Best evidence summary for prevention and management of enteral feeding intolerance in critically ill patients.

AIM: To evaluate and summarize the evidence for prevention and management of enteral feeding intolerance in critically ill patients and provide reference for clinical practice. DESIGN: This study was an evidence summary followed by the evidence summary reporting standard of Fudan University Center for Evidence-based Nursing. METHODS: Current literatures were systematically searched for the best evidence for prevention and management of enteral feeding intolerance in critically ill patients. Literature types included clinical guidelines, best practice information sheets, expert consensuses, systematic reviews, evidence summaries and cohort studies. DATA SOURCES: UpToDate, BMJ Best Practice, Joanna Briggs Institute, Guidelines International Network, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Scottish Intercollegiate Guidelines Network, the Cochrane Library, Embase, PubMed, Sinomed, Web of Science, Yi Maitong Guidelines Network, DynaMed, MEDLINE, CNKI, WanFang database, Chinese Medical Journal Full-text Database, European Society for Clinical Nutrition and Metabolism website, the American Society for Parenteral and Enteral Nutrition website were searched from January 2012 to April 2023. RESULTS: We finally identified 18 articles that had high-quality results. We summarized the 24 pieces of best evidence from these articles, covering five aspects: screening and assessment of the risk of enteral nutritional tolerance; formulation of enteral nutrition preparations; enteral nutritional feeding implementation; feeding intolerance symptom prevention and management; and multidisciplinary management. Of these pieces of evidence, 19 were 'strong' and 5 were 'weak', 7 pieces of evidence were recommended in level one and 4 pieces of evidence were recommended in level two. CONCLUSION: The following 24 pieces of evidence for prevention and management of enteral feeding intolerance in critically ill patients were finally recommended. However, as these evidences came from different countries, relevant factors such as the clinical environment should be evaluated before application. Future studies should focus on more specific symptoms of feeding intolerance and more targeted prevention design applications. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: The clinical medical staffs are recommended to take evidence-based recommendations for the implementation of standardized enteral nutrition to improve patient outcomes and decrease gastrointestinal intolerance in critically ill patients. IMPACT: The management of enteral nutrition feeding intolerance has always been a challenge and difficulty in critically ill patients. This study summarizes 24 pieces of the best evidence for prevention and management of enteral nutrition feeding intolerance in critically ill patients. Following and implementing these 24 pieces of evidence is beneficial to the prevention and management of feeding intolerance in clinical practice. The 24 pieces of evidence include five aspects, including screening and assessment of the risk of enteral nutritional tolerance, formulation of enteral nutrition preparations, enteral nutritional feeding implementation, feeding intolerance symptom prevention and management and multidisciplinary management. These five aspects constitute a good implementation process. Screening and assessment of enteral nutritional tolerance throughout intervention are important guarantees for developing a feasible nutrition program in critically ill patients. This study will be benefit to global medical workers in the nutritional management of critically ill patients. REPORTING METHOD: This evidence summary followed the evidence summary reporting specifications of Fudan University Center for Evidence-based Nursing, which were based on the methodological process for the summary of the evidence produced by the Joanna Briggs Institute (JBI). The reporting specifications include problem establishment, literature retrieval, literature screening, literature evaluation, the summary and grading of evidence and the formation of practical suggestions. This study was based on the evidence summary reporting specifications of the Fudan University Center for the Evidence-based Nursing, the register name is 'Best evidence summary for prevention and management of enteral feeding intolerance in critically ill patients', the registration number is 'ES20231823'.

Molecular bases for the stronger plastic response to high nitrate in the invasive plant Xanthium strumarium compared with its native congener.

MAIN CONCLUSION: High expressions of nitrate use and photosynthesis-related transcripts contribute to the stronger plasticity to high nitrate for the invader relative to its native congener, which may be driven by hormones. Strong phenotypic plasticity is often considered as one of the main mechanisms underlying exotic plant invasions. However, few studies have been conducted to investigate the related molecular mechanisms. Here, we determined the differences in the plastic responses to high nitrate between the invasive plant X. strumarium and its native congener, and the molecular bases by transcriptome analysis and quantitative real-time PCR validation. Our results showed that the invader had higher plasticity of growth, nitrogen accumulation and photosynthesis in responses to high nitrate than its native congener. Compared with its congener, more N utilization-related transcripts, including nitrate transporter 1/peptide transporter family 6.2 and nitrate reductase 1, were induced by high nitrate in the root of X. strumarium, improving its N utilization ability. More transcripts coding for photosynthetic antenna proteins were also induced by high nitrate in the shoot of X. strumarium, enhancing its photosynthesis. Hormones may be involved in the regulation of the plastic responses to high nitrate in the two species. Our study contributes to understanding the molecular mechanisms underlying the stronger plasticity of the invader in responses to high nitrate, and the potential function of plant hormones in these processes, providing bases for precise control of invasive plants using modern molecular techniques.

A Long-Term Monitoring Method of Corrosion Damage of Prestressed Anchor Cable.

Based on high-stress characteristics of prestressed anchor cables, this paper develops an axial-distributed testing method to test corrosion damage of prestressed anchor cables. The positioning accuracy and corrosion range of an axial-distributed optical fiber sensor is studied, and its mathematical model between corrosion mass loss and axial fiber strain is established. The experimental results show that the fiber strain from an axial-distributed sensor enables one to reflect the corrosion rate along a prestressed anchor. Moreover, it has a greater sensitivity when an anchored cable has a higher stress. The mathematical model between corrosion mass loss and axial fiber strain is determined to be ε=4723.64ρ+2592.95. The corrosion location along the anchor cable is characterized by axial fiber strain. Therefore, this work provides an insight for cable corrosion.

Psychometric evaluation of the Chinese version of the Upper Limb Lymphedema Quality of Life Questionnaire in breast cancer-related lymphedema patients.

PURPOSE: The purpose of this study was to translate and evaluate the psychometric properties of the Chinese version of the Upper Limb Lymphedema Quality of Life Questionnaire (C-ULLQoL). METHODS: Eighty-five participants completed the C-ULLQoL and the Functional Assessment of Cancer Therapy-Breast (C-FACT-B). The Cronbach's alpha (α) was used to determine the internal consistency, and intraclass correlation coefficients (ICCs) - to evaluate the test-retest reliability. The content validity index (CVI) was assessed by a group of experts. Construct validity was examined by performing factor analysis and criterion validity by observing the correlations between C-ULLQoL with C-FACT-B. RESULTS: Cronbach's α of the total scale was 0.930. ICC scores ranged from 0.874 to 0.938. The content validity of C-ULLQoL was acceptable. Two factors (65.488% of the variance) were extracted by exploratory factor analysis. A significant correlation was observed between C-ULLQoL and C-FACT-B (r = -0.611, p < 0.01). CONCLUSION: The C-ULLQoL is a reliable and valid questionnaire that can be used in clinic and scientific practice for evaluating health-related quality of life in Chinese patients with breast cancer-related lymphedema.IMPLICATIONS FOR REHABILITATIONAn effective and comprehensive scale to measure the health-related quality of life (HRQoL) is essential because breast cancer-related lymphedema (BCRL) leads to various complications for patients, caregivers, and society.The Chinese version of the Upper Limb Lymphedema Quality of Life Scale (C-ULLQoL) is a valid, reliable, and practical instrument to comprehensively assess HRQoL in Chinese patients with BCRL.The C-ULLQoL can be used in both clinical and research settings to evaluate HRQoL of BCRL patients in China.

Evaluation of Concrete Carbonation Based on a Fiber Bragg Grating Sensor.

The carbonation of concrete greatly affects its service life. In this paper, fiber Bragg grating (FBG) sensors were used to investigate the relationship between concrete carbonation and its mechanical properties. A T130 High Sensitivity Strain Cable Sensor with a good linearity was used to monitor the internal strain in concrete, to investigate the variation in the elastic modulus of concrete with carbonation time. A mathematical model of elastic modulus and carbonation time of concrete based on FBG was established. At the same time, the authors explored the relationship between the carbonation depth and compressive strength of concrete and the carbonation time using a phenolphthalein solution test and a compressive strength test, respectively. The experimental results indicate that the carbonation depth, compressive strength, and elastic modulus of concrete increase with carbonation time. In the early stage of carbonation, these three parameters increase rapidly, while they grow slowly in the later stage of carbonation. The varying trend of the elastic modulus of concrete is consistent with the compressive strength, which shows a binomial relationship. Therefore, the elastic modulus, measured using FBG sensors, is used as an indicator of the characterization of the carbonation resistance of concrete. This work provides a new approach for concrete carbonation detection and assessment.

Prediction Method of Steel Corrosion Rate Based on the Helix Distributed Sensor.

Corrosion of steel bars is of great significance for safety and service life of reinforced concrete structures. This work develops a prediction method for steel corrosion mass loss rate before the crack of concrete structure based on a spiral distributed fiber optic sensor. Reinforced concrete sample instrumented with a spiral distributed fiber optic sensor were prepared. The mathematic relationship between the corrosion mass loss rate of steel bar and the spiral distributed strain is theoretically derived. Meanwhile, numerical analysis by MATLAB shows that these parameters such as the protective layer thickness, corrosion mass loss rate, bar diameter, corrosion expansion coefficient have a remarkable influence on spiral distributed strain. Additionally, electrical accelerated corrosion experiment was performed on the reinforced concrete specimens. The helix strain along the distributed sensor was used to evaluate the corrosion mass loss of steel bar. Further, the influencing factors on the corrosion sensitivity are illustrated here and the corrosion mass loss rate before concrete crack is also quantified. This research provides insights into the corrosion deteriorate mechanism.

Effectiveness of Chinese Native Culture Education for Improving Undergraduate Nursing Students' Transcultural Self-Efficacy.

Aim: The aim of this study is to evaluate the impact of Chinese native culture education based on Chinese native culture on the intercultural competence of undergraduate nursing students. Method: A quasi-experimental design with pretest and posttest was used. We recruited nursing students from 4 classes of the School of Nursing in our hospital in 2016 as research subjects. Undergraduate nursing students (n = 79) who completed one semester of education in indigenous Chinese culture completed a demographic questionnaire and the transcultural self-efficacy tool (TSET). Chinese native culture education is the topics related to nursing, consistent with the culture of Chinese patients under the background of Chinese native culture, including the dietary habits, taboos, religions, values, particularly Chinese medicine, and specific diseases. The control group (n = 91) was students who did not participate in Chinese native culture education and completed the instrument during the same time frame. Result: Students who participated in Chinese native cultural education significantly improved their transcultural self-efficacy in three dimensions: cognition, emotion, and practice. Compared with the control group, the students in the cultural education group had higher change scores in three sizes of transcultural self-efficacy. Conclusion: When strengthening cultural education for undergraduate nursing students, adding content related to Chinese native culture can improve their transcultural self-efficacy and meet the growing cultural needs of patients.

Study of the Associations between Color Doppler Ultrasound Grading of Hyperthyroidism and Biochemical Data on Thyroid Function.

Objective: The main study objective was to investigate the correlation between the color Doppler ultrasound grading of hyperthyroidism and the biochemical data of thyroid function. Methods: Seventy-six patients were diagnosed with hyperthyroidism based on clinical and laboratory data at our hospital. The patients were examined using color Doppler ultrasound and laboratory investigations before starting 131I treatment. First, patients were divided into two groups based on the blood flow distribution determined by ultrasound. If the blood flow signal in the parenchyma was scattered and thinned, with dispersive points and discontinuous streaky distribution, the blood flow distribution area in the sample frame was less than or equal to 1/2 of the sample frame area and was judged to be level 1. If the parenchyma was filled with diffuse blood flow signals or if most areas had depicted rich blood flow distribution when the area of blood flow distribution in the sampling frame was greater than 1/2 of the sampling frame area, it was judged to be level 2. Then, the correlations between color Doppler ultrasound grading and biochemical data of thyroid function were analyzed. The indices included FT3, FT4, TSH, anti-TG, anti-TPO, and TRAb. Parameters of thyroid homeostasis, including thyroid's secretory capacity (SPINA-GT), the total deiodinase activity (SPINA-GD), Jostel's TSH index, and the thyrotroph thyroid hormone sensitivity index (TTSI), were calculated and compared. Results: Correlations were noted between color Doppler ultrasound grading and FT3, FT4, TRAb, SPINA-GT, TSHI, and TTSI. Moreover, FT3, FT4, TRAb, SPINA-GT, TSHI, and TTSI were higher in level 2 patients compared with level 1 patients. Conclusion: Correlations were noted between color Doppler ultrasound grading and biochemical data of thyroid function.

Effect of Laser Vocal Cord Surgery under Laryngeal Microscope Combined with Nano-silver Dressing Antibacterial Nursing on Efficacy and Quality of Life of Patients with Laryngeal Cancer.

To explore the adoption effect of nano-silver medical antibacterial dressing in the perioperative treatment of patients with laryngeal cancer, 120 patients with early laryngeal cancer were selected as the research objects. According to the different treatments, they were averagely divided into the test group (laser vocal cord surgery under a laryngeal microscope and nano-silver medical antibacterial dressing) and the control group (laser vocal cord surgery under a laryngeal microscope and sterilized vaseline gauze). The results showed that there were considerable differences in dressing-change times, dressing-change cost, hospital stay, and recovery time between both groups (P<0.05). The number of mild pain cases in the test group was more than that in the control group at 1, 3, and 5 days after surgery, with statistically considerable differences (P<0.05). There were substantial differences in wound area between the two groups at 3 and 5 days after surgery, and the test group was larger than the control group (P<0.05). In the test group, 0 patients had postoperative reinfection, wound dehiscence, and wound hernia. In the control group, 3 patients had postoperative reinfection, 1 had wound dehiscence, and 1 had wound hernia. In summary, compared with traditional sterilized vaseline gauze, the nano-silver medical antibacterial dressing could reduce postoperative dressing pain and promote the recovery of wounds, thus shortening the hospital stay and improving the quality of life of patients after surgery.

Analysis on the Effect of the Rehabilitation Intervention-Centered Targeted Nursing Model on the Cardiac Function Recovery and Negative Emotions in Patients with Acute Myocardial Infarction.

Rehabilitation intervention which refers to the functional training by caregivers with the aid of specialized nursing techniques and the progressive promotion of patients' training initiative, with the purpose of improving mobility and quality of life, is of great significance. The purpose of the study was to investigate the effect of the rehabilitation intervention-centered targeted nursing model on the cardiac function recovery and negative emotions in patients with acute myocardial infarction (AMI). A total of 120 AMI patients admitted to our hospital between January 2019 and January 2020 were selected as the study subjects and randomly divided into group A (n = 60) and group B (n = 60), in which the group B patients received routine nursing combined with rehabilitation intervention, while based on the treatment in group B, the patients in group A underwent rehabilitation intervention-centered targeted nursing model. Then, the cardiac function indexes, negative emotion score, levels of risk factors for heart failure, complication rate (CR), and the quality of life (QOL) of the patients were compared between the two groups. The cardiac function indexes of the patients after nursing in group A were significantly better than those in group B (P < 0.001); the negative emotion scores of the patients after nursing in group A were significantly lower than those in group B (P < 0.001); the levels of risk factors for heart failure of the patients after nursing in group A were significantly lower than those in group B (P < 0.001); the CR of the patients in group A at 15 d and 30 d after admission was significantly lower than that in group B (P < 0.05); the QOL scores of the patients after nursing in group A were significantly higher than those in group B (P < 0.001). Rehabilitation intervention-centered targeted nursing model can optimize cardiac function, weaken the levels of risk factors for heart failure, reduce the incidence of complications, improve psychological conditions, and enhance the quality of life in AMI patients, which is worthy of application and promotion in clinical practice.

A Spiral Distributed Monitoring Method for Steel Rebar Corrosion.

This paper proposes a novel spiral-wound, optic-fiber sensor to monitor the corrosion of steel bars. At the same time, the winding parameters, such as winding angle and pitch, were first theoretically deduced. Then, to decrease light loss, a practically distributed sensor wound onto the protective mortar layer was developed by increasing the winding curvature radius. The spiral distributed sensors were experimentally verified for their feasibility. Experimental results showed that the spiral fiber strain depended on the thickness of the protective mortar layer. Furthermore, the spiral distributed strain well reflected the cracking process of concrete. In addition, the concrete cracking time depended on the thickness of the protective concrete layer. Accordingly, this method is feasible for evaluating the initial and final cracking behaviors of concrete structures and provides a sight for steel bar corrosion.

A Combined Positioning Method Used for Identification of Concrete Cracks.

Fully distributed fiber optic sensors are characteristically used for the measurement of long distances and continuous distribution of space. However, due to the different fiber type, fiber length, ambient temperature and strain, fully distributed fiber optic sensors fail to locate damage accurately and cause a greater error. Therefore, this paper proposes a new positioning method of combining fully distributed fiber optic sensors with fiber Bragg gratings, which enables accurately the localization of a structural damage during the long-term monitoring of fully distributed fiber optic sensors. Moreover, the coupling mechanism of the reflected light from fiber grating and excited Brillouin scattering light is illustrated. Further, it is experimentally verified by locating the cracks of 2 m long reinforced concrete beams. The experimental results show that this proposed method is capable of monitoring the generation of the beam crack and further locating the crack on the concrete beam with an approximate error of 10 cm.

Dynamic contrast-enhanced MRI differentiates hepatocellular carcinoma from hepatic metastasis of rectal cancer by extracting pharmacokinetic parameters and radiomic features.

The aim of the present study was to explore how dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may differentiate hepatocellular carcinoma (HCC) from hepatic metastasis of rectal cancer (HMRC) by extracting pharmacokinetic parameters and radiomic features. A total of 75 patients, including 41 cases with HCC and 34 cases with HMRC, underwent DCE-MRI examination. Dual-input two-compartment extended Tofts tracer kinetic model attached to a specialized image post-processing software package from OmniKinetics; GE Healthcare was used to calculate the values of the pharmacokinetic parameters and radiomic features, which were extracted from the lesions at the same region of interest. These values were evaluated using Student's t-test and receiver operating characteristic curves, and discriminant models were built to differentiate between HCC and HRMC. The results identified statistically significant differences in the values of the pharmacokinetic parameters hepatic perfusion index (HPI), endothelial transfer constant (Ktrans), initial area under the gadolinium concentration curve during the first 60 sec (IAUC) between the HCC and HRMC groups. In addition, statistically significant differences in 17 radiomic features were observed between the two groups (P<0.05). The areas under the receiver operating characteristic (ROC) curves of the pharmacokinetic parameters Ktrans, IAUC and HPI were 0.73, 0.77 and 0.67, respectively. The range of the areas under the ROC curves of the 17 radiomic features with statistical differences was 0.63-0.79. In addition, when pharmacokinetic parameters and radiomic features were incorporated, the area under the ROC curve was 0.86. The accuracy of Fisher's discriminant analysis model based on radiomic features was 89.3%, and the leave-one-out cross-validation accuracy was 80.0%. In conclusion, DCE-MRI was demonstrated to be useful in the differential diagnosis of HCC and HMRC by extracting pharmacokinetic parameters and radiomic features, and incorporation of the two paths improved the diagnostic efficacy. A discriminant model based on radiomic features further enhanced the identification of HCC and HMRC.

Evaluation of Caspase-3 Activity During Apoptosis with Fluorescence Lifetime-Based Cytometry Measurements and Phasor Analyses.

Caspase-3 is a well-described protease with many roles that impact the fate of a cell. During apoptosis, caspase-3 acts as an executioner caspase with important proteolytic functions that lead to the final stages of programmed cell death. Owing to this key role, caspase-3 is exploited intracellularly as a target of control of apoptosis for therapeutic outcomes. Yet the activation of caspase-3 during apoptosis is challenged by other roles and functions (e.g., paracrine signaling). This brief report presents a way to track caspase-3 levels using a flow cytometer that measures excited state fluorescence lifetimes and a signal processing approach that leads to a graphical phasor-based interpretation. An established Förster resonance energy transfer (FRET) bioprobe was used for this test; the connected donor and acceptor fluorophore is cleavable by caspase-3 during apoptosis induction. With the cell-by-cell decay kinetic data and phasor analyses we generate a caspase activation trajectory, which is used to interpret activation throughout apoptosis. When lifetime-based cytometry is combined with a FRET bioprobe and phasor analyses, enzyme activation can be simplified and quantified with phase and modulation data. We envision extrapolating this approach to high content screening, and reinforce the power of phasor approaches with cytometric data. Analyses such as these can be used to cluster cells by their phase and modulation "lifetime fingerprint" when the intracellular fluorescent probe is utilized as a sensor of enzyme activity. © 2020 The Authors. Cytometry Part A published by Wiley Periodicals LLC on behalf of International Society for Advancement of Cytometry.

Erratum: Influencing factors of transient elastography in detecting liver stiffness.

[This corrects the article DOI: 10.3892/etm.2016.3617.].

Correlations between health-promoting lifestyle and health-related quality of life among elderly people with hypertension in Hengyang, Hunan, China.

Hypertension is considered as an important public health problem in developed and developing countries. The disease is closely associated with health-promoting lifestyle (HPL), and it seems that HPL plays an important role in improving health-related quality of life (HRQOL). This cross-sectional study is to investigate the effects of health-promoting lifestyle (HPL) on health-related quality of life in elderly people with hypertension from a community health service center in Hengyang, Hunan, PR China.Totally 530 elderly patients with hypertension from the community health service center were included in this study, who were asked to fill in a questionnaire (504 patients responded). HPL was assessed by the health-promoting lifestyle profile II (HPLP-II), and HRQOL was measured by the Short Form Health Survey Questionnaire (SF-36).HPL among these elderly people with hypertension was at moderate level (125.02 ±â€Š21), with the highest score for nutrition and the lowest score for health responsibility. Moreover, HRQOL among these elderly hypertensive people was at moderate level (54.36 ±â€Š21.18). Role-emotional domain score was far below average, vitality domain was a little below average, social functioning and general health domains were a little above average, and other domains were far above average. Furthermore, HPL and HRQOL were positively correlated (P < .01). According to the standardized regression coefficients, the influencing factors for HRQOL included (in a descending order) the health responsibility, physical activity, interpersonal relationships, stress management, spiritual growth, and nutrition.HPL and HRQOL were both relatively poor in the elderly people with hypertension from the community health service center. HPL represents an important factor affecting HRQOL of elderly people with hypertension. HRQOL could be improved through promoting HPL (such as health responsibility and physical activity).

The evaluation of endocrine disrupting effects of tert-butylphenols towards estrogenic receptor α, androgen receptor and thyroid hormone receptor ß and aquatic toxicities towards freshwater organisms.

The phenolic compounds have posed public concern for potential threats to human health and ecosystem. Tert-butylphenols (TBPs), as one group of emerging contaminants, showed potential endocrine disrupting effects and aquatic toxicities. In the present study, we detected concentrations of 2,4-DTBP ranging from <0.001 to 0.057 µg/L (detection limit: 0.001 µg/L) in drinking water source from the Qiantang River in East China in April 2016. The endocrine disrupting effects of 2-TBP, 2,4-DTBP and 2,6-DTBP toward human estrogen receptor α (ERα), androgen receptor (AR) and thyroid hormone receptor ß (TRß) were evaluated using human recombinant two-hybrid yeast bioassay. Their aquatic toxicities were investigated with indicator organisms including Photobacterium phosphoreum, Vibrio fischeri and freshwater green alga Chlamydomonas reinhardtii. 2-TBP and 2,4-DTBP exhibited moderate antagonistic effects toward human ERα and AR in a concentration-dependent manner. 2-TBP significantly inhibited the light emission of P. phosphoreum. 2-TBP, 2,4-DTBP and 2,6-DTBP significantly inhibited the growth of C. reinhardtii and reduced the chlorophyll content. Our results suggest the potential adverse effects of TBPs on human health and aquatic organisms. The data will facilitate further risk assessment of TBPs and related contaminants.

Bipolar Switching Properties of Neodymium Oxide RRAM Devices Using by a Low Temperature Improvement Method.

Bipolar resistive switching properties and endurance switching behavior of the neodymium oxide (Nd2O3) thin films resistive random access memory (RRAM) devices for a high resistive status/low resistive status (HRS/LRS) using a low temperature supercritical carbon dioxide fluid (SCF) improvement post-treatment process were investigated. Electrical and physical properties improvement of Nd2O3 thin films were measured by X-ray diffraction (XRD), scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and current versus voltage (I-V) measurement. The metal-like behavior of ohmic conduction mechanism and metallic cluster reaction of hopping conduction mechanism in initial metallic filament path forming process of the SCF-treated thin films RRAM devices was assumed and discussed. Finally, the electrical conduction mechanism of the thin films RRAM derives for set/reset was also discussed and verified in filament path physical model.

Simultaneous determination of 16 macrolide antibiotics and 4 metabolites in milk by using Quick, Easy, Cheap, Effective, Rugged, and Safe extraction (QuEChERS) and high performance liquid chromatography tandem mass spectrometry.

A novel analytical method was developed and validated for simultaneous analysis of 16 macrolide antibiotics and 4 metabolites in milk. A modified quick, easy, cheap, effective, rugged, and safe extraction method (QuEChERS) optimized by response surface methodology (RSM) was used for sample preparation. All the drugs were subsequently separated and detected by high performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS), using roxithromycin as internal standards for maximum accuracy and precision. The method was validated following the guidelines specified in Commission Decision 2002/657/EC. The recoveries of all the analytes were in the range of 62.27%-115.28%. Most macrolide antibiotics and metabolites could be detected in the concentration of 1-100ng/mL with good correlation coefficient (r2>0.998). The LODs and LOQs of all analytes were in the range of 0.30-0.85µg/kg and 1.1-4.0µg/kg, respectively. The intra-day and inter-day precision were lower than 10% and 15%, respectively. The developed method has been successfully applied to screen these compounds in different milk products.

Influencing factors of transient elastography in detecting liver stiffness.

Liver stiffness, which correlates well with liver fibrosis stage, can be measured noninvasively by transient elastography, also known as Fibroscan. The present study aimed to determine the independent factors influencing Fibroscan detection by multiple regression analysis. A total of 181 patients who required liver biopsy were enrolled. Liver stiffness measurement (LSM) was detected by Fibroscan on the day of liver biopsy, while clinical information and routine biochemical examination results were also collected. Correlation was analyzed by Spearman's correlation, and multiple regression analysis was performed to analyze the independent influencing factors. The results demonstrated that platelet (PLT) levels, serum albumin (ALB), prothrombin activity (PTA) and body mass index (BMI) were independent predictors of liver stiffness. The contribution of these four predictors to the regression equation was in the following descending order: PLT (negative correlation) > ALB (negative correlation) > PTA (negative correlation) > BMI (positive correlation). In conclusion, the parameters of PLT, ALB, PTA and BMI are independent predicting factors affecting Fibroscan detection. Therefore, the diagnosis and evaluation of liver fibrosis should comprehensively consider the results of Fibroscan, and clinical and laboratory examinations.