Objective:To develop a method for determining deoxynivalenol in four kinds of traditional Chinese herbal medicines. Methods:After being extracted by water, purified by an immunoaffinity column, deoxynivalenol was analyzed by LC-MS-MS. Results:The calibration curve was linear within the range of 2-50 ng·ml-1 for deoxynivalenol. The recovery was 68. 7%-88. 3%. Conclusion:The method is simple, sensitive and accurate in the determination of deoxynivalenol in Semen Ziziphi Spinosae, Semen Sojae Praepara-tum, Semen Coicis and Fructus Psoraleae.

Objective To evaluate file efficacy and safty of central venous cathetr compared with conventional chest tube for closed pleural drainage in the treatment of traumatic hemothorax Method Totally 299 patients of traumatic hemothorax with middling or large effusions,in emergency department,Second Hospital .Affiliated to Medical College of Zhejiang University,from January 2003 to May 2007,were prospective controlled studied.All the 299 patients of were divided into catheter group (n=156) or tube group(n=143) according as patients'hospitalization date was odd or even number respectively.Patients in catheter group underwent drainage by central venous catheter using the Seldinger technique,and patients in tube group did by conventional chest tube using conventional technique.A unue drainage bag system or a wate seal system was connected with the end of the catheter or the tube respectively.The surgical operation time,the successful rate of treatment,the occurreuce rate of serious complications,the using rate of anodyne,the time of cut concrescence and the occurrence rate of cut infection were compared,and the drainage time and the correlative expenses in patients treated successfully were further compared.The data were analyzed by using t or X2 test with SPSS 13.0.A P value less than 0.05 indicated statistical signficance.Results Compared with robe group,the surgical operation time,the using rate of anodyne,the time of cut concrescence and the occurrence rate of cut infection were significantly decreased(P<0.05) in catheter group.There were not significant differences between two groups in the suecessful rate of treatment and the occurrence rate of serious complications(P>0.05).There were not significant differences between two groups in the drainage time and the corrective expenses of patients treated successfully(>0.05).Conclusions Use of central venous catheter catheters for closed pleural drainage in the treatment of traumatic hemothorax is effective,safe,and well-tolerated.It was more simple and less invasive as a procedure compared with conventional large-bore chest robe.

Objective To investigate the risk factors for sensorineural hearing loss (SNHL) in patients with nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT).Methods From January 2012 to January 2013,29 patients with histopathologically confirmed NPC who received radiotherapy alone or concurrent chemoradiotherapy were included in this study.All patients underwent hearing tests,including pure tone audiometry and acoustic immittance measurement,before and after the IMRT.The cochlear doses for each ear were also collected for analysis.A prospective analysis was performed to investigate the relationship between cochlear dose and SNHL in patients with NPC,and the effects of other factors,including time after radiotherapy,chemotherapy,T stage,and age,were also analyzed.Results Of the 58 ears studied,6(10％) had low-frequency SNHL,and 17 (29％) had highfrequency SNHL.There were significant differences in mean cochlear doses between the patients who developed SNHL after radiotherapy and those who did not (left ears:46.1 Gy vs.35.5 Gy,P =0.006;right ears:45.0 Gy vs.35.8 Gy,P =0.009).When the mean cochlear dose was less than 44 Gy,only 15％ (6/38) of ears had high-frequency SNHL.The invasion of skull base bone was also a significant risk factor for SNHL(P =0.047),but age,chemotherapy,and time after IMRT were not significant risk factors.Conclusions The mean cochlear dose and invasion of skull base bone are significant risk factors for SNHL in patients with NPC after radiotherapy.It is recommended that the mean cochlear dose should be limited to 44 Gy to minimize the incidence of SNHL after IMRT.

Objective To study the epidemiological characteristics of diabetes mellitus and to provide effective prevention and intervention methods in rural area in Kunming.Methods A cross-sectional study was conducted among 3 440 permanent residents aged 20～74 years in kunming rural districts.Results The general prevalence rate of diabetes was 4.01% and the standardized rate was 2.90%.The standardized prevalent rate for male(3.55%) was higher than that for female(2.61%),and the prevalence rates varied among different groups of rural inhabitants.Conclusion It is necessary to take effective methods to prevent and control diabetes in rural area.

Objective To investigate the reasons of blood pressure not reached standard in community outpatients with hypertension.Methods During January 2001 to December 2006,2798 patients fitting the China hypertension guide standard providing prevention and curing were involved in this study.From them,1574 cases were treated repeatedly,and the blood pressure did not continuously reach the controlled standard.The reasons were analyzed by regular visiting and correspondence with patients.Results The reasons of blood pressure not reached controlled standard related with chiefly the following factors:patient had bad compliance,and not positively intervened the way of life,and not took medicine according to the doctor's advice;doctors were not familiar with the methods of preventing hypertension and the treatment was nonstandrad.Conclusion The reasons of blood pressure not reaching standard in community outpatients with hypertension mainly are that the patients have poor knowledge about hypertension and compliance,and the treatment is nonstandrad.

The development and influencing factors of compliance behavior of investigators in clinical trials were explored. According to literature review, a hypothetical model of development of compliance behavior of investigators in clinical trials was established, and the influencing factors of compliance behavior of investigators and their interrelationships were studied based on questionnaire survey of five hundred investigators sampled randomly from one hundred clinical trial institutions in China. Cronbach's alpha coefficient and structural equation modeling were adopted to empirically analyze the results. Six variables in the hypothetical model were included: compliance behavior of investigators, credibility of clinical trial, capability of government regulation, quality control of sponsor, quality control of clinical institution and compliance intention of investigators. Empirical analysis showed that the compliance behavior of investigators in clinical trial was directly affected by compliance intention of investigators, quality control of sponsor and quality control of clinical institution. In addition, credibility of clinical trial and capability of government regulation indirectly affected the compliance behavior of investigators in clinical trial through influencing the compliance intention of investigators, quality control of sponsor and quality control of clinical institution. Quality control of sponsor was affected by credibility of clinical trial and capability of government regulation while quality control of clinical institution was only influenced by capability of government regulation.

Objective To explore factors associated with prolonged emergency room (ER) stay of critically ill patients admitted so as to accelerate throughput of emergency patients.Methods Data of critically ill patients admitted into the emergency room of a tertiary teaching hospital in 2010 were retrospectively studied.Stepwise Cox regression analysis was used to determine factors likely associated with prolonged stay in ER.Results ( 1 ) A total of 6246 critical illnesses were admitted into emergency room,the ER length of stay [M (Qr)] was 11 h (3 ～23 h).Of them,56.6％ patients stayed in ER more than 6 h and 21.6％ over 24 h.(2) Univariate analysis showed the major factors contributing to prolonged stay in ER were insufficient inpatient bed capacity,followed by poor family finances,complicated diseases needed care from multiple departments,emergency operation,lack of specialty wards,lack of department bearing main responsibility of critical care,age,gender and arrival time to ER.(3) Multivariate analysis showed that the main factors contributing to prolonged stay were insufficient inpatient beds,poor family finances,complicated diseases needed treatment from multiple departments,emergency operation,lack of specialty wards,lack of department bearing main responsibility of treatment,gender and arrival time to ER.Age was not an independent factor.Conclusions Plenty of critically ill patients admitted to this hospital had prolonged stay in emergency room with variety of factors.The possible factors contributing to this were insufficient inpatient bed capacity,poor family finances and complicated diseases needed care from multiple departments,and this investigation deserves a further study.

ObjectiveTo evaluate the function of the salivary glands with gustatory stimulation by using MR DWI.MethodsA prospective study was conducted in 30 patients with nasopharyngeal carcinoma who had normal salivary function.A DWI sequence was performed on the salivary glands at resting state,and continually repeated on the parotid immediately after oral ascorbic acid stimulation over a period of 21 minutes (once every 18 seconds).The multiple b-values (0,400,600,800,1000 s/mm2) were used.ADC maps were evaluated with a manually placed region of interest including the entire salivary gland.The ADC of each gland was obtained by taking the mean of values on three contiguous sections containing the largest areas of the gland.The paired two-tailed Student t test was used to compare the ADC values of the parotid and the submandibular glands at rest,and of the parotid before and after stimulation.ResultsThe mean ADC value at rest was significantly lower in the parotid [ (1.23 ±0.12) × 10-3 mm2/s] than in the submandibular glands [(1.34 ± 0.07 ) × 10 -3 mm2/s,t =4.545,P ＜ 0.01 ].After acid stimulation,the ADC value increased from the baseline to (1.41 ±0.19) × 10-3 mm2/s firstly and then fluctuated at the following time,with a peak value of ( 1.49 ± 0.20 )× 10 -3 mm2/s and the average value of ( 1.36 ±0.17) × 10-3 mm2/s.The average value was significantly different from the baseline value (t =15.127,t =11.905,P ＜ 0.01 ).The minimum value [ ( 1.24 ± 0.14) × 10-3 mm2/s] was not significantly different compared to the baseline value (t =1.329,P ＞ 0.05 ).ConclusionMR DW1 can noninvasively evaluate the physiologic changes of salivary glands before and after acid stimulation.

Objective To investigate the relationship between serum cholinesterase(ChE) and acute-phase proteins in patients with multiple trauma, then to evaluate their significance to judge prognosis. Method It's a prospective observation study. Patients with multiple trauma admitted to emergency intensive care unit,Second Af-filiated Hospital, Zhejiang Universieg, school of medicihe within 24 h after trauma from Oct. 2005 to Oct. 2007 were enrolled. And those with chronic liver disease, touching orgnaophosphorus, active tuberculosis, tumor, in-fection of major organ before trauma, liver injury or age < 18 year were excluded. Among 81 patients, 57 were male and24 female. The average age was (46±18) years, and the average injury severity score was (34.0±11.9).Seventy six healthy were selected as controls, 53 male and 23 female, with an average age of (44±16)years. The exclusion standards were the same as those in patients. Both groups had same gender proportion and age. Senum ChE and acute-phase proteins(APP) including albumin(ALB), prealbumin(PAB), transferrin(TRF),C-reactive protein(CRP) in patients were detected at 1, 3, 7 d after trauma. The acute physiology and chronic health evaluation Ⅲ (APACHEⅢ) was recorded simuhancously. Serum ChE, ALB, PAB, TRF, CRP in the controls were also detected. All of these indexes in the controls were compared with thoses in patients by t test or rank surn test. The dynamic changes of serum ChE and APPs in patients were analyzed by one way repeated mea-sures ANOVA. The relationships between serum ChE and those APPs and the relationships between APACHE Ⅲ and these indexes were analyzed by Pearson correlation analysis. We also compared these indexes between patients with different outcomes by t test or rank sum test. The values of serum ChE and those APPs to judge prognosis were evaluated by logistic regression analysis. Results Patients had lower serum ChE, ALB, PAB, TRF and higher CRP than the healthy at 1, 3, 7 d post trauma. Serum ChE activity in patients was reducod over 25% (42.3%～50.2%) than that in the healthy, and showed a tendency to decrease after trauma, which resembled PAB and TRF. Serum ChE was positively correlated with ALB, PAB and TRF at 1, 3, 7 d, and negatively correlated with CRP at 3, 7 d. At 1, 3, 7 d post trauma, APACHEⅢ in patients was negatively correlated with serum ChE and TRF, but negatively correlated with ALB only at 1 d, and negatively correlated with PAB only at 1,7 d, and posi-tively correlated with CRP only at 7 d. Non-survivors had lower serum ChE activity and TRF than survivors at 1,3,7 d after trauma, but had lower ALB only at 7 d after trauma and had lower PAB only at 1,7 d after trauma than survivors, and had higher CRP than survivors only at 7 d after trauma. Logistic regression analysis showed serum ChE and PAB were the only two independent risk factors to judge prognosis. Conclusions Serum ChE may be in-cluded as negative acute-phase protein, and is better than other APPs in reflecting injury severity and prognosis in patients with multiple trauma.

AIM:To bring forward a method of determining aflatoxin G_2、G_1、B_2、B_1 in six kinds of traditional Chinese drugs by HPLC.METHODS:After being extracted by 70% methanol,purified by immunoaffinity column,aflatoxins were analysed by HPLC with fluorescence detection.RESULTS:Aflatoxin G_2、B_2 showed a good linear relationship at a range of 1.5-60pg,and Aflatoxin G_1、B_1 at a range of 5-200 pg,r＞0.999 9.The recovery was between 60%-120%.CONCLUSION:The method is simple,accurate and can be used to determine aflatoxin G_2、G_1、B_2、B_1 in Naoliqing Pill,Renshen Yangrong Pill,Rensen Jiapi Pill,Sanqi Tablet,Jinshuibao Capsule and Bailine Capsule.