Comparative pharmacokinetic study of five flavonoids in normal rats and rats with gastric ulcer following oral administration of Mongolian medicine, Shudage - 4 by UPLC – ESI – MS/MS

Purpose: To develop a simple, rapid and sensitive ultra-performance liquid chromatography - electrospray ionization-mass spectrometry (UPLC–ESI–MS/MS) method was developed and fully validated for the simultaneous determination of galangin, kaempferide, galangin-3-methylether, kaempferol and quercetin in rat plasma after oral administration of Mongolian Medicine, Shudage-4 extracts. Methods: The galangin, kaempferide, galangin-3-methylether, kaempferol and quercetin were separated on a C18 column using 0.1 % formic acid at a flow rate of 0.4 mL / min and detected by a mass spectrometer in negative-ion mode with selected reaction monitoring (SRM) mode. Plasma samples were processed with a simple deproteinization technique using ethyl acetate and acetonitrile. Following the protein precipitation, the plasma samples were evaporated under gentle stream of nitrogen and analyzed by above method. Naringin was used as an internal standard (IS). Method validation was performed according to the Chinese Food and Drug Administration guidelines. Results: A good linearity (r2 ≥ 0.9990) was showed by the UPLC – ESI – MS / MS method, the low limits of quantification for galangin, kaempferide, galangin-3-methylether, kaempferol and quercetin were 229.8, 78.8, 32.0, 123.7 and 137.8 ng / mL, respectively. The results of inter-day and intra-day precisions met the experimental requirement (< 7.8 %). The matrix effect and recovery efficiency of the five analytes were more than 72.9 and 88.7 % respectively. The stability of the analytes were satisfactory. The UPLC – ESI – MS / MS method has been used for the five analytes’ pharmacokinetics study successfully after gastrointestinal route of the Mongolian Medicine Shudage-4. The pharmacokinetic parameters showed significant differences (P < 0.05) between the normal and gastric ulcer groups. The metabolism and transport of the five analytes in gastric ulcer rates were faster than in normal rats after administration of Shudage - 4 extract. Double-peak phenomenon appeared in galangin, galangin – 3 - methylether and quercetin. Conclusion: The results suggest that the metabolism and transport of Mongolian Medicine Shudage-4 in gastric ulcer rats is faster than in normal rats and may be enriched and acted on at the lesion site. Keywords: UPLC – ESI – MS / MS; Mongolian medicine; Shudage - 4; pharmacokinetics; gastric ulce

Corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis

AIM: To investigate the clinical effect of corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis.<p>METHODS: There were 168 cases suffered keratomycosis that the focus located shallow of the cornea and was not obvious to drug, who registered in our hospital from March 2005 to June 2010. In surgery we removed plate layer to cormea clear, the region was greater than focus for 0.5mm,then we injected fluconazole which is 2g/L density in corneal stroma to make the edema area greater than Removal of area for 0.5mm. At last we took pedicle conjunctival flap to cover the plant bed by continuous suture. Postoperative day use drug to drop eye and to observe that whether recurrent of the keratomycosis and how was the edema degrade, the blood supply of conjunctival graft pieces, how about the stimulating signs of the surgery eye, the vision.<p>RESULTS: The improvement rate was 96.2% after surgery for seven days and the cure rate was 95.5% after surgery for one months. We found in 157 eyes accepted trigeminy surgery there were 6 eyes recurrence and the recurrence rate was 3.8%. The mean time of corneal stromal edema faded away was 13.4 hours. After surgery for one month there were 39 eyes(24.8%)whose vision removed than preoperative, there were 91 eyes(58.0%)whose vision were same as preoperative and there were 27 eyes(17.2%)whose vision lower than preoperative. In these operations the loss ratio of corneal endothelium was from 0%-8%, the mean was 2.9%. The irritative symptoms postoperative were mild for 87%, moderate for 10% and severe for 3%. By this surgery the mean length of stay was 7.3 days so the mean hospitalization expenses only were 2160 RMB. Three months after surgery, 4 cases were slight corneal ectasia.<p>CONCLUSION: This operation combined corneal layer plate removal, Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis which was in early-to-mid was affordable and curative effect. So which could be used in some district which shortage the cornea donor

A Wideband Printed Directional Antenna Array with Impedance Regulating Load

We proposed a broadband directional antenna array working at mobile communication frequency band, which achieves a relative bandwidth of 50.7%. This binary antenna array is fed by two branches of the balanced microstrip. To enhance the antenna bandwidth, we introduced a section of loading metal strip. The antenna prototype has a S11 lower than −10 dB within the 1.5 GHz to 2.52 GHz frequency band, particularly from 2.01 GHz to 2.50 GHz, the S11 is lower than −15 dB. The gain varies with relatively small variation within the working band, which is 5.4 dBi to 8.7 dBi

Connection between the decadal variability in the Southern Ocean circulation and the Southern Annular Mode

Author Posting. © American Geophysical Union, 2007. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geophysical Research Letters 34 (2007): L16604, doi:10.1029/2007GL030526.Previous studies demonstrated the remarkable upward trend of the Southern Annular Mode (SAM) and Southern Ocean wind stress in association with anthropogenic forcing. An oceanic reanalysis data set is used to investigate the response of the circulation in the Southern Ocean to the decadal variability of SAM. Our results indicate the strengthening and the poleward shift of the northward Ekman velocity as well as the Ekman pumping rate, which led to a corresponding strengthening trend in the Deacon Cell. This strengthening, in turn, intensified the meridional density gradient and the tilting of the isopycnal surfaces. On the interannual time scale, the Antarctic Circumpolar Currents (ACC) transport exhibits a positive correlation with SAM index as seen separately in observations. However, there is no significant trend in the total transport of ACC. Possible reasons are discussed.This work was supported by the Chinese Academy of Sciences (Grant KZSW2-YW-214), the Natural Science Foundation of China (Grant 40640420557) and National Basic Research Program of China (Grant 2006CB403604) for X-Y. Yang and D. Wang, and by W. Alan Clark Chair from Woods Hole Oceanographic Institution for R.X. Huang

Multimodal prevention of emergence cough following nasal endoscopic surgery under general anesthesia: a double-blind randomized trial

PurposeCough during emergence from anesthesia is a common problem and may cause adverse events. Monotherapy faces uncertainty in preventing emergence cough due to individual differences. We aimed to evaluate the efficacy and safety of multimodal intervention for preventing emergence cough in patients following nasal endoscopic surgery.MethodsIn this double-blind randomized trial, 150 adult patients undergoing nasal endoscopic surgery were randomly allocated into three groups. For the control group (n = 50), anesthesia was performed according to clinical routine, no intervention was provided. For the double intervention group (n = 50), normal saline 3 mL was sprayed endotracheally before intubation, 0.4 μg/kg dexmedetomidine was infused over 10 min after intubation, and target-controlled remifentanil infusion was maintained at an effect-site concentration of 1.5 ng/mL before extubation after surgery. For the multimodal intervention group (n = 50), 0.5% ropivacaine 3 mL was sprayed endotracheally before intubation, dexmedetomidine and remifentanil were administered as those in the double intervention group. The primary endpoint was the incidence of emergence cough, defined as single cough or more from end of surgery to 5 min after extubation.ResultsThe incidences of emergence cough were 98% (49/50) in the control group, 90% (45/50) in the double group, and 70% (35/50) in the multimodal group, respectively. The incidence was significantly lower in the multimodal group than those in the control (relative risk 0.71; 95% CI 0.59 to 0.86; p &lt; 0.001) and double (relative risk 0.78; 95% CI 0.63 to 0.95; p = 0.012) groups; the difference between the double and control groups was not statistically significant (relative risk 0.92; 95% CI 0.83 to 1.02; p = 0.20). The severity of sore throat was significantly lower in the multimodal group than that in the control group (median difference-1; 95% CI −2 to 0; p = 0.016). Adverse events did not differ among the three groups.ConclusionFor adult patients undergoing endonasal surgery, multimodal intervention including ropivacaine topical anesthesia before intubation, dexmedetomidine administration after intubation, and remifentanil infusion before extubation after surgery significantly reduced emergence cough and was safe

Optimal strategy for delirium detection in older patients admitted to intensive care unit after non-cardiac surgery

BackgroundDelirium detection is challenging due to the fluctuating nature and frequent hypoactive presentation. This study aimed to determine an optimal strategy that detects delirium with higher sensitivity but lower effort in older patients admitted to the intensive care unit (ICU) after surgery.MethodsThis was a secondary analysis of the database from a randomized trial. Seven hundred older patients (aged ≥65 years) who were admitted to the ICU after elective noncardiac surgery were enrolled. Delirium was assessed with the Confusion Assessment Method for the ICU (CAM-ICU) twice daily during the first 7 days postoperatively. The sensitivity of different strategies in detecting delirium were analyzed and compared.ResultsOf all enrolled patients, 111 (15.9%; 95% CI: 13.3% to 18.8%) developed at least one episode of delirium during the first 7 postoperative days. Among patients who developed delirium, 60.4% (67/111) had their first delirium onset on postoperative day 1, 84.7% (94/111) by the end of day 2, 91.9% (102/111) by the end of day 3, and 99.1% (110/111) by the end of day 4. Compared with delirium assessment twice daily for 7 days, twice-daily measurements for 5 days detected 100% of delirium patients with 71% efforts; twice-daily measurements for 4 days detected 99% (95% CI: 94% to 100%) of delirium patients with 57% efforts; twice-daily assessment for 3 days detected 92% (95% CI: 85% to 96%) of delirium patients with only 43% efforts.ConclusionsFor older patients admitted to the ICU after elective noncardiac surgery, it is reasonable to detect delirium with the CAM-ICU twice daily for no more than 5 days, and if the personnel and funds are insufficient, 4 days could be sufficient