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A rapid and sensitive high-performance liquid chromatography-high-resolution orbitrap mass spectrometry method was developed for the simultaneous screening of 354 organic poisons and metabolites in blood and urine, including drugs, medications, pesticides, rodenticides, veterinary drugs, alkaloids, and mycotoxins with a multi-toxicant chromatography-mass spectrometry information library. The method and library showed good prospects in clinical poisoning screening and forensic toxicological identification. Blood and urine samples were extracted successively with ethyl acetate in acidic and alkaline conditions; then, the extract was blown to nearly dry by nitrogen gas and redissolved with methanol-aqueous solution (v:v, 50:50), and the dissolved solution was analyzed by LC-MS/MS after filtering. Precursor ions' m/z was set for identification, retention time, fragment ions, and isotopic pattern which were used for confirmation. No interference peaks were found in the blank samples, showing good specificity. The LODs of toxicants in urine and blood were 1.00×10

Objective To evaluate the improvement of motor, anxiety, and depression in patients with blepharospasm with the use of botulinum toxin type A (BTX-A) and repetitive transcranial magnetic stimulation (rTMS). Methods A total of 63 BEB patients accompanied by anxiety/depression were enrolled, among which 28 patients were treated with the injection of botulinum toxin type A (BTX-A) alone, while 35 patients were treated with BTX-A injection combined with rTMS. All patients were followed up for 6 months, and the overall efficacy was evaluated. Results BTX-A alone treatment and combined rTMS treatment could both significantly improve the symptoms of patients, and the effective rate was 92.86% and 94.29%, respectively. The duration of efficacy was significantly longer in the combined rTMS treatment group (16.89±3.39 weeks) than in BTX-A treatment group (13.04±3.48 weeks). After treatment, SDS score of BTX-A treatment group and combined rTMS treatment group was 49.69±7.90 and 49.46±6.73, respectively, and there was no significant difference between the two treatment groups; SAS score of BTX-A treatment group and combined rTMS treatment group was 53.88±7.34 and 48.79±6.62, respectively, and there was significant difference between the two treatment groups. Conclusion Compared to BTX-A alone treatment, BTX-A combined with rTMS can effectively improve the effect of BTX-A, prolong the duration of blepharospasm relief, and significantly reduce depression and anxiety in patients with BEB.

Bisphenol analogues, amphenicol antibiotics, and phthalate have widely aroused public concerns due to their adverse effects on human health. In this study, a rapid and sensitive method for determination of nine bisphenol analogues, three amphenicol antibiotics, and six phthalate metabolites in the urine based on ultra-high-performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry was developed and validated. The sample pretreatment condition on the base of mixed-mode anion-exchange (Oasis MAX) SPE was optimized to separate bisphenol analogues and amphenicol antibiotics from phthalate metabolites: the former were detected with a mobile phase of 0.1% ammonium water solution/methanol containing 0.1% ammonium water solution in negative mode, whereas the latter were determined with a mobile phase of 0.1% acetic acid solution/acetonitrile containing 0.1% acetic acid in negative mode. The limits of detection were less than 0.26 ng/mL for bisphenol analogues, 0.12 ng/mL for amphenicol antibiotics, and 0.14 ng/mL for phathalate metabolites. The recoveries of all target analytes in three fortification levels ranged from 72.02 to 117.64% with the relative standard deviations of no larger than 14.51%. The matrix effect was adjusted by isotopically labeled internal standards. This proposed method was successfully applied to analyze 40 actual urines and 13 out of 18 studied compounds were detected. Graphical abstract Simultaneous determination of nine bisphenol analogues, three amphenicol antibiotics, and six phthalate metabolites in human urine samples.

Perfluorooctanoic acid (PFOA) in environmental media contains numerous isomers/enantiomers because of the PFOA manufacturing process and biological degradation of PFOA precursors. Few methods for analyzing PFOA enantiomers have been described. A simple derivatization method using (S)-1-phenethyl chloride that was developed to allow PFOA isomers/enantiomers to be separated by gas chromatography and analyzed by electron-capture negative ionization mass spectrometry is described here. PFOA standards were analyzed, and enantiomers of the chiral isomers perfluoro-3-methyl-heptanoic acid, perfluoro-4-methyl-heptanoic acid, and perfluoro-3,5-dimethyl-hexanoic acid were separated using an HP-5MS column. Linear PFOA and perfluoro-6-methyl-heptanoic acid were chromatographically separated from these enantiomers. The linear ranges (giving correlation coefficients r > 0.997) of the calibration curves for the isomers were 0.010–3.00 ng/mL. PFOA isomer/enantiomer concentrations in river water were determined using the method. The method separated the enantiomers of perfluoro-3-methyl-heptanoic acid and perfluoro-4-methyl-heptanoic acid, the isomers of perfluoro-6-methyl-heptanoic acid, and linear PFOA in river water. No significant differences were found between the PFOA enantiomer/isomer compositions of the sample and technical PFOA. Enantiomer ratios can provide information about the sources and transport of pollutant isomers/enantiomers in the environment. Enantiomeric separation requires effective separation techniques. Our method achieved chiral separation using a non-chiral GC column that is often used in general analytical laboratories. The method could be used to investigate the sources and fates of PFOA and the isomers/enantiomers of other potentially toxic persistent pollutants in the environment and the risks posed to humans.

Urinary cotinine and NNAL are the biomarkers of tobacco smoke exposure and tobacco specific nitrosamines (TSNAs), respectively. A new method for the simultaneous analysis of them by hydrophilic interaction liquid chromatography tandem mass (HILIC-MS/MS) combined with PRiME HLB solid phase extraction (SPE) was developed. The sample matrix was removed effectively with PRiME HLB SPE and HILIC separation. The linearities were good in a range of 5.00-3.00 × 103 ng/L for NNAL and 0.200-4.00 × 102 μg/L for cotinine. The method detection limit of NNAL (0.0580 ng/L) was better than that in other literatures, and 0.0240 μg/L for cotinine. Recoveries were 91.6-110% and 88.7-113% with relative standard deviations of 3.78-9.12% and 0.120-1.15% for NNAL and cotinine, respectively. 29 urine samples were detected by the established method. The contents of NNAL and cotinine were 0.590-66.7 ng/g·Cr and 2.86-1.34 × 103 μg/g·Cr, respectively. Moreover, the results showed that urinary NNAL and cotinine were significantly positive correlation, even in passive smokers.

A new and simple one-pot hydrothermal method was used for the preparation of ZnO/Zn2GeO4 (ZG) composites. Cu was subsequently loaded on ZG-2 composites by an impregnation method to obtain ternary ZG-2-Cu photocatalysts. The ZG-2-5%Cu composite showed optimum photocatalytic water splitting (H2 production) performance under simulated sunlight illumination. Cu sedimentation enhanced light absorption and prevented electron–hole pair recombination. The photoinduced electrons are believed to migrate from the conduction band (CB) of ZnO and Zn2GeO4 to Cu, allowing fast separation of the photogenerated electrons and holes. The facile synthesis and the excellent photocatalytic performance of ZG-2-5%Cu make it a good material to conduct the H2 evolution reaction.

The glucuronide conjugate of 1-hydroxypyrene (1-OHP-G) is a sensitive and reliable index biomarker for assessing low exposure to polycyclic aromatic hydrocarbons (PAHs). A simple method for determining 1-OHP-G in human urine with ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was established and applied to evaluate the exposure level of PAHs of pregnant women in a large sample size. After the urine sample was extracted with ethyl acetate, 0.2 mL of the aqueous phase was diluted to 1.0 mL with 5 mmol/L ammonium acetate before injection. The chromatographic separation was performed on a C18 column with a gradient elution and identification was conducted on a tandem mass spectrometry with electrospray ionization in negative mode. 1-OHP-d9-G was used as an internal standard to improve precision. The method was validated and good linearity was obtained in the range of 0.1∼2.0 ng/mL. The limit of detection (LOD) and the limit of quantification (LOQ) of 1-OHP-G were 0.015 and 0.051 ng/mL. Intra-day and inter-day precision were 4.3 and 6.7 %, respectively. The spiked recoveries were 79.4∼106 % for urine samples. This method was rapid, sensitive, and very suitable for batch analysis of urine. Six hundred seventy-five urine samples of pregnant women from the cities of Fuzhou, Shenzhen, and Nanning of P.R. China were analyzed with the proposed method. The medians of 1-OHP-G concentration were 0.27 μg/g.cr (n = 201), 0.30 μg/g.cr (n = 212), and 0.51 μg/g.cr (n = 262) for the cities of Fuzhou, Shenzhen, and Nanning, respectively. 1-OHP-G concentrations in urine samples of pregnant women from the cities of Fuzhou and Shenzhen in coastal areas were both significantly lower than that of Nanning City in inland region (p < 0.001).

Effective decomposition of antibiotic sulfadiazine (SD) in a Fe0-catalyzed sonochemical Fenton like system (Sono-FL) was demonstrated. By using the response surface methodology (RSM), an optimized experimental condition of pH 7.00, 0.94 mM Fe0, 1.90 mM persulfate (PS) and 20 W ultrasound (US) power was concluded, which could reach the predicted SD degradation efficiency of 90%. Afterwards, effects of wastewater matrix (five inorganic anions and two chelating agents) on the SD degradation were investigated in the system, respectively. It was found that the SD degradation could be inhibited by SO42−, NO3−, HCO3−/CO32− and H2PO4− to different extents. Cl− would lead to an enhancement with a low dosage (5 mM), but an inhibition with a high dosage (100 mM). Unexpectedly, chlorinated organic intermediates were also found as SD decomposed. Appropriate dosages of oxalic acid (OxA) or EDTA could benefit the SD degradation in the Sono-FL system, while excessive chelating agents would play as competitive pollutants. It was summarized that inorganic anions would mainly react with SO4 − and/or OH to form sub-radicals of less oxidative potential. OxA and EDTA would not only participate in complexing dissolution of Fe0 but also provide additional oxidants such as H2O2 and [FeIVO]2+, through the electron transfer reactions caused by the iron-ligands species.

A new kind of solid solution (CdxZn2-xGeO4) was prepared using the facile hydrothermal method for the first time. The crystal structure, morphology and light absorption property of the products were studied systematically. Compared with pure Zn2GeO4, CdxZn2-xGeO4 solid solutions had narrower band gap and were able to respond to wider range of the sunlight. Upon simulated sunlight irradiation, the hydrogen evolution activities of CdxZn2-xGeO4 solid solutions were much higher than that of the pure Zn2GeO4. Furthermore, the highest H2 generation rate (15.00 mmol g−1 h−1) was achieved over the Cd1.0Zn1.0GeO4, which was approximately 24.2 times higher than that of pure Zn2GeO4 (0.62 mmol g−1 h−1). The PL, EIS and photocurrent measurements proved the fast transfer and rapid seperation of electron-hole pairs were succeeded in Cd1.0Zn1.0GeO4, which led to the promotion of the photocatalytic activity. The feasible way to synthesize solid solutions could be useful in the design of other systems with excellent photocatalytic performance.

Modified porous spherical Li1.2Mn0.534Ni0.133Co0.133O2 has been successfully synthesized via a co-precipitation method, adopting graphene and carbon nanotube conductive liquid (GNL) as a template and surface modified material. The unique porous structure and the larger specific surface area of the porous Li1.2Mn0.534Ni0.133Co0.133O2 contribute to both the increase in the first coulombic efficiency, from 76.3% to 82.0%, and the enhancement of the rate capability, demonstrating initial discharge capacities of 276.2, 245.8, 218.8, 203.9, 178.8, 135.9 and 97.5 mA h g−1 at different discharge rates of 0.1, 0.2, 0.5, 1.0, 2.0, 5.0 and 10 C, respectively. Even after suffering 100 cycles of charge–discharge, the porous Li-rich cathode can still deliver a discharge capacity of 235.5 mA h g−1, suggesting a high capacity retention of 86.2% compared to the initial discharge capacity (273.3 mA h g−1). Besides, the diffusion coefficient of the Li+ investigated by the cyclic voltammetry technique is approximately 10−12 cm2 s−1, indicating faster kinetics of the lithium ions for the modified porous Li1.2Mn0.534Ni0.133Co0.133O2 compared with the ordinary Li1.2Mn0.534Ni0.133Co0.133O2 (∼10−13 cm2 s−1). In fact, the introduction of GNL as a template not only leads to the porous structure of the Li-rich cathode material but also brings about improvement to the crystallinity and size of the grains, which can be ascribed to the combined effect of the GNL with the carbonate precursors of MCO3 (M = Mn, Ni, Co) during the recrystallization process.

The analytical method of nicotine and cotinine in human urine with hydrophilic interaction chromatography-tandem mass spectrometry (HILIC-MS/MS) was established. After the urine sample containing nicotine-d4 and cotinine-d3 isotope internal standards being diluted with water, the filtrate was introduced into ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) for analysis. Separation was performed on an ACQUITY UPLC® BEH HILIC column (50 mm×3.0 mm, 1.7 μ m), in which methanol and 0.1% (v/v) ammonia were used as the mobile phases with isocratic elution at 0.2 mL/min of flow rate. Positive ion scan mode was used for mass spectrometry measurement and calibration curves were plotted for quantification determination. A good linearity could be obtained in the range of 1.0-1000 μ g/L for nicotine and cotinine with the linear coefficients of 0.9949 and 0.9958, respectively. The limits of detection of nicotine and cotinine were 0.082 μ g/L and 0.077 μ g/L, and the limits of quantification were 0.27 μ g/L and 0.26 μ g/L, respectively. The recoveries of the spiked urine samples were 90.4%-103.5% and 93.0%-104.6%, and the relative standard deviations (RSDs) were 4.80%-6.21% and 4.22%-7.15% for nicotine and cotinine respectively. The established method was applied to the analyis of 200 urine samples. Based on the investigation information of the urine of the smoking people, the nicotine contents were 26.68-854.30 μ g/L, and the cotinine contents were 36.66-1191.18 μ g/L (n=86, Mnicotine=76.00 μ g/L, Mcotinine=83.52 μ g/L, M:median); of the nonsmoking people, the nicotine contents were 5.08-69.66 μ g/L, and the cotinine contents were 3.16-28.21 μ g/L (n=114, Mnicotine=7.53 μ g/L, Mcotinine=3.79 μ g/L). The method is simple, sensitive and rapid. It is suitable for batch analysis of nicotine and cotinine in urine, and it can meet the requirement of evaluating the human tobacco exposure.

In this study, a novel ultrasound-enhanced heterogeneous Fe 0 /persulfate (US/Fe 0 /PS) system was developed and investigated for the degradation of an antibiotic sulfadiazine (SD). It was demonstrated that the US/Fe 0 /PS system could achieve a significant synergy in the degradation efficiency of SD, as compared to its corresponding comparative systems. The SD degradation in the US/Fe 0 /PS system could be applied by the pseudo-first-order kinetic with a k obs (SD) value of 3.4 ± 0.20 h −1 . Affecting factors such as initial pH, dosage ratio of [Fe 0 ]:[PS], US input power and reaction temperature were further studied. SD could be effectively degraded with a relatively low PS dosage at a broad pH range of 3–7. Simultaneous evolution of soluble iron species and PS was evaluated in three comparative systems (US/Fe 0 , Fe 0 /PS and US/Fe 0 /PS) during the reaction. It could be concluded that the promotional role of US would be dual in the US/Fe 0 /PS system, i.e. enhancement in the heterogeneous iron corrosion reactions and acceleration in the bulk radical reactions. Identification of the degradation intermediates indicated that sulfate radical (SO 4 − ) oxidation was the main SD degradation pathway. Attacking of the amine group in the benzene ring would be its first step, followed by cleavage of C–N bonds in the heterocyclic ring. Another degradation pathway, i.e. direct cleavage of the S–N bond should be also present.

Li-rich layered cathode materials Li1.13[Ni0.233Mn0.534Co0.233]0.87O2 are successfully synthesized by a co-precipitation method with hexadecyl trimethyl ammonium bromide (CTAB) as a surfactant. The structural and electrochemical feature changes of the resulting cathode materials have been studied thoroughly. When CTAB is considered as a surfactant, well-crystallized Li-rich layered cathode materials are obtained with Li2CO3 treatment for the festoon-like precursor hierarchically assembled by nanoplates. Among these oxides, the sample synthesized with CTAB shows a stable mixed phase on the edge of the powder particles and exhibits excellent electrochemical performance. The product delivers the highest initial discharge capacity of 394 mA h g−1 at 0.1 C (1 C = 200 mA g−1) between 2.5 and 4.8 V and 84.1% capacity is retained after 100 cycles. It is considered that the higher capacity and superior rate capability would be ascribed to the activation effect of CTAB, which can form a stable mixed structure and thus effectively alleviate the layered/spinel structure change during cycling.

In this study, synergistic degradation of antibiotic norfloxacin (NOR) was obtained in a novel sonochemical ultrasound/zero-valent iron/tetraphosphate system (US/ZVI/TPP). Compared to three common organic ligands (EDTA, EDDS, and DTPA), TPP could perform more excellently in activation of O

A generalized model for determining minimum-cost preventive maintenance schedules of a maintained reliability system is presented. Through balancing the cost of system failure during operation against the cost of planned maintenance, an optimal policy is established which minimizes the expected cost rate. A simple equation to determine the optimal period between maintenances for a system with the known failure distribution is acquired, and the calculation for the system with Gamma failure distribution is given.

An optimal model for determining minimum-cost spare number for systems with components connected in series where the failure time of components follow any general distribution is presented. The component availability with a certain number of spares is derived through renewal process theory and the system availability is obtained with system reliability analysis method. The object of the optimization problem is to minimize the total spare cost of the system under the requirement of specified system availability. Genetic algorithms are used to find the optimal amount of spares for each component. Finally, an illustrative example is given. Keywords-renewal process; system availability; spare optimization; genetic algorithms

A novel method for simultaneous determination of eight organochlorine pesticides in aqueous samples by solvent demulsification-dispersive liquid-liquid microextraction based on solidification of floating organic drop coupled with gas chromatography-mass spectrometry (GC-MS) was established. A mixture of extractant (n-hexadecane) and dispersive agent (ace-tone) at the ratio of 1/5 (v/v) was injected into aqueous sample to form an emulsion and an extraction process was accomplished. The demulsifier (750μL acetone) was then injected to break up the emulsion. The two phases were separated quickly without centrifugation. After being solidified in an ice-bath, the upper layer (n-hexadecane) was transferred into an Eppendorf tube and analyzed by GC-MS after melted at room temperature. Factors affecting extraction efficiency such as the type and volume of extractant, dispersive agent and demulsifier, also ionic strength and pH value of extraction system were studied. Under the optimized conditions, the working curve of the proposed method provided a good linearity in the range of 0.025-2.00μg/L (r = 0.999 5-0.999 9). The detection limits of the organochlorine pesticides calculated by Hubaux-Vos method were 0.012-0.024μg/L and the relative standard deviations (RSDs) ranged from 3.15% to 4.53%. The enrichment factors (EF) were 96-101. When the method was applied to the determination of farmland water, the average spiked recoveries were 96.77%-102.93% with the relative standard deviations of 2.68%-4.86%. The proposed method is sensitive and fast. It also has the advantage of little organic solvent consumption so that it is friendly to environment and suitable for batch analysis of organochlorine pesticides in aqueous samples. Meanwhile, it provides technical and methodological support for achieving the automation of sample pretreatment.

Objective To study the effect of Lichong Decoction (Lichong Decoction for strengthening anti-pathogenic Qi and eliminating blood stasis) on the expression of insulin-like growth factor-l (IGF-I) and proliferating cell nuclear antigen (PCNA) mRNA in a rat model of uterine leiomyoma. Methods Fifty female Wistar rats were randomized into a normal control group, model group, Lichong Decoction group, Guizhifuling Capsule (Capsule containing Cassia Twig and Poria) group, and Mifepristone group. The uterine leiomyoma model was established by peritoneal injections of exogenous estrogen and progesterone hormone. The ultrastructural changes in cells of rat uterine tissues were observed with transmission electron microscopy, and the expression of IGF-I and PCNA mRNA was detected by real-time fluorescent quantitative PCR. Results Following treatment, cells in the Lichong Decoction group appeared to be arranged normally, the cellular morphology were almost in a normal state, hyperplasia and hypertrophy of the chondrio-some was reduced, collagen fibers were arranged in a regular manner, without obvious hyperplasia, and the expression of IGF-I and PCNA mRNA was significantly decreased compared with the model group ( P Conclusions The effect of Lichong Decoction on uterine leiomyoma is related to its function in reducing the expression of IGF-I and PCNA mRNA.

The method for the analysis of glucosamine hydrochloride in health foods using high performance anion exchange chromatography was established. The determination of glucosamine hydrochloride was performed on an AminoPac PA10 column (2 mm x 250 mm) with a pulse amperometric detector with an Au working electrode and an Ag/AgCl reference electrode. The linear range was 0.05 - 10.0 mg/L, and the detection limit was 0.012 mg/L. The relative standard deviations for the determination of the standard and a sample were 0.69% and 1.38%, respectively. The satisfactory results were obtained for the analysis of health food samples with the proposed method, and the spiked recovery was 96.6% - 105.2%. In comparison with the national standard method, the relative deviations of the determination results were -1.4% - 1.0%. The method is sensitive and precise. One analysis can be completed within 5 min. This method was available for the determination of glucosamine hydrochloride in health foods.

The objective of this study was to evaluate whether the discrepancy between clinic and home blood pressure (BP) in hypertensive subjects would disappear or diminish in magnitude if the BP measurement was taken under controlled conditions differing only with respect to location (clinic vs. home). Three hundred and sixty-seven patients aged 34−84 years with primary hypertension were enrolled. All of the patients or their spouses were taught to measure BP correctly with their own sphygmomanometer at home. The home BP value (HBP) was calculated as the average of 45 readings over 15 days. On days 6, 12, and 18 of the measurement period, rather than measuring their BP at home, patients and their spouses were asked to visit the hospital at the usual time of their BP measurement and to bring their own sphygmomanometer. The clinic BP value (CBP) was calculated as the average of the 9 readings taken on these visits by the patients or their spouses. The “white-coat phenomenon” (WCP) was considered to be present when the difference between the CBP and HBP was greater than 20/10 mmHg. The mean reading of home systolic/diastolic BP was 134.7/79.1 mmHg and the mean reading of clinic systolic/diastolic BP was 149.8/86.4 mmHg. In the total subject group, the prevalence rate of WCP was 31%−35% if the WCP was defined as ΔBP (CBP − HBP) ≥20 mmHg/10 mmHg. In conclusion, ruling out the influence of different factors, including time of day, the sphygmomanometer, the individual taking the BP measurement, the climate, and the patients' health or mood, the WCP was still found to exist to a statistically significant degree. This study indicated that teaching patients to measure their own BP at home is an effective procedure to obtain a more accurate result of their BP level. It also helped to involve the patients more actively in controlling their hypertension. (Hypertens Res 2008; 31: 37−41)

A Monte Carlo simulation scheme is presented to study the behavior of fatigue crack propagation under random overloads. Overloads of Poisson flow with uniform distribution on base-line constant-amplitude cyclic loads are considered. The retardation effect of overload on fatigue crack growth is taken into account by using Wheeler retardation model. The fatigue crack growth curve from initial crack size till fatigue fracture is simulated step by step. With the large number of the simulated samples, the average fatigue crack propagation life is obtained and the influences of overload intensity and magnitude on fatigue lifetime are studied.

建立了悬浮固化分散液液微萃取-毛细管电泳法同时测定水中磺酰脲类除草剂残留的方法.以十二醇为萃取剂、甲醇为分散剂,采用悬浮固化分散液液微萃取技术对水样进行分离提取,并结合毛细管电泳法进行测定.该方法可以有效提取、分离、检测水中残留的微量苯磺隆、吡嘧磺隆、苄嘧磺隆等9种磺酰脲类除草剂,各待测物在10.0～1 000 μg/L范围内线性关系良好,相关系数r≥0.992,方法检出限为2.40～ 7.50 μg/L,方法精密度为6.55％～13.9％.将该方法用于实际水样的测定,取得了较满意的结果,加标回收率为82.0％～104％.该方法简便快速,适合水中磺酰脲类除草剂的同时测定.

Xiaomei Chen and Jianyu Weng contributed equally to this study. The outcomes ofrelapsed or refractory acute myeloid leukemia (RR-AML) are poor and effective salvage regimens are urgently needed. We present a study of 14 patients with RR-AML (median age 42years, range 18-65years; male n=12, female n= 2) treated with CLAT regimen, which consisted of cladribine 5mg/m² per day i.v. 2-3 hour on days 1-5, cytarabine 1.0g/m² per day i.v. 4 hours after cladribine on days 1-5, topotecan 1.25mg/m² per day i.v. 4 hours after cytarabine on days1-5 and G-CSF 300ug per day subcutaneous injection on days until neutrophile granulocyte recovery. Total of fourteen patients were included into the study from June 2013 to June 2015, Two (14.3%) patients were relapsed and twelve (85.7%) patients were refractory, 4 of 14 patients were relapsed or refractory after allogeneic-HSCT. Two patients died of invasive fungal infection before the assessment. Seven patients (58.3%) achieved complete remission (CR), and one patient (8.3%) achieved partial remission (PR), the rest patients (33.3%) did not respond (NR). The overall response rate was 66.7%. Following CLAT treatment, four patients with CR underwent allogeneic hematopoietic stem cell transplantation (HSCT) or microtransplantation. The median relapse-free survival (RFS) for RR-AML patients receiving CLAT regimen was 8.6 (range 2-16) months. Thirteen patients developed grade 4 granulocytopenia and thrombocytopenia, the median duration was 13(range 2 to 21) days and12 (range 2 to 21) days, respectively. The most common non-hematological side effects included nausea, vomiting, diarrhoea, and were grade 1/2. The CLAT regimen seems promising for the treatment of patients, and it was well tolerated. This regimen offers an alternative treatment for those patients with RR-AML who have received severe intensive treatment, especially with anthracycline-containing chemotherapy. The project was sponsored by grants from National Natural Science Foundation of China (No. 30972790; No.81270648; No.81370665; No.81300446) Provincial Natural Science Foundation of Guangdong (No. S2012010009560) Provincial Science and Technology Planning Project of Guangdong (No.2013B021800186; No.2013B021800201), and Science and Technology Planning Project of Guangzhou (No. 201400000003-4, 201400000003-1). Disclosures No relevant conflicts of interest to declare.

Objectives Sublethal bactericidal antibiotics promote the formation of multidrug-tolerant persisters. Clinically, serum drug concentration increases gradually and reaches the peak level with high killing efficiency some time after administration. This study aimed to investigate if the initial low antibiotic concentration would promote persister formation in Klebsiella pneumoniae, an increasingly important nosocomial pathogen. Methods Time-dependent killings of K. pneumoniae by different types of bactericidal antibiotics were conducted to determine the existence of multidrug-tolerant K. pneumoniae persisters. Killing experiments with antibiotic gradient feeding were then conducted for a K. pneumoniae laboratory strain (ATCC 10031) and a clinical isolate (YWSCU-03) by adding antibiotics step by step until the drug peak serum concentration was attained. Results Multidrug-tolerant persisters indeed existed in K. pneumoniae and the persistence decreased with increasing drug concentrations or prolonged treatments. Antibiotic gradient feeding, to simulate a gradual increase in serum drug concentration, not only significantly elevated the persistence of ATCC 10031 and YWSCU-03, but also increased the frequency of drug-resistant mutant formation in YWSCU-03. Conclusions After administration, the initial low serum drug concentration could promote the formation of multidrug-tolerant bacterial persisters, which could survive the lethal drug concentrations attained later and potentially render the antibiotic treatment fruitless. Therefore, antibiotic treatments should be based on the comprehensive analysis of, not only drug pharmacokinetics, but also the synergistic effect between pharmacokinetics and persister formation.

A method for determining collagen in tendon by reversed-phase high performance liquid chromatography (RP-HPLC) was developed. After hydrolysis with hydrochloric acid, the collagen in samples was decomposed into hydroxyproline which hydroxyproline can be derivatized with 2, 4-dinitrochlorobenzene for the determination by HPLC (reversed-phase C18 column, 0.01 mol/L NaAc-HAc (pH 6.0)-CH3CN (80: 20, v/v) as mobile phase, detection at 360 nm). The factors influencing hydrolysis, derivatization and HPLC analysis were studied and optimized. Sixty samples were analyzed with the proposed method. The linear range was from 3 microg/L to 100 mg/L and the detection limit was 3 microg/L. The relative standard deviation (RSD) of determination was 1.95%. The recoveries of spiked samples were 98.4%-110.8%. The results show that the method is sensitive, accurate and suitable for tendon determination.

A method for the determination of chlorhexidine acetate in disinfectors using capillary electrophoresis (CE) was developed using the following conditions: detection wavelength, 254 nm; applied voltage, 15 kV; uncoated fused silica capillary column, 50 cm x 75 microm i.d.; buffer, 15 mmol/L phosphate and acetonitrile (60:40, v/v). Under the optimum conditions, chlorhexidine acetate in disinfectors was determinated in 4 min. The effects of different parameters, such as buffer component, buffer concentration, buffer pH value and electrophoretic voltage, on the CE analysis of chlorhexidine acetate were studied in detail. The linear range of the proposed method was 0.01-0.10 g/L. The detection limit was 0.004 mg/L. The relative standard deviation (RSD) of absorbance was 3.97% and the RSD of migration time was 2.99%. The spiked recoveries of samples were 91.4%-116.6%. The method was compared with the high performance liquid chromatographic method and the relative error was less than 4.0%. The proposed method was simple, quick and suitable for disinfector analysis.

Abstract 4163 Background Acute myelogenous leukemia (AML) is generally looked upon as a heterogeneous group of different entities originating from the malignant transformation of a hematopoietic progenitor or stem cell. AML incidence increases with age. AML is associated with a poor prognosis, particularly in older patients. The poor prognosis in older adults is because of a combination of factors, including a larger proportion of cases with adverse-risk cytogenetics and other deleterious genetic and epigenetic changes, lower rates of achieving complete remission with intensive chemotherapy, higher risk of disease recurrence after achieving remission, greater comorbidity, inability to tolerate conventional allogeneic bone marrow transplantation regimens, and other adverse prognostic factors. The outlook for these patients remains dismal and little progress as been made in the last two decades. Current treatment of elderly AML consists of intensive chemotherapy with an anthracycline and a cytarabine. To evaluate our progress in the diagnosis, treatment and outcome of this condition, we reviewed the reports of 93 newly diagnosed acute myeloid leukaemia patients>/=55 years of age admitted to our department between 2003 and 2007. Methods A retrospective chart review was performed of 93 patients >/=55 years of age diagnosed with acute myeloid leukemia. The clinical efficacy was observed and the overall survival(OS) were analyzed. Results Median age of patients was 66 (range 55-88) years, 69 patients(74%) received a combination of an anthracycline and a cytarabine, either mitoxantrone per day on days 1, 2(MA),or 35 mg/m2 pirarubicin(TA) 7–8mg/m2 or idarubicin per day on days 1, 2 (IA). Each patient was given 100mg/m2 cytarabine intravenously per day for 7 days. And 24 patients (26%) were untreated. Total CR rate was 45% after 2 regimens. Only 3 patients happened to early death. The median period of the bone marrow depression is 19 days. The follow-up was ended at Aug 2008 year. Median survival of the treated patients was 256 days and it was significantly (P = 0.003) different from the untreated patients(66 days). Of the treated group, 7 patients were still alive, and the longest time was more than 6 years. Conclusions The prognosis of acute myeloid leukemia in older patients remains poor, but the anthracycline chemotherapy seems to improve the outcomes among older with AML. For this difficult patient cohort, it is a better treatment that can exert a more selective anti-leukaemic activity whilst not suppressing normal haemopoiesis or having significant systemic toxicities. Disclosures: No relevant conflicts of interest to declare.

Abstract 1147 Poster Board I-169 In the past twenty years, allogeneic hematopoietic stem cells transplantation (Allo-HSCT) has been accepted as the most effective treatment for many hematologic malignancies. However, the successful rate of allo-HSCT has been limited by transplantation-related mortality and malignancies relapse, no matter using traditional intensity conditioning or reduced-intensity conditioning. In this study, we presented ninety-two patients with hematopoietic malignancies received fludarabine combinasion with modified Bu/Cy (FABC) conditioning regimen before allogeneic hematopoietic stem cell transplantation. Ninety-two patients with hematological malignancies (58 males, 34 females) ranged in age from 14 to 50 (median 28) years. These patients were diagnosed with acute lymphoblastic leukemia (ALL, n=30), acute myelogenous leukemia(AML, n=24), chronic myelogenous leukemia (CML, n=33; CP, n=27; CML-AP, n=5; CML-BC, n=1), myelodysplastic syndrome ( MDS, n=3), chronic myelomonocytic leukemia (CMML, n=1), and one patient coexisted chronic myelomonocytic leukemia and T lymphoblast cell lymphoma. Fifty-five (59.8%) patients were at high risk. From June 2004 to October 2008, 92 patients gave their informed consent and received conditioning regimen with fludarabine-based modified Bu/Cy (FABC conditioning regimen) in allo-HSCT. The FABC regimen consist of cytarabine 2.0 g/ m2 on day -9, busulphan (Bu) 3.2 mg/kg per day for intravenous on days -8 to day-6, followed by cyclophosphamide (Cy) 60 mg/kg per day on days -5 and day-4, combined fludarabin 30 mg/m2 per day for three consecutive days, on days -6 to day-4, and Me-CCNU (1-(2-Chloroethyl)-3-(4-ethylnitrobiphenyl Cylohexyl4)-1- Nitrosourea) 250 mg/m2 on day -3. Graft-versus-host-disease(GVHD) prophylaxis consisted of cyclosporine A, short-term MTX and Mycophenolate Mofefil (MMF 1.0g/day, on d-8 to d-1). Anti-T-lymphocyte globulin (2.5 mg·kg-1·d -1, on d-3 to d-1) was added to patients with mismatched sibling or unrelated donors. Follow-up was performed on 30 December, 2008. Ninety-two patients engrafted successfully, the median time for ANC >0.5×109/L was 12 (8 to 22) days, and for BPC > 20×109/L was 12 (7 -32) days. Detected by short tandem repeat (STR)-PCR, complete donor chimerism was comfirmed in all patients on day +21 or day+30. The incidence of acute GVHD was 25% (23/92), and grades 3 to 4 acute GVHD developed in 8 (8.7%) of 92 patients with in 100 days after HSCT. Chronic GVHD developed in 40(47.6%) of 84 patients who were alive more than 100 days after HSCT, and the incidence of extensive cGVHD was 35.7%(30/84). The transplant related mortality (TRM) was 19.6% (18/92), mainly from severe infection (n=7), acute or chronic GVHD (n=5), transplant associated-microangiopathy (n=2), diffusion alveolar hemorrhage (n=2), and post-transplant lymphoproliferative disorders (n=2). With a median follow-up of 16.2(1.5 to 54.5) months, 70 (76.1%) of the 92 patients were alive and 67(72.8%) were disease-free. The probabilities of OS at 1 year and 2 years was 80% and 72.5%, and DFS was 79.1% and 71.4%, respectively. These results suggest that the fludarabine-based modified Bu/Cy conditioning regimen (FABC) should reduce severe acute GVHD and accelerate hematopoietis resconsition without increasing chronic GVHD and lower leukemia relapse rates even in high-risk patients. Footnotes Corresponding author Disclosure No relevant conflicts of interest to declare.

ObjectiveTo study on effects of Lichong decoction on expression of apoptosis-controlling genes, Bcl-2 and Bcl-2-associated X protein (Bax) mRNAs in hysteromyoma tissue of the hysteromyoma model rat.MethodsFifty Wistar female rats were randomly divided into a normal group, a model group, a Lichong decoction group, a Guizifuling capsule group and a Mifepristone group. The hysteromyoma rat model was established by intraperitoneal injection of exogenous estrin and progestogens. Pathological examination of uterine tissue, uterine coefficient and uterine transverse diameter were made under optic microscope and expressions of Bcl-2 and Bax mRNAs in uterine tissue in the groups were detected with real-time fluorescent quantitative polymerase chain reaction (PCR) technique.ResultsAfter treatment, under microscope it was found that in the Lichong decoction group myometrium thinned, muscle fiber slightly overgrowth or long and thin, regular arrangement, inserting phenomenon of inner circular muscle and external longitudinal muscle was occasionally or not seen in the Lichong decoction group. The uterine coefficient and the uterine transverse diameter significantly decreased (P