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Developing analytical methods for the chemical components of natural medicines remains a challenge due to its diversity and complexity. Miao-Fu-Zhi-Tong (MFZT) granules, an ethnic Yi herbal prescription, comprises 10 herbs and has been clinically applied for gouty arthritis (GA) therapy. Herein, a series of chemical profiling strategies including in-house library matching, molecular networking and MS/MS fragmentation behavior validation based on ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) were developed for qualitative analysis of MFZT granules. A total of 207 compounds were identified or characterized in which several rare guanidines were discovered and profiled into alkyl substituted or cyclic subtypes. Moreover, network pharmacology analysis indicated that MFZT's anti-gout mechanism was mostly associated with the nuclear factor kappa-B (NF-κB) signaling, nucleotide oligomerization domain (NOD)-like signaling and rheumatoid arthritis pathways, along with the synergistic effect of 84 potential active compounds. In addition, a quantitative analytical method was developed to simultaneously determine the 29 potential effective components. Among them, berberine, pellodendrine, 3-feruloylquinic acid, neoastilbin, isoacteoside and chlorogenic acid derivatives at higher concentrations were considered as the chemical markers for quality control. These findings provide a holistic chemical basis for MFZT granules and will support the development of effective analytical methods for the herbal formulas of natural medicines.
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Humanos , Cromatografia Líquida de Alta Pressão/métodos , Espectrometria de Massas em Tandem/métodos , Medicamentos de Ervas Chinesas/química , Controle de Qualidade , Artrite GotosaRESUMO
Objective To evaluate and compare the consistency and repeatability of three-dimensional ultrasound (3D-US) virtual organ computer-aided analysis (VOCAL) technique and two-dimensional ultrasound (2D-US) in the measurement of thyroid volume.Methods The thyroid volume of 50 healthy female adults aged 18 to 68 years were measured by 2D-US and 3D-US.The 2D-US was used to measure the three diameter lines (L,H,W) of the largest thyroid section,and the thyroid volume was calculated by the classical ellipsoid formula V=0.523×L×H×W.The 3D-US VOCAL technique was used to acquire the thyroid three-dimensional data,and VOCAL software was used to measure the thyroid volume.The two methods of measurement were also compared and analyzed.Results The coefficient of variation in the intra-assay was 0.738％ and 1.59％ respectively for the 3D-US VOCAL technology and traditional 2D-US measurement of thyroid volume,and the 95％ limit of agreement in the intra-assay was (-0.26 cm3,0.22 cm3) and (-0.32 cm3,0.46 cm3).In addition,the correlation coefficient in the inter-assay were 0.970xx and 0.942xx,and the 95％ limit of agreement were (-0.36 cm3,0.37 cm3) and (-0.75 cm3,0.64 cm3).To compare the two methods of measuring thyroid volume,the 3D-US VOCAL had a lower variation coefficient in the intra-assay,a higher correlation coefficient in the inter-assay and a narrower 95％ limit of agreement,which showed that the repeatability of the 3D-US VOCAL technique measuring was better than the traditional 2D-US in measuring thyroid volume.Conclusions The 3D-US VOCAL technique shows a higher repeatability in measuring thyroid than traditional 2D-US.As a safe,simple and feasible precise measurement method,it provides a reliable and effective new method for clinical measurement of irregular organ volume.
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Objective To investigate the reason for misdiagnosis of real-time contrast-enhanced ultrasound (CEUS) in identifying benign and malignant thyroid nodules and the impact of nodule size and calcification on CEUS result.Methods Retrospective analysis were carried out in 331 cases of thyroid disease patients with 421 nodules.All the nodules were performed CEUS and confirmed by pathology.Results In the total of 421 nodules,33 nodular goiters were misdiagnosed as thyroid carcinoma.8 nodular goiters were misdiagnosed as thyroid adenoma.8 thyroid carcinomas were misdiagnosed as nodular goiter,2 thyroid carcinomas were misdiagnosed as thyroid adenoma.The accuracy of diagnosis for thyroid benign and malignant lesions by CEUS was 87.89％,and the misdiagnosis rate was 12.11％.The size of the thyroid nodule and the form of calcification had influence on diagnosis.In the group with diameter of the nodule less than 10 mm,the misdiagnosis rate was higher compared with the other two groups,and the difference was statistically significant (P＜0.05).In addition,the misdiagnosis rate in the group with bulky calcification was higher than microcalcifications group,and the difference was statistically significant (P＜0.05).Conclusion The size of the thyroid nodule and the form of calcification have some impact on diagnosis of CEUS.To make clear the reason for misdiagnosis is beneficial to improve the diagnostic level of thyroid diseases.
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Objective To analyze the misdiagnosed cases of the nodular goiter (NG)in real-time contrast-enhanced ultrasound(CEUS),in order to improve the diagnostic accuracy of NG.Methods Two-hundred and sixty-five cases of NG CEUS images,especially the 48 nodules in 44 misdiagnosis cases,were retrospectively analyzed to find out the main reasons of the misdiagnosis.In addition,the factors which effected the results of CEUS such as size,number and calcification of NG nodules were summarized.Results There were 42 nodules misdiagnosed as thyroid cancer,5 nodules misdiagnosed as thyroid adenoma and 1 nodular goiter misdiagnosed as subacute thyroiditis in 874 nodular goiter cases.The misdiagnosis rate of nodular goiter was 5.49% (48/874)by the diagnostic criterion of homogeneous enhancement in CEUS.The differences size and calcification of nodules had a significant impact on CEUS.The misdiagnosis rate of the NG nodules with major diameter less than 10 mm was much higher than that of more than 10 mm,the misdiagnosis rate of NG nodules with coarse calcification was much higher than the situation of microcalcification(P <0.05).Conclusions Major diameter less than 10mm and coarse calcifications of NG nodular are the main factors which influence the results of CEUS.
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Objective To explore the sensitivity of contrast-enhanced ultrasound (CEUS) and ultrasonic elastography(UE) in detecting different sizes of thyroid papillary carcinoma.Methods 64 cases of thyroid papillary carcinoma were divided into two groups according to the diameter size(group 1,≤1 cm;group 2,＞ 1 cm) and examined by the contrast-enhanced ultrasound and elastography,then the features were analyzed and the sensitivity for detecting of the two methods in different groups were compared.Results The sensitivity for detecting in CEUS was higher than in UE,which had significant difference between two methods.CEUS and UE were valuable for detecting and they had no difference in sensitivity for detecting in group 1.There was a significant difference in sensitivity for detecting between two methods in group 2.Conclusions Both CEUS and UE were valuable in diagnosis of thyroid papillary carcinoma and the sensitivity for detecting in CEUS is higher than in UE in group 2.
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Objective To evaluate the diagnostic value of conventional ultrasound and contrastenhanced ultrasound(CEUS) in calcified thyroid nodules.Methods 122 cases of calcified thyroid nodules confirmed by pathology were underwent conventional ultrasound and CEUS.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound and CEUS were evaluated.Receiver operating characteristic (ROC) curve was constructed to assess the differential diagnosis value of conventional ultrasound and CEUS in calcified thyroid nodules.Results There were 73 benign and 49 malignant nodules among 122 calcified thyroid nodules.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound were 49.98％,76.71％,58.54％,69.14％ and 65.57％,while for CEUS were 89.80％,91.78％,88.00％,93.06％ and 90.98％,respectively.There was statistical difference for each index between the two methods (all P ＜0.05).The area under ROC curve of CEUS was 0.908,which was bigger than conventional ultrasound.Conclusions Compared with conventional ultrasound,CEUS has higher value in differential diagnosis of benign and malignant calcified thyroid nodules.
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Objective To evaluate the value of the differential diagnosis of benign and malignant thyroid nodules under the background of Hashimoto' s thyroiditis (HT) using contrast-enhanced ultrasonography (CEUS).Methods Ninety-three single thyroid nodules with HT confirmed by operations and pathology were given CEUS examination,and time-intensity curves were drawn by using TomTec analyzing software.The parameters as follows:rise time (RT),time to peak (TTP),mean transit time (mTT) and maximum intensity(IMAX) were compared by independent-samples t test,and the diagnostic value of parameters were analyzed by receiver operating characteristic (ROC) curve.Results In 93nodules,there were 56 benign thyroid nodules,and 37 malignant thyroid nodules.(1) After injection of contrast media,the enhancement and wash-out in benign nodules were mostly the same with peripheral gland,as well as the enhance intensity.Malignant nodules presented lower enhancement,with later rise time and earlier wash-out compared to peripheral gland.(2) mTT was longer,while IMAX was higher in benign nodules than those in malignant nodules (P ＜0.05).But there were no significant differences in RT or TTP between the two groups.(3) The cut-off value in diagnosis of benign and malignant thyroid nodules with HT assessed by ROC curve were mTT 21.70 s,IMAX 86.41％.When mTT,IMAX,and combination of the two parameters were used for the diagnosis of malignant thyroid nodules with HT,the sensitivity were 86.5 ％,83.8 ％,97.3 ％ and the specificity were 69.6 ％,75.0 ％,48.2 ％,respectively.Conclusions CEUS is helpful to identify the benign and malignant thyroid nodules under the background of HT.
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Objective To evaluate the diagnostic value of thyroid microcarcinoma using contrastenhanced ultrasound(CEUS).Methods The CEUS characteristics of 31 lesions in patients with thyroid microcarcinoma which were confirmed by surgery and pathology were retrospectively analyzed.[Results]The enhancement features of 31 lesions were hypoenhancement,morphological irregularity,and lack of a complete envelope.The time intensity curve showed late washed in and late washed out.The start-time of the lesions was later than that of normal thyroid tissue.The enhancement intensities of the lesions were lower than that of normal thyroid tissue.Conclusions The contrast enhancement patternshypoenhancement,suggested that the CEUS might provide a useful,quantitative analysis method for the diagnosis of thyroid microcarcinoma,which can improve diagnostic confidence in thyroid microcarcinoma.
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Objective To investigate the different roles of two-dimensional,color Doppler ultrasound and real-time ultrasound elastography in the diagnosis of Hashimoto's thyroiditis(HT).Methods One hundred and forty-one patients clinically diagnosed as HT underwent traditional ultrasound and elastography.The patients were classified into three groups,the hyperthyroidism group,the hypothyroidism group and the euthyroidism group.One hundred and eight volunteers with normal thyroid functions were enrolled as control group.Ultrasonic characteristics (size,echo,accompanied nodules,blood flow distribution of thyroid) and thyroid elastic parameters were recorded and analyzed.Results ①Focal hypoechoic pattern was mainly seen in the group of HT hyperthyroidim,diffuse hypoechoic pattern was mainly seen in the groups of HT euthyroidism,diffuse hypoechoic pattern with heterogeneous linear hyperechoic and nodular changes were mainly seen in the HT hypothyroidism group.②Blood flow reduced according to the order by the hyperthyroidim group,euthyroidism group and hypothyroidism group.③Patients with HT hyperthyroidism had elastic image pattern Ⅰ.Patients with HT euthyroidism had pattern Ⅰ and pattern Ⅱ.Patients with HT hypothyroidism had pattern Ⅱ and pattern Ⅲ.④There were significant differences (P＜0.05) between the mean elastic strain and the ratio of the blue area in each group.Conclusions Real-time ultrasound elastography is helpful for the diagnosis of HT.
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Objective To study the clinic imaging features and the clinic applications of the contrastenhanced ultrasound(CEUS) in the diagnosis of gallbladder carcinoma.Methods The characteristics of CEUS were reviewed in 24 patients with gallbladder carcinoma proven pathologically. Results After injection of SonoVue, all gallbladder carcinoma of 24 cases showed enhancement and these lesions looked clearer than those in conventional ultrasound.The analysis of time-intensity curve indicated the upslope of curve was steep in the lesions,which was flat in normal liver parenchyma around.In 10 cases of thick wall of gallbladder carcinoma, quick and obvious enhancement was seen in 9 cases, 1 case showed poor enhancement during scanning,but thick and tortile blood vessels could be seen in the thickening wall.Quick and uneven enhancement was been seen in both 8 cases of soft-tissue mass and 6 cases of nodules within gallbladder.Five cases of gallbladder carcinoma with liver metastasis revealed more liver metastasis depend on CEUS.Conclusions CEUS plays an important role in diagnosis and improving the diagnostic accuracy for gallbladder carcinoma.
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Objective To provide the normal hemodynamic parameters of uterine several arteries in reproductive women.Methods The hemodynamic parameters including peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI),pulsatility index(PI)and systolic/diastolic velocity ratio(S/D) of uterine artery(UTA),arcuate artery(AA),radial artery(RA)and spiral artery (SA) in 66 reproductive women were studied by transvaginal color Doppler(TVCD).The results were analyzed with T test.Results The flow of uterine several arteries in normal reproductive women was all detected well.From UTA to SA,parameters gradually decreased.In the secretory phase of menstrual cycle,the change of SA which EDV value was higher and RI value was lower was the most obviously.Conclusion The uterine hemodynamics in productive period is in close relalionship with menstrual cycle.We can predict the time of menstrual cycle according RI value of SA.