Upper limb lymphedema as the initial symptom of malignant disease / 中华普通外科杂志

Objective:To investigate the diagnosis of malignancy with upper limb lymphedema as the initial sign and symptoms.Methods:Clinical data of 6 patients with malignant lymphedema admitted at the Department of Lymphatic Surgery, Beijing Shijitan Hospital, Capital Medical University, from May 2007, to Dec 2018 were retrospectively analyzed.Results:The age of these 6 patients ranged from 50 to 78 years. The time from the occurrence of lymphedema to the diagnosis of malignant tumors ranged from 1 month to 15 years. Limb swelling occurred in all 6 cases. Local lymphadenopathy occurred in 4 cases and limb paresthesia occurred in 2 cases. Pathological diagnosis showed that the tumor originated from epithelial tissue in 3 cases, mesenchymal tissue in 2 cases and lymphatic system in 1 case. Pathological diagnosis showed that the tumor originated from epithelial tissue in 3 cases, mesenchymal tissue in 2 cases and lymphatic system in 1 case.Conclusions:To avoid delays in the diagnosis and therapy of malignant lymphedema, physicians should actively look for signs or symptoms of lymphedema during the follow-up period and promptly manage patients developing problems.

Study on wavelength overlapping HPLC fingerprint and multi-component content determination of Danshen / 中国中药杂志

This project was launched to and establish the wavelength overlapping HPLC fingerprint for Danshen and determine the contents of 7 component in Danshen. The chromatographic fingerprints were built by using Agilent Eclipse Plus C_(18)( 4. 6 mm×100 mm,3. 5 μm) as stationary phase and 0. 1% formic acid solution( A)-acetonitrile( B) as mobile phase with gradient elution( 0-5 min,10%-20% B; 5-20 min,20%-30% B; 20-25 min,30%-50% B; 25-40 min,50%-65% B; 40-45 min,65%-80% B; 45-46 min,80%-10% B; 46-50 min,10% B) at a flow rate of 1 mL·min~(-1). The column temperature was maintained at 30 ℃ and the detection wavelength was set at 250,280,310 and 340 nm. The technique of wavelength overlapping fingerprint was established and the contents of 7 indicative compounds have been determined in this method. The results of wavelength overlapping HPLC fingerprint showed all-around information of the fingerprints at 250,280,310 and 340 nm,and the similarity among 17 batches of Danshen was over 0. 828-0. 936. In wavelength overlapping HPLC fingerprint,15 common peaks were selected as the common peaks,and 7 contents of them were indentified as rosmarinic acid,salvianolic acid B,salvianolic acid A,phenolic acid,dihydrotanshinone Ⅰ,tanshinone Ⅰ and tanshinone ⅡA. The results of methodological study demonstrated that the method met the requirements of the determination. The method established in this study is simple,convenient and durable,which can provide a scientific basis for the quality control of Danshen.

Impact of anemia and chronic kidney disease on the risk of cardiovascular disease and all-cause mortality among diabetic patients / 北京大学学报(医学版)

OBJECTIVE@#To explore the association between anemia and cardiovascular disease and all-cause mortality among diabetic patients, and whether the association is modified by the presence of chronic kidney disease (CKD).@*METHODS@#Physical examination data of 8 563 patients with diabetes who met the inclusion and exclusion criteria between 2010 and 2011 were collected, based on the prospective cohort data of Kailuan study. The deadline of the follow-up was December 31, 2015, and the endpoints comprised all-cause mortality and cardiovascular disease. Survival analysis was performed by Kaplan-Meier method. Cox proportional hazards regression model was used to assess the association between anemia with or without CKD, and cardiovascular events and all-cause mortality after adjustment for confounding factors.@*RESULTS@#The average age of the subjects was (57.3±10.3) years, of whom the patients with anemia accounted for 5.2%. The proportion of the patients with anemia combined with CKD was higher than that of the patients without anemia (27.2% vs. 20.8%, P=0.001). The median follow-up time was 4.9 years (interquartile range: 4.6-5.2 years). During the follow-up period, 559 patients died, and 434 patients had cardiovascular disease. Compared with the patients without anemia, the all-cause mortality rate of the patients with anemia was higher (3 220.3/100 000 person-years vs. 1 257.9/100 000 person-years, P<0.001). There was no statistically significant difference in the incidence of cardiovascular disease between the above two groups (999.8/100 000 person-years vs. 1 081.2/100 000 person-years, P>0.05). The mortality and incidence of cardiovascular disease among the patients with CKD were higher than those of the patients without CKD (2 558.3/100 000 person-years vs. 1 044.0/100 000 person-years, P<0.001; 1 605.9/100 000 person-years vs. 941.6/100 000 person-years, P<0.001). Results of Cox regression model showed that, after adjustment for confounding factors, the all-cause mortality risk increased by 95% in the diabetic patients with anemia (HR=1.95, 95% CI: 1.50-2.54). Anemia and CKD significantly increased the mortality risk among diabetic patients (HR=3.61, 95% CI: 2.48-5.26). The CKD patients without anemia had an increased risk of cardiovascular disease (HR=1.41, 95% CI: 1.13-1.74).@*CONCLUSION@#Anemia is associated with an increased mortality risk in Chinese diabetic patients. Patients with CKD have an increased risk of cardiovascular disease and mortality. The all-cause mortality risk increases significantly in anemia patients with the presence of CKD, which indicates that we should focus on the prevention and treatment of diabetic patients with anemia and CKD.

Concentration Determination of Voriconazole in Human Plasma by UPLC-MS/MS and Its Clinical Application / 中国药房

OBJECTIVE:To develop a method for concentration determination of voriconazole in human plasma and apply it in the clinic. METHODS:UPLC-MS/MS method was adopted. Using ketoconazole as internal standard,the determination was per-formed on Shim-pack VP-ODS column with mobile phase consisted of water(containing 1‰ formic acid and 2 mmol/L ammonium acetate)-acetonitrile(gradient elution)at flow rate of 0.3 ml/min and column temperature of 40℃.The electrospray ion source,pos-itive ionizing pattern and multiple reaction monitoring were used;the mass transition ion-pairs of voriconazole and internal standard were m/z 351.2→282.2 and m/z 532.1→490.2. RESULTS:The linear range of voriconazole were 1-10 000 ng/ml (r=0.999 5,n=5),and the limit of quantitation was 1 ng/ml;RSDs of inter-day and intra-day were all lower than 10%;method recovery was higher than 90%(RSD<8%),and extraction recovery was higher than 70%(RSD<8%). The plasma concentrations of voriconazole in 10 patients with invasive fungal infection determined by this method were 507.33-7 011.24 ng/ml,and those of 3 patients were outside the recommended treatment concentration range. CONCLUSIONS:The established method is fast,accurate and sensitive,and can be applied for the therapeutic drug monitoring of voriconazole.

Pharmacokinetic translational research from bench to bedside / 中国药科大学学报

@#The pharmacokinetic translation from bench to bedside has been an important component in translational research. Based on non-clinical pharmacokinetic research results, scale factor allometric model and physiology- based pharmacokinetic model were used to investigate the translational method of pharmacokinetic parameters from quantitative pharmacology perspective. The method includes the reasonable extrapolation of translation for inter-species and analysis of in vivo-in vitro differences. The pharmacokinetic translation model from bench to bedside will help to optimize clinical administration into simulation study.

Combined Pharmacokinetics-pharmacodynamics Study of Rabeprazole in Inhibition of Gastric Acid Secretion / 医药导报

Objective To investigate the pharmacokinetics ( PK ) and pharmacodynamics ( PD ) processes of rabeprazole in inhibiting gastric acid secretion with the combined PK-PD model. Methods A total of 10 healthy volunteers were given a intravenous infusion of 20 mg rabeprazole over a 30-min period. The concentration of rabeprazole in the plasma at different time points was detected by HPLC,and the PK parameters were calculated by DAS 2. 0 software. At the same time the intragastric pH was monitored over 24 hours to fit the PD parameters with indirect inhibition model. Results The main PK parameters,t1/2,Cmax,and AUC were(60. 5±17. 3)min,(1 299. 1±201. 0)ng·mL-1,and(106. 4±26. 0)mg·min·L-1, respectively.The corresponding PD parameters,Kin,Ke,IC50 and Imax were(8.200±3.362)h-1,(1.080±0.378)h-1,(0.286± 0. 129)mg·L-1 and(6. 93± 2. 15)pH,respectively. Conclusion The PK of rabeprazole in healthy volunteers conforms to one compartment model,and the PD fits the indirect response inhibition model. The equation can effectively establish the relationship between the blood drug concentration and the effect.

The identification and pharmacokinetic studies of metabolites of salvianolic acid B after intravenous administration in rats / 中国天然药物

AIM@#To identify and quantify the major metabolites of salvianolic acid B (SAB) after intravenous injection in rats.@*METHODS@#LC-IT/TOF-MS was used to identify the metabolites in rat bile, plasma, and urine; LC-MS/MS was used to quantify the two major metabolites.@*RESULTS@#In rat bile, plasma, and urine, nine metabolites were identified, including methylated metabolites of SAB, lithospermic acid (LSA), the decarboxylation and methylation metabolites of LSA, salvianolic acid S (SAS), and dehydrated-SAS. The t1/2 of monomethyl-SAB and LSA were both very short, and monomethyl-SAB had a larger AUC than LSA in rats.@*CONCLUSION@#Nine metabolites were found, the metabolic pathway was described, and the pharmacokinetic profiles of LSA and monomethyl-SAB were studied, thereby clarifying that methylation was the dominant metabolic pathway for SAB in rats.

Effect of diammonium glycyrrhizinate on entecavir pharmacokinetics in rats / 中国天然药物

AIM@#This study was designed to explore the effects of short-term and long-term pretreatment of diammonium glycyrrhizinate (GLN) on the pharmacokinetics of entecavir (ETV) in rats.@*METHODS@#Male SD rats were randomized into short-term and long-term experimental groups, respectively. In the short-term experiment, the control group received saline, the low dose group received GLN 13.5 mg·kg(-1) and the high dose group received GLN 40.5 mg·kg(-1). ETV (0.09 mg·kg(-1)) was given i.g. 0.5 h after saline/GLN administration. For the long-term experiment, rats were allocated into two experimental designs. The control group received saline/ETV (0.09 mg·kg(-1)), the low dose group received GLN 13.5 mg·kg(-1)/ETV 0.09 mg·kg(-1) + GLN 13.5 mg·kg(-1), while the high dose group received GLN 40.5 mg·kg(-1)/ETV 0.09 mg·kg(-1) + GLN 40.5 mg·kg(-1); all administration was continued for 15 days. On the 16(th) day, 0.09 mg·kg(-1) ETV was administrated to all groups. Blood samples were obtained at different time points after ETV administration to determine plasma ETV concentrations.@*RESULTS@#Pretreatment with glycyrrhizin resulted in no significant alterations in the main pharmacokinetic parameters of ETV in the short-term and long-term administration experiments.@*CONCLUSION@#Diammonium glycyrrhizinate has no effect on ETV pharmacokinetics in rats.

Advancement in researches of role of Hedgehog signal pathway in pathogenesis of pancreatic cancer / 中华肝胆外科杂志

The Hedgehog (Hh) signaling pathway plays a key role in the embryonic development, which is formed by the Hedgehog(Hh) , membrane-receptor complex Patched (Ptch) and Smoothened (Smo), multifunctional transcription factors Glioma-associated oncogene homolog (Gli) and other signal molecules. The Hh signaling pathway controls a variety of developing processes, however, no or less expression is observed in the normal pancreas tissues.The mutational activation of the Hh signaling pathway is associated with tumorigenesis and metastasis of the pancreatic cancer. The aim of this review is to present a brief overview of the Hedgehog signaling pathway in the mechanism of the tumorigenesis of the pancreatic cancer.

Progress in research of processing of fructus Evodiae-Rhizoma Coptidis and research thoughts and methods of its processing mechanism / 中国中药杂志

This article ascended the history and successive changes of the processing research of Fructus Evodiae-Rhizoma Coptidis, and its application in classic prescription; made a summary on the research of the processing technology and substances of Fructus Evodiae-Rhizoma Coptidis; discussed the progress in the research of processing of Fructus Evodiae-Rhizoma Coptidis; expounded the overview on mechanism research of the processing of Fructus Evodiae-Rhizoma Coptidis, and proposed new thoughts and methods for the processing of Fructus Evodiae-Rhizoma Coptidis.

The level of serum lipids,body-fat content of obesity rats,and the relationship between intracellular calciumand ventricular arrhythmia / 中国地方病学杂志

Objective To study the level of serum lipids and body-fat content of high-fat diet induced pbesity rats(DIO).explore the relationship between intracellular caleium and ventrieufar arrhythmia.Methods Sixty male Sprague-Dawley(SD)rats were divided into control group(15)and experiment group(45),high-fat diet was administrated for 12 weeks to established obesity model,15 rats were selected into obesity group according to their body weight gain.The standard 2-lead electrocardiograph was used to detect the incidence and scores of arrhythmia induced by barium chloride(BaCl2,0.1 mg/kg)for 1 hour on every 8 rats from different groups respectively.Body-fat content.the level of serum total cholesterol(TC),triglyceride(TG),low density lipopmtein cholesterol (LDL-C) and high density lipopmtein cholesterol (HDL-C)were measured.The epididymal(EP),retroperitoneal (RE) and mesenteric(ME)white adipose pads was measured to obtain the body fat content.Single ventricular myrocytes of rats were isolated by enzymatic dissociation.The confocal laser scanning microscope was used to record basic intraceUular calcium level([Ca2+]i).Results The body-fat content in obesity group[(7.71±0.74)%] was significantly higher than control group[(4.69±0.37)%](t＝3.650,P＜0.05).The level of serum TC,TGand LDL-C were significantly higher(t＝3.801,2.778,3.536.P＜0.05) in obesity group[(1.26±0.04),(0.58±0.10),(0.51±0.04)mmol/L]than those in control group[(0.92±0.08),(0.29+0.03),(0.31±0.04) mmol/L].The level of serum HDL-C wa8 decreased gradually from control group[(0.53±0.05)mmol/L] toobesity group[(0.52±0.02)mmol/L],but there waft no significant difference between them(t＝0.186,P＞0.05).The incidence of arrhythmia induced by BaCl2(0.1 mg/kg)in obesity group was significantly higher than controlgroup(X2＝5.333,P＜0.05),and the scores of arrhythmla was increased in obesity group(2.5±0.6)too.The fluorescence intensity standing for[Ca2+]i was increased significantly(t＝2.409,P＜0.05)from obesity group(247.96±20.03)to control group (174.25±23.13).Conclusion As the free cytosolic calcium begin to accumulate,the arrhythmia morbidity is increased in obesity rats.

The Diagnostic Value of Cystography with Low-concentration Contrast Medium in Diagnosing Small Tumor of Urinary Bladder / 实用放射学杂志

Objective To evaluate the value of cystography with low-concentration contrast medium in diagnosing small tumor of urinary bladder.Methods Cystography in 187 cases with bladder disease from 1992 to 2001 was performed using 6%～8% Meglumine Diatrizoate 100～120 ml under TV monitored.Radiogrames of A-P position and bilateral oblique position were taken when the focus was found.The radiogram on patient’s position at head low was adopted when necessary.Results Of 187 cases,106 cases of bladder tumors were detected,including 8 cases of small bladder tumor(≤1.0 cm in diameter),3 cases were misdiagnosed,the detectable rate was 73.0%.All cases were confirmed by operation and pathologiy.In these 8 cases,1 case was adenocarcinoma,5 cases were transitional epithelia cell carcinoma,2 cases were papilloma.The X-ray appearances were nipple-like or cauliflower shape with filling defect,a narrow pedicel could be occasionally found in papilloma or transitional epithelia cell carcinoma and it had somewhat movement when changed patient’s position.Conclusion Cystography with low-concentration contrast medium is a non-injury procedure in diagnosis of small tumor of urinary bladder.