Comprehensive quality evaluation of Guge fengtong tablets / 中国药房

OBJECTIVE To establish a method for the content determination of 11 components such as protodioscin in Guge fengtong tablets， and to evaluate the comprehensive quality of Guge fengtong tablets by combining with chemometric analysis and entropy weight-technique for order preference by similarity to ideal solution （EW-TOPSIS） method. METHODS HPLC method was adopted. The determination was performed on Agilent Eclipse Plus C18 column with a mobile phase consisted of acetonitrile- 0.2% phosphoric acid solution at the flow rate of 1.0 mL/min by gradient elution. The column temperature was set at 30 ℃ . The detection wavelengths were set at 203 nm （0-28 min， protodioscin， methyl protodioscin， pseudoprotodioscin， dioscin） and 280 nm （28-60 min， catechin， epicatechin， liquiritigenin， medicarpin， 6-gingerol， 8-gingerol， 10-gingerol）； the sample size was 10 μL. Using epicatechin as the internal reference， quantitative analysis of multi-components by single marker （QAMS） method was used to determine the contents of protodioscin， methyl protodioscin， pseudoprotodioscin， dioscin， catechin， liquiritigenin， medicarpin， 6-gingerol， 8-gingerol and 10-gingerol， which were compared with the results of the external standard method. SPSS 26.0 software and SIMCA 14.1 software were used for principal component analysis and orthogonal partial least squares-discriminant analysis， with variable importance in projection （VIP） value greater than 1 as the standard， to screen for differential markers that affect the quality； the EW-TOPSIS method was adopted to evaluate the quality of 15 batches of samples comprehensively.RESULTS The contents of protodioscin， methyl protodioscin， pseudoprotodioscin， dioscin， catechin， liquiritigenin， medi-carpin， 6-gingerol， 8-gingerol and 10-gingerol determined by HPLC combined with QAMS were 6.330-10.863， 1.150-2.274， 0.431- 0.740， 2.818-4.823， 0.826-1.510， 0.043-0.094， 0.079-0.231， 0.479-1.020， 0.146-0.288， 0.118-0.318 mg/g， respectively； there were no statistical significances， compared with the external standard method （P＞0.05）. A total of 15 batches of samples were clustered into 3 groups， with S1-S6， S7-S10， and S11-S15 clustered into one group， respectively. The VIP values of protodioscin， epicatechin， dioscin and 6-gingerol were greater than 1. Euclidean closeness values of the optimal solution （C）i for 15 batches of samples were 0.163 5 to 0.703 7， and Ci values of S11-S15 were all higher than 0.6. CONCLUSIONS The established QAMS method is accurate and simple， and can be used for comprehensive quality evaluation of Guge fengtong tablets， by combining with chemometric analysis and EW-TOPSIS method. Protodioscin， epicatechin， dioscin and 6-gingerol are the differential markers that affect the quality of Guge fengtong tablets. Samples S11-S15 have better quality.

The incidence of non-thyroidal illness syndrome in children with type 1 diabetes mellitus and correlated factors analysis / 中华实用儿科临床杂志

Objective:To explore the incidence of non-thyroidal illness syndrome (NTIS) in children with type 1 diabetes mellitus (T1DM) and the correlation between triiodothyronine level and the severity of T1DM, thus providing evidence for clinical diagnosis and treatment.Methods:A total of 125 children initially diagnosed as T1DM at the Department of Endocrinology and Genetic Metabolism of Children′s Hospital of Shanghai Jiao Tong University from January 2015 to December 2019 were recruited.The data were retrospectively analyzed.The incidence of NTIS in T1DM children was explored.T1DM children were classified into euthyroid group and NTIS group, two independent sample t-test were used to compare the differences in multiple factors between euthyroid group and NTIS group in children with T1DM, and Spearman correlation analysis was used to further analyze the correlation between the levels of free triiodothyronine (FT3), total triiodothyronine (TT3) and the severity of children with primary T1DM. Results:The incidence of NTIS in 125 T1DM children was 26.4%(33/125 cases). FT3, TT3, total thyroxine (TT4), thyrotropin (TSH), pH value, HCO 3- and high density lipoprotein cholesterol (HDL-C) levels in NTIS group were significantly lower than those of euthyroid group [(3.10±0.45) pmol/L vs.(4.85±0.75) pmol/L, (0.60±0.28) nmol/L vs.(1.05±0.38) nmol/L, (65.77±23.41) nmol/L vs.(89.57±18.23) nmol/L, (0.91±0.89) mIU/L vs.(2.05±0.76) mIU/L, 7.21±0.17 vs.7.31±0.18, (11.49±7.54) mmol/L vs.(16.80±8.38) mmol/L, (1.08±0.49) mmol/L vs.(1.28±0.44) mmol/L]( t=4.56, 5.67, 4.48, 5.61, 2.82, 2.68, and 2.53, all P<0.05). Moreover, the anion gap (AG) level, blood glucose (BG) and triglyceride in NTIS group were significantly higher than those of euthyroid group [(22.53±8.33) mmol/L vs.(16.94±7.52) mmol/L, (24.85±4.71) mmol/L vs.(21.46±6.64) mmol/L, (2.72±2.05) mmol/L vs.(2.33±3.05) mmol/L]( t=3.22, 2.67 and 2.04, all P<0.05). The incidence of diabetic ketoacidosis (DKA) was statistically significant in euthyroid group, NTIS group and abnormal thyroid disease group (33.3% vs.63.6% vs.35.7%)( χ2=8.990, P<0.05). In T1DM children, FT3 was positively correlated with pH value and HCO 3-, and negatively correlated with AG level ( r=0.376 9, 0.439 7 and -0.411 9, all P<0.05). In addition, TT3 was positively correlated with pH value and HCO 3-, and negatively correlated with AG and BG ( r=0.513 2, 0.539 8, -0.482 4 and -0.211 5, all P<0.05). Conclusions:Children with T1DM are prone to have abnormal thyroid hormone levels, and the incidence of NTIS was 26.4%.The incidence of DKA differed in T1DM children with different thyroid functions.FT3 or TT3 level may contribute to evaluate the disease severity of T1DM children.

1H NMR-based metabolomics study of intervention effects ofleonurine on acute myocardial ischemia in rats / 中国药理学通报

Aim To investigate metabolomic profiles of acute myocardial ischemia (AMI) in rat plasma and explore the intervention effects and its mechanism of leonurine using a metabolomics approach based on nuclear magnetic resonance (NMR).Methods The plasma metabolomic characteristics in rats of sham group,AMI model group,and leonurine-treated group were detected by 1H NMR,and the different metabolites between AMI group and sham group or leonurine-treated group were analyzed by pattern recognition and multivariate data analysis.Results Orthogonal partial least squares discriminant analysis (OPLS-DA) demonstrated that six metabolites related to AMI were screened out,including alanine,lysine,glycine,creatine,N-acetyl glycoprotein,and O-acetyl glycoprotein and all their levels were elevated in AMI group compared to sham group.Treatment of leonurine decreased the levels of alanine,lysine,and glycine,and increased the levels of choline,phosphocholine,and scyllo-inositol compared with the model group.Conclusions Leonurine can improve amino acid metabolism disorder under AMI conditions and enhance the function of choline and inositol pathway,which may explain its cardioprotective effect.The developed metabolomics approach in this study is a powerful tool for the investigation of the cardioprotective effect of leonurine and provide a new insight to understand its pharmacological mechanism.

Investigation and Analysis of Perioperative Prophylactic Use of Antibiotics in Thoracic Surgery Depart-ment of 7 Hospitals in Nantong City after the Implementation of Special Rectification / 中国药房

OBJECTIVE:To investigate the perioperative prophylactic use of antibiotics in thoracic surgery department of 7 hos-pitals in Nantong city,and to provide reference for rational drug use in clinic. METHODS:In retrospective study,6652 dis-charged patients with thoracic surgery were selected from 7"third-level hospitals"of Nantong city during 2015-2016. The gender, age,length of stay,preoperative medication,medication timing,classification of incision,operation time,drug name,usage and dosage,route of administration,drug combination and prognosis were analyzed statistically. According to the relevant regulations of special rectification and the principle of perioperative antibiotics use,the rationality of antibiotics use was evaluated. RE-SULTS:Among 6652 patients,there were 2761 cases of typeⅠincision and 3891 cases of typeⅡincision. All of them used anti-biotics. Primary prophylactic time was 0.5-2 h before operation in 5282 cases,accounting for 79.40％;1370 cases were given medicine more than 2 h before surgery or after surgery,accounting for 20.60％. Totally 1070 cases received prophylactic medica-tion within 48 h,accounting for 16.09％;5582 cases received prophylactic medication more than 48 h,accounting for 83.91％. A total of 5702 cases were given only one antibiotic,and 950 cases received two-drug combination. A total of 6342 patients used an-tibiotics irrationally,accounting for 95.34％. Eight categories 15 kinds of antibiotics were involved. β-lactam/β-lactamase inhibi-tors,fluoroquinolones and cephalosporins were mostly used. CONCLUSIONS:After the implementation of special rectification, there are still many irrational phenomena in the prophylactic use of antibiotics in thoracic surgery department of 7 hospitals in Nan-tong city. Some indexes exceed the national standard and still need to be further managed and improved.

Value of single photon emission computed tomography/computerized tomography in the diagnosis of hyperparathyroidism and the comparative study with multiple imaging modality / 中南大学学报(医学版)

OBJECTIVE@#To compare the diagnostic value among the single photon emission computed tomography/computerized tomography (SPECT/CT), (99m)Tc-sestamibi (MIBI) planar scintigraphy, ultrasonography (US) and computerized tomography (CT) in diagnosis of patients with hyperparathyroidism (HPT).
@*METHODS@#A total of 59 patients were retrospectively recruited for this study. The patients received parathyroidectomy and were verified by pathological examination. Among them, 31, 28 and 26 patients received SPECT/CT, (99m)Tc-MIBI planar scintigraphy, US and CT, respectively, before the parathyroidectomy. The sensitivity for localization or qualitation was compared between SPECT/CT and (99m)Tc-MIBI planar scintigraphy; the sensitivity, specificity and accuracy were compared among the SPECT/CT, (99m)Tc-MIBI planar scintigraphy, US and CT.
@*RESULTS@#There was no statistical difference in the sensitivity of localization between SPECT/CT and (99m)Tc-MIBI planar scintigraphy (P>0.05); however, the SPECT/CT exhibited more sensitive than the (99m)Tc-MIBI planar scintigraphy in detection of hyperplastic lesions (P<0.05). Among the four imaging modalities, SPECT/CT had advantages over (99m)Tc-MIBI planar scintigraphy in terms of accuracy (P<0.05). In contrast, the sensitivity of CT was not as good as that of SPECT/CT and US (both P<0.05). For the diagnosis of lesions with a diameter more than 1 cm, the sensitivity of SPECT/CT was the best (all P<0.05). However, the sensitivity of US was the best in diagnosis of lesions with a diameter less than 1 cm (all P<0.05).
@*CONCLUSION@#The SPECT/CT is more effective than (99m)Tc-MIBI planar scintigraphy in diagnosis of HPT, especially in diagnosis of hyperplastic lesions. Both of SPECT/CT and US are recommended to localize the target parathyroid lesions of HPT before the parathyroidectomy.

The clinical research on catheter constant drainage combined with pericardial perfusion lentinan for malignant pericardial effusion caused by lung cancer / 中国医师进修杂志

Objective To evaluate the effect and safety of catheter constant drainage combined with pericardial perfusion lentinan in treatment of patients with malignant pericardial effusion caused by lung cancer.Methods One hundred and eighteen patients with malignant pericardial effusion caused by lung cancer were divided into 2 groups by table of random digit,the treatment group (56 cases) was treated by pericardial perfusion lentinan after catheter constant drainage by central venous catheter,and the control group (62 cases) was treated by pericardial perfusion cisplatin after catheter constant drainage by central venous catheter.The therapeutic effect and adverse reaction were contrasted between the two groups.Results There was no significant difference in effective rate between treatment group and control group [89.3％(50/56) vs.83.9％ (52/62),x2 =0.736,P =0.391].The adverse reaction rate of treatment group was significantly lower than that of control group [8.9％ (5/56) vs.24.2％ (15/62),x2 =4.871,P =0.027].There was no significant difference in recurrence rate between treatment group and control group [14.3％(8/56) vs.11.3％(7/62),x2 =0.004,P =0.948].Conclusions Catheter constant drainage combined with pericardial perfusion lentinan for malignant pericardial effusion caused by lung cancer is safety and effective,and can be widely applied to clinical application.

Expression of type Ⅰ transforming growth factor ? receptor in renal cortex of streptozotocin-induced type Ⅱ diabetic rats and the regulation of valsartan / 中国临床药理学与治疗学

AIM: To study the expression of type Ⅰtransforming growth factor ?(T?R-Ⅰ)in renal cortex in streptozotocin-induced type Ⅱ diabetic mellitus and the regulation of valsartan. METHODS: The rat models of type Ⅱ diabetic rats were made. At the end of the 20th weeks,the kidneys were taken out to measure the expression of T?R-ⅠmRNA by RT-PCR. RESULTS: The expression of T?R-ⅠmRNA in diabetic rats without any therapy ( 0.72? 0.14) was higher than that in control ( 0.26? 0.12) (P