OBJECTIVE To analyze the monitoring performance and testing efficacy and reliability of standardized disposable B-D test pack and standard linen test pack,and summarize the corrective actions based on failure analyses for future reference.METHODS The two different test packs were employed to evaluate the vacuum performance of dynamic air removal sterilizer.RESULTS We enrolled 400 standardized disposable B-D test packs and standard linen test packs respectively.The disposable pack failed 4 cases with the success ratio 99%,while the linen pack failed 30 cases with the success ratio 92.5%.CONCLUSIONS The poor conformity of hand-made linen test pack,variation of steam pressure,sterilizer failure,and unprofessionalism of sterilizer operator contribute as main failure causes in B-D test.Standardized disposable B-D test pack can decrease subjective factors significantly,and the test results are more reliable and standardized.

Objective To study 18F-deoxyglucose-positron emission tomography and CT fusion (FDG PET) in three dimensional conformal radiotherapy for non-small -c ell lung carcinoma (NSCLC). Methods Gross tumor volume (GTV) of 13 NSCLC patient s were determined by FDG PET and CT separately (GTV PET-CT and GTV CT ), which were then compared. Results Except 2 patients, all the other patients' GTV PET-CT dif fered from their GTV CT. Compared with GTV CT, GTV PET-CT was in creased by an avera ge of 29.2?cm3 in 5 patients and decreased by an average of 41.6?cm3 in 6 patien ts. Conclusions 18F-deoxyglucose-positron emission tomography, which can improve target definition between benign and malignant lesions in the lung, is proved t o be more sensitive and specific in detecting mediastinal lymph node involvement . FDG PET may provide accurate target definition and improve the local control.

According to the points and difficulties of aminophylline monitoring experiments, oriented by problems, specific teaching case was designed to practice case teaching. The analysis of the results of classroom performance, teaching effect evaluation, peer evaluation and students' feedback showed that case teaching promoted the initiatives of students' learning as well as improved the teaching effect compared with the traditional teaching method. Furthermore, it improved their clinical thinking ability through theory and practical cases and helped the teachers to learn while teaching.

OBJECTIVE:To determine the equilibrium solubility of albendazole(ABZ)and its apparent oil-water partition coef-ficient. METHODS:The equilibrium solubility of ABZ in various solutions was determined at 37 ℃ by HPLC and saturation solu-bility method,including water,7 kinds of common organic solvents with different polarities(methanol,ethanol,etc.),organic ac-id(oleic acid,glacial acetic acid,lactic acid,formic acid),hydrochloric acid of pH 1.2,phosphate buffer solution(PBS)of dif-ferent pHs(2.0-7.8)and 6 kinds of common surfactants with mass concentrations of 10,50 and 100 mg/ml(polysorbate 80,polox-amer,etc.). The apparent oil-water partition coefficient(P)was calculated with the concentration ratio of ABZ in oil phase(N-oc-tyl alcohol)and water phase(water and PBS of different pHs)after partition equilibrium. RESULTS:The equilibrium solubility of ABZ reached(0.26±0.02)μg/ml in water,with the lgP of 3.66±0.01. The equilibrium solubility of ABZ in common organic sol-vents and organic acids was higher than in water. The higher the polarity of the organic solvent was and the weaker of organic acid was,the weaker of its ability to solubilize ABZ would be. The equilibrium solubility of ABZ was higher in the medium of pH 1.2-2.5 than in that of pH 5.0-7.8. The ability of the surfactant to solubilize ABZ was related to its type,and the higher of the mass concentration of the surfactant was,the stronger of its ability to solubilize ABZ became. lgP was less than 1.6 at pH 1.2-2.0 and changed little at pH 5.0-7.8 [(3.71 ± 0.26)-(3.68 ± 0.26)]. CONCLUSIONS:ABZ is insoluble in water. Its equilibrium solubility demonstrates a negative correlation with the polarity of the organic solvent and a positive correlation with the acidity of the organic acid and with the mass concentration of the surfactant. It has higher water solubility and lower lipid solubility in a strong acidic en-vironment,and higher lipid solubility and weaker water solubility in weak acidic,weak basic and neutral environments.

OBJECTIVE:To optimize freeze-drying technology of albendazole nanosuspension so as to prepare albendazole nanometer powder. METHODS:By adopting freeze-drying method,with particle size and Zeta potential as the indexes,single fac-tor test and verification were made on pre-freezing temperature and the type,ratio and mass fraction of cryoprotectants,and then the albendazole nanosuspension prepared by liquid phase precipitation method was made into albendazole nanometer powder. RE-SULTS:When the pre-freezing temperature was-20℃and the cryoprotectant was 4%glucose-mannitol(3∶7),the average parti-cle size of the prepared nanometer powder was (208.03 ± 2.13) nm,and average Zeta potential was (-15.53 ± 0.18) mV. CON-CLUSIONS:Albendazole nanometer powder with better particle size and potential can be prepared by freeze-drying technology.

Objective To investigate the mechanism and effect of the spinal cord outlet of the skull base on Chiari Ⅰ malformation with syringomyelia.Methods The cervical spinal cord stem angle (Anbc),slope angle of cervical vertebra (Ansc) of Chiari Ⅰ malformation were measured.In foramen magnum (Llf) and anterior vertebral canal level (Laf),spinal canal(Ac),spinal cord (As) and inferior hernia area (Ah) were measured.Angle,area and ratio were compared in Chiari Ⅰ malformation with syringomyelia,Chiari Ⅰ malformation without syringomyelia and normal control group.Results Ansc,Anbc-Ansc had significant differences among control group and Chiari Ⅰ malformation patients (all P＜0.001).In Llf,Laf,As had significant differences among three groups (all P＜0.05),further comparison of the two showed there were significant differences between Chiari Ⅰ malformation with syringomyelia patients and control group,Chiari Ⅰ malformation without syringomyelia patients and control group in Llf(all P＜0.05).In Llf,Laf,Ac in Chiari Ⅰ malformation with syringomyelia was smaller than control group (P＜0.05).Ah in Llf,Lafand Lh in Llf had no statistical significant difference between Chiari Ⅰ malformation with and without syringomyelia patients (all P＞0.05).In Llf,Laf,As/Ac had statistical significant difference among Chiari Ⅰ malformation with and without syringomyelia patients,control group (all P＜0.001),further comparison of the two showed As/Ac in Llf had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group (P＜0.05),As/Ac in La had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group,between Chiari Ⅰ malformation without syringomyelia patients and control group (all P＜0.05),Conclusion The cervical spinal cord,Ansc reducing,narrow vertebral proportion increase are important factors to promote Chiari Ⅰ malformation syringomyelia.

OBJECTIVETo explore the long-term effects of the uvulopalatopharyngoplasty (UPPP) combined with oral appliance (OA) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODSThirty patients with severe OSAHS confirmed by polysomnography (PSG) according to their apnea hypopnea index (AHI) and lowest SaO2 during sleep were selected using random permutation table and divided into only UPPP group(U group, n = 15) and UPPP with OA group (UA group, n = 15). The follow-up period was 2 years. PSG was performed in 0.5 year and 2 years after operation. AHI, lowest SaO2 and Tmax were tested and evaluated.

RESULTSThe effectiveness of two groups was the same after 0.5 year. Two years after operation, the values [AHI: (18.06 ± 2.24) times/h; lowest SaO2: (88.64 ± 10.37)% and Tmax: (20.5 ± 17.6) s] in UA group were better than that [AHI: (49.73 ± 3.35) times/h; lowest SaO2: (79.56 ± 4.87)% and Tmax: (41.3 ± 19.7) s] in U group. The number of effectiveness was 9 and the number of ineffectiveness was 6 in U group, while in UA group, the number of effectiveness was 14 and the number of ineffectiveness was 1(P < 0.05).

CONCLUSIONSLong-term result of combined treatment was better than that of UPPP only.

Humans ; Orthodontic Appliances ; Palate ; surgery ; Pharynx ; surgery ; Polysomnography ; Sleep ; Sleep Apnea, Obstructive ; surgery ; Uvula ; surgery

Objective: To establish an accurate and selective UPLC-MS/MS) method for the determination of afatinib in rat plas-ma. Methods: Protein precipitating by acetonitrile was used to prepare the samples. A CORTECS BEH C18column ( 50 mm × 2. 1 mm, 1. 6 μm) was used to separate the analytes at 40℃. The mobile phase consisted of acetonitrile and water (0. 1% formic acid) with the flow rate of 0. 4 ml·min-1. The analytes were quantified by multiple reaction monitoring ( MRM) mode with positive electrospray ionization, while the target fragment ions were m/z 486. 19→112. 1 for afatinib and m/z 557. 3→112. 15 for neratinib (IS). Results: The calibration curve obtained good linearity for afatinib within the range of 1–200 ng·ml-1(r=0. 998 1), and the LLOQ in rat plasma was 1. 0 ng/ml. The intra-and inter-day precisions were both≤9. 51% . The recovery of afatinib from plasma was above 77. 1% . After intragastric administration and intravenous administration of afatinib in rats, the t1/2was 7. 19 h and 2. 69 h, Cmax was 97. 78 ng·ml-1and 123. 37 ng·ml-1,and AUC(0-∞)was 1 505. 4 ng·ml-1·h and 405. 55 ng·ml-1·h, respectively. Con-clusion: The validated method can be applied in the pharmacokinetic study of afatinib at the intragastric and intravenous dosage of 10 and 2 mg·kg-1, respectively.

OBJECTIVE: To assess the clinical efficacy and health economic value of non-invasive prenatal testing (NIPT) for the prenatal screening of common fetal chromosomal aneuploidies. METHODS: 10 612 pregnant women from October 2017 to December 2019 presented at the antenatal screening clinic of the General Hospital of Tianjin Medical University were selected as the study subjects. Results of NIPT and invasive prenatal diagnosis and follow-up outcome for the 10 612 pregnant women were retrospectively analyzed and compared. Meanwhile, NIPT data for two periods were analyzed for assessing the health economic value of NIPT as the second- or first-tier screening strategy for the prenatal diagnosis of fetal trisomies 21, 18 and 13. RESULTS: The NIPT was successful in 10 528 (99.72%) subjects, with the sensitivity for fetal trisomies 21, 18 and 13 being 100%, 92.86% and 100%, and the positive predictive value (PPV) being 89.74%, 61.90% and 44.44%, respectively. The PPV of NIPT for sex chromosome aneuploidies was 34.21%. Except for one false negative case of trisomy 18, the negative predictive value for trisomy 21, trisomy 13 and other chromosomal abnormalities were 100%. For pregnant women with high risk by serological screening, advanced maternal age or abnormal ultrasound soft markers, NIPT has yielded a significantly increased high risk ratio. There was no statistical difference in the PPV of NIPT among pregnant women from each subgroup. NIPT would have higher health economic value as a second-tier screening until 2019, while compared to 2015 ~ 2017, its incremental cost-effectiveness ratio as a first-tier screening had declined clearly. CONCLUSION The screening efficacy of NIPT for trisomies 21, 18 and 13 for a mixed population is significantly better than conventional serological screening, but it is relatively low for sex chromosomal abnormalities. NIPT can also be recommended for populations with relatively high risks along with detailed pre- and post-test genetic counselling. From the perspective of health economics, except for open neural tube defects, it is possible for NIPT to replace the conventional serological screening in the future as its cost continues to decrease.
Pregnancy ; Female ; Humans ; Trisomy/genetics* ; Retrospective Studies ; Prenatal Diagnosis/methods* ; Down Syndrome/genetics* ; Aneuploidy ; Chromosome Aberrations ; Trisomy 18 Syndrome/genetics* ; Sex Chromosome Aberrations ; Fetus

Objective The aim of this study is to understand the impairment and compensation mechanism of brain function in untreated primary insomnia (PI) patients.The approach of fractional amplitude of low frequency fluctuation (fALFF) is used to analyze raw data between the PI patients and the normal control group in resting state using functional magnetic resonance imaging (fMRI).Methods Fifty-nine PI patients,admitted to our hospital from November 2015 to November 2016,and 47 age-,education-,and gender-matched normal healthy subjects were chosen in our study.Pittsburg sleep quality index (PSQI),insomnia severity index (ISI) were employed to evaluate the sleep quality.Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were employed to evaluate the emotion.Resting state fMRI and fALFF analyses were used to compare the functional regional activities.The correlations of fALFF data with PSQI,SAS and SDS scores were analyzed.Results In PI patients,2 had mild to moderate insomnia,41 had moderate insomnia,and 16 had serious insomnia.ISI scores in the normal healthy subjects were less than 7.The PSQI,SAS,SDS and ISI scores in the PI patients were significantly higher than those in the normal healthy subjects (P＜0.05).As compared with the control group,the PI group had significantly increased fALFF value in the right hippocampus (HIP),right parahippocampa gyms,right amygdala,and bilateral thalamus.The fALFF value was positively correlated PSQI,SASandSDSscores (r=0.582,P=0.000;r=0.617,P=0.000;r=0.653,P=0.000).Conclusion Some brain regions in the PI patients are abnormal in the resting state,which can reflex functional regional activities of PI patients.