A target molecule affinity-ultrafiltration liquid chromatography-electrospray ionization tandem mass spectrometric (LC-ESI-MSn) method was established for rapid screening acetylcholinesterase (AChE) inhibitors from total alkaloids of fibraurea recisa Pierre.A total of 12 potential inhibitors were screened from Fibraurea recisa Pierre.and 6 compounds were identified including palmatine,berberine,jatrorrhizine,palmatrubine,7,8-dihydro-8-hydroxyberberine and groenlandicine.The AChE inhibitory activity of these 6 compounds was validated in vitro.Palmatine showed the strongest inhibitory activity for AChE,which was stronger than that of donepezil hydrochloride,demonstrating the potential of palmatine as anti-Alzheimer's drug.This method is simple,rapid,and accurate for directly screening active ingredients which can inhibit AChE from complex extract of traditional Chinese medicines.

Objective To explore the effect of the solution-focused approach when applied in real cross-sectional assessment of young nurses. Methods Totally 136 young nurses who worked in Hai'an Affiliated Hospital of Nantong University for less than 3 years were selected by stratified sampling and random number table, and equally divided into an observation group and a control group between January and December 2015. Nurses in the control group were assessed through the real cross-sectional approach, while nurses in the observation group were not only assessed through the real cross-sectional approach, but also intervened through the solution-focused approach. Then the two groups were compared according to the results of the real cross-sectional assessment and Selfrating Anxiety Scale (SAS) before and after the intervention. Results Before the intervention, there was no statistical significance in the two groups' results of the real cross-sectional assessment and SAS (P>0.05); Psychologically intervened with the solution-focused approach, the observation group's score for the real cross-sectional assessment (82.044±2.195) was higher than that of the control group (75.573±4.536), and the observation group's SAS score (39.058±4.270) was lower than that of the control group (51.382±5.411) (t=10.588,14.742;P<0.05).Conclusions The solution-focused approach, when applied in real cross-sectional assessment of young nurses, helps to reduce nurses' mental pressure and anxiety and build up their confidence substantially, thus improving their real performance capability.

OBJECTIVETo analyze complications after laparoscopic Ladd operation for intestinal malrotation, related causes and possible solutions.

METHODSClinical data of 81 neonates who underwent laparoscopic Ladd operations for intestinal malrotation in the Children's Hospital, Zhejiang University School of Medicine between January 2015 and January 2018 were reviewed. The abdominal complications and findings during operation and reoperation were analyzed.

RESULTSOperations were successfully completed in all patients, and there was no patient converted to open surgery. The annular pancreas in 6 cases and duodenal diaphragm in 4 cases were confirmed during the operation. The recurrent volvulus developed in 3 patients (3.7%), of whom 2 cases were confirmed to have midgut necrosis during open surgery 1 week and 3 months after laparoscopic Ladd operation, and both finally died; 1 case was corrected by second laparoscopic operation. Cecal perforation occurred in 1 patient (1.2%), which was caused by intensive high frequency coagulation of the appendiceal stump. One patient (1.2%) developed chylous ascites and improved after conservative treatment. Adhesive small bowel obstruction was observed in 3 cases (3.7%), and all relieved after conservative treatment.

CONCLUSIONSLaparoscopic Ladd operation for intestinal malrotation in neonates was effective, and the incidence of abdominal complications may be minimized by experienced skills and strict perioperative management.