Objective: To propose updates and amendments for the nitroglycerin tablets quality in the Chinese pharmacopoeia 2020 due to the failure of effective separation of 4 known impurities and nonseparation of free nitrate ion and excipients.
Methods: Related substances were analyzed using gradient elution by HPLC, and free nitrate ion was determined on SAX column by different HPLC method.
Results: Using the improved method to test the related substances and free nitrate ion of nitroglycerin tablets,the content of the maximum individual impurity were not more than 0.5%, the total content was not more than 2.4% and the content of free nitrate ion was not more than 6.3%.
Conclusion: The improved method is accurate and feasible. It provided a reference for the updates and amendments of the quality standard of nitroglycerin tablets in the Chinese Pharmacopoeia 2020.

The α-synuclein, the main component of Lewy bodies, is closely related to Parkinson's disease (PD) development. Mesenchymal stem cell transplantation has shown a remarkable prospect in PD treatment, and indirect regulation of abnormal α-synuclein-related microenvironment is a key part of its neuroprotective mechanism, but the specific mechanism is extremely complex and remains unclear. We briefly discuss the roles of mesenchymal stem cells in regulating the abnormal α-synuclein related microenvironment by enhancing α-synuclein autophagy, increasing hydrolysis of α-Syn aggregates, and inhibiting α-synuclein intercellular transmission, to help in mesenchymal stem cell transplantation for PD treatment.

Objective:To analyse the pathogenic bacteria distribution and clinical characteristics of late-onset sepsis (LOS) among premature infants with gestational age less than 34 weeks in Henan Province.Methods:The clinical data of 6 590 premature infants admitted to 17 medical institutions in Henan Province from January 2019 to December 2020 were retrospectively analyzed. The gestational age of infants was less than 34 weeks and was admitted to the neonatal ward within 7 days after birth. SPSS 19.0 statistical software was used for data analysis.Results:Among 6 590 premature infants LOS developed in 751 cases (11.40%), of whom the diagnosis was confirmed in 276 cases (36.75%) and 475 cases (63.25%) were diagnosed clinically. The fatality rate related to LOS was 13.58%. There were significant differences in the incidence of LOS and infection-related mortality among infants with different gestational ages and body weights ( χ2=388.894 and 13.572, χ2=472.282 and 9.257, P<0.05 or <0.01). Among 276 children with confirmed LOS, 286 strains of pathogenic bacteria were isolated. Gram-negative bacteria were most prevalent (178 strains), accounting for 62.24% of all infections, followed by fungi (58 strains, 20.28%). Klebsiella pneumoniae was most frequently detected Gram-negative bacteria (117 strains, 40.91%), among which 32.48% (38/117) was carbapenem-resistant Klebsiella pneumoniae. The proportion of diagnosed sepsis, the proportion of catheterization, and the infection-related mortality of infants with LOS in tertiary hospitals were all higher than those in secondary hospitals ( χ2=6.212, 5.313 and 4.435, all P<0.05). The proportion of exclusive breastfeeding in secondary hospitals was lower than that in tertiary hospitals ( χ2=19.216, P<0.05). The time of antibacterial drug use before infection in specialized hospitals was longer than that in general hospitals ( χ2=3.276, P<0.05). Conclusion:The incidence of LOS among preterm infants in Henan Province is high, which was mainly caused by Gram-negative bacteria. The clinical characteristics of LOS caused by different pathogens and in different health institutions are different, the prevention and control strategy should be developed accordingly to reduce the incidence LOS of preterm premature infants.

With the rapid development of instrument technology , Raman spectrometer has become one of the fastest growing type of instrument in the molecular spectroscopy . In recent years , Raman spectrometer gradually emerging in the application in the domain of biology and medicine , Raman spectroscopy technology appears new development constantly in the rapid identification and classification of microorganisms because of its rapid , efficient, sensitive, noninvasive, repeatability and other unique advantages.This article describes its application in the rapid detection of bacteria , viruses and other microorganisms , and also prospects for the application of Raman spectroscopy in future clinical work .

As a novel,label-free and non-invasive detection modality,terahertz(THz,1THz=1012 Hz)spectroscopy has been widely used in various areas.For instance,in the biomedical field,it has great potentials to provide real-time scanning of living cells and tissues due to its unique advantages.Significant achievements have been reached in cell detection, related to bacterial identification, cancer cell characterization and blood cell detection.In tissue detection, the THz spectroscopy can be used to provide real-time scanning of living tissues and fast diagnosis.Furthermore, a single system which integrated THz spectroscopy and THz imaging would be able to collect information more sensitive and comprehensive. However,the clinical adaption of THz spectroscopy is still a controversial issue attributed to some intrinsic limitations and technical bottlenecks.In this article, both the application of THz spectroscopy in cell and tissue detection and the existing challenges and strategies to accelerate clinical applications were reviewed comprehensively.

Objective To investigate the relationship between single nucleotide polymorphism (SNP) of BARD 1 gene and BRCA1 gene in epithelial ovarian cancer (EOC).Methods Nineteen EOC patients with BRCA1 gene mutation and 50 EOC cases without BRCA1 gene mutation between January 2016 and October 2016 were collected,and all EOC were diagnosed by pathological method.BARD1 gene variants were detected by next generation sequencing (NGS).The SNP of BARD1 gene was analyzed by Pearson linear correlation.Logistic regression analysis was used to research the clinicopathologic features and BRCA1 gene mutation associated with BARD1 gene SNP.Pearson's chi-square test was used to analyze the association between BARD1 gene Val507Met,Arg378Ser and Pro24Ser with different clinicopathologic features and BRCA1 gene mutation risk.Results (1) Eight BARD1 gene variants were found in 69 ovarian cancer patients,in which Val507Met,Arg378Ser and Pro24Ser were common variants,and the rate of mutation were all 54％ (37/69).(2) There was a significant linear correlation among Val507Met,Arg378Ser and Pro24Ser (all P＜0.01).(3) Obvious differences were found in Val507Met,Arg378Ser and Pro24Ser of BARD1 gene between BRCA1+ and BRCA1 (all P＜0.05).(4) No differences were found between BARD1 gene Val507Met,Arg378Ser and Pro24Ser and the clinicopathologic features (all P＞0.05),while obvious differences were found in BRCA1 gene mutation compared to the controls group.The risk of BRCA1 mutation in Val507Met and Arg378Ser were more evident in subjects with negative family history,positive menopause history,negative tubal ligation,onset age (≤60 years old) and sensitivity to platinum-based chemotherapy in EOC (all P＜0.05),while Pro24Ser was only more evident in positive menopause history of EOC (P＜0.05).Conclusions BARD1 Val507Met,Arg378Ser and Pro24Ser are the common genotypes,which are associated with BRCA1 mutation in EOC.The family history,menopause history,tubal ligation,onset age and sensitivity to platinum-based chemotherapy have effects on BARD1 SNP in the risk of BRCA1 gene mutation.

Objective To investigate the mutations of BRCA genes in sporadic high grade serous ovarian cancer (HGSOC) and study its clinical significance. Methods Sixty-eight patients between January 2015 and January 2016 from the Affiliated Cancer Hospital of Zhengzhou University were collected who were based on pathological diagnosis of ovarian cancer and had no reported family history, and all patients firstly hospitalized were untreated in other hospitals before. (1)The BRCA genes were detected by next-generation sequencing (NGS) method. (2)The serum tumor markers included carcinoembryonic antigen (CEA), CA125, CA199, and human epididymis protein 4 (HE4) were detected by the chemiluminescence methods, and their correlation was analyzed by Pearson linear correlation. Descriptive statistics and comparisons were performed using two-tailed t-tests, Pearson′s chi square test, Fisher′s exact tests or logistic regression analysis as appropriate to research the clinicopathologic features associated with BRCA mutations, including age, International Federation of Gynecology and Obstetrics(FIGO)stage, platinum-based chemotherapy sensitivity, distant metastases, serum tumor markers (STM). Results (1) Fifteen cases (22%, 15/68) BRCA mutations were identified (BRCA1: 11 cases; BRCA2: 4 cases), and four novel mutations were observed. (2) The levels of CEA, CA199, and HE4 were lower in BRCA mutations compared to that in control group, while no significant differences were found (P>0.05), but the level of CA125 was much higher in BRCA mutation group than that in controls (t=-3.536,P=0.003). Further linear regression analysis found that there was a significant linear correlation between CA125 and HE4 group (r=0.494,P<0.01), and the same correlation as CEA and CA199 group (r=0.897,P<0.01). (3) Single factor analysis showed that no significant differences were observed in onset age, FIGO stage, distant metastasis, and STM between BRCA+and BRCA- group (P>0.05), while significant differences were found in CA125 and sensitivity to platinum-based chemotherapy between the patients with BRCA mutation and wild type (P<0.05). The multiple factors analysis showed that the high level of CA125 was a independent risk factor of BRCA mutations in sporadic HGSOC (P=0.007). Conclusion The combination of CA125 with BRCA have great clinical significance, the mutation of BRCA gene could guild the clinical chemotherapy regiments.

Objective To observe and care Ahmed glaucoma valve implantation early postoperative complications for diabetic patients with neovascular glaucoma , hoping to reduce complications and all its implications hazard .Methods The clinical data of 38 patients ( 38 eyes ) with diabetic neovascular glaucoma who underwent Ahmed glaucoma valve implantation were observed and targeted treatments .Results Among 38 patients (38 eyes) with diabetic neovascular glaucoma , there were 7 cases (7 eyes) with ocular hypotension and shallow anterior chamber , 4 cases ( 4 eyes ) with transient ocular hypertension , 12 cases ( 12 eyes ) with hyphema, 2 cases (2 eyes) with valve tube blockage in the early postoperative .Compared postoperative intraocular pressure with that of preoperative , intraocular pressure was decreased with the average decline (34.17 ±14.99)mmHg.There were 11 cases (11 eyes) with improved vision, one case (one eye) with decreased vision, and 26 cases (26 eyes) with stable vision.Conclusions Blood sugar of stability control in perioperative , patient psychological counseling , individualized treatment of intraoperative and timely detection of postoperative complications to give the right treatment and care with the doctors , can get a more satisfactory clinical efficacy .

Objective To investigate the bacterial resistance in nationwide and understand the distribution of bacterial and resistance trend.MethodsThe 6507 clinical isolates were collected from 19 hospitals in 17 cities.The susceptibility tests were performed using agar dilution method recommended by Clinical and Laboratory Standards Institute (CLSI) in central laboratory.The values of MIC50,MIC90 and MICrange were calculated by SPSS 17.0 and the susceptibilities of isolates to antimicrobial agents were determined by using CLSI (2010) guideline.Of all 6507 isolates,4691 strains were collected from target wards and 1816 were isolated from others wards.ResultsAmong 4691 strains,1156 were Gram-positive (24.6％ ) and 3535 were Gram-negative (75.4％).Based on the minimum inhibitory concentration results,the prevalence of methicillin resistant Stapylococcus aureus and methicillin resistant Stapylococcus epidermidis are 51.6％ ( 325/630 ) and 87.0％ ( 228/262 ) respectively.Staphylococci showing intermediate or full resistance to vancomycin were not observed. Coagulase negative Staphylococci showed 2.5％ (16/642)intermediate rate and 1.6％ ( 10/642 ) full resistance rate to teicoplanin,and showed 0.5％ ( 3/642 )resistance rate to linezolid.Antibiotic resistance rate of Enterococcus faecalis to ampicillin was 17.1％(19/111),while the resistance rate of Enterococcus faecium to ampicillin reached up to 85.0％(164/193).Three Enterococcus faecium were resistant to glycopeptides.The prevalence of penicillin resistance Streptococcus pneumoniae and penicillin intermediate Streptococcus pneumoniae were 41.2％ ( 145/352) and 37.2％ (131/352) respectively based on oral penicillin criterion,while the prevalence were 0.0％ (0/352) and 6.0％(21/352) based on vein to non-meningitis criterion.A vast majority of Enterobacteriaceae maintained high susceptibility to carbapenems,with resistance rate less than 2.0％.In addition,tigecycline,moxalactam,fosfomycin and amikacin displayed desirable antibacterial activity against Enterbacteriaceae,and resistance rates to these drugs were all less than 10.0％.For non-fermenting Gramnegative isolates,resistance rate of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 23.1％ ( 139/601 ) and 53.5％ (419/784) respectively.Resistance rate of Acinetobacter baumannii was much higher than that during the period 2007 - 2008.Colistin,tigecycline,minocycline and fosfomycin demonstrated good antibacterial activity against Acinetobacter baumannii in vitro.Conclusions Compared with MOHNARIN 2007 -2008year surveillance results, significant increase in resistance rate of Acinetobacter baumannii was demonstrated.Resistant strains to linezolid and tigecycline were found.Bacterial resistance has been a widespread problem in our country,which requires much more attention.

OBJECTIVE To investigate the distribution and the drug resistance changes of the pathogenic bacteria isolated from the blood culture specimens collected during the period of 2006-2008.METHODS Blood culture of patients in our hospital was performed by BacT/Alert 240 and the isolated bacteria were identified by API and Microscan and tested for drug resistance against antimicrobial agent by K-B method.A retrospective analysis was made to the blood culture results during the period of 2006-2008 with WHONET 5.4 software.RESULTS Gram-negative rods were the predominant bacteria which caused sepsicemia.The isolated rates of Escherichia coli took the first place during the period of 2006-2008.Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus(SAU) were also the most important pathogens which caused blood infection.The infection rate of coagulase negative staphylococcus(CNS) and P.aeruginosa had increasing tendency.Imipenem and meropenem were the most effective antibiotics(100%) to E.coli and K.pneumoniae.Then amikacin and cefoxitin also had high susceptibility to E.coli and K.pneumoniae.Furthermore,drug susceptibility in 2008 was higher than that of two years before.All antibacterials had low drug susceptibility to P.aeruginosa,and its drug resistance rate rised obviously.The drug resistance situation of Acinetobacter baumannii was serious.Except imipenem and meropenem had relatively higher susceptibility(20-69.2%),the susceptibility to other antibacterials was lower than 41.7%.Vancomycin,teicoplanin and quinupristin/dalfopristin were the most effective antibiotics to(SAU).CONCLUSIONS The species and drug resistance of the bacteria isolated from blood specimens have changed.More attention should be paid to the detection and surveillance of bacterial resistance in blood culture to promote the rational use of antibiotics.