobe, 114 ( 18. 1％) in the temporal lobe, 78 (12. 4％) in the parietal lobe,87(12. 7％) in the occipital lobe,28(4. 4％) in the thalamus and 10(1. 6％) in the brainstem. The frequency of hippocampal involvement was 3. 4％(5 mm),4. 8％(10 mm) and 8. 2％(20 mm). The univariate and multivariate logistic analyses indicated that with the risk of hippocampal involvement in patients aged> 60 years was significantly increased (OR= 11. 576 P= 0. 042). Conclusions The probability of brain metastasis within 10 mm around the hippocampus is low. HA-WBRT can control the intracranial lesions and reduce cognitive impairment,which is a safe and feasible treatment method.

OBJECTIVE: To report on a child with mental retardation caused by SYNGAP1 gene mutation. METHODS: Peripheral blood samples were collected from the proband and her parents. High throughput sequencing (HTS) was employed for screening for potential mutation in the patient. Suspected mutation was validated by Sanger sequencing of the child and her parents. RESULTS: By HTS, a previously unknown mutation [c.1656C>A (p.C552*)] was found in exon 10 of the SYNGAP1 gene in the proband. Sanger sequencing confirmed the heterozygous nature of the mutation and that neither of her parents carried the same mutation. CONCLUSION The dysmorphism and developmental delay of the child were probably due to the pathogenic mutation of the SYNGAP1 gene. HTS can facilitate elucidation of the genetic etiology with efficiency, which has great significance in the diagnosis, treatment and prognosis of the child.
Child ; Exons ; Female ; Heterozygote ; High-Throughput Nucleotide Sequencing ; Humans ; Intellectual Disability ; genetics ; Mutation ; ras GTPase-Activating Proteins ; genetics

Objective: To explore the association between long-term changes in blood pressure (BP) levels and the incidence of cardiovascular diseases (CVD). Methods: A total of 5 752 participants, who participated baseline examination in 1992-1993 and re-examination in 2007, were followed up till December 31, 2013 according to the study protocol of the Chinese Multi-provincial Cohort Study. Participants were stratified by baseline BP and re-examination BP and cross-combined into 9 subgroups. The 20-year incidence of acute cardiovascular events, acute coronary heart disease (CHD) and acute stroke events were analyzed and association between disease incidence and 15-year changes in BP were determined using the competing risk regression model. Results: (1) There were 523 CVD events (170 CHD, 373 stroke) during the 20 years follow up. The number of participants with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) of <130/80 mmHg (1 mmHg=0.133 kPa), 130-139/80-89 mmHg, and hypertension were 2 892 (50.3%), 1 328 (23.1%) and 1 532 (26.6%), respectively. (2) Among participants with baseline SBP of 130-139 mmHg or DBP of 80-89 mmHg, 870 (65.5%) progressed to hypertension and 279 (21.0%) maintained at the same stratum over a 15-year follow up period. (3) After adjustment for age, sex, body mass index, smoking status, diabetes, total cholesterol, and high-density lipoprotein cholesterol at baseline, participants maintained SBP/DBP at 130-139/80-89 mmHg had a higher risk of developing acute cardiovascular events, CHD and stroke with the hazard ratios (HR) and 95% confidence interval (95%CI) of 2.04 (1.16, 3.57), 3.29 (1.30, 8.35) and 1.63 (0.80, 3.33), compared with those who maintained their SBP < 130 mmHg and DBP <80 mmHg. Participants whose BP increased from 130-139/80-89 mmHg to hypertension over the follow up period had 2.81-fold (1.84, 4.29), 3.17-fold (1.43, 7.03) and 2.71-fold (1.65, 4.44) higher risk for the incidence of acute cardiovascular events, CHD, and stroke, respectively, compared with participants who maintained their SBP <130 mmHg and DBP <80 mmHg. Conclusions Participants with SBP/DBP of 130-139/80-89 mmHg have a high long-term risk for progression to hypertension. Sustained exposure to SBP/DBP of 130-139/80-89 mmHg or higher increases the risk of CVD incidence, and our results highlight the importance of early prevention for participants with this BP stratum.