RESUMO
Objective: To establish the HPLC fingerprint and the determination method of three index components of the classical herbal formula substance benchmarks of Xiebai Powder. Methods: Fingerprint chromatographic conditions were as following: detection wavelength 254 nm/325 nm, column temperature 35 ℃; flow rate 0.8 mL/min; injection volume 25 μL; mobile phase consisting of 0.1% aqueous formic acid (A) and acetonitrile (B); binary gradient elution: 0-20 min, 5%-10% B; 20-33 min, 10%-15% B; 33-50 min, 15%-20% B; 50-95 min, 20%-58% B. Ten batches of substance benchmarks of Xiebai Powder fingerprints were collected and evaluated by the Chinese Pharmacopoeia Committee "Chinese Medicine Chromatographic Fingerprint Similarity Evaluation System 2012 Edition" software. Chromatographic conditions of content determination: detection wavelength 237 nm, column temperature 30 ℃; flow rate 1.0 mL/min; injection volume 5 μL; mobile phase consisting of 0.1% aqueous phosphoric acid (A) and acetonitrile (B) for binary gradient elution: 0-10 min, 5%-20% B; 10-18 min, 20%-60% B; 18-26 min, 60%-100% B; 26-38 min, 100% B; 38-41 min, 100%-5% B; 41-45 min, 5% B. Results: Based on the matching results, 55 common peaks were determined at a wavelength of 254 nm, and 57 common peaks were determined at a wavelength of 325 nm. Three substances, mulberroside A (S), liquiritin and ammonium glycyrrhizinate, were identified in the common peaks. After methodological research, its precision, stability and reproducibility were good. Ten batches of substance benchmarks of Xiebai Powder fingerprints were evaluated with reference fingerprints, and their similarities were greater than 0.9. The average recovery rates of mulberroside A (S), liquiritin and ammonium glycyrrhizinate were 97.82%, 97.40% and 105.81%, respectively. The RSD (n = 6) was 4.41%, 2.51% and 1.19%, respectively, which met the require of 2015 edition of the Chinese Pharmacopoeia. The three components had good linearity in the range of 25.25-2525 ng, 25-2 500 ng and 8.5-850 ng, respectively. The method had good precision, stability and repeatability. The contents of 10 batches of substance benchmarks of Xiebai was determined. The content of mulberry A was 11.6-35.5 mg/g, the content of liquiritin was 0.1-1.6 mg/g, and the content of glycyrrhizic acid was 0.3-2.5 mg/g. The range of the contents of these ingredients was large, which indicated that the quality of mulberry husks and licorice herbs from different places was quite different. Conclusion: The establishment of the HPLC fingerprint and the determination method of three index components of the classical herbal formula substance benchmarks of Xiebai Powder provided some bases for the study of the quality standard of substance benchmarks of Xiebai Powder.
RESUMO
ABSTRACT Background: It is important but difficult to treat complex fistula-in-ano due to the high recurrent rate and following incontinence. Ligation of the intersphincteric fistula tract (LIFT), a novel surgical procedure with the advantage of avoiding anal incontinence, has a variable success rate of 57-94.4 %. Aim: To evaluate the long-term outcomes of modified LIFT operative procedure - ligation of intersphincteric fistula tract - to treat complex fistula-in-ano. Methods: Retrospective analysis of 62 cases of complex fistula-in-ano. The group was treated with the modified approach of LIFT (curved incision was made in the anal canal skin; purse-string suture was performed around the fistula; the residual fistulas were removed in a tunnel-based way) and had a follow-up time of more than one year. Patient´s preoperative general condition, postoperative efficacy and their anal function were compared. Results: The median age of the participants was 34, and 43 (69.4%) cases were male. Forty-one (66.1%) cases were of high transsphincteric fistula, four (6.5%) cases of high intrasphincter fistula, and 17 (27.4%) cases of anterior anal fistula in female. The median follow-up duration was 24.5 (range, 12-51) months. The success rate in the end of follow-up was 83.9% (52/62). The anorectal pressure and Cleveland Clinic Florida Fecal Incontinence (CCF-FI) evaluated three months before and after the operation did not find apparent changes. Conclusions: Compared with LIFT, the modified LIFT remarkably reduces postoperative failure and the recurrence rate of complex fistula with acceptable long-term outcomes.
RESUMO Racional: É importante, mas difícil de se tratar fístula anal complexa devido à alta taxa de recorrência e de incontinência pós-operatória. A ligadura do trajeto da fístula interesfincteriana (LIFT) - um novo procedimento cirúrgico com a vantagem de evitar a incontinência anal - tem taxa de sucesso variável entre 57-94,4%. Objetivo: Avaliar os resultados em longo prazo do procedimento cirúrgico LIFT modificado - ligadura do trato interesfincteriano com fístula - para tratar fístula complexa anal. Métodos: Análise retrospectiva de 62 casos de fístula complexa no ânus tratados com abordagem modificada de LIFT (incisão curva na pele do canal anal; sutura em bolsa realizada em torno da fístula; as fístulas residuais removidas em um túnel) e teve tempo de acompanhamento de mais de um ano. A condição geral pré-operatória dos pacientes, a eficácia pós-operatória e a função anal foram comparadas. Resultados: A mediana de idade dos participantes foi de 34 anos, e 43 (69,4%) dos casos eram de homens. Quarenta e um (66,1%) casos eram de fístula transesfincteriana alta, quatro (6,5%) de fístula intra-esfincteriana alta e 17 (27,4%) de fístula anal anterior em mulheres. A mediana da duração do acompanhamento foi de 24,5 meses (12-51). A taxa de sucesso no final do acompanhamento foi de 83,9% (52/62). A pressão anorretal e a Incontinência Fecal da Cleveland Clinic Florida (CCF-FI) avaliadas três meses antes e após a operação não encontraram alterações aparentes. Conclusões: Comparado com o LIFT, o LIFT modificado reduz notavelmente a falha pós-operatória e a taxa de recorrência de fístula complexa com resultados aceitáveis em longo prazo.