Objective To establish a rapid, sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of acyclovir (the metabolite of valacyclovir hydrochloride) in human plasma. Methods After addition of ganciclovir as internal standard (IS), plasma samples were prepared by one-step protein precipitation using acetonitrile as precipitant, followed by an isocratic elution with 0.1% formic acid 3.5μm) column. Detection was performed on a triple-quadrupole mass spectrometer utilizing electrospray ionization (ESI) interface operating in positive ion and selected reaction monitoring (SRM) mode with the precursor to product ion transitions m/z 226.2→152.1 for acyclovir and m/z 256.2→152.1 for the IS. Results The analytical results demonstrated a good linearity over the ranges from 0.005 to 4μg/mL (r=0.9999) for valacyclovir hydrochloride. The relative standard deviations (RSD) of intra-batch and inter-batch were less than 4.06% and 9.23%, respectively. The limit of detection and lower limit of quantification in human plasma were 2ng/mL and 5ng/mL, respectively. Conclusion The method was simple, sensitive, accurate and reproducible and has been successfully applied to a bioequivalence study of valacyclovir hydrochloride capsules in Chinese healthy male volunteers.

AIM: To investigate the feasibility and efficacy of tissue plasminogen activator (tPA) injection into the optic nerve as a treatment for retinal vein occlusion in rabbits. METHODS: Rose Bengal-mediated laser-induced retinal vein occlusions were produced in rabbit eyes. Fluorescein angiography (FA) was performed on each eye 3 days before laser irradiation and 30 minutes after laser irradiation.The treatment group (n=20 veins) received intra-optic nerve injection of tPA (12.5μg in 0.05mL BSS) and the controls (n=24 veins) received 0.05mL BSS. FA was repeated to determine the recanalization of the vessel at 3 and 7 days after treatment, followed by histological examination.RESULTS: Rose Bengal-mediated laser-induced retinal vein occlusions were successfully developed and confirmed by FA. The incidence of the recanalization of the vessels in treatment animals was 70.0%, while 16.7% in the control animals (P=0.001). CONCLUSION: Intra-optic nerve tPA injection increased the incidence of recanalization of the occluded vessels. Although further studies are needed, our data suggested that injection of tPA into the optic nerve may have a potential benefit in the treatment of central retinal vein occlusion.

AIM: To investigate the safety of tissue plasminogen activator (tPA) intra optic nerve injection in rabbits. METHODS: Group 1 and 2 (6 eyes in each group) received injection of tPA 25μg and 12.5μg in 0.1mL balanced saline solution (BSS). Group 3 (6 eyes) received injection of 0 1mL BSS. Six eyes in group four as a normal control received no injection. The eyes were examined with slit lamp biomicroscope, indirect ophthalmoscope, visual evoked potentials (VEP) and electroretinography (ERG) at 1, 3, 7, 14 and 28 days after injection. RESULTS: No evidence of optic nerve or retinal toxicity or physical damage were revealed by ophthalmoscopy, VEP, and ERGs after the injection of tPA into the optic nerve. The means of the latency of the first peak of the VEP were 24.6±1.5, 24.1±1.9, 24.0±2.0 and 24.6±1.3mS respectively for the above specified groups (P=0.4112). The means of the amplitude of the first peak of the VEPs were 124±42, 145±41, 132±48 and 117±29μV respectively (P=0.0649). The means of the latency of a-waves were 6.0±0.4, 5.9±0.4, 5.9±0.5 and 5.8±0.3 mS respectively (P=0.6279). The means of the amplitude of a-waves were 110±14, 112±15, 110±16 and 108±11μV respectively (P=0.7248). The means of the amplitude of b-waves were 151±12, 148±14, 144±16 and 141±20μV respectively (P =0.0957).CONCLUSION: Injection of tPA upto 25μg in 0.1mL into optic nerve is well tolerated.

Adult ; Altitude ; Arteries ; metabolism ; Calcitonin Gene-Related Peptide ; blood ; Humans ; beta-Endorphin ; blood

Objective To identify the potential value of event-related potentials ( ERPs ) and electroencephalogram(EEG) in early diagnosis of dementia.Methods From June 2008 to July 2011,113 patients with dementia were recruited fom First Affiliated Hospital of Anhui College of Traditional Chinese Medicine.Meanwhile,100 healthy individuals conducting physical examination at this hospital were collected as the control group.P300 and EEG were measured in patients and healthy controls.Results ( 1 ) Compared with healthy controls,patients with early diagnosis of dementia had significantly longer latency(402.5 ± 37.4)ms vs.( 320.4 ± 23.5 ) ms ;t =19.40 ; P =0.02 ) and lower amplitude of P300 ( 3.76 ± 1.76 ) μV vs.( 5.32 ± 1.38 )μV;t=7.24;P=0.01 ).(2)Significant higher proportionof abnormal EEG cases was found in individuals with dementia (68/113,60.2％ ) than that of participants in the healthy control group(34/100,34.0％ ) ( x2 =13.54,P ＜0.01 ).Specifically,patients with early diagnosis of dementia had significantly higher prevalence of moderate (26.5 ％ [ 18/68 ] vs.5.9 ％ [ 2/34 ] ; x2 =4.85,P =0.02 ) and severe ( 8.8 ％ [ 6/68 ] vs.2.9 ％ [ 1/34 ] ; x2 =1.22,P =0.02 ) abnormal EEG than healthy controls,while there were no significant difference of the proportions of mild or borderline abnormal EEG between the two groups ( P ＞ 0.05 ).Conclusion P300 is an extraordinary objective indicator for early diagnosis of dementia.EEG can provide evidence of impaired brain function for individuals with dementia.

Purpose To investigate the adverse reactions and management in the process of transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy).Materials and Methods A total of 976 patients with infertility accepting 3D-HyCoSy in Jiangsu Provincial Hospital of Traditional Chinese Medicine,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,from December 2014 to August 2016 were retrospectively analyzed.The pain degree was evaluated using visual analog scale (VAS).Adverse reactions,including contrast countercurrent,vomiting,syncope and allergies,were recorded.The relationship between adverse reactions and ultrasound imaging signs was explored.Results There were 66 cases (6.76％) of VAS grade 0,346 cases of mild pain (35.45％),374 cases of moderate pain (38.32％) and 190 cases (19.47％) of severe pain.With the increase in the degree of tubal obstruction,the degree of pain gradually increased.Pain was the most common adverse reaction among patients,followed by vomiting (15 cases,1.54％),syncope (1 case,0.10％),and allergies (1 case,0.10％).The incidence of contrast countercurrent was 12.30％ (120 cases).The adverse reaction incidence of patients with abnormal ultrasound imaging signs was significantly higher than that of patients with normal signs (x2=29.02,P＜0.01).Conclusion With the extensive use of 3D-HyCoSy examination,its clinical application value has attracted a lot of attention,meanwhile,the understanding of its safety and related adverse reactions should also be improved.The state of patients should be closely observed before,during and after 3D-HyCoSy.Medical personnel should watch out for syncope and allergic reactions,and prepare for emergency management.

Objective To evaluate the value of magnetic resonance imaging features in differentiating soft tissue lipoma from well-differentiated liposarcoma.Methods MR images of 30 patients with histologically verified fat-containing tumors(22 lipomas and 8 well-differentiated liposarcomas)were retrospectively reviewed.Well-differentiated liposarcomas and benign lipomas were compared in terms of the size of the lesion,percentage of adipose component,number of thick septa,nodular and(or)patchy nonadipose component,contrast enhancement patterns and the margin characters of the lesion.Results The mean size of lipomas[(64?35)mm]was significantly smaller(t=4.263,P

This study examined the corneal permeability of topical eye drop solutions added with various corneal penetrating accelerators and gadolinium-diethylene triamine pentaacetic acid (Gd-DTPA) by nuclear magnetic resonance imaging (MRI). Twenty-four New Zealand rabbits were randomly divided into 3 groups according to the random digits table: Gd-DTPA group, in which the rabbits received 23.45% Gd-DTPA; hyaluronic acid group, in which 23.45% Gd-DTPA plus 0.2% hyaluronic acid was administered; azone group, in which 23.45% Gd-DTPA with 0.2% azone was given. Fifty microliters of the eye drops was instilled into the conjunctive sac every 5 min, for a total of 6 applications in each group. Contrast medium signals in the cornea, anterior chamber, posterior chamber, and vitreous body were scanned successively by MRI. The morphology and cell density of the corneal endothelium were examined before and 24 h after the treatment. The results showed that the residence time of Gd-DTPA in the conjunctival sac in the hyaluronic acid and azone groups was longer than that in the Gd-DTPA group. The signals in the anterior chamber of the Gd-DTPA and hyaluronic acid groups were increased slightly, and those in the azone group strengthened sharply. The signal intensity continuously rose over 80 min before reaching plateau. The strengthening rate of signals in the anterior chamber was 19.63% in the Gd-DTPA group, 53.42% in the sodium hyaluronate group, and 226.94% in the azone group. No signal was detected in the posterior chamber or vitreous body in all the 3 groups. Corneal morphology and cell density did not show any significant changes after the treatment in all the 3 groups. It was concluded that azone can significantly improve the corneal permeability of drugs that are similar to Gd-DTPA in molecular weight and molecular size, and MRI is a noninvasive technique that can dynamically detect eye drop metabolism in real time.

Objective To explore the effect of anterior decompression plus posterior intradural release in treatment of old thoracolumbar fractures with paraparesis. Methods A total of 22 patients with old thoracolumbar fractures with paraparesis were admitted to our hospital since January 2004 to Jan-uary 2008. Before admission, all patients were treated with decompression and internal fixation with pos-terior pedicle system, with bony compression to the spinal cord found through CT scanning and intact spi-nal cord found by MRI but without obvious neurofunction recovery. Of all, 20 patients were kept with the original posterior fixation except for two patients that were fixed with Z-plate after removal of posterior hardware. Autologous bone grafts from iliac were utilized in all patients. Intradural release was done 3-6 months after anterior decompression. Results Of all, 19 patients were followed up for 17-49 months (average 28 months). Twenty patients obtained varied recovery of neurofunction after anterior decompres-sion, with ASIA motor scores increasing from average 59.4 points before decompression to 71.3 after de-compression. The followed-up patients won further recovery after secondary posterior intradural release, with ASIA motor scores further increasing to average 80.6 points. Conclusion For patients with old thoracolumbar fractures combined with paraparesis, the release of intradural sear and fibrocompression is also important besides anterior decompression.

Objective To study the intervention effect of the fluorosis with the high aluminum plus soybean, selenium powder, spiral algae. Methods Two week-long SD rats were randomly allocated into 5 groups bases on body weight with 8 in each group, respectively being control, the high fluoride aluminum,the high fluoride aluminum plus soybean, the high fluoride aluminum plus selenium and the high fluoride aluminum plus spiral algae group. The control group was fed with corn produced in non-endemic area containing 5.20 mg/L of fluoride and 6.80 mg/L of aluminum and tap water of fluoride 0.70 mg/L and aluminum 0.20 mg/L. Other groups were fed primarily with corn produced in the endemic area with the content of fluoride of 110.00 mg/L and aluminum of 19.70 mg/L and tap water with high aluminum also with fluoride of 0.70 mg/L and aluminum of 90.00 mg/L. The high fluoride aluminum plus soybean group was added soybean in the beginning of the experiment, approximately 30% of the total amount. Selenium (3.00 mg/kg) was given to the high fluoride aluminum plus selenium groups and spiral algae (1000.00 mg/kg) to the high fluoride aluminum plus spiral algae groups after dental fluorosis was formed. The experiment lasted for 22 weeks. In the end of the experiment 24-hour urine and bones of the limbs were collected to test the content of fluorine and aluminum. The ultrastructure of femur spongiosa was observed under electron microscope. Results ① Bone fluoride in high fluoride aluminum group [(204.07 ± 63.78)mg/kg] was higher than that in the control group, high fluoride aluminum plus soybean group, high fluoride aluminum plus selenium group and high fluoride aluminum plus spiral algae group[(30.06 ± 6.11), (54.12 ± 14.56), (30.44 ± 5.02), (105.08 ± 21.07)mg/kg, t = 0.62,0.53,0.62,0.35, all P < 0.01], indicating that it was lower in high fluoride aluminum plus selenium group than high fluoride aluminum plus spiral algae group(t = 0.27, P < 0.01). ② The urinary fluoride levels in high fluoride aluminum group [(4.52 ± 3.09)mg/L] was higher than that in the control group [(0.89± 0.37)mg/L, t = 0.23, P < 0.01] and lower than that in the fluoride aluminum plus selenium group[(10.38 ± 1.58) mg/L, t = 0.34, P < 0.01], it was higher in high fluoride sluminum with selenium group than that in the high fluoride aluminum plus soybean group and high fluoride aluminum plus spiral algae group[(5.56 ± 1.69), (4.38 ± 3.36)mg/L, t = 0.28,0.35, all P < 0.05]. ③ The bone aluminum level in the control group[(3.32 ± 3.02)mg/kg] was lower than that in the high fluoride aluminum group, high fluoride aluminum plus soybean group, high fluoride aluminum plus selenium group and high fluoride aluminum plus spiral algae group [(374.21 ± 56.11), (118.20 ± 23.59), (114.01 ± 22.84), (67.11 ± 11.53)mg/kg, t = 1.42,0.44,0.42,0.24, all P < 0.05], it was higher in the high fluoride aluminum group than high fluoride aluminum plus the soybean and selenium and spiral algae groups (t = 0.56,0.57,0.68, all P < 0.01)lower in high fluoride aluminum plus spiral algae group than the soybean plus selenium group(t = 0.11,0.10, all P < 0.05). ④The urine aluminum level in high fluoride aluminum group [(1.14 ± 0.32)mg/L] was higher than that in the control group and the high fluoride aluminum plus the soybean group [(0.66 ± 0.10) mg/L, t = 1.92,2.24, all P< 0.05] and that in high fluoride aluminum plus the soybean group was lower than aluminum plus the selenium[(1.03 ± 0.22)mg/L] and aluminum plus spiral algae group[(1.10 ± 0.28) mg/L, t = 1.73,2.06, all P < 0.05]. ⑤ Under electron microscope, the collagenous fiber was arranged in disorder in high aluminum fluorine group, the trabeculum of bone merged into patches or mostly vanished, This phenomenon was alleviated in the intervened group compared to the high aluminum fluorine group, in an attenuating order of the selenium group, the spiral algae and the soybean group. Conclusion In this experiment the intervention measure alleviates fluorosis, the selenium is the best, spiral algae the second and soybean the last.