Simultaneous Determination of Ibrutinib, Dihydroxydiol Ibrutinib, and Zanubrutinib in Human Plasma by Liquid Chromatography-Mass Spectrometry/Mass Spectrometry.

BACKGROUND: Ibrutinib and zanubrutinib are Bruton tyrosine kinase inhibitors used to treat mantle cell lymphoma, chronic lymphocytic leukemia, and small lymphocytic lymphoma. Dihydroxydiol ibrutinib (DHI) is an active metabolite of the drug. A liquid chromatography-tandem mass spectrometry method was developed to detect ibrutinib, DHI, and zanubrutinib in human plasma. METHODS: The method involved a protein precipitation step, followed by chromatographic separation using a gradient of 10 mM ammonium acetate (containing 0.1% formic acid)-acetonitrile. Ibrutinib-d5 was used as an internal standard. Analytes were separated within 6.5 minutes. The optimized multiple reaction monitoring transitions of m/z 441.1 → 304.2, 475.2 → 304.2, 472.2 → 455.2, and 446.2 → 309.2 were selected to inspect ibrutinib, DHI, zanubrutinib, and the internal standards in positive ion mode. RESULTS: The validated curve ranges included 0.200-800, 0.500-500, and 1.00-1000 ng/mL for ibrutinib, DHI, and zanubrutinib, respectively. The precisions of the lower limit of quantification of samples were below 15.5%, the precisions of the other level samples were below 11.4%, and the accuracies were between -8.6% and 8.4%. The matrix effect and extraction recovery of all compounds ranged between 97.6%-109.0% and 93.9%-105.2%, respectively. The selectivity, accuracy, precision, matrix effect, and extraction recovery results were acceptable according to international method validation guidelines. CONCLUSIONS: A simple and rapid method was developed and validated in this study. This method was used to analyze plasma concentrations of ibrutinib and zanubrutinib in patients with mantle cell lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, or diffuse large B-cell lymphoma. The selected patients were aged between 44 and 74 years.

Determination of Orelabrutinib in Human Plasma Using LC-MS/MS.

BACKGROUND: Orelabrutinib is a second-generation Bruton tyrosine kinase inhibitor that improves the management of B-cell malignancies. The objective of this study was to develop and validate an LC-MS/MS method for quantifying orelabrutinib in human plasma. METHODS: Plasma samples were processed using acetonitrile to precipitate proteins. Ibrutinib-d5 was used as the internal standard. The mobile phase comprised 10 mM ammonium formate containing 0.1% formic acid and acetonitrile (62:38, vol/vol). The multiple reaction monitoring transitions at m / z = 428.1 → 411.2 and 446.2 → 309.2 were selected for orelabrutinib and ibrutinib-d5, respectively, after ionization in the positive mode. RESULTS: Total runtime was 4.5 minutes. The validated curve ranges were 1.00-500 ng/mL. This method exhibited acceptable selectivity, dilution integrity, matrix effects, and recovery. Interrun and intrarun accuracy ranged from -3.4% to 6.5%, and interrun and intrarun precision was between 2.8% and 12.8%. Stability was studied under different conditions. The incurred sample reanalysis demonstrated good reproducibility. CONCLUSIONS: The LC-MS/MS method provided a simple, specific, and rapid quantification of orelabrutinib in the plasma of patients with mantle cell lymphoma or chronic lymphocytic leukemia/small lymphocytic lymphoma. The results indicated that orelabrutinib exhibits large variability between individuals and should be prudently used in combination with CYP3A4 inhibitors.

LC-MS/MS methods for determination of venetoclax in human plasma and cerebrospinal fluid.

We developed and validated sensitive MS/MS methods for the determination of venetoclax, an oral selective B-cell lymphoma-2 inhibitor, in human plasma and cerebrospinal fluid (CSF). Acetonitrile was used as protein precipitant. The mobile phase was 10 mM ammonium formate consisting of 0.1% formic acid and acetonitrile (40:60, v/v). The analytes were separated on an ACQUITY UPLC HSS T3 column (2.1 × 50 mm, 1.8 µm) in 5 min. An API 4000 mass spectrometer was selected to quantify venetoclax and internal standard using m/z 868.3 → 636.3 and 876.3 → 644.3 under multiple response monitoring mode. In plasma, the calibration curve exhibited good linearity ranging from 20.0 to 5000 ng/mL, whereas in the CSF, the linear range was 0.500-100 ng/mL. The matrix effect of venetoclax and internal standard (venetoclax-d8) was not obvious in both plasma and CSF. The inter- and intra-run accuracy was within ±11.9%, and the inter- and intra-run precision was below 13.6%. Both methods had no carryover, and the recovery was close to 100%. The validated methods were employed to quantify the concentrations of venetoclax in the plasma and CSF of patients diagnosed with chronic lymphocytic leukemia or acute myelogenous leukemia.

Simultaneous Determination of Orelabrutinib, Zanubrutinib, Ibrutinib and Its Active Metabolite in Human Plasma Using LC-MS/MS.

Ibrutinib, orelabrutinib, and zanubrutinib are all Bruton's tyrosine kinase inhibitors, which have greatly improved the treatment of B-cell malignancies. In this study, an LC-MS/MS method was developed and validated for the determination of orelabrutinib, zanubrutinib, ibrutinib, and its active metabolite dihydrodiol ibrutinib in human plasma. The Ibrutinib-d5 was used as the internal standard. Pretreatment was performed using a simple protein precipitation step using acetonitrile. The ACQUITY UPLC HSS T3 column (2.1×50 mm, 1.8 µm) was used to separate the analytes, and the run time was 6.5 min. The mobile phase consisted of acetonitrile and 10 mM of ammonium formate, which contained 0.1% formic acid. The multiple reactions' monitoring transitions were selected at m/z 428.1→411.2, 472.2→455.2, 441.1→304.2, 475.2→304.2 and 446.2→309.2 respectively for orelabrutinib, zanubrutinib, ibrutinib, dihydrodiol ibrutinib and ibrutinib-d5 using positive ion electrospray ionization. The standard curves were linear, from 0.400 to 200 ng/mL for ibrutinib and dihydrodiol ibrutinib, 1.00-500 ng/mL for orelabrutinib, and 2.00-1000 ng/mL for zanubrutinib. Selectivity, the lower limit of quantitation, precision, accuracy, matrix effect, recovery, stability, and dilution integrity all met the acceptance criteria of FDA guidance. This method was used to quantify the plasma levels of orelabrutinib, zanubrutinib, ibrutinib, and dihydrodiol ibrutinib in clinical patients.

Effect of fracture orientation on detection accuracy of vertical root fractures in non-endodontically treated teeth using cone beam computed tomography.

OBJECTIVES: This study aimed to investigate the effect of fracture orientation on the detection accuracy of vertical root fractures (VRFs) in non-endodontically treated teeth using four different cone beam computed tomography (CBCT) units. MATERIALS AND METHODS: Thirty eight out of 148 extracted human permanent teeth were chosen randomly, and VRFs were artificially induced to result in 20 mesiodistally and 18 buccolingually oriented root fractures. The fracture width was subsequently measured. All the teeth were scanned with four CBCT units. CBCT images were evaluated independently by two observers. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated for each observer and fracture orientation. The AUC between the two fracture orientations was compared using Z test. RESULTS: The mean fracture width was 140 µm (standard deviation 26.8 µm). A statistically significant difference was found between the mesiodistal and buccolingual VRFs for the AUC from the CBCT unit 3D Accuitomo 170 (p = 0.02). There were no statistically significant differences between the mesiodistal and buccolingual VRFs for AUCs from the CBCT units NewTom VGi (p = 0.21), ProMax 3D Mid (p = 0.23), and i-CAT FLX (p = 0.21). CONCLUSION: Fracture orientations of teeth with VRFs in non-endodontically treated teeth may play a role in the detection accuracy of CBCT images, but this effect seems to be dependent on the CBCT unit used. CLINICAL RELEVANCE: Although for most of the CBCT units tested, the fracture orientation of VRF in non-endodontically treated teeth seems not to play a role for the diagnosis, clinical data is needed to further assess the impact of different devices on VRF detection.

Genome-wide characterization of microsatellites and genetic diversity assessment of spinach in the Chinese germplasm collection.

Spinach is a nutritional leafy green vegetable, and it also serves as a model species for studying sex chromosome evolution. Genetic marker development and genome structure analysis are important in breeding practice and theoretical evolution studies of spinach. In this study, the frequency and distribution of different microsatellites in the recently released draft spinach genome were characterized. A total of 261,002 perfect microsatellites were identified (estimated frequency: ~262.1 loci/Mbp). The most abundant microsatellites were tetranucleotide and trinucleotide, accounting for 33.2% and 27.7% of the total number of microsatellites, respectively. A total of 105 primer pairs were designed and screened, and 34 were polymorphic among the detected spinach cultivars. Combined with seven primer sets developed previously, 41 primer pairs were used to investigate genetic diversity among 43 spinach cultivars in China. The average polymorphism information content value of the 41 markers was 0.43, representing an intermediate level. The spinach cultivars had a low genetic diversity, and no detectable common factors were shared by each group in the UPGMA dendrogram. This study's findings facilitate further investigations on the organization of the microsatellites in spinach genome and provide clues for future breeding applications of spinach in China.

Navigation-Guided Extraction of Impacted Supernumerary Teeth: A Case Report.

Supernumerary teeth usually result in retarded eruption, malocclusion, poor esthetics, and cyst formation. Management involves surgical extraction, which can be challenging in certain complicated cases owing to the risk of injury to young permanent tooth germs or fragile roots. The present report describes a novel preoperative computer-assisted and intraoperative navigation-guided surgical treatment for a case of complicated impacted supernumerary teeth. The report highlights accurate tooth location and minimal invasion with use of the navigation-guided system. Moreover, it discusses various treatment considerations during such a procedure.

The landscape of transposable elements and satellite DNAs in the genome of a dioecious plant spinach (Spinacia oleracea L.).

BACKGROUND: Repetitive sequences, including transposable elements (TEs) and satellite DNAs, occupy a considerable portion of plant genomes. Analysis of the repeat fraction benefits the understanding of genome structure and evolution. Spinach (Spinacia oleracea L.), an important vegetable crop, is also a model dioecious plant species for studying sex determination and sex chromosome evolution. However, the repetitive sequences of the spinach genome have not been fully investigated. RESULTS: We extensively analyzed the repetitive components of draft spinach genome, especially TEs and satellites, by different strategies. A total of 16,002 full-length TEs were identified. Among the most abundant long terminal repeat (LTR) retrotransposons (REs), Copia elements were overrepresented compared with Gypsy ones. Angela was the most dominating Copia lineage; Ogre/Tat was the most abundant Gypsy lineage. The mean insertion age of LTR-REs was 1.42 million years; approximately 83.7% of these elements were retrotransposed during the last two million years. RepeatMasker totally masked about 64.05% of the spinach genome, with LTR-REs, non-LTR-REs, and DNA transposons occupying 49.2, 2.4, and 5.6%, respectively. Fluorescence in situ hybridization (FISH) analysis showed that most LTR-REs dispersed all over the chromosomes, by contrast, elements of CRM lineage were distributed at the centromeric region of all chromosomes. In addition, Ogre/Tat lineage mainly accumulated on sex chromosomes, and satellites Spsat2 and Spsat3 were exclusively located at the telomeric region of the short arm of sex chromosomes. CONCLUSIONS: We reliably annotated the TE fraction of the draft genome of spinach. FISH analysis indicates that Ogre/Tat lineage and the sex chromosome-specific satellites DNAs might participate in sex chromosome formation and evolution. Based on FISH signals of microsatellites, together with 45S rDNA, a fine karyotype of spinach was established. This study improves our knowledge of repetitive sequence organization in spinach genome and aids in accurate spinach karyotype construction.

[Developmental expression changes of IGF2 and IGFBP3 genes in adipose tissue of two pig breeds].

To investigate the developmental expression patterns of Insulin-like Growth Factor 2 (IGF2) and Insulin-like Growth Factor Binding protein 3 (IGFBP3) genes at the age of 30, 60, 90, 120 and 150 days in back subcutaneous fat tissue of Landrace and Taihu pigs, real-time fluorescence quantitative PCR was applied. Results showed that the expression level of IGF2 mRNA in Landrace pigs was significantly higher at 30 days than other days (P<0.01), then gradually declined and lowest at 120 days, obviously increased at 150 days. In Taihu pigs, it was relatively higher at 30~60 days, lowest at 90 days, increased rapidly at 120 days, and then decreased. Developmental expression patterns of IGFBP3 mRNA in the two pig breeds were similar, which were highest at 30 days, declined significantly at 60 days (P<0.05) then maintained steady, but a little fluctuant between ages in each breed. In addition, the expression level of IGF2 mRNA in Taihu pigs was significantly higher than that of Landrace pigs at the age of 120 days (P<0.01), and the expression level of IGFBP3 mRNA in Taihu pigs was significantly lower than that of Landrace at the age of 150 days (P<0.01), with no significant difference between the two pig breeds at other ages (P>0.05). The results suggest that the expression of IGF2 and IGFBP3 mRNA in the adipose tissue of pigs exhibits specific developmental changes and different patterns between the two pig breeds. The expression decrease of IGF2 may be related to adipocyte hyperplasia.

A six-site method for the evaluation of periodontal bone loss in cone-beam CT images.

OBJECTIVES: In contrast to two-dimensional planar images, a measuring point is hardly repeatedly determined in a CBCT image when alveolar bone loss is assessed. Thus, the aim of the present study was to propose a six-site measuring method, which is closely related to anatomical structure, for the evaluation of alveolar bone loss in CBCT images. METHODS: 150 measuring points in 11 molars and 14 premolars from 6 patients (2 males and 4 females) were included. CBCT images of the teeth were acquired prior to periodontal surgery. Four observers measured the distances between cemento-enamel junctions and the apical bases of the periodontal bone defect at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual/palatal, mid-lingual/palatal and disto-lingual/palatal sites in CBCT images. Direct measurements of the six sites were correspondingly obtained in the subsequent periodontal surgeries. Differences between the distances measured in the CBCT images and during the surgery were analysed. Interobserver and intraobserver variances were tested. RESULTS: No statistically significant difference was found between the surgical and CBCT measurements (p = 0.84). Diagnostic coincidence rates of four observers were 86.7%, 87.3%, 88.7% and 88.0%, respectively. The interobserver (p = 0.95) and intraobserver (p = 0.30) variances were not significant. CONCLUSIONS: The six-site measuring method validated in the present study may be a useful three-dimensional measuring method for the evaluation of periodontal disease.

Analysis of anaphylactic shock caused by 17 types of traditional Chinese medicine injections used to treat cardiovascular and cerebrovascular diseases.

Several reports describing anaphylactic shock following treatment of cardiovascular and cerebrovascular diseases with Chinese herbal injections were described. Our analysis of these reports showed that anaphylactic shock caused by traditional Chinese medicine (TCM) injections for the treatment of cardiovascular and cerebrovascular diseases is common but also sometimes fatal. Therefore, we proposed the following four suggestions for improving the clinical safety of delivering Chinese herbal injections and reducing the occurrence of allergic shock. First, patients with cardiovascular and cerebrovascular diseases are at high risk, so they should only be given TCM injections after a doctor's diagnosis and approval. Second, people in allergic groups can suffer anaphylactic shock, so vigilance is important in the treatment of all age groups, although even more caution should be exercised when treating children or elderly people. In fact, TCM injections may not be appropriate for those age groups, so that they should be carefully considered before treatment. Third, no significant gender differences have been noted in patients with anaphylactic shock, so all patients should be carefully monitored, irrespective of gender. Fourth, the timeframe in which different drugs cause anaphylactic shock varies; thus, patients should be observed as long as possible.