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Objective@#To investigate the profiles of blood amino acid and acylcarnitine in early neonates with neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) and the sensitivity of newborn screening, and to explore potential biochemical metabolic markers for newborn screening program.@*Methods@#Amino acid and acylcarnitine profiles in dried blood spots of newborn screening program were analyzed by tandem mass spectrometry (MS/MS). A total of 158 651 neonates born in Guangzhou from January 1, 2015 to June 30, 2019 were enrolled in this newborn screening program, and additionally 55 patients with NICCD confirmed by SLC25A13 gene analysis in Guangzhou Women and Children Medical Center were included in this study. NICCD screen-positive was defined as the cutoff value of citrulline (Cit) ≥ 30 μmol/L. The values of blood sampling time of the true positive group and those of the false negative group were compared by t-test. The levels of amino acid and acylcarnitine among different groups, including true positive group (Cit≥30 μmol/L), false negative group (Cit 21-<30 μmol/L and Cit<21 μmol/L) and the normal control group, were analyzed by F test, respectively.@*Results@#Among 158 651 neonates, 39 neonates were positive for NICCD screening. Three of them were confirmed NICCD and 4 cases were found to be false negatives. The positive predictive value was 7.7% and the sensitivity was about 43.0%. Among 55 patients with NICCD, 18 cases (18/55, 32.7%) were true positives and 37 cases (37/55, 67.3%) were false negatives based on the cutoff value of citrulline in the dried blood spots for newborn screening. The blood sampling time was significantly different between true positive group and false negative group ((4.28±1.6) vs. (2.98±0.74) d, t=4.06, P<0.01). The increased levels of tyrosine((176.0±98.4) μmol/L), methionine ((37.0±26.9) μmol/L) and phenylalanine ((133.0±80.9)μmol/L) in Cit≥30 μmol/L group (n=18) were significantly different as compared with those in the other three groups, respectively (F=117.0, 58.5, 135.0, P<0.01). The levels of arginine ( (10.0±9.2) , (11.0±9.3) , (9.0±17.8) μmol/L), valine ( (119.0±29.8) , (107.6±14.1) , (102±68) μmol/L) and leucine ( (167.0±37.1) , (161.0±37.7) , (163.5±180.6) μmol/L) were not statistically significant among groups of Cit≥30 μmol/L(n=18), Cit21-<30 μmol/L(n=7) and Cit<21μmol/L(n=30,P>0.05), but they were significantly higher than those of the normal control group ((4±3), (78±21), (114.0±31.5) μmol/L, n=1 000), respectively(F=30.1, 23.0, 29.8, P<0.01). Alanine (Ala) ( (150±50) , (156.0±30.2), (168±105), (152±52) μmol/L) levels showed no significant difference (F=0.86, P>0.05) but the ratios of Ala/Cit (1.52±1.44, 6.82±1.56, 12.06±7.71, 19.42±6.27) decreased significantly among the four groups (F=69.0, P<0.05). The acylcarnitine levels showed no statistically significant results among the different groups (P>0.05). With Cit≥30 μmol/L and Ala/Cit<7.5 as cutoff values, the number of screen-positive cases reduced from 39 to 22 cases with no additional false negative case. With Cit≥21 μmol/L and Ala/Cit<7.5 as cutoff values the number of screen-positive cases increased to 117 cases with 1 additional true positive.@*Conclusions@#The profiles of blood amino acid in early neonates with NICCD present the increased levels of multiple amino acids including citrulline, tyrosine, methionine and phenylalanine, and decreased ratio of Ala/Cit. Taking citrulline and ratio of Ala/Cit as screening markers can improve the positive predictive value appropriately. The limited sensitivity of NICCD newborn screening may be related to early blood sampling time.
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Objective To detect the effect of Danhong injection on cerebral vascular hemodynamic parameters, Cys-c and Hcy in patients with transient cerebral ischemia(TIA), and analyze its clinical effect. Methods 80 TIA patients were selected. The patients were divided into a control group and a Danhong injection observation group with 40 cases each group. The control group was given conventional treatment, and the observation group was given conventional treatment and Danhong injection. The treatment course was 14 d. The hemodynamic parameters, Cys-c and Hcy expresssion were observed. Clinical effect was analyzed. Results After treatment, average blood flow speed (20.07 ± 4.28 cm/s vs. 16.17 ± 2.46 cm/s, t=5.230), average blood flow (11.14 ± 2.24 ml/s vs. 9.54 ± 1.65 ml/s, t=3.637), and cerebral vascular resistance (1 602.4 ± 98.3 kPa/s·m-1 vs. 1 738.5 ± 104.3 kPa/s·m-1, t=6.024) was significantly improved in the observation group than those in the control group (P<0.05). Cys-c (0.48 ± 0.11 mg/L vs. 0.71 ± 0.14 mg/L, t=8.170) and Hcy (17.45 ± 3.26 μmol/L vs. 23.62 ± 4.12 μmol/L, t=7.428) were significantly decreased in the observation group than those in the control group (P<0.05). The recurrence rate of TIA and cerebral infarction were 7.5% and 5% in observation group, which were significantly lower than that of 22.5% and 15% in control group (χ2=2.451, P<0.05;χ2=2.630, P<0.05).Conclusion Danhong injection can reduce the expression of Cys-c and Hcy and recurrence rate of TIA and cerebral infarction.
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OBJECTIVE: To optimize the extraction process of Xiaozheng plaster, a traditional Chinese medicine. METHODS: Xiaozheng plaster was prepared by water extraction and alcohol precipitation method with stachydrine content in water and the yield of powdered extract as evaluation indexes. The orthogonal test was carried out to optimize the reasonable parameters of the extraction process. RESULTS: The optimal extraction process for the prescription was adding 12-fold of water and decocting for 90 minutes at each time for three times altogether with alcohol precipitation concentration at 45%. CONCLUSION: The extractive condition can be optimized through visual analysis and the preparation technology is feasible.
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OBJECTIVE:To establish quality control method for rupining strapping.METHODS:The qualitation of Herba Epimedii,Rhizoma Bolbostemmae and fructus toosendan in rupining strapping was conducted by TLC.The principal drug-epimedium herb was determined by column chromatography-HPLC.RESULTS:Herba Epimedii,Rhizoma Bolbostemmae and fructus toosendan could all be identified in TLC.Good linear correlation of icariin was observed when the sample size was0.428?g～2.568?g(r=0.9998).The average recovery was94.57%(RSD=1.43%).CONCLUSION:The method is sensi-tive,accurate,and reproducible.It can be used for the quality control of rupining stripping.
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OBJECTIVE:To observe on the curative effect of compound glycyrrhizin in the treatment of chronic hepatitis B with hepatic fibrosis.METHODS:146cases of chronic hepatitis B with hepatic fibrosis were administered by i.v.drop daily for4weeks with compound glycyrrhizin injection40ml～100ml,into which5%glucose injection(250ml)was added,then a sequential therapy was adopted in which all the patients were treated with50mg oral compound glycyrrhizin tablets3times per day for3months.RESULTS:The total effective rates after4weeks of first stage treatment and the sequential therapy were67.12%and81.51%(P