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Objective:High performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was used to quantify the levels of vitamins A, D and E in pregnant women during the second trimester, and to investigate the change trends of serum vitamins A, D and E levels during pregnancy.Method:A total of 720 pregnant women with an average age of (29.7±4.4) years and 12-22 weeks of gestation were included from October 1, 2021 to October 30, 2022 in the obstetrics department of the People′s Hospital of Wuhan University. The concentrations of vitamins A, D and E were determined by HPLC-MS/MS. The concentration levels of each group were statistically analyzed and the deficiency rate were calculated.Results:The distribution range of vitamin A, D and E (95% CI) was 0.74-2.74 μmol/L, 2.88-25.37 ng/ml and 6.18-35.08 μmol/L, with the deficiency rates were 9.30%, 93.76% and 35.83%, respectively. Vitamin A, D and E levels in the twin group were (1.67±0.51) μmol/L, (13.18±7.44) ng/ml and 11.97 (8.85, 14.60) μmol/L, respectively. They were significantly higher than those in the singlet group (1.45±0.36) μmol/L, (10.87±5.26) ng/ml and 10.46 (6.99, 14.11) μmol/L, with statistical significance by independent sample t-test ( P<0.001). The concentration of vitamin D in the lower BMI group (<22 kg/m 2) was (12.54±5.74) ng/ml, significantly higher than that in the fat group (≥22 kg/m 2) (10.46±4.90) ng/ml, and the rank-sum test was statistically significant ( P<0.001). Conclusion:In this study, the levels of three vitamins were monitored in mid-pregnancy using HPLC-MS/MS, and the changes of serum vitamin A, D, and E levels during pregnancy were analyzed.
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Objective:To establish an ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for plasma caffeine concentration detection, and to explore the clinical value of caffeine therapeutic drug monitoring (TDM) in the treatment of premature infants with respiratory distress syndrome (RDS).Method:Take the plasma sample in a centrifuge tube, add the caffeine deuterated isotope internal standard, then add the protein precipitant, vortex the mixture thoroughly, and centrifuge the supernatant to enter the mass spectrometry analysis. The mobile phase were methanol and water, gradient elution; the column temperature was 45 ℃, the method was established using Shimadzu LC-30AD-CL liquid system and AB SCIEX 4500 QTRAP mass spectrometer, and the sensitivity, specificity, linearity, accuracy imprecision, matrix effect, and carry-over of the method were evaluated. Sample from 30 patients diagnosed with neonatal RSD were collected in the Department of Neonatology of Renmin Hospital of Wuhan University from February to April 2021, then detected the trough concentration of caffeine in premature infants with RDS after taking the same dose of caffeine to assess the impact of individual variation on caffeine drug concentration.Results:The detection limit of caffeine was 0.02 μg/ml, and the lowest limit of quantification was 0.05 μg/ml. It showed good linearity ( R2=0.9986, R>0.99) in the concentration range from 1.0 to 100.0 μg/ml, specificity (recovery rate of 85.52%-114.12%), accuracy (recovery rate 85.97%-114.53%), intra-day and inter-day imprecision ( CV 6.01%-11.28%), matrix effects and carryover pollution were negligible. The trough concentration of 30 preterm infants with RSD after taking the same dose of caffeine (10 mg/kg) was (25.45±11.61) μg/ml, and the coefficient of variation was 44.88%. Conclusion:This study established an accurate and reliable UPLC-MS/MS method with low sample consumption to monitor the blood concentration of caffeine; caffeine TDM has certain clinical application value, which can be used to assist RDS diagnosis and treatment and improve the efficacy of caffeine.
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Low ionizability and poor chemical instability make some target analytes not suitable for direct LC-MS/MS analysis. To improve the detection performance, chemical derivation is frequently imported. However, such technology involves multiple disciplines such as laboratory medicine, organic chemistry and separation science. At present, it′s still a challenge for general application of chemical derivatization in routine clinical laboratories in our country. This article summarizes the key scientific connotation of chemical derivatization in the detection of vitamins, steroids, neurotransmitters and therapeutic drugs, and describes the derivatization approaches for development of chemical mass spectrometry in the future.
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Objective A highly feasible and reliable ultra-high performance liquid chromatography tandem mass spectrometry(UPLC-MS/MS)method was presented for therapeutic drug monitoring of five anti-schizophrenic drugs (aripiprazole, amisulpride, olanzapine, paliperidone and ziprasidone) simultaneously and the reference range of plasma concentration was investigated.Methods establishment and evaluation.The selectivity,accuracy,precision,stability and linear range of established UPLC-MS/MS method were evaluated according to FDA and CLSI.After a ten-month clinical application, a retrospective analysis of 253 positive samples was carried out to investigate conformance of the AGNP therapeutic reference range for Chinese patients.Results The five anti-schizophrenic drugs could be simultaneously measured by the established UPLC-MS/MS within 6 minutes.The LOQs were 0.1 to 9.0 ng/ml.The correlation coefficients were all higher than 0.997 7.The intra-day and inter-day precisions were less than 11.1%,and the recoveries ranged from 86.2% to 104.8%.The clinical results suggested the good consistency in reference range with AGNP for olanzapine, aripiprazole, paliperidone and ziprasidone.While for amisulpride, the plasma concentration level(445.2 ±231.5)ng/ml was significantly higher than the AGNP-recommended range(100 -320)ng/ml.Conclusion The established UPLC-MS/MS method was very suitable for monitoring anti-schizophrenic drugs.
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In the past decade, liquid chromatography-mass spectrometry has undergone rapid development in clinical laboratory medicine.Benefiting from the high sensitivity and specificity, as well as the capability of multi-component analysis in the single run, such technology is regarded as an excellent alternative to conventional immunoassays towards newborn screening for the genetic diseases, therapeutic drug monitoring and endocrine hormones detection.With the continuing progress in expertise-training, quality assurance and methodology standardization, it could be expected that liquid chromatography-mass spectrometry would become a dynamic and crucial part for routine clinical applications in the near future.
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Chronic diarrhea is a common complaint in gastroentology department,which is classified into a variety of types.While as eosinophilic gastroenteritis is a rare cause.A 50-year-old male patient was admitted with a 2-year history of diarrhea worsened for 10 months.Fasting could alleviate the diarrhea.Laboratory findings demonstrated anemia,low vitamins and minerals,fat malabsorption and abnormal D-xylose absorption test,delayed gastric emptying.According to the endoscopic biopsy of gastrointestinal mucosa,the diagnosis of eosinophilic gastroenteritis was made.Diabetic neuropathy may aggravate the symptom.The diarrhea resolved after the administration of steroids.
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Objective To investigate the prevalence of metabolic syndrome in patients with maintenance hemodialysis, and to analyze the potential risk factors. Methods The clinical data of 472 patients with maintenance hemodialysis from 7 blood purification centers were collected. Patients were divided into the MS group and the non-MS group. The demographic data , anthropometric examinations , dialysis prescription and results of laboratory were compared between these two groups. Multivariate Logistic regression analysis was performed to analyze the risk factors of MS. Results The morbidity of MS was 34.75%. There were significant differences in weight , waist circumference , waist-hip ratio , frequency of dialysis , time of hemodialysis perweek , urea reduction ratio, urea clearance index (Kt/v), iron, intact parathyroid hormone (iPTH), leukocytes, high sensitivity C-reactive protein (hs-CRP) between these two groups (P < 0.05, resectively). Multivariate Logistic regression analysis revealed that iron (OR = 1.084, P = 0.042), iPTH (OR = 1.754, P = 0.035), waist-hip 1ratio (OR = 2.013,P = 0.021), hs-CRP (OR = 4.245,P = 0.000)were correlated with MS. Conclusion The morbidity of MS in patients with maintenance hemodialysis is higher. Iron, iPTH, waist-hip ratio, hs-CRP are potential risk fctors of MS for the patients with maintenance hemodialysis.
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Objective To analyze the difference between primary biliary cirrhosis (PBC) and primary Sj(o)gren's syndrome (pSS) and primary biliary cirrhosis complicating with Sj(o)gren's syndrome (SS) in clinical features,anti-60 000 SSA multiple antigenic peptides (MAPs) detection rate,and explore the potential mechanisms of PBC with SS.Methods MAPs were artificially synthesized.Enzyme-linked immunosorbent assay (ELISA) was done to detect anti-MAPs antibodies in the sera of the three groups of patients.The detection rates of anti-MAPs antibodies were compared among groups and the relations of anti-MAPs antibodies with clinical features were analyzed.Chi-square test,Fisher's exact test,t test or Wilcoxon signed rank test were conducted in this study.Results There was no significant difference in clinical features,liver function tests and antibody profiles between PBC and PBC with SS.Significant difference of anti-MAP20 antibody detection rote was detected between pSS and PBC with SS groups [25％(7/28) vs 0(0/25),x2=7.201 1,P=0.007 3],and anti-MAP3,7 and 17 antibody detection rates in PBC with SS patients [4％(1/25),4％(1/25),8％(2/25)] were similar to pSS [4％(1/28),7％(2/28),7％(2/28)].The anti-MAP7 antibody and anti-MAP12 antibody detection rates were significantly higher in patients with splenomegaly than patients without splenomegaly [38％(3/8) vs 2％(2/84),38％(3/8) vs 4％(3/84); P=0.039 4,P=0.039 4],while the antiMAP17 antibody detection rate was significantly lower in patients with salivary gland injury than patients without salivary gland injury [5％(3/64) vs 39％(5/13); x2=4.431 8,P=0.035 3].Conclusion There is significant difference in the anti-MAPs detection rates among the three patients groups,and the detection rate may be higher in patients with certain clinical manifestations.
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One hundred and twenty one patients on maintenance hemodialysis ( MHD) from Januaury 2004 to Januaury 2009 in our hospital were enrolled in the study. Demographic characteristics, clinical data and causes of disease were documented, the survival probability was estimated with Kaplan-Meier method and the prognostic factors were analyzed with Cox regression model. The median follow-up duration was 28. 9 months. The 1,3, 5-year survival rates were 93. 0% , 66. 5% and 45. 8% respectively. By Kaplan-Meirie analysis, cardiovascular disease (x2 =6. 582, P =0. 010) , age of starting dialysis (x2= 12.439, P= 0.002), urea clearance index Kt/V ( x2 =7.633, P=0.006) and albumin levels ( x2 = 4.512, P= 0.034) were closely related to prognosis. Cox regression analysis showed Kt/V, cardiovascular disease and age of starting dialysis were independent prognostic factors ( relative risk were 3. 204, 2. 994, 2. 543 respectively).
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Malignant islet cell tumor, a rare type of neuroendocrine carcinoma, biologically behaves in an aggressive way and is difficulty to be treated. Sunitinib malate, a novel tyrosine kinase inhibitor, demonstrates a high efficacy in treating malignant islet cell tumor as shown by promising results in recent trials.
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Objective To investigate the relationship between serum visfatin level and coronary artery stenosis.Methods Based on coronary angiography,85 patients were diagnosed as coronary heart disease.According to oral glucose tolerance test,these patients were divided into 3 groups,34 patients with normal glucose tolerance(CHD group),25 with impaired glucose regulation(CIG group),and 26 with type 2 diabetes mellitus(CDM group).30 non-comary heart disease subjects with normal glucose tolerance were selected as the control group(CON group),and they underwent coronary CT angiography scan and were confirmed coronary disease-free.Blood pressure,body mass index(BMI),waist circumference(WC),waist hip ratio(WHR),fasting plasma glucose(FPG),blood lipid analysis,fasting insulin,and HbA1C were determined.Serum visfatin concentration was assayed and the status of coronary artery was assessed.Coronary artery stenosis was screened by coronary interventional angiography and assessed by Gemini scoring system in CHD,CIG,and CDM groups.Results Compared with control group,serum visfatin in CHD,CIG,and CDM groups were significantly higher(all P<0.05).Compared with CHD group,serum visfatin in CIG and CDM groups were significantly higher(all P<0.05).The correlation analysis showed that serum visfatin level was positively correlated with the involved branches of coronary arteries(r=0.807,P<0.01),serum visfatin level was positively related with Gensini coronary artery score(r=0.669,P<0.01).Visfatin was also positively correlated with WC,WHR,triglyceride(TG,r=0.200,P=0.032,r=0.185,P=0.047,r=0.321,P<0.01),while high density lipoprotein cholesterol(HDL-C)was negatively correlated with visfatin(r=-0.354,P<0.01).Multiple regression analysis showed that senlm hvel of TG and WC were the main influencing factors of visfatin.Conclusion (1)The level of serum visfatin may reflect the severity of coronary artery stenosis,detection of visfatin helps to make early diagnosis of CHD.(2)The raised serum level of visfatin in comary heart disease patients with imparied glucose tolerance is consistent with clinical evidence that diabetic patients have more severe coronary diseases.(3)WC and serum TG are main inilucencing factors,suggesting that visfatin is correlated with abdominal obesity.
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Thirty patients with confirmed primary sjogren syndrome and thrombocytopenia during January 2002 and December 2007 were investigated.All the participants received 0.5 mg·kg-1·d-1 Prednisone and 100 ms/d CosA for 1 year.Clinical symptoms and the levels of white blood eell.platelet count,erythrocyte sedimentation rate,liver function,immunoglobin,and rheumatoid factors were recored before and after the treatment.After one-year follow.up,platelet count was elevated(t=11.4179,P< 0.01).There was no significant change in erythrocyte sedimentation rate.The concentrations of immunoglobin and rheumatoid factors were significantly decreased at 1 year(t=5.4222,P<0.01;t= 9.2857.P<0.01).Prednisone plus CosA could effectively treat primary sjOgren syndrome combined with thrombocytopenia and result in fewer side effects.