最新刊期
卷 32 ， 期 15 ， 2021
- 摘要：OBJECTIVE：To investigate the s ynergy between centralized drug volume-based purchasing （called“volume- based purchasing”for short ）and medical insurance negotiation policy. METHODS ：From the aspects of economic and social benefits ， the synergy of volume-based purchasing and medical insurance negotiation was analyzed by using the methods of literature analysis，policy interpretation and interview. The corresponding suggestions were put forward for the problems of the supply and use of drugs. RESULTS & CONCLUSIONS ：The synergy of volume-based purchasing and medical insurance negotiation in terms of economic benefits include medical insurance fund management optimization to improve fund utilization efficiency improvement ； medical insurance fund payment optimization to reduce transaction cost ；network promotion of medical security information platform to reduce the cost of information exchange. The synergy of volume-based purchasing and medical insurance negotiation in terms of social benefits includes relevant index assessment of drug quality evaluation to improve drug quality evaluation system ； medical service level improvement to form compound medical insurance payment mode under total budget management ；enterprise supervision driven by market to reduce the pressure of government supervision. The relevant departments should continue to strengthen the comprehensive management of medical institutions to reduce the phenomenon of irrational drug use ；strengthen policy convergence ，avoid the poor implementation of medical insurance drug adjustment policy ，so that the policy dividend of volume-based purchasing and medical insurance negotiation can benefit the people more through system reform ，optimal allocation of funds ，etc.关键词：Centralized drug volume-based purchasing;Medical insurance negotiation;Synergy;Medical reform
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To provide reference f or optimizing the curriculum management system of continuing education for licensed pharmacists in China. METHODS ： The content and implementation system of continuing education curriculum management for licensed pharmacists in the United States was introduced ，and policy suggestions were put forward for the curriculum construction and management system optimization of continuing education for licensed pharmacists in China. RESULTS & CONCLUSIONS ：The curriculum management of continuing education for licensed pharmacists in the United States has clear curriculum objectives ，missions and plans ，and evaluates the basic situation of the trainees before continuing education starts ，so as to carry out modular management of the curriculum （including continuing education courses based on knowledge ，application and practice）. In terms of the implementation system of continuing education in the United States ，ACPE has put forward a lifelong learning model （pharmacist continuing career development model ）that emphasizes autonomy and personalization ，and has detailed regulations on teaching methods ，learning cycle and fees. At the same time ，ACPE requires that the feedback of participants on the curriculum must be collected. Combined with the practice in China ，it is suggested that the relevant departments should formulate the Curriculum Standard of Continuing Education for Licensed Pharmacists ， implement standardized management of the curriculum，improve the assessment mechanism of continuing education curriculum ，flexibly grant credits based on the actual education effect ，constantly update the concept and mode of continuing education ，and localize the international theory ，so as to continuously improve the continuing education management system of licensed pharmacists in China.关键词：Continuing education;Licensed pharmacist;Curriculum;Standardized management;United States
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the imp rovement effects of 2-dodecyl-6-methoxycyclohexa-2，5-diene-1，4-dione（DMDD） from Averrhoa carambola on H 9c2 myocardial cell injury induced by high glucose and its mechanism. METHODS ：H9c2 myocardial cells were divided into normal group ，high glucose group ，osmotic pressure control group ，DMDD high ，medium and low concentration groups （8，4，2 μmol/L）. Normal group and high glucose group were treated with low glucose DMEM medium （containing 5.5 mmol/L glucose ，similarly hereinafter ） and high glucose DMEM medium （containing 33.3 mmol/L glucose ， similarly hereinafter ）for 48 h，respectively. The cells in osmotic pressure control group were cultured in low glucose DMEM medium containing 27.5 mmol/L mannitol for 48 h. In DMDD groups ，cells were cultured in high glucose DMEM medium for 24 h， and then in high glucose DMEM medium containing corresponding concentration of DMDD for 24 h. At the end of cell culture ，MTT metho d was used to detect the cell survival rate. The activities of ROS ， GSH-Px and LDH in cellsupernatant were detected by using related kits. ELISA assay was used to detect the levels of TNF-α and IL-6 in cell supernatant. Cell apoptosis was d etected by acridine orange/ethidium bromide （AO/EB）staining. Western blot assay was used to detect the expression of apoptosis related proteins （cleaved caspase- 3，Bcl-2，Bax）and the phosphorylation level of nuclear factor κB （NF-κB）/NF-κB suppressor protein α（IκBα）signaling pathway related proteins （NF-κB p65，IκBα）. RESULTS ：Compared with the normal group ，survival rate ，the activity of GSH-Px and protein expression of Bcl- 2 in high glucose groups were decreased significantly（P＜0.01）；the activities of ROS and LDH ，the levels of TNF-α and IL-6，the protein expression of Bax and cleaved caspase-3，and the phosphorylation level of NF-κB p65 and IκBα were increased significantly（P＜0.01）；the cells showed orange yellow fluorescence ，and the number of cells with fuzzy morphology increased significantly ，showing an obvious apoptotic state. There was no statistical significance in above indexes of osmotic pressure control group compared with normal group. Compared with high glucose group ，the activities or levels of above indexes （except for cell survival rate an LDH activity in low concentration group ）were reversed significantly in DMDD groups （P＜0.05 or P＜0.01）；the orange yellow fluorescence in the cells decreased significantly ，and the cell morphology was relatively complete. CONCLUSIONS ：DMDD can significantly improve H9c2 myocardial cell injury induced by high glucose ；the mechanism of which may be associated with suppressing oxidative stress and inflammatory response ，regulating the expression of apoptosis related protein and NF-κB/IκBα pathway related protein.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To obs erve the protective effect of protoca techuic aldehyde（PAL）on neurovascular unit （NVU） homeostasis damage in rats after cerebral ischemia-reperfusion injury （CIRI）. METHODS ：SD rats were randomly divided into sham operation group ，model group ，PAL high-dose and low-dose groups （10，20 mg/kg），with 11 rats in each group. Administration groups were given relevant medicine intragastrically. Sham operation group and model group were given the same volume of normal saline intragastrically ，10 mL/kg once a day ，for 5 days. After last administration ，CIRI model was induced by suture method ；the ultrastructural changes of NVU were observed by transmission electron microscope. Western blot assay was used to detect the expression of NUV related proteins （MAP-2，GFAP，AQP-4）in cerebral tissue. Immunofluorescence staining was used to observe the positive expression of above proteins in cerebral cortex. RESULTS ：Compared with sham operation group ， blood-brain barrier （BBB）structure of model group was destroyed severely ，the vascular lumen became narrower ，lateral edema of endothelial cells was severe ，and the thickness of basement membrane varied ；the nuclei of neurons were pyknosis and there was a large area of edema in the surrounding tissues ；the structure of glial cells was seriously damaged ，the cell body was shrunk and organelles were lost ；protein expression （or positive expression ）of MAP- 2 in brain tissue （or cerebral cortex ）were significantly decreased （P＜0.05 or P＜0.01），while protein expression （or positive expression ） of GFAP and AQP- 4 were increased significantly（P＜0.01）. After PAL intervention ，the rats had less BBB damage ，and the morphology of vascular lumen and basement membrane were not completely destroyed ；the damage of neurons was alleviated ，the pyknosis of neurons was decreased ， the chromatin was homogeneous and the heterochromatin was decreased；the damage of glial cell structure was alleviated protein expression of GFAP and AQP- 4（except for low-dose group） in cerebral tissue and positive expression of MAP- 2 and GFAP protein in cerebral cortex were reversed @qq.com significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：PAL can protect the stability of NVU from damage in CIRI model rats； the mechanism may be related to up-regulating the expression of MAP- 2 protein in cerebral cortex and down-regulating the expression of GFAP and AQP- 4 protein in brain tissue.关键词：Protocatechuic aldehyde;Cerebral ischemia-reperfusion injury;Neurovascular unit;Cerebral cortex;Rats
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the research status ，hotspots and frontier cha nges of drug-induced kidney injury （DIKI）， and to provide reference for the research of DIKI in China. METHODS ：Literatures related to DIKI published from 2001 to 2020 were retrieved from Web of Science database. CiteSpace 5.7.R2 software was used to conduct visualization analysis for DIKI related literatures from aspects of the number of publications ，authors and cited authors ，institutions，countries，related disciplines ， co-cited journals ，co-cited literatures and keywords. RESULTS ：A total of 1 320 literatures were included ，and the number of published literatures about DIKI researches showed an upward trend during 2001-2020. The most studies and the highest co-citations were devoted by the Yale University scholar Mark A Perazella （18 literatures，cited for 137 times）. There were 76 countries carrying out research in this field ，among which the United States had the first advantage （445 literatures，accounting for 34.29％ of the total number of literatures ）. A total of 2 175 institutions participated in this field ，of which Yale University contributed the most publications ；pharmacology，nephrology，toxicology and other related disciplines were involved in this field ；Kidney International（652 literatures，USA）published the most research in this field ；the most frequently cited literature was “Drug- induced nephrotoxicity ：clinical impact and preclinical in vitro models ”，published by Tiong et al in 2014. Through the keyword cluster analysis ，the research hotspots in this field mainly focused on the risk factors of DIKI ，the research of DIKI in special groups，the mechanism of DIKI related drugs ，the exploration of DIKI biomarkers ，and the preclinical research of DIKI. CONCLUSIONS：DIKI’s research has been paid more and more attention by scholars ，but the cooperation between China and other countries in this field is limited. In the future ，more attention should be paid to the research hotspot in this field and international exchanges and cooperation should be strengthened.关键词：Drug-induced kidney injury;Visualization analysis;Research hotspot;International cooperation
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To establish the HPLC fingerprints of ethanol extracts of Dendrobium nobile from different habitats ， and to study spectrum effect relationship of its anti-inflammatory effect. METHODS ：The ethanol extracts from 12 batches of D. nobile from different habitats （S1-S12）were prepared. The fingerprints of ethanol extracts from 12 batches of D. nobile were established by HPLC and TCM Fingerprint Similarity Evaluation System （version 2012）. Common peaks were identified and the similarity was evaluated. Using the contents of inflammatory factors （IL-4，IL-6）as anti-inflammatory indexes ，ELISA was used to investigate the effects of ethanol extracts from 12 batches of D. nobile on RAW 264.7 macrophages in inflammatory model induced by lipopolysaccharide. Grey correlation analysis was used to analyze the correlation between common peaks and anti-inflammatory indexes in the fingerprint of ethanol extract from D. nobile . RESULTS ：There were 18 common peaks in ethanol extracts from 12 batches of D. nobile ，and No. 12 peak was identified as dendrophenol. The similarity of each sample was 0.911-0.996. The content of IL- 4 in cell culture medium was significantly reduced by ethanol extracts of D. nobile S1-S12（P＜0.05 or P＜0.01）；the content of IL- 6 in cell culture was significantly reduced by ethanol extracts of D. nobile S1-S8，S10（P＜0.05 or P＜0.01）. Grey correlation analysis found that except for peaks 4 and 18，the correlation degree between the other common peaks and the content of IL- 4 was greater than 0.6，and the correlation degree between peaks 5 and 7 and the content of IL- 4 was greater than 0.8；except for peaks 9，14，4，3 and 18，the correlation degree between the other common peaks and the content of IL- 6 was greater than 0.6，and the correlation degree between peaks 1，12 and 13 and the content of IL- 6 was greater than 0.8. CONCLUSIONS ：HPLC fingerprints of ethanol extracts from 12 batches of D. nobile ； from different habitats have high similarity and good consistency in composition ； the chemical constituents represented by peaks 1，5，7，12（dendrophenol）and 13 may 769096783@qq.com be potential anti-inflammatory components of D. nobile .
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the effe cts of the water extract from Carpesium cernuum （AECC）on the proliferation ， metastasis and invasion of prostate cancer PC 3 cells. METHODS ：Cells were divided into control group and different concentration groups of AECC （5，10，20，40，80 μg/L），and then treated with relevant medicine or medium for different time （24，48，72 h）. The survival rates of cells were detected. Cells were divided into control group ，and AECC low ，medium and high concentration groups（20，40，80 μg/L）. After cultured for 24 h，Hoechst 33258 staining and flow cytometry were used to detect the apoptosis of cells. The number of cell metastasis and invasion were detected by Transwell assay. RT-qPCR and Western blot assay were applied to detect the mRNA and protein expression of β-catenin signaling pathway related migration and apoptosis proteins （β-catenin， MMP-7，c-Myc，caspase-3，Bcl-2 and Bax ）in AECC low and medium concentration groups. RESULTS ：With the increase of the concentration and culture time ，the survival rates of cells in AECC different concentration groups were significantly lower than control group （P＜0.05 or P＜0.01），and showed a decreasing trend. Compared with control group ，the early apoptosis rate （except the medium concentration group ）and the number of cell metastasis and invasion in AECC groups ，the mRNA and protein expression of MMP- 7，c-Myc（except for the low concentration group ）and Bcl- 2（except for mRNA of the low concentration group）in AECC low and medium concentration groups were decreased significantly （P＜0.05 or P＜0.01）. Late apoptosis rate of AECC groups ，the mRNA and protein expression of β-catenin，caspases-3（except for the low concentration group ），Bax（except for mRNA of the low concentration group ）in AECC low and medium concentration groups were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：AECC could inhibit the proliferation ，metastasis and invasion of PC 3 cells；the mechanism of which may be associated with regulating the expression of β-catenin signaling pathway related migration and apoptotic factors.关键词：Carpesium cernuum;Prostate cancer PC 3 cells;β-catenin;Proliferation;Metastasis;Invasion
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study chemical constitue nts of Asplenium sampsoni ，and to investigate its antitussive effects preliminarily. METHODS ： The 75％ ethanol extract was isolated from A. sampsoni and purified by silica gel column chromatography. The structures of the compounds were identified by physicochemical properties and spectral data （mass spectrum ， hydrogen spectrum and carbon spectrum ）. Kunming mice were randomly divided into negative control group ，test group （the doses of 7 monomers were 0.12 g/kg），and positive control group （same dose of benproperine phosphate ），with 10 mice in each group. The antitussive effect of each compound was evaluated by the method of inducing cough with concentrated ammonia water. RESULTS：Totally 13 compounds were isolated and identified from ethyl acetate and petroleum ether parts of 75％ ethanol extract of A. sampsoni ，i.e. 4-hydroxy-acetophenone（Ⅰ），4-hydroxy-ethyl phenylacetate （Ⅱ），luteolin（Ⅲ），apigenin（Ⅳ），quercetin （Ⅴ），formononetin（Ⅵ），acacetin（Ⅶ），protocatechuic acid （Ⅷ），isorosmarinoside（Ⅸ），quercetin-3-O-β-D-glucopyranoside （Ⅹ），isorhamnetin-3-O-β-D-glucopyranoside（Ⅺ），methyl palmitate （Ⅻ）and imperatorin （XⅢ）. Luteolin could significantly prolong the cough latency and reduce the times of cough in mice （P＜0.05）. CONCLUSIONS ：Thirteen compounds are isolated from this plant for the first time ；luteolin has certain antitussive effect ，and may be the antitussive active component of the plant.关键词：Asplenium sampsoni;Chemical constituents;Structure identification;Antitussive effect
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To establish the UPLC fingerprint of Polygonum cuspidatum ，and to determine the contents of four active ingredients and to provide reference for the quality evaluation of P. cuspidatum . METHODS ：The determination was performed on Waters BEH C 18 column（100 mm×2.1 mm，1.7 μm）with mobile phase consisted of acetonitrile- 0.2％ formic acid （gradient elution ）at flow rate of 0.4 mL/min. The column temperature was 40 ℃，and detection wavelength was 290 nm. The sample size was 1 μL. The fingerprints were evaluated by similarity calculation，cluster analysis and orthogonal partial least square discriminant analysis （OPLS-DA）. Using polydatin as internal standard ，relative calibration factors of resveratrol ，emodin-8-O- β-D-glucoside and emodin were determined to develop a method of QAMS. The contents of 4 above components in 15 batches of P. cuspidatum were calculated by relative calibration factors. The results of QAMS were compared with those of external standard. RESULTS：UPLC fingerprints of 15 batches of P. cuspidatum were established ，and 12 common peaks were confirmed. Five components were identified ，i.e. polydatin ，resveratrol，emodin-8-O-β-D-glucoside，emodin，emodin methyl ether. The fingerprint similarity of 15 batches of P. cuspidatum was in the range of 0.865-0.976. According to cluster analysis ，15 batches of P. cuspidatum were classified into 4 categories，showing certain regularity of origin. Seven markers were identified by OPLS-DA method. The order of difference significance was peak 7＞emodin-8-O-β-D-glucoside＞resveratrol＞peak 8＞polydatin＞peak 1＞ peak 10. The relative deviation among the contents of resveratrol ，emodin-8-O-β-D-glucoside and emodin in 15 batches of P. cuspidatum determined by QAMS and external standard method was less than 5.0％，indicating that there was no significant difference between the two methods. CONCLUSIONS ：UPLC fingerprint combined with QAMS method is convenient and reliable for the quality evaluation of P. cuspidatum ；the quality of P. cuspidatum produced in Chongqing and Anhui province is better.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the effects of Plantago asiatica polysaccharide on the proliferation ，migration and invasion of breast cancer cells ，and to investigate its mechanism preliminarily. METHODS ：Using human breast cancer cell MDA-MB- 231 as subjects ，MTT method was adopted to detect the effects of different concentrations of P. asiatica polysaccharide（8，16，32，64 mg/L）on the cell proliferation ability ，and survival rate of the cells was calculated. Scratch test and Transwell invasion test were used to detect the effects of different concentrations of P. asiatica polysaccharide（8，16 mg/L）on cell migration ability and invasion ability. Western blot assay was used to detect the expression of epithelial-mesenchymal transition （EMT）-related proteins [matrix metalloproteinase- 2（MMP-2），MMP-9，E-cadherin，N-cadherin，vimentin]. RESULTS ：Results of MTT assay showed that survival rate of the cells in 32，64 mg/L P. asiatica polysaccharide groups were significantly lower than control group （P＜0.05 or P＜0.01），so that 8，16 mg/L，which did not affect the cell survival rate ，were used as the follow-up drug concentrations. Compared with control group ，relative mobility （12，24 h），relative invasion rate and relative expression of MMP- 2，MMP-9， N-cadherin and vimentin protein were decreased significantly in 8，16 mg/L P. asiatica polysaccharide groups （P＜0.05 or P＜ 0.01），while relative expression of E-cadherin protein was increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：P. asiatica polysaccharide can inhibit the proliferation of breast cancer cells MDA-MB- 231，and inhibit the migration and invasion of the cells by regulating the expression of metastasis and EMT-related proteins.关键词：Plantago asiatica polysaccharide;Breast cancer;MDA-MB-231 cells;Proliferation;Migration;Invasion
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To establish a meth od for the simultaneous determination of 7 active components in Mori Australis Cortex and Mori Cortex from different sources in Chongqing area ，so as to provide reference for improving the quality control standards of Mori Australis Cortex and Mori Cortex and comparing the equivalence of their quality. METHODS ：HPLC method was used to determine the contents of neochlorogenic acid ，mulberroside A ，chlorogenic acid ，astragalin，kaempferol，morusin and isoquercetin in 58 batches of Mori Australis Cortex and Mori Cortex. The chromatographic column was Diamonsil C 18 with mobile phase consisted of 0.1％ formic acid solution-acetonitrile （gradient elution ） at the flow rate of 1.0 mL/min. The detection wavelength was 280 nm，column temperature was 30 ℃，and the injection volume was 10 μL. Using SPSS 22.0 software， independent sample t-test，principal component analysis and cluster analysis were used to analyze the content difference of the above-mentioned 7 active components in Mori Australis Cortex and Mori Cortex. RESULTS ：There was a good linear relationship between the peak area and the concentration of the above 7 active components （r≥0.999 0）. The RSDs of precision ，stability（24 h），repeatability，durability and recovery were less than 3％. The average contents of neochlorogenic acid ，mulberroside A ， chlorogenic acid ， astragalin， kaempferol， morusin and 023-58576130。E-mail：1025473978@qq.com isoquercetin in Mori Australis Cortex were 0.304，22.462， 1.730，1.308，1.593，2.842 and 0.657 mg/g，respectively. Those of Mori Cortex were 0.305，22.995，2.486，2.438， 2.916，4.158 and 1.264 mg/g，respectively. The results of independent sample t-test showed that only the content of kaempferol in the above 7 active components of Mori Australis Cortex and Mori Cortex had significant difference （P＜0.05）. The results of principal component analysis and cluster analysis showed that there was no significant difference in the contents of above 7 active components between Mori Australis Cortex and Mori Cortex. CONCLUSIONS：The established HPLC method is simple ，sensitive and accurate ，which can provide a reference for improving the quality control standard of Mori Australis Cortex and Mori Cortex. Mori Australis Cortex and Mori Cortex have certain quality equivalence in main active components ，and the Mori Australis Cortex from M. australis and M. cathayana can be used as a substitute for the Mori Cortex.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To prepare Azelnidipine enteric solid dispersion and evaluate its quality. METHODS ：Azelnidipine enteric solid dispersion was prepared by solvent method. Taking cumulative dissolution rate as the index ，single factor test was used to optimize carrier material type and its ratio. The quality of the product was evaluated by DSC ，XRD and FTIR ，and its stability was investigated. RESULTS ：After azelnidipine and carrier material of Eudragit L 100-55 acrylic resin were prepared to enteric solid dispersion at a ratio of 1∶5（m/m），its dissolution rate was significantly improved. DSC ，XRD and FTIR method had all verified the crystal form of azelnidipine changed and it existed in amorphous form. The results of stability test showed that Azelnidipine enteric solid dispersion was stable under high temperature （60 ℃），high humidity （75％）and strong light [ （4 500±500）lx] for 10 days. CONCLUSIONS ：Azelnidipine enteric solid dispersion by solvent method with Eudragit L 100-55 acrylic resin as carrier can eliminate the influence of crystal form ，improve dissolution and has good stability.关键词：Azelnidipine;Enteric solid dispersion;Solvent method;Quality evaluation;Stability
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To provide reference for clinical safe and rational drug use by mining adverse drug events （ADE） signals for tocilizumab. METHODS ：Data of ADE reports related to tocilizumab in the first quarter of 2015 to second quarter of 2020 were collected from US FDA adverse event reporting system. After data standardization ，the proportional imbalance method was used for ADE signal mining. RESULTS ：A total of 163 718 ADE reports were extracted ，in which tocilizumab was primary suspected drug ，involving 26 674 patients. In 26 674 patients，the proportion of female （73.69％）was higher than that of male （19.04％），and the age was mainly 60-74 years old （21.19％）. Among the 163 718 ADE reports ，the main reporting countries were the United States （70.15％），Canada（15.95％），Japan（3.33％），Australia（3.05％）and Brazil （1.43％）；consumers （31.35％）and doctors （24.94％）were the main reporting staff. A total of 747 ADE signals for tocilizumab were obtained ， commonly rheumatoid arthritis ，joint pain and pain ；and the signals as the increase of disability assessment scale score ，the decrease of disability assessment scale score ，abnormal diastolic blood pressure and abnormal systolic blood pressure were strong. A total of 33 kinds of ADE signals were found ，which were not recorded in the instructions of tocilizumab ，and mainly abnormal laboratory indicators such as decreased oxygen saturation ，decreased blood pressure and abnormal heart rate. ADE mainly involved 27 system organs ，including musculoskeletal and connective tissue ，various reactions of systemic diseases and drug delivery site ， various examinations. CONCLUSIONS ：In addition to the ADE mentioned in the drug instructions ，when using tocilizumab in clinic，attention should also be paid close to blood oxygen saturation ，blood pressure ，blood routine indexes and other laboratory indicators，and intervention measures should be taken early when ADE occurs ，so as to ensure the safety and effectiveness of drug use.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the mode of regional volume-based proc urement of injection ，design complete and effective volume-based procurement plan of injection ，and to provide decision-making basis for government departments. METHODS ：The official documents of all provinces/provincial-level alliances that carried out injection volume-based procurement were retrieved as of Feb. 8th，2021. Content analysis method was used to sort out and compare volume-based procurement types ，grouping methods ， product selection methods and other information of injection. Combined with the existing information ，the suggestions were put forward for improving volume-based procurement mode and the improved volume-based procurement mode framework. RESULTS & CONCLUSIONS ：By Feb. 8th，2021，a total of 13 provinces/provincial-level alliances have launched volume-based procurement of injections ，mainly involving antibiotics and proton pump inhibitors ；a comprehensive evaluation system was used for evaluation for many provinces/provincial-level alliances. Comprehensive evaluation system involves the price and quality of injection ，and enterprise credit ，etc.，and include a variety of factors other than price into evaluation scope. But the comprehensive evaluation system is still in its preliminary application stage ，and has differences in each province/provincial-level. Its details need to be perfected and it has not yet formed a unified standard. In the future，the way of product quality inspection needs to be refined. On the existing basis ，it has been constructed and improved that comprehensive evaluation system framework include efficacy ，safety，economy and other indicators. It is suggested to promote the comprehensive clinical evaluation of com drugs and apply more re al world data for product review ，so as to further reduce drug price，and promote the hea lthy development of the pharmaceutical industry.关键词：Injection;Regional volume-based procurement;Mode;Comprehensive evaluation system
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the improvement ef fects of sanggenone C on lipid accumulation in human liver cancer HepG2 cells induced by free fatty acid （FFA）. METHODS ：HepG2 cells were divided into control group ，model group ， fenofibrate group （10 μmol/L），sangerone C low ，medium and high concentration groups （2，4，8 μmol/L）. Except for control group，other groups were treated with 1 mmol/L FFA to induce lipid accumulation model ，and administration groups were cultured with relevant medium containing drugs. The lipid accumulation was observed by oil red O staining ，and lipid level and triglyceride （TG） content were also determined. Real-time PCR and Western blot assay were adopted to detect the mRNA and protein expression of PPARα，CPT-1，SREBP-1c，FAS，SIRT1 and PGC- 1α in HepG2 cells. RESULTS ：Compared with control group ， the nucleus was atrophied significantly and the volume became smaller ，and the number of lipid droplets was significantly increased；the level of lipid ，TG content ，mRNA and protein expression of SREBP- 1c and FAS were significantly increased （P＜ 0.05 or P＜0.01），mRNA and protein expression of PPARα，CPT-1，SIRT1 and PGC- 1α were decreased significantly（P＜0.01）. Compared with model group ，no obvious nucleus atrophy and normal volume were observed in sangerone C groups ，and the number of lipid droplets was significantly reduced ；the levels of lipid ，TG content ，mRNA and protein expression of PPARα pathway related genes （except for SREBP- 1c protein in saggenone C low concentration group ）were significantly reversed （P＜ 0.05 or P＜0.01）. CONCLUSIONS ：Sangenone C can significantly improve the lipid accumulation of HepG 2 cells，and its mechanism may associated with regulating PPAR α signaling pathway，improving cell lipid oxidation ability and inhibiting lipid synthesis.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To observe the effects of Compound danshen drip ping pills on the prevention of contrast-induced nephropathy（CIN）after percutaneous coronary intervention （PCI）and its influence on clinical prognosis. METHODS ：From Jan. to Jun. 2020，240 patients with coronary heart disease receiving PCI in Tianjin Chest Hospital were randomly divided into control group（120 cases）and Danshen dripping pills group （120 cases）according to random number table. The patients in both groups were injected with Lippaclitanol injection 1-5 mL slowly through radial or femoral artery sheath ，and intravenous hydration was performed before and after PCI ；Danshen dripping pills group was additionally given Compound danshen dripping pills 270 mg orally for a long term ，three times a day ，three days before and after PCI ，on the basis of the control group. The levels of renal function indexes [serum creatinine （Scr），blood urea nitrogen （BUN），cystatin C （Cys-C），creatinine clearance rate （Ccr）]， inflammatory reaction indexes [high sensitivity C-reactive protein （hs-CRP）， interleukin-6 （IL-6）] and oxidative stress index [malondialdehyde （MDA）] were observed in 2 groups before and 72 hours after PCI. The occurrence of CIN in 2 groups was recorded 3 days after PCI therapy ；the occurrence of major cardiovascular adverse events was also observed during 1-year follow-up period. RESULTS ：Before treatment ，there was no significant difference in serum renal function indexes ，inflammatory reaction indexes and oxidative stress index between 2 groups（P＞0.05）. Seventy-two hours after PCI ，serum levels of Scr ，BUN， Cys-C，hs-CRP，IL-6 and MDA were increased significantly in 2 groups than before treatment ，while the Ccr were decreased significantly；those indexes of Danshen dripping pills group were significantly better than those of control group （P＜ 0.05）. The incidence of CIN in Danshen dripping pills group was 4.2％ after treatment ， and total incidence of major cardiovascular adverse events was 13.3％ during follow-up period，which were sign ificantly lower than 13.3％ and 27.5％ of control group （P＜0.05）. CONCLUSIONS ：Compound danshen dripping pills may have a certain effect on the prevention of CIN in coronary heart disease patients after PCI ，and can reduce the incidence of major cardiovascular adverse events.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To provide reference for the selection of more economical programmed death- 1（PD-1）/programmed death-ligand 1（PD-L1）inhibitors for National Medical Insurance List and the quality improvement of related economic evaluation. METHODS：Retrieved from CNKI ，VIP，Wanfang database ，PubMed，Web of Science and Ovid Embase ，economic evaluation studies including listed PD- 1/PD-L1 inhibitors of China were collected during the inception to Oct. 2020. CHEERS checklist was used to evaluate the quality of the included literatures ，and the methodological characteristics and economic evaluation results of the included studies were analyzed systematically. RESULTS ：A total of 14 literatures were included ，all of which were model-based and with moderate or high quality. However ，there were still some deficiencies in the included literatures ，mainly manifesting as the insufficient reports on the reasons for setting or selecting model parameters ，as well as the great uncertainty of clinical effect data and utility value. Only 3 of the 8 PD-1/PD-L1 inhibitors listed in China were involved in the included literatures. Compared with chemotherapy or targeted therapy plan ，9 literatures（64.29％）showed that the therapy plan containing PD- 1/PD-L1 inhibitors was not cost-effective. CONCLUSIONS ：The economic evidence of domestic PD- 1/PD-L1 inhibitors is lacking ，the higher price of imported PD- 1/PD-L1 inhibitors lead to poor economic performance. The existing economic evaluations has some shortcomings in methodological application and parameter selection. Pharmaceutical enterprises should fill in the data gaps and adjust the pricing strategy，researchers should improve the standardization of research ，and medical insurance decision-making departments should improve the judgment on the quality of economic evidences ，so as to promote more economical drugs to be included in the National Medical Insurance List.关键词：PD-1/PD-L1 inhibitors;Pharmacoeconomics;Systematic analysis
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To investigate the occurrence of medication errors （ME）in patients with hyperuricemia/gout and its related factors ，in order to avoid and reduce the occurrence of related ADE and ensure the safety of drug use in patients. METHODS：The ME reports related to hyperuricemia/gout were collected from National Monitoring Network for Clinical Safe Drug Use during Sept. 22nd，2012 to Jul. 9th，2020，and then analyzed in terms of reporting provinces ，classification and drugs involved，error content ，initiator and error factors. RESULTS ：A total of 179 ME reports ，which met inclusion criteria ，were included from 47 hospitals in 11 provinces. The drugs involved mainly included benbromarone （36 cases，20.11％），allopurinol （31 cases，17.32％），calcium carbonate D 3（30 cases，16.76％），inverting sugar electrolyte （24 cases，13.41％）and sodium bicarbonate（22 cases，12.29％）. Grade B ME were the most frequently reported （124 cases，69.27％）；severe ME occurred in 3 cases（1.68％）. The main errors were contraindications ，accounting for 70 cases（37.43％，mainly involving calcium carbonate D 3 and inverting sugar electrolyte ）. The people who caused ME were mainly doctors ，involving 126 cases（70.39％，the main content of errors was contraindications ）. The main error factors for ME were personnel factors ，involving 120 cases（67.04％，mainly lacking of knowledge ），followed by environmental factors （33 cases，mainly equipment failure ）. CONCLUSIONS ：ME in patients with hyperuricemia/gout are mainly caused by uric acid-lowering drugs and non-uric acid-lowering drugs that cause changes in uric acid. The main error contents include contraindications ，which were mostly caused by non-uric acid-lowering drugs and doctors. The main error factors are lack of knowledge and equipment failure. It is suggested to strengthen personnel training or introduce clinical medication support decision-making system ，while pay attention to the correct use and maintenance of related equipment in the process of drug use.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To construct the evaluation system for TCM pharmaceutical care quality in public hospitals of Jilin province，and to provide reference for improving the quality of TCM pharmaceutical care in public hospitals. METHODS ：On Nov. 2020，20 relevant personnel and 10 experts in the field of TCM in Jilin province were selected by theoretical sampling method and objective sampling method ，respectively；grounded theory and Delphi method were adopted to sort out and score the evaluation system of TCM pharmaceutical care quality in public hospitals. Analytic hierarchy process （AHP）was used to determine the weight of each index. RESULTS ：In the two rounds of evaluation ，experts’enthusiasm，authority and opinion coordination were relatively high. Finally ，the evaluation system of TCM pharmaceutical care quality in public hospitals of Jilin Province was constructed ， consisting of 5 criterion layer indexes and 27 field layer indexes. The weights of the five criterion layer indexes from high to low are 0.290 for TCM pharmaceutical care management ，0.283 for TCM pharmaceutical care equipment ，0.163 for TCM prescription rationality，0.150 for TCM quality management ，0.144 for TCM pharmaceutical care ability. CONCLUSIONS ：The evaluation system of TCM pharmaceutical care quality in public hospitals of Jilin province established in this study is scientific and applicable ， and provides a basis for improving the quality of TCM pharmaceutical care in public hospitals. Public hospitals can set up priority improvement dimensions according to the results of the quality evaluation system ，and focus the limited human and material resources on priority improvement indexes.
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发布时间：2022-06-21 -
Application of Team Situational Simulation Education and Teaching Mode in Clinical Pharmacy Teaching
摘要：OBJECTIVE：To explore th e applicatio n of team situatio nal simulation education and teaching mode in clinical pharmacy teaching. METHODS ：A total of 60 clinical pharmacy interns were selected as the research objects ，and course disease was type 2 diabetes mellitus. Thirty interns were randomly selected as control group ，using traditional teaching mode ；other 30 interns were selected as trial group ，which carried out team situational simulation education and teaching mode. The teaching effects were evaluated by using the satisfaction of interns to the two modes ，the comprehensive score of graduation examination and the self-evaluation of learning effect. RESULTS ：Compared with traditional teaching mode ，team situational simulation education and teaching mode was conducive to stimulate the learning interest of interns ，improve their interpersonal communication ability ， cultivate teamwork spirit ，improve the awareness of humanistic care ，and cultivate the professional attitude of clinical pharmacists （P＜0.05）. Compared with control group ，the comprehensive score of trial group was dominantly increased （P＜0.001），and the scores of professional quality ，humanistic care and communication skills in the trial group were significantly higher than control group（P＜0.01）. In terms of self-evaluation of learning effect ，except for the pathogenesis of type 2 diabetes and the commonly used treatment regimens ，the self-evaluation scores of the other items in trial group were significantly higher than control group （P＜0.05 or P＜0.01）. CONCLUSIONS ：Team situational simulation education and teaching mode is superior to traditional teaching mode for clinical pharmacy teaching.关键词：Team situational simulation education and teaching mode;Clinical pharmacy;Teaching method- 60
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发布时间：2022-06-21
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