Research Progress on Forensic Toxicology of Z-drugs / 法医学杂志

The Z-drugs (zolpidem, zopiclone, and zaleplon), as the innovative hypnotics, have an improvement over the traditional benzodiazepines in the management of insomnia. Z-drugs have significant hypnotic effects by reducing sleep latency and improving sleep quality, though duration of sleep may not be significantly increased. As benzodiazepines, Z-drugs exert their effects through increasing the transmission of γ-aminobutyric acid. Z-drugs overdose are less likely to be fatal, more likely would result in poisoning. Z-drugs can be detected in blood, urine, saliva, and other postmortem specimens through liquid chromatography-mass spectrometry techniques. Zolpidem and zaleplon exhibit significant postmortem redistribution. Z-drugs have improved pharmacokinetic profiles, but incidence of neuropsychiatric sequelae, poisoning, and death may prove to be similar to the other hypnotics. This review focuses on the pharmacology and toxicology of Z-drugs with respect to their adverse effect profile and toxicity and toxicology data in the field of forensic medicine.

UFLC fingerprint of Huoxiang Zhengqi Dripping Pill / 中草药

Objective: To establish the ultra-fast liquid chromatographic (UFLC) fingerprint of Huoxiang Zhengqi Dripping Pill (HZDP) for evaluating the quality of the preparation. Methods: The UFLC separation was achieved on an Waters Acquity UPLC BEH C18 column (100 mm × 2.1 mm, 1.7 μm) with acetonitrile (A)-0.2% formic acid solution (B) as mobile phase at the flow rate of 0.4 mL/min by gradient elution of 0-6 min, 10% →15% A, 6-9 min, 15% →20% A, 9-14 min, 20% →30% A, 14-19 min, 30% → 50% A, 19-21 min, 50% →65% A, 21-26 min, 65% →75% A, 26-28 min, 75% A, 28-30 min, 75% →10% A, 30-32 min, 10% A. The column temperature was 30 ℃. The UV detection wavelength was 300 nm. The similarity of 11 batches of HZDP was analyzed with similarity evaluation system for chromatographic fingerprint of tradition Chinese medicine (Version 2004 A). Results: Fingerprints of 11 batches of HZDP were established and 18 common peaks were identified, 13 of which belonged to herbs and were identified by the reference substance and UFLC-IT-TOF/MS. Among them, five common peaks (peaks 6, 7, 9, 10, and 12) came from Angelicae Dahuricae Radix, three common peaks (peaks 4, 5, and 8) came from Citri Reticulatae Pericarpium, four common peaks (peak 1, 2, 11, and13) came from Magnoliae Officmalis Cortex, and one common peak (peak 17) came from Atractlodis Rhizoma. Conclusion: The method is rapid, accurate, reliable, and reproducible. The established fingerprint could provide the references for the study of substance basis and quality control of HZDP.

Study on the relationship between aspirin resistance and incidence of myonecrosis after non-emergent percutaneous coronary intervention / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the occurrence of aspirin resistance in coronary heart disease (CHD) patients and its influence on myonecrosis among patients undergoing non-emergent percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>256 CHD patients who have been on aspirin (100 mg/d) for at least 7 days were recruited based on aspirin responsiveness determination. All the patients were divided into two groups: aspirin-resistant group and aspirin-sensitive group. For all patients scheduled for non-emergent PCI, a loading dose of 300 mg of clopidogrel was given at least 12 h before PCI and a 75 mg maintenance dose was given every morning before and after PCI. The incidence of myonecrosis was evaluated by the levels of creatine kinase-myocardial band (CK-MB) and troponin I (TnI) before and after PCI.</p><p><b>RESULTS</b>Aspirin resistance was found in 67 (26.2%) patients and 189 (73.8%) patients were aspirin-sensitive. There was a significantly higher proportion of female subjects in the aspirin-resistant group. The incidence of any CK-MB elevation was 38 (56.7%) in aspirin-resistant group and 42 (22.2%) in aspirin-sensitive group (P < 0.01). The elevation of TnI was observed in 41 (61.2%) of the aspirin-resistant group and in 67 (35.4%) of the aspirin-sensitive group (P < 0.05). Multivariate analysis revealed that aspirin resistance was an independent predictor for CK-MB elevation after PCI (OR = 2.5; 95% CI 1.5 to 6.5; P < 0.05).</p><p><b>CONCLUSION</b>Aspirin resistance exists in some CHD patients, which increases the risk of myonecrosis following non-emergent PCI.</p>