Assessment of Risk Factors Affecting Refractive Outcomes after Phacovitrectomy for Epiretinal Membrane

Purpose@#To investigate factors associated with refractive outcomes after phacovitrectomy for epiretinal membrane (ERM). @*Methods@#Retrospective review of patients undergoing phacovitrectomy for ERM was done. The main outcome measure was predictive refraction error (PE), defined as observed refraction error – target refraction error, calculated by the SRK/T, Haigis, and SRK II formulae. PE was measured at postoperative 1, 3, and 6 months. Simple and multiple linear regression analysis were used to evaluate factors associated with PE. @*Results@#A total of 53 eyes of 53 patients were included. The mean PEs at postoperative 1, 3, and 6 months were all negative, implying myopic shift in all patients regardless of the intraocular lens formula used. Haigis formula showed the least myopic shift among the three formulae (p = 0.001, Friedman test). There was no significant difference in PE depending on preoperative central macular thickness (CMT) in subgroup analysis. On stepwise multiple linear regression analysis, ERM etiology (β = 0.759, p = 0.004, SRK/T formula; β = 0.733, p = 0.008, Haigis formula; β = 0.933, p < 0.001, SRK II formula), preoperative anterior chamber depth (β = –0.662, p = 0.013, Haigis formula; β = –0.747, p = 0.003, SRK II formula), and decrease of CMT (β = –0.003, p = 0.025, SRK/T formula) were significantly associated with PE at postoperative 6 months. @*Conclusions@#Myopic shift in PE was observed after combined phacovitrectomy for epiretinal membrane. ERM etiology, preoperative anterior chamber depth, and decrease of CMT were significantly associated with PE at postoperative 6 months. There was no difference in PE after surgery between the two groups defined by CMT (≥500 and <500 μm).

A Case of Orbital Eccrine Hidrocystoma

Purpose@#To report the first domestic case of orbital eccrine hidrocystoma.Case summary: A 40-year-old man visited our clinic after an orbital mass was discovered in the left eye. Orbital magnetic resonance imaging showed a well-defined 1 cm mass on the superomedial side of the orbit, slightly posterior to the globe. The mass was excised completely without rupture through an incision to the upper eyelid skin. The mass appeared more like a cyst than a hemangioma. The diagnosis of eccrine hidrocystoma was confirmed histopathologically. The patient recovered and there was no recurrence at the 6-month follow-up. @*Conclusions@#Although orbital eccrine hidrocystoma is very rare, it should be included in the differential diagnosis of orbital tumors.

The Lived Experiences of Patient’s Families with the Intensive Care Unit Diary / 중환자간호학회지

Purpose@#: Intensive care unit (ICU) diaries have been implemented across the international ICU community. This study aimed to comprehend the meaning and nature of the lived experience of patients’ families using the ICU diary in Korea. @*Methods@#: This qualitative study adopted van Manen’s hermeneutic phenomenology. The participants comprised eight women and two men who were the family members of patients in the ICU for more than three days. Data were collected using in-depth interviews and observation from July 2018 to January 2019. @*Results@#: Patients’ families who experienced the ICU diary recognized it with six beings according to time: a good idea, forgotten stuff, burdensome work, touching service, my stuff, and a thing in the memory. The ICU diary had three essential meanings for the families: communication, solace and hope, and a record of life. These findings were rearranged according to van Manen’s fundamental existential, and the lived things and lived others were remarkably confirmed. @*Conclusion@#: Patients’ families experienced various ICU diary forms over time and recognized an ICU diary as a means of communication. Therefore, the ICU diary is expected to be used as an intervention between families and healthcare providers in the ICU to support mutual communication.

Effects of Atomoxetine for the Treatment of Neurogenic Orthostatic Hypotension in Patients With Alpha-synucleinopathies: A Systematic Review of Randomized Controlled Trials and a Focus-Group Discussion

Background@#and PurposeNeurogenic orthostatic hypotension (nOH) is one of the most important nonmotor symptoms in patients with α-synucleinopathies. Atomoxetine is a selective norepinephrine transporter blocker that is a treatment option for nOH. This systematic review and expert focus-group study was designed to obtain evidence from published data and clinical experiences of Korean movement-disorder specialists about the efficacy and safety of atomoxetine for the pharmacological treatment of nOH in patients with α-synucleinopathies. @*Methods@#The study comprised a systematic review and a focus-group discussion with clinicians. For the systematic review, multiple comprehensive databases including MEDLINE, Embase, Cochrane Library, CINAHL, PsycInfo, and KoreaMed were searched to retrieve articles that assessed the outcomes of atomoxetine therapy. A focus-group discussion was additionally performed to solicit opinions from experts with experience in managing nOH. @*Results@#The literature review process yielded only four randomized controlled trials on atomoxetine matching the inclusion criteria. Atomoxetine effectively increased systolic blood pressure and improved OH-related symptoms as monotherapy or in combination with other drugs. Its effects were pronounced in cases with central autonomic failure, including multiple-system atrophy (MSA). Atomoxetine might be a safe monotherapy regarding the risk of supine hypertension. @*Conclusions@#Atomoxetine is an effective and safe option for short-term nOH management, which could be more evident in patients with central autonomic dysfunction such as MSA. However, there is a paucity of evidence in the literature, and data from the focus-group discussion were inadequate, and so further investigation is warranted.

Mitochondria in reproduction / 대한생식의학회지

In reproduction, mitochondria produce bioenergy, help to synthesize biomolecules, and support the ovaries, oogenesis, and preimplantation embryos, thereby facilitating healthy live births. However, the regulatory mechanism of mitochondria in oocytes and embryos during oogenesis and embryo development has not been clearly elucidated. The functional activity of mitochondria is crucial for determining the quality of oocytes and embryos; therefore, the underlying mechanism must be better understood. In this review, we summarize the specific role of mitochondria in reproduction in oocytes and embryos. We also briefly discuss the recovery of mitochondrial function in gametes and zygotes. First, we introduce the general characteristics of mitochondria in cells, including their roles in adenosine triphosphate and reactive oxygen species production, calcium homeostasis, and programmed cell death. Second, we present the unique characteristics of mitochondria in female reproduction, covering the bottleneck theory, mitochondrial shape, and mitochondrial metabolic pathways during oogenesis and preimplantation embryo development. Mitochondrial dysfunction is associated with ovarian aging, a diminished ovarian reserve, a poor ovarian response, and several reproduction problems in gametes and zygotes, such as aneuploidy and genetic disorders. Finally, we briefly describe which factors are involved in mitochondrial dysfunction and how mitochondrial function can be recovered in reproduction. We hope to provide a new viewpoint regarding factors that can overcome mitochondrial dysfunction in the field of reproductive medicine.

Role of enkephalin derivative in promoting wound healing and scar remodeling via increased epidermal growth factor in a mouse model

Background@#Enkephalin, an endogenous neuropeptide, binds to the delta (δ) opioid receptor and exerts an antinociceptive effect. Recent studies have suggested that neuropeptides might effectuate cutaneous wound healing. Therefore, we investigated the effects of an enkephalin derivative on wound healing and scar formation in vivo. @*Methods@#Enkephalin derivatives (leucine-enkephalin) were synthesized using the alanine scan method, and the most promising derivative (E10) was selected for further testing. In 15 C57BL/6N mice, two full-thickness skin defects (10 mm in diameter) were made on both sides of the back (left side, enkephalin group; right side, control group). The enkephalin group was administered 100 μL of E10 (AGGFL, 200 μg/mL), and the control group received phosphate-buffered saline. The wound size was digitally analyzed on days 2, 4, 7, and 10. After 21 days, the scar tissues were histologically evaluated for the scar depression index (SDI), and the epidermal growth factor (EGF) concentration was assessed using an enzyme-linked immunosorbent assay. @*Results@#The skin defect percentages were 98.4%±17.9% (day 2), 83.2%±24.0% (day 4), 39.7%±17.4% (day 7), and 16.2%±10.0% (day 10) in the control group and 86.1%±15.0% (day 2), 61.4%±11.6% (day 4), 26.6%±8.8% (day 7), and 16.4%±8.8% (day 10) in the enkephalin group. The SDI values were significantly lower in the enkephalin group (0.06±0.19) than in the control group (0.22±0.13, P<0.001). The EGF level was significantly higher in the enkephalin group (102.2±22.6 pg/mL) than in the control group (42.1±20.5 pg/mL, P<0.001). @*Conclusions@#An enkephalin derivative promoted wound healing and reduced depressed scar formation in a mouse model.

Quality of Images Reconstructed by Deep Learning Reconstruction Algorithm for Head and Neck CT Angiography at 100 kVp / 中国医学科学院学报

Objective To evaluate the impact of deep learning reconstruction algorithm on the image quality of head and neck CT angiography (CTA) at 100 kVp. Methods CT scanning was performed at 100 kVp for the 37 patients who underwent head and neck CTA in PUMC Hospital from March to April in 2021.Four sets of images were reconstructed by three-dimensional adaptive iterative dose reduction (AIDR 3D) and advanced intelligent Clear-IQ engine (AiCE) (low,medium,and high intensity algorithms),respectively.The average CT value,standard deviation (SD),signal-to-noise ratio (SNR),and contrast-to-noise ratio (CNR) of the region of interest in the transverse section image were calculated.Furthermore,the four sets of sagittal maximum intensity projection images of the anterior cerebral artery were scored (1 point:poor,5 points:excellent). Results The SNR and CNR showed differences in the images reconstructed by AiCE (low,medium,and high intensity) and AIDR 3D (all P<0.01).The quality scores of the image reconstructed by AiCE (low,medium,and high intensity) and AIDR 3D were 4.78±0.41,4.92±0.27,4.97±0.16,and 3.92±0.27,respectively,which showed statistically significant differences (all P<0.001). Conclusion AiCE outperformed AIDR 3D in reconstructing the images of head and neck CTA at 100 kVp,being capable of improving image quality and applicable in clinical examinations.

Multiple Injections of Adipose-Derived Stem Cells Improve Graft Survival in Human-to-Rat Skin Xenotransplantation through Immune Modulation

BACKGROUND@#Adipose-derived stem cells (ADSCs) exert immunomodulatory effects in the treatment of transplant rejection. This study aimed to evaluate the effects of ADSCs on the skin graft survival in a human-to-rat xenograft transplantation model and to compare single and multiple injections of ADSCs. @*METHODS@#Full-thickness human skin xenografts were transplanted into the backs of Sprague–Dawley rats. The rats were injected subcutaneously on postoperative days 0, 3, and 5. The injections were as follows: triple injections of phosphate-buffered saline (PBS group), a single injection of ADSCs and double injections of PBS (ADSC 9 1 group), and triple injections of ADSCs (ADSC 9 3 group). The immunomodulatory effects of ADSCs on human skin xenografts were assessed. @*RESULTS@#Triple injections of ADSCs considerably delayed cell-mediated xenograft rejection compared with the PBS and ADSC 9 1 groups. The vascularization and collagen type 1–3 ratios in the ADSC 9 3 group were significantly higher than those in the other groups. In addition, intragraft infiltration of CD3-, CD4-, CD8-, and CD68-positive cells was reduced in the ADSC 9 3 group. Furthermore, in the ADSC 9 3 group, the expression levels of proinflammatory cytokine interferon-gamma (IFN-c) were decreased and immunosuppressive prostaglandin E synthase (PGES) was increased in the xenograft and lymph node samples. @*CONCLUSION@#This study presented that triple injections of ADSCs appeared to be superior to a single injection in suppressing cell-mediated xenograft rejection. The immunomodulatory effects of ADSCs are associated with the downregulation of IFN-c and upregulation of PGES in skin xenografts and lymph nodes.

Reliability of a chairside CAD-CAM surgical guide for dental implant surgery on the anterior maxilla: An in vitro study

PURPOSE@#. This study evaluated the reliability of the chair-side CAD-CAM surgical guide (CSG) in the anterior maxilla by comparing its accuracy with the laboratory 3D-printed surgical guide (3DSG) and manual surgical guide (MSG) concerning different levels of dentists' surgical experience. @*MATERIALS AND METHODS@#. Ten surgical guides of each type (MSG, 3DSG, and CSG) were fabricated on a control study model with missing right and left central incisors. Sixty implants were placed in 30 study models by two dentists (one inexperienced and one experienced) using three different types of surgical guides. Horizontal deviations at shoulder and at apex, vertical, and angular deviations were measured after superimposing the planned and placed implant positions in the software. Kruskal-Wallis and Mann-Whitney U tests were used to compare the accuracy of three types of surgical guides in each dentist group and the accuracy of each surgical guide between two dentists (α = .05). @*RESULTS@#. There were no significant differences in any deviations between CSG and 3DSG, apart from angular deviation, for both dentists’ groups. Moreover, both CSG and 3DSG showed no significant differences in accuracy between the two dentists (P > .05). In contrast, MSG demonstrated significant differences from CSG and 3DSG and a significant difference in accuracy between the two dentists (P < .05). @*CONCLUSION@#. CSG provides superior accuracy to MSG in implant placement in the maxillary anterior region and is comparable to 3DSG at different levels of surgical experience, while offering the benefits of shorter manufacturing time and reduced patient visits.

Postoperative Refractive Outcomes of Biometric Formulas in Phacovitrectomy with Gas Tamponade

Purpose@#To investigate the refractive accuracy of intraocular lens (IOL) power calculation for biometric formulas in phacovitrectomy. @*Methods@#This retrospective study included 357 eyes of 357 patients who underwent phacovitrectomy using four commonly available IOL power formulas: Hoffer Q (87 eyes), Holladay 1 (78 eyes), Holladay 2 (91 eyes), and SRK/T (101 eyes). The mean refractive error (ME) and the mean absolute refractive error (MAE) were calculated based on the predicted postoperative refraction error, and they were compared using analysis of variance test. Subjects were divided into high myopic eyes (axial length, ≥26 mm) and nonhigh myopic eyes (axial length, <26 mm). @*Results@#The ME and the MAE after phacovitrectomy did not show a significant difference among the four IOL power formulas (p = 0.546 and p = 0.495, respectively). There was no significant statistical difference in formulas when the eyes were grouped into high myopia and nonhigh myopia (ME: p = 0.526 and p = 0.482, respectively; MAE: p = 0.715 and p = 0.627, respectively). The ME showed myopic shift in all formulas regardless of IOL formula used. The ME showed greater myopic shift in high myopia group than nonhigh myopia group in all formulas. @*Conclusions@#Our study did not find evidence for superiority of any formula in phacovitrectomy. However, in phacovitrectomy, possible myopic shift should be considered for IOL power calculation. Especially, in phacovitrecotmy in patients with high myopia, more myopic shift should be considered when selecting IOL.

Survey of Foodservice Management Status according to Welfare Facility Type for Disabled Persons

This study aimed to determine foodservice and hygiene management statuses at welfare facilities catering to disabled persons by facility type to provide basic data for foodservice management guidelines. An online survey was distributed to workers at 1,984 welfare facilities for disabled persons in Korea, and 531 facilities responded, which represented a response rate of 26.8%. The survey requested general information about the facilities, facility users, meals, hygiene, and management. Statistical analyses were performed, and frequency analysis and the chi-square test were used to investigate responses by facility type. The survey results revealed that daycare centers were most common and accounted for 27.4% of responses. Residential facilities for the severely disabled and sheltered workshops accounted for 16.9% and 16.4%, respectively, and residential facilities by disability type accounted for 13.0%. The presence of dietitians at welfare facilities varied by facility type. Welfare centers for the disabled (94.7%) had the highest percentage of dietitians, followed by residential facilities for the severely disabled (87.8%). On the other hand, sheltered workshops and daycare centers for disabled persons had the lowest percentages of dietitians (10.3% and 4.1%, respectively). This study highlights the variations that exist in foodservice management across different welfare facilities for disabled persons and emphasizes the challenges faced by those responsible for managing foodservices and maintaining hygiene, particularly in large facilities with no dietitians. Therefore, we recommend tailored meal management guidelines be developed for each type of welfare facility for disabled persons.

Extraction of mandibular third molars: relationship of preoperative anxiety with body mass index, serum high-sensitivity C-reactive protein levels, and visual analog scale scores and predictors of postoperative complications

Objectives@#Patients undergoing oral surgery exhibit high anxiety, which may elevate their cortisol levels and affect postoperative recovery. Overweight patients are often encountered in the dental clinic due to the increasing prevalence of overweight. We aimed to investigate the relationships between preoperatively assessed body mass index (BMI), serum cortisol and high-sensitivity C-reactive protein (hs-CRP) levels, and visual analog scale (VAS) scores and preoperative anxiety in patients undergoing mandibular third molar (MM3) extraction and to identify predictors of postoperative complications. @*Patients and Methods@#We analyzed 43 patients (age, 20-42 years) undergoing MM3 extraction. At the first visit, patients completed the Modified Dental Anxiety Scale (MDAS) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaires. Their BMI and VAS scores were also calculated. The participants underwent blood tests 1 hour before MM3 extraction. On the first postoperative day, the participants’ VAS scores and serum hs-CRP levels were reevaluated. @*Results@#We found that BMI was significantly correlated with preoperative VAS scores. Further, BMI and preoperative hs-CRP levels were significantly correlated among women and patients undergoing extractions of fully impacted MM3s. No correlations were found between serum cortisol and other variables. The preoperative MDAS and VAS scores were significantly positively correlated, especially among patients undergoing extractions of fully impacted MM3s. Multiple linear regression showed that BMI and the eruption status of the MM3 were significant predictors of postoperative hsCRP levels and VAS scores, respectively. @*Conclusion@#In MM3 removals, patients with higher BMI showed elevated hs-CRP and higher VAS scores before surgery. Patients with higher anxiety among those undergoing extractions of fully impacted MM3s showed higher preoperative VAS scores. The two main predictors of postoperative complications were BMI and MM3 eruption status.

The double-barrier technique using platelet-rich fibrin for closure of oroantral fistulas

An oroantral fistula (OAF) or oroantral communication (OAC) is an opening between the oral cavity and the maxillary sinus. If left untreated, these openings may cause chronic maxillary sinusitis. Although small defects (diameter <5 mm) may close spontaneously, larger communications require surgical intervention. Various studies have been conducted on OAC closure using a platelet-rich fibrin (PRF) membrane; most of these prior studies have involved simple direct application of PRF clots. This study introduces a new “double-barrier technique” using PRF for closure of an OAF involving sinus mucosal lifting and closure. The PRF material is inserted into the prepared maxillary sinus space, and the buccal advancement flap covers the oral side. This technique was successfully used to treat two patients with chronic OAF in the posterior maxillary region after implant removal or tooth extraction. The use of a PRF membrane in a double-barrier technique may have advantages in soft-tissue healing and could enable easy closure of chronic OAF with minimal trauma.

Comparing the Expression of Canonical and Non-Canonical Inflammasomes Across Glioma Grades: Evaluating Their Potential as an Aggressiveness Marker

Background@#Inflammasomes are key in the initiation of inflammatory responses and serve to de-fend the organism. However, when the immune system is imbalanced, these complexes contribute to tumor progression. The purpose of this study was to investigate the effect of non-canonical inflammasomes on glioma malignancy. @*Methods@#We performed bioinformatics analysis to confirm the expression of canonical andnon-canonical inflammasome-related molecules according to the degree of malignancy through immunohistochemical examination of glioma tissues obtained with patient consent from our institution. @*Results@#Bioinformatics analysis confirmed that the expression levels of non-canonical inflam-masome-related molecules were significantly higher in tumor tissues than in normal tissues, and they also increased according to malignancy, which adversely affected the survival rate. Furthermore, in gliomas, positive correlations were found between N-form gasdermin-D, a key molecule associated with the non-canonical inflammasome, and other related molecules, including NLRP3, caspase-1, caspase-4, and caspase-5. These results were verified by immunohistochemical examination of glioma tissues, and the expression levels of these molecules also increased significantly with increasing grade.In addition, the features of pyroptosis were confirmed. @*Conclusion@#This study identified the potential of non-canonical inflammasomes as aggressiveness markers for gliomas and presented a perspective for improving glioma treatment.

The significance of split-face studies and electromyography in forehead rejuvenation

Background@#Botulinum toxin is a neurotoxic substance with a wide range of uses, from the treatment of musculoskeletal spasms to antiaging regimens by improving wrinkles. Split-face studies in which drugs are injected in the right and left sides of the faces have been actively conducted in botulinum toxin studies. In this study, we aimed to investigate the reliability of a split-face study for determining the effectiveness of botulinum toxin based on eyebrow height and movement, and electromyography results. @*Methods@#Thirty-one women aged 35 to 55 years were included in the study. Eyebrow height was measured as the distance from the eyebrows to the upper eyelid margin on the primary gaze, and eyebrow movement was measured as the distance when the forehead was wrinkled for 5 seconds. A noninvasive method was used for electromyography of the frontalis muscles. @*Results@#No statistically significant differences in right and left eyebrow heights and movements, and electromyography findings (p= 0.256, p= 1.000, and p= 0.978, respectively) were found. Pearson correlation analysis showed that electromyography muscle activity is positively associated with eyebrow movement, respectively (p< 0.001). @*Conclusion@#We advocate the reliability of split-face study and the usefulness of electromyography of frontalis muscle in forehead rejuvenation research.

Bloodless de-epithelialization in reduction mammoplasty with hydrodissection using a digital automatic anesthesia injector: case series

De-epithelialization is a technique that thins out the epidermis layer of the skin to resurface defects in a cavity or to implant a flap pedicle subcutaneously, preserving the subdermal plexus to support the vascularity of the flap. However, in reduction mammoplasty, de-epithelialization of the pedicle is a time-consuming and tedious step. Although various methods have been proposed to facilitate the completion of this step, a standard has not been established. We used a digital automatic injector that could inject a mixture of lidocaine and epinephrine at a constant, adjustable rate without any special effort. With this method, we could inject local anesthetic into the junction of the epidermis and dermis accurately, which saved time by making dissection easier (hydrodis-section) and decreased bleeding during de-epithelialization. Furthermore, we could use less of the lidocaine and epinephrine mixture, thereby reducing its potential side effects.

Brain magnetic resonance imaging (MRI) findings in central precocious puberty patients: is routine MRI necessary for newly diagnosed patients?

Purpose@#The overall incidence of central precocious puberty (CPP) has increased in recent decades, and brain magnetic resonance imaging (MRI) evaluations are recommended in cases of suspected brain lesions. This study aimed to investigate the prevalence of MRI abnormalities and to evaluate the need for routine brain MRI in patients with newly diagnosed CPP. @*Methods@#This retrospective study reviewed the data of patients newly diagnosed with CPP who underwent routine pituitary MRI at Korea University Anam Hospital from March 2020 to September 2021. A total of 199 girls and 24 boys was enrolled in this study. Positive MRI findings were categorized as abnormal pituitary, nonpituitary incidental, and pathological. In addition, we investigated the incidence of MRI abnormalities and evaluated their associations with clinical and biochemical factors. @*Results@#Positive brain MRI findings were observed in 84 patients (37.7%). Pituitary abnormalities were found in 54 patients (24.2%), with Rathke cleft cysts being the most common (16.1%). Incidental nonpituitary findings were observed in 29 patients (13.0%), while a pathological brain lesion (diagnosed as hypothalamic hamartoma) was observed in only 1 female patient (0.4%). No significant differences in sex or age were found in incidence of pituitary abnormalities or nonpituitary incidental findings. Compared with headache controls, significant associations were observed between abnormal pituitary findings on MRI and CPP (unadjusted odds ratio, 3.979; 95% confidence interval, 1.726–9.173). @*Conclusion@#True pathological findings were rare, even though the prevalence of abnormalities on pituitary MRI in patients with CPP was relatively high. Considering its cost-effectiveness, MRI screenings should be carefully considered in patients with CPP.

Determination of monosaccharide composition of polysaccharide and free monosaccharides in Cistanches Herba by ion chromatography-integral pulsed amperometry / 药学学报

Polysaccharides and free monosaccharides are important active components in Cistanches Herba, which have functions of anti-aging and immunological activity regulation. The study of monosaccharide composition in polysaccharide and free monosaccharide can lay a foundation for the study of primary structure, spatial structure of Cistanche polysaccharide and biological activity of Cistanches Herba. In this study, a method of water extraction and alcohol precipitation was used to extract Cistanche polysaccharide. Trifluoroacetic acid was selected as the hydrolytic acid for polysaccharide hydrolysis. An orthogonal experimental method is established. Three levels of acid concentration, hydrolysis temperature and hydrolysis time were selected to investigate the optimal hydrolysis condition. The optimal hydrolysis condition was 0.08 mol·L-1 trifluoroacetic acid hydrolysis at 100 ℃ for 3 h. The free monosaccharides of Cistanches Herba were extracted by water extraction. The established ion chromatogram integrated pulsed amperometry method can efficiently separate 11 monosaccharides in a short time. The method has good repeatability and high sensitivity, methodological experiment results meet the requirements of quantitative determination. It can accurately determine the monosaccharide composition of Cistanche polysaccharide and free monosaccharide content. Ion chromatography does not require derivatization operation and the pre-treatment steps are simple. This method can measure fructose, but PMP derivation-HPLC method can't. The monosaccharide composition of Cistanche polysaccharide include fucose, arabinose, rhamnose-galactose, glucose, xylose, mannose, fructose, ribose and glucuronic acid, among which the contents of glucose and fructose are relatively high. The free monosaccharides in the water extract of Cistanches Herba include glucose, fructose and mannose.

Analysis of the of Pb, Cd and As in decoction of Lindera aggregata (Sims) Kosterm. by PBET digestion in vitro/Caco-2 cell model and their cumulative risk assessment / 药学学报

Inductively coupled plasma mass spectrometry (ICP-MS) was applied to determine the concentrations of lead (Pb), cadmium (Cd) and arsenic (As) in Lindera aggregata (Sims) Kosterm. The physiologically based extraction test (PBET) digestion in vitro/Caco-2 cell model was established to investigate the bioaccessible contents of Pb, Cd and As in decoction of Lindera aggregata (Sims) Kosterm. The target-organ toxicity dose modification of HI method (TTD) was used to evaluate the cumulative risk caused by the combined exposure of the total levels of Pb, Cd and As in Lindera aggregata (Sims) Kosterm. and the bioaccessible contents in the decoction. The results showed that the total contents of Pb, Cd and As in 4 batches of samples were in the range of 2.901-3.872, 1.299-1.800 and 0.062-0.216 mg·kg-1, respectively. After transportation by Cacco-2 cells, the bioaccessible contents of Pb, Cd, and As in the decoction were in the range of 0.045-0.080, 0.070-0.112 and 0.004-0.018 mg·kg-1. The results of risk assessment showed that calculated by the total amounts of heavy metals in the Lindera aggregata (Sims) Kosterm., for the end points of nervous system, the cumulative risks of co-exposure of heavy metals in 3 batches of samples were of concern. After decoction and transportation by Caco-2 cells, for the end points of cardiovascular system, blood, nervous system, kidney and testis, the TTD modification of HI values of all batches of samples were less than 1, and the health risks were acceptable. The study provided methodology basis for a more objective assessment of the health risks of heavy metals and harmful elements in traditional Chinese medicine and for a more scientific limit standard of heavy metals and harmful elements.

Advances in research on small molecule regulators targeting HBV cccDNA generation and transcription / 药学学报

Hepatitis B virus (HBV) represents a significant global public health challenge. Despite the availability of several approved drugs for hepatitis B treatment, the persistence of covalently closed circular DNA (cccDNA) renders HBV eradication elusive, thereby leading to disease relapse after drug withdrawal. This paper reviews the regulatory mechanisms of cccDNA formation, transcription and replication, and summarizes the research progress of related small molecule regulators from the perspective of medicinal chemistry.