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@#The aim of the study was to develop a simple, rapid and accurate LC-MS/MS method for the determination of digoxin.Digoxin-d3 was taken as the internal standard (IS), and sample preparation was achieved by liquid-liquid extraction.Chromatographic separation was performed on a Kinetex C18 column (2.1 mm × 50 mm, 2.6 μm; Phenomenex) using an isocratic elution with merely 2 min for each sample.The mobile phase consisted of water and acetonitrile solutions, both containing 1 mmol/L ammonium acetate and 1 mmol/L formic acid (55∶45).The detection was conducted on a TripleQuadTM 4500MD mass spectrometer coupled with electrospray ionization interface under positive-ion multiple reaction monitoring mode.The transitions were m/z 798.5 → 651.3 and m/z 801.6 → 654.4 for digoxin and digoxin-d3, respectively.Results showed that the method was linear over the range of 0.100-20.0 ng/mL.The selectivity, accuracy and precision, recovery and stability of the method were all within the acceptable limits with no matrix effect.This method was successfully applied to a girl treated with digoxin with substantial improvement of therapeutic effect and elimination of toxic reaction, so it can provide valuable fuidance and reference for individualized medication in clinical practice.
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@#With the rapid development of biopharmaceuticals, therapeutic monoclonal antibodies (mAbs) are widely accepted due to their low side-effects and high therapeutic efficacy. Individual differences in the response to mAb drugs put forward new requirements for therapeutic drug monitoring of antibody drugs.Therefore, the need for accurate and robust bioanalytical methods is increasing.Recently, LC-MS/MS has been gaining increasing interest in the field of large molecules.In this article, the recent advances in this emerging field are reviewed, along with common issues and analytical approaches.Thus, this review article is helpful for better understanding the advance of LC-MS/MS technique in the field of therapeutic drug monitoring for mAbs.
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OBJECTIVE：To observe the therapeutic efficacy an d safety of rebamipide modified quadruple therapy in the treatment of Helicobacter pylori （HP）positive gastric-ulcer. METHODS ：Totally 150 patients with HP positive gastric-ulcer in our hospital from Mar. 2018 to Mar. 2020 were randomly divided into traditional group and modified group according to random number table ，with 75 cases in each group. Traditional group was given Amoxicillin capsules 1.0 g orally ，twice a day + Clarithromycin tablets 0.5 g orally ，twice a day+ Omeprazole enteric-coated capsules 20 mg orally ，twice a day+Colloidal bismuth pectin capsules 200 mg orally ，twice a day. Modified group was additionally given Rebamipide capsules 0.1 g orally ，3 times a day，Amoxicillin capsule ，Clarithromycin tablet and Omeprazole enteric-coated ca psule（same usage and dosage as traditional group）. Both groups were given medicine for consecutive 8 weeks，and were reexamined 2 weeks after drug withdrawal. After 2 weeks of treatment ，HP eradication rate ，total response rate ，the levels of serum MTL ，CCK，G17，PGⅠ and PG Ⅱ，PGⅠ/Ⅱ were observed in 2 groups. The occurrence of ADR was recorded. RESULTS ：HP eradication rate and total response rate of modified group were significantly higher than traditional group （P＜0.05）. Before treatment ，there was no significant difference in the serum levels of MTL ，CCK，G17，PGⅠ or PG Ⅱ，PGⅠ/PGⅡ between 2 groups（P＞0.05）. After treatment ，the levels of serum CCK ，G17，PG Ⅰ and PG Ⅱ in 2 groups were significantly lower than before treatment ，and modified group was significantly lower than traditional group （P＜0.05）；the serum level of MLT and PG Ⅰ/PGⅡ were significantly higher than before treatment，and modified group was significantly higher than traditional group （P＜0.05）. There was no significant difference in the total incidence of ADR between 2 groups（P＞0.05）. CONCLUSIONS ：Rebamipide modified quadruple therapy can significantly improve therapeutic efficacy and HP eradication rate of HP positive gastric-ulcer patients ，and regulate its ga strointestinal hormone Δ and PG levels with good safety.
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Objective@#To analyze the epidemiological and clinical characteristics of patients with 2019 novel coronavirus (2019-nCoV) infection in Shenyang.@*Methods@#The epidemiological and clinical characteristics of 30 patients diagnosed with 2019-nCoV infection admitted to Shenyang sixth people's hospital on January 22, 2020 and February 8, 2020 were retrospectively analyzed.@*Results@#Among the 30 cases, 21 were imported, including 17 from Hubei Province and four from other provinces. Nine cases were local infections. There were 18 men and 12 women, aging from 21 to 72 years with the median of 43 years. Eight cases had underlying diseases including hypertension, diabetes, coronary heart disease and bronchitis. On admission, two (7%) cases were mild, 19 (63%) cases were ordinary, eight (27%) cases were severe, and one (3%) case was critical. Clinical manifestations mainly include fever, with or without upper respiratory tract symptoms, normal, decreased or slightly increased white blood cell counts, mainly decreased lymphocyte counts, normal or increased c-reactive protein, and normal procalcitonin. The computed tomography (CT) of the early stage of the lungs showed that multiple patchy ground glass shadows were mainly accompanied by consolidation, which often involved both lungs or multiple lobes of one lung. At the moment, the clinical treatment mainly included respiratory support, symptomatic treatment, antiviral treatment adn anti-bacterial treatment. By February 15, a total of nine cases were cured and discharged, including one mild case, six ordinary cases, and two severe cases. In the comparisons between mild/ordinary patients and severe/critical patients, the fever duration in the severe/critical group (median 11.5 d) was significantly longer than that in the light/normal group (median 2 d) (Z=-2.292, P=0.022), and the laboratory tests indicated elevated d-dimer levels (Z=-2.669, P=0.008) and more cases with neutrophilic/lymphocyte ratio > 3 (Z=-4.071, P<0.01).@*Conclusions@#In Shenyang, the early cases with 2019-nCoV infection are mainly imported cases, and expanding local infections gradually develop. Clinical manifestations are mainly characterized by fever and cough. Lung CT performance shows multiple ground glass shadows, mainly accompanied by consolidation. CT changes in the lungs should be closely monitored during the treatment, and CT findings in the lungs may change earlier than the clinical manifestations. Prolonged fever duration, elevated d-dimer level and neutrophil/lymphocyte ratio >3 could be used as early warning indicators for severe cases.
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Objective:To analyze the epidemiological and clinical characteristics of patients with corona virus disease 2019 (COVID-2019) in Shenyang City.Methods:The epidemiological and clinical characteristics of 30 patients diagnosed with COVID-2019 admitted to Shenyang Sixth People′s Hospital from January 22 to February 8, 2020 were retrospectively analyzed. The independent t test, Mann-Whitney test and Fisher′s exact test were used for statistical analysis. Results:Among the 30 cases, 21 were imported, including 17 from Hubei Province and four from other provinces. Nine cases were local infections. There were 18 men and 12 women, aging from 21 to 72 years with the median of 43 years. Eight cases had underlying diseases including hypertension, diabetes, coronary heart disease and bronchitis. On admission, two (7%) cases were mild, 19(63%) cases were ordinary, eight (27%) cases were severe, and one (3%) case was critical. Clinical manifestations mainly included fever, with or without upper respiratory tract symptoms, normal, decreased or slightly increased white blood cell counts, mainly decreased lymphocyte counts, normal or increased C reactive protein, and normal procalcitonin. The computed tomography (CT) of the early stage of the lungs showed that multiple patchy ground glass shadows were mainly accompanied by consolidation, which often involved both lungs or multiple lobes of one lung. At the moment, the clinical treatment mainly included respiratory support, symptomatic treatment, antiviral treatment and anti-bacterial treatment. By February 15, a total of nine cases were cured and discharged, including one mild case, six ordinary cases, and two severe cases. In the comparisons between mild/ordinary patients and severe/critical patients, the fever duration in the severe/critical group (median 11.5 d) was significantly longer than that in the mild/ordinary group (median 2.0 d) ( Z=-2.292, P=0.022), and the laboratory tests indicated more cases with elevated D-dimer levels ( Z=-2.669, P=0.008) and neutrophilic/lymphocyte ratio >3.0 ( Z=-4.071, P<0.01). Conclusions:In Shenyang City, the early cases with COVID-19 infection are mainly imported cases, and expanding local infections gradually develop. Clinical manifestations are mainly characterized by fever and cough. Lung CT imagings show multiple ground glass shadows, mainly accompanied by consolidation. CT changes in the lungs should be closely monitored during the treatment, and CT findings in the lungs may change earlier than the clinical manifestations. Prolonged fever duration, elevated D-dimer level and neutrophil/lymphocyte ratio >3.0 could be used as early warning indicators for severe cases.
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Objective To understand the pathogenicity and multilocus sequence typing (MLST) characteristics of the pathogenic strain of Burkholderia pseudomallei (Bp) in Hainan,and provide a reference for studying the structural characteristics and phylogenetic characteristics of pathogenic Bp in Hainan.Methods The data of patients with melioidosis in Hainan,who were treated in Hainan General Hospital from 2011 to 2018,and Bp pathogenic strains isolated from patient infected specimens were collected.The Bp pathogenic strains were genotyped by MLST method,and the distribution characteristics of the sequence type (ST) were analyzed.The ST of all Bp pathogenic strains was analyzed by eBURST v3 software to establish the evolutionary relationship map.Results A total of 91 cases of melioidosis patients were studied,including 76 males and 15 females;the ages were mainly concentrated in 40-70 years old;clinical manifestations included sepsis,pulmonary infection and local abscess;and the most common diseases were diabetes.A total of 91 Bp pathogenic strains were observed,of which 85 Bp pathogenic strains were distributed in coastal areas of Hainan,accounting for 93.41％;identified by MLST method,39 ST were discovered,the most common were ST46 (13 strains),ST55 (12 strains),STS0 (8 strains) and ST58 (7 strains),accounting for 14.29％,13.19％,8.79％ and 7.69％,respectively;except ST46 was widely distributed in the coastal areas of Hainan,the ST55,ST50 and ST58 were concentrated in the southwest,northeast and southeast regions of Hainan.Compared with the MLST database,ST30 (3 strains) was currently found only in Hainan,ST562 (4 strains) had been reported in northern Australia,and the remaining ST models had been reported in southeast Asia.The eBURST v3 software divided the 39 ST into 3 subtypes and 18 individual types.Among them,the subtypes with ST300 as the original type had the most number of ST,including 17 ST,57 Bp pathogenic strains;compared with the MLST database,the ST300 was mainly distributed in southeast Asian regions such as Thailand.Conclusions The ST of Bp pathogenic strains in Hainan has high regional diversity and genetic diversity,and is closely related to Bp in southeast Asian regions such as Thailand.
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@# Objective To study the efficacy of medication management, symptom management and community reentry skills-training modules to prevent rural patients with schizophrenia from relapse and increase their social function.Methods 89 subjects were randomly assigned to the skills training group (45 cases) and the control group (44 cases). Both groups received the same treatments, but the skills training courses were given to the skills training group for twelve weeks when the subjects were addmitted into the trial and at their one-year follow-up timepoint respectively. And a two-year follow-up was carried out. All subjects were evaluated with PANSS, SDSS, relapse and employeement.Results 89 subjects had completed the study. The skills training group demonstrated clinical Results significantly superior to those of the control group on overall improvement according to PANSS and SDSS. Substantially, statistically significant advantages of the skills training group were related to 1) the rate of relapse (11.1% vs 31.8%), 2) the rate of employment (37.8% vs 15.9%).Conclusion Medication management, symptom management and community-re-entry skills-training modules are effective in reducing patients' psychiatric symptoms, preventing them from relapse and increasing their social function.