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BACKGROUND:Due to the lack of mechanical stimulation generated by functional loading,alveolar bone atrophy and bone loss in the missing area prevents the effective embedding of dental implants.Therefore,it is necessary to implant bone meal during implantation to compensate for the lack of alveolar bone height on the stability of the implant. OBJECTIVE:To derive the optimal time point for second-stage restorations from a biomechanical perspective by means of finite element analysis,thereby providing a biomechanical basis for selecting the correct time point for second-stage restoration to shorten the clinical course of dental implantation. METHODS:Three-dimensional finite element models of the maxilla were developed for normal,16-deficient with conventional implant surgery(model B)and 16-deficient with internal maxillary sinus lift(model A).Model A was filled with hydroxyapatite bone powder between the mucosa and the maxillary sinus floor,and Model B and the normal maxillary bone model did not require bone grafting.The healing time of bone grafting was set at 3-9 months postoperatively,and a force of 200 N was applied to the adjacent teeth at 3-5 months postoperatively,and directly to the implant at 6-9 months,simulating the load applied to the implant in the second stage of restoration.Biomechanical analysis of the three models was performed with the aid of the implants and the surrounding hard and soft tissues. RESULTS AND CONCLUSION:The stress on Model A and Model B was around 103 MPa and 95 MPa respectively when the force was directly loaded onto the implant.Bone grafting increased the stress values on the implant,while not doing bone grafting reduced the stress on the implant and the whole system.As the strength of the bone powder increased,the stress values on the alveolar bone decreased.When the healing time was up to 6-9 months postoperatively,the stress values were ranked as follows:normal model<Model B<Model A,when the force was loaded in the implant or the corresponding first molar sites.The stress on the maxilla after dental implantation was higher than that on the normal maxilla.There was a slight downward trend in cancellous bone stress in Model A and significantly lower stress levels in Model B than in the normal mandible model at 6-9 months.To conclude,the use of the original alveolar bone for restoration can improve the survival rate of the implant;the second-stage restoration can be considered after 6 months when sufficient alveolar bone height is obtained after implantation.In clinical application,the timing of second-stage restoration can be adjusted appropriately on the basis of the patient's bone quality,lifestyle,age and other factors after comprehensive determination.
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OBJECTIVE@#This study aimed to investigate the potential relationship between urinary metals copper (Cu), arsenic (As), strontium (Sr), barium (Ba), iron (Fe), lead (Pb) and manganese (Mn) and grip strength.@*METHODS@#We used linear regression models, quantile g-computation and Bayesian kernel machine regression (BKMR) to assess the relationship between metals and grip strength.@*RESULTS@#In the multimetal linear regression, Cu (β = -2.119), As (β = -1.318), Sr (β = -2.480), Ba (β = 0.781), Fe (β = 1.130) and Mn (β = -0.404) were significantly correlated with grip strength ( P < 0.05). The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was -1.007 (95% confidence interval: -1.362, -0.652; P < 0.001) when each quartile of the mixture of the seven metals was increased. Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength, with Cu, As and Sr being negatively associated with grip strength levels. In the total population, potential interactions were observed between As and Mn and between Cu and Mn ( P interactions of 0.003 and 0.018, respectively).@*CONCLUSION@#In summary, this study suggests that combined exposure to metal mixtures is negatively associated with grip strength. Cu, Sr and As were negatively correlated with grip strength levels, and there were potential interactions between As and Mn and between Cu and Mn.
Subject(s)
Cross-Sectional Studies , Bayes Theorem , China/epidemiology , Metals/toxicity , Arsenic , StrontiumABSTRACT
@#Abstract: Objective To explore the threshold of ALT for initiating antiviral therapy in HBV infected patients, and to provide a basis for initiating antiviral therapy in chronic HBV-infected patients. Methods This retrospective cohort study recruited 707 consecutive treatment-naïve chronic hepatitis B (CHB) patients undergoing diagnostic liver biopsy in the department of infectious diseases of the Affiliated Hospital of Yan′an University from October 2013 to August 2018. Liver biopsy specimens were obtained under ultrasound guidance using Menghini 16G disposable needles. The METAVIR scoring system, which is commonly used internationally, was used to divide the patients into the group with mild liver tissue injury and the group with significant liver tissue injury, and the alanine aminotransferase (ALT) levels were measured separately. Receiver operating characteristic (ROC) curve and Mann-Whitney U test were used to evaluate the diagnostic value of ALT for significant liver tissue injury under different demographic characteristics. Results Of 707 patients, 292 (41.30%) had significant liver tissue injury confirmed by liver biopsy (METAVIR ≥A2 and/or F2). When the ULN of ALT was set to NICE criteria (30 U/L for males, 19 U/L for females), AASLD criteria (35 U/L for males, 25 U/L for females) and EASL or APASL criteria (40 U/L for males and females), CHB patients with <ULN accounted for 32.38%, 35.03% and 36.07% of significant liver tissue injury, respectively. And significant liver tissue injury in CHB patients with 1-2×ULN accounted for 41.99%, 41.85% and 50.30%, respectively. The optimal ALT critical values were 33 U/L for overall patients, 25 U/L for females, 45 U/L for males, 45 U/L for ≤30 years olds, 33 U/L for>30 years olds, 22 U/L for HBeAg negative and 31 U/L for HBeAg positive patients. Conclusions The threshold of ALT for initiating antiviral therapy in chronic HBV patients should be individualized, especially should be down-regulated for the females, olders and HBeAg-negative patients.
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Objective: To compare and analyze the perioperative clinical effects of minimally invasive Ivor-Lewis esophagectomy (MIE-Ivor-Lewis) and minimally invasive McKeown esophagectomy (MIE-McKeown). Methods: A total of 147 patients who underwent endoscopic esophageal cancer surgery from April 2018 to August 2019 were selected, including 85 patients undergoing MIE-McKeown surgery and 62 patients undergoing MIE-Ivor-Lewis surgery. The measurement data were expressed as (x±s), the comparison of normally distributed measurement data was performed by independent sample t-test, and the comparison of count data was performed by χ(2) test or Fisher's exact test. Results: The operation time of McKeown (M) group and Ivor-Lewis (IL) group were (219.2±72.4) minutes and (225.8±65.3) minutes. The mediastinal lymph node dissection number of M and IL groups were 13.3±4.8 and 11.6±6.5, respectively. The number of left recurrent laryngeal nerve lymph node dissection were 3.5±1.2 and 3.1±1.4, respectively. The intraoperative blood loss were (178.3±41.3) ml and (163.2±64.1) ml, respectively. The number of patients reoperated for postoperative bleeding were 1 and 0, respectively. The number of patients with postoperative gastric bleeding were 0 and 1, respectively. The postoperative chest tube retention time were (2.8±1.3) days and (3.1±1.2) days, respectively. The number of patients with anastomotic leakage were 7 and 1, respectively. The number of patients with lung infection were 13 and 5, respectively, and with chylothorax were 2 and 1, respectively, without statistically significant difference (P>0.05). The number of patients with hoarseness were 11 and 3, respectively. The total incidence of complication were 41.2% (35/85) and 17.7% (11/62), and the postoperative hospital stay were (14.7±6.5) days and (12.3±2.3) days, with statistical difference (P<0.05). Conclusion: MIE-Ivor-Lewis and MIE-McKeown are safe and effective in treating esophageal cancer, but the complication of MIE-Ivor-Lewis is less than that of MIE-Mckeown, and the perioperative clinical effect of MIE-Ivor-Lewis is better than that of MIE-McKeown.
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Humans , Anastomotic Leak/etiology , Esophageal Neoplasms/surgery , Esophagectomy/adverse effects , Minimally Invasive Surgical Procedures/adverse effects , Postoperative Complications/epidemiology , Retrospective Studies , Treatment OutcomeABSTRACT
Objective:To investigate the clinical characteristics and risk factors of alcoholic liver disease (ALD) combined with type 2 diabetes mellitus (T2DM).Methods:The clinical data of 70 patients with ALD combined with T2DM (ALD + T2DM group) who received treatment from March 2015 to March 2020 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. The clinical data of 69 patients with ALD (ALD group) and 69 patients with T2DM (T2DM group) who concurrently received treatment were also analyzed. Sex, age, body mass index, drinking habits and other basic information in the three groups were collected. The risk factors of ALD combined with T2DM were evaluated by logistic regression analysis.Results:The daily alcohol intake and years of drinking in the ALD + T2DM group were (110.97 ± 79.78) g/d and (25.17 ± 10.05) years, respectively, which were significantly higher than (91.48 ± 64.26) g/d and (21.78 ± 8.91) years respectively in the ALD group ( t = 1.699, 2.102, both P < 0.05). The incidence of metabolic syndrome in the ALD + T2DM group was 34.3% (24/70), which was significantly higher than 15.9% (11/69) in the ALD group ( χ2 = 6.210, P < 0.05). The activity ratio of aspartate aminotransferase/alanine aminotransferase, total bilirubin level, gamma glutamyl transpeptidase activity in the ALD + T2DM group were 1.59 ± 0.93, (64.73 ± 39.90) μmol/L, (522.93 ± 353.66) U/L, respectively, which were significantly higher than (1.04 ± 0.53), (10.37 ± 4.51) μmol/L, (35.73 ± 23.99) U/L, respectively in the T2DM group ( t = 4.280, 3.780, 5.045, all P < 0.05). Triacylglycerol level in the ALD + T2DM group was significantly higher than that in the ALD group [(1.69 ± 1.04) mmol/L vs. (1.28 ± 0.87) mmol/L, t = 2.523, P < 0.05). Prothrombin time and lactate dehydrogenase activity in the ALD + T2DM group were (13.13 ± 2.79) s and (226.17 ± 79.93) U/L, respectively, which were significantly higher than (10.41 ± 0.84) s, (172.63 ± 39.34) U/L, respectively in the T2DM group ( t = 7.715, 4.969, both P < 0.05). Multivariate Logistic regression analysis showed that prothrombin time, triacylglycerol level, years of drinking, gamma glutamyl transpeptidase activity, and amount of drinking were the main risk factors for ALD combined with T2DM ( OR = 2.010, 3.270, 1.230, 1.060, 1.006, all P < 0.05). Conclusion:Patients with ALD combined with T2DM are prone to metabolic syndrome and lipid disorders, which may aggravate the disease. Prothrombin time, triacylglycerol level, years of drinking play an important role in the development of ALD combined with T2DM.
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Objective:To investigate the relationship between Helicobacter pylori(Hp)infection and carotid atherosclerosis(CAS)in the elderly, in order to provide an empirical basis for the prevention and treatment of cardiovascular and cerebrovascular diseases in the elderly.Methods:A total of 287 patients aged 60 years and over admitted to the First Affiliated Hospital of Guangxi Medical University, who underwent the 13C-urea breath test( 13C-UBT), carotid color and two-dimensional Doppler ultrasonography from October 2015 to January 2019, were retrospectively enrolled.Patients were divided into the Hp infection group(n=137)and the non-Hp infection group(n=150). Common high-risk pathogenic factors, blood biochemical indicators, carotid intima-media thickness(IMT)and detection rate of carotid plaque were compared between the two groups. Results:Common high-risk pathogenic factors including age, gender, hypertension, diabetes, obesity, smoking, alcohol consumption, dyslipidemia, and hyperuricemia showed no significant difference between the two groups( P>0.05). The level of high-density lipoprotein cholesterol(HDL-C)was lower in the Hp infection group than in the non-Hp infection group( P<0.05). There was no difference in levels of white blood cells, neutrophils, total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), homocysteine, fasting blood glucose, creatinine or uric acid between the two groups( P>0.05). The detection rates of increased carotid IMT and carotid plaques were higher in the Hp infection group than in the non-Hp infection group(65.0% or 89 cases vs.48.7% or 73 cases, 76.6% or 105 cases vs.64.7% or 97 cases, P<0.01 and 0.05). The detection rate of carotid plaques in the Hp-infected group was higher than that in the non-Hp-infected group( P<0.05). The combined detection rate of increased carotid IMT and plaques was higher in the Hp infection group than in the non-Hp infection group(56.2% or 77cases vs.32.7% or 49 cases, P<0.01). Conclusions:Hp infection may play a role in the occurrence and progression of carotid atherosclerosis through initiating abnormal lipid metabolism.Early intervention and treatment may reduce the incidence of carotid atherosclerosis in patients with Hp infection.
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Curcumin( Cur) is a natural active substance extracted from the roots or tubers of traditional Chinese medicinal materials. It has anti-inflammatory and anti-tumor activities on brain diseases. Due to the poor stability,low solubility,poor absorption and low bioavailability of curcumin,N-acetyl-L-cysteine( NAC) was used as an absorption enhancer and mixed with curcumin to improve the absorption of curcumin in the body. In this paper,curcumin was smashed by airflow pulverization,and Cur-NAC mixtures were prepared by being grinded with liquid. Then,the raw material and the product were analyzed by differential scanning calorimetry( DSC),X-ray diffraction( XRD) for structural characterization. The dissolution was determined by high performance liquid chromatography( HPLC) analysis. The characteristic peaks of the samples prepared by grinding method were similar to those of the raw materials,while the melting temperature and the accumulated dissolution degree were not significantly changed. The crystal forms of the products were not changed,and no new crystal form was formed after grinding. After the administration of intranasal powder,blood samples were collected from the orbit,while the whole brain tissues were removed from the skull and dissected into 10 anatomical regions. The concentrations of curcumin in these samples were determined by UPLC-MS/MS. The concentrations of curcumin in plasma and brain were compared at different time points. After intranasal administration of two drugs,it was found that the concentration of curcumin after sniffing up the mixtures in plasma was high,and the concentration of the drug in the olfactory bulb,hippocampus,and pons was increased significantly. Within 0. 083-0. 5 h,the olfactory bulb,piriform lobe and hippocampus remained high concentrations,the endodermis,striatum,hypothalamus and midbrain reached high concentrations within 1-3 h; and the cerebellum,pons and brain extension maintained relatively high concentrations within 3-7 h. The experiment showed that nasal administration of Cur-NAC mixtures can significantly improve the bioavailability of curcumin,and lead to significant differences in brain tissue distribution.
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Animals , Rats , Acetylcysteine , Pharmacology , Administration, Intranasal , Biological Availability , Brain , Brain Chemistry , Chromatography, Liquid , Curcumin , Pharmacokinetics , Tandem Mass Spectrometry , Tissue DistributionABSTRACT
Increasingly more people are in a state between health and disease due to different life styles, which modern medicine calls “suboptimal health”. If the suboptimal health state lasts too long and not interfered in time, it will eventually progress to disease. Early identification of suboptimal health status and early intervention are important for preventing diseases and restoring a healthy state. There are many ways for detecting suboptimal health. A more objective method to diagnose suboptimal health status is by experimental indicators of laboratory medicine. However, there are difficulties in establishing the parameters and reference value ranges in laboratory detection of suboptimal health, and laboratory medicine needs to combine big data analysis and machine learning to make a scientific evaluation of suboptimal health status.
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OBJECTIVE: To summarize the clinical features of spinal muscular atrophy complicated with pulmonary infection in children,and to improve clinicians' understanding of the disease and improve the prognosis. METHODS: The clinical data of 36 children with SMA complicated with pulmonary infection,who were admitted to Yuying Children's Hospital of the Second Affiliated Hospital of Wenzhou Medical University from January 1,2008 to December 31,2017,were retrospectively analyzed. RESULTS: Among of the 36 patients,19 were typeⅠ,9 were typeⅡ,and 8 were typeⅢ. The common clinical manifestations and signs were fever,cough,shortness of breath,laborious breathing,three-concave signs,and crackles in the lungs. Respiratory failure occurred in 11 children,including 7 children(63.6%)with typeⅠSMA,2 children(18.2%)with typeⅡ SMA and 2 children(18.2%)with typeⅢ SMA. Imaging findings showed 5 cases of scoliosis,3 cases being typeⅡ SMA,and 2 being typeⅢ SMA. Pathogenic tests were positive in 18 children:10 cases(55.5%)of type Ⅰ SMA,4 cases(22.2%)of typeⅡ SMA,4 cases(22.2%)of typeⅢ SMA;nosocomial mixed infection with conditioned pathogens was common,among which Burkholderia cepacia was the most common. Three patients died in the hospital,22 patients improved and discharged,and the remaining 11 patients gave up treatment. The number of hospitalizations,the incidence of severe pneumonia and respiratory failure was significantly different between the first 5 years(2008-2012)and the last 5 years(2013-2018)(P<0.05). CONCLUSION: SMA is verysusceptible to pulmonary infection. We should be alert to opportunistic pathogenic bacteria infection and use mechanical ventilation in time for respiratory failure patients. Active and effective respiratory care can reduce the incidence of pulmonary infection and improve the prognosis of SMA children.
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Objective:To explore the effect of nano-carbon in lymph node dissection for thyroid cancer.Methods:46 patients with thyriod cancer were randomly divided into treatment group and control group.The identification rate of lymph nodes,lymph node positivity and parathyroid function were compared after surgery.Results:Compare to the control group,the identification rate of lymph nodes in treatment group was higher (P<0.05),but there was no significant difference on lymph node positivity (P>0.05).what's more,patients with low blood calcium and parathyroid hormone in treatment group were less than that in control group after surgery (P<0.05).The difference of severity of clinical symptoms was not statistically significant (P>0.05).Conclusion:Nano-carbon increases the lymph node identification rate and reduces the risk of parathyriod injury in patients with thyroidectomy.
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To investigate the effect and regulatory mechanism of puerarin on pulmonary arterial hypertension due to hypoxia and the possible accompanying pulmonary fibrosis, The rat model of hypoxic pulmonary hypertension and the rat model of hypoxia were established. Totally 18 clean-grade SD rats were fed and randomly divided into normal control group, model group and hypoxia+medicine group. Each group received intraperitoneal injection 30 min before modeling every day; hypoxia+medicine group was injected with 20 mg·kg⁻¹ puerarin. Normal control group and model group were injected with the equal volume of 0.9% NaCl solution. Normal control group was cultured under normal conditions in the laboratory, while model group and hypoxia+medicine group were cultured in ahypoxia environment for 21 days to observe rat hypoxic characteristics and make the preliminary judgment about modeling. Afterwards, small animal echocardiography, right cardiac catheterization, HE dyeing and other experiments were used to verify the successful modeling, and puerarin has a therapeutic effect in pulmonary hypertension caused by hypoxia in SD rats. Fluorescence quantitative PCR, Western blot and immunofluorescence method were used to detect the changes caused by hypoxia pulmonary fibrosis-associated protein. It was found that puerarin could be given in anoxia to promote the expressions of CD31, VE-cadherin, inhibit the expressions of α-SMA, vimentin and fibronection, namely the inhibition of vascular wall thickening. Puerarin has the therapeutic effect on the pulmonary hypertension and accompanying pulmonary fibrosis in rats induced by hypoxia.
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Objective To analyze adverse pregnancy outcomes among women with high risk and low risk during prenatal screening. Methods Clinical data of 180006 pregnancies in 5 prenatal screening center in Hangzhou were collected. We compared the adverse pregnancy outcomes of high and low risk pregnancies. Results Among 180006 pregnancies (age<35 years old), there were 10296 high-risk cases and 169710 low-risk cases, with 168654 cases followed. There were 9406 high-risk cases of Down's syndrome (DS) (5.23%), 273 high-risk cases of Edwards' syndrome (ES) (0.15%) and 617 high-risk cases of open neural tube defect (ONTD) (0.34%) . The detection rate of pregnancy outcome of premature birth, spontaneous abortion, termination of pregnancy, stillbirth in the high risk was 5.46%, 0.80%, 1.80%, 0.37%, respectively, and that rate in low risk results was 3.50%, 0.21%, 0.38%, 0.18%, respectively. Adverse pregnancy outcomes in high-risk group were significantly higher than that in low-risk group (all P<0.001) . The actual incidence rate of DS, ES or ONTD in high-risk group (4.56‰, 1.65‰, 0.97‰, respectively) were significantly higher than that in low-risk group (0.12‰, 0.04‰, 0.09‰, respectively, all P<0.001) . The detection rates of prenatal screening were 70.15%, 68.00% and 38.46%, and false positive rates were 5.23% , 0.14% and 0.34% . Conclusion High risk of serum prenatal screening analysis is associated with adverse pregnancy outcomes. The number of pregnancies experienced invasive prenatal diagnosis can be reduced by routine serum prenatal screening. That is an Effective method to reduce the birth defects.
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Objective To investigate the clinical and rehabilitation treatment of hypertrophic olivary degeneration(HOD)secondary to brainstem hemorrhage.Methods The clinical data of one patient with HOD secondary to pontine hemorrhage was retrospectively analyzed. In addition to the disability of the primary disease,involuntary jitter of the right limb gradually presented and aggravated.The patient re-ceived physical therapy,occupational therapy,acupuncture,hydrotherapy and medication.Results After one and a half-month rehabilitation and treatment,the patient improved from standing unsteadily and unable to walk to standing and walking independently.The score of Berg Balance Scale improved from 28 to 38,and the score of modified Barthel Index improved from 70 to 80.The involuntary jitter of the right limb was relieved.Conclusion The symptoms and disabilities of HOD secondary to pontine hemorrhage can be relieved by medication and rehabilitation,and the activities of daily living can be improved.
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BACKGROUND: Zirconia all-ceramic restorations have been widely used in the repair of various complicated dental or dentition defects. Considering its surface chemical inertness, zirconia bonding is extremely crucial for the clinical practice of zirconia all-ceramic restorations. Currently, there are a variety of clinically selectable bonding materials and surface treatments for dental restorations. OBJECTIVE: To study the effects of different surface treatments and binders on the bonding performance of zirconia. METHODS: Zirconia tiles with different diameters were made and randomly divided into 16 groups (n=30 per group). Super-Bond C & B, polycarboxylic acid zinc binder, Panavia F resin cements and Fuji I of glass ionomer cements were selected. The surface of zirconia was treated by four different methods, including grinding, sand blasting, silane treatment and sand blasting plus silane treatment. Zirconia tiles were bonded by different binders, placed into static distilled at 37 ℃ for 24 hours, and then the shear bond strength was detected using a universal testing machine. RESULTS AND CONCLUSION: (1) With the use of the same binder, four surface treatments showed different effects on the bonding strength (P < 0.05), and the strongest bonding strength appeared after sandblasting plus silane treatment on the zirconia surface. (2) With the use of the same surface treatment, different binders showed different effects on the bonding strength (P < 0.05). Super-Bond C & B binder exhibited the best bonding effect, followed by Panavia F resin cements and Fuji I of glass ionomer cements, and polycarboxylic acid zinc binder showed the worst bonding effect. To conclude, these four surface treatments can all enhance the bonding strength to a certain extent, and Super-Bond C & B binder with sandblasting and silane treatment can achieve the highest bonding strength on the zirconia surface.
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To investigate the effect of taurine(Tau) on ICAM-1, VCAM-1 by p-p38 pathway in bovine pulmonary artery endothelial cells(PAECs) and explore its mechanism of action. Generation 4-12 cells in primary cultures of PAECs were used in experiments and divided into five groups: control group, hypoxia(hyp) group, inhibitor(SB203580) group, treatment(Tau) group, and treatment+inhibitor(SB+Tau) group. The concentration of Tau:100 mmol•L⁻¹; p38 inhibitor SB203580: 20 μmol•L⁻¹; and the treatment time was 12 h. MTT assay was used to detect the inhibitory effect of different concentrations of Tau on PAECs. Western blot and Real-time PCR method were used to detect the p38 pathway proteins and ICAM-1, VCAM-1 expression levels. Immunofluorescence was used to investigate p38 nuclear displacement situation. The results of MTT showed that the inhibitory effect was gradually increased with increasing concentrations of Tau. Western blot and RT-PCR revealed that the protein and mRNA expression levels of ICAM-1, VCAM-1 were reduced by Tau. Western blot and immunofluorescence showed Tau can inhibit p38 activation. Tau may decrease the expression levels of VCAM-1 and ICAM-1 in endothelial cells induced by hypoxia through MAPK p38 pathway.
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The current problem with the hospital registration system in our country is that many patterns among different hospi -tals are not standard which leads to poor efficiency and makes patients inconvenient .We analyzed these mussy patterns and suggested some solutions in combination with the practical situation in our hospital and finally designed a new registration booking system which solves the problem of "long time for payments , registration and treatment waiting"by providing online registration and payment in order to simplify the medical procedures .
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The current problem with the hospital registration system in our country is that many patterns among different hospi -tals are not standard which leads to poor efficiency and makes patients inconvenient .We analyzed these mussy patterns and suggested some solutions in combination with the practical situation in our hospital and finally designed a new registration booking system which solves the problem of "long time for payments , registration and treatment waiting"by providing online registration and payment in order to simplify the medical procedures .
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To study the metabolic products of main compounds of Chuankezhi injection in rat, 12 Sprague Dawley rats were classed into 2 groups, a blank control group and an intermuscular administration group, respectively. Rat feces and urine samples were collected from 0-24 h and 24-48 h after administration. All the samples were ultrasonically treated with methanol and then analyzed using LC-LTQ Orbitrap MSn. By comparison with the total ion chromatogram of samples from the blank control group, the metabolites in the samples of drug-treated group were screened. These metabolites were further analyzed by multistage product ion scanning and comparison of retention time with reference substances. As a result, a total of 12 flavonoid metabolites were tentatively identified from the rat feces and no metabolite was discovered in the rat urine. Epimedin C and icariin were detected in the rat blood samples after 30 min of administration, but their metabolites and other original flavones were not detected. Furthermore, no original flavones and their metabolites were detected in rat blood samples after 2 and 4 h of administration. The potential metabolism paths were further characterized and the principal in vivo transformation of flavones from Chuankezhi injection were deglycosylation, dehydration, methylation, oxidation and isomerization in rats.
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To study pharmacokinetic characteristics of epimedin A, B, C and icariin after intermuscular administration of Chuankezhi injection to rat. The established RRLC-MS/MS method was applied for simultaneous determination of four analytes in rat plasma and calculating their pharmacokinetic parameters. As a result, each analyte showed a good linear relationship in the concentration range of 1-1 000 μg•L⁻¹.The intra-day precise was 96.9%-107.5% with RSD<5.99%, inter-day precise was 92.3%-105.0% with RSD<10.16%. The relative recovery of four analytes was 88.1%-101.1% with RSD<7.9% and their absolute recovery was 72.0%-86.6% with RSD<6.3%. After intermuscular administration of Chuankezhi injection, the plasma concentration of four flavonoid glycosides rapidly arose to peaks at about 10 min, and then quickly declined in rat. Tmax of epimedin A, B, C and icariin was 0.21, 0.19, 0.16 and 0.49 h, respectively, and their mean elimination half-life(t1/2z) was 0.60, 0.62, 0.47 and 0.49 h. The established method was validated to be sensitive, rapid and specific for determination of the four analytes. Serum concentration of 4 species of epimedium flavonoids in Chuankezhi injection was low, and their absorption and elimination seem quickly, displaying similar pharmacokinetic characteristics in this study.
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A quantitative method for epimedin A, B, C and icariin in rat plasma was established using LC-MS/MS after intermuscular administration of Chuankezhi injection to rat. Chromatographic separation was performed on an Agilent Eclipse XDB-C18 column (150 mm×2.1 mm, 5.0 μm) at 40℃. Mobile phase consisted of acetonitrile -0.1% formic acid in water (35:65), and the flow rate was 0.22 mL·min-1. The LC effluent was detected and analyzed using an ESI-triple quadrupole tandem mass spectrometer under the multiple reaction monitoring (MRM) in the negative ion mode. The plasma samples were treated with solid phase extraction prior to LC-MS/MS analysis. As a result, all of the four analytes displayed a good linearity over the concentration of 1-1000 ng·mL-1. The RSDs of intra-day and inter-day assays were less than 5.99% and 10.16%, respectively. The relative recovery of each analyte was between 88.1%-101.1% with RSD<7.9% and the absolute recovery was between 72.0%-86.6% (RSD<6.3%). In conclusion, the established method shows good specificity, sensitivity and efficiency for quantifying the four flavonoid glycosides contained in rat plasma.