Clinical value of lymph node dissection of No. 14cd during pancreaticoduodenectomy in patients with pancreatic head carcinoma / 中华外科杂志

Objectives: To evaluate the positive rate of left posterior lymph nodes of the superior mesenteric artery (14cd-LN) in patients undergoing pancreaticoduodenectomy for pancreatic head carcinoma,to analyze the impact of 14cd-LN dissection on lymph node staging and tumor TNM staging. Methods: The clinical and pathological data of 103 consecutive patients with pancreatic cancer who underwent pancreaticoduodenectomy at Pancreatic Center,the First Affiliated Hospital of Nanjing Medical University from January to December 2022 were analyzed,retrospectively. There were 69 males and 34 females,with an age(M (IQR))of 63.0 (14.0) years (range:48.0 to 86.0 years). The χ2 test and Fisher's exact probability method was used for comparison of the count data between the groups,respectively. The rank sum test was used for comparison of the measurement data between groups. Univariate and multivariate Logistic regression analyzes were used for the analysis of risk factors. Results: All 103 patients underwent pancreaticoduodenectomy successfully using the left-sided uncinate process and the artery first approach. Pathological examination showed pancreatic ductal adenocarcinoma in all cases. The location of the tumors was the pancreatic head in 40 cases,pancreatic head-uncinate in 45 cases,and pancreatic head-neck in 18 cases. Of the 103 patients,38 cases had moderately differentiated tumor and 65 cases had poorly differentiated tumor. The diameter of the lesions was 3.2 (0.8) cm (range:1.7 to 6.5 cm),the number of lymph nodes harvested was 25 (10) (range:11 to 53),and the number of positive lymph nodes was 1 (3) (range:0 to 40). The lymph node stage was stage N0 in 35 cases (34.0%),stage N1 in 43 cases (41.7%),and stage N2 in 25 cases (24.3%). TNM staging was stage ⅠA in 5 cases (4.9%),stage ⅠB in 19 cases (18.4%),stage ⅡA in 2 cases (1.9%),stage ⅡB in 38 cases (36.9%),stage Ⅲ in 38 cases (36.9%),and stage Ⅳ in 1 case (1.0%). In 103 patients with pancreatic head cancer,the overall positivity rate for 14cd-LN was 31.1% (32/103),and the positive rates for 14c-LN and 14d-LN were 21.4% (22/103) and 18.4% (19/103),respectively. 14cd-LN dissection increased the number of lymph nodes (P<0.01) and positive lymph nodes (P<0.01). As a result of the 14cd-LN dissection,the lymph node stage was changed in 6 patients,including 5 patients changed from N0 to N1 and 1 patient changed from N1 to N2. Similarly,the TNM stage was changed in 5 patients,including 2 patients changed from stage ⅠB to ⅡB,2 patients changed from stage ⅡA to ⅡB,and 1 patient changed from stage ⅡB to Ⅲ. Tumors located in the pancreatic head-uncinate (OR=3.43,95%CI:1.08 to 10.93,P=0.037) and the positivity of 7,8,9,12 LN (OR=5.45,95%CI:1.45 to 20.44,P=0.012) were independent risk factors for 14c-LN metastasis; while tumors with diameter >3 cm (OR=3.93,95%CI:1.08 to 14.33,P=0.038) and the positivity of 7,8,9,12 LN (OR=11.09,95%CI:2.69 to 45.80,P=0.001) were independent risk factors for 14d-LN metastasis. Conclusion: Due to its high positive rate in pancreatic head cancer,dissection of 14cd-LN during pancreaticoduodenectomy should be recommended,which can increase the number of lymph nodes harvested,provide a more accurate lymph node staging and TNM staging.

Comparison of distal pancreatectomy with celiac axis resection and sub-adventitial divestment technique for locally advanced or borderline resectable pancreatic body cancer / 中华外科杂志

Objective: To compare the outcomes of modified Appleby procedure and sub-adventitial divestment technique for locally advanced or borderline resectable pancreatic body cancer. Methods: A total of consecutive 58 patients(33 males and 25 females) who were diagnosed as locally advanced or borderline resectable pancreatic body cancer and underwent distal pancreatectomy at Pancreas Center, First Affiliated Hospital of Nanjing Medical University between September 2013 and May 2019 were retrospectively reviewed. The age(M(IQR)) was 62(9)years(range: 43 to 79 years). Thirty-one patients underwent distal pancreatectomy with celiac axis resection (DP-CAR) and 27 patients underwent distal pancreatectomy with sub-adventitial divestment technique(SDT). Perioperative parameters and follow-up data of these patients were analyzed. Quantitative data were compared with Wilcoxon test while categorical variables were compared with χ2 test or Fisher's exact test. Survival results were estimated by the Kaplan-Meier survival method with a Log-rank test. Results: There were no differences in age,gender,body mass index,abdominal symptoms,comorbidity or preoperative serum CA19-9 between two groups(all P>0.05). Obvious preoperative weight loss was more common in the group of SDT(48.1%(13/27) vs. 19.4%(6/31),χ²=5.431,P=0.020). Longer operative time(310(123) minutes vs. 254(137)minutes, Z=2.277,P=0.023),higher rate of combined organ resection(41.9%(13/31) vs. 14.8%(4/27),χ²=5.123,P=0.041) and longer postoperative hospital stay(15(10) days vs. 11(5)days,Z=2.292,P=0.022) were observed in the group of DP-CAR. Moreover,rate of overall morbidities was also higher (71.0%(22/31) vs. 29.6%(8/27),χ2=9.876,P=0.003),implicated by clinically relevant postoperative pancreatic fistula(61.3%(19/31) vs. 29.6%(8/27),χ2=5.814,P=0.020) in the DP-CAR group. Tumor size of the DP-CAR group was bigger(4.9(1.5)cm vs. 4.0(1.2)cm,Z=2.343,P=0.019) but no difference was seen between the DP-CAR group and SDT group in R0+R1(<1 mm) resection rate (84.0%(21/25) vs. 90.0%(18/20),P=0.678) and LNR(12.0(23.0)% vs. 9.0(18.0)%,Z=1.238,P=0.216),as well as median disease free survival(11.7 months vs. 11.4 months,Z=0.019,P=0.892) and median overall survival(16.3 months vs. 13.7 months,Z=0.172,P=0.679). Conclusions: Both DP-CAR and distal pancreatectomy with SDT are relatively safe and feasible for locally advanced or borderline resectable pancreatic body cancer. Compared with arterial resection,SDT may contribute to lower rates of postoperative complications and shorter duration of hospitalization,but no significant benefit is seen in long-term survival.

Comparative clinical efficacy analysis of pancreatoduodenectomy for distal bile duct and pancreatic head cancer: a report of 1 005 cases / 中华外科杂志

Objective: To compare and analyze the clinical efficacy of pancreaticoduodenectomy for distal bile duct cancer and pancreatic head cancer. Methods: Clinical data of 1 005 patients who underwent pancreaticoduodenectomy and postoperative pathological examination confirmed the diagnosis of distal bile duct cancer and pancreatic head cancer at the Pancreas Center of the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2020 were analyzed retrospectively. There were 112 cases in the distal bile duct cancer group, 71 males and 41 females,with age (M(IQR)) of 65(15) years(range: 40 to 87 years); 893 cases in the pancreatic head cancer group, 534 males and 359 females,with age of 64(13)years(range: 16 to 91 years). The differences between clinicopathological characteristics and postoperative overall survival of the two groups were analyzed by χ2 test, Fisher's exact probability method, rank sum test or log-rank test, respectively. The difference in postoperative overall survival between the two groups was compared using Kaplan-Meier method after propensity score matching (1∶1). Results: Compared with the pancreatic head cancer group,the distal bile duct cancer group had shorter operative time (240.0(134.0) minutes vs. 261.0(97.0) minutes, Z=2.712, P=0.007),less proportion of combined venous resection (4.5% (5/112) vs. 19.4% (173/893), χ²=15.177,P<0.01),smaller tumor diameter (2.0(1.0) cm vs. 3.0(1.5) cm,Z=10.567,P<0.01),higher well/moderate differentiation ratio (51.4% (56/112) vs. 38.0% (337/893), χ²=7.328, P=0.007),fewer positive lymph nodes (0(1) vs. 1(3), Z=5.824, P<0.01),and higher R0 resection rate (77.7% (87/112) vs. 38.3%(342/893), χ²=64.399, P<0.01),but with a higher incidence of overall postoperative complications (50.0% (56/112) vs. 36.3% (324/892), χ²=7.913,P=0.005),postoperative pancreatic fistula (28.6% (32/112) vs. 13.9% (124/893), χ²=16.318,P<0.01),and postoperative abdominal infection (21.4% (24/112) vs. 8.6% (77/892), χ²=18.001,P<0.01). After propensity score matching, there was no statistical difference in postoperative overall survival time between patients in the distal bile duct cancer group and the pancreatic head cancer group (50.6 months vs. 35.1 months,Z=1.640,P=0.201),and multifactorial analysis showed that tumor site was not an independent risk factor affecting the prognosis of patients in both groups after matching (HR=0.73,95%CI:0.43 to 1.23,P=0.238). Conclusions: Patients with distal bile duct cancer are more likely to benefit from early diagnosis and surgical treatment than patients with pancreatic head cancer,but with a relative higher postoperative complication rates. The different tumor origin site is not an independent risk factor for prognosis of patients with distal bile duct cancer and pancreatic head cancer after propensity score matching.

Role and mechanism of endoplasmic reticulum stress response induced by wear particles in osteolysis / 中国骨伤

OBJECTIVE@#To analyze the role of endoplasmic reticulum stress response in the development of osteoblast apoptosis and osteolysis in osteolytic bone tissue, and to explore the causes of artificial joint loosening, so as to provide new ideas and theoretical basis for the prevention and treatment of artificial joint loosening.@*METHODS@#The animal model of osteolysis induced by wear particles was established by mouse skull, and randomly divided into 4 groups, 7 rats in each group:group 1, blank control group;group 2, wear particles tial6v4 nano alloy powder (TiNPs) group;group 3, endoplasmic reticulum stress response positive control (TiNPs+Tg) group; group 4, endoplasmic reticulum stress response inhibitor (TiNPs+4-PBA) group. The pathological changes of osteolysis were observed by toluidine blue staining, HE staining and ALP staining;the expression of endoplasmic reticulum stress response marker protein was detected by Western Blotting;the apoptosis of osteoblasts in osteolytic skull tissue was detected by TUNEL and Caspase-3 immunohistochemistry.@*RESULTS@#Wear particles TiNPs can induce osteolysis in vitro, aggravate the infiltration of inflammatory cells and inhibit the differentiation and maturation of osteoblasts. At the same time, wear particles can also up regulate the markers of endoplasmic reticulum stress response and promote the apoptosis of osteoblasts in osteolytic bone tissue. After adding 4-PBA, an inhibitor of endoplasmic reticulum stress (4-PBA), on the basis of wear particles TiNPs, the symptoms of osteolysis were significantly relieved, bone erosion and inflammatory infiltration were significantly reduced, the differentiation and maturation of osteoblasts were improved, the number of apoptotic osteoblasts decreased sharply, and the expression of endoplasmic reticulum stress marker protein gradually decreased.@*CONCLUSION@#Endoplasmic reticulum stress is involved in the formation of osteolysis and plays an important role in the occurrence and development of osteolysis. At the same time, endoplasmic reticulum stress can be used as a new therapeutic target to provide new ideas and methods for clinical reversal or treatment of osteolysis and aseptic loosening.

Effects of chemokine CCL2 on learning memory in rats and its mechanisms / 中国药理学通报

Aim To investigate the role of chemokine CC motif ligand 2(CCL2) in leaning memory of rats and its mechanisms. Methods Forty male SD rats were randomly divided into five groups, namely, control, sham, CCL2(0.5, 5, 50 ng) group. Except control group, stereotaxic technique was used in this study to perform bilateral hippocampal injection. Mor-ris water maze ( MWM ) was employed to assess the learning and memory ability of rats from day 3 to day 8. Hippocampus was removed on the 10th day. qPCR was used to detect the relative mRNA expression of caspase-8, caspase-3 and phosphate-activated glutami-nase(PAG). ELISA was used to calculate the content of tumor necrosis factor a ( TNF- A ) , acetylcholine (AChE) and the activity of glutamine synthetase (GS). Results Compared to sham group, the latency and swimming distance in each CCL2-treated group were significantly extended, and the crossing times and the percentage of distance in target quadrant of each CCL2-treated group were shorter; the relative mRNA expression of caspase-8, caspase-3 and PAG in each CCL2-treated group were higher than those of sham group; each CCL2-treated group had elevated expression of TNF-a and AChE while the activity of GS in each group decreased. Conclusions CCL2 can impair learning and memory in rats, which may involve in-flammation, excitotoxicity, decreased ACh expression and mediated cell apoptosis.

Progress on laminoplasty in spinal canal disease / 中国骨伤

Surgery is the preferred method for the treatment of spinal canal disease, surgical method involves laminectomy and laminoplasty. The ideal spinal surgery not only should fully expose the spinal canal, completely resect the occupied position and remove the spinal cord compression, but also should maintain the stability of spinal biomechanics. Because of the different realization of clinician to safeguard and rebuild the spinal stabilization during opertion of spinal canal disease, and choice of surgical method and how to maintain the stability of spine biomechanics has become a hot of research in this field. Many scholars have studied it in order to reduce the influence of laminectomy on the spinal stability. Laminoplasty can directly relieve the nerve roots compression caused by increasing or reconstruction of vertebral canal volume, and allow the migration of spinal cord to dorsum and depart from disc and vertebral body. Laminoplasty not only can fully expose and decompress during operative, but also may prevent the postoperative spinal instability. In addition to these condition of extensive disease, severe bone destruction or combined with osteoporosis, the laminoplasty is the most ideal method for single spinal canal disease in theoretically.

Comparative study on two types of 3S and P-loops digestive reconstruction after total gastrectomy for gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the clinical effect of 3S-type and P-loops digestive reconstruction after total gastrectomy for gastric cancer.</p><p><b>METHODS</b>From February 2005 to February 2009, 85 cases underwent total gastrectomy in The First Affiliated Hospital of Henan University of Science and Technology. Two types of digestive reconstruction were performed with 3S-type jejunum(n=46) and P-loops Roux-en-Y esophagojejunostomy(n=39). The postoperative complications, nutrition index and the quality of life at half a year after surgery were comparatively analyzed.</p><p><b>RESULTS</b>Two types of digestive reconstruction had no statistical differences in operative time, postoperative complications and mortality(P>0.05). Compared with P-loops Roux-en-Y esophagojejunostomy at 6 months after operation, 3S-type jejunum had a lower incidence in dumping syndrome[4.3% (2/46) vs. 10.3% (4/39), P<0.05] and reflux esophagitis [10.8% (5/46) vs. 33.3% (13/39), P<0.05]. 3S-type jejunum was superior to P-loops Roux-en-Y esophagojejunostomy in serum total protein(55.7±3.1 g/L vs 50.3±5.1 g/L, P<0.05), albumin(36.5±3.6 g/L vs. 31.6±4.4 g/L, P<0.05), hemoglobin(120.2±13.4 g/L vs. 110.4±23.0 g/L, P<0.05), and nutritional assessment index(73.2±4.8 vs. 56.0±6.3, P<0.05).</p><p><b>CONCLUSION</b>Reconstruction of stomach with 3S-type jejunum may be an effective way to prevent reflux esophagitis and dumping syndrome, and to improve the nutritional status and the quality of life.</p>

Artificial liver support system in treatment of liver failure after acute poisoning / 世界急诊医学杂志（英文）

BACKGROUND: Acute poisoning (AP) may cause failure of the liver and kidney, and even death. This study aimed to investigate the efficacy of artificial liver support system (ALSS) on the treatment of liver failure after acute poisoning. METHODS: A total of 31 patients with liver failure caused by AP were admitted to emergency ICU, central ICU, and Department of Gastroenterology from 2005 to 2009 in Zhongshan Hospital Affiliated to Xiamen University, China. Among them, 13 patients served as a treatment group, and used ALSS in addition to detoxification treatment and protective treatment of liver function, and the other 18 patients served as a control group receiving detoxification treatment and protective treatment of liver function. RESULTS: In the treatment group, 10 patients (76.9％) were cured or improved, 2 died, and 1 was discharged against advice. In the 18 patients in the control group, 7 (38.9％) were cured or improved, 3 died, and 8 were discharged against advice. There was a significant difference in the rates of improvement between the two groups (P<0.05). CONCLUSION: ALSS is a safe and effective clinical method for the treatment of acute toxic liver failure.

Pentamer guided HLA-restricted epitope identification for mucoprotein 4 antigen of pancreatic ductal adenocarcinoma / 中华外科杂志

<p><b>OBJECTIVES</b>To identify HLA-restricted epitope of mucoprotein 4 (MUC4) antigen as a tumor associated antigen of pancreatic ductal adenocarcinoma (PDAC), and to validate its natural presentation in PDAC patient peripheral blood.</p><p><b>METHODS</b>Two epitope prediction databases (SYFPEITHI and ProPred-I) were used to predict HLA-A*0201 restricted MUC4 epitope, T2 cell assay was used to determine the peptide binding affinity with HLA-A*0201 molecule. Dendritic cells (DCs) were induced from the HLA-A* 0201-positive healthy individuals' peripheral blood mononuclear cells (PBMC). Mature DCs were pulsed with synthesized peptides. Autologous CD8(+) T cells from the HLA-A* 0201 healthy donor were stimulated with the peptide-pulsed DCs as CTL. CTL activity was assessed by lactate dehydrogenase release assay and IFN-γ released by enzyme-linked immunospot assay. Pentamer was synthesized for HLA-A* 0201 restricted epitope P1126, then was used to detect specific CTL in PBMC of PDAC patients.</p><p><b>RESULTS</b>Five candidate HLA-A*0201 epitopes were predicted, LLLGVGTFV (P1125) and LLGVGTFVV (P1126) were determined as the two with more HLA-A*0201 affinity. Mature DCs could be induced from PBMCs. CTL induced by peptide P1126 could lyses T2 cells pulsed with peptide P1126 and HCT-116 cells [MUC4(+), HLA-A2(+)]. The number of CTL induced by peptide P1126 which could secret IFN-γ (130.3 ± 6.6) was obviously higher than that in the negative group. By Pentamer assay, P1126-pentamer and CD8 double positive CTL could be detected in PBMC of PDAC patients with MUC4(+) than patients with MUC4(-), but no significant difference of CTL frequency between patients with HLA-A2(+) and with HLA-A2(-) in MUC4(+) PDAC patients.</p><p><b>CONCLUSIONS</b>Tumor associated antigen MUC4-derived HLA-A* 0201-restrictive cytotoxic T lymphocyte (CTL) epitope P1126 can induce CTL reaction. The CTL can secret immunologic active material to induce the specific target cells lysis. P1126 epitope can be naturally presented in PBMC of PDAC patients, but its HLA-restriction may not be perfect.</p>

Diagnosis and surgical treatment for non-functional islet cell tumor: a retrospective analysis of 44 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the methods of diagnosis and surgical treatment for nonfunctional islet cell tumor (NICT).</p><p><b>METHODS</b>Forty-four patients with non-functional islet cell tumor treated at the First Affiliated Hospital of Nanjing Medical University during January 1968 to June 2008 were analyzed retrospectively. There were 9 males and 35 females, aged from 7- to 70-years-old. Clinical manifestation: 15 cases (34.1%) of abdominal masses, 17 patients (38.6%) with epigastric or back pain, 5 cases of jaundice, 5 cases (11.4%) for upper abdominal fullness or vomiting, 10 cases (22.7%) of pancreatic tumor noticed by routine health checkups or imaging examinations. Imaging examination: CT scan, sonography, ERCP, MRI, upper GI series were performed in 33 (75.0%), 16 (36.4%), 6 (13.6%), 2 (4.5%), and 10 cases (22.7%) respectively. Operation methods: 39 patients (88.6%) underwent surgical resection and the other 5 patients did not.</p><p><b></b>RESULTS</p><p><b>COMPLICATIONS</b>pancreatic fistula in 7 patients (15.9%), intra-abdominal bleeding in 4 (9.1%), gastrojejunal anastomosis outlet obstruction in 1 (2.3%), biliary fistula in 2 (4.5%) and incisional infection in 3 (6.8%). Surgery related mortality happened in 2 patients (4.5%), both treated before 1999. Twenty-five patients underwent operation between January 1999 and June 2008 were followed up for 6 to 108 months. All survive except one died 75 months after the surgery for unknown reason.</p><p><b>CONCLUSIONS</b>No specific clinical manifestation is recognized for non-functional islet cell tumor. Spiral CT is an optimal diagnostic method, while surgery is the first choice for treatment. Middle segmental pancreatectomy has become an alternative surgical protocol for NICT.</p>

Association between the concentration of particulate matters and the hospital emergency room visits for circulatory diseases: a case-crossover study / 中华流行病学杂志

Objective To explore the association between the concentration of particulate matters with an aerodynamic diameter of <10 μm ( PM10 ) and the hospital emergency room visits for circulatory diseases ( International Classification of Diseases, tenth vision ICD-10 : 100-199) in Beijing, China. Methods We collected data for daily hospital emergency room visits of circulatory diseases ( ICD-10:I00-I99 ) from Peking University Third Hospital and from the ambient air PM10 through the Beijing Municipal Environmental Monitoring Center. A time-stratified case-crossover design was used to evaluate associations between circulatory disease health outcomes and PM10.Results The no-lagged unidirectional case-crossover design with 1:4 matched pairs had the highest odds ratios (ORs) between PM10 and the hospital emergency room visits for circulatory diseases. After adjusting the temperature and the relative humidity, a 10μg/m3 increased in the PM10 were found associated with the emergency room visits on value of ORs of 1.006(95% CI:1.003-1.008) for the total circulatory diseases ( ICD-10:I00-I99), 1.003 (95% CI:0.996-1.010) for coronary heart disease ( ICD-10:I20-I25 ), 1.005 ( 95 % CI:0.997-1.013 ) for cardiac arrhythmia ( ICE)-10:I47-I49), 1.019 (95 % CI:1.005-1.033 ) for heart failure disease ( ICD-10:I50 ),and 1.003 ( 95 % CI : 0.998-1.007 ) for cerebrovascular diseases ( ICD-10:I60-I69 ), respectively. Conclusion These findings suggested that elevated levels of ambient PM10 were positively associated with hospital emergency room visits for the total number of circulatory diseases and heart failure disease.

Advances in residues analysis of pesticide in Chinese herbal medicine and new technological development / 中国中药杂志

The current methods to prepare and determine pesticide residues in Chinese herbal medicine were summarized in this paper. In addition,the new techniques to prepare and determine pesticide residues used in recent years was reviewed, which included solid-phase micro-extraction (SPME) , supercritical fluid extraction ( SFE) , accelerated solvent extraction (ASE) , immune affinity chromatography (IAC), supercritical fluid chromatography (SFC), column switching high performance liquid chromatography (CSHPLC), high performance liquid chromatography/mass spectrometry (HPLC/MS), capillary electrophoresis (CE) and capillary zone electrophoresis (CZE) , and immune analysis (IA), etc. To sum up, these would bring a great progress in analysis of the pesticide residues in Chinese herbal medicine, and make it more rapidly, accurately and normatively.

Molecular forms of TFF1 in normal gastric mucosa and its relationship with canceration / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the molecular forms of TFF1 in normal gastric mucosa and its expression in normal, gastric carcinoma, atypical hyperplasia, and intestinalized gastric mucosa.</p><p><b>METHODS</b>The molecular forms of TFF1 in normal gastric mucosa was observed by western blotting. The expression of TFF1 in normal, gastric carcinoma, atypical hyperplasia, and intestinalization gastric mucosa was assayed immunohistochemically.</p><p><b>RESULTS</b>TFF1 existed in normal gastric mucosa in forms of monomer, dimer and 21-kD TFF1 complex, with the last being the richest. TFF1 was expressed mainly in the epithelial cytoplasm of the mucosa in the gastric body and antrum, especially around the nucleus, and the closer to the lumen, the higher the expression. TFF1 expression in the tissues adjacent to gastric carcinoma was higher than that in normal gastric mucosa (P<0.001), and the expression in gastric adenocarcinoma was positively correlated to differentiation of adenocarcinoma. No TFF1 was expressed in poorly differentiated adenocarcinoma. The expression of TFF1 in moderate and well differentiated adenocarcinoma was a little lower than that in normal mucosa (P>0.05). The gastric mucosa with atypical hyperplasia had significantly higher TFF1 expression than normal gastric mucosa (P<0.001), and TFF1 was not detected in intestinalized gastric mucosa. There was no significant difference in TFF1 expression between gastric mucosa around the intestinalized tissues and normal gastric mucosa (P>0.05).</p><p><b>CONCLUSIONS</b>TFF1 plays an important part in protection and restitution of the gastric mucosa, and TFF1 may be related to suppression and differentiation of carcinoma.</p>

Recent advances in the determination methods of aflatoxins / 中国中药杂志

Aflatoxins are very harmful pollutants generally existing in peanuts, corns, farm products and so on. Many methods for the determination of aflatoxins have been developed in recent thirty years. The limits for aflatoxins have been set down for foods and farm products in different countries successively. In China, the methods for the determination of aflatoxins in foods cannot meet the need of new limit regulations. Aflatoxins were found in some traditional Chinese medicines according to some literatures. But the detective method and standard for the determination of aflatoxins is not established in active pharmacopoeia. The analytical methods for aflatoxins have been summarized in this paper, which can provide the references to the researchers who are engaged in the determination of aflatoxins in traditional Chinese medicines and foods. This paper mainly focuses on the liquid chromatography method with immunoaffinity column cleanup using post-column derivatization system for aflatoxins. Aflatoxins can be adsorbed in the immunoaffinity column peculiarly on the basis of this method, and then they can be eluted with organic solvent. It is the best way for cleanup using immunoaffinity column for the determination of aflatoxins in traditional Chinese medicines. This HPLC method with fluorescence detector using post-column derivatization system is a commonly used method in different countries, and it is more sensitive and accurate. Our studies have also proved that this method, that is: the liquid chromatography methods with immunoaffinity column cleanup using post-column derivatization system for aflatoxins, is the best method, which is suitable for the determination of aflatoxins in traditional Chinese medicines.

HPLC analysis of alfatoxins in medicinal herb extracts by immunoaffinity column cleanup and post-column bromination / 中国中药杂志

<p><b>OBJECTIVE</b>To develop a new and accurate method to quantify aflatoxins in medicinal herbs.</p><p><b>METHOD</b>This method consists of sample extraction by using MeOH-H2O (7:3), followed by clean-up with an immunoaffinity column, and finally HPLC determination with fluorescence detection. Aflatoxins B1 and G1 are determined as their bromine derivatives, produced in an on-line post-column derivatization system.</p><p><b>RESULT</b>The overall average recoveries for different medicinal herbs spiked at two levels of standards were from 90.4% to 99.7%. The detection limit was 0.06 microg x kg(-1) for aflatoxins G2 and B2, and 0.20 microg x kg(-1) for aflatoxins G1 and B1.</p><p><b>CONCLUSION</b>The use of immunoaffinity column provides excellent cleanup of interfering substances. The method has been applied successfully to analyze 96 natural drugs.</p>

Enantioseparation of amlodipine maleate by capillary electrophoresis using colominic acid as a chiral selector and the mechanism of chiral recognition / 药学学报

<p><b>AIM</b>Colominic acid, a novel chiral selector, was applied to enantioseparation of dihydropyridine derivative by capillary electrophoresis. A new method was developed for enantioseparation of amlodipine maleate, a novel calcium channel blocking therapeutic agent. The chiral recognition mechanism of colominic acid to amlodipine maleate was studied.</p><p><b>METHODS</b>Capillary electrophoresis was performed, and the effects of separation conditions on chiral separation were examined, including concentration of chiral selector, buffer pH, capillary temperature, applied voltage and molecular mass of colominic acid.</p><p><b>RESULTS</b>The optimum conditions were additive concentration of 8.0%, buffer pH at 3.00, capillary temperature at 15 degrees C, 12 kV for applied voltage and 3 x 10(4) for molecular mass of colominic acid. Under optimum conditions complete separation was achieved between the enantiomers of amlodipine maleate with resolution as high as 2.20.</p><p><b>CONCLUSION</b>The cliral separation was based on the multipoint recognition between colominic acid and amlodipine maleate. It is recommended that this simple, rapid and selective method be used for enantioseparation of amlodipine maleate. As far as polysaccharides were concerned, colominic acid was first used for enantioseparation of amlodipine maleate.</p>

Comparison between the post-column derivatization with bromine by HPLC and the fluorometric analysis for determination of aflatoxins in medicinal herbs and plant extracts / 药学学报

<p><b>AIM</b>To compare the post-column derivatization technique (IAC-PCD-HPLC) for the determination of aflatoxins B1, B2, G1 and G2 and the rapid procedure with fluorometric analysis (SFB) for the determination of total aflatoxins.</p><p><b>METHODS</b>The method of post-column derivatization with bromine by HPLC consisted of extraction of the sample with MeOH-H2O (70:30) followed by clean-up of the extracts with immunoaffinity columns and finally, HPLC determination with fluorescence detection. Aflatoxins B1 and G1 were determined as their bromine derivatives, produced in an on-line post-column derivatization system. In SFB method, samples were ground and extracted with methanol-water (70:30). A portion of the extract was cleaned up by passage through a immunoaffinity column, One mL of purified extract was derivatized with a bromine reagent, and fluorescence of the solution was immediately quantified with a calibrated fluorometer containing a broad wavelength pulsed xenon light source.</p><p><b>RESULTS</b>In IAC-HPLC method, the overall average recoveries for three different medicinal herbs spiked at levels of 1.3 and 2.6 ng x g(-1) of total aflatoxins ranged from 93% to 97%. The detection limit was 0. 06 microg x kg(-1) for both G2 and B2 and 0.20 microg x kg(-1) for both G1 and B1, based on a signal/noise 3:1 and the precision (within-laboratory relative standard deviation) ranged from 0.8% to 1.4%. Each of aflatoxins B1, B2, G1 and G2 in 39 kind medicinal materials were determined by IAC-PCD-HPLC, and the total aflatoxins were determined by SFB.</p><p><b>CONCLUSION</b>The SFB method is not the suitable method for the determination of total aflatoxins in medicinal herbs and plant extracts.</p>

The prevalence of mild cognitive impairment among residents aged 55 or over in Chengdu area / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the prevalence of mild cognitive impairment (MCI) in the urban and the rural areas in Chengdu, Southwest China.</p><p><b>METHODS</b>Residents aged 55 or over were selected by stratified random cluster sampling from 19 districts, cities, and counties of Chengdu area in Sichuan province. A two-stage survey was carried out. In the first stage, CMMSE, CES-D were used as screening instruments. In the second stage, Diagnostic questionnaires of dementia and CDR were used as diagnostic instruments. The diagnostic criteria of mild cognitive impairment adopted from Petersen's were: (1) memory complaint; (2) normal activities of daily living; (3) normal general cognitive function; (4) memory impairment incompatible with age; (5) not demented; (6) CDR = 0.5 and (7) exclusion of the reversible cognitive impairment caused by other factors (i.e. depression).</p><p><b>RESULTS</b>Three thousand, nine hundred and ten subjects were examined. The prevalence rates of MCI was 2.4%. The MCI prevalence rates in the urban and the rural areas were 1.5%, 2.5% respectively, without significant difference. The MCI prevalence in males and females were 1.8%, 2.9% respectively. Prevalence rate in female was higher than in males with significant difference. Prevalence of illiteracy (4.0%) was the highest among different educational levels. The accumulated prevalence increased with age.</p><p><b>CONCLUSION</b>The prevalence of MCI (2.4%) was slightly higher than the prevalence of AD (2.05%) in the same areas of Chengdu. MCI seemed to be a high risk factor for AD which should to be followed up. Early intervention in MCI might be helpful in the prevention of AD.</p>

Application of hierarchical cluster with high-performance liquid chromatography in the classification of genus Clinopodium chinensis / 中国中药杂志

<p><b>OBJECTIVE</b>To realize the relationships of the plants of genus C. chinensis in our country and confirm the feasible quality of the application of Hierarchical cluster in the classification of genus C. chinensis.</p><p><b>METHOD</b>The chemical information of 20 samples of 10 kinds of plants was obtained with high-performance liquid chromatographic method and classification based on their chemical information was made through Hierarchical cluster. Flavonoids and saponins were the main components of the C. chinensis plants. We did the high-performance liquid chromatography from the flavonoids and saponins side respectively.</p><p><b>RESULT</b>Expected results were achieved in the Hierarchical clusters of the chromatographic data of the plants of genus C. chinensis which supplied the foundation for studying crude drugs categorys and those close of C. chinensis.</p><p><b>CONCLUSION</b>The cluster and identification results show the method is acceptable, simple, rapid, inexpensive and repeatable.</p>