Correlation of "Medicinal Tissue-property， Taste， and Efficacy-clinical Application" of Traditional Chinese Medicine from Plant Skin / 中国实验方剂学杂志

ObjectiveTo investigate the functions and characteristics of traditional Chinese medicine （TCM） from plant skin and their Chinese patent medicines and explore the related laws of the medicinal tissue， property， taste， efficacy， and clinical application， so as to strengthen the theory of identifying symptoms for qualities and provide references for the development and utilization of TCM from plant skin and their Chinese patent medicines. MethodBy reviewing the 2020 edition of the Chinese Pharmacopoeia and some local pharmacopeias， TCM from plant skin and their Chinese patent medicines were screened out， and the characteristics， functions， and precautions of TCM from plant skin and their Chinese patent medicines were summarized. Statistical analysis was carried out with Excel. ResultA total of 62 TCM from plant skin were found， mainly distributed in one kingdom， three phyla， and 31 families. In terms of the family genus， Rutaceae>Leguminosae>Cucurbitaceae. In terms of the medicinal tissue， bark>root bark>fruit bark>seed bark. In terms of property and taste， warm>cold>plain>cool>hot， and bitter>sweet=pungent>acidic. In terms of meridians， lung>liver>spleen>heart>colorectal>kidney>stomach=bladder. In terms of TCM classification， most of them belong to the category of heat-clearing medicines. There were 485 types of Chinese patent medicines from plant skin， with the most Chinese patent medicines containing Citri Reticulatae Pericarpium. Among the forms of administration， pills were the most predominant. In terms of the tastes of the medicines， bitter and sweet flavors predominated. In terms of functions， medicines for strengthening the body resistance were the most. For the precautions， contraindications during pregnancy were the most common. ConclusionThere is a correlation among medicinal tissue， property， taste， efficacy， and clinical application of TCM from plant skin. It is also necessary to pay attention to the contraindications of the medicines and rationally choose TCM from plant skin and their Chinese patent medicines under the guidance of TCM theory based on syndrome differentiation and treatment.

Correlation Analysis of Traditional Chinese Medicines from Fungi Based on "Habit-Growth Environment-part-medicinal Properties" / 中国实验方剂学杂志

ObjectiveThe relevant laws among the biological characteristics， medicinal parts， growth environment， and medicinal properties and efficacy of traditional Chinese medicines （TCM） from fungi were excavated， so as to strengthen the theory of distinguishing symptoms for quality and provide a reference for the development and utilization of TCM from fungi. MethodThe medicinal parts， meridians for properties and tastes， heterotrophic mode， and efficacy of commonly used TCM from fungi were summarized. By consulting the Compendium of Materia Medica， Shennong Materia Medica， Flora of China， and literature， the TCM from fungi indexed in the 2020 edition of the Chinese Pharmacopoeia and some local pharmacopeias were checked. ResultA total of 28 common TCM from fungi were selected. Different TCMs from fungi have different meridians for properties and tastes， medicinal parts， habits， and growth environments. The relevant information was counted. Among the four properties， plain>cold>warm. Among the five tastes， sweet>bitter>light>pungent=salty. In terms of medicinal parts， fruiting body>sclerotia>complex>spermia=outer skin=other. In terms of meridians， lung>liver=heart>spleen=kidney>stomach. In terms of habits， parasitism>saprophysis>symbiosis=facultative parasitism=facultative saprophysis. ConclusionTCM from fungi are mainly parasitic and saprophytic， and the plain property and sweet taste the most. The meridians are mostly lung， heart， and liver. Nourishment and diuresis are the main efficacy. There is a certain correlation between the color， habit， medicinal parts， and growth environment of TCM from fungi and their properties， tastes， and efficacy， providing comprehensive literature reference and theoretical basis for their in-depth research， clinical use， and resource development.

Correlation of "Parts-components-properties" of Traditional Chinese Medicines from Latex-containing Plants / 中国实验方剂学杂志

ObjectiveTo investigate the correlation among the botanical characteristics， biological characteristics， chemical composition， and medicinal properties and efficacy of traditional Chinese medicines （TCM） from latex-containing plants， so as to strengthen the theory of "identifying symptoms for qualities" and provide a reference for the development and utilization of the latex-containing plant resources. MethodStatistics on the meridians for properties and tastes， efficacy， medicinal parts， family and genus， and chemical components of TCM from latex-containing plants were carried out. A total of 53 TCM from latex-containing plants included in the 2020 edition of the Chinese Pharmacopoeia were screened by mining the Chinese Botanical Journal， Chinese Materia Medica， Dictionary of Traditional Chinese Medicines， and related literature. In addition， their meridians for properties and tastes， medicinal parts， chemical components， and TCM classifications were summarized and statistically analyzed by using Excel 2013 and ChiPlot 2023.3.31 software. ResultIt was found that latex-containing plants were mainly distributed in one kingdom， one phylum， two classes， and 20 families， and most of the TCM from latex-containing plants belonged to Dicotyledonaceae under Angiosperms. In terms of properties and tastes， plain>cold>warm>cool>hot and bitter>pungent>sweet>sour>salty. In terms of meridians， liver>lung>kidney>spleen=large intestine=stomach>heart>bladder=gallbladder=small intestines. In terms of medicinal parts， roots （root， rhizomes， tuberous root， and root bark）>resin>seed>whole herb （whole herb and above-ground part）>stem （stem and branch）>fruit>leaf>flower=skin. In terms of research on chemical components， they were mostly glycosides. In terms of TCM classification， they were mostly medicines for activating blood circulation and removing blood stasis. ConclusionThe TCM from latex-containing plants is mainly plain， with a uniform warm and cold distribution. The tastes are mainly bitter and pungent， and the major meridians are the liver and lung. The roots and resins are mainly used as medicines. The components mostly contain glycosides， alkaloids， and volatile oils， and most of them are medicines for activating blood circulation and removing blood stasis， as well as for removing heat and toxins. There is a certain degree of correlation among the growth habits， medicinal parts， chemical components， and the properties， tastes， and efficacy of the TCM from latex-containing plants. It may provide a reference for resource development and utilization of TCM from latex-containing plants.

Analysis of gene variation and long-term follow-up in children with phenylalanine hydroxylase deficiency diagnosed by newborn screening / 浙江大学学报·医学版

OBJECTIVES@#To retrospectively analyze the variation and characteristics of phenylalanine hydroxylase (PAH) gene, and to observe the long-term treatment effect and follow-up of newborns with PAH deficiency.@*METHODS@#Clinical data, treatment and follow-up results of 198 patients with PAH deficiency diagnosed by newborn screening in Jinan from 1996 to 2021 were collected. The genetic analysis of 55 patients with PAH deficiency diagnosed by newborn screening in Jinan and 213 patients referred from the surrounding areas of Jinan were summarized. Gene variations were checked by a customized Panel gene detection method. Blood phenylalanine-concentration and physical development indicators including height and weight were regularly monitored. Intellectual development was assessed using a neuropsychological development scale for patients aged 0-6 years and academic performance, and brain injury in patients was assessed using brain magnetic resonance imaging.@*RESULTS@#c.728G>A, c.158G>A, c.721C>T, c.1068C>A, c.611A>G variations were common in PAH gene. The genotype of c.158G>A variation is compound heterozygous variation, with mainly a mild hyperpheny-lalaninemia. 168 patients with PAH deficiency who were followed-up regularly had normal physical development without dwarfism or malnutrition. Among the 33 preschool patients who underwent mental development assessment, 2 were mentally retarded and the initial treatment age was older than 6 months. Nine patients with an average age of (17.13±2.42) years completed brain magnetic resonance imaging, one case was normal, and 8 cases were abnormal. There were patchy or patchy hyperintense foci near the bilateral lateral ventricles on T2WI, and the intellectual development was normal. Compared with the other eight patients, the blood phenylalanine concentration of the normal child was better and stably controlled within the ideal range.@*CONCLUSIONS@#c.728G>A, c.158G>A, c.721C>T, c.1068C>A, c.611A>G variations were common in PAH gene. After standardized treatment, most patients with PAH deficiency diagnosed by screening can obtain normal growth and intellectual development in adolescence, but there are different degrees of organic lesions in the cerebral white matter.

Analysis of biochemical and genetic screening results for neonatal methylmalonic acidemia / 中华实用儿科临床杂志

Objective:To investigate the incidence rate and gene variation of methylmalonic academia (MMA) in Ji′nan city by analyzing biochemical and genetic screening results, and to explore the carrier frequency of MMA-related pathogenic genes in the population in Ji′nan.Methods:The children diagnosed with MMA by tandem mass spectrometry screening in Ji′nan Neonatal Disease Screening Centre from May 2011 to May 2022 were enrolled in this study.Their genetic test results were retrospectively analyzed and summarized.The dried heel blood tablets collected from 6 800 newborns were tested for neonatal gene screening. MMAA, MMAB, MMACHC and MMUT genes in 4 800 cases were detected by high-throughput sequencing+ target area capture technology.Ultra-multiplex polymerase chain reaction+ target gene locus capture technology was used to detect 174 target loci of 8 genes related to MMA in 2 000 cases.The hotspot mutation and related gene carrier rate of MMA were analyzed. Results:A total of 367 452 newborns were screened by tandem mass spectrometry, and 103 cases (56 males and 47 females) were diagnosed with MMA by screening.The estimated incidence of MMA was 1∶3 567.Among the 103 MMA cases, 76 were genetically diagnosed, and 4 gene variants of MMA ( MMAHC, MMUT, MMAA, MMADHC) were identified.A total of 6 800 neonates underwent neonatal genetic screening.Three of them were diagnosed with MMA.About 318 infants carried pathogenic variants of MMA, with a total carrier rate of 4.68%.Specifically, the carrier rates of MMACHC and MMUT gene variants were 3.09%(210/6 800) and 1.43% (97/6 800), respectively. Conclusions:MMA is the most common organic acid metabolism disorder in our country.The incidence and carrier rate of this disease are high in Jinan city.Neonatal genetic screening is an important supplement to neonatal biochemical screening.Carrier screening for MMA-related pathogenic genes is recommended for couples of childbearing age in Jinan.

Thalassemia screening and genotyping in Southwest Guizhou Autonomous Prefecture of Guizhou Province / 中华地方病学杂志

Objective:To analyze the thalassemia screening and genotyping in Southwest Guizhou Autonomous Prefecture (referred it as Qianxinan Prefecture), this essay provides the theoretical reference for clinical diagnosis of thalassemia and suspicious cases.Methods:The pregnant women, spouses and neonates who were screened for thalassemia gene in Qian Xi Nan People's Hospital from January 2016 to December 2020 were selected as the research subjects, and peripheral blood or umbilical cord blood samples were collected to extract DNA. The gap-polymerase chain reaction (Gap-PCR) and next-generation sequencing (NGS) technology were used to screen thalassemia, and ArcMap 10.8 software was adopted to map the local spatial distribution of thalassemia based on the screening data.Results:A total of 67 185 cases of people from various regions in Qianxinan Prefecture were screened, and 8 202 cases of thalassemia gene carriers were detected, with a total detection rate of 12.21%. Among them, 5 660 cases of α-thalassemia, with a detection rate of 8.42%; 2 132 cases of β-thalassemia, with a detection rate of 3.17%; 410 cases of αβ complex thalassemia, with a detection rate of 0.61%. In the detection of thalassemia genes, 27 genotypes of α-thalassemia were detected, mainly αα/-α 3.7, accounting for 41.13% (2 328/5 660); 33 genotypes of β-thalassemia were detected, mainly β CD17(A>T)/β A, accounting for 44.09% (940/2 132); 55 genotypes of αβ complex thalassemia were detected, and αα/-α 3.7 complexed β CD17(A>T)/β A dominated, accounting for 21.22% (87/410). There were high incidence areas in the spatial distribution of thalassemia, which were Wangmo County and Ceheng County, and the detection rate was 26.76% (1 438/5 374), 24.39% (1 314/5 387), respectively. Conclusions:The detection rate of thalassemia gene in Qianxinan Prefecture is relatively high, mainly αα/-α 3.7 genotype of α-thalassemia. Wangmo County and Ceheng County are high-incidence areas of thalassemia, and screening efforts should be continued.

Progress on radiotherapy of primary central nervous system lymphoma / 中华放射肿瘤学杂志

Primary central nervous system lymphoma (PCNSL) is a rare aggressive non-Hodgkin′s lymphoma that occurs in the brain, spinal cord, meninges or eyes. Diffuse large B-cell lymphoma accounts for the vast majority, of which non-GCB subtype is more common. The median survival time of untreated patients is only 3 months. Surgical removal of the tumor alone has no obvious survival benefit. Early single use of whole brain radiation therapy (WBRT) yields a high remission rate, but the duration is short, and delayed neurotoxicity is an important complication, especially for elderly patients. Subsequent studies found that high-dose methotrexate-based chemotherapy combined with WBRT significantly improved the prognosis of this disease. However, combination therapy increases the risk of neurotoxicity, and this strategy has been questioned. In recent years, reduced-dose WBRT and autologous hematopoietic stem cell transplantation have gradually replaced the previous standard-dose WBRT. This article reviews the progress on the radiotherapy for PCNSL.

Effects of different treatment regimens before allogeneic-hematopoietic stem cell transplantation on the outcome after transplantation of patients with myelodysplastic syndrome: a meta analysis / 白血病·淋巴瘤

Objective:To systematically evaluate effects of different treatment schemes before allogeneic-hematopoietic stem cell transplantation (allo-HSCT) on the long-term relapse and survival of patients with myelodysplastic syndrome (MDS) after transplantation.Methods:The related literatures were searched from databases of Ovid, Cochrane Library, PubMed, Embase, CNKI, VIP, WanFang and CBM from inception to December 2019. And then 2 reviewers independently extracted data, assessed methodological quality and crosschecked on the included literatures. According to the treatment methods, the cases included in the literatures were divided into demethylation drug (decitabine or azacytidine) treatment (demethylation treatment group) and traditional treatment regimen (including chemotherapy and support treatment) (traditional treatment group). RevMan 5.3 software was used to analyze overall survival (OS), recurrence, non-relapse mortality (NRM) and relapse free survival (RFS).Results:Finally, 10 articles were included. The results of meta-analysis showed that in the traditional treatment group, the differences of 3-year OS rate [44.6% (146/327) vs. 35.5%(138/389); OR = 0.93, 95% CI 0.38-2.27, P = 0.87], the recurrence rate [32.4% (106/327) vs. 37.3% (145/389); OR = 1.00, 95% CI 0.49-2.05, P = 0.99], NRM [26.3% (86/327) vs. 27.0% (105/389); OR = 1.05, 95% CI 0.75-1.49, P = 0.77], RFS rate [9.2% (30/327) vs. 12.6% (49/389); OR = 0.74, 95% CI 0.26-2.10, P = 0.57] between the chemotherapy group and the support treatment group were not statistically significant. The differences of 3-year OS rate [40.7% (165/405) vs. 45.9% (290/632); OR = 0.98, 95% CI 0.71-1.36, P = 0.28], recurrence rate [32.6% (132/405) vs. 38.3% (242/632); OR = 1.05, 95% CI 0.79-2.05, P = 0.25], NRM [27.2% (110/405) vs. 24.8% (157/632); OR = 0.81, 95% CI 0.59-1.11, P = 0.68], RFS rate [46.7% (189/405) vs. 42.2 (267/632); OR = 0.84, 95% CI 0.63-1.12, P = 0.85] between demethylation treatment group and traditional treatment group were not statistically significant. There were no significant differences in 3-year OS rate, recurrence rate, NRM and RFS rate between demethylation treatment group and chemotherapy group, demethylation treatment group and support treatment group (all P > 0.05). Conclusion:Different treatment regimens before allo-HSCT have no significant effect on survival or recurrence after transplantation for patients with MDS.

Repeatability of OPD-Scan Ⅲ and its consistency with Pentacam in measuring keratometry and astigmatism / 中华实验眼科杂志

Objective:To analyze the repeatability of keratometry and astigmatism values measured by the OPD-Scan Ⅲ and the agreement of the parameters measured by OPD-Scan Ⅲ and Pentacam.Methods:A diagnostic test study design was adopted.Fifty patients (100 eyes) with refractive errors, aged from 21 to 35 years old, were selected from Second Affiliated Hospital of Nantong University and Lixiang Eye Hospital of Soochow University during August 2018.Spherical equivalent, astigmatim degree and axis were measured by Autorefraction.Corneal biometric measurements were measured three times continuously with the above two instruments.Keratometry values at the flat axis (K1), keratometry values at the steep axis (K2), astigmatim degree, axis, vector parameters J0 (Jackson cross cylinder at 0°or 180°) and J45 (Jackson cross cylinder at 45°) were recorded.Intraclass correlation coefficient (ICC) was used for repeatability analysis.Wilcoxon signed rank test, Spearman correlation analysis and Bland-Altman graphs were employed to analyze the comparability.This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Lixiang Eye Hospital of Soochow University (No.SLER2018112). Written informed consent was obtained from each patient prior to any examination.Results:The ICC of K1, K2, astigmatism, astigmatic axis, J0 and J45 measured by OPD-Scan Ⅲ were all greater than 0.900; the ICC of the astigmatism measured by Pentacam was 0.896, and the ICC of the other parameters measured by Pentacam were greater than 0.900; The values of K2, astigmatism, J0 and J45 measured by OPD-Scan Ⅲ were greater than those measured by Pentacam, and the differences were statistically significant (all at P<0.05). The values of K1, K2, astigmatism degree, axis, J0 and J45 measured by OPD-Scan Ⅲ were positively correlated with those measured by Pentacam (r s=0.981, 0.982, 0.900, 0.737, 0.921, 0.703, all at P<0.01). The 95% agreement of limits (LOA) of K1, K2, astigmatism, axis, J0 and J45 measurement difference between OPD-Scan Ⅲ and Pentacam were -0.52-0.50 D, -0.39-0.59 D, -0.37-0.48 D, -17.29°-20.38°, -0.12-0.24 D and -0.22-0.28 D, respectively. Conclusions:OPD-Scan Ⅲ has high credibility in measuring corneal refractive power and astigmatism degree, but its 95% LOA of astigmatism axis is too large to be accepted clinically.

Hepatic metastases after cervical cancer surgery: clinical analysis of 13 cases / 中华妇产科杂志

Objective:To investigate the clinical characteristics of patients with hepatic metastasis after cervical cancer operation, and analyze the risk factors and prognostic factors of hepatic metastasis.Methods:A total of 1 312 patients with stage Ⅰa2-Ⅱb2 cervical cancer received radical surgery from January 2013 to January 2016 in the First Affiliated Hospital of Zhengzhou University were collected, of which 13 cases (0.99%, 13/1 312) had hepatic metastasis after operation. A retrospective analysis was conducted on clinical features of patients with hepatic metastasis after cervical cancer operation. T-test, chi-square test, rank sum test and logistic regression were used to analyze the risk factors of hepatic metastasis after surgery of cervical cancer operation. Kaplan-Meier method was used for survival analysis. Log-rank test was used for screening of prognostic factors in patients with postoperative hepatic metastasis.Results:(1) Clinical features: there were 3 cases of simple hepatic metastasis without obvious clinical symptoms, 2 patients with perihepatic lymph node metastasis showed only low back pain, 8 patients with multiple extrahepatic metastases, and their clinical symptoms were related to the site of metastasis. Five cases out of 9 (5/9) with liver metastasis had abnormal tumor marker results. The abnormal kinds of tumor markers were mainly carcinoembryonic antigen (CEA), CA 125, CA 199, and CA 72-4. The interval time of hepatic metastasis after operation was 2-22 months. (2) Analysis of risk factors for hepatic metastasis: univariate analysis showed that lymph node metastasis, histological type, infiltration depth, and lymph-vascular space invasionwere associated with hepatic metastasis after cervical cancer surgery ( P<0.05).Multivariate analysis showed that lymph node metastasis and small cell carcinoma were independent risk factors for postoperative hepatic metastasis ( P<0.05). (3) Prognostic factors in patients with hepatic metastasis:among 13 patients with postoperative hepatic metastases from cervical cancer, 9 died during the follow-up period and 4 survived. The median total survival time after hepatic metastases was 7 months (range 3-32 months). Univariate analysis showed that multiple extrahepatic metastases and treatment after hepatic metastasis had significant effects on the prognosis of patients with hepatic metastasis after cervical cancer operation ( P<0.05). Conclusions:The interval of hepatic metastasis after surgery for cervical cancer operation is within 2 years. Patients with lymph node metastasis and small cell carcinoma are more prone to postoperative hepatic metastasis. The prognosis of patients with extrahepatic multiple metastases is poor, and individualized treatment should be carried out after comprehensive analysis for patients with hepatic metastasis after cervical cancer operation.

Distribution of posterior corneal astigmatism and its effect on the calculation of Toric intraocular lens / 中华实验眼科杂志

Objective To analysis the distribution of posterior corneal astigmatism (PA) and evaluate the influence of keratometric astigmatism (KA) and total corneal astigmatism (TCA) on the calculation of Toric intraocular lens (Toric IOL) in patients with age-related cataract (ARC) and high corneal astigmatism.Methods An observational study design was adopted.Pentacam was used to measure 200 eyes of 181 patients with ARC and KA＞0.75 D in Affiliated Hospital of Nantong University from August 2016 to April 2017.KA,PA,TCA and anterior corneal astigmatism (AA) were recorded.The astigmatism magnitude and axis of PA was studied.The subjects were divided into astigmatism with the rule group,astigmatism against the rule group and oblique astigmatism group according to the axis of AA.The correlations of decomposition values between PA and AA or KA and TCA in each group were analyzed by Pearson linear correlation analysis.The difference of decomposition values between KA and TCA in each group was compared by paired sample t test.The type and axis of Toric IOL were calculated by online formula according to KA and TCA.This study followed the Declaration of Helsinki and written informed consent was obtained from each patient prior to any medical examination.Results The mean astigmatic magnitudes of PA was -0.32 D×93.1°.PA exceeded 0.5 D in 22 eyes (11％).The steepest posterior corneal meridian was vertically aligned in 163 eyes (81.5％).The decomposition value KP(0) and KP (45) of PA were positively correlated with those ofAA (r=0.480,P＜0.001;r=0.251,P＜0.001).The mean astigmatic magnitudes of KA and TCA were 1.44D×89.6° and 1.32 D×89.5° in astigmatism with the rule group,1.39 D×153.4° and 1.71 D×154.4° in astigmatism against the rule group and 1.13 D× 122.0° and 1.24 D× 124.2° in oblique astigmatism group.53 eyes (69.7％) had KA higher than TCA in astigmatism with the rule group.82 eyes (87.3％) had KA lower than TCA in astigmatism against the rule group;20 eyes (66.7％) had KA lower than TCA in oblique astigmatism group.There were significant differences in KP (0) between KA and TCA in different astigmatism groups (all at P＜0.001).The calculated Toric IOL type were inconsistent in 85 eyes(42.5％) and the calculated axis were inconsistent in 176 eye s (88.2％).Conclusions In patients with high corneal astigmatism,the astigmatism type of PA is mostly astigmatism against the rule.Ignoring the PA can lead to deviation of Toric IOL type selection and axis placement in some patients.For patients who cannot measure PA or TCA,the type of Toric IOL should be adjusted appropriately.

Research progress of correcting corneal astigmatism in cataract surgery / 中华实验眼科杂志

Correction of astigmatism is an important part of refractive cataract surgery.Currently,methods of combined corneal astigmatism correction in cataract surgery mainly include keratotomy and Toric intraocular lens (IOL) implantation.Whether it is a scalpel or femtosecond laser keratotomy,the effects of astigmatism correction is related to the position,shape,length and depth of the incisions,configuration,and distance between incisions and optic axis.Moreover,the pattern and material of Toric IOL can affect its rotation stability and effects of astigmatism correction.This article reviewed recent progress of correcting corneal astigmatism in cataract surgery,which provided reference for ophthalmologists in clinical.

Advance in Prediction for Outcome of Cervical Whiplash-associated Disorders (review) / 中国康复理论与实践

@#Whiplash-associated disorders of the cervical vertebrae develop unevenly after the injury, and the recovery process is complicated and non-linear. It is important to identify factors related with poor recovery in the early stages, to select proper treatment and rehabilitation. However, there are too many prognostic factors related to the clinical outcome, while the Clinical Prediction Rules (CPR) are used to help decision-making. Now there are only Whiplash CPR, Assessment Tool for Whiplash Injuries Developed from A Prospective Observational Study and CPR-like Tool undergone the clinical trials.

Content Determination of Urea in Urea [13C] Capsules by High Performance Cation-exchange Chromatogra-phy / 中国药房

OBJECTIVE:To determine the content of urea in Urea [13C] capsules by high performance cation-exchange chroma-tography (HPCEC). METHODS:The determination was performed on Zorbax 300 SCX column with mobile phases consisting of acetonitrile-0.1% phosphoric acid (20:80,V/V) at the flow rate of 1.0 mL/min. The detection wavelength was set at 200 nm and column temperature was 35 ℃. The sample size was 20 μL. RESULTS:The linear range of urea was 0.0039-1.0030 mg/ml(r=0.9997). The limit of quantitation was 3.918 μg/mL and the limit of detection was 0.975 μg/mL. RSDs of precision,stability and repetitive test were all lower than 2.0%. The recovery ranged 99.3%-101.0%(RSD=0.67%,n=9). CONCLUSIONS:The meth-od is simple,rapid,sensitive and suitable for the content determination of urea in Urea [13C] capsules.

Contents Determination of Citric Acid in Fentanyl Citrate Raw Materials and Its Injection by Ion Chroma-tography / 中国药房

OBJECTIVE:To determine the contents of citric acid in fentanyl citrate raw materials and its injection by ion chro-matography. METHODS:The determination was performed on Thermo Dionex IonPacTM AS11-HC column with mobile phase con-sisted of potassium hydroxide (gradient elution) at the flow rate of 1.0 mL/min. The column temperature was 35 ℃,and sample size was 20 μL. The detector was suppressed conductivity detector. RESULTS:The linear range of citric acid were 0.1157-74.05 μg/mL(r=0.9995). The limit of quantitation was 0.1150 μg/mL,and the limit of detection was 0.0400 μg/mL;RSDs of preci-sion,stability and reproducibility tests were all lower than 2.0%;the average recoveries were 99.6%-101.5%(RSD=0.68%,n=9). CONCLUSIONS:The method is environmentally-friendly and simple with good accuracy and precision,and suitable for the contents determination of citric acid in fentanyl citrate raw materials and injection.

A nomogram for the intraoperative prediction of non-sentinel lymph node metastasis in breast cancer patients / 中国癌症杂志

Background and purpose: When patients have positive sentinel lymph node (SLN), axillary lymph node dissection (ALND) is usually performed, but most of them have no metastasis in the non-sentinel lymph node (nSLN). It is of great significance to predict metastasis of nSLN precisely. The aim of the study was to establish a nomogram for the intraoperative prediction of nSLN metastasis in breast cancer patients using one-step nucleic acid amplification (OSNA) techniques and to direct the subsequent therapy for breast cancer effectively. Methods: Of 552 breast cancer patients who underwent SLN biopsy in the 2010 OSNA clinical trial, 103 with SLN metastasis treated with ALND were assessed to establish a nomogram for intraoperative prediction of nSLN based on the molecular diagnosis. A validation cohort of 61 patients who met the similar criteria in the 2015 OSNA clinical trial subsequently validated it. Results: Primary tumor size, total tumor load, the number of positive SLNs and negative SLNs were associated with the presence of nSLN metastasis based on the multivariable logistic regression results, and a nomogram was established with these variables. Its area under the ROC curve was 0.814 for the predictive model and it was 0.842 in the re-validation cohort. The tumor size assessed by the postoperative histological examination was replaced by the size evaluated by the imaging examination, and the area under the ROC curve was 0.838. There was no statistically significant difference in the accuracy compared with the former validation data (P=0.7406). Conclusion: The predictive nomogram based on the molecular diagnosis can predict the nSLN metastases intra/post-operatively. It appears to be obviously superior to other predictive models and may help to guide the axillary management and to make decisions about radiation target region.

Research on the new trancer of sentinel lymph node biopsy in breast cancer patients / 中国癌症杂志

Sentinel lymph node biopsy has been proved to be the standard treatment for early breast cancer patients with negative axillary lymph node. The study related to the tracer has become one of the hottest topics in breast cancer research. At present, the biopsy is often performed using the tracer of isotope, blue dye or both of them. However, some deifciencies of the 2 tracers restrained their applications, which resulted that the rate of the procedure is limited to only about 60% of patients in developed countries and less than 5% of patients in China and other developing countries. In recent years, a variety of new tracers have emerged, such as indocyanine green, contrast-enhanced ultra-sound using microbubbles, superparamagnetic iron oxide nanoparticles. In this article, we introduced the characteristics of these 3 substances and reviewed the related research on the new tracers. In conclusion, the new tracers are still in the preliminary stage of research, and further research is needed for clinical application.

The study of a novel tracer for breast cancer sentinel lymph node biopsy in an animal model / 中国癌症杂志

Background and purpose:Sentinel lymph node biopsy has replaced axillary lymph node dissec-tion as the standard staging procedure in early breast cancer patients with clinically negative axillary lymph nodes. It is a critical step for staging and treatment. This study investigated the localization effect of a novel tracer for breast cancer sentinel lymph node biopsy [indocyanine green (ICG)-rituximab (R)], using the hind limb drainage in mice as an animal model.Methods:For exploring the optimal dose and imaging time, different doses of ICG-R were injected subcutane-ously to the dorsum of the foot in the BALB/c mice. Then the lfuorescence vasculature imaging instrument was used continuously to observe the popliteal fossa lymph node (as sentinel lymph node) from the injection to 3 h after injection. For exploring the sustained localization effect, the optimal dose of ICG-R was injected and the imaging instrument was used from imaging to 24 h after injection.Results:The time from injection to imaging and the time from injection to the optimal imaging were shortened with the increased doses, and the imaging rate of the second or third level node increased accordingly. The best dosage of the novel tracer was 0.12 μg (dosage of indocyanine green) and the time from injection to the optimal imaging was about 34 min. After the observation for 24 h, the imaging rate of sentinel lymphnode was maintained at 100%, and the imaging rate of the second and the third level lymph node increased from 0% to 20% and 10%, respectively.Conclusion:ICG-R could clearly locate the sentinel lymph node. There is no imaging of the second level lymph node within 6 h. The novel tracer has high value in the clinical application.

Content Determination of Acetic Acid in Octreotide Acetate for Injection by IEC / 中国药房

OBJECTIVE:To determine the content of acetic acid in Octreotide acetate for injection by IEC,and provide reference for the improvement of pharmacopoeia standards. METHODS:The column was Rezex ROA-Organic Acid H+ with mobile phase of 0.002 5 mol/L sulfuric acid at a flow rate of 0.5 ml/min,the detection wavelength was 210 nm,column temperature was 45℃,and in-jection volume was 100 μl. RESULTS:The linear range of acetic acid was 0.394 4 μg/ml-78.89 μg/ml(r=0.999 9);RSDs of preci-sion,stability and reproducibility tests were all lower than 2%;the limit of quantification was 197.2 ng/ml,and limit of detection was 78.89 ng/ml;recovery was 104.71%-109.78%(RSD=1.34%,n=9). CONCLUSIONS:The method is environmental and simple with good accuracy and precision,and suitable for the content determination of acetic acid in Octreotide acetate for injection.

The value of combined MRS and DWI in diagnosis of cervical cord injury / 实用放射学杂志

Objective To explore the value of MRS and DWI in diagnosis of cervical spinal cord injury.Methods The MRI plain scan images of 95 cases who suffering from cervical spinal cord injury were analyzed.They were divided into two groups according to the T2 signal of cervical cord,63 cases in Group A(incomplete injury group)with no abnormal on T2 ,32 cases in Group B(complete injury group)with high signal on T2 .The other 50 cases with no injury of cervical cord were recruited as control group (Group C). All the cases were performed with MRS and DWI.The N-acetyl aspartic acid(NAA),choline compounds(Cho)and creatine(Cr)as well as the peak area of lactic acid (Lac)on MRS,and apparent diffusion coefficient(ADC)on DTI were measured separately.Mean-while,NAA/Cho,NAA/Cr,Cho/Cr,Lac/Cho and ADC were analyzed.Results On MRS sequence,the values of NAA/Cho and NAA/Cr were lower in Group B (P <0.05)when compared with Group A.The values of NAA/Cho and NAA/Cr were also lower in Group B,when compared Group C.However,the value of Lac/Cho in Group B was higher than it in Group C(P <0.05).When com-pared Group A with Group C,the value of Lac/Cho only increased in the former.However,on DWI,the value of ADC in Group A was(0.79±0.1 7)×10 -3 mm2/s,lower than that of Group C(0.93±0.1 5)×10 -3 mm2/s (P =0.026);the value of ADC in Group B was(1.21±0.20)×10 -3 mm2/s,significantly higher than that of Group C(P =0.01 7).When compared with Group B,the value of ADC in Group A was a lightly lower (P =0.143)with no statistical significance.Conclusion MRS can noninvasively and quantita-tively reflect the changes of metabolism of medium in injured cervical cord and help characterize the severity and degree of cervical cord injury from metabolic and molecular level.DWI has high sensitivity on early diagnosis of cervical cord injury.The combination of MRS and DWI has important value for formulating reasonable treatment plan and prognostic evaluation.