We report on 3 patients who presented with symptoms of Ki obstruction, Ki deficiency, and disorder of the body's fluid metabolism, successfully treated with bukuryoingohangekobokuto. In our experience, bukuryoingohangekobokuto has been effective in 25 of the 30 patients (6 men and 24 women) to whom is has been administered, who also presented with Ki obstructions, Ki deficiencies and disorders of the body's fluid metabolism as mentioned above. The most common subjective symptom in all these effectively-treated patients was hot flashes. Other signs were epigastric pain or discomfort accompanied by chest signs and symptoms, such as palpitations, heartburn, chest oppression or dyspnea. The most common objective findings in these effectively-treated patients were pulsation at the pit of the stomach and navel, and a fluid sound in the stomach upon palpation. Based on our experiences, we believe that prescription of bukuryoingohangekobokuto is best indicated when the presence of the above-mentioned symptoms and findings has been confirmed.
symptoms <1> ; Liquid substance ; Cases ; seconds ; findings

Filariasis, a parasitic infection endemic in parts of India, Myanmar, islands of the South Pacific, West and East Africa and Saudi Arabia can be diagnosed from various types of cytopathological specimens. This case documents the detection of filarial infection from hydrocele fluid cytology in a 30-year-old Myanmar migrant worker in Malaysia.
Liquid substance ; Cellular aspects of ; Infection as complication of medical care ; Microfilaria ; Myanmar

Prostatic Acid Phosphatase (PAP) is mostly found in the epithelial cells and secretions of the prostate gland. It has also been found to be present in several tissues and biological fluid. Gross cystic breast disease is the commonest benign breast condition and several studies have shown that women with palpable breast cysts may have a higher risk of developing breast cancer. There are two types of breast cyst and women with apocrine breast cyst may have a higher risk of developing breast cancer than women with breast cysts lined by flattened epithelium. The growth inhibitory effect of transforming growth factor beta (TGF-beta) on epithelial cells suggests a potential protective role in breast cancer. TGF-beta is secreted as a high molecular weight complex in a biologically inactive or latent form and activation of TGF-beta is necessary for the exertion of its effects on target cells. Prostate specific antigen (PSA) has been found in breast cyst fluid (BCF) and it may have a protective effect on the development of several carcinomas by activating TGF-beta. As a similar molecule to PSA, PAP may also involve in this mechanism. We investigated the presence of PAP in two groups of BCF using an ELISA kit. PAP was found to be present in BCF but there was not a statistically significant difference between the two cyst groups. The presence of PAP in BCF may suggest its possible role in the development of breast cancer from cystic breast diseases. A possible role of PAP on TGF-beta activation needs further investigation.
Breast ; Pulmonary artery pressure ; Cysts ; Transforming Growth Factor beta ; Liquid substance

Objective To establish accurate and rapid methods to identify four new synthetic cannabinoids （JWH-203, JWH-122, 5F-APINACA and AB-CHMINACA） in blood samples. Methods The whole blood samples were extracted by acetonitrile and methanol, screened by gas chromatography-mass spectrometry （GC-MS） then confirmed by liquid chromatography-tandem mass spectrometry （LC-MS/MS） method, and multiple reaction monitoring （MRM） mode was used for quantitative analysis. Results The GC-MS method needed 21 min to complete the analysis, while the LC-MS/MS method needed 5 min. The AB-CHMINACA, JWH-203, 5F-APINACA and JWH-122 all used quasi molecular ion peak as a parent ion. The precursor-product ion combinations were m/z 357.4→312.2, m/z 340.2→125.0, m/z 384.1→135.1 and m/z 356.4→169.2. The four synthetic cannabinoids in blood samples had good linearity in the 1-250 ng/mL mass concentration range （r>0.99）. The limits of detection （LODs） were in the range of 0.1-0.5 ng/mL, the recovery rate was 85.4%-95.2%, the RSD less than 10.0%, and the matrix effect was 80.3%-92.8%. Conclusion The GC-MS and LC-MS/MS chromatographic behaviors and mass spectrometry analysis information of four synthetic cannabinoids were obtained in this study, and the possible causes of differences in chromatographic behaviors were discussed preliminarily. Therefore this study has a suggestive effect on judging the development trend of synthetic cannabinoids. This method can be used for rapid identification of four synthetic cannabinoids in blood, which can provide reference for identification of new synthetic cannabinoids when they are proliferating at present.
Blood Chemical Analysis/methods* ; Cannabinoids/blood* ; Chromatography, Liquid ; Humans ; Limit of Detection ; Substance Abuse Detection/methods* ; Tandem Mass Spectrometry

OBJECTIVE: To propose a method for simultaneous determination of codeine(COD), 6-monoacetyl-morphine (6-MAM), morphine (MOR), morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) in human urine by ultra performance liquid chromatography with tandem mass spectrometry (UPLC-MS/MS). METHODS: After precipitation of protein by acetonitrile, the urine samples, with added the morphine-d3 (MOR-d3) and morphine-3-Glucuronide-d3 (M3G-d3) as internal standards, were pre-treated by Sirocco protein precipitation plate, and then analyzed by UPLC-MS/MS. RESULTS: The limit of detection was 0.2 ng/mL for both COD and MAM, the limit of quantitation was 0.5 ng/mL for both COD and MAM. The limit of detection was 0.5 ng/mL for MOR, M3G and M6G, the limit of quantitation was 1 ng/mL for them. The linear correlation coefficients were not less than 0.9997, both the inter-day and intra-day precisions were less than 10%, the recoveries were in the range of 70.0% to 98.3%, the matrix effects were about 50.5% to 99.0%. CONCLUSION This proposed method is simple, rapid and accurate, it could be applied in forensic toxicological analysis.
Chromatography, Liquid/methods* ; Codeine/urine* ; Humans ; Limit of Detection ; Morphine/urine* ; Morphine Derivatives/urine* ; Reproducibility of Results ; Sensitivity and Specificity ; Substance Abuse Detection/methods* ; Tandem Mass Spectrometry/methods*

OBJECTIVE: To develop a method for determining ethyl glucuronide (EtG) in blood and urine by liquid chromatograph coupled with tandem mass spectrometer (LC-MS/MS). METHODS: After blood and urine de-proteined by acetonitrile, the supernate obtained from a centrifuge was analyzed by LC-MS/MS. RESULTS: Determination limit of EtG in both blood and urine was 0.05 pg/mL, with a linear range of 0.10-5.00 microg/mL (r > 0.999). Accuracy in both matrixes was 95%-109%. Inter- and intra-day RSD were less than 12%. The method showed an excellent performance when it was used to analyze authentic blood and urine samples for EtG. CONCLUSION The method is capable for blood and urine EtG analysis.
Alcoholism/urine* ; Biomarkers/urine* ; Chromatography, Liquid/methods* ; Ethanol/metabolism* ; Forensic Toxicology/methods* ; Glucuronates/urine* ; Humans ; Reproducibility of Results ; Sensitivity and Specificity ; Substance Abuse Detection/methods* ; Tandem Mass Spectrometry/methods*

OBJECTIVE: To establish a screening and confirmation method for psychotropic drugs and their metabolites in human blood and urine by HPLC-LTQ Orbitrap MS. METHODS: The samples were pretreated with Sirocco protein precipitation plate, and then analyzed by HPLC-LTQ Orbitrap MS. The method was validated in terms of the limit of detection (LOD). An accurate mass database was created for psychotropic drugs screening. RESULTS: The LOD for most of 56 determined compounds was < or = 0.1 ng/mL. The accurate mass database included the accurate mass information of 61 psychotropic drugs. CONCLUSION The method is accurate, rapid, sensitive and the database is suitable for psychotropic drugs screening and confirmation.
Chromatography, High Pressure Liquid/methods* ; Forensic Toxicology ; Humans ; Mass Spectrometry/methods* ; Molecular Structure ; Molecular Weight ; Psychotropic Drugs/urine* ; Reproducibility of Results ; Sensitivity and Specificity ; Substance Abuse Detection/methods*

OBJECTIVE: To compare morphine and codeine concentration in urines of heroin abusers and codeine users and to discuss the judgment index to distinguish between heroin abuser and codeine user. METHODS: The urines of heroin abusers and codeine users were collected at different time periods. After protein precipitation, the urine samples were conducted for the qualitative and quantitative analysis of morphine and codeine by UPLC-MS/MS. And the results were all statistically analyzed. RESULTS: Statistical analysis showed that morphine and codeine concentration in urines of heroin abusers and codeine users were both abnormal distributions. The probability of the heroin abuser would be more than 95% and less than 5% for the codeine user when the concentration of morphine in urine sample was more than 67 ng/mL. The probability of the codeine user would be more than 95% and less than 5% for the heroin abuser when the concentration of morphine in urine sample was less than 67 ng/mL. CONCLUSION The morphine concentration in urine could be used as a criterion to distinguish the heroin abuser from the codeine user, while the codeine concentration could not.
Administration, Oral ; Chromatography, High Pressure Liquid ; Codeine/urine* ; Forensic Toxicology/methods* ; Heroin Dependence/urine* ; Humans ; Morphine/urine* ; Solutions ; Substance Abuse Detection/methods* ; Tandem Mass Spectrometry/methods*

OBJECTIVES: To infer the frequency of dosage and medication history investigate of the victims in drug facilitated cases by the segmental analysis of clonazepam in hair. METHODS: Freezing milling under liquid nitrogen environment combined with ultrasonic bath was used as sample pretreatment in this study, and liquid chromatography-tandem mass spectrometry was used for the segmental analysis of the hair samples collected from 6 victims in different cases. The concentrations of clonazepam and 7-aminoclonazepam were detected in each hair section. RESULTS: Clonazepam and its metabolite 7-aminoclonazepam were detected in parts of hair sections from the 6 victims. The occurrence time of drug peak concentration was consistent with the intake timing provided by victims. CONCLUSIONS Segmental analysis of hair can provide the information of frequency of dosage and intake timing, which shows an unique evidential value in drug facilitated crimes.
Adult ; Chromatography, Liquid ; Clonazepam/analysis* ; Crime ; Forensic Medicine/methods* ; Forensic Toxicology ; Hair/chemistry* ; Humans ; Mass Spectrometry ; Spectrometry, Mass, Electrospray Ionization ; Substance Abuse Detection/methods* ; Ultrasonics

OBJECTIVES: To identify the new designer drugs which are totally unknown and not in the routine testing list by the technologies such as high-resolution mass spectrometry in drug facilitated sexual assault, in order to solve the problem in actual cases. METHODS: The milky fluid from an actual case was extracted and analyzed using LC-QE, ¹H-NMR and GC-MS, respectively. The accurate masses and cluster ions isotope patterns of unknown compound were obtained by LC-QE. The molecular formula was confirmed as C₁₆H₁₂C₂N₂O based on the protons number of ¹H-NMR. The isomers diclazepam and 4-chlorodiazepam were separated and detected with GC-MS. RESULTS: The new designer benzodiazepine as diclazepam in the milky fluid was identified. The results provided direct evidence for the investigation and qualitative analysis of such cases. CONCLUSIONS The combined application of various methods, including LC-QE, ¹H-NMR and GC-MS, can be used to detect unknown new psychoactive substances.
Benzodiazepines/chemistry* ; Benzodiazepinones ; Chromatography, Liquid/methods* ; Designer Drugs/chemistry* ; Female ; Gas Chromatography-Mass Spectrometry/methods* ; Humans ; Male ; Mass Spectrometry/methods* ; Sex Offenses ; Substance Abuse Detection/methods* ; Toxicology/methods*