OBJECTIVE:To establish RP-HPLC method for the simultaneous determination content of rabeprazole(RAB)and its two metabolites thioether-rabeprazole(TE)and demethylated thioether-rabeprazole(DMTE)in human plasma.METHODS:The plasma samples were extracted with ethyl acetate;The Diamonsil C 18 reversed-phase column was used as analytical column,the mobile phase was consisted of methanol-water-glacial acetic acid-triethylamine(40∶60∶0.4∶0.1)with a flow rate at1.0ml/min,the ultraviolet detection wavelength was288nm.RESULTS:Good separation of chromatographic peaks of RAB,TE and DMTE were manifested.The mean recovery of which were110.40%,87.28%and98.21%respectively.CONCLUSION:The method was sensitive and accurate,and it meets the requirements for the study of pharmacokinetic of rabeprazole.

Objective To explore the predictive value of combined measurement of D-dimer (D-D),fibrinogen (FIB),and peripheral blood leukocyte count (PBLC) for the severity of acute pancreatitis (AP).Methods We collected the clinical data of 134 hospitalized patients who were diagnosed with AP in the General Hospital of Ningxia Medical University from January 2014 to January 2016.These patients were divided into mild acute pancreatitis (MAP) group (n =72) and severe acute pancreatitis (SAP) group (n =62).Also,these patients were divided into hyperlipidemic acute pancreatitis (HAP) group (n =43) and biliogenic acute pancreatitis (BAP) group (n =91).The initial measurements of D-D,FIB,and PBLC for the patients who were admitted to the hospital within 24 hours of onset and received no treatment before admission were collected.The t test was used for comparison of normally distributed continuous data,while the Mann-Whitney U test was used for non-normally distributed continuous data.The chi-square test was used for comparison of categorical data.In addition,the Spearman correlation test and Pearson correlation test were used for correlation analyses.The receiver operating characteristic (ROC) curve was used to analyze the predictive values of D-D,FIB,and PBLC for the severity of AP.Results Compared with the MAP group,the SAP group had significantly increased D-D and FIB levels in peripheral blood (Z =-3.171,P =0.002;t =-2.339,P =0.021).Compared with the HAP group,the BAP group had a significantly higher D-D level (Z =-4.178,P ＜ 0.001),an insignificantly higher FIB level (P ＞ 0.05),and a significantly lower PBLC (t =2.466,P =0.015).The areas under the ROC curve (AUCs) of D-D,FIB,and PBLC were 0.659,0.611,and 0.591,respectively,and D-D had a higher value than FIB and PBLC in predicting the severity of SAP.The AUC of a combination of D-D,FIB,and PBLC was 0.712.Plasma D-D and FIB levels were positively correlated with the severity of AP (r =0.275 and 0.192,P =0.001 and 0.026).Conclusions D-D,FIB,and PBLC are important for early judgment of the severity of AP,and a combination of the three markers has greater significance.

The prevalence rate of nonalcoholic fatty liver disease (NAFLD) has been increasing year by year.However,since the complex pathogenesis of NAFLD has not been fully clarified,there still lacks a gold standard for the diagnosis and treatment of NAFLD.5-Hydroxytryptamine (5-HT) can affect the development and progression of NAFLD via several links and thus change the course of NAFLD.This article introduces the association between 5-HT and NAFLD,the role of 5-HT in the pathogenesis of NAFLD,and its future application in treatment.

Objective: To investigate acid-suppression efficacy of proton pump inhibitors (PPIs) in relation to CYP2C19 genetic polymorphism on patients with peptic ulcer. Methods: By an open, randomized and control trial, fifty nine patients with active peptic ulcer were randomly assigned to receive one of three PPIs on a single dose (20 mg of each drug): omeprazole group (n = 19), rabeprazole group (n = 20) and esomeprazole group (n = 20). Intragastric pH was recorded 1 hour before and 24 hours after administration. CYP2C19 genotype was tested in all patients. Results: The EMs/PMs ratio of each group was 16/3,17/3 and 17/3, respectively. The total time that intragastric pH>4, time percent pH>4 and median pH in PMs patients were significantly higher than those in EMs patients of omeprazole group (P < 0.05). But all these differences were not found in rabeprazole group and esomeprazole group. The pH of nocturnal acid breakthrough (NAB) in both rabeprazole group and esomeprazole group was higher than that of omeprazole group, while there was no significant difference between rabeprazole group and esomeprazole group. Conclusion: The acid-suppression efficacy of omeprazole is highly dependent on CYP2C19 genetic polymorphism, while CYP2C19 genetic polymorphism may have a little influence on the acid-suppression efficacy of rabeprazole and esomeprazole. The acid-suppression action of rabeprazole and esomeprazole is superior to omeprazole, especially on night acid secretion.

Objective: To investigate acid-suppression efficacy of proton pump inhibitors (PPIs) in relation to CYP2C19 genetic polymorphism on patients with peptic ulcer. Methods: By an open, randomized and control trial, fifty nine patients with active peptic ulcer were randomly assigned to receive one of three PPIs on a single dose (20 mg of each drug): omeprazole group (n = 19), rabeprazole group (n = 20) and esomeprazole group (n = 20). Intragastric pH was recorded 1 hour before and 24 hours after administration. CYP2C19 genotype was tested in all patients. Results: The EMs/PMs ratio of each group was 16/3,17/3 and 17/3, respectively. The total time that intragastric pH>4, time percent pH>4 and median pH in PMs patients were significantly higher than those in EMs patients of omeprazole group (P < 0.05). But all these differences were not found in rabeprazole group and esomeprazole group. The pH of nocturnal acid breakthrough (NAB) in both rabeprazole group and esomeprazole group was higher than that of omeprazole group, while there was no significant difference between rabeprazole group and esomeprazole group. Conclusion: The acid-suppression efficacy of omeprazole is highly dependent on CYP2C19 genetic polymorphism, while CYP2C19 genetic polymorphism may have a little influence on the acid-suppression efficacy of rabeprazole and esomeprazole. The acid-suppression action of rabeprazole and esomeprazole is superior to omeprazole, especially on night acid secretion.

Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome caused by liver damage factors except alcohol and has the major feature of diffuse macrovesicular hepatocyte steatosis.Thetwo-hit hypothesis can partly explain the pathogenesis of NAFLD.Recent studies have found that ceramide is a key molecular messenger involved in the development and progression of NAFLD,and as a sphingolipid,it is closely associated with the two-hit hypothesis.This article reviews the role of ceramide in NAFLD.

BACKGROUND: Previous studies demonstrated that,metabolic phenotype of cytochrome P450 2C19 has genetic polymorphism,which presents with extensive or poor metabolisms and has great differences in races and individuals.OBJECTIVE: To study the genotype distribution of cytochrome P450 2C19 in Xinjiang Uigur population.METHODS: In total 144 unrelated Uigur and 156 unrelated Han subjects were genotyped for cytochrome P450 2C19 by polymerase chain reaction-restriction fragment length polymorphism.The differences of gene phenotype and gene frequency were compared between Uigur and Han populations.RESULTS AND CONCLUSION: The frequency of extensive metabolism wt/wt,wt/m and wt/m1+wt/m2 of Uigur was notably higher than that of Han population(P<0.05),but the frequency of poor metabolism m1/m1 was obviously lower than that of Han population(P<0.05).There were significant differences between Uigur and Han populations in allele frequency wt,m1 and m2(P<0.05),especially m1,which was 58-fold of m2(P<0.01).The results revealed that,distribution frequency m1/m1 of poor metabolism of Uigur is obviously lower than that in Han population,and m1 frequency is higher than that of Han population,accordingly,m1 is the main gene mutation of cytochrome P450 2C19 in Uigur population.

Objective To investigate the diagnostic value of the instant gastrointestinal ultrasound contrast agent in the digestive diseases. Methods Five hundred and seventy-nine patients received the examination of the color Doppler after they drinked the ultrasonic contrast agent. Then the results were analyzed by consistency analysis. Results There was high consistency between the two examinations in the normal control, gastritis, peptic ulcer, gastric cancer and gastric leiomyoma. The Kappa value was 0.768, 0.913, 0.925, 0.939 and 1.000, respectively. But the consistency in the gastric polyp was low , the Kappa value was 0.368. Conclusion The color Doppler through the instant gastrointestinal ultrasound contrast agent has high diagnostic value in the common diseases of the digestive system.

Nonalcoholic fatty liver disease (NAFLD)has become a major liver disease in the world and its prevalence rate continues to in-crease. As a component of metabolic syndrome,it has become a risk factor for many serious cerebrovascular and cardiovascular diseases. Due to the complex pathogenesis of NAFLD or the combined/ mutual effect of pathogenic factors,there are still no widely accepted effective therapies. In recent years,more and more studies have revealed new pathogeneses of NAFLD and the prospects of corresponding treatment. This article introduces the recent advances in the treatment of NAFLD,including lifestyle intervention,drug therapy,integrated traditional Chinese and Western medicine therapy,and bariatric surgery. In the aspect of drug therapy,this article introduces the drugs commonly used in clinical practice and new drugs in phase Ⅱ and Ⅲ clinical trials and their therapeutic effects.