Objective:To establish an ultra-high performance liquid chromatography-tandem mass spectrometry(UPLC-MS-MS)method for the determination of 2-mercaptobenzothiazole(MBT)genotoxic impurities in cefazoxime sodium for injection and to analyze the detection of domestic samples from 28 manufacturers.Methods:The UPLC analysis was performed on a Phenomenex Luna Omega C18 column,(2.1 mm × 100 mm,1.6 μm)with the column temperature 30 ℃.The mobile phases A was 2 mmol·L-1 ammonium acetate(contai-ning 0.001％formic acid)and the mobile phase B was acetonitrile with gradient elute.The flow rate was 0.3 mL·min-1.The injection volume was 5 μL.The electrospray ionization(ESI)source in positive mode and multiple reaction monitoring(MRM)were used for the detection of MBT,and external standard method for quanti-tative analysis.Results:The linear relationship of MBT was good in the concentration range of 1.4-58.12 ng·mL-1(r=0.999).The limit of detection was 1.453 pg and the limit of quantification was 7.265 pg.The average recoveries of low,medium and high concentrations were 106.8％,107.1％and 109.0％,respectively with the relative standard deviation(RSD)all less than 2.0％.The relative standard deviation(RSD)of repeatability was less than 6.0％.The content of MBT in the samples from 28 domestic enterprises was all less than 10 ppm,but there were obvious differences in the detected amount among all enterprises which is due to different production processes.Conclusion:The established method can be used for the qualitative and quantitative detection of MBT in cefazoxime sodium for injection and the partical enterprises which have been detected MBT impurities need to further raise the warning.

Objective:To search, evaluate, and summarize the best evidence for difficult peripheral intravenous catheterization in children.Methods:Following the "6S" evidence pyramid model, literature related to the management of difficult peripheral veins in children was searched in both English and Chinese databases including UpToDate, BMJ Best Practice, National Guidelines Clearinghouse, the Joanna Briggs Institute Evidence-Based Health Care Database, PubMed, Medlive, SinoMed, CNKI, and Wanfang Database. The search period was from the establishment of the database to January 2023. Two researchers trained in systematic evidence-based nursing, independently evaluated the quality of included literature and extracted relevant evidence.Results:Five articles were included: two guidelines, two expert consensuses, and one systematic review. 19 best evidence were summarized, covering five aspects: difficult vein quality management, difficult vein assessment, difficult intravenous catheterization site and needle type selection, difficult intravenous catheterization auxiliary methods, and handling of failed difficult intravenous catheterization.Conclusions:This study summarizes the best evidence for difficult peripheral intravenous catheterization in children, demonstrating clinical nursing practicality. It provides evidence-based guidance for pediatric nursing staff performing difficult intravenous catheterization.

Objective:To establish an ultra-high performance liquid chromatography-tandem mass spectrometry(UPLC-MS-MS)method for the determination of 2-mercaptobenzothiazole(MBT)genotoxic impurities in cefazoxime sodium for injection and to analyze the detection of domestic samples from 28 manufacturers.Methods:The UPLC analysis was performed on a Phenomenex Luna Omega C18 column,(2.1 mm × 100 mm,1.6 μm)with the column temperature 30 ℃.The mobile phases A was 2 mmol·L-1 ammonium acetate(contai-ning 0.001％formic acid)and the mobile phase B was acetonitrile with gradient elute.The flow rate was 0.3 mL·min-1.The injection volume was 5 μL.The electrospray ionization(ESI)source in positive mode and multiple reaction monitoring(MRM)were used for the detection of MBT,and external standard method for quanti-tative analysis.Results:The linear relationship of MBT was good in the concentration range of 1.4-58.12 ng·mL-1(r=0.999).The limit of detection was 1.453 pg and the limit of quantification was 7.265 pg.The average recoveries of low,medium and high concentrations were 106.8％,107.1％and 109.0％,respectively with the relative standard deviation(RSD)all less than 2.0％.The relative standard deviation(RSD)of repeatability was less than 6.0％.The content of MBT in the samples from 28 domestic enterprises was all less than 10 ppm,but there were obvious differences in the detected amount among all enterprises which is due to different production processes.Conclusion:The established method can be used for the qualitative and quantitative detection of MBT in cefazoxime sodium for injection and the partical enterprises which have been detected MBT impurities need to further raise the warning.

Objective To investigate the morphological changes of whole brain gray matter in patients with postherpetic neuralgia(PHN),and evaluate the correlation between morphological changes of whole brain gray matter,visual analogue scale (VAS) and duration of PHN.Methods By using VBM-DARTEL method,firstly the 3D T1WI structure images of 17 patients with PHN and 17 normal control were preprocessed,then the segmented gray matter volume was compared between the two groups, and the correlation between difference of cerebral gray matter volume,VAS and duration of PHN were analyzed.Results Compared with the normal control, gray matter decrease in PHN group was found in bilateral orbital frontal regions(orbital gyrus,rectus gyri),left inferior frontal gyrus,left insular lobe, left caudate, right cingulate gyrus,left superior temporal gyrus, left cuneus, bilateral cerebellum posterior lobe and bilateral cerebellum anterior lobe.And gray matter increase in PHN group was found in bilateral superior frontal gyri, left middle frontal gyrus, vermis, pons.The gyrus volume change for two hemispheres was asymmetric (the left side greater than the right side).These different brain region changes in gray matter volume for patients with PHN were not correlated with VAS and duration of PHN.

Objective To investigate the effectiveness of panoramic mandibular index (PMI) in detecting the bone mineral density (BMD) of mandibular bone and whole-body bone in patients with chronic end-stage renal failure. Methods A total of thirty patients with peritoneal dialysis treatment were used as experimental group and 31 healthy adults were used as control group. The panoramic jaw tomography was taken for the measurement of superior PMI (sPMI) and inferior PMI (iPMI) in two groups. The dual-energy X-ray absorptiometry (DXA) was used to detect BMD of lumbar spine bone. Data were compared between two groups. The correlation of sPMI, iPMI and BMD of lumbar spine bone was analyzed. Results All indicators including sPMI(0.262 2 ± 0.026 7 vs 0.284 2 ± 0.025 4, t=3.301) , iPMI (0.314 1 ± 0.028 3 vs 0.334 1 ± 0.027 5, t=2.808) and BMD of lumbar spine bone (0.832 3 ± 0.101 0 vs 0.906 9 ± 0.113 6,t=2.709) were significantly lower in experimental group than those in control group (P＜0.01). There was a positive correlation between sPMI and iPMI with BMD of lumbar spine bone (r=0.439 and 0.389, P＜0.05). The BMD of lumbar spine bone was significantly lower in female patients than that of male patients in control group (0.849 7±0.114 7 vs 0.968 0±0.076 3,t=3.357). The BMD of lumbar spine bone was also significantly lower in female patients than that of male patients in experimental group (0.775 4±0.068 4 vs 0.882 1±0.099 9,t=3.365). There were no significant differences in values of sPMI and iPMI between male and female patients of two groups. Conclusion The BMD of mandibular bone is lower in patients with chronic end-stage renal failure than that of the normal people. PMI index is a simple and effective method to detect the BMD of mandibular bone, which can reflect the BMD of whole body bone in patients with chronic end-stage renal disease.

Objective To evaluate liver biopsy for the diagnosis in liver transplant patients with suspected acute rejection. Methods From Oct. 2004 to Apr. 2005, liver biopsies were performed 53 times in 39 transplant cases. Results Based on Banff schema for grading liver allograft rejection, laboratory abnormalities and result of treatment, acute rejection was diagnosed on 16 episodes, preservation injury in 12, bile duct strictures in 9, drug-induced injury in 11, chronic rejection in 3 and acute hepatic failure in 2. Conclusions Hepatocyte ballooning with necrosis features preservation injury. Drug-induced injury commonly has a combination of hepatocyte denaturalization with mild portal inflammation. Histologic features of early bile duct strictures in liver biopsy show prominent bile ductular proliferation and the canalicular cholestasis with mild hepatocyte damage which help to exclude acute rejection.