Rapid determination of four herbicides in urine with ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry / 预防医学

Objective@#To establish a ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry method for rapid simultaneous determination of quinclorac, acetochlor, butachlor and metolachlor in urine.@*Methods@#Urine samples were diluted 10 times, prepared into the mixed standard solution, and subjected to gradient elution on the ACQUITY UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm) with 0.1% formic acid and acetonitrile as the mobile phase. The quinclorac, acetochlor, metolachlor and butachlor levels were determined using electrospray ionization-positive ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry with the multiple reaction monitoring mode.@*Results@#Four herbicides were effectively separated on the ACQUITY UPLC BEH C18 column (100 mm× 2.1 mm, 1.7 μm), and good linear relationships were observed for quinclorac, acetochlor and butachlor at 1 to 25 μg/L and for metolachlor at 0.2 to 25 μg/L, with all linear correlation coefficients of >0.999. The detection limts of quinclorac, acetochlor, butachlor and metolachlor were 0.10, 0.10, 0.20 and 0.01 μg/L, respectively. The recovery rates of quinclorac, acetochlor and butachlor were 107.42%, 93.94% and 90.27% from urine samples at a spiked level of 5 µg/L, with relative standard deviations of 4.82%, 3.84% and 6.76%, and the recovery rate of metolachlor was 89.51% at a spiked level of 0.5 µg/L, with a relative standard deviation of 8.98%.@*Conclusion@#The chromatography and mass spectrometry conditions are optimized in this ultra-high performance liquid chromatography-tandem mass spectrometry, which is effective for rapid simultaneous determination of quinclorac, acetochlor, metolachlor and butachlor in urine samples.

Four Cases of the Rare Skin Manifestation: Monoclonal-Proteinemia / 罕见病研究

The skin manifestations of monoclonal(M)-proteinemia are rare and present in patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering plasma cell myeloma (SMM) and multiple myeloma (MM). In this study, we reported 4 cases with M-proteinemia-related rare skin lesions, including pyoderma gangrenosum (PG), erythema elevatum diutinum (EED), cutis laxa (CL) and lichen myxedematosus(LM). These skin lesions are specific, where the potential mechanism was immune-mediated paraneoplastic syndrome rather than direct plasma cell infiltration. Anti-plasma cell treatment was effective in treating skin lesions. The clinical outcome of MM-related skin changes was correlated to tumor control, whereas the prognosis of MGUS or SMM related skin lesions was favorable. Skin involvement in M-proteinemia is extremely rare and less well-known, which greatly impairs quality of life. The diagnosis and treatment of these 4 cases support the need for futher study.

Investigation of Ascending Aortic Distensibility and Risk Factors in Pre-hypertension Patients / 中国循环杂志

Objective: To explore the features of ascending aortic distensibility (AAD) and risk factors in pre-hypertension (PHT) patients. Methods: A total of 206 participants who received retrospective ECG-triggered coronary CTA by physical check-up or by clinically suspected coronary artery disease (CTA) were enrolled. The participants were divided into 2 groups: Control group, the subjects with normal blood pressure,n=85 and Pre-hypertension group,n=121. A 128 slice dual-source CT scanner was used and the image was automatically reconstructed at every 5% absolute phases in entire R-R interval. The beginning of left coronary artery plane was deifned as the reference and 25 mm above the reference plane was deifned as interested region. ADD value was calculated. Results: Compared with Control group, Pre-hypertension group had decreased AAD,P0.05; ADD value was similar among different gender and blood lipid levels. Correlation analysis presented that AAD was negatively related to age (r=-0.69,P=0.001), systolic blood pressure (r=-0.37,P=0.001), pulse pressure(r=-0.43,P=0.001) and glycosylated hemoglobin (r=-0.43,P<0.05). Age and systolic blood pressure were the independent risk factors for AAD decline (standardized β=-0.66,P=0.001) and (standardized β=-0.44,P=0.001). Conclusion: Without additional contrast media consumption and radiation dosage, retrospective ECG-triggered coronary CTA may detect AAD changes with risk factors at the early stage in pre-hypertension patients which is helpful to distinguish the high risk individuals.

Tryptophan metabolism in patients with primary immune thrombocytopenia with high dose of dexamethasone / 中华血液学杂志

Objective@#To test whether the tryptophan metabolism was abnormal in newly diagnosed ITP patients as well as in these patients after treatment with dexamethasone.@*Methods@#Newly diagnosed patients with ITP between Jan 2014 and May 2015 were enrolled, including 14 females and 11 males, with a median age of 57 years and a median PLT count of 16 (0-32) ×109/L. All patients were treated with oral dexamethasone. The expression levels of IDO mRNA and TTS mRNA in peripheral blood mononuclear cells (PBMC) were analyzed by real-time quantitative polymerase chain reaction. ELISA was used to test the concentrations of IDO and TTS in serum. The concentrations of plasma kynurenine and tryptophan were detected by high-pressure liquid chromatography. Samples from healthy individuals were tested as controls.@*Results@#①After dexamethasone treatment, 17 patients resulted in persistent remission, 2 cases were ineffective, and relapse occurred in 6 cases at a median follow-up of 11 (6-18) months. ②Before and after dexamethasone treatment, the relative expression of indoleamine2,3-dioxygenase (IDO) mRNA and tryptophanyl t-RNA synthetase (TTS) mRNA showed that there were significant decline in persistent remission group (2.54±0.86 vs 19.85±5.36, t=3.188, P=0.003; 0.68±0.19 vs 45.39±15.83, t=2.842, P=0.008) , compared with the normal control group, the difference was not statistically significant (t=2.313, P=0.027; t=1.127, P=0.268) . After treatment, the IDO concentration decreased [ (19.34±0.42) U/ml] and the TTS concentration was markedly increased [ (13.37±0.54) μg/L] in sustained remission group compared with that before treatment [ (21.91±0.37) U/ml] as well as that in normal controls. In particularly, abnormal tryptophan catabolism could be recovered in these 17 patients with persistent remission [Try: (19.85±5.36) μmol/L vs (19.65±4.55) μmol/L, t=1.027, P=0.311; Kyn: (0.56±0.26) μmol/L vs (0.58±0.23) μmol/L, t=2.075, P=0.448]. ③There was no obviously difference in the relative expression of IDO mRNA and TTS mRNA, the concentration of IDO and TTS and the abnormal tryptophan catabolism between before and after treatment of dexamethasone in patients without response and relapsed patients (all P>0.01) .@*Conclusion@#The tryptophan catabolism was abnormal in ITP patients, and it could be recovered in patients with persistent remission.

The assessment of symptomatic burden among Ph/BCR- ABL negative myeloproliferative neoplasm patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the value of myeloproliferative neoplasms Symptom Assessment Form total symptom score (MPN-SAF-TSS)in assessing constitutional symptoms among Ph/BCR- ABL negative myeloproliferative neoplasm (MPN)patients.</p><p><b>METHODS</b>A cohort of 628 MPN patients were evaluated by MPN- SAF- TSS.</p><p><b>RESULTS</b>Fatigue was the most common symptom (76.0%, 76.2%vs 89.9%)and the highest average severity of all the symptoms (3.46±2.97, 3.47±2.99vs 4.74±3.04 scores)among polycythemia vera (PV), essential thrombocythemia (ET)and primary myelofibrosis (PMF)patients. Using the MPN- SAF- TSS analysis, PMF patients showed highest burden of symptoms (28.9 ± 19.1), followed by PV patients (19.2 ± 16.8), and finally ET patients (17.1 ± 15.3). Instinct differences were observed between PMF and PV patients (χ(2)=6.371,P=0.021), PMF and ET patients (χ(2)= 14.020,P<0.001). No significant difference was found between PV and ET patients (χ(2)=2.281,P=0.191).</p><p><b>CONCLUSION</b>MPN- SAF- TSS was effective in evaluating the symptomatic burden among Ph/BCRABL negative MPN patients and could be used for serial assessment in this clinical setting.</p>

Preliminary Study of Renal Perfusion Imaging by Computed Tomography in Patients of Essential Hypertension With Target Organ Damage / 中国循环杂志

Objective: To assess the renal cortical perfusion parameters by the imaging of computed tomography (CT) in patients of essential hypertension (EH) with target organ damage. Methods: A total of 90 subjects with the entire information including 59 EH patients were studied. The EH patients were divided into 2 groups: EH + target organ damage group,n=30 and EH without target organ damage group,n=29. In addition, there was a Control group,n=31 healthy volunteers. All subjects received 128-slice dual-source CT renal perfusion scanning, the quantitative perfusion of renal cortex blood lfow (BF), blood volume (BV), time to peak (TTP) and the mean transit time (MTT) were examined and compared among different groups. Results: There were 90/97 (92.8%) participants eligible for perfusion analysis. Compared to Control group, EH without target organ damage group had the similar parameters of BF, BV, MTT and TTP,P>0.05. While EH + target organ damage group had decreased BF (214.6 ± 36.1) ml/(min?100 ml ) than Control group (262.1 ± 26.6) ml/(min?100 ml ),P0.05. Compared to EH without target organ damage group, the EH + target organ damage group presented decreased BF (214.6 ±3 6.1) ml/(min?100 ml ) vs (268.9 ± 33.1) ml/(min?100 ml ), P Conclusion: CT imaging may evaluate the renal cortical perfusion changes, and especially BF which can relfect the renal perfusion more sensitively than other parameters in EH + target organ damage patients.

Prognostic significance of monosomal karyotype in acute myeloid leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the prognostic significance of monosomal karyotype (MK) in patients with acute myeloid leukemia (AML).</p><p><b>METHODS</b>The clinical data of 498 AML patients were analyzed retrospectively.</p><p><b>RESULTS</b>Of the 498 patients, 233 (46.8%) cases had an abnormal karyotype. 42 patients fulfilled the criteria for MK, which were 8.4% of all cases and 18.0% of patients with abnormal karyotype, respectively. The most frequent autosomal monosomies were -7 and -17. 70 patients had complex karyotype (CK), in all patients and patients with abnormal karyotype accounted for 14.1% and 30.0%, respectively. Patients with MK were associated with significantly older (median age 62.5 vs 52 years, P=0.003), and lower HGB concentrations (62.5 vs 77 g/L, P=0.009) and lower WBC counts (7.0×10⁹/L vs 11.7×10⁹/L, P=0.008). Among MK cases, the most frequent chromosome abnormalities were complex karyotype, -7, -5, 7q-, and 5q-. In univariate analysis, MK patients had worse survival than those without MK (7.3 months vs 26.3 months, P<0.001). CK patients also had poorer outcomes than patients without CK (14.8 months vs 26.3 months, P<0.001). In CK patients, survival was worse in MK patients than patients without MK (7.4 months vs 19.2 months, P=0.007). By COX analysis, MK was an independent prognostic factor, beyond NCCN criteria and CK [HR=2.610 (1.632-4.175), P<0.001].</p><p><b>CONCLUSION</b>MK was an independent adverse prognostic factor in AML patients.</p>

The early diagnosis value of MRI for detecting spinal inflammatory lesions in ankylosing spondylitis / 实用放射学杂志

Objective To investigate the early diagnosis value of MR by detecting spinal inflammatory lesions in ankylosing spon-dylitis (AS).Methods Forty patients were involved in this study,including 20 cases with short inflammatory back pain (IBP)histo-ry (duration ≤18 months)and 20 cases with long IBP history (duration ≥24 months).MR images were analyzed retrospectively. Results Patients with a short history of IBP had 7 lesions in vertebral bodies (anterior/posterior spondylitis and spondylodiscitis) and 33 lesions in posterior spinal structures (arthritis of costovertebral joints,costotransversal joints,zygapophyseal joints and en-thesitis of spinal ligaments).Patients with a long history of IBP had 27 lesions in vertebral bodies and 24 lesions in posterior spinal structures.Patients with a short history of IBP had significantly more lesions in posterior spinal structures than in vertebral bodies with 82.5% (33/40)vs 1 7.5% (7/40),respectively (P <0.01).In contrast,patients with a long history of IBP had significantly more inflammation in vertebral bodies with 79.4% (27/34)vs 20.6% (7/34),respectively (P <0.01).Conclusion Inflammatory spinal lesions in patients with a short history of IBP are seen more often in the posterior structures.Early detection of inflammatory spinal lesions by MRI is useful for early diagnosis of AS.

Analysis of Extra-cardiac Findings by Coronary Computed Tomography Angiography in Patients With Suspected Coronary Artery Disease / 中国循环杂志

Objective: To quantitatively study the incidental extra-cardiac ifndings (ECFs) by coronary computed tomography angiography (CCTA) in patients with suspected coronary artery disease (CAD) in order to better recognize those lesions in clinical practice. Methods: A total of 1169 suspected CAD patients received CCTA in our hospital from 2011-06 to 2013-03 and 1030 patients were enrolled in this study. There were 589 in-patients, 441 out-patients and 549 patients≥60 years of age,481 patients Results: There were 197/1030 (19.1%) patients having 224 ECFs and 27 (2.6%) patients having 2 ECFs; 90/1030 (8.7%) patients having 106 signiifcant lesions including 3 (0.3%) of lung cancer and 8 (0.8%) of pulmonary embolism; 107 patients with 118 lesions without signiifcance. ECFs were found in 114/589 (19.4%) in-patients and in 83/441 (18.8%) out-patients, P>0.05; 76/481 (15.8%) of patients Conclusion: Unexpected ECFs detection rate was 19.1% in patients undergoing CCTA without further radiation exposure by reconstruction with the full FOV setting, and 8.7% of ECFs had clinical signiifcance. Radiologists should routinely analyze the extra-cardiac organs in CCTA.

A study of prognostic value of cytogenetics in patients with primary myelofibrosis / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the prognostic value of cytogenetics in Chinese with primary myelofibrosis (PMF).</p><p><b>METHODS</b>Four hundred and thirty-nine Chinese patients with PMF were retrospectively analyzed. The Kaplan-Meier method, the Log-rank test, the likelihood ratio test and the COX proportional hazards regression model were used to evaluate the prognostic scoring systems.</p><p><b>RESULTS</b>Four hundred and thirty-nine Chinese patients with PMF were analyzed with a median age of 56 years (range: 8-83), including 298 males and 141 females. The DIPSS-plus system could effectively evaluate prognosis in Chinese patients with PMF. There was significantly higher predictive power for survival for the DIPSS-plus group compared with the DIPSS group (P=0.006, -2 log-likelihood ratios of 989.5 and 1001.9 for the DIPSS-plus and DIPSS systems, respectively). Univariate analysis indicated that the patients with a normal karyotype, a complex karyotype that was not a monosomal karyotype, +8 only or a balanced translocation only had better survival. Following two cytogenetic risk categories were constructed: favorable karyotype including subjects with a normal karyotype, a complex karyotype that was not a monosomal karyotype, +8 only or a balanced translocation only and unfavorable karyotype included all others. The modified DIPSS-Chinese prognostic model was proposed by adopting cytogenetic categories and DIPSS- Chinese risk group. The median survival of patients classified in low risk (163 subjects), intermediate-1 risk (187 subjects), intermediate-2 risk (82 subjects) and high risk (7 subjects) were not reached, 74 (95% CI 42-106), 39 (95% CI 26-52) and 12(95% CI 1-25)months, respectively, and there was a statistically significant difference in overall survival among the four risk groups (P<0.01).</p><p><b>CONCLUSION</b>The DIPSS-plus had significantly higher predictive power than the DIPSS group in Chinese patients with PMF and the modified DIPSS-Chinese system based on the cytogenetic features of Chinese patients was proposed and worked well for prognostic indication.</p>

Comparison of low-dose thalidomide and prednisone combined with or without danazol for the treatment of primary myelofibrosis-associated anemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To observe the clinical effects of low-dose thalidomide (THAL) and prednisone (PRED) with or without danazol (DANA) in patients with primary myelofibrosis (PMF) associated anemia.</p><p><b>METHODS</b>A cohort of 58 PMF patients with anemia (Hb<100 g/L) were retrospectively studied. Of them, 28 patients were treated with THAL and PRED (THAL-PRED group), and the rest with THAL, PRED and DANA (THAL-PRED-DANA group). The hematological response was assessed according to the modified criteria of the International Working Group in 2006, and the myelofibrosis degree was evaluated at 3 and 12 month after treatment.</p><p><b>RESULTS</b>The total response rate was 56.9%(33/58) including 1.7% (1/58) partial remission (PR) and 55.2% (32/58) clinical improvement (CI). There was no statistical difference in the response rate between THAL-PRED and THAL-PREDDANA groups (50.0% vs 63.3%, P=0.306). However, the median response duration of clinical improvement, erythroid response (CI-E) and total response prolonged in THAL-PRED-DANA than THALPRED group (61.5w vs 22w, P=0.015; 75w vs 30w, P=0.007, respectively). Myelofibrosis degree at 3 and 12 months after treatment decreased significantly than before treatment (P=0.000 and 0.005, respectively). Side-effects in both groups were only grade 1-2.</p><p><b>CONCLUSION</b>Low-dose THAL together with PRED appeared to be effective in the treatment of PMF-associated anemia, and the response duration would prolong significantly if combined with DANA.</p>

Effect of tephroseris kirilowii turez, houlub extract on U266 multiple myeloma cell line / 白血病·淋巴瘤

Objective To study cytotoxic and antineoplastic effect in vitro of tephroseris kirilowii turez, houlub extract on U266 multiple myeloma cell line. Methods U266 cells were cocultured with the tephroseris kirilowii turez, houlub extract. Cytotoxicity assay was used by CCK-8 detection kit. Cell cycle and apoptosis were determined using flow cytometry(FCM) analysis. Results Extract of tephroseris kirilowii turez, houlub showed strong cytotoxicity against U266 cells.The IC50 was about 3.2 mg/L. After exposure of U266 cells to the drug, the distribution of cell cycle was changed compared with that of the controls. When the durg concentration was 1.25, 2.5, 5 and 10 mg/L. respectively, the pencentages of cells in the G0/G1 phase were decreased with (34.12±0.49) %, (38.06 ± 0.63) % , (27.46±0.61) %, (15.91±0.32) %, respectively, while those in the S phase were increased with (4.98± 0.50) %, (4.01±0.22) %, (4.16±0.15) % and (5.04±0.12) % in G2/ M phase were increased with (50.05 ±1.12) %, (51.27±0.71) %, (51.84±0.73) % and (55.11±0.25) %, respectively, and apoptosis cells were increased. Apoptosis of U266 cells inadose-depadeut manner could be deteted with staining of Annexix V FITC/PI testing through FCM. Conclusion Tephroseris kirilowii turez extract showed strong cytotoxic effect on U266 cells. The antineoplsastic mechanism of the drug can be partly due to its induced apoptotic effect.

An study of Tephroseris Kirilowii Turez.Houlub extract on cell cycle and apoptosis marker AnnexinV/PI of U266 / 国际中医中药杂志

Objective To study Tephroseris Kirilowii Turez.Houlub extract on cell cycle and apoptosis marker AnnexinV/PI of U266 in vitro..Methods U266 cells were cultured together with Tephroseris Kirilowii Turez.Houlub extract.Cell cycle and apoptosis marker AnnexinV/PI were detected by flow cytometry(FCM).Results After exposure of U266 cells to Tephroseris Kirilowii Turez.Houlub extract.the cell cycle distribution was changed.There Was a decrease of cells in the G0/G1 phase with an increase of cells in the S phase and G2/M phase and apoptosis.FCM with staining of Annexix V FITC/PI showed a dependence of apoptotic cells with the dosage of Tephroseris Kirilowii Turez.Houlub extract.Conclusion Tephroseris Kirilowii Turez extract has strong cell apoptosis effect on U266 cells.

Course of Infection Control in College Education:Necessities for Its Setting-up / 中华医院感染学杂志

OBJECTIVE Infection control(IC) is one of the most important issues involved in the administration of modern hospitals in the world.The aim of this survey is to analyze the necessities to set up some courses on IC for undergraduates during their 5-year studying.METHODS In this study,71 academic staffs in Guanghua School of Stomatology and 74 fourth and fifth year undergraduates were surveyed by questionnaires about the necessities and knowledge of IC.RESULTS The finding showed that both academic staffs and students did not have well-educated knowledge of infection control,and they all agreed with an importance of IC course in college education system.CONCLUSIONS Setting-up an infection control course may be essential as an elemental education course in college.

Comparison of medical humanistic education between the mainland,Hong Kong and Taiwan / 中华医学教育探索杂志

Based on the comparison of medical humanistic education among The Mainland,Hong Kong and Taiwan,this article arrives at the conclusion that the gap in the field of humanity education in the Mainland is one of the important reasons that cause the ever-tenser physician-patient relationship in nowadays.So we propose the countermeasures actively.By increasing the humanity courses,changing the teaching method,reinforcing the construction of talented staff in humanity,creating the environment for the humanity education and so on,we reinforce humanity quality of medical students in order to improve our medical education.

Reflections on Teaching of Medical Imaging Equipment Science / 医疗卫生装备

The medical imaging equipment science is one of the rapidly development science in the medical domain. Based on the characteristics of Medical Imaging Equipment Science, this paper discusses the reflections from the aspects of teachers, teaching contents, teaching schemes and practice teaching.

Application of BLADE technique in MR abdomen scanning / 医疗卫生装备

Objective To investigate the advantages of BLADE technique in MR T2WI/TSE abdomen scanning. Methods 36 cases, which had obvious motion defects with conventional T2WI/TSE axial abdomen scanning because of psychology or disease, performed T2WI/BLADE/TSE scan with the same regions. Then the image quality was compared, and amendment of motion defects was reviewed. The equipment was SIEMENCE 3.0T scanner and phased-array coil. Results Motion defects of all images with T2WI/BLADE/TSE were attenuated with different degree compared with T2WI/TSE. All images with T2WI/BLADE/TSE satisfied the diagnostic demand. Conclusion The BLADE technique in abdomen scanning solves the difficult problem of impossible MR scan with uneven breath and trembling patients because of psychology or disease, and obtains good diagnostic imaging.

Ethical Reflection on Imaging Trials in Clinical Practice / 中国医学伦理学

This article introduces ethical problems emerging in the imaging trials in clinical practice,and stresses the importance of protecting the privacy of volunteers and patients,and their legal rights of informed consent.This article also stresses the importance of the respect for the basic human right of volunteers and patients,and puts forward some countermeasures to promote the efficiency and reasonable supervision system in the clinical trials.Last but not least,it also emphasizes the significance of a personalized-style of care for volunteers and patients.

Comparison of Medical Humanistic Education between China and Britain / 中国医学伦理学

Nowadays,with the ever-tenser physician-patient relationship,construction of medical professionalism has turned out to be a heated topic.This essay tries to explore the construction of medical professionalism from the perspective of cultivating a humanistic culture among medical students.Based on the comparison of medical humanistic education between China and Britain,this article arrives at the conclusion that defective humanistic education is one of important reasons that cause the inadequacy of medical professionalism among Chinese physicians,and points out some effectual measures to improve the medical professionalism in our country by the inspiration from our British counterparts.