Ion chromatography(IC)can make up the deficiency of LC or GC for the analysis of ionic drugs because of the unique separation mechanism,so IC is more and more widely applied in the field of drug analysis. In the paper,the application of IC is reviewed in the quality control of chemical drugs.

Objective To explore the application of echocardiography to guide interatrial septal puncture and evaluate the clinical effect in PBMV. Methods One hundren and sixty two patients were categorized into two groups according to whether echocardiography was applied in atrial septal puncture and real time monitoring. X-ray fluoroscopy guidence was used during atrial septal puncture in group 1 and in group 2, X-ray as well as echocardiography were used. The clinical outcomes were analyzed and contrasted between the 2 group. Results (1) The mean mitral pressure gradient dropped obviously in group 2 immediately after PBMV compared with group 1 (6.4?2.6 mm?Hg vs 10.2?3.7 mm?Hg,P

Objective To investigate the effect of emulsified isoflurane preconditioning on postsynaptic density protein 95 (PSD95) activation in brain during focal cerebral ischemia-reperfusion (I/R)injury in rats.Methods Thirty-two pathogen-free male SD rats weighing 280-300 g were randomly divided into 4 groups (n =8each): sham operation group(group S),group I/R,emulsified isoflurane group(group EI) and lipid emulsion group(group LE).Focal cerebral I/R was induced by middle cerebral artery occlusion for 2 h followed by reperfusion.8％ emulsified isoflurane 10.5 ml/mg or 30％ lipid emulsion 10.5 ml/mg was injected intraperitoneally at 24h before I/R in groups EI and LE respectively.The neurologic deficit score (NDS) was evaluated at 6 h of reperfusion and then 4 rats were sacrificed,and brains were removed for determination of phosphorylatied PSD95 (pPSD95) expression in ischemia cortex and hippocampus by Western blot.Four rats were sacrificed at 24 h of reperfusion and then their brains were removed for determination of infarct volume percentage.Results NDS,infarct volume percentage and pPSD95 expression in ischemia cortex and hippocampus were higher in groups I/R,EI and LE than in group S( P ＜ 0.01 ).NDS,infarct volume percentage and pPSD95 expression in ischemia cortex and hippocampus were lower in group EI than in group I/R( P ＜ 0.05).There was no significant difference in NDS,infarct volume percentage and pPSD95 expression between groups I/R and LE(P ＞ 0.05).Conclusion Emulsified isoflurane preconditioning can attenuate focal cerebral I/R injury in rats by inhibiting PSD95 activation in brain.

ObjectiveTo investigate the effects of emulsified isoflurane preconditioning on the expression of platelet-activating factor (PAF) and PAF receptor during focal cerebral ischemia-reperfusion (I/R) in rats.MethodsThirty-two healthy adult male SD rats weighing 250-300 g were randomly divided into 4 groups ( n =8each):group sham operation (group S); group I/R; group emulsified isoflurane preconditioning( group EI) and group lipid emulsion (group LE).Focal cerebral I/R was induced by 2 h occlusion of middle cerebral artery followed by reperfusion in groups I/R,EI and LE.8％ emulsified isoflurane 10.5 ml/kg and 30％ lipid emulsion 10.5 ml/kg were injected intraperitoneally at 24 h before cerebral ischemia in groups EI and LE respectively.The neurologic deficit score (NDS) (0 =no deficit,4 =unable to control) was evaluated at 12 h of reperfusion.Venous blood samples were collected for measurement of plasma PAF concentration.The animals were then sacrificed and their brains removed for determination of infarct size (by TTC staining) and PAF receptor expression in hippocampus and cerebral cortex (by Western blot).ResultsFocal cerebral I/R significantly increased NDS,the infarct size,plasma PAF concentration and PAF receptor expression in cerebral cortex and hippocampus in group I/R as compared with group S.Emulsified isoflurane preconditioning significantly attenuated the focal cerebral I/R induced above changes in group EI as compared with group I/R,but there was no significant difference between groups I/R and LE.ConclusionEmulsified isoflurane preconditioning can attenuate focal cerebral I/R injury by inhibiting PAF and PAF receptor expression.

Objective To evaluate the value of endoscopic ultrasonography ( EUS) combined with conventional endoscopy for prediction of invasion depth of early gastric cancer and its therapeutic decision-making. Methods Patients with biopsy-proven gastric cancer underwent EUS and conventional endoscopy from July 2011 to January 2018 in Ningbo No. 2 Hospital. A total of 129 patients with early gastric cancer confirmed by postoperative pathology were enrolled in the study. The sensitivity, specificity, positive predictive value, negative predictive value, consistency ( the value of Kappa ) and area under receiver operating characteristic curve ( AUC) of EUS, conventional endoscopy and combination of two methods to assess the accuracy of tumor infiltration depth were analyzed. The accuracy of therapeutic decision-making based on the EUS, conventional endoscopy and combination of two methods were assessed. Results In intramucosal cancer, the sensitivity, specificity, positive predictive value, negative predictive value, the value of Kappa and AUC of EUS were 75. 00％, 82. 22％, 88. 73％, 63. 79％, 0. 536 and 0. 797, respectively, and for conventional endoscopy, these statistical values were 61. 9％, 93. 33％, 94. 55％, 56. 76％, 0. 481, and 0. 801, respectively. For the combination of two methods, these statistical values were 85. 71％, 82. 22％, 90. 00％, 75. 51％, 0. 666 and 0. 850, respectively. In submucosal cancer, the sensitivity, specificity, positive predictive value, negative predictive value, the value of Kappa and AUC of EUS were 51. 11％, 86. 91％, 67. 65％, 76. 84％, 0. 403 and 0. 697, respectively, and for conventional endoscopy, these statistical values were 57. 78％, 73. 81％, 54. 17％, 76. 54％, 0. 311 and 0. 678, respectively. For the combination of two methods, these statistical values were 71. 11％, 90. 48％, 80. 00％, 85. 39％, 0. 632 and 0. 817, respectively. The accuracies of therapeutic decision-making of EUS, conventional endoscopy and the combination of two methods were 83. 72％, 68. 22％ and 92. 25％, respectively. Conclusion Patients who are diagnosed as intramucosal caner by conventional endoscopy should not be recommended to undergo EUS. For those whose invasion depth is unclear, or diagnosed as submucosal cancer or deeper by conventional endoscopy, EUS should be performed for reassessment. The combination of two methods can improve the accuracy of distinguishing intramucosal and submucosal caners and therapeutic decision-making. Trial registration Chinese Clinical Trial Registry, ChiCTR-DDT-13003299.

Objective To preliminary formulated 2017 Chinese rare disease survey list by experts consensus.Methods By using checklist methods,we selected studied diseases from five available rare disease data sources in China.By summarizing,proofreading,removing of duplicate data,the primary survey list with 344 diseases was formulated.By organizing two rounds of consensus conferences,experts voted and revised the survey list,then ultimately formulated 2017 Chinese rare disease survey list.Results According to the poll,in selected 344 rare diseases which were discussed in consensus conferences,54 diseases were suggested to be deleted,9 pairs of diseases were suggested to be incorporated.For Chinese and English names of these rare diseases,306/344 diseases conform to nomenclature by discussion.According to the experts' tips and advice,we revised the primary survey list and ultimately formulated 2017 Chinese rare disease survey list including 281 diseases.Conclusions Experts consensus combines the scientificity of methodology and clinical experience of experts.In the background of medical big data and targeted poverty alleviation,the early stage of study is in accordance with the main stream of thought for the national survey of rate disease in China.

Objective To investigate the effects of helicobacter pylori(Hp)on pathological changes and mucin5AC(MUC5AC)ex-pression in lung tissue of rats with chronic obstructive pulmonary disease(COPD).Methods Thirty-three Wistar rats were randomly di-vided into blank group(n=9),COPD group(n=9),Hp group(n=9),COPD+Hp group(n=6).Cigarette smoking combined with intratracheal instillation of lipopolysaccharide was used in COPD group and COPD+Hp group,and Hp intragastric administration was used in Hp group and COPD+Hp group.The establishment of the model after one month,the lung tissues of rats were collected,the pathology of lung tissue was observed by hematoxylin-eosin(HE)staining,the proliferation of airway goblet cells was observed by Alcian blue pe-riodic acid-Schiff(AB-PAS)staining,the expression level of MUC5AC protein was detected by immunohistochemistry,and the ex-pression level of MUC5AC mRNA was detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).Results Compared with the blank group,the goblet cell count per unit length of airway,the expression of MUC5AC protein and mRNA in lung tis-sue in COPD group,Hp group and COPD+Hp group were significantly increased,and the differences were statistically significant(P＜0.05).Compared with COPD+Hp group,the goblet cell count per unit length of airway,the expression of MUC5AC protein and mRNA in lung tissue in COPD group and Hp group were lower,and the differences were statistically significant(P＜0.05).Conclusion Hp infection aggravates the inflammatory reaction and the proliferation of goblet cells in the airway of COPD,increases the airway secretion and the expression of MUC5AC,and promotes the progression of COPD.

Objective To evaluate the performance of an artificial intelligence ( AI ) assisted diagnosis system for diabetic retinopathy ( DR) based on deep learning theory. Methods Diagnostic performance of a robot assisted diagnosis system called SongYue for DR was trained by using 25297 retinal images tagged by fundus doctors from multiple hospitals in China. Four types of DR detection model consisting of abnormal DR,referable DR,severe non-proliferative and proliferative DR as well as proliferative DR according to fundus leisions identification were established. The ability of the system to distinguish DR was determined by using receiver operator characteristic (ROC) analysis,sensitivity and specificity of the system. Results SongYue system achieved an area under the ROC curve ( AUC) of 0. 920 for successfully distinguishing normal images from those DR with a sensitivity of 96. 0％at a specificity of 87. 9％. The AUC of SongYue for referable DR was 0. 925,sensitivity was 90. 4％,and specificity was 95. 2％. For severe non-proliferative and proliferative DR,AUC was 0. 845,sensitivity was 72. 7％,and specificity was 96. 2％. For proliferative DR, AUC was 0. 855, sensitivity was 73. 5％, and specificity was 97. 3％. Conclusions SongYue robot assisted diagnosis system has high AUC,sensitivity and specificity for identifying DR, showing good clinical applicable benefits.

Background and objective Lung cancer is the malignant tumor with the highest incidence rate and the heaviest disease burden in China.In recent years,lung cancer has shown a high incidence trend,seriously affecting the health of the population.In this paper,we analyze the characteristics of lung cancer incidence in 2019 and the trend of incidence rate from 2010-2019 in the tumor registration area of Gansu province,in order to provide a reference basis for the development of lung cancer prevention and control strategies in Gansu province.Methods By analyzing the cases of lung cancer incidence in the tumor registration area of Gansu province in 2019,we calculated the incidence rate,medium incidence rate,world in-cidence rate and other related indexes;we used Joinpoint to calculate the annual percentage change(APC)for trend analysis.Results In 2019,a total of 3757 new cases of lung cancer were reported in Gansu province,accounting for 14.96%of all new malignant tumors.The incidence rate,medium incidence rate and world incidence rate and world rate of lung cancer were 40.52/105,25.78/105,25.86/105;and the cumulative rate of 0-74 years old,and the truncation rate of 35-64 years old were 3.23%,40.03/105,respectively.The incidence of lung cancer rises with age,and is high in the age group of 40 years and above,and the incidence peaks in the male and female populations in the group of 75 years and above,and the group of 80 years and above,respectively.The crude incidence rate of lung cancer in the tumor registration area of Gansu province from 2010-2019 showed an overall increasing trend,and the rate of increase was relatively fast,with an APC 5.39%(P<0.05);Separately,accord-ing to gender,urban and rural areas,the incidence of lung cancer in all populations showed an increasing trend,and the APC of male,female,urban and rural populations were 4.98%,6.39%,6.26%,and 4.64%,respectively(all P<0.05).According to the trend analysis of lung cancer incidence rate by age group,only lung cancer incidence in the age group of 65 years and above increased at an annual average rate of 4.15%(P<0.05).Conclusion The incidence rate of lung cancer in the tumor registration area of Gansu province from 2010 to 2019 shows a rising trend year by year,and there are differences in the incidence of lung cancer in people of different genders,regions and age groups,so comprehensive prevention and control work should be carried out for the key populations of lung cancer incidence.

Objective:To integrate the experience of terminal care of nurses in Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU) .Methods:Qualitative and mixed studies related to the terminal care by neonatal and pediatric nurses were systematically searched on the Cochrane Library, the Australia Joanna Briggs Institute Evidence-based Health Care Center Database, PubMed, EBSCO, Web of Science, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP and the China Biomedical Medicine Database. The search time limit was from the establishment of the database to May 2022. The article quality was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center (2016). Meta-synthesis was performed using the aggregation integration method.Results:A total of 9 articles were included. A total of 32 research results were extracted and summarized into 7 categories, forming 3 integrated results, including the ethical dilemmas and complex care experiences of nurses in NICU and PICU during the implementation of palliative care, the attitudes and coping strategies of neonatal and pediatric nurses in responding to death events, the realistic dilemmas and needs of nurses in NICU and PICU during terminal care.Conclusions:Terminal care in NICU and PICU requires multiple efforts. Hospital managers should pay attention to the emotional burden of nurses during terminal care, and enhance their positive coping ability, and focus on improving the terminal care environment and resources in NICU and PICU to provide high-quality terminal care services for children.