最新刊期
卷 32 ， 期 12 ， 2021
- 摘要：OBJECTIVE：To provide reference for accelerating the process of prescription outflow in China by using “Internet+ medicare”. METHODS ：Based on stakeholder perspective ，the stakeholder model of prescription outflow was constructed under the background of “Internet + ”. By analyzing stakeholders （hospital，patient，government，drugstore and third-part consultation platform）who impeded the prescription outflow and their demands ，the obstacles and causes of promoting prescription outflow under the background of “Internet+”were summarized to put forward relevant countermeasures and suggestions. RESULTS & CONCLUSIONS：“Internet+Medicare”accelerated the process of prescriptions outflow by improving the convenience in each links of medical treatment ，but there were still obstacles in prescription source ，patient flow ，supporting policies and system construction to continue promoting prescription outflow. The reason lied in the pressure of hospital operation and the diagnosis demand of doctors；the treatment demand of patients could not be satisfied by the receiving party of prescription outflow ；the difficulty of government supervision and system construction ；immature supervision mode of the third-party consultation platform and online pharmacies，and the platform technology research and development to be break through. To continue promoting prescription outflow under the background of “Internet + ”needs to strengthen top-level design ，establish supporting systems ，break the regional restrictions，build a unified and standardized prescription circulation information platform ；formulate the prescription outflow assessment standard and encouragement mechanism of hospital ，enhance the ability of the third-part platforms and pharmacies to undertake the prescription ，strengthen the publicity and education of patients ，enhance their channel awareness and risk awareness. The exploration mode of prescription outflow in which all stakeholders develop together and cooperate with each other is formed finally so as to promote the outflow of prescription.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To provid e reference for the medicinal resources and clinical application of Tibetan medicine “Dida”. METHODS：Delphi method was adopted. By reviewing literatures ，confirming consultation scope ，inviting experts engaged in clinical，scientific research ，teaching and production of Tibetan medicine. Two methods ，online inquiry and on-site questionnaire ， were used for expert consultation to evaluate the differences and problems existing in the utilization of “Dida”medicinal resources until a consensus was reached ，consensus on the medicinal resources and clinical application of Tibetan medicine “Dida”was determined finally. RESULTS & CONCLUSIONS ：A total of 33 experts participated in the two rounds of consultation. According to the results of literature research ，the first round set up 16 inquiry indicators ；and then according to expert opinions to modify the index system ，the second round set up 18 inquiry indicators. After two rounds of inquiry ，a consensus was finally reached on 16 items on the original name ，quality standards and clinical application of Tibetan medicine “Dida”，and 2 items related to the characteristics and compatibilities of “Dida”had not reach common views. The consensuses of 16 items mainly cover the original name of “Dida”and the evolution of geographic information ，the rational selection of “Dida”medicinal materials ，the effectiveness and safety of clinical use of “Dida”.关键词：Delphi method;Tibetan medicine;Dida;Medicinal resources;Clinical applicatio n;Expert conse nsus
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To provide assistance for the smooth implementation of classification management policies of retail pharmacies in Guangdong province and the scientific supervision of retail pharmacies by relevant departments. METHODS ：In this study，key interviews were conducted among 68 interviewees，involving experts from Guangdong drug regulatory department ，head of retail pharmacies and research experts on relevant policies of universities. The current situation ，problems and suggestions of the classification management policy of retail pharmacies in Guangdong province were summarized. RESULTS & CONCLUSIONS ： The implementation of the classification management policies for retail pharmacies in Guangdong province operated well. Drug regulatory authorities at all levels could conduct daily supervision in accordance with policy requirements. Retail pharmacies operated in strict accordance with the classification management policy and established a relatively complete quality management system. However ，there were still problems such as difficulty in policy implementation ，insufficient policy clarity ，increased regulatory pressure and regulatory risks from government regulatory agencies ，rising operating costs and increasing pressure in retail pharmacies，the large gap of licensed pharmacists ，difficult to investigate and deal with “affiliation of certificate ”behavior，and difficult survival for remote pharmacies ，and the impact on the convenience of drug use of the public. It is suggested to improve the content of the policy ，introduce related supporting measures ，strengthen the construction of the supervisory team ，increase policy publicity，improve the ways and methods to investigate and deal with the “affiliation of certificate ”behavior of licensed pharmacists， and help retail pharmacies to diversify their operations and chain operations. It is recommended that relevant government departments should further improve the content of the policy and actively adjust the supervision methods to make the policy better implemented.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To establish t he metho d for the content determination of pulegone in Schizonepetae tenuifolia decoction pieces and its compound preparation. METHODS ：Hollow fiber liquid-phase microextraction coupled with HPLC （HF-LPME-HPLC） was adopted. Based on single factor tests ，HF-LPME condition of S. tenuifolia decoction pieces and its compound preparation （taking Compound S. tenuifolia granule as an expample ） was optimized by central composite design-response surface methodology using pulegone enrichment multiple as index ，with the concentration of sample phase solution （NaCl），extraction time and stirring speed as factors. Validation test was conducted. HPLC method was adopted to determine the content of pulegone. The determination was performed on Hypersil C 18 column with mobile phase consisted of methanol- 0.3％ phosphoric acid （gradient elution ）at the flow rate of 1.0 mL/min. The detection wavelength was set at 252 nm，the column temperature was 25 ℃. The sample size was 20 μL. The feasibility of HF-LPME-HPLC method established in this study was validated by using HPLC method stated in the item of S. tenuifolia decoction pieces in 2020 edition of Chinese Pharmacopoeia （part Ⅰ）as reference. RESULTS ：The optimum HF-LPME conditions included n-nonanol as the extraction solvent ，sample phase solution with 11％ NaCl and pH value of 7，stirring speed of 800 r/min，extraction time of 36 min. Results of HPLC methodology investigation showed that linear range of pulegone were 0.05-5 μg/mL（r＝0.999 0）. The limits of detection and quantitation were 0.4 and 1.3 ng/mL，respectively. RSDs of intra-day and inter-day precision were 1.8％-4.0％ and 1.5％-4.1％（n＝3），respectively. RSDs of reproducibility and stability tests （24 h）were all lower than 8％（n＝6）. Average recoveries of S. tenuifolia decoction pieces and Compound S. tenuifolia granule were 102.6％-105.1％ and 97.2％-102.3％，respectively；RSDs were not higher than 4.1％ and 6.2％（n＝3）. The average contents of pulegone in S. tenuifolia decoction pieces determined by pharmacopoeia method and established method were 0.84 mg/g（RSD＝4.3％ ，n＝3）and 0.87 mg/g（RSD＝5.5％ ，n＝3），respectively，with no significant difference （P＞0.05）. CONCLUSIONS ：The established HF-LPME-HPLC method can enrich and concentrate pulegone ， shows strong purification ability and high sensitivity ，and can be used to determine the contents of pulegone in S. tenuifolia decoction pieces and its compound preparation.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To preliminarily investigate the improveme nt effects and mechanism of Mongolian medicine Saorilao-4 decoction on specific pulmonary fibrosis model rats. METHODS ：Male SD rats were randomly divided into normal control group ，model group ，positive control group （pirfenidone，0.163 g/kg）and Saorilao- 4 decoction low ，medium and high dose groups （0.899，1.798，3.596 g/kg），8 rats in each group. Except for normal control group ，other groups were given 6 mg/mL bleomycin intratracheally at 5 mg/kg once to induce the specific pulmonary fibrosis model. From the first day after modeling ， normal control group and model group were given normal saline intragastrically ，other groups were given corresponding drugs intragastrically，once a day ，10 mL/kg，for 4 weeks. During the experimental period ，the general condition of the rats in each group was observed and the body mass was weighed. Twenty-four h after last medication ，the appearance morphology of rat l ung in each group were observed. The morphological characteristics of lung tissues were observed by HE and Masson staining. ELISA was adopted to determine the activity of SOD and the content of MDA in serum ，the contents of hydroxyproline （HYP），IL-1β，IL-6，hyaluronidase（HA），laminin（LN）precollagen type Ⅲ（PC-Ⅲ）and collagen type Ⅳ（Col-Ⅳ）in lung tissue. RT-PCR was used to determine the mRNA 发。E-mail：bwf007007@sina.com expression of TGF-β 1，Smad3 and Smad 7 in lung tissue. RESULTS：Compared with model group ，the activity ，hair and diet of the rats in each dose group of Saorilao- 4 decoction and positive control group were significant ly improved ，and the body mass after the last administration was significantly increased ； the pathological change of lung and pulmonary fibrosis were significantly improved ，and the activity of SOD in serum was increased significantly. Serum content of MDA （except for Saorilao- 4 decoction medium dose group ），the contents of HYP （except for Saorilao- 4 decoction high dose group ），IL-1β，IL-6，HA，LN，PC-Ⅲ，Col-Ⅳ（except for Saorilao- 4 decoction high dose group）as well as mRNA expression of TGF-β1 and Smad 3 in lung tissue were significantly decreased ；mRNA expression of Smad 7 was significantly increased （P＜0.05 or P＜0.01）. CONCLUSIONS ：Saorilao-4 decoction can significantly improve the lung pathological changes ，delay and reverse the progression of pulmonary fibrosis in specific pulmonary fibrosis model rats ，the mechanism of which may be related to the inhibition of inflammatory response ， improvement of lipid peroxidation ， down-regulation of TGF-β1 and Smad 3 mRNA expression ，and up-regulation of Smad 7 mRNA expression.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To ex plore the protective effects of Longbie capsule contained serum （called“LBJN”for short ）on the apoptosis of chondrocytes induced by YAP inhibitor verteporfin and its mechanism. METHODS ：Primary human knee osteoarthritis（OA）chondrocytes were extracted by two-step enzymatic digestion ，and then identif ied by toluidine blue staining and type Ⅱ collagen immunofluorescence staining. The effects of 2，5 μmol/L verteporfin alone or combined with 5％LBJN on cell apoptosis were detected by flow cytometry. Solvent control （0.1％ DMSO）and 5％ LBJN were set. Western blot assay was adopted to detect the expression of apoptosis related proteins （YAP，Bcl-2，cleaved-caspase-3） after treated with 0.1％DMSO（solvent control ），2 μmol/L verteporfin，2 μmol/L verteporfin+5％LBJN 和 0（blank control ），2.5％ LBJN and 5％ LBJN for 48 h. The expression of autophagy related proteins （mTOR，Beclin-1，LC3A/B） after treated with 0 （blank control ），2.5％，5％ LBJN for 48 h were det ected by Western blot assay. RESULTS ：The isolated cells accorded with the characteristics of chondrocytes. Compared with 0.1％DMSO， the apoptosis rates of cells were increased significantly after treated with 2，5 μmol/L verteporfin（P＜0.05），and the effects of the two concentrations were similar （P＞0.05）. Compared with verteporfin alone ，2，5 μmol/L verteporfin combined with 5％LBJN could significantly decrease the apoptotic rate of cells （P＜0.05）. Compared with 0.1％DMSO，the protein expression of YAP and Bcl-2 were decreased significantly after treated with 2 μ mol/L verteporfin （P＜0.05）， while the protein expression of cleaved-caspase-3 were increased significantly （P＜0.05）. Compared with 2 μmol/L verteporfin，protein expression of YAP and Bcl-2 were increased significantly after treated with 2 μmol/L verteporfin+5％LBJN（P＜0.05），while the protein expression of cleaved-caspase-3 were decreased significantly （P＜0.05）. Compared with blank control ，the protein expression of YAP ，Bcl-2 and Beclin-1 were increased significantly after treated with 2.5％，5％LBJN（P＜0.05），while protein expression of cleaved-caspase- 3 and mTOR were decreased significantly （P＜0.05）. CONCLUSIONS ：LBJN can block the apoptosis of chondrocytes induced by YAP inhibitor verteporfin ，and its mechanism may be related to regulating the expression of apoptosis related proteins and enhancing autophagy of chondrocytes.关键词：Longbie capsule;Contained serum;Osteoarthritis;Chondrocytes;YAP inhibitor;Apoptosis;Autophagy
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To analyze and compare th e contents of 6 kinds of monosaccharide in Astragalus membranaceus from different growth years . METHODS ：2-4 years old A. membranaceus from three areas were extracted with water extraction and alcohol precipitation ，Sevage deproteinization to obtain A. membranaceus polysaccharide. The samples were firstly hydrolyzed with trifluoroacetic acid （TFA）and then derivatized by 1-phenyl-3-methyl-5-pyrazolone（PMP）. HPLC analysis was adopted to determine the contents of 6 kinds of monosaccharide as mannose ，rhamnose，galacturonic acid ，glucose，galactose，arabinose. The determination was performed on Symmetry C 18 column with phosphate buffer solution （pH 6.8）-acetonitrile（84∶16，V/V）as mobile phase at the flow rate of 1.0 mL/min. The detection wavelength was 245 nm，and column temperature was 35 ℃. The sample size was 20 µL. RESULTS ：The contents of mannose ，rhamnose，galacturonic acid ，glucose，galactose and arabinose were 0.50-0.94， 0.76-1.60，3.35-7.86，87.33-275.77，1.95-8.96，2.35-14.04 mg/g，respectively. Total contents of monosaccharide from 2，3，4 years old A. membranaceus were 98.26-139.92，173.81-295.71，122.37-182.41 mg/g，respectively. There was significant difference in the contents of glucose between 3 old years A. membranaceus and 2，4 old years A. membranaceus （162.71-275.77 mg/g vs. 87.33-107.70，111.54-167.26 mg/g，P＜0.05）. CONCLUSIONS ：Above 6 monosaccharides are detected in 2，3，4 years old A. membranaceus，among which the content of glucose is the highest. The content of glucose in 3 years old A. membranaceus is higher than that in 2 and 4 years old A. membranaceus .关键词：Astragalus membra naceus;Polysaccharides;Monosaccharides;Pre-column derivatization;HPLC
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To establ ish characteristic pattern of vinegar-processed product of Schisandra chinensis formula granules from different habitats ，and to determine the contents of 5 components. METHODS ：HPLC method was adopted. The determination was performed on Agilent ZORBAX SB-C 18 column with mobile phase consisted of acetonitrile-water （gradient elution）at the flow rate of 1.0 mL/min. The column temperature was set at 30 ℃，and detection wavelength was set at 220 nm. The sample size was 10 µL. Using schisandrin as reference ，HPLC characteristic pattern of 19 batches of vinegar-processed S. chinensis formula granules was drawn. The similarity evaluation was performed with Similarity Evaluation System of TCM Chromatographic Fingerprints （2012 edition），and common peaks were confirmed. The contents of schisandrin ，schisandrol， angeloylgomisin H ，schizandrin and deoxyschizandrin were determined by same method. RESULTS ：There were 8 common peaks in 19 batches of vinegar-processed S. chinensis formula granules ，and the similarities were all above 0.996；five of them were identified as schisandrin ，schisandrol，angeloylgomisin H ，schizandrin and deoxyschizandrin ，respectively. The linear range of schisandrin，schisandrol，angeloylgomisin H ，schizandrin and deoxyschizandrin were 0.030-0.380，0.016-0.195，0.009-0.115， 0.006-0.078 and 0.011-0.138 μg（r＞0.999），respectively. RSDs of precision ，stability（24 h）and reproducibility tests were all lower than 2％. Average recoveries were 99.84％，99.54％，99.28％，100.03％，100.27％（RSD＜1.4％，n＝9）. Average contents of five components in 19 batches of samples were in the range of 0.15％-0.36％，0.02％-0.16％，0.02％-0.06％，0.02％-0.08％ and 0.08％-0.17％，respectively；among them ，total contents of five components in sample S 18 and S 19 from Hebei province were relatively high ，while those were relatively low in sample S 16 and S 17（RSD＝42％）；RSD of total content in other samples （S1-S15）was 12％，and was lower than that of Hebei province ；total content of five components were higher in sample from Jilin province. CONCLUSIONS ： Established characteristic pattern and method for the content determination are specific and reproducible，and can be used for the quality evaluation of vinegar-processed S. chinensis formula granules. The total content fluctuation of vinegar-processed product of S. chinensis formula granules from Liaoning ，Jilin and Heilongjiang provinces is lower than that in Hebei province ，and the quality of vinegar-processed Δ 基金项目：国家中药标准化项目（No.ZYB2H-Y-GD-13） ＊主管中药师 ，硕士 。研究方向 ：中药质量标准 。E-mail： S. chinensis formula granules from Jilin province is the best. lzz332@126.com
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To investigate the composition-activity relationship of the antioxidant active component in essential oil of Lavandula angustifolia from Xinjiang. METHODS ：Antioxidant activity of essential oil of L. angustifolia was evaluated with 1，1-diphenyl-2-picrylhydrazyl（DPPH）free radicals scavenging method. GC-MS combined with retention index were adopted to qualitatively analyze the compounds. The relationship of chemical components with antioxidant activity of essential oil of L. angustifolia was analyzed by principal component analysis （PCA） and partial least squares analyses （PLS）. The variable importance in projection （VIP＞1）was used to screen the components which had great contribution to the elimination of DPPH free radical. RESULTS ：The IC 50 values of essential oil in 9 batches of L. angustifolia from 3 different varieties was 4.82-9.88 mg/mL，IC50 of France blue was 6.66-8.58 mg/mL，IC50 of H- 701 and Xinxun- 4 were 4.82-7.73 mg/mL and 9.55-9.88 mg/mL，respectively. A total of 40 chemical components were identified of essentil oil in 9 batches of L. angustifolia . Results of PCA analysis showed that accumulative variance contribution rate of former 2 main components was 81.8％；9 batches of samples were divided into 3 regions， and different varieties were classified into one category ；the characteristic variable components of the essential oil of French blue samples were lavandulyl acetate corresponding to peak 32 and trans- β-ocimene corresponding to peak 9；the characteristic variable components of the essential oil of H- 701 samples were linalool corresponding to peak 16，linalyl acetate corresponding to peak 30 and terpinen- 4-ol corresponding to peak 21；the characteristic variable components of the essential oil of Xinxun- 4 samples were eucalyptol corresponding to peak 8，camphor corresponding to peak 18 and 2-borneol corresponding to peak 20. The compound with the greatest antioxidant activity was linalool corresponding to peak 16 （VIP＝2.940 0），followed by terpenein- 4-ol corresponding to peak 21（VIP＝2.863 1），caryophyllene corresponding to peak 35（VIP＝2.570 8）and eucalyptol corresponding to peak 8（VIP＝2.115 8）. CONCLUSIONS ：The essential oil of L. angustifolia has certain antioxidant activity ，and H- 701 sample has higher antioxidant activity. Linalool corresponding to peak 16 is the most important component of essential oil of L. angustifolia in eliminating DPPH free radical.关键词：Essential oil of Lavandula angustifolia;Antioxidant activity;GC-MS;Composition-activity relationship
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the co rrelation of the chro maticity value of Schizonepeta tenuifolia charcoal of different processing time（0-40 min，similarly herein after）with multiple indicators ，and to reveal the quality change law of S. tenuifolia charcoal during processing and confirm the terminal time. METHODS ：The contents of ethanol-soluble extracts from S. tenuifolia charcoal decoction pieces of different processing time were determined. UPLC fingerprint of S. tenuifolia decoction pieces and S. tenuifolia charcoal decoction pieces of different processing time were established ，and the similarity evaluation was also conducted. The chromatographic peaks were confirmed by comparison with substance control. The same UPLC conditions were used to determine the contents of index components （hesperidin，rosmarinic acid ，menthone）in S. tenuifolia charcoal decoction pieces of different processing time. The colorimetric method was used to measure the chromaticity value of S. tenuifolia charcoal decoction pieces of different processing time. Meanwhile ，sample of processing 0 min was used as a control to calculate the total color value （E）and the total color difference value （ΔE）. Pearson correlation analysis ，cluster analysis and orthogonal partial least squares discriminant analysis （OPLS-DA）were performed on the ethanol-soluble extracts ，index component contents ，chromatographic peak area and chromaticity value. The terminal time of processing S. tenuifolia charcoal was conf irmed，and validation test was also conducted. RESULTS ：With the extension of processing time ， the content of ethanol-soluble extract in S. tenuifolia charcoal qq.com decoction pieces gradually decreased. A total of 17 chromato- graphic peaks were identified in 12 batches of S. tenuifolia decoction piece ，and its si milarity with the control fingerprint was greater than 0.9. 21 chromatographic peaks were identified in S. tenuifolia charcoal decoction pieces of different processing time，and its similarity with the chromatogram of sample of processing 0 min decreased with the processing time ，and the similarity after 18 min was lower than 0.9. The chromatographic peak 9 was hesperidin ，peak 10 was rosmarinic acid and peak 17 was menthone. The determination of content and chromaticity value showed that with the extension of processing time ，the contents of hesperidin ，rosmarinic acid and menthone decreased gradually ；the color L，b and E values of S. tenuifolia charcoal decoction piece powder decreased gradually ，and the a and ΔE values increased gradually. Pearson correlation analysis showed that the contents of ethanol-soluble extract ，hesperidin，rosmarinic acid and menthone ，the peak areas of 15 chromatographic peaks （peak 2，7-15，17-21）were significantly positively correlated with E value（P＜0.01）；the peak areas of 5 chromatographic peaks （peak 1，3-6）were significantly negatively correlated with E value（P＜0.01），but peak area of peak 16 was not related to E value（P＞ 0.05）. Results of cluster analysis showed that S. tenuifolia charcoal decoction pieces of different processing time were divided into 2 categories；the first category was processed for 0-16 min，and the second category was processed for 18-40 min. The results of OPLS-DA showed that the VIP values of peak 6 area（2.800 75），L value（2.327 54），peak 3 area（1.793 39），b value（1.735 78） and peak 5 area（1.244 04）were greater than 1. The final processing time of S. tenuifolia charcoal was 18 min. The results of validation experiment showed that the L，a and b values of S. tenuifolia charcoal decoction piece were 20.22-22.00，4.44-7.67， 9.78-13.00，and ΔE were 13.50-14.12，respectively. CONCLUSIONS ：The chromaticity value of S. tenuifolia charcoal decoction pieces of different processing time is closely related to the contents of ethanol-soluble extract ，hesperidin，rosmarinic acid ， menthone and the area of 20 chromatographic peaks. It is suggested that the terminal time of processing S. tenuifolia is 18 min.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To optimize the honey-stir-fried technology of Chelidonium majus . METHODS ：Taking the mass ratio of water to honey ，the ratio of honey water to C. majus ，stir-fired temperature ，stir-fired time as the factors ，the total contents of chelidonine ，coptisine hydrochloride ，sanguinarine，berberine，chelerythrine as response values ，Box-Behnken response surface method was used to optimize the processing technology ，and valifation test was conducted. RESULTS ：The optimum process conditions were as follows the ratio of water to refined honey 1∶1.9（g/g），the ratio of honey water to C. majus 21∶100（g/g）， stir-fried temperature 122 ℃，stir-fried time 10.40 min. After 3 times of validation ，average total contents of 5 components was 10.37 mg/g（RSD＝0.23％），relative error of which with predicted value （10.39 mg/g）was 0.19％. CONCLUSIONS ：The optimized honey-stir-fried technology of C. majus is stable and feasible.关键词：Chelidonium majus;Honey-stir-fried technology;Box-Behnken response surface method;Content determination
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To isolate the water extract of polysaccharide from Cistanche tubulosa ，and to investigate their immunocompetence in vitro . METHODS ：AB-8 macroporous adsorption resin was used to decolorize C. tubulosa polysaccharide. The decolorization process was optimized by orthogonal test with retention rate and decolorization rate of polysaccharide as comprehensive score ，and using adsorption rate ，decolorization time ，sample concentration as factors. The verification tests were conducted. DEAE- 650M ion exchange column was used to separate the water extract of decolorized C. tubulosa polysaccharide. CCK-8 assay was used to detect the effect s of different concentration of polysaccharide （6.25-100 μg/mL）before and after isolation on the proliferation rate of mice macrophage RAW 264.7. Griess method and ELISA assay were adopted to detect the effects of low ， medium and high concentration of polysaccharide （12.5，25，50 μg/mL）on the release of NO ，IL-6 and TNF-α in LPS-induced RAW264.7 cells. RESULTS ：In the optimal decolorization process of AB- 8 macroporous adsorption resin ，the adsorption flow rate was 1.2 BV/h，the decolorization time was 9 h，and sample concentration was 25 mg/mL. The comprehensive scores of 3 times of verification tests were 63.43％，63.29％ and 63.34％，respectively，with an average of 63.35％（RSD＝0.11％，n＝3）. One neutral polysaccharide （CTZ）and 5 acid polysaccharides （CT1，CT2，CT3，CT4，CT5）were isolated from the polysaccharide of C. cistanche ，the contents were 299.2，168.0，123.2，121.6，54.4，11.2 mg/g. Compared with control group ，6.25-100 μg/mL CTZ （except for 6.25 μg/mL），CT2，CT4，CT5 and 6.25 μg/mL CTC（the polysaccharide before seperation ）could significantly increase the proliferation rate of RAW 264.7 cells（P＜0.05），while 6.25-100 μg/mL CT1，CT3 and 50 μg/mL CTC could decrease te proliferation rate of RAW 264.7 cells（P＜0.05）. Compared with LPS group ，the release of NO were decreased significantly in low，medium and high concentration groups of CTC ，CT2，CT3 and CT 5，CTZ low concentration group （P＜0.05），while were increased significantly in high concentration groups of CT 1 and CT 4 （P＜0.05）. The release of IL- 6 （except for CT 1 high concentration group and CT 5 low concentration group ）and TNF-α（except for CT 1 medium concentration group ）were decreased significantly in low ，medium and high concentration groups （P＜0.05）. CONCLUSIONS ：The optimized decolorization technology of macroporous adsorption resin is stable and feasible in the study. One neutral polysaccharide and 5 acidic polysaccharides can be isolated from water extract of C. tubulosa polysaccharides，among which CT 2 polysaccharide has stronger anti-inflammatory ability.关键词：Cistanche tubulosa polysaccharide;Decolorization;Separation;Immunocompetence
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the effects and mechanism of panaxadiol （PD） on Tau protein phosphorylation in the SH-SY5Y cells transfected with APP gene（APP-SH-SY5Y）. METHODS ：The target of PD and non-receptor tyrosine kinases Fyn was verified by molecular docking. SH-SY 5Y cells were cultured in vitro ，and the APP-SH-SY 5Y cell models and green fluorescent （GFP）-SH-SY5Y cell model （control cell ）was constructed. The expression of Aβ1-42 was detected so as to verify the success of APP-SH-SY5Y cell model. Taking GFP-SH-SY 5Y cells as control ，the effects of 5，10，20，30，40 μmol/L PD and 125，250， 500，1 000，2 000 nmol/L PP 2（Fyn inhibitor ，positive control ）on the survival rate of APP-SH-SY 5Y cells were detected by CCK-8 assay after treated for 24 h，so as to confirm the optimal concentration. The concentration of Ca 2 + ，the ratio fophosphorylated Tau protein （p-Tau）/Tau，phosphorylatedn Src（p-Src）/Fyn and phosphorylated glutamate receptor 2B（p-GluN2B）/ GluN2B were detected in APP-SH-SY 5Y cells after trated with the optimal concentration of PD and PP 2 for 24 h. RESULTS ：The results of molecular simulation docking showed that PD could target Fyn protein. Compared with GFP-SH-SY 5Y cells ，the protein expression of Aβ1-42 in APP-SH-SY 5Y cell were increased significantly （P＜0.01）. The optimal concentration of PD and PP 2 were 20 μmol/L and 500 nmol/L. The 20 μmol/L PD and 500 nmol/L PP 2 could increase the survival rate of the cells and reduced the concentration of Ca 2+，the ratio of p-Tau/Tau ，p-Src/Fyn，and p-GluN 2B/GluN2B. CONCLUSIONS：PD can reduce the the phosphorylation of Tau protein through inhibiting Fyn/GluN 2B signaling pathway.关键词：Panaxadiol;APP-SH-SY5Y cells;Tau protein;Phosphorylation;Fyn/GluN2B signaling pathway
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To evaluate the economic s of osimertinib versus first-generation EGFR-TKIs in the first-line treatment of EGFR mutation-positive locally advanced or metastatic non-small cell lung cancer （NSCLC），and to provide evidence-based reference for medical and healthy decision-making in China. METHODS ：From respective of health care system ，Markov model was developed by using patientsurvival data and published literature datato simulate 10 years of direct medical costs and quality-adjusted life years （QALY）for EGFR mutation-positive locally advanced or metastatic NSCLC patients ，with a model cycle length of 3 weeks，and the discount rate of 5％. One-way sensitivity analysis and probabilistic sensitivity analysis were used to evaluate the effects of parameter changes on the stability of the model results. RESULTS ：In the base-case analysis ，compared with the first-generation EGFR-TKIs ，osimertinib could obtain 0.40 QALYs more ，with an incremental cost of 163 531.55 yuan and an incremental cost-utility ratio （ICER）of 409 321.54 yuan/QALY，which was higher than the willingness-to-pay （WTP）threshold in China（3 times per capita GDP in China in 2019 of 212 676 yuan/QALY）. The results of one-way sensitivity analysis showed that the utility value of progression-free survival status and the price of osimertinib had the greatest impact on ICER. The results of probability sensitivity analysis showed that the probability of osimertinib to be cost-effective was 11.00％ at the WTP threshold in China. When the price of osimertinib decreased by 30％，50％ and 70％，the probability of osimertinib to be cost-effective was 26.20％，47.40％，and 74.30％ at the WTP threshold of 212 676 yuan/QALY，respectively. CONCLUSIONS ：When Chinese 3 times per capita GDP in 2019 is used as the criterion for judgment ，osimertinib is not economical compared with the first-generation EGFR-TKIs in first-line treatment of locally advanced or metastatic NSCLC with EGFR mutation-positive. Appropriate price reduction can improve its economy.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To observe the therapeutic efficacy an d safety of rebamipide modified quadruple therapy in the treatment of Helicobacter pylori （HP）positive gastric-ulcer. METHODS ：Totally 150 patients with HP positive gastric-ulcer in our hospital from Mar. 2018 to Mar. 2020 were randomly divided into traditional group and modified group according to random number table ，with 75 cases in each group. Traditional group was given Amoxicillin capsules 1.0 g orally ，twice a day + Clarithromycin tablets 0.5 g orally ，twice a day+ Omeprazole enteric-coated capsules 20 mg orally ，twice a day+Colloidal bismuth pectin capsules 200 mg orally ，twice a day. Modified group was additionally given Rebamipide capsules 0.1 g orally ，3 times a day，Amoxicillin capsule ，Clarithromycin tablet and Omeprazole enteric-coated ca psule（same usage and dosage as traditional group）. Both groups were given medicine for consecutive 8 weeks，and were reexamined 2 weeks after drug withdrawal. After 2 weeks of treatment ，HP eradication rate ，total response rate ，the levels of serum MTL ，CCK，G17，PGⅠ and PG Ⅱ，PGⅠ/Ⅱ were observed in 2 groups. The occurrence of ADR was recorded. RESULTS ：HP eradication rate and total response rate of modified group were significantly higher than traditional group （P＜0.05）. Before treatment ，there was no significant difference in the serum levels of MTL ，CCK，G17，PGⅠ or PG Ⅱ，PGⅠ/PGⅡ between 2 groups（P＞0.05）. After treatment ，the levels of serum CCK ，G17，PG Ⅰ and PG Ⅱ in 2 groups were significantly lower than before treatment ，and modified group was significantly lower than traditional group （P＜0.05）；the serum level of MLT and PG Ⅰ/PGⅡ were significantly higher than before treatment，and modified group was significantly higher than traditional group （P＜0.05）. There was no significant difference in the total incidence of ADR between 2 groups（P＞0.05）. CONCLUSIONS ：Rebamipide modified quadruple therapy can significantly improve therapeutic efficacy and HP eradication rate of HP positive gastric-ulcer patients ，and regulate its ga strointestinal hormone Δ and PG levels with good safety.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To investigate the efficacy of hormone combined with cyclophosphamide in the treatment of connective tissue disease-associated interstitial lung disease （CTD-ILD）and to analyze its influential factors. METHODS ：100 patients diagnosed as CTD-ILD in our hospital from Jan. 2018 to Jan. 2019 were randomly divided into observation group and control group ，with 50 cases in each group. Control group was treated with Compound cyclophosphamide tablets ，50 mg each time，3-4 times each day. Observation group was additionally treated with Prednisone acetate tablets ，10 mg each time ，3-4 times each day ，on the basis of control group. Treatment courses of 2 groups lasted for 6 months. The clinical efficacy ，the occurrence of ADR，lung function before and after treatment ，the levels of peripheral IL- 6，CRP and PCT and quality of life （SGRQ score ）were compared between 2 groups. According to the therapeutic efficacy ，all patients were divided into effective group and ineffective group. The related factors influencing the clinical efficacy of CTD-ILD were analyzed by univariate and multivariate Logistic regression analysis. RESULTS ：After treatment ，total response rate ，FVC，FEV1 and DLCO of observation group were significantly higher than those of control group ，while SGRQ score ，levels of IL- 6，CRP and PCT in peripheral blood were significantly lower than control group （P＜0.05）. There was no significant difference in the total incidence of ADR between 2 groups（P＞0.05）. Univariate analysis showed that there were no significant differences in gender ，age，past medical history and CTD type between effective group and ineffective group （P＞0.05）. However ，there were statistical significancant differences in the distribution of different levels of IL- 6，CRP and PCT in peripheral blood between 2 groups（P＜0.05）. Multivariate Logistic regression analysis showed that IL- 6 was an independent risk factor for therapeutic efficacy of combined therapy [OR （95％CI）＝ 4.537（3.668，10.352），P＝0.002]. CONCLUSIONS ：Hormone combined with cyclophosphamide can significantly improve the therapeutic efficacy of CTD-ILD patients ，improve their lung function and quality of life ，and reduce the expression level of inflammatory factors. The level of IL- 6 is an independent risk factor affecting the efficacy of the treatment ，and its changes should be paid close attention to during the treatment.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To systematically evaluate the occurren ce of non-immune related adverse events （AEs）caused by immune checkpoint inhibitors （ICIs）alone or combined with routine chemotherapy in the treatment of non-small cell lung cancer （NSCLC），and to provide evidence-based reference for clinical medication. METHODS ：Retrieved from PubMed ，Cochrane Library，Embase，CNKI，CBM，VIP and Wanfang database during the inception to Oct. 2020，randomized controlled trials （RCT） about ICIs alone or combined with routine chemotherapy （trial group ）versus routine chemotherapy or placebo combined with routine chemotherapy （control group ） were collected. After literature screening and data extraction ，the quality of included literatures were evaluated with bias risk evaluation tool recommended by Cochrane systematic evaluator manual 5.1.0. Meta-analysis was performed by using Rev Man 5.3 software and Stata 15.0 software. Sensitivity analysis was conducted with Stata 15.0 software. Inverted funnel plot and Egger ’s test were used to analyze publication bias. RESULTS ：A total of 20 RCTs were included ， involving 12 283 patients. Results of Meta-analysis showed that the incidence of all grades and s evere AEs ，anemia，neutropenia， vomiting and alopecia as well as the incidence of thrombocytopenia，nausea and peripheral neuropathy in all grades of trial group were all significantly lower than control com group（P＜0.05）. There was no statistical significance in the incidence of termination of treatment ， death， severe thrombocytopenia， severe nausea and severe peripheral neuropathy or all grades and severe diarrhea between 2 groups（P＞0.05）. Subgroup analysis showed that the incidence of all grade and total severe AEs ，the incidence of anemia ，neutropenia，thrombocytopenia，clinically relevant symptoms （except for severe diarrhea），termination of treatment and death of patients receiving ICIs alone in trial group were significantly lower than control group（P＜0.05）. The incidence of ermination of treatment and death ，the incidence of nausea ，vomiting，diarrhea and alopecia in all grade ，severe diarrhea of patients receiving ICIs and chemotherapy in trial group were all significantly higher than control group （P＜0.05）. Sensitivity analysis supported the above results. Analyze publication bias results showed that the possibility of publication bias in this study was small. CONCLUSIONS ：For NSCLC patients ，the safety of ICIs is better than that of routine chemotherapy or placebo combined with routine chemotherapy in the treatment-related AEs ，hematologic toxicity and clinically relevant symptoms ；however，the risks of treatment discontinuation ，AEs-induced deaths ，and all-grade nausea ，vomiting， diarrhea，alopecia and severe diarrhea will be increased in the ICIs combined with routine chemotherapy.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To esta blish a special management system of carbapenems ，and to standardize the clinical and rational application of carbapenem antibacterial drugs. METHODS ：According to the requirements of the relevant documents of National Health Commission of the People ’s Republic of China ，the special management system of carbapenems in the First Affiliated Hospital of University of Science and Technology of China （called“our hospital ”in short ）was constructed. The use intensity，reasonable rate of prescription and the detection rate of carbapenem resistant Enterobacteriaceae were analyzed before and after management. RESULTS ：The special management system of carbapenems in our hospital included organization construction，information construction of special management ，prescription review of special management drugs ，prescription comment intervention and so on. After the implementation of the special management system ，the intensity of carbapenems use decreased from 2.78 to 2.03，the reasonable rate of prescription increased from 62.8％ to 98.3％（P＜0.05）. The detection rates of Acinetobacter baumannii ，Escherichia coli and Pseudomonas aeruginosa resistance to carbapenems decreased from 91.4％，2.4％， 49.5％ to 79.7％，1.6％，39.7％，respectively. However ，the detection rate of Klebsiella pneumoniae resistance to imipenem increased from 34.4％ to 50.0％. CONCLUSIONS ：The special management system of carbapenems in our hospital has achieved some results in practice ，which helps to reduce the abuse of these drugs and improve the reasonable level of drug use and reduce the detection rate of drug-resistant bacteria. At the same time ，hospital infection control of K. pneumoniae resistance to imipenem should be strengthened.关键词：Carbapenems;Special management;Rational drug use
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To provide reference for establishing stan dardized construction standard system of “internet+TCM pharmacy”. METHODS ： Questionnaire through literature review ， investigation and expert consultation were compiled. A questionnaire survey was carried out among TCM staff to understand the current situation and problems of “internet + TCM pharmacy”in Chinese medical institutions. Based on the results of the questionnaire ，a frame of standardized construction standard system for “internet+TCM pharmacy ”was tried to constructed. RESULTS & CONCLUSIONS：A total of 74 questionnaires were distributed and 74 were returned ，including 1 invalid questionnaire ，with an effective rate of 98.65％. Among the 73 respondents， more than 60％ were from TCM hospitals ，or with the title of vice senior or above ，and 55（75.3％）were national TCM characteristic technology inheritance talents. The survey results showed that more than 80％ of TCM pharmacies in medical institutions were equipped with full-time reviewers ，provided decocting service ，set up decocting room ，and carried out distribution service，and could achieve the same-day or part of the same-day delivery. More than half of the respondents believed that the prescriptions of TCM decoction pieces in their medical institutions were issued in strict accordance with the relevant requirements ， the rational drug use monitoring software was used ，and the error analysis of relevant work links was carried out regularly ， prescription coping training was regularly carried out for dispensers ，and decoction knowledge and operation process training were carried out for decoction personnel. However ，the vast majority of respondents （67，accounting for 91.8％）thought that their medical institutions only used traditional methods to control and evaluate the quality of finished decoction products. The results of the evaluation of the importance of 6 links and 17 key points of operation showed that the highest concentration of opinions was the quality of decoction pieces ，and the key points of operation were special drug treatment. The results of principle component analysis and maximum variance analysis showed that current construction of “internet+TCM pharmacy ”was mainly reflected in the two dimensions as TCM decocting ，consultation and distribution servi ces. Statistical analysis indicated that there were significant differences in staff training ，awareness of laws and policies ， regular error analysis ，patient satisfaction survey ，optimization of payment and consulting services among different levels and categories institutions （P＜0.05）. It was necessary to carry out the standardization construction of “internet+TCM pharmacy”. It is suggested that the standard system for standardized construction of“Internet + TCM pharmacy ”should be established from 5 aspects：basic construction conditions ，the standardization of procurement and acceptance ，the standardization of dispensing ，the standardization of decocting and distribution service and the standardization of pharmaceutical consultation services.关键词：Questionnaire survey;Internet+TCM pharmacy;Standardized construction;Standard system
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To investigate the effects of pharmaceutical management intervention on the use of TCM injection in primary medical institutions. METHODS ：Twenty grass-roots health centers in Yichun city ，Jiangxi province were randomly selected. Relying on Department of Pharmacy and Health Services of the Municipal Health Committee and the Quality Control Center for Pharmacy Affairs of the City ，Yichun People ’s Hospital took the lead in establishing the prescription evaluation criteria for TCM injection ，training pharmaceutical service skills ，conducting special reviews on prescriptions/medical orders ，improving control measures ，obtaining relevant data of drug use in primary health centers by issuing questionnaires on the use of TCM injection and randomly selecting prescriptions/medical orders for comments. The relevant data without drug administration （before intervention）from Jan. to Jun. 2018 were taken as the non-intervention group ，and the relevant data with drug administration （after intervention）from Jan. to Jun. 2019 were taken as the intervention group. The use of TCM medicine injection ，DDDs，DDC and sequencing ratio were compared before and after intervention. At the same time ，the prescriptions/medical orders of TCM injections before（1 222 copies）and after （1005 copies）intervention were randomly selected for comment and the reasonable situations of the prescriptions/medical orders were compared before and after the intervention. RESULTS ：After intervention ，total amount ， consumption sum and DDDs of top 10 TCM injections in the list of amount were significantly decreased. The reasonable rate of prescriptions and medical orders was 48.04％ before intervention ， but increased to 70.65％ after intervention. Besides ， unreasonable situations before and after intervention all manifested as inappropriate indications. After the intervention ，the unreasonable rates of Xuesaitong powder for injection （lyophilized），Xueshuantong injection ，Xingnaojing injection （two specifications），Shengmai injection ，Xueshuantong for injection （lyophilized）and Qingkailing injection were significantly lower than before intevention （P＜0.05）. CONCLUSIONS ：Pharmaceutical administration intervention can reduce the total amount and the consumption sun of TCM injection in primary medical institutions ，and promote rational drug use in the clinic.关键词：Pharmaceutical administration;Primary medical institutions;TCM injection;Rationality evaluation;Prescription
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发布时间：2022-06-21
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