Objective To develop and validate a simple and reliable HPLC method for the analysis of flee and total carnitine in human serum and to investigate its clinical significance. Methods After proteins in serum were precipitated with a precipitating reagent, carnitine in serum was derivatized to form its ester. HPLC separation of the sample solution was performed on a Lichrospher SiO2 column and detected by ultraviolet absorbance at 260 nm. A mobile phase composed of acetonitrile-citric acid-triethanolamine was found to be the most suitable for this separation at a flow rate of 1.2 ml/min and enabled the baseline separation of the carnitine from interferences with isocratic elution. The free and total carnitine levels in serum were studied in 347 subjects. Results Under the chromatographic conditions described, the carnitine derivative had a retention time of approximately 10 min. Good separation and detectability of carnitine in human serum sample were obtained. The method proved to be linear in the range of carnitine from 0 μmol/L to 400 μmol/L The relative standard deviations of within-assay ( n = 5 ) for free and total carnitine analysis were 3.36% and 1.97% , respectively, and between-assay (n =7) for free and total carnitine analysis were 3.04% and 1.77%, respectively. The average recovery was 98. 2% for free camitine and 96.3% for total carnitine, respectively. The average L-carnitine concentrations in the 347 subjects were as follows: total carnitine (52. 2 ± 8. 6 ) μmol/L, free carnitine ( 42. 3 ± 8. 3 ) μmol/L and acylcarnitine ( 9. 9 ± 2. 9 )μmol/L in the male group ( n = 182), and total carnitine (48.2 ± 9. 9 ) μmol/L, free camitine ( 37.9 ±8. 7) μmol/L and acylcarnitine ( 10. 3 ± 3.5 ) μmol/L in the female group ( n = 165 ). Statistical analysis showed that total and free carnitine levels of male were higher than that of female ( P <0. 01 ) while there was not statistical difference of acylcarnitine levels between two groups ( P > 0. 05). Conclusion The method has been successfully applied to the simultaneous determination of free and total carnitine in serum with good sensitivity, specificity and repeatability, and this is a useful guidance for the clinic therapy and the mechanism study on the diseases associated with carnitine.

Objective: Carnitine,the only carrier for the fatty acid crossing into mitochondria for oxidization,has a significant effect on the metabolism serum lipids.The purpose of this study is to investigate the effects of different doses of carnitine supplement on serum lipids in hyperlipemia rabbits. Methods: Twenty-eight rabbits were equally randomized into a control and three experimental groups,the former fed on high-fat diet,and the latter on carnitine at the dose of 100,200 and 400 mg/kg respectively every day in addition to high-fat diet.Blood samples were collected from the central artery of the rabbits for the measurement of the total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein B(ApoB) and free carnitine in the serum,their body weight obtained at 0,1,2,3,4 and 5 weeks,and the effects of different doses of carnitine supplement were observed on serum lipids.Results: All the 28 rabbits were included in the result analysis.The hyperlipemia model was successfully established after 4 weeks of high-fat diet.Compared with the control group,the experimental groups showed a remarkable decrease in the levels of TC,TG,LDL-C and AapoB and an increase in that of HDL-C in the serum,positively correlated with the dose and time of carnitine supplement.With the lengthening of time,the effects of different doses of carnitine supplement on the serum lipids was gradually decreased.Conclusion: Carnitine supplement can inhibit the increase of the levels of TC,TG,LDL-C and AapoB in the serum of the rabbits with hyperlipemia induced by high-fat diet and the effect is positively correlated with the dose and time of carnitine supplement.

Objective:To systematically evaluate the clinical efficacy of Yiqi Yangyin Huoxue method for the treatment of diabetic retinopathy (DR).Methods:Clinical research literature about Yiqi Yangyin Huoxue method for the treatment of DR was retrieved from China Biomedical Literature Database (CBM), VIP information Chinese Periodical Service Platform (VIP), China National Knowledge Infrastructure (CNKI), Wanfang data, Cochrane Library and PubMed database from the establishment of the databases to December 31, 2021. RevMan5.3 software was used for meta-analysis.Results:A total of 18 articles were included, with a total of 1 487 patients. The results of meta-analysis showed that Yiqi Yangyin Huoxue method for the treatment of DR had curative effect advantages in improving the total clinical effective rate [ RR=1.31, 95% CI (1.21,1.41), P<0.001], the vision [ MD=0.12, 95% CI (0.07, 0.17), P<0.001], the level of whole blood reduced viscosity low shear [ MD=-2.80, 95% CI (-3.76, -1.84), P<0.001], the level of whole blood reduced viscosity high shear [ MD=-0.69, 95% CI (-1.15, -0.24), P=0.003], and plasma viscosity [ MD=-0.31, 95% CI (-0.51, -0.12), P=0.002], decreasing serum vascular endothelial growth factor [ SMD=-1.04, 95% CI (-1.26, -0.81), P<0.001], increasing TCM symptom score [ MD=-3.79, 95% CI (-6.16,-1.42), P=0.002], reducing the level of tumor necrosis factor-α [ SMD=-2.53, 95% CI (-3.55, -1.50), P<0.001] which were better than that of pure Western medicine ( P<0.05). Conclusion:The application of Yiqi Yangyin Huoxue method for the treatment of DR can improve vision, hemorheology and TCM symptoms, improve the total clinical response rate, and reduce the levels of VEGF and TNF-α, with high clinical safety.

Objective:To explore the mechanism of Coptidis Rhizoma- Puerariae Lobamle Radix on the treatment of diabetic retinopathy (DR) and diabetic nephropathy (DN) by means of network pharmacology. Methods:The TCMSP and UniProt databases were used to retrieve the active components and targets of Coptidis Rhizoma and Puerariae Lobamle Radix. GeneCards and OMIM databases were used to search for DR and DN genes, and the online tool Venny was used to obtain intersection targets. Cytoscape 3.8.2 software was used to construct a network diagram of "components-targets", and the STRING platform was used to construct a protein interaction (PPI) network. GO function and KEGG pathway enrichment analysis were carried out through the DAVID annotation database. Molecular docking verification was performed. Results:A total of 18 active components and 74 disease-drug intersection targets were screened out from Coptidis Rhizoma- Puerariae Lobamle Radix. GO functional enrichment analysis showed that intersection targets were mainly concentrated in biological processes such as inflammation and apoptosis, involving cellular components such as extracellular space, plasma membrane, and cytoplasm, and was related to molecular functions such as protein binding, ATP binding, and enzyme binding. Enrichment analysis of KEGG revealed that the intersection target may be related to TNF signaling pathway, Toll-like receptor signaling pathway, PI3K-Akt signaling pathway, etc. The results of molecular docking showed that the core component had a good binding energy with the core targets. Conclusion:Coptidis Rhizoma-Puerariae Lobamle Radix may regulate TNF signal pathway, Toll-like receptor signal pathway and PI3K/Akt signal pathway through TNF, IL6, TP53 and other targets, and play a role in inhibiting cell apoptosis, oxidative stress and reducing inflammation.

【Objective】 To investigate the profiles of RhC, c, E, and e antigens and phenotypes in 4 704 inpatients from multiple regions, i. e. Nanning, Guangzhou and Shenzhen, and provide data information for compatibility blood transfusion of Rh blood group. 【Methods】 The Rh blood group antigens were detected by microcolumn gel cards from three manufactures. If the test and the control results are inconsistent, a third-party reagent would be used, and traditional tube method for confirmation if needed. The Chi-square test and Fisher's exact test were used to analyze antigen frequency and Rh phenotypes in each region. 【Results】 Among the 4 704 inpatients, the frequency of C, c, E, and e antigen was e(91.77%)>C(85.64%)>c(49.62%)>E(41.60%), and Rh phenotypes distribution was CCee(49.40%)>CcEe(27.53%)>Ccee(8.16%)>ccEE(7.74%)>ccEe(4.89%)>CCEe(0.96%)>ccee(0.83%)>CcEE(0.47%)>CCEE(0.02%). There were significant differences in Rh blood type distribution among Nanning, Guangzhou and Shenzhen(P<0.05). Differences in Rh phenotype distribution between male and female were noticed in Shenzhen(P< 0.05), but not in Nanning or Guangzhou. 【Conclusion】 The distribution of Rh blood group in Shenzhen, Nanning and Guangzhou were significantly different from each other, therefore regional characteristics should be considered when carrying out Rh-compatible blood transfusion, so as to guarantee the security of transfusion and reduce the incidence of unexpected antibodies.

【Objective】 To strengthen the management of transfusion adverse events, so as to reduce the occurrence of medical damage and accidents, and guarantee the safety of blood transfusion. 【Methods】 The adverse events of blood transfusion reported in our hospital from July 2016 to December 2022 were collected, the reasons were tracked, and continuous improvements were made. 【Results】 From 2016 to 2022, a total of 315 transfusion adverse events were reported, including 233(73.97%, 233/315) cases of transfusion reactions and 82(26.03%, 82/315) transfusion adverse events. There were 271 328 transfusion cases in the same period, and the incidence of transfusion reactions was 0.858 7‰(233/271 328). The number of transfusion application was 129 887, and the incidence of transfusion adverse event is 0.631 3‰(82/129 887). Sixty-eigtht(82.93%, 68/82) cases of transfusion adverse events were caused by human factors, while the other 14(17.07%, 14/82) cases were non-human factors. According to the linear regression analysis, we have concluded that the year is a significant indicator for transfusion reaction rates (P<0.05), but not for transfusion adverse event rates (P>0.05). 【Conclusion】 Strengthening the management of reporting adverse events in clinical blood transfusion, monitoring the incidence, analyzing and improving different types of adverse events by management tools can reduce the medical risks of blood transfusion and help to guarantee the safety of clinical blood transfusion.

【Objective】 To investigate the factors influencing the length of hospital stays of the acute fatty liver of pregnancy (AFLP) patients, so as to establish the prediction model. 【Methods】 A total of 49 patients diagnosed as AFLP)in ShenZhen People’s Hospital between January 2008 and January 2023 were retrospectively analyzed. According to the median length of hospital stays, the patients were divided into two groups: Group A(n=21)and Group B(n=28). Preoperative general laboratory data, clinical features and postpartum adverse outcomes in both groups were analyzed. Multivariate binary logistic regression was used to analyze the independent factors affecting the length of hospital stays for AFLP, and a prediction model for hospitalization time was established. 【Results】 Comparison between Group B and Group A were as follows: hospital stays(d)(15.5 vs 8), preoperative icterus(%)[16(57.1%)vs 3(14.3%)], thrombin time(TT)(s)(24.2 vs 21.3), prothrombin time(PT)(s)(16.8 vs 15.3), activated partial thromboplastin time(APTT)(s)(52.3 vs 40.7), total bilirubin(TBIL)(μmol/L)(77.2 vs 45.2), indirect bilirubin(IBIL)(μmol/L)(21.2 vs 10), creatinine(Cre)(μmol/L)[(171.97±53.34) vs (131.81±45.06]), TT extension(%)[24(85.7%)vs 11(52.4%)], APTT extension(%)[27(96.4%)vs 7(33.3%)], IBIL elevation(%)[19(67.9%)vs 4(19%)], Cre concentration rise(%)[21(75%)vs 8(38%)], number of postpartum plasma exchange sessions(%)[23(82.1%)vs 5(23.8%)], postpregnancy co-infection phenomenon(%)[21(75%)vs 4(19%)], with Group B significantly higher than Group A. The preoperative platelet count(×10⁹/L)(128 vs 221)and the concentration of fibrinogen(g/L)[0.9 vs 1.6] in Group B were significantly lower than those in Group A. Univariate logistic regression analysis showed that preoperative icterus, postpregnancy co-infection phenomenon, number of postpartum plasma exchange sessions, preoperative TT extension, preoperative APTT extension, Cre concentration rise were influencing factors for the hospital stays of AFLP patients. According to the minimum result of Akaike information criterion, the multivariate binary logistic regression analysis (step-wise selection) showed that the number of postpartum plasma exchange sessions, icterus, preoperative APTT extension were the independent risk factor influencing the hospital stays of AFLP patients, and the logistic regression prediction model was established by incorporating the above three factors. Regularization techniques were further employed in linear regression to address and assess overfitting issues. Additionally, the confidence interval for the estimated effect sizes in each model have been acquired by bootstrapping techniques. 【Conclusion】 Preoperative icterus, preoperative APTT extension(APTT>43s)and the number of postpartum plasma exchange sessions were the independent risk factor influencing the hospital stays of AFLP patients and the logistic regression prediction model with high predictive effectiveness was established successfully.