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ObjectiveTo determine the contents of four kinds of indole alkaloids （rhynchophylline， isorhynchophylline， corynoxeine， isocorynoxeine） in Uncaria by high-performance liquid chromatography-mass spectrometry-automatic internal standard （HPLC-MS-AIS）. MethodsChromatographic separation was performed using C18 column （3.0 mm×50 mm， 3.3 μm）， and the mobile phase， comprising 0.1% formic acid aqueous solution-acetonitrile （82∶18， V/V）， was eluted at a flow rate of 0.5 mL/min and column temperature of 30℃. Mass spectrometric detection was performed using an electrospray ionization source and positive multiple-reaction monitoring mode at a voltage capillary of 4 000 V. The mass-to-charge ratio （m/z） transition was 385.25/160.10 for rhynchophylline， 385.30/160.10 for isorhynchophylline， 383.25/160.15 for corynoxeine and 383.25/160.15 for isocorynoxeine， respectively. The injection volume was kept constant at 2 μL. ResultsThe linear concentration ranges of rhynchophylline， isorhynchophylline， corynoxeine and isocorynoxeine were 2.30~600.00 ng/mL （r=0.999 3）， 2.30~600.00 ng/mL （r=0.999 2）， 2.47~650.00 ng/mL （r=0.999 4） and 2.47~650.00 ng/mL （r=0.999 2）， respectively. The relative standard deviation （RSD） of precision and stability were all lower than 5.00%， the accuracy ranged from 92.40% to 104.10%， and the average recovery was 95.90%~104.60%. ConclusionHPLC-MS-AIS method is simple and accurate for the determination of four kinds of alkaloids in Uncaria， and can be used as a new method for quality control of Uncaria.
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ObjectiveTo develop a two-dimensional high-performance liquid chromatography （2D-HPLC） for simultaneous determination of the contents of four kinds of Uncaria alkaloids： rhynchophylline， isorhynchophylline， corynoxeine and isocorynoxeine. MethodsThe 2D-HPLC apparatus was comprised of a first chromatographic column in version Aston SC2 （3.5 mm×25 mm， 5 μm）， an intermediate column in version Aston SH C18 （3.5 mm×10 mm， 5 μm）， and an analytical column in version Aston SCB （4.6 mm×125 mm， 5 μm）. The mobile phase of the first and second liquid chromatography system were CAA-1 and mixed mobile phase （V BPI-1 basic mobile phase ∶ V MPI-1 mobile phase ∶ V OPI-1 organic mobile phase = 45∶14∶41）. The chromatographic parameters included a flow rate of 1.0 mL/min， a column temperature of 40℃， a wavelength of 254 nm， an injection volume of 500 μL and a detection time of 9.5 min. ResultsThe linear ranges of rhynchophylline， isorhynchophylline， corynoxeine and isocorynoxeine were 9.77~10 000.00 ng/mL （r=0.999 6）， 10.74~11 000.00 ng/mL （r=0.999 7）， 10.74~11 000.00 ng/mL （r=0.999 7）， 10.74~11 000.00 ng/mL（r=0.999 6）， respectively. The relative standard deviation （RSD） of precision， stability and repeatability were all less than 5.00%. The accuracy was 95.20%~104.01%， and the recovery rate was 93.63%~101.38%. ConclusionThe 2D-HPLC developed for simultaneous determination of four kinds of alkaloids in Uncaria is simple and accurate， which can be used as a new method for quality control of Uncaria.
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Objective:To explore the status of volume management behavior in patients with peritoneal dialysis, and to explore the relationship between health belief and volume management behavior.Methods:Convenient sampling was used to select 129 patients who underwent regular dialysis in the peritoneal dialysis center of the General Hospital of Ningxia Medical University from January to December 2019. The general condition questionnaire, Health Belief Scale, and Capacity Management Behavior Scale for patients with peritoneal dialysis were used.Results:The total score of the Capacity Management Behavior Scale of peritoneal dialysis patients was 20.23±3.54. Among all the entries: "Weigh and record the infusion volume and drainage volume" and "Regular monitoring of renal function and electrolytes and other related examinations as directed by the doctor" scored higher; while the item "Eat less high-salt and high-sodium food and adjust fluid intake according to the amount of ultrafiltration, edema and urine output" item scored lower; single factor analysis found that different educational levels, different employment conditions, whether had diabetes mellius and different over hydration had statistical significance ( F value was 3.911, t values were 2.409, 4.990, 6.070, P<0.05). The dimension of the perception maintenance capacity balance disorder was negatively correlated with the total score and each dimension of the capacity management behavior( r values were -0.243, -0.260, -0.299, P<0.05) , and the liquid intake self-efficacy dimension is positively correlated with the total score and each dimension of the capacity management behavior ( r values were 0.329, 0.397, 0.393, P<0.05). Conclusions:The level of capacity management behavior of peritoneal dialysis patients needs to be improved; employment status, and whether he has diabetes or not are the influencing factors of the patients' capacity management behavior; in health beliefs, perception of maintenance of volume balance disorders and self-efficacy and peritoneal dialysis are correlated with patients' capacity management behaviors.
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Objective:To investigate the effect of hemoglobin (Hb) volatility on cardiovascular prognosis in peritoneal dialysis (PD) patients.Methods:Retrospective cohort study was designed. Patients undergoing stable PD for more than 3 months and followed up regularly for at least 1 year were enrolled from May 1, 2013 to October 31, 2014 in the General Hospital of Ningxia Medical University. According to the Hb variation based on the mean changes in Hb standard deviation at 1 month, 3 months, 6 months, 12 months over baseline Hb, all patients were divided into low volatility group (≤10 g/L), moderate volatility group (>10-20 g/L) and high volatility group (>20 g/L), and baseline information were compared among these groups. Kaplan-Meier survival analysis and Cox regression equation were used to analyze the relationship between Hb variation and cardiovascular mortality and all-cause mortality. Besides, the patients were divided into qualified group (Hb≥110 g/L) and substandard group (Hb<110 g/L) by the Hb level at the study endpoint (cardiovascular death and all-cause death) according to KDIGO guidelines and relevant literature. Cox regression analysis was used to analyze the relationship between Hb variation and cardiovascular death in qualified group or substandard group. Multivariate linear regression analysis was used to analyze the related factors of Hb fluctuation in PD patients.Results:A total of 267 patients were enrolled. There were 160 males (59.93%) in this study. The age was (52.66±13.72) years old, and the median dialysis age was 37(21, 61) months. The patients' baseline Hb (before dialysis) was (80.16±14.89) g/L and at the end of the study Hb was (105.34±22.08) g/L. Body mass index and baseline Hb levels in the high volatility group were lower than those in low volatility group and moderate volatility group (all P<0.05). Both moderate and high volatility groups had lower estimated glomerular filtration rate than that in low volatility group, and high volatility group had higher urea nitrogen level than that in low volatility group (all P<0.05). The amount of erythropoietin usage in the high volatility group was higher than that in moderate volatility group ( P<0.05). The Kaplan-Meier survival analysis results showed that there was no significant difference in survival rate for all-cause death (Log-rank χ2=0.735, P=0.693) and cardiovascular death (Log-rank χ2=2.961, P=0.228) in different Hb volatility groups. Cox regression analysis showed that after adjusting for age, sex, serum creatinine, and blood albumin, higher Hb volatility was associated with a lower risk of cardiovascular death ( HR=0.972, 95% CI 0.947-0.999, P=0.040). After adjusting for related confounding factors, higher Hb volatility was still a protective factor for cardiovascular death in the substandard group ( HR=0.946, 95% CI 0.903-0.992, P=0.022), but there was no significant correlation between Hb fluctuation and all-cause death. Multivariate linear regression analysis results showed that the fluctuation level of Hb was positively correlated with Kt/V ( B=4.682, 95% CI 2.480-6.884, P<0.001) and erythropoietin dosages ( B=0.001, 95% CI 0-0.001, P=0.003), and negatively correlated with baseline Hb ( B=-0.554, 95% CI -0.651--0.457, P<0.001). Conclusions:High Hb variability is a protective factor for cardiovascular death in PD patients with lower Hb level (substandard Hb). Adopting a reasonable program to correct anemia timely to reach the standard level has a greater impact on reducing risk of cardiovascular death in PD patients than Hb variation in anemia treatment.
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Objective To investigate health beliefs and fluid status in diabetic peritoneal dialysis patients, to explore the relation between fluid status and health beliefs in diabetic peritoneal dialysis patients. Methods The data were collected from the peritoneal dialysis center in Ningxia Medical University General Hospital from January 2014 through January 2015. A total of 64 diabetic peritoneal dialysis patients were recruited and investigated with health beliefs scale, fluid status and laboratory index, the influencing factors were analyzed with Logistic regression. Results Levels of perceived barriers in diabetic peritoneal dialysis patients was the lowest. The score of perceived barriers, levels of albumin and daily water intake in pedal edema diabetic peritoneal dialysis patients were 35.34±10.31, (29.90±4.51) g/L,(860.34±516.71) ml/d, and the results in the non-pedal edema patients were 31.67±12.47, (32.72±6.87) g/L, (872.22±271.85) ml/d, the difference was significant (t=-1.99,2.09,-3.07, P<0.05 or 0.01). Perceived barriers in diabetic peritoneal dialysis patients was positively correlated with edematous level (r=0.16,P<0.05) and perceived capacity balancing was negatively correlated with edematous level (r=-0.25,P<0.05). Regression analysis showed that marital status,dialysis age,daily water intake and perceived barriers were the main factors influencing fluid control in diabetic peritoneal dialysis patients. Conclusions Fluid control in diabetic peritoneal dialysis patients is affected by their health beliefs, this indicates that diabetic peritoneal dialysis patients must have insufficient awareness of fluid status and fluid adherence. It is suggested that they should establish comprehensive health beliefs.
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Objective To explore the influence of knowing about disease on hope level,anxiety and depression of patients with gastric cancer.Methods 120 gastric cancer patients were examined by Herth Hope Index,Hamilton Anxiety Scale(HAMA) and Hamilton Depression Scale(HAMD).Results Gastric cancer patients who did not know about their diseases accounted for 67.5％.Scores of hope level,anxiety and depression of patients were not obviously different between knowing and not knowing about disease groups.The relevant factors that affected the level of hope in gastric cancer patients were anxiety and family income.Conclusions The knowing or not knowing about disease are not the influencing factors that affected the hope level in gastric cancer patients as well as anxiety and depression.The relevant factors that affected the level of hope in gastric cancer patients are anxiety and family income.Patients can benefit from more factual information about the diagnosis.