Adenocarcinoma ; diagnosis ; pathology ; surgery ; Adenocarcinoma, Mucinous ; diagnosis ; pathology ; surgery ; Adult ; Aged ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; surgery ; Cholecystectomy ; methods ; Female ; Follow-Up Studies ; Gallbladder Neoplasms ; diagnosis ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Survival Rate

Objective:To develop a quantitative HPLC method for the analysis of eight impurities in active pharmaceutical ingredi-ent (API) asenapine maleate. Methods:The substances were analyzed using an Inertsil ODS-3 C18 column (250 mm × 4. 6 mm, 5μm), and gradiently eluted by the mobile phase A of 0. 1% aqueous trifluoroacetic acid and mobile phase B of acetonitrile in a flow rate of 1. 0 ml·min-1 with the detection wavelength of 220 nm and the column temperature of 35℃. Results:Asenapine was separa-ted completely from the impurities. The calibration curve of asenapine was linear within the range of 0. 45-1 458 μg · ml-1 ( r =1. 000 0), and that the impurities was linear within the range of 0. 4-30. 0μg·ml-1(r>0. 999). The mean recovery of the impurities was 93. 1%-106. 7%(n=9). Conclusion:The method is simple,sensitive and reproducible with good specificity and reliability,which can be used in the quality control of asenapine maleate.

Infant hair is a good medium to assess the cumulative exposure level of infant in the mother ' s body. Chlorinated persistent organic pollutants were ubiquitous and with the highest volume concentration in the human body. In this experiment, 20 infant hairs were collected from Beijing. The sample was overnight incubated in HCl, extracted with the mixture of hexane and dichloromethane, and cleaned up by a cartridge filled with alumina and acidified silica. The final eluate was concentrated, and 16 kinds of typical chlorinated persistent organic pollutants were detected with gas chromatography_high resolution mass spectrometry ( HRGC_MS). The results showed that the detection limit of the target compounds in sample was 1. 00-2. 50 μg/kg, the recovery of surrogate in all samples was more than 67 . 6%, and the range of recoveries for target compounds in spiked sample was 62. 5%-92. 3%. The positive rate is 100% for hexachlorobenzene,β_HCH and p, pˊ_DDE, 85% for γ_HCH, 50% for PCB28, and 40% for PCB52. The concentrations of Hexachlorobenzene, HCHs, DDTs and PCBs were 5. 48-8. 40 μg/kg, 3. 86-27. 1 μg/kg, 1. 16-18. 3 μg/kg and 2. 20-22. 1 μg/kg, respectively. The average concentrations were 7. 84 μg/kg for hexachlorobenzene, 6. 93 μg/kg for HCHs, 5. 53 μg/kg for DDTs, and 3. 44 μg/kg for PCBs. The method and the analysis results can be used to evaluate the accumulation level and cumulative exposure level of 16 target compounds for fetal in motherˊs body.

A method for the real-time polymerase chain reaction ( PCR ) coupled with high specific invader assay to detect single nucleotide polymorphism ( SNP) was established. To reduce the background signal, the amount of flap endonuclease 1 ( FEN1 enzyme ) and wild-type detection probe was optimized. Under the optimum conditions including 0. 05 μmo/L invasive oligonucleotide probe, 0. 125 μmol/L wild-type detection probe, 0. 5 μmol/L mutation detection probe, 0. 25 μmol/L each fluorescence resonance energy transfer (FRET) probe and 1. 5 U FEN1, the background signal of wild-type sample and mutation sample was dramatically decreased and the background interference to the detecting results was thus eliminated. A total of 21 cases of aldehyde dehydrogenase-2*2 ( ALDH2*2 ) , 19 cases of cytochrome p450 2 C19*2 ( CYP2 C19*2 ) and 19 cases of CYP2C19*3 were analyzed with the established method, and the genotypes of ALDH2*2 were 10 cases of GG homozygote, 8 cases of GA heterozygote and 3 cases of AA homozygote; the genotypes of CYP2C19*2 were 9 cases of GG homozygote, 8 cases of GA heterozygote and 2 cases of AA homozygote;and the genotypes of CYP2C19*3 were 18 cases of GG homozygote and 1 case of GA heterozygote. These results were consistent with those by pyrosequencing. The established method was specific, simple, short time-consuming and low cost, and could be used for the detection of SNP genotyping with non-polluting in single closed tube.

Objective To explore the causes of per-hospitalization high inpatient expenditure of a tertiary hospital in 2015,by analyzing the influencing factors.Methods We retrospectively studied 1 282 inpatient cases who cost more than 100 000 yuan per case at a tertiary hospital in 2015,analyzing statistically major influencing factors of such expenditure in variance analysis and multiple stepwise regression analysis.Results The average days of stay of these cases were 27.6 days,and the average medical cost of those cases was 149 153 yuan per person.Costs for medicines and material made up a large proportion of medical costs,respectively accounting for 33.38% and 31.98% of the total.The days of stay,prognosis of the patient,complications as well as hospital infection,surgeries,gender of the patients constituted major factors on inpatient medical expenditure.Conclusions Reducing the average days of stay,guiding reasonable applications of drugs and medical materials,strengthening management on operations and controlling excessive medical services are effective approaches to reducing excessive growth of medical costs.

Objective:To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with health education in the treatment of refractory depression and its effects on cognitive function and sleep quality.Methods:Ninety patients with refractory depression who received treatment in Hangzhou Seventh People's Hospital from January 2018 to January 2021 were included in this study. They were randomly assigned to receive either rTMS (control group, n = 45) or rTMS combined with health education (observation group, n = 45). All patients received 4 weeks of treatment. Clinical efficacy, the scores of the Clinical Global Impressions (CGI) Scale and the Hamilton Rating Scale for Depression (HAMD), cognitive function, sleep quality, and quality of life pre- and post-intervention were compared between the two groups. Results:Total response rate was significantly higher in the observation group than in the control group [91.11% (41/45) vs. 71.11% (32/45), χ2 = 5.87, P < 0.05]. CGI scores post-intervention were significantly higher in the observation group than in the control group [(45.23 ± 7.89) points vs. (27.64 ± 4.53) points, t = 12.97, P < 0.05]. HAMD scores were significantly lower in the observation group than in the control group [(16.32 ± 2.76) points vs. (21.86 ± 3.98) points, t = 7.67, P < 0.05]. The number of categories achieved and the number of correct responses post-intervention in the observation group were (3.83 ± 0.61) and (85.45 ± 7.87), respectively, which were significantly higher than those in the control group [(2.98 ± 0.37), (73.25 ± 6.12), t = 7.99, 8.20, both P < 0.05]. The number of perseverative errors post-intervention in the observation group was significantly lower than that in the control group [(32.02 ± 1.89) vs. (35.12 ± 2.09), t = 7.38, P < 0.05]. The Pittsburgh Sleep Quality Index post-intervention was significantly lower in the observation group than in the control group [(9.84 ± 1.56) points vs. (12.32 ± 1.62) points, t = 7.39, P < 0.05). The scores of social function, material well-being, physical function, and psychological function post-intervention in the observation group were (59.98 ± 5.31) points, (34.23 ± 4.12) points, (56.87 ± 5.32) points, and (47.28 ± 5.65) points, which were significantly higher than those in the control group [(45.23 ± 6.57) points, (27.98 ± 2.65) points, (43.24 ± 4.53) points, (36.21 ± 4.12) points, t = 11.71, 8.55, 13.08, 10.62, all P < 0.05]. Conclusion:rTMS combined with health education is highly effective on refractory depression. The combined therapy can improve cognitive function and sleep quality and is of great innovation and science.

Objective To evaluate the effectiveness of minimally invasive therapy on treating hypertensive cerebral hemorrhage.Methods 40 cases hypertensive cerebral hemorrhage were randomly divided into two groups, 20 cases were received the minimally invasive drainage therapy and 20 cases medicine therapy.Results Effective rate was high(P

OBJECTIVETo establish the association between the geometric anatomical characteristics of the patients and the corresponding three-dimensional (3D) dose distribution of radiotherapy plan via feed-forward back-propagation neural network for clinical prediction of the plan dosimetric features.

METHODSA total of 25 fixed 13-field clinical prostate cancer intensity-modulated radiation therapy (IMRT)/stereotactic body radiation therapy (SBRT) plans were collected with a prescribed dose of 50 Gy. With the distance from each voxel to the planned target volume (PTV) boundary, the distance from each voxel to each organ-at-risk (OAR), and the volume of PTV as the geometric anatomical characteristics of the patients, the voxel deposition dose was used as the plan dosimetric feature. A neural network was used to construct the correlation model between the selected input features and output dose distribution, and the model was trained with 20 randomly selected cases and verified in 5 cases.

RESULTSThe constructed model showed a small model training error, small dose differences among the verification samples, and produced accurate prediction results. In the model training, the point-to-point mean dose difference (hereinafter dose difference) of the 3D dose distribution was no greater than 0.0919∓3.6726 Gy, and the average of the relative volume values corresponding to the fixed dose sequence in the DVH (hereinafter DVH difference) did not exceed 1.7%. The dose differences among the 5 samples for validation was 0.1634∓10.5246 Gy with percent dose differences within 2.5% and DVH differences within 3%. The 3D dose distribution showed that the dose difference was small with reasonable predicted dose distribution. This model showed better performances for dose distribution prediction for bladder and rectum than for the femoral heads.

CONCLUSIONWe established the relationships between the geometric anatomical characteristics of the patients and the corresponding planning 3D dose distribution via feed-forward back-propagation neural network in patients receiving IMRT/SBRT for the same tumor site. The proposed model provides individualized quality standards for automatic plan quality control.

Activated protein C (APC) is known to be beneficial on ischemia reperfusion injury in myocardium. However, the protection mechanism of APC is not fully understood. The purpose of this study was to investigate the effects and possible mechanisms of APC on myocardial ischemic damage. Artificially ventilated anaesthetized Sprague-Dawley rats were subjected to a 30 min of left anterior descending coronary artery occlusion followed by 2 hr of reperfusion. Rats were randomly divided into four groups; Sham, I/R, APC preconditioning and postconditioning group. Myocardial infarct size, apoptosis index, the phosphorylation of ERK1/2, Bcl-2, Bax and cytochrome c genes and proteins were assessed. In APC-administrated rat hearts, regardless of the timing of administration, infarct size was consistently reduced compared to ischemia/reperfusion (I/R) rats. APC improved the expression of ERK1/2 and anti-apoptotic protein Bcl-2 which were significantly reduced in the I/R rats. APC reduced the expression of pro-apoptotic genes, Bax and cytochrome c. These findings suggest that APC produces cardioprotective effect by preserving the expression of proteins and genes involved in anti-apoptotic pathways, regardless of the timing of administration.
Animals ; Apoptosis ; Cytochromes c/genetics/metabolism ; Hemodynamics/physiology ; Male ; Mitogen-Activated Protein Kinase 1/metabolism ; Mitogen-Activated Protein Kinase 3/metabolism ; Myocardial Reperfusion Injury/metabolism/pathology/*prevention & control ; Myocardium/*metabolism/pathology ; Phosphorylation ; Protein C/*therapeutic use ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; bcl-2-Associated X Protein/metabolism

Actins ; chemistry ; Amides ; therapeutic use ; Animals ; Apoptosis ; drug effects ; Cytoskeleton ; drug effects ; Enzyme Inhibitors ; therapeutic use ; Female ; Liver Neoplasms, Experimental ; drug therapy ; pathology ; Mice ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Pyridines ; therapeutic use ; ras Proteins ; analysis ; rho-Associated Kinases ; analysis ; antagonists & inhibitors ; rhoA GTP-Binding Protein ; analysis ; rhoC GTP-Binding Protein