Copeptin,the C-terminal portion of provasopressin,is a novel neurohormone of the arginine vasopressin (AVP)system,and is known to be co-released with AVP from hypothalamus.As a surrogate marker of the AVP system,copeptin has gradually replaced AVP in several clinical studies largely due to its structural and methodological advantages.Copeptin has been regarded as a marker of non-specific stress response.In recent years,copeptin attracts more and more attention especially in cardiovascular conditions (heart failure and acute coronary syndromes).The present review primarily focuses on copeptin detection,its general advantages,and its potential clinical value in a variety of cardiovascular conditions.

Objective To explore drug resistance and distribution of multidrug-resistant(MDR)Mycobacterium tuberculosis (M.tuberculosis)in a county-level hospital,so as to strengthen the prevention and control of health-care-associated infection with M.tuberculosis .Methods Specimens with positive sputum smear were performed M. tuberculosis culture and drug resistance testing,and distribution of MDR tuberculosis patients in the departments before isolation were investigated retrospectively.Results Of 488 patients with tuberculosis,254 were positive for sputum smear,122 M.tuberculosis strains were isolated from positive sputum smear patients,120 isolates were per-formed drug susceptibility testing,results revealed that 86 isolates were drug-resistant strains,46 of which were monodrug-resistant,40 were MDR.Of MDR strains,16 were all resistant to isoniazide,rifampicin,streptomycin, and ethambutol.The percentage of monodrug-resistance,MDR,pandrug resistance was 9.43%,8.20%,and 3.28% respectively.Medical imaging department,ultrasound department,and respiratory disease department were the main units of M.tuberculosis exposure.Conclusion The percentage of MDR M.tuberculosis is high among M. tuberculosis ,surveillance should be intensified,so as to prevent the transmission in hospital.

A method was developed for simultaneous determination of Clozapine, Quetiapine and Risperidone in human serum by fully automated online solid phase extraction ( SPE )-high performance liquid chromatography. With Capcell MF Ph-1 column as SPE cartridge and Acclaim C18 as analytical column, high
selectivity could be achieved by this method according to the selective complementarity of the two columns. In the experiment, ACN-H2 O was used as the SPE mobile phase with a flow rate of 1 mL/min and ACN-10 mmol/L NH4 Ac was used as the analytical mobile phase with a flow rate of 1 mL/min. Serum samples were injected directly into the SPE column and the biological matrix was washed out with the loading solvent. By rotation of the switching valve, Clozapine, Quetiapine and Risperidone were eluted from the SPE cartridge in the back-flush mode and transferred to the analytical column by the chromatographic mobile phase. The whole time of the online SPE purification and chromatographic separation of the analytes was 18 min. Calibration curve of Clozapine with good linearity ( r=0 . 9996 ) was obtained in the range of 10-1800 μg/L in human serum, and the recoveries at low, medium and high concentration levels were 118. 4%, 105. 0% and 105 . 4%. Calibration curve of Quetiapine with good linearity ( r=0 . 9997 ) was obtained in the range of 3 . 6-640 μg/L in human serum, and the recoveries at low, medium and high concentration levels were 112. 8%, 101 . 1% and 101 . 5%. Calibration curve of Risperidone with good linearity ( r=0 . 9995 ) was obtained in the range of 0. 71-128 μg/L in human serum, and the recoveries at low, medium and high concentration levels were 100. 7%, 97. 2% and 98. 8%. In conclusion, the established automated online SPE-HPLC-UV method demonstrated good performance in terms of linearity, specificity, limits of quantification, and was successfully utilized to quantify Clozapine, Quetiapine and Risperidone in human serum.

Primary esophageal small cell carcinoma (PESCC) is a rare disease first described by McKeown in 1952. PESCC is characterized by high malignancy, distant metastasis, and poor prognosis. The incidence of PESCC has significantly increased world-wide in recent years. However, practice guidelines that concern the histological origin, clinical diagnosis methods, therapies, and prog-nosis of PESCC are still not well established because of the paucity of cases and lack of large prospective randomized research. This ar-ticle aims to outline recent advances in the clinical and therapeutic aspects of PESCC as well as review the different opinions concerned to better understand PESCC and solve clinical problems.

The purpose of this study is to investigate the enantioselectivity of norgestrel (NG) transdermal permeation and the potential influence of linalool and lipids on the enantioselectivity. In vitro skin permeation studies of NG across the excised rat skins were performed with Valia-Chien diffusion cells, and the permeation samples were analyzed by enantioselective HPLC. The possible enantioselective permeation of NG across intact rat back skin and lipids extracted rat back skin and the influence of linalool were evaluated. The skin permeation rate of dl-NG was two times higher than that of l-NG when donor solutions (EtOH/H2O 2 : 8, v/v) containing l-NG or dl-NG. It may be mainly attributed to the solubility discrepancy between enantiomer and racemate. The enantioselective permeation of dl-NG across intact rat skin was observed when the donor solutions containing dl-linalool. The permeation flux of l-NG was 22% higher than that of d-NG. But interestingly, the enantioselective permeation of dl-NG disappeared under the same experimental condition except that the lipid extracted rat skin was used. Attenuated total reflection-fourier transform infrared spectroscopy analysis of stratum corneum showed that the wave number for asymmetric CH2 stretching vibrations of lipids treated with dl-linalool was greater than that of the control. The results indicated that the enantioselective permeation of NG may be contributed by the interaction between dl-linalool and lipids. More than half of lipids were composed of ceramides. The stereospecific interaction maybe existed among chiral enhancer (linalool), lipids (ceramides) and/or chiral drugs (NG).

OBJECTIVETo assess the exposure level of total N-nitroso compounds (TNOCs) in the residents of high- and low-risk areas for esophageal cancer in southern China.

METHODSSamples of duplicate plate diets and 12 hr overnight urine were collected from 120 male adults in each of the 2 areas, a high-risk area (Nanao county) and a low-risk area (Lufeng county) for esophageal cancer. The 240 male healthy subjects (35 - 64 years old) were selected by a 3-stage random cluster sampling procedure. Levels of TNOC, N-nitrosamino acids (NAAs) and volatile N-nitroso compounds (VNOC) in the samples were measured by Thermo Energy Analyzer.

RESULTSThe detectable rate (95%) of diet TNOC, daily dietary TNOC intake (4.25 +/- 0.84) micromol/day, 12-hr urinary TNOC excretion levels (1.76 +/- 0.23 ng/12 h) and daily dietary intake of VNOC (266 +/- 31.2 microg/day) in the high-risk area were all significantly higher than those of the low-risk area. Oesophageal cancer mortality rates were positively and significantly associated with daily dietary TNOC intake and 12-hr urinary TNOC excretion. Urinary NAAs excretion levels were not different in the two areas.

CONCLUSIONThe results suggest that TNOCs may be implicated in the etiology of esophageal cancer in southern China.

Adult ; China ; Esophageal Neoplasms ; etiology ; mortality ; Humans ; Male ; Middle Aged ; Nitroso Compounds ; administration & dosage ; adverse effects ; urine

Background and purpose:Rectal small cell carcinoma is high malignant tumor and prone to early metastasis. It is rare in the clinical and its prognosis is poor. The aim of this article was to analyze clinical characteristics and summarize the diagnosis,treatment and prognosis of rectal small cell carcinoma.Methods:Clinical data of 16 cases with rectal small cell carcinoma conifrmed by pathology from Jan. 2001 to Jan. 2013 in the Tumor Hospital Affiliated to Zhengzhou University Hospital were analyzed retrospectively.Results:Among the 16 rectal small cell carcinoma patients (mean age is 58.5 years), 9 were male, 7 were female; 4 cases in stageⅡ, 7 cases in stageⅢ and 5 cases in stageⅣ. Ten cases underwent surgical treatment, of which 6 cases underwent radical surgery, 4 cases underwent palliative surgery;6 cases received chemotherapy alone, 2 cases received chemoradiotherapy, 2 cases did not receive any treatment postoperatively. Five cases were lost opportunity for operation, of which 3 cases underwent chemotherapy alone and 2 cases underwent chemoradiotherapy. One case did not receive any treatment. Among 10 cases of resection of the lesions, 5 cases had vascular invasion and 7 cases had local lymph node metastasis. All patients received 7-65 months of follow-up. The median survival was 15.4 months. The 6 months, 1 year, 2 years, 3 years and 5 years survival rates were 58.4%, 46.2%, 26.6%, 13.1% and 6.2% respectively. The prognosis of patients was associated with tumor staging, presence of vascular invasion and lymph node metastasis, and type of operation (P<0.05); but not related to age, gender and tumor size (P>0.05).Conclusion:The biologic behavior of rectal small cell carcinoma which is a rare disease and similar to small cell lung cancer, and its prognosis is poor. Treatment methods include surgery, radiotherapy and chemotherapy. The overall result is poor.

Objective To compare the clinical outcomes of two D3 embryo and single blastocyst transfer in patients retrieving different oocytes, so as to provide data support for selecting a clinical transfer strategy. Methods We made a retrospective analysis of patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI)between January and December 2014 in the Reproductive Medicine Center,the Third Affiliated Hospital of Zhengzhou University.The patients were divided into three groups according to the number of oocytes received:Group A (5-9 oocytes),Group B (10 - 14 oocytes)and Group C (≥ 1 5 oocytes).Patients in each group all received four different transfer methods as follows:transfer of two fresh D3 embryos (a ),transfer of one fresh blastocyst (b ),transfer of two D3 frozen embryos (c ),and transfer of one frozen blastocyst (d ).We compared the 2PN fertilization rate of oocytes,rate of available embryos and rate of good embryos among the three groups.We also compared the embryo implantation rate,biochemical pregnancy rate,clinical pregnancy rate, multiplets rate and abortion rate among the four transfer methods in each group.Results ① There were 667, 573,and 479 transfer cycles in Group A,Group B and Group C,respectively.The 2PN fertilization rate of IVF and available embryos rate was significantly higher in Group A than in Group B and Group C (P =0.003/P <0.001).② There was no significant difference in biochemical pregnancy rate,clinical pregnancy rate or abortion rate with the four transfer methods in Group A (P >0.05),but the implantation rate of c was significantly lower than that of a and d (P =0.027/0.020),d had a higher implantation rate than a and c in Group B (P =0.005/0.001).In Group C,the biochemical pregnancy rate and clinical pregnancy rate of d were significantly higher than those of a (P =0.048/0.027)and c (P =0.003/0.001).Patients in Group C also had a higher implantation rate than D3 embryos (P <0.05).③ The multiple pregnancy rate of single blastocyst transfer decreased compared with D3 embryos transfer in the three groups (P <0.05).Conclusion Single blastocyst transfer has both higher implantation rate and lower multiple pregnancy rate in high response patients (1 5 or more oocytes received).For patients who received 5-9 and 10-14 oocytes,D3 embryos have a similar clinical pregnancy rate with that of single blastocyst but a higher multiple pregnancy rate.Single vitrified-warmed blastocyst transfer has a higher clinical pregnancy rate.It is the best transfer method for patients who received more than 10 oocytes.

Objective To study the efficacy of performing transvaginal Prosima mesh with high uterosacral ligament suspension (HUS) in treatment of severe pelvic organ prolapse (POP).Methods From July 2010 to February 2011,70 patients with severe POP underwent transvaginal prosima mesh with HUS in First Affiliated Hospital,General Hospital of People's Liberation Army.Clinical parameters of perioperation were collected.After 1 month and 2 - 3 months,perineal two-dimensional ultrasound examination was performed to measure mesh length in midsagittal plane.Validated prolapse quality of life questionnaires,pelvic floor distress inventsry short form 20 (PFDI-20) and pelvic floor impact questionnaire short form 7 (PFIQ-7) were used to evaluate the therapeutic effect.The mean results of pre-operative PFIQ-7 and PFDI-20 was 54 and 51,respectively.Results Median operation time was ( 195 ± 47 ) min and median blood loss was (160 ±64) ml.All the patients were followed for a mean time of 13 months (2 - 19 months).Seven cases were found with mesh exposure with less than 1 cm2.The objective cure rate was 100％.The mean score of post-operative PFIQ-7 and PFDI-20 were both 19,which were significantly lower than those of preoperation ( P ＜ 0.05 ).Anterior Prosima mesh was 3.5 cm at 1 month by ultrasound examination,and the second result of ultrasound scans was 2.8 cm at 2 - 3 month,which were both shortened 2.5 cm and 3.2 cm when compared with that of original size.Conclusions Transvaginal Prosima mesh placement with HUS is a safe and efficient surgery with less complication.Although mesh became shorter after 2 - 3 month,it did not affect surgery efficacy.

Objective To study the objective and subjective therapeutic effect of total and partial (LeFort) colpocleisis in treatment of severe pelvic organ prolapsed ( POP) in selected elderly patients.Methods From Oct 2005 to Feb.2010,63 severe POP patients[59-87 years,median age (75 ±6) years]with stage Ⅲ and Ⅳ by POP-Q system underwent total and partial colpocleisis.The mean age was (75 ±6)years (59-87 years).Fifty-eight patients(58/63,92% )present more than one kind of medical disease.There were 53 cases with uterus prolapse,1 case with cervix prolapse and 9 cases with vaginal vault prolapse.Seven patients were recurrent POP from previous surgery.Twenty-three patients(36% ) presentedvoiding difficulty.Seven patients (17%) presented obstructive bowel symptom.Three patients (5%) presented fecal incontinence,and 28 patients(44% )presented either had urinary incontinence or history of that Among 63 patients,48 patients (76% ) underwent total colpoclesis,and 15 (24% ) patients partial colpoclesis.Meanwhile,58 (92% ) patients underwent levator myorrhaphy plus perineorrhaphy and 20 (32% ) patients underwent anti-urinary incontinence procedure ( TVT-0 ),respectively.Patients were followed up to evaluate therapeutic effect at 2 months and 1 year after surgery.Objective evaluation included the POP-Q and the length of vagina,genital hiatus,perineal body.A nonvalidated Body Image and Satisfaction Questionnaire was completed for subjective evaluation.Results The mean operating time of 63 patients was (105 ±48) minutes,which was (128 ±58) in total and (82 ±26) minutes partial procedures,which exhibited significant difference(P<0.05).The mean blood loss was (187 ± 128) ml (50-600 ml),total and partial procedures caused (232 ± 159) and (101 ±54) ml,respectively,which also showed significant difference ( P < 0.05 ).No intraoperative injury or death occurred.The rate of postoperative complications was 5% (3/63).Mean follow-up time of 63 patients was 22.5 months (1-51 months).All patients had POP-Q staging score ≤Ⅰ.No recurrent patient was observed.At 1 year after operation,the mean preoperative total vaginal length (TVL) and genital hiatus (GH) of (7.7 ± 1.1) and (5.5 ± 1.5)cm were decreased to (3.4 ± 1'.l)and (2.3 ±0.5) cm (P<0.01) ;and perineal body (PB) measurements was increased from (2.6±0.9) to (3.4 ±0.9)cm(P <0.01).Three (5%,3/63) patients had mild urinary incontinence after the operation.Twenty-three patients with voiding difficulty presenting the mean postvoid residual volumes (110 ± 38) ml(50-235 ml) were decreased to 12 ml after the operation.Obstructive bowel symptom was improved in 6(54%,6/11) patients,and fecal incontinence improved in 2(2/3).One year after the operation,52 ( 82% ) patients completed the nonvalidated Body Image and Satisfaction Questionnaire.49 (94% ) patients said either 'very satisfied' or 'satisfied' with the outcome of their surgery,while 3 ( 6% ) reported unsatisfied or not at all satisfied.Conclusions The objective and subjective curative rates of colpocleisis in treatment of severe POP are high with lower morbidity and recurrence.Colpocleisis is a safe and effective management in selected elderly patients with severe POP,who no longer desire to maintain vaginal coital function.