Content determination and chemometric analysis of 11 components in Xueli zhike syrup / 中国药房

OBJECTIVE To determine the contents of 11 components in Xueli zhike syrup， establish its chemometric method and provide reference for its quality control. METHODS HPLC method was established to simultaneously determine the contents of amygdalin， deapi-platycoside E， platycoside E， platycodin D3， euscaphic acid， tormentic acid， maslinic acid， corosolic acid， praeruptorin A， praeruptorin B and praeruptorin E in 12 batches of Xueli zhike syrup. The quality evaluation of 12 batches of samples was performed by chemometrics. RESULTS The 11 components had good linear relationships within their respective ranges （r≥0.999 1）； RSDs of precision， reproducibility and stability （24 h） tests were all lower than 2.00%. The average recovery rates ranged 96.90%-100.01% （RSDs were all lower than 2.00%）. Cluster analysis showed that 12 batches of samples were clustered into 3 groups. Principal component analysis showed that the first two principal components could represent 88.53% information of 11 components in Xueli zhike syrup. Partial least squares-discrimination analysis showed that euscaphic acid， amygdalin and praeruptorin A were the main potential markers affecting the quality of Xueli zhike syrup. CONCLUSIONS The established method can be used to control the quality of Xueli zhike syrup.

Efficacy and safety of Regan Syrup in treatment of common cold (wind-heat syndrome):a multicenter, randomized, double-blind, double-dummy, placebo and positive drug-controlled, parallel, phase Ⅱb clinical trial / 中国中药杂志

Regan Syrup has the effect of clearing heat, releasing exterior, benefiting pharynx and relieving cough, and previous phase Ⅱ clinical trial showed that the efficacy of Regan Syrup high-dose and low-dose groups was better than that of the placebo group, and there was no statistically significant difference in the safety between the three groups. The present study was conducted to further investigate the efficacy and safety of the recommended dose(20 mL) of Regan Syrup in the treatment of common cold(wind-heat syndrome). Patients who met the inclusion and exclusion criteria were selected and divided into the test group(Regan Syrup+Shufeng Jiedu Capsules placebo), positive drug group(Regan Syrup placebo+Shufeng Jiedu Capsules) and placebo group(Regan Syrup placebo+Shufeng Jiedu Capsules placebo) at a 1∶1∶1 using a block randomization method. The course of treatment was 3 days. A total of 119 subjects were included from six study centers, 39 in the test group, 40 in the positive drug group and 40 in the placebo group. The onset time of antipyretic effect was shorter in the test group than in the placebo group(P≤0.01) and the positive drug group, but the difference between the test group and the positive drug group was not significant. The test group was superior to the positive drug group in terms of fever resolution(P<0.05), and had a shorter onset time of fever resolution than the placebo group, but without obvious difference between the two groups. Compared to the positive drug group, the test group had shortened disappearance time of all symptoms(P≤0.000 1). In addition, the test group was better than the positive drug group and the placebo group in relieving symptoms of sore throat and fever(P<0.05), and in terms of clinical efficacy, the recovery rate of common cold(wind-heat syndrome) was improved in the test group compared to that in the placebo group(P<0.05). On the fourth day after treatment, the total TCM syndrome score in both test group and positive drug group was lower than that in the placebo group(P<0.05). There was no significant difference in the incidence of adverse events between three groups and none of them experienced any serious adverse events related to the study drug. The results indicated that Regan Syrup could shorten the onset time of antipyretic effect, reduce the time of fever resolution, alleviate the symptoms such as sore throat and fever caused by wind-heat cold, reduce the total score of Chinese medicine symptoms, and improve the clinical recovery rate with good safety.

Functional decompensation after administration of compound diphenoxylate in a maple syrup urine disease patient:case report and literature review / 中华全科医师杂志

A 14-year girl was admitted with akinesia and difficulty walking due to gait instability after two oral doses of compound diphenoxylate (lomotil). When she was 18-month old, drowsiness and inability to walk were observed after taking lomotil, the symptoms were relieved by taking B vitamins for treatment. The laboratory tests showed the increased blood branched chain amino acid levels; gene detection indicated that the child had compound heterozygous variations of c.745G>A(p.G249S) and c.485-1G>C in the BCKDHA gene. The girl was finally diagnosed as maple syrup urine disease. The domestic and foreign literature was searched, and 11 child cases of maple syrup urine disease with onset of unsteadiness and ataxia were reported, none of whom was associated with oral administration of compound diphenoxylate.

Necrosis en espejo de ganglios basales en la enfermedad de la orina con olor a jarabe de arce. Presentación de un caso / Mirror necrosis of basal ganglia in maple syrup urine disease. A case report

RESUMEN La enfermedad de la orina con olor a jarabe de arce es una enfermedad genética autosómica recesiva, cerebral degenerativa. Es causada por un déficit en la actividad de la deshidrogenasa de los cetoácidos de cadena ramificada, que provoca inadecuado almacenamiento de los tres aminoácidos esenciales de dicha cadena. Esto genera una neurotoxicidad severa que puede llevar a la muerte. Se manifiesta clínicamente por deterioro neurológico, retraso psicomotor, problemas de alimentación, orina con olor característico. Sus consecuencias cerebrales pueden ser definidas mediante tomografía axial computarizada. Este artículo tiene como objetivo presentar un caso de enfermedad de la orina con olor a jarabe de arce con hipodensidad bilateral de los ganglios basales por necrosis en espejo, detectado mediante estudio tomográfico. Se trata de una paciente femenina, de 9 años de edad con cuadro anterior de cetoacidosis no diabética. Posterior a la realización de apendicectomía, comenzó con cuadro comatoso que requirió estudio tomográfico mediante el cual se constató edema cerebral. Evolucionó tórpidamente, por lo que requirió nuevo estudio tomográfico que demostró empeoramiento de las condiciones neurológicas al reflejarse en la imagen hipodensidad bilateral a nivel de los núcleos basales por necrosis. La enfermedad de la orina con olor a jarabe de arce es una afección rara, con diversas formas clínicas. Requiere de estudios de laboratorio que la confirmen e imágenes como tomografía computarizada que, como en este caso, ayuden a evidenciar el daño neurológico. Fue muy característica la hipodensidad de ganglios basales asociada a edema cerebral.

ABSTRACT Maple syrup urine disease is an autosomal recessive genetic degenerative brain disease. It is caused by a deficit in branched-chain ketoacid dehydrogenase activity, which causes inadequate storage of the three essential amino acids of said chain. This generates severe neurotoxicity that can lead to death. It is clinically manifested by neurological deterioration, psychomotor retardation, feeding problems, urine with a characteristic odor. Its cerebral consequences can be defined by computerized axial tomography. This article aims to present a case of maple syrup urine disease with bilateral hypodensity of the basal ganglia due to mirror necrosis, detected by tomographic study. This is a 9-years-old female patient with a history of non-diabetic ketoacidosis. After the appendectomy, she began with a coma that required a tomographic study, which revealed cerebral edema. She evolved torpidly, requiring a new tomographic study that showed worsening of the neurological conditions as bilateral hypodensity at the level of the basal nuclei due to necrosis was reflected in the image. Maple syrup urine disease is a rare condition with various clinical forms. It requires laboratory studies to confirm it and images such as computed tomography that, as in this case, help to show the neurological damage. The hypodensity of the basal ganglia associated with cerebral edema was very characteristic.

A Clinical Study to Evaluate Efficacy of KVGAP’S Femicare Syrup on Raktapradara w.s.r to Dysfunctional Uterine Bleeding

Dysfunctional uterine bleeding (Raktapradara) is the commonest gynaecological disorder affecting the quality women’s life of reproductive age group. A clinical study was conducted with KVGAP’S Femicare Syrup on 28 patients of DUB. KVGAP’S Femicare syrup is a polyherbal Ayurvedic formulation prepared from ingredients like Ashoka, Ashwagandha, Gokshura, Guduchi, Shatavari, Manjhistha, Usheera, Kumari, Sariva, Pippali, and Shilajathu. The parameters assessed were number of bleeding episodes, excessive bleeding, investigators global assessment scale, VAS for pain, participants overall assessment scale, clot and interval (number of days of the cycle). Patients were assessed at the beginning of the trail, after 1 month and after 2 months. 56.52%, 73.08%, 77.6%, 85%, 81.93%, 100% improvement were observed in the clinical parameters assessed (number of bleeding episodes, excessive bleeding, investigators global assessment scale, VAS for pain, participants overall assessment scale, clot) respectively. Results were statistically significant. Interval didn’t show any changes. Out of 28 patients in this study, 1 patient shown mild improvement, 11 patients (39%) were shown moderate improvement and 16 patients (57%) had marked improvement. Overall effect of the treatment was 77.31%. This study showed that KVGAP’S Femicare syrup showed promising results in treating DUB. Hence it can be concluded that KVGAP’S Femicare Syrup is effective and safe in the management of dysfunctional uterine bleeding.

A Comparative Clinical Study to Evaluate the Efficacy of Nayopayam Syrup and Vyaghryadi Syrup in the Management of Tamaka Shwasa

Tamaka shwasa is a Pitta Sthana Samudbava Pranavaha srotovikara in which the aggravated Kapha and Vata doshas plays a major role in causing Sthanasamshraya in the Pranavaha srotas, where Udrita kapha gets accumulated and causes obstruction to the normal movement of Prana Vata, which ends up in Pratiloma Gati of Vata producing the Lakshanas of Shwasa. This pathology is similar with that explained in modern i.e., bronchial asthma, where the inflammation of the airway is produced by broncho-constriction. The peak incidence of bronchial asthma is seen in 5 to 10 years of age group. Its prevalence range is 4 to 32% for 6 to 7 years old children. In childhood, there is a 2:1 male/female preponderance but the sex ratio gets equalizes by age 30. The prevalence of bronchial asthma is increasing by age worldwide. Nayopayam Kashayam and Vyaghryadi Kashayam having Vatakaphahara and Shawasahara property, mentioned in Arogya Raksha Kalpa Drumam and Ashtanga Hrdayam respectively are the formulations taken for the study

Herbal Textual Research on Maltose in Famous Classical Formulas / 中国实验方剂学杂志

In this paper， the name， varieties， raw materials and manufacturing technology of maltose in the famous classical formulas were researched by consulting the herbal medicines， medical books， prescription books and modern literature of past dynasties， which provided the basis for the development and utilization of formulas containing maltose. Through textual research， it can be seen that the name of maltose has been derived from its shape， texture， preparation method， raw materials and producing area. In ancient times， maltose was mainly divided into soft and hard types according to the texture. Those who are wet and soft as honey are called "syrup" or "jelly"， while those who are hard and white are called "malt" and "sugar". In modern times， they are mostly called malt sugar， only jelly is used as medicine， and malt is mostly used as food. Throughout the ages， medicinal maltose were made of Oryza sativa var. glutinosa as the raw material and Hordeum vulgare as malt， prepared by fermenting， decocting and concentrating. The maltose made from other cereals such as Setaria italica var. germanica， Panicum miliaceum is slightly inferior in quality. The 2020 edition of Chinese Pharmacopoeia did not include maltose， but included malt sugar， a pharmaceutical excipient， which was a crystal powder with high purity. But maltose was included in the national food standard and the local processing specification. Based on the textual research results， it is suggested that malt syrup in GB/T 20883-2017 can be used as the reference for the development of formulas containing maltose， and O. sativa var. glutinosa， H. vulgare are clearly used as raw materials.

Study on HPTLC identification of one-plate multi-drug and HPLC content determination method for Jizhi syrup / 中国药房

OBJECTIVE To optimize the existing t hin layer chromatography （TLC）identification and content determination methods of Jizhi syrup. METHODS High performance thin-layer chromatography （HPTLC）was used to identify five medicinal materials in Jizhi syrup ，such as Ilex chinensis ，Houttuynia cordata ，Peucedanum praeruptorum ，Citrus aurantium ，Glycyrrhiza uralensis. High performance liquid chromatography （HPLC）was used to determine the contents of procatechuic acid ，ephedrine hydrochloride and naringin in Jizhi syrup. RESULTS HPTLC results showed that the identification spots of pedunculoside ， praeruptorin A ，naringin，and liquiritin were clearly displayed ，and the retention factors were in the range of 0.2 to 0.8. After validation，the method had been proved to be strongly specific ，robust and repeatable. HPLC results showed that the linear ranges of protocatechuic acid ，ephedrine hydrochloride and naringin were 4.32-431.67，1.14-114.17 and 7.02-702.33 μg/mL（all r＞ 0.996），respectively. The average recoveries were 100.61％，100.40％ and 99.22％，and RSDs were all less than 2.00％. RSDs of precision（n＝6），stability（24 h，n＝7）and repeatability （n＝6）were all less than 2.00％. The average contents of the three components in 10 batches were 623.3，152.1，1 213.9 μg/mL（RSD＜10.00％），respectively. CONCLUSIONS In this study ， HPTLC method of one-plate multi-drug is established for the identification of Jizhi syrup. One sample pretreatment method and two TLC conditions are used to realize the rapid identification of five kinds of medicinal materials. An HPLC method is established to determine the content of Jizhi syrup ，which realizes the fast quantification of three active components in Jizhi syrup ，and can be used to optimize the identification and content determination items in the existing legal quality standards of Jizhi syrup.

Quantitative Determination of Branched-Chain Amino Acids in Dried Blood Spot Samples by LC-MSMS and its Application in Diagnosis and Follow-Up of Chilean Patients with Maple Syrup Urine Disease

Abstract Elevation of branched-chain amino acids (BCAAs) in biological fluids indicates a deficiency in the branched-chain ketoacid dehydrogenase complex, which causes maple syrup urine disease (MSUD). Detection of increased levels of alloisoleucine confirms the diagnosis, while routine monitoring of leucine concentration is crucial for preventing metabolic decompensation and neurological dysfunction. In the metabolic center at Universidad de Chile, we have confirmed and monitored more than fifty MSUD patients in the last 20 years. Most diagnoses were made by clinical and sibling diagnosis, as MSUD is not included in the Chilean national newborn screening program. Shortening diagnosis time has a fundamental impact on the outcome of patients, therefore we focused on implementing detection of BCAAs in dried blood spot by liquid chromatography mass spectrometry (LC-MSMS) for disease confirmation as well as for biochemical monitoring. Retrospective analysis of samples from 9 diagnosed MSUD patients were performed; BCAAs values were determined via MSMS and LC-MSMS conducted in parallel. Leucine and alloisoleucine levels were positively correlated with patient's diagnosis age. Alloisoleucine was significatively elevated as early as 24 hr after birth. A predictable variation in BCAAs levels after nutritional intervention among diagnosed MSUD patients was found.

Clinical utility of low branched-chain amino acid modular diets in patients with isovaleric aciduria and maple syrup urine disease

@#Introduction: Modular diets (MDs) with low amount of offending amino acids have been developed using locally available food ingredients as alternatives to commercial formulas for the treatment of branched-chain organic acidurias (BCOAs). Herein, we conducted a clinical investigation of MDs in patients with BCOAs. Methods: Modular diet A (MDA), with low leucine was produced for maple syrup urine disease (MSUD), and modular diet B (MDB) products, MDB-1, -2, -3, and -4, with low leucine, valine, methionine and threonine were made for isovaleric aciduria (IVA)/methylmalonic aciduria (MMA)/propionic aciduria (PA). Children aged 4-18 years, with MSUD, IVA, PA or MMA were invited to participate in the study. The research subjects switched from metabolic formula protocol to modular diet protocol. They were followed-up at 0, 1, 2, 4, and 6 months. Clinical efficacies of MDs were determined by completion of study, compliance to MDs, clinical outcomes and complications, and parental satisfaction. Results: Six children (2 MSUD and 4 IVA) participated and completed the study. Compliance to MDA was 100% in MSUD subjects with G-tube feeding, while compliance to MDB varied among self-fed individuals with IVA. One subject with MSUD was clinically stable throughout the study, while the other experienced metabolic instability. All IVA individuals showed clinical and laboratory stability during the study. One MSUD and three IVA families preferred the metabolic formula, whereas the other IVA family reported no preference and the other MSUD subject preferred MDs. Conclusion: We provided a proof of concept in developing modular diets for BCOAs, and showed favourable outcomes when using MDs in IVA and varying clinical benefits in MSUD.

Heterozygous living donor liver transplantation for pediatric maple syrup urine disease with new compound mutation of BCKDHB gene: a case report and literature review / 器官移植

Objective To evaluate the clinical efficacy of heterozygous living donor liver transplantation for pediatric maple syrup urine disease. Methods A 3-year-old boy was admitted to the hospital on July 5, 2017 due to maple syrup urine disease for half a year. The child presented with paroxysmal dysarthria and motor dysfunction of the lower limbs under fasting status for half a year, accompanied with obvious maple syrup urine odor and slow language development. No other growth abnormality or mental defects were observed. Serum branched chain amino acid (BCAA) assay detected that the level of leucine was 684 μmol/L and 559 μmol/L for the valine. The child was diagnosed with maple syrup urine disease type b based on gene detection combined with BCAA assay. Living donor liver transplantation from his biological father was performed. Postoperatively, routine immunosuppression, anti-virus, anti-infection therapies, maintenance of fluid, electrolyte, and acid-base balance and other necessary nutritional support were given. The dose of tacrolimus was adjusted according to biochemical parameters and cytochrome P450(CYP)3A5 genotype of the recipient. Glucocorticoid administration was terminated at approximately 6 months after operation. Results The liver function of the recipient was recovered to normal range at postoperative 1 month, and basically stabilized at 3 years after surgery. The amino acid level was decreased to normal level immediately after operation, and BCAA was continually declined after normal diet for postoperative 1 month. As of the submission date, the recipient grew well in a stable condition and achieved high quality of life. Conclusions Heterozygous living donor liver transplantation is a safe and effective treatment of maple syrup urine disease, which reduces the possibility of sudden acute metabolic events, significantly improves the quality of life of the recipient and provides a novel idea for surgical treatment of maple syrup urine disease.

One step assay of the four plant ingredients in Yangxue Anshen syrup by HPLC method / 药学实践杂志

Objective To establish a HPLC method for simultaneous determination of quercitrin, luteoloside, rutin and 2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside in Yangxue Anshen syrup. Methods Waters symmetry C18 column (250 mm×4.6 mm, 5 μm) was used with 0.1% acetic acid (A) and methanol (B) as the mobile phase. Gradient elution was performed at a flow rate of 1.0 ml/min, 0-15 min, 95%-90%A; 15-35 min, 90%-70%A; 35-55 min, 70%-60%A; 55-85 min, 60%-50%A; 85-95 min, 10%A. The detection wavelengths were 256 nm and 320 nm. Column temperature was 30 ℃ and the injection volume was 10 μl. Results Quercitrin, luteoloside, rutin and 2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside showed good linear relationship within the range of 10-300, 5.0-150.0, 5.0-150.0, 20.0-600.0 µg/ml(r≥0.9989), respectively. The average recovery was (96.75±1.41)%, (99.61±1.01)%, (97.18±1.96)% and(99.12±0.97)% (n=6), respectively. Conclusion The established method is simple, accurate and stable, which can be used for the simultaneous determination of 4 components in Yangxue Anshen syrup.

Prospective production of fructose and single cell protein from date palm waste

BACKGROUND: Fructose and single cell protein are important products for the food market. Abundant amounts of low-grade dates worldwide are annually wasted. In this study, highly concentrated fructose syrups and single cell protein were obtained through selective fermentation of date extracts by Saccharomyces cerevisiae. RESULTS: The effect of air flow (0.1, 0.5, 0.75, 1, 1.25 and 1.5 vvm) and pH (4.5, 4.8, 5, 5.3 and 5.6) was investigated. Higher air flow led to lower fructose yield. The optimum cell mass production of 10 g/L was achieved at air flow of 1.25 vvm with the fructose yield of 91%. Similar cell mass production was obtained in the range pH of 5.0­5.6, while less cell mass was obtained at pH less than 5. Controlling the pH at 4.5, 5.0 and 5.3 failed to improve the production of cell mass which were 5.6, 5.9 and 5.4 g/L respectively; however, better fructose yield was obtained. CONCLUSIONS: Extension of the modified Gompertz enabled excellent predictions of the cell mass, fructose production and fructose fraction. The proposed model was also successfully validated against data from literatures. Thus, the model will be useful for wide application of biological processes.

Compliance with 14 day zinc therapy for acute diarrhoea: a prospective observational study

Background: Acute diarrheal diseases remain a leading cause of global morbidity and mortality in young children. The effective implementation of provision of zinc in addition to low osmolarity ORS remains very poor.Methods: A prospective observational study was done to determine compliance with zinc therapy on 103 children aged between two months to five years with acute gastroenteritis. They were started on WHO ORS and zinc in the form of syrup (20 mg/day in those >6 months of age and 10mg/day in those <6 months of age) and advised to continue for 14 days. Further episodes of diarrhea was considered as the primary outcome variable. Number of days zinc taken was considered as the primary explanatory variable. p-value <0.05 was considered statistically significant.Results: The mean age was 19.49'14.41 months. The compliance to complete 14-day zinc therapy was 62.14%.' The mean number of days zinc was taken was 11.28'3.81 days. In 11.65% of participants, there was further episodes of diarrhea. The main reasons for discontinuation were diarrhea stopped (45%), Ignorance (37.5%), URI (12.5%).Conclusions: Findings indicate that the syrup formulation is acceptable, but further efforts are required to enhance adherence. These findings also highlight the importance of guiding in ensuring adherence to zinc duration while also addressing the tendency of caregivers to terminate treatment once a child appears to have recovered from an acute diarrheal episode.

Diálisis peritoneal en un neonato con enfermedad de la orina con olor a jarabe de arce. A propósito de un caso / Peritoneal dialysis in a neonate with maple syrup urine disease. A case report

La enfermedad de jarabe de arce es una entidad autosómica recesiva producida por un error congénito en el metabolismo de tres aminoácidos esenciales de cadena ramificada: valina, leucina e isoleucina. La forma neonatal de esta enfermedad se manifiesta por un cuadro de compromiso neurológico grave y progresivo, asociado a un olor peculiar de la orina, consecuencia de la eliminación del exceso de estos aminoácidos. Este olor a azúcar quemada remeda a la melaza obtenida de los arces, lo que da nombre a esta enfermedad. El mejor método para eliminar estos tóxicos es la hemodiafiltración, pero, en los centros en los que esta práctica no es posible, la diálisis peritoneal constituye una alternativa.Se presenta a un recién nacido con leucinosis, con compromiso grave del sistema nervioso central, en quien la diálisis peritoneal fue de utilidad para superar la descompensación metabólica.

Maple syrup disease is an autosomal recessive entity caused by a congenital error in the metabolism of three essential branched-chain amino acids: valine, leucine and isoleucine. The neonatal form of this disease is expressed by a severe and progressive neurological compromise, associated with a peculiar smell of urine, a consequence of the elimination of the excess of these amino acids. This smell of burnt sugar mimics the molasses obtained from maples, which gives its name to this disease. The best method to eliminate these toxins is hemodiafiltration, but in centers where this practice is not possible, peritoneal dialysis is an alternative.We present a newborn with leukinosis with severe central nervous system involvement in whom peritoneal dialysis was useful to overcome metabolic decompensation.

Preferential mode of zinc and adherence to treatment: zinc syrup or zinc tablet

Background: Diarrhoea has evident itself among the leading causes of under-five childhood mortality globally as well as in India. Although the benefits of zinc supplementation in diarrhoea management have been established, there remain many barriers to the widespread implementation of this treatment strategy. In India, a very small proportion of children in need, 20 per cent in urban and merely 5 per cent in rural, have access to zinc supplementation. The study aimed to assess zinc adherence in the community and find out the preferential mode of zinc as tablet or syrup, to stick to the scheduled adherence.Methods: The proposed method of study is a simple household survey complimented by secondary research around the preference and usage of zinc and ORS among under five children, suffered from diarrhoea in the last 14 days preceding the survey date.Results: The study revealed that 95 per cent of the respondents preferred zinc syrup over zinc tablet for treatment of diarrhoea due to its ease to administer and palatable taste to children. Eighty nine per cent of the total urban and 62 per cent of total rural respondents received zinc in syrup form, indicating the preferred mode of zinc by service providers over tablets.Conclusions: It has been observed that the caregivers tend to give the complete dosage of zinc if it is available in the syrup form. However, it is important to generate evidence to understand the preferential mode of zinc; tablet or syrup in terms of administration of drug, its usage and its cost.

Study on HPLC Fingerprints of Nauclea officinalis Extract Syrup and Content Determination of 9 Components / 中国药房

OBJECTIVE： To establish HPLC fingerprints of Nauclea officinalis extract syrup， and to determine the contents of 9 components. METHODS： HPLC method was adopted. The determination was performed on Diamonsil C18（2）column with mobile phase consisted of acetonitrile-0.1％ phosphoric acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 240 nm， and column temperature was 30 ℃. The sample size was 10 μL. Using strictosamide as reference， HPLC chromatograms of 20 batches of N. officinalis extract syrup were drawn. The similarity of HPLC chromatograms were evaluated by using TCM Fingerprint Similarity Evaluation System （2004A edition） to confirm common peaks. The contents of 9 components were determined by standard curves. RESULTS： There were 26 common peaks in 20 batches of HPLC chromatograms， and the similarity was higher than 0.98. Compared with mixed control， 9 chemical components were identified， such as 3，4-dihydroxybenzoic acid， neochlorogenic acid， loganic acid， chlorogenic acid， cryptochlorogenic acid， swertioside， pumiloside， strictosamide and vincosamide. The linear range of 9 components were 17.24-275.84， 7.56-120.96， 15.40-246.40， 7.84-125.44， 8.64-138.24， 7.96-127.36， 8.40-134.40， 48.56-776.96， 4.16-66.56 μg/mL（all r≥0. 999）， respectively. The limits of detection were 0.043 1， 0.126 0， 0.038 5， 0.130 7， 0.144 0， 0.066 3， 0.070 0， 0.012 1， 0.052 0 μg/mL， respectively. The limits of quantitation were 0.215 5， 0.189 0， 0.077 0， 0.196 0， 0.288 0， 0.132 7， 0.105 0， 0.097 6， 0.138 7 μg/mL， respectively. RSDs of precision， stability and reproducibility tests were all lower than 2.0％ （n＝6）. Average recoveries were 99.6％、106.3％、100.1％、102.0％、98.4％、100.0％、99.3％、100.6％ and 101.2％， and RSDs were 1.20％、0.24％、0.59％、1.00％、0.73％、1.30％、1.10％、1.80％、1.90％（n＝6）. CONCLUSIONS： Established HPLC fingerprints and quantitative determination method of N. officinalis extract syrup are accurate， specific and sensitive. It can provides reference for quality control of N. officinalis extract syrup.

A comprehensive policy for reducing sugar beverages for healthy life extension

The excessive consumption of sugar-sweetened beverages is a public health concern worldwide. Several clinical trials examining the effects of consuming sucrose or high-fructose corn syrup demonstrated the link between this consumption and increased risk factors for cardiometabolic diseases. In this issue of Environmental Health and Preventive Medicine, Li et al. examined the sugar-sweetened beverage consumption among undergraduate students and evaluated the relationship between this consumption and the "late" chronotype, sleep duration, and weight increase. They concluded that the sugar-sweetened beverage intake might mediate the associations among sleep duration, late chronotype, and weight gain and that the intake of sugar-sweetened beverages in the evening may be a risk factor for the development of overweight/obesity. A systematic review and meta-analysis of prospective cohort studies and randomized controlled trials provided evidence that the consumption of sugar-sweetened beverages promotes weight gain in both children and adults. The World Health Organization guideline highly recommends reducing the intake of sugars to less than 10% of one's total energy intake. The Dietary Approaches to Stop Hypertension diet and the Mediterranean diet were shown to help individuals refrain from sweets and sugar-containing beverages. A global evaluation revealed how much disability during accumulated lifetime hours is due to sugar-sweetened beverages. Interventions are necessary, but many individuals find it quite difficult to reduce or eliminate their high intake of sugar-sweetened beverages. The taxation of sugar-sweetened beverages was demonstrated to have a significant positive influence on individuals' planned purchases and the probability of the purchase of healthy beverages. Western countries are working on the social regulation of sugar-sweetened beverages, but Japan has not implemented any similar regulations. The social regulation of sugar-sweetened beverages is necessary to stop the increase of diabetes morbidity and the increase in dementia that often accompanies this morbidity.

Characteristics of poisoning in younger children according to different forms of the drugs

PURPOSE: This study aimed to investigate the characteristics of poisoning drug ingested by younger children, and to compare the clinical outcome by drug forms.METHODS: This was a retrospective analysis based on medical records from the Emergency Department based Injury In-depth Surveillance (EDIIS) registry in Korea from January to December 2015. Patients aged 7 years or younger visiting the emergency department (ED) with drug poisoning were included. We classified the forms of drugs as tablets or syrup, and analyzed the characteristics by size, color, and shape. In addition, clinical outcomes and ED length of stay were compared according to the drug forms.RESULTS: A total of 308 cases were collected, and 202 patients finally were analyzed. Tablets and capsules (TACs) were more common than syrup (67.3% vs. 32.7%). Regarding clinical outcomes, patients who took TACs had higher admission rate (17.6% vs. 7.6%, P = 0.040) without a significant difference in ED length of stay compared to those who took syrups. While commonly ingested drugs in TACs were hormones, sedative and analgesics, frequent drugs in syrup were antihistamines and cold drugs. In 136 case of TACs, median long and short axes were 0.85 cm (interquartile range [IQR], 0.7–1.1 cm) and 0.72 cm (IQR, 0.59–0.82 cm), respectively. Chromatic TACs were 80 cases (58.8%) and more common than achromatic TACs. Round shapes were preferred than angular ones (96.3% vs. 3.7%).CONCLUSION: In younger children poisonings, the TACs showed higher incidence and admission rate compared to syrups. Especially, chromatic TACs and round shapes were preferred. Therefore, drugs with these characteristics need to be stored more carefully.

Effects of commercial dry syrups on tooth surfaces / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to investigate the effects of dry syrups on bovine tooth surfaces. METHODS: Each specimen of the extracted bovine teeth enamel was treated with two types of dry syrup (experimental group), mineral water (negative control group), and liquid syrup (positive control group) (n=12 per group). The specimens were immersed for 1, 5, and 10 minutes and subsequently analyzed for surface microhardness changes using a Vickers hardness tester. RESULTS: The surface microhardness of sound enamel decreased as the immersion time increased. In addition, the microhardness difference (ΔVHN) among the groups after immersion for 10 minutes in both liquid syrup and two types of dry syrup was higher than that after immersion in mineral water (P0.05). CONCLUSIONS: These results imply the erosive potential of dry syrup on tooth surfaces. The longer the contact time with teeth, greater is the risk of dental erosion. Therefore, it is recommended that the mouth be rinsed with water after drinking the syrup.