Because of their physiological and anatomical immaturity, premature infants are prone to disorders of glucose metabolism. In the ifrst week after birth, infants have the greater risk of abnormal glucose metabolism. Compared with term infants, the glucose/insulin homeostasis of preterm infants is very different. This article reviewed the characteristics of glycometabolism in premature infant and the methods of glucose test.

Objective To study the pain relief effectiveness of the combined spinal epidural analgesia(CSEA) and the inhalation of nitrous oxide, and the influences on the mothers and infants Methods The 300 cases of pregnant women were randomly divided into 3 groups: CSEA group,nitrous oxide group and control group The nitrous oxide group was that pregnant women inhaled nitrous oxide premixed with oxygen (50%∶50%),the pregnant women of the CSEA group were injected fentanyl and bupivacaine in the subarachnoid and epidural space,analgesic was not used in the control group The degree of labor pain, duration of the labor,way of delivery, bleeding volume, rate of anoxia of newborn,blood gas analysis to maternal radius artery and fetal umbilical blood among 3 groups were observed Results The effect for analgesia labor of the CSEA group was much better than that of the nitrous oxide group ( P 0 05) In the second stage of labor,the 3 groups were alike to each other The bleeding volume of caesarean section (373?77) ml in the nitrous oxide group was much more than the other 2 groups, there was no difference between the CSEA group (259?78) ml and the control group (239?89) ml The rate of obstetric forceps of CSEA group was higher than the control group ( P

OBJECTIVE:To establish a method for simultaneous determination of valsartan and hydrochlorothiazide in Valsar-tan hydrochlorothiazide tablets. METHODS:UPLC was adopted. The determination was performed on Phenomenex C18 column with mobile phase consisted of [0.1% phosphoric acid solution-acetonitrile(95 : 5,V/V)]-[0.1% phosphoric acid solution-acetonitrile (5 : 95,V/V)](gradient elution)at the flow rate of 0.25 mL/min. The detection wavelength was set at 272 nm,and the column tem-perature was 35 ℃. The sample size was 1.5 μL. RESULTS:The linear range were 8.1-324.2 μg/mL for valsartan(r=0.9999)and 1.2-50.1 μg/mL for hydrochlorothiazide(r=0.9999). The limits of quantitation were 0.24,0.04 ng,and the limits of detection were 0.06,0.01 ng. RSDs of precision,stability and reproducibility tests were less than 2.0%;recoveries were 97.69%-100.35%for valsartan(RSD=1.03%,n=9)and 98.27%-100.60% for hydrochlorothiazide(RSD=0.83%,n=9). CONCLUSIONS:The method is simple,rapid and accurate,and can be used for the simultaneous determination of valsartan and hydrochlorothiazide in Valsartan hydrochlorothiazide tablets.

Objective To study the risk factors of MRI for the prediction of collapse in patients with avascular necrosis of the femoral head.Methods Twenty-two patients (39 hips) diagnosed avascular necrosis of femoral head by MR were enrolled in our study.The following MR appearances were evaluated:bone marrow edema,joint fluids,signal intensity and location of the lesion.The volume and surface area of the necrosis zone were calculated.The time of follow-up was 18-84 months (median,25 months).Logistic regression analysis was used to predict the risk factors by SPSS 13.0.The maximum value of Youden index was selected as the critical point to predict the collapse of femoral head and to define the sensitivity,specificity and accuracy.Results In the 39 hips with femoral head necrosis,21 hips had collapse.Bilateral collapse occurred in 5 cases.In 25 hips with the necrosis surface larger than 25％,collapse occurred in 21 (84％); In 8 hips with the volume of femoral head necrosis larger than 30％,collapse occurred in all cases; 1n 33 hips with the necrosis locating at the superolateral quadrant,collapse occurred in 21 (63.6％); In 22 hips with necrotic areas showing heterogeneous signal intensity,collapse occurred in 18(81.8％) ;In 25 hips with large amount of joint effusion,collapse occurred in 16 (64％) ;in 18 hips with bone marrow edema,collapse occurred in 13 (65％).Joint fluid,heterogeneous signal intensity and lesions in the superolateral quadrant,volume ratio,and area ratio were the high risk factors,while bone marrow edema was a relatively low risk factor.The area under ROC curves for area ratio of NASA was greater than that for volume ratio (0.987 vs 0.902).When the critical value for area ratio was 26.7％,the true positive rate was 95.2％,true negative rate was 94.4％,and Youden's index was 0.896.Conclusions The collapse of necrosis of femoral head may result from many factors.The femoral head was easy to collapse when it had large enough area of necrosis and mixed signal intensity,a large amount of joint effusion,bone marrow edema,and superolateral quadrant location.The critical value for area ratio to predict the collapse of femoral head was about 26.7％.The area ratio is more accurate than volume ratio in predicting the collapse of necrosis of femoral head.

Objective To detect the osteopontin(OPN)expression in renal tissue of rats with fluorosis and low calcium diet,and study the role of OPN in renal injury of fluorosis.Methods Forty-eight aged 1 month Wistar rats,80-120 g,were randomly divided into 4 groups by 2×2 factorial design(the number of female and male in each group was equal):the control group,high-flluoride group,low-calcium group and low-calcium with high-fluoride group.All rats of the fluorosis groups were fed with feed containing corn exposed to coal-burning from endemic fluorosis areas with high fluoride(100 mg/kg,corn),the other two groups were fed with feed containing coru from nonendemic fluorosis areas(fluoride 5 mg/kg,corn).After 16 weeks,the rats were killed.The change of teeth was examined,and the incidence rate of dental fluorosis was calculated.The expressions of both protein and mRNA of OPN in rat renal tissue were determined by RT-PCR and immunohistochemistry after four-month experimentation.Results The growth of teeth was very well in the control group and the low-calcium group.The two high-fluoride groups showed evident dental fluorosis(100%).The results of immunohistochemistry showed that the OPN protein was localized in renal tubule cytoplasm.The OPN-positive cells from renal tissue were lightly and scatteredly stained in control and low-calcium groups.The OPN-positive cells had deeper color in high-fluoride group and low-calcium with high-fluoride group,widely distributed in the renal tubular epithelial cells.The protein expression of OPN in the two groups exposed to fluoride(168.64±13.21,169.26±8.92)was significantly higher than those of the corresponding control group(145.78±10.26,all P<0.01)and low-calcium group(149.60±16.84,all P<0.01).The mRNA expression of OPN in the two groups exposed to fluoride(1.89±0.37,1.94±0.22)was significantly higher than those of the corresponding control group(1.32±0.26,all P<0.05)and low-calcium group(1.30±0.186,P<0.05),respectively.High fluoride influenced the expression of protein and mRNA of OPN(F=13.821,4.24,all P<0.05).Low calcium did not affect the expression of protein and mRNA of OPN(F=2.164,0.58,all P>0.05).However,high fluoride and low calcium had a cross interaction on the expression of protein and mRNA of OPN(F=6.257,432,all P<0.05).Conclusions Over-dose fluoride enhances the expression of OPN.The higher expression observed in the cases exposed to high fluoride concentration is associated with serious renal injury.OPN may he a potential marker for renal injury in fluorosis.Moreover,over-dose fluoride and low calcium make the renal injury worse,indicating low calcium plays an important part in renal injury by fluoride.

Objective: To establish a ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry method for rapid simultaneous determination of quinclorac, acetochlor, butachlor and metolachlor in urine. Methods: Urine samples were diluted 10 times, prepared into the mixed standard solution, and subjected to gradient elution on the ACQUITY UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm) with 0.1% formic acid and acetonitrile as the mobile phase. The quinclorac, acetochlor, metolachlor and butachlor levels were determined using electrospray ionization-positive ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry with the multiple reaction monitoring mode. Results: Four herbicides were effectively separated on the ACQUITY UPLC BEH C18 column (100 mm× 2.1 mm, 1.7 μm), and good linear relationships were observed for quinclorac, acetochlor and butachlor at 1 to 25 μg/L and for metolachlor at 0.2 to 25 μg/L, with all linear correlation coefficients of >0.999. The detection limts of quinclorac, acetochlor, butachlor and metolachlor were 0.10, 0.10, 0.20 and 0.01 μg/L, respectively. The recovery rates of quinclorac, acetochlor and butachlor were 107.42%, 93.94% and 90.27% from urine samples at a spiked level of 5 µg/L, with relative standard deviations of 4.82%, 3.84% and 6.76%, and the recovery rate of metolachlor was 89.51% at a spiked level of 0.5 µg/L, with a relative standard deviation of 8.98%. Conclusion The chromatography and mass spectrometry conditions are optimized in this ultra-high performance liquid chromatography-tandem mass spectrometry, which is effective for rapid simultaneous determination of quinclorac, acetochlor, metolachlor and butachlor in urine samples.

Objective To evaluate the impact of multiple lacunar infarction (MLI) on the outcomes of mild cognitive impairment (MCI). Methods MCI patients were selected in outpatients and hospitalized patients using a common international standard MCI screen. Magnetic resonance imaging (MRI) and computer tomography (CT) were used to determine the presence of MLI. MCI patients were followed up for 6～24 months and their cognitive status and the impact of MLI on MCI were evaluated using Kaplan-Meier survival analysis. Results One hundred twenty patients were diagnosed as having MCI based on clinical evaluation and neuropsychological assessment. Among them, 43 (35.8%) patients had MLI and the rest 77 (64.1%) patients did not have. Twenty-seven MCI patients with MLI (62.8%) developed dementia, while 15 MCI patients without MLI (19.4%) developed dementia during 6～24 months follow-up. Kaplan-Meier analysis indicated that the incidence of dementia was significantly higher in patients with MLI than in patients without MLI did (P＜0.05). Conclusions MCI patients with MLI are more prone to dementia. These results suggest that early interventions aimed at controlling the modifiable risks are warranted for dementia prevention in MCI patients with MLI.

Objective To evaluate the value of cholangiography for early diagnosis of ischemic-type biliary lasions(ITBL) after liver transplantation. Methods Two hundred and fifty-three patients with liver transplantaion between Jan 2004 and Oct 2006 were recruited. Initial cholangiography was compared with terminal cholangiography to evaluate the value of initial cholangiography of ITBL. The t test, Chi-square test, sum rank test were used for statistics. Results Based on initial cholangiography, 189 patients were diagnosed with normal appearance, while 64 patients were diagnosed with abnormal appearance. The abnormal initial cholangiography appearances included poor filling in 33 patients and irregularity in 31 patients. Based on terminal cholangiogruphy, 199 patients were diagnosed with normal appearance and 54 patients with ITBL In patients with abnormal initial cholangiography, ITBL was occurred in 39 of 64 patients including 10 of 33 poor frlling patients and 29 of 31 irregularity patients. In patients with normal initial appearance, ITBL was only occurred in 15 of 189 patients. The abnormal initial cholangiography was associated with ITBL significantly (X2 = 79.999, P = 0.000, r = 0.490). Initial cholangiography had an overall sensitivity of 72.22%, and specificity of 87.44%, with positive and negative predictive values of 60.94% and 92.06%, respectively. The abnormal initial cholangiogruphy was a risk factor of ITBL by logistic regression analyses(OR=15.193, P=0.000). Conclusion The abnormal initial cholangiography is associated with ITBL Initial cholangiography, especially minimal irregular of intrabepatic biliary tract, is a sensitive and specific method for the detection of ITBL after liver transplantation.

Objective:To establish a headspace capillary gas chromatography method for the determination of residual solvents in erlotinib hydrochloride .Methods:A DB-624 capillary column (30 m ×0.53 mm, 3.0 μm) was used and the carrier gas was nitro-gen.The flow rate was 2.0 ml· min-1 and the inlet temperature was 190℃.The FID detector temperature was 230 ℃.The column temperature program was with the initial temperature of 35℃( maitaining 8 min) , risen to 170℃with the rate of 28℃· min-1 ( main-taining 8 min) , and then risen to 200℃with the rate of 32℃· min-1 ( maintaining 7 min) .The headspace vial temperature was 100℃and the time was 30 min.Results:Ethanol, isopropanol, methylene chloride and n-butanol had a good linear relationship within the range of 0.68-409.14 μg· ml-1 (r=0.999 8),0.67-404.88 μg· ml-1 (r=0.999 8),1.71-51.31μg· ml-1 (r=0.999 7) and 0.72-431.12 μg· ml-1(r=0.999 8), respectively.The average recovery was 99.0% (RSD=0.41%, n=9), 100.2%(RSD=0.52%, n=9),97.1%(RSD=1.75%, n =9) and 102.5% (RSD=1.08%, n=9), respectively.Conclusion: The method is simple and accurate , which can be used for the determination of four residual organic solvents in erlotinib hydrochloride .