Objective To evaluate the diagnosis accuracy for coronary stenosis from diameter measurements of differ?ent severities of stenosis by using gemstone spectral imaging (GSI). Methods Totally 3 different coronary artery models(in?ternal diameter:3.00 mm) that with different severities of stenosis (residual lumen diameter ratio:75%, 50%and 25%) were placed in a pulsating cardiac phantom (ALPHA 1-VT PC, Fuyo Corporation, Japan). The coronary phantom was scanned in two models:gemstone spectral imaging (GSI) and axial scan model(AXIAL). All the spectral imaging data were analyzed by using GSI viewer to reconstruct the VMS images (40-140 keV by 10 keV interval) and AXIAL. CT values (HU) of the re?mained lumen from all different stenosis lumens were measured. The residual rate (%) was calculated by dividing the diame?ters of the remained lumen to normal lumen on the reformatted short axial images. One-way ANOVA was used to compare the measurement difference of residual rates between VMS images. Student t-test was used to compare the measurement dif?ference of residual rate between VMS and AXIAL. Bland-Altman test was used to compare the measured residual rates and the gold standard. Results There were no significant differences in measured residual rate betweeb VMS images (P>0.05). From student t-test, only significant difference was found on 50%stenosis between 70 keV VMS and AXIAL(t=4.617,P<0.042). From the Bland-Altman test, measurement of residual rate was more accurate from 70 keV VMS than that of AXIAL by taking the stenosis rate of real model as gold standard(t=14.560,P<0.001). Conclusion VMS image (70 keV) shows more accurate rate than AXIAL images on both diameter measurement and evaluation of the coronary stenosis.

Objective To discuss the application value of the capillary electrophoresis in detecting the glycosylation hemoglobin (HbA1c)level.Methods By utilizing the uncoated fused silica capillary column(30 cm in length and 25 μm in diameter)and the specific adsorption peak,the HbA1c levels in the healthy people,patients with diabetes mellitus(DM)and high risk people were de-tected by the photodiode array(PDA)method at the wavelength of 415 nm.During the research process,the precision and accuracy were perfomred the accuracy analysis.Results HbA1c could be effectively separated from non-HbA1c,with a sharp peak.And the relative quantity of HbA1c could be determined.Conclusion The capillary electrophoresis is characterized by specificity,high precision,and high accuracy.Therefore,it should be widely applied in clinic.

Objective To investigate the efficacy of relaparoscopic common bile duct exploration in choledocholithiasis.Methods 50 patients who underwent LC/OC/LCBDE/OCBDE for biliary surgery with choledocholithiasis were randomized into two groups:Group A (n ＝25) laparoscopic approach and Group B (n =25) open approach.The operation time,hospital stay,cost of hospitalization and postoperative complications were compared.Results There was no significant difference in the operation time,liver functional index,postoperative bile leakage rate and cost of hospitalization between the two groups.The postoperative hospital stay in group A was shorter than that in group B (7.1 ± 1.5 vs 12.4 ±4.3 days,P ＜0.05),as was the volume of intraoperative blood loss (58.3 ± 24.2 ml vs 108.6 ± 35.7 ml,P ＜ 0.05),recovery of gastrointestinal function (26.3 ±3.6 vs 58.2 ±6.3 hours,P ＜0.05),postoperative analgesia (7/25 vs 17/25,P＜0.05) and wound infection rate (1/25 vs 6/25,P＜0.05).Conclusions Relaparoscopic commonbile duct exploration for recurrent choledocholithiasis appeared to be a safe,feasible,and efficacious procedure when carried out by expert laparoscopic surgeons.The procedure is worth promoting.

Polymyxin B, which is a last-line antibiotic for extensively drug-resistant Gram-negative bacterial infections, became available in China in Dec. 2017. As dose adjustments are based solely on clinical experience of risk toxicity, treatment failure, and emergence of resistance, there is an urgent clinical need to perform therapeutic drug monitoring (TDM) to optimize the use of polymyxin B. It is thus necessary to standardize operating procedures to ensure the accuracy of TDM and provide evidence for their rational use. We report a consensus on TDM guidelines for polymyxin B, as endorsed by the Infection and Chemotherapy Committee of the Shanghai Medical Association and the Therapeutic Drug Monitoring Committee of the Chinese Pharmacological Society. The consensus panel was composed of clinicians, pharmacists, and microbiologists from different provinces in China and Australia who made recommendations regarding target concentrations, sample collection, reporting, and explanation of TDM results. The guidelines provide the first-ever consensus on conducting TDM of polymyxin B, and are intended to guide optimal clinical use.
Humans ; Anti-Bacterial Agents/therapeutic use* ; China ; Drug Monitoring/methods* ; Polymyxin B ; Practice Guidelines as Topic