Objective: To develop an approach for simultaneous detection of multi-mycotoxins in fresh fruits, so as to provide technical supports for mycotoxins surveillance in fresh fruits. Methods: Fresh fruits were collected from markets and homogenized. Then, 2 g of fresh fruits were added with 10 mL of 0.1% formic acid ( 99∶1, v/v ) in acetonitrile and wortexed for 10 min. Following extraction with 1 g of sodium chloride and 4 g of anhydrous sodium sulfate, samples were centrifuged and 5 mL of the supernatant was cleaned up with 25 mg C18. Following centrifugation, the supernatant was dried under nitrogen. The residue was dissolved in 300 μL of methanol-acetonitrile mixture solution ( 1∶1, v/v ), and mixed evenly in 700 μL of the distilled water. Samples were then eluted in gradient series of 0.1% formic acid and 5 mmol ammonium formate and methanol-acetonitrile mixture solution ( 1∶1, v/v ). The 15 mycotoxins were determined using liquid chromatography-tandem mass spectrometry ( LC-MS/MS ) with electrospray ion source (ESI+/ESI-) under multiple reaction monitoring. In addition, a matrix-matched standard curve was employed for quantitative analysis. Results: There was a good linear relationship for 15 mycotoxins at concentrations of 0.25 to 10 ng/mL ( R2>0.992 ), the LC-MS/MS method showed the detection limits of 0.1-1.0 μg/kg, the spiked recovery rates of 71.68%-117.50%, and the relative standard deviations ( RSDs ) of 0.01%-13.60%. The detection rate of mycotoxins was 27.09% in 203 fresh fruits sold in markets. Conclusions The optimized LC-MS/MS method can be used for simultaneous determination of multi-mycotoxins in fresh fruits.

AIM To study lipid-lowering effects of gallic acid on glutamate-induced obesity mice.METHODS The obese model was established through subcutaneous injection of 3mg/(g · d)sodium glutamate into neonatal mice.After the model was established,the mice were divided into normal control group,model group,positive control group [simvastatin 30 mg/(kg · d)],high-,and low-dose group of gallic acid [400,200 mg/(kg · d)],and were intragastrically administered for ten weeks.Mice in each group after the last administration were fasted for 12 h except water.Blood was sampled from mouse eyes.The organs and adipose were obtained to determine the organ index and fat index.The levels of HDL-C,TG,LDL-C and TC in serum and liver were determined by using the corresponding reagent kit,and the serum leptin level was determined by ELISA kit and simultaneous determination of SOD,GSH-Px and MDA levels in liver.RESULTS Compared with the normal control group,the body weight and fat weight significantly increased in the model group;the levels of TC,TG and LDL-C in serum and liver significantly increased;the serum leptin level significantly reduced;the activity levels of SOD and GSH-Px in the liver significantly reduced;and the level of MDA significantly increased.Compared with the model control group,the body weight and fat weight significantly reduced in the gallic acid group mice and the levels of TC and TG significantly reduced in the serum and liver;SOD and GSH-Px levels significantly increased,MDA level significantly decreased in the liver.CONCLUSION Gallic acid can significantly reduce the blood lipid level of glutamate-induced obese mice.

Objective To probe into the present professional identity among physicians and to explore the influencing factors on identity.Methods A custom-made professional identity scale was used to study 277physicians in two public hospitals in Wuhan and Wenzhou.Results The scale consists of professional reward and recognition,professional capacity and professional significance.The total score of physicians' professional identity and that of the three dimensions were 1.89 and 1.26,2.42,2.02 respectively.Regression analysis showed that the predictors of the total score were:age,reward and penalty system,salary system,the work-family conflict (P＜0.05),and the predictors could account for 22.8％ of the variation.Those for professional reward and recognition were:Education,age,reward and penalty system,patient-doctor relationship,and income satisfaction,and the perdicators could account for 13.6％ of the variation.Those of professional significance were:age,reward and penalty system,and work-family conflict,and the predicators could account for 17.9％ of the variation.Conclusion Professional identity of physicians was found at a high level in general,yet their professional reward and recognition were found with a lower score.It is recommended to build a better hospital system for salary and reward/penalty management,improve doctor-patient relationship and minimize work-family conflict,for the purpose of raising their professional identity.

Objective To observe the clinical manifestation and pathological immunohistochemical features of intraspinal extramedullary peripheral primitive neuroeetodermal tumour (PNET). Methods From Apr. 1996 to Aug. 2007, totally 5 patients with intraspinal extramedullary peripheral PNET were treated, including 3 male and 2 female, aging from 11 to 48 years. The primary site was cervical vertebral in 2 (C5-C7 and C5-T1 ) and thoracic vertebral in 4( T4-T6, T6-T8 ,T4-T5 and C5-T1 ). The clinical manifestation was paresis of limbs in 5 and incontinence in 4. All the patients were pathologically diagnosed Results All of the three patients who had CD99 staining expressed CD99 ( + ). All the 5 patients received surgery followed by radiotherapy and 4 received postoperative chemotherapy. The most common treatment failure was local recurrence. The overall survival time of the 5 patients was 4.8year,2.5year,2. 1ycar, 1.6year and 0.8 year respectively. Conclusions Intraspinal extramedullary peripheral PNET is highly malignant tumor.Patients have very poor survival and local control New treatment protocol should be studied to improve the local disease control and increase remission rate. To distinguish central PNET from peripheral PNET has crucial significance since different entities have different treatment protocol and prognosis.

Objective To evaluate the hemostatic efficacy of complex sponge and drug-loaded complex sponge on hepatic and splenic wounds in rabbits. Methods Complex sponge was prepared by means of cross-linking and lyophilization. Then, the sponge was immersed into the tranexamic acid solution and lyophilized to obtain the drug-loaded sponge. The complex sponge and drug-loaded complex sponge were respectively used on the hepatic and splenic wounds of rabbits to observe the bleeding time and blood loss under normal and liquemine anticoagulation respectively. The gelatin sponge and the chitosan sponge were used as controls. Results Under normal condition, the hemostatic time and blood loss of the complex sponge was decreased obviously compared with the gelatin sponge ( P＜ 0. 01 ) and compared with the chitosan sponge ( P ＜ 0. 05 ). Posterior to liquemine anticoagulation, the hemostatic time was increased obviously in the gelatin sponge but showed no difference for the chitosan sponge and the complex sponge. Compared with complex sponge, the hemostatic efficacy of the tranexamic acid-loaded complex sponge was improved markedly for normal rabbits. While the hemostatic efficacy showed no significant change for rabbits with coagulation disorders, when there was no linear relationship between the hemostatic efficacy and the content of tranexamic acid. Conclusions The hemostatic efficacy of the complex sponge and the drug-loaded complex sponge surpass obviously that of the gelatin sponge, especially for the rabbits with coagulation disorders.

Objective To observe the protective effect of sufentanil pretreatment on the rats with acute gastric mucosa lesion (AGML) induced by water immersion and restrain stress (WIRS) and its effect on TRPV1 mRNA expression in the hypothalamus and gastric mucosa. Methods Thirty male Wistar rats were randomly designed into 3 groups, including the normal control group (Group NC, n = 10), the group treated with WRIS for 6 h (Group WIRS, n = 10) and the group pretreated with sufentanil (Group SF, n = 10). The model of AGML was established by the classic WIRS method , and observed for the general extent of gastric mucosal injury at WIRS for 6 hr, and calculated gastric mucosal injury ulcer index (UI) and the PH value of gastric juice; The quantification of TRPV1 mRNA expression in hypothalamus and gastric mucosa was performed using quantitative real-time PCR; In addition, the activity of super oxide dismutase (SOD) and the level of malondialdehyde (MDA) in serum were detected. Results Compared with group NC, gastric mucosal in Group WIRS was injured more seriously , and the UI and the activity of MDA were also obviously increased , but the change of SOD activity was not apparent; The TRPV1 expression in gastric mucosal decreased apparently. Sufentanil pretreatment could effectively relieve gastric mucosal injury induced by WIRS , and make the UI and the activity of MDA decreased , and up-regulate TRPV1 mRNA expression in the hypothalamus and gastric mucosa. Conclusions Sufentanil pretreatment can effectively relieve AGML induced by WIRS , which may be related to the control of oxidative stress response , the reduced gastric acid secretion , and the upregulation of the TRPV1 mRNA expression in the central and periphera nerve.

Objective To explore the prognostic value of N-terminal pro-brain natriuretic peptide ( NT-pro-BNP) levels in critically ill infants. Methods Eighty-one critically ill infants were enrolled from January 2013 to January 2014 in pediatric intensive care unit. The minimum of pediatric critical illness score ( PCIS) and the number of dysfunction organs were calculated within 24 hour after admission. According to PCIS,the critically ill infants were divided into extremely critical group(PCIS≤70,n=25),critical group (PCIS 71-80,n=30)and non-critical group(PCIS>80,n=26). According to the prognosis,the critically ill infants were divided into survival group (n=68)and death group(n=13). The serum NT-pro-BNP levels were determined on the first day,third day and convalescent phase. The relationships of serum NT-pro-BNP levels with PCIS and the number of dysfunction organs and prognosis were observed. Results The study showed statistical significances of serum NT-pro-BNP levels among the extremely critical group, critical group and non-critical group,whether on the first day,or on the third day and convalescent phase(P<0. 01). There were statistical significances of serum NT-pro-BNP levels among different stages of the disease in each group(P<0. 01). Compared with survival group,PCIS was significantly lower and the serum NT-pro-BNP levels and the number of dysfunction organs were significantly higher in death group. The serum NT-pro-BNP level on the third day was higher than that on the first day in death group ( P<0. 01 ) , while no significant difference was found in survival group. The serum NT-pro-BNP levels on the first day and the third day and PCIS were negatively correlated(r= -0. 59,P<0. 01;r= -0. 66,P<0. 01). The serum NT-pro-BNP levels on the first day and the third day and the number of dysfunction organs were positively correlated(r=0. 40,P<0. 05;r=0. 57,P<0. 01). Conclusion The serum NT-pro-BNP levels of the critically ill infants are correlated with disease severity,and can be useful for assessing the severity of critical illness.

Objective To investigate the selection of operative method and peri operative managements for osteoporotic femoral intertrochanteric fracture in elderly patients aged over 75 years.Methods A total of 132 consecutive patients aged 75-91 years with osteoporotic intertrochanteric fractures from July 2009 to July 2012 were retrospectively analyzed.47 patients were treated with dynamic hip screw (DHS group),44 patients with proximal femoral nail anti-rotation (PFNA group) and 41 patients with Gamma Ⅲ nail (Gamma Ⅲ group).The peri-operative managements,operation circumstance,the time for fracture union,postoperative complications and the degree of functional recovery were analyzed and compared between the 3 groups.Results The mean surgical time was shorter in Gamma Ⅲ nail and PFNA groups than in DHS group [(68.7±9.1) min,(80.5±11.3) min vs (112.2±18.4) min,both P＜0.01].The mean blood loss was less in the Gamma Ⅲ nail and PFNA groups than in DHS group[(156.9±18.5) ml,(183.4±21.3) ml vs (296.2±29.6) ml,both P＜0.01].The mean time for fracture healing was shorter in Gamma [Ⅲ nail and PFNA groups than inDHSgroup [(12.6±2.4) weeks,(13.1±2.4) weeks vs (15.3±3.2) weeks,both P＜ 0.05],and it has no obvious difference between Gamma Ⅲ nail and PFNA groups (P＞0.05).There were significant differences in postoperative complications between Gamma Ⅲ nail,PFNA groups and DHS group (2 cases,3 cases vv 11 cases,P＜0.05,respectively).The mean Harris hip score had no significantly difference among DHS,Gamma Ⅲ nail and PFNA groups (87.4±11.6,90.2±13.0 vs 88.9±12.3,both P＞0.05).Conclusions The 3 operative methods for stable intertrochanteric fracture are feasible and effective in elderly patients,but for unstable intertrochanteric fractures,the treatment with Gamma Ⅲ nail and PFNA has advantages.

Objective To evaluate the efficacy of intensity-madulated radiotherapy(IMRT) as the primary treatment in nasopharyngeal carcinoma (NPC). Methods Between November 2001 and March 2006,147 newly diagnosed NPC patients were treated with IMRT. The disease was Stage I in 3 patients, Stage Ⅱ in 35,Stage Ⅲ in 67 and Stage Ⅳ in 42. For T1-2 disease,the prescription dose was 70 Gy to the gross tumor volume( GTVnx) and positive neck nodes ,60 Gy to the planning target volume I, and 50-56 Gy to the clinically negative neck. For T3-4 disease,the prescription dose was 74-78 Gy to GTVnx. The local control rate(LC),overall survival (OS), disease-free survival (DFS) and distant metastasis-free survival (DMFS) were estimated by Kaplan-Meier method. Results The 3-year LC, OS, DFS and DMFS of the whole group were 93.2% ,93.5% ,72.6% and 74.4% ,respectively. T stage was a significant predictor of LC and OS. For patients with T1-2 and T3-4 disease,the LC was 100% and 86.9% (P=0.007) and OS was 95.5% and 91.3% (P=0.030), respectively. N stage was a significant predictor of OS, DFS and DMFS(P=0.03,0.004 and 0.0004,respectively). The grade Ⅰ+ Ⅱ and Ⅲ acute toxieities of parotid were 96.6% and 1.4%. The rate of grade Ⅱ xerostomia at 3-month, 6-month, 1-year and 2-year after radiotherapy were 43.0%, 12.0% ,4.9% and 3.2%. Conclusions The treatment results are promising according to our target definition and dose prescription protocol for nasopharyngeal carcinoma.

Objective To study the dynamic change of anatomy and dosimetry distribution and its influence during intensity modulated radiation therapy(IMRT) for nasopharyngeal carcinoma(NPC). Methods From June 2006 to August 2007,12 patients with stage Ⅲ-Ⅳ NPC receiving initial IMRT concurrently combined with chemotherapy were included in the study. The target volumes and,involving organs were contoured on the first set of spiral CT images. When IMRT planning was finished,a second CT scans was acquired to rectify the treatment center. Weekly spiral CT images acquired during the treatment period according to the same treatment center were fused with the first CT images. In order to determine the best time of replanning, modified plan target volume( PTV1 ) and normal organs( parotids and outline) were contoured on the fusion interface by a single physician. Changes of each structure throughout treatment period were measured by a system software. Then the dose distributions were computed and evaluated for replanning CT using the same beams arrangement in the original plan. Cumulative dose was estimated compared with the original plan. Results The volume of outlines and parotids decreased gradually, and the change came to peak in the fifth week. So the fifth and first week CT scans were selected as research objectives. No significant changes in maximal and mean dose was observed in the brainstem, spinal cord or mandible. Despite volume changes,D99 and D95 of the PTV1 did not change siguificantly(P＞0.05). D95 of the bilateral parotids increased significantly ( PL = 0.03,PR = 0.01 ). Conclusions During IMRT for NPC, the volume of PTV1, the outlines and parotids decrease,and the change come to peak in the fifth week. Comparing to the first treatment plan, the dose parameters of the parotids increase significantly in the second plan based on the fifth week CT,but those of the brainstem,cord,mandible and PTV1 change slightly.