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Objective@#To evaluate the diagnostic efficacy of Japan Narrow Band Imaging Expert Team(JNET) classification under narrow-band imaging (NBI) for colorectal laterally spreading tumors.@*Methods@#Data of 170 laterally spreading tumors (LST) detected by NBI and pigment dyeing were reviewed in the retrospective study. JNET classification under NBI was used for rediagnosis based on surface pattern and vessel pattern. Pit pattern(PP) was observed under pigment dyeing using PP classification. The results were compared with histologic results after endoscopic resection or surgery.@*Results@#The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of JNET classification and PP classification were 92.2% VS 70.3%, 82.3% VS 85.0%, 74.7% VS 72.6%, 94.9% VS 83.5%, 85.9% VS 79.7%, respectively (P=0.159). The consistency rates of JNET classification and PP classification in predicting shallow invasion depth of LST were 6.1% and 8.3% respectively and the consistency rates in predicting deep invasion were 30.8% and 4.8%, respectively.@*Conclusion@#JNET classification under NBI is effective in predicting malignant laterally spreading tumors, however, its efficacy in predicting tumor invasion depth is unsatisfied. PP classification can be used to improve the diagnostic accuracy for those with diagnostic difficulty.
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Objective To evaluate the diagnostic efficacy of Japan Narrow Band Imaging Expert Team(JNET)classification under narrow-band imaging (NBI)for colorectal laterally spreading tumors. Methods Data of 170 laterally spreading tumors (LST)detected by NBI and pigment dyeing were reviewed in the retrospective study. JNET classification under NBI was used for rediagnosis based on surface pattern and vessel pattern. Pit pattern(PP)was observed under pigment dyeing using PP classification. The results were compared with histologic results after endoscopic resection or surgery. Results The diagnostic sensitivity,specificity, positive predictive value, negative predictive value and accuracy of JNET classification and PP classification were 92. 2％ VS 70. 3％,82. 3％ VS 85. 0％,74. 7％ VS 72. 6％,94. 9％VS 83. 5％,85. 9％ VS 79. 7％,respectively (P= 0. 159). The consistency rates of JNET classification and PP classification in predicting shallow invasion depth of LST were 6. 1％ and 8. 3％ respectively and the consistency rates in predicting deep invasion were 30. 8％ and 4. 8％,respectively. Conclusion JNET classification under NBI is effective in predicting malignant laterally spreading tumors,however,its efficacy in predicting tumor invasion depth is unsatisfied. PP classification can be used to improve the diagnostic accuracy for those with diagnostic difficulty.
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Objective To investigate the clinical,endoscopic and pathological features of gastritis cystica profunda (GCP).Methods A total of 40 patients with GCP confirmed by pathology who received endoscopic or surgical treatment at Renji Hospital,School of Medicine,Shanghai Jiaotong University from May 2013 to May 2018,were included in the retrospective analysis.The clinical data such as population composition,clinical manifestations,endoscopic findings and pathological results were summarized and analyzed.Results Among the 40 patients were predominantly males (75.0％,30/40),and the mean age of onset was 61.2 years.The most common sites were cardia (32.5％,13/40) and gastric antrum (30.0％,12/40).The clinical symptoms of the patients were atypical and it was difficult to diagnose GCP with routine endoscopy examination.The endoscopic findings were mostly type 0-Ⅱ (50.0％,20/40).GCP with neoplastic lesions accounted for 55％ (22/40).Unconditional logistic regression analysis showed that male (P =0.013,OR =31.093,95％ CI:2.079-464.976) and Helicobacter pylori infection (P =0.041,OR =10.225,95％ CI:1.096-95.411) were risk factors for GCP with neoplastic lesions.Conclusion GCP commonly occurs in middle-aged and elderly men,and varies in different manifestations under white light endoscopy.GCP is not a benign lesion,but can also coexist with neoplastic lesions,which are mostly differentiated intramucosal cancer.
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Objective To study the mangiferin absorption process of mangiferin polymorphs in SD rats thus to find out the optimal crystal form and explore the factors that may affect the clinical effects of mangiferin. Methods Each rat was given one of three crystal forms of mangiferin. Plasma concentration of mangiferin were determined by HPLC-MS method. After liquidliquid extraction by ethyl acetate, the chromatographic separation was carried out on an Agilent ZORBAX SB-C18 (2.1 mm× 100 mm,3.5 μm) with a mobile phase consisting of methanol-0.1％ formic acid aqueous solution (30:70) . Mass spectrometry were performed in positive ion mode. Ion mass-to-charge ratio was set at 445 and 447 for mangiferin and, cefuroxime sodium (internal standard) respectivel for quantitive analysis. Results The main pharmacokinetic parameters of mangiferin form II, Ⅴ, Ⅵ were as follows: AUC(0-24 h) were (1323. 27 ± 218. 07) ,(1974. 34 ± 469. 24) ,(1737. 79 ± 623. 06) ng · mL-1 · h, respectively; Cmax were (321.92±85.18) ,(455.83±277.07) ,(319.92±86.07) μg·L-1, respectively; tmax were (0.70±0.45) , (0.50±0.32) ,(0.50± 0.34) h, respectively; t1/2z were (2.78± 1.72) ,(5.29± 2.67) ,(5.31± 2.82) h, respectively. Conclusion The main pharmacokinetic parameters of mangiferin polymorphs in plasma of rats are different, and mangiferin form Ⅴ has the hightest AUC(0-24 h) and Cmax.
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Different polymorphs of drugs have different molecular arrangements or molecular forces. Raman spectroscopy can reflect the change of molecular polarizability and can be used for the detection of drug polymorphs. The technology has been recorded for the analysis of polymorphism in European Pharmacacopoeia, British Pharamacopoeia and Chinese pharmacopoeia. This review focuses on the application of Raman spectroscopy in the study of pharmaceutical polymorphism. The advances in Raman spectroscopy in the qualitative, quantitative and dynamic processes of drug polymorphism are summarized and analyzed systematically, aiming to provide reference for researchers in related fields.
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Objective According to the clinical medicinal crystal form———form γ of levonorgestrel, to establish the quantitative analysis method for levonorgestrel form γ by powder X-ray diffraction (PXRD) . Methods Firstly, single crystal X-ray diffractometry and powder X-ray diffractometry were used to confirm that the prepared levonorgestrel form γ was 100％ polymorphic purity, which provided a standard sample for quantitative analysis by single peak method; then, the standard samples of different quality levonorgestrel form γ for powder X-ray diffraction were weighed, the peak intensity values of characteristic diffraction peaks d = 6.4 , d = 6. 1 and d = 5. 6 of form γ as quantitative parameters selected, a linear relationship between the peak intensity value and the quality of form γ was established; finally, the content of levonorgestrel form γ was quantitatively analyzed. Results The peak intensity values of characteristic diffraction peaks d = 6.4 , d = 6.1 and d = 5.6 of levonorgestrel form γ and the quality showed a good linear relationship.In the range of form γ masses of 5 mg to 50 mg, the regression linear equations wereY = 459.59X+5 536.5, R2 = 0.993 0, Y = 430.03X+6 867.6, R2 = 0.990 5,Y = 615.95X+ 6 209.5, R2 = 0.990 8,respectively. Conclusion The method is simple, rapid, accurate and reliable, it can be used as quality control method for levonorgestrel polymorphs.
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Polymorphism of chemical drugs has become a hot topic in pharmaceutical research at home and abroad. In this review, the phenomena, causes and significance of polymorphism were introduced briefly. The international drug development process and characteristics of the polymorphic drug development in our country were analyzed. Finally, the present situation and development in China was summarized from four aspects including the basic theory, technical methods, intellectual property rights and supervision. This paper can provide a reference for correct understanding the research level of polymorphic drugs in China and clarifying the direction of polymorphic drug research.
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Background:DNA methylation is a vital part of epigenetic modification,and is closely related with the development and progress of multiple tumors such as colorectal cancer. However,its mechanism is not fully clarified. Screening specific methylation gene and construct the methylation expression profile of tumor has become the current research hotspot. Aims:To screen the differential methylation loci in colorectal cancer and para-cancerous normal tissue by gene methylation microarray technique,and to construct specific differential methylation gene profile of colorectal cancer. Methods:Methylation 450K bead-chip was applied to detect the methylation status in colorectal cancer and para-cancerous normal tissues of 6 cases. A total of 431 467 loci were analyzed and compared. Aberrant methylation loci were screened according to P value,and the hypermethylation loci and hypomethylation loci were differentiated by delta beta value. Moreover,the function of differential methylation gene was further analyzed by GO analysis and KEGG analysis. Results:A total of 3 649 differential methylation loci were found by comparing colorectal cancer tissue and para-cancerous normal tissue,including 1 259 hypermethylation loci,which mainly located in promoter and genosome,and 2 390 hypomethylation loci,which mainly located in intergenic region and genosome. A panel of aberrant methylation gene loci was screened out,including hypermethylation gene loci such as SLC15A3 and hypomethylation gene loci such as ACOT2,TTLL8 and UHRF1. GO analysis and KEGG analysis showed that the function of these genes might be correlated with DNA binding,transcription factor activity and signal transduction pathway. Conclusions:There are many differential methylation loci in colorectal cancer and para-cancerous normal tissues,suggesting that aberrant DNA methylation is closely related with the development and progress of colorectal cancer. DNA methylation microarray technique could be applied for preliminary screening of differential methylation loci. However,constructing the differential methylation profile in colorectal cancer as a clinical biomarker should be further validated.
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Objective To establish an innovative methods for the identification of nimodipine polymorphs. Methods Nimodipine of two crystal forms were prepared by rapid solvent removal and identified by powder X-ray diffraction, infrared spectroscopy and Raman spectroscopy.The dissolution study of the powder samples were carried out in six different mediums. Results Powder X-ray diffraction patterns of crystal form A and B could be used for the identification of crystal forms of nimodipine.Crystal form B has characteristic diffraction peaks at 2θ=5° and 2θ=13° in the pattern,while crystal form A has characteristic diffraction peaks at 2θ=27° distinguishing two crystal forms effectively. Raman spectrum could be used to identify the crystal forms.Compared with Raman spectra of crystal form B, there exists characteristic scattering peak at 500 cm-1 in crystal form A. According to the position and intensity of the peaks of crystal form A and B, it could distinguish two crystal types effectively.The results of dissolution tests showed that the solubility of crystal form A is better than crystal form B. Conclusion Various analysis techniques in different principle were used in the research, such as Powder X-ray diffraction, Infrared spectroscopy and Raman Spectroscopy etc.Crystal forms were confirmed in several aspects according to the properties of different crystal form, and the solubility of crystal form A is better than crystal form B.
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Objective To study polymorphism of the free radical scavenger edaravone and to find the one which has good advantages to the clinical medication. Methods Preparation of four forms of edaravone through kinds of physical or chemical methods. These polymorphs were characterized by single crystal X-ray diffraction method (SXRD), powder X-ray diffraction method (PXRD), differential scanning calorimetry method (DSC), infrared spectrum method (IR) and melting point method (MP);a variety of influence factors experiment were used to research the stability of polymorphs. Solid edaravone in different forms were orally administered to SD rats respectively, the plasma concentration of the drug was determined by HPLC, and the pharmacokinetic characteristic of different forms was compared according to the HPLC results. Results Four forms(form A, form B, form C, form D) and the preparation of pure crystal forms were obtained by crystal screening technology. These polymorphs were identified by PXRD, DSC and IR. The edaravone polymorphs have an influence on the stability and pharmacokinetic. Conclusion Edaravone research provideds a variety of crystal material composition, preparation methods, stability, solubility and pharmacokinetic characteristic, and form A has been proved of good advantage one. This research provides data and technology support for choice of preponderant pharmaceutical polymorphs and drug quality standard improvement.
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Objective To establish an innovative methods for the identification of nimodipine polymorphs. Methods Nimodipine of two crystal forms were prepared by rapid solvent removal and identified by powder X-ray diffraction, infrared spectroscopy and Raman spectroscopy.The dissolution study of the powder samples were carried out in six different mediums. Results Powder X-ray diffraction patterns of crystal form A and B could be used for the identification of crystal forms of nimodipine.Crystal form B has characteristic diffraction peaks at 2θ=5° and 2θ=13° in the pattern,while crystal form A has characteristic diffraction peaks at 2θ=27° distinguishing two crystal forms effectively. Raman spectrum could be used to identify the crystal forms.Compared with Raman spectra of crystal form B, there exists characteristic scattering peak at 500 cm-1 in crystal form A. According to the position and intensity of the peaks of crystal form A and B, it could distinguish two crystal types effectively.The results of dissolution tests showed that the solubility of crystal form A is better than crystal form B. Conclusion Various analysis techniques in different principle were used in the research, such as Powder X-ray diffraction, Infrared spectroscopy and Raman Spectroscopy etc.Crystal forms were confirmed in several aspects according to the properties of different crystal form, and the solubility of crystal form A is better than crystal form B.
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Objective To study polymorphism of the free radical scavenger edaravone and to find the one which has good advantages to the clinical medication. Methods Preparation of four forms of edaravone through kinds of physical or chemical methods. These polymorphs were characterized by single crystal X-ray diffraction method (SXRD), powder X-ray diffraction method (PXRD), differential scanning calorimetry method (DSC), infrared spectrum method (IR) and melting point method (MP);a variety of influence factors experiment were used to research the stability of polymorphs. Solid edaravone in different forms were orally administered to SD rats respectively, the plasma concentration of the drug was determined by HPLC, and the pharmacokinetic characteristic of different forms was compared according to the HPLC results. Results Four forms(form A, form B, form C, form D) and the preparation of pure crystal forms were obtained by crystal screening technology. These polymorphs were identified by PXRD, DSC and IR. The edaravone polymorphs have an influence on the stability and pharmacokinetic. Conclusion Edaravone research provideds a variety of crystal material composition, preparation methods, stability, solubility and pharmacokinetic characteristic, and form A has been proved of good advantage one. This research provides data and technology support for choice of preponderant pharmaceutical polymorphs and drug quality standard improvement.
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Objective To systematically study solvatomorphism of indomethacin and provide a scientific basis for the quality control of the solvated impurities in this drug. Methods By changing the recrystallization solvent, solvent volume, recrystallization temperature, time and pressure, nine solvates and four non-solvated forms were discovered and prepared. The differential scanning calorimetry (DSC), thermogravimetric analysis ( TGA), X-ray powder diffraction ( PXRD) and infrared spectrometry (IR) were introduced for characterization analysis. Furthermore, the test of influencing factors was used to explore the stability of solvate crystal form and the crystal transformation rules among them. Results Nine solvates were prepared, which including two solvates reported for the first time in this work. Results showed that crystal forms of the 9 solvates have different types or proportions of crystal solvents according to the various results of DSC, TGA, PXRD and IR. Moreover, the nine solvates prepared in this work were metastable crystal forms which could be transformed to non-medicinal forms. Conclusion The composition, thermodynamic property and transformation rule of all the solvates are elucidated in this work. In addition, an effective method for qualitative or quantitative analysis of these solvates was established. The standard graphs and data were used as basic data and scientific basis for the solvate control in the manufacturing of indomethacin.
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Objective To establish a method for qualitative identification of polymorphs in pharmaceutical solid preparations of active pharmaceutical ingredients ( API ) . Methods We obtained the powder diffraction patterns of the polymorphic drug substance like nimodipine and roxithromycin in solid preparation material and completed quantitative identification for polymorphs by the quantitative detection and using PXRD technology, deduction calculation through the powder X-ray diffraction and comparing with standard diagram. Results Through the analysis of nimodipine and roxithromycin which came from 27 batches of solid preparations from 11 different manufacturers, and comparing to the standard patterns of pure polymorphs, the quantitative identification of different crystalline states of API in pharmaceutical preparations had been established. Conclusion The qualitative detection method for polymorphs of API in pharmaceutical preparations by powder X-ray diffraction has wide applicability and high accuracy, which can be used to identify the polymorphism of API in solid preparation,and also used to control the quality of solid preparations commonly as a qualitative analysis method.
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Objective To evaluate the impact of epidural anesthesia with levobupivacaine combined with general anesthesia on colon surgery. Methods Sixty patients undergoing elective radical procedure for colon carcinoma were randomLy divided into four groups: saline group (group S), 0.125% levobupivacaine group (group L1), 0.25% levobupivacaine group (group L2), and 0.5% levobupivacaine group (group L3). Group S received normal saline of 10 mL epidurally and then infusion of 5 mL·h-1 until the procedure was finished; groups L1, L2, and L3 received levobupivacaine instead. Anesthetic induction was performed after epidural puncture. Mean blood pressure and heart rate were recorded at 8 time points including 5 min after entering into the operation room, 1 min after intubation, skin incision, abdominal exploration, 1 h after skin incision, completion of operation, extubation, and leaving PACU; meanwhile blood glucose and cortisol were detected, anesthesia time, time to PACU stay, bleeding, transfusion volume, adverse reaction, and doses of propofol, remifentanil, ephedrine, and fentanyl were noted. Results Time to PACU stay was longer in S group than in other 3 groups. Doses of remifentanil and fentanyl were larger in L1 group than in L2 group and L3 group. Ephedrine dose in L3 group was larger than in other 3 groups. Blood sugar in L1 group was higher than L2 group and L3 group. Cortisol in S group was higher than in other 3 group. Cortisol in L1 group was higher than in L3 group. The number of patients with hypotension was greater in L3 group than other 3 groups. Conclusions Continue epidural infusion of 0.25%levobupivacaine can reduce stress response and opioid uses, shorten PACU stay, whereas it does not increase use of ephedrine.
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Targeted therapeutic strategy for cancer stem cells (CSCs) is the key to prevent tumor relapse and metastasis. The im-portant roles of epigenetic regulation on the development of stem cells and gene reprogram of somatic cells suggest that this process may remarkably affect the occurrence and development of CSCs. The epigenome, which comprises DNA methylation, histone modifica-tions, chromatin structures, and non-coding RNAs, controls gene expression patterns. In renal cell carcinoma (RCC), aberrant changes occur in the epigenome. To date, cells with CSC properties from RCC have been successfully isolated using different methods, such as sorting using the Hoechst 33342 side population, forming tumor spheroid, and sorting CD105 cell surface biomarker. According to the progress in genetic studies on RCC, in addition to DNA sequence, the abnormality in the regulatory mechanism has considerable func-tions in tumor progression. Epigenetic changes may be integral to the behavior of cancer progenitor cells and their progeny. Knowledge on epigenetics in renal tumorigenesis process is beneficial in the development of new therapeutic modalities and may deliver new prog-nostic and early diagnostic markers. This paper reviews the latest development in the study of RCC stem cells and the underlying mech-anisms of epigenetic regulation on the development of CSCs in RCC.
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Objective To evaluate the effectiveness of intratracheal tube suctioning by respiratory mechanics measurement.Methods The indexes of respiratory mechanics,including respiratory rate,expiratory tidal volume,% leak around the tube,dynamic respiratory compliance and mean airway resistance were measured just before and 20 minutes after intraendotracheal tube suction in mechanical ventilated children with respiratory failure.Results Fifty-two measurements was carried out in 11 patie nts.The mean values of respiratory risistance was (116.73±27.12)cmH2O/L.s before suctioning and (93.38±26.64)cmH2O/L.s after suctioning,with significant differrence(P＜0.01)；The mean values of % leak around the tacheal tube dereased from(18.12±4.12)% before suctioning to (8.71±3.76)% after suctioning (P＜0.05),The mean values of expiratory tidal valume was markedly increased from(7.31±2.12)ml/kg before suctioning to(5.72±1.2)ml/kg after suctioning(P＜0.01),The total respiraory rate markedly decreased after suctioning.Conclusion The respiratory mechanics measurement is very useful to evaluate the airway patient.The removal of secretions is crucial in respiratory managemet.
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Objective To observe the effect of Fugong Decoction(Decoction for Uterine Restroation) as assistant therapy of medicinal abortion for early pregnancy.Methods The 134 early pregnancy women who were volunteers of medicinal abortion were randomized into a treatment group and a control group with 67 cases in each.The control group was treated with Mifepristone and Misoprostol while the treatment group treated with Fugong Decoction based on these drugs.Totally they were treated for 7 days.The abortion effect,volume of vaginal bleeding,bleeding time,and time of urine human chorionic gonadotrophin(HCG) changed to negative were observed.Results In the treatment group,the time of discharge of gestational sac,volume of vaginal bleeding,bleeding time,time of urine HCG changed to negative,and abortion effect were all better than those of the control group,with significant difference(P