Preparation Process and Quality Standard of Rougan Huaxian Ointment

[Objectives] To establish the preparation process and quality standard of Rougan Huaxian ointment.[Methods] The L 9(3 4) orthogonal test was employed to optimize the preparation process by considering the multiplication of water addition, extraction time, and extraction frequency as influencing factors. The dry paste yield was utilized as the evaluation criterion, in conjunction with the actual production conditions. Thin layer chromatography was employed to identify Radix Astragali, Lycii Fructus, Herba Dendrobii, and Rhizoma Polygoni Cuspidati. Ethanol served as the solvent for the determination of ethanol-soluble extractives using the cold immersion method.[Results] The preparation process was conducted as follows: the specified quantity of medicinal materials was combined with water for extraction purposes, performed in two separate stages. In each stage, eight times the amount of water was added. The first extraction lasted for 1.5 h, while the second extraction was completed in 1.0 h. The resulting liquid was then concentrated into a thick paste with a relative density ranging from 1.25 to 1.30 at a temperature of 60 ℃. The thin-layer chromatography analysis of Radix Astragali, Lycii Fructus, Herba Dendrobii, and Rhizoma Polygoni Cuspidati demonstrated distinct spots, effective separation, and the absence of interference from negative samples. Additionally, the ethanol-soluble extractives yielded a minimum of 8.0% in terms of dry weight.[Conclusions] The preparation process for Rougan Huaxian ointment is both stable and feasible. Furthermore, the quality standards established for this preparation are unique and reproducible, thereby facilitating effective quality control.

Research Progress of Bowel Preparation for Colonoscopy

Colorectal cancer ranks third in the global cancer data in 2020. Colorectal scope is the most effective method to diagnose colorectal diseases such as benign and malignant colorectal tumors. The poor quality of intestinal preparation causes an increased rate of missed diagnosis of colorectal tumors, reduces the rate of cecal intubation for colorectal examination, increases the discomfort, and reduces the compliance of re-examination. Therefore, we should try our best to improve the quality of intestinal preparation. This study reviewed the latest advances related to the preoperative preparation for colonoscopy. Recent research shows that smartphone apps can provide more detailed education and guidance on bowel preparation;Pre-packaged foods are more suitable as a way to eat before colonoscopy. The use of smaller doses, better taste of cathartic agents, and some auxiliary measures, combined with the patient’s situation to provide personalized intestinal preparation measures to improve the quality of intestinal preparation. Starting from the quality of colonoscopy bowel preparation, continuous improvement of patients’ tolerance to bowel preparation, continuous improvement of bowel preparation plan based on individual factors’ needs, and better communication with examined subjects by using existing scientific information technology, may be the hot spot of colonoscopy bowel preparation research in the next few years.

Factors influencing quality of bowel preparation for colonoscopy

Recent technological advances in colonoscopy have led to improvements in both image enhancement and procedural performance.However,the utility of these technological advancements remain dependent on the quality of bowel preparation during colonoscopy.Poor bowel preparation has been shown to be associated with lower quality indicators of colonoscopy performance,such as reduced cecal intubation rates,increased patient discomfort and lower adenoma detection.The most popular bowel preparation regimes currently used are based on either Polyethylene glycol-electrolyte,a non-absorbable solution,or aqueous sodium phosphate,a lowvolume hyperosmotic solution.Statements from various international societies and several reviews have suggested that the efficacy of bowel preparation regimes based on both purgatives are similar,although patients' compliance with these regimes may differ somewhat.Many studies have now shown that factors other than the type of bowel preparation regime used,can influence the quality of bowel preparation among adult patients undergoing colonoscopy.These factors can be broadly categorized as either patient-related or procedure-related.Studies from both Asia and the West have identified patient-related factors such as an increased age,male gender,presence of co-morbidity and socioeconomic status of patients to be associated with poor bowel preparation among adults undergoing routine out-patient colonoscopy.Additionally,procedure-related factors such as adherence to bowel preparation instructions,timing of bowel purgative administration and appointment waiting times for colonoscopy are recognized to influence the quality of colon cleansing.Knowledge of these factors should aid clinicians in modifying bowel preparation regimes accordingly,such that the quality of colonoscopy performance and delivery of service to patients can be optimised.

Bowel preparations as quality indicators for colonoscopy

Colonoscopy is the principal investigative procedure for colorectal neoplasms because it can detect and remove most precancerous lesions.The effectiveness of colonoscopy depends on the quality of the examination.Bowel preparation is an essential part of high-quality colonoscopies because only an optimal colonic cleansing allows the colonoscopist to clearly view the entire colonic mucosa and to identify any polyps or other lesions.Suboptimal bowel preparation not only prolongs the overall procedure time,decreases the cecal intubation rate,and increases the costs associated with colonoscopy but also increases the risk of missing polyps or adenomas during the colonoscopy.Therefore,a repeat examination or a shorter colonoscopy follow-up interval may be suitable strategies for a patient with suboptimal bowel preparation.

HPLC Fingerprint with Multi-components Analysis for Quality Consistency Evaluation of Traditional Chinese Medicine Si-Mo-Tang Oral Liquid Preparation

Si-Mo-Tang（SMT） oral liquid preparation, a traditional Chinese medicine, was prepared from four crude herbal drugs, Fructus Aurantii Submaturus, Radix Aucklandiae, Semen Arecae and Radix Linderae Aggregatae. A combinative method using HPLC fingerprint and quantitative analysis was developed and validated for quality consistency evaluation of SMT. Individual HPLC chromatograms were evaluated against the mean chromatogram generated via a similarity evaluation computer program. Data from chromatographic fingerprints were also processed with principal component analysis（PCA） and hierarchical cluster analysis（HCA）. Additionally, six components （naringin, isonaringin, hesperidin, neohesperidin, norisoboldine and potassium sorbate） in SMT were simultaneously determined to interpret the quality consistency. For fingerprint analysis, 20 peaks were selected as the characteristic peaks to evaluate the similarities of 26 SMT collected from different manufacturers. Among the 20 characteristic peaks, 10 peaks were assigned to be naringin, hesperidin, neohesperidin, isonaringin, neoeriocitrin, tangeretin, nobiletin, norisoboldine, 5-（ethoxymethyl）furan-2-carbaldehyde and potassium sorbate, respectively. The results of similarity analysis, PCA and HCA, indicate that the samples from different manufacturers were consistent with each other in composition. The results from the quantitative data show that the contents of six compounds were significantly different in SMT oral liquid preparations from different manufacturers. The combinative method of chromatographic fingerprint with quantitative analysis developed here offered an efficient way for the quality consistency evaluation of the traditional Chinese medicine SMT.

Preparation of Potato Whole Flour and Its Effects on Quality of Flour Products: A Review

When harvested the potato has a high moisture content, this could make its transportation and storage difficult. To help solve the transportation difficulties, potato is made into whole flour by many food processing companies. Potato whole flour has high nutritional value and may be regarded as beneficial to human health and fitness. In addition to the direct use of potato whole flour,it can also be used as added ingredients into other food products. This study summarizes and analyzes the processing technology of potato whole flour and its application in noodle products.

Review:Layer⁃Number Controllable Preparation of High⁃Quality Graphene for Wide Applications

Graphene, a well-known two-dimensional(2 D) material, has sparked broad enthusiasm in both scientific and industrial communities in these years, due to its exceptional electrical, thermal, mechanical, and versatile properties. However, many properties and applications of graphene are layer-number dependent. The preparation of high-quality graphene with controlled layer numbers is full of challenge, since the layer number varies much with the synthesis routes and relevant experimental conditions. Hence, there is an urgent need to improve the layer-number controllability of graphene preparation. Generally, graphene can be prepared by two complementary approaches: "top-down" and "bottom-up". Since they have their own advantages, the recent advances in the layer-number tunable preparation of high-quality graphene are separately studied from the two aspects in this review, especially those dedicated to single parameter. Some effective strategies are discussed in detail, mainly including 1) supercritical-CO2 assisted sonication, electrochemical exfoliation of graphite intercalation compounds, and layer-by-layer thinning with plasma or laser, for "top-down" graphene;2) chemical vapor deposition(CVD) on dual-metal substrate, ion-implantation CVD, layer-by-layer CVD, plasma-enhanced CVD, layered-double-hydroxides template-assisted CVD;and 3) graphite-enclosure assisted epitaxial growth and pulsed-magnetron-sputtering assisted physical vapor deposition for "bottom-up" graphene on various substrates. In addition, the respective advantages of graphene with different layer numbers in properties and applications are also presented. Finally, the contribution concludes with some important perspectives on the remained challenges and future perspectives.

Use of automated irrigation pumps improves quality of bowel preparation for colonoscopy

AIM: To evaluate the effectiveness of automated irrigation pumps(AIPs) in improving the quality of the bowel preparation and the yield of colonoscopy.METHODS: A retrospective observational study was conducted at a single medical center. Outpatient colonoscopies performed during a 4-mo time period when AIPs were not in use, were compared to colonoscopies performed during control period. The main outcomes measured were quality of bowel preparation, procedures aborted due to poor preparation, recommendations to repeat at short interval due to suboptimal bowel preparation and adenoma detection rates.RESULTS: One thousand and thirty-seven colonoscopies were included. A higher proportion of cases did not achieve a satisfactory bowel preparation when AIPs were not used(24.4% vs 10.3%, P < 0.01). The number of procedures aborted due to inadequate preparation was not significantly different, however a repeat procedure at a short interval was recommended in a higher proportion of cases when AIPs were not used(21.3% vs 6.9%, P < 0.01). Good or excellent preparation was 2.91(95%CI: 2.04-4.15) times more likely when AIPs were used. Detection of polyps and adenomas was not significantly different.CONCLUSION: AIP use during colonoscopy results in a higher proportion of colonic preparation rated as satisfactory, although polyp detection rate is not significantly affected. Recommendations for repeat colonoscopy at shorter interval significantly decrease with the use of AIPs. This study supports the use of the irrigation pumps in endoscopy units to improve the quality of colonoscopy.

Preparation and Quality Evaluation of Toltrazuril Nanoemulsion

To determine the prescription and preparation method of toltrazuril nanoemulsion, we selected liquid paraffin, ethyl acetate, soybean oil, IPM and oleic acid as the oil phases, while RH-40, EL-40, OP-10, Tween-80 and Span-80 were the surfactants, and alcohol, 1,2-ropanediol, ispropanl, glycerol and PEG-400 were the co-surfactants. The best prescription was acquired through pseudo-ternary phase diagrams. The result showed that ethyl acetate, Tween-80 and 1,2-propanediol could facilitate the formation of nanoemulsion. The optimum prescription was surfactant：co-surfactant：oil phase：water phase =2：1：2：5, with the solubilizer of 10%. This prescription can prepare stable toltrazuril nanoemulsion.

Discussion on the Quality Evaluation Method of Traditional Chinese Medicine Compound Preparations

As an important representative of the modernization of the Chinese medicine industry,traditional Chinese medicine(TCM)compound preparations are an indispensable part of the development of TCM.The complex ingredients and unclear action mechanism of TCM compound preparations restrict the development of TCM.In line with this problem,the modern TCM research has made extensive remarkable achievements.From the single indicator in the past to multiple indicator,the research on the combination of TCM fingerprints and pharmacodynamics also has made great progress.The introduction of quality evaluation methods such as the"quantitative analysis of multi-components by a single marker","dose-effect"indicator,"Bioactive Equivalent Combinatorial Components"(BECCs)and TCM quality markers have brought new ideas for quality control of TCM compound preparations.

Study on Model for Assessment of Quality Management Performance of Coal Preparation Plant in CIMS

In this paper the method to calculate intangible quality cost is put forward for the first time based on the production and management characteristics of coal preparation plant. A model for assessment of quality management performance of coal preparation plant is established on the ground of quality cost. By using of CIMS integration environment the strategy to carry out the model and the application example are also offered. It provides a new and feasible way to assess performance quality management of coal preparation plant.

Study on Preparation Process and Quality Standard of Tianlu Tongluo Granules

[Objectives]This study was conducted to optimize the preparation process of Tianlu Tongluo Granules and establish its quality standard.[Methods]Tianlu Tongluo Granules was prepared by an orthogonal test.TLC was used to identify Radix Astragali preparata,Radix Paeoniae Alba,Scutellariae Radix and Acori Tatarinowii Rhizoma in the granules,and the content of paeoniflorin in the finished product was determined by HPLC.[Results]The extraction process of Tianlu Tongluo Granules was as follows:adding 6 times of water,and decocting twice,1 h/time.In the forming process,the optimal ratio of thick paste to excipients as 10∶8.6,and the optimal ratio of excipients dextrin:starch:colloidal silicon dioxide was 6.5∶0.5∶1.6.The results showed that TLC spots were obvious,the separation was significant,and the specificity was strong.The paeoniflorin content had a good linear relationship in the concentration range of 5.9048-590.48 mg/L(r=0.9999).The average sample recovery was 101.10%,and the RSD was 1.18%.[Conclusions]The preparation process is stable and reasonable,and the established quality control method is specific and reproducible,and can be used for the quality control of Tianlu Tongluo Granules.

Preparation of Rosmarinic Acid Injection from Folium perillae

[Objective] To extract the effective component rosmarinic acid from Folium perillae,study preparation technology and quality control of rosmarinic acid injection and provide test basis for hemorheological drug development and clinic application.[Method]The coarse powder of Folium perillae(40 μm)was lixiviated with hot water and acidized to make aqueous extracts.Rosmarinic acid from the aqueous mixture was extracted with Ethyl Acetate.And Et Ac was evaporated to obtain primary product.The injection was purified by pH adjustment.Concentration of rosmarinic acid in the injection was detected by high performance liquid chromatography(HPLC).Contents of tannin,resin and oxalate were eliminated according to the Chinese Pharmacopeia(2005 edition).Stability,irritation,haemolyticus,LD50 and thermogenic substance of this injection were also detected.[Result]The content of rosmarinic acid in Folium perillae injection is 2.81 mg/ml,and the content of LD50 was 406.82 mg/kg.This injection was consistent with the stipulation of Chinese Pharmacopeia(2005 edition).[Conclusion]The preparation technology of this experiment was reasonable.The stable qualities of the prepared injection meet the injection requirement.

Research Progress of Bowel Preparation for Colonoscopy

Colorectal cancer ranks third in the global cancer data in 2020.Colorectal scope is the most effective method to diagnose colorectal diseases such as benign and malignant colorectal tumors.The poor quality of intestinal preparation causes an increased rate of missed diagnosis of colorectal tumors,reduces the rate of cecal intubation for colorectal examination,increases the discomfort,and reduces the compliance of re-examination.Therefore,we should try our best to improve the quality of intestinal preparation.This study reviewed the latest advances related to the preoperative preparation for colonoscopy.Recent research shows that smartphone apps can provide more detailed education and guidance on bowel preparation;Pre-packaged foods are more suitable as a way to eat before colonoscopy.The use of smaller doses,better taste of cathartic agents,and some auxiliary measures,combined with the patient’s situation to provide personalized intestinal preparation measures to improve the quality of intestinal preparation.Starting from the quality of colonoscopy bowel preparation,continuous improvement of patients’tolerance to bowel preparation,continuous improvement of bowel preparation plan based on individual factors’needs,and better communication with examined subjects by using existing scientific information technology,may be the hot spot of colonoscopy bowel preparation research in the next few years.

Predictors of suboptimal bowel preparation in asymptomatic patients undergoing average-risk screening colonoscopy

AIM To identify risk factors for a suboptimal preparation among a population undergoing screening or surveillance colonoscopy.METHODS Retrospective review of the University of Michigan and Veteran's Administration(VA) Hospital records from 2009 to identify patients age 50 and older who underwent screening or surveillance procedure and had resection of polyps less than 1 cm in size and no more than 2 polyps. Patients with inflammatory bowel disease or a family history of colorectal cancer were excluded. Suboptimal procedures were defined as procedure preparations categorized as fair, poor or inadequate by the endoscopist. Multivariable logistic regression was used to identify predictors of suboptimal preparation.RESULTS Of 4427 colonoscopies reviewed, 2401 met our inclusion criteria and were analyzed. Of our population, 16% had a suboptimal preparation. African Americans were 70% more likely to have a suboptimal preparation(95%CI: 1.2-2.4). Univariable analysis revealed that narcotic and tricyclic antidepressants(TCA) use, diabetes, prep type, site(VA vs non-VA), and presence of a gastroenterology(GI) fellow were associated with suboptimal prep quality. In a multivariable model controlling for gender, age, ethnicity, procedure site and presence of a GI fellow, diabetes [odds ratio(OR) = 2.3; 95%CI: 1.6-3.2], TCA use(OR = 2.5; 95%CI: 1.3-4.9), narcotic use(OR = 1.7; 95%CI: 1.2-2.5) and Miralax-Gatorade prep vs 4L polyethylene glycol 3350(OR = 0.6; 95%CI: 0.4-0.9) were associated with a suboptimal prep quality. CONCLUSION Diabetes, narcotics use and TCA use were identified as predictors of poor preparation in screening colonoscopies while Miralax-Gatorade preps were associated with better bowel preparation.

Withdrawal time in excellent or very poor bowel preparation qualities

AIM: To evaluate association(s) between withdrawal time and polyp detection in various bowel preparation qualities. METHODS: Retrospective cohort analysis of screening colonoscopies performed between January 2005 and June 2011 for patients with average risk of colorectal cancer. Exclusion criteria included patients with a personal history of adenomatous polyps or colon cancer, prior colonic resection, significant family history of colorectal cancer, screening colonoscopy after other abnormal screening tests such as flexible sigmoidoscopy or barium enema, and screening colonoscopies during in-patient care. All procedures were performed or directly supervised by gastroenterologists. Main measurements were number of colonic segments with polyps and total number of colonic polyps.RESULTS: Multivariate analysis of 8331 colonosco-pies showed longer withdrawal time was associated with more colonic segments with polyps in good(adjusted OR = 1.16; 95%CI: 1.13-1.19), fair(OR = 1.13; 95%CI: 1.10-1.17), and poor(OR = 1.18; 95%CI: 1.11-1.26) bowel preparation qualities. A higher number of total polyps was associated with longer withdrawal time in good(OR = 1.15; 95%CI: 1.13-1.18), fair(OR = 1.13; 95%CI: 1.10-1.16), and poor(OR = 1.20; 95%CI: 1.13-1.29) bowel preparation qualities. Longer withdrawal time was not associated with more colonic segments with polyps or greater number of colonic polyps in bowel preparations with excellent(OR = 1.07, 95%CI: 0.99-1.26; OR = 1.11, 95%CI: 0.99-1.24, respectively) and very poor(OR = 1.02, 95%CI: 0.99-1.12; OR = 1.05, 95%CI: 0.99-1.10, respectively) qualities.CONCLUSION: Longer withdrawal time is not associated with higher polyp number detected in colonoscopies with excellent or very poor bowel preparation quality.

Ensure preparation and capsule endoscopy:A two-center prospective study

AIM:To compare small bowel(SB) cleanliness and capsule endoscopy(CE) image quality following Ensure,polyethylene glycol(PEG) and standard preparations.METHODS:A preparation protocol for CE that is both efficacious and acceptable to patients remains elusive.Considering the physiological function of the SB as a site for the digestion and absorption of food and not as a stool reservoir,preparation consisting of a liquid,fiber-free formula ingested one day before a CE study might have an advantage over other kinds of preparations.We conducted a prospective,blind-topreparation,two-center study that compared four types of preparations.The participants' demographic and clinical data were collected.Gastric and SB transit times were calculated.The presence of bile in the duodenum was scored by a single,blinded-to-preparation gastroenterologist expert in CE,as was cleanliness within the proximal,middle and distal part of the SB.A four-point scale was used(grade 1 = no bile or residue,grade 4 ≥ 90% of lumen full of bile or residual material).RESULTS:The 198 consecutive patients who were referred to CE studies due to routine medical reasons were divided into four groups.They all observed a 12-h overnight fast before undergoing CE.Throughout the 24 h preceding the fast,control group 1(n = 45 patients) ate light unrestricted meals,control group 2(n = 81) also ate light meals but free of fruits and vegetables,the PEG group(n = 50) ate unrestricted light meals and ingested the PEG preparation,and the Ensure group(n = 22) ingested only the Ensure formula.Preparation with Ensure improved the visualization of duodenal mucosa(a score of 1.76) by decreasing the bile content compared to preparation with PEG(a score of 2.9)(P = 0.053).Overall,as expected,there was less residue and stool in the proximal part of the SB than in the middle and distal parts in all groups.The total score of cleanliness throughout the length of the SB showed some benefit for Ensure(a score of 1.8) over control group 2(a score of 2)(P = 0.06).The cleanliness grading of the proximal and distal parts of the SB was similar in all four groups(P = 0.6 for both).The cleanliness in the middle part of the SB in the PEG(a score of 1.8) and Ensure groups(a score of 1.7) was equally better than that of control group 2(a score of 2.1)(P = 0.057 and P = 0.07,respectively).All 50 PEG patients had diarrhea as an anticipated side effect,compared with only one patient in the Ensure group.CONCLUSION:Preparation with Ensure,a liquid,fiber-free formula has advantages over standard and PEG preparations,with significantly fewer side effects than PEG.

Preoperative bowel preparation does not favor the management of colorectal anastomotic leak

BACKGROUND Controversy exists regarding the impact of preoperative bowel preparation on patients undergoing colorectal surgery. This is due to previous research studies,which fail to demonstrate protective effects of mechanical bowel preparation against postoperative complications. However, in recent studies, combination therapy with oral antibiotics(OAB) and mechanical bowel preparation seems to be beneficial for patients undergoing an elective colorectal operation.AIM To determine the association between preoperative bowel preparation and postoperative anastomotic leak management(surgical vs non-surgical).METHODS Patients with anastomotic leak after colorectal surgery were identified from the 2013 and 2014 Colectomy Targeted American College of Surgeons National Surgical Quality Improvement Program(ACS-NSQIP) database and were employed for analysis. Every patient was assigned to one of three following groups based on the type of preoperative bowel preparation: first groupmechanical bowel preparation in combination with OAB, second groupmechanical bowel preparation alone, and third group-no preparation.RESULTS A total of 652 patients had anastomotic leak after a colectomy from January 1,2013 through December 31, 2014. Baseline characteristics were assessed and found that there were no statistically significant differences between the three groups in terms of age, gender, race, American Society of Anesthesiologists score,and other preoperative characteristics. A χ~2 test of homogeneity was conducted and there was no statistically/clinically significant difference between the three categories of bowel preparation in terms of reoperation.CONCLUSION The implementation of mechanical bowel preparation and antibiotic use in patients who are going to undergo a colon resection does not influence the treatment of any possible anastomotic leakage.

Combinative Approaches of Chemistry, Pharmacology and Toxicology for the Optimal Pharmaceutical Preparation of an Anti-arthritic Chinese Medicine Formulation QFJBT

Objective Qing Fu Juan Bi Tang(QFJBT)is an anti-arthritic Chinese medicine formula consisting of five herbs:Aconiti Lateralis Radix Praeparata(Fu Zi,附子),Sinomenii Caulis(Qing Feng Teng,青风藤),Astragali Radix(Huang Qi,黄芪),Paeoniae Radix Alba(Bai Shao,白芍)and Moutan Cortex(Mu Dan Pi,牡丹皮),which have well-established histories of use for treatment of rheumatic and arthritic diseases.We intended to establish the optimized and standardized pharmaceutical procedures and manufacturing processes for the pilot production of QFJBT to develop it as a novel botanical drug product for treatment of rheumatoid arthritis(RA).Methods The combinative approaches of chemical assessment,toxicological and pharmacological evaluation were explored to define the pharmaceutical preparation of QFJBT.Results The optimized and standardized pharmaceutical procedures and manufacturing processes for the pilot production of QFJBT were established in terms of greatest chemical contents of bioactive constituents,potent anti-inflammatory and antinociceptive activities,and favorable safety profile.Quality analysis of the pilot product of QFJBT by high-performance liquid chromatography(HPLC)demonstrated that the chromatographic fingerprint profiles of three batches of QFJBT were basically identical and the contents of four characteristic and bioactive markers were relatively consistent.General toxicological studies showed a favorable safety profile of QFJBT.The maximum tolerated single dose of QFJBT was determined in both sexes of rats to be 33.63 g/kg body weight which is equivalent to 346 times of clinical dose.In the chronic oral toxicity study,the results of laboratory investigation showed that QFJBT at doses of 3.89,6.80 and 9.72 g/kg body weight(equivalent to 40,70 and 100-fold clinical doses,respectively)caused no changes in all hematological parameters and blood biochemical parameters of rats.No mortality or specific toxic responses were observed in animals after three months of repeated dosing with QFJBT.Conclusion The optimized and standardized pharmaceutical and manufacturing processes for the production of QFJBT have been successfully screened and identified through established rigorous in-process controls.