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Primary biliary cholangitis (PBC) is a chronic intrahepatic cholestatic disease. This article summarizes and reviews the histopathological features of PBC and the role of pathological examination in the diagnosis and treatment of PBC, as well as the role of pathology in staging and prognosis, the diagnosis of atypical PBC and overlap syndrome, the analysis of reasons for poor response to ursodeoxycholic acid, and identification of diseases or exclusion of other comorbidities, so as to improve the awareness of the role of pathological examination in PBC among clinicians.
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A case of limbic encephalitis with positive anti-leucine-rich glioma inactivated 1 protein (LGI1) antibody and anti-myelin oligodendrocyte glycoprotein (MOG) antibody was reported. The patient was a middle-aged male with a history of retinal vein occlusion. The main symptoms were temporal lobe epilepsy, facial arm dystonia, autonomic nerve dysfunction. Magnetic resonance imaging showed long T 2 signal in the right hippocampus without enhancement and normal perfusion. Electroencephalogram showed paroxysmal slow wave and sharp slow wave in interictal period. Blood anti-MOG antibody, blood and cerebrospinal fluid anti-LGI1 antibody were double positive. The main diagnosis was limbic encephalitis. After treatment with hormone and gamma globulin, the symptoms were improved and double antibodies were turned negative. Anti-LGI1/MOG double positive cases are rare, and the clinical manifestations and imaging manifestations of double positive antibody cases are not completely consistent with those with each single antibody, with different characteristics. This report can help clinicians enhance awareness.
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Objective:To investigate the predictive value of preoperative left atrial diameter in postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) in patients with coronary artery disease (CAD) and its influencing factors.Methods:This study was a prospective observational study. A total of 113 patients with CABG surgery were enrolled in Beijing Anzhen Hospital affiliated to Capital Medical University from January 2020 to December 2020. Preoperative coronary angiography, echocardiography and blood test were finished. The number of graft vessel was counted during the operation. The occurrence of POAF was confirmed by electrocardiogram or electrocardiograph monitoring after surgery. The preoperative baseline data, blood test, perioperative complications and other indicators of patients with or without POAF were compared.Results:According to the inclusion criteria and exclusion criteria, 90 patients undergoing CABG were enrolled in the study[71 males and 19 females, aged from 42 to 75, mean age (62±8)years old]. The incidence of POAF was 27.8%(25 cases). The left atrial diameter[40(36-43)mm vs. 35(33-37)mm, P=0.00]and troponin I[4.76(0.87-13.60)ng/ml vs. 1.48(0.56-4.52)ng/ml, P=0.04] in patients with POAF were significantly higher than that in patients without POAF. Compared to patients without POAF, POAF significantly increased the incidence of stroke[4(16%) vs. 0(0), P=0.01], ICU stay[67(24-96) days vs. 22(19-41) days, P=0.00] and hospital stay[21(19-24) days vs. 16(14-24) days, P=0.05]. Binary logistic regression showed that left atrial diameter was significantly correlated with the occurrence of POAF ( OR=1.9, 95% CI: 1.39-2.79, P<0.001). ROC curve analysis showed that 40 mm of left atrial diameter was a predictor of POAF( AUC=0.82, sensitivity 52%, specificity 100%, P<0.001). Linear regression analysis showed that left atrial diameter was significantly positively correlated with hypersensitive C-reactive protein ( Beta=0.24, 95% CI: 0.00-0.26, P=0.043). Conclusion:POAF significantly increased the incidence of stroke after CABG. Preoperative left atrial diameter is an independent predictor for POAF, which is closely related to the systemic inflammatory response.
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Retinitis pigmentosa is a hereditary disease which is characterized by damage in retinal photoreceptor cells and retinal pigment epithelium. Its main clinical features include low vision with night blindness, progressive visual field defects, and abnormal electroretinograms. The development of gene sequencing, the diagnosis and treatment methods of retinitis pigmentosa update year by year, including gene therapy, stem cell therapy, optogenetic therapy, etc. However, there is still a big gap in these treatments from laboratory technology into effective clinical treatment drugs. Some problems which include immune response, potential mutagenesis and tumorigenesis of the inserted region, genetic toxicity, quality and stability of gene technology and stem cell technology, mass production and promotion of clinical grade drugs, and optimization of the effectiveness of drugs and surgery, etc, remain to be solved by researchers.
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Tetralogy of Fallot (TOF) is one the most common cyanotic congenital heart diseases. With the advancement of surgical techniques, most patients can achieve long term survival. However, they often encounter right ventricular dysfunction in the late course. Echocardiogram, one of the major techniques used in the postoperative follow-up, is assuming a growing role in the assessment of right ventricular function. Hereby, we reviewed the echocardiographic indices for right ventricular systolic function commonly used in the follow-up of TOF patients, so as to provide new insights into their treatment.
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Objective:To investigate the relationship between preoperative high-sensitivity C-reactive protein (Hs-CRP) levels and clinical outcomes of patients undergoing off-pump coronary artery bypass graft (OPCABG) surgery.Methods:We prospectively selected 123 patients who received OPCABG at Beijing Anzhen Hospital from January 2019 to October 2019, and collected relevant preoperative and postoperative data. Patients were divided into a normal Hs-CRP group(78 cases) and an elevated Hs-CRP group(45 cases)according to the cutoff value (2 mg/L) of Hs-CRP level. The data of the two groups were compared, and regression analysis was performed on the postoperative data with differences to define independent factors.Results:The leukocyte count in the Hs-CRP group was significantly higher than that in the normal Hs-CRP group[(6.5±1.6)×10 9/ml vs. (7.4±2.1) ×10 9/ml, t=-2.839, P=0.005]. In the elevated Hs-CRP group, proportion of patients with atrial post-CABG atrial fibrillation (38% vs. 19%, χ2=5.100, P=0.024), duration of hospitalization[(21.2±7.1)days vs.(16.0±4.6)days, t=-4.469, P=0.000], hospital costs[(143.1±30.7)×10 3 yuan vs. (123.7±21.8)×10 3 yuan, t=-4.090, P=0.000]were significantly higher than those in the normal Hs-CRP level group. Smoking ( OR=1.660, 95% CI: 1.186-1.993, P=0.031) and Hs-CRP ( OR=1.170, 95% CI: 1.050-1.294, P=0.007) were independent risk factors for post-CABG atrial fibrillation. Hs-CRP ( B=0.436, 95% CI: 0.197-0.675, P=0.000) and left ventricular ejection fraction (LVEF, B=-0.180, 95% CI: -0.289--0.071, P=0.001) were independent influencing factors of duration of hospitalization. Hypertension ( B=-11.256, 95% CI: -20.670--1.842, P=0.020), Hs-CRP( B=1.235, 95% CI: 0.217-2.254, P=0.018) and LVEF ( B=-1.168, 95% CI: -1.634--0.702, P=0.000) were independent influencing factors of hospital costs. Conclusion:The preoperative Hs-CRP level of OPCABG is an independent influencing factor of post-CABG atrial fibrillation, duration of hospitalization and hospital costs. This finding lays the foundation for Hs-CRP combined with other indicators to accurately predict the prognosis of OPCABG and screen high-risk patients.
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Objective:To investigate the predictive value of cerebroplacental ratio (CPR) for adverse perinatal outcomes of induction of labor in prolonged pregnancy.Methods:This retrospective study recruited 315 singleton pregnant women who had induced labor due to prolonged pregnancy (≥41 gestational weeks) in the First Affiliated Hospital of Chongqing Medical University from January 1, 2019 to April 30, 2020. Based on the occurrence of adverse perinatal outcomes (emergency delivery due to persistent abnormal fetal heart rate monitoring, umbilical artery blood pH at birth <7.2, 5 min Apgar scores<7, transferring to neonatal intensive care unit after birth, chorioamnionitis and vaginal delivery converted to cesarean section), they were divided into two groups: case group ( n=76) and normal group ( n=239). Clinical features and umbilical artery blood flow, middle cerebral artery (MCA) flow and CPR measured in the last ultrasound scan before induction were compared between the two groups using student's t-test, Mann-Whitney U test and Chi-square test. Receiver operating characteristic (ROC) curve was used to analyze the predictive values of umbilical artery blood flow, MCA flow and CPR for the adverse perinatal outcomes. Multivariate logistic regression analysis was used to screen the meaningful predictors. Results:Compared with the normal group, the umbilical artery pulsatility index (PI) (0.9±0.1 vs 0.8±0.1, t=-5.458, P<0.001) and the percentage of abnormal CPR (<1.0) increased significantly [21.1%(16/76) vs 6.3%(15/239), χ2=14.190, P<0.001] in the case group, while the MCA-PI and CPR decreased significantly (1.1±0.2 vs 1.3±0.3, t=5.658, P<0.001; 1.2±0.3 vs 1.6±0.5, t=8.940, P<0.001). The areas under the ROC curves of umbilical artery PI, MCA-PI and CPR for predicting adverse perinatal outcomes were 0.71, 0.71 and 0.77, respectively. CPR had the highest sensitivity (0.74) compared with umbilical artery PI (0.68) and MCA-PI (0.71), but the specificity of them were similar (0.67, 0.66 and 0.66). Multivariate logistic regression analysis showed that only CPR was the independent risk factor for adverse perinatal outcomes ( OR=0.028, 95% CI: 0.010-0.080, P<0.001). Conclusions:As an indicator for early prediction of adverse perinatal outcomes of induction of labor in prolonged pregnancy, CPR was more sensitive but less specific.
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Objective:To investigate the value of whole-lesion histogram parameters of apparent diffusion coefficient (ADC) in evaluating and predicting the pathological complete response(PCR) to neoadjuvant chemotherapy (NAC) in different subtypes of breast cancer.Methods:This retrospective study included 117 patients with breast cancer who underwent MRI examination before NAC prior to surgery from January 2016 to December 2017 in the First Affiliated Hospital of Nanjing University. All cases were divided into Luminal B, HER2 positive ( n=21) and triple negative ( n=26) groups. The surgical pathology after chemotherapy was evaluated by Miller-Payne (M-P) system and the patients were divided into PCR group and non-PCR (nPCR) group. Firevoxel software was used to generate the whole-lesion ADC histogram. The parameters included mean (ADC mean), skewness, kurtosis, the minimum (ADC min), the maximum (ADC max), 10th percentile(ADC 10%), 50th percentile (ADC 50%) and 90th percentile (ADC 90%). The two independent samples t test or Mann-Whitney U test was used to compare the differences between PCR and nPCR groups in each subtype. The diagnostic performance of statistically different ADC parameters for predicting PCR was evaluated by receiver operating characteristic (ROC) curve. Results:Kurtosis was significantly higher in PCR group than that in nPCR group in HER2 positive subtype ( P=0.039). It achieved an area under the curve (AUC) of 0.813 with sensitivity of 100% and specificity of 68.7% at the optimal cutoff value (1.861) for differentiating PCR from nPCR cases. In triple negative subtype, ADC mean and ADC 50% were smaller in PCR group than those in nPCR group ( P=0.028,0.013). They achieved AUCs of 0.800, 0.842, respectively. When ADC mean of 1.030×10 -3 mm 2/s and ADC 50% of 0.976×10 -3 mm 2/s were used as cutoff value to differentiate PCR from nPCR, the sensitivities were 75.0%, 80.0% and the specificities were 83.3%, 83.3%, respectively. Conclusion:Kurtosis can predict post-NAC PCR in patients with HER2 positive breast cancer, while ADC 50% has a high value in predicting post NAC PCR of triple negative breast cancer patients.
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Objective:To analyze the cerebroplacental blood flow distribution characteristics in monochorionic-diamniotic(MCDA) twin pregnancies with stageⅠ-Ⅱof twin-twin transfusion syndrome (TTTS), and investigate the predictive value of cerebroplacental ratio (CPR) in the stageⅡ of TTTS.Methods:The cerebroplacental blood flow distribution were analyzed retrospectively in 68 cases from June 2017 to June 2019 in the First Affiliated Hospital of Chongqing Medical University (34 cases for each stage) with TTTS, including the umbilical artery pulsatility index (UA-PI), middle cerebral artery peak systolic velocity (MCA-PSV), middle cerebral artery pulsatility index (MCA-PI), CPR, and their discordances(UA-PI disc, MCA-PSV disc, MCA-PI disc and CPR disc). Results:The differences of UA-PI, MCA-PI, and CPR between donors and recipients in TTTS Ⅱ were statistically significant (all P<0.05), the differences of UA-PI disc, MCA-PI disc and CPR disc between TTTS Ⅰ and TTTS Ⅱ were statistically significant (all P<0.05). Multivariate Logistic regression analyses showed that only CPR disc was independently associated with the stage Ⅱ of TTTS( P<0.05), and it had moderate predictive accuracy for the stage Ⅱ of TTTS with an area under the curve of 0.766, a sensitivity of 64.71% and a specificity of 82.35%( P<0.001). Conclusions:More cerebroplacental blood flow discordances are observed and CPR disc is closely related to stageⅡof TTTS.
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OBJECTIVE@#To develop a cell-based system for the diagnosis of vitamin K-dependent coagulation factor deficiency 1 (VKCFD1).@*METHODS@#In HEK293 cells stably expressing the reporter gene FIX-Gla-PC, the gamma-glutamyl carboxylase (GGCX) gene was knocked out by using CRISPR/Cas9 technology. Enzyme-linked immunosorbent assay (ELISA), DNA sequencing and Western blotting were used to identify the GGCX gene knockout cells. A quickchange point variant method was used to construct the GGCX variant. ELISA was used to assess the influence of GGCX variant on the activity of reporter gene.@*RESULTS@#Two monoclonal cell lines with no reporter activity by ELISA was identified. Edition and knockout of the GGCX gene was confirmed by DNA sequencing and Western blotting. The activity of the reporter gene was recovered by transfection of the wild-type GGCX gene. Thereby two monoclonal cells with GGCX knockout were obtained. By comparing the wild-type and pathogenic GGCX variants, the reporter activity was decreased in the pathogenic variants significantly.@*CONCLUSION@#A cell-based system for the detection of GGCX activity was successfully developed, which can be used for the diagnosis of VKCFD1 caused by GGCX variants.
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In recent years, mass spectrometry has been widely used to study membrane protein structure and function. However, the application of mass spectrometry to study integral membrane protein is limited because there are many hydrophobic amino acids in the trans-membrane domain of integral membrane protein to cause low sequence coverage detected by LC-MS/MS. Therefore, we used vitamin K epoxide reductase (VKORC1), a human integral membrane protein, as a model to optimize the digestion conditions of chymotrypsin, and developed an in-gel digestion method of chymotrypsin to improve sequence coverage of membrane protein by mass spectrometry. By exploring the effects of calcium concentration, pH value and buffer system on the percentage of sequence coverage, number of total detected and types of unique peptide, and the size of unique peptide, sequence coverage and peptide diversity could be considered under condition of Tris-HCl buffer with 5-10 mmol/L calcium ion concentration and pH value 8.0-8.5. This method could make the sequence coverage of membrane protein to reach more than 80%. It could be widely used in the study of membrane protein structure and function, identification of interaction site between membrane proteins, and identification of binding site between membrane protein and small molecular drug.
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Humans , Amino Acid Sequence , Chromatography, Liquid , Chymotrypsin/metabolism , Digestion , Membrane Proteins , Tandem Mass Spectrometry , Trypsin , Vitamin K Epoxide ReductasesABSTRACT
Objective:To investigate the effect and mechanism of obstructive sleep apnea hypopnea syndrome(OSAHS) on nocturnal angina in patients who undergo coronary artery bypass grafting(CABG).Methods:According to the inclusion criteria and exclusion criteria, this prospective observational study included 76 patients who underwent CABG at Beijing Anzhen Hospital affiliated to Capital Medical University from January 2018 to December 2018. Patients included 60 males and 16 females, mean aged(61.4±7.3) years, BMI(25.7±2.3) kg/m 2. Portable sleep respiration monitoring and bedside ECG monitoring were performed before surgery. According to the apnea index(AHI), patients were divided into mild or no OSAHS group(AHI<15, 35 patients) and moderate to severe OSAHS group(AHI≥15, 41 patients). Baseline data, hematologic examination, degree of coronary stenosis, sleep breathing examination, night time heart rate and incidence of atrial fibrillation, and nocturnal angina were compared between the two group. Results:Combined with mild or no OSAHS group, moderate to severe OSAHS group had a significantly higher syntax-score(47.3±10.6 vs 35.1±6.8), a significantly higher proportion of coronary diffuse lesions(53.7% vs 31.4%), a significantly faster heart rate[(94.3±21.5)times/min vs(74.8±10.0) times/min], a significantly higher proportion of nocturnal angina(29.2% vs 2.9%). The differences were statistically significant( P<0.05). Binary logistic regression analysis showed that the fastest heart rate at night significantly affected the occurrence of nocturnal angina in CABG patients( OR=1.320, 95% CI: 1.084-1.607, P=0.006), the syntax-score, the fastest heart rate at night significantly affected the degree of OSAHS in CABG patients( OR=1.269, 95% CI: 1.094-1.473, P=0.002; OR=1.066, 95% CI: 1.004-1.131, P=0.036). Two linear regression showed a significant linear correlation between AHI with the fastest heart rate and syntax-score at night( R2=0.576, P<0.001; R2=0.658, P<0.001). Conclusion:OSAHS can significantly aggravate the degree of coronary artery stenosis in CABG patients, and further increase the incidence of nocturnal angina by significantly increasing nighttime heart rate.
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Objective@#To understand the etiology of hepatopathy of unknown etiology in patients undergoing liver biopsy.@*Methods@#Demographic data and pathological examination reports of patients with hepatopathy of unknown etiology who underwent liver biopsy examination at outpatient and inpatient of the Second Hospital of Nanjing between January 2017 and June 2018 were retrospectively collected. All liver histopathological sections combined with clinical and pathological features based on liver biopsy examinations were diagnosed by a reputed clinician and a pathologist.@*Results@#A total of 470 cases with hepatopathy of unknown etiology who underwent liver biopsy were enrolled. Of these, 425 cases (90.4%) had a definite diagnosed disease after comprehensive analysis of pathological and clinical data. The diagnosis of hepatopathy of unknown etiology included 11 diseases: 90 cases with autoimmune hepatitis had autoimmune liver disease (19.1%), 38 cases had primary biliary cholangitis (8.1%), 43 cases with overlap syndrome of autoimmune hepatitis had primary biliary cholangitis (9.1%), 118 cases had drug-induced liver injury (25.1%), 75 cases had nonalcoholic fatty liver disease (NAFLD) (16.0%), 12 cases had alcoholic liver disease (2.6 cases) %), 15 cases (3.2%) had vascular liver disease, 7 cases (1.5%) had hereditary metabolic liver disease, 5 cases (1.1%) had other systemic diseases, 16 cases (3.4%) had more than two kinds of liver diseases, and 6 cases (1.3%) had others rare liver diseases.@*Conclusion@#Over 90% cause of the hepatopathy of unknown etiology in the long run can be determined, and the main causes are autoimmune liver disease, drug-induced liver injury, and nonalcoholic fatty liver disease, which needs multidisciplinary cooperation to diagnose, and clinicians need to master the basic and clinical knowledge of liver diseases as well as liver pathology, hepatobiliary imaging, and genetics.
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Objective@#To analyze the cerebroplacental blood flow distribution characteristics in monochorionic-diamniotic (MCDA) twin pregnancies with selective fetal growth restriction (sFGR), and investigate the relationship between co-twin cerebroplacental blood flow discordances and co-twin birth weight discordances (BWdisc).@*Methods@#The cerebroplacental blood flow distribution characteristics and their discordances were analyzed retrospectively in 52 MCDA twin pregnancies with normal growth (control group) and 52 with sFGR (case group), including the umbilical artery pulsatility index (UA-PI), middle cerebral artery peak systolic velocity (MCA-PSV), middle cerebral artery pulsatility index (MCA-PI), cerebroplacental ratio (CPR), and their discordances (UA-PIdisc, MCA-PSVdisc, MCA-PIdisc and CPRdisc).@*Results@#Compared to the control group, UA-PIdisc, MCA-PIdisc and CPRdisc increased significantly (all P<0.01). UA-PIdisc, MCA-PIdisc and CPRdisc were related positively to BWdisc as shown by correlation analyses (r=0.488, 0.414, 0.592; all P<0.001), and they had moderate predictive accuracy for sFGR with area under the curves of 0.743, 0.662 and 0.778, with sensitivity of 48.08%, 67.31% and 71.15%, and specificity of 92.31%, 59.62% and 78.85% (all P<0.01). Multivariate Logistic regression analyses showed that only CPRdisc were independently associated with sFGR (P<0.05).@*Conclusions@#More cerebroplacental blood flow discordances are observed in MCDA twin pregnancies with sFGR. Co-twin cerebroplacental blood flow discordance is related to BWdisc.
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The integrated curriculums of basic medicine in Shanxi Medical University are as follows: nine basic medical courses were integrated into 10 medical modules, with additional training including PBL and TBL case discussion, clinical clerkship, flipped classroom and other non-integrated subjects etc. In order to assess the interest of students for integrated curriculum, their intrinsic motivation, as well as their comprehension and application of medical knowledge, we gave anonymous questionnaire to 149 students, 16 teachers in basic medicine, and 10 teachers in clinical medicine. Results showed that more than 90% students were willing to take the integrated curriculum and participate in PBL and TBL case discussion, and students who were unwilling to take the curriculum were less than 10%, they thought that the knowledge of new curriculum system was incoherent. The proportion of students from higher grade who were unwilling to participate in the flipped classroom was increased from 6.7% to 95.0%. Most of the teachers both in basic and clinic medicine believed that new curriculum system was helpful for students to comprehend basic medical knowledge and strengthen their discriminating ability, but did not function in improving students' practical ability. In the further reform on teaching, details like the coherence of knowledge and the content selected when self-studying should be improved.
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Objective To analyze the cerebroplacental blood flow distribution characteristics in monochorionic‐diamniotic ( MCDA ) twin pregnancies with selective fetal grow th restriction ( sFGR ) ,and investigate the relationship between co‐twin cerebroplacental blood flow discordances and co‐twin birth weight discordances ( BWdisc ) . Methods The cerebroplacental blood flow distribution characteristics and their discordances were analyzed retrospectively in 52 MCDA twin pregnancies with normal grow th ( control group) and 52 with sFGR ( case group) ,including the umbilical artery pulsatility index ( U A‐PI) ,middle cerebral artery peak systolic velocity ( MCA‐PSV ) ,middle cerebral artery pulsatility index ( MCA‐PI ) , cerebroplacental ratio ( CPR ) ,and their discordances ( U A‐PIdisc ,MCA‐PSVdisc ,MCA‐PIdisc and CPRdisc ) . Results Compared to the control group ,UA‐PIdisc ,MCA‐PIdisc and CPRdisc increased significantly ( all P ＜0 .01) . U A‐PIdisc ,MCA‐PIdisc and CPRdisc were related positively to BW disc as show n by correlation analyses ( r＝0 .488 ,0 .414 ,0 .592 ;all P ＜ 0 .001) ,and they had moderate predictive accuracy for sFGR with area under the curves of 0 .743 ,0 .662 and 0 .778 , with sensitivity of 48 .08% ,67 .31% and 71 .15% , and specificity of 92 .31% ,59 .62% and 78 .85% ( all P ＜ 0 .01 ) . M ultivariate Logistic regression analyses showed that only CPRdisc were independently associated with sFGR ( P ＜ 0 .05 ) . Conclusions More cerebroplacental blood flow discordances are observed in MCDA twin pregnancies with sFGR . Co‐twin cerebroplacental blood flow discordance is related to BW disc .
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The integrated curriculums of basic medicine in Shanxi Medical University are as follows:nine basic medical courses were integrated into 10 medical modules,with additional training including PBL and TBL case discussion,clinical clerkship,flipped classroom and other non-integrated subjects etc.In order to assess the interest of students for integrated curriculum,their intrinsic motivation,as well as their comprehension and application of medical knowledge,we gave anonymous questionnaire to 149 students,16 teachers in basic medicine,and 10 teachers in clinical medicine.Results showed that more than 90％ students were willing to take the integrated curriculum and participate in PBL and TBL case discussion,and students who were unwilling to take the curriculum were less than 10％,they thought that the knowledge of new curriculum system was incoherent.The proportion of students from higher grade who were unwilling to participate in the flipped classroom was increased from 6.7％ to 95.0％.Most of the teachers both in basic and clinic medicine believed that new curriculum system was helpful for students to comprehend basic medical knowledge and strengthen their discriminating ability,but did not function in improving students' practical ability.In the further reform on teaching,details like the coherence of knowledge and the content selected when self-studying should be improved.
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OBJECTIVE： To establish a method for simultaneous determination of residual methanol， ethanol， acetonitrile， isopropanol， methylbenzene， tetrahydrofuran and ethyl acetate in Nilethylenol raw material. METHODS： GC was performed. The determination was performed on DB-WAX capillary column. The detector was hydrogen flame ionization detector with split ratio of 5 ∶ 1. The carrier gas was nitrogen （purity： 99.999％） at the flow rate of 1.0 mL/min. The sample size was 1 μL， directly sampling with bonded crosslinked polyethylene glycol as stationary phase. The initial temperature was 40 ℃ and was maintained for 5 min， increased to 90 ℃ at 10 ℃/min， and then increased to 200 ℃ at 5 ℃/min. The temperature of injector was 220 ℃， and detector temperature was 230 ℃. RESULTS： The linear range was 0.24-12.00 μg/mL for methanol （r＝0.999 7）， 0.40-20.00 μg/mL for ethanol （r＝0.999 5）， 0.033-1.64 μg/mL for acetonitrile （r＝0.999 8）， 0.40-20.00 μg/mL for isopropanol （r＝0.999 5）， 0.071-3.56 μg/mL for methylbenzene （r＝0.999 6）， 0.058-2.88 μg/mL for tetrahydrofuran （r＝0.999 8）， 0.40-20.00 μg/mL for ethyl acetate （r＝0.999 7）， respectively. The limits of quantitation were 0.24， 0.40， 0.033， 0.40， 0.071， 0.058， 0.40 μg/mL， respectively. The limits of detection were 0.08， 0.10， 0.01， 0.13， 0.02， 0.02， 0.13 μg/mL， respectively. RSDs of precision， stability and reproducibility tests were all lower than 2％. The recoveries were 98.17％-100.48％ （RSD＝0.92％，n＝9）， 97.77％-101.30％（RSD＝1.32％，n＝9）， 97.56％-100.85％（RSD＝1.20％，n＝9）， 98.64％-100.92％（RSD＝0.87％，n＝9）， 98.54％-100.62％（RSD＝0.76％，n＝9），98.26％-100.00％（RSD＝0.74％，n＝9）， 98.30％-100.59％（RSD＝0.76％，n＝9）， respectively. CONCLUSIONS： The method has high sensitivity and good accuracy， and can be used for the simultaneous determination of residual methanol， ethanol， acetonitrile， isopropane， methylbenzene， tetrahydrofuran and ethyl acetate in Nilethylenol raw material.
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Anti-mitochondrial antibody (AMA) is a typical serum marker for primary biliary cholangitis (PBC), and the diagnosis of AMA-negative PBC may easily be neglected in clinical practice. This article analyzes the differences in epidemiology, clinical and pathological features, and treatment outcome between AMA-negative and AMA-positive PBC and points out that there are significant differences between them in the symptom of pruritus, immunoglobulin M, and severity of bile duct injury. For patients with a clinical diagnosis of AMA-negative PBC, immunofluorescence assay combined with immunological detection should be performed to exclude the false-negative result of AMA, and a confirmed diagnosis can be made with reference to the manifestation of cholestasis, positive results of anti-sp100, anti-gp210, and anti-ANA antibodies, and typical hyperactive cholangitis based on pathological examination. Differential diagnosis of this disease with other types of bile duct injury or absence of bile duct should be taken seriously in clinical practice.
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Anti-mitochondrial antibody (AMA) is a typical serum marker for primary biliary cholangitis (PBC), and the diagnosis of AMA-negative PBC may easily be neglected in clinical practice. This article analyzes the differences in epidemiology, clinical and pathological features, and treatment outcome between AMA-negative and AMA-positive PBC and points out that there are significant differences between them in the symptom of pruritus, immunoglobulin M, and severity of bile duct injury. For patients with a clinical diagnosis of AMA-negative PBC, immunofluorescence assay combined with immunological detection should be performed to exclude the false-negative result of AMA, and a confirmed diagnosis can be made with reference to the manifestation of cholestasis, positive results of anti-sp100, anti-gp210, and anti-ANA antibodies, and typical hyperactive cholangitis based on pathological examination. Differential diagnosis of this disease with other types of bile duct injury or absence of bile duct should be taken seriously in clinical practice.