Determination of tromethamine residues in human coagulation factor Ⅷ by high performance liquid chromatography method / 中国输血杂志

【Objective】 To develop and verify high performance liquid chromatography (HPLC) detection for tromethamine (Tris) residues in human coagulation factor Ⅷ. 【Methods】 Alanine was used as internal standard, and AQC for pre-column derivation. Inertsil® ODS-SP was adopted, and acetic acid-sodium acetate buffer and acetonitrile were used for gradient elution at the flow rate of 1 mL/min and column temperature of 37℃. The 25 μL sample was loaded and determined by UV-detector with detection wavelength at 248 nm. This method was then verified. 【Results】 Glycine, sodium citrate and calcium chloride showed no interference with the detection of tromethamine (Tris) residues. The recovery rate of spike samples was within 90.0%~100.8%. The RSD in repeatability test were 2.5%, 0.7% and 1.2%, respectively, and in intermediate precision test 0.8%. The tromethamine (Tris) at concentrates of (0.5~4.0)μg/mL showed good linear relationship to the peak area to internal standard, of which the regression equation was Y=0.012 9X-0.000 782, R=0.999 97.The quantitative detection limit was 0.04μg/mL. 【Conclusion】 The HPLC for determination of tromethamine (Tris) residues in human coagulation factor Ⅷ was successfully developed, which showed good linearity as well as high specificity, precision and accuracy.

Establishment of kinetic detection method for PKA content / 中国输血杂志

【Objective】 To develop and verify a kinetic method for the determination of prekallikrein activator (PKA) content. 【Methods】 The optimal reaction conditions were determined by comparing the factors of pH and ionic strength of different sample dilution buffers, incubation time of each procedure, and incubation temperature. The accuracy, specificity, precision, linearity, stability and durability of the method were validated. 【Results】 The sample was diluted with 0.05 mol/L Tris-HCl buffer (pH8.5, containing 0.15 mol/L NaCl) and incubated by prekallikrein (PK) at 37℃ for 20 min. After that, the substrate S-2302 was added. Within 10 min before the measurement, the absorbance change rate reached △A405/min. The validation results indicated that the linear range of the method was (0.5~4.0)IU/mL, while the recovery of calibration standard was 96.9%~103.7% with the R2 value more than 0.99. The specificity test showed that human serum albumin, excipients of intravenous human immunoglobulin (pH4), low pH and protein content had no significant effect on the detection of PKA, The recovery rates of standard sample solution in the specificity experiment were 98.0% (0.9% sodium chloride solution), 95.3% (0.46% sodium caprylate solution), 96.7% (10% maltose solution, pH4.0), 94.0%(20%BSA), and 94.0%(5%BSA, pH4.0), respectively. The accuracy and precision of the method can meet requirements in the range between 0.5 and 4.0 IU/mL. The inter-batch recovery rate of quality control samples were between 96.4%~109.5% with the coefficients of variation(CV) between 0.2%~6.9%, while the intra-batch recovery rate were between 101.5%~102.9% with the CV between 2.6%~5.9%. The linearity, accuracy and precision of the assay can meet the requirements when PK and S-2302 were placed at room temperature for less than 6 hours, with the recovery rate of quality control samples between 94.9%~109.9%. The end-point method and kinetic method were used to determine the PKA in 20 batches of human serum albumin, and the consistency showed that there was no significant difference between the two methods(P>0.05). 【Conclusion】 A kinetic method for determination of PKA content with good linearity, specificity, accuracy, precision, stability and durability has been established. Compared with the method in ChP, the new method is more convenient, accurate and rapid to determine the content of PKA in human albumin and human immunoglobulin (pH4) for intravenous injection.

Imaging diagnosis of prostatic hyperplasia and prostate cancer / 局解手术学杂志

Objective To explore the methods of improving diagnosis correctness between the patients with prostate cancer and benign prostatic hyperplasia.Methods Totally 87 patients with benign prostatic hyperplasia or prostate cancer which confirmed by MRI and prostate biopsy for the PSA significantly increased in our hospital from July 2013 to March 2016 were collected.By using the three methods of the PI-RADS V2 score,the T2WI+DWI/ADC+DCE-MRI+MRS and PI-RADS V2 score+MRS to diagnose,and comparing with the pathology results,the diagnostic consistency of the two physicians were analyzed.The sensitivity,accuracy and specificity of three ways were compared,and the correlation between PI-RADS V2 score and Gleason score were calculated.Results The diagnostic consistency of the two physicians:PI-RADS V2 score,K=0.951;T2WI+DWI/ADC+DCE-MRI+MRS score,K=0.838;PI-RADS V2+MRSI score,K=0.937.The correlation between PI-RADS V2 score and Gleason score,r=0.871,P=0.001 4;diagnostic sensitivity,specificity and accuracy of PI-RADS V2 score were 77.3％,74.4％,75.9％;diagnostic sensitivity,specificity and accuracy of T2WI+DWI/ADC+DCE-MRI+MRS were 88.6％,76.7％,82.8％;diagnostic sensitivity,specificity and accuracy of PI-RADS V2+MRSI score were 86.4％,81.4％,83.9％,respectively.Conclusion Compared with the traditional diagnostic methods,the combination of new prostate report and data system and MRSI can improve the diagnostic accuracy of prostate cancer and benign prostatic hyperplasia.The PI-RADS V2 score is more objective and accurate in the description of the lesion,but the low signal of benign hyperplastic nodules in transitional zone should be dialogued carefully through a variety of image parameters.

Morphological changes of mitral valve geometry caused by repair procedure / 上海交通大学学报（医学版）

Objective · To assess the morphological changes of mitral valve geometry after mitral valve repair by using real-time 3D transesophageal echocardiography. Methods · The clinical data including 3D echocardiography of 36 patients undergoing mitral valve repair for mitral valve prolapse and 56 patients without mitral valve diseases were collected. Parameters of mitral annular and leaflet geometry were acquired and analyzed. Results · The ellipse index of the two-dimensional view (E2D), and non-planar leaflet angle (θNPA) were decreased, while other parameters were increased significantly in patients with mitral valve prolapse compared with controls before mitral valve repair. After repair, patients displayed larger θNPA, and still smaller E2D.Some parameters also get smaller, such as the anterior to posterior diameter of the mitral annulus, the anterolateral to posteromedial coaptation diameter,the minimum circumference of the three-dimensional view of the annulus, the minimum area of the two-dimensional view of the annulus, the exposed area of the anterior leaflet, inter-commissural diameter. Other parameters were not changed significantly. All parameters showed no significant difference between respect group and resect group in posterior valve prolapse before and after mitral valve repair. Conclusion · The repair procedure can restore the function of the mitral valve effectively. In view of the morphology, the geometry of the mitral valve annulus is still different from the normal apparently after the mitral valve repair, but the normal morphology of the leaflets can be regained. It seems to have similar curative effect morphologically for patients with posterior leaflet prolapse to have respect or resect strategy.

Clinical value of color Doppler ultrasound and computed tomography angiography in diagnosis and interventional therapy of Budd-Chiari syndrome / 局解手术学杂志

Objective To evaluate the clinical value of color Doppler ultrasound (CDUS) and computed tomography angiography (CTA) in diagnosis of Budd-Chiari syndrome(BCS).Methods The CDUS and CTA data about 33 BCS patients diagnosed by digital subtraction angiography(DSA) and treated by interventional therapy were retrospectively analyzed.All of 33 patients with BCS were examined with CDUS,26 cases of then received CTA.The diagnostic value of BCS between two methods were compared.Results The diagnostic accordance rate of CDUS and CTA for BCS were 90.9％ and 96.2％ respectively,which had no significant statistical difference(P ＞ 0.05).The two methods could not only comprehensively systematically reflect the morphologic changes of liver and spleen,the stenosis and blood flow state of the lesion regions,but also clearly display the intrahepatic/extrahepatic collateral vessels trend in the abdomen.One week after interventional therapy,the CUDS results showed blood vessels pristine and stable hemodynamics.Conclusion CDUS is the preferred imaging in the diagnosis and postoperative re-examination of BCS.While,CTA can provide many important parameters for preoperative assessment and operation way.

CT and MRI imaging features of primary ventricular lymphoma / 局解手术学杂志

Objective To evaluate the CT and MRI imaging features of primary ventricular lymphoma ,so as to provide a reference for the diagnosis and differential diagnosis of the disease .Methods The clinical data and imaging findings of primary ventricular lymphoma in one case was retrospectively analyzed with literature review and compared with primary lymphoma in parenchymal brain .Results Slightly high density tumor presented with regular shape in the trigone of lateral ventricles on CT findings , and slightly low signal intensity on T 1 and slightly high signal intensity on T 2 appeared on MRI findings with small cystic necrosis in tumour .An enhancement scan showed obviously enriched, and there was perilesional edema.After 14 day’s dehydration treatment, rechecked indicated that the lesions were significantly en-larged, the shape were irregula , the area of cystic necrosis was enlarged , heterogeneous enhanced scanning were enhanced , perilesional ede-ma became more heavier , and the imaging feature of “closed fist” appeared .It was proved to be diffuse large B cell lymphoma with surgical pathologic examination , and there was no lymphoma in other regions of the body with whole body PET-CT examination , which was clinically diagnosed as primary ventricular lymphoma .Conclusion Primary ventricular lymphoma is rarely reported ,and it has similar imaging mani-festations with primary lymphoma in parenchymal brain .The combination of multiple imaging modalities will be helpful to diagnosis and dif -ferential diagnosis for the suspected patients .

CT diagnosis and differential diagnosis of mucoepidermoid carcinoma of the lung / 局解手术学杂志

Objective To improve the diagnostic accuracy by analyzing the computed tomography ( CT) characteristic performance of mucoepidermoid carcinoma of the lung. Methods CT findings 15 cases proved by pathology of mucoepidermoid carcinoma of the lung were retrospectively analyzed,and CT characteristic performance were studied by reviewing the literatures. Results The mucoepidermoid carcino-ma were located in right bronchial of 8 cases,left bronchial of 6 cases,peripheral part of the lung of 1 case. Calcification was seen in 7 mas-ses. Most masses density was not homogeneous at plain scanning. Venous phase have significantly enhanced compared with arterial phase. Ten cases showed obstructive pneumonia and atelectasis,3 cases with mediastinal lymph node metastases. Conclusion Multiple mucoepidermoid carcinoma of the lung grows extension of the long axis of bronchial,calcification be seen in most of patients. The enhanced mode of the lesions appeared as continuous progressive enhancement,some were illustrated with post obstructive pneumonia or atelectasis,CT have a certain value of diagnosis and diffenertial diagnosis.

Clinical application and value of dual-source spiral CT enhanced scan and multiplanar reformatting in diagnosis of gastric cancer / 局解手术学杂志

Objective To discuss the clinical application and value of dual-source spiral CT enhanced scan and multiplanar reformatting ( MPR) in the diagnosis of gastric cancer. Methods The 335 patients with gastric cancer who conducted dual-source spiral CT enhanced scan of upper abdomen under the hypotonic state before the definite pathological diagnosis were retrospectively analyzed,and had multi-di-mensional multiplanar reconstruction for the enhanced thin-section CT data by the multiplanar reformatting technique. Results Of 335 ca-ses,288 cases were detected by simple axial data,the detection rate was 86. 0%,320 cases were detected by MPR,the detection rate was 95. 5%,the differences were statistically significant (P<0. 05). The overall accuracy rate of Preoperative T staging by conventional axial and MPR images were 78. 3% and 89. 1% respectively, the difference was statistically significant. The overall accuracy rate of preoperative N staging by two methods were 73. 6% and 82. 3%,respectively,the difference was not significant. Conclusion Application of dual source spiral CT multiplanar reconstruction can significantly improve the detection rate of gastric cancer,and the average accuracy rate of preopera-tive TNM staging for gastric cancer is 84. 6%.

Association of heart rate variability with 5-minute Apgar score in neonates with severe asphyxia / 临床儿科杂志

Objective To explore the relationship between 5-minute Apgar score and heart rate variability (HRV) in severely asphyxiated neonates. Methods A total of 103 severely asphyxiated neonates with 1-minute Apgar score of 0 to 3 points were selected. They were divided into Group A (>7 points, n=50) and Group B (≤7 points, n=53) based on 5-minute Apgar score. Meanwhile, 40 full-term neonates with 1-and 5-minute Apgar score greater than 7 points were selected as control group. 24-hour dynamic electrocardiogram was performed and HRV was analyzed on the third day after birth in three groups. Results PNN50, rMSSD, SDSD were decreased and SDNN, SDANN were increased in group B as compared with group A and control group (P0.05). Conclusions Neonatal asphyxia can cause damage to autonomic nervous system. 5-minute Apgar score and HRV can be joint-ly used as a non-invasive index in autonomic nervous damage and its prognosis in asphyxiated newborns.