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ObjectiveTo investigate the effect of Chaihu Guizhitang on triple-negative breast cancer （TNBC） cells based on hypoxia-inducible factor-1α （HIF-1α）/vascular endothelial growth factor A （VEGFA） signaling pathway. MethodTNBC xenograft model was established and the cells were randomized into model group， capecitabine group （0.2 mg·kg-1）， Chaihu Guizhitang low-dose group， medium-dose group， and high-dose group （10.62， 21.23， 42.46 g·kg-1）， with 10 mice in each group. After 21 days of medication， the content of tumor necrosis factor-α （TNF-α） in serum was detected by enzyme-linked immunosorbent assay （ELISA）. The expression of HIF-1α mRNA was detected by real-time fluorogenic quantitative polymerase chain reaction （real-time PCR）. Immunohistochemistry （IHC） was employed to detect the expression of HIF-1α， TNF-α， and VEGFA in tumor tissues， and CD34 staining to examine the angiogenesis in tumor tissues. Microvessel density （MVD） was calculated， and the protein expression of HIF-1α， VEGFA， and epidermal growth factor receptor （EGFR） in tumor tissues was measured by Western blot. ResultCompared with the model group， the rest four groups showed low levels of TNF-α （P<0.01）， HIF-1α mRNA （P<0.01）， expression of HIF-1α， TNF-α， VEGFA， and CD34 in cells， and MVD （P<0.05， P<0.01）， and low protein levels of HIF-1α， VEGFA， and EGFR （P<0.01）. Compared with capecitabine group， medium-dose and high-dose Chaihu Guizhitang decreased the level of TNF-α （P<0.01）， HIF-1α mRNA （P<0.01）， expression of HIF-1α， TNF-α， and VEGFA in cells （P<0.01）， CD34 expression， MVD， and protein levels of HIF-1α， VEGFA， and EGFR （P<0.01）. ConclusionChaihu Guizhitang may inhibit the angiogenesis in TNBC cells by regulating the expression of HIF-1α/VEGFA signaling pathway， thus exerting anti-tumor effect.
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OBJECTIVE To compare the safety of high-dose methotrexate （HD-MTX） via peripherally inserted central catheter （PICC） and totally implantable venous access port （TIVAP） in pediatric patients with malignant brain tumors. METHODS Patients with malignant brain tumors who received HD-MTX via PICCs or TIVAPs in our hospital from July 2018 to April 2022 were retrospectively analyzed. Clinical data were collected to compare differences in blood concentration of methotrexate （MTX），the incidence of adverse events （including adverse drug reactions and catheter-related complications） and length of stay in hospital. Multivariate linear regression was applied to analyze the factors that influenced the blood concentration of MTX. RESULTS A total of 107 patients were included in the study，with 65 patients in the PICC group and 42 patients in the TIVAP group. Blood concentration of MTX at 24 h （C24 h） in TIVAP group was significantly higher than PICC group （[ 126.87±61.99） μmol/L vs. （102.45±48.77） μmol/L，P＜0.05）. There was no significant difference in blood concentration of MTX at 42 h （C42 h），compared with PICC group （P＞0.05）. Results of multivariate linear regression analysis showed that TIVAP was associated with the increase of C24 h（P＜0.05）. No significant differences were observed in the incidence of adverse events and the length of stay in the hospital between 2 groups （P＞0.05）. CONCLUSIONS Risk of adverse events is not increased，although the MTX C24 h level is elevated after administration of TIVAP. TIVAP is a safe choice for HD-MTX therapy with implementing therapeutic drug monitoring.
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O BJECTIVE To optimize stir-frying with saltwater technology of Citrus reticulata . METHODS Taking the contents of limonin ，nomilin and obacunone ，color difference value and free radical scavenging rate of 1，1-diphenyl-2-trinitrophenyl hydrazine （DPPH） as the indexes ，the entropy weight method was used for comprehensive evaluation. The stir-frying with saltwater technology of C. reticulata was optimized by central composite design-response surface method by using water-salt ratio ，stewing time，frying temperature and frying time as factors. RESULTS The optimal stir-frying with saltwater technology of C. reticulata included water-salt ratio of 8 ∶ 1（mL/g），stewing time of 22 min，frying time of 9 min and frying temperature of 158 ℃. After three times of validation tests ，the average comprehensive score of the optimized technology was 92.35（RSD＝2.19％），and its relative error with the predicted value （93.25）was 1.10％. CONCLUSIONS The optimal stir-frying with saltwater technology is stable and feasible.
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As a traditional Chinese medicinal material， Citri Sarcodactylis Fructus is often used as medicine after steaming to reduce its pungency and give full play to its medicinal effects. By consulting the relevant literature， this paper intends to sort out the related researches on the processing history， modern processing standard records， flavor and meridian tropism， efficacy， processing and taking methods， processing technology， chemical composition， pharmacological effects and quality analysis of Citri Sarcodactylis Fructus. It is found that the processing methods of Citri Sarcodactylis Fructus in the past dynasties are mainly roasting， distilled into dew， aging， frying， salting and steaming， of which steaming is the most common. In modern times， steaming is mainly used in Guangdong and Sichuan. The descriptions of flavor and meridian tropism and efficacy of Citri Sarcodactylis Fructus in the past dynasties are basically consistent with the modern descriptions. Its taste is pungent， bitter and acidic， and it is warm in nature. It belongs to the liver， spleen， stomach and lung meridians. Citri Sarcodactylis Fructus contains volatile oil， flavonoids and their glycosides， coumarins and limonins and other compounds. In recent years， high performance liquid chromatography （HPLC）， gas chromatography-mass spectrometry （GC-MS） and ultra performance liquid chromatography-mass spectrometry （UPLC-MS） and other methods are commonly used for the chemical composition analysis. Citri Sarcodactylis Fructus has the activities of relieving cough， reducing phlegm， relieving asthma， anti-inflammation， anti-bacteria and anti-oxidation， etc. After processing， its volatile and non-volatile components， and pharmacological effects all have a certain change. However， the current research on processing of Citri Sarcodactylis Fructus is not in-depth enough. It is necessary to further analyze the material basis of steaming to reduce dryness， explore its dryness medicinal substances and dryness-effect quantitative correlation， so as to clarify its processing mechanism， and provide basis for the subsequent processing research， resource development and comprehensive application of Citri Sarcodactylis Fructus in the future.
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Citri Reticulatae Pericarpium is a commonly used traditional Chinese medicine in China. By referring to herbal monographs and related research documents， and comparing all editions of Chinese Pharmacopoeia and local processing specifications， the processing history， modern processing specifications， study on chemical constituents and pharmacological effects before and after processing of Citri Reticulatae Pericarpium were summarized. It was found that the processing methods of Citri Reticulatae Pericarpium in the past dynasties were mainly cleansing， cutting and frying. The processing methods of Citri Reticulatae Pericarpium included in all editions of Chinese Pharmacopoeia were all cleansing and cutting. In modern local processing specifications， there were mainly processing methods such as frying， steaming and carbonizing. The components of Citri Reticulatae Pericarpium were mainly volatile oil and flavonoids. After processing， the total amount of volatile oil generally decreased， and the contents and compositions of volatile oil and flavonoids also changed. It may be the main reason for the difference of efficacy before and after processing. At present， the optimization of processing technology of Citri Reticulatae Pericarpium mainly focuses on steaming， processing with vinegar and baking. Pharmacological research on Citri Reticulatae Pericarpium mainly focuses on reducing blood lipid， relieving cough， relieving asthma and resolving phlegm， and inhibiting pulmonary fibrosis. The current research on the processing methods of Citri Reticulatae Pericarpium is not in-depth enough， the material basis of many processing methods has not been clarified， and the research on the efficacy before and after processing is not in-depth enough. Further research is needed to clarify the material basis and mechanism after the processing of Citri Reticulatae Pericarpium， so as to standardize the processing method and establish specific quality standards.
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Objective:To observe and analyze the structural characteristics of the optic discs in high myopia (HM) combined with primary open-angle glaucoma (POAG) and the optic disc parameters with diagnostic efficacy.Methods:A cross-sectional study. From August 2020 to March 2021, a total of 114 eyes of 68 patients with POAG, HM and healthy volunteers who were diagnosed by Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University were included in the study. Among them, 21 POAG patients (39 eyes) were divided into H+P group (9 patients, 18 eyes) and non-H+P group (12 patients, 21 eyes) according to whether or not HM was combined; 26 HM patients (37 eyes) were selected as HM group; 21 healthy volunteers (38 eyes) were selected as normal control group. The subjects included 31 males (51 eyes) and 37 females (63 eyes), whose average age was 36.93±12.60 years old. Diopter, central corneal thickness (CCT) and axial length (AL) were measured. There was no significant difference in age ( F=8.333), sex composition ratio ( χ2=0.863), and CCT ( F=1.425) among the four groups ( P>0.05); while, there were significant differences in AL ( F=69.956), diopter ( F=37.711), visual field index (VFI) ( F=43.254) and mean defect (MD) ( F=49.793) among the four groups ( P<0.01). Enhanced depth imaging using optical coherence tomography was used to obtain the tilt parameters, the disc rim parameters, the lamina cribrosa parameters and the retinal nerve fiber layer (RNFL) thickness. The tilt parameters included optic disc horizontal diameter, optic disc vertical diameter, optic disc ellipse index (horizontal diameter/vertical diameter); the disc rim parameters included Bruch’s membrane opening-minimal rim width (BMO), optic cup area, optic disc area, disc rim area, cup-disc area ratio; the lamina cribrosa parameters included anterior laminar insertion depth (ALID), prelaminar neural tissue (PLNT), and lamina cribrosa thickness. The pairwise comparison between groups were performed by ANOVA test. Pearson correlation analysis was used to analyze the correlation between disc tilt parameters, disc rim parameters, lamina cribrosa parameters and visual field parameters, as well as between disc rim parameters and RNFL thickness. According to receiver operating characteristic (ROC) curve and area under the curve (AUC), the predictive value of those above related factors for HM combined with POAG was evaluated. Results:Tilt parameters: compared with the optic disc horizontal diameter of non-H+P group, those of normal control group, HM group and H+P group were significantly decreased ( P<0.05), the ellipse indices of HM group and H+P group were significantly lower than those of normal control group and non-H+P group ( P<0.05). The results of correlation analysis showed that the optic disc horizontal and vertical diameters were negatively correlated with MD ( r=-0.302,-0.235; P=0.002, 0.017), and negatively correlated with VFI ( r=-0.291,-0.246; P=0.003, 0.013). Disc rim parameters: the disc cup area and cup-disc area ratio of non-H+P group and H+P group were significantly larger than those of normal control group and HM group ( P<0.05). The disc rim area and the average BMO of HM group, non-H+P group and H+P group were significantly smaller than those of normal control group ( P<0.05). The results of correlation analysis showed that the cup-disc area ratio ( r=-0.584), the average BMO ( r=0.650) had the highest correlation with the average RNFL thickness ( P<0.001). The superior, inferior, nasal and temporal BMO were all positively correlated with the corresponding quadrant RNFL thicknesses ( r=0.431, 0.656, 0.362, 0.375; P<0.05); the optic disc rim area, the average BMO were positively correlated with MD ( r=0.449, 0.618) and VFI ( r=0.449, 0.605) ( P<0.05), among which the correlation of the average BMO was the highest; the optic cup area and cup-disc area ratio were negatively correlated with MD ( r=-0.346,-0.559) and VFI ( r=-0.312,-0.548) ( P<0.001), among which the correlation of the cup-disc area ratio was the highest. Lamina cribrosa parameters: ALID of non-H+P group and H+P group were significantly deeper than those of normal control group and HM group ( P<0.05). LC of non-H+P group and H+P group were significantly thinner than those of normal control group and HM group ( P<0.05). The results of correlation analysis showed that ALID was negatively correlated with MD and VFI ( r=-0.402, P<0.001), VFI ( r=-0.405, P=0.001); LC was positively correlated with MD and VFI ( r=0.403, P<0.001), VFI ( r=-0.401, P=0.015). Comparison of diagnostic efficiency between various optic disc parameters: the results of ROC analysis showed that the cup-disc area ratio had the highest diagnostic performance (AUC=0.847, P=0.007), the maximum Youden index was 0.563, the sensitivity and specificity were 0.833 and 0.730, respectively, and the best critical value was 0.340. Conclusions:Optic disc tilt is more pronounced in HM combined with POAG; BMO in each quadrant could objectively reflect the disc rim defect of HM combined with POAG; the thinning and the backward shift of the lamina cribrosa were consistent with the aggravation of the visual field defect. Among them, the cup-disc area ratio had better diagnostic performance.
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Objective:To analyze the clinical and gene mutation characteristics of congenital disorder of glycosylation (CDG) caused by compound heterozygous mutation of the COG6 gene ( COG6-CDG). Methods:This study retrospectively analyzed the clinical data and genetic test results of a patient with COG6-CDG in Bayi Children's Hospital, the Seventh Affiliated Medical Center of Chinese PLA General Hospital, in August 2019. Literature was retrieved with keywords including COG6, COG6-CDG, congenital disorders of glycosylation typeⅡL and congenital disorders of glycosylationⅡL in China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, and Web of Science Database from the establishment to July 2020, to summarize the clinical and genetic characteristics of COG6-CDG. Results:(1) Case report: The 59-day-old baby boy, with a gestational age of 27 +5 weeks and birth weight of 1 180 g, presented with multi-system involvement on admission, including unidentified progressive hepatosplenomegaly with jaundice and ascites, persistent thrombocytopenia, microcephaly, hypotonia, hypohidrosis, hyperkeratosis, and recurrent hyperthermia, infection, and hypoglycemia, as well as dysfunctions of the heart, gastrointestinal tract, lungs, kidneys, ocular fundus, and the coagulation system. Despite given ventilator-assisted ventilation, anti-infection therapy, abdominal puncture and drainage, and blood transfusion, the patient still had an aggravated condition and eventually died of multiple organ failures 192 d after birth. Genetic analysis showed that the nuclear family carried compound heterozygous mutations in the COG6 gene (NM_020751.2), including missense mutations of c.662C>T(p.T221M) in exon 7 and c.443T>C(p.I148T) in exon 5, which were both novel mutations and originated from the mother and father, respectively. (2) Literature review: Eight related papers were retrieved, including 20 cases. The main manifestations were various degrees of nervous system abnormalities and growth retardation, complicated by abnormalities of the liver, heart, gastrointestinal tract, blood, immunity, teeth, and bones. All the reported cases suffered from mental and growth retardation, and nine deaths were reported. A total of 11 COG6 gene mutations were identified, and most of them were c.1167-24A>G splicing mutations in a deep intron (seven cases), followed by c.1646G>T (four cases) and c.511C>T (three cases). Conclusions:COG6-CDG commonly manifests as multi-system and multi-organ dysfunctions with poor prognosis. Gene detection is conducive to the accurate diagnosis of COG6-CDG. Our case carries compound heterozygous mutations of c.662C>T(p.T221M) and c.443T>C(p.I148T), which are unreported novel mutations.
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Objective:To analyze the literature on stigma of foreign patients with epilepsy, to understand the research hotspots and research frontiers in this field, and to provide reference for the research in this field in China.Methods:The data was analyzed by HistCite software by searching the "Web of Science TM Core Collection" database. Results:A total of 740 related articles were retrieved, and the number of publications was on the rise. Jacoby A was a high-yielding author. The EPILEPSY & BEHAVIOR journals had the largest number of publications. The United States and the United Kingdom were leading in this field. The research institutes were mainly universities. The research hotspots focus on four aspects: research population, quality of life, knowledge attitude, and influencing factors.Conclusion:The study of stigma in patients with epilepsy is receiving increasing attention from the international community, but there is still a large gap between China and the leading countries in this field. Domestic scholars can learn from foreign research directions and methods to explore the level of stigma, influencing factors and effective intervention programs to provide patients with better treatment results and improve patient quality of life.
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OBJECTIVE：To evaluate the correlation between color difference values and active constituent contents of crude and processed Zingiber officinale . METHODS ：HPLC method was adopted to determint the content of 6 active constituents. The color difference values of crude and processed Z. officinale [lightness（L＊），red-green axis component （a＊），yellow-blue axis component（b＊）] were determined by chromatic aberration meter . SPSS 24.0 software was adopted for the correlation analysis between color difference values and active constituent contents. RESULTS ：The linear range of zingiberone ，6-gingerol， 8-gingerol， 6-shogaol， diacetoxy-6-gingerol and 10-gingerol were 2.65-105.90， 10.15-406.00， 4.87-194.80， 5.28-211.20， 6.14-245.70，7.02-280.80 μg/mL（r＞0.999）. The limits of quantification were 7.46，13.68，14.37，16.62，17.03，17.99 ng，and the limits of detection were 2.24，4.11，4.31，4.99，5.11，5.40 ng，respectively. RSDs of precision ，stability，and repeatability tests were all lower than 3％. The average recovery rates were 101.34％，102.14％，101.22％；103.12％，103.74％，103.54％；103.06％，properties critical for cell migration and invasion. induced EMT through downregulation of NF-κB-Snail sig- naling in breast cancer cells enchymal transition and activation of TLR 4/JNK signal - 98.55％，99.43％；99.36％，103.51％，101.21％；100.85％，99.42％，99.60％；100.39％，97.69％，103.84％（RSD were all lower than 3％，n＝3），respectively. The contents of them were 0-0.66，0.06-7.57，0.03-1.45，0.29-3.47，0.15-2.85，0.04-2.83 mg/g， respectively. L＊ and b＊ values were negative correlated with the processing degree of Z. officinale significantly（P＜0.01），a＊ showed a significantly positive correlation with the processing degree （P＜0.05）. L＊and b＊ values showed a significantly negative correlation with the content of zingiberone before and after processing ，but positively correlated with the other five components （P＜0.01）. a＊ showed a significantly positive correlation with the content of zingiberone ，but had no correlation with other five components（P＞0.05）. The crude and processed Z. officinale were positive correlated with the content of zingiberone ，negatively correlated with other five components （P＜0.01）. CONCLUSIONS ：There is a certain correlation between the color difference values of crude and processed Z. officinale and the contents of their active constituents. With the deepening of the processing ，a＊ values is increased ，L＊ values and b＊ values is decreased ；the content of zingiberone increases ，the contents of 6-gingerol， 8-gingerol，6-shogaol，diacetoxy-6-gingerol，10-gingerol reduce.
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OBJECTIVE：To establish a method for the content determination of apigenin and piperine in the water extract as well as eucalyptol and cumin aldehyde in the volatile oil of Mongolian medicine Sugmel- 3 decoction. METHODS ：HPLC method was adopted for the content determination of apigenin and piperine. GC method was used for the content determination of eucalyptol and cumin aldehyde. The determination of HPLC method was performed on Agilent Eclipse XDB-C 18 column with mobile phase consisted of methanol- 0.1％ phosphoric acid aqueous solution at flow rate of 1.0 mL/min；the detection wavelength was set at 225 nm（apigenin）and 342 nm（piperine）；the column temperature was set at 30 ℃ with sample size of 10 μL. The determination of GC method was performed on Dimensions SH-Rtx- 1 capillary column with high-purity hydrogen as carrier gas ； the injector temperature was set at 270 ℃，with flow rate of carrier gas 1 mL/min by temperature programmed ；the sample size was 1 μL，and split ratio was 1 ∶ 10. RESULTS：The linear ranges of apigenin ，piperine，eucalyptol and cumin aldehyde were 12.5-200 μg/g/mL（r＝0.999 6），87.3-139.7 μg/mL（r＝0.999 9），136-2 187 μg/mL（r＝0.999 9），39-635 μg/mL（r＝0.999 9）， respectively. The quantitation limits were 0.02，0.06，0.06，0.12 μg/mL，respectively. The detection limits were 0.01，0.02，0.03， 0.04 μg/mL. RSDs of precision，stability and reproducibility tests were all less than 4％. The recovery rates of the samples were 89.26％ -97.26％（RSD＝2.69％ ，n＝6），94.20％ -104.01％（RSD＝3.64％ ，n＝6），98.51％ -110.11％（RSD＝3.87％ ，n＝6）， 95.76％-107.82％（RSD＝4.12％，n＝6），respectively. The contents of above components were 0.769-0.828，7.741-7.981，5.284 7- 5.846 6，1.038 6-1.101 2 mg/g（n＝3）. CONCLUSIONS：The established method is simple and feasible ，and can be used for quality control of different parts of Mongolian medicine Sugmel- 3 decoction.
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Objective:To explore the detection rate, missed diagnosis rate, and clinical significance of incidental extra-hip findings (IEHFs) in hip joint MRI.Methods:The data of 1 734 cases who underwent MRI examination of hip joint from September 2014 to September 2018 at the First Central Hospital of Baoding City were retrospectively analyzed. According to the revised CT colonography reporting and data system (C-RADS), the IEHFs were divided into 4 types using structural imaging reading method. E1 type was anatomical variation; E2 type was sign without clinical significance; E3 type was sign with little clinical significance; E4 type was sign with important clinical significance. The types and distributions of IEHFs were analyzed, and the results of structural imaging reading were compared with those of the initial MRI reports. The missed diagnosis rate was calculated in this group.Results:Among the 1 734 patients, 1 651 of IEHFs were found in 1 064 patients. There were 1 080 E2 type IEHFs (65.4%, 1 080/1 651), with cervical cysts (26.0%, 281/1 080) accounting for the largest number. There were 354 IEHFs of E3 type (21.4%, 354/1 651), with most cases were prostatic hyperplasia (47.2%, 167/354). There were 217 IEHFs of E4 type (13.1%, 217/1 651), most of which were the enlarged lymph nodes in the inguinal region (30.9%, 67/217). E2 and E3 IEHFs accounted for a great proportion in male patients. The proportion of E2 IEHFs was the largest in female patients. There was significant difference in IEHFs composition between male and female patients (χ2=294.080, P<0.001). The IEHFs of patients under 60 years old were mainly E2 type, while those of over 60 years old patients were mainly E3 type. There was significant difference in IEHFs composition among different age groups (χ2=206.702, P<0.001). The overall missed diagnosis rate of IEHFs was 85.2% (1 406/1 651). The missed diagnosis rate of E2 was the highest (91.1%, 984/1 080), and that of E4 was the lowest (63.1%, 137/217). Conclusion:The incidence of IEHFs in patients undergoing hip joint MRI are prevalent. The structural imaging reading method can increase the detection of IEHFs. Therefore, it is suggested that revised C-RADS be used to grade IEHFs to reduce the rate of missed diagnosis.
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Objective@#To understand the epidemiologic characteristics of fall in the elderly in Shanghai, as well as the differences between urban and rural areas, and provide evidence for targeted fall prevention and intervention.@*Methods@#From January to March in 2017, a questionnaire survey was conducted in the elderly aged 60 or above selected from 7 urban communities and 6 rural communities in Shanghai to understand the epidemiologic characteristics of fall in the elderly and analyze the gender and urban-rural differences.@*Results@#In urban area, a total of 3 386 elderly people were surveyed, in whom 441 (13.0%) had fall and 261 (7.7%) were injured after fall. In rural area, a total of 2 826 elderly people were surveyed, in whom 320 (11.3%) had fall and 169 (6.0%) were injured after fall. Fall risk in women were higher than that in men in both urban and rural areas with OR of 1.62 (95%CI: 1.42-1.86) and 1.16 (95%CI: 1.38-1.98) respectively, but the differences of fall related injury were not significant. Compared with urban areas, fall risk and fall related injury risk were both lower in rural areas with OR of 0.86 (95%CI: 0.73-0.99) and 0.74 (95%CI: 0.56-0.99). Compared with urban areas, men had lower risk for fall, and women had lower risk for fall related injury with OR of 0.68 (95%CI: 0.51-0.90) and 0.66 (95%CI: 0.47-0.93) respectively. Fall mainly occurred at home. Fall in urban area more frequently occurred on stairs, and fall in rural area more frequently occurred during farming. More than 60% of the falls had environmental risk factors. Slippery ground and uneven ground were main reasons. The incidence of fracture resulted from fall was high indicated by 89 fracture cases in urban areas (28.2%) and 64 fracture cases in rural areas (36.1%).@*Conclusions@#The risk for fall in Shanghai had gender and urban-rural differences. Targeted intervention should be conducted according to the characteristics of fall in the elderly.
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Objective@#To investigate the epidemiological and clinical characteristics of 91 cases of dengue fever outbreak in Jiangxi Province in 2019, and to strengthen the management and prevention of dengue fever.@*Methods@#The clinical data, laboratory results and etiology tests of 91 patients with dengue fever from the Ninth Hospital of Nanchang, Zhangshu People′s Hospital, Fengcheng People′s Hospital and Nanchang County People′s Hospital from July 31, 2019 to September 27, 2019 were retrospectively collected. The t test was used for continuous variables and chi-square test was used for categorical variables.@*Results@#A total of 91 dengue fever patients were reviewed. The patients age ranged from 4 to 87 years old, and the majority were adult patients. Most patients were farmers and they all had mosquito-biting history. Local cases were the major source of this outbreak. The incubation time was (5.19±2.96) days. All patients had fever over 38 ℃. Thirty-eight (41.8%) patients developed rashes, mainly distributed on the limbs and trunk, and 15 patients (16.5%) developed myalgia and fatigue. The incidence of rashes in patients admitted in September was 15.9% (7/44), which was significantly lower than 68.1% (32/47) in July and August (χ2=25.262, P<0.01). The incidence of headache in patients admitted in September was 27.3%(12/44), which was significantly lower than 78.7% (37/47) in July and August (χ2 =24.206, P<0.01). Among the 91 patients, 64 (70.3%) patients had white blood cell counts less than 4×109/L, 14(15.4%) patients had platelet counts less than 50×109/L. The positive rate of dengue non-structural protein 1 (NS1) antigen was 100.0%(37/37), the positive rates of dengue antibody IgM and IgG were 50.0%(11/22) and 13.6%(3/22), respectively. Among the 113 serum samples tested for dengue virus RNA, 106 were identified with dengue virus type-1 and two were dengue virus type-2. In 22 patients who received tests within 7 days, the positive rate of NS1 antigen was 100.0% (22/22), the IgM and IgG positive rates were 50.0%(11/22) and 13.6% (3/22), respectively, and 19 patients were infected with dengue type-1. Among the IgM antibody positive cases, the onset days before sampling was (5.09±1.64) days, longer than that of IgM antibody negative cases ((2.82±1.83) days), with statistical significance (t=3.063, P=0.007). The onset time before sampling in dengue virus RNA-positive group was (3.53±1.87) days, which was shorter than that of RNA-negative group ((6.67±0.58) days), and the difference was statistically significant (t=2.839, P=0.013).@*Conclusions@#The dengue fever outbreak cases in Jiangxi Province in 2019 have typical clinical manifestations of dengue fever. Using the NS1 antigen test, IgM and IgG antibody tests and real-time fluorescent quantitative polymerase chain reaction for dengue virus genotyping during early onset of the disease can assistant clinicians in clinical management, controlling infectious source and stopping disease transmission.
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Objective@#To study the threshold values of lactic acid (Lac)and buffuer excess (BE) when neonatal umbilical arterial blood gas is at pH <7.20.@*Methods@#A total of 2 518 pregnant women admitted in Beijing New Century Women and Children′s Hospital from January 2017 to February 2019 were enrolled.The general conditions in perinatal period and labor methods were counted.Umbilical cord arterial blood was immediately collected before the first cry of newborn and was detected on the Abbott I-STAT automatic blood gas analyzer from the United States, and then the umbilical arterial blood gas was measured.We analyzed the perinatal factors affecting umbilical arterial blood gas.We studied the threshold values of Lac and BE for neonal asphyxia by receiver operating characteristic curve.@*Results@#(1)Maternal anemia, Streptococcus agalactiae infection, precipitate labour, placenta abnormalities had no significant impact on neonatal umbilical artery blood gas.The Lac value in blood gas was higher in the group of premature rupture of fetal membranes and fetal intrauterine distress.The value of BE was lower in the group with premature rupture of fetal membranes and fetal distress (P<0.05). The Lac value in cesarean section group was the lowest[(1.79±1.25) mmol/L], while that in midwifery group was the highest[(4.45±1.58) mmol/L]. pH value was the lowest (7.25±0.07) in the midwifery group and the highest (7.31±0.06) in the cesarean section group.The value of BE was the lowest in the midwifery group[-(5.66±2.52) mmol/L], and the highest in the cesarean section group[-(2.99±2.28) mmol/L], with statistically significant differences among the three groups (P<0.05). (2) Multiple linear regression analysis showed that fetal delivery mode, fetal intrauterine distress, premature rupture of membranes, and gestational diabetes were the factors affecting Lac level in umbilical artery blood gas of newborns.Methods of delivery, intrauterine distress, premature rupture of membranes and placental abnormalities were the factors that affected the BE value of umbilical artery blood gas in newborns.(3) A total of 199 cases with pH value <7.2 were diagnosed as asphyxia, and the receiver operating characteristic curve of Lac and BE values of neonatal umbilical artery blood gas for the diagnosis of asphyxia was drawn.When Lac was >3.97 mmol/L, the sensitivity and specificity of the diagnosis of asphyxia were 0.864 and 0.791, respectively.When BE was ≤-6 mmol/L, the diagnostic sensitivity and specificity of asphyxia were 0.613 and 0.756, respectively.@*Conclusion@#Neonatal umbilical arterial blood gas is affected by many factors.The effect of accouche on umbilical arterial blood gas is large.When there is asphyxia with pH <7.2, the cut points of Lac and BE are >3.97 mmol/L and ≤-6 mmol/L, respectively.
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Objective To investigate the epidemiological and clinical characteristics of 91 cases of dengue fever outbreak in Jiangxi Province in 2019,and to strengthen the management and prevention of dengue fever.Methods The clinical data,laboratory results and etiology tests of 91 patients with dengue fever from the Ninth Hospital of Nanchang,Zhangshu People's Hospital,Fengcheng People' s Hospital and Nanchang County People's Hospital from July 31,2019 to September 27,2019 were retrospectively collected.The t test was used for continuous variables and chi-square test was used for categorical variables.Results A total of 91 dengue fever patients were reviewed.The patients age ranged from 4 to 87 years old,and the majority were adult patients.Most patients were farmers and they all had mosquito-biting history.Local cases were the major source of this outbreak.The incubation time was(5.19±2.96)days.All patients had fever over 38℃.Thirty-eight(41.8％)patients developed rashes,mainly distributed on the limbs and trunk,and 15 patients(16.5％)developed myalgia and fatigue.The incidence of rashes in patients admitted in September was 15.9％(7/44),which was significantly lower than 68.1％(32/47)in July and August(x2 = 25.262,P ＜0.01).The incidence of headache in patients admitted in September was 27.3％(12/44),which was significantly lower than 78.7％(37/47)in July and August(x2=24.206,P ＜ 0.01).Among the 91 patients,64(70.3％)patients had white blood cell counts less than 4×109/L,14(15.4％)patients had platelet counts less than 50×109/L.The positive rate of dengue non-structural protein 1(NS1)antigen was 100.0％(37/37),the positive rates of dengue antibody IgM and IgG were 50.0％(11/22)and 13.6％(3/22),respectively.Among the 113 serum samples tested for dengue virus RNA,106 were identified with dengue virus type-1 and two were dengue virus type-2.In 22 patients who received tests within 7 days,the positive rate of NS1 antigen was 100.0％(22/22),the IgM and IgG positive rates were 50.0％(11/22)and 13.6％(3/22),respectively,and 19 patients were infected with dengue type-1.Among the IgM antibody positive cases,the onset days before sampling was(5.09±1.64)days,longer than that of IgM antibody negative cases((2.82± 1.83)days),with statistical significance(t = 3.063,P = O.007).The onset time before sampling in dengue virus RNA-positive group was(3.53±1.87)days,which was shorter than that of RN A-negative group((6.67± 0.58)days),and the difference was statistically significant(t = 2.839,P = 0.013).Conclusions The dengue fever outbreak cases in Jiangxi Province in 2019 have typical clinical manifestations of dengue fever.Using the NS1 antigen test,IgM and IgG antibody tests and real-time fluorescent quantitative polymerase chain reaction for dengue virus genotyping during early onset of the disease can assistant clinicians in clinical management,controlling infectious source and stopping disease transmission.
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Objective To study the threshold values of lactic acid ( Lac) and buffuer excess ( BE) when neonatal umbilical arterial blood gas is at pH <7. 20. Methods A total of 2 518 pregnant women admitted in Beijing New Century Women and Children′s Hospital from January 2017 to February 2019 were enrolled. The general conditions in perinatal period and labor methods were counted. Umbilical cord arterial blood was immediately collected before the first cry of newborn and was detected on the Abbott I-STAT auto-matic blood gas analyzer from the United States,and then the umbilical arterial blood gas was measured. We analyzed the perinatal factors affecting umbilical arterial blood gas. We studied the threshold values of Lac and BE for neonal asphyxia by receiver operating characteristic curve. Results (1)Maternal anemia,Strep-tococcus agalactiae infection,precipitate labour,placenta abnormalities had no significant impact on neonatal umbilical artery blood gas. The Lac value in blood gas was higher in the group of premature rupture of fetal membranes and fetal intrauterine distress. The value of BE was lower in the group with premature rupture of fetal membranes and fetal distress ( P <0. 05 ). The Lac value in cesarean section group was the lowest [(1. 79 ± 1. 25) mmol/L],while that in midwifery group was the highest[(4. 45 ± 1. 58) mmol/L]. pH value was the lowest (7. 25 ± 0. 07) in the midwifery group and the highest (7. 31 ± 0. 06) in the cesarean section group. The value of BE was the lowest in the midwifery group[ －(5. 66 ± 2. 52) mmol/L],and the highest in the cesarean section group[ －(2. 99 ± 2. 28) mmol/L],with statistically significant differences among the three groups (P<0. 05). (2) Multiple linear regression analysis showed that fetal delivery mode, fetal intrauterine distress,premature rupture of membranes,and gestational diabetes were the factors affecting Lac level in umbilical artery blood gas of newborns. Methods of delivery,intrauterine distress,premature rup-ture of membranes and placental abnormalities were the factors that affected the BE value of umbilical artery blood gas in newborns. (3) A total of 199 cases with pH value <7. 2 were diagnosed as asphyxia,and the receiver operating characteristic curve of Lac and BE values of neonatal umbilical artery blood gas for the diagnosis of asphyxia was drawn. When Lac was >3. 97 mmol/L,the sensitivity and specificity of the diag-nosis of asphyxia were 0. 864 and 0. 791,respectively. When BE was≤－6 mmol/L,the diagnostic sensitivi-ty and specificity of asphyxia were 0. 613 and 0. 756,respectively. Conclusion Neonatal umbilical arterial blood gas is affected by many factors. The effect of accouche on umbilical arterial blood gas is large. When there is asphyxia with pH <7. 2,the cut points of Lac and BE are >3. 97 mmol/L and ≤ －6 mmol/L, respectively.
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OBJECTIVE： To study the correlation between the color of Moutan Cortex and the contents of effective components before and after carbonized， and to provide reference for identification and quality evaluation of Moutan Cortex and its charcoal piece decoction. METHODS： Using colorimeter determination of Moutan Cortex and Moutan Cortex charcoal decoction pieces powder chroma space parameter [lightness value （L*）， red， green and component values （a*）， yellow and blue component value （b*） and total color difference value （E*ab）]， HPLC method for content determination of 10 effective components （gallic acid， 5-HMF， catechins， oxypaeoniflorin， paeoniflorin， quercetin， benzoyl paeoniflorin， isorhamnetin， paeonol， kaempferide） content in Moutan Cortex and Moutan Cortex charcoal decoction pieces. On this basis， the correlation between the content of effective components and the chromaticity space parameter of a color was studied by SPSS 21.0 software. RESULTS： There was no correlation between gallic acid content and the chromaticity space parameter of a color （P＞0.05）. There was an extremely significant negative correlation between 5-HMF content and L*， b*， E*ab （P＜0.01）， and an extremely significant positive correlation between 5-HMF content and a* （P＜0.01）. The content of paeoniflorin was positively correlated with L*， b* and E*ab， but not with a* （P＞0.05）. The content of oxidized paeoniflorin was positively correlated with L* and E*ab （P＜0.01）， and negatively correlated with a* （P＜0.01）， but not with b* （P＞0.05）. The content of catechins， quercetin， benzoyl paeoniflorin， isorhamnin， paeonol and kaempferol were positively correlated with L*， b* and E*ab （P＞0.05）， and negatively correlated with a* （P＞0.05）. CONCLUSIONS： Chromatic aberration technology can quantify the color of Moutan Cortex and its charcoal decoction pieces， and there is a significant correlation between the color of Moutan Cortex before and after processing and the content of its active ingredients.
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OBJECTIVE： To study the effects of simvastatin combined with rivaroxaban on pharmacokinetics of rivaroxaban in rats. METHODS： Thirty rats were randomly divided into rivaroxaban group （intragastric administration of normal saline+rivaroxaban 2.6 mg/kg）， simvastatin+rivaroxaban group （intragastric administration of simvastatin 5.3 mg/kg+rivaroxaban 2.6 mg/kg）， with 15 rats in each group. The rats were given normal saline/simvastatin intragastrically for 5 d， once a day， and then given intragastric administration of rivaroxaban+normal saline/simvastain once. The blood samples were collected from orbital cavity of rats before medication and 0.25， 0.5， 0.75， 1， 1.5， 2， 4， 8， 12， 24 h after medication. The plasma concentration of rivaroxaban was determined by LC-MS/MS. Plasma concentration-time curves were drawn， and the pharmacokinetic parameters were fitted by DAS 2.1.1 software. RESULTS： The pharmacokinetic parameters of rivaroxaban group and simvastatin+rivaroxaban group in rats included that AUC0-24 h were （2 599.86±791.82） and （2 777.74±989.25） ng·h/mL； AUC0-∞ were （3 053.28± 1 116.06） ng·h/mL and （3 396.78±1 409.80） ng·h/mL； t1/2 were （8.06±3.52） h and （9.25±4.18） h； tmax were（0.65±0.28） h and （0.60±0.13） h； CLZ were （0.95±0.32） L/（h·kg） and （0.88±0.34） L/（h·kg）； Vd were（10.37±4.43） L/kg and （11.07±4.48） L/kg； cmax were （424.93±145.30） ng/mL and （507.15±132.40） ng/mL. Compared with rivaroxaban group， AUC0-24 h， AUC0-∞， t1/2， Vd and cmax of simvastatin+rivaroxaban group increased by 6.40％， 10.11％， 12.86％， 6.32％， 16.21％； tmax and CLZ decreased by 8.33％ and 7.95％. There was no significant difference （P＞0.05）. CONCLUSIONS： There is no significant change in pharmacokinetic parameters of rivaroxaban in rats after combination of simvastatin （5.3 mg/kg） and rivaroxaban （2.6 mg/kg）.
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OBJECTIVE:To optimize the drying technology of Zingiber officinale peel and establish its quality standard. METHODS:Moisture content was determined in samples after being dried for different time(0.5-10.0 h)under 50,60,70,80, 90 ℃. Optimal drying time under each temperature was screened by using moisture content of 7%-13% as dryness for controlling standard. Then contents of 6-gingerol,8-gingerol,6-shogaol,10-gingerol in samples dried for optimal drying time under different temperatures were measured,using the 4 gingerol contents as indexes to optimize the drying temperature and time. And verification test was conducted. The moisture,total ash,water soluble extract,volatile oil,6-gingerol,8-gingerol and 10-gingerol of Z. offici-nale peel from 10 different producing areas were detected to establish quality standard after being dried with the optimal technology. RESULTS:The drying time of Z. officinale peel under 50,60,70,80,90 ℃ was determined as 10.0,4.2,2.6,1.5,1.1 h,re-spectively. The optimal drying technology was 50 ℃ drying for 10.0 h. Verification test showed RSDs of 6-gingerol,8-gingerol, 6-shogaol,10-gingerol contents were 1.46%,1.09%,1.35%,1.12%(n=3),respectively. The quality standard of Z. officinale peel was suggested that total ash was no more than 18.0%;water soluble extract,volatile oil,6-gingerol,8-gingerol,10-gingerol were respectively no less than 18.0%,1.30%,0.730%,0.060%,0.100%. CONCLUSIONS:The optimized drying technology of Z. officinale peel is reasonable,reliable,stable and simple,which provides a scientific basis for standardizing the drying technolo-gy and quality standard of Z. officinale peel. The established quality standard is feasible.
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OBJECTIVE:To establish a method for the concentration determination of nateglinide in rats'plasma and study its pharmacokinetic characteristics in rats in vivo. METHODS:UPLC was performed on the column of Acquity UPLC? BEH C18 with mobile phase of acetonitrile-10 mmol/L potassium dihydrogen phosphate buffer(41:59,V/V)at flow rate of 0.38 mL/min,with col-umn temperature of 35 ℃,detection wavelength of 210 nm and volume of 2 μL. 18 Wister rats were intragastrically administrated nateglinide 16 mg/kg. Blood sample 0.4 mL was taken from medial canthus before administration and after 10,20,30,45,60, 90,120,180,240,360,480 min of administration. The concentration of nateglinide in rats'plasma was determined;then DAS 2.1.1 software was used to calculate its pharmacokinetic parameters. RESULTS:Nateglinide showed good linear relationship in 0.05-6.4μg/mL(r=0.9993),lower limit of quantification was 0.05μg/mL;RSDs of inter-day(n=5),intra-day(n=3)and sta-bility (n=3) tests were lower than 10%;extraction recovery rate and method recovery rate were 78.71%-80.56%,91.78%-100.42%(RSD<10%,n=5),respectively. After rats were intragastrically administrated nateglinide,AUC0-8 h was (5.87 ± 2.32)μg·h/mL,AUC0-∞was(6.11±2.48)μg·h/mL,t1/2 was(1.72±0.55)h,tmax was(0.67±0.29)h and cmax was(3.34±1.23)μg/mL. CONCLUSIONS:The method is accurate,rapid with strong specificity,and can be used for the concentration determination of nat-eglinide in rats in vivo;nateglinide is absorbed and metabolized quickly in rats in vivo.