Myocardial injury caused by infection of coronavirus / 中华危重病急救医学

Coronaviruses are single-stranded RNA viruses that are common in animals. In the past 20 years, there have been three large-scale epidemics of coronaviruses, including severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease (COVID). Heart disease is an independent risk factor for severe COVID. At the same time, SARS-CoV-2 infection is often complicated with myocardial injury, which is closely related to poor prognosis. The receptors of SARS coronavirus are angiotensin-converting enzyme 2 (ACE2) and CD209L, among which ACE2 is the main receptor, and ACE2 is abundant in the heart. The receptor of MERS-coronavirus is dipeptide peptidase 4 (DPP4), which is not expressed in myocardial cells, but existed in vascular endothelial cells and blood. These receptors are important factors for the myocardial injury caused by coronavirus infection.

Clinical features and risk factors for secondary hemophagocytic lymphohistiocytosis in elderly patients with severe SARS-CoV-2 infection: a multicenter retrospective cohort study / 中华危重病急救医学

Objective:To explore the incidence of secondary hemophagocytic lymphohistiocytosis (sHLH) in elderly patients with severe SARS-CoV-2 infection, and to analyze and summarize its clinical features and risk factors for early identification of high-risk groups.Methods:A retrospective cohort study was conducted. From January to May 2020, No. 960 Hospital of People's Liberation Army, the Second Hospital Affiliated to Cheeloo College of Medicine of Shandong Province, the First Rehabilitation Hospital of Shandong Province, the Public Health Clinical Center Affiliated to Shandong University, and Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine received 248 patients over 60 years old who were diagnosed with severe SARS-CoV-2 infection during their assistance to Hubei or support for diagnosis and treatment of SARS-CoV-2 infection in Shandong Province. The clinical data of patients were collected. According to the hemophagocytic lymphohistiocytosis diagnosis scoring (HScore) criteria, the patients were divided into sHLH group (HScore > 169) and non-sHLH group (HScore < 98). The demographic data, clinical features, laboratory results, the proportion of organ failure and 60-day mortality of patients were collected and compared between the two groups. The risk factors of sHLH and 60-day death were evaluated through binary multivariate Logistic regression analysis in elderly patients with severe SARS-CoV-2 infection. The receiver operator characteristic curve (ROC curve) was plotted to analyze the diagnostic value of indicators only or combined for sHLH.Results:Among 248 elderly patients with severe SARS-CoV-2 infection, 82 patients with incomplete data and untraceable clinical outcomes, and 35 patients with HScore of 98-169 were excluded. Finally, 131 patients were enrolled in the final follow-up and statistics, including 25 patients in the sHLH group and 106 patients in the non-sHLH group. Compared with the non-sHLH group, plasma albumin (ALB), hemoglobin (Hb), lymphocyte count (LYM), platelet count (PLT), fibrinogen (Fib) and prealbumin (PAB) in the sHLH group were significantly reduced, while alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), MB isoenzyme of creatine kinase (CK-MB), serum creatinine (SCr), C-reactive protein (CRP), D-dimer, ferritin (Fer), lactate dehydrogenase (LDH), procalcitonin (PCT), cardiac troponin I (cTnI), triglycerides (TG), interleukin-6 (IL-6), total bilirubin (TBil) were significantly higher. The fever and fatigue in the sHLH group were more severe than those in the non-sHLH group, and the patients in the sHLH group had higher rates of shock, acute kidney injury, liver dysfunction, and cardiac injury than the non-sHLH group. The 60-day mortality of patient in the sHLH group was significantly higher than that in the non-sHLH group [84.0% (21/25) vs. 40.6% (43/106), P < 0.01]. Binary multivariate Logistic regression analysis showed that high Fer [odds ratio ( OR) = 0.997, 95% confidence interval (95% CI) was 0.996-0.998], D-dimer ( OR = 0.960, 95% CI was 0.944-0.977), LDH ( OR = 0.998, 95% CI was 0.997-0.999) and TG ( OR = 0.706, 95% CI was 0.579-0.860) were independent risk factors for sHLH in elderly patients with severe SARS-CoV-2 infection (all P < 0.01), while elevated Fer ( OR = 1.001, 95% CI was 1.001-1.002), LDH ( OR = 1.004, 95% CI was 1.002-1.005) and D-dimer ( OR = 1.036, 95% CI was 1.018-1.055) were independent risk factors for 60-day death of patients (all P < 0.01). The death risk of the sHLH patients was 7.692 times higher than that of the non-sHLH patients ( OR = 7.692, 95% CI was 2.466-23.987, P = 0.000). ROC curve analysis showed that a three-composite-index composed of LDH, D-dimer and TG had good diagnostic value for sHLH in elderly patients with severe SARS-CoV-2 infection [area under the ROC curve (AUC) = 0.920, 95% CI was 0.866-0.973, P = 0.000]. Conclusions:Elderly patients with severe SARS-CoV-2 infection complicated by sHLH tend to be critically ill and have refractory status and worse prognosis. High Fer, LDH, D-dimer and TG are independent risk factors for sHLH, and are highly suggestive of poor outcome. The comprehensive index composed of LDH, D-dimer and TG has good diagnostic value, and can be used as an early screening tool for sHLH in elderly patients with severe SARS-CoV-2 infection.

Target serum concentration of vancomycin may be reached earlier with a loading dose / 中华医学杂志(英文版)

BACKGROUND@#Vancomycin treatment failure against vancomycin-susceptible gram-positive cocci is not rare in the intensive care unit (ICU). One of the reasons for this is the substandard drug trough concentration. We aimed to examine the hypothesis that the target serum concentration could be reached earlier with a loading dose of vancomycin.@*METHODS@#This retrospective cohort study was conducted at our ICU between June 2018 and June 2020 and involved patients who were suspected of having, or confirmed to have, gram-positive cocci infection and treated with vancomycin. One group of the patients was administered a loading dose of vancomycin (loading group) and compared with the group that did not receive a loading dose (control group). The baseline characteristics, vancomycin serum concentrations, and clinical outcomes were collected and analyzed.@*RESULTS@#Fifty-five patients were finally included, of which 29 received a loading dose of vancomycin. The serum concentration of vancomycin before the second dose was significantly higher for the loading group than for the control group (10.3 ± 6.1 mg/L vs. 5.7 ± 4.4 mg/L, P = 0.002). The results for both groups were similar before the fifth dose (12.4 ± 7.3 mg/L vs. 10.3 ± 6.3 mg/L in the loading and the control groups, respectively; P = 0.251). The 28-day mortality was lower for the loading group than for the control group (6.7% vs. 34.6% in the loading and control groups, respectively; P = 0.026). No significant differences were observed in serum creatinine (Cr) concentrations of the two groups.@*CONCLUSION@#With the loading dose of vancomycin, the target serum concentration of vancomycin may be reached earlier without increasing the risk of acute kidney injury.@*TRIAL REGISTRATION@#https://www.chictr.org.cn; ChiCTR2000035369.

The renal protective effect of Mongolian medicine rhubarb-3 decoction on rats with chronic renal failure based on TGF-(i/Smad signaling pathway / 中国药理学通报

Aim To study the protective effect of Mon¬golian medicine rhubarb-3 decoction on renal function of CRF model rats and explore its mechanism.Meth¬ods SD rats were randomly divided into normal group and model group.The model group was established by adenine gavage.After successful modeling, they were randomly divided into model, positive, rhubarb-3 de¬coction low, medium and high dose groups, which were administered at intervals for 12 weeks.The bio¬chemical detection of CSF, BUN and Scr was per¬formed.The pathological changes of renal tissues were observed by HE and Masson staining.The expression of PCNA and a-SMA in renal tissues was detected by immunohistochemistry.The mRNA expressions of CK18, Vimentin, TGF-pi and FN in kidney tissues were detected by RT-PCR.The expressions of a-SMA, E-cadherin, PCNA, Smad2, Smad3 protein in kidney tissue were detected by Western blot.TGF-pi induced abnormal proliferation of I IMC and interstitial transfor¬ mation of HK-2, and at the same time, it was treated with serum containing rhubarb-3 decoction.The prolif¬eration of HMC was detected by CCK-8.Interstitial transformation of HK-2 was detected by RT-PCR.Re- suits Compared with the model group, BUN and Scr in CRF rats decreased, and the expression of fibrosis- related proteins and genes in renal tissue decreased af¬ter rhubarb-3 decoction treatment.The serum contai¬ning rhubarb-3 decoction significantly inhibited HMC proliferation and HK-2 interstitial transformation.Con¬clusions Rhubarb-3 Decoction can improve renal function in CRF model rats, and its mechanism may be related to inhibiting HMC proliferation and HK-2 inter¬stitial transformation and probably regulating TGF-f}/ Smad signaling pathway.

Practical procedure of prone position ventilation in critical coronavirus disease 2019 patients / 中华危重病急救医学

Prone position ventilation has become an important part of lung protective ventilation in acute respiratory distress syndrome (ARDS) patients. Timely and appropriate implementation can improve the mortality of such patients. The same is true for patients with critical coronavirus disease 2019 (COVID-19) patients, but safety assessment, control of implementation details and prevention of complications still need to be further standardized during the practical procedure of prone position ventilation. The purpose of this paper is to explain the specific requirements and key points of prone position ventilation in critical COVID-19 patients, in order to promote the application of prone position ventilation in the treatment of patients with critical COVID-19 and reduce the occurrence of related complications.

Advances in External Attentional Focus Strategy for Stroke Rehabilitation (review) / 中国康复理论与实践

External attentional focus strategy (EFs) is wildly used for athletes and healthy people to learn motor skills, and is also useful for motor function rehabilitation in patients with neurological disorders. This paper reviewed the concept, theoretical basis and application of EFs in stroke rehabilitation, which is effective on motor function. However, the timing of intervention remains to be further clarified.

Postprandial proximal gastric acid pocket and its association with gastroesophageal acid reflux in patients with short-segment Barrett's esophagus / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#To determine the characteristics of postprandial proximal gastric acid pockets (PPGAPs) and their association with gastroesophageal acid reflux in patients with Barrett's esophagus (BE).@*METHODS@#Fifteen patients with BE (defined by columnar lined esophagus of ≥1 cm) and 15 healthy individuals that were matched for age, gender, and body mass index, were recruited. The fasting intragastric pH and the appearance time, length, lowest pH, and mean pH of the PPGAP were determined using a single pH electrode pull-through experiment. For BE patients, a gastroesophageal reflux disease questionnaire (GerdQ) was completed and esophageal 24-h pH monitoring was carried out.@*RESULTS@#The PPGAP was significantly longer (5 (3, 5) cm vs. 2 (1, 2) cm) and the lowest pH (1.1 (0.8, 1.5) vs. 1.6 (1.4, 1.9)) was significantly lower in patients with short-segment BE than in healthy individuals. The PPGAP started to appear proximally from the gastroesophageal pH step-up point to the esophageal lumen. The acidity of the PPGAP was higher in the distal segment than in the proximal segment. In short-segment BE patients, there were significant correlations between the acidity and the appearance time and length of the PPGAP. The length and acidity of the PPGAP were positively associated with gastroesophageal acid reflux episodes. The acidity of the PPGAP was associated with the DeMeester scores, the GerdQ scores, and the fasting intragastric pH.@*CONCLUSIONS@#In patients with short-segment BE, a PPGAP is commonly seen. Its length and acidity of PPGAP are associated with gastroesophageal acid reflux, the DeMeester score, and the GerdQ score in patients with short-segment BE.

Effect of Mangiferin on Morphology of Relevant Vessels and MCP-1/CCR-2 Pathway in Spontaneously Hypertensive Rats / 中国实验方剂学杂志

Objective:To observe the morphological changes of carotid artery, thoracic aorta and superior mesenteric artery in spontaneously hypertensive rats(SHR), in order to further study the effect of Mangiferin on the expressions of inflammatory factors and monocyte chemoattract protein-1 (MCP-1)/c-chemokine receptor type 2 (CCR-2) pathway in SHR. Method:Forty spontaneously hypertensive rats were randomly divided into model group, benazepril group (10 mg·kg-1·d-1) and low, medium and high-dose mangiferin groups (25, 50, 100 mg·kg-1·d-1). Eight male WKY rats of the same age were selected as normal control group. Systolic blood pressure was observed every two weeks after eight weeks of administration. Morphology of carotid artery, thoracic aorta and superior mesenteric artery was observed by hematoxylin-eosin (HE) staining. Immunohistochemical assay (IHC) and Western blot were used to detect MCP-1 and CCR-2 protein expressions in thoracic aorta. MCP-1 and CCR-2 mRNA expression levels in thoracic aorta were detected by Real-time quantitative fluorescence PCR (Real-time PCR). Result:Compared with the normal group, the inflammatory cells in the model group increased significantly, the systolic blood pressure was significantly higher than that in the WKY group (PPPPConclusion:There are inflammation damages in carotid artery, thoracic aorta and superior mesenteric artery of spontaneously hypertensive rats. Mangiferin has an anti-inflammatory effect by possibly inhibiting the expressions of MCP-1/CCR-2 pathway in SHR vessels.

Clinical study of different sedative methods in critically ill patients after heart surgery / 天津医药

Objective To study the effect of light sedation and traditional sedation (moderate sedation with daily sedation interruption) on hemodynamic indexes and prognosis in critically ill patients after cardiac surgery. Methods A total of 134 patients who were ventilated delay after heart surgery in our hospital from January to June 2017 were enrolled in this study. The patients were randomly divided into light sedation group (RASS score-1-1, n=65) and traditional sedation group (RASS score -3--2, n=69). All patients received sufentanil for postoperative analgesia. The light sedation group received propofol and/or dexmedetomidine as sedative drugs after operation, and the conventional sedation group used midazolam for postoperative sedation. The hemodynamic indexes, the first time of weaning off the ventilator, the duration of mechanical ventilation and ICU stay were compared between the two groups. Patients with low cardiac output syndrome after surgery were analyzed in subgroups. Results (1) There were no significant differences in heart function, operative complications and other indicators between the two groups after surgery (all P＞0.05). The low cardiac output syndrome was found in 12 patients in the light sedation group and 10 cases in the traditional sedation group. (2) Hemodynamic monitoring results displayed that the sedation/central venous oxygen saturation (SvO2/ScvO2) and cardiac index (CI) were higher after sedation than before sedation in both groups (all P＜0.05), but there was no significant difference between the two groups (all P＞0.05). Subgroup analysis showed that the SvO2/ScvO2index was higher in patients with low cardiac output syndrome in the traditional sedative group than that in the light sedation group (P＜0.05). There was no difference in the SvO2/ScvO2 index in patients with non-low cardiac output syndrome between two groups. (3) Compared with the traditional sedation group, the first off-line time, the total mechanical ventilation after surgery and the ICU stay time were significantly shortened, and the incidence of postoperative delirium was decreased in the light sedation group (all P＜0.05). Subgroup analysis showed that in patients with non-low cardiac output syndrome, the first off-line time, total postoperative mechanical ventilation time and total ICU stay were significantly shorter in the light sedation group than those in the traditional sedation group (all P＜0.05). There was no significant difference in patients with low cardiac output syndrome between the two groups (P＞0.05). Conclusion Patients with non-low cardiac output syndrome after cardiac surgery benefit significantly from the superficial sedative strategy, and the postoperative mechanical ventilation time and ICU residence time are reduced. The moderate sedation may contribute to the early cardiac function recovery in patients with low cardiac output syndrome.

Neuromuscular Activation in Patients with Chronic Ankle Instability (review) / 中国康复理论与实践

This article introduced the neuromuscular activation characteristics of patients with chronic ankle instability during dif-ferent movement patterns, and explained the reasons of deficits of neuromuscular control in lower extremity muscle ac-tivity, kinetics, and kinematics, which aimed at further clarifying the mechanism of chronic ankle instability, and provid-ing theoretical basis for its rehabilitation training.

Significance of serum IgG4 and CA19-9 in diagnosis and antidiastole of IgG4 related cholangitis / 中国免疫学杂志

Objective:To investigate the value of autoantibodies and serum levels of IgG4 and CA19-9 in the diagnosis of IgG4 associated cholangitis (IgG4-SC).Methods:Detect the serum IgG4 and CA19-9 of 41 clinical cases of IgG4-SC patients,162 clinical cases of non IgG4-SC patients and 40 healthy human serum samples by immunoassay and direct chemiluminescence methods, also detect the antinuclear antibodies (ANA),anti neutrophil antibody (ANCA),anti smooth muscle antibody (SMA) and anti mitochondrial antibody (AMA) of the above serum samples by indirect immunofluorescence and analyze the detection results.Results:①The positive rates of ANA,ANCA,SMA and AMA in patients with IgG4-SC were 41.46%,7.32%,0 and 2.44%.Among them,the positive rate of ANA was significantly different from that of the normal control group(P<0.01),and the positive rate of SMA and AMA was significantly different from that of non IgG4-SC group(P<0.01),and so as the positive rate of ANCA do with that of PSC group.②The number of serum IgG4 and CA19-9 increased samples were significantly compared with the normal control group (P<0.01);the area under the ROC curve (AUC) was 0.979 and 0.646,respectively,and P<0.05.Conclusion:The high level of serum IgG4 and CA19-9 and autoantibody detection are of great accuracy and important clinical value in the differential diagnosis of IgG4-SC.

Qualitative and Quantitative Analysis of Active Components of Copditis Rhizoma in Gandouling Pills by HPLC / 中国中医药信息杂志

Objective To optimize the HPLC conditions for active components of Coptidis Rhizoma; To establish qualitative and quantitative analysis method for related components of Coptidis Rhizoma in Gandouling Pills. Methods HPLC was used for the qualitative and quantitative analysis of related components of Coptidis Rhizoma in Gandouling Pills.With acetonitrile:0.05 mol/L potassium dihydrogen phosphate solution=50:50(per 100 mL was added 0.4 g sodium dodecyl sulfate, and then adjusted pH to 4.0 with phosphoric acid) as mobile phase, the flow rate was 1.0 mL/min and the detection wavelength was 345 nm. Results Four components of Coptidis Rhizoma can be identified, including berberine, coptisine, berberine hydrochloride and palmatine chloride, and the negative control had no disturbance. Berberine hydrochloride reference and the absorbance peak area value showed a good linear relationship within 0.058-0.580 μg sample volume, and palmatine chloride reference was the same within 0.030-0.300 μg sample volume. The average recovery was 98.18% and 99.99%, and RSD was 2.40% and 1.70%, respectively. Conclusion The method is simple, accurate and with good repeatability, which can be applied effectively to the quality control of Gandouling Pills.

Application of PDCA circle management method to fine management of medical consumables item / 医疗卫生装备

Objective To apply PDCA circle management method to eliminate redundant medical consumables items and reduce the burden of consumables item information system,so as to realize fine management of medical consumables.Methods The consumables items un-mobilized during 2013 to 2015 were summarized,and the causes were analyzed.The redundant consumables items were sealed up in the materials management system.Results The utilization rate of consumables items were increased from 61％ to 82％,and the target value was 71％,that is,fine management was realized.Conclusion PDCA method can optimize the management of medical consumables items,and enhance the efficiency of materials information system.

Study on the Improvement of Quality Standard of Compound Shougong Powder / 中国药房

OBJECTIVE:To improve the quality standard of Compound shougong powder.METHODS:Gekko japonicas and Armeniaca mume were identified by microscopic identification.TLC method was adopted to identify processed Fallopia multiflora qualitatively.The content of 2,3,5,4-tetrahydroxystilbene-2-O-β-D-glucoside (stilbene glycoside) was determined by HPLC.The determination was performed on Agilent Zorbax Eclipse XDB-C18 column with mobile phase consisted of acetonitrile-water (19 ∶ 81,V/V) at the flow rate of 1.0 mL/min.The detection wavelength was set at 320 nm,and column temperature was 25 ℃.The sample size was 10 μL.RESULTS:Microscopic characteristics of skin fragments and scales of G.japonicas and the pollen grains of A.mume were significant without interference from negative control.TLC spots of F.multiflora were clear and well-separated without interference from negative control.The linear range of stilbene glucoside were 23-368 μg/mL (r=0.999 9).RSDs of precision,stability and reproducibility tests were all lower than 1.0％.The recoveries ranged 98.69％-101.61％ (RSD=0.94％,n =9).CONCLUSIONS:Improved standard can effectively control the quality of Compound shougong powder.

Study on the Improvement of Quality Standard of Compound Shougong Powder / 中国药房

OBJECTIVE:To improve the quality standard of Compound shougong powder.METHODS:Gekko japonicas and Armeniaca mume were identified by microscopic identification.TLC method was adopted to identify processed Fallopia multiflora qualitatively.The content of 2,3,5,4-tetrahydroxystilbene-2-O-β-D-glucoside (stilbene glycoside) was determined by HPLC.The determination was performed on Agilent Zorbax Eclipse XDB-C18 column with mobile phase consisted of acetonitrile-water (19 ∶ 81,V/V) at the flow rate of 1.0 mL/min.The detection wavelength was set at 320 nm,and column temperature was 25 ℃.The sample size was 10 μL.RESULTS:Microscopic characteristics of skin fragments and scales of G.japonicas and the pollen grains of A.mume were significant without interference from negative control.TLC spots of F.multiflora were clear and well-separated without interference from negative control.The linear range of stilbene glucoside were 23-368 μg/mL (r=0.999 9).RSDs of precision,stability and reproducibility tests were all lower than 1.0％.The recoveries ranged 98.69％-101.61％ (RSD=0.94％,n =9).CONCLUSIONS:Improved standard can effectively control the quality of Compound shougong powder.

Coronary microcirculation and short-term prognosis in patients with type 2 diabetes and poor glucose controls who underwent elective percutaneous coronary intervention for acute myocardial infarction / 中国介入心脏病学杂志

Objective To evaluate the status of microcirculation and to compare the short-term prognosis after elective PCI for AMI between patients with poorly controlled type2 diabetes and patients without type 2 diabetes. Methods According to the clinical history and HbA1c values,all patients were divided into 2 groups:diabetic group (group A,n=24) and non-diabetic group (group B,n=32).Basic clinical data, left ventricular end diastolic diameter (LVEDD) and left ventricular shot ejection fraction (LVEF)immediately and 3 months after operation measured by echocardiography and the result of coronary angiography were compared between the two groups. The rate of MACE 3 months after PCI was also compared. A pressure-temperature sensor wire was used to measure the index of microcirculation resistance(IMR)immediately after PCI. Results 1.The mean IMR value in group A was higher than group B(29.12±7.45)vs.(22.74±6.87);P=0.011.The HbA1c levels has positive correlation with the IMR value(r=0.324;P=0.048). 2. The mean LVEDD and the mean LVEF Rad no signifi cant diff erence between two groups before PCI. The mean LVEDD of group A at 3 months after PCI was significantly larger than group B(52.3±4.8)mm vs.(48.6±5.1)mm,P=0.019,the mean LVEF of group A 3 months post PCI was lower than that of group B(48.6±7.3)% vs.(56.1±4.7)%,P=0.003.The mean increase in LVEDD at 3 months after PCI in group A was higher than group B(4.1±6.3)mm vs.(0.8±4.4)mm, p=0.005 and the mean increase in LVEF in group A was significantly lower than in group B(–1.9±6.8)% vs. (4.3±5.4)%,P=0.007. 3. HbA1chad positive correlation with LVEDD(r=0.324,p=0.048)and its increase at 3 months postoperatively(r=–0.422,P=0.005).4. Risk estimation found type 2 diabetes was an independent risk factor for poor recovery of LVEF. The MACE rate was signifi cantly higher in Group A than in Group B(35.7% vs.9.4%,P=0.018).Conclusions Patients with type2 diabetes were more prone to suffer from coronary microcirculatory dysfunction and had poor recovery of cardiac function. Poorly controlled type 2 diabetes was an independent risk factor for poor recovery of cardiac function and short-term prognosis was worse in diabetic patients who had elective PCI.

"Study on wilforlide A before and after compatibility according to ""conteract the toxicity of another drug""" / 中国基层医药

Objective To discuss the synergistic mechanism of compatibility of Tripterygium Wilfordii and Astragalus,and to determine wilforlide A before and after compatibility.Methods To research Tripterygium Wilfordii single medicinal materials,Tripterygium Wilfordii compatibility of Astragalus and Tripterygium Wilfordii reference substance using the HPLC method,so as to provide further verification by the change of wilforlide A.Results The content of wilforlide A was 0.00 324% by measuring Tripterygium Wilfordii single medicinal materials.The content of wilforlide A was 0.00 184% by measuring Tripterygium Wilfordii compatibility of Astragalus.Conclusion The content of wilforlide A was decreased before and after compatibility and toxicity can be reduced.The synergistic mech-anism of the compatibility of Tripterygium Wilfordii and Astragalus is conteract the toxicity of another drugin posse.

Values of different biomarkers for diagnosis of Henoch-Schönlein purpura in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To screen biomarkers which can be used as an auxiliary method in the diagnosis of Henoch-Schönlein purpura (HSP) and to evaluate their diagnostic values by receiver operating characteristic (ROC) curve analysis.</p><p><b>METHODS</b>A total of 127 children diagnosed with HSP between April 2012 and March 2014 were included in the HSP group and an equal number of healthy children were included in the control group. Twelve parameters, i.e., serum amyloid protein A (SAA), interleukin-6 (IL-6), immunoglobulins (IgA, IgG, IgM, and IgE), C-reactive protein (CRP), white blood cell (WBC) count, complements C3 and C4, anti-streptolysin O, and ferritin, were analyzed. The values of the screened biomarkers for diagnosis of HSP were assessed by ROC curve analysis.</p><p><b>RESULTS</b>The HSP group had significantly higher levels of SAA, IL-6, CRP, WBC, IgA, and IgM than the control group (P<0.05). The areas under the ROC curve of SAA, IL-6, WBC, IgA, and IgM for the diagnosis of HSP were higher than 0.7 (P<0.05). The optimal cut-off values of SAA, IgA, IgM, WBC, and IL-6 for the diagnosis of HSP were 3.035 μg/mL, 1579.5 mg/L, 922.5 mg/L, 8.850 × 10⁹/L, and 7.035 pg/mL, respectively; the corresponding sensitivities of the optimal cut-off values for the diagnosis of HSP were 95.1%, 75.6%, 72.3%, 78.0%, and 63.4%, respectively, and the corresponding specificities were 90.2%, 85.4%, 82.4%, 70.7%, and 80.5%, respectively.</p><p><b>CONCLUSIONS</b>SAA, IgA, IgM, WBC, and IL-6 are valuable biomarkers for clinical diagnosis of HSP and among them SAA seems to be the best one.</p>

Content Determination of Sodium Danshensu inBawei Qidan Capsule by HPLC / 中国中医药信息杂志

Objective To establish an HPLC method for the content determination of sodium Danshensu inBawei Qidan Capsule.Methods HPLC was applied and the determination was performed on Shim-pack CLC-ODS C18 column (250 mm×4.6 mm, 5μm) with methanol-water- acetic acid (7∶92∶1, V/V/V) solution at a flow rate of 1.0 mL/min and detection wavelength at 281 nm. The column temperature was 30℃, and injection volume was 10μL.Results Through methodological study, the linear range of sodium Danshensu was 0.494 4-4.944μg (r=0.9996), the average recovery was 97.20%, RSD=1.13%.Conclusion The HPLC method for the content determination of sodium Danshensu inBawei QidanCapsule was user-friendly, accurate and reliable, with good repeatability and stability, which can be used for quality control ofBawei Qidan Capsule.

Quantitative research on toxic component-wilforlide A in Xinfeng capsules before and after compatibility / 中国基层医药

Objective To study the content changes of wilforlide A in Xinfeng capsules before and after compatibility.Methods The content of wilforlide A was determined in Xinfeng capsules ester content and in Tripterygium wilfordii Hook.f.single solution by TLCS method.Developing solvents:chloroform and methanol (85:1),scanning wavelength:230 nm.Results Wilforlide A showed a good linear relationship in 1.700-5.100p g,the regression equation is Y =1 118.766 + 3 253.751 X (r =0.999).The average recovery of the wilforlide A in Xinfeng capsules was 102.84％,and RSD was 3.64％.The average recovery of the wilforlide A in the Tripterygium wilfordii Hook.f.single decoction was 98.14％,and RSD was 2.21％,compatibility levels before and after the change (compatibility with 0.179mg/g,0.136mg/g after compatibility).Conclusion The established TLCS method was simple,specific and accurately quantitative.The comparative study found that the compatibility of Xinfeng capsules Tripterygium reduced the content of wilforlide A,which may be related to decreasing toxicity.