药品中核磁共振检测定性能力验证样品制备与评价结果分析

目的：评价参与药品中核磁共振检测定性能力验证实验室的检测能力。方法：制备高纯阿魏酸纯度标准物质;参照国家标准物质研制技术规范采用单因素方差分析考察样品均匀性;采用t检验考察样品分别在高温和光照下储藏7天、14天的运输稳定性,采用标准曲线法考察样品在常温放置12个月的长期稳定性;按照CNAS规定的程序实施本次能力验证。结果：阿魏酸纯度标准物质在均匀性、稳定性方面均能满足药品中核磁共振检测定性能力验证使用的要求。在13家实验室16台仪器的反馈结果中,12家15台仪器的测定结果评定为合格,1家实验室的1台仪器结果为不合格,合格率为93.75%。结论：本次能力验证可以真实地反映参试单位的检测水平,绝大多数参加能力验证的实验室具备了药品中核磁共振检测定性能力。     

Generation and Characterization of Six Recombinant Botulinum Neurotoxins as Reference Material to Serve in an International Proficiency Test

The detection and identification of botulinum neurotoxins (BoNT) is complex due to the existence of seven serotypes, derived mosaic toxins and more than 40 subtypes. Expert laboratories currently use different technical approaches to detect, identify and quantify BoNT, but due to the lack of (certified) reference materials, analytical results can hardly be compared. In this study, the six BoNT/A1–F1 prototypes were successfully produced by recombinant techniques, facilitating handling, as well as improving purity, yield, reproducibility and biosafety. All six BoNTs were quantitatively nicked into active di-chain toxins linked by a disulfide bridge. The materials were thoroughly characterized with respect to purity, identity, protein concentration, catalytic and biological activities. For BoNT/A₁, B₁ and E₁, serotypes pathogenic to humans, the catalytic activity and the precise protein concentration were determined by Endopep-mass spectrometry and validated amino acid analysis, respectively. In addition, BoNT/A₁, B₁, E₁ and F₁ were successfully detected by immunological assays, unambiguously identified by mass spectrometric-based methods, and their specific activities were assigned by the mouse LD₅₀ bioassay. The potencies of all six BoNT/A1–F1 were quantified by the ex vivo mouse phrenic nerve hemidiaphragm assay, allowing a direct comparison. In conclusion, highly pure recombinant BoNT reference materials were produced, thoroughly characterized and employed as spiking material in a worldwide BoNT proficiency test organized by the EQuATox consortium.     

2019年四川省药品无菌检查能力验证实施及结果分析

目的:通过组织药品无菌检查能力验证,了解和评价本省药品检验机构和药品生产企业微生物检测的技术现状,并通过对不满意结果的问题分析,提高相关机构的药品微生物检测能力.方法:按照GB/T 27043-2012《合格评定能力验证的通用要求》和CNAS-GL003:2018《能力验证样品均匀性和稳定性评价指南》,设计方案、制备样...     

Botulinum Neurotoxins: Qualitative and Quantitative Analysis Using the Mouse Phrenic Nerve Hemidiaphragm Assay (MPN)

The historical method for the detection of botulinum neurotoxin (BoNT) is represented by the mouse bioassay (MBA) measuring the animal survival rate. Since the endpoint of the MBA is the death of the mice due to paralysis of the respiratory muscle, an ex vivo animal replacement method, called mouse phrenic nerve (MPN) assay, employs the isolated N. phrenicus-hemidiaphragm tissue. Here, BoNT causes a dose-dependent characteristic decrease of the contraction amplitude of the indirectly stimulated muscle. Within the EQuATox BoNT proficiency 13 test samples were analysed using the MPN assay by serial dilution to a bath concentration resulting in a paralysis time within the range of calibration curves generated with BoNT/A, B and E standards, respectively. For serotype identification the diluted samples were pre-incubated with polyclonal anti-BoNT/A, B or E antitoxin or a combination of each. All 13 samples were qualitatively correctly identified thereby delivering superior results compared to single in vitro methods like LFA, ELISA and LC-MS/MS. Having characterized the BoNT serotype, the final bath concentrations were calculated using the calibration curves and then multiplied by the respective dilution factor to obtain the sample concentration. Depending on the source of the BoNT standards used, the quantitation of ten BoNT/A containing samples delivered a mean z-score of 7 and of three BoNT/B or BoNT/E containing samples z-scores <2, respectively.     

实验动物中绿脓杆菌检测能力验证的结果与分析

目的：对全国实验动物质量检测实验室进行绿脓杆菌检测能力的验证。方法由 CNAS组织,中国食品药品检定研究院负责协调及实施,向全国参与本次能力验证的实验动物质量检测单位分发“实验动物粪便中绿脓杆菌检测”样品,并在规定的时限内反馈检测结果及报告。结果本次能力验证共有全国20个实验动物质检实验室参加,收到反馈结果和报告共19份。结果满意的实验室有16个,占80%;结果不满意的实验室有4个,占20%。结论国内实验动物质检单位整体具备可靠的绿脓杆菌检测能力,并进一步促进了参与实验室对实验动物病原菌检测能力的提高。     

Results of a Saxitoxin Proficiency Test Including Characterization of Reference Material and Stability Studies

A saxitoxin (STX) proficiency test (PT) was organized as part of the Establishment of Quality Assurance for the Detection of Biological Toxins of Potential Bioterrorism Risk (EQuATox) project. The aim of this PT was to provide an evaluation of existing methods and the European laboratories’ capabilities for the analysis of STX and some of its analogues in real samples. Homogenized mussel material and algal cell materials containing paralytic shellfish poisoning (PSP) toxins were produced as reference sample matrices. The reference material was characterized using various analytical methods. Acidified algal extract samples at two concentration levels were prepared from a bulk culture of PSP toxins producing dinoflagellate Alexandrium ostenfeldii. The homogeneity and stability of the prepared PT samples were studied and found to be fit-for-purpose. Thereafter, eight STX PT samples were sent to ten participating laboratories from eight countries. The PT offered the participating laboratories the possibility to assess their performance regarding the qualitative and quantitative detection of PSP toxins. Various techniques such as official Association of Official Analytical Chemists (AOAC) methods, immunoassays, and liquid chromatography-mass spectrometry were used for sample analyses.     

从能力验证样品来探讨沙门氏菌的各种检测方法

目的 通过对能力验证样品沙门氏菌的检验,探讨各种检测方法的特性,为食品、药品中沙门氏菌快速检测及鉴定提供参考。方法 按照中国食品药品检定研究院下发的《能力验证作业指导书》,结合食品安全国家标准GB4789.4-2016和本实验室沙门氏菌常用检测方法进行平行检测,对样品进行分离、鉴定。结果 2份样品分别鉴定为鼠伤寒沙门氏菌和沙门氏菌Ⅲb （肠沙门氏菌双相亚利桑那亚种）。结论 以国标、中国药典收载的传统方法为基础检测方法,加入简便快捷的其他检测方法作为辅助,可以确保结果的快速获得和准确性。     

人血白蛋白的蛋白质含量测定能力验证结果与分析

目的：对全国血液制品批签发授权药检机构及相关生产企业或单位实验室的人血白蛋白蛋白质含量检测能力进行评价。方法：选择符合要求的人血白蛋白产品作为原料进行合并、除菌、分装。制备后按照《中国药典》2015年版三部蛋白质含量（凯式定氮）测定,组织协作标定后确立指定值。均一性和稳定性监测合格后按能力验证要求发放样品。以多中心协作标定结果作为评价参加者能力验证结果的依据。结果：能力验证样品确立的指定值及其参考范围为（193.30±5.08） g·L^-1,参加本次能力验证的药检机构或企业实验室共13家,10家实验室结果为优秀,1家实验室为合格,2家实验室为不满意。整体满意率为84.6%,优秀率76.9%,不合格率15.4%。结论：国内血液制品的7家批签发授权药检机构能力验证结果均为优秀,部分企业实验室能力验证结果为满意,但也有个别实验室测定结果出现偏差,参加者应调查并改进。     

Characterization of Ricin and R. communis Agglutinin Reference Materials

Ricinus communis intoxications have been known for centuries and were attributed to the toxic protein ricin. Due to its toxicity, availability, ease of preparation, and the lack of medical countermeasures, ricin attracted interest as a potential biological warfare agent. While different technologies for ricin analysis have been established, hardly any universally agreed-upon “gold standards” are available. Expert laboratories currently use differently purified in-house materials, making any comparison of accuracy and sensitivity of different methods nearly impossible. Technically challenging is the discrimination of ricin from R. communis agglutinin (RCA120), a less toxic but highly homologous protein also contained in R. communis. Here, we established both highly pure ricin and RCA120 reference materials which were extensively characterized by gel electrophoresis, liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI MS/MS), and matrix-assisted laser desorption ionization–time of flight approaches as well as immunological and functional techniques. Purity reached >97% for ricin and >99% for RCA120. Different isoforms of ricin and RCA120 were identified unambiguously and distinguished by LC-ESI MS/MS. In terms of function, a real-time cytotoxicity assay showed that ricin is approximately 300-fold more toxic than RCA120. The highly pure ricin and RCA120 reference materials were used to conduct an international proficiency test.     

Rapid Microfluidic Assay for the Detection of Botulinum Neurotoxin in Animal Sera

Potent Botulinum neurotoxins (BoNTs) represent a threat to public health and safety. Botulism is a disease caused by BoNT intoxication that results in muscle paralysis that can be fatal. Sensitive assays capable of detecting BoNTs from different substrates and settings are essential to limit foodborne contamination and morbidity. In this report, we describe a rapid 96-well microfluidic double sandwich immunoassay for the sensitive detection of BoNT-A from animal sera. This BoNT microfluidic assay requires only 5 μL of serum, provides results in 75 min using a standard fluorescence microplate reader and generates minimal hazardous waste. The assay has a <30 pg·mL⁻¹ limit of detection (LOD) of BoNT-A from spiked human serum. This sensitive microfluidic BoNT-A assay offers a fast and simplified workflow suitable for the detection of BoNT-A from serum samples of limited volume in most laboratory settings.     

稳态输入电流试验能力验证的样品制备与技术分析

目的 介绍稳态输入电流能力验证项目实施情况,为科学、高效地组织管理全国医疗器械检测机构能力验证提供参考.方法 从稳态输入电流能力验证项目中样品制备步骤和技术分析结果两方面进行讨论.结果与结论 稳态输入电流能力验证项目中,样品的制备重点在于控制好方案设计、元器件选购、样品组装以及样品稳定性和均匀性考核4个环节.对本次能力验证结果出现的问题进行分析和总结,提示需要进一步加强对标准的理解,对实验仪器进行校准,严格控制试验环境,对检验人员进行相关培训,才能确保试验结果的准确性.     

川贝母PCR-RFLP法鉴别检验能力验证活动分析

目的：考察相关实验室执行《中华人民共和国药典》川贝母PCR-RFLP法鉴别检验项目的技术能力,促进分子生物学技术在中药检定中的广泛应用。方法：测试样品为粉末,对样品的均匀性和稳定性进行评价,样品种类分为阳性和阴性两种,采用随机单盲方式分配至参与能力验证的实验室。各实验室按照作业指导书进行检测,并以规定格式书写原始记录。检测结果与样品性质一致的实验室为满意。对各实验室的反馈结果进行汇总和分析。结果：最终报名参加的实验室总计50家,能力验证结果为满意的26家,占52%,不满意24家,占48%。其中3家试验室未按要求返回结果,判定为不满意。分别统计不同类型参加实验室的满意率,地市级食药检机构满意率最高,为70.6%。结论：总体满意率偏低,川贝母PCR-RFLP法鉴别检验项目的整体技术水平有待提高。     

Organisation of Multi-Mycotoxin Proficiency Tests: Evaluation of the Performances of the Laboratories Using the Triple A Rating Approach

In accordance with the International Standard Organization ISO 17043, two proficiency tests (PTs) for the simultaneous determination of aflatoxins (AFB₁, AFB₂, AFG₁, AFG₂); deoxynivalenol; fumonisins FB₁, FB_2, and B₃; ochratoxin A, the T-2 toxin; and the HT-2 toxin were conducted in 2019 and 2020 using cornflakes and rusk flours that were prepared in house. The homogeneity and the stability of these materials were verified according to the criteria laid down in ISO 13528 using randomly selected samples. Most of the targeted toxins were found to be homogenously distributed in both materials with no significant changes during the timescale of the PTs. Next, the materials were distributed to approximately 25 participating laboratories from Europe, Canada, and the United States. The obtained datasets were computed using robust statistics. The outliers were checked and removed, and the toxin concentrations were assigned as the consensus value of the results of the participants at Horwitz ratios <1.2. The z scores were generated for all mycotoxins, and the results were pooled to calculate the relative sum of squared z scores (SZ2) indexes and were clustered according to the triple A rating. Overall, at least 80% of the participating laboratories achieved good and acceptable performances. The most frequent categories assigned to good performances (SZ2 ≤ 2) were AAA (51%) and BAA (13%). Clusters of BBA + CBA (6%) included laboratories reporting acceptable z scores <90% of the total z scores for less than 90% or 50% of the mycotoxins targeted in the 2 matrices. The triple A rating seems to be appropriate in evaluating the performances of laboratories involved in multi-mycotoxin analyses. Accredited and non-accredited analytical methods achieved good and acceptable performances.     

藏药六味木香丸的定性定量检测方法研究

目的： 建立藏药六味木香丸的定性定量检测方法,为质量标准修订提供参考。方法：采用TLC法对藏药六味木香丸中木香、石榴子、余甘子和荜茇进行定性鉴别;采用HPLC法测定藏药六味木香丸中木香烃内酯和去氢木香烃内酯的含量,使用C18（4.6 mm×250 mm,5 μm）色谱柱,以乙腈-水（65∶35）为流动相,流速1.0 mL·min^-1,检测波长225 nm,柱温25℃。结果：薄层色谱斑点清晰,分离度良好,阴性样品无干扰。木香烃内酯质量浓度在12~60 μg·mL^-1范围内线性关系良好（r=0.9997）,平均回收率（n=6）为98.8%,RSD=1.6%;去氢木香烃内酯质量浓度在17~85 μg·mL^-1范围内线性关系良好（r=0.9996）,平均回收率（n=6）为99.8%,RSD=1.4%。结论：所建立的方法准确、可靠,专属性强,可用于六味木香丸的质量控制。     

首批矛头蝮蛇血凝酶国家标准品及对照品的研制

目的：建立首批矛头蝮蛇血凝酶国家标准品及对照品。方法：对矛头蝮蛇血凝酶标准品进行了理化分析、效价测定及稳定性考察;对矛头蝮蛇血凝酶对照品进行了结构确证、纯度考察、理化分析及稳定性考察。结果：建立了效价定值为101单位/支的矛头蝮蛇血凝酶标准品用于效价测定;建立了结构准确、纯度较高的矛头蝮蛇血凝酶对照品用于鉴别及检查测定。结论：首批矛头蝮蛇血凝酶国家标准品及对照品的研制规范了相关药品质量,为酶类生化药物的质量研究提供了思路及依据。     

常规法与细菌集菌法复试无菌检测中可疑阳性样品的结果比较

目的:建立鉴定样品灭菌彻底与否的方法,以杜绝药物医疗事故的发生.方法:将常规法检测中的可疑阳性样品(5个品种、20批次),用常规法和细菌集菌法进行复试.结果:常规法复试的阳性率为0;细菌集菌法复试的阳性率为65.0%,其中20%甘露醇注射液为87.5%,5%葡萄糖注射液为66.6%,10%葡萄糖注射液为50.0%.结论:细菌集菌法不受外环境污染,能高效、快速、准确地检验样品的灭菌情况,是药物制剂质量控制的好方法.     

Using Standardized fMRI Protocols to Identify Patterns of Prefrontal Circuit Dysregulation that are Common and Specific to Cognitive and Emotional Tasks in Major Depressive Disorder: First Wave Results from the iSPOT-D Study

Functional neuroimaging studies have implicated dysregulation of prefrontal circuits in major depressive disorder (MDD), and these circuits are a viable target for predicting treatment outcomes. However, because of the heterogeneity of tasks and samples used in studies to date, it is unclear whether the central dysfunction is one of prefrontal hyperreactivity or hyporeactivity. We used a standardized battery of tasks and protocols for functional magnetic resonance imaging, to identify the common vs the specific prefrontal circuits engaged by these tasks in the same 30 outpatients with MDD compared with 30 matched, healthy control participants, recruited as part of the International Study to Predict Optimized Treatment in Depression (iSPOT-D). Reflecting cognitive neuroscience theory and established evidence, the battery included cognitive tasks designed to assess functions of selective attention, sustained attention-working memory and response inhibition, and emotion tasks to assess explicit conscious and implicit nonconscious viewing of facial emotion. MDD participants were distinguished by a distinctive biosignature of: hypoactivation of the dorsolateral prefrontal cortex during working memory updating and during conscious negative emotion processing; hyperactivation of the dorsomedial prefrontal cortex during working memory and response inhibition cognitive tasks and hypoactivation of the dorsomedial prefrontal during conscious processing of positive emotion. These results show that the use of standardized tasks in the same participants provides a way to tease out prefrontal circuitry dysfunction related to cognitive and emotional functions, and not to methodological or sample variations. These findings provide the frame of reference for identifying prefrontal biomarker predictors of treatment outcomes in MDD.     

我院住院肺炎患儿病原菌及药敏试验结果分析

目的:了解近年我院儿科住院患儿肺炎病原菌及药敏试验结果,指导临床用药.方法:统计我院儿科2009年1月～2010年3月期间住院肺炎患儿痰培养结果及药物敏感情况,对选择抗生素治疗肺炎进行评价.结果:217例痰培养结果中G+菌以金黄色葡萄球菌、I型肺炎链球菌为主,其中金黄色葡萄球菌对阿莫西林/克拉维酸、亚胺培南敏感,对青霉...     

Practical Application of Novel Test Methods to Evaluate the Potency of Botulinum Toxin: A Comparison Analysis among Widely Used Products in Korea

The safe and effective dosing of botulinum neurotoxins (BoNTs) requires accurate and reliable methods to measure their potency. Several novel methods have been introduced over the past decade; however, only few studies have compared the potency of BoNT products with that of the LD50 and other alternative assays. Therefore, the objective of this study was to comparatively evaluate widely used BoNT products using various test methods. Four types of BoNTs (prabotulinumtoxin A, onabotulinumtoxin A, neubotulinumtoxin A, and letibotulinumtoxin A) were used in this study. The estimated potency was assessed using the LD50 assay, and the total BoNT type A protein levels were measured using the enzyme-linked immunosorbent assay (ELISA). The in vitro efficacy of the BoNTs was determined using fluorescence resonance energy transfer (FRET) and surface plasmon resonance (SPR) assays. The results showed differences in the total amount of BoNT protein and the cleavage activity of SNAP-25 within all types of BoNTs. The SPR study seemed to be useful for evaluating the potency by specifically measuring intact 19S neurotoxin, and these results provide new insights for assessing different BoNT products.     

Cost-Effectiveness of Treating Upper Limb Spasticity Due to Stroke with Botulinum Toxin Type A: Results from the Botulinum Toxin for the Upper Limb after Stroke (BoTULS) Trial

Stroke imposes significant burdens on health services and society, and as such there is a growing need to assess the cost-effectiveness of stroke treatment to ensure maximum benefit is derived from limited resources. This study compared the cost-effectiveness of treating post-stroke upper limb spasticity with botulinum toxin type A plus an upper limb therapy programme against the therapy programme alone. Data on resource use and health outcomes were prospectively collected for 333 patients with post-stroke upper limb spasticity taking part in a randomized trial and combined to estimate the incremental cost per quality adjusted life year (QALY) gained of botulinum toxin type A plus therapy relative to therapy alone. The base case incremental cost-effectiveness ratio (ICER) of botulinum toxin type A plus therapy was £93,500 per QALY gained. The probability of botulinum toxin type A plus therapy being cost-effective at the England and Wales cost-effectiveness threshold value of £20,000 per QALY was 0.36. The point estimates of the ICER remained above £20,000 per QALY for a range of sensitivity analyses, and the probability of botulinum toxin type A plus therapy being cost-effective at the threshold value did not exceed 0.39, regardless of the assumptions made.