ObjectiveTo explore the contrast-enhanced ultrasonography features of postpartum placenta implantation and its clinical value in diagnosis of postpartum placenta implantation.MethodsBetween April 2009 and May 2013, twelve patients with clinically suspected placenta implantation underwent contrast-enhanced ultrasonography in Hubei Maternal and Child Health Hospital. The location and extent of intrauterine lesions and perfusion features of contrast agent were observed. The contrast-enhanced ultrasonography features of postpartum placenta implantation were analyzed and compared with postoperative pathological diagnosis.ResultsIn twelve patients with placenta implantation, eleven showed enhancement. Only one lesion showed no enhancement, which was diagnosed as placental degeneration and calcification on postoperative pathology. One case was placenta adhesions conifrmed by postoperative pathological diagnosis, which presented with a hyperenhanced lesion in uterine cavity with a clear boundary to myometrium. Six cases were placenta implantation confirmed by postoperative pathological diagnosis, which presented with a residual placenta surrounded with extremely thin or evendiscontinuous uterine serosa. Five cases were placenta penetration confirmed by postoperative pathological diagnosis, which presented with a residual placenta penetrating the uterine serosa and contrast agent spilling out. All cases in this study were cured by operation.ConclusionsContrast-enhanced ultrasound could diagnose placenta implantation via the difference of tissue perfusion. The lesion of placenta implantation showed enhancement after injection of contrast agent. If discontinuous uterine serosa and contrast agent spilling was observed, placenta penetrating uterine serosa should be considered. Contrast-enhanced ultrasound has important clinical value in diagnosing postpartum placenta implantation and observing postoperative recovery processes of uterine rupture.

Objective:To establish an HPLC method to determine the content of chloramphenicol, salicylic acid and the related substances in compound chloramphenicol alcoholic solutions. Methods:The analytical column was Agilent Eclipse XDB-C18 (150 mm × 4. 6 mm,5 μm), 0. 8% acetic acid solution- acetonitrile(60∶40) was used as the mobile phase with the flow rate of 1. 0 ml· min-1 , the detection wavelength was 290nm for chloramphenicol and salicylic acid, and 272nm for the related substances, the column temperature was 25℃,and the injection volume was 10 μl. Results: Chloramphenicol and salicylic acid were completely separated from the related substances. The linear relationship of chloramphenicol ranged from 14. 88 to 297. 60μg·ml-1(r=0. 999 9), and the average recovery was 101. 18% with RSD of 0. 82%(n=9). The linear relationship of salicylic acid ranged from 9. 72 to 194. 40μg· ml-1(r=1. 000 0), and the average recovery was 99. 78% with RSD of 0. 27%(n=9). Conclusion:The method is good in resolu-tion, reproducibility and sensitivity. It is suitable for the determination of the two components and related substances in compound chloramphenicol alcoholic solutions.

Objective To explore the diagnostic value of ultrasound-guided aspiration biopsy in patients with unexplained refractory ascites.Methods The data of 25 cases of unexplained refractory ascites were retrospectively analyzed.For all the cases the diagnosis was based on the examination of contrast enhanced CT or ultrasound.Ultrasound-guided aspiration biopsy of locally thickened peritoneum or ti- ny masses in ascites was performed.Reults Ultrosonographic image of all cases was as follows.10 cases,with locally thickened peritone- um,were isoechoic or hypoechioc.In 2 of 10 cases contrast enhanced ultrasound examination was done,and the images were characterized by an obvious enhancement in arterial phase and quick wash-out in veinous phase.In 7 cases there was irregularly thickened peritoneum, accompanied by adhesion and caking of the omentum.Cystic formation in ascites or in peritoneum was found in 5 cases.Solid mass in asci- tes was found in 2 cases,and splenomegaly and enlarged pancreas were found in 1 case.Ultrasound-gnided aspiration biopsy was perfomed in all the patients.Among them 4 patients were operated on later.Histopathologic examination showed malignency in 20 patients.Among them,malignant peritoneal mesothelioma accoumted for 6 cases,pancreatic cystoadenoma in 2,mestastic adenocarcinoma in 9,malignant schwannoma in 1,lymphoma in 1,and histiocytoma in 1 patient.In the other 5 cases the lesion was benign,and it was verified by follow- up for about 6 months.Among them there were 3 cases of tuberculosis,1 case of inflammatory disease and 1 case of retroperitonesl fibro- sis.Conclusion Ultrasound-guided aspiration biopsy is valuable in the diagnosis of locally thickened peritoneum and tiny mass in ascitic fluid,and is valuable for diagnosis of unexplained refractory ascites.

Objective:To establish a method for the content determination of triptolide, total diterpenoids and total alkaloids in Leigongteng oral solution to provide basis for the quality control. Methods:An HPLC analysis was used to detect the content of triptol-ide, which was carried out on an Eclipse XDB-C18 column (150 mm × 4. 6 mm, 5μm) with the mobile phase consisting of acetonitrile-water with gradient elution. The flow rate was maintained at 1. 0 ml·min-1 , the column temperature was kept at 40℃ and the detec-tion wavelength was set at 218 nm. Using triptolide and wilforine as the contrast, the total diterpenoids and total alkaloids were deter-mined by UV-Vis spectrophotometry. Results:There were good linear relationship in the determination of triptolide, total diterpenoids (caculated as triptolide) and total alkaloids (caculated as wilforine) (r≥0. 999 8), the average recovery were 91. 96%, 90. 56%, 99. 18%, and the RSD were less than 3%. Conclusion:The method is with good reproducibility and stability, which can be used for the quality control of Leigongteng oral solution.

Objective:To establish an HPLC method for determining the content of aspirin and sodium salicylat in A-Liu spirits and study the stability of the two components under different storage conditions. Methods:The analytical column was Agilent Eclipse XDB-C18(150 mm ×4.6 mm, 5 μm) ,0.01 mol·L-1 potassium dihydrogen phosphate (adjusting pH to 2.3 with potassium acid) -acetonitrile-methanol(55∶15∶30) was used as the mobile phase at the flow rate of 1. 0ml·min-1 , the detection wavelength was 280 nm and the column temperature was 30℃. The contents of aspirin and sodium salicylat were regularly determined under such storage conditions as ambient temperature, constant temperature and humidity(30℃ ± 2℃,65% ± 5%) and refrigeration (4℃ ± 2℃). Re-sults:The average recovery and RSD were 100. 06% and 0. 80%(n=9) for aspirin, and 100. 53% and 0. 82%(n=9) for sodium salicylat. Aspirin and sodium salicylat showed good linear relationship within the range of 31.0-310.0 μg·ml-1(r=0.999 9)and 30. 5-305. 0 μg·ml-1(r=0. 999 5), respectively. Under the three storage conditions, the content of aspirin was decreased, while that of sodium salicylat was increased, suggesting the temperature could significantly affect the hydrolysis rate and content of aspirin Conclusion:The method is promising with good resolution, reproducibility and sensitivity. It is recommended that the method be used to determine the content of aspirin and sodium salicylat in A-Liu spirits, and aspirin isn't stable under different storage conditions.

Objective To investigate the influence of tiotropium bromide on lung function index,quality of life and re-hospitalization risk of patients with bronchial dilation and pulmonary infection.Methods 100 patients with bronchiectasis and lung infection were chosen,and they were randomly divided into control group (50 patients) with BAL used alone and observation group(50 patients) with tiotropium bromide on the basis of control group.The short-term clinical effects,the levels of FVC,FEV1 and FEV1 ％,BODE index scores and QLI scores before and after treatment,and re-hospitalization rate of the two groups were compared.Results The short-term effective rate of the observation group was significantly higher than that of the control group(94.00％ vs.76.00％,x2 =7.81,P ＜ 0.05).The levels of FVC,FEV1 and FEV1％ after treatment of both two groups were significantly higherthan before treatment[(2.78 ±0.57)L vs.(2.15 ± 0.33) L,(3.60 ± 0.71) L vs.(2.20 ± 0.36) L;(2.15 ± 0.42)L vs.(1.23 ±0.32)L,(2.77±0.59)L vs.(1.17 ±0.29)L;(65.25 ±11.45)％ vs.(51.79 ±9.23)％,(77.46 ±15.80) ％ vs.(52.02 ± 9.36) ％,t =2.34,2.97;2.52,3.07;2.47,3.12,all P ＜ 0.05].After treatment,the levels of FVC,FEV1 and FEV1 ％ of the observation group were significantly higher than control group [(3.60 ± 0.71) L vs.(2.78 ±0.57)L;(2.77 ±0.59)L vs.(2.15 ±0.42)L;(77.46±15.80)％ vs.(65.25 ± 11.45)％,t =2.26,2.44,2.30,all P ＜0.05].The QLI score and BODE index scores after treatment of both two groups were significantly better than before treatment[(3.37 ± 0.54) points vs.(3.95 ± 0.65) points,(2.11 ± 0.40) points vs.(3.87 ±0.61)points,(7.28 ±1.18)points vs.(5.04 ± 0.95) points,(8.69 ± 1.54) points vs.(5.13 ±0.98) points,t =2.29,2.81;2.50,2.96,all P ＜ 0.05].After treatment,the QLI score and BODE index scores of the observation group were significantly better than the control group[(2.11 ±0.40) points vs.(3.37 ±0.54) points,(8.69 ± 1.54) points vs.(7.28 ± 1.18)points,t =2.21,2.44,all P ＜ 0.05].The re-hospitalization rate of the observation group was significantly lower than that of the control group (16.00％ vs.2.00％;28.00％ vs.6.00％;x2 =8.02,9.74,all P ＜ 0.05).Conclusion Selective cholinergic receptor blocker combined with BAL in the treatment of patients with bronchial dilation and pulmonary infection can efficiently relieve the respiratory symptoms,improve lung function,improve the quality of life and is helpful to avoid re-hospitalization occurrence.

Objective To investigate the effects of a single exposure or multiple exposures with equivalent total duration of exposure to sevoflurane on the histological morphology and neurons ultrastructure changes in neonatal rats hippocampus CA1.Methods A total of 45 male Sprague-Dawley rats on postnatal day 7,weighing 14-18 g,were randomly divided into three groups (n=15 each): Control group (group C),single exposure to sevoflurane group (group SS),multiple exposures to sevoflurane group (group TS).In group SS,the rats inhaled 3% sevoflurane for 6 h on postnatal day 7.In group TS,the rats inhaled 3% sevoflurane for 2 h on postnatal day 7,8 and 9.In group C,the rats inhaled 60% oxygen on the corresponding day age.Rats were sacrificed and brain were seperated on postnatal day 14.CA1 pyramidal neurons pathological morphology and quantity changes were observed by Hematoxylin-Eosin (HE) and Nissl staining.In the meantime,transmission electron microscopy was used for observing neurons ultrastructure and measuring the thickness of the postsynaptic density and the length of the postsynaptic active area.Results Nissl staining and HE indicated that multiple exposures and a single 6 h exposure to sevoflurane resulted in severer neurons loss and sparse arrangement relative to group C (P<0.05),Multiple exposures to sevoflurane resulted in greater neurons loss compared with a single 6-h exposure (P<0.05).Transmission electron microscope indicated that damage of CA1 neuronal subcellular organelle induced by multiple exposures and a single 6 h exposure was severer compared with group C.Both multiple exposures and a single exposure lead to decreased thickness of the postsynaptic density and shorter length of the postsynaptic active area (P<0.05).Multiple exposures to sevoflurane caused greater damaged than a single exposure (P<0.05).Conclusion Both a single and multiple exposure to sevoflurane induced CA1 neurons loss and ultrastructure changes in neonatal rats.Compared with a single exposure,multiple exposures to sevoflurane resulted in greater neurons morphology injury.

OBJECTIVE: The purpose of the present study was to investigate the prevalence of hearing loss by studying the current status of hearing loss, risk factors of hearing loss, exposure level of noise, and everyday habit of hearing in a group of university students, so as to provide information for hearing loss prevention in university students. METHOD: According to the purposive sampling method, 642 freshmen students participated in the study. Pure tone audiometry, and exposure level of noise scale were performed in all participants. RESULT: (1) According to the hearing loss criterion of WHO/PDH97.3, high frequency hearing loss, and noise induced threshold shifts, the hearing loss prevalence was 0.36%, 20.91% and 6.73%, respectively. (2) Multivariant Logistic regression analysis of high-frequency hearing loss indicated that traffic noise exposure and ear infection were risk factor of high frequency hearing loss. CONCLUSION There is a high prevalence of high frequency hearing loss in university students (20.91%), which was high related with traffic noise exposure and ear infection.
Audiometry, Pure-Tone ; Cross-Sectional Studies ; Hearing Loss, High-Frequency ; epidemiology ; Humans ; Noise ; adverse effects ; Prevalence ; Risk Factors ; Students ; Universities

Objective To study food-borne disease related behavior of the floating population in Hangzhou city. Methods A questionnaire on food-borne disease related behaviors was formulated based on Delphi method. A family-based retrospective investigation was conducted by unified trained investigators to analyze the frequency of food-borne disease related behaviors of family food providers during the past month in several floating-population centers of Hangzhou city. The investigation was conducted among 150 adults of every survey spot quarterly during a one-year period. Data were analyzed using Mann-Whitney U test. Results According to all 1 781 valid recovery questionnaires, 82.42%subjects had a family income less than 50 000 yuan per year and 87.42%of them had junior-middle-school or lower levels of education. The proportions of subjects who always cleaned kitchen tools, covered the garbage can and kept house out of flies, roaches and mice were 42.50%, 55.87% and 61.09%, respectively. The proportions of subjects who always purchased intact packaged food and food under warranty were 39.70%and 52.33%, respectively. The proportions of subjects who always used tapped water, cleaned hands before food processing, cooked eggsand other foods till well-done were 66.03%, 51.94%, 53.62%, 35.99% and 32.62%, respectively. The proportions of subjects who always stored food in containers with cover and for no more than 3 days in freezer were 20.89%and 30.88%, respectively. The frequencies of food-borne disease related behaviors mentioned above were significantly higher among migrants who originated from urban areas, received education above junior-middle-school and had a family income no less than 50 000 yuan/y than the others (P<0.05). Conclusion In order to correct the risky behaviors during food consuming, processing and storage, targeted intervention is necessary among family food providers of floating population families.

Objective To analyze the clinical features and pulmonary radiological findings of primary anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis (AAV).Methods Clinical data of 271 ANCA positive primary AAV patients admitted in Shanghai Ruijin Hospital from January 2003 to November 2015 were retrospectively analyzed.Among 271 patients,there were 211 myeloperoxidase (MPO)-ANCA positive cases (MPO subgroup),52 proteinase 3 (PR3)-ANCA positive cases (PR3 subgroup),and 8 dual positive cases (dual subgroup) according to ANCA classification.The demography,clinical characteristics,pulmonary radiological manifestation and renal function were compared among three subgroups.Results MPO subgroup had more renal (x2 =4.968,P =0.026) and constitutional symptoms (x2.=8.901,P =0.003) than PR3 group,while PR3 group had more ENT symptoms (x2 =19.843,P ＜ 0.001),cough (x2 =6.623,P =0.010),hemoptysis (x2 =8.656,P =0.003),dyspnea (x2 =5.127,P =0.024),buccal and ocular mucosal symptoms (x2 =4.818,P =0.028) than MPO group.In lung radiology,interstitial manifestations were displayed more frequently in MPO than PR3 group (x2 =4.237,P =0.040),while pulmonary nodules was more frequent in PR3 than MPO group (x2 =4.503,P =0.034).Dual subgroup tended to have more nervous,respiratory and renal impairment.Renal function showed that MPO subgroup had higher creatinine (Z =-5.529,P ＜ 0.001),urea (Z =-4.646,P ＜ 0.001) and uric acid levels (Z =-2.331,P =0.020) than PR3 subgroup.Dual subgroup had higher creatinine (Z =-3.251,P =0.001) and urea (Z =-2.882,P =0.004) levels than PR3 subgroup,but there was no difference with MPO subgroup.Conclusion There are significant differences in both clinical and pulmonary radiological manifestations between the MPO and PR3-ANCA subgroup of primary AAV.