Objective:To develop and validate gas chromatographic methods for the determination of residual benzene in carbomer copolymer,carbomer homopolymer and carbomer interpolymer,to address the issues of the current method in the Chinese Pharmacopoeia in the actual detection process,such as low sensitivity and poor repeatability of benzene detection in the mixed reference solution,and to optimize and improve the current stand-ards for series of carbomer pharmaceutical excipients.Methods:Samples were separated on a column DB-624(30 m ×0.530 mm,3.00 μm)with temperature programming,the inlet temperature of 140 ℃,the detector tem-perature of 250 ℃,and the split ratio of 5∶1.The external standard method was adopted for the quantitative deter-mination of residual benzene.Results:The linearity was great across the range of 0.04-1.00 μg·mL-1(r=0.996 8),the injection precision of benzene was 6.8％(n=6),and the average recovery rate was 96.89％(RSD=8.1％,n=9).Conclusion:The gas chromatographic method established in this research is more specif-ic,with higher accuracy and precision compared to the current method in the Chinese Pharmacopoeia.This optimized method is more suitable for the determination of residual benzene content in carbomer copolymer,car-bomer homopolymer and carbomer interpolymer,providing reference and guidance for the quality management and the control of carbomer.

Objective:To explore the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on brain functional remodeling and function of core muscle group in patients with stroke.Methods:A total of 104 patients with stroke who admitted to Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2022 to June 2023 were prospectively selected,and they were randomly divided into a control group(52 cases,received conventional rehabilitation treatment)and a study group(52 cases,received conventional rehabilitation+high-frequency rTMS treatment).The differences in clinical efficacy,brain functional remodeling(LI value),and postural assessment scale for stroke(PASS)of the function of core muscle group and manual muscle test(MMT)scores of core muscle group between two groups were analyzed.Results:The total effective rate of clinical treatment in study group was 92.31％,which was significantly higher than that in the control group(73.08％),and the difference was significant(x2=6.718,P＜0.05).There were no significant difference in the scores of PASS and MMT between the two groups before treatment(P＞0.05).The scores of PASS and MMT of two groups after treatment were significantly higher than those before treatment(t=21.017,13.359,P＜0.05),respectively.After treatment,the PASS and MMT scores of study group were respectively(31.15±1.78)points and(11.88±2.03)points,which were significantly higher than those[(28.33±1.82)points and(9.41±2.27)points]of control group(t=7.988,5.849,P＜0.05),respectively.After treatment,the brain activation areas of study group mainly distributed in the precentral gyrus,precuneus,somatosensory area,cerebellum and ipsilateral supplementary motor area,which appeared a trend of centralization.The distribution of brain activation areas of control group after treatment still showed the characteristics of bilateral extensive activation,which did not appear significant changes than those before treatment.There was no significant difference in LI value between the two groups before treatment(P＞0.05).After treatment,the LI values of two groups were significantly improved,and the LI value of study group was significantly higher than that of control group(t=17.199,P＜0.05).Pearson correlation analysis was performed on the LI values and the scores of PASS and MMT when the hemiplegic side of the patients of two groups conducted chunking motion.The results showed that the LI values appeared significantly positive correlation with PASS score and MMT score(r=0.863,0.847,P＜0.05),respectively.Both two groups did not occur serious abnormal reactions during the treatment.Two patients of study group reported they occurred mild dizziness and headache,which were relieved by themselves after rest.Conclusion:High-frequency rTMS can effectively improve the treatment effect for patients with stroke,and promote the recovery of the motor function area of brain and the function of core muscle group of patients.

Objective: To examine the correlation between frailty and lifestyle factors among middle-aged and elderly populations, so as to provide insights into the management of frailty among middle-aged and elderly populations. Methods : Middle-aged and elderly residents at ages of 45 ot 69 years were recruited using the convenient sampling method from seven townships in Changxing County of Zhejiang Province from 2019 to 2020. The demographic characteristics and lifestyle factors were collected using questionnaires, and the frailty was measured using the Chinese version of Tilburg Frailty Indicator ( TFI ). Factors affecting frailty were identified among middle-aged and elderly populations using the multivariable logistic regression model. Results: A total of 7 170 residents were surveyed, including 2 780 males ( 38.77% ) and 4 390 females ( 61.23% ), which had a median age of 56 (interquartile range, 10) years. The median frailty score was 2 (interquartile range, 3 ) among the study subjects, and the median frailty score was 2 ( interquartile range, 2 ) among residents at ages of 45 to 59 years, and 2 (interquartile range, 3) among residents at ages of 60 to 69 years. The overall detection of frailty was 16.07%, and the detection of frailty was 13.52% among subjects at ages of 45 to 59 years and 21.01% among subjects at ages of 60 to 69 years. Multivariable logistic regression analysis identified physical activity ( OR=0.826, 95%CI: 0.719-0.949 ) and sleep quality ( OR: 3.376-11.493, 95%CI: 2.907-15.808 ) as factors affecting frailty among middle-aged and elderly residents. Following age stratification, physical activity ( OR=0.817, 95%CI: 0.681-0.981 ) and sleep quality ( OR: 3.076-11.566, 95%CI: 2.518-18.216 ) as factors affecting frailty among subjects at ages of 45 to 59 years, while sleep quality ( OR: 3.777-11.827, 95%CI: 3.002-18.547 ) significantly correlated with frailty among residents at ages of 60 to 69 years. Conclusion Physical activity and sleep quality are associated with the risk of frailty among middle-aged and elderly populations.

For the quality control of cetomacrogol 1000, a gas chromatographic method for the determination of residual impurities in cetomacrogol 1000, such as ethylene oxide, 1, 4-dioxane, ethylene glycol, diethylene glycol and triethylene glycol, was established and validated.The DB-1 column with headspace injection was used to detect ethylene oxide and 1, 4-dioxane with the inlet temperature of 150 °C, the FID temperature of 250 °C, the headspace equilibration temperature of 70 °C and the equilibration time of 45 min.The VF-17MS column with liquid injection was used to detect ethylene glycol, diethylene glycol and triethylene glycol with the inlet temperature of 270 °C, and the FID temperature of 290 °C.The results showed that ethylene oxide and 1,4-dioxane have a good linearity within their specified addition amount ranges (r > 0.999), with the RSD of precision of below 8.0% and the average recovery rates of 90.6% and 101.2%; and that ethylene glycol, diethylene glycol and triethylene glycol also have a good linearity between 3 ? 60 μg/mL (r > 0.999), with the RSD of precision of below 3.0%, and the recovery rates of 96% ~ 103%.The method established in this study has good specificity, linearity, precision and recovery rate, which can effectively detect the multi-component and trace impurities.

Atherosclerotic plaque rupture is the main cause of many cardiovascular diseases, and biomechanical factors play an important role in the process of plaque rupture. In the study of plaque biomechanics, there are relatively few studies based on fatigue fracture failure theory, and most of them mainly focus on the whole fatigue propagation process from crack initiation to plaque rupture, while there are few studies on the influence of crack on plaque rupture at a certain time in the process of fatigue propagation. In this paper, a two-dimensional plaque model with crack was established. Based on the theory of fracture mechanics and combined with the finite element numerical simulation method, the stress intensity factor (SIF) and related influencing factors at the crack tip in the plaque were studied. The SIF was used to measure the influence of crack on plaque rupture. The results show that the existence of crack can lead to local stress concentration, which increases the risk of plaque rupture. The SIF at the crack tip in the plaque was positively correlated with blood pressure, but negatively correlated with fibrous cap thickness and lipid pool stiffness. The effect of the thickness and angle of lipid pool on the SIF at the crack tip in the plaque was less than 4%, which could be ignored. This study provides a theoretical basis for the risk assessment of plaque rupture with cracks.
Biomechanical Phenomena ; Computer Simulation ; Humans ; Plaque, Atherosclerotic ; Stress, Mechanical

The gas chromatography method was developed for the determination of ethylene glycol, diethylene glycol and triethylene glycol in poloxamer 188 to provide scientific basis for the quality control. The samples was separated on column VF-17ms(30 m×0. 53 mm, 1. 0 μm)with temperature programming, inlet temperature was 270 °C, detector temperature was 290 °C and the split ratio was 10 ∶1. The method showed great linearity over the range of 6-15 μg/mL(r≥0. 999). The injection precision(n=8)of the three residual impurities were 3. 3%, 3. 0%, 2. 3% and the average recoveries were 99. 05%(RSD=2. 9%, n=9), 102. 20%(RSD=4. 0%, n=9), 101. 91%(RSD=3. 1%, n=9), respectively. The analytical method is specific, accurate and sensitive, which is suitable for the determination of ethylene glycol, diethylene glycol and triethylene glycol in poloxamer 188, providing reference and guidance for the production and quality control of poloxamer 188.

Objective: To investigate the clinical effects of immediate nipple reconstruction with a local mastectomy flap in secondary breast reconstruction by deep inferior epigastric artery perforator (DIEP) flap. Methods: A free bipedicle DIEP flap was raised and folded upward to form the breast. Meanwhile, a deepithelialized lower mastectomy flap with a distant skin paddle was elevated and pulled throughout the reconstructed breast. The skin paddle was carefully sutured to the position of future nipple. Three weeks later, the pedicle of mastectomy flap was divided, and the paddle was modeled to form the new nipple. Results: From February 2011 to June 2016, 42 patients who had previously undergone unilateral modified mastectomies underwent the breast reconstructions and immediate nipple reconstructions. All flaps survived postoperatively. The average projection of the reconstructed nipple was measured as (16.3±2.4) mm immediately after the operation and gradually decreased to (8.4±1.3) mm by one year follow up. 35 patients ranked the aesthetic appearance of the reconstructed nipple and breast very good or good. Conclusions The immediate nipple reconstruction with a local mastectomy flap and breast reconstruction by DIEP flap could achieve a good breast shape and maintain a long term residual nipple projection, which results in considerable patient satisfaction.

Chimeric antigen receptor T-cell strategy targeting CD19 (CART19) has prominent anti-tumor effect for relapsed/refractory B-cell lymphomas. CART19-associated complications have been gradually recognized, however, late-onset complications have not been extensively studied. Herein, for the first time we report a diffuse large B-cell lymphoma patient with terminal ileum involvement obtained rapid remission and developed spontaneous terminal ileal perforation 38 days following CART19 infusion. The late-onset perforation reminds us that, for the safety of CART treatment, more cautions are warranted for the management of delayed GI complications.
B-Lymphocytes* ; Humans ; Ileum ; Lymphoma, B-Cell* ; Receptors, Antigen* ; T-Lymphocytes*

Objective To study the effects of modified ligation of intersphincteric fistula tract (LITF)for low anal fistula.Methods A total of 40 consecutives were divided randomly into experiment and control groups(each 20 cases).The patients in experiment group received modified LITF and patients in control group adopted traditional anal fistula resection,then to compare the effects.Results The wound healing time in experiment group[(17.8 ± 4.5)d]was shorter than that in control group[(24.7 ± 5.8) d](P<0.05);the duration of pain in experiment group[(6.9 ± 1.5)d]was longer than that in control group[(4.0 ± 1.3)d](P<0.05);the postoperative anal function score in experiment group(3.7 ± 2.5)was better than that in control group(3.7 ± 2.5)(P<0.05).There were no significant differences in cure rate,pain at first day after operation and recurrence rate between two groups(P>0.05).Conclu-sion It is more effective,less injury,less pain,shorter course,less recurrence and better anal function of modified LITF.

Objective To assess the efficacy and safety of modified ligation of the intersphincteric fistula tract (LIFT) for low anal fistula.Methods We follow-up visited 20 patients with low anal fistula underwent modified LIFT procedures (Since the outer edge shape of anal fistula incision fistula and the branch into the intersphincteric groove,proximal lateral internal sphincterotomy ligation.The wound was closed to the whole layer of closed suture after removal of the pipe wall).Median follow-up duration was 10(range 3-15) months.To compile statistics on the wound healing time,the clinical healing rate,the recurrence rate and the fecal incontinence score (Wexner score) of those patients.Results The wound healing time was (15.3 ± 4.8) d.The prime success rate of fistula healing was 75 ％ (15/20) after the modified LIFT procedure.2 cases of low complex anal fistula presented with wound infection,and 3 cases (including 1 cases of simple low anal fistula,2 cases of low complex anal fistula)had fistula with infection.They were cured after appropriate treatment.During follow-up of 3 to 15 (median 10)months,1 cases of simple low anal fistula recurred in third months after surgery.To the end of the follow-up,the total clinical healing rate was 95％ (19/20),of which 12 cases of low complex anal fistula total cure rate was 100％ (12/12).Preoperative fecal incontinence scores (Wexner score)were all 0 points.At the final follow-up,18 (90％)cases of fecal incontinence score were 0 points,1 (5 ％) cases were 2 points and 1 (5 ％) cases were 1 points.Conclusion Modified LIFT is better balance the relationship between cure rate and anal function.The sphincter preservation is complete.The fistula is thoroughly cleared.The cure rate is high.The recurrence rate is low.Does not cause anal defects and deformities.It has little influence on the function of anal control,the operation is simple,and it is suitable to be popularized.