Progress in Diagnosis and Treatment of Autoimmune Hypophysitis / 罕见病研究

Autoimmune hypophysitis is a rare disorder characterized by autoimmune-mediated inflammation of the pituitary, among which lymphocytic hypophysitis is the most common type that occurs mainly in young women of reproductive ages. Its common clinical manifestation includes headache, visual dysfunction, hypopituitarism and etc. Typical magnetic resonance imaging shows diffuse homogenous enlargement of the pituitary gland with gadolinium enhancement and stalk thickening. Pituitary biopsy with histopathological examination is the gold standard for the diagnosis of autoimmune hypophysitis, but it should be performed with extra care in that transsphenoidal surgery is invasive and may cause pituitary insufficiency. Closely relating to clinical manifestation of the patients and the radiological features is advised for diagnosis. Good response to glucocorticoid therapy also help confirm the diagnosis. Full course of pharmacological glucocorticoid treatment can effectively control the clinical symptoms, reduce the mass effects, and promote the resumption of pituitary functions. Surgery is usually necessary for xanthomatous and granulomatous hypophysitis. Pathophysiological mechanism, diagnostic biomarkers, and need studying further.

Research progress of mesenchymal stem cell-derived exosomes in oxidative stress injury / 第二军医大学学报

Oxidative stress damage is known to be a major factor leading to many diseases. Mesenchymal stem cellderived exosomes (MSC-exos) are enriched with various proteins, lipids, coding RNAs and non-coding RNAs, and alleviate oxidative stress damage and stimulate the regeneration response of damaged tissues and cells. MSC-exos hold a great potential for the treatment of diseases caused by oxidative stress. In this review, we summarized the research progress of MSC-exos in cardiovascular injury, lung injury, kidney injury and liver cell injury caused by oxidative stress.

Determination of Oleandrin in Blood and Liver Samples by LC-MS/MS / 法医学杂志

Objective To develop a liquid chromatography-tandem mass spectrometry (LC-MS/MS) analytical method for the determination of oleandrin in blood and liver tissues, which could be applied to the cases of death caused by oleander poisoning.Methods Blood or liver tissues underwent a liquidliquid extraction (LLE) using ethyl acetate, and the extract was separated on an Agilent ZORBAX SB-C18column and eluted with a gradient of acetonitrile and 20 mmol/L ammonium acetate (containing0.1％formic acid).Oleandrin was detected using electrospray positive ionization (ESI+) with multiplereaction monitoring (MRM) mode.Results Oleandrin showed excellent linearity in both blood and liver samples in the corresponding linear range (r＞0.995 0), with detection limits 1 ng/mL and 2 ng/g, respectively, extraction recovery rates greater than 70.50％, both intra-and inter-day precisions less than10.71％, accuracies 98.42％-111.63％, and matrix effects 91.52％-106.39％.The method was successfully applied to a case of suspected oleander poisoning.Oleandrin was detected in the blood, urine, liver tissues, bile, stomach wall tissues and stomach contents of the cadaver, with the content ranging from65.5 to 29 600.0 ng/mL (ng/g).Conclusion The method developed in this study is simple and convenient to operate with good selectivity, and is suitable for the analysis of oleandrin in biological samples such as blood and liver tissues, which can provide technical support for forensic identification and clinical diagnosis and treatment of oleander poisoning.

Prenylated flavonoids from the roots of Artocarpus heterophyllus / 药学学报

Ten isoprenylated flavonoids were isolated from 95% ethanol extraction of Artocarpus heterophyllus, with a combination of various chromatographic approaches, including ODS, MCI, CHP-20 P, Sephadex LH-20 and high performance liquid chromatography. On the basis of physic-chemical characters and spectroscopic data analysis, these compounds were identified as artoheteroid E (1), cycloheterophyllin (2), artelastoxanthone (3), artoindonesianin Q (4), cudraflavone C (5), 8-(γ,γ-dimethylallyl)-5,2',4'-trihydroxy-7-methoxyflavone (6), kuwanon T (7), 6-(3-methylbut-2-enyl) apigenin (8), 5,7,2',4'-tetrahydroxy-6-(3-methylbut-3-enyl) flavone (9), albanin A (10). Among them, compound 1 is a new one, while compounds 2-4 were isolated for the first time from the plant of Artocarpus heterophyllus. All isolated compounds were screened for their inhibitory abilities against cathepsin K. Of them, compounds 3-5, 7 and 10 showed inhibitory effects with the IC50 values of 0.9, 1.6, 4.5, 24.5 and 63.5 μmol·L-1, respectively.

Phenolic constituents from roots of Artocarpus heterophyllus / 中草药

Objective: To investigate the phenolic constituents from the roots of Artocarpus heterophyllus. Methods: Compounds were isolated from the roots of the plant by column chromatography over ODS, MCI GEL CHP-20P, Sephadex LH-20 and by preparative HPLC. Their structures were identified by the analysis of their physicochemical properties and the spectral data of NMR and MS. Results: Seventeen phenolic compounds were isolated from the roots of the plant, namely 1-O-feruloylglycerol (1), hypargystilbene A (2), oxyresveratrol (3), 2', 3, 4', 5, 5'-pentahydroxy-cis-stilbene (4), resveratrol (5), ethyl 2, 4-dihydroxybenzoate (6), ethyl 3, 4-dihydroxybenzoate (7), umbelliferone (8), 8-(3, 3-dimethylallyl)-6, 7-dihydroxycoumarin (9), morachalcone A (10), artocarpanone (11), styracifolin C (12), cudraflavone C (13), heterophyllin (14), cycloheterophyllin (15), artonin A (16), and artonin B (17). Conclusion: It is the first report of the occurrence of compound 9 as a natural product. Compounds 1, 4, and 6 are isolated from the plants of Moraceae family for the first time. Compound 8 is first obtained from the plants of Artocarpus J. R. et G. Forst., while compounds 3, 5, 10, 11, 14, and 15 are first found in A. heterophyllus.

Determination of Triptolide and Wilforlide A in Biological Samples by LC-MS/MS / 法医学杂志

OBJECTIVE@#To determinate triptolide and wilforlide A in biological samples by liquid chromatography-tandem mass spectrometry (LC-MS/MS) method and to verify the method.@*METHODS@#After 0.4 mL blood, urine or 0.4 g hepatic tissues with internal standard were extracted by ethyl acetate, they were separated on a Allure PFP Propyl (100 mm x 2.1 mm, 5 µm) with a mobile phase of methanol-20 mmol/L ammonium acetate using gradient elution. For mass spectrometric detection, electrospray ionization (ESI⁺) in positive mode was elected and the data was collected using multiple-reaction monitoring (MRM).@*RESULTS@#The linearity was good (r > 0.995 0) and the limit of detection was 2 ng/mL or 2 ng/g for triptolide and wilforlide A. The recovery was 61.08%-102.98%. The intra-day and inter-day precision was less than 12.58% for each biological sample, and the accuracy was 90.61%-105.80%.@*CONCLUSION@#This method is simple, convenient and good selective, and could be applied to analysis of triptolide and wilforlide A in different biological samples. And the method may provide technical support for forensic medicine identification, clinical diagnosis and treatment of tripterygium wilfordii Hook. f. poisoning.

Simultaneous screening for 45 poisonous alkaloids in blood by LC-MS/MS / 法医学杂志

OBJECTIVE@#To develop a liquid chromatography-tandem mass spectrometry (LC-MS/MS) screening method for 45 poisonous alkaloids in blood.@*METHODS@#Identification was based on the compound's retention time and two precursor-to-production transitions. The method involved a liquid-liquid extraction (LLE) followed by LC-MS/MS with multiple-reaction monitoring (MRM). When 1 mL of blood was extracted with diethyl ether at pH = 9.2 with SKF525A as the internal standard, the target compounds were analyzed with LC-MS/MS in the positive ionization mode.@*RESULTS@#The target alkaloids had good linearity (r>0.995 1), both the intra-day precision and inter-day precision being less than 14.77%. The limits of detection ranged from 0.05 to 25 ng/mL in blood.@*CONCLUSION@#The method is selective and sensitive in detecting poisonous alkaloids with a total running time of 12 minutes; therefore it was successfully applied to some actual cases of suspected alkaloids poisoning.

Robot-assisted pedicle screw insertion for scoliosis: First 14 cases in China / 第二军医大学学报

Objective To report our experience on robot-assisted pedicle screw insertion for scoliosis surgery and to verify the insertion accuracy. Methods A total of 14 patients with scoliosis were treated with robot-assisted pedicle screw insertion surgery (6 males and 8 females), including 12 suffering from idiopathic scoliosis and 2 suffering from congenital scoliosis. The time used by the robotic operation, times of X-ray used, and time for the robotic registration were recorded. CT images were used for evaluating the position of screws after the surgery. Results A total of 148 screws were inserted by the robot-guided machine. Averagely it took (1.7±0.9) times to set the platform for registration, (11.2±7.7) times for using X-ray per operation, and (19.3±6.2) min for each registration(time needed for setting the platform plus X-ray). After finishing the registration, it took an average of (2.4±0.9) min to insert a screw. The coronal Cobb angle was corrected from 50.1° (40°-63°) before operation to 12.8° (2°-28°) after operation, with a correction rate of 74.9% on average. CT images showed that the accuracy of robot-assisted pedicle screw insertion was 95.3% (141/148). Conclusion Mazor robot-guided pedicle screw placement is accurate and safe for scoliosis, and it may be a promising trend in spine surgery.

Cultural development needs of students in military medical university / 中华医学教育探索杂志

The cultural development needs of contemporary college students generally are displayed as varied contents,rich types and distinctive characteristics.Students in military medical universities shoulder the responsibilities of both soldiers and medical students,their cultural development needs are often in contradiction to military culture,thus bringing challenges to the culture construction in military medical universities.By introducing activities from civilians and soldiers,constructing hidden cultural platforms,improving hardware facilities and other innovative methods,we can actively guide students' ideological direction and play a better culturally educational function of military schools.