Objective To determine enantiomeric impurity of etomidate using high performance liquid chromatography. Methods (R)-etomidate and (S)-etomidate were isopropanol-n-hexane. The flow rate of the mobile phase was 0.5mL/min. The detected wavelength was 242nm. Results (R)-etomidate and (S)-etomidate could be separated completely under these conditions. The precision of (R)-etomidate was 1.57% (n=3). The limit of detection of (R)-etomidate was 4.25ng/mL. The average percentage content of (S)-etomidate was 0.09% in the samples. Conclusion The method was repeatable and sufficiently sensitive to determine the enantiomeric impurity of etomidate. It allows the quantitation of the impurities at the 0.085% (w/w) level relative to etomidate at a concentration of the test solution of 5mg/mL.

AIM: To explore a simple, reliable method for tissue processing and section staining by extracting DNA from the manually microdissectioned specimen, and to identify whether the extracted DNA is useful in the following study at molecule level. METHODS: The experiment was performed at the pathological laboratory of Guangdong Medical College from July 2004 to July 2007. The paraffin imbedding tissue sections of cervical cancer were thoroughly deparaffinized after mounted on slides for a long period of time. The nucleus was slightly stained with hematoxylin and microdissectioned under inverted microscope. The microdissectioned samples were put into EP tubes filled with digestion buffer to split the cells and then the DNA was extracted. During the whole course, PE tubes did not change, and the complicated phenol/chloroform extraction did not perform. The DNA extraction was rapid and simple. RESULTS: The DNA was measured by the spectrophotometer with concentrations from 0.14 to 5.25 g/L and absorbance values of A260/A280 were 1.6-1.8. All samples were amplified with PCR to produce expected length specific target fragment (231 bp). CONCLUSION: Rapid DNA extraction after manual tissue microdissection can produce adequate amount of DNA and maintain good quality of DNA template for PCR. The DNA meets the need of the following molecular experiments.

Objective To evaluate whether sofosbuvir (SOF)-based direct-acting antiviral agents (DAAs) combined with ribavirin (RBV) (combined RBV) can yield benefits to the recipients infected with hepatitis C virus (HCV) genotype 1 (GT1) after liver transplantation through systematic evaluation and Meta-analysis. Methods Multiple databases at home and abroad were systematically searched, the literature screening was conducted according to relevant standards, the quality of literatures was evaluated and data extraction was performed. The literature was divided into two groups according to the recipients with HCV-GT1 hepatitis after liver transplantation who received the treatment combined RBV or SOF-based DAAs alone without RBV (not combined RBV). Meta-analysis of the data was carried out using Rev Man 5.3 and R3.4.3 software. The incidence of sustained virological response 12 weeks (SVR12) after therapy was evaluated. Results A total of 2 195 articles were retrieved, and 6 articles published in English were eventually included according to the inclusion criteria. The Meta-analysis results demonstrated that the incidence of SVR12 did not significantly differ between the combined RBV and not combined RBV groups (P=0.28). However, the incidence of anemia in the combined RBV group was significantly higher than that in the other group (P < 0.01). Both combined RBV and not combined RBV therapies were efficacious in treating HCV-GT1a and HCV-GT1b subtypes after liver transplantation with similar clinical efficacy (P=0.33). The incidence of SVR in HCV-GT1 recipients did not significantly differ after receiving 12- and 24-weeks therapy after liver transplantation (P=0.95). Conclusions When SOF-based DAAs regimen is adopted to treat HCV-GT1 in recipients after liver transplantation, combination with RBV not only fails to improve the virus clearance rate and bring clinical benefits, but also increases the risk of anemia in the recipients.

Objective To explore the career success of nursing and the level of nursing informatics competence, and to analyzed the correlation between them. Methods From May 2016 to February 2017, a total of 700 nurses from 4 classⅢ grade A hospitals in Guangzhou and Fuzhou were selected by convenience sampling method and investigated by a self-designed general information questionnaire, the Chinese Version of Career Success Scale (CCSS) and Nursing Informatics Competence Scale (NICS). In this study, 700 questionnaires were issued and 648 questionnaires were collected. The effective recovery rate of the questionnaire was 92.57%. After soring out the data of the subjects, SPSS 19.0 was applied for statistical analysis (descriptive analysis, Pearson correlation analysis and multiple linear regression analysis). Results The total score of 648 nurses' CCSS was (34.45±7.69), with a score rate of 62.64%, which was at a moderate level. The total score of NICS was (117.30±20.04), with a score rate of 73.71%, which was at a moderate and upper level. The scores each dimension and the total score of the CCSS were positively related to the scores of each dimension and the total score of NICS (P< 0.001). The results of multiple stepwise linear regression showed that the nursing information awareness, professional title, nursing information management ability and gender could predict 62.2% variance of the total score of CCSS. Nursing information consciousness, gender and nursing information management ability could predict 57.9% variance of career satisfaction. Conclusions It is found that the success level of nurses' career was at a moderate level, and the nursing informatics competence affects the career success level of nurses.

OBJECTIVE: To analysis the characteristics of sudden sensorineural hearing loss (SSHL) patients with tinnitus, and explore the relationship of characteristics of tinnitus and audiology. METHOD: Patients diagnosed as SSHL with tinnitus were studied in the research. All patients' clinical features were analyzed, such as tinnitus frequency, pure tone audiometry, tinnitus, hearing loss degree, results of residual inhibition test. RESULT: Thirty cases were identified as mild degree hearing loss, 13 cases as moderate degree, 28 cases as severe degree and 34 cases as profound degree. And hearing impaired frequency of 13 cases was ascertained at low-frequency, 39 cases at middle-high-frequency, and 53 cases at full-range-frequency. The incidence of patients with low-frequency was about 41. 9% (44/105), and it was about 21. 9% (23/105) in those with middle-frequency. And it was 36. 2% (38/105) in cases of high-frequency tinnitus. The chi-square test show statistically significant differences between patients with the low-frequency, middle-frequency and high-frequency of the hearing loss (P<0. 05). In tinnitus residual inhibition test, positive rate of convergence type masking curve was about 72.0%, tinnitus separated type masking curve 20.0%, overlapping type was 57.9%, and the spacing type was 43.5%. There was a statistically significant difference among cases with different type masking curve (P<0. 05)with the spacing residual inhibition test positive rate. CONCLUSION There are individual differences of clinical characteristics among SSHL patients with tinnitus. Tinnitus frequency is consistent with the frequency of hearing loss. Patients had the more serious the degree of hearing loss, who had more serious tinnitus grading. Cases with the converged type curve will be fit for tinnitus masking. Therefore, combining the tinnitus detection with the audiological tests, we could obtain the clinical characteristics of SSHL patients with tinnitus.
Audiometry, Pure-Tone ; Deafness ; Hearing Loss ; Hearing Loss, Sensorineural ; complications ; pathology ; Humans ; Tinnitus ; complications ; pathology

Varicella(chickenpox)is an acute infectious disease with high incidence in children. It is mainly transmitted through the airborne route and vaccination is the best measure for the prevention and control. Data from post-marketing studies show the effectiveness of varicella vaccines is 80%-85%, and two-dose regimen is significantly more effective than one-dose. After inclusion of varicella vaccines into the national immunization programme, there has been a clear decrease in varicella morbidity. Despite the lack of direct evidence, there remains the risk that varicella-zoster virus might latent in the dorsal route ganglia after vaccination. Therefore, more safe and effective novel varicella vaccines are under development. This paper reviewed the progress in varicella vaccine development and their long-term efficacy and safety.

Objective:To propose a strategy for detecting early gastric cancer (EGC) under high-definition gastroscopy.Methods:Data of 469 lesions of EGC or high grade intraepithelial neoplasia (HGIN) confirmed by pathology detected at The Seventh Medical Center of Chinese People′s Liberation Army General Hospital from January 2013 to January 2020 were collected and gastroscopic images were re-interpreted. The Helicobacter pylori ( HP) infection status, lesion location in the area of atrophy or at the cardia, morphological type of lesions, lesions with/without clear or regular boundary, and lesion color were analyzed for morphological characteristics of EGC and HGIN under high-definition gastroscopy. Results:Among the 469 lesions of EGC or HGIN, HP-negative lesions accounted for 2.1% (10/469) and ulcerative lesions for 7.7% (36/469). Among non-ulcerative lesions of suspected HP infection ( n=423), there were 28 lesions in the cardia outside the atrophic area and 82.1% (23/28) were reddish under white light imaging. There were 29 non-cardiac lesions outside the atrophic area and 82.8% (24/29) were white or showed clear border under white light imaging. Inside the atrophic area, there were 73 elevated lesions, 95.9% (70/73) of which had clear border or irregular depression on the top. There were 293 flat/depressed lesions in the atrophic area, and 90.8% (266/293) had irregular border or were brown under narrow band imaging. Conclusion:According to the status of HP infection, the location and morphological category of lesions, above endoscopic features can be used as clues to detect EGC and HGIN.

NACHT-LRR-PYD-containing proteins 3 (NLRP3) inflammasome regulates the maturation and secretion of proinflammatory cytokines including interleukin-1β and interleukin-18,as well as immune and inflammatory response,through the activation of cysteine aspartate specific protease-1.Inflammatory response caused by the activation of NLRP3 inflammasome may participate in the development and progression of nonalcoholic fatty fiver disease (NAFLD).Therefore,exploration of the role ofNLRP3 inflammasome in NAFLD is important for the understanding of the pathogenesis of NAFLD and discovery of new therapeutic targets.

Objective To investigate the teaching effects of flipped class model on the Surgery Intensive Care Unit (SICU) nurses' ability of autonomic learning. Methods From July to December 2015, a total of 38 nurses who worked in SICU of Zhejiang Cancer Hospital were selected as the research objects by convenience sampling method. The nurses were trained in postoperative pain management knowledge by flipped class model, and were evaluated before and after the training by rating scale of self-directed learning competence for nurses. Results The total score of rating scale of self-directed learning competence for nurses, self motivation belief, task analysis, self monitoring and regulation, self evaluation were (128.26±18.69), (54.50±7.65), (22.05±3.66), (37.57±5.82) and (14.13±2.67) after the training, which all improved than (108.89±15.71), (47.18±6.61), (18.03±3.33), (31.37±5.24) and (12.32±2.14) respectively before training. The differences were statistically significant (t=-4.889, -4.460, -5.013, -4.883, -3.266; P<0.05). Conclusions Flipped class teaching model improves nurses' autonomous learning ability comprehensively and provide a new teaching mode for nurses' training.