Objective: To establish a method for HPLC determination of ursolic acid in Kangzhitong Jiangzhi Capsule.Methods: HPLC,chromatographic column Kromasil C18(4.6mm?250 mm,5?m)and the mobile phase consisted of methyl alcoholwater-ammonium acetate-acetonitrile(9∶25∶0.8∶65) were used to find ursolic acid.The flow rate was 1.0ml?min and the detector wave-length was set at 215nm.Results: The calibration curve was in good linearity over the range of 64-320?g/ml(r=0.9996).The average recovery rate was 100.10%,with RSD=1.32%.Conclusion: This method is simple,accurate and reproducible so it can be used to determine the content of ursolic acid in Kangzhitong Jiangzhi Capsule.

Abstract: Objective　This article summarizes the clinical characteristics and diagnosis and treatment experience of an elderly patient infected with Omicron variant BA.5.1.3 of COVID-19 in Hainan Province. Methods　The clinical data and treatment of an elderly patient infected with Omicron variant BA.5.1.3 of COVID-19 admitted to Haikou designated hospital on August 15, 2022 were retrospectively analyzed. Results　A 107-year-old female patient was admitted to the hospital with "fever and cough for 1 day". Two of her family members have infected with COVID-19. The patient initially developed fever, accompanied by cough, expectoration, a little white sticky sputum, accompanied by sore throat, muscle pain, fatigue. Nucleic acid test was positive in throat swab, indicating Omicron variant BA.5.1.3 infection. The patient was diagnosed as mild COVID-19 and treated with antiviral therapy, Chinese medicine conditioning, anticoagulation, electrolyte disorder regulation and symptomatic treatment for 9 days. The patient's clinical symptoms were relieved, and she was cured and discharged after two negative nucleic acid tests. One week later, the patient recovered well. Conclusions　Omicron variant BA.5.1.3 is highly infectious, and comprehensive treatment such as antiviral treatment and traditional Chinese medicine treatment has achieved good efficacy. For elderly patients, attention should be paid to maintaining the stability of organ function and internal environment, which is helpful to improve the prognosis of patients.

A suitable ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS) method was developed for the determination of 11 mycotoxins with isotope internal standard in malt. The mycotoxins in malt were extracted and purified by one-step ultrasonic extraction procedure using acetonitrile/water/acetic acid (80 : 19 : 1), and then detected and confirmed by UPLC-MS/MS, and quantified by isotope labeled AFB1 ([13C17]-AFB1) and ZEN ([13C18]-ZEN) internal standards. Rapid separation of the 11 mycotoxins was successfully achieved on a Phenomenex Kinetex C18 column (100 mm x 2.1 mm, 2.6 μm) with gradient elution using the mobile phase of methanol containing 0.1% formic acid and 2 mmol x L(-1) ammonium acetate in water. Simultaneous acquisition was performed in multiple reaction monitoring (MRM) mode with electrospray ionization (ESI) source operated in both positive and negative ionization modes. The established method provided a good linearity for the 11 mycotoxins within their respective linear ranges with correlation coefficients all higher than 0.999 1. The average recoveries ranged from 75.0% to 117.0% with relative standard deviations (RSDs) below 5.1%. The limits of detection (LODs) and quantitation (LOQs) ranged from 0.05 to 30 μg x kg(-1) and 0.15 to 87.5 μg x kg(-1), respectively, which were below the maximum residue levels (MRLs) set by the European Union. Twenty malt samples were analyzed and nine samples were detected with mycotoxins, which were confirmed according to the same fragment ions found in positive samples and the standards at the same retention time. This study has demonstrated that the one-step extraction procedure of mycotoxins from complex matrices coupled to UPLC-MS/MS method is simple, quick, accurate and sensitive for quantitative and qualitative analysis of multiple mycotoxins in malt.
Chromatography, High Pressure Liquid ; Fermentation ; Hordeum ; chemistry ; Limit of Detection ; Mycotoxins ; analysis ; isolation & purification ; Tandem Mass Spectrometry

Objective To investigate the relationship between blood concentration of sodium valproate and the anti‐epileptic effect and the influencing factors of blood concentration of sodium valproate ,and to provide evidence for clinical individual adminis‐tration .Methods The blood concentrations of 133 cases of patients treated with sodium valproate were determined in the affiliated Yongchuan hospital of Chongqing medical university ,the monitoring results of blood concentration were statistically analyzed ,and the anti‐epileptic effect of 133 cases of patients were observed and analyzed .Results The epilepsy of 80 cases of patients were con‐trolled ,accounted for 60 .15% of the total number;in the 69 cases of patients within the effective blood drug concentration (50-100 mg/L) ,the epilepsy of 51 cases of patients were controlled ,accounting for 38 .35% .In the 44 cases of patients whose blood drug concentration were less than 50mg/L ,the epilepsy of 26 cases of patients were not controlled .The distribution of blood concentra‐tion between men and women were similar .The blood concentrations among each age group were different ,the blood concentrations of 52 .87% patients in the adult group were below or above therapeutic range that were 39 .13% in the minor group .The adverse reactions were increase with the increase of blood concentration .Conclusion There are differences between the blood concentrations of sodium valproate and clinical effect ,the reasonable individual administration should be conducted according to the patient′s blood concentrations of sodium valproate ,the epilepsy control situation of patients and the patients′age .

Background Researching the pathological characteristics and components of cells in internal limiting membrane of idiopathic macular hole (IMH) has an important clinical significance for the prevention of IMH.However,the study results are still disputable.Objective This study was to investigate the histopathological features of internal limiting membrane of IMH and the types of cells inside it, and explore the pathomechanism of IMH.Methods Seven specimens of internal limiting membrane were obtained during the vitrectomy with IMH patients in the Second Affiliated Hospital of Guangzhou Medical University from February 2012 to August 2013 under the informed consent of patients.The histopathological examination was performed for the structural observation and cellular identification of internal limiting membrane.The expression and location of glial fibrillary acidic protein (GFAP), CD45 and CD44 in internal limiting membrane were examined by using immunochemistry and immunofluorescence technology.Results All the seven specimens showed continuous undulating membrane with red staining.Two specimens appeared to be uniform in thickness and few cells were distributed in the specimens.The internal limiting membranes were uneven in thickness in the other specimens with retinal pigment epithelial cells,neuroglia cells,fibrocytes,macrophages and lymphocytes in them.Immunochemistry showed the positive expression of GFAP in the outer layer of the specimens.CD45 positive cells were detected in the internal limiting membranes, and CD44 was detected in the inner layer of the specimens.Conclusions Few cells exist in the internal limiting memranes of IMH.However,neuroglia cells and CD45 positive cells emerge in the internal limiting memranes of stage 3 or above IMH eyes, indicating the proliferation of cells and immuno-inflammation response exist during the IMH development.The up-regulation of CD44 expression promotes inflammatory response of internal limiting memranes.

Objective To detect the serum growth hormone(GH),insulin-like growth factor-I(IGF-Ⅰ),insulin-like growth factor binging protein-3(IGFBP-3) levels in children with hypothyroidism and explore the change regulation of GH-IGF axis and thyroxine.Methods Fifty-six hypothyroidism children were divided into congonital hypothyroidism(CH)(14 cases) and Hashimoto's thyroiditis(32 cases).Serum GH,IGF-Ⅰ,IGFBP-3 levels of 56 hypothyroidism children before and after luothyroxine sodium L-T4 treatment and 50 normal children were detected with radioimmunoassay or enzyme-linked immunosorbent assay methods.Results Serum IGF-I,IGFBP-3 levels in 9 CH newborn group were lower,and they were normal after thyroxine substitute therapy.But those of 5 children with CH and 32 cases with Hashimoto's thyroiditis were not significantly changed.Conclusions The GH-IGF axis is inordinate in the CH children,which is an important reason of stature short.Early thyroxine substitute therapy is very helpful to maintain normal growth and development of children with CH.

Objective To explore the value of somatostatin receptor scintigraphy(SRS) in evaluating the immune activity of orbital inflammatory pseudotumor associated with systemic vasculitis.Methods Twenty-five patients with orbital inflammatory pseudotumor associated with systemic vasculitis (10 males,15 females,average age:(51.2± 14.2) years) underwent SRS.The uptake ratio (UR) of orbital inflammatory pseudotumor was obtained.(1) Patients were divided into group A (with immune activity) and group B (without immune activity) according to Birmingham vasculitis activity score (BVAS).The difference of UR between the 2 groups was compared by two-sample t test.The difference of UR before and after treatment in 12 patients was also compared.(2) Based on the results by BVAS,ROC curve was used to obtain the cut-off value of UR,as well as the diagnostic efficiency and Youden index.The consistency between SRS and BVAS was calculated.(3)Patients were divided into two groups according to the cut-off value of UR and the prognosis difference between them was compared by Fisher exact test.(4)The expression of SSTR2 and SSTR5 was observed by immunohistochemistry.Results (1) UR in group A was significantly higher than that in group B (2.09±0.44 vs 1.32±0.46,t =5.94,P＜0.01).After glucocorticoids treatment,the UR in group A reduced significantly (t=4.07,P＜0.01),but not in group B (t=1.76,P＞0.05).(2)ROC curve analysis identified UR cut-off value as 1.66,with the sensitivity of 87.5％,specificity of 95.7％,positive predictive value of 95.2％,negative predictive value of 88.0％,accuracy of 91.3％ and Youden index of 83.2％.The consistency between SRS and BVAS was strong (Kappa =0.840).(3) The prognosis was significantly different between patients with UR≥ 1.66 and UR＜1.66 (P＜0.05).(4) The immunohistochemical results revealed high expression of SSTR2 and SSTR5 in inflammatory cells in patients with immune activity.Conclusion SRS has potential value in evaluating the immune activity of orbital inflammatory pseudotumor associated with systemic vasculitis.

0.99.The quantitive restriction was 0.1 ?g/mL,the recovery rate was over 70%.The RSD of intra-and inter-day was less than 15%.The pharmacokinetic parameters of flavonoids were different from each other after ig and iv administration.The absolute bioavailability of flavonoids were 12.9%,10.8%,2.2%,10.2% and 5.9%,respectively.Conclusion The method is sensitive,specific,accurate,and is not only useful for guiding the bioavailability study on the corolla of A. manihot,but also for establishing a reasonable clinical dosage program.The four flavonols in the corolla of A.manihot can be rapidly distributed and eliminated in rats,the pharmacokinetics of two routes of administration are different.A novel integrated pharmacokinetic approach to describing the holistic pharmacokinetic properties of Chinese materia medica has been successfully developed and validated using four flavonols of A.manihot as a model herbal medicine.This study would be a new try for guiding the holistic pharmacokinetic study in consistence with the intrinsic theory and characteristics of traditional Chinese medicine.

Objective To investigate the relationship between peritoneal macrophages (PMAs) and inflammatory reaction in a rat model of severe acute pancreatitis (SAP). Methods Sprague-Dawley rats were randomly divided into control group and SAP group. To induce SAP in rats, 40 g/L sodium taurocholate (0.1 mL/100 g) was injected into the pancreatic duct through retrograde exposure of pancreatic bile duct in hepatic porta. One-third of rats were sacrificed at 3, 6 or 12 h after modeling. PMAs were extracted, and incubated for 24 h in a humidified 5% carbon dioxide incubator. The expressions of tumor necrosis factor alpha (TNF-α) and interleukin-1β (IL-1β) mRNA in PMAs were measured by semi-quantitative RT-PCR. The levels of TNF-α and IL-1β in culture medium and serum were evaluated.The histological changes of pancreas were examined. Rosults The expressions of TNF-α mRNA and IL-1β mRNA in PMAs were significantly higher in SAP group than in control group at each time point (P<0.01). The concentrations of TNF-α and IL-1β in culture medium and serum were significantly elevated in SAP group compared with control group (P<0.01). The histological analysis of pancreas indicated that the damage was more severe in SAP group than in cuntrol group (P<0.01). Conclusion PMAs secrete cytokines into pancreatitis-associated ascitic fluid, and this study demonstrates a correlation between SAP and the activation of PMAs.

Objective To study the drug resistance of infection bacteria deriving from acute appendicitis patients.Methods The separation and the drug sensitive characteristic of bacteria deriving from the specimen of acute appendicitis patients were ana-lyzed,who were admitted in the general department of our hospital from January to June 2013.Results One hundred and six bacte-ria strains were isolated.Among them,100 (94.34%)strains were Gram negative bacteria strains,including escherichia coli,kleb-siella pneumonia bacillus and verdigris fake single spore bacterium,in a proportion of 67.92%,1 1.32% and 5.66% respectively. The resistance of piperacillin,ciprofloxacin,gentamycin,levofloxacin,tobramycin and cefepime was high in Gram negative bacteria, while the lower resistance to piperacillin/ tazobactam,cefoxitin and imipenem.Conclusion The resistant rate of acute appendicitis infection bacteria is high.