Potential and applications of capillary electrophoresis for analyzing traditional Chinese medicine: a critical review

In situ growth of dual-responsive polymer as coating for open tubular capillary electrochromatographic separation of epimedins

Recently, open tubular capillary electrochromatography (OT-CEC) has captured considerable interest; its efficient separation capability hinges on the interactions between analytes and polymer coatings. However, in situ growth of stimuli-responsive polymers as coatings has been rarely studied and is crucial for expanding the OT-CEC technique and its application. Herein, following poly(styrene-maleicanhydride) (PSM) chemically bonded onto the inner surface of the capillary, a dual pH/temperature stimuli-responsive block copolymer, P(SMN-COOH), was prepared by in situ polymerizing poly(N-isopropylacrylamide) carboxylic acid terminated [P(N-COOH)] in PSM. An OT-CEC protocol was first explored using the coated capillary for epimedins separation. As a proof of concept, the developed OT-CEC system facilitated hydrogen bonding and tuning the hydrophilic/hydrophobic interactions between the test analytes and the P(SMN-COOH) coating by varying buffer pH and environmental temperature. Four epimedins with similar chemical structures were baseline separated under 40 °C at pH 10.0, exhibiting dramatical improvement in separation efficiency in comparison to its performance under 25 °C at pH 4.0. In addition, the coated capillary showed good repeatability and reusability with relative standard deviations for migration time and peak area between 0.7 and 1.7% and between 2.9 and 4.6%, respectively, and no significant changes after six runs. This work introduces a paradigm for efficient OT-CEC separation of herbal medicines through adjusting the interactions between analytes and smart polymer coatings, addressing polymer coating design and OT-CEC challenges.

Development of a Non-Target Screening and Quantitative Analysis Strategy Based on UPLC-Q-TOF/MS and UPLC-QQQ/MS to Improve the Quality Control of Wuling Capsule

Herbal medicine has been widely valued because of its remarkable efficacy and minimal side effects. The quantitative analysis of herbal medicines is essential to ensure their safety and efficacy. The simultaneous detection of multiple quality markers (Q-markers) has emerged as an important approach and trend in herbal medicine quality control. In recent years, non-targeted screening has become an effective strategy for the discovery and identification of unknown compounds. This study developed a non-targeted screening and quantitative analysis strategy to discover, identify and quantify the multiple components that truly represent the efficacy of Wuling capsule. Within this strategy, 18 types of flavonoids were tentatively discovered and identified from Wuling capsule by analyzing mass cleavage pathways, the precise molecular weights of compounds, and comparing the data with a database. Ten types of flavonoids were determined after the comparison of the standards. Additionally, following the evaluation of the regression equation, linear range, limit of detection (LOD), limit of quantitation (LOQ), precision, repeatability, and recovery of the proposed quantitative method, six flavonoids were quantified. This method successfully screened, identified, and quantified the potential active components in Wuling capsule, providing insights for improving the quality control standards in other herbal medicines.

Fluorescence enhancement of flavonoids and its application in ingredient determination for some traditional Chinese medicines by CE-LIF

Flavonoids are widely used in the treatment of various diseases due to their antioxidant, anti-inflammatory, anticancer and antiviral properties. Fluorescence detection is rarely applied for the determination of flavonoids because of their weak fluorescence. In this work, a method of fluorescence enhancement of flavonoids was firstly introduced by using sodium acetate for flavonoid derivatization. The study discovered that flavonoids, with a hydroxyl at the C3 position, had the ability to emit strong fluorescence after derivatization. Five flavonoids, kaempferide, galangin, isorhamnetin, kaempferol and quercetin, having a special structure, were selected, derivatized and analyzed by capillary electrophoresis with laser-induced fluorescence detection. Under the optimal conditions, the five flavonoids could be completely separated within 3 minutes. Good linear relationships were obtained for all analytes and the limits of detection for the five flavonoids were in the range of 1.18-4.67 × 10^-7 mol L^-1. Finally, the method was applied to the determination of flavonoids in five traditional Chinese medicines: aster, chamomile, galangal, tangerine peel and cacumen biotae. Flavonoids were successfully found in all these medicines by the developed method. The recoveries were in the range of 84.2-111%. The method developed in this study was fast, sensitive and reliable for the determination of flavonoids.

Fabrication of a Magnetic Porous Organic Polymer for α-Glucosidase Immobilization and Its Application in Inhibitor Screening

The technology based on immobilized enzymes was employed to screen the constituents inhibiting disease-related enzyme activity from traditional Chinese medicine, which is expected to become an important approach of innovative drug development. Herein, the Fe₃O₄@POP composite with a core-shell structure was constructed for the first time with Fe₃O₄ magnetic nanoparticles as the core, 1,3,5-tris (4-aminophenyl) benzene (TAPB) and 2,5-divinylterephthalaldehyde (DVA) as organic monomers, and used as the support for immobilizing α-glucosidase. Fe₃O₄@POP was characterized by transmission electron microscopy, energy-dispersive spectrometry, Fourier transform infrared, powder X-ray diffraction, X-ray photoelectron spectroscopy, and vibrating sample magnetometry. Fe₃O₄@POP exhibited a distinct core-shell structure and excellent magnetic response (45.2 emu g^-1). α-Glucosidase was covalently immobilized on core-shell Fe₃O₄@POP magnetic nanoparticles using glutaraldehyde as the cross-linking agent. The immobilized α-glucosidase possessed improved pH stability and thermal stability as well as good storage stability and reusability. More importantly, the immobilized enzyme exhibited a lower K_m value and enhanced affinity for the substrate than the free one. The immobilized α-glucosidase was subsequently used for inhibitor screening from 18 traditional Chinese medicines in combination with capillary electrophoresis analysis among which Rhodiola rosea exhibited the highest enzyme inhibitory activity. These positive results demonstrated that such magnetic POP-based core-shell nanoparticles were a promising carrier for enzyme immobilization and the screening strategy based on immobilized enzyme provided an effective way to rapidly explore the targeted active compounds from medicinal plants.

Analysis of the Effect of Mindfulness Behavior Intervention Combined with Progressive Breathing Training on Pulmonary Function Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

Purpose

Studies have shown that 50%-70% of patients with chronic obstructive pulmonary disease (COPD) have fatigue in addition to respiratory symptoms, so relieving respiratory symptoms and reducing fatigue are the main treatment objectives for COPD patients. This study focuses on the effect of positive behavioral intervention combined with progressive breathing training on pulmonary function rehabilitation in patients with COPD.

Methods

86 patients who underwent COPD treatment in our hospital between August 2020 and December 2021 were selected as study subjects and were divided into control (n = 43) and study groups (n = 43) using the random number table method. Patients in the control group were given conventional care, treatment, and health guidance, while patients in the study group were given positive behavioral intervention combined with progressive breathing training on this basis. Patients in both groups were compared on the basis of Multidimensional Fatigue Inventory 20 (MFI-20) score, the Medical Coping Questionnaire (MCMQ score), the Massive Attentional Awareness Scale (MAAS) score, and pulmonary function indicators (including the percentage of forced expiratory volume one second (FEV1%), peak expiratory flow (PEF), forced vital capacity (FVC), and 6-min walk distance (6MWD)) and quality of life (MCMQ) scores before and after 12 weeks of intervention.

Results

After 12 weeks of intervention, the study group had higher MFI-20 scores (comprehensive fatigue, physical fatigue, reduced activity, decreased power, and mental fatigue), confrontation scores on the MCMQ scale, MAAS scores (observation, description, nonjudgmental to intrinsic experience, nonresponsiveness to intrinsic experience, and perceived behavior), FEV1%, PEF, FVC, and 6MWD levels than the control group (P < 0.05). The scores of avoidance and submission on the MCMQ scale, and all scores of quality of life (cough, expectoration, shortness of breath, chest tightness, housework, going out, sleep, and energy) were lower than those of the control group (P < 0.05).

Conclusion

Positive behavioral interventions combined with progressive breathing training have a strengthening effect on the clinical treatment of COPD patients. Positive behavioral interventions combined with progressive breathing training are simple to implement as individual self-regulation methods and can be practiced on their own after being familiar with certain methods and techniques, and long-term adherence helps individuals cope with the stimulation of adverse events. Trail Registration. The clinical registration number for this research is L2020083.

Preoperative Nutritional Risk Assessment for Predicting Complications after Radical Cystectomy plus Urinary Diversion for Bladder Cancer

Objective

To investigate the predictive value of preoperative nutritional risk assessment on the occurrence of complications after radical cystectomy plus urinary diversion for bladder cancer.

Methods

Retrospective analysis of 178 patients with bladder cancer between July 2010 and March 2022 who underwent elective radical cystectomy plus urinary diversion was conducted. The occurrence of complications within 90 days after surgery was counted for all patients, and the postoperative complication rates of patients with and without nutritional risk were compared and analyzed. Also, logistic regression analysis was used to assess the relative risk coefficients of NRS-2002 and the occurrence of postoperative complications.

Results

Comparison of clinicopathological characteristics and surgical conditions between the two groups showed that the proportion of combined diabetes mellitus, operative time, and postoperative hospital stay were higher in the nutritional risk group (NRS ≥3 score) than in the no nutritional risk group (NRS <3 score), while the preoperative blood albumin (ALB) level was lower than that in the no nutritional risk group (NRS <3 score). The results of multifactorial risk regression analysis showed that low preoperative ALB level and high NRS score were independent risk factors for postoperative complications in bladder cancer (P < 0.05).

Conclusion

The NRS-2002 nutritional risk score has good predictive value for the incidence of postoperative complications in patients with bladder cancer and provides a scientific basis for perioperative nutritional support.

Type 2 Diabetes Mellitus (T2DM) and Carbohydrate Metabolism in Relation to T2DM from Endocrinology, Neurophysiology, Molecular Biology, and Biochemistry Perspectives

Type 2 diabetes mellitus (T2DM) is a severe disease caused by metabolic disorders, particularly carbohydrate metabolism disorders. The disease is a fatal global trouble characterised by high prevalence rates, causing death, blindness, kidney failure, myocardial infarction, amputation of lower limps, and stroke. Biochemical metabolic pathways like glycolysis, gluconeogenesis, glycogenesis, and glycogenolysis are critical pathways that regulate blood glucose levels with the glucokinase (GK) enzyme playing a central role in glucose homeostasis. Any factor that perturbs the aforementioned biochemical pathways is detrimental. Endocrinological, neurophysiological, and molecular biological pathways that are linked to carbohydrate metabolism should be studied, grasped, and manipulated in order to alleviate T2DM global chaos. The challenge, howbeit, is that, since the body is an integration of systems that complement one another, studying one “isolated” system is not very useful. This paper serves to discuss endocrinology, neurophysiology, and molecular biology pathways that are involved in carbohydrate metabolism in relation to T2DM.

Application of Operating Room Nursing Intervention to Incision Infection of Patients Undergoing Gastrointestinal Surgery Can Reduce Complications and Improve Gastrointestinal Function

Objective

To observe the influence of nursing intervention in operation rooms on incision infection of patients undergoing gastrointestinal surgery and the improvement of gastrointestinal function.

Methods

A total of 340 patients who underwent gastrointestinal surgery in our hospital from June 2020 to August 2021 were included. According to the random number table, they were divided into the conventional nursing group (n = 170) and the operating room nursing group (n = 170). The conventional nursing group was treated with routine nursing intervention, while the operating room nursing group was treated with operating room nursing intervention. The incision infection, healing, gastrointestinal function recovery, and complications in the two groups were compared, and the patient care satisfaction was recorded.

Results

The incidence of incision swelling, pain, and incision secretion in the operating room nursing group was significantly lower than that in the conventional nursing group (p < 0.05). The patients in the operating room nursing group had higher grade A healing than in the conventional nursing group, and lower grade B and grade C healing than in the conventional nursing group (p < 0.05). The time of anal exhaust, first defecation, and the time of gastric tube removal in the operating room nursing group were lower than those in the conventional nursing group (p < 0.05). The incidence of postoperative complications, such as incision infection, incision dehiscence, early inflammatory bowel adhesion, and abdominal abscess, in the operating room nursing group was lower than that in the conventional nursing group (p < 0.05). The total satisfaction degree in the operating room nursing group was significantly higher than that in the conventional nursing group (p < 0.05).

Conclusion

Nursing intervention in operation room can reduce complications and improve gastrointestinal function when applied to patients undergoing gastrointestinal surgery due to incision infection.

Clinical Impact of Nurses-Physicians Collaboration Intervention on the Treatment of Immune Recurrent Spontaneous Abortion with Low-Molecular-Weight Heparin

Anticoagulation is currently the preferred and effective treatment for patients with recurrent spontaneous abortion (RSA), but, due to the prevalence of mood disorders in RSA patients and the high number of adverse effects associated with long-term medication, effective care measures are often required. In this study, 94 patients with immune-type RSA who were admitted to our hospital from January 2018 to June 2019 were selected and randomly divided into a control group and a study group of 47 patients each; both groups received low-molecular-weight heparin treatment after admission, and the control group received conventional nursing interventions during treatment, while the patients in the study group received integrated medical and nursing care interventions. Pregnancy outcomes, pre- and postintervention scores on the Self-Assessment Scale (SAS), Self-Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI), levels of serum gamma-interferon (IFN-γ) and interleukin-4 (IL-4) and their ratios, complications, and patient satisfaction with the intervention were observed in both groups. The results showed that the success rate of fetal preservation in the study group (89.36%) was significantly higher than that in the control group (68.09%) (P < 0.05). After treatment, SAS, SDS, and PSQI scores decreased in both groups, with the study group being lower (P < 0.05). IFN-γ and IFN-γ/IL-4 levels decreased and IL-4 levels increased in both groups after treatment, with IFN-γ and IFN-γ/IL-4 being significantly lower and IL-4 levels being significantly higher in the study group than in the control group (P < 0.05). The incidence of adverse drug reactions in the study group was significantly lower than that in the control group (P < 0.05). Patients in the study group were more satisfied with all aspects of the intervention than the control group (P < 0.05). These results suggest that nurses-physicians collaboration intervention may improve the effectiveness of low-molecular-weight heparin therapy in patients with immune-type RSA. It helps to improve patient pregnancy outcomes, mood, sleep quality, and immune function and increases patient satisfaction.

Safety of Different Anesthesia Methods Combined with Intravenous Fast Channel Anesthesia in Lower Extremity Orthopedic Surgery of the Elderly

Objective

To compare the safety of different anesthesia methods combined with intravenous fast channel anesthesia in elderly lower extremity surgery and the effect on postoperative outcome.

Methods

A total of 106 elderly patients who underwent lower extremity orthopedic surgery in our hospital from February 2018 to February 2021 were selected and randomly divided into the control group (n = 53) and the observation group (n = 53) according to random number table. All patients received intravenous fast-track anesthesia. On this basis, the control group received spinal-epidural anesthesia, and the observation group received iliac fascial space block on the affected side combined with sciatic nerve block. The operation conditions, blood pressure and heart rate changes, awakening time, postoperative ICU admission rate, and complications were compared between the two groups.

Results

There was no statistical difference in the success rate of one-time operation between the two groups (P > 0.05). The times of using analgesics and vasoactive drugs and the dosage of propofol in the observation group during the operation were lower than those in the control group, and the difference was statistically significant (P < 0.05). At T2, T3, and T4, the levels of HR, DBP, and SBP in the observation group were lower than those in the control group, and the difference was statistically significant (P < 0.05). After operation, the time of awakening, spontaneous breathing recovery, and extubation in the observation group were lower than those in the control group, and the difference were statistically significant (P < 0.05). The incidence of complications in the observation group was lower than that in the control group, the cognitive impairment was the most significant one in the incidence of single complication, and the difference was statistically significant (P < 0.05).

Conclusion

Based on the combined intravenous fast channel anesthesia, the operation difficulty of the affected side iliac fascial space block combined with sciatic nerve block is the same as that of spinal-epidural anesthesia. It has a higher success rate of one operation, better analgesic and anesthetic effects during the operation, and little effect on blood flow of patients. It can maintain relatively stable heart rate and blood pressure and does not easily cause postoperative complications. Its safety is higher than that of spinal-epidural anesthesia.

Difference between Acyclovir and Ganciclovir in the Treatment of Children with Epstein-Barr Virus-Associated Infectious Mononucleosis

Objective

To investigate the efficacy differences between acyclovir and ganciclovir in the treatment of children with Epstein-Barr virus (EBV)- associated infectious mononucleosis (IM).

Methods

A total of 128 children with EBV-IM who were admitted to our hospital from February 2019 to February 2021 were selected and randomly divided into the acyclovir group (n = 64) and the ganciclovir group (n = 64) according to the random number table method. All the children were given symptomatic treatments such as protecting the liver and reducing fever. On this basis, the acyclovir group was given an intravenous drip of acyclovir, while the ganciclovir group was given an intravenous drip of ganciclovir. The treatment was continued for 7 days. After the treatment, the clinical efficacy, disappearance time of symptoms and signs, related blood routine indexes, EBV-DNA negative conversion rate, and the incidence of adverse reactions during the treatment were compared between the two groups.

Results

After treatment, the total effective rate of the ganciclovir group (92.19%) was higher than that of the acyclovir group (73.44%) and the difference was statistically significant (P < 0.05). The disappearance time for the symptoms and signs of angina, fever, lymphadenopathy, hepatomegaly, and splenomegaly in the ganciclovir group was lower than that in the acyclovir group, and the difference was statistically significant (P < 0.05). After treatment, the levels of atypical lymphocyte proportion, lymphocyte proportion, and WBC count in the two groups were lower than those before treatment, the levels in the ganciclovir group were lower than those in the acyclovir group, and the difference was statistically significant (P < 0.05). After treatment, the EBV-DNA negative conversion rate (81.25%) in the ganciclovir group was higher than that in the acyclovir group (60.93%) and the difference was statistically significant (P < 0.05). During treatment, the incidence of adverse reactions in the ganciclovir group was significantly lower than that in the acyclovir group and the difference was statistically significant (P < 0.05).

Conclusion

In the treatment of children with EBV-IM, the therapeutic effect of ganciclovir is obviously superior to that of acyclovir. Ganciclovir can quickly eliminate the symptoms of angina, fever, enlarged lymph nodes, and other signs in children, can improve abnormal blood indicators, and has a higher negative conversion rate of EBV and less adverse reactions.