UHPLC-MS/MS for plasma lamotrigine analysis and comparison with a homogenous enzyme immunoassay.

Aims: To develop and validate a UHPLC-MS/MS method for lamotrigine (LTG) analysis in human plasma and evaluate its agreement with a homogenous enzyme immunoassay (HEIA). Materials & methods: The UHPLC-MS/MS method was developed and validated according to the USFDA/EMA guidelines. A Bland-Altman plot was used to evaluate the agreement between UHPLC-MS/MS and HEIA. Results: Samples were pretreated with one-step protein precipitation and separated in 2.6 min. The intra- and inter-day bias and imprecisions were -15.8 to 15.0% and less than 11.17%, respectively. The recovery and matrix factor were 98.30 to 111.97%. The mean overestimation of UHPLC-MS/MS compared with HEIA was 21.57%. Conclusion: A rapid, sensitive and robust UHPLC-MS/MS method for plasma LTG analysis was developed and validated and was a 21.57% overestimation compared with HEIA.

[Discussion on the relationship between the disposal time of hypobaric oxygen chamber and the establishment of rat cardiac arrest model at high altitude].

OBJECTIVE: To establish the rat cardiac arrest model in high-altitude hypobaric hypoxia environment, and to explore the effect of the treatment time in the hypobaric oxygen chamber on the reproduction of high-altitude rat cardiac arrest model. METHODS: SPF grade healthy male Sprague-Dawley (SD) rats were used as observation subjects. The experiment was conducted in two different altitude areas. The rats from the Plateau Branch of Institute of Cardiopulmonary and Cerebral Resuscitation of Sun Yat-sen University (Xining, Qinghai) were weighed and numbered, and they were placed in a hypobaric oxygen chamber (simulated altitude of 3 000 meters, speed of ascent and descent of 15 m/min, temperature of 20 centigrade, cabin pressure of 69.5 kPa, cabin oxygen pressure of 14.5 kPa). After 30 days of feeding, the rats were obtained according to random number table method, and the cardiac arrest model was established by asphyxia method as the 30-day hypobaric hypoxia group. After 60 days of feeding, rats were randomly selected again, and the cardiac arrest model was established as the 60-day hypobaric hypoxia group. Thirty rats were randomly selected from the Institute of Cardiopulmonary Cerebral Resuscitation at Sun Yat-sen University (Guangzhou, Guangdong) by the same method, and the cardiac arrest model was established as the plain control group. The differences in the body weight of rat modeling precursors and the induction time of asphyxia during the modeling process among different groups were compared. RESULTS: Finally, cardiac arrest model was established in 16 rats in the 30-day hypobaric hypoxia group and in 22 rats in the 60-day hypobaric hypoxia group. There was no significant difference in the body weight of rats before modeling among the plain control group, 30-day hypobaric hypoxia group and 60-day hypobaric hypoxia group [g: 429.00 (389.25, 440.75), 440.00 (415.50, 486.25), 440.00 (400.00, 452.50), all P > 0.05]. The asphyxia induction time of rats in the 60-day hypobaric hypoxia group was significantly longer than that in the 30-day hypobaric hypoxia group (s: 294.59±75.39 vs. 234.31±93.86, P < 0.01), even about 1.4 times of the plain control group (s: 294.59±75.39 vs. 208.73±30.88, P < 0.01). There was no significant difference in the asphyxia induction time between the 30-day hypobaric hypoxia group and the plain control group (P > 0.05). CONCLUSIONS: Rats treated in a hypobaric oxygen chamber for 60 days are more suitable for the preparation of high-altitude cardiac arrest model, and are also consistent with the oxygen reserve and hypoxia tolerance of high-altitude rats.

Orbitally forced and internal changes in West African rainfall interannual-to-decadal variability for the last 6000 years.

Recent variability in West African monsoon rainfall (WAMR) has been shown to be influenced by multiple ocean-atmosphere modes, including the El Niño Southern Oscillation, Atlantic Multidecadal Oscillation and the Interdecadal Pacific Oscillation. How these modes will change in response to long term forcing is less well understood. Here we use four transient simulations driven by changes in orbital forcing and greenhouse gas concentrations over the past 6000 years to examine the relationship between West African monsoon rainfall multiscale variability and changes in the modes associated with this variability. All four models show a near linear decline in monsoon rainfall over the past 6000 years in response to the gradual weakening of the interhemispheric gradient in sea surface temperatures. The only indices that show a long-term trend are those associated with the strengthening of the El Niño Southern Oscillation from the mid-Holocene onwards. At the interannual-to-decadal timescale, WAMR variability is largely influenced by Pacific-Atlantic - Mediterranean Sea teleconnections in all simulations; the exact configurations are model sensitive. The WAMR interannual-to-decadal variability depicts marked multi-centennial oscillations, with La Niña/negative Pacific Decadal Oscillation and a weakening and/or poleward shift of subtropical high-pressure systems over the Atlantic favoring wet WAMR anomalies. The WAMR interannual-to-decadal variability also depicts an overall decreasing trend throughout the Holocene that is consistent among the simulations. This decreasing trend relates to changes in the North Atlantic and Gulf of Guinea Sea Surface Temperature variability. Supplementary Information: The online version contains supplementary material available at 10.1007/s00382-023-07023-y.

Impact of paleoclimate on present and future evolution of the Greenland Ice Sheet.

Using transient climate forcing based on simulations from the Alfred Wegener Institute Earth System Model (AWI-ESM), we simulate the evolution of the Greenland Ice Sheet (GrIS) from the last interglacial (125 ka, kiloyear before present) to 2100 AD with the Parallel Ice Sheet Model (PISM). The impact of paleoclimate, especially Holocene climate, on the present and future evolution of the GrIS is explored. Our simulations of the past show close agreement with reconstructions with respect to the recent timing of the peaks in ice volume and the climate of Greenland. The maximum and minimum ice volume at around 18-17 ka and 6-5 ka lag the respective extremes in climate by several thousand years, implying that the ice volume response of the GrIS strongly lags climatic changes. Given that Greenland's climate was getting colder from the Holocene Thermal Maximum (i.e., 8 ka) to the Pre-Industrial era, our simulation implies that the GrIS experienced growth from the mid-Holocene to the industrial era. Due to this background trend, the GrIS still gains mass until the second half of the 20th century, even though anthropogenic warming begins around 1850 AD. This is also in agreement with observational evidence showing mass loss of the GrIS does not begin earlier than the late 20th century. Our results highlight that the present evolution of the GrIS is not only controlled by the recent climate changes, but is also affected by paleoclimate, especially the relatively warm Holocene climate. We propose that the GrIS was not in equilibrium throughout the entire Holocene and that the slow response to Holocene climate needs to be represented in ice sheet simulations in order to predict ice mass loss, and therefore sea level rise, accurately.

CEC separation of ofloxacin enantiomers using imprinted microparticles prepared in molecular crowding conditions.

Molecular crowding is a new concept to obtain molecularly imprinted polymers (MIPs) with greater capacity and selectivity, which could shift the equilibrium of a print molecule reacting with functional monomers in the direction of complex formation side. In this work, molecular crowding agent was first applied to the preparation of MIPs microparticles by precipitation polymerization. A new system of molecular crowding surrounding was developed, composed of polystyrene and tetrahydrofuran, in the presence of the template (S)-ofloxacin. Partial filling capillary electrochromatography (CEC) was utilized to evaluate imprinting effect of the resulting microparticles by chiral separations of ofloxacin. Some important parameters in the preparation, i.e. template to monomer ratio, influence of cross-linking monomers and functional monomer composition on the CEC separation of MIP microparticles were investigated. Baseline separation of ofloxacin (R(s) =1.53) was obtained under optimized conditions and the highest theory plate of the later eluent (S)-ofloxacin was 5400. The textural and morphological parameters for imprinted particles, such as Brunauer-Emmett-Teller surface areas, pore volumes and pore size distributions have also been determined. Compared to the MIP microparticle prepared by conventional precipitation polymerization, the (S)-ofloxacin-imprinted particles formed under molecular crowding conditions showed higher selectivity (α=1.09) and separation efficiency (<25 min) in the CEC mode.

Implementation of Knowledge Management in Chinese Hospitals.

The implementation of knowledge management (KM) in hospitals affects efficiency and outcomes of hospitals. However, few studies explored the implementation of KM in China. Twenty-two questions were designed concerning KM implementation status in over 50 hospitals. In order to understand the KM level and attitude to KM of the hospital's managers, a random sampling survey was conducted among 138 managers from 50 different scales of hospitals in 15 provinces of China. The survey showed that overall level of KM implementation in Chinese hospitals was still low and differed among different scales of hospitals (P<0.05, or P<0.01). In all the hospitals investigated, 63.8% did not implement KM yet, among which 46% even had not planned for that. 49.8% of the hospitals investigated had no training program about KM ever and the main source of hospital staff to get knowledge was internet. It suggested that hospital managers should make much more efforts to get to know and understand theories on KM, so that hospital KM could be promoted more rapidly.

Simultaneous determination of plasma methotrexate and 7-hydroxy methotrexate by UHPLC-MS/MS in patients receiving high-dose methotrexate therapy.

The plasma concentrations of methotrexate (MTX) and its major metabolite 7-hydroxy methotrexate (7-OH-MTX) are highly correlated with the toxicities in patients with high-dose MTX therapy. Routine monitoring of MTX and 7-OH-MTX plasma levels is useful for dose adjustment of rescue drugs and toxicity prevention. A UHPLC-MS/MS method for simultaneous determination of plasma MTX and 7-OH-MTX was developed, validated, and applied in 181 plasma samples. The ion transition was m/z 455.2 → 308.2 for MTX and m/z 471.2 → 324.1 for 7-OH-MTX. The flow rate was 0.4 mL/min with a run time of 2.6 min. The calibration range was 0.002-2 µM for MTX, and 0.01-10 µM for 7-OH-MTX. The intra-day and inter-day inaccuracy and imprecision were -5.50% to 10.93% and less than 9.20% for both analytes. The internal standard (MTX-D3) normalized recovery and matrix factor were consistent at four quality control levels. 14 h, 38 h, and 62 h after dosing, MTX and 7-OH-MTX plasma levels were significantly higher in patients with impaired renal function compared to those with normal renal function. 7-OH-MTX plasma levels were significantly higher in patients with impaired liver function compared to those with normal liver function.