Objective To establish a purification,enrichment and test method of tetrodotoxin in blood.Methods Through the investigation of various hydrophilic chromatographic columns,the comparison of extraction effects of different types of solid phase extraction columns and the interference analysis of mixed peaks on qualitative ion pairs,the matrix influence of tetrodotoxin was reduced,and the detection sensitivity and qualitative accuracy were improved.Results Tetrodotoxin is highly polar and easily inhibited by the matrix,while conventional precipitation protein method has low sensitivity and isomer double peaks,and the C18 column is not reserved.After comprehensive comparative analysis,the weak cation exchange column PWC column is finally used for purification and enrichment.Complete elution was achieved using 0.5 mL 10%formic acid and 50%acetonitrile aqueous solution.Seperation was performed on an Atlantis HILIC column,with qualitative ion pairs set at m/z,320.10>162.15 and 284.15.The detection limit of the method was 0.061 ng/mL.Conclusion The established PWC solid-phase extraction-LC/MS detection method demonstrates significant purification efficacy,minimal matrix influence,unobstructed chromatographic peaks,markedly improved detection sensitivity.This approach is operationally simple,and applicable to forensic casework.

Objective To establish a purification,enrichment and test method of tetrodotoxin in blood.Methods Through the investigation of various hydrophilic chromatographic columns,the comparison of extraction effects of different types of solid phase extraction columns and the interference analysis of mixed peaks on qualitative ion pairs,the matrix influence of tetrodotoxin was reduced,and the detection sensitivity and qualitative accuracy were improved.Results Tetrodotoxin is highly polar and easily inhibited by the matrix,while conventional precipitation protein method has low sensitivity and isomer double peaks,and the C18 column is not reserved.After comprehensive comparative analysis,the weak cation exchange column PWC column is finally used for purification and enrichment.Complete elution was achieved using 0.5 mL 10%formic acid and 50%acetonitrile aqueous solution.Seperation was performed on an Atlantis HILIC column,with qualitative ion pairs set at m/z,320.10>162.15 and 284.15.The detection limit of the method was 0.061 ng/mL.Conclusion The established PWC solid-phase extraction-LC/MS detection method demonstrates significant purification efficacy,minimal matrix influence,unobstructed chromatographic peaks,markedly improved detection sensitivity.This approach is operationally simple,and applicable to forensic casework.

Objective:To explore the effect of continuous nursing based on Siebens domain management model in patients with Parkinson's disease after deep brain stimulation.Methods:From January 2021 to June 2022, convenience sampling was used to select 169 Parkinson's disease patients who underwent deep brain electrical stimulation in the Functional Neurosurgery of Beijing Tiantan Hospital as the study subject. The patients were divided into a control group of 84 cases and an observation group of 85 cases using the random number table method. The control group received routine continuous nursing, while the observation group received the continuous nursing based on Siebens domain management model on the basis of the control group. This study compared the Activity of Daily Living (ADL) Scale, Morisky Medication Adherence Scale (MMAS), 39-item Parkinson Disease Questionnaire (PDQ-39), Parkinson's Disease Sleep Scale (PDSS) scores, and unexpected program control rate between two groups of patients after six months of discharge.Results:After six months of discharge, the ability of daily living score, quality of life score, and sleep quality score of both groups of patients improved compared to before intervention ( P<0.05), and the medication adherence of the observation group patients improved compared to before intervention ( P<0.05), and the differences were statistically significant. The ability of daily living score, medication adherence, quality of life score, and sleep quality score of the observation group patients after six months were higher than those of the control group, and the differences were statistically significant ( P<0.05). Within six months after discharge, the unexpected program control rate of the observation group was statistically lower than that of the control group ( P<0.05) . Conclusions:In the treatment and discharge rehabilitation process of Parkinson's patients treated with deep brain electrical stimulation, adopting continuous nursing based on the Siebens domain management model can help ensure patient medication compliance, improve postoperative sleep quality and quality of life, reduce unexpected program control frequency, and have certain clinical practice value.

Objective To investigate the diagnostic value of random forest(RF)model based on CT images and clinical data for preoperative T staging of colorectal cancer. Methods Four hundred and fifty patients with colorectal cancer who were pathologically confirmed by surgery and underwent preoperative CT examinationinthe first hospital of Jilin university from January 2016 to July 2016 were included retrospectively(Stage≤T2,T3,and T4 each has 150 cases).According to the ratio of 2:1,the patients were divided into training set(300 cases)and test set(150 cases,stage ≤T2,T3,and T4 each has 50 cases)by computer random software. Each of 450 patients had one lesion. All the patients underwent preoperative abdominal and pelvic contrast-enhanced CT scan.The clinical,imaging and pathological data[gender,age, carcinoembryonic antigen (CEA) level, carbohydrate antigen 19-9 (CA19-9) expression, intestinal wall deformation, maximum diameter of tumorand thickness of intestinal wall, location, enhancement homogeneity and enhancement rate]of these patients were collected.The correlation between the collected factors and pathological T staging was analyzed by Spearman correlation analysis.The preoperative staging model of colorectal cancer was established by RF algorithm in the training set.Two kinds of methods(model and traditional method)were used to diagnose T stage of the patients in the test set.The accuracy of the two methods was calculated by postoperative pathological staging as the gold standard.The consistency test was used to evaluate the consistency of the RF model results with the pathological results. Results T-staging was positively correlated with CEA, CA19-9, intestinal wall deformation, tumor size and thickness of intestinal wall(r=0.449,0.291,0.624,0.573,0.386;P<0.05).Age,location,enhancement homogeneity and enhancement rate were slightly negatively correlated with T-staging(r=-0.115,-0.245,-0.120 and-0.339;P<0.05).The predictive results of the model in≤T2,T3,and T4 stage cancers were moderately and highly consistent with the standard of pathology,and the Kappa value were 0.769,0.615 and 0.800,respectively.The total accuracy rate of the model andthe traditional method are 80.7%(121/150)and 54.0%(81/150). Conclusion Application of random forest model based on multi-slice spiral CT images and clinical data can improve the diagnostic efficacy of preoperative T stage of colorectal cancer.

Endoplasmic reticulum plays a key role in both basic structure formation and function performance of microenviron-ment. Endoplasmic reticulum homeostasis unbalance caused by endoplasmic reticulum stress has become a hot research topic in recent years. This paper focuses on the role of endoplasmic retic-ulum stress in ischemic stroke. Research progress of related sig-naling pathways were reviewed, especially mechanisms through which endoplasmic reticulum stress trigger the inflammatory reac-tion, so as to provide a new research method for prevention of is-chemic stroke.

To study the clinicopothologic diagnosis and treatment of small cell neuroendocrine carcinoma of the cervix(SCNCC)in relion to its outcome. Eight cases of SCNCC treated within 10 years in our hospital were reviewed and andlyzed retrospectively and followed up in our clinic. The clinical and pathologic classifications were correct, namely:Ⅰa 1,Ⅰb 2,Ⅱa 2, Ⅱb 1; Ⅲa 1 and Ⅲb 1 case. Three early cases had total hysterectomy with all pelvic lymph nodes removed and 5 late cases had radio therapy only.Of them 5 cases died 13～38 months after treatment,averaging 19 months, 3 liviny,for 3,4 and 5 months,respectively,one case, however,with metastasis to kidney.SCNCC is a rare tumor of high malignancy with early metastasis and poor prognosis.It should be recognized early and treated with Wertheim's operation and total removal of pelvic lymph nodes with postoperative radio or chemotherapy. Late cases might be benefited by radio or chemotherapy.

To study the nodal distribution in endometrial carcinoma and to evaluate its effect on recurrence and survival, 230 patients with endometrial carcinoma were reviewed and analyzed. 32(20 25%)cases were found to have lymph node metastasis. Stage Ⅲc disease was defined by positive PLN alone in 22 cases, positive PLN and PALN in 4 cases, and positive PALN alone in 6 cases. Positive peritoneal cytology and adnexal metastasis were present in 10 patients. Only 2/10 of these patients had isolated positive PLN whereas 8/10 had positive PALN ( P 0 05). These findings indicate that PALN involvement is common in patients with FIGO Stage Ⅲc endometrial cancer, and suggest that PLN sampling alone may result in underdiagnosis of disease, and dissection of PALN may have a significant therapeutic role.