OBJECTIVE:To develop an LC-MS method for the determination of the concentration of duloxetine in human plasma.METHODS:Plasma sample(0.2 mL)was taken,with the protein precipitated twice using acetonitrile.The mobile phase consisted of 20 mmol?L-1 ammonium acetate(pH3.5)-methanol-acetonitrile(38∶20∶42).The sample was separated on a Thermo C18 column with plasma concentrations(time-concentration profile)of duloxetine in 10 healthy volunteers determined by LC-MS after taking a single oral dose of duloxetine enteric-capsule(22.4,44.8 or 67.2 mg).RESULTS:The calibration curve of duloxetine was linear over the concentration range of 0.78～100 ng?mL-1(r=0.999 5)with the recovery at 100.8%,the RSD of intra-day and inter-day at no more than 7.8% and 9.3%,respectively.CONCLUSION:The method developed in our study was proved to be accurate and sensitive,and suitable for the pharmacokinetic study of duloxetine.

A novel HPLC-CAD method coupled with on-line solid phase extraction ( SPE ) for the determination of erythrocin which was widely used in livestock farming was developed. After mixed with diatomite, 5. 0 g manure sample was put into the cell and extracted with hot water at 70℃ and 10. 3 MPa. An on-line SPE methodology was applied to pre-treat the sample, and the sample was seperated on an Acclaim 120 C18 column and analyzed by corona CAD detector using acetonitrile and 0. 1% formic acid as mobile phase. Good linearity for erythrocin was obtained in the range of 21-2000 μg/kg. The detection limit was 6. 3 μg/kg. The average recoveries were 79. 2%-87. 5%.

Purpose Using quantitative morphometric techniques, To analyzse the developmental characteristics of pulmonary arterial and alveolar with a porcine model of cyanotic congenital heart defect with decreased pulmonary blood flow that we had established. Methods Lung biopsy specimens were taken from animals of control ( C) and cyanosis ( D) groups and than sectioned and stained. The morphological observation and the method of half-quantitative morphometric technique were applied to measure the following char-acteristics:the media thickness ( MT) and the percentage of media thickness ( MT%) , the media section area ( MS%) and the per-centage of media section area ( MS) , the numbers of micro-arteries per square centimeter ( APSC) . In addition, we calculated the ratio of CMA, PMA and NMA in the same section of lung biopsy specimens. Results There showed universally distended, irregular and thin-walled vessels in the lung biopsy specimens of group D under the light microscope. There was an increased number of pulmonary arteries whose media were hypoplastic. The MT, MT% and MS, MS% in group D were significantly less than those of group C ( all P<0. 001), the APSC was also less in group D than in group C (P<0. 01), but MAN were not significantly different between two groups (P>0. 05). Electron microscopy revealed endothelial swell and irregularity, a thinned basement membrane, a disorganized or disrupted elastic fibers layer. The smooth muscle of vascular media shrunk. In addition to these, other changes included the mitochon-drion vacuolization, a diminished cellular organelle and type Ⅱ alveolar epithelial hyperplasia. Conclusion The pulmonary vessels are evidently hypoplastic or degenerated in cyanotic congenital heart defect with decreased pulmonary blood flow, and the function is thought to be influenced by the morphological changes. To promote the pulmonary artery growth and improve this pathophysiological state, it is critical to increase the pulmonary blood flow.

Objective To observe the inhibitory effect of matrine on K-ras gene mutation colon cancer, and to clarify the inhibitory mechanism. Methods SW480 cells were treated with different concentrations of matrine. MTS method was used to detect the proliferation of SW480 cell lines. The apoptosis of SW480 cells was measured by flow cytometry. The migration of SW480 cells was examined by the scratch test. The expression of MEK1/2 protein was detected by Western blotting method. Results Compared with the blank control group, matrine (0.125-1 mg/mL) could inhibit the growth and proliferation of human colorectal cancer SW480 cell lines, promote the apoptosis, restrain the migration of SW480 cells, and inhibit the expression of MEK1/2 protein(P < 0.05), the effect showing a dose-dependent trend. Conclusion Matrine can effectively inhibit the proliferation and migration of SW480 cells, and promote SW480 cell apoptosis through the down-regulation of MEK1/2 protein expression in MAPK signal pathway system.

Objective To review our experiences of diagnostic methods and surgical treatment of the left superior vena cava (LSVC) draining into the left atrium.Methods Nineteen patients with LSVC draining into the left atrium were diagnosed and treated surgically from February 1998 to January 2012.All the cases were combined with other congenital heart diseases including patent ductus arteriosus,ventricular septal defect,atrial septal defect,single atrium,triatriatum,partial endocardial cushion defect,anomalous pulmonary venous drainage,right ventricle outflow stenosis,pulmonary valve stenosis,tetralogy of Fallot,double outlet right ventricle,complete endocardial cushion defect,tricuspid atresia.The patients were diagnosed through different methods including echocartiographic examination,cardiac catheterization,computer tomography,and explored during the operation,even postoperatively.All were treated surgically with four techniques including simple ligation to the LSVC,including ligation during a redo procedure; intra atrial rerouting to drainage the flow from the LSVC to the right atrium,atrial septum reconstruction to make the outlet of the LSVC lying in the right side of the patched atrial septal,and bidirectional Glenn shunt to get a physiological result.Results No mortality postoperatively.All the cases were uneventful postoperatively.And the main postoperative course was related only to the main diagnosis of congenital heart disease,not to the left superior vena cava draining into the left atrium.The echo examination result was satisfied before the discharge.The early and long term follow-up(1-11 years) results are excellent,no arrhythmia,no cardiac deficits after echo examination,including stenosis obstruction and residual shunt.No death.Conclusion The diagnostic methods of the LSVC draining into the left atrium are difficult,the only way to make the diagnosis clearly enough before the operation is depending on improving of more and more comprehending to this rare cardiac anomaly,by the pediatric cardiologists,the sinologist,the intensive care unit,and the pediatric cardiae surgeons.The choice of different surgical treatment is depending on the diagnosis and the findings during the operations,and the results are excellent after a suitable choice made.

OBJECTIVETo improve the results of the soft tissue expansion technique.

METHODSTwo expanders were buried in the same soft tissue pocket in an overlapping pattern. The inflation process was carried out routinely.

RESULTS19 cases of various tissue defects were treated with the overlapping tissue expansion technique since March 1999. Good results have been achieved.

CONCLUSIONThe overlapping tissue expansion technique can provide much more expanded tissue and reduce complications compared with the traditional expansion technique. It is especially suitable for repair of the defects at the facial and cervical region.

Adolescent ; Adult ; Burns ; surgery ; Child ; Dermatologic Surgical Procedures ; Female ; Humans ; Male ; Skin ; injuries ; Skin Transplantation ; Surgical Flaps ; Tissue Expansion ; methods

Objective:To investigate the morphological characteristics and operative methods of mixed total anomalous pulmonary venous connection (TAPVC), and to analyze the risk factors of postoperative death.Methods:From January 2011 to January 2019, 17 cases of mixed TAPVC were operated in Department of Cardiovascular Surgery, Beijing Children′s Hospital, Capital Medical University, with 10 males and 7 females.The average age was (4.4±3.8) months (1-15 months) and the average body mass was (5.6±1.7) kg (3.5-10.0 kg), including 1 case of ventricular septal defect, 17 cases of atrial septal defect and 15 cases of ductus arteriosus.Preoperative pulmonary vein stenosis was discovered in 4 cases and severe pulmonary hypertension was in 10 cases.A total of 5 cases needed ventilator support before operation, and 2 cases needed emergency operation.The diagnosis was confirmed by color Doppler ultrasound and CT before operation.There were 2 cases of type Ⅰ (type 2+ 2), 13 cases of type Ⅱ (type 3+ 1), and 2 cases of type Ⅲ (anatomic variant).Results:All the patients were treated through operation.The principle of operation was to correct all pulmonary veins to the left atrium.The cardiopulmonary bypass time was (182.3±122.8) min, the aortic occlusion time was (84.3±15.9) min, the postoperative ventilator support time was (92.9±70.0) h, and the monitoring room time was (6.9±4.9) d. In this group, 3 cases died in hospital (17.6%) and 1 case died out of hospital (5.9%).Conclusions:The mortality of mixed TAPVC type Ⅲ was high, while preoperative pulmonary vein stenosis, severe pulmonary hypertension and the combination of sub-cardiac type were the important risk factors of death.The operation mode depends on the anatomic drainage mode, so individualized operation is recommended.

Objective:To investigate the diagnosis, surgical methods, perioperative treatment and surgical results of Kommerell's diverticulum with double aortic arch in infants.Methods:From December 2014 to December 2019, 22 cases of double aortic arch combined with Kommerell diverticulum were operated in our hospital, 14 males and 8 females, with an average age of (13.7±11.6) months (1-36 months) and mean body mass of (9.8±3.4)kg (5-20 kg). The children had respiratory symptoms such as asthmatic suffocation, shortness of breath, repeated respiratory tract infection and chronic cough before operation. All patients underwent cardiac CT examination. The average diverticulum was 8 mm×9 mm, in the trachea The average compression degree of the lower segment was 56%±16% (30%-80%). The distal part of the left arch was atresia and Kommerell's diverticulum was found in all patients. The operation methods were left aortic arch separation, ligament separation and diverticulectomy. In one case, tracheal stent was placed simultaneously during the operation because of severe tracheal malacia.Results:The average time in the ward was(1.4±0.8)days (1-4)days, and the average time in hospital was (6.7±2.8)days (4-13 days). The average follow-up period was (25.5±16.9) months (2-60 months). During the follow-up period, 18 children had no persistent respiratory symptoms, and 4 children had only slight respiratory symptoms.Conclusion:Kommerell's diverticulum can also be combined with double aortic arch. The operation method is to separate the aortic arch and ligament at the atresia end and resect the diverticulum at the same time. It has a good early prognosis and may eliminate the residual symptoms and late complications.

To screen the pathogenic mutation location in a genetic family with the neurofibromatosis (NF1) by the next generation sequencing and analyze the clinical phenotype,Illumina Miseq sequencing was applied to capture and analyze the target regions of NF1 family's probands,and furtherly find out the suspicious mutations,as well as to verify the family members by Sanger sequencing.Two rare variants were identified in proband,including the heterozygous missense mutation c.C3649T (p.P1217S) in KIF1B gene and the missense mutation c.T6311C (p.L2104P) on exon 41 of NF1 gene (NM_000267.3).The amino acid at position 2104 was found to be changed from leucine to proline in NF1.The protein prediction SIFT and Polyphen-2 values were 0,0.997,which predicted a conformational change in the encoded protein and eventually affected its function.The mutation c.T6311C in NF1 gene was detected in all patients in this family,which showed genetic co-segregation.The clinical phenotype was neurofibroma in the spinal canal.There were no café au lait spots,iris Lisch nodules,scoliosis,tinnitus,heating loss,or elevated intracranial pressure.The missense mutation c.T6311C (p.L2104P) in NF1 gene might be the genetic cause of this hereditary disease of neurofibromatosis.