Objective Through application of clinical pathway in hospitalization patients undergoing uterectomy, we aimed to study the efficacy of clinical pathway in uterectomy patients. Methods 120 patients randomly sampled into the experimental group and the control group with 60 in each. The experimental group received diagnosis, treatment, nursing and rehabilitation according to the clinical pathway table, patients in the control group received routine nursing interventions. The average hospitalization days, medical costs, patient satisfaction degree, disease cognition, first exercise time after operation and medical disputes were compared between the two groups. Results The average hospitalization days and hospitalization costs of the experimental group were obviously lower than those in the control group, patients' satisfaction degree, knowledge of health and first functional exercise time in the experimental group were better than those of the control group, while the medical disputes in the experimental group were obviously de -creased in the experimental group. Conclusions Application of clinical pathway in nursing care for uterectomy patients can effectively decrease hospitalization days, medical costs and disputes. It is also helpful for patients to cooperate with doctors in diagnosis, treatment, nursing, thus increase the satisfaction degree of patients, ensure the reasonable use of medical resources and promote the sustainable improvement of nursing quality.

BACKGROUND: With the understanding of pathology of cervical diseases, cervical curvature has become one of
the important indexes of long-term clinical outcome. To restore and maintain cervical curvature has a profound impact on cervical long-term stabilization and cervical biomechanical environment.
OBJECTIVE: To evaluate long-term influence of selective consecutive three-level appliance of intervertebral Solis cage on cervical curvature for spondylotic myelopathy.
METHODS: From June 2008 to December 2010, 22 spondylotic myelopathy patients were treated with
consecutive three-level anterior cervical Solis fusion. There were 14 males, 8 females, with an average age of
45.1 years (ranged from 26-73 years). There were two cases of C2/3/4/5, seven cases of C3/4/5/6, 12 cases of C4/5/6/7, and one case of C5/6/7/T1 , total y 66 intervertebral spaces. Al cases were fol owed up for 2 years.
RESULTS AND CONCLUSION: Average blood loss amount was 40 mL (20-80 mL). Average operation time was 121 minutes (100-175 minutes). After fol ow-up for 30.7 months, al segments were fused. There was no implant migration or vertebral body col apse. Pre-operative JOA score was 11.94±3.61, 15.56±1.13 at 6 months post-operation, and 15.21±1.85 at 2 years after implantation. Pre-operative cervical curvature was (1.86±3.24) mm,(4.83±1.78) mm at 6 months post-operation, and (4.44±3.36) mm at 2 years after implantation. There were significant differences between pre-operative and at 6 months post-operation, pre-operative and at 2 years post-operation (P < 0.05). There was no significant difference between 6-month and 2-year post-operation (P > 0.05). Results indicated that selective consecutive three-level appliance of intervertebral cage for spondylotic myelopathy could improve cervical curvature and have long-term favorable clinical outcomes.

Objective To study the changes of corneal sensitivity in diabetic and nondiabetic subjects after phacoemulsification. Methods This trial involved 42 diabetic subjects(42eyes)and 46 nondiabetic subjects(46 eyes)with cataract.All eyes were underwent phacoemulsification.Corneal sensitivities were tested before surgery and 1 day,1 week,1 month,3 month,6 month after surgery.Results The corneal sensitivity of diabetic subjects was greatly reduced at 1 day,1 week,1 month,3 month after surgery(P＜0.05),and returned to the preoperative values at 6 month(P＞0.05).The corneal sensitivity of nondiabetic subjects was reduced at 1 day,1 week,1 month af- ter surgery(P＜0.05),and returned to the preoperative values at 3 month(P＞0.05).The corneal sensitivity of diabetic subjects was lower than nondiabetic subjects before surgery(P＜0.05).The reduced range of corneal sensitivity in diabetic subjects was greater than that of nondiabetic subjects(P＜0.05).Conclusions The corneal sensitivity is decreased and the recovery is postponed after poacoemul- sification in diabetic subjects.

Objective To investigate the effectiveness and technical points of anatomical liver resection by trans-Glisson Sheath methylene blue staining in treatment of hepatolithiasis of right posterior lobe.Methods The clinical data of 12 cases of hepatolithiasis of right posterior lobe treated with anatomical liver resection by Glisson sheath methylene blue staining were retrospectively analyzed.Result 6 of 12 patients had undergone more than 2 previous biliary surgeries.All patients underwent contrast-enhanced CT scan and portography,hepatolithiasis of segment Ⅵ in 4 cases,right posterior lobe in 8 cases,accompanied by left lateral lobe bile duct stones in 2 cases,the right caudate lobe bile duct stones in 1 case.Methylene blue was injected into the portal vein,the methylene blue interface of segment Ⅵ or right posterior lobe displays well.Methylene blue interface was larger than the ischemia interface,which is in accordance with the anatomy.Along the methylene blue interface,hepatic resection was performed including right posterior lobe resection (n =9),segment Ⅵ resection (n =3),and combined with left lateral lobe resection (n =2) and the right caudate lobe resection (n =1).There was no postoperative mortality.Incision infection occurred in 5 cases,4 had right pleural effusion and 2 had a biliary fistula that were treated conservatively.With a mean follow-up period of 3.2 years,all patients are symptoms free and stone free.Conclusions Anatomical liver resection by methylene blue staining is a safe and effective treatment for hepatolithiasis of right posterior lobe.

A rapid, sensitive and convenient LC-MS/MS method was developed for the determination of γ-aminobutyric acid (GABA) in human plasma. d2-γ-Aminobutyric acid (d2-GABA) was synthesized as internal standard (IS). After extraction from human plasma by protein precipitation with acetonitrile, all analytes were separated on a Luna HILIC column (100 mm x 3.0 mm, 3 μm) using an isocratic mobile phase of water: acetonitrile: formic acid (20 : 80 : 0.12) with a flow rate of 0.5 mL x min(-1). Acquisition of mass spectrometric data was performed in multiple reaction monitoring mode (MRM) in positive electrospray ionization using the transitions of m/z 104 --> 69 for GABA and m/z 106 --> 71 for d2-GABA. The method was linear in the concentration range of 5.00 to 1 000 ng x mL(-1). The intra- and inter-day precisions were within 9.9%, and accuracy ranged from 99.1% to 104%, within the acceptable limit across all concentrations. The method was successfully applied to a pharmacokinetic study of GABA tablets in healthy Chinese volunteers.
Chromatography, Liquid ; Humans ; Tandem Mass Spectrometry ; gamma-Aminobutyric Acid ; blood

Objective To prepare the chitosan nanoparticles loading 5-[125Ⅰ] Iodo-2'-deoxyuridine (125Ⅰ-UdR-CS-DLN) at 100-200 nm in diameter, and analyze the characteristic of drug sustained-releasing and tumor targeting. Methods Orthogonal experimental design and One-way analysis were applied to optimize the preparation of 125Ⅰ-UdR-CS-DLN using tripolyphosphate cross-linking. Dynamic dialysis was utilized to investigate the in vitro releasing characteristics of the nanoparticles. The tumor targeting effect of the nanoparticles was observed with laser confocal microscopy. Results The optimal conditions for preparing the nanoparticles at particle diameters (70. 39 ± 5.12 ) nm (PDI 0. 16 ± 0. 012 ) were 1 g/L of CS, 2 g/L of TPP, stirring rate 600 r/min, relative molecular mass of CS 3 × 103. The TEM results showed that the exterior of the nanoparticles was spheroid, with a uniform and fine dispersivity. The optimized condition with the initial 125Ⅰ-UdR concentration of 2. 96 MBq/ml at pH5 provided the highest loading capacity (1253. 55 MBq/g) and the highest entrapment rate (42. 35% ). The in vitro releasing curves of 125Ⅰ-UdR-CS-DLN followed Higuchi equation, shown a characteristic of long-acting preparation.Laser confocal microscopy observations approved that the tumor cells uptake of FITC-CS-nanoparticles were significantly more than that of normal cells. Conclusions Chitosan nanoparticles loading 125Ⅰ-UdR at diameters range 127. 81 ± 15. 25 nm (PDI 0. 240 ± 0. 035 ) were successfully prepared with the optimized conditions, and showed a characteristic of sustained-releasing and tumor targeting. The chitosan-based nanotechnology provided a new and efficient approach for the application of 125Ⅰ-UdR in intracellular radiotherapy for tumor.

Objective To study the influence of breast-feeding on the common neonatal comorbidities of very low birth weight (ELBW) infants.Method A retrospective study was conducted in our hospital from July 2014 to September 2015.The ELBW infants with birth weight between 1 000 g and 1 500 g were enrolled into the study.The infants were assigned into three groups according to human milk intake during hospitalization:high-volume breast feeding group (the high-volume group) (human milk equal to or greater than 75％),small-volume breast feeding group (the small-volume group) (human milk less than 75％) and premature formula group (the formula group) (exclusive formula fed during hospitalization).The general status,weight gain,the incidences of gastrointestinal dysfunction,neonatal necrotizing enterocolitis (NEC),late onset sepsis,premature retinopathy (ROP),bronchopulmonary dysplasia (BPD) and periventricular leukomalacia (PVL) during hospitalization were compared between the three groups.Logistic regression analysis was applied.Result A total of 210 cases were included in the study.32 cases in the high-volume group,73 cases in the small-volume group and 105 in the formula group.The incidence of NEC (Bell's stage Ⅱ and Ⅲ) in the high-volume group was significantly lower than the small-volume group and the formula group (6.3％ vs.24.7％,26.7％) (P ＜ 0.05).No statistical differences existed as for the incidences of gastrointestinal dysfunction,sepsis,ROP,BPD,and PVL (P ＞0.05).Logistic regression analysis showed that the odds ratio (OR) of survival without NEC in the highvolume group were 0.183 compared with the formula group and 0.204 compared with the small-volume group;and the 95％ confidence interval were 0.041 ～0.818,0.044 ～ 0.938 respectively.No statistically significant differences existed among the three groups in the growth rate of body weight,the time needed to regain birth weight,the time needed to reach total enteral nutrition and the length of hospital stay (P ＞0.05).Conclusion High-volume breast milk intake can reduce the incidence of NEC (Bell's stage Ⅱ and Ⅲ).Breast-feeding has little adverse effects on common comorbidities of ELBW infants.Enhanced breastfeeding has similar efficacy comparing with formula feeding in the catch-up growth.

Objective Inquire into the relationship between diabetic peripheral neuropathy(DPN)pathogenic factor and Antigangliosides antibody(Anti-GS-Ab)in type 2 diabetes mellitus. Methods It was examined by enzyme-linked immunosorbent assays(ELISA)to the levels of serum Anti-gangliosides(Anti-GS)in 2 DM and DPN as well as healthy.Results The positive rate of Anti-GS-IgM,IgG in DPN group were 46.7% and 20.0%.repectivily it was obviously higher than normal group and 2 DM group.Conclusion The relationship between the DPN and Anti-GS-Ab is a close.It show that Anti-GS-Ab play an important role in DPN pathological process.

AIM　To develop a sensitive and specific LC/MS/MS method for determination of amlodipine in human plasma. METHODS　Amlodipine and internal standard 4′-hydroxypropafenone were extracted from plasma using liquid-liquid extraction, then separated on a Zorbax C8 column. The mobile phase consisted of acetonitrile-water-formic acid (75∶35∶1), at a flow-rate of 0.4 mL*min-1. A Finnigan TSQ tandem mass spectrometer equipped with electrospray ionization source was used as detector and was operated in the positive ion mode. Selected reaction monitoring (SRM) using the precursor → product ion combinations of m/z 409 → 238 and m/z 358 → 116 was used to quantify amlodipine and internal standard, respectively. RESULTS　The linear calibration curves were obtained in the concentration range of 0.4-16.0 ng*mL-1. The limit of quantification was 0.4 ng*mL-1. Each plasma sample was chromatographed within 3.7 min. The method was successfully used in several pharmacokinetic studies for amlodipine. More than 1 500 plasma samples were assayed within two weeks. CONCLUSION　The method is proved to be suitable for clinical investigation of amlodipine pharmacokinetics, which offers advantages of specificity, speed, and greater sensitivity over the previously reported methods.