A rapid analytical method for simultaneous determination of 32 kinds of multi-residue veterinary drugs in eggs was developed using a modified QuEChERS technique based on a reduced graphene oxide-coated melamine sponge(r-GO@MeS)by ultra-high performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS).The influences of graphene oxide(GO)concentrations,sponge dosages,and purification modes on drug recoveries were investigated during the purification process.The optimal purification conditions involved using a GO concentration of 0.5 mg/mL,a sponge dosage of 6.0 cm3/mL,and a dynamic purification mode of 5 extrusion cycles.Separation was achieved using an Agilent Eclipse Plus C18 RRHD column(100 mm×2.1 mm,1.8 μm),and quantitative analysis was performed by the external standard method using an electrospray ionization source(ESI)in multiple reaction monitoring(MRM)mode.The results showed that all 32 kinds of veterinary drugs exhibited good linear correlation with coefficients greater than 0.999,and matrix effects(MEs)ranging from?7.8%to 18.9%.The limits of detection(LODs)and quantification(LOQs)ranged from 0.2 to 10.2 μg/kg and from 0.6 to 28.0 μg/kg,respectively.The recoveries for the three spiked levels were in the range of 66.5%?117.5%,with intra-day and inter-day precision(Relative standard deviation)below 13.3%and 16.3%,respectively.The synthetic r-GO@MeS exhibited efficient matrix purification without the need of high-speed centrifugation or strong magnetic field assistance.This significantly shorted the sample pretreatment time and improved the convenience of the matrix purification process.Combined with UPLC-MS/MS,the method was suitable for the rapid determination of multi-residue veterinary drugs in eggs.

Objective To investigate the influence of modified Shashen Maidong Decoction combined with Camrelizumab immunotherapy plus chemotherapy on the efficacy,survival status and serum cytokeratin 19 fragment(CYFRA21-1)and neuron-specific enolase(NSE)levels in patients with advanced non-small cell lung cancer(NSCLC).Methods Forty patients with advanced NSCLC of lung-stomach yin deficiency with intense heat-toxin type were randomly divided into a control group and a study group,with 20 patients in each group.The patients in the control group were given Camrelizumab immunotherapy plus chemotherapy,and the patients in the study group were given modified Shashen Maidong Decoction combined with Camrelizumab immunotherapy plus chemotherapy,with 21 days as a course of treatment and for a total of 4 courses of treatment.The changes of serum NSE and CYFRA21-1 levels in the two groups before and after treatment were observed,and the clinical efficacy,survival status and the incidence of toxic and side effects were compared between the two groups.Results(1)After 4 courses of treatment,the total effective rate of the study group was 70.00%(14/20),which was significantly higher than that of the control group(9/20,45.00%),but the intergroup comparison(tested by chi-square test)showed that the difference was not statistically significant(P＞0.05).(2)After 2 years of follow-up,the overall survival(OS),time to progression(TTP),and progression-free survival(PFS)of the patients in the study group were significantly prolonged compared with those in the control group(P＜0.01).(3)After treatment,the serum NSE and CYFRA21-1 levels of the patients in the two groups were decreased compared with those before treatment(P＜0.05),and the decrease of serum NSE and CYFRA21-1 levels in the study group was significantly superior to that in the control group(P＜0.01).(4)The incidence of toxic and side effects in the study group was 25.00%(5/20),which was significantly lower than that of 65.00%(13/20)in the control group,and the intergroup comparison showed that the difference was statistically significant(P＜0.05).Conclusion Modified Shashen Maidong Decoction combined with Camrelizumab immunotherapy plus chemotherapy has satisfactory therapeutic effect on patients with advanced NSCLC,which can reduce the toxic and side effects of chemotherapy,lower the level of serum tumor markers,and prolong the survival period and time to progression(TTP)of the patients.

Objective To observe the effects of modified Poge Jiuxin decoction combined with acupuncture in the treatment of septic cardiomyopathy(SIC),and explore its possible mechanism.Methods Totally 72 patients with SIC admitted to Chengdu First People's Hospital from January 2022 to June 2023 were enrolled.The patients were divided into control group and treatment group according to random number table method,with 36 cases in each group.Patients in control group received basic treatment for SIC.On this basis,the treatment group was administrated with modified Poge Jiuxin decoction[includes Prepared Aconite 30 g(earlier decocted),Red Ginseng 30 g(another stew),Cornel Meat 60 g,Dried Ginger 30 g,Raw Keel 30 g(earlier decocted),Raw Oyster 30 g(earlier decocted),Magnet 30 g(earlier decocted),Poria Cocos 90 g,Plantain Seeds 30 g(in bag),Roasted Licorice 60 g,Musk 0.5 g(artificial)],one dose a day,100 mL in 3 meals a day.Acupuncture at bilateral Zusanli,Guangyuan,Neiguan,Sanyinjiao and Qihai points,twice a day.Both groups were treated for 7 days.The changes of C-reactive protein(CRP),procalcitonin(PCT),cardiac tropomin I(cTnI),N-terminal pro-B type natriuretic peptide(NT-proBNP)and lactic acid(Lac)were observed before and after treatment,acute physiology and chronic health evaluationⅡ(APACHEⅡ)and sequential organ failure assessment(SOFA)were calculated,left ventricular ejection fraction(LVEF),left ventricle fractional shortening(LVFS),and mitral orifice early/late diastolic blood flow velocity ratio(E/A ratio)were measured with echocardiography,the heart rate(HR),mean arterial pressure(MAP),mechanical ventilation time,vasoactive drug use time,in the intensive care unit(ICU)stay time,the incidence of multiple organ dysfunction syndrome(MODS)and 28-day mortality were recorded.Results After treatment,the indexes of inflammation(CRP,PCT),myocardial markers(cTnI,NT-proBNP),hemodynamics and perfusion(HR,Lac),illness severity score(APACHEⅡ,SOFA)and the 28-day mortality in the two groups were significantly reduced,while LVEF and MAP were significantly increased compared to before treatment.The improvement of various indexes in the treatment group were better than those in the control group[CRP(mg/L):22.18±9.46 vs.68.45±13.46,PCT(μg/L):1.16±0.59 vs.4.35±1.28,LVEF:0.48±0.06 vs.0.41±0.05,cTnI(μg/L):0.60±0.14 vs.0.98±0.30,NT-proBNP(ng/L):204.35±26.54 vs.240.12±56.12,HR(bmp):88.75±10.05 vs.98.57±10.56,MAP(mmHg,1 mmHg≈0.133 kPa):82.10±5.08 vs.73.46±3.55,Lac(mmol/L):0.75±0.28 vs.1.60±0.36,APACHEⅡscore:10.46±1.80 vs.15.50±2.16,SOFA score:2.60±1.24 vs.6.76±1.60,all P<0.05].After treatment,LVFS and E/A ratio in the two groups increased significantly compared to those before treatment,however,there was no significant difference between the treatment group and the control group after treatment[LVFS:(25.12±3.46)%vs.(22.61±3.88)%,E/A ratio:1.16±0.46 vs.0.96±0.32,both P>0.05].The vasoactive drug use time and ICU stay time were shortened in the treatment group than those in the control group[vasoactive drug use time(days):9.62±3.05 vs.10.48±3.40,ICU stay time(days):12.51±2.04 vs.13.72±1.14,both P<0.05],the incidence of MODS and the 28-day mortality were lower than those of the control group[38.89%(14/36)vs.52.77%(9/36),44.44%(16/36)vs.47.22%(17/36)],but there were no statistical differences(both P>0.05).Conclusion Modified Poge Jiuxin decoction combined with acupuncture can effectively improve the prognosis of patients with SIC,and its mechanism may be related to inhibition of inflammatory reaction and improvement of cardiac function.

Objective To investigate clinical characteristics and the risk factors of sepsis-induced myocardial dysfunction(SIMD),and to provide evidence for the diagnosis,treatment and prevention of SIMD.Methods The clinical data of 284 patients with sepsis(≥18 years old)admitted to the department of critical care medicine of Chengdu Integrated Traditional Chinese Medicine&Western Medicine Hospital/Chengdu First People's Hospital from January 2020 to December 2022 were retrospectively analyzed.This includes gender,age,chronic underlying diseases,the mean arterial pressure(MAP),heart rate(HR),laboratory test results,disease severity score,the proportion of requiring mechanical ventilation,vasoactive drugs treatment and renal replacement therapy,length of intensive care medicine(ICU)stay and the 28-day mortality.Patients were divided into SIMD group and non-SIMD group according to the occurrence of SIMD,allowing for an analysis of the clinical characteristics of two groups of patients.Univariate and multivariate Logistic regression analyses were used to identify the risk factors of SIMD,and receiver operator characteristic curve(ROC curve)were plotted to analyze the predictive value of each risk factor for the occurrence of SIMD.Results A total of 284 septic patients were included,including 136 cases(47.89％)in the SIMD group and 148 cases(52.11％)in the non-SIMD group.Compared with the non-SIMD group,the levels of age,N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac tropomin I(cTnI),lactic acid(Lac)at admission to ICU,the proportion of vasoactive drugs treatment,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)and sequential organ failure assessment(SOFA)in the SIMD group were significantly higher than those in the non-SIMD group[age(years):75.92±2.35 vs.55.02±1.68,NT-proBNP(ng/L):3 037.00±544.50 vs.2 493.92±630.21,cTnI(μg/L):0.12±0.07 vs.0.06±0.03,Lac in ICU(mmol/L):4.46±1.21 vs.2.98±1.02,the proportion of vasoactive drugs treatment:40.44％(55/136)vs.21.62％(32/148),APACHEⅡ score:24.25±1.02 vs.20.95±0.85,SOFA score:7.41±4.69 vs.6.21±2.81,all P<0.05],but the 24-hour Lac clearance rate of the SIMD group was significantly lower than that of the non-SIMD group[(13.80±7.01)％vs.(25.41±8.90)％,P<0.05].Multivariate Logistic regression analysis showed that age≥75 years,24-hour Lac clearance rate and NT-proBNP≥3 000 ng/L were the independent factors of SIMD in patients with sepsis[odds ratio(OR)and 95％confidence interval(95％CI)were 5.990(2.143-16.742),0.348(0.155-0.786)and 2.708(1.093-6.711),P values were 0.001,0.011 and 0.031].ROC curve analysis showed that age,24-hour Lac clearance rate,NT-proBNP had predictive value for the development of SIMD[area under the curve(AUC)were 0.637,0.811,0.743,95％CI were 0.573-0.701,0.761-0.860,0.687-0.800,all P<0.05].Conclusions SIMD occurs more frequently in patients with sepsis.Increased age,elevated NT-proBNP,and reduced 24-hour Lac clearance rate are independent risk factors of SIMD,warranting clinical attention.

This study aims to explore the effect of tryptanthrin on potential metabolic biomarkers in the serum of mice with ulcerative colitis(UC) induced by dextran sulfate sodium(DSS) based on liquid chromatography-mass spectrometry(LC-MS) and predict the related metabolic pathways. C57BL/6 mice were randomly assigned into a tryptanthrin group, a sulfasalazine group, a control group, and a model group. The mouse model of UC was established by free drinking of 3% DSS solution for 11 days, and corresponding drugs were adminsitrated at the same time. The signs of mice were observed and the disease activity index(DAI) score was recorded from the first day. Colon tissue samples were collected after the experiment and observed by hematoxylin-eosin(HE) staining. The levels of interleukin-4(IL-4), interleukin-10(IL-10), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), and interleukin-8(IL-8) in the serum were measured by enzyme linked immunosorbent assay(ELISA). The serum samples were collected from 6 mice in each group for widely targeted metabolomics. The metabolic pathways were enriched by MetaboAnalyst 5.0. The results showed that compared with the model group, tryptanthrin treatment decreased the DAI score(P<0.05), alleviated the injury of the colon tissue and the infiltration of inflammatory cells, lowered the levels of proinflammatory cytokines, and elevated the levels of anti-inflammatory cytokines in the serum. The metabolomic analysis revealed 28 differential metabolites which were involved in 3 metabolic pathways including purine metabolism, arachidonic acid metabolism, and tryptophan metabolism. Tryptanthrin may restore the metabolism of the mice with UC induced by DSS to the normal level by regulating the purine metabolism, arachidonic acid metabolism, and tryptophan metabolism. This study employed metabolomics to analyze the mechanism of tryptanthrin in the treatment of UC, providing an experimental basis for the utilization and development of tryptanthrin.
Mice ; Animals ; Colitis, Ulcerative/drug therapy* ; Tryptophan ; Arachidonic Acid/metabolism* ; Mice, Inbred C57BL ; Colon ; Cytokines/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Interleukin-6/metabolism* ; Metabolomics ; Purines/therapeutic use* ; Dextran Sulfate/metabolism* ; Disease Models, Animal ; Colitis/chemically induced*

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

OBJECTIVE: To observe the clinical efficacy of transcutaneous electrical acupoint stimulation (TEAS) combined with warm acupuncture in treating breast cancer associated with upper limb lymphedema (BCRL). METHODS: This was a retrospective cohort study using a paired control design. Fifty-two BCRL patients were assigned to the control group (27 cases) and the treatment group (25 cases). The patients in the control group were treated with lymphedema comprehensive detumescence treatment (CDT) for 4 weeks, including systematic therapy composed of manual lymphatic drainage, compression bandage, skincare, and functional exercise. The patients in the treatment group were treated with TEAS combined with warm acupuncture based on the control group methods. Each treatment lasted for 30 min and was applied twice a week for 4 weeks. The arm circumference (AC) of different positions of the affected limb and the degree of swelling of the affected limb were evaluated before the first treatment and after the last treatment. The clinical efficacy was evaluated according to the degree of edema before and after treatment. All adverse events during treatment were recorded. RESULTS: The patients' AC and the swelling feeling of the affected limb in the treatment group and the control group were both reduced compared with those before treatment. Compared with the control group, AC of the wrist joint transverse stria, the midpoint between the wrist joint transverse stria and the elbow joint transverse stria in the treatment group were significantly reduced (P<0.05). The decrease in AC diameter at the midpoint between the elbow joint transverse stria and the axillary transverse stria was the most significant (P<0.01). The swelling degree of the affected limbs in the treatment group was significantly lower than before treatment, and was significantly lower compared with the control group after treatment (P<0.01). The total effective rate was 72% in the treatment group, significantly higher than that in the control group (55.56%, P<0.05). No serious adverse events occured in either group. CONCLUSIONS TEAS combined with warm acupuncture can effectively reduce AC and swelling feeling of the affected limb in patients with BCRL. The effect is better than that of CDT therapy alone. (Registration No. ChiCTR2200062075).
Humans ; Female ; Breast Neoplasms/therapy* ; Acupuncture Points ; Retrospective Studies ; Lymphedema/complications* ; Acupuncture Therapy/adverse effects* ; Upper Extremity ; Treatment Outcome

This study selected three typical Chinese herbs with cold property(Rhei Radix et Rhizoma, Scutellariae Radix, and Coptidis Rhizoma) and another three with heat property(Cinnamomi Cortex, Zingiberris Rhizoma, and Aconiti Lateralis Radix Praeparata) to observe their regulatory effects on metabolism in animal organism, especially on lipid and energy metabolism in mice after a short-(7 d) and long-term(35 d) intervention. The mRNA expression levels of lipid metabolism genes in epididymal adipose tissue and liver were determined by real-time PCR. The oxygen consumption, carbon dioxide production, and energy consumption were detected by metabolic system. After the short-term intervention, the Chinese herbs with heat property significantly reduced epididymal adipose tissue index and elevated the expression levels of acetyl-CoA carboxylase(ACC), lipoprotein lipase(LPL), and carnitine-palmityl transferase 1(CPT-1) in liver and epididymal adipose tissues. However, those with cold property promoted the expression of above-mentioned genes in epididymal adipose tissue. After the long-term intervention, cold and heat Chinese herbs had no significant effect on epididymal adipose tissue index of animals, while cold Chinese herbs could increase carbon dioxide production and energy consumption and reduce activity. These findings demonstrated that the short-term intervention effects of cold and heat Chinese herbs on animal metabolism were significantly stronger than the long-term intervention effects. Specifically, the short-term intervention with cold Chinese herbs enhanced the lipid metabolism in epididymal adipose tissue, while the heat Chinese herbs promoted lipid metabolism in epididymal adipose tissue and liver. The long-term intervention with cold and heat Chinese herbs resulted in no obvious change in lipid level, but long-term intervention with cold Chinese herbs accelerated energy consumption of the body. This study preliminarily observed the effects of cold and heat Chinese herbs on normal animal physiology from lipid and energy metabolism, which would provide reference for explaining the biological basis of Chinese herbs with cold or heat property based on biological response.
Aconitum ; Animals ; Carbon Dioxide ; China ; Drugs, Chinese Herbal/pharmacology* ; Energy Metabolism ; Hot Temperature ; Lipids ; Mice

In our previous study, we found that Si Miao Formula (SMF) had the effect of improving the disorder of glucose metabolism caused by high fat and high sucrose diet, and significantly altered the composition of gut microbiota, especially increasing the level of Akkermansia muciniphila (A. muciniphila). However, it is unclear that the role of intestinal flora and A. muciniphila play in SMF improving blood glucose homeostasis, and the mechanism of how SMF increases the level of A. muciniphila. Therefore, this study will explore the correlation between SMF improving the insulin resistance and increasing the level of A. muciniphila, as well as the mechanism of SMF-induced growth of A. muciniphila using the in vitro and in vivo experiments. We explored the effect of intestinal flora and A. muciniphila on SMF-improved insulin resistance through fecal microbiota transplantation (FMT) and antibiotic intervention. In order to study the mechanisms underlying SMF on elevating A. muciniphila, we disassembled SMF to find the key component which can particularly elevate the number of A. muciniphila. Using the in vitro anaerobic culture system combined with cell and animal experiments, we explored the mechanism of the key component in elevating A. muciniphila. The research was approved by the Animal Ethical and Welfare Committee of Shanghai University of Traditional Chinese Medicine. Our results showed that the gut microbiota altered by SMF can improve high fat and sucrose diet induced insulin resistance in recipient mice, and the improvement was closely related to the abundance of A. muciniphila. Cortex Phellodendri played the most important role in regulating the composition of intestinal flora and increasing the number of A. muciniphila, of which, berberine was the key component of Cortex Phellodendri which up regulated A. muciniphila. We have found that berberine cannot directly promote the growth of A. muciniphila in vitro, but it can stimulate the expression of mucin, which, in turn, promote the growth of A. muciniphila. The above results show that the improved insulin sensitiviy by SMF depends on the increased level of A. muciniphila. The effect of SMF on elevating the amount of A. muciniphila might be correlated with the increased expression of mucin stimulated by berberine.

OBJECTIVE: To investigate the application value of liquid crystal digital display goniometer in total hip arthroplasty. METHODS: From January 2018 to December 2019, 83 patients underwent primary total hip arthroplasty, including 28 males and 55 females, aged 42 to 81 (70.4±7.9) years. There were 63 cases of femoral neck fracture and 20 cases of avascular necrosis of femoral head. All patients used liquid crystal digital goniometer to control the anteversion of acetabular cup prosthesis during operation, and CT scanning was used to measure the anteversion of acetabular cup after operation. The two methods were compared to understand the accuracy of using liquid crystal digital goniometer. RESULTS: Postoperative CT measurement showed that the acetabular anteversion of all patients was in the safe area advocated by Lewinnek. The anteversion angle of acetabular cup measured by liquid crystal digital goniometer was 14.20(12.80 to 15.40)°, and the anteversion angle of acetabular cup measured by postoperative CT scan was 14.20 (13.40 to 15.50)°. There was no significant difference between the two ( CONCLUSION It is an accurate and reliable method to control the anteversion of acetabular cup with liquid crystal digital display angle instrument, which has a good auxiliary reference value.
Acetabulum/surgery* ; Arthroplasty, Replacement, Hip ; Female ; Hip Prosthesis ; Humans ; Liquid Crystals ; Male ; Retrospective Studies