ObjectiveTo evaluate the success of Qi-deficiency model of Balb/C-nu mice established by swimming exhaustion test from the view of biomarkers and metabolic pathways by metabonomics. MethodBalb/C-nu mice were randomly divided into the normal group and Qi-deficiency group， Qi-deficiency model was established by swimming with 5% body weight metal fixed at the tail for 15 consecutive days until exhaustion （nose tip immersion time>5 s）. The urine metabonomics was analyzed by ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF/MS）， and the mobile phase was acetonitrile （A）-0.1% formic acid aqueous solution （B） for gradient elution （0-1 min， 5%-8%A； 1-4 min， 8%-8.5%A； 4-5 min， 8.5%-12%A； 5-10 min， 12%-40%A； 10-12 min， 40%-100%A； 12-15 min， 100%A）， the flow rate was 0.3 mL·min^-1， the injection volume was 10 μL， electrospray ionization （ESI） in positive and negative ion modes was used in MS analysis， the MS data were acquired in full-scan mode from m/z 50-1 000. Principal component analysis （PCA）， orthogonal partial least squares-discriminant analysis （OPLS-DA）， human metabolome database （HMDB）， high collision energy ion fragments collected by MS^E and tandem MS （MS/MS） ion information were used to identify potential biomarkers. Kyoto Encyclopedia of Genes and Genomes （KEGG） database and MetaboAnalyst 5.0 were used to analyze the corresponding metabolic pathways and pathway enrichment of biomarkers. ResultEndogenous substances in urine of mice in normal group and Qi-deficiency group were obviously separated， and there were 24 biomarkers with significant difference. The metabolic pathways involved in these biomarkers were tricarboxylic acid cycle， glycolysis metabolism， amino acid metabolism， fatty acid metabolism， pyrimidine metabolism， steroid hormone biosynthesis and tryptophan metabolism. Among them， the metabolic pathways related to energy were tricarboxylic acid cycle， glycolysis metabolism， amino acid metabolism， fatty acid metabolism， pyrimidine metabolism and steroid hormone biosynthesis. ConclusionThrough the investigation of urine metabonomics， combined with the physical signs， the Qi-deficiency model established by swimming exhaustion test in Balb/C-nu mice is successfully evaluated， and it is also verified that there is a close correlation between Qi-deficiency and energy metabolism.

Objective:To summarize the clinical and laboratory characteristics of infectious mononucleosis (IM) in children.Methods:Clinical features and laboratory results of 270 cases with IM admitted to the Department of Pediatrics in Strategic Support Force Medical Center of People′s Liberation Army from January 2012 to December 2020 were retrospectively analyzed. χ2 test was used for comparison between groups. Results:IM mainly occurred in children aged 5 months to 18 years old in autumn and spring.The highest incidence rate (105 cases, 38.9%) was 3-<6 years old (preschoolers). There were 253 cases (93.7%) with fever, 266 cases (98.5%) with adenopharyngitis, 196 cases (72.6%) with tonsil pseudomembrane or exudation, 248 cases (91.9%) with cervical lymphadenopathy, 92 cases (34.1%) with eyelid edema, 202 cases (74.8%) with nasal obstruction, 124 cases (45.9%) with nasal obstruction and snoring, 24 cases (8.9%) with rash, and 112 cases (41.5%) with splenomegaly.A total of 225 cases (83.3%) presented with typical triplets of IM (fever, adenopharyngitis and cervical lymphadenopathy). Sixty-two IM patients were complicated with pulmonary infections and 3 cases with diarrhea.The main co-infection pathogens in children with IM were Mycoplasma pneumonia (MP) (79 cases, 29.3%), influenza A or B virus (34 cases, 12.6%), Streptococcus pneumonia (SP) (18 cases, 6.7%), adenovirus (22 cases, 8.1%) and cytomegalovirus (3 cases, 1.11%). A total of 46 cases (17.0%) had multiple infections.Laboratory test results suggested that absolute lymphocyte count ≥5.0×10 9/L was found in 199 cases (73.7%), and abnormal lymphocyte ratio >0.10 was found in 225 cases (83.3%). Some children had elevated transaminase levels.Epstein-Barr virus capsid antigen-immunoglobulin M (EBV-VCA-IgM) was positive in 249 cases (92.2%), Epstein-Barr virus capsid antigen-immunoglobulin G (EBV-VCA-IgG) was positive in 238 cases (88.1%), and Epstein-Barr virus nuclear antigen-immunoglobulin G (EBV-NA-IgG) was negative in all cases.EBV-VCA-IgG showed low affinity in all cases (<40%). EBV DNA tests of peripheral blood plasma were carried in 153 cases, of which 118 cases (77.1%) were positive. Conclusions:EBV related IM mainly attacks preschoolers.Most patients are presented with typical triplets of IM.Eyelid edema, nasal obstruction, snoring, splenomegaly and elevated transaminase levels are prevalent in IM children.Most cases have a favorable prognosis.

Enrichment of trace bioactive constituents and metabolites from complex biological samples is chal-lenging. This study presented a one-pot synthesis of magnetic polydopamine nanoparticles (Fe3O4@-SiO2@PDA NPs) with multiple recognition sites for the magnetic dispersive solid-phase extraction (MDSPE) of ginsenosides from rat plasma treated with white ginseng. The extracted ginsenosides were characterized by combining an ultra-high-performance liquid chromatography coupled to a high-resolution mass spectrometry with supplemental UNIFI libraries. Response surface methodology was statistically used to optimize the extraction procedure of the ginsenosides. The reusability of Fe3O4@-SiO2@PDA NPs was also examined and the results showed that the recovery rate exceeded 80％ after recycling 6 times. Furthermore, the proposed method showed greater enrichment efficiency and could rapidly determine and characterize 23 ginsenoside prototypes and metabolites from plasma. In com-parison, conventional methanol method can only detect 8 ginsenosides from the same plasma samples. The proposed approach can provide methodological reference for the trace determination and charac-terization of different bioactive ingredients and metabolites of traditional Chinese medicines and food.

Phenylketonuria (PKU) is a newborn inherited metabolic disorder caused by the genetic deficiency of hepatic enzyme phenylalanine hydroxylase (PAH) which thus in metabolic disorder of phenylalanine. In this study, ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was used to analyze the accurate amount of coenzyme Q10 (CoQ10) and the relative amount of CoQ9 in newborn dried blood spot (DBS) collected from 5 PKU newborns (3 and 30 days after birth, respectively) and 20 healthy newborns. The content of CoQ10 was (122.1±24.9 ng/mL) and (59.0±12.0 ng/mL) in DBS from healthy newborns and PKU newborns, respectively. The relative contents of cholesterol and glucose in the DBS were determined by gas chromatography-mass spectrometry (GC-MS). In comparison with healthy newborn group, the levels of CoQ10, CoQ9, cholesterol and glucose were all significantly decreased in PKU newborns. The increased content of Phe and the decreased content of CoQ10 showed significant inverse correlation in the DBS from PKU. This study provides references for diet therapy of PKU newborns.

An untargeted urinary metabonomics method based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry ( UPLC-Q-TOF-MS ) has been established to investigate the mechanism of Schisandra chinensis in treating diabetes and its complications. The urinary biomarkers related to the therapeutic effects of Schisandra chinensis on the diabetes rats were analyzed. In urine, 28 kinds of endogenous metabolites were identified as potential biomarkers, including 13 endogenous metabolites in positive ion mode, 15 endogenous metabolites in negative ion mode, and hippuric acid detected both in positive and negative ion modes. The results revealed that Schisandra chinensis mainly affected the pathways of pentose and glucuronate interconversions, riboflavin metabolism, pantothenate and CoA biosynthesis, arginine and proline metabolism, intestinal bacteria metabolism, ascorbate and aldarate metabolism and tryptophan metabolism in diabetic rats. Combined with biological analysis of these pathways, the therapeutic mechanism of Schisandra chinensis on diabetes and its complications was verified. Based on the biological function of each pathway, the effect of Schisandra chinensis on diabetic nephropathy is stronger. Moreover, it also has the effects of protecting liver, decreasing fat and antioxidant activity.

Objective To compare the clinical outcome of intramedullary nail with locking plate in the treatment of two-part proximal humerus fractures.Methods PubMed,SpringerLink,EMBASE,The Cochrane Library,Medline,Science Direct,CNKI,Wanfang Data and VIP database were searched for relevant studies comparing intramedullary nailing and locking plate fixation of two-part proximal humerus fractures.A meta-analysis of the two methods was conducted using the RevMan 5.0.Differences between the two methods were compared with respect to operation time,intraoperative bleeding,bone union time,Constant score and postoperative complication incidence.Results Seven studies were included in the meta-analysis,with 136 patients treated with intramedullary nail and 159 patients treated with locking plate.Intramedullary nailing showed advantages over locking plate fixation with regards to operation time (WMD =-27.71,95％ CI-36.07--19.35,P ＜ 0.05),intraoperative blood loss (WMD =-114.18,95％ CI-169.91--58.45,P ＜ 0.01) and bone union time (WMD =-2.91,95％ CI-5.80--0.01,P ＜ 0.05).While the two methods showed no significant differences in Constant score (WMD =-2.84,95 ％ CI-5.90--0.22,P ＞ 0.05) and postoperative complication incidence (OR =0.89,95％ CI 0.43-1.84,P ＞ 0.05).Conclusion Intramedullary nail is superior to locking plate in operation time,intraoperative blood loss and bone union time for the treatment of two-part proximal humerus fractures,but the two methods are similar in Constant score and postoperative complications rate.

A serumal metabonomics method based on UPLC/Q-TOF-MS was established to investigate the mechanism of Schisandra chinensis to treating diabetic nephropathy. The diabetic model was established by feeding with high-fat and high-sucrose chow and streptozotocin intraperitoneal injection. After intragastric administration for 12 weeks, the content of protein and creatinine in rat urine was detected. The results showed that Schisandra chinensis could reduce the content of protein in urine of diabetic rat ( p<0 . 05 ) and ameliorate the condition of diabetic nephropathy. The serum metabolic profiling was analysed by using UPLC/Q-TOF-MS and partial least squares-discriminated analysis ( PLS-DA) was used for data analysis. The score of PLS-DA showed that there was significant difference among the metabolic profile of control group, model group and Schisandra chinensis group ( WWZ ) . Potential biomarkers of Schisandra chinensis ameliorating diabetic nephropathy were selected by orthogonal partial least squares ( OPLS)-DA model. According to the results of OPLS-DA, the MS/MS data of each compound which provided greater contribution to separation of each group were searched from the HMDB databases. Seven endogenous metabolites were identified as potential biomarkers such as xanthurenic acid, palmitic amide, oleamide, uric acid, 5-hydroxyhexanoic acid, p-cresol sulfate, and p-cresol glucuronide. The results revealed that Schisandra chinensis mainly affected the pathways of tryptophan metabolism, gut microbiota metabolism, purine metabolism and fatty acid metabolism to treating type 2 diabetes mellitus. The gut microbiota metabolism and purine metabolism was an important pathway on diabetic nephropathy.

The brain pharmacokinetics of hyperoside and 1 , 5-dicaffeoylquinic acid and the effects of acanthopanax senticosus leaves on neurotransmitters in cerebral ischemic rat brain were investigated. In the study, acute incompleteness cerebral ischemia model was developed by ligating the bilateral common carotid arteries of rats. The differences of brain pharmacokinetics of hyperoside and 1,5-dicaffeoylquinic acid between control and cerebral ischemic rats were determined by online microdialysis coupled with MS/MS method. At the same time, the contents of glutamic acid (Glu), aspartic acid (Asp), γ-aminobutyric acid (GABA), serotonin (5-HT) , dopamine ( DA) , and acetylcholine( Ach) in rat hippocampus among different groups were determined simultaneously in MRM mode. ACE 5 C18-AR column was used for separation. Results showed that the online analytical method had excellent linearity (R2>0. 99). The accuracy and precision could meet the analysis requirement. Besides, the hyperoside and 1,5-dicaffeoylquinic acid penetrated the blood-brain barrier successfully and metabolized quickly, but the absorption reduced and elimination became faster in cerebral ischemic rats; the contents of Glu, Asp, GABA and DA in brain issue of cerebral ischemic rats decreased significantly ( p<0 . 01 ) and the level of Ach increased remarkably ( p<0 . 05 ) after a preventive medication with the extract of acanthopanax senticosus leaves for one week.

High-speed counter-current chromatography (HSCCC) was used to high performance separate and prepare lignans from Schisandrae chinensis fructus. The solvent system is composed of n-hexane-ethyl acetate-methanol-water (9 : 1 : 5 : 5) and n-hexane-ethyl acetate-methanol-water (9 : 1 : 9 : 5), speed is at 900 r.min-1, and flow rate is at 2.0 mL.min-1. Five fractions from Schisandrae chinensis fructus extract were separated and prepared with one HSCCC process. They were identified as schisandrin, gomisin J, schisandrol B, schisantherin A and deoxyschizandrin by electrospray ionization-multiple tandem mass spectrometry (ESI-MSn), respectively. Their contents were obtained in 98.74%, 94.32%, 99.53%, 94.23% and 98.68% by ultra high performance liquid chromatography (UPLC), separately. The rapid and simple method can be applied for the preparation of lignans from Schisandrae chinensis fructus.

To evaluate the effects of ginseng aqueous extract on learning and memory abilities and neurochemicals in diabetic encephalopathy rat brain. Diabetes mellitus model was established. Cognitive abilities were evaluated with Morris water maze test by the indexes of escape latency time ( ELT) , times of passing through the target area and the percent of swimming track in goal quadrant. We applied online MD-LC-MS/MS method to determine eight neurochemicals in rat hippocampus among different groups in MRM mode. Venusil C18 column was used for separation. Treatment with ginseng aqueous extract significantly improved the cognitive abilities of diabetic rats (p<0. 05). The method had excellent linearity (R2>0. 99). The accuracy and precision could meet the analysis requirement. Comparing with the model group, the concentrations of taurine and acetylcholine were significantly increased ( p<0 . 01 ) after treated with ginseng aqueous extract, but the glutamic acid, aspartic acid,γ-aminobutyric acid, serine, dopamine and serotonine decreased dramatically. Ginseng aqueous extract can efficiently regulate the levels of eight neurochemials in diabetic rat brain to normal.