Objective: To establish a bacterial endotoxin detection method for vidarabine monophosphate for injection and conduct methodological validation for harmanizing the quality control standard of this product.
Methods: According to the Chinese Pharmacopoeia 2020 volume Ⅳ general chapter 1143“Bacterial endotoxin test”, the limit of bacterial endotoxin was determined,interference test and endotoxin testing were performed.
Results: The bacterial endotoxin test were performed on 25 batches of test samples provided by 15 manufacturers according to the experienced experimented limitation which is the amount of endotoxin in 1 mg of adenosine monophosphate should be less than 0.06 EU. All results were found to be in compliance with the specified standards.
Conclusion: The established bacterial endotoxin method can be used for quality control of vidarabine monophosphate for injection.

Background and aim:Few studies have reported hepatitis B surface antigen(HBsAg)kinetics after nucleos(t)ide analog(NA)discontinuation in patients with noncirrhotic chronic hepatitis B(CHB).The study specifically investigated long-term HBsAg kinetics after NA discontinuation. Methods:Between January 2014 to January 2024,this study prospectively enrolled 106 outpatients with noncirrhotic CHB who met the discontinuation criteria after NA consolidation treatment.Demographic,clinical,and laboratory data were collected and analyzed after NA discontinuation. Results:Ninety-six patients who finished 5 years of follow-up were included.HBsAg remained unde-tectable in 29 patients with end of treatment(EOT)HBsAg negativity.Among 67 patients with EOT HBsAg positivity,HBsAg seroclearance occurred in 12(17.9％)patients with an estimated annual inci-dence of HBsAg seroclearance of 3.6％.Patients with EOT HBsAg levels of ≤1000 IU/mL had a higher HBsAg seroclearance rate than those with EOT HBsAg levels of＞1000 IU/mL(33.3％vs.5.4％).The pro-portion of patients with HBsAg ≤1000 IU/mL increased during follow-up.Logistic regression analysis indicated that the EOT HBsAg level was an independent factor for HBsAg seroclearance and an HBsAg level decline exceeding 1 log10 IU/mL.The optimal EOT HBsAg cutoff for both HBsAg seroclearance and an HBsAg level decline exceeding 1 log10 IU/mL was 359 IU/mL. Conclusions:Patients with EOT HBsAg negativity experienced no relapse and maintained HBsAg sero-clearance during 5 years of follow-up after NA discontinuation.A higher HBsAg seroclearance rate can be obtained in patients with EOT HBsAg levels of ≤1000 IU/mL during 5 years of follow-up after NA discontinuation.Close monitoring and proper NA retreatment are recommended to guarantee the safety of NA discontinuation.

Objective:To explore benefit finding in patients receiving combined heart-lung transplantation (CHLT) , and provide a reference for improving clinical nursing work.Methods:From September to October 2019, totally 6 patients who survived after CHLT in the Department of Cardiac Surgery at the First Affiliated Hospital of Guangzhou Medical University were selected by purposive sampling for semi-structured interviews in terms of their benefit finding using phenomenological methods. Colaizzi's seven-step analysis was used to organize and analyze the interview results.Results:The patients undergoing CHLT showed a sense of benefit finding, which could be summarized into four themes, namely, changes in mental quality (learning to be grateful and contented, understanding the meaning of life, learning to be open-minded and optimistic) , improved learning initiative (actively learning drug-related knowledge, the knowledge of rehabilitation and exercise, the knowledge of diet and nutrition, and the knowledge of prevention of complications) , perceiving social support (family members changed life habits, family members actively learned disease knowledge, improved communication between patients and family members and friends) , and actively planning future life.Conclusions:The patients receiving CHLT can experience a sense of benefit finding in the rehabilitation after organ transplantation. Medical staff should understand the sense of benefit finding in patients receiving CHLT, promote the early generation of benefiting finding, and provide targeted guidance to patients.

Objective To improve the clinical prognosis of patients by reviewing ten years epidemiology data of acute poisoning inpatients.Methods The epidemiology data of the acute poisoning inpatients from 2006-2015 were retrospectively analyzed.The indexes including age,gender,nationality,geographical distribution,substance of poison,seasons,diagnosis and fee-for-service were collected.Results There were 1 083 patients with acute poisoning in total,624 cases (57.6％) for gas poisoning,213 cases (19.7％) for pesticide poisoning,136 cases (12.6％) for drug poisoning,74 cases (6.8％) for food poisoning and 36 cases for others.The ration of male to female was 0.94:1.The age of 31 to 45 range accounted for the highest proportion.The incidence of poisoning in 2011-2015 was significantly higher than that in 2006-2010 (P ＜0.05).The geographical distribution was also significantly different (P ＜0.05),most of the cases were in Shihezi city,then were Manasi and Sawan counties.Among the 1 083 patients,59％ cases were cured,33.6％ cases were improved after treatment,and the mortality rate was 2.6％.Feefor-service was also significantly increased in the older patients or males,and substance of poisoning dependent.The highest treatment cost was carbon monoxide poisoning,then were pesticide,drugs and food.Conclusions The common causes of poisoning in Shihezi city were carbon monoxide,organophosphorus pesticide,botulism and drugs,more emergency medical service should prevent poisoning and treat these patients.

Objective To study the Effect of Liuwei anxiao capsules combined with omeprazole for the gastric electrical parameters and gastrointestinal motility related indexes of patients with functional dyspepsia. Methods 86 patients with functional dyspepsia in our hospital from December 2014 to July 2016 were selected,and all the patients were randomly divided into control group and observation group,43 cases in each group,the control group were treated with omeprazole,the observation group were treated with Liuwei anxiao capsules on the basis of the control group,then the total effective rates of different symptoms,signs,gastric electrical parameters and gastrointestinal motility related indexes before and after the treatment of two groups were compared. Results The total effective rates of observation group with abdominal pain,abdominal distension,early satiety and belching were all higher than those of control group (P<0.05).3,7 and 14 days after treatment,compared with the pre-treatment, the difference of gastric electrical parameters between the two groups was statistically significant (P<0.05),the ratio of normal slow rhythm rhythm, main electrogastric power and electrogastric frequency in observation group were higher than those in control group (P<0.05),the percentage of bradycardia was lower than that in control group (P<0.05);there were significant differences in the indexes of gastrointestinal motility between the two groups before treatment (P<0.05),the level of MTL before and after meals was higher in the observation group than that in the control group (P<0.05), and the levels of SS before and after meals were lower than those in the control group (P<0.05). Conclusion Liuwei anxiao capsules combined with omeprazole in the treatment of functional dyspepsia in patients with significant effect,can significantly improve the patient's gastric electrical parameters and gastrointestinal motility related indicators,and improve the clinical symptoms.

Objective To observe the positional relationship of lumbar nerve roots and its main adjacent structures with CT data, and to conduct 3D construction and measurement,so as to provide anatomical basis for percutaneous lumbar diskectomy(PLD).Methods CT serial tomography dataset of 30 healthy adults' lumbosacral portions were imported into Mimics 17.0 software to segment related structures and obtain the layers of different structures.The structures were 3D reconstructed and virtually demonstrated.The lumbar nerve roots and their main surrounding structures were observed and measured.Results The minimum distances between the lumbar nerve roots and the superior articular processes increased gradually from L3 to L4 intervertebral disc layer to L5 to S1 intervertebral disc layer.The 3D model clearly displayed the morphology and spatial relationship of the lumbar nerve roots and their adjacent structures in lumbosacral portion.The lower the lumbar intervertebral discs were,the thicker they were.The distances from the middle point of the back of lumbar intervertebral disc to the end of the superior spinous process of lumbar vertebra increased at first and decreased then,and the distance in L3 to L4 intervertebral disc layer was the farthest.Conclusion The relationship between lumbar nerve roots and superior articular processes,the intervertebral disc thickness variance and the change of the distances from lumbar intervertebral disc to the end of the superior spinous process have been analyzed in this study,and the clinic basis has been laid for percutaneous lumbar diskectomy.

Objective To analyze the biological activity of bioactive peptides in human breast milk and to find the polypeptides so as to investigate the preventive and therapeutic effects of breast milk-derived bioactive peptides on neonatal necrotizing enterocolitis(NEC).Methods Six mothers who gave birth to preterm neonates were enrolled in this study and 5 mL of their breast milk secreted within 2-5 postnatal days were collected for 6 times and blended subsequently.Bioactive peptides from maternal milk of the preterm infants were separated by ultrafiltration and analyzed by using tandem mass spectrometry.Polypeptides possibly with biological function were screened out by using bioinformatics software and the protein function cluster online analysis software was used to predict the polypeptides associated with infection according to the biological function of their precursor proteins.The ATCC25922,an Escherichia coli strain commonly associated with infection in NEC and drug solution (sulbactarr/cefoperazone) were used to conduct the drug susceptibility testing and bactericidal kinetics testing,so as to verify the antibacterial effects of bioactive peptides in the breast milk.Results Four thousand three hundred and eleven peptides contained in breast milk were identified successfully,of which 1 370 were non-differential peptides,and 188 peptides possibly with biological activity and 11 peptides were associated with infection.The peptide compound in the breast milk had antimicrobial activity and bactericidal power against Escherichia coli.Conclusions The active peptide compounds in the breast milk have antimicrobial activity,which play an important role in the prevention of NEC.Finding the true antimicrobial peptides with in vivo and in vitro biological activity by using antimicrobial spectrum test is expected.

Objective To investigate the significance of detection of Serum anti‐Helicobacter pylori(HP)and pepsinogen(PG) in patients with reflux esophagitis(RE) .Methods 118 RE patients (RE group) ,60 patients with other other gastropathy (other gas‐tropathy group) and 60 healthy subjects (healthy group) were detected serum HP antibodies ,PG levels ,compared serum PGⅠ ,PGⅡ level ,PGR and HP antibody positive rate between the RE group ,the other gastropathy group and the healthy group ,between the patients at different pathological degrees of the RE group .Results The levels of PG Ⅰ ,PGR and HP antibody positive rate of the RE group were lower than those of the other gastropathy group and the healthy group ,the healthy group was lower than the other gastropathy group ,the difference was statistically significant (P<0 .05) ,and compared with the control group ,there was no signifi‐cant difference in serum PG Ⅱ levels (P>0 .05);The serum PGⅠ level ,PGR and HP antibody positive rate of patients in grade A , B of the RE group were lower than those of the patients in grade C ,D (P<0 .05) ,the difference was statistically significant ,and there was no statistical significance in serum PG Ⅱ levels of the patients in grade C ,D (P>0 .05) .Conclusion The serum PGⅠlevel ,PGR and HP antibody positive rate of the patients with RE decrease ,HP infection is a protective mechanism of RE ,the dis‐ease exacerbates with the infection decreases ,detection of serum HP antibody and the level of PG has important clinical value in the diagnosis and prognosis of RE .

Objective To study the early diagnostic value of olfactory function measurement to Alzheimer disease (AD). Method Detected the thresholds of detectability, identification threshold with pictu.re-based odor identification test in 21 AD patients (AD group) and 21 healthy elderly people (control group), and evaluated the relationship with mini-mental state examination (MMSE). Results AD group was impaired on threshglds of detectability [(1.81±0.75) scores], identification threshold [(2.48±0.68) scores]compared with control group [(1.24±0.89) scores and (2.00±0.71) scores, P< 0.05]. The thres holds of detectability and identification threshold were related to MMSE in AD group (r =-0.50,-0.54, P< 0.01). Conclusion The early diagnostic value of olfactory function measurement to AD is very great.

BACKGROUND: Oxfordshire Community Stroke Project(OCSP) is a new type of clinical classification for subdividing cerebral infarction(CI) conducted on the basis of a large-scale of investigation of stroke in the population of Oxfordshire Community, England in 1991. This kind of classification completely bases on the clinical manifestations without the help of diagnostic instruments, which can predict site and size of the lesion and the involved vessels.OBJECTIVE: To acknowledge the clinical classification of CI patients with Bamford's OCSP and its significance in predicting their long-term functional prognosis.DESIGN: Clinical observation, comparison and verified study based on patients.SETTING: Neurological department in a university hospital.PARTICIPANTS: Between January 1st and December 31st 2001, totally 126 patients with cerebrovascular disease were hospitalized in the Neurological Department of First Affiliated Hospital of Xi' an Jiaotong University,including 82 males and 44 females.METHODS: Totally 126 in-patients with CI were subdivided with Bamford's OCSP classification, and their disablity was assessed with Barthel index (BI)and modified Rankin Scale(mRS) when they were discharged and 3 months and 6 months later.MAIN OUTCOME MEASURES: Classification of patients with CI and their scores of BI and mRS when they were discharged and 3 months and 6months later.RESULTS: Of the 126 patients, 8(6. 3% ) patients were confirmed of total anterior circulation infarction (TACI), 29 (23. 0% ) of part anterior circulation infarction(PACI), 78(61.9% ) of lacunar infarction(LACI), 11(8.7%) of posterior circulation infarction(POCI) . They were followed-up for 6 months, and meanwhile 12 patients died. Of the other 114 cases the prognosis of TACI was the worst, while the prognosis of POCI and LACI was relatively better than that of PACI.CONCLUSION: CI is predominated by LACI. OCSP is effective for predicting long-term functional prognosis of patients with CI. But it is necessary to make multi-center prospective study on a much larger scale of samples of disease.