Bilateral Congenital Upper Eyelid Eversion (Ectropion): A Rare Presentation Responded Well to Conservative Treatment at Temeke Regional Referral Hospital-Tanzania

Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down’s syndrome and black babies. If diagnosed early and treated properly, the condition can be managed without surgery. We report a case of non syndromic congenital bilateral severe upper eyelid eversion in otherwise normal 3 days old neonate of African descent (Tanzanian), born by vaginal delivery. The case was conservatively managed by lubricants, antibiotics and eyelid patching. We report this case because from the best of our knowledge it has never been documented here at our hospital and Tanzania before.

Transfer of Paralytic Shellfish Toxins via Marine Food Chains:A Simulated Experiment

Objective To study the transfer of paralytic shellfish toxins （PST） using four simulated marine food chains： dinoflagellate Alexandrium tamarense→Artemia Artemia salina→Mysid shrimp Neomysis awatschensis; A. tamarense→N. awatschensis; A. tamarense→A, salina→Perch Lateolabrax japonicus; and A. tamarense→L, japonicus. Methods The ingestion of A. tamarense, a producer of PST, by L. japonicus, N. awatschensis, and A. salina was first confirmed by microscopic observation of A. tamarense cells in the intestine samples of the three different organisms, and by the analysis of Chl.a levels in the samples. Toxin accumulation in L. japonicus and N. awatschensis directly from the feeding on A. tamarense or indirectly through the vector of A. salina was then studied, The toxicity of samples was measured using the AOAC mouse bioassay method, and the toxin content and profile of A. tamarense were analyzed by the HPLC method. Results Both A. salina and N. awatschensis could ingest A. tamarense cells. However, the ingestion capability of A. salina exceeded that of N. awatschensis. After the exposure to the culture of A. tamarense （2 000 cells·mL^-1） for 70 minutes, the content of Chl.a in A. salina and N. awatschensis reached 0.87 and 0.024 μg.mg^-1, respectively. Besides, A. tamarense cells existed in the intestines of L. japonicus, N. awatschensis and A. salina by microscopic observation. Therefore, the three organisms could ingest A. tamarense cells directly. A. salina could accumulate high content of PST, and the toxicity of A. salina in samples collected on days 1, 4, and 5 of the experiment was 2.18, 2.6, and 2.1 MU.g^-1, respectively. All extracts from the samples could lead to death of tested mice within 7 minutes, and the toxin content in anemia sample collected on the 1st day was estimated to be 1.65×10 ^5 μg STX equal/individual. Toxin accumulation in L japonicus and N. awatschensis directly from the feeding on A. tamarense or indirectly from the vector ofA. salina was also studied. The mice injected with extracts from L japonicus and N. awatschensis samples that accumulated PST either directly or indirectly showed PST intoxication symptoms, indicating that low levels of PST existed in these samples. Conclusion Paralytic shellfish toxins can be transferred to L. japonicus, N. awatschensis, and A. salina from A. tamarense directly or indirectly via the food chains.

Acute acquired concomitant esotropia with congenital paralytic strabismus:A case report

BACKGROUND An unusual case of acute acquired concomitant esotropia(AACE)with congenital paralytic strabismus in the right eye is reported.CASE SUMMARY A 23-year-old woman presented with complaints of binocular diplopia and esotropia of the right eye lasting 4 years and head tilt to the left since 1 year after birth.The Bielschowsky head tilt test showed right hypertropia on a right head tilt.She did not report any other intracranial pathology.A diagnosis of AACE and right congenital paralytic strabismus was made.Then,she underwent medial rectus muscle recession and lateral rectus muscle resection combined with inferior oblique muscle myectomy in the right eye.One day after surgery,the patient reported that she had no diplopia at either distance or near fixation and was found to be orthophoric in the primary position;furthermore,her head posture immediately and markedly improved.CONCLUSION In future clinical work,in cases of AACE combined with other types of strabismus,we can perform conventional single surgery for both at the same time,and the two types of strabismus can be solved simultaneously.

Surgical Treatment of Ectropion at Polyclinic “SHOSHI” in Prishtina—Case Report

Ectropion is an outward turning of the eyelid margin, as a result the conjunctiva is permanently irritated, thickened and dry. Since the lacrimal puncta are moved away from the eyeball, the tear elimination is difficult, tears are always present. Materials and Methods: This study includes patients suffering from senile ectropion, who were treated surgically at Polyclinic “SHOSHI” in Prishtina. Our study includes 19 patients suffering from senile ectropion, out of which, 17 were older than 75 years old and in those patients the ectropion was preset on both lower eyelids, while 2 patients were under 75 years old and the ectropion was present only on one side lower eyelid. Prior to surgery, patients have undergone laboratory examinations. The surgery was performed under local anesthesia. The suturing was done in three layers using 6.0 vicryl sutures. No operative or post-operative complications were encountered. Purpose: The purpose of this case report study is to show the success of the surgical treatment of ectropion, a procedure that is mainly performed so the tear elimination is enabled, and there are no tears present constantly. Conclusion: In old patients where the eyelid is turned outwards its margin, conjunctiva is constantly irritated, thickened and dry, the best method of treatment is the surgical treatment, making it possible for the tears to drain properly.

Multi-year assessment of paralytic shellfish toxins in hard clam species along the coastline of Jiangsu Province, China

Paralytic shellfish toxins(PSTs) are notorious neurotoxins that threaten public health and food safety worldwide.Although PST monitoring programs have recently been established throughout China, the profiles and variation of PSTs in important commercial clams(e.g., Mactra veneriformis, Ruditapes philippinarum, and Meretrix meretrix) along the Jiangsu Province coastline remain largely unexplored. In this study, a validated hydrophilic interaction liquid chromatography–tandem mass spectrometry(HILIC-MS/MS) method was used to examine PST profiles and levels in 540 clam samples from natural production areas along Jiangsu Province coastline during2014–2016. Although the PST levels(≤6.38 μg saxitotoxin equivalents(eq)/kg) were consistently below European Union regulatory limits(≤800 μg saxitotoxin eq/kg) during this time period, saxitotoxin, decarbamoylsaxitotoxin,and gonyautoxins 1 and 4 were detected, and nearly 40% of the samples were saxitotoxin-positive. The PST levels also varied significantly by seasons, with peak values observed in May during 2014–2016. This is the first systematic report of PSTs in clams from Jiangsu Province, and additional research and protective measures are needed to ensure the safety of clams harvested in this area.

Comparative study on in vitro transformation of paralytic shellfish poisoning (PSP) toxins in different shellfish tissues

Dissected tissues of three shellfish species, the Chinese scallop, Chlamys farreri, Manila clam, Ruditapes philippinarurn, and Razor shell, Solen strictu were evaluated for in vitro transformation of paralytic shellfish poisoning （PSP） toxins. Tissue homogenates were incubated with extraction from toxic algae Alexandriurn rninutura to determine toxin conversion. The effects of heating and addition of a natural reductant （glutathione） on toxin conversion were also assessed. The toxin profile was investigated through high performance liquid chromatography with fluorescence detection （HPLC-FLD）. The evident variations in the toxin content were observed only in Chinese scallop viscera homogenates. The concentration of GTX4 was reduced by 45% （approximately 0.8 μmol/dm^3） and 25% （approximately 1 μmol/dm^3） for GTX1, while GTX2 and GTX3 increased by six times （approximately 1 μmol/dm^3） and 3 times （approximately 0.3μmol/dm^3） respectively. Simultaneously, the total toxicity decreased by 38% during the 48 h incubation period, the final toxicity was 20.4 nmol STXeq/g. Furthermore, heated Chinese scallop viscera homogenates samples were compared with non-heated samples. The concentration of the GTX4 and GTX1 was clearly 28% （approximately 0.53 μmol/dm^3） and 17% （approximately 0.69μmol/dm^3） higher in heated samples, GTX2 and GTX3 were four times （0.66 μmol/dm^3） and two times （0.187 μmol/dm^3） lower respectively. GSH （＋） Chinese scallop viscera homogenates samples were compared with GSH （-） samples, the concentration in the GTX4 and GTX1 was 9% （approximately 0.12 μmol/dm^3） and 11% （approximately 0.36 μmol/dm^3） lower respectively, GTX2 and GTX3 was 17% （approximately 0.14 μmol/dm^3） and 19% （approximately 0.006 μmol/dm^3） higher respectively. In contrast,there was a little change in the concentration of PSP toxins of Manila clam and Razor shell tissue ho- mogenates. These observations on three shellfish tissues confirmed that there were species-specific differences in PSP toxins transformation. PSP toxins transformation was more pronounced in viscera tissue than in muscle tissue. PSP toxins was possibly interfered by some carbamoylase enzyme, and the activity in Chinese scallop viscera tissue is more remarkable than in the other two species.

A new simple screening method for the detection of paralytic shellfish poisoning toxins

The current testing for paralytic shellfish poisoning(PSP) in shellfish is based on the mouse bioassay(MBA).To alleviate animal welfare concerns,we evaluated the utility of using sublethal indicators of toxicity as an alternative to measuring time to death.Live mice were injected with a PSP congener and the changes in neurotransmitter levels were measured 60,90,and 120 min after injection.Acetylcholine(ACh) was the most sensitive marker for PSP toxicity.The changes in neurotransmitter levels were most pronounced in the blood.Thus,measurement of Ach levels in the blood may serve as a sensitive predictor for PSP that would not require sacrifice of the mice.This method was relatively simple,sensitive(less than 1 μg/kg weight,equivalent to 20 ng/mL),low maintenance,and rapid(less than 60 min).

Identification of Monitoring Organ in Bivalves for Early Warning of Paralytic Shellfish Toxins Accumulation

Bivalve farming plays a dominant role in mariculture in China.Paralytic shellfish toxins(PSTs)can be accumulated in bivalves and cause poisoning the consumers.A sensitive detection of PSTs can provide early warning to decrease poisoning events in bivalve consuming.PSTs are traditionally examined using the whole soft-tissues.However,PSTs accumulation varies dramatically in different tissues of bivalves.Some tough tissues/organs(such as mantle),which account for a large proportion of the total soft body,exhibit a lower accumulation of PSTs and make the toxin extraction time-and reagent-consuming,potentially decreasing the accuracy and sensitivity of PSTs monitoring in bivalves.To develop a sensitive and cost-effective approach for PSTs examination in massively farmed bivalves,we fed three commercially important bivalves,Yesso scallop Patinopecten yessoensis,Pacific oyster Crassostrea gigas,and blue mussel Mytilus edulis with PSTs-producing dinoflagellate Alexandrium catenella,and detected PSTs concentration in different tissues.For all three bivalve species,the digestive gland accumulated much more PSTs than other tissues,and the digestive gland’s toxicity was significantly correlated with the PSTs toxicity of the whole soft-tissues,with r^(2)=0.94,0.92,and 0.94 for Yesso scallop,Pacific oyster,and blue mussel,respectively.When the toxicity of the whole soft-tissues reached 80μgSTXeq(100g)^(−1),the regulatory limit for commercial shellfish,the digestive gland’s toxicity reached 571.48,498.90,and 859.20μgSTXeq(100g)^(−1) in Yesso scallop,Pacific oyster,and blue mussel,respectively.Our results indicate that digestive gland can be used for the sensitive and cost-effective monitoring of PSTs in bivalves.

Depuration of paralytic shellfish toxins in Japanese scallop(Patinopecten yessoensis) in natural environment

To study the paralytic shellfish toxins（PSTs） depuration in Japanese scallop Patinopecten yessoensis in natural environment, Japanese scallops naturally contaminated with paralytic shellfish poisoning（PSP） toxins in the Dayao Bay in the northern Huanghai Sea are transited to Qipanmo waters in the Bohai Sea of no reported PSTs incidents. The levels and profile of PSTs during 30-day depuration are detected by the high performance liquid chromatography with fluorescence detection（HPLC-FLD）. The results show that the toxicity of the PSTs in soft tissues decreases to a relatively low level at Day 9. Moreover, the depurated ratio at the early stage of the PSTs depuration is higher than that at the later stage. The toxicity analysis of dissected organs reveals that the digestive gland is the most contaminated PSTs part, which is of important implication for the human health and scallop aquiculture. The mortality of Japanese scallops during PSTs depuration experiment is relevant to PSTs level in the soft tissue.

Evaluation of mouse bioassay results in an inter-laboratory comparison for paralytic shellfish poisoning toxins

An inter-laboratory comparison of the AOAC mouse bioassay for paralytic shellfish poisoning (PSP) toxicity in shellfish was carried out among 25 Chinese laboratories to examine the overall performance for PSP testing in China, and to analyze the main factors affecting the performance of this method. The toxic scallop Patinopecten yessoensis collected from coast of Bohai Sea, China, was used as a test sample in the comparison study. The results were reported and evaluated using robust statistical methods. The z scores showed that 80%, 8%, and 12% of laboratories reported satisfactory results, unsatisfactory results, and questionable results, respectively. This evaluation demonstrates that the PSP mouse bioassay is an appropriate method for screening and testing PSP toxicity in shellfish. However, it was found that the experience and skill of technicians, as well as the body weight and health status of mice being used significantly affected the accuracy of the method.

Identifi cation of paralytic shellfi sh toxin-producing microalgae using machine learning and deep learning methods

Paralytic shellfi sh poisoning(PSP)microalgae,as one of the harmful algal blooms,causes great damage to the of fshore fi shery,marine culture,and marine ecological environment.At present,there is no technique for real-time accurate identifi cation of toxic microalgae,by combining three-dimensional fluorescence with machine learning(ML)and deep learning(DL),we developed methods to classify the PSP and non-PSP microalgae.The average classifi cation accuracies of these two methods for microalgae are above 90%,and the accuracies for discriminating 12 microalgae species in PSP and non-PSP microalgae are above 94%.When the emission wavelength is 650-690 nm,the fl uorescence characteristics bands(excitation wavelength)occur dif ferently at 410-480 nm and 500-560 nm for PSP and non-PSP microalgae,respectively.The identification accuracies of ML models(support vector machine(SVM),and k-nearest neighbor rule(k-NN)),and DL model(convolutional neural network(CNN))to PSP microalgae are 96.25%,96.36%,and 95.88%respectively,indicating that ML and DL are suitable for the classifi cation of toxic microalgae.

Surgical Correction for Paralytic Strabismus Using T-Plate Anchor

External or internal ophthalmoloplegia will result in a complete or a partial ocular dysmotility leading to a debilitating and variable manifest binocular diplopia for a majority of the patients. Complete third, forth and sixth nerve cranial nerve palsies are among the many number of etiologies appearing as paralytic strabismus. Successful clinical management, elimination of symptomatic diplopia in the primary field of gaze and increased binocular field of motor and sensory fusion as a result of the oculomotor nerve (III) palsy are challenging tasks for physicians facing this difficult clinical entity. Here we report a novel surgical technique in the clinical management of this disease through suture-fixation of medial rectus muscle onto Titanium plate (T-plate) already anchored into the nasal orbital wall.

Upper Eyelid Myocutaneous Flap and External Tarsorrhaphy, Two Combined Minimally Invasive Techniques in the Functional and Cosmetic Correction of Cicatricial Ectropion of the Lower Eyelid: An Experience of Two Clinical Cases Follow in Short Term

Cicatricial ectropion of the eyelid is an eversion of its edge, which has moved away from the globe. It is frequently the result of cicatricial retraction after trauma. The main risk is the occurrence of a corneal ulcer or chronic conjunctivitis. Their treatment is often difficult, especially when the ectropion is old and significant. There are several classic techniques for correcting cicatricial ectropions, but the technique of the myocutaneous flap combined with external tarsorrhaphy without damage to the canthal ligament is minimally invasive, not very widespread, yet responds very well to the rules of plastic surgery. We report two cases of post-traumatic cicatricial ectropions of the left lower eyelid, respectively in a 33-year-old and an 87-year-old, treated using this technique. The surgical procedure was performed in two stages, after evaluation of the skin of the flap to be harvested: harvesting of the flap and closure plasty including external tarsorrhaphy. Patient follow-up did not note any complications. This combined technique offers a minimally invasive alternative for the often-delicate treatment of ectropions.

液相色谱-串联质谱法在双壳贝类麻痹性贝毒检测中的应用及影响因素研究进展

麻痹性贝毒(paralytic shellfish poison,PSP)是危害最大、分布最广的海洋生物毒素,给人类健康、渔业经济及海洋环境带来巨大威胁。双壳贝类是消费者摄入PSP的主要来源,随着PSP中毒事件频发,全球对双壳贝类中PSP检测技术的要求越来越高。本文首先介绍PSP理化性质,其次从前处理提取净化、仪器条件、基质效应、方法验证方面对液相色谱-串联质谱(liquid chromatography-tandem mass spectrometry,LC-MS/MS)法在双壳贝类中PSP检测中的优劣势进行总结,经对比分析发现,目前1%乙酸已成为LC-MS/MS检测技术中最常用的PSP提取试剂,石墨化炭黑填料和亲水相互作用液相色谱分别更适用于净化、分离双壳贝类中PSP提取物,影响基质效应的因素主要为内源性干扰如磷脂、蛋白质等,外源性干扰如检测方法中有机物和聚合物残留等杂质。本文重点分析LC-MS/MS研究发展趋势,以期为双壳贝类中PSP的检测提供参考,也为贝类养殖产业绿色发展及政府监管提供技术支持。

Lateral tarsal strip procedure for involutional ectropion: A retrospective analysis of 85 cases and a comprehensive literature review

Purpose:To evaluate the postoperative effect of the lateral tarsal strip(LTS)procedure in treating lower eyelid involutional ectropion.Methods:A retrospective study was performed on 85 eyelids in 67 patients with involutional ectropion who underwent LTS procedure.Pre-and postoperative lower eyelid laxity and ocular symptoms as well as perioperative complications were evaluated.Snap back test was performed to evaluate the elasticity of lateral canthal tendon loosening and,a lower lid distraction test was performed to evaluate the degree of severity before surgery.Ocular surface diseases were evaluated by the Ocular Surface Disease Index(OSDI),and symptoms including conjunctivitis,corneal ulcer,dry eye syndrome,and ocular pain were recorded.All patients were evaluated within one week and during the follow-up period of 4.2
8.3 months.Furthermore,we reviewed the studies that also investigated the surgical effect of the LTS procedure in the literature from 1979 to 2019.Results:The success rate was 95%.Only four eyelids required a second surgical intervention.Seventy-three(86%)eyelids had an excellent position after surgery,9(11%)only little improvement,and three had no improvement.No significant difference was found in the postoperative effects between different degrees of ectropion(p>0.05).No statistical correlation was found between surgical improvements and the ectropion severity(P>0.05).Fiftytwo out of 85 eyes had no discomfort after the surgery.Mild complications included epiphora in 13 eyes(three cases caused by lacrimal punctum eversion),ocular pain in 12 eyes,wound hemorrhage in 12 eyes,and edema in 9 eyelids immediately after surgery,in which 91.2%(n=21)disappeared within one week and did not need any further treatment.Conclusions:The lateral tarsal strip procedure can provide an aesthetically pleasing result for correcting the mild to moderate lower eyelid ectropion while maintaining decent eyelid function.

核桃灸治疗后天性麻痹性斜视对眼球活动度的影响

目的研究核桃灸治疗后天性麻痹性斜视对患者斜视度、眼球活动度、氧化应激水平的影响。方法采用前瞻性研究,选取2021年1月至2022年12月在济南市第二人民医院中医眼科接受治疗的90例后天性麻痹性斜视患者作为研究对象,其中男52例、女38例,年龄(42.87±3.86)岁,病程(21.73±3.23)d,通过随机数字表法分为基础治疗组(30例)、针刺组(30例)、核桃灸组(30例)。基础治疗组针对病因治疗原发病,给予红花注射液静脉滴注,甲钴胺注射液穴位注射;针刺组在基础治疗组的基础上给予针刺治疗;核桃灸组在基础治疗组的基础上给予核桃灸治疗,共治疗4周。对比3组治疗前及治疗4周后斜视度、眼球活动度、氧化应激水平[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)],治疗后临床疗效及治疗期间不良反应发生情况。统计学方法采用χ^(2)检验、t检验、单因素方差分析。结果核桃灸组总有效率高于针刺组、基础治疗组[93.33%(28/30)比73.33%(22/30)、63.33%(19/30)],差异有统计学意义(χ^(2)=7.826,P=0.020)。治疗4周后,核桃灸组斜视度及MDA水平均低于针刺组、基础治疗组[(13.51±3.52)PD比(23.64±3.52)PD、(20.18±3.90)PD,(3.96±0.46)nmol/L比(4.34±0.48)nmol/L、(4.91±0.45)nmol/L],眼球活动度及SOD、GSH-PX水平均高于针刺组、基础治疗组[(287.72±21.46)mm^(2)比(246.01±24.23)mm^(2)、(231.73±20.81)mm^(2),(128.82±15.25)U/ml比(117.90±14.46)U/ml、(109.02±15.52)U/ml,(138.97±18.26)U/L比(123.85±12.32)U/L、(113.14±11.31)U/L],差异均有统计学意义(均P<0.05)。治疗期间,3组患者不良反应发生率比较,差异无统计学意义(χ2=1.450,P=0.484)。结论核桃灸可降低后天性麻痹性斜视患者斜视度,提高眼球活动度,调节氧化应激水平,疗效确切,安全性高。

后天性麻痹性斜视3例分析

目的探讨后天性麻痹性斜视特异性病因及处理方法。方法回顾性分析3例后天性麻痹性斜视患者的临床资料。结果3例患者为儿童,均突然起病,表现为明显的眼球运动障碍,诊断为麻痹性斜视,发病原因及全身伴随症状各异。其中,间叶来源恶性肿瘤患儿对症治疗后,症状明显好转,右眼眼位正位,轻度外转受限,无复视;中耳炎患儿抗感染治疗17 d后,右眼正位,外转无明显受限,无复视;重症肌无力患儿对症治疗后,症状明显改善,双眼睑基本无下垂,左眼下转稍受限,外转正常。结论后天性麻痹性斜视病因复杂且病情多变,可伴有全身或神经系统异常。某些疾病表现为眼外肌麻痹常首诊为麻痹性斜视,明确病因有助于临床制定正确的治疗方案。

砭石穴位按摩联合半夏厚朴汤加减治疗经皮椎体成形术后麻痹性肠梗阻的疗效观察

目的探讨砭石穴位按摩联合半夏厚朴汤加减治疗经皮椎体成形术后麻痹性肠梗阻的疗效。方法前瞻性选取2022年9月至2023年8月在武汉市中医医院进行经皮椎体成形术后发生麻痹性肠梗阻患者,共80例,按照随机数字表法将其分为试验组和对照组,每组各40例。2组均给予常规治疗,对照组在常规治疗基础上给予半夏厚朴汤加减,观察组在对照组基础上加用砭石穴位按摩。比较2组患者的平均治疗时间、疗效、胃肠功能恢复时间和腹痛腹胀缓解时间,比较2组治疗前后血清胃肠激素水平、焦虑和抑郁程度。结果试验组平均治疗时间为(4.52±1.85)d,显著少于对照组[(7.56±3.50)d],差异有统计学意义(P<0.05)。试验组的治疗总有效率为95.00%,高于对照组(80.00%),差异有统计学意义(P<0.05)。试验组的首次肛门排气时间、肠鸣音恢复时间、首次耐受固体食物时间、首次排便时间、腹痛腹胀缓解时间分别为(23.21±6.78)h、(17.56±7.28)h、(6.57±1.28)h、(34.35±10.31)h、(2.65±0.75)d,均短于对照组[(40.79±12.89)h、(35.18±10.34)h、(8.02±1.35)h、(47.68±12.45)h、(5.70±1.35)d],差异均有统计学意义(P<0.05)。治疗后,2组患者的血清胃动素、胃泌素、P物质水平均高于治疗前,且试验组患者的血清胃动素、胃泌素、P物质水平分别为(218.38±14.95)、(290.52±12.93)、(111.63±18.73)ng/L,均高于对照组[(180.60±17.63)、(231.60±14.25)、(94.86±15.46)ng/L],差异均有统计学意义(P<0.05)。治疗后,2组患者的SAS、SDS评分均较治疗前降低,且试验组SAS、SDS评分分别为(42.98±4.63)、(43.61±5.12)分,均低于对照组[(56.86±5.02)、(54.63±5.87)分],差异均有统计学意义(P<0.05)。结论砭石穴位按摩联合半夏厚朴汤加减治疗经皮椎体成形术后麻痹性肠梗阻疗效显著,具有治疗天数少、胃肠功能恢复时间和腹痛腹胀缓解时间短、提高血清胃肠激素水平、加强胃肠功能动力、减轻患者的焦虑和抑郁程度的优势。

基于UPLC-Q-ExactiveMS构建麻痹性贝类毒素的特征指纹溯源技术

麻痹性贝类毒素污染是世界共同关注和重点管控的食品安全问题,其溯源一直是产业监管的难点和技术重点。基于指纹溯源技术理论,采用室内模拟3种产毒藻暴露紫贻贝后风险形成过程,开发基于超高效液相色谱-四极杆-静电场轨道阱高分辨质谱(UPLC-Q-Exactive MS)鉴定麻痹性贝类毒素区域特征的指纹溯源技术。结果表明,采用乙腈/甲醇/丙酮(体积比为1︰1︰1)混合溶液作为提取剂,C8色谱柱联合正离子模式,质荷比(m/z)100~600和Amide色谱柱联合正离子模式,m/z 600~1500作为色谱质谱检测条件下,提取的化合物数量较多且稳定性良好,覆盖了40.4%指纹信息;紫贻贝与产毒藻中的共检出11种毒素成分,且具有高度相关性。N-磺酰胺甲酰基类毒素(如C类)和膝沟藻毒素(GTX类)在暴露期发生了显著的代谢转化;将摄食3种产毒藻后紫贻贝的差异化合物与特征毒素组分进行主成分分析及正交偏最小二乘法判别分析,共筛选出13种复合指纹物质。构建6种特征物质的Fisher判别模型,交叉验证准确率为88.9%,可实现产毒藻种溯源。该研究建立了基于超高效液相色谱-四极杆-静电场轨道阱高分辨质谱UPLC-Q-Exactive MS紫贻贝特征指纹溯源技术,初步实现了从污染麻痹性贝类毒素的贝类到肇事藻种的逆向溯源,可应用于贻贝麻痹性贝类毒素风险溯源研究。

风牵偏视病因病机探讨及临床应用

风牵偏视相当于西医学的后天麻痹性斜视,是眼科常见疾病之一。本文通过梳理古代医药典籍及现代文献分析发现,该病发病原因主要与风、湿两邪有关。其中风邪可分为外风、内风致病,外风致病多由于正气不足或外风亢盛,内风致病则可能与肝阳化风、热极生风、血虚及血瘀生风相关。此外,外风、内风可相兼致病。湿邪所致本病也有内、外之分,外湿所致本病多因气候或居处潮湿、冒雨淋水等涉湿过度造成湿邪侵袭人体,内湿致病则多因中焦不运、水湿内停。风湿亦可相兼为病,常见风邪挟杂湿邪所致风痰结聚证型。该病治疗应在整体观念理论指导下,遵循治病必求其本原则,在遣方用药中重视立足病因病机,基于辨证论治选用方证对应的方剂能取得较好临床效果。