Intramedullary spinal schwannomas are rare benign spinal cord tumors and are easily misdiagnosed because of the imaging characteristics shared with intramedullary glioma. Correct preoperative definitive diagnosis is essential for treatment and prognosis. To improve the preoperative diagnostic strategy, clinical and imaging data of seven patients with intramedullary spinal schwannoma (6 men, mean age 44 years, mean duration of illness 4.2 years) treated in our department between 2003 and 2010 were collected and retrospectively evaluated. The cervical cord was affected in five patients, followed by the thoracic cord in two. All seven cases were misdiagnosed as intramedullary glioma based on the imaging characteristics. Comparison of the clinical features of these 7 patients with those of patients with intramedullary tumors (173 ependymomas and 70 astrocytomas) admitted during the same period revealed significant differences in somatic pain and root pain as the initial symptoms between intramedullary spinal schwannomas and ependymomas (p ＝ 0.005) and between intramedullary spinal schwannomas and astrocytomas (p ＝ 0.019), but not between ependymomas and astrocytomas (p ＝ 0.175). Root or somatic pain as an initial symptom is important for the preoperative diagnosis of intramedullary spinal schwannoma, especially if the imaging characteristics are not entirely specific.

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Jin-Mu-Gan-Mao tablet is a well-known traditional Chinese medicinal preparation, which has been used to treat the common cold in China. In this study, a systematic method was established for the qualitative and quantitative analysis of the major constituents in Jin-Mu-Gan-Mao tablet. First, a method of high-performance liquid chromatography with diode-array detection and quadrupole time-of-flight mass spectrometry was developed for identification of the multi-constituents. Thirty-one compounds including ten phenolic acids, 18 flavonoids, and three iridoid glycosides were clearly identified by comparison with the reference standards, and 11 compounds were deduced by comparison with the literature data. Second, a new quantitative analysis method of Jin-Mu-Gan-Mao tablet was established by high-performance liquid chromatography with diode-array detection. Twelve compounds, either with high contents or strong bioactivities, were chosen as marker components. This analytical method was validated through intra- and interday precision, repeatability, and stability, with respective relative standard deviations less than 1.74, 2.54, 2.44, and 2.48%. The limits of detection and quantification were less than 0.327 and 0.881 μg/mL, respectively. The overall recoveries ranged from 97.04-102.76% (relative standard deviation ≤ 2.91%). Then this validated method was applied to determine ten batches of Jin-Mu-Gan-Mao tablet. The results indicated that these new approaches can be applicable for the qualitative and quantitative analysis of Jin-Mu-Gan-Mao tablet.

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