Objective:To investigate the impact of various conditions on the adsorption of quetiapine by activated carbon, establish a method for evaluating the adsorption efficacy of activated carbon on quetiapine, and assess the adsorption effects both in vitro and in vivo.Methods:In vitro experiments involved incubating activated carbon with quetiapine under different conditions, including varying organic solvent contents, types of organic solvents, adsorption temperatures, adsorption times, and pH. After reaching equilibrium, the mixtures were centrifuged, and the supernatants were collected. The concentration of quetiapine in the supernatants was measured using LC-MS/MS, and the adsorption rates were calculated. The log-transformed concentration of activated carbon was used as the independent variable and the adsorption rate as the dependent variable for function fitting using Origin 2021 software. In the in vivo experiments, rats were administered quetiapine orally, followed by 125 mg/mL of activated carbon in the experimental group. Blood samples were collected at multiple time points pre- and post-administration (0.17 h, 0.33 h, 0.50 h, 0.75 h, 1 h, 1.5 h, 2 h, 4 h, 6 h, 12 h, and 24 h). Plasma samples were pre-treated and the quetiapine concentrations were determined using LC-MS/MS. Pharmacokinetic parameters for both control and experimental groups were calculated using DAS 2.0 software.Results:The factors such as organic solvent content, type of organic solvent, adsorption temperature, adsorption time, and pH value significantly influenced the adsorption efficiency of quetiapine by activated carbon, leading to the optimization and standardization of the in vitro adsorption methodology. Among the 100 different adsorption function models tested, the Boltzmann function was identified as the most suitable models for describing the adsorption of quetiapine by activated carbon. Pharmacokinetic analysis showed that the experimental group treated with activated carbon exhibited significantly reduced C max and AUC for quetiapine compared to the control group. Conclusion:The results of both in vitro and in vivo experiments demonstrate that activated carbon effectively adsorbs quetiapine, providing a potential method for mitigating quetiapine absorption.

Purpose To explore the expression of autoph-agy-related 7(ATG7)in breast cancer and its effect on the breast cancer development.Methods Immunohistochemistry(IHC)was used to detect ATG7 protein expression in breast cancer tissues and the relationship between ATG7 and clinico-pathological features was analyzed.ShRNA was used to interfere with the expression of ATG7 in breast cancer cell line MCF-7.Puromycin was used to screen for stably transfected cells and Western blot was used to detect transfection efficiency.The effect of ATG7 knockdown cells on proliferation ability was de-tected by CCK8 and clone formation experiments.The effect of ATG7 knockdown cells on tumorigenicity in vivo was detected by subcutaneous tumor formation experiment in nude mice.Results IHC showed that ATG7 expression in breast cancer tissues was mainly localized in cytoplasm,and its expression was significant-ly correlated with tumor size and Ki67 expression(P＜0.05).ATG7-shRNA significantly interfered with ATG7 expression in breast cancer cells MCF-7.CCK8 and clone formation experi-ments showed that ATG7 knockdown promoted the cell prolifera-tion compared with the control group.The experiment of subcu-taneous tumor formation in nude mice showed that the tumor for-mation ability of mice was significantly increased after ATG7 knockdown compared with the control group.Conclusion ATG7 may inhibit the proliferation capacity of breast cancer and could be a potential target for breast cancer therapy.

Purpose To explore the association of RIPK1 expression and Miller-Payne score after neoadjuvant therapy and its effect on chemotherapy sensitivity in breast cancer.Methods Immunohistochemistry(IHC)was used to detect RIPK1 in paraffin samples from breast cancer.Western blot was used to detect the expression of RIPK1 in different breast cancer cell lines,knockdown cell lines were constructed.CCK-8,clone for-mation experiment and flow cytometry were used to detect the effect of knockdown RIPK1 on the sensitivity of cells to chemo-therapy.Results The IHC results showed that the high expres-sion rate of RIPK1 was 69.0％(20/29)in the resistant group and 42.9％(15/35)in the sensitive group,and the expression of RIPK1 was significantly correlated with the Miller-Payne score(P=0.037).Western blot assay showed that the expression levels of RIPK1 were different in different cell lines,RIPK1 knockdown cell lines were constructed and induced apoptosis u-sing different concentrations of drugs.CCK-8,clone formation experiment and flow cytometry showed that knockdown of RIPK1 could decrease the cell survival rate,increase the apoptosis rate and decrease the colony formation rate compared with the control group.Conclusion Knockdown of RIPK1 promotes chemother-apy sensitivity of breast cancer cells.

Purpose To explore the association of RIPK1 expression and Miller-Payne score after neoadjuvant therapy and its effect on chemotherapy sensitivity in breast cancer.Methods Immunohistochemistry(IHC)was used to detect RIPK1 in paraffin samples from breast cancer.Western blot was used to detect the expression of RIPK1 in different breast cancer cell lines,knockdown cell lines were constructed.CCK-8,clone for-mation experiment and flow cytometry were used to detect the effect of knockdown RIPK1 on the sensitivity of cells to chemo-therapy.Results The IHC results showed that the high expres-sion rate of RIPK1 was 69.0％(20/29)in the resistant group and 42.9％(15/35)in the sensitive group,and the expression of RIPK1 was significantly correlated with the Miller-Payne score(P=0.037).Western blot assay showed that the expression levels of RIPK1 were different in different cell lines,RIPK1 knockdown cell lines were constructed and induced apoptosis u-sing different concentrations of drugs.CCK-8,clone formation experiment and flow cytometry showed that knockdown of RIPK1 could decrease the cell survival rate,increase the apoptosis rate and decrease the colony formation rate compared with the control group.Conclusion Knockdown of RIPK1 promotes chemother-apy sensitivity of breast cancer cells.

Objective:To explore the clinical characteristics of poisoned patients with poisons purchase online.Methods:A retrospective case-control study was conducted on poisoned patients purchased poisons online from 1st January 2021 to 31th May 2022 in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University. The clinical data including sex, age, way of medical treatment, cause of poisoning, exposure routes, category of toxic drugs, gastric lavage, toxic detection and prognosis of patients were collected and compared with those patients obtained poisons at stores as the control group.Results:Totally 318 poisoned patients were included in this study, of which 44 (13.8%) were obtained poisons online. Compared with the patients obtained poisons at stores, the patients obtained poisons online were younger ( P<0.001), and had higher proportion of suicide intention ( P=0.006), more oral route exposure ( P=0.029), and more proportions of receiving gastric lavage before transfer to the hospital ( P=0.001). Pesticides and fertilizers with organic heterocycles were the main types of poisons in the online group, and there was no statistical difference in the distribution of poisons compared with the control group. Mixed drug poisoning was the leading cause in both online group (27.8%) and control group (38.8%) in drug overdose poisoned types, followed by dextromethorphan (16.7%) and estazolam (15.5%) in the online group. Conclusions:Young people are the main group getting poisons through the Internet. Health education should be strengthened for this group, and online shopping platforms should pay attention to the poisoning risk of potential overdose drugs or poisons transactions.

Objective:To evaluate the therapeutic effect of hemopurification on acute chlorfenapyr poisoning according to the blood concentration of chlorfenapyr and to provide experience for clinical treatment.Methods:Two patients who presented to our Emergency Department following an ingestion of chlorfenapyr and then were treated with hemopurification in 2022 were included. The concentrations of chlorfenapyr and its highly toxic metabolite tralopyril were dynamically monitored, and the clinical data of the patients were collected.Results:Case 1 was given hemoperfusion for the first time 13 hours after ingestion. During l hour hemoperfusion, the tralopyril decreased by 28.82%. The concentration increased and exceeded the pre-perfusion level after 2 hours of hemoperfusion. After three times of hemoperfusion, the concentrations of chlorfenapyr and tralopyril were still higher than those before the first time, reaching 248 ng/mL and 1 307 ng/mL respectively. The concentration of chlorfenapyr showed a downward trend after 130 h, and the tralopyril in blood reached the peak 3 164 ng/mL at 130 h and decreased to 2 707 ng/mL at 178 h. In case 2, the blood chlorfenapyr and tralopyril concentration was 392 ng/mL and 7 598 ng/mL respectively 150 hours after ingestion. The blood chlorfenapyr concentration decreased by 37.75% respectively after first hemoperfusion, and the tralopyril concentration decreased by 38.02% respectively. During 85 hours of continuous veno-venous hemodiafiltration (CVVHDF), the concentration of tralopyril was maintained at 4 234~6 410 ng/mL. Case 1 was followed up to 12 days and lost follow-up. Case 2 died and the survival time was 247 hours.Conclusions:Hemoperfusion can scavenge tralopyril, but CVVHDF has poor scavenging ability for tralopyril. And the apparent volume of distribution (Vd) of chlorfenapyr and tralopyril are large. After ingestion, chlorfenapyr spreads to various tissues quickly, and it is easy to accumulate in the adipose tissue. The chlorfenapyr in the tissue slowly is released back to the blood and stays in the blood for a long time. The peak concentration of chlorfenapyr appeared earlier than that of tralopyril. Clinicians should pay attention to the early removal of toxins from the digestive tract.

Objective To explore the role of magnetic resonance spectroscopy in evaluating the severity and prognosis of patients with brain stem injury. Methods A total of 45 patients with brain injury (the study group)and 10 healthy people(the control group)were retrospectively analyzed in Affiliated Anqing Hospital,Anhui Medical University during March 2015 to October 2016 using magnetic resonance spectroscopy.The NAA/Cr,NAA/Cho and Cho/Cr value in brain stem were analyzed. The clinical severity score (GCS) and Glasgow outcome scale (GOS)were also analyzed in our study. Results Compared with the normal group,patients in the study group had lower NAA level, NAA/Cho value but higher Cho/Cr value (P < 0.05). The severer the injury, the more obvious in NAA peak decrease. Cho peak increased and NAA/Cho ratio decreased. NAA/Cho, NAA/Cr and Cho/Cr values in the group with good prognosis were similar to those in the normal control group, but significantly different to the group with poor prognosis (P < 0.05). NAA/Cr, NAA/Cho and Cho/Cr values correlates with GOS in patients with brain stem injury. Conclusions Magnetic resonance spectroscopy can be used to measure the metabolic status of patients with brain stem injury,which is of great significance in the evaluation the severity of brain stem injury and prognosis.

Objective To observe the expression of aquaporin 4 (AQP-4) in contused brain tissue and its relationship with brain edema following brain trauma.Methods A retrospective case control analysis was made on 42 patients with severe brain trauma admitted from January 2015 to March 2016.There were 23 males and 19 females,aged from 23 to 62 years [(35.5 ± 5.6) years].Glasgow coma score (GCS) was 3-5 points in 7 patients,6-8 points in 23 and 9-10 points in 12.Brain tissue removed from the area 1 cm near the contusion during the cranial surgery were allocated to study group (n =42),while brain tissue removed far from the contusion after internal decompression were used as control (n =8).Ultrastructure of brain tissues was observed under electron microscope.Water content of brain tissue was measured by dry-wet weight method and expression of AQP-4 was measured by immunohistochemical method at postinjury hours ＜ 6,6-12,12-24,24-72,72-96 and ＞ 96.Results Morphology and structure of brain tissue in control group were normal.Whereas in study group,the intracellular and interstitial edema were obvious and morphological structure were damaged.Water content and AQP-4 expression in control group showed no obvious increase after operation(73.55 ±0.10,0.193 ±0.016).Water content in study group increased significantly compared to control group and reached the peak value (81.28 ± 0.56) at postinjury 24-72 hours (P ＜ 0.01).AQP-4 expression in study group increased at postinjury 6 hours (0.242 ±0.023) and reached a peak at postinjury 24-72 hours (0.338 ± 0.013),with significant difference compared to control group (P ＜ 0.05).Correlation analysis showed change of brain water content was positively correlated with expression level of AQP-4 (r =0.931,P ＜ 0.01).Conclusion Expression of AQP-4 in the injured area of brain trauma is significantly increased along with the increase of water content,suggests that the upregulation of AQP-4 plays an important role in traumatic brain edema.

Objective To investigate the surgical treatment of growth hormone (GH) pituitary tumors combined with cardiomyopathy patients and its clinical effect.Methods A total of 15 patients with GH pituitary tumors combined with cardiomyopathy were enrolled and underwent surgical treatment from February 2007 to May 2015 in our hospital.Pituitary endocrinology,brain magnetic resonance imaging,echocardiography diagram were inspected before and after surgery.Serum GH level,left ventricular diastolic diameter (LVIDd),thickness of the interventricular septum (IVST),left ventricular posterior wall thickness (LVPWT),left ventricular ejection fraction (EF),and mitral valve flow spectrum ratio (E/A) were detected by noninvasive methods and compared before and after treatment.Results Through the pituitary adenomas via nasal-sphenoid sinus surgery,total removal of the tumors were noted in 9 patients,subtotal resection in 4 patients,and partial resection in two patients.GH level,LVIDd,IVST,GH,LVPWT,E/A and EF after resection of pituitary tumor were significantly improved as compared with those before resection (P＜0.05).In the long-term follow-up,the cure rate was 35.68％,and the remission rate was 76.36％.Conclusion Surgical resection of pituitary tumor with good control of growth hormone levels can significantly improve the cardiac structure and function,thereby,GH pituitary tumor patients with cardiomyopathy can obtain satisfactory therapeutic effect.