OBJECTIVE To investigate the stability of 5-fluorouracil （5-FU） in human blood and to establish a standardized clinical sampling and delivery procedure for therapeutic drug monitoring （TDM） of 5-FU. METHODS The EDTA-anticoagulated whole blood was used as the matrix to prepare stability assessment samples of 5-FU at both low （200 ng/mL） and high （5 000 ng/mL） concentrations （with groups without stabilizer and with 1% volume ratio of stabilizer）. The stability assessment samples were placed under room temperature （[ 25±2） ℃] and refrigerated （2-8 ℃） conditions， with sampling at 0， 0.5， 1， 2， 4， 7， and 24 h. After vortexing and centrifugation， the upper plasma layer was collected； proteins were precipitated using methanol， and the concentration of 5-FU in plasma was determined by liquid chromatography-tandem mass spectrometry. Based on the whole blood stability results， clinical sampling and delivery procedures were established. RESULTS The concentration of 5-FU in blank whole blood samples without stabilizers was significantly lower than that in samples with stabilizers （P＜0.05）. However， varying volumes （10， 25， 50 μL） of stabilizers had no significant effect on the measured concentrations of 5-FU in stability assessment samples with low and high concentrations （P＞0.05）. Without the addition of a stabilizer， low- and high-concentration 5-FU whole blood samples remained stable at room temperature for 0.5 h and 1 h， respectively， and under refrigeration for 2 h and 7 h， respectively. After the addition of a 1% stabilizer， the whole blood samples remained stable for up to 24 h under both room temperature and refrigerated conditions. Based on these findings， the following procedure was established： after collection， whole blood samples could be temporarily stored at room temperature （≤0.5 h） or at 4　℃ （≤2 h）， and transported at 2-8　℃. Upon delivery to the laboratory， a 1% volume ratio of stabilizer must be added immediately， followed by centrifugation within 24 h. The resulting plasma should be stored at －20 ℃ . CONCLUSIONS 5-FU in whole blood exhibits poor stability at room temperature. Refrigeration at 2-8　℃ slightly improves stability ， but degradation still occurs rapidly. Adding a stabilizer at a 1% volume ratio significantly prolongs the refrigerated storage time. The established sampling and transport procedure for 5-FU TDM innovatively introduces the stabilizer addition step at the laboratory sample reception stage （rather than immediately after blood draw）. This approach ensures analytical quality while offering greater adaptability to real-world clinical sampling conditions， significantly improving practical feasibility.

Coronary heart disease （CHD） with atherosclerosis is a common chronic disease worldwide， and anxiety and depression are potential and crucial risk factors for adverse prognosis in CHD. Chaihu Longgu Mulitang （CLMT）， first mentioned in the Shang Han Lun （《伤寒论》）， is a classic prescription for treating Shaoyang diseases combined with disturbance of the mind and spirit， with the effects of harmonizing Shaoyang and calming the mind. Current research on mechanisms has shown that CLMT can play a role in CHD complicated with anxiety and depression through multiple pathways， including regulating related signaling pathways， inhibiting the expression of inflammatory factors， improving oxidative stress damage， modulating neurotransmitter levels， suppressing the hypothalamic-pituitary-adrenal axis， promoting mobilization of mesenchymal stem cells from the bone marrow， and inhibiting platelet activation. Clinical studies have demonstrated that CLMT significantly improves symptoms such as angina and insomnia caused by CHD complicated with anxiety and depression， effectively reduces negative emotions， improves traditional Chinese medicine （TCM） syndrome scores， and decreases levels of inflammatory factors. Furthermore， it has fewer adverse reactions and higher safety than conventional western medicine treatments. This article provides a review of the mechanisms and clinical studies of CLMT in the treatment of CHD complicated with anxiety and depression based on a comprehensive analysis of literature from the China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， PubMed， and other databases in the past 15 years， in order to provide references for further research on the use of CLMT in the management of CHD complicated with anxiety and depression.

Objective:To compare the efficacy and safety between microvascular anastomostive device (MAD) and hand-sewn (HS) in free flap reconstruction.Methods:Databases in Pubmed, Embase, CNKI, Wanfang, CBM and Weipu etc. The comparative study of MAD device and manual suture in free flap repair of soft tissue defects published in domestic and foreign official journals from January, 1950 to October, 2019 was collected. The quality of the included studies was strictly evaluated and relevant data were extracted. Revman 5.3 software was used to analyze all relevant data.Results:Fifteen trials with 5 539 patients were included. There was significant difference between MAD and HS in time of venous anastomoses ( SMD=-5.46, 95% CI: -7.50, -3.41, P<0.001), time of artery anastomoses ( SMD=-5.16, 95% CI: -9.61, -0.71, P=0.02), vascular crisis ( RR=0.49, 95% CI: 0.34, 0.70, P<0.001) and flap necrosis ( RR=0.52, 95% CI: 0.32, 0.86, P=0.01), the difference between the 2 groups was statistically significant ( P< 0.05). Conclusion:According to the analyses of the pooled results of MAD group and HS group, the data tend to suggest that MAD is superior to HS in the reconstruction with free flap.

Objective:To compare the clinical characteristics of critically ill pregnant women admitted to the intensive care unit (ICU) with different admission methods, in order to make more effective and rational use of ICU resources.Methods:A retrospective study was conducted. The clinical data of critically ill pregnant women admitted to ICU of Peking University Third Hospital from January 2006 to July 2019 were analyzed. According to the admission mode to ICU, the pregnant women were divided into emergency admission group (transferred to ICU on the same day or the next day due to critical illness) and planned admission group (transferred to ICU 2 days after admitting in obstetric ward). The clinical characteristics of ICU critical pregnant women, such as the incidence, causes of admission, severity of the disease, main treatment measures, mortality, and medical expenses were collected, and a comparative analysis between the two groups was performed.Results:During the nearly 14 years, a total of 576 critical pregnant women in ICU were enrolled, accounting for 0.8% (576/71 790) of the total number of obstetric inpatients and 4.6% (576/12 412) of the total number of ICU inpatients. Seven maternal deaths accounted for 1.2% of all critically pregnant women transferred to ICU, and the overall mortality of pregnant women was 10/100 thousand. Of the 576 critically pregnant women, there were 327 patients (56.8%) in the emergency admission group and 249 patients (43.2%) in the planned admission group. Compared with the planned admission group, the proportion of elective cesarean section in the emergency admission group was significantly lower (17.7% vs. 94.0%, P < 0.01), and the proportion of emergency cesarean section was significantly higher (65.1% vs. 2.4%, P < 0.01), the acute physiology and chronic health evaluation (APACHE Ⅱ, APACHE Ⅲ) scores, simplified acute physiology score Ⅱ (SAPS Ⅱ) and Marshall score were significantly higher [APACHE Ⅱ score: 6.0 (4.0, 9.8) vs. 4.0 (3.0, 7.0), APACHE Ⅲ score: 14.0 (11.0, 20.3) vs. 12.0 (9.0, 16.0), SAPS Ⅱ score: 8 (0, 12) vs. 3 (0, 8), Marshall score: 2 (1, 4) vs. 1 (1, 3), all P < 0.01]. The length of ICU stay in the emergency admission group was significantly longer than that in the planned admission group [days: 2 (1, 5) vs. 2 (1, 3), P < 0.01], and the total length of hospital stay was significantly shorter [days: 9 (7, 13) vs. 13 (10, 18), P < 0.01]. Both in the emergency admission group and the planned admission group, obstetric factors were the main reason for admission, 60.9% (199/327) and 70.3% (175/249), respectively. The proportion of postpartum hemorrhage was the highest [35.2% (115/327) and 57.0% (142/249)], followed by preeclampsia/eclampsia [7.0% (23/327) and 7.6% (19/249)]. Only 7 of the 19 critically pregnant women with puerperal infection were planned admission. All 21 patients with acute fatty liver of pregnancy (AFLP) during pregnancy were emergency admission. Among the emergency and planned admission patients, 73 patients (22.3%) and 42 patients (16.9%) required mechanical ventilation (duration of mechanical ventilation > 24 hours), 99 patients (30.3%) and 35 patients (14.1%) needed vasoactive agents, 67 patients (20.5%) and 20 patients (8.0%) received hemodynamic monitoring, and 123 patients (37.6%) and 154 patients (61.8%) were given anticoagulation therapy, respectively. In terms of severity score of critical pregnant women, there were significant differences in APACHE Ⅱ, APACHE Ⅲ, SAPS Ⅱ and Marshall scores of pregnant women with different diseases. Among them, the APACHE Ⅲ, SAPS Ⅱ and Marshall scores of AFLP were the highest [21.0 (15.0, 32.5), 12.0 (6.0, 16.5) and 6.0 (3.5, 8.0), respectively]. The APACHE Ⅱ and APACHE Ⅲ scores of postpartum hemorrhage were the lowest [4.0 (3.0, 7.0), 12.0 (10.0, 16.0)]. The SAPS Ⅱ score of pneumonia was the lowest [2.0 (0, 14.0)]. The Marshall score for puerperal infection was the lowest [1.0 (0, 3.0)]. In terms of the total medical expenses, the cost in the emergency admission group was significantly lower than that in the planned admission group [10 thousand Yuan: 3.1 (2.0, 4.7) vs. 4.1 (2.9, 5.8), P < 0.05]. Conclusions:Compared with the critically ill pregnant women who planned to be admitted to ICU, the patients emergency admitted to ICU were more complicated and urgent, and the severity of the condition was scored higher. At present, the severity scoring system commonly used in ICU can only partly evaluate the severity of critically ill pregnant women, therefore, it is necessary to design the specific severity scoring system for critically ill pregnant women to effectively and rationally use the precious ICU resources.

Objective To understand the situation of college students' knowledge, attitude and practice (KAP) of innovation and entrepreneurship activities and analyze their influencing factors, in order to provide a scientific basis for further promotion of innovation and entrepreneurship activities. Methods A self-administered questionnaire survey using cluster sampling method was conducted among 850 undergraduates in a medical university in May, 2018. The demographic characteristics and questions pertaining to the KAP of innovation and entrepreneurship activities were collected, The weighted scores of KAP were calculated using the Delphi method. Chi-square test, multivariate logistic regression and linear regression analysis were used to analyze the data. Results A total of 850 questionnaires were sent out and 800 valid questionnaires were collected. The average scores and pass rates for the knowledge, attitude and practice of the 800 college students were (0.54 ±0.14), 38.1％; (0.56 ±0.23), 51.5％; and (0.37 ±0.19), 12.6％, respectively. Knowledge: the pass rate for the concepts related to innovation and entrepreneurship was 70.5％, and the pass rate for the policies related to innovation and entrepreneurship was 17.2％. The pass rate of senior students and excellent students were higher than those of junior students and students of lower academic competence (P=0.000, P=0.004). Attitudes: the pass rate for attitude towards the relationship between innovation and entrepreneurship and personal development was 63.6％, the pass rate for attitudes towards participation in innovation and entrepreneurship was 49.8％, and the pass rate for attitudes towards the school continuing to carry out innovation and entrepreneurship related activities was 23.8％. Practice:the pass rates for participation in scientific research and academic activities and social practice , voluntary cultivation of innovation ability and self-employment were 8.5％, 62.9％, 11.9％and 27.3％, respectively. The pass rate of senior grades was higher than that of junior grades (P=0.001). Scores for knowledge and those of attitude are positively correlated. Scores for practice and those of knowledge and attitude are positively correlated. Conclusion The higher pass rates for medical college students' attitude toward innovation and entrepreneurship activities as compared to those for knowledge and practice indicates high eagerness toward participation in innovation and entrepreneurship activities; a high rate knowledge is conducive to the cultivation of attitudes and the improvement of participation in activities . Therefore , it is necessary to strengthen the efforts in carrying out innovation and entrepreneurship activities , improve publicity and education, and promote the awareness-raising of innovation and entrepreneurship.

Objective To observe and compare the efficacy and safety of docetaxel or oxaliplatin combined with fluorouracil drugs in the treatment of advanced gastric cancer.Methods A total of 80 patients with advanced gastric cancer were randomly divided into observation group and control group,with 40 cases per group.The patients in the control group were treated with docetaxel combined with fluorouracil drugs for chemotherapy,while the patients in the observation group was treated with oxaliplatin combined with fluorouracil drugs for chemotherapy.The clinical outcomes,the overall survival (OS),the progression free survival (PFS) and the adverse advents during treatment in the two groups were observed and compared.Results There were no statistically significant differences in the distribution of the clinical outcomes and the clinical efficiency between the two groups (P ＞ 0.05).There were no statistically significant differences in the estimated median values of OS and PFS between the two groups (P ＞ 0.05).The incidence of white blood cell declining of the patients in the observation group was significantly lower,while the incidence of peripheral neurotoxicity was significantly higher than that in the control group,and there were statistically significant differences between the two groups (P ＜ 0.05).Conclusion In the treatment of advanced gastric cancer,the application of docetaxel combined with fluorouracil drugs for chemotherapy or oxaliplatin combined with fluorouracil drugs for chemotherapy can achieve basically equal therapeutic effects,but there are differences in the adverse advents.Both of them are the effective alternative in chemotherapy for advanced gastric cancer.

Objective To observe and compare the efficacy and safety of docetaxel or oxaliplatin combined with fluorouracil drugs in the treatment of advanced gastric cancer.Methods A total of 80 patients with advanced gastric cancer were randomly divided into observation group and control group,with 40 cases per group.The patients in the control group were treated with docetaxel combined with fluorouracil drugs for chemotherapy,while the patients in the observation group was treated with oxaliplatin combined with fluorouracil drugs for chemotherapy.The clinical outcomes,the overall survival (OS),the progression free survival (PFS) and the adverse advents during treatment in the two groups were observed and compared.Results There were no statistically significant differences in the distribution of the clinical outcomes and the clinical efficiency between the two groups (P ＞ 0.05).There were no statistically significant differences in the estimated median values of OS and PFS between the two groups (P ＞ 0.05).The incidence of white blood cell declining of the patients in the observation group was significantly lower,while the incidence of peripheral neurotoxicity was significantly higher than that in the control group,and there were statistically significant differences between the two groups (P ＜ 0.05).Conclusion In the treatment of advanced gastric cancer,the application of docetaxel combined with fluorouracil drugs for chemotherapy or oxaliplatin combined with fluorouracil drugs for chemotherapy can achieve basically equal therapeutic effects,but there are differences in the adverse advents.Both of them are the effective alternative in chemotherapy for advanced gastric cancer.

Objective:To study the association between non-syndrome cleft lip and palate (NSCL/P)and MAFB (rs6072081, rs6065259,rs17820943,rs11696257)gene polymorphism in NingXia Hui and Han population.Methods:512 cases of NSCL/P,258 case of Hui nationality and 254 of Han,174 cases of complete 3 core family members(patients and their parents),142 cases of single parents families(patients and their single parents),were collected in patient group.505 cases of healthy newborns were collected in control group.The MAFB gene SNPs were determined with TaqMan SNPs genotyping methods and the data were analyzed by case-con-trol analysis,transmission disequilibrium test(TDT)and family based association test(FBAT).Results:Case-control analysis found that,there was a statistical significance of the genotypes and allele frequency between patients and the controls in MAFB of the 4 locus (P <0.05);but all of the 4 locus showed no difference in patients with cleft palate(P >0.05).Conclusion:The 4 locus single nucle-otide polymorphism was associated with NSCL/P in Ningxia population.

OBJECTIVETo study the chemical constituents of the roasted seeds of Cassia obtusifolia, and to illuminate the change of its effective components before and after being roasted.

METHODThe compounds were isolated and repeatedly purified by macroporous resin, silica gel column chromatography. Their structures were elucidated by physical and chemical properties and NMR data.

RESULTThree components were obtained from ethanol extract, and the structures were identified as nor-rubrofusarin-6-O-beta-D-(6'-O-acetyl) -glucopyranoside (1), 1-desmethyl- aurantio-obtusin-2-O-beta-D-glucopyranoside (2), obtusin (3).

CONCLUSIONCompounds 1 and 2 were isolated from the roasted seeds of C. obtusifolia for the first time, and compound 1 was a new compound.

Cassia ; chemistry ; Glycosides ; analysis ; isolation & purification ; Hot Temperature ; Plant Extracts ; analysis ; isolation & purification ; Seeds ; chemistry