Establishment and preliminary application of detection of Mycobacterium tuberculosis in sputum based on variable number tandem repeat / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To establish a laboratory method for detection of Mycobacterium tuberculosis in sputum based on variable number tandem repeat (VNTR).</p><p><b>METHODS</b>Mycobacterium tuberculosis was tested by VNTR and fluorescent quantitative reverse transcription polymerase chain reaction (FQ-PCR) in 130 sputum samples from patients with pulmonary tuberculosis and 200 specimens from patients with other lung diseases. According to the amplification conditions and clinical detection needs, MTUB21, MUTB04, QUB18, QUB26, QUB11b, MIRU31, MIRU10 and MIRU26 were selected as test targets. The results of VNTR and FQ-PCR were compared with Lowenstein-Jensen culture and clinical diagnosis, and analyzed by chi-square test.</p><p><b>RESULTS</b>With the results of L-J culture as the standard, the sensitivity and specificity of VNTR were 93.1% (108/116) and 97.7% (209/214), and those of FQ-PCR were 94.0% (109/116) and 96.7% (207/214), respectively; no significant difference was observed between two groups (χ2=0.352, P=0.569). Using the clinical diagnosis as the standard, the sensitivity and specificity of VNTR were 86.9% (113/130) and 100% (200/200), and those of FQ-PCR were 87.7% (114/130) and 99.0% (198/200), respectively; the difference was not statistically significant (χ2=0.030, P=0.862). In 113 VNTR positive samples, the molecular codes differed from each other in 98.2% samples (111/113); only 2 samples had identical code (5-4-6-8-5-5-3-8).</p><p><b>CONCLUSION</b>The study suggests that VNTR provides a promising method for diagnosis of clinical tuberculosis.</p>

Simultaneous Determination of Five Active Ingredients in Xialiqi Capsule by UPLC / 中国药房

OBJECTIVE:To establish a method for simultaneous determination of calycosin-7-glucoside,specnuezhenide,ber-berine hydrochloride,palmatine hydrochloride and rosmarinic acid in Xialiqi capsule. METHODS:UPLC was performed on the col-umn of Shield RP18 with mobile phase of nitrile-0.2%formic acid(gradient elution)at a flow rate of 0.2 ml/min,the column tem-perature was 35 ℃,the detection wavelength was 240 nm,and the injection volume was 1 μl. RESULTS:The linear range was 0.619-39.6 μg/ml for calycosin-7-glucoside(r=0.999 9),1.181-115.6 μg/ml for specnuezhenide(r=0.999 9),0.89-57.2 μg/ml for berberine hydrochloride(r=0.999 9),1.16-74 μg/ml for palmatine hydrochloride(r=0.999 9)and 2.47-157.8 μg/ml for rosmarinic acid(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 3%,recoveries were 97.98%-102.44%(RSD=1.49%,n=9),97.37%-100.96%(RSD=1.13%,n=9),98.53%-102.30%(RSD=1.40%,n=9),97.06%-102.21%(RSD=1.46%,n=9)and 100.10%-102.25%(RSD=0.68%,n=9),respectively. CONCLUSIONS:The method is simple,rapid and reproducible,and can be used for the quality control of Xialiqi capsule.

A survey of correlation between serum 25-hydroxyvitamin D levels and dyslipidemia rlsk among middle-aged individuals in Beijing / 中华内科杂志

Objective To evaluate vitamin D status in middle-aged subjects in Beijing and explore the correlation between serum 25-hydroxyvitamin D[25(OH)D] levels and dyslipidemia.Methods A total of 448 individuals over 40 years old were enrolled in the cross-sectional survey.The general information,blood biochemical and lipid profiles and serum 25 (OH) D levels were collected.The subjects were either divided into two groups (the dyslipidemia group and the non-dyslipidemia group) based on the lipid levels,or four groups according to quartiles of 25 (OH) D levels.The association between 25 (OH) D levels and dyslipidemia risk was analyzed by a logistic regression analysis.Results A total of 234 cases were in dyslipidemia group,which accounted for 52.23％ of the subjects.The serum 25 (OH) D levels were significantly lower in the dyslipidemia group than in the non-dyslipidemia group both in men and in women (all P ＜ 0.05).The median serum 25 (OH) D level in the total subjects was 15.7 (12.2,20.1) μg/L with 91.1％ subjects of serum 25 (OH) D level ＜ 30 μg/L.The proportion of subjects with dyslipidemia (high TC,high TG,high LDL-C,or low HDL-C) increased with the decrease of 25 (OH) D level quartiles (P ＜0.05).After adjustment of confounding factors,the logistic regression analysis showed that subjects in the lowest 25 (OH) D quartile group had 143％ higher risks for dyslipidemia than those in the highest quartile group.Conclusion These findings indicate that 25 (OH) D insufficiency is highly prevalent among middleaged individuals and it may be associated with the risk of dyslipidemia.

Application of Dry Granulation Technology in Production of Lianhua Qingwen Capsules / 中国中医药信息杂志

Objective To solve the agglomeration problem in the former process, dry granulation technology was used to prepare the granules of Lianhua Qingwen Capsules. Methods Complexity and granule yield coefficient were set as inspection indexes. The optimum subsidiary material and its amount were optimized. The parameters of dry granulation technology were optimized by orthogonal test. Then, granule yield, angle of repose, and bulk density were compared with those of wet granulation technology. Results Starch was set as subsidiary material. The optimum technology is roll pressure of 12 MPa, rotation speed of 5 r/min, and feed speed of 10 r/min. The yield of granules prepared by dry granulation technology was significantly higher than that of wet granulation technology. Conclusion The dry granulation technology can effectively improve the agglomeration of the granulation process of Lianhua Qingwen Capsules, and was suitable for granulating process of Lianhua Qingwen Capsules.

Identification of Loganin Metabolites in Rats by UPLC-Q-TOF-MS/MS / 中国中医药信息杂志

Objective To identify the metabolites of loganin in rat urine through using ultra high performance liquid chromatography combined with triple TOF mass spectrometry (UPLC-Q-TOF/MS/MS) after oral administration of loganin;To summarize the metabolic pathway of loganin. Methods Rats were given a gavage with loganin. The urine samples were prepared by use of solid phase extraction (SPE). The chromatographic separation was performed on an UPLC C18 column with gradient elution program of acetonitrile and 0.1% formic acid aqueous as mobile phase. Dynamic background subtraction (DBS) technology was employed to trigger information dependent acquisition (IDA) to obtain the characteristic fragment ions of metabolites. Results MetabolitePilot software including several data processing methods were employed to speculate the structures of liganin metabolites and three metabolites were identified. Then, the metabolic pathway of loganin in rats was summarized. Conclusion The analytical method was simple, credible and highly-sensible, which is useful for screening and identifying trace constituents in vivo.

Application of Dynamic Ultrasound Countercurrent Extraction Technology in Industrialization of Lianhua Qingwen Capsule / 中国中医药信息杂志

Objective To study the application of dynamic ultrasound countercurrent extraction technology in industrialization of Lianhua Qingwen Capsule by multi-index optimization. Methods Ultrasonic temperature and ultrasonic time were investigated by using single factor design. The three factors of dry extract yield, the active ingredient content, and fingerprints were selected as the optimization indexes to investigate the solvent consumption and extraction time between the dynamic ultrasound countercurrent extraction process and the original reflux extraction process under the fixed conditions of process parameters. Results Compared with traditional reflux extraction technology, dynamic ultrasound countercurrent extraction technology effectively reduced the alcohol consumption and saved extraction time on the basis of guarantee of the active ingredient content. Conclusion Dynamic ultrasound countercurrent extraction process, with simple and fast advantages, can be used to Lianhua Qingwen Capsule production, which can significantly reduce production costs and increase productivity.

Analysis of bone minimal density and bone quantitative ultrasound in men with osteoporotic risks / 中华老年医学杂志

Objective To analyze the features of bone minimal density and bone quantitative ultrasound in men with different osteoporotic risk graded by osteoporosis self-assessment tool for Asian (OSTA).Methods After exclude the secondary osteoporosis,724 subjects over 50 years old were involved.The parameters of hight,weight,quantitative ultrasound index (QUI),QUS-T score were examined.The bone density (BMD) were measured by dual-energy X-ray absorptiometry (DXA)in 120 elderly men.All subjects were grouped into low (osteoporotic) risk group,moderate risk group and high risk group by OSTA index.120 subjects measured BMD were grouped into normal bone mass group,osteopenia group and osteoporosis group by WHO standard.The differences and correlation analysis in BMD,QUST,and QUI between these groups were analysed.Results The percents of low risk people,moderate risk people and high risk people were 56.4％ (408 cases),28.2％ (204cases),15.5％ (112 cases),respectively.There were 30.0％ (36 cases) normal bone mass people,58.3％ (70 cases) osteopenia people and 11.7％ (14 cases) osteoporosis people in groups measured BMD.QUS-T score,QUI were gradually decreased in groups of low risk,moderate risk and high risk (-0.56±1.09,-0.88±-1.28,-1.21±1.40; 98.47±19.04,92.62±22.49,87.68±24.43; all P ＜0.05) and had statistical significant differences between low risk and moderate risk,high risk groups,while had no differences between moderate risk and high risk groups.The femoral neck BMD and total BMD were gradually decreased in all the three groups (0.89±0.12,0.85±0.10,0.77± 0.10; 1.0±0.15,0.93 ± 0.11,0.83±0.1; all P＜0.01).Osteoporosis in the three groups were 3.4％ (2 cases),13.0％ (6 cases),37.5％ (6 cases),respectively and osteoporosis percents in moderate risk group and high risk group were higher compared with low risk group (x2=11.77,P＜0.01).QUS-T score and QUI decreased gradually in groups of normal mass,osteopenia and osteoporosis (0.99±0.08,-0.70±1.07,-1.96±0.73; 109.26±17.05,96.15±18.20,72.54±10.00; F=10.47,11.73,all P＜ 0.01).Except for lumbar BMD,a positive linear correlation emerged between OSTA and QUS-T score,QUI,hip BMD(all P＜0.01).The values of R with femoral neck BMD,torch BMD and total hip BMD were 0.45,0.38,0.39,respectively.And the same value with QUS-T score and QUI was 0.23.Conclusions With the decreasing of OSTA index,risk of osteoporosis is increased and QUS-T score,QUI and BMD are decreased gradually.There are positive linear correlation between OSTA index and QUS-T score,QUI,hip BMD.

Difference in blood pressure in left and right extremities / 中华健康管理学杂志

Objective To explore if there is a difference in blood pressure in left and right extremities.Methods A total of 20164 adults who took part in health check-up at Health Examination Center of Chinese PLA General Hospital between December 2009 and August 2011were enrolled in this study.Age,height and body weight were recorded,and blood pressure in extremities was measured in synchronous way by using an arteriosclerosis detector.Results (1) Blood pressure in upper left extremity was slightly higher than that in upper and lower right extremity ( all P =0.0001).( 2 ) Difference in diastolic blood pressure in upper left and right limbs in females (2.1±6.7) mm Hg(1mm Hg =0.133 kPa) was more significant than that in males (1.4 +6.5 ) mm Hg ( P =0.0000).In males,difference in systolic blood pressure between two lower extremities ( 2.3 ± 9.6 )mm Hg was more significant than that in females (1.9 ±13.4) mm Hg ( P =0.0225 ).( 3 ) The above mentioned differences were found in low or normal weight and over-weight/obesity populations,which was not correlated with body mess index.(4) The difference of diastolic blood pressure in left and right limbs of relatively taller adults ( ＞170 cm) was more significant than that in shorter populations ( ＜170 cm ) (P =0.001).Conclusion The differences in blood pressure in left and right extremities do exist.

The correlation between hyperinsulinemia and pulse wave velocity / 中华内科杂志

Objective To study the correlation between hyperinsulinemia (HIns) and arteriosclerosis in one community in Beijing. Methods Subjects who received arteriosclerosis screening in physical examination annually were studied. All subjects were received 75g oral glucose tolerance test (OGTT) to evaluate glucose metabolic level, and brachial-ankle pulse wave velocity (baPWV) examination to evaluate arteriosclerosis. The correlation between hyperinsulinemia and pulse wave velocity was analyzed. Results Among all the 1046 subjects under investigation, baPWV of subjects with HIns was higher than subjects with normoinsulinemia (NIns) in different glucose metabolism status [normal glucose tolerance, ( 1381.2 ±280. 8) cm/s vs ( 1280. 3 ±218. 7) cm/s; imparied glucose regulation, ( 1557. 5 ±319.3) cm/s vs (1474.7 ±305. 1) cm/s; diabetes, (1764.3 ±476.6) cm/s vs (1664.2 ±374.6)cm/s], especially in subjects with normal glucose tolerance ( P ＜ 0.01 ). The prevalence of cardiovascular risk factors in subjects with HIns was much higher than subjects with NIns ( P ＜ 0.01 ). Multiple logistic regression analysis showed that hyperinsulinemia was the risk factor of arteriosclerosis, and the OR (95%CI) of subjects with HIns was 1.91 (1. 169-3. 105, P ＜0.01 ) as compared to the subjects with NIns. Conclusion The subjects with HIns suffered from much more metabolic risk factors than NIns.Hyperinsulinemia that closely correlated with baPWV was a risk factor of arteriosclerosis.

The clinical characteristics and trend of conversion to type 2 diabetes mellitus of individuals with normal glucose tolerance-hyperinsulinemia / 中华内科杂志

Objective To study the outcomes and influencing factors of the conversion from normal glucose tolerance -hyperinsulinemia (NCT-HINS) to diabetes in the population of a community in Beijing.Methods All the subjects investigated received 75 g oral glucose tolerance test (OGTT) for diabetes screening carried out in May, 2006 and May, 2008. Data were calculated to analyze the outcomes and influencing factors of the conversion. HINS was diagnosed if fasting serum insulin & 15 mIU/L and/or 2-hour serum insulin after glucose loading ≥ 80 mIU/L Results The prevalence of NGT-HINS in the community in 2006 and 2008 was 5.28% and 8.67% (P<0.01) respectively and that of diabetes mellitus (DM) and impaired glucose regulation (IGR) was 3.52% , 6.56% in 2006 and 4.42% ,6.47% in 2008.The probability of the conversion from NGT-HINS to IGR and DM was 18.6% and 2.3% , being much higher than that from normal glucose tolerance- normoinsulinemia (NGT-NINS) (5.4% and 0.7% , P <0.01). However, the probability of the conversion from NGT-HINS to DM was 2.3% , which was much lower than that from IGR (26.3% , P <0.01). The reason might be that individuals with NGT-HINS had a higher waist circumference, BMI, fasting plasma glucose, 2 h plasma glucose and TG but a lower HDL-C than individuals with NGT-NINS in 2006. The HOMA β-cell function index/HOMA insulin resistance index (HBCI/IR) of individuals with NGT-HINS was much lower than that of individuals with NGT-NINS, but much higher than that of individuals with IGR. Logistic regression analysis showed that age, TG and HBCI/IR were the major influencing factors of the conversion from NGT to glucose metabolic disorders.Conclusions The probability of conversion from NGT to DM was increased remarkably when HINS was diagnosed. The reason might be that individuals with NGT-HINS suffered more metabolic risk factors and had a decreased β-cell function. Therefore, individuals with NGT-HINS should be paid attention to in diabetes prevention study.

Simultaneous determination of ginsenosides and epimedium flavonoids in rat urine by HPLC-UV-ELSD / 中国中药杂志

<p><b>OBJECTIVE</b>To develop and validate a HPLC-UV-ELSD method for the simultaneous determination of ginsenosides and epimedium flavonoids in rat urine after intravenous administration of Jiweiling freeze-dried powder.</p><p><b>METHOD</b>Chromatographic separation was performed on a C18 HPLC column, with gradient elution of acetonitrile and water as mobile phase. An UV detector was used at detection wavelength of 220 nm. An evaporative light scattering detector (ELSD) was used at drift tube temperature of 80 degrees C and gas pressure of 172.4 kPa.</p><p><b>RESULT</b>The calibration curves were linear over the investigated concentration ranges with all correlation coefficients higher than 0.998. The a intra- and inter-day RSD were less than 9.1% and the relative errors were verage extraction recoveries for all compounds were between 88.67% and 101.2%. The within the range of -11.58% to 10.89%.</p><p><b>CONCLUSION</b>The proposed method showed appropriate accuracy and selectivity and was successfully applied to the rat urine samples analysis of saponins and flavonoids after intravenous administration of Jiweiling freeze-dried powder, which may provide some references to the apprehension of the action mechanism and clinical application.</p>

Safety of metformin in the treatment of elderly type 2 diabetes mellitus / 中华内科杂志

Objective To evaluate the safety of mefformin in the treatment of elderly type 2 diabetes mellitus(T2DM). Methods Two hundred and forty-three cases of elderly T2DM hospitalized from Jan.1996 to Dec. 2006 were reviewed; the changes of fasting blood glucose(FBG), postprandial blood glucose (PBG), glycosylated hemoglobin (HbA1c), liver and renal function and blood lactic acid were evaluate before and after treatment. Results The mean time of treatment with mefformin was (6.6±3.9) years (3 months-21 years)in these 243 cases. The levels of FBG, PBG and HbAlc significantly reduced after treatment with mefformin only in 43 cases (17.7%), mefformin combined with other oral hypoglycemic drugs in 124 cases (51.0%) and mefformin combined with insulin in 76 cases (31.3%). There was only 18.1% of the cases with normal range ( > 80 ml/min) of creatinine clearance rate (Ccr), and 25.8% of the cases with Ccr≤50 ml/min. The liver and renal function as well as the blood lactic acid had no significant change after treatment no matter in total cases or in different groups separated by Ccr.Conclusions Mefformin is safety in the treatment of elderly T2DM patients. Ageing is not the contraindication of mefformin. To the patients with high risk, we should monitoring the level of blood lactic acid.

Comparative study on the determination of ankle-brachial index with Doppler ultrasound and electronic sphygmomanometer / 解放军医学杂志

Objective To evaluate the feasibility of detecting peripheral artery disease (PAD) using ankle-brachial index (ABI) determined by an electronic sphygmomanometer in patients with type 2 diabetes mellitus (DM). Method The brachial blood pressure and the ankle blood pressure were measured in each upper limbs and lower limbs by the Doppler ultrasound method and the electronic sphygmomanometer method in fifty-nine DM patients who were selected from Department of Geriatric Endocrinology of General Hospital of PLA. ABI was calculated with the formula of ABI = ankle systolic blood pressure/ brachial systolic blood pressure. The measurement data were expressed as x?s. Then the data of systolic pressure and ABI were analyzed by paired Student's t tests and correlations. The related diagnosis criteria of PAD, such as sensitivity, specificity, positive predictive value, negative predictive value, and the global accuracy were calculated. Furthermore, the correlation of brachial blood pressure as measured by the electronic sphygmomanometer and the mercury column sphygmomanometer was compared. Results There were no significant differences but good correlations between the data of systolic pressures and ABI obtained as measured by two methods. The correlation for systolic pressure was: right upper limbs 0.92, P

Clinical characteristics of hypertension in the aged patients with metabolic syndrome / 解放军医学杂志

Objective To analyze the characteristics of hypertension by cross-sectional study of the aged patients with metabolic syndrome (MS). Methods The data, collected from senile population who underwent medical examination in the General Hospital of PLA in 2005, were analyzed retrospectively in order to identify the clinical features of hypertension in aged patients with MS, and the significance of hypertension, as single or one of the components of MS, the prevalence of MS, including the prevalence of MS and its component ailments, prevalence of hypertension in MS population, the constituent ratio of MS and coronary heart disease, and cerebrovascular disease in patients with hypertension. Results The prevalence of MS was 32.19%, in which 8.16% patients were having all the four metabolic abnormalities. Hypertension was the most common metabolic abnormality with a prevalence of 61.78%, which tended to increase with increasing age. The most common combination in MS was abnormalities of blood pressure, glucose and BMI, with a prevalence of 24.67%. Among the population with hypertension, 46.67% of them could be diagnosed as MS, accounting for 89.57% of all MS patients. Patients with MS but without hypertension accounted for only 10.43%. Hypertension complicated with MS or another metabolic disorder showed a high risk of cardiovascular diseases, and the prevalence was 73.52% and 72.69%, respectively. No significant difference was found in the incidence of cerebrovascular disease. The prevalence of abnormal renal function was significantly increased in the group of MS with hypertension, by 1.69 and 1.65 folds of that in the group without MS and the group only with MS and without hypertension. Conclusions There was higher prevalence of MS in the elderly people, and in about 2/3 hypertensive patients it co-existed with one of the components of MS. Hypertension was the most common disorder in MS. Patients with MS and hypertension are having a higher risk of suffering from cardiovascular diseases and abnormal renal function.