最新刊期
      卷 32 ， 期 17 ， 2021
      • LI Gaojie,CHEN Lei,XI Xiaoyu
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To provid e a more accurate calculation method for the determination of drug negotiation base price ， pharmacoeconomic calculation and budget impact analysis and calculation in the process of medical insurance access with buy-and-gift strategy. METHODS ：By the model method and literature research ，understanding the existing price conversion methods of the anti-cancer drugs that currently implement the buy-and-gift strategy ，a new method of drug price conversion was explored on the basis of the survival data of patients in different disease states ，and the core idea and calculation process of the algorithm were analyzed by an example. RESULTS ：The new algorithm was combined with the survival data of patients under different disease states. Its calculation process mainly included obtaining the actual duration of medication use per unit cycle and the theoretical amount of medication ，determining the aid model for anti-cancer drugs under buy-and-gift strategy ，converting the actual price. The simulation calculation was carried out under the one-step drug donation mode ，periodic drug donation mode and preferential installment drug donation mode. CONCLUSIONS ：The conversion method of anti-cancer drug price under buy-and-gift strategy based on survival data makes up for the shortcoming that the existing calculation methods are difficult to reflect the actual price of anti-cancer drugs ，and provides a new calculation method for calculating the actual reference price of anti-cancer drugs for medical insurance access.  
        关键词：Buy-and-gift strategy;Anti-cancer drugs;Survival data;Aid model;Drug price conversion;Algorithm   
        85
        |
        9
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619721 false
        发布时间：2022-06-21
      • WANG Shengming,TIAN Kan,WANG Zihong
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To know about the current situation and trend of encouraged generic drug catalogue policy in China ， and to put forward countermeasures and suggestions for the better implementation of the policy. METHODS ：The evolution of encouraged generic drug catalogue policy in China ，the characteristics of 2 batches of included types in encouraged generic drug catalogue，the implementation effect of the first batch of encouraged generic drug catalogue ，the development trend and existing problems of encouraged generic drug catalogue policy were analyzed to put forward corresponding suggestions. RESULTS & CONCLUSIONS：The evolution of encouraged generic drug catalogue policy in China can be roughly divided into embryonic stage，policy design stage and policy implementation and adjustment stage. The first batch of included types in encouraged generic drug catalogue are mainly drugs whose patents are about to expire and the competition is insufficient ，drugs with clinical necessity ， definite curative effect and short supply ，and varieties for special clinical purposes such as the prevention and treatment of major infectious diseases and rare diseases ，and children ’s use. The second batch of included types in encouraged generic drug catalogue are mainly those with expired patents （about to expired ）and insufficient competition ，and also those with special clinical uses. Among the types of the first batch of encouraged generic drug catalogue ，the number of abbreviated new drug application （ADNA） increased by 18，involving a total of 8 varieties；only 3 ADNA were included in the priority review ，accounting for 16.67％. In 2019 and 2020，218 and 119 varieties were newly included in the medical insurance catalogue ，and 3 varieties were newly included in the encouraged generic drugs catalogue （accounting for 1.4％ and 2.5％ respectively）. At present ，encouraged generic drug catalogue policy in China has the trend and characteristics of patent oriented regression ，lack of priority review and approval system，and enhanced linkage with the medical insurance catalogue. It is suggested to adhere to the original intention of the Opinions of the State Council on Deepening the Reform of the Review and Approval System and Encouraging the Innovation of Drugs and Medical Devices in 2017，continue to adhere to the patent orientation of encouraged generic drug catalogue ，and improve the priority review system of generic drugs in the catalogue ，explore the “first imitation market monopoly period ”system in line with the characteristics of encouraged generic drug catalogue policy in China with reference to the U.S. FDA competitive imitation therapy guidelines ，and further strengthen the cooperation between government departments in the implementation of the encouraged generic drug catalogue policy.  
        关键词：Encouraged generic drug catalogue;Policy;Patent;Generic drug   
        81
        |
        1
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619467 false
        发布时间：2022-06-21
      • DU Yao,CHEN Rui,ZHU Gaofeng,ZHANG Jiquan,TANG Lei
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To i nvestigate the metabolism stabilities of novel hypoglycemic compound LSM- 13 in rat liver microsomes，and to analyze the possible metabolites. METHODS ：LSM-13 was dissolved in rat liver microsome incubation system initiated by reduced nicotinamide adenine dinucleotide phosphate ，and was incubated in water at 37 ℃. The reaction was terminated with acetonitrile at 0，5，10，15，30，45 and 60 min，respectively. Using indomethacin as internal standard ，the concentration of LSM-13 in incubation system was determined by HPLC. The residual percentage and enzyme kinetic parameters of LSM- 13 were calculated at different incubation time points with the concentration of LSM- 13 incubated for 0 min as reference. UPLC-Q-TOF/MS was used to analyze and speculate the metabolites of LSM- 13 in rat liver microsomes. RESULTS ：After 60 min incubation ，the remaining percentage of LSM- 13 was（56.07±0.95）％，the half-life was 42.78 min，and the intrinsic clearance was 0.032 4 mL/（min·mg）. Compared with total ion flow diagram of rat liver microsome blank samples ，three chromatographic peaks were added in the samples incubated for 60 min；the corresponding molecular ion peaks were m/z 505.133 8，417.102 4，293.111 7 [M+H]+；the possible metabolites may be dehydrogenation ，O-debentylation and hydrolysis products of LSM- 13. CONCLUSIONS ： The compound LSM- 13 has moderate stability in rat liver microsomes ，and may undergo dehydrogenation ，O-debentylation and hydrolysis.  
        关键词：Hypoglycemic compound;LSM-13;Rat liver microsomes;Stability;Metabolites   
        86
        |
        12
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619709 false
        发布时间：2022-06-21
      • ZHAO Jun,SUN Jialin,LIU Hongling,LIU Guangwei,LI Xiangpeng,CANG Huaiqin,LIANG Yu,ZHANG Chuanzhou,HAN Bing,SUI Zhongguo
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To explo re the potential molecular mechanism of ursolic acid in the treatment of osteoporosis （OP）. METHODS：TCMSP，PubMed database and UniProt database were used to screen potential targets of monomer compound ursolic acid. OP related target genes were searched with GeneCards database. The common target genes of component-disease were obtained by Venny 2.1 online mapping tool. The protein-protein interaction （PPI）network of component-disease common target genes was constructed by using STRING database ，and topological analysis was carried out ；the core target genes ，whose degree value was greater than the average degree value ，were screened. GO functional annotation and KEGG pathway enrichment analysis of component-disease common target genes were carried out by DAVID database. AutoDock Vina 1.1.2 software was used for molecular docking ，using protein encoded by the core target gene as receptor and ursolic acid as ligand. RESULTS ：A total of 55 ursolic acid related target genes and 4 273 OP related target genes were excavated ，with a total of 44 common target genes. PPI network with above common target genes included 44 nodes and 513 edges，with an average node degree of 23.3. There were 24 core target genes ，including VEGFA，TP53，IL6，CASP3. There were 340 GO functional items were enriched （corrected P＜ 0.05），including 263 biological processes （negative regulation of apoptosis ，etc.），25 molecular functions （protein binding ，etc.） and 52 cell components （cytosol，etc.）. There were 90 KEGG signaling pathways （corrected P＜0.05），such as tumor pathway ， hepatitis B pathway ，TNF signaling pathway ，viral carcinogenesis and phosphatidylinositol 3 kinase/protein kinase B （PI3K-Akt） signaling pathway. The binding energy between ursolic acid and 6 proteins encoded by core target genes such as TP53 was lower than －5 kcal/mol，which had strong binding activity. CONCLUSIONS ：The therapeutic effect of ursolic acid on OP may be achieved by regulating VEGFA，TP53，IL6，CASP3，JUN and other core target genes and acting on multiple key pathways such as cancer pathway ， hepatitis B and TNF signaling  
          
        99
        |
        18
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619476 false
        发布时间：2022-06-21
      • MA Qiang,CHEN Jie,MIAO Jiawei,XIONG Shu,PANG Yi,DENG Xuesong
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To study the effects of costunolide （COS）on the cell cycle distribution and apoptosis of human breast cancer SK-BR- 3 cells and its mechanism. METHODS ：Human breast cancer SK-BR- 3 cells were divided into blank control group，and COS groups of 10，20，30，40，50 μmol/L. MTT assay was used to detect the effects of COS on cell proliferation. SK-BR-3 cells were divided into blank control group ，COS low ，medium and high concentration groups （10，20，30 μmol/L）. After cultured for 24 h，flow cytometry was used to detect the distribution of cell cycle. Hoechst 33258 fluorescence staining was used to detect cell apoptosis. Western blot assay was used to detect the expression of p 53，caspase-3，Bcl-2，Bax，p21，CDK2 and cyclinE. RESULTS ：Compared with blank control group ，COS could significantly inhibit the proliferation of SK-BR- 3 cells（P＜ 0.05 or P＜0.01），and in a dose and time-dependent manner. Low ，medium and high concentrations of COS could induce cell apoptosis and arrest cell at G 1/S phase （P＜0.05 or P＜0.01），could significantly up-regulate the protein expression of p 53， caspase-3，Bax and p 21（P＜0.05 or P＜0.01），and could significantly down-regulate the protein expression of Bcl- 2，CDK2 and cyclinE（P＜0.01）. CONCLUSIONS ：COS can inhibit the proliferation of human breast cancer SK-BR- 3 cells and induce cell apoptosis and cell cycle arrest. The mechanism may be related to the regulation of p 53/Bax/Bcl-2/caspase-3 apoptosis signal pathway.  
        关键词：Costunolide;SK-BR-3 cells;Cell proliferation;Cell cycle;Cell apoptosis   
        66
        |
        9
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619696 false
        发布时间：2022-06-21
      • LIN Jing,LIANG Jie,HUANG Chunyan,WEI Jinyu,HUANG Dongfang,HU Jue,QI Jinli,CHEN Huihua
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To establish HPLC fingerprints of different polar parts of Zhuang medicine Calonyction muricatum ， and to study its spectrum-effect relationship with analgesic and anti-inflammatory effects. METHODS ：The total part ，ethyl acetate part，n-butanol part and water part of C. muricatum were prepared. HPLC fingerprints of different polar parts were established by HPLC method combined with the Similarity Evaluation System of TCM Chromatogramtic Fingerprint （2012A），and the common peaks were identified. Using writhing times and ear swelling degree in mice as analgesic and anti-inflammatory indexes ，analgesic and anti-inflammatory activity of different polar parts of C. muricatum were investigated. The correlation of the common peaks of HPLC fingerprint with analgesic and anti-inflammatory indexes was analyzed by grey correlation analysis ，bivariate correlation analysis and partial least square （PLS） method. RESULTS ： There were 11 common peaks for the different polar parts of C. muricatum ，and 5 components were identified by reference comparison，i.e. neochlorogenic acid （peak 3），chlorogenic acid （peak 5）， cryptochlorogenic acid （peak 6）， isochlorogenic acid A （peak 10），isochlorogenic acid C （peak 11）. The grey correlation analysis showed that the correlation between all common peaks and analgesic and anti- inflammatory effects were greater than 0.6 （except the correlation between peak 6 and analgesic effects ），showing correlation relationship ；the correlation of peaks 3，7 and 10 with analgesic and anti-inflammatory effects were all greater than 0.8，which was highly related. Bivariate correlation analysis showed that the correlation of peak 1，3，4，7，9，10，11 with analgesic and anti-inflammatory effects were all greater than 0.6，showing correlation relationship. PLS method showed that peaks 1，3，4，7，9，10，11 contributed greatly to playing an analgesic and anti-inflammatory role. CONCLUSIONS ：HPLC fingerprints of different polar parts of C. muricatum is established and five common peak components were identified. Neochlorogenic acid ，isochlorogenic acid A ，isochlorogenic acid C and chemical components represented by peaks 1，4，7，9 may be the pharmacodynamic substances of C. muricatum to exert analgesic and anti-inflammatory effects.  
        关键词：Calonyction muricatum;Analgesic and anti-inflammatory;Fingerprint;Spectrum-effect relationship   
        55
        |
        3
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619493 false
        发布时间：2022-06-21
      • XIAO Dan,FAN Dongsheng,LIU Xing,KONG Yi,XUE Jinjing,GAO Yuan
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To establish the fingerprint of Adiantum capillusveneris from different producing areas ，and to conduct chemometric analysis and content determination of differential components ，so as to provide reference for quality control of A. capillusveneris . METHODS ：HPLC-DAD combined with Similarity Evaluation System of TCM Chromatogramtic Fingerprint （2004 A edition ）were used to establish fingerprint of 19 batches of A. capillusveneris from different producing areas （S1-S19）. Common peaks were confirmed and their similarities were evaluated. Chemometric analysis methods such as cluster analysis ， principle component analysis （PCA），orthogonal partial least squares discriminant analysis （OPLS-DA）were used to evaluate the quality of 19 batches of A. capillusveneris from different producing areas ，screen the differential components ，and determine the contents of some differential components. RESULTS ：Among 19 batches of A. capillusveneris from different producing areas ，22 common peaks were confirmed ；peak 9 was chlorogenic acid ，peak 17 was quercetin- 3-O-β-D-glucopyranoside，peak 20 was kaempferol-3-O-rutoside；the similarity of 19 batches of sample were 0.677-0.962. Through cluster analysis ，it was found that S 7 and S 10 were clustered into one category ；S15 and S 18 were clustered into one category ；and S 1-S6，S8，S9，S11-S14，S16，S17 and S 19 were clustered into one category. PCA and OPLS-DA found that S 7 and S 10 were clustered into one category ；S15 were clustered into one category ；S18 were clustered into one category ；S1-S6，S8，S9，S11-S14，S16，S17 and S 19 were clustered into one category. Chlorogenic acid ，quercetin-3-O-β-D-glucopyranoside，kaempferol-3-O-rutoside and chemical composition represented by peak 14 were the differential components of the〔2017〕2841）； medicinal material. Among 19 batches of A. capillusveneris ， average contents of chlorogenic acid and quercetin- 3-O-β-D- glucopyranoside and kaempferol- 3-O-rutoside were 0.10-4.25， 0.31-7.11，0.61-12.00 mg/g，respectively. CONCLUSIONS ： 电话：0851-86614212。 HPLC-DAD fingerprints of A. capillusveneris from different producing areas are establishe d in the study ，and three common peaks are identified. Four differential components affecting the quality of A. capillusveneris are screened ， and the contents of chlorogenic acid ， quercetin-3-O-β-D-glucopyranoside and kaempferol-3-O-rutoside in A. capillusveneris from different producing areas were significantly different.  
        关键词：Adiantum capillusveneris;HPLC-DAD;Fingerprint;Chemometric analysis;Differential component;Content   
        31
        |
        4
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619682 false
        发布时间：2022-06-21
      • QU Tingli,LIU Teng,ZHENG Qian,LU Xiaolin,ZHAO Zhengbao,LI Zhenyu
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To study metabonomics of secondary components of Astragalus membranaceus injection on leukopenia model mice. METHODS ：The mice were divided into normal group ，model group ，A. membranaceus injection group （0.004 mL/g），secondary components low-dose ，medium-dose and high-dose groups （0.004，0.008，0.016 mL/g），with 7 mice in each group. Except for normal group ，other groups were given cyclophosphamide （80 mg/kg） intraperitoneally to induce leukopenia model. After modeling ，administration groups were given relevant medicine intraperitoneally ，and normal group and model group were given constant volume of sterile water for injection intraperitoneally ，once a day ，for consecutive 7 days. During the experiment ，the changes of body weight of mice were measured every 2 days. After the last administration ，the blood routine indexes [white blood cell （WBC），neutrophil（NE），lymphocyte（LY）and monocyte （MO）counts] of mice were detected by animal blood analyzer. UPLC-Q Exactive Orbitrap-HRMS combined with multivariate statistical analysis were used to analyze the metabonomics of mice serum. RESULTS ：Compared with model group ，body weight of mice in the secondary component low-dose group increased significantly on the 4th and 8th day of administration （P＜0.05），and the counts of WBC ，NE，LY and MO in serum of mice in secondary component groups increased significantly （P＜0.05 or P＜0.01）. Metabonomic analysis showed that the secondary components of A. membranaceus injection could significantly regulate the contents of 8 endogenous metabolites in serum， including spermidine ， uric acid ， citric acid ， nicotinamide， eicosapentaenoic acid ， linoleic acid ， erucamide and sphingosine-1-phosphate. Their effects involved linoleic acid metabolism pathway ，nicotinic acid and nicotinamide metabolism pathway and tricarboxylic acid cycle pathway. CONCLUSIONS ：The secondary components of A. membranaceus injection possess the effect of increasing white blood cells in leukopenia model mice ，the mechanism of which may be related to intervention of linoleic acid metabolism pathway ， nicotinic acid and nicotinamide metabolism pathway ，and tricarboxylic acid cycle pathway.  
          
        42
        |
        6
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619507 false
        发布时间：2022-06-21
      • HUANG Yuankai,CHEN Lei,LI Ying,XI Xiaoyu
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To construct a calculation method which can accurately reflect the medical insurance fund expenditure of intervention scheme for cross-year survival patients ，and to provide reference for the research of medical insurance budget impact analysis（BIA）. METHODS ：Based on survival data of cohort model ，taking the patients diagnosed in each cycle in each year as a cohort，the number of per capita survival cycle of cohort patients in each state in the study year was calculated ，i.e. the average survival time ；on this basis ，the total cost of patients in all cohorts in the study year was calculated according to the number of people in each cohort and the per capita cost each cycle in each state. Taking the intervention scheme of a cancer as an example ， the calculation was carried out by the established algorithm ，and the calculation results were compared with the results of several common algorithms ；at the same time ，the application suggestions were put forward for the expansion of the constructed algorithm in special cases. RESULTS & CONCLUSIONS ：Compared with the several common algorithms ，the calculation process of the constructed algorithm is more in line with the process of medical insurance fund expenditure related to drug intervention scheme in the real world ，and it can flexibly adapt to the calculation needs in a variety of special situations. This algorithm can more accurately calculate the medical insurance fund expenditure of a intervention scheme in a specific year ，and to a certain extent solve the problem of inaccurate prediction of medical insurance fund expenditure due to insufficient consideration of cross-year survival patients or simple and rough calculation process. It can provide a more accurate method choice for the research of medical insurance BIA in China.  
        关键词：Budget impact analysis;Cross-year survival;Medical insurance fund expenditure;Calculation method;Survival   
        65
        |
        6
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619671 false
        发布时间：2022-06-21
      • HU Jie,YANG Chaojin,HE Xingsong,MING Zheng,XIE Zhihui
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To investigate the effects and mechanism of Jidesh eng anti-venom tablet on local wound inflammation and systemic inflammatory response of snake bite patients. METHODS ：Totally 64 patients with snake bite admitted to our hospital during Jun. 2018-Jun. 2020 were randomly divided into control group and observation group ，with 32 cases in each group. Both groups received routine treatment ，such as debridement ，drainage，flushing，sealing，anti-venom，anti-infection，anti-fibrinolysis and anti-shock. Observation group was additionally given Jidesheng anti-venom tablet for internal and external use ，for consecutive 7 d. Related indexes of systemic inflammatory response ，local wound condition ，hospital stay ，laboratory indexes of important organs，coagulation function index ，wound inflammatory cell counts ，serum levels of inflammatory cytokines and chemokine ，the occurrence of ADR were compared between 2 groups. RESULTS ：After treatment ，most of related indexes of systemic inflammatory response （RR，HR and WBC ），local wound condition （local pain disappearance time ，wound detumescence time ）， hospital stay ，laboratory indexes of important organs （AST，ALT，Scr，BUN，CKB，CK-MB），coagulation function index （t-PA， PAI-1，TAT，SFMC），wound inflammatory cell （macrophages，neutrophils，lymphocytes）count，serum levels of inflammatory cytokines（TNF-α，IL-1，IL-6，hs-CRP，NF-κB）and chemokine （MCP-1，CXCL-8）in 2 groups were significantly better than before treatment （P＜0.05）；most indexes of observation group were significantly better than those of control group （P＜0.05）. No severe ADR was found in 2 groups. CONCLUSIONS ：Jidesheng anti-venom tablet as auxiliary treatment can significantly reduce the local wound inflammation and systemic inflammatory response of snake bite patients ；the mechanism is probably related to reducing the levels of chemokine MCP- 1 and CXCL- 8 and inflammatory cytokines hs-CRP and NF-κB.  
          
        68
        |
        1
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619659 false
        发布时间：2022-06-21
      • ZHANG Tian,LI Ting,WU Lili,PEI Yifang,TAN Ling
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To evaluate the efficacy ，safety and econom y of donepezil in the treatment of Alzheimer ’s disease （AD），so as to provide evidence-based evidence for clinical rational drug use. METHODS ：Retrieved from PubMed ，Embase，the Cochrane Library ，CNKI，Wanfang database ，CBM and health technology assessment （HTA）organization websites ，systematic review/Meta-analysis，economic evaluation and HTA reports about donepezil in the treatment of AD were collected during the inception to Feb. 2021. Data extraction and quality evaluation were carried out for the literature that met the inclusion and exclusion criteria，and the research results were summarized and analyzed qualitatively. RESULTS ：A total of 26 studies were included ， including 15 systematic reviews/Meta-analysis ，and 11 economic studies ；HTA reports were not included. The results showed that in terms of effectiveness ，compared with placebo ，donepezil could significantly improve the cognitive function ，activity of daily life，mental behavior and overall function of AD patients （P＜0.05）；compared with rivastigmine ，donepezil could significantly improve cognitive function of AD patients （P＜0.05）；compared with galantamine ，donepezil could significantly improve cognitive function and overall function （P＜0.05），but there was no statistical significance in terms of improving mental behavioral symptoms（P＞0.05）；there was no statistical significance between donepezil and memantine in improving cognitive function ， psychobehavioral symptoms and activities of daily living in AD patients （P＞0.05），but donepezil was weaker than memantine in overall functional （P＜0.05）. In terms of safety ，there was no significant difference in the tolerance and mortality in patients using donepezil and placebo （P＞0.05）；donepezil was better tolerated than rivastigmine and galantamine （P＜0.05）；there was no significant difference in the incidence of ADR for donepezil compared with placebo ， metamine and other non-placebo mail：15201008872@163.com controlled drugs （P＞0.05）. Economic studies showed that # compared with rivastigmine ，placebo and no AD-related drug treatment，donepezil could prolong quality adjusted life years （QALY）and saved medical costs ，which was more cost-effective. Compared with conventional treatment for basic disease and memantine，although donepezil could prolong QALY ，whether it had economic advantages still needed to confirmed in combination with national or regional health resource conditions. CONCLUSIONS ：Donepezil is ralatively effective ，safe and economical in the treatment of AD.  
        关键词：Donepezil;Alzheimer’s disease;Efficacy;Safety;Economy;Rapid health technology assessment   
        67
        |
        7
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619646 false
        发布时间：2022-06-21
      • ZHAO Chengsi,YAO Weijie,PENG Bo,YANG Yafei,LAN Zhu,DONG Tongtong,SHI Jinping,WANG Zuozheng
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To overview the systematic review on the effectiveness of indomethacin in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis （PEP），and to provide reliable evidence-based reference for the prevention of PEP. METHODS ：Retrieved from PubMed ，the Cochrane Library ，Embase，CBM，CNKI，Wanfang database and VIP，systematic review on indomethacin in the prevention of PEP were collected during the inception to Nov. 2020. The methodological quality ，report quality and evidence quality of the included studies were evaluated by AMSTAR 2 scale，PRISMA statement and GRADE method. The effectiveness of PEP prevention was described. RESULTS ：Finally，23 systematic reviews were obtained ，including 12 in Chinese and 11 in English. Tweenty-two systematic reviews showed that compared with placebo ， indomethacin could effectively reduce the incidence of PEP. Eight systematic reviews showed that indomethacin significantly reduced the incidence of moderate and severe PEP compared with placebo. Five systematic reviews showed that indomethacin could reduce the incidence of postoperative hyperamylasemia compared with placebo. Three systematic reviews showed that indomethacin also had a good preventive effect on people with high risk of PEP. PRISMA score of included systematic reviews ranged from 15 to 25. The quality evaluation of AMSTAR 2 methodology included in systematic reviews was low ，and the key items of complete report were 4，9，11 and 13. The GRADE evidence quality evaluation of the included systematic reviews showed that the quality of the evidence was concentrated in the low level. CONCLUSIONS ：Indomethacin has a certain effect in the prevention of PEP ，but the overall evidence quality of the included literatures is generally not high. It needs to be further validated by high-quality clinical research.  
          
        43
        |
        6
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619631 false
        发布时间：2022-06-21
      • WEI Ting,DU Saifei,LIU Bin,ZHANG Li,YANG Ning,YU Yuncui,WANG Xiaoling
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To reevaluate the guidelines/cons ensus，systematic review/Meta-analysis of proton pump inhibitors （PPIs）in the prevention of drug-induced gastrointestinal injury ，and to provide evidence-based reference for its clinical use. METHODS： The relevant guidelines/consensus and systematic review/Meta-analysis literatures at home and abroad were systematically reviewed ，and the re evaluation was carried out from the effectiveness ，safety and economy dimensions to analyze the current situation of clinical use of PPIs in the prevention of drug-induced gastrointestinal injury in adults and children. RESULTS ： A total of 14 clinical guidelines/consensus and 10 systematic review/Meta-analysis literatures of PPIs for the prevention of drug-related gastrointestinal injury at home and abroad were sorted out and included. In terms of effectiveness ，PPIs could prevent various drug-related gastric mucosal damage ，gastrointestinal bleeding and other damage to the digestive tract ，but PPIs had not yet obtained the indication for children in China ；PPIs were widely used in the treatment of children ’s digestive tract diseases ，which belonged to off-label medication. In terms of safety ，the common adverse reactions of PPIs included headache ，gastrointestinal symptoms，etc. There may be risks of kidney disease and fracture during long-term application. In terms of economy ，for some patients with digestive tract and cardiovascular disease risk ，the economic benefit of NSAIDs combined with PPIs were higher ； esomeprazole 20 mg and 40 mg daily were equally effective in preventing ulcer recurrence caused by NSAIDs ，but increasing the dose could not improve the preventive effect. CONCLUSIONS ：The preventive effect of PPIs on drug-induced gastrointestinal injury is supported by evidence-based evidence. It has good safety in adults and has certain economic benefits ；but it belongs to off-label drug use in children in China ，and the safety and economy still need to refer to the results of adult studies. In the future ，a number of multicenter prospective clinical studies based on Chinese pediatric population are still needed to provide more support for the prevention and treatment of drug-induced gastrointestinal injury by PPIs in children.  
          
        101
        |
        2
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619612 false
        发布时间：2022-06-21
      • ZHUANG Wei,YAN Suying,LIN Xiaolan,CHEN Fei,GAO Li,FENG Yingnan,TANG Jing,JIA Beibei,CHU Yanqi
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To est ablish the working mode of the first pharmaceutical ward rounds of clinical pharmacists in our hospital，in order to provide a useful reference for establishing a national standardized pharmaceutical ward rounds model. METHODS：By sharing the clinical cases of the first pharmaceutical ward rounds ，the work content and process of the first pharmaceutical ward rounds in our hospital were introduced. RESULTS & CONCLUSIONS ：The clinical pharmacist ’s first pharmaceutical ward round in our hospital mainly includes self introduction of clinical pharmacists ，diagnosis of patients ’condition under the guidance of doctors ，collection and evaluation of patients ’previous medication information （including previous medication varieties ，usage methods ，efficacy and safety evaluation ），assistance for doctors in formulating initial treatment plan ， carrying out initial medication and diet education ，and intensive communication and cooperation with nurses. The development of first pharmaceutical ward rounds promotes the rational use of drugs in clinic ，elevates the hospitalization satisfaction of patients and improves the professional quality of clinical pharmacists.  
        关键词：Clinical pharmacists;First pharmaceutical ward rounds;Working mode;Standardized pharmaceutical ward round   
        89
        |
        1
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619597 false
        发布时间：2022-06-21
      • YANG Silu,LIU Bo,XU Fan
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To dev elop and apply a parenteral nutrition prescription decision support system for medical institutions and provide theoretical basis for improving clinical parenteral nutrition precision treatment. METHODS ：Based on the review points of parenteral nutrition prescription ，the parenteral nutrition prescription decision support system was designed ；the function points and prescription review logic of each module of the system were discussed ，and the system was also used to review 100 pieces of clinical parenteral nutrition prescriptions. RESULTS ：Information-based parenteral nutrition prescription decision support system included evaluation index management module ，drug management module ，index knowledge management module ， index calculation and evaluation module ，feedback and tracking module. The logic of parenteral nutrition prescription review were based on the evaluation indexes ，and rationality knowledge base ，safety knowledge base and drug attribute base were constructed. Based on the above knowledge bases ，patient information and prescription information call and calculation ，the evaluation result set of safety and rationality of the prescription was finally formed. Based on this design concept ，the parenteral nutrition prescription decision support system realized the automatic review and warning of various indicators in TNA prescription ，and can quickly and efficiently review the safety and rationality of parenteral nutrition prescription. Through manual judgment ，the audit results of 100 prescriptions by the system were all correct. CONCLUSIONS ：The basis of parenteral nutrition prescription review is the formulation of evaluation indexes ，and the technical difficulty lies in considering the individuality and rationality as well as the safety and stability of parenteral nutrition solution at the same time. The application of a well-structured information system will promote the precise and reasonable medication of parenteral nutrition and improve work efficiency of medical personnel.  
        关键词：Parenteral nutrition;Prescription review;Informatization;System   
        84
        |
        8
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619588 false
        发布时间：2022-06-21
      • LI Xiao,QIU Bo,REN Bingnan,DONG Zhanjun
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To promote the safe use of severe ADR-inducing drugs in special population in our hospital. METHODS：According to detailed quantitative scoring rules of Quick Guide for Drug Evaluation and Selection in Chinese Medical Institutions，comprehensive evaluation database of drugs in our hospital was established. Drugs with ADR rating or ADE general terminology standard rating of 1，2，3 and 4 under the "safety" dimension were obtained from the database. According to the difference of the incidence of ADR ，4 kinds of severe ADR-inducing drugs ，such as very common （incidence≥10％），common （incidence 1％-＜10％），occasional（incidence 0.1％-＜1％）and rare （incidence ＜0.1％），were obtained. According to the quantitative scores of these 4 kinds of drugs in six special groups ，such as children ，pregnant women ，lactating women ，the elderly，patients with abnormal liver function ，and patients with abnormal kidney function ，the feasibility for special population to use drugs that cause severe ADR was analyzed. RESULTS ：Among 1 172 chemical drugs in drug comprehensive evaluation database of our hospital ，18，73，61，and 357 kinds can cause very common ，common，occasional and rare severe ADR ， respectively. Among them ，the incidence of severe ADR caused by tumor drugs was high ，so it was necessary to pay close attention to the use of tumor drugs in special populations. Totally 173 kinds of drugs were prohibited for children because the instructions clearly showed organ toxicity ，cytotoxicity and there were no guidelines recommending their use in children ，so the clinical medication should be used with extraordinary caution. There were 278 and 228 drugs prohibited for pregnant women and lactating women，which were prohibited for pregnant or lactating period due to embryonic toxicity and reproductive toxicity. There were 13 prohibited drugs for the elderly ，most of which were specialized drugs. Five kinds of drugs were prohibited in patients with abnormal liver function and seven were prohibited in patients with abnormal kidney function ，most of which were tumor drugs with strong hepatorenal toxicity. CONCLUSIONS ：Established quantitative score system can provide effective guidance for the safe use of severe ADR-inducing drugs among 6 special populations as children ，pregant women ，lactating women ，the elderly ，the patients with abnormal liver function and the patients with renal  
          
        773
        |
        2
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619577 false
        发布时间：2022-06-21
      • SU Yachun,JIANG Zhiwei
        Vol. 32, Issue 17, (2021)
        摘要：OBJECTIVE：To explore n ew ideas for the intell igent development of pharmaceutical care under the background of “Internet + ”. METHODS ：Through the exploration and practice of “Internet + pharmaceutical care ”mode in Jiangsu Provincial Hospital of TCM ，the management and experience of “Internet + pharmaceutical care ”were combed out ，the results were summarized，and new thinking was put forward. RESULTS & CONCLUSIONS ：After conducting “Internet+pharmaceutical care ” practice for more than three years ，the hospital had shifted from offline services to “offline + online ”services，and drugs were delivered on line ；the mode had improved patient satisfaction ，closely connected doctors ，pharmacies and patients ，and explored new pharmaceutical care pattern of oversea anti-epidemic ，full played the advantages of pharmaceutical care in Internet healthcare ； embodies the value of pharmaceutical care ，and promoted new ecosystem of pharmaceutical care. Under the background of “Internet+”，it is necessary to let the three pronged approach （management of prescription ，drug quality and logistics enterprises ） become the key point of “Internet+pharmaceutical care ”，let data enhance the competitiveness of pharmaceutical services ，enable independent innovation to promote pharmaceutical development ，and make intelligent medicine become an innovative entry point for promoting pharmaceutical development ，constantly explore a new prospect of integrated development of medical health and information technology.  
        关键词：Internet +;Pharmaceutical care;Intelligent pharmacy;Information productivity   
        772
        |
        3
        |
        0
        <HTML>
        <L-PDF><Meta-XML>
        <引用本文> <批量引用> 27619569 false
        发布时间：2022-06-21
      0