OBJECTIVE:To establish a HPLC method for the determination of dolastron mesylate.METHODS:The sample was separated on Diamonsil C18 column.The mobile phase consisted of acetonitrile-water-1mol? L-1 ammonium formate(450∶ 440∶ 110)(pH=8.0 adjusted with trithylamine)with a flow rate of 1.0mL? min-1.The UV detection wavelength was set at 285nm and the sample size was 20? L.RESULTS:The linear range of dolasetron mesylate was 24～ 56? g? min-1(r=0.999 6),with average recovery at 99.7%(RSD=0.74%).CONCLUSION:The established is simple,sensitive and reproducible,and suitable for the quality control of dolasetron mesylate.

Objective To approach rehabilitation nursing measures in using the allogeneic ten-don to re-establish the anterior cruciate ligament of knee through the tibia twin tunnel under arthroscopy.Methods Mental nursing and direct functional exercises was given to 30 patients who received this kind of operation from November,2006 to July,2007,and functional exercises of flection and extention of knee joint by steps,functional exercises of muscle force of quadficeps muscle and back muscle group of legs and the correct using of artificial brace of knee joint.Results Range of joint motion could reach 95°after 2 weeks and 125°after 4 weeks postoperation.Score of joint function(Lysholm)could reach(74.8±5.7)after 6 weeks,(80.0±2.3)after 9 weeks,(91.8±3.4)after 12 weeks, and(94.5±2.2)after 1 year.Conclusion Selective perioperative rehabilitation nursing instruction is the important guarantee of function recovery.

Objective To explore the long term effects of gestational diabetes mellitus (GDM)on offsprings of affected women.Methods One hundred and twenty-four singleton pregnant women with GDM,who delivered in Department of Obstetrics and Gynecology,Peking University First Hospital from June 14,2006 to December 31,2007,were enrolled as the study group.Ninety-eight singleton pregnant women with normal glucose metabolism who delivered at the corresponding period were enrolled as the control group.The follow-up study was performed from November 6,2010 to January 31,2011 on their offsprings.Anthropometry indexes,including height,weight,waist circumference,systolic and diastolic blood pressure (DBP),triceps skin fold (TSF) and sub-scapular skin fold (SSF) were measured.According to the development standard of children less than five years old issued by World Health Organization in 2006,there were six detailed evaluation indicators including length/height for age z-score (HAZ),weight for age z-score (WAZ),weight for length/ height z score (WHZ),body mass index (BMI) for age z-score (BAZ),triceps skin folds for agez-score (TSFZ) and sub-scapular skin folds for age z-score (SSFZ).Chi-square,t-test or variance analysis were applied.Results (1) No statistical difference on age,birth weight,sex,height,weight,BMI,waist circumference,blood pressure,TSF and SSF was found between offsprings of study and control group (P＞0.05).(2) Offsprings in both groups were further divided into macrosomia and non-microsomia subgroups,i.e.GDM macrosomic subgroup (n =15),GDM nonmacrosomic subgroup (n=109),control macrosomia subgroup (n=6) and control non-macrosomia subgroup (n=92).Significant difference was shown amont the four subgroups in weight [(19.8±3.9),(17.0±1.9),(17.7±1.7)and (17.2±1.7) kg,F=6.238,P＜0.001],BMI (17.6±2.6,16.0±1.2,16.6±1.1 and 16.2±1.1,F=5.901,P＜0.001),waist circumference [(53.6±5.3),(49.9±2.7),(50.9±3.3) and (50.4±0.9) cm,F=5.307,P＜0.001],WHZ (1.40±1.44,0.45±0.81,0.88±0.75 and 0,60±0.87,F=5.269,P=0.002),HAZ (1.22±0.78,0.47±0.82,0.98±0.74 and 0.50±1.00,F=3.668,P=0.013),WAZ (1.68±1.23,0.58±0.79,1.15±0.85and 0.71±0.93,F=7.361,P＜0.001) and BAZ (1.41±1.52,0.42±0.84,0.81±0.76 and 0.60±0.90,F=5.210,P =0.002).While comparing between each two subgroups,there was statistical difference between GDM macrosomia subgroup and GDM non macrosomia subgroup,and between GDM marosomia subgroup and control non-macrosomia group.(3) While comparing GDM macrosomia and GDM non-macrosomia subgroup with control group [weight (17.2±2.5) kg,BMI (16.2± 1.4),waist circumference (50.5 ± 3.6) cm,DBP (55.2 ± 6.9)mm Hg,SSF(6.1 ± 1.8) mm,WHZ (0.62±0.87),HAZ (0.53±0.99),WAZ (0.73±0.92),BAZ(0.61±0.89)],the weight (F=9.283,P＜0.001),BMI (F=8.707,P＜0.001),waist circumference (F=7.934,P＜0.001),DBP(F=3.123,P=0.046),SSF (F=3.499,P=0.032),WHZ (F=7.639,P＜0.001),HAZ(F=4.709,P=0.010),WAZ (F=10.302,P＜0.001) and BAZ (F=7.689,P＜0.001) was higher in GDM group than the control group.(4) The proportions of overweight and obesity were higher in GDM macrosomia subgroup than in GDM non-macrosomia and control groups [overweight:9/15 vs24.8％ (27/109) and 24.5％ (24/98),x2 =8.870,P=0.012; obesity:5/15 vs 7.3％(8/109) and 9.2％(9/98),x2=10.083,P=0.006].If all subjects were divided into macrosomia and non-macrosomia group,then the proportion of overweight and obesity was higher in the former group [overweight:52.4％ (11/21) vs24.4％(49/201),x2=7.560,P=0.006; obesity:28.6％ (6/21)vs 7.9％(16/201),x2 =9.047,P=0.003].Conclusions GDM may have long term adverse effect on the development of offsprings at three-four-year-old with higher incidence of obesity or high diastolic blood pressure in macrosomic babies of GDM mothers than in non macrosomic babies of GDM mothers or babies of non GDM mothers.

OBJECTIVE To investigate the distribution scope of the pan-drug resistant bacteria in the SICU patients including their producing environment and high risk factors in these two years and to approach its prevention and treatment policy. METHODS The distribution scope and the high risk factors of the pan-drug resistant bacteria in SICU were reviewed and analyzed from Jan 2005 to Jan 2007.RESULTS There were 11 cases in the period from Jan 2005 to Jan 2006; and was only 1 case from Jan 2006 to Jan 2007. CONCLUSIONS To establish the drug resistance monitoring system, attach great importance to isolation and education, to monitor the original region of the pan-drug resistant bacteria, and to adopt the comprehensive antibiotic policy to control the drug resistant bacteria. Among them, the early effective isolation of high risk patients may be very effective to reduce the producing and developing of the pan-drug resistant bacteria.

Objective To investigate the effect of high viral loads(HBV DNA concentration in blood ＞2.0 copy/ml)on the vertical transmission of hepatitis B virus in mothers with HBV DNA positivity.Method Forty pregnant women with HBV DNA positivity were divided randomly.double-blindly into 2 groups:at 28 weeks of pregnancy,one group received oral lamivudine(100 mg/d)and the other received oral placebo.The serum HBV DNA loads were tested at 28 and 40 weeks'gestation in mothers,and serum HBV DNA,HBsAg,HBeAg and anti-HBs were examined in infants at 12 month follow up.Result Thirtynine infants finished(one twins)the follow up,and 2 infants lost(5%).Among them 4 infants were confirmed to be HBV infection(10%,4/39),2 in the treatment group(10%,2/20)and 2 in the control group(11%,2/19)(P＞0.05).The serum HBV DNA levels of 40 weeks'gestation in the treatment group,compared with the levels of 28 weeks'gestation in the treatment group and 40 weeks'gestation in the control group,showed a significant decline(P＜0.01).The HBV DNA levels of the mothers whose infants were infected,were(3.1±3.4) copy/ml,(3.1±3.2) copy/ml during 28 and 40 weeks'gestation,and for mothers whose infants were non-infected,the levels were(3.4±2.2) copy/ml,(2.6±1.5) copy/ml respectively(P＞0.05).The mean values of anti-HBs of 18 infants in the treatment group showed no significant difference as compared to 17 infants in the control group,(594±416)U/L vs (458±398) U/L (P＞0.05).Conclusion The pregnant women's HBV DNA loads could be obviously decreased from high viral loads (HBV DNA concentrations in blood＞2.0 copy/ml)after they take lamivudine from 36 weeks'gestation.But it might not reduce the maternal-fetal vertical transmission of HBV infection.

Objective To study nuclear factor E-2 related factor 2(NrF-2) and heme oxygenase -1(Ho-1) expression and to explore its clinical significance.Methods From February 2016 to June 2016, 176 cases human gastric tissue paraffin blocks selected in department of pathology in Hangzhou Cancer Hospital, including 78 cases of gastric cancer, 78 cases of normal tissue were analyzed.And the expressions of NrF-2 and Ho-1 were detected by immunohistochemistry in two groups of human gastric tissue.Results The levels of NrF-2 and Ho-1 in gastric cancer group were(0.752 ± 0.098),(0.862 ±0.081) were significantly higher than those in normal group(0.381 ±0.068),(0.412 ±0.083);NrF-2, the positive expression rate of Ho-1 in gastric wall invasion degree of T3 +T4 with lymph node metastasis, NTM stage III and IV gastric cancer tissues were significantly increased.The differences were statistically significant ( P <0.05 ) .Conclusion NrF-2 and Ho-1 play the important role in the development of gastric cancer and NrF-2, the positive expression rate of Ho-1 in the gastric carcinoma and gastric wall invasion, lymph node metastasis and NTM staging are closely related.The clinical diagnosis if the combined detection of NrF-2 and Ho-1, is conducive to the early diagnosis of gastric cancer and the prognosis of the disease.

Objective To study the expression and significance of fatty acid synthase ligand ( sFas ) and soluble fatty acid synthase receptor (sFasL) on the neoadjuvant chemotherapy of breast cancer.Methods 84 cases of patients with breast cancer neoadjuvant chemotherapy were recorded from January 2015 to January 2016 in our hospital as breast cancer group,another 84 cases of healthy subjects as control group,the two groups were measured sFas,the positive rate of sFasL.At the same time,respectively before and after neoadjuvant chemotherapy, detection of patients serum sFas, sFasL levels and breast cancer.According to the clinical curative effect were divided into effective group and ineffective group , compared two groups of serum sFas, sFasL levels.Results Breast cancer group called sFas and sFasL positive rate was 58.33% (49/84) and 100.00%(84/84),were significantly higher than that of control group 38.10%(32/84) and 0.00% (0/84);The level of sFas in patients with neoadjuvant chemotherapy was significantly lower than that of neoadjuvant chemotherapy, and the level of sFas in neoadjuvant chemotherapy group was significantly higher than that in ineffective group, the difference was statistically significant (P<0.05).Conclusion In the course of neoadjuvant chemotherapy for breast cancer,the efficacy of neoadjuvant chemotherapy can be effectively detected by detecting the level of serum sFas in patients with breast cancer , while sFasL has no significant change in the neoadjuvant chemotherapy of breast cancer.

Acanthopanax sessiliflorus fruit is a traditional Chinese drug, which mainly contains triterpene, lignans, coumarin and flavonoids etc. It has such pharmacological activities as anti-inflammatory analgesic, antioxidant, anti platelet aggregation and so on. The article summarized the chemical constituents, quality control and pharmacological activities of Acanthopanax sessiliflorus fruit to provide reference for the further research and development of the traditional Chinese drug.

Objective To investigate the accuracy of high-resolution magnetic resonance imaging (MRI) in diagnosis of the lymph nodes metastases (LNMs) and stage of rectal cancer (RC).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 65 patients with RC who were admitted to the Peking University People's Hospital between April 2014 and April 2016 were collected.The results of postoperative pathological examination:of 65 patients with RC,24 had positive LNMs and 41 had negative LNMs;N0,N1 and N2 were respectively detected in 41,14 and 10 patients.Imaging data were captured using 3.0-Tesla MRI and body phased-array coil.Diagnostic criteria for LNMs of RC:criterion 1:irregular lymph node boundaries and signal characteristics were not considered;criterion 2:heterogeneous signal of lymph nodes and boundary characteristics were not considered;criterion 3:irregular lymph node boundaries and / or heterogeneous signal of lymph nodes.The American Joint Committee on Cancer (AJCC) cancer staging manual (7th edition) have established the N staging scheme for RC.Lymph nodes distribution according to the rectal lymphatic drainage:D1was located in fascia of the mesorectum;D1a above the level of tumor;D1b at the level of tumor;D1c under the level of tumor;D2 around the superior rectal artery and root of inferior mesenteric artery;D3 on the side of pelvic cavity.Observation indicators:(1) Efficiency and comparison of LNMs of RC diagnosed by high-resolution MRI according to the 3 criteria (postoperative pathological result as a gold standard).(2) Efficiency and comparison of N stage of RC diagnosed by high-resolution MRIaccording to the 3 criteria (postoperative pathological result as a gold standard).(3) Efficiency of LNMs of RC diagnosed by high-resolution MRI according to the maximum short diameter of lymph nodes:① maximum short diameter distribution of positive and negative LNMs of RC;②sensitivity,specificity,accuracy and consistency of LNMs diagnosed using different maximum short diameter of lymph nodes as a threshold (postoperative pathological result as a gold standard);③ comparison of accuracy of LNMs diagnosed using maximum short diameter of lymph nodes with highest diagnostic accuracy as a threshold and using the 3 criteria;④ sensitivity,specificity,accuracy and consistency (postoperative pathological result as a gold standard) of LNMs diagnosed using maximum short diameter of lymph nodes with highest diagnostic accuracy as a threshold combined with the highest efficiency in the (1),and its comparison in accuracy of LNMs with highest diagnostic accuracy as a threshold.(4) Distribution of LNMs of RC diagnosed by high-resolution MRI according to the 3 criteria.(5) Follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect patients' postoperative survival up to October 2016.The sensitivity,specificity,accuracy and comparison of ratio were respectively done by the chi-square test.Kappa test was used for consistency,tκ ≤ 0.40was used as low consistency,0.40＜κ≤0.60 as moderate consistency,0.60＜κ≤0.80 as higher consistency,and κ＞ 0.80 very high consistency.Results (1) Efficiency and comparison of LNMs of RC diagnosed by highresolution MRIaccording to the 3 criteria:accuracies of LNMs of RC diagnosed by high-resolution MRI according to the criterion 1,2 and 3 were respectively 93.8％,87.7％ and 90.8％,showing very.high,higher and very high consistencies compared with postoperative pathological results (κ =0.87,0.74,0.81,P＜0.05),and with no statistically significant difference in diagnostic accuracy among them (x2=1.495,P＞0.05).(2) Efficiency and comparison of N stage of RC diagnosed by high-resolution MRI according to the 3 criteria:accuracies of N stage of RC diagnosed by high-resolution MRI according to the criterion 1,2 and 3 were respectively 87.7％,83.1％ and 84.6％,showing the same higher consistencies compared with postoperative pathological result (κ =0.77,0.68,0.72,P＜0.05),and with no statistically significant difference in N stage among them (x2=0.567,P＞0.05).(3) Efficiency of LNMs of RC diagnosed by high-resolution MRI according to the maximum short diameter of lymph nodes:① maximum short diameter distribution of positive and negative LNMs of RC:maximum short diameter ranges were respectively 3-18 mm in positive LNMs and 1-9 mm in negative LNMs,and maximum short diameter ＜3 mm and ≥ 10 mm were respectively negative and positive LNMs.② Efficiency of LNMs of RC diagnosed using different maximum short diameter of lymph nodes as a threshold:diagnostic accuracy of 70.8％was the highest when maximum short diameter ＞7 mm was used as a standard of positive LNMs,showing a low consistency compared with postoperative pathological result (κ =0.29,P＜0.05).③ Comparison of accuracy of LNMs diagnosed using maximum short diameter of lymph nodes ＞7 mm as a threshold and using the 3 criteria:there was a statistically significant difference among them (x2 =15.637,P＜0.05);accuracies of LNMs of RC diagnosed by high-resolution MRI according to the criterion 1,2 and 3 were higher than that diagnosed using maximum short diameter of lymph nodes ＞7 mm as a threshold (x2 =10.354,5.656,6.923,P＜0.05).④Comparison of accuracy of LNMs diagnosed using maximum short diameter of lymph nodes ＞7 mm combined with the criterion 3 as a threshold and using maximum short diameter ＞7 mm as a threshold:the criterion 3 was used as a threshold because there was no statistically significant difference in diagnostic accuracy among the 3 criteria (P＞ 0.05).Diagnostic accuracy was 78.5％ when maximum short diameter ＞7 mm combined with the criterion 3 as a threshold,showing a low consistency compared with postoperative pathological result (κ =0.36,P＜0.05),with no statistically significant difference in diagnostic accuracy compared with maximum short diameter ＞ 7 mm as a threshold (x2=0.154,P＞0.05).(4) Distribution of LNMs of RC diagnosed by high-resolution MRI according to the 3 criteria:positive LNMs of RC diagnosed by high-resolution MRI located mostly in D1 (76.1％-83.1％)and D1b(77.8％-81.4％).(5) Follow-up situations:of 65 patients,54 were followed up for 6-25 months,with a median time of 14 months.During the follow-up,7 patients had distant metastases and 47 had tumor-free survival.Conclusions There are higher accuracies of LNMs and N stage of RC diagnosed using preoperative highresolution MRI.Diagnostic accuracy of LNMs of RC cannot be improved when characteristics of lymph node morphology and size are used as a diagnostic standard.The positive LNMs of RC locate mostly in D1 and Dib.

OBJECTIVE:To approach the correlations of carbamazepine concentration in serum with clinical therapeutic effect,dosage,sex,age and body weight in epileptic children.METHODS:158 monitoring records for serum concentration of carbamazepine in children with epilepsy in our clinical pharmacy department were consulted retrospectively.Data such as serum concentration,sex and age were recorded into data base and were analyzed using SPSS 13.0 software.RESULTS:No significant correlation was noted between serum concentration of carbamazepine in epileptic children and sex.However,serum concentration of carbamazepine was closely correlated with clinical therapeutic effect,dosage,age and body weight.CONCLUSION:The individual difference in the metabolic processes of carbamazepine was concerned with age and body weight,so it's necessary to make individualized regime according to child's specific condition and monitoring results.