Objective To analyze the imaging characteristics of hepatic involvement in Langerhans cell histiocytosis(LCH) in children on MRCP, MRI and CT. Methods Twenty-nine children from three children hospitals in China, who were diagnosed as hepatic involvement by disseminated LCH during Aug 2008 and Jan 2015 were included in this study. Their MRCP (n=16), MRI (n=22), contrast?enhanced CT (n=15) data were retrospectively analyzed. The stenoses and dilatation of the intrahepatic bile ducts, the common hepatic bile duct and its first order branches and the common bile duct were evaluated on the MRCP image. The size and shape of the liver, the imaging characteristics of the periportal lesions in the Glisson sheath and hepatic parenchymal lesions were also evaluated on the cross?sectional images. Results MRCP indicated alternative stenoses/dilatation of the bile duct tree (n=16), stenoses of the common hepatic duct and its first?order branches (n=15), partialindistinctness of the common bile duct (n=2) and multiple cystic lesions along the biliary tree (n=5). On the cross?sectional images, the periportal lesions in the Glisson sheath were observed in 28 children. On MRI, the periportal lesions were shown in all the 22 children with MRI, presented as hypo-signal intensity on T1WI, hyper?signal intensity on T2WI (n=11) or mixed?signal intensity on T1WI and T2WI (n=11); On CT, the periportal lesions were found in 14 of the 15 children with CT, presenting as low density (n=13) and mixed density (n=1). Multiple nodular or cyst?like parenchymal lesions were observed in 21 patients including 18 patients on MRI and 5 patients on enhanced CT. Sixteen patients presented as hypo?intensity on T1WI, hyper?intensity on T2WI and low density on plain CT, and 5 patients with iso? or hypo?intensity on T1WI, hypo?intensity on T2WI,and milder enhancement relative to the adjacent parenchyma on contrast?enhanced CT. Conclusions The imaging characteristics of hepatic involvement by LCH include alternative stenoses and dilatation of the intrahepatic ducts, stenoses of the common hepatic bile duct and its first?order branches on MRCP, the periportal lesions in the Glisson sheath and hepatic parenchymal nodular or cyst?like lesions on cross?sectional images.

An approach was proposed to evaluate preparation technology by means of fingerprint-peak matching technology of high performance liquid chromatography with diode array detector (HPLC-DAD).Similarity and hierarchical clustering analysis (HCA) were applied to identify the 15 batches of Xiaochaihu granules from different manufacturers and our laboratory,and peak pattern matching between the composite formulae and Radix Bupleuri Chinensis,which was one of the main ingredients of Xiaochaihu granules,was utilized to evaluate the preparation technology of Xiaochaihu granules via the indexes of the relative deviation of retention time (RT) and UV spectrum feature similarity of their corresponding peaks.Eleven matching peaks were found between Xiaochalhu granules and Radix Bupleuri Chinensis.However,the saikosaponin A and saikosaponin D,which are the important active components in Radix Bupleuri Chinensis,were not found in Xiaochaihu granules from any manufacturers.The peak areas of 11 characteristic peaks of Xiaochaihu granules samples formed a matrix of 11 × 15.The result of HCA showed that Xiaochaihu granules samples were divided into four kinds of category.Xiaochaihu granules samples from the same manufacturer were basically clustered of the same category.The results suggested that the saikosaponin A and saikosaponin D are prone to structural transformation under the condition of decoction and in the presence of the organic acidic components.These active components,existing in raw herb,might transform to a series of non-active secondary saikosaponin due to unfavourable preparation technology.So the conventional decoction-based preparation technology of Xiaochaihu granules might greatly affect its quality and therapeutic effectiveness. This study demonstrates that fingerprint-peak matching technology can not only be used for quality control of this composite formulae,but also provide some guidance for preparation technology of Xiaochaihu granules.

A simple and accurate high-performance liquid chromatography (HPLC) coupled with diode array detector (DAD) and evaporative light scattering detector (ELSD) was established for the determination of six bioactive compounds in Zhenqi Fuzheng preparation (ZFP).The monitoring wavelengths were 254,275 and 328 nm.Under the optimum conditions,good separation was achieved,and the assay was fully validated in respect of precision,repeatability and accuracy.The proposed method was successfully applied to quantify the six ingredients in 31 batches of ZFP samples and evaluate the variation by hierarchical cluster analysis (HCA),which demonstrated significant variations on the content of these compounds in the samples from different manufacturers with different preparation procedures.The developed HPLC method can be used as a valid analytical method to evaluate the intrinsic quality of this preparation.

A simple and accurate high-performance liquid chromatography（HPLC）coupled with diode array detector（DAD）and evaporative light scattering detector（ELSD）was established for the determination of six bioactive compounds in Zhenqi Fuzheng preparation（ZFP）.The monitoring wavelengths were 254,275 and 328 nm.Under the optimum conditions,good separation was achieved,and the assay was fully validated in respect of precision,repeatability and accuracy.The proposed method was successfully applied to quantify the six ingredients in 31 batches of ZFP samples and evaluate the variation by hierarchical cluster analysis（HCA）,which demonstrated significant variations on the content of these compounds in the samples from different manufacturers with different preparation procedures.The developed HPLC method can be used as a valid analytical method to evaluate the intrinsic quality of this preparation.

OBJECTIVETo determine bergapten's concentration in plasma and observe its pharmacokinetics in rats using a combined LC-MS/MS analytical method.

METHODBlood samples were separated on a Hypersil ODS column (4.6 mm x 250 mm, 5 mm) at a temperature of 30 degrees C, and mobile phase consisted of water and methanol (22.5: 77.5) at a flow rate of 0.8 mL x min(-1).

RESULTThe methodological study showed a good linear relationship of 8.12-162.4 g x L(-1) (r = 0.9999). The inner and inter-days relative standard deviations were both less than 10% , indicating legitimate precise and accuracy to the requirement of biological sample analysis.

CONCLUSIONThe method is suitable for in vivo quantitative analysis for bergapten due to its accuracy, sensitivity and specificity. The pharmacokinetic process in rats forms a two-compartment model with first-order absorption.

Animals ; Chromatography, Liquid ; Male ; Methoxsalen ; analogs & derivatives ; blood ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley ; Reference Values ; Reproducibility of Results ; Sensitivity and Specificity ; Tandem Mass Spectrometry ; Time Factors

Objective To evaluate the effectiveness of different medicine treatment strategies on the social functions promotion on the patients with treatment-resistant depression (TRD). Methods 375 Patients with TRD were randomly grouped into 8 groups, and each group was received 8 weeks different treatment for paroxetine,venlafaxine, mirtazapine, paroxetine plus risperidone, paroxetine plus sodium valproate, paroxetine plus buspirone, paroxetine plus trazodone,or paroxetine plus thyroxine, respectively. The efficacy and social functions were evaluated with HAMD-17, SDSS and SF-36. Results There were significant difference in SDSS scores between 8th week and the baseline( P＜0.01 ) , and for social functions factor scores of SF-36 there was significant difference between 4th ,8th week and the baseline in each groups( P＜0.01 ). There were significant difference in social functions factor scores of SF-36 and subtracting scores between 4th and 8th week in all groups except group paroxetine and group venlafaxine(P ＜ 0.05 or P ＜ 0.01 ). There were significant difference in SDSS subtracting scores at 8th week among 8 groups( paroxetine plus risperidone group 7.05 ± 6.39, mirtazapine group 6.53 ± 4.75, paroxetine plusthyroxine group 5.14 ± 4.94, paroxetine group 5.13 ± 4.94 ,paroxetine plus trazodone group 5.00 ± 4.94, paroxetine plus sodium valproate group 4.60 ± 4.09, venlafaxine group 4.57 ± 4.18, paroxetine plus buspirone group 4.24 ± 4.95 ) ( Z = 2.076, P ＜ 0.05 ), between group paroxetine plus risperidone and group venlafaxine , group paroxetine plus sodium valproate, group paroxetine plus buspirone,as group mirtazapine and group paroxetine plus buspirone(P＜ 0.05 ), respectively. The influencing factors on improving social functions are the severity, improvement of depressive symptoms and latest onset time. Conclusions These 8 treatment strategies all can promote social functions on the patients with TRD. But the intensity and chronological order of improvement werent the same among 8 groups. The influencing factors on improving social functions are the severity, improvement of depressive symptoms and latest onset time.

OBJECTIVETo develop a HPLC method for determination of matrine, oxymatrine; ferulic acid, L-shikonin and beta, beta-dimethylacrylshikonin in compound preparatioti of Dangguishuan.

METHODThe chromatogtaphic separation was performed on a Kromasil ODS C18 column (4.6 mm x 250 mm, 5 microm) maintaining at 30 degrees C during the whole process. The mobile phase consisted of methanol and 0.1% triethylamine aqueous solution (adjusted with phosphoric acid, pH 3) at a flow rate of 1.0 mL x min(-1). The detection wavelength was set at 220 nm for matririne and oxymatrine, 316 nm for ferulic acid, 516 nm for L-shikonin and beta, beta-dimethylacrylshikonin, respectively.

RESULTAll the compounds showed good linearity (r > 0.9996) in the range of the test concentrations, and the average recoveries of the method is betwuen 96.92% and 102.22%, RSD < 3.1%.

CONCLUSIONThe method is proved to be credible, sensitive, accurate and repeatable. It can be applied to determine of matrine, oxymatrine, ferulic acid, L-shikonin and beta, beta-dimethylacrylshikonin in compound preparation of Dangguishuan simultaneously, and provide a basal method of quality control to this preparation and other relative preparations.

Alkaloids ; analysis ; Chromatography, High Pressure Liquid ; methods ; Coumaric Acids ; analysis ; Drugs, Chinese Herbal ; analysis ; Naphthoquinones ; analysis ; Quinolizines ; analysis

Objective·To compare the clinical features between different subtype bipolar patients with first mania episode, and to contribute to early identification of bipolar disorder. Methods·This study was based on the database named as National Bipolar Mania Pathway Survey (BIPAS). From November 2012 to January 2013, bipolar patients from 26 mental health facilities in China were enrolled in current study. The clinical features were compared between mania patients of different subtypes, including hypomania (groupⅠ), mania without psychotic symptoms (groupⅡ), mania with psychotic symptoms (group Ⅲ) and mixed state (group Ⅳ). Results·There was significant difference in the percentage of clinical symptoms between different subtype bipolar patients with first mania episode, especially the mania and anxiety related symptoms. Group Ⅰ, Ⅲ , Ⅳ were further compared with groupⅡ, which was considered as the typical bipolar disorder. The results showed that the mania related symptoms was significantly higher in group Ⅱ, but anxiety related symptoms was significantly higher in group Ⅰ, Ⅲ, Ⅳ. Moreover, Logistic regression analysis revealed that more eloquent or humor and unusually restless could be in favor of the diagnosis of hypomania; younger and mania or hypomania as first episode might be in favor of the diagnosis of mania with psychotic symptoms; older, national minorities and unusually restless could be in favor of the diagnosis of mixed state. Conclusion·The clinical features between different subtype bipolar patients with first mania episode are various, and analysis of the clinical features can contribute to early identification of bipolar disorder.

Objective:To analyze the clinical characteristics, cerebrospinal fluid (CSF) and other auxiliary examination results of febrile children with convulsions in order to provide the evidence for clinical recognition of central nervous system (CNS) infection and its etiology.Methods:The clinical data of 64 fever patients with convulsions admitted at the Department of Neurology, Shanghai Children′s Medical Center, Shanghai Jiaotong University School of Medicine were analyzed retrospectively.According to the results of the routine biochemical examination of CSF, they were divided into 2 groups as CSF normal group (44/64 cases, 69%) and CSF abnormal group (20/64 cases, 31%). Their age, gender, clinical manifestations, physical symptoms and auxiliary examination results were compared between the two groups. Logistic regression analysis was performed to explore the independent risk factors of abnormal CSF results.Twenty children with abnormal CSF results were divided into the normal glucose group (12/20 cases, 60%) and the glucose reduction group (8/20 cases, 40%) according to the glucose level of CSF.The fever duration, serum inflammation markers, CSF routine and biochemical indexes of the two groups were compared. Results:According to Logistic multivariate unconditional regression analysis, the mental state change ( OR=435.99, P=0.010), abnormal neurological signs ( OR=65.25, P=0.023) and vomiting ( OR=20.56, P=0.048) were the high risk factors of abnormal CSF results.Among the children with abnormal CSF results, in the glucose reduction and normal glucose groups, the fever duration was 12.50 (7.75-16.75) d and 4.00 (3.00-5.75) d, respectively; the level of CSF protein were 3 000 (1 745-3 000) mg/L and 648 (469-1 734) mg/L, respectively; the erythrocyte sedimentation rate (ESR) was 71.50(56.00-97.50) mm/1 h and 20.50 (12.00-26.00) mm/1 h, respectively; the procalcitonin level was 2.76(0.90-20.72) g/L and 0.23 (0.03-1.00) g/L, respectively; the C-reactive protein (CRP) level was 123.00 (33.00-177.75) mg/L and 12.50(4.25-57.75) mg/L, respectively.The fever duration, CSF protein level, ESR, procalcitonin level and CRP level were statistically different between the glucose reduction and normal glucose groups (all P<0.05). Conclusions:In fever children with convulsions, vomiting, the mental state change, and abnormal neurological signs are the high risk factors of abnormal CSF results, suggesting the possibility of CNS infections and the need of early diagnosis by CSF and other auxiliary examinations.In addition, a low level of CSF glucose in children with abnormal CSF results may be a potential and powerful clue for purulent meningitis.Timely etiological tests are required for confirmation, and antibiotics treatments should be applied as early as possible.