Transcutaneous electrical acupoint stimulation benefits postoperative pain relief of oocyte retrieval: A randomized controlled trial.

BACKGROUND: Transvaginal oocyte retrieval is frequently followed by adverse events related to anesthesia and the procedure. Some research showed that transcutaneous electrical acupoint stimulation (TEAS) can relieve intraoperative pain and postoperative nausea. OBJECTIVE: This study examined whether TEAS can alleviate pain and relieve adverse symptoms after oocyte retrieval. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: Altogether 128 patients were randomly divided into the TEAS group and the mock TEAS group. The two groups received a 30-minute-long TEAS or mock TEAS treatment that began 30 min after oocyte retrieval. MAIN OUTCOME MEASURES: The primary outcome was the visual analog scale (VAS) pain score. Secondary outcomes were pressure pain threshold, McGill score, pain rating index (PRI), present pain intensity (PPI), VAS stress score, VAS anxiety score, and postoperative adverse symptoms. RESULTS: The baseline characteristics of the two groups were comparable (P > 0.05). The VAS pain scores of the TEAS group were lower than those of the mock TEAS group at 60 and 90 min after oocyte retrieval (P < 0.05). The McGill score, PRI and PPI in the TEAS group were significantly lower than those in the control group at 60 min after oocyte retrieval (P < 0.05). However, the two groups had equivalent beneficial effects regarding the negative emotions, such as nervousness and anxiety (P > 0.05). The TEAS group was superior to the mock TEAS group for relieving postoperative adverse symptoms (P < 0.05). CONCLUSION: TEAS treatment can relieve postoperative pain and postoperative adverse symptoms for patients undergoing oocyte retrieval. Please cite this article as: Liu LY, Su Y, Wang RR, Lai YY, Huang L, Li YT, Tao XY, Su MH, Zheng XY, Huang SC, Wu YN, Yu SY, Liang FR, Yang J. Transcutaneous electrical acupoint stimulation benefits postoperative pain relief of oocyte retrieval: A randomized controlled trial. J Integr Med. 2024; 22(1): 32-38.

Electroactive membrane fusion-liposome for increased electron transfer to enhance radiodynamic therapy.

Dynamic therapies have potential in cancer treatments but have limitations in efficiency and penetration depth. Here a membrane-integrated liposome (MIL) is created to coat titanium dioxide (TiO2) nanoparticles to enhance electron transfer and increase radical production under low-dose X-ray irradiation. The exoelectrogenic Shewanella oneidensis MR-1 microorganism presents an innate capability for extracellular electron transfer (EET). An EET-mimicking photocatalytic system is created by coating the TiO2 nanoparticles with the MIL, which significantly enhances superoxide anions generation under low-dose (1 Gy) X-ray activation. The c-type cytochromes-constructed electron channel in the membrane mimics electron transfer to surrounding oxygen. Moreover, the hole transport in the valence band is also observed for water oxidation to produce hydroxyl radicals. The TiO2@MIL system is demonstrated against orthotopic liver tumours in vivo.

Analysis of mRNA-miRNA interaction network reveals the role of CAFs-derived exosomes in the immune regulation of oral squamous cell carcinoma.

BACKGROUND: Cancer-associated fibroblasts (CAFs) have significant tumor regulatory functions, and CAFs-derived exosomes (CAFs-Exo) released from CAFs play an important role in the progression of oral squamous cell carcinoma (OSCC). However, a lack of comprehensive molecular biological analysis leaves the regulatory mechanisms of CAFs-Exo in OSCC unclear. METHODS: We used platelet derived growth factor-BB (PDGF-BB) to induce the transformation of human oral mucosa fibroblast (hOMF) into CAFs, and extracted exosomes from the supernatant of CAFs and hOMF. We validated the effect of CAFs-Exo on tumor progression by exosomes co-culture with Cal-27 and tumor-forming in nude mice. The cellular and exosomal transcriptomes were sequenced, and immune regulatory genes were screened and validated using mRNA-miRNA interaction network analysis in combination with publicly available databases. RESULTS: The results showed that CAFs-Exo had a stronger ability to promote OSCC proliferation and was associated with immunosuppression. We discovered that the presence of immune-related genes in CAFs-Exo may regulate the expression of PIGR, CD81, UACA, and PTTG1IP in Cal-27 by analyzing CAFs-Exo sequencing data and publicly available TCGA data. This may account for the ability of CAFs-Exo to exert immunomodulation and promote OSCC proliferation. CONCLUSIONS: CAFs-Exo was found to be involved in tumor immune regulation through hsa-miR-139-5p, ACTR2 and EIF6, while PIGR, CD81, UACA and PTTG1IP may be potentially effective targets for the treatment of OSCC in the future.

The feasibility of a multimodal exercise program for sedentary postmenopausal women with urinary incontinence: A pilot randomized controlled trial.

OBJECTIVES: The aim was to investigate the feasibility and effects of an eight-week multimodal exercise program in sedentary postmenopausal women with urinary incontinence (UI) compared with pelvic floor muscle training (PFMT) only. STUDY DESIGN: This was a pilot randomized controlled trial. The participants were randomly allocated to either the intervention group (IG), who received a multimodal exercise program that incorporated aerobic exercise, resistance exercise, and PFMT, or the control group (CG), who received PFMT only. The intervention was provided twice weekly for eight weeks. MAIN OUTCOME MEASURES: The primary outcome was feasibility in relation to consent rate, attendance, withdrawal rate, satisfaction with program, and adverse events. The secondary outcomes included pelvic floor muscle function (assessed using digital palpation and manometry), UI-specific quality of life (QoL) (rated on the International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life [ICIQ-LUTSqol]), symptom severity (assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI SF] and a bladder diary), and physical activity levels (rated on the International Physical Activity Questionnaire- short form [IPAQ]). RESULTS: Thirty-three of 63 eligible participants (52.4 %) consented to participate in the study and 26 completed it (IG n = 13, CG n = 13); the withdrawal rate was lower in the IG than in the CG (13.3 % vs 27.8 %). In both groups the attendance rate was 100 % and the satisfaction rate was 84.6 %. No adverse events were reported. The intention-to-treat analysis showed that UI-specific QoL (p = 0.011, mean difference: -5.62, 95 % CI: -9.67 to -1.57) and symptom severity measured using the ICIQ-UI SF (p = 0.001, mean difference: -3.23, 95 % CI: -4.93 to -1.54) were significantly improved in the IG after intervention, while no significant changes were found in the CG after intervention. The daytime frequency (p = 0.001) and number of leakages (p = 0.045) recorded in the bladder diary were significantly reduced in the CG after intervention. No significant differences between groups were found on any of the outcome measurements after intervention, except the daytime frequency from the bladder diary, which was significantly more reduced in the CG than in the IG (p = 0.003, mean difference: -0.28, 95 % CI: -2.25 to 1.67). CONCLUSION: An eight-week multimodal exercise program is feasible for sedentary postmenopausal women with UI, and the multimodal exercise program demonstrated potential benefits for improving UI-specific QoL and symptom severity in this population. The trial was registered at ClinicalTrials.gov (NCT04351750).

Early Rise of Serum hCG in Gestational Diabetes Mellitus Women With Live Birth Through In Vitro Fertilization Procedure.

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. The characteristics of early human chorionic gonadotropin (hCG) levels and the rise pattern in patients with GDM after in vitro fertilization (IVF) are unclear. The present investigation was a retrospective cohort analysis of eligible viable pregnancies achieved through IVF in the authors' hospital between October 2015 and June 2020. The characteristics of initial hCG concentration and the rise pattern in patients with GDM after IVF, and the difference between those of normoglycemic pregnant women, were explored. Using random-effects models, the preferred pattern to describe the increase in log hCG was a quadratic. When gestational age was within 39 days, the linear model adequately characterized the profile, and the average slope was 0.173, yielding a predicted increase of 1.55 (55%) in 1 day and 3.11 (211%) in 2 days. Absolute hCG values-but not the rate of rise-were significantly higher in double embryo transfers and twin pregnancies. Curves reflecting hCG rise from the GDM and non-GDM groups did not differ substantially. The proportion of patients with low initial hCG values (16 days post-oocyte retrieval <100 mIU/ml) was higher in the GDM group (5% vs. 2.09%), although the difference was not statistically significant. Early hCG rise in pregnant women after IVF-whether GDM or non-GDM-could be characterized by quadratic and linear models. However, hCG values on days 14 and 16 post-oocyte retrieval in the GDM group were lower than those in the non-GDM group, with the exception of twin pregnancies. Low hCG values in early pregnancy may be a clue to help predict GDM in the subsequent gestation period.

An immunochromatographic assay utilizing magnetic nanoparticles to detect major peanut allergen Ara h 1 in processed foods.

This study describes an immunomagnetic nanoparticle (IMNP)-based lateral flow assay (LFA) for detecting the major peanut allergen Ara h 1. We developed a clearly specific method in identifying peanut from ten other seeds and nuts, and a good visual limit of detection (vLOD) of 0.01 µg/mL Ara h 1 in PBS. PBS that contains 1 M NaCl and 2% Tween 20 was determined to be the optimal extraction buffer for isolating Ara h 1 from cookie, milk and chocolate with vLOD values of 0.5 µg/g, 0.5 µg/mL, and 1 µg/g, respectively. Forty two processed foods were simultaneously analyzed using this method and an AOAC-approved ELISA kit. The specificity and sensitivity of this assay were thus determined to be 100 and 95%, respectively. This new IMNP-based LFA has potential as a rapid tool for screening processed foods for Ara h 1 residues.

Prognostic performance of different lymph node classification systems in young gastric cancer.

BACKGROUND: Accurate staging plays a pivotal role in cancer care. The lymph node (LN) ratio (LNR) and the log odds of positive LNs (LODDS) have been suggested as alternatives to the N staging since the TNM system has the risk of stage migration. The prognostic significance of LNR and LODDS in young patients with gastric cancer (GC) has not been reported. This study aims to investigate the correlations between LNR and LODDS and survival of young patients with GC, and compare the predictive performance of these LN staging methods. METHODS: GC patients before the age of 40 from 2004 to 2016 in the Surveillance, Epidemiology and End Results database were enrolled. The prognostic evaluation of the N factor, LNR and LODDS was compared using the time-dependent receiver operating characteristic (ROC) analysis, area under the curve (AUC), C-index and Akaike information criterion (AIC). RESULTS: Multivariate survival analysis identified that the LNR and LODDS were significantly independent prognostic indicators for overall survival (OS) in young patients with GC and in the subgroups comprised of patients with ≤15 LNs examined. The time-dependent ROC curves of the LNR and LODDS were continuously superior to that of the N factor in predicting OS during the observation period. And the AUCs revealed that the predictive accuracy of the LNR and LODDS was remarkably superior to the N factor at 1 and 3 years (P<0.05). The model incorporating LNR or LODDS had higher C-index and lower AIC when comparing to the model incorporating the N factor. CONCLUSIONS: The LNR and LODDS improve accuracy of survival risk prediction in young patients with GC when comparing to the N factor. These two novel LN classification methods should be considered as alternatives to the N staging for the prognostic prediction of young patients with GC.

Prognostic significance and function of MCM10 in human hepatocellular carcinoma.

Aim: To investigate the role of MCM10, a conserved replication factor, in hepatocellular carcinoma (HCC). Methods: We used data from 364 HCC patients in the Cancer Genome Atlas database and conducted in vitro experiments to confirm the role of MCM10. Results: High MCM10 expression correlated with poor HCC patient outcome and was an independent prognosticator for HCC. Time-dependent receiver operating characteristic curve analysis found that the sequential trend of MCM10 for survival was not inferior to that of the tumor node metastasis stage. The MCM10 model had a higher C-index than the non-MCM10 model, indicating that incorporating MCM10 into a multivariate model improves the model's prognostic accuracy for HCC. Genetic alterations of MCM10 prominently correlated with an unfavorable HCC outcome. Conclusion: Our findings strongly suggest using the MCM10 gene as a prognostic indicator in HCC.

Lay abstract Hepatocellular carcinoma is one of the most aggressive malignant cancers globally. Our study investigated the role of a conserved replication factor, MCM10, in hepatocellular carcinoma. We performed some bioinformatics analysis and in vitro experiments, and successfully found that MCM10 has a good predictive value for survival in patients with hepatocellular carcinoma.

MicroRNA-205-5p targets the HOXD9-Snail1 axis to inhibit triple negative breast cancer cell proliferation and chemoresistance.

MicroRNA-205 (miR-205) is believed to be related to the progress of tumors. HOXD9 has been proved to be expressed abnormally in several kinds of cancers. However, the role of miR-205 and HOXD9 in breast cancer remains unclear. The biological role of miR-205 in breast cancer cell proliferation and chemoresistance was investigated. The expression of miR-205 in clinical tissues and breast cancer cell lines were analyzed using quantitative real-time PCR test (qRT-PCR). Overexpression and knockdown models of miR-205 were established to study cell proliferation and chemotherapy-resistant. Moreover, the potential relationships between miR-205 and HOXD9/Snail1 were measured using qRT-PCR, western blot, and chemotherapy-resistant study. miR-205 was lowly expressed in breast cancer tissues and cell lines. Overexpression of miR-205 could inhibit cell proliferation and chemotherapy-resistance. Moreover, we proved that miR-205 could target the HOXD9-Snail1 axis to suppress triple negative breast cancer cell proliferation and chemoresistance. The activation of Snail1 gene by HOXD9 was also proved in this study. The present study may provide a novel insight for the therapeutic strategies of breast cancer through targeting miR-205/HOXD9/Snail1.

Intelligent detection endoscopic assistant: An artificial intelligence-based system for monitoring blind spots during esophagogastroduodenoscopy in real-time.

BACKGROUND: Observation of the entire stomach during esophagogastroduodenoscopy (EGD) is important; however, there is a lack of effective evaluation tools. AIMS: To develop an artificial intelligence (AI)-assisted EGD system able to automatically monitor blind spots in real-time. METHODS: An AI-based system, called the Intelligent Detection Endoscopic Assistant (IDEA), was developed using a deep convolutional neural network (DCNN) and long short-term memory (LSTM). The performance of IDEA for recognition of gastric sites in images and videos was evaluated. Primary outcomes included diagnostic accuracy, sensitivity, and specificity. RESULTS: A total of 170,297 images and 5779 endoscopic videos were collected to develop the system. As the test group, 3100 EGD images were acquired to evaluate the performance of DCNN in recognition of gastric sites in images. The sensitivity, specificity, and accuracy of DCNN were determined as 97.18%,99.91%, and 99.83%, respectively. To assess the performance of IDEA in recognition of gastric sites in EGD videos, 129 videos were used as the test group. The sensitivity, specificity, and accuracy of IDEA were 96.29%,93.32%, and 95.30%, respectively. CONCLUSIONS: IDEA achieved high accuracy for recognition of gastric sites in real-time. The system can be applied as a powerful assistant tool for monitoring blind spots during EGD.

Long non-coding RNA 00152 slicing represses the growth and aggressiveness of hemangioma cell by modulating miR-139-5p.

Long non-coding RNA (lncRNA) linc00152 has been recognized as an oncogenic lncRNA in various cancers. This study attempts to investigate the roles of linc00152 in the metastasis-related traits of infantile hemangioma (IH). Linc00152 was overexpressed in the proliferating-phase hemangioma tissues when compared with that in involuting-phase. Downregulation of linc00152 strikingly suppressed the cell viability, migration and invasion of hemangioma cells. Furthermore, silence of linc00152 repressed the growth and lung metastasis of hemangioma cell in vivo. Subsequent analysis revealed that linc00152 bound with miR-139-5p and linc00152 expression was inversely correlated with the level of miR-139-5p in IH. Same effects of miR-139-5p transfection on HemECs cells were observed as downregulation of linc00152. Moreover, tumor protein D52 (TPD52) was confirmed to be the target of miR-139-5p. Besides, the anti-tumor effect of linc00152 silence on hemangioma cell was reversed by rexpression of TPD52. This study demonstrates that downregulatuon of linc00152 restrains the aggressiveness of hemangioma cell in vitro and in vivo via interacting with miR-139-5p and further modulates the level of TPD52.

Protective roles of carbonic anhydrase 8 in Machado-Joseph Disease.

Machado-Joseph disease (MJD)/Spinocerebellar ataxia type 3 (SCA3) is an inherited neurodegenerative disease that can lead to a regression of motor coordination and muscle control in the extremities. It is known that expansion of CAG repeats encodes abnormally long polyQ in mutant ataxin-3, the disease protein. It is also noted that mutant ataxin-3 interacts with 1,4,5-trisphosphate receptor type 1 (IP3R1) and induces abnormal Ca2+ release. Previously, we have shown a significant increase in the expression of carbonic anhydrase VIII (CA8) in SK-N-SH-MJD78 cells, which are human neuroblastoma cells overexpressing mutant ataxin-3 with 78 glutamine repeats. In the current study, we showed the presence of significantly increased CA8 expression in MJD mouse cerebellum in either early or late disease stage, with a gradual decrease in CA8 expression as the MJD mice naturally aged. By immunofluorescence and immunoprecipitation analysis, we also found that CA8 co-localized and interacted with mutant ataxin-3 in SK-N-SH-MJD78 cells harboring overexpressed CA8 (SK-MJD78-CA8). In addition, we found that SK-MJD78-CA8 cells, as well as cerebellar granule neurons (CGNs) of MJD transgenic (Tg) mouse with overexpressed CA8, were more resistant to reactive oxygen species (ROS) stress than the control cells. Importantly, overexpression of CA8 in SK-MJD78-CA8 cells and in MJD CGNs rescued abnormal Ca2+ release and caused an increase in cell survival. In summary, we demonstrate the protective function of CA8 in MJD disease models and speculate that the declining expression of CA8 following an initial increased expression may be related to the late onset phenomenon of MJD.

Rapidly detecting major peanut allergen-Ara h2 in edible oils using a new immunomagnetic nanoparticle-based lateral flow assay.

Ara h2 is a major peanut allergen that induces rashes, vomiting, diarrhea, and anaphylactic shock. Since peanut is a major source in producing edible oils globally, Ara h2 residues can be present in various edible oils. In this work, an immunomagnetic nanoparticle-based lateral flow assay for identifying Ara h2 in edible oils is developed. This assay exhibits high sensitivity with a visual detection limit of 0.1 mg/kg Ara h2 in oil, and favorable specificity in differentiating peanut from seeds and nuts. The calculated CV values of intra- and inter-assay were 6.73-10.21% and 4.75-8.57%, respectively, indicating high reproducibility. In an analysis of 26 oil products, Ara h2 was detected in two peanut oils as 0.122 ±â€¯0.026 mg/kg and 0.247 ±â€¯0.027 mg/kg. The entire method takes 5 h, including a 3.5-h sample preparation. Hence, this method has the potential to be an effective way to screen edible oils for Ara h2.

Dynamic Changes of the Frequency of Classic and Inflammatory Monocytes Subsets and Natural Killer Cells in Chronic Hepatitis C Patients Treated by Direct-Acting Antiviral Agents.

OBJECTIVE: Up to now, little was known about the immunological changes of chronic hepatitis C (CHC) patients treated with direct-acting antiviral agents (DAAs); we try to explore the effect of DAAs on the frequency of monocytes, NK cells, and cytokines that promote their activation. METHODS: 15 treatment-naive CHC patients and 10 healthy controls were recruited. Patients were examined before DAAs therapy (0 w) and at week 4 (4 w) and week 12 (12 w) of therapy. Percentage of monocytes and NK cells of the peripheral blood was analyzed by flow cytometry. Serum cytokines IL-12, IL-18, CXCL10, CXCL11, sCD14, and sCD163 were measured by enzyme linked immunosorbent assay. RESULTS: The frequency of CD3-CD16+CD56+ NK cells and classic CD14++CD16- monocytes decreased, while CD14+CD16+ monocytes and cytokines IL-12, IL-18, CXCL10, CXCL11, sCD14, and sCD163 increased at 0 w compared to healthy controls. During DAAs treatment, the decreased NK cells and classic monocytes gradually increased to normal levels; the increased inflammatory monocytes and cytokines IL-12 and CXCL11 decreased to normal levels, but the increased cytokines IL-18, CXCL10, sCD14, and sCD163 still remained at high levels at 12 w though they decreased rapidly from 0 w. CONCLUSION: Our results showed that DAAs treatment attenuated the activation of monocytes and NK cells in CHC patients. Trial registration number is NCT03063723.

An ethical evaluation index system for clinical approval of medical technology in China: A structural equation model study.

OBJECTIVE: To construct a quantitative ethical evaluation index system for the clinical approval of medical technology in China. METHODS: Exploratory factor analysis (EFA) and first-order confirmatory factor analysis (CFA) based on a structure equation model (SEM), higher-order CFA and normalisation were used to establish an ethical evaluation index system for the clinical approval of medical technology. Data were processed in SPSS 13.0 and Lisre l5.3. RESULTS: There were 52 third class indices, 15 second class indices, and 3 first class indices in this ethical evaluation index system. The weight of each index was calculated by normalisation. CONCLUSION: This study developed a three-level ethical evaluation index system, comprising 70 indices, for the clinical approval of medical technology.

A Battery-Less, Implantable Neuro-Electronic Interface for Studying the Mechanisms of Deep Brain Stimulation in Rat Models.

Although deep brain stimulation (DBS) has been a promising alternative for treating several neural disorders, the mechanisms underlying the DBS remain not fully understood. As rat models provide the advantage of recording and stimulating different disease-related regions simultaneously, this paper proposes a battery-less, implantable neuro-electronic interface suitable for studying DBS mechanisms with a freely-moving rat. The neuro-electronic interface mainly consists of a microsystem able to interact with eight different brain regions bi-directionally and simultaneously. To minimize the size of the implant, the microsystem receives power and transmits data through a single coil. In addition, particular attention is paid to the capability of recording neural activities right after each stimulation, so as to acquire information on how stimulations modulate neural activities. The microsystem has been fabricated with the standard 0.18 µm CMOS technology. The chip area is 7.74 mm (2) , and the microsystem is able to operate with a single supply voltage of 1 V. The wireless interface allows a maximum power of 10 mW to be transmitted together with either uplink or downlink data at a rate of 2 Mbps or 100 kbps, respectively. The input referred noise of recording amplifiers is 1.16 µVrms, and the stimulation voltage is tunable from 1.5 V to 4.5 V with 5-bit resolution. After the electrical functionality of the microsystem is tested, the capability of the microsystem to interface with rat brain is further examined and compared with conventional instruments. All experimental results are presented and discussed in this paper.

Roles of carbonic anhydrase 8 in neuronal cells and zebrafish.

BACKGROUND: Carbonic anhydrase 8 (CA8) is an isozyme of α-carbonic anhydrases (CAs). Previous studies showed that CA8 can be detected in human adult brain, with more intense expression in the cerebellum. Single mutations in CA8 were reported to cause novel syndromes like ataxia, mild mental retardation or the predisposition to quadrupedal gait. METHODS: In the present study, we examine the functions of CA8 in neuronal cell lines, mouse cerebellar granule neurons and zebrafish. RESULTS AND CONCLUSIONS: We demonstrated that overexpression of CA8 in neuronal cells significantly decreased cell death under staurosporine treatment. Moreover, CA8 overexpression significantly increased cell migration and invasion ability in neuronal cells and in mouse cerebellar granule neurons, implicating that CA8 may be involved in neuron motility and oncogenesis. By using zebrafish as an animal model, motor reflection of 3dpf zebrafish embryos was significantly affected after the down-regulation of CA8 through ca8 morpholino. CONCLUSIONS: We concluded that CA8 overexpression desensitizes neuronal cells to STS induced apoptotic stress and increases cell migration and invasion ability in neuronal cells. In addition, down-regulated CA8 decreases neuron mobility in neuronal cells and leads to abnormal calcium release in cerebellar granule neurons. Knockdown of the ca8 gene results in an abnormal movement pattern in zebrafish. GENERAL SIGNIFICANCE: Our findings provide evidence to support that the impaired protective function of CA8 contributes to human neuropathology, and to suggest that zebrafish can be used as an animal model to study the biological functions of human CA8 in vivo.

Penicillin analyses by capillary electrochromatography-mass spectrometry with different charged poly(stearyl methacrylate-divinylbenzene) monoliths as stationary phases.

This study describes the ability of an on-line concentration capillary electrochromatography (CEC) coupled with mass spectrometry (MS) for the determination of eight common penicillin antibiotics. Poly(stearyl methacrylate-divinylbenzene) (poly(SMA-DVB)) based monolithic columns prepared under the same conditions but differing only in the charged monomer were used as separation columns. Vinylbenzyl trimethylammonium chloride (VBTA) and vinylbenzenesulfonate (VBSA) were employed as the positively charged monolith and negatively charged monolith, respectively. Results indicated that poly(SMA-DVB-VBTA) monolithic column provided reproducible performance for penicillin separation through ion-exchange interaction, while the negatively charged poly(SMA-DVB-VBSA) column produced unstable separation due to the electrostatic repulsion between the electrophilic analytes and the negatively charged stationary phase. On-line concentration steps of step-gradient elution combined with anion selective injection (ASEI) were used to enhance the detection sensitivity of the CEC-MS method and all penicillin detection sensitivities were further improved (reduction in the limits of detection from 1.9-31 µg/L (normal injection mode) to 0.05-0.2 µg/L (on-line concentration mode)). Finally, this optimal on-line concentration CEC-MS method was applied to trace penicillin analyses in milk samples.