Aim:To develop a practical chiral CE method for the quantitative determination of the unwanted enantiomer[( R )-enantiomer]presented in zolmitriptan. Methods:The background electrolyte was 20 mmol/L sodium dihydrogenphosphate solution with 1% S-β-CD,adjusted to pH 3.50 with phosphoric acid. A fused-silica capillary(60 cm×50 μm ID,effective length 51.5 cm)was used at 20 ℃ for the separation. The applied voltage was -30 kV. The samples were loaded by hydrodynamic injection(50 mbar pressure,6 s). UV was measured at 220 nm. Results:Zolmitriptan and its chiral impurity were baseline resolved ( R s=6.66). The linearity was good over the concentration range from 4 to 80 μg/mL( r =0.999 8) of ( R )-enantiomer. The injection precision (expressed as CV%) was 2.83%. The average recovery was 99.97%( n =9). The limit of detection was 1.5 μg/mL. The host-guest complex binding constants were 964 and 905 mol-1 for ( R )-enantiomer and zolmitriptan,respectively. Conclusion:The method is suitable for the determination of ( R )-enantiomer in zolmitriptan and binding constants of zolmitriptan enantiomers to S-β-CD.

In this paper, the fluorogenic property of vindoline was exploited and, as a probe, used to analyze the interaction of vindoline with HSA by fluorescence and absorption spectra in combination with molecular modeling under a simulated physiological conditions. The evidences from synchronous fluorescence and absorption spectroscopes showed the effect of vindoline on the microenvironment around HSA in aqueous solution. Data obtained by the fluorescence spectroscopy indicated that binding of vindoline with HSA leads to dramatic enhancement of the fluorescence emission intensity. The binding constants and the number of binding sites between vindoline and HSA at different temperatures (303, 310 and 317 K) were calculated according to the data obtained from fluorescence titration. Molecular docking was performed to reveal the possible binding mode or mechanism and suggested that vindoline can bind strongly to HSA. It is considered that vindoline binds to HSA mainly by a hydrophobic interaction and there are four hydrogen bonds interactions between the drug and the residues Ala291, Arg222, Arg218 and Lys195, separately. Fluorescent displacement measurements confirmed that vindoline bind HSA on site II. The thermodynamic parameters obtained (the enthalpy change deltaH0 and the entropy change deltaS0 were calculated to be -10.30 kJ x mol(-1) and 79.98 J x mol(-1) x K(-1), respectively, according to the Van't Hoff equation) suggested that hydrophobic and electrostatic interaction is the predominant intermolecular forces stabilizing the complex.

Objective To evaluate the application of nutritional risk screening in children hospitalized in general surgery department,in order to provide the basis for selecting the screening tool.Methods Nutritional risk screening was performed on 123 children hospitalized in the general surgical department by using the Assessment of Malnutrition in Paediatrics (STAMP) and Paediatric Yorkhill Malnutrition Score (PYMS).The malnutrition prevalence based on the World Health Organization (WHO) child growth standards(WHO standards) was evaluated.The data of hospital stay and total hospital expenses were recorded and analyzed.Results By using the STAMP and PYMS,76.4％ (94/123 cases) and 85.4％ (105/123 cases) of the patients had low-moderate nutritional risk,23.6％ (29/123 cases) of the patients and 14.6％ (18/123 cases) had high nutritional risk,respectively.The malnutrition prevalence was 17.9％ (22/123 cases) based on WHO standards.Children with high nutritional risk screened by STAMP,PYMS and malnutrition evaluated by WHO standards had significantly longer hospital stay(days) and higher total hospital expenses(yuan) compared with those in low-moderate nutritional risk or non-malnutrition patients,and the differences were statictically significant (hospital stay:STAMP:M =8.50 ＞ 7.00,Z =-2.608,P =0.008;PYMS:M =8.00 ＞6.25,Z =-2.761,P =0.006;WHO standards:M =8.25 ＞6.75,Z =-2.812,P =0.005.Total hospital expenses:STAMP:M =4 970.46 ＞ 2 939.07,Z =-2.913,P =0.004;PYMS:M =5 486.57 ＞ 3 294.96,Z =-3.024,P =0.002;WHO standards:M =5 515.87 ＞ 3 170.04,Z =-3.098,P =0.002).According to WHO standards,the sensitivity,specificity,Youden index,positive predictive value and negative predictive value of STAMP and PYMS were 68.2％ vs.77.3％,86.1％ vs.99.0％,54.3％ vs.76.3％,51.7％ vs.94.4％,92.6％ vs.95.2％ respectively.Conclusion Both STAMP and PYMS can be used for nutritional risk screening in hospitalized children in general surgery department,while sensitivity and specificity of PYMS are better than those of STAMP.

Objective To investigate the status of nutritional risk and clinical outcome in children hospitalized in the general surgical department, which can provide basis for clinical nutritional support and selecting the screening tool. Methods Nutritional risk screening was performed on 506 children hospitalized in the general surgical department by using the Paediatric Yorkhill Malnutrition Score (PYMS). The data on incidence of complications, parenteral nutritional support during hospitalization, length of hospital stay and total hospital expenses were recorded. Results Of the 506 cases, 64.6%(327/506) had low nutritional risk, 27.1%(137/506) had moderate nutritional risk, and 8.3%(42/506) had high nutritional risk. Hepatic and gall diseases were the most common types of moderate nutritional risk (55.2%, 16/29), intestinal obstruction were the most common types of high nutritional risk (23.1%, 6/26). The incidence of complications, parenteral nutritional support during hospitalization, length of hospital stay and total hospital expenses were 10.2%(14/137), 21.9%(30/137), (9.54±4.95) d, (6 899.13±3 281.18) yuan RMB and 21.4%(9/42), 35.7%(15/42), (10.60±7.25) d, (7 521.64±6 026.23) yuan RMB in moderate or high nutritional risk children, and 0.9%(3/327), 3.1%(10/327), (17.17 ± 4.17) d, (4 691.96 ± 3 114.43) yuan RMB in low nutritional risk children, and there were significant differences (χ2/F=18.665-64.554, P<0.05). Conclusions Moderate or high nutritional risk is seen in children hospitalized in the surgical department. High nutritional risk score is correlated with adverse clinical outcome. PYMS can be used for nutritional risk screening in hospitalized children.

Objective To evaluate the rationale of lowering the cutoff value of normal fasting plasma glucose (FPG) by studying the cardiovascular risk factors in subjects with different FPG levels and different glucose tolerance states. Methods A population-based survey of diabetes was undertaken in 1994, data from 15564 Chinese adults (age≥25) who adopted 75 g-oral glucose tolerance test were analyzed. Results (1) The frequencies of BMI≥25 kg/m 2 , hypertension, hypertriglyceridemia, metabolic syndrome were increasing with graded FPG levels at a 0.56 mmol/L interval. FPG at 5.0-5.6 mmol/L level overweight frequency elevated significantly (P=0.001), and FPG at 5.6-6.1 mmol/L level the metabolic syndrome and other components also elevated (P

Objective To explore the dynamic management methods of pediatric nursing with limited human resources.Methods Nurses within the same ability level were deployed within the level and were trained intensively by job rotation. According to different job needs, after completion of induction training, new nurses were trained rotationally on neonatal transport, emergency and ICU, so as to improve clinical post allocation. Five nurses and five doctors were randomly selected from the 32 nursing units in the Children′s Hospital of Soochow University and were surveyed by self-designed questionnaire about their satisfaction degree. Results The manpower structure tended to be more reasonable with intensive skill training and adjustment;after implementation of dynamic post management system of pediatric nursing, medical staffs′ satisfaction toward nursing human resource management was significantly improved (P＜0.05).Conclusions Nursing manpower ratio structure directly affects nursing quality, patients′ satisfaction and medical staffs′ satisfaction. Optimizing the structure improves nursing safety and stability of the nursing team.

Objective To explore the lived experience of children with acute leukemia about acupoint therapy during chemotherapy, so as to provide the theoretical and practice evidence for development of more scientific nursing measures. Methods Totally 14 children with acute leukemia participated in half-structured interviews regarding their experience of acupoint therapy.The NVivo 10.0 software was used to supervise, excavate and seek data.The data were analyzed by the Co1aizzi phenomenological methodology. Results Five themes were extracted including benefit sense,a sense of accomplishment of self-fulfilling, a sense of attachment to medical, sigh with emotion the magic of traditional Chinese medicine and bearable mild discomfort. Conclusions The experience of children with acute leukemiais positive feelings for the most part, nursing staff should listen to them and give corresponding nursing according to specific circumstances in order to improve the quality of nursing.

Objective To explore the work experience after the change of professional role of the new head nurse in pediatrics,and to provide a basis for development of a more scientific training program in the future.Methods A total of 12 cases of pediatric new head nurses were interviewed by semistructured interview.The NVivol0.0 software was used to supervise,excavate and seek data.The data were analyzed by the Colaizzi phenomenological methodology.Results Four themes were extracted including role maladjustment,difficult to cope with stress,achievement of self growth,and expectation of the nursing department.Conclusions The new head nurse in pediatrics is under great pressure,the nursing managers should pay more attention to their growth process,provide timely support and conduct regular pre job training for them,so that they can adapt to the head nurse's positions as soon as possible,so as to ensure the quality and safety of nursing.

Objective To investigate if improving or slowing the progression of glucose intolerance might be linked with the reduction of cardiovascular disease(CVD)events and mortality in a Da Qing population with prediabetes.Methods In 1986,577 subjects with impaired glucose tolerance in 33 clinics in Daqing city were randomly assigned to either the control group or one of three lifestyle intervention groups(diet,exercise,or diet plus exercise)to receive a 6 year lifestyle intervention.All the participants were followed for 14 years(1993-2006)after completion of the 6 year active interventions to assess the long-term effect of the interventions.In this post-hoc analysis,the participants were stratified into four subgroups(quartiles)based on their 2 h plasma glucose(2hPG)level after glucose loading at the end of the active intervention,in order to analyze the impact of plasma glucose level on CVD events and mortality.Results During the 20-year follow-up,there were a total of 142 deaths(68 of which were attributed to CVD)and 211 first CVD events(145 strokes and 66 myocardial infarctions).From the highest to the lowest levels of 2hPG in the 4 quartiles,the all-cause mortality(17.8,12.7,10.9,and 9.7/1 000 personyears),CVD mortality(9.1,5.9,6.1,and 4.9/1 1300 person-years)and the incidence of first CVD events(30.4.24.0,18.8,and 19.7/1 000 person-years)showed a clear trend of decline.In multivariate analyses,controlled for age,sex,body mass index,smoking habit,blood pressure,and intervention methods at baseline,the results showed that the 5 mmol/L elevation of 2hPG level after glucose loading in 1992 significantly increased the all-cause mortality(HR 1.335.P=0.005),the incidences offirst CVD events(HR 1.227,P=0.012)and stroke(HR 1.213,P=0.026).Conclusion In pre-diabetes population.if the lifestyle intenrentions are substantially efficacious in improving glucose intolerance,the CVD risk and mortality will be reduced.

Objective To test the reliability and validity of the Chinese version of State Behavioral Scale for Mechanically Ventilated Children (SBS). Methods The English version of SBS was revised and translated into Chinese version. The reliability and validity of the Chinese version of SBS was tested in 172 mechanically ventilated children. Results The Cronbach α coefficient of the Chinese SBS was 0.986. The item-level content validity index of Chinese SBS were 0.83-0.10, and the scale- level content validity index of Chinese SBS was 0.932. The correlation coefficient between the score of Chinese SBS and the Comfort Scale (CS) was 0.919 (P<0.01). Conclusions The Chinese version of SBS has been proved to be reliable and valid.It can be used to sedation assessment for mechanically ventilated children.