Endocardial fibroelastosis(EFE) is a rare heart disease with a thickening of the endocardium by layers of collagenous and elastic fibres.Patients with EFE have diastolic and systolic heart failure.With the improvement of medicine,some progress has been achieved in EFE research.This article gave a comprehensive review to deepen the understanding of EFE.

OBJECTIVE： To establish a method for the determination of 33 kinds of pesticide residues in Panax ginseng C.A.Mey by GC-MS/MS and LC-MS/MS. METHODS： The 53 chemical monomers of 33 pesticide residues clearly prohibited by the Chinese ministry of agriculture were selected as the detection indicators. The samples were extracted with acetonitrile by high speed homogenizer. An LC-MS/MS analysis was performed on a CORTECSTM UPLC C18(2.1 mm×150 mm, 1.6 μm) column with isocratic elution of 0.1% formic acid (containing 5 mmol•L-1 ammonium formate) is mobile phase A, 95% acetonitrile(containing 5 mmol•L-1 ammonium formate and 0.1% formic acid)is mobile phase B.Electrospray ionization(ESI)source was applied by positive ionization in multiple reaction monitoring(MRM)modes. GC-MS/MS analysis was performed on a DM17ms(30 m×0.25 mm, 0.25 μm)capillary column with electron impact(EI)source, electron impact (EI) source was applied by positive ionization in multiple reaction monitoring modes (MRM). RESULTS: The correlation coefficient r of 33 pesticide residues showed good linearity in the linear range of 2 to 20 ng•mL-1 was greater than 0.990 0. The average recoveries at spiked levels of low level and high level (0.01 and 0.04 mg•kg-1), repeat 5 times per level. The average recovery was 87.57%-120.98%, and the RSD was between 1.45%-14.03%. CONCLUSION： The method can quickly and effectively detect pesticide residues in ginseng.

OBJECTIVE:To optimize the decoction process of agkistrodon. METHODS:RP-HPLC with pre-column derivatiza-tion was adopted. With the contents of 4 main amino acids in agkistrodon as index,the decoction process(decocting times,heating time,water quantity and medicinal material crushing granularity) was optimized by orthogonal tests and verified. RESULTS:The optimal technology of the decoction process of agkistrodon was as 3 times of decoction,60 min of heating time,50 ml of water consumption for 0.90 g medicinal material and No.6 sieve. The results of verification test showed the total extraction of 4 kinds of amino acids was 72.68 mg/g(RSD=3.77%,n=3). CONCLUSIONS:The decoction technology can be used for the decoction pro-cess of agkistrodon,and it is stable and feasible.

Objective To evaluate the apparent diffusion coefficient(ADC) value of mono-exponential diffusion weighted imaging(DWI) and the true diffusion coefficient(D) value, related diffusion coefficient(D*) value, perfusion fraction (f) value of bi-exponential model DWI in reflecting the expression of vascular endothelial growth factor (VEGF).Methods Using immunohistochemical staining method to detect VEGF expression in the 28 cases of gastric carcinoma tissue section and the surrounding normal gastric tissue.The differences of ADC value, D value, D* value, f value in different VEGF expression grading and gastric carcinoma classification were analyzed respectively.Results The differences of ADC value, D value, f value between different VEGF grading were statically significant,as the higher VEGF grading accompanied wth the lower ADC values, D value and the higher of f value;and the differences of the parameters between high and low differentiated gastric carcinoma were also statically significant (P<0.05).Conclusion The ADC value of mono-exponential DWI and the D value,f value of bi-exponential model DWI could evaluate the expression of VEGF and reflect the gastric carcinoma angiogenesis.

Abstract? AIM: To analyze the ocular manifestations of meningiomas in the trigone of the lateral ventricle, discuss the relevant factors of visual impairment in these patients and things need attention clinically.?METHODS:Retrospectively study on the clinical data of 90 eyes in 45 patients diagnosed of trigonal meningiomas treated at Beijing Tian Tan Hospital from October 2011 to October 2015.Preoperative examinations including visual acuity, optic disc findings, visual field, size of tumors and other change in MRI were analyzed.?RESULTS: Patients'age was 12-68 years old ( mean 41.7 ±13.7 years ). Male/female ratio was 1 ∶4.6. Decreased visual acuity occurred in 18 eyes.Optic disc edema was found in 24 eyes and optic disc pale in 6 eyes. Fourty -seven eyes had visual field defect, mostly homonymous hemianopia or defect. The maximum diameter of tumors was 2.1-9.6cm (4.8±1.7cm).Range of tumor volume was 3.02-193.2cm3(48.3±47.8cm3).A positive correlation of preoperative visual field defect was found with tumor volume, tumor maximum diameter, and brain midline shift respectively. While the preoperative visual field defect was not found any correlation with age, gender, course, and the enlargement of the ventricle and the edema of the tissue around the tumors. After Mann-Whitney U test, the differences on tumor volume, the maximum diameter of tumors, and brain midline shift between the two groups were significant.? CONCLUSION: Patients with trigonal meningiomas often have ocular signs and symptoms.The major reason of visual field defect is the damage of optic radiation around the tumor.The specific position of injured optic radiation determines the type and extent of visual field defect.Both ophthalmologist and neurosurgeon should pay attention to tumors nearby posterior visual pathway. Doing neurophthalmology examinations for these patients and realizing the position between the tumor and posterior visual pathway will be helpful and necessary in surgical planning.

Objective:To evaluate the effects of intermittent change the angle of operating table on the skin in pressure areas of patients in prone position.Methods:A total of 150 hospitalized patients for elective surgical treatment in Yantai Yuhuangding Hospital from January 2019 to June 2019 were selected as subjects. The patients were divided into control group, 15° test group and 30° test group by random number table method, with 50 patients in each group. The control group received routine intraoperative pressure ulcer prevention measures, the 15° test group on the control group, the itinerant nurses adjusted the angle of the operating table according to the left 15°-supine-right 15° every half hour, and the 30° test group on the control group, the itinerant nurses adjusted the angle of the operating table according to the left 30°-supine-right 30° every half hour. The incidence of surgically related pressure ulcers and doctors' satisfaction with the surgical position of the three groups of patients were evaluated.Results:Pressure ulcers occurred in 8 patients of the control group, the incidence of pressure ulcers was 16%. Pressure ulcer occurred in 0 patient of the 15° test group, the incidence of pressure ulcers was 0. Pressure ulcers occurred in 2 cases in the 30° test group, the incidence of pressure ulcers was 4%. The difference was statistically significant ( χ2 value was 10.120, P<0.05). Further comparison showed that the incidence of pressure ulcers was statistically significant between the control group and the 15° test group ( P<0.016 7), while the incidence of pressure ulcers was not statistically significant between the control group and the 30° test group, between the 15° test group and the 30° test group ( P>0.016 7). The results of the postoperative doctors' satisfaction with the surgical body position were (27.880 ± 1.637), (27.520 ± 1.693), (26.920 ± 1.947) points in the control group, the 15° test group and the 30° test group, there was a statistically significant difference among the three groups ( F value was 3.779, P<0.05). Further comparison showed that there was no statistically significant difference in the score of surgical position satisfaction between the control group and the 15° test group, between the 15° test group and the 30° test group ( P>0.05). The satisfaction score of surgeons in the control group was higher than that in the 30° test group, and the difference was statistically significant( P<0.05). Conclusions:Intermittent adjustment of surgical position can reduce the incidence of pressure ulcers and improve the quality of nursing in the operating room without affecting the convenience of the surgeon. The optimal effect was achieved by adjusting the angle of the operating bed according to the left-leaning 15°-supine-right-leaning 15°at an interval of 30 minutes.

Objective To compare the consistency of thrombelastography (TEG) and light transmittance aggregometry (LTA) in monitoring the antiplatelet therapy of the patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI),and observe the changes of mean platelet volume (MPV) of the patients treated with aspirin and clopidogrel after PCI.Methods A total of 177 patients undergoing PCI and the treatment of aspirin and clopidogrel in Peking University First Hospital during March 2014 and May 2015 were enrolled in the study.Their adenosine diphosphate (ADP) or arachidonic acid (AA) induced platelet inhibition rates determined by TEG,MPV before and after antiplatelet therapy,and the maximum platelet aggregation rates measured by LTA from 99 patients were retrospectively analyzed.Results There was no any correlation between the maximum aggregation rates measured by LTA and the platelet inhibition rates determined by TEG regardless of using ADP or AA as agonist (all P ＞ 0.05).The detection rates of clopidogrel hyporesponsiveness determined by LTA and TEG were 30.3％ and 45.5％,respectively,while those of aspirin hyporesponsiveness were 19.2％ and 31.3％,respectively.The detection rate of hyporesponsiveness determined by LTA was significant lower than that by TEG (P ＜ 0.05).The MPVs after antiplatelet therapy were significant lower than that before treatment (all P ＜ 0.01) regardless of clopidogrel hyporesponsive or sensitive and aspirin hyporesponsive or sensitive.The MPVs in clopidogrel hyporesponsive group before and after treatment were significantly lower than that in clopidogrel sensitive group (all P ＜ 0.05).The PLT counts in clopidogrel or aspirin hyporesponsive groups after treatment were significantly higher than that before treatment (all P ＜ 0.05).Conclusion There is poor correlation between LTA and TEG.It should be noted that the incidence rate of antiplatelet drug hyporesponsiveness is high in clinical practice.The MPVs of the patients significantly decrease after antiplatelet therapy.The patients with a significant increase of PLT after antiplatelet therapy are more likely to become drug hyporesponsiveness,while the patients with lower MPV are more likely to have clopidogrel hyporesponsiveness.

ObjectiveTo study current status of benign breast diseases and metabolic syndrome in professional women in Chongqing and relative risk factors. MethodsProfessional women (2604 cases )in Chongqing were surveyed by random cluster sampling.The biochemical indicators such as blood lipid were determined by cholesterin oxidase.The indicators such as height and weight were measured by physical examination.Chi-square test and logistic regression were used in statistical analysis. Results The morbidity rate of benign breast diseases, metabolic syndrome, hyperglycaemia, hypertension, hyperlipidemia, and obesity in our study was 19.27％ (429/2226), 7.91％ ( 176/2226 ), 8.04％ ( 179/2226 ), 23.23％ ( 517/2226 ), 24.21％ ( 539/2226 ) and 20.5％ (457/2226) respectively.The difference of mobidity rate between different age group and different career had statistical significance.Office workers and civil servants were high risk population.Age was negatively correlated with benign breast diseases.There was no relation between benign breast diseases and metabolic syndrome.ConculsionsThe morbidity rate of benign breast diseases and metabolic symdrome in professional women in Chongqing is relatively high.A good lifestyle, breast self-examination and regular physicial examination are recommended.

Plasma quinolone concentrations are not routinely measured in clinical practice.However,in order to optimize quinolone treatment,monitoring of plasma concentrations could sometimes be useful particularly in critically ill patients.In this study,anti-sparfloxacin antibody was obtained by immunizing rabbits with sparfloxacin conjugated with bovine serum albumin using isobutyl chloroformate method.After the assay procedure was optimized,the standard curve of sparfloxacin was established.The practical measuring range of the competitive ELISA extended from 5 ng/mL to 2 μtg/mL.The recovery rates and coefficients of variation for rat plasma,urine and tissues were 87.7-106.2％ and 4.8-15.3％,respectively.To demonstrate the potential of the ELISA,a preliminary pharmacokinetics and tissue distribution study of sparfloxacin in rats and quantitative analysis of sparfloxacin in several pharmaceuticals were performed and compared with high-performance liquid chromatography (HPLC).The experimental data indicated that the proposed method would be a valuable tool in therapeutic drug monitoring (TDM) for sparfloxacin.