最新刊期
卷 32 ， 期 5 ， 2021
- 摘要：OBJECTIVE：To study general chara cteristics and medication of medical damage liability disputes cases caused by medication error ， and to provide references for related departments and medical staff for preventing and reducing medication-induced medical disputes. METHODS ：A total of 240 cases of medical damage liability disputes cases caused by medication error were collected from Peking University ’s Fabao Law Database during Jan. 2001 to Feb. 2020，and analyzed in terms of general situation ，damage outcome ，level of the hospital involved ，liability judgment and compensation ，types of medication error and drug types. RESULTS ：medication-related medical damage liability disputes accounted for 25.3％ of overall medical damage disputes ；the most damage result of patients was death （68.3％）；medical negligence forensic appraisal was conducted as the main appraisal pattern with a proportion of 57.9％；the average case compensation was 203，000 yuan；the hospitals involved were mainly tertiary hospitals （48.8％）；the main type of medication error involved was prescription error ； chemical medicine was mainly involved ，of which the top three categories were systemic antibacterial ，systemic corticosteroids and antipsychotics. CONCLUSIONS ：ADR caused by medication errors are the common causes of medical disputes. Medical institutions should focus on improving the relevant systems and processes ，strengthen the construction of pharmaceutical information and automation system ，and reduce the probability of medication errors ；at the same time ，great importance should be paid to the cultivation of pharmaceutical talents in hospital ，give full play to the role of pharmacists ，and strengthen the monitoring and intervention of medication errors. Finally ，the relevant national judicial departments should constantly improve the settlement mechanism of medical damage liability disputes to provide reasonable protection for both doctors and patients.关键词：Medication error;Medical damage liability dispute;Medication safety
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the r elationship between corporate social responsibility ，financing constraints and corporate performance of listed pharmaceutical companies ，so as to provide reference for pharmaceutical enterprises to fulfill their social responsibility in China. METHODS ：Taking 211 A-share listed pharmaceutical companies in China from 2015 to 2018 as samples ， using corporate performance as explained variables ，corporate social responsibility and financing constraints as explanatory variables，asset size ，equity nature ，growth，R&D investment ，marketing investment and annual as control variables ，a multiple regression equation was constructed to study the relationship among corporate social responsibility performance ，financial constraints and corporate performance and put forward the suggestions. RESULTS ：Corporate social responsibility had a significant positive impact on corporate financial performance ；in the promotion of corporate social responsibility on corporate performance ， finacing constratins couldn ’t inhibit the promote function. CONCLUSIONS ：In China ’s pharmaceutical industry ，the awareness of corporate social responsibility needs to be improved ；pharmaceutical enterprises actively perform social responsibility will interactively promote corporate performance. The overall financial constraints faced by Chinese pharmaceutical enterprises are not high，and enterprises which facing financial constraints will better improve their performance by fulfilling corporate social responsibility. It is suggested that the government should promote the legislative process of corporate social responsibility ； pharmaceutical enterprises should enhance the awareness of social responsibility and pay attention to the impact of financing constraints；investors should pay real-time attention to the responsibility information and actual performance of pharmaceutical enterprises.关键词：Listed pharmaceutical company;Corporate social responsibility;Financing constraints;Corporate performance
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To k now about t he current situation of pre-prescription review in medical institutions in China ，and provide reference for quality improvement of pre-prescription review in medical institutions. METHODS ：Retrieved from PubMed ， the Cochrane library ，EMbase（Ovid platform ），CNKI，CBM，VIP and Wanfang databases ，the studies about pre-prescription review in medical institutions in China were collected during the inception to Mar. 2020. After data extraction of the literatures met the inclusion and exclusion criteria ，descriptive analysis was used. RESULTS ：A total of 38 literatures were included ，involving 29 medical institutions ，of which 25 were third-grade class-A medical institutions （86.21％），22 comprehensive medical institutions （75.86％）；pre-prescription review was carried out from 2007 to 2019. Totally 84.62％ of medical institutions adopted the mode of “systematic review+manual review ”，and the main audited prescriptions were outpatient （emergency）prescriptions（76.00％）. Medical institutions adopting this mode mainly adopted the mode that auditing pharmacists rechecked the problem prescriptions intercepted by the system. The average manual review time of problem prescriptions in 8 medical institutions was within 60 s；the number of auditing pharmacists in 16 reported medical institutions ranged from 1 to 8，and educational degree of auditing pharmacists in 1 reported medical institution were bachelor degree or above. Their professional titles of 6 reported medical institutions were junior or above （83.33％）. Eleven medical institutions had full-time auditing posts （90.91％）. Success rate of problem prescription intervention was 93.99％ ；pre-prescription review could increase the qualification rate of prescription. CONCLUSION：The pre-prescription review in medical institutions in China has achieved certain results ，but still faces some problems，such as imperfect information system ，insufficient ability of auditing pharmacists and poor communication between doctors and pharmacists ，which will be the aspects that should be paid attention to in the future.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To provide reference for improving the continuing education system for licensed pharmacists in China by learning from the mature experience of the continuing education system of licensed pharmacists in the UK. METHODS ： Literature research method was adopted to summarize and analyze the organizational structure ，specific contents and implementation methods of the continuing education system for licensed pharmacists in the UK by combing the English and Chinese literatures ， official policies and reports of the continuing education system for licensed pharmacists in the UK. The suggestions and reflections were put forward to improve the continuing education system of licensed pharmacists in China. RESULTS & CONCLUSIONS ：The management organization of continuing education system for licensed pharmacists in the UK is mainly UK Association of Boards of Pharmacy，the organizations of which provide continuing education include pharmacy associations ，pharmaceutical education institutions，pharmaceutical colleges and universities. Continuing education system of licensed pharmacists in the UK is relatively perfect，including personal needs analysis ，systematic continuing education courses ，self-education and evaluation reflection of licensed pharmacists ，forming a systematic circulation system ；continuing education is carried out for pharmacists in different practicing fields ，with equal emphasis on theory and practice. In terms of continuing education ，the UK focuses on face-to-face ， one-to-one training ，and provides many free continuing education courses. Compared with the UK ，the continuing education system of licensed pharmacists in China still has some gaps. For example ，the self-education and self-evaluation awareness of licensed pharmacists is not strong ，the content and form of continuing education lack of pertinence and practicality ，and the re-registration management of pharmacists ’practicing qualifications is more formalistic. It is recommended that licensed pharmacists in China establish the concept of self-education ，strengthen the practicality of continuing education for pharmacists ，carry out refined continuing education for pharmacists in different fields of practice ，and strengthen the management of re-registration of licensed pharmacists，so as to form a systematic and effective circulation system for continuing education of licensed pharmacists in China.关键词：UK;Licensed pharmacist;Continuing education system;Enlightenment
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To improve the quality standard of M ongolian med icine Artemisia sacrorum ，and to provide scientific basis for comprehensive quality evaluation. METHODS ：The appearance and microscopic characteristics of A. sacrorum were identified；scopoletin，chlorogenic acid ，caffeic acid ，scopoletin and 3，5-dicaffeoylquinic acid were identified quantitatively by TLC；the contents of above 5 components were determined by HPLC. The water content ，total ash and extract were examined. RESULTS：The stem of A. sacrorum was cylindrical ，and its surface was purple or purple-brown or cyan-brown ；the leaves were ovate or oblong-ovate ，fragrant；the flowers were yellow ，head-shaped，subglobose or hemispherical. The powder was green or yellow-green，its pollen grain had three germination ；the parenchymal cell clusters with sharp edges and numerous threaded ducts ， occasionally having marginal pitted ducts ；its wood fibers were in bundles mostly. Results of TLC showed that the spots of the same color were found in the corresponding positions of chromatogram for 5 substance control and samples. The linear range of scopoletin， chlorogenic acid ， caffeic acid ， scopolactone and 3，5-dicaffeoylquinic acid were 85.60-428.00， 10.16-101.60， 10.20-102.00，40.84-408.40 and 40.80-408.00 μg/mL（all r＞0.999 0）. RSDs of precision ，stability，repeatability tests were all less than 3.00％（n＝6）. The average recoveries were 103.07％，99.66％，98.37％，97.78％，98.40％（all RSDs ＜3.00％，n＝6）. The contents of the above-mentioned 5 compounds in 10 batches of samples were 0.36％-1.23％，0.09％-0.51％，0.04％-0.13％， 0.61％ -1.13％ ，0.12％ -1.11％ ，respectively；the average com contents of water ，total ash and water soluble extract were 6.25％，5.86％，26.50％，respectively. CONCLU SIONS：O the basis of the original quality standard of A. sacrorum ， microscopic identification，TLC identification ，content determination and examination items of water ，total ash and extract are added. The method shows good precision ，accuracy and stability ，which can provide reference for more scientific and standardized evaluation of the quality of this medicinal material.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To esta blish a method for determining the contents of lupenone and stigmasterol in the rhizome ，stem and leaf of Mosa basjoo from the same plant ，and to provide reference for the substitute resource for the effective components of M. basjoo . METHODS ：UPLC method was adopted. The determination was performed on Zorbax Rrhd Eclipse Plus C 18 column （100 mm×2.1 mm，1.8 μm）with mobile phase consisted of acetonitrile-methanol （78.5∶21.5，V/V）. The detection wavelength was set at 210 nm；the flow rate was 0.15 mL/min；the column temperature was 30 ℃ and the sample size was 1 μL. The results of content determination of lupinone and stigmasterol in the rhizome ，stem and leaf of 9 batches of M. basjoo from the same plant were analyzed by the methods of comparative analysis between groups ，principal component analysis and cluster analysis. RESULTS：The mass concentration of lupenone and stigmasterol had a good linear relationship with the corresponding peak area within the range of 11.16-357.10 and 8.83-160.40 g/mL（R2 were 0.999 2 and 0.999 1，respectively）. RSDs of precision ， repeatability and stability tests were all less than 3％. The average recovery rates of lupenone and stigmasterol were 101.44％ and 98.32％，and the RSDs were 1.77％ and 1.81％（n＝6），respectively. The average contents of lupenone and stigmasterol in stems of M. Basjoo were significantly higher than those of rhizome and leaves of M. basjoo （P＜0.05）. There was no statistical significance in the contents of lupenone and stigmasterol between stem and leaf of M. basjoo from same plant （P＞0.05）. Results of principal component analysis showed that the contents of lupanone and stigmasterol were different in rhizome ，stem and leaf of M. basjoo from the same plant. Rhizome ，stem and leaf of M. basjoo were divided into three types through cluster analysis ，among which the rhizome had significant difference with the other two parts. CONCLUSIONS ：The method is simple ，rapid，specific， reproducible and accurate. It can be used for the content determination of lupenone and stigmasterol in different parts of M. basjoo . The stem of M. basjoo can replace the rhizome of M. basjoo as the source of lupinone and stigmasterol.关键词：Mosa basjoo;Medicinal part;UPLC;Content determination;Principal component analysis;Cluster analysis
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the effect of Cangfu daotan pill （CDP）containing serum on autophagy of ovarian granulosa cells（GCs）of rat. METHODS ：Three-month-old SD rat were divided into normal saline group （normal saline ，ig），FSH injection group（10.71 IU/kg，ih），CDP irrigation high-dose ，medium-dose and low-dse groups [ 0.5，1，2 mg/g（by crude drug ），ig]，with 6 rats in each group. They were given relevant medicine subcutaneously/intragastrically ，once a day ，for consecutive 3 days. After last medication ，blood sample was collected from the abdominal aorta to obtain drug-containing serum. GCs of rat were divided into blank control group ，model group ，FSH group （positive control ）and CDP high-dose ，medium-dose and low-dose groups. The autophagy model was induced by giving testosterone propionate ，except that the blank control group was directly added with 100 μL serum of normal saline group. Then model group was given 100 μL serum of normal saline group，and administration groups were given 100 μL drug-containing serum of corresponding drug group. The contents of estradiol（E2）and progesterone （P）in supernatant of cells were determined by ELISA. Western blot assay was used to detect protein expression of PI 3K，Akt and mTOR in cells. The mRNA expression of PI 3K，Akt，mTOR，Beclin 1，LC3Ⅰ，LC3Ⅱ and p 62 were detected by RT-PCR. RESULTS ： Compared with blank control group ，the content of E 2 in supernatant ，relative mRNA and protein expression of PI 3K，Akt and mTOR were decreased significantly in model group （P＜0.01），while relative mRNA expression of Beclin 1，LC3Ⅰ and LC 3Ⅱ were increased significantly （P＜0.01）. Compared with model group ，the content of E 2 in supernatant were significantly increased in FSH group ，CDP medium-dose and high-dose groups ，while relative mRNA expression of Beclin 1，LC3Ⅰ，LC3Ⅱ and p 62 were decreased significantly （P＜0.05 or P＜0.01）；relative mRNA and protein expression of PI 3K，Akt and mTOR were increased significantly in administration groups （P＜0.05 or P＜0.01）. CONCLUSIONS ：CDP can inhibit autophagy of GCs by activating related protein and mRNA expression of PI 3K/Akt/ mTOR signaling pathway.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the mechanism of H uanglian jiedu decoction （HJD）regulating macrophage polarization in order to explore its anti-inflammatory mechanism. METHODS ：The active components and predicted targets of HJD were screened through TCMSP and Swiss Target Prediction database ；the related targets of macrophage polarization were obtained by GeneCards and OMIM database ，and the network diagram of active ingredient-macrophage polarization target of HJD was drawn by using Cytoscape 3.6.0 software；protein interaction network was constructed by String database and core targets were extracted. Gene ontology（GO）enrichment analysis and Kyoto Encyclopedia of genes and genomes （KEGG）pathway enrichment analysis were carried out by using Cytoscape 3.6.0 software and DAVID website. Combined with the results of network pharmacology analysis ， RAW264.7 macrophage cells were divided into blank control group ，model group ，simvastatin group （10 μmol/L）and serum containing HJD group （obtained from the blood after the rats were given HJD at the dose of 10 g/kg）. Except the blank control group and model group were added culture medium ， the other groups were added with 100 μ L of relevant drug solution or serum containing drug. After 2 h of culture ，except for the blank control group ，LPS solution （100 μg/L）was added to the other groups for 24 h to induce inflammation. Western blot assay was used to detect the expression of AMPK. mRNA expression of M 1 type polarization factor （IL-1 β，iNOS）and M 2 type polarization factor （IL-10，Fizz1）were detected by RT-PCR. RESULTS ：A total of 50 active components of HJD （such as acacetin ，wogonin，quercetin，β-sitosterol）were screened ， which could regulate macrophage polarization through 12 GO items （such as anoikis ，astrocyte activation ），and 20 KEGG pathways（such as estrogen signaling pathway ，bladder cancer pathway ，AMPK signaling pathway ）. The results of cell test showed that compared with blank control group ，the expression of AMPK protein ，Fizz1 and IL- 10 mRNA in model group were significantly decreased （P＜0.01），while the expression of IL- 1β and iNOS mRNA were significantly increased（P＜0.01）； compared with model group ，the expression of AMPK protein ，Fizz1 and IL- 10 mRNA in serum containing HJD group and simvastatin group were significantly increased （P＜0.05 or P＜0.01），while the expression of IL- 1β and iNOS mRNA were significantly decreased （P＜0.01）. CONCLUSIONS ：HJD can regulate macrophage polarization through multiple targets and pathways；it can up regulate the expression of M 2-type polarization factors and down-regulate the expression of M 1-type polarization factors through AMPK signaling pathway ，regulate macrophage polarization and play an anti-inflammatory role.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To establish HPLC fingerprint of Coptis chinensis inflorescence，and study its spectrum-effect relationship with antioxidant and antibacterial effects. METHODS ：Taking 14 batches of C. chinensis inflorescence from different producing areas as the object ，HPLC method was adopted. The determination was performed on Supersil C 18 column with mobile phase consisted of acetonitrile- 0.1％ phosphoric acid solution（gradient elution ）at the flow rate of 1.0 mL/min. The column temperature was set at 25 ℃. The detection wavelength was set at 329 nm，and sample size was 10 μL. The fingerprints of 14 batches of C. chinensis inflorescence were established by Similarity Evaluation System of TCM Fingerprint （2012 A edition ），and the similarity evaluation and common peak identification were carried out. Taking DPPH free radical scavenging rate and hydroxyl radical scavenging rate as antioxidant effects index ，relative antibacterial activity （Escherichia coli ）as antibacterial effect index ， SPSS 21.0 software was adopted to analyze the Pearson correlation between common peaks of C. chinensis inflorescence and above efficacy indexes ；their spectrum-effect relationship was established and validated. RESULTS ：A total of 7 common peaks were obtained in HPLC fingerprint of C. chinensis inflorescence，and the similarity was no less than 0.916. No. 5 peak was identified as berberine hydrochloride. Seven common peaks were positively correlated with DPPH free radical scavenging rate ；No. 1-3，4，6，7 peaks were positively correlated with hydroxyl radical scavenging rate ，while No. 5 peak was negatively correlated with hydroxyl radical scavenging rate. There was a positive correlation between No. 5 peak and antibacterial activity in vitro . After validation ， relative error between the predicted values and the measured values of DPPH free radical scavenging rate ，hydroxyl radical scavenging rate and relative antibacterial activity was 0.92％- 14.5％ . CONLUSIONS ：The established spectrum-effect relationship model can be used to evaluate antioxidant andantibacterial effects of C. chinensis inflorescence. The chemical components represented by No. 1，2，3，4，6，7 peaks are the material basis of antioxidant effect of C. chinensis inflorescence， and berberine hydrochloride is the material basis of antibacterial effect.关键词：Coptis chinensis inflorescence;HPLC;Fingerprint;Antioxidant activity;Antibacterial activity;Material basis
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To establis h the UPLC fingerprint of Poria co cos aqueous extract ，and to investigate its relationship with sedative and hypnotic effect. METHODS ：Ten batches of P. cocos from different areas were extracted with water to obtain the aqueous extract. UPLC method was adopted. The determination was performed on Waters HSS-C 18 column with mobile phase consisted of 0.1％ phosphoric acid solution-acetonitrile-methanol （gradient elution ） at the flow rate of 0.4-0.2 mL/min. The detection wavelengths were set at 210 and 242 nm. The column temperature was 40 ℃，and sample size was 2 μL. The fingerprints of 10 batches of P. cocos aqueous extracts were established by using the Similarity Evaluation System of TCM Fingerprint （2012A version），and the common peaks were identified. The sedative and hypnotic effects of 10 batches of P. cocos aqueous extracts from different areas under the synergistic action of pentobarbital sodium were investigated by taking the sleeping rate ，sleep latency and sleep duration of mice as the single efficacy index. After data transformation of single efficacy index and total efficacy （single indexes calculated by analytic hierarchy process ），grey correlation analysis was used to analyze the correlation between the common peaks in fingerprint of P. cocos aqueous extract and the single efficacy index and total efficacy. RESULTS ：There were 24 common peaks in 10 batches of aqueous extract of P. cocos ， and 11 components were identified ， i.e. 16 α-hydroxydehydrotrametenolic acid （peak 6），16α-hydroxytrametendic acid （peak 7），poricoic acid B （peak 9），dehydrotumulosic acid（peak 10），poricoic acid A （peak 12），polyporenic acid C （peak 15），3-O-acetyl-16α-hydroxydehydrotrametenolic acid （peak 17），dehydropachymic acid （peak 20），pachymic acid （peak 21），dehydrotrametenolic acid （peak 22），dehydroeburicoic acid （peak 24）. Grey correlation analysis showed ，the correlation between 24 peaks and sleep duration was greater than 0.6（0.611 5- 0.811 8）；the correlation between 24 peaks and sleep latency was greater than 0.6（0.605 9-0.790 4），except for peaks 14，24 and 2；the correlation of 24 peaks between sleeping rate was greater than 0.6（0.606 4-0.721 6），except for peaks 23，19，17 and 5； the correlation of 24 peaks between total efficacy was greater than 0.6（0.619 0-0.781 2），except for peaks 2，5，19. The top 10 chromatographic peaks related to the total efficacy were peak 15（polyporenic acid C ），peak 16，peak 8，peak 11，peak 12 （poricoic acid A ）， peak 1， peak 7 （16 α-hydroxytrametendicacid）， peak 3， peak 9 （poricoic acid B ） and peak 20 （dehydropachymic acid ）. CONCLUSIONS ：UPLC fingerprint of P. cocos aqueous extract was established and 11 components were identified. Ten components such as polyporus acid C are closely related to the total efficacy of sedation and hypnosis ，which preliminarily reveal the material basis of the sedative and hypnotic effect of P. cocos .
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To investigate the activity of lycorine to the in vivo apoptosis of tumor cells in H 22-bearing mice and its mechanism. METHODS ：Kunming mice were inoculated subcutaneously with ascites of H 22 hepatoma mice in the armpit of forelimb to establish solid tumor model. After modeling ，mice were randomly divided into negative control group ，positive control group（hydroxycamptothecin 6 mg/kg），lycorine low-dose ，medium-dose and high-dose groups （10，20，40 mg/kg），with 10 mice in each group. Negative control group was given constant volume of normal saline intragastrically ，and administration groups were given relevant medicine intragastrically ，once a day ，for consecutive 7 days. After last medication ，the weight of tumor was detected and anti-tumor rate was calculated. Ascites tumor model of mice was established by intraperitoneal injection of H 22 hepatoma mice ascites ，and then were grouped with same method and given relevant medicine as above. After last medication ， survival time of mice was recorded and the life prolongation rate was calculated. The early apoptotic rate of tumor cells in mice was detected by flow cytometry. On the basis of normal control group （normal mice without tumor ），the mitochondrial membrane permeability of tumor cells in each group was investigated by Calcein AM staining. The changes of mitochondrial potential were investigated by Rhodamine 123 staining. Colorimetry and Western blot assay were adopted to detect the Caspase-3 activity and expression of apoptosis-related protein （Bcl-2，Bax，Cyt-C and Caspase- 9）. RESULTS ：Compared with negative control UN- group，the tumor weight of positive control group and lycorine PYSCT-2017208） groups were decreased significantly ，while the survival time was significantly prolonged ，and the early apoptotic rate of tumor cells was significantly increased （P＜0.05 or P＜0.01）；the anti-tumor rates were 39.41％ ， 23.36％ ， 36.50％ ， 56.93％，and life prolonga tion rates were 49.23％，29.09％， E-mail：ym913@yahoo.com.cn 50.19％，69.08％. Compared with normal control group ，the mitochondrial membrane permeability ，Caspase-3 protein activity and protein expression of Cyt-C and Caspase- 9 were significantly increased，while the mitochondrial membrane potential and Bcl- 2/Bax ratio were decreased significantly （P＜0.05 or P＜0.01）. Compared with negative control group ，mitochondrial membrane permeability and Bcl- 2/Bax ratio were decreased significantly in administration groups ，while mitochondrial permeability ，Caspase-3 protein activity and protein expression of Cyt-C and Caspase- 9 were significantly increased （P＜0.05 or P＜0.01）. CONCLUSIONS ：Lycorine can induce the apoptosis of tumor cells in H22-bearing mice ，the effects of which may be associated with opening mitochondrial membrane permeability transition pore to increase mitochondrial permeability ， decreasing mitochondrial membrane potential and up-regulating the expression of apoptosis-related proteins.关键词：Lycorine;Tumor-bearing mice;Mitochondrial;Anti-tumor;Apoptosis;Mechanism
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To study the effect of isofla vaspidicacid PB （called PB for short ）on the biofilm adhesion and the gene expression of ergosterol metabolism related enzymes in Trichophyton rubrum . METHODS ：M38-A2 method was adopted to determine MIC of PB to T. rubrum . MTT assay was used to screen the biolfilm condition and initial adhesion period of T. rubrum . The effects of different concentrations of PB （40，80，160 µg/mL）on the adhesion duration of T. rubrum （growth control group without PB was set up ，similarly hereinafter ）were evaluated and the adhesion rate was calculated by using XTT assay ；the effects of different concentrations of PB （20，40，80 µg/mL）on the biofilm formation of T. rubrum at different initial adhesion periods （3，5，9 h）were observed and the adhesion rate was calculated by using XTT assay combined with inverted microscope ；qRT-PCR method was used to detect the effects of PB （320 µg/mL）on the mRNA expression of ergosterol metabolism related enzyme gene ERG6 and ERG11 in biofilm of T. rubrum . RESULTS ：MIC of PB to T. rubrum was 20 µg/mL. The biofilm of T. rubrum in RPMI-1640 medium containing 10％ FBS was the most metabolism activity at 6 h of initial adhesion. Compared with growth control group ，after treated with different concentrations of PB ，adhesion rate and mRNA expression of ERG6 and ERG11 in biofilm were decreased significantly （P＜0.01）. Hyphae decreased or even disappeared ，and the adhesion inhibition rate （at 5 and 9 h of initial adhesion ）increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：PB can inhibit the adhesion of T. rubrum and reduce the hyphae ；the mechanism may be associated with the inhibition of the biofilm adhesion and mRNA expression of ergosterol metabolism related enzyme gene ERG6 and ERG11.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To identify Amomum villosum from different habitats and its adulterants. METHODS ：Through the identification methods of microscopic characteristics ，microscopic characteristics maps of 9 batches of A. villosum from genuine producing areas ，domestic commercially available A. villosum and its adulterants were obtained. The feature maps were extracted digitally and analyzed by SPSS 21.0 software. RESULTS ：Commercially available A. villosum was mainly from Guangdong ， Guangxi，Yunnan and Fujian ；the collected adulterants of A. villosum included A. villosum Lour. var. xanthioides T.L.Wu et Senjen ， A. aurantiacum H. T. Tsai et S. W. Zhao and other A. species from Yunnan Xishuangbanna ， Laos and Myanmar. Under the microscope，it was observed that microscopic characteristics of surface （such as exocarp color ，prickle，non-glandular hairs ， endocarp color ，endocarp oil chamber ） of A. villosum from different habitats and its adulterants were different. There was statistically significant difference in fruit width values and endocarp oil point diameter among all samples （P＜0.05）. CONCLUSIONS：The microscopic characteristics maps of A. villosum from different habitats and its adulterants by the microscopic characteristics identification methods will make up for the deficiency of traditional experience identification. The quantitative analysis of micro-property and the establishment of micro-property database of A. villosum can provide reference for the property identification and quality control of this medicinal material.关键词：Microscopic characteristics;Identification;Amomum villosum;Adulterants
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To mine t he data of adverse even ts of 7 kinds of commonly used fluid therapy drugs （normal Ringer ’ s solution ，Ringer’s lactate solution ，Ringer’s acetate solution ，hydroxyethyl starch ，succinylated gelatin ，dextran and human albumin） based on FAERS database of FDA ，in order to provide reference for carrying out fluid therapy in clinic safely. METHODS：Data from the first quarter of 2004 to the fourth quarter of 2019（64 quarters）in FAERS database were downloaded. After data cleaning ，adverse drug event report cases related to 7 kinds of fluid therapy drug as the primary and secondary suspected drugs were extracted ，and ADR signal was mined by using the reporting odds ratio method （ROR）and the proportional reporting ratio method （PRR）. RESULTS ：A total of 2 383 adverse event reports were extracted ，including 26 reports（1.09％）of normal Ringer’s solution ，479 reports（20.10％）of Ringer ’s lactate solution ，65 reports（2.73％）of Ringer ’s acetate solution ，256 reports （10.74％）of hydroxyethyl starch ，79 reports（3.32％）of succinylated gelatin ，154 reports（6.46％）of dextran ，1 324 reports （55.56％）of human albumin. Totally 879 cases（36.89％）were male and 985 cases（41.33％）were female ，the rest were unknown. The main age was 18-64 years old （950 cases，39.87％）；most of the reporters were doctors （634 cases，26.60％）. Totally 382 cases（16.03％）died. Among the adverse event reports of fluid therapy drugs ，70 cases（14.61％）administered Ringer ’s lactated solution and 259 cases（19.56％）administered human albumin died. Among them ，the top three adverse events in the number of reports were immune system diseases ，heart organ diseases ，vascular and lymphatic diseases. CONCLUSIONS ：ADRs of fluid therapy drugs are mainly related to immune system and heart organ. In the process of them ，especially for patients with allergic history and heart disease ，patients’volume indicators should be closely monitored ；during fluid therapy ，especially during the use of colloids ， great importance should be attached to renal and urinary system related adverse events ， and renal function should be closely monitored .
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To investigate the effects of rabepr azole on the pharmacokinetic characteristics of clopidogrel and its active metabolite in healthy volunteers with different CYP2C19 genotypes. METHODS ：Healthy volunteers were selected as subjects，and then randomly divided into extensive metabolizer （EM）group，intermediate metabolizer （IM）group，and poor metabolizer（PM）group with 8 subjects in each group ，according to their CYP2C19 genotypes by random number table. In single-dose，randomized，open，two-cycle-crossover design ，each group was given Clopidogrel bisulfate tablets 300 mg or Clopidogrel bisulfate tablets 300 mg+Rabeprazole sodium enteric-coated tablets 20 mg. UPLC-MS/MS method was adopted to detect the concentration of clopidogrel and its active metabolite derivative （MP-H4）. The pharmacokinetic parameters were calculated and compared by DAS 2.0 software. RESULTS ：There was no statistical significance in clinical data as age ，height， body weight ，liver enzymes and serum creatinine among 3 kinds of metabolism subjects （P＞0.05）. Compared with subjects receiving clopidogrel alone ，cmax and AUC 0－t of clopidogrel of subjects combined with rabeprazole in EM group were increased by 36％ and 27％，while those of MP-H 4 were decreased by 34％ and 28％（P＜0.01）；cmax and AUC 0－t of clopidogrel of subjects combined with rabeprazole in IM group were increased by 19％ and 18％，while those of MP-H 4 were decreased by 19％ and 16％ （P＜0.05 or P＜0.01）；there was no statistical significance in cmax and AUC 0－t of clopidogrel and MP-H 4 in PM group after receiving rabeprazole additionally as well as tmax of clopidogrel and MP-H 4 in all metablism subjects ，compared with clopidogrel alone（P＞0.05）. CONCLUSIONS ：Among CYP2C19 EM and IM subjects ，combined use of rabeprazole can significantly increase the exposure of clopidogrel and decrease the exposure of its active metabolite MP-H 4，but has no significant impact on clopidogrel and its active metabolite in CYP2C19 PM subjects.关键词：Clopidogrel;Active motabolite;Rabeprazole;CYP2C19;Genotype;Pharmacokinetics;Drug interaction
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发布时间：2022-06-21 - 摘要：OBJECTIVE： To systematically evaluate th e ther apeutic effects of conservative treatment combined with water-soluble contrast agents for adhesive small bowel obstruction ，and to provide evidence-based reference for clinical medication. METHODS：Retrieved from Cochrane library ，PubMed，Embase，Wanfang database and CNKI during the inception to Sept. 2020，RCTs about conservative treatment combined with water-soluble contrast agents in the therapeutic efficacy for adhesive small bowel obstruction were collected. After literature screening and data extraction ，the quality of included literatures were evaluated with Cochrane system evaluator manual 5.1.0 and Jadad scale. Meta-analysis was conducted by using Rev Man 5.3 and Stata 16 software. RESULTS ：A total of 15 RCTs were included ，with 1 429 patients in total. Results of Meta-analysis showed that the use of water-soluble contrast agents significantly reduced the surgical needs of patients with adhesive small bowel obstruction [OR ＝ 0.64，95％CI（0.50，0.81），P＜0.001]；reduced the remission time of non-surgical patients [MD ＝－23.37， 95％CI（－32.17， －14.57），P＜0.001]，hospital stay days of non-surgical patients [MD ＝－2.21，95％CI（－2.52，－1.90），P＜0.001] and hospital stay days of all patients [MD ＝－2.43，95％CI（－3.93，－0.92），P＝0.002]，and would not increase the incidence of complications [OR ＝1.15，95％CI（0.63，2.10），P＝0.65]，but could not reduce mortality [OR ＝1.26，95％CI（0.94，3.24），P＝ 0.63] or the probability of bowel resection [OR ＝0.93，95％CI（0.57，1.52），P＝0.78]. CONCLUSIONS ：The combined use of water-soluble contrast agents for patients with adhesive small bowel obstruction is safe and effective ，can reduce the patient ’s surgical requirements ，and is beneficial to reduce the length of hospital stay and time for symptom relief.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To investigate the ro le of clinical pharmacists in the therapy of fetal tachycardia by oral administration of digoxin through mother. METHODS ：The clinical pharmacists participated in the whole process of drug therapy for a pregnant woman with fetal tachycardia. According to 31+6 weeks of gestation ，the fetal heart rate of 230 beats/min at admission，clinical pharmacists provided the suggestion for the doctor about the safety and blood concentration determination of digoxin in the treatment of fetal tachycardia by mother. The patient ’s blood potassium value was lower than the normal range ，and it was suggested that potassium should be supplemented before digoxin was used ，and the initial dose of digoxin was 0.5 mg per 12 h. On the 7th day in the hospital ，the dosage of digoxin should be adjusted to maintaining dose （0.25 mg per 12 h）；on the 11th day in the hospital ，the patient ’s blood sodium value was low ，and the clinical pharmacists gave diet guidance. At the same time ， the clinical pharmacists explained the adverse reactions of digoxin to the doctors ，nurses and patients ，and closely observed and educated the patients. RESULTS ：Doctors adopted the suggestions of the clinical pharmacists. The fetal heart rate decreased to 180 beats/min from hospital after 13 days of treatment. The maternal digoxin concentration remained stable. No adverse drug reactions occurred in the mother and infant. CONCLUSIONS ：Maternal and child safety should be taken into account in the medication of pregnant patients. The clinical pharmacists assisting doctors to formulate medication strategying ，and carrying out pharmaceutical care for patients ，can ensure the effectiveness and safety of medication for fetal tachycardia.关键词：Intrauterine treatment;Fetal tachycardia;Digoxin;Pharmaceutical care;Clinical pharmacist
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To investigate the effects of integrated su pervision mode by doctors ，pharmacists and nurses on the whole-process implementation of therapeutic drug monitoring （TDM）. METHODS ：The patients monitored with TDM in our hospital admitted from Jan. to Dec. 2018 were selected as control group ，treated with the traditional drug supervision mode （i.e. the work of doctors ，nurses and pharmacists was relatively independent ）. Treatment group was composed of inpatients monitored with TDM from Jan. to Dec. 2019，treated with the integrated supervision mode of doctors ，nurses and pharmacists （i.e. doctors ，nurses and pharmacists cooperated with each other ，taking the patients and sample as the center ，pharmacists as the key link formulated the implementation standards of each link ，and clarified their respective responsibilities ）. The concentration compliance rate ，the incidence of incorrect samples ，critical value notification rate ，clinical satisfaction ，drug recommendation feedback and adoption ， compliance rates of 6 kinds of monitored drugs （sodium valproate ，digoxin，tacrolimus，cyclosporin，methotrexate，vancomycin） were compared between two groups. RESULTS ：The overall compliance rate ，critical value notification rate and clinical satisfaction rate of the observation group were respectively 64.57％，99.39％ and 97.22％，which were significantly higher than 57.86％， 96.80％ and 92.22％ of control group （P＜0.05）. The incidence of incorrect samples in observation group was 0.72％，which was significantly lower than 3.09％ of control group （P＜0.001）. The feedback rate of individual pharmacists （89.19％），the feedback rate of doctors （80.50％）and the adoption rate of medication suggestions （69.98％）in the observation group were significantly higher than control group （50.34％ ，71.46％ and 55.36％ ，P＜0.001）. The compliance rate of tacrolimus concentration in observation group was slightly lower than control group （73.40％ vs 75.77％，P＞0.05）. The concentration compliance rate of other 5 varieties was higher than control group ，and the differences of valproate sodium ，digoxin and vancomycin concentrations between two groups were statistically significant （P＜0.05）. CONCLUSIONS ：The implementation of integrated doctors ，nurses and pharmacists supervision mode in TDM can effectively improve the drug concentration compliance rate ，realize the . dynamic supervision and feedback of individualized drug use ， which is conducive to ensure the safety of clinical medication.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To establish quantitative e valuation system of the prophylactic use of antibiotics in orthopedic type Ⅰ incision surgery ，and to provide reference for evaluating the rational prevention use of antibiotics in this type surgery scientifically. METHODS：Based on the Guidelines of Clinical Use of Antimicrobial Agents （2015 edition），drug instructions ，related guidelines and references ，experts from relevant departments jointly discussed and formulated the evaluation criteria for the rationality of the use of antibiotics in type Ⅰ incision in orthopedic surgery. AHP method was used to assign the weights for various indexes of evaluation criteria ；TOPSIS method was used to retrospectively analyze and evaluate the rationality of 120 cases of type Ⅰ incision surgery from 3 orthopedic departments in Peking University People ’s Hospital during Sept. 1st-30th，2019. RESULTS ：Established evaluation system included 4 primary indicators （medication indication ，usage and dosage ，medication timing ，other factors ）and 12 secondary indicators. Among the secondary indicators ，indications，drug selection and timing of preoperative administration were the most important （weights were 0.209，0.140，0.117）. Among 120 cases，30.83％ of drug use were reasonable ，47.50％ were basically reasonable and 21.67％ were unreasonable. Evaluation results obtained by AHP-TOPSIS were consistent with the actual situation. CONCLUSIONS ：The rationality evaluation method of prophylactic use of antibiotics in type Ⅰ incision surgery based on AHP-TOPSIS method can quantitatively evaluate the rationality of drug use by combining multiple indicators. The method is feasible ，operable，and the evaluation results can be quantified ，which has a wide range of application.关键词：Type Ⅰ incision;Orthopedic department;Antibiotics;Rational drug use;Analytic hierarchy process;TOPSIS
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发布时间：2022-06-21
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