Identification and determination of the major constituents in traditional Chinese medicine Longdan Xiegan Pill by HPLC-DAD-ESI-MS

A novel and sensitive HPLC-UV method has been developed for the simultaneous determination of twelve major compounds in Longdan Xiegan Pill.The chemical profile of the twelve compounds,including geniposidic acid（1）,geniposide（2）,gentiopicroside（3）,liquiritin（4）,crocin（5）,baicalin（6）,wogonoside（7）,baicalein（8）,glycyrrhizic acid（9）,wogonin（10）,oroxylin A（11）and aristolochic acid A（12）,was acquired using high-performance liquid chromatography-diode array detector coupled with an electrospray tandem mass spectrometer（HPLC-DAD-ESI-MS）.The analysis was performed on a Dikma Platisil ODS C18 column（250 mm×4.6 mm,5 μm）with a gradient solvent system of acetonitrile-0.1% aqueous formic acid.The validation was carried out and the linearities（r〉0.9996）,repeatability（RSD〈1.8%）,intra-and inter-day precision（RSD〈1.3%）,and recoveries（ranging from 96.6% to 103.4%）were acceptable.The limits of detection（LOD）of these compounds ranged from 0.29 to 4.17 ng.Aristolochic acid A,which is the toxic ingredient,was not detected in all the batches of Longdan Xiegan Pill.Furthermore,hierarchical cluster analysis was used to evaluate the variation of the herbal prescription.The proposed method is simple,effective and suitable for the quality control of this traditional Chinese medicine（TCM）.

Simultaneous Determination of Bufadienolides and Qualitative Evaluation for Venenum Bufonis by High Performance Liquid Chromatography

A high performance liquid chromatographic method was used for the simultaneous identification and qualitative evaluation of 12 bufadienolides（resibufogenin, einobufagin, cinobufaginol, arenobufagin, bufalin, bufotalin, gamabufotalin, cinobufotalin, ψ-bufaranogin, desacetylcinobufagin, telocinobufagin and resibufogenol） in Venenum Bufonis. The chromatographic separation was performed on a Dikma C18 analytical column via gradient elution with an aqueous solution of acetonitrile and 0.3% acetic acid at a flow rate of 0.8 mL/min. The method was validated to be acceptable in consideration of linearity（r2 〉 0.9992） and recovery（ranged from 98.9% to 102.0%）. The limits of detection of the bufadienolides were from 0.48 ng for bufalin to 6.00 ng for cinobufotalin. The intra-day and inter-day precisions of the method were evaluated and were less than 3.0%. The method was successfully used to analyze 19 batches of Venenum Bufonis, and the similarity values between batches were calculated by Similarity Evaluation System for Chromatographic Fingerprint of TCM（Version 2004A, Chinese Pharmacopoeia Committee, Beijing）. The results show that the contents of bufadienolides in the medicine and the similarity values based on these bufadienolides varied significantly from batch to batch. This proposed method could be utilized to qualify and control Venenum Bufonis to ensure its safety and efficacy in application.

Transgenerational Transmission of Addiction Problems

This paper aims to evaluate the possible transgenerational transmission of a mechanism of addiction triggered by a specific type of attachment and the prevalence of psychological trauma in the descendants. 22 adults (alcoholics, drug addicts, and heroin addicts) aged 23 to 56 followed in an addictology treatment centre are participated. Measurements: We evaluated the prevalence of family ascendants on our population using two semi structured interviews and a genogram. Potential psychological trauma was measured with the Child Trauma Questionnaire (CTQ) and the quality of attachment with the Attachment Style Questionnaire (ASQ). Findings: 95% of patients have direct ascendants who suffer from addiction. 86% of patients suffered emotional negligence during childhood. Physical abuse is frequent (41%) as well as emotional abuse (50%), which proves a form of mistreatment and explains the presence of an insecure attachment. Conclusion: Addicts have often been neglected and have lived in emotional deprivation during childhood, which is the reason for an insecure attachment. The ascendants, who often suffer from addiction themselves, have, because of their pathology, contributed to a possible transgenerational transmission of the mechanism of addiction via the quality of the affective links with their children.

Cutaneous leishmaniasis control in Alta Verapaz (northern Guatemala): evaluating current efforts through stakeholders' experiences

Background:Cutaneous leishmaniasis(CL),endemic in Guatemala,mostly affects poor people living in the northern region.A national control program that ineludes surveillanee,diagnose,and treatment offered free of cost by the Ministry of Health(MoH)has been in place since 2003.However,the incidence is increasing and treatment rates are not optimal,suggesting that current efforts are not being effective.This study aimed to understand barriers and facilitators of CL control in Guatemala as experienced and perceived by key stakeholders in order to comprehend what works well and does not and suggest evidence-informed interventions.Methods:The study was conducted in the Coban municipality,the most endemic of Guatemala,situated in the Department of Alta Verapaz.Data were collected during May and June 2019 via focus groups and semi-structured interviews with key stakeholders,including local and national health personnel and residents of four communities of the endemic region.Thematic and content analysis of the collected data was conducted using NVIVO.Results:Three overarching issues hamper the effectiveness of current CL efforts:resource scarcity,treatment challenges,and knowledge-action gaps.Scarce economic resources from the MoH and community residents negatively impact incidence,detection of cases and treatment rates in that preventive action is insufficient and healthcare access is low.In addition,local health workers often lack specialized CL training and access to the national CL control guidelines.With regards to the population living in the study area,misunderstanding of disease causation,shame associated with CL lesions,treatment pain fear,and long(often uncertain)waiting times for diagnose and treatment negatively affect people's willingness to seek help,treatment adherence,and their trust on the healthcare provided.Conclusions:Culturally sensitive CL preventive action must be developed.Given the scarce economic resources available for CL control in the country,the involvement of trained community health workers and the inelusion of thermotherapy as a treatment option is also advised.Other cost-effective actions include:ensuring all health workers receive CL training and have access to national CL control guidelines,improving national procurement system to avoid treatment shortages,and provision of motorized vehicles to increase active surveillance and treatment rates.