The diagnostic value of high-resolution ultrasonography for the detection of anterior disc displacement of the temporomandibular joint: a meta-analysis employing the HSROC statistical model.

The study aimed to assess the diagnostic value of high-resolution ultrasonography (HR-US) in the detection of anterior disc displacement (ADD) of the temporomandibular joint. Relevant trials reported in MEDLINE, the Chinese National Knowledge Infrastructure Database, the Chinese Biomedical Literature Database, and Embase were identified. A manual search was also performed. The quality of retrieved data was evaluated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria. Data were extracted and cross-checked, and a statistically rigorous meta-analysis was performed using a hierarchical summary receiver operating characteristic model (HSROC). The clinical utility of results was assessed using Fagan nomograms (Bayes theory). All data were evaluated using Stata software. A total 11 studies including 1096 subjects were included in the analysis; all reported the utility of HR-US for the diagnosis of ADD with reduction (ADDWR) and without reduction (ADDWoR). For ADDWR, the weighted sensitivity and specificity were 0.83 (95% confidence interval (CI) 0.78-0.88) and 0.85 (95% CI 0.76-0.92) respectively. The lambda value was 3.41 (95% CI 2.37-4.46) and the Fagan nomogram pre-test probability 58%, with a positive likelihood ratio (LR) of 6.01. The positive post-test probability was 89%, with a negative LR of 0.20. The negative post-test probability was 21%. The positive increase in diagnostic utility was 31% and the negative decrement in that value 37%. For ADDWoR, the weighted sensitivity and specificity values were 0.72 (95% CI 0.59-0.81) and 0.90 (95% CI 0.86-0.93), respectively. The lambda value was 3.69 (95% CI 2.39-4.99) and the Fagan nomogram pre-test probability 38%, with a positive LR of 7.00. The positive post-test probability was 82%, with a negative LR of 0.32. The negative post-test probability was 16%. The increase in diagnostic utility was 44% and the negative decrement in that value 22%. HR-US delivers acceptable performance when used to diagnose ADD, being superior for the detection of ADDWoR than ADDWR, and exhibiting a lower negative diagnostic value in the detection of ADDWoR than ADDWR. HR-US may serve as a new method for the rapid diagnosis of ADD. The method has the advantages of simplicity and low cost. Given the uncertainty in some of the estimated values, more high-quality studies are needed to assess that diagnostic efficacy.

Studies on standardization of folium strobilanthis, radix strobilanthis and their preparations.

Determination of 4(3H)-quinazolinone, a newly found antiviral and immunopatentiating constituent was proposed as a method of evaluating the quality of two antiviral Chinese herbal drugs Daqingye (Folium Strobilanthis) and Banlangen(Radix Strobilanthis) and their preparations ('Antipyretic and common cold granules', 'Banlangen granules'). An HPLC method for determining the content of 4(3H)-quinazolinone was established with satisfactory results. The method showed good linearity (r = 0.9998, n = 5) in the range of 0.25-50 micrograms/mL of 4(3H)-quinazolinone, the average recovery was above 99% with RSD < 0.78% (n = 3).

[Study of quality control on herbal drugs and preparations of daqingye and banlangen].

This paper first suggests that 2,4 (1H,3H) quinazolinedione (QZL) may be used as a quality control standard for the Chinese herbal drugs Daqingye (Folium Strobilanthis et Polygoni) and Banlangen (Radix Strobilanthis) as well as its preparations. QZL was found for the first time from the above mentioned two Chinese herbal drugs which has a representative property. Its content is stable. This made it possible to solve the difficulty of quality control for the preparations "antipyretic and common cold granules" and "Banlangan granules" and provide a reliable assay method to evaluate the quality of the herbal preparations. By changing the wavelength and using gradient elution in HPLC, 3 constituents can be determined through one injection by the present method, thus the time of determination may be shortened and the efficiency of assay increased. The method showed good linearity (r = 0.99998, n = 4) in the range of 0.2-3.2 micrograms/ml of QZL, the average recovery was above 95% with RSD < 1.5% (n = 3). HPLC condition: Column: LiChrosorb RP 18; elution gradient: methanol from 35% to 90% in water solution; determination wavelength: 226 nm and 288 nm.

[Chemical studies of Strobilanthes cusia].

Seven compounds have been isolated from the whole plant of Strobilanthes cusia (Nees) O. Ktze. Three of them are triterpenes (I-III), two are indole alkaloids (IV, V), two are quinazolinone alkaloids (VI, VII). On the basis of spectral analysis and physicochemical properties, their structures were established as lupeol (I), betulin (II), lupenone (III), indigo (IV), indirubin (V), 4(3H)-quinazolinone (VI), 2,4(1H,3H)-quinazolinedione (VII). VI and VII were found from natural plant for the first time. The results of the pharmacological tests demonstrate that compound V has anticancer activity and compound VI has hypotensive action. Compound VII can be quantitatively determined by HPLC, which may serve as a quality control standard for materia medica and its preparations. Compounds VI and VII have been confirmed by means of synthesis.