Fatigue injury in volleyball players under jump resistance training / Lesão por fadiga em jogadores de voleibol sob treino de resistência com salto / Lesión por fatiga en jugadoras de voleibol bajo entrenamiento de resistencia con salto

ABSTRACT Introduction The rapid development of competitive sports in the world requires volleyball players not just sufficient physical fitness but also the ability to understand and learn advanced techniques and tactics. In response to the increasing pace of competitive sports, research on fatigue injuries in volleyball players must be deepened and expanded, making coaches and players aware of sports injuries and their means of prevention. Objective Explore the fatigue injury characteristics in volleyball players under jump resistance training. Methods 157 volleyball players from eight sports colleges were selected as the research subject. Composed of 94 male volleyball players and 63 female volleyball players. Results In the investigation of the 157 volleyball players, 153 had some degree of injury, representing a total of 97.1% of the players, and only four non-injured, representing 1.80%; 95 people were injured in special technical training (61.20%); 43 were injured in advanced training (27.62%); 17 people were injured in preparatory activities (10.86%). No one was injured during relaxation activities. Conclusion Preventive measures for fatigue injuries in volleyball players include strengthening with medical supervision and balanced exercise load distribution. With attention to rational preparation of activities including strengthening and knee joint flexibility. Evidence level II; Therapeutic Studies - Investigating the results.

RESUMO Introdução O rápido desenvolvimento dos esportes competitivos no mundo exige que os jogadores de voleibol não tenham apenas aptidão física suficiente, mas também a capacidade de compreender e apreender técnicas e táticas avançadas. Para atender ao ritmo crescente da competição esportiva, deve-se aprofundar e ampliar as pesquisas sobre lesões por fadiga em jogadores de voleibol, fazendo com que treinadores e jogadores se atentem às lesões esportivas e seus meios de prevenção. Objetivo Explorar as características da lesão por fadiga em jogadores de voleibol sob treino de resistência com salto. Métodos 157 jogadores de voleibol de oito faculdades esportivas foram selecionados como objeto de pesquisa. Compostos por 94 jogadores de voleibol masculinos e 63 jogadoras de voleibol feminino. Resultados Na investigação dos 157 jogadores de voleibol, 153 apresentaram algum grau de lesão, representando um total de 97,1% dos jogadores, e apenas 4 não lesionados, representando 1,80%; 95 pessoas ficaram feridas em treinos técnicos especiais (61,20%); 43 feriram-se no treino avançado (27,62%); 17 pessoas feriram-se em atividades preparatórias (10,86%). Ninguém se feriu durante as atividades de relaxamento. Conclusão Medidas preventivas para lesões por fadiga em jogadores de voleibol incluem principalmente o fortalecimento com supervisão médica, a distribuição equilibrada da carga de exercício. Com atenção ao preparo racional das atividades incluindo o fortalecimento e a flexibilidade articular do joelho. Nível de evidência II; Estudos terapêuticos - Investigação de resultados.

RESUMEN Introducción El rápido desarrollo de los deportes de competición en el mundo exige a los jugadores de voleibol no sólo una buena forma física, sino también la capacidad de entender y comprender técnicas y tácticas avanzadas. Para hacer frente al creciente ritmo de la competición deportiva, se debe profundizar y ampliar la investigación sobre las lesiones por fatiga en los jugadores de voleibol, concienciando a entrenadores y jugadores sobre las lesiones deportivas y sus medios de prevención. Objetivo Explorar las características de las lesiones por fatiga en jugadores de voleibol sometidos a un entrenamiento de resistencia con saltos. Métodos Se seleccionaron como objeto de investigación 157 jugadoras de voleibol de ocho escuelas deportivas. Compuesto por 94 jugadores de voleibol masculinos y 63 jugadores de voleibol femeninos. Resultados En la investigación de los 157 jugadores de voleibol, 153 presentaron algún grado de lesión, lo que representa un total del 97,1% de los jugadores, y sólo 4 no lesionados, lo que representa el 1,80%; 95 personas se lesionaron en el entrenamiento técnico especial (61,20%); 43 se lesionaron en el entrenamiento avanzado (27,62%); 17 personas se lesionaron en las actividades preparatorias (10,86%). Nadie resultó herido durante las actividades de relajación. Conclusión Las medidas preventivas de las lesiones por fatiga en los jugadores de voleibol incluyen principalmente el fortalecimiento con supervisión médica, la distribución equilibrada de la carga de ejercicio. Con atención a la preparación racional de las actividades, incluyendo el fortalecimiento y la flexibilidad de la articulación de la rodilla. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Progress on the pathogenesis and treatment of IgG4-related disease / 药学学报

IgG4-related disease (IgG4-RD) is a newly recognized fibro-inflammatory condition of autoimmune etiology in recent twenty years, mainly manifesting as mass-forming lesions in single or multiple organs. In the past, it was often missed or misdiagnosed as inflammation or tumor. Patients may die from multiple organ failure due to end-stage fibrosis if they are not treated promptly. However, the number of clinically confirmed cases has gradually increased with the improvement of diagnostic level in recent years, and these patients have benefited greatly after receiving early treatment. Although patients generally respond well to traditional immunosuppressors including glucocorticoids and disease-modifying anti-rheumatic drugs, refractory and recurrent cases, even patients with glucocorticoid contraindication are common. Important mechanistic insights have been derived from studies of B-cell depletion therapy, but greater awareness of the pathophysiology of IgG4-RD is still badly needed to identify novel therapeutic targets. In this article, we reviewed the pathogenesis progress and promising therapy of IgG4-RD to seek better clinical management of IgG4-RD.

Study of intermolecular interactions of piroxicam polymorphs / 药学学报

Piroxicam has polymorphism. Different crystalline forms can exhibit different physicochemical properties and biological activities. Analysis of the intermolecular interactions is essential to reveal the formation mechanism and differences of polymorphs. In this paper, Hirshfeld surface analysis and semi-empirical methods were used to calculate and analyze the intermolecular interactions in seven polymorphic forms of piroxicam. The results show that the Hirshfeld surface analysis method can clearly and intuitively reveal the intermolecular interactions, among which H…H, O…H/H…O and N…H/H…N interactions account for 95% of the total energy. There are differences in the proportion and distribution of the forces of different crystal forms. The energy calculation shows that the lattice energy of the hydrate is significantly lower than that of the anhydrous forms, and in the specific energy distribution, the contribution of the dispersion force is the most prominent. Further interaction energy analysis was found that within the distance of 3.8 Å from the center of the piroxicam molecule, different crystalline forms of piroxicam molecule have different interaction energies with surrounding molecules.

Risk factors of postoperative surgical site infection in colon cancer based on a single center database / 中华胃肠外科杂志

Objective: To explore the incidence and risk factors of postoperative surgical site infection (SSI) after colon cancer surgery. Methods: A retrospective case-control study was performed. Patients diagnosed with colon cancer who underwent radical surgery between January 2016 and May 2021 were included, and demographic characteristics, comorbidities, laboratory tests, surgical data and postoperative complications were extracted from the specialized prospective database at Department of General Surgery, Peking Union Medical College Hospital. Case exclusion criteria: (1) simultaneously multiple primary colon cancer; (2) segmental resection, subtotal colectomy, or total colectomy; (3) patients undergoing colostomy/ileostomy during the operation or in the state of colostomy/ileostomy before the operation; (4) patients receiving natural orifice specimen extraction surgery or transvaginal colon surgery; (5) patients with the history of colectomy; (6) emergency operation due to intestinal obstruction, perforation and acute bleeding; (7) intestinal diversion operation; (8) benign lesions confirmed by postoperative pathology; (9) patients not following the colorectal clinical pathway of our department for intestinal preparation and antibiotic application. Univariate analysis and multivariate analysis were used to determine the risk factors of SSI after colon cancer surgery. Results: A total of 1291 patients were enrolled in the study. 94.3% (1217/1291) of cases received laparoscopic surgery. The incidence of overall SSI was 5.3% (69/1291). According to tumor location, the incidence of SSI in the right colon, transverse colon, left colon and sigmoid colon was 8.6% (40/465), 5.2% (11/213), 7.1% (7/98) and 2.1% (11/515) respectively. According to resection range, the incidence of SSI after right hemicolectomy, transverse colectomy, left hemicolectomy and sigmoid colectomy was 8.2% (48/588), 4.5% (2/44), 4.8% (8 /167) and 2.2% (11/492) respectively. Univariate analysis showed that preoperative BUN≥7.14 mmol/L, tumor site, resection range, intestinal anastomotic approach, postoperative diarrhea, anastomotic leakage, postoperative pneumonia, and anastomotic technique were related to SSI (all P<0.05). Multivariate analysis revealed that anastomotic leakage (OR=22.074, 95%CI: 6.172-78.953, P<0.001), pneumonia (OR=4.100, 95%CI: 1.546-10.869, P=0.005), intracorporeal anastomosis (OR=5.288, 95%CI: 2.919-9.577,P<0.001) were independent risk factors of SSI. Subgroup analysis showed that in right hemicolectomy, the incidence of SSI in intracorporeal anastomosis was 19.8% (32/162), which was significantly higher than that in extracorporeal anastomosis (3.8%, 16/426, χ(2)=40.064, P<0.001). In transverse colectomy [5.0% (2/40) vs. 0, χ(2)=0.210, P=1.000], left hemicolectomy [5.4% (8/148) vs. 0, χ(2)=1.079, P=0.599] and sigmoid colectomy [2.1% (10/482) vs. 10.0% (1/10), χ(2)=2.815, P=0.204], no significant differences of SSI incidence were found between intracorporeal anastomosis and extracorporeal anastomosis (all P>0.05). Conclusions: The incidence of SSI increases with the resection range from sigmoid colectomy to right hemicolectomy. Intracorporeal anastomosis and postoperative anastomotic leakage are independent risk factors of SSI. Attentions should be paid to the possibility of postoperative pneumonia and actively effective treatment measures should be carried out.

Safety and prognosis analysis of transanal total mesorectal excision versus laparoscopic mesorectal excision for mid-low rectal cancer / 中华胃肠外科杂志

Objective: To compare the short-term and long-term outcomes between transanal total mesorectal excision (taTME) and laparoscopic total mesorectal excision (laTME) for mid-to-low rectal cancer and to evaluate the learning curve of taTME. Methods: This study was a retrospective cohort study. Firstly, consecutive patients undergoing total mesorectal excision who were registered in the prospective established database of Division of Colorectal Diseases, Department of General Surgery, Peking Union Medical College Hospital during July 2014 to June 2020 were recruited. The enrolled patients were divided into taTME and laTME group. The demographic data, clinical characteristics, neoadjuvant treatment, intraoperative and postoperative complications, pathological results and follow-up data were extracted from the database. The primary endpoint was the incidence of anastomotic leakage and the secondary endpoints included the 3-year disease-free survival (DFS) and the 3-year local recurrence rate. Independent t-test for comparison between groups of normally distributed measures; skewed measures were expressed as M (range). Categorical variables were expressed as examples (%) and the χ(2) or Fisher exact probability was used for comparison between groups. When comparing the incidence of anastomotic leakage, 5 variables including sex, BMI, clinical stage evaluated by MRI, distance from tumor to anal margin evaluated by MRI, and whether receiving neoadjuvant treatment were balanced by propensity score matching (PSM) to adjust confounders. Kaplan-Meier curve and Log-rank test were used to compare the DFS of two groups. Cox proportional hazard model was used to analyze and determine the independent risk factors affecting the DFS of patients with mid-low rectal cancer. Secondly, the data of consecutive patients undergoing taTME performed by the same surgical team (the trananal procedures were performed by the same main surgeon) from February 2017 to March 2021 were separately extracted and analyzed. The multidimensional cumulative sum (CUSUM) control chart was used to draw the learning curve of taTME. The outcomes of 'mature' taTME cases through learning curve were compared with laTME cases and the independent risk factors of DFS of 'mature' cases were also analyzed. Results: Two hundred and forty-three patients were eventually enrolled, including 182 undergoing laTME and 61 undergoing taTME. After PSM, both fifty-two patients were in laTME group and taTME group respectively, and patients of these two groups had comparable characteristics in sex, age, BMI, clinical tumor stage, distance from tumor to anal margin by MRI, mesorectal fasciae (MRF) and extramural vascular invasion (EMVI) by MRI and proportion of receiving neoadjuvant treatment. After PSM, as compared to laTME group, taTME group showed significantly longer operation time [(198.4±58.3) min vs. (147.9±47.3) min, t=-4.321, P<0.001], higher ratio of blood loss >100 ml during surgery [17.3% (9/52) vs. 0, P=0.003], higher incidence of anastomotic leakage [26.9% (14/52) vs. 3.8% (2/52), χ(2)=10.636, P=0.001] and higher morbidity of overall postoperative complications [55.8%(29/52) vs. 19.2% (10/52), χ(2)=14.810, P<0.001]. Total harvested lymph nodes and circumferential resection margin involvement were comparable between two groups (both P>0.05). The median follow-up for the whole group was 24 (1 to 72) months, with 4 cases lost, giving a follow-up rate of 98.4% (239/243). The laTME group had significantly better 3-year DFS than taTME group (83.9% vs. 73.0%, P=0.019), while the 3-year local recurrence rate was similar in two groups (1.7% vs. 3.6%, P=0.420). Multivariate analysis showed that and taTME surgery (HR=3.202, 95%CI: 1.592-6.441, P=0.001) the postoperative pathological staging of UICC stage II (HR=13.862, 95%CI:1.810-106.150, P=0.011), stage III (HR=8.705, 95%CI: 1.104-68.670, P=0.040) were independent risk factors for 3-year DFS. Analysis of taTME learning curve revealed that surgeons would cross over the learning stage after performing 28 cases. To compare the two groups excluding the cases within the learning stage, there was no significant difference between two groups after PSM no matter in the incidence of anastomotic leakage [taTME: 6.7%(1/15); laTME: 5.3% (2/38), P=1.000] or overall complications [taTME: 33.3%(5/15), laTME: 26.3%(10/38), P=0.737]. The taTME was still an independent risk factor of 3-year DFS only analyzing patients crossing over the learning stage (HR=5.351, 95%CI:1.666-17.192, P=0.005), and whether crossing over the learning stage was not the independent risk factor of 3-year DFS for mid-low rectal cancer patients undergoing taTME (HR=0.954, 95%CI:0.227-4.017, P=0.949). Conclusions: Compared with conventional laTME, taTME may increase the risk of anastomotic leakage and compromise the oncological outcomes. Performing taTME within the learning stage may significantly increase the risk of postoperative anastomotic leakage.

Quality value transfer of substance benchmarks in Sanpian Decoction / 中国中药杂志

According to the polarity of different components in Sanpian Decoction, two fingerprints were established. Then the substance benchmark freeze-dried powder of 15 batches of Sanpian Decoction was prepared, followed by the determination of the fingerprints, index component content, and dry extract rates, the identification of attribution of characteristic peaks, and the calculation of similarities between these fingerprints and the reference(R), the content and transfer rate ranges of ferulic acid, sinapine thiocyanate, liquiritin, and glycyrrhizic acid, and the dry extract rate range. The results showed that the similarities of 15 batches of the substance benchmark fingerprints with R were all greater than 0.900.Further summarization of the characteristic peaks revealed that there were a total of 20 characteristic peaks in fingerprint 1, among which, eight were from Sinapis Semen, four from Paeoniae Radix Alba, six from Chuanxiong Rhizoma, and two from Glycyrrhizae Radix et Rhizoma. A total of 16 characteristic peaks were observed in fingerprint 2, including one from Sinapis Semen, three from Paeoniae Radix Alba, eight from Chuanxiong Rhizoma, and four from Glycyrrhizae Radix et Rhizoma. The average dry extract rate of 15 batches of substance benchmarks was 18.25%, with a dry extract rate range of 16.28%-20.76%. The index component content and transfer rate ranges were listed as follows: 0.15%-0.18% and 38.81%-58.05% for ferulic acid; 0.26%-0.42% and 36.51%-51.02% for sinapine thiocyanate; 0.09%-0.15% and 48.80%-76.61% for liquiritin; 0.13%-0.24% and 23.45%-35.61% for glycyrrhizic acid. The fingerprint, dry extract rate, and index component content determination was combined for analyzing the quality value transfer of substance benchmarks in the classic prescription Sanpian Decoction.The established quality evaluation method for the substance benchmarks was stable and feasible, which has provided a basis for the quality control of Sanpian Decoction and the follow-up development of related preparations.

Application progress on taste evaluation methods for oral preparations / 中国中药杂志

Taste is an important factor affecting the medicinal properties of oral preparations and patient compliance with medication, and also an important evaluation index for oral preparation design and clinical application. How to characterize the taste objectively, accurately, simply, and efficiently is a bottleneck problem that restricts the taste design, development, and utilization of oral preparations. At present, the commonly used taste assessment methods for oral preparations are traditional human taste panel, electronic tongue, animal preference test, in vitro release study, and electrophysiological test. The traditional human taste panel is the first choice for taste evaluation, but it is limited by poor subjectivity and reproducibility. Therefore, despite some limitations, the other four taste assessment methods have been applied in the pharmaceutical industry as auxiliary methods. This study reviewed the detection principles, applicability, advantages, and disadvantages of the above methods to provide references for the taste correction research and taste assessment of oral preparations, improve patient compliance and the competitiveness of oral preparation products in the industry, and promote the development of oral preparation technologies.

Oral administration of TRPV4 inhibitor improves atrial calcium handling abnormalities in sterile pericarditis rats / 生理学报

Atrial Ca2+ handling abnormalities, mainly involving the dysfunction of ryanodine receptor (RyR) and sarcoplasmic reticulum Ca2+-ATPase (SERCA), play a role in the pathogenesis of atrial fibrillation (AF). Previously, we found that the expression and function of transient receptor potential vanilloid subtype 4 (TRPV4) are upregulated in a sterile pericarditis (SP) rat model of AF, and oral administration of TRPV4 inhibitor GSK2193874 alleviates AF in this animal model. The aim of this study was to investigate whether oral administration of GSK2193874 could alleviate atrial Ca2+ handling abnormalities in SP rats. A SP rat model of AF was established by daubing sterile talcum powder on both atria of Sprague-Dawley (SD) rats after a pericardiotomy, to simulate the pathogenesis of postoperative atrial fibrillation (POAF). On the 3rd postoperative day, Ca2+ signals of atria were collected in isolated perfused hearts by optical mapping. Ca2+ transient duration (CaD), alternan, and the recovery properties of Ca2+ transient (CaT) were quantified and analyzed. GSK2193874 treatment reversed the abnormal prolongation of time to peak (determined mainly by RyR activity) and CaD (determined mainly by SERCA activity), as well as the regional heterogeneity of CaD in SP rats. Furthermore, GSK2193874 treatment relieved alternan in SP rats, and reduced its incidence of discordant alternan (DIS-ALT). More importantly, GSK2193874 treatment prevented the reduction of the S2/S1 CaT ratio (determined mainly by RyR refractoriness) in SP rats, and decreased its regional heterogeneity. Taken together, oral administration of TRPV4 inhibitor alleviates Ca2+ handling abnormalities in SP rats primarily by blocking the TRPV4-Ca2+-RyR pathway, and thus exerts therapeutic effect on POAF.

Efficacy of liraglutide combined with enpagliflozin in the treatment of obesity complicated by type 2 diabetes mellitus / 中国基层医药

Objective:To investigate the efficacy of liraglutide combined with enpagliflozin in the treatment of obesity complicated by type 2 diabetes mellitus.Methods:A total of 160 obesity patients with type 2 diabetes mellitus who received treatment in Yuyao People's Hospital, China between October 2018 and October 2019 were included in this study. They were randomly assigned to receive repaglinide, insulin detemir and metformin in combination (control group, n = 80) or liraglutide, enpagliflozin and metformin in combination (treatment group, n = 80). After 3 months of treatment, fasting blood glucose, glycosylated hemoglobin, 2-hour postprandial blood glucose, body mass index, tumor necrosis factor-alpha, C-reactive protein, interleukin-6, leptin, adiponectin, and vaspin as well as the incidence of adverse reactions were compared between the control and treatment groups. Results:After treatment, fasting blood glucose, glycosylated hemoglobin, 2-hour postprandial blood glucose and body mass index were reduced in each group. They were (7.89 ± 1.02) mmol/L, (8.10 ± 1.25) %, (11.10 ± 1.59) mmol/L, (23.18 ± 2.19) kg/m 2, respectively in the observation group, which were significantly lower than those in the control group [(9.88 ± 1.27) mmol/L, (11.20 ± 1.85)%, (13.67 ± 2.01) mmol/L, (27.80 ± 2.51) kg/m 2, t1 = 10.927, t2 = 12.418, t3 = 8.969, t4 = 12.405, all P < 0.001). After treatment, tumor necrosis factor-alpha, C-reactive protein and interleukin-6 levels were reduced in each group. Their levels in the observation group were [(51.19 ± 3.19) pg/L, (2.14 ± 0.31) mg/L, (4.07 ± 0.67) pg/L, respectively, which were significantly lower than those in the control group [(62.18 ± 4.10) pg/L, (3.66 ± 0.58) mg/L, (5.96 ± 0.81) pg/L, t1 = 18.922, t2 = 20.672, t3 = 8.969, all P < 0.001). After treatment, leptin and vaspin levels were reduced in each group, and their values in the observation group were (5.48±0.94) μg/L, (1.62 ± 0.37) μg/L, respectively, which were significantly lower than those in the control group [(6.59 ± 0.82) μg/L, (1.99 ± 0.52) μg/L, t1=7.959, t2=10.323, both P < 0.001]. Adiponectin level increased in each group, and it was significantly higher in the observation group than in the control group [(7.13 ± 1.52) mg/L vs. (5.12 ± 0.85) mg/L, t3 = 5.185, P < 0.001]. There was no significant difference in the incidence of adverse reactions between control and observation groups ( χ2 = 0.313, P > 0.05). Conclusion:Liraglutide combined with enpagliflozin for the treatment of obesity complicated by type 2 diabetes mellitus is highly effective. It can effectively lower blood glucose level, reduce body mass and inflammatory reactions, further regulate serum vaspin, leptin and adiponectin levels and is highly safe. Therefore, this method can be widely used in the clinic.

Exploration on an orderly clinical practical teaching pattern of ultrasonography / 中华医学教育探索杂志

Objective:To explore an efficient method of practical teaching for ultrasonography.Methods:There were 41 five-year clinical medical students intending to learn ultrasonography in the spring semester of 2019. After completing common theory courses, they were divided into two groups randomly for practice courses, which consisted of two modules: Lecture and Hands-on. Lecture included case-based learning while Hands-on included pictures reading. Each group followed different sequence of modules. There were assessments of ultrasound theory, practice or the combination of both before, during and after practice courses.Results:The theory and practice ability of each group improved significantly after practice courses ( P < 0.05). Moreover, the group whose Hands-on module preceded Lecture module got the higher scores in the evaluation of the combined ability of theory and practice ( P < 0.05). Conclusion:The theory was as important as the practice during the clerkship of ultrasonography. The clinical practical teaching pattern that Hands-on precedes Lecture has achieved better teaching effects.

Textual Research on Ancient and Modern Literature of Xiao Chengqitang / 中国实验方剂学杂志

Xiao chengqitang is recorded in Treatise on Febrile Diseases written by ZHANG Zhong-jing in the Eastern Han dynasty. It is composed of Rhei Radix et Rhizoma， Magnoliae Officinalis Cortex and Aurantii Fructus Immaturus， which is mainly used to treat mild exogenous Yangming Fu-viscera excess syndrome. This formula has been included in the Catalogue of Ancient Classical Prescription （The First Batch）. However， the processing specifications and doses recorded in the original formula are different from the modern usage， which results in some difficulties in the research and development of Xiao Chengqitang granules. For clarifying the key information， such as historical evolution of prescription， dose conversion， the origin and processing specifications of each medicine in the prescription， the paper systematically analyzes the ancient medical books and related literature in the past dynasties and refers to the life experience of ZHANG Zhong-jing. Then the modern prescription and decocting methods of Xiao Chengqitang were determined as follows：composing 55.2 g of Rhei Radix et Rhizoma （Rheum officinale） washed with wine， 27.6 g of Magnoliae Officinalis Cortex （Magnolia officinalis） processed with ginger and 39.0 g of stir-fried Aurantii Fructus Immaturus （Citrus aurantium）， adding 800 mL of water， decocting to 240 mL and filtrating.

Analysis on UPLC Fingerprint and Determination of Multi-index Components in Pipa Qingfeiyin / 中国实验方剂学杂志

Objective:To establish the ultraperformance liquid chromatography （UPLC） fingerprint of Pipa Qingfeiyin substance benchmark， and to establish a quantitative analysis method for simultaneous determination of the contents of five index components， so as to provide reference for the quality control and evaluation of this famous classical formula. Method:ACQUITY UPLC^® CSH^TM C₁₈ column （2.1 mm×100 mm， 1.7 μm） was used with mobile phase of acetonitrile （A）-0.1% formic acid aqueous solution （B） for gradient elution （0-7 min， 5%-7%A； 7-11 min， 7%-8%A； 11-22 min， 8%-14%A； 22-30 min， 14%-15%A； 30-35 min， 15%-25%A； 35-42 min， 25%-40%A； 42-45 min， 40%-50%A； 45-50 min， 50%-60%A）， the flow rate was 0.35 mL·min^-1， the column temperature was 25 ℃， the detection wavelengths were 278 nm and 248 nm. UPLC fingerprints of 15 batches of Pipa Qingfeiyin substance benchmark were established， and the "Similarity Evaluation System of Chromatographic Fingerprint of Traditional Chinese Medicine" software （2012 edition） was used for similarity analysis， and the common peaks were assigned. Cluster analysis （CA）， principal component analysis （PCA） and orthogonal partial least squares discriminant analysis （OPLS-DA） were used to evaluate the fingerprint data. UPLC fingerprint method was used to simultaneously determine the contents of five components in the substance benchmark. Result:The method validation of fingerprint and determination method was good， the similarities between 15 batches of Pipa Qingfeiyin substance benchmark and their control fingerprint were ≥0.997， 23 common peaks were identified and 11 chromatographic peaks were identified. CA， PCA and OPLS-DA divided 15 batches of the substance benchmark into two groups. The linear relationship of phellodendrine hydrochloride， chlorogenic acid， berberine hydrochloride， palmatine hydrochloride and ammonium glycyrrhizinate was good in a certain range of concentration （<italic>R</italic>²>0.999）， their average recovery was 96.47%-101.16%， and the contents of these five components in the substance benchmark were 0.87-2.00， 1.53-5.95， 18.45-33.97， 3.87-6.29， 1.02-4.12 mg·g^-1， respectively. Conclusion:The established UPLC fingerprint and multi-index component content determination methods have strong specificity， good resolution and high sensitivity， it can be characterized except for the Ginseng Radix et Rhizoma flavor， which can provide reference for the quality control and evaluation of Pipa Qingfeiyin compound preparation.

Quality Value Transmitting of Substance Benchmark of Xiebaisan / 中国实验方剂学杂志

Objective:Based on fingerprint， index component content and dry extract yield， a quality evaluation method for substance benchmark of Xiebaisan was established to study the key quality attributes， to explore the quantitative transfer relationship between decoction pieces and substance benchmark， and to preliminarily formulate the quality standard of substance benchmark of Xiebaisan. Method:The substance benchmark of Xiebaisan was prepared according to the records of ancient formulas， fingerprints of 15 batches of decoction pieces and substance benchmarks were collected by high performance liquid chromatography （HPLC） and the index components were determined with the mobile phase of acetonitrile-0.05% phosphoric acid solution for gradient elution. The dry extract yield， fingerprint similarity and transfer rate of index components were combined to study the quantity value transmitting. Result:Ten characteristic peaks were identified in fingerprint of the substance benchmark and two characteristic peaks from stir-fried Mori Cortex， four characteristic peaks from baked Lycii Cortex， four characteristic peaks from Glycyrrhizae Radix et Rhizoma Praeparata cum Melle. Mulberroside A， liquiritin and glycyrrhizic acid were used as index components for the determination， the contents of mulberroside A， liquiritin and glycyrrhizic acid in substance benchmark of Xiebaisan were 2.69%-4.26%， 0.09%-0.17% and 0.09%-0.16%， and their transfer rates were （31.37±4.14）%， （36.12±4.03）% and （12.25±0.88）%， respectively. The similarity of fingerprint of substance benchmarks was good， the fingerprint similarities of 14 batches of substance benchmarks and control fingerprint were >0.9. The dry extract yield of substance benchmark of Xiebaisan ranged from 8.09% to 11.29%. Conclusion:The established quality evaluation method of substance benchmark of Xiebaisan is scientific and reasonable， and the transfer process of decoction pieces to substance benchmarks is stable and controllable. The preliminary quality standard of the substance benchmark can provide basis and reference for the development of modern preparations of Xiebaisan in the future.

Correlation between subclinical hypothyroidism and outcomes of patients with acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate the correlation between subclinical hypothyroidism (SCH) and clinical outcomes of patients with acute ischemic stroke.Methods:From July 2014 to October 2017, patients with acute ischemic stroke admitted to Jiangsu Shengze Hospital Affiliated to Nanjing Medical University were enrolled retrospectively. Their demographic and baseline clinical and laboratory data were collected. The modified Rankin Scale was used to evaluate the clinical outcome at 3 months after the onset of symptoms. Multivariate logistic regression analysis was used to determine the independent correlation between SCH and clinical outcome of patients with acute ischemic stroke. Results:A total of 200 patients with acute ischemic stroke were enrolled, including 107 males (53.5%) and 93 females (46.5%). Their age was 69.67±11.38 years. There were 45 patients (22.5%) with SCH, 160 (80.0%) with good outcomes, and 40 (20.0%) had poor outcomes. Univariate analysis showed that there were significant differences in the baseline National Institutes of Health Stroke Scale (NIHSS) score, stroke etiology classification and the proportion of patients with SCH between the poor outcome group and the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that high NIHSS score (odds ratio 2.884, 95% confidence interval 2.005-4.147; P=0.001) and SCH (odds ratio 19.527, 95% confidence interval 2.334-163.386; P=0.006) were the independent risk factors for poor outcomes. Conclusion:High NIHSS score and SCH were associated with the poor outcomes at 3 months after the onset of acute ischemic stroke.

Analysis of the correlative characteristics of national occupational health standards based on social network analytic method / 中国职业医学

OBJECTIVE: To explore the correlative characteristics of the National Occupational Health Standards by social network analytic method. METHODS: The national occupational health standards were searched and collected through the National Health Commission of the People′s Republic of China and the National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention. And the normative reference file related information was extracted to build standard coupling matrix. UCINET6 software for Windows was used to compute the node feature specifications. The network topology diagram of standard mutual citation relationship was drawn using Netdraw 2.054. RESULTS: A total of 269 national occupational health standards were included, involving 361 normative references files. Among them, the highest degree centrality was 48.064 in GBZ/T 251 Guidelines for Prevention and Control of Occupational Hazard in Foundry of Automobile Manufacturing. The highest closeness centrality and betweenness centrality were 27.386 and 33.210, respectively, in GBZ 2.1 Occupational Exposure Limits for Hazardous Agents in the Workplace--Part 1 : Chemical Hazardous Agents. The topographic map of standard mutual reference network indicated that five national occupational health standards were located in the central position of the mutual reference network, which included GBZ 1 Hygiene Standards for the Design of Industrial Enterprises, GBZ 2.1 Occupational Exposure Limits for Hazardous Agents in the Workplace--Part 1: Chemical Hazardous Agents, GBZ 2.2 Occupational Exposure Limits for Hazardous Agents in the Workplace--Part 2: Physical Agents, GBZ 158 Warning Sign for Occupational Hazards in the Workplace and GBZ 159 Specifications of Air Sampling for Hazardous Substances Monitoring in the Workplace. CONCLUSION: The five national occupational health standards located in the central position of the mutual reference network were the key nodes that have a greater influence on other standards, and can be the focus of future standard management.

Analysis on quality value transfer of substance benchmarks of Zhenwu Decoction / 中国中药杂志

By preparing 15 batches of Zhenwu Decoction substance benchmarks,the characteristic map,index component content and paste-forming rate were determined to define the peak attribution,similarity range,paste-forming rate range,paeoniflorin and6-gingerol content range and transfer rate range. The similarity between the substance benchmark characteristic map and the control map R generated from the 15 batches of substance benchmarks was higher than 0. 970. There were 19 characteristic peaks in total. By further summarization of the characteristic peaks,it could be seen that tuckahoe had 3 characteristic peaks,white peony root had 10 characteristic peaks,atractylodes had 3 characteristic peaks,ginger had 1 characteristic peak,and Aconite root had 3 characteristic peaks; among them,white peony root and aconite root had 1 common peak. The contents and transfer rates of the 15 batches were0. 50%-0. 93 and 16. 11%-26. 20%; those for 6-gingerol were 0. 018 2%-0. 033 9% and 13. 16%-24. 10%,respectively. The pasteforming rate ranged from 10. 00% to 14. 85%. In this study,the transfer process of substance benchmark value of classic formula Zhenwu Decoction was analyzed based on the characteristic map,the paste-forming rate and the content of the index components; a scientific and stable substance benchmark quality evaluation method was preliminarily established to provide a basis for subsequent development of classic formula Zhenwu Decoction and quality control of relevant preparations.

Analysis on quality value transmitting of substance benchmark of Houpo Wenzhong Decoction / 中国中药杂志

By preparing 15 batches of lyophilized powder samples of substance benchmark in Houpo Wenzhong Decoction,the fingerprint,index component content and extract rate were determined,and the characteristic peaks,the range of similarity with the reference map,the content range and transfer rate range of magnolol,hesperidin,glycyrrhizic acid and pinocembrin,the extract rate range and the change range were clarified. The results showed that the similarity between the fingerprint of substance benchmark and the reference map R generated from the 15 batches of substance benchmark samples was higher than 0. 90. The assignment of the characteristic peaks in the full prescription's fingerprint of the herbs except Poria cocos was clarified. Nineteen characteristic peaks were assigned,and 12 characteristic peaks were assigned by the reference substance,of which 4 were from Magnolia ocinalis Cortex,5 from Exocarpium Citri Rubrum,2 from Radix aucklandiae,3 from Glycyrrhiza Radix et Rhizoma,4 from Semen Alpiniae Katsumadai,and one from Rhizoma Zingiberis and Zingiber officinale Roscoe. The index component content range and transfer rate range were 0. 80%-1. 14% and 20. 25%-39. 61% for hesperidin,0. 49%-0. 79% and 23. 09%-33. 87%for glycyrrhizic acid,0. 03%-0. 07% and 3. 55%-10. 09% for pinocembrin,0. 15%-0. 38% and 8. 08%-24. 35% for magnolol. The extract rate range and the change range were22. 60%-25. 57% and 12. 67%-23. 68% respectively. In this study,we introduced the concepts of index component content,fingerprint,extract rate,explored the transfer relation of quality value transmitting of substance benchmark in Houpo Wenzhong Decoction,and initially established the quality standard of Houpo Wenzhong Decoction,all of which would provide ideas for the development and research of similar prescriptions.

Establishment of a cocrystal characterization method for sacubitril valsartan sodium / 药学学报

Sacubitril valsartan sodium (LCZ696) is an ionic cocrystal drug. The purpose of this study was to explore the cocrystal features of LC696 by establishing a variety of characterization methods, and thus provide basic research data for effective quality control. The cocrystal characteristics of LCZ696 and its tablets were identified by applying analytical means including powder X-ray diffraction (PXRD), fourier transform infrared spectroscopy (FTIR), Raman spectra (RM), differential scanning calorimetry (DSC) and solid-state nuclear magnetic resonance spectroscopy (ssNMR). The crystalline water and hygroscopicity of LCZ696 were analyzed by thermogravimetric analysis (TGA), dynamic vapor sorption (DVS), hygroscopicity test and Karl Fischer reaction method. The results show that PXRD, FTIR, DSC and ssNMR can effectively distinguish the features of LCZ696 cocrystal, sacubitril monomer, valsartan monomer, and sacubitril-valsartan (1∶1) mixture. RM can be used as a supplementary approach. Combined with the analysis by TGA, DVS, hygroscopicity test and Karl Fischer reaction method results, LCZ696 contains 2.5 crystalline water molecules and is very hygroscopic; we recommend that LCZ696 be stored in an environment with a relative humidity below 60%. By characterizing the crystal features we can establish quality control measure and evaluate the stability of the drug tablets. This study provides data in support for the establishment of the LCZ696 quality standard.

Preparation, characterization and improved solubility of ticagrelor salts / 药学学报

Four salts of ticagrelor, ticagrelor-3,5-dinitrobenzoic acid, ticagrelor-pyrazinamide, ticagrelor-D-proline and ticagrelor-L-proline were prepared by solvent suspension and liquid-assisted grinding to improve the solubility of ticagrelor. The compounds were characterized by powder X-ray diffraction, Fourier transform infrared spectroscopy, differential scanning calorimetry, nuclear magnetic resonance spectroscopy, elemental analysis, and the intermolecular salt-bonding forces were analyzed. The equilibrium solubility of salts and pure drug in hydrochloride buffer pH 1.2 and phosphate buffer pH 6.8 were measured by high-performance liquid chromatography. Ticagrelor was salted with 3,5-dinitrobenzoic acid, pyrazinamide, D-proline, L-proline all in a stoichiometric ratio of 1∶1; with the exception of ticagrelor-D-proline, the solubility of the other three salts provided significantly improved solubility in hydrochloride buffer pH 1.2, and the equilibrium solubility of ticagrelor-3,5-dinitrobenzoic acid was increased by approximately 1.7 folds as compared to pure drug. Salt-forming technology is convenient and can improve the solubility of ticagrelor.