最新刊期
卷 35 ， 期 19 ， 2024
- 摘要：OBJECTIVETo provide reference for the application of patient preference information in China by studying the application of patient preference information in the premarketing decision-making of medical products in the United States.METHODSThe literature research method was used to explore the general situation， legal basis， and participants of the collection and application of patient preference information in the United States， analyze the application of patient preference information in premarketing decision-making of medical products in detail， and analyze the application status and challenges of patient preference information in China， so as to put forward suggestions. RESULTS & CONCLUSIONSUnited States has promoted the collection and application of patient preference information through several patient participation projects and legislation. The patient preference information is used to support premarketing decision-making of medical products： providing information for medical product development and design， and assisting clinical trial design in the research and development process； helping to support FDA’s marketing approval decisions， identifying patient groups whose benefits outweigh risks， and included in medical product descriptions in the marketing approval process. The application of patient preference information in China lacks the guidance of higher-level legal documents， and there are no targeted guidance documents. It is suggested that China should learn from the experience of the United States and clearly encourage the research and application of patient preference in higher-level legal documents； develop specific guidance documents for the collection and application of patient preference information； determine the weight and form of patient preference information to be considered in regulatory decision-making according to national conditions.关键词：drug;medical device;premarketing decision
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发布时间：2024-10-11 - 摘要：OBJECTIVETo investigate a method for dynamic monitoring of drug consumption （DMDC） based on statistical process control （SPC）， aiming to improve the macro-supervisory capacity in the process of drug utilization.METHODSThe lists of key monitoring drug varieties in our hospital were established based on drug cost and relevant national documents. Monthly consumption data of key monitoring drug varieties in the entire hospital， outpatient pharmacy and inpatient pharmacy were taken as monitoring objects，and the DMDC model was established using SPC’s X control chart， moving range control chart， and exponentially weighted moving-average control chart， monitoring from three dimensions： single-month consumption， range variation， and consumption trend. Rosuvastatin， metoprolol and meropenem were taken as examples to demonstrate the monitoring capabilities of the DMDC model.RESULTSLists of key monitoring drug varieties were established for entire hospital， outpatient pharmacy and inpatient pharmacy， containing 203， 167 and 200 varieties， respectively. After excluding drug varieties that could not be modeled and for which modeling failed， 179， 116 and 172 DMDC models were successfully established for these three drug consumption areas， respectively. During the first four months of 2024， these three groups of model separately warned 54， 32 and 62 drug varieties. The DMDC model successfully monitored the monthly consumption of drugs，such as rosuvastatin throughout the hospital， metoprolol in outpatient pharmacy， and meropenem in inpatient pharmacy. Compared with the previously used floating rate ranking method in our hospital， the application of the DMDC model significantly improved the scope and depth of drug monitoring， with the monitored drug varieties greatly expanded from about 50 to 179， and the monitoring dimensions increased from a single dimension to three.CONCLUSIONSThe DMDC model based on SPC is effective and feasible，suitable for monitoring drug varieties with stable monthly consumption.关键词：drug dynamic monitoring;statistical process control
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发布时间：2024-10-11 - 摘要：OBJECTIVETo quantitatively evaluate the “dual channel” management policy of national medical insurance negotiation drugs at the provincial level， analyze the shortcomings and excellent experience and provide reference for the optimization of the policy.METHODSTaking the “double-channel” management policy of national medical insurance negotiation drugs in 31 provinces as the research object， text mining method was used to summarize the key contents of the policy； the policy modeling consistency （PMC） index model is constructed， and the “dual channel” management policies of 31 provinces are quantitatively analyzed through the evaluation model. Taking Beijing and Chongqing as examples， the differences between good policies and acceptable policies are compared.RESULTSAmong the 31 provinces， the PMC index of 18 provinces is between 6.00 and ＜8.00， which belongs to the excellent policies. The PMC index of 13 provinces is between 4.00 and ＜6.00， which belongs to acceptable policies. The policies of Beijing and Chongqing are consistent in 5 aspects， such as policy nature and policy effectiveness， while there are differences in 4 aspects， such as policy content and policy audience.CONCLUSIONThe “dual channel” management policies in most provinces are at a relatively perfect level， and some provinces need to continuously optimize the policy design and improve the policy rules according to the actual situation of their own medical and health development； establish the management mode of designated pharmacies， clarify the selection rules and exit mechanism； pay attention to the construction of pharmaceutical care， and promote the outflow of prescriptions.关键词：dual channel;PMC index model;text mining method;policy research;quantitative evaluation
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发布时间：2024-10-11 - 摘要：OBJECTIVETo know about the current status of medical order auditing in pharmacy intravenous admixture service （PIVAS） of medical institutions nationwide， further improve the management of medical orders in PIVAS， and reduce and eliminate the occurrence of intravenous medication administration errors.METHODSThrough the questionnaire survey method， to address the problems and current situation of PIVAS medical order auditing in medical institutions nationwide， experts from each province （autonomous region， municipality directly under the central government） in the research group were responsible for organizing the PIVAS directors of relevant medical institutions in their provinces to fill in the questionnaires on medical order audit and inappropriate medical order interventions， and conduct a statistical analysis of the results.RESULTSA total of valid 751 responses were received to the PIVAS questionnaire on the review of medical prescriptions. Our PIVAS medical order audit is mainly carried out by a combination of manual and computer. The median number of medical orders were audited by PIVAS per day were 700.00-771.00； the median number of new medical orders were audited by PIVAS per day were 209.68-215.00； medical order auditing rates were 85.50%-92.44% averagely； the inappropriate doctor’s orders accounted for 1.82%-1.89% averagely； the intervention rates of inappropriate medical orders ranged 74.90%-79.41%， the success rates of intervention were 79.62%-87.28% averagely； the medication refund rates were 2.92%-3.08%.CONCLUSIONSMost of the PIVAS in China’s healthcare institutions use medical order review software to assist in the review of medical orders， and there are cases of individual PIVAS in which medical orders are not reviewed comprehensively and inappropriate orders are not intervened in， and the standards and processes of medical prescription review need to be improved. It is recommended to emphasize the pharmacist’s responsibility system， standardize the use of prescription review software； gradually expand the scope of medical order review， and adopt a multi-departmental collaborative approach so as to increase the success rate of intervention for inappropriate prescriptions and reduce the rate of PIVAS withdrawals.关键词：medical order auditing;prescription review software
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发布时间：2024-10-11 - 摘要：OBJECTIVETo explore the improvement effect and mechanism of petroleum ether extract of Saposhnikovia divaricata on rheumatoid arthritis （RA） rats by regulating neutrophil extracellular traps （NETs）.METHODSEstablishment of rat RA model using bovine type Ⅱ collagen and Freund’s complete adjuvant. The model rats were randomly divided into model group and low-dose， middle-dose and high-dose groups （55， 110， 220 mg/kg） of petroleum ether extract of S. divaricata； the normal group without modeling was also established， with 10 rats in each group. Each group was given corresponding drugs or constant volume of 2% Tween-80 solution intragastrically， once a day， for consecutive 28 days. The toe swelling degree in rats was observed， and the arthritis index （AI） was scored. The serum levels of interleukin-1β （IL-1β）， IL-10， IL-17， tumor necrosis factor-α （TNF-α）， 25-hydroxyvitamin D3 [25（OH）D3]， myeloperoxidase （MPO）， neutrophil elastase （NE） and NETs in rats were detected. The histopathological changes in ankle joint were observed. The expression of citrullinated histone H3 （CitH3） in ankle joint as well as the expressions of cytochrome P450 24A1 （CYP24A1）， cytochrome P450 27B1 （CYP27B1）， vitamin D receptor （VDR） and peptidyl arginine deiminase 4 （PAD4） in synovium were all determined.RESULTSCompared with the model group， the toe swelling degree and AI score in the middle-dose and high-dose groups of petroleum ether extract of S. divaricata decreased significantly from day 14 to day 28 after administration （P＜0.05 or P＜0.01）. The serum levels of IL-1β， IL-17， TNF-α， MPO， NE and NETs decreased significantly， while the levels of IL-10 and 25（OH）D3 increased significantly （P＜0.05 or P＜0.01）. The widened ankle joint space and the improved structure were found； the expression of CitH3 in ankle joint， and the expressions of CYP24A1 and PAD4 in synovium were down-regulated significantly， while the expressions of CYP27B1 and VDR were up-regulated significantly in synovium （P＜0.05 or P＜0.01）.CONCLUSIONSThe petroleum ether extract of S. divaricata may inhibit the production of NETs and improve the symptoms of RA by regulating the vitamin D system.关键词：Saposhnikovia divaricata;petroleum ether extract;vitamin D;neutrophil extracellular traps;inflammatory factors
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发布时间：2024-10-11 - 摘要：OBJECTIVETo study the protective effect and mechanism of Bupleurum chinense polysaccharides （BCP） on acute liver injury （ALI） in mice.METHODSOverall 40 mice were randomly divided into normal group， model group， positive control group （Baogan tablet， 550 mg/kg）， BCP high-dose and low-dose groups （400， 100 mg/kg）， with 8 mice in each group. The drug was administered intragastrical once a day for 7 days. One hour after the last administration， except for the normal group， mice in other groups were injected with 20 mg/kg concanavalin A solution through the tail vein to establish ALI model. After injection of concanavalin A solution for 12 h， the liver and spleen indexes of mice were measured， and the pathological changes of liver and spleen tissue were observed； the serum levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT） and lactate dehydrogenase （LDH） were detected， and the levels of superoxide dismutase （SOD） and malondialdehyde （MDA） in liver tissue were detected. The levels of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6） and IL-1β in serum and liver tissue of mice were determined， as well as the protein expression levels of nuclear factor-κB （NF-κB）， Toll-like receptor 4 （TLR4）， nuclear factor erythroid 2-related factor 2 （Nrf2） and heme oxygenase-1 （HO-1） in liver tissue were also detected.RESULTSCompared with the normal group， the liver tissue of mice in the model group was necrotic and infiltrated with inflammatory cells； spleen enlargement， increased bleeding and decreased lymphocytes were observed， liver and spleen indexes were increased significantly （P＜0.01）； the serum levels of AST， ALT and LDH， the levels of TNF-α， IL-6 and IL-1β in serum and liver tissue， as well as the MDA level， protein expressions of TLR4， NF-κB and HO-1 in liver tissue were all increased significantly （P＜0.05 or P＜0.01）. The levels of SOD and protein expression of Nrf2 in liver tissue were all decreased significantly （P＜0.05）. Compared with the model group， the pathological damages of the liver and the spleen tissues in mice alleviated in BCP high-dose and low-dose groups， and most of liver and spleen indexes， the above indexes of serum and liver tissue were reversed significantly （P＜0.05 or P＜0.01）.CONCLUSIONSBCP has a protective effect on ALI， the mechanism of which may be related to the inhibition of TLR4/NF-κB signaling pathway and the activation of the Nrf2/HO-1 signaling pathway.关键词：acute liver injury;TLR4/NF-κB signaling pathway;Nrf2/HO-1 signaling pathway
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发布时间：2024-10-11 - 摘要：OBJECTIVETo provide reference for basic analysis of the pharmacodynamic substance in Stahlianthus involucratus.METHODSOverall 24 SD male rats were randomly divided into blank group （purified water）， and administration group （ethanol extract of S. involucratus， 15.75 g/kg， calculated by crude drug）， with 12 rats in each group. They were given drug liquid/purified water intragastrically， twice a day， every 6-8 h， for consecutive 3 days. After medication， the blood， urine and fecal samples were collected from two groups of rats. UPLC-Q-Exactive-MS technology was used to identify the chemical constituents in the ethanol extract of S. involucratus， and metabolites in the blood， urine and fecal of rats after intragastrical administration of the ethanol extract of S. involucratus. Multivariate statistical analysis was employed to screen various serum metabolites. Metabolic pathways were analyzed by MetaboAnalyst 5.0 platform.RESULTSA total of 38 chemical constituents were identified from the ethanol extract of S. involucratus， including fourteen prototype components and three metabolites identified from urine samples， nine prototype components identified from fecal samples， and ten prototype components and one metabolite identified from serum samples. A total of 71 differential metabolites were screened from two groups of rat serum samples， of which 44 differential metabolites， such as ferulic acid， glycyrrhizin， were up-regulated and 27 differential metabolites， such as arachidonic acid， phenylacetylglutamine， were down-regulated. The 71 differential metabolites were mainly enriched in 11 metabolic pathways， including phenylalanine metabolism， linoleic acid metabolism， arachidonic acid metabolism， and tryptophan metabolism.CONCLUSIONSFerulic acid， liquiritigenin， isofraxidin and formononetin may be the material basis that directly exert pharmacological effects of S. involucratus. S. involucratus may exert anti-inflammatory effects by affecting metabolic pathways， including arachidonic acid metabolism and tryptophan metabolism.关键词：chemical constituents;pharmacodynamic substances;internal metabolism;inflammation;UPLC-Q-Exactive-MS technology
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发布时间：2024-10-11 - 摘要：OBJECTIVETo investigate the effects of different drying methods on the quality of Chrysanthemum morifolium， and to provide a basis for the harvesting and processing of C. morifolium.METHODSTwenty-five samples were obtained by drying the fresh products using 7 types and 25 kinds of drying methods， and the unqualified samples were removed by taking their appearance and moisture content as elimination indexes. The contents of six active ingredients （chlorogenic acid， luteoloside， 3，5-O-dicaffeoylquinic acid， quercetin， lignoceroside， baicalin） were used as indicators， and combined with principal component analysis （PCA）， partial least square method-discriminant analysis （PLS-DA）， PCA comprehensive score ranking and the best samples obtained from each drying method to select 6 experimental samples comprehensively. The quality of 6 kinds of samples was evaluated using the activities and stability of oxidation-related enzymes （polyphenol oxidase， peroxidase） and the microscopic morphology of the petal surface as evaluation indexes.RESULTSThe results of PCA and PLS-DA showed significant differences in the quality of samples obtained by different drying methods， and chlorogenic acid， 3，5-O-dicaffeoylquinic acid and baicalin might be the main reasons for the differences among the samples. The herbs treated with 100 ℃ steam fixation for 1 min combined with blast drying at 50 ℃ for 4 hours had the highest comprehensive score of active ingredients. The oxidation-related enzymes in C. morifolium treated with microwave 800 W fixation for 1 minute followed by 50 ℃ air drying for 4 hours and 100 ℃ steam sterilization for 1 minute followed by 50 ℃ drying for 4 hours were completely inactivated， and the stability was better than that of samples obtained by other drying methods. The observation results of the microstructure of the petal surface showed that the sample obtained by drying at a microwave power of 400 W for 6 minutes had the highest integrity and flatness compared to the above two samples.CONCLUSIONSFrom the perspective of finished product quality and drying efficiency， 100 ℃ steam fixation for 1 min combined with blast drying at 50 ℃ for 4 hours is the best drying method for C. morifolium.关键词：origin processing;drying method;chlorogenic acid;3，5-O-dicaffeoylquinic acid;baicalin
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发布时间：2024-10-11 - 摘要：OBJECTIVETo study the effect of Runzao zhiyang capsule （RZZY） on gut microbiota and its metabolites short-chain fatty acids （SCFA） in eczema rats， in order to reveal the improvement effect and possible mechanism of RZZY on eczema.METHODSThe rats were divided into normal group， model group， desloratadine group （1.5 mg/kg）， and RZZY low-dose and high-dose groups （0.6， 1.2 g/kg）. Except for the normal group， the eczema model was established in other groups by applying the 2，4-dinitrochlorobenzene solution to the hair removal area to sensitize it； they were given relevant drugs intragastrically， once a day， for consecutive 2 weeks. After medication， the skin thickness of rats was measured， and the eczema area and severity index （EASI） scoring and pathology scoring were performed； the structure of gut microbiota was analyzed by 16S rDNA sequencing. The contents of SCFA （including acetic acid， propionic acid， and butyric acid） in feces were determined by gas phase-mass spectrometry. The expressions of signal transduction and activator of transcription 3 （STAT3） in the colon and skin were detected.RESULTSRZZY significantly alleviated skin swelling and ulceration and reduced EASI， skin thickness and pathological score in eczema rats （P＜0.05）. RZZY significantly increased ACE， Sobs and Shannon indexes （P＜0.05） and promoted the microbiota of eczema rats to return to normal structure. RZZY increased the abundance of Firmicutes and Lachnospira， Lactobacillus and Alistipes， while decreased the abundance of Bacteroidetes and Bacteroides. RZZY significantly increased the contents of propionic acid and butyric acid in the feces of eczema rats （P＜0.05）， while significantly down-regulated the expressions of STAT3 protein in the colon and skin （P＜0.05）.CONCLUSIONSRZZY can improve SCFA levels by regulating gut microbiota， thereby inhibiting STAT3 expression， playing an anti-inflammatory role， and improving skin inflammation in eczema rats.关键词：eczema;gut microbiota;short-chain fatty acid
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发布时间：2024-10-11 - 摘要：OBJECTIVETo provide reference for Smilax glabra quality control.METHODSUPLC method was established to simultaneously determine the contents of 5-O-caffeoylshikimic acid， neoastilbin， astilbin， neoisoastilbin， isoastilbin， engelitin， resveratrol and isoengelitin in 20 batches of S. glabra from different areas （No. S1-S20）. The quality evaluation of 20 batches of samples was performed by chemometrics； the differential biomarkers that affected the quality of S. glabra were screened.RESULTSThe measured 8 components had good linear relationship within the range of measured concentration （r≥0.999 6）. RSDs of precision， repeatability and stability tests （24 h） were all lower than 2.00% （n＝6）. The average recoveries varied between 97.60% and 106.40% （RSDs were all lower than 2.00%， n＝6）. Cluster analysis showed that the samples produced in Zhejiang （S1-S5） and Jiangxi （S6-S10） were clustered into one category； the samples produced in Hunan （S11-S15） were clustered into one category； the samples produced in Yunnan （S16-S20） were clustered into one category. Principal component analysis showed that the first two principal components could represent 85.60% information of 8 components in S. glabra. Partial least squares-discriminant analysis showed that variable importance projection values of 5-O-caffeoylshikimic acid， astilbin， isoastilbin and neoastilbin were all greater than 1.CONCLUSIONSThere are differences in the contents of the above 8 components in S. glabra from different origins； 5-O-caffeoylshikimic acid， astilbin， isoastilbin and neoastilbin may be differential markers affecting the quality of S. glabra.关键词：chemometrics;content determination;UPLC;5-O-caffeoylshikimic acid;astilbin;isoastilbin;neoastilbin
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发布时间：2024-10-11 - 摘要：OBJECTIVETo evaluate the economics of trastuzumab deruxtecan versus the physician-selected chemotherapy （TPC） regimen in the second-line treatment of advanced breast cancer with epidermal growth factor receptor 2 （HER-2） low expression from the perspective of the Chinese healthcare system.METHODSBased on the data of DESTINY-Breast04 clinical trial， the dynamic Markov model was constructed. The time frame of the model simulation was 10 years， and the cycle was 3 weeks. Taking cost， quality-adjusted life year （QALY） and incremental cost-effectiveness ratio （ICER） as the model output indicators， the discount rate of 5% was applied， and 3 times China’s per capita gross domestic product （GDP） in 2023 was taken as the willingness-to-pay （WTP） threshold value. Cost-utility analysis was used to evaluate the economics of the two treatment regiments in the hormone receptor-positive cohort and all patient cohorts， and uncertainty analysis was used to verify the robustness of the basic analysis result.RESULTSThe results of the basic analysis showed that compared with the TPC regimen， the ICER value of trastuzumab deruxtecan regimen were 1 045 655.76 and 906 404.99 yuan/QALY in the hormone receptor-positive cohort and all patients， respectively， both exceeding the WTP threshold （268 074 yuan/QALY）. The results of single factor sensitivity analysis showed that progression-free survival utility value， the price of trastuzumab deruxtecan and progression disease utility had a significant influence on the model results. The results of probability sensitivity analysis showed that when the WTP threshold was 3 times China’s per capita GDP in 2023， the probability of economic viability of trastuzumab deruxtecan was 0. The results of scenario analysis showed that when the patient assistance program for trastuzumab deruxtecan was considered， the probability of trastuzumab deruxtecan regimen being economical was 0. However， when the price of trastuzumab deruxtecan was reduced by 70%， the probability of its being cost-effective was significantly increased to 82.80%.CONCLUSIONSAt a WTP threshold of 3 times China’s per capita GDP in 2023， the trastuzumab deruxtecan regimen is not cost-effective compared to TPC regimen for the second-line treatment of advanced breast cancer with HER-2 low expression. Reducing the price of trastuzumab deruxtecan by region can improve its cost-effectiveness.关键词：advanced breast cancer;HER-2 low expression;second-line treatment;Markov model;pharmacoeconomics
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发布时间：2024-10-11 - 摘要：OBJECTIVETo investigate the clinical effect of Budigafol combined with Staphylococcus and neisseria tablets in maintenance treatment of patients with stable moderate to severe chronic obstructive pulmonary disease （COPD）.METHODSA total of 122 patients with stable moderate to severe COPD who were admitted to the infections diseases ward of the department of respiratory and critical care medicine in our hospital from October 1， 2021 to January 31， 2023 were divided into control group （n＝61） and observation group （n＝61） according to the random number table method. Patients in the control group were treated with Budigafol inhalation aerosol alone （2 presses each time， twice a day）， and patients in the observation group were treated with Staphylococcus and neisseria tablets （1.2 mg each time， 3 times a day） on the basis of the control group. The treatment course of both groups was 3 months. The quality of life， exercise tolerance， lung function， inflammatory indexes， immune function， as well as the number of acute attacks of COPD and the occurrence of adverse reactions were compared between the two groups before and after treatment.RESULTSControl group and observation group shed 12 and 9 patients， respectively. After treatment， the 6 minute walking distance of the two groups of patients was significantly prolonged compared with that before treatment （P＜0.05）. The COPD assessment test questionnaire score， St George’s respiratory questionnaire score， the ratio of residual volume to total lung capacity， the fractional exhaled nitric oxide， the serum levels of C-reactive protein and interleukin-6 were significantly decreased compared with those before treatment （P＜0.05）. The forced expiratory volume in one second （FEV1）， the ratio of FEV1 to forced vital capacity， the percentage of the measured value of carbon monoxide diffusion capacity to the predicted value， and the percentage of the measured value of FEV1 to the predicted value were significantly increased compared with those before treatment （P＜0.05）. The improvement of the above indicators in the observation group was significantly better than that in the control group （P＜0.05）. Compared with before treatment， there was no statistical significance in the immune function indexes of the control group or the serum levels of immunoglobulin A （IgA） and IgM in the observation group after treatment （P＞0.05）. The percentages of CD3+， CD4+， B lymphocytes and natural killer cells， the levels of CD4+/CD8+ and IgG were significantly increased in the observation group （P＜0.05）， the percentage of CD8+ cells was significantly decreased （P＜0.05）， and the improvement degree of the observation group was significantly better than that of the control group （P＜0.05）. There was no significant difference in the number of acute exacerbations of COPD during the follow-up period and the incidence of adverse events during treatment between the two groups （P＞0.05）.CONCLUSIONSBudigafol combined with Staphylococcus and neisseria tablets can effectively improve the immune function of patients with stable moderate to severe COPD， further reduce the level of inflammation， and improve their exercise tolerance and their quality of life with good safety.关键词：Staphylococcus and neisseria tablets;chronic obstructive pulmonary disease;quality of life;6 minute walking distance;lung function;inflammatory;immune function
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发布时间：2024-10-11 - 摘要：OBJECTIVETo study the correlation between SLCO1B1 （521T＞C and 388A＞G） gene polymorphisms and the efficacy and safety of rosuvastatin.METHODSRetrieved from PubMed， Embase， Cochrane Library， PharmGKB， CNKI database and Wanfang database， the studies about the effects of 521T＞C and 388A＞G gene polymorphisms on the efficacy and safety of rosuvastatin were collected during the inception to Dec. 2023. The included data were analyzed by using RevMan 5.3 software.RESULTSA total of 16 studies were included. The results of meta-analysis showed that 521T＞C gene polymorphism was significantly correlated with the efficacy of rosuvastatin. In the dominant gene model， compared with TT genotype， CC+TC genotype significantly improved the efficacy of rosuvastatin in raising high-density lipoprotein cholesterol （HDL-C） [MD＝2.38， 95%CI（0.61，4.16）， P＝0.009 0]. In the homozygous gene model， compared with TT genotype， CC genotype significantly improved the efficacy of rosuvastatin in reducing total cholesterol [MD＝－7.50，95%CI（－13.05， －1.95）， P＝0.008 0]. In heterozygous gene model， compared with TT genotype， TC genotype significantly improved rosuvastatin in reducing low-density lipoprotein cholesterol （LDL-C） [MD＝－5.14， 95%CI（－9.74， －0.53）， P＝0.03] and increasing HDL-C [MD＝5.67， 95%CI（2.61， 8.73）， P＝0.000 3]. 388A＞G gene polymorphism was also significantly correlated with the efficacy of rosuvastatin. In dominant or homozygous gene models， compared with AA genotype， GG+AG genotype [MD＝－6.88， 95%CI （－7.46， －6.30），P＜0.000 1] or GG genotype [MD＝－9.23， 95%CI（－9.41， 9.04）， P＜0.000 1] significantly improved the efficacy of rosuvastatin in lowering LDL-C. In the heterozygous gene model， compared with AA genotype， AG genotype significantly improved the efficacy of rosuvastatin in lowering LDL-C [MD＝－3.00， 95%CI（－3.19， －2.82）， P＜0.000 1]， total cholesterol [MD＝－5.80， 95%CI（－6.00， －5.59）， P＜0.000 1] and triglyceride [MD＝－11.79， 95%CI（－19.57， －4.02）， P＝0.003 0]. In the recessive gene model， compared with AA+AG genotype， GG genotype significantly improved the therapeutic efficacy of rosuvastatin in reducing LDL-C[MD＝－4.31， 95%CI（－8.47， －0.14）， P＝0.040 0] and elevating HDL-C [MD＝4.49， 95%CI（2.20， 6.77）， P＝0.000 1]. Under 4 gene models， there was a significant correlation between 521T＞C gene polymorphism and rosuvastatin-related ADR probability （P＜0.05）， but no significant correlation was found in 388A＞G gene polymorphism （P＞0.05）.CONCLUSIONSThe polymorphism of 521T＞C gene is significantly related to the efficacy and safety of rosuvastatin in lowering lipid， and the C allele may be one of the factors leading to the increase of rosuvastatin in lipid-lowering efficacy and ADR. 388A＞G gene polymorphism is significantly associated with the lipid-lowering efficacy of rosuvastatin， but not with its safety.关键词：gene polymorphism;rosuvastatin;efficacy;safety;meta-analysis
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发布时间：2024-10-11 - 摘要：OBJECTIVETo provide reference for constructing scientific and reasonable pharmaceutical service mode for hospitalized patients with chronic airway diseases.METHODSFrom October 2023 to March 2024， 250 patients with chronic obstructive pulmonary disease and acute exacerbation of asthma who were hospitalized in the respiratory department of Hebei General Hospital and received pharmaceutical care （PC） were randomly divided into control group （125 cases） and observation group （125 cases）. The control group received general pharmaceutical services throughout their hospitalization， while the observation group received standardized and graded pharmaceutical services throughout their hospitalization. The differences in clinical value indicators， humanistic value indicators， and quality management indicators were compared among different PC service models.RESULTSAmong clinical value evaluation indicators， the observation group had better achievement rate of disease treatment goals， correct use score of inhalation devices， the incidence of adverse drug reactions， and the number of drug-related problems solved than the control group （P＜0.05）. Among the humanistic evaluation indicators， compared with the control group， the observation group had better medication compliance scores， pharmacist intervention success rates， and patient satisfaction scores （P＜0.05）. Among quality management evaluation indicators， the proportion of drug costs， the proportion of intravenous medication， the use rate of antibiotics， the intensity of antibiotic use， and the number of pharmaceutical services in the observation group were significantly better than the control group （P＜0.05）.CONCLUSIONSStandardized and graded pharmaceutical care services have improved the efficiency of pharmacists and service effectiveness， making it a new pharmaceutical service model worth promoting.关键词：pharmaceutical care;graded monitoring;chronic airway disease
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发布时间：2024-10-11 - 摘要：OBJECTIVETo investigate the reasons for interrupting menopausal hormone therapy in patients with menopausal syndrome and analyze the influencing factors that may lead to treatment interruption.METHODSThe patients who visited our menopause medicine clinic from March 2022 to November 2023 and established a menopausal health manual were collected retrospectively. The case data were collected through the medical history registered in the manual and the outpatient medical record system. Telephone follow-up was conducted among the patients who had received menopausal hormone therapy to know about whether they were taking medication and to record the reasons for treatment interruption. Univariate analysis and multivariate Logistic regression analysis were adopted to investigate the influencing factors of discontinuing menopausal hormone therapy in patients with menopausal syndrome.RESULTSA total of 183 patients receiving menopause hormone therapy were enrolled. They were divided into interruption group （78 cases） and continuation group （105 cases） according to whether the treatment was interrupted. The results of telephone follow-up showed that the reasons in turn for interruption were perceiving ineffectiveness（16.67%）， concerning about medication risk（15.38%）， the existence of caution case（12.82%） and adverse reactions（10.26%）. The results of univariate analysis showed that there were statistically significant differences in occupation， complications， medication regimen， bone condition and blood viscosity between the two groups （P＜0.05）. Multivariate Logistic regression analysis showed that the absence of complications， osteopenia and osteoporosis， working in public institution and retirement， and the continuous sequential medication regimen favored continuation of menopausal hormone therapy （P＜0.05）.CONCLUSIONSThe interruption rate of menopausal hormone therapy is relatively high， and patients are greatly affected by perceiving ineffectiveness and concerning about medication risks， the existence of caution case， and adverse reactions. Complications can cause patients to interrupt treatment， while factors such as osteopenia and osteoporosis， working in public institutions and retirement， and continuous sequential medication regimens make patients more inclined to choose to continue menopausal hormone therapy.关键词：menopausal hormone therapy;interruption of treatment;influencing factors
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发布时间：2024-10-11 - 摘要：OBJECTIVETo provide reference for medication therapy management （MTM） of diabetic patients complicated with cardiovascular disease.METHODSA 63-year-old male diabetic patient who suffered from temporary headache every morning after percutaneous coronary intervention （PCI） visited the neurology department of our hospital， and then was recommended to the pharmaceutical outpatient department. The pharmacists thought that the patient’s symptoms of headache， severe constipation and hyperuricemia were more likely induced by the medication used. The pharmacists further found that his atherosclerotic cardiovascular disease （ASCVD） influencing factors such as blood pressure， heart rate， blood glucose and blood lipids did not reach standard. The pharmacists provided MTM services for the patient through pharmacy inquiry and adverse drug reactions judgement， medication evaluation， medication reconciliation， medication education and pharmacy follow-up.RESULTSThrough fifteen MTM services for thirteen weeks， the pharmacists reconciliated and optimized the medication therapy plan， discontinued the use of Isosorbide mononitrate sustained-release tablets， Nifedipine controlled-release tablets， and Indapamide tablets， which caused adverse drug reactions； the number of drugs was adjusted from fifteen to seven， and the symptom of headache disappeared； severe constipation had also been significantly improved， and hyperuricemia dropped to normal range. The ASCVD influencing factors of blood pressure， heart rate， fasting plasma glucose， glycosylated hemoglobin， low-density lipoprotein cholesterol and uric acid were reduced from ＞140/90 mmHg（1 mmHg＝0.133 kPa）， 70-80 beats per minute， 7.71 mmol/L， 7.2%， 2.13 mmol/L and 494 μmol/L before MTM services to ＜130/80 mmHg， 55-60 beats per minute， 6.22 mmol/L， 6.3%， 1.55 mmol/L and 348 μmol/L after MTM services.CONCLUSIONSThe pharmacists providing MTM services to the patients can improve their quality of life and therapeutic efficacy， reduce medication risks， and enhance the level of rational drug use in hospitals and pharmaceutical service capabilities.关键词：pharmaceutical outpatient department;diabetes;cardiovascular disease;drug reconciliation
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发布时间：2024-10-11 - 摘要：OBJECTIVETo correctly identify and respond to severe systemic allergic reactions caused by Wujia shenghua capsules during the postpartum period， provide a reference for medication use in obstetrics and gynecology departments， and promote rational drug use.METHODSClinical pharmacists participated in the pharmaceutical monitoring and treatment process for a case of severe systemic allergic reaction after using Wujia shenghua capsules during the postpartum period. They screened the medication used by the patient during hospitalization and evaluated the relationship between the allergic reaction and Wujia shenghua capsules， as well as the possible causes of the reaction. RESULTS &CONCLUSIONSThe relationship between severe systemic allergic reactions in the patient and Wujia shenghua capsules is evaluated as “likely related”， suggesting that patients with the allergic constitution should be vigilant when using Wujia shenghua capsules during the postpartum period， and pharmaceutical monitoring should be strengthened to avoid the simultaneous use of drugs with the same mechanism or potential interactions.关键词：severe systemic allergic reactions;pharmaceutical monitoring;adverse drug reactions
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发布时间：2024-10-11 - 摘要：Colorectal cancer is one of the leading causes of cancer-related deaths worldwide. Specific gut microbiota can identify high-risk populations for colorectal cancer and may slow disease progression by regulating apoptosis， producing intestinal metabolites， and enhancing chemotherapy efficacy （reducing side effects and improving chemotherapy resistance）. Saponins represented by ginsenoside K are found widely in traditional medicines such as Panax ginseng and Panax notoginseng. After metabolized by gut microbiota， they play a role in preventing and treating colorectal cancer by modulating chronic inflammation， adjusting the composition of gut microbiota， generating microbial metabolites， and participating in immune regulation.关键词：gut microbiota;colorectal cancer;Akkermansia muciniphila;mechanism
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发布时间：2024-10-11 - 摘要：enile macular degeneration（SMD） is a degenerative disease of the macular region of the eye that causes visual impairment in older people worldwide. It is the focus and difficulty of the treatment of ophthalmic diseases at home and abroad. This paper reviewed traditional Chinese medicine （TCM） active ingredients for the treatment and prevention of SMD， and its new ocular delivery preparations. Studies have shown that many active ingredients of TCM can inhibit the progression of SMD through various ways such as anti-oxidation， solid lipid nanoparticles， microemulsions/nanoemulsions， in-situ gel， etc. However， due to the low solubility， chemical instability and difficulty in overcoming the eye barrier of most TCM active ingredients， their clinical application in the treatment of SMD is seriously hindered. New preparations， such as liposomes， solid lipid nanoparticles， microemulsion/nanoemulsion， in situ gels， have good application prospects in ocular drug delivery.关键词：active ingredients of traditional Chinese medicine;oxidative stress;inflammation;nano preparation
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发布时间：2024-10-11 - 摘要：Chronic pain refers to pain that persists or recurs for more than 3 months and has a high comorbidity rate with emotions such as depression and anxiety. The complex pathogenesis of comorbid depressive symptoms in chronic pain poses great challenges to clinical diagnosis and treatment. This article reviews the research progress on the effect mechanism on the comorbid depressive symptoms in chronic pain by traditional Chinese medicine monomers， compound formulas， and acupuncture therapy in recent years. It is found that traditional Chinese medicine monomers （flavonoids， phenols， terpenes， coumarins， alkaloids）， traditional Chinese medicine formulas （Aconitum carmichaeli decoction， Chaihu guizhi decoction， etc.）， and acupuncture therapy （acupuncture at acupoints such as Baihui， Yintang， Hegu， and Taichong） can effectively improve comorbid depressive symptoms in chronic pain by regulating the levels of neurotransmitters， brain-derived neurotrophic factors and inflammatory factors， and the activity of glial cells in the central nervous system.关键词：traditional Chinese medicine monomer;traditional Chinese medicine compound formulas;neurotransmitters;inflammation;mechanism
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发布时间：2024-10-11 - 摘要：Dysregulation of transforming growth factor β （TGF-β） signaling pathway is related to the occurrence and development of various pathological conditions， including tumors. In the early stage of tumorigenesis， TGF-β， as an anti-proliferation and pro-differentiation factor， plays an anticancer role. In advanced tumors， TGF-β can stimulate tumor progression and metastasis through its effect on the tumor microenvironment （such as promoting angiogenesis， fibrosis， immune suppression， and regulating cellular metabolism）. A variety of TGF-β signaling pathway inhibitors have been tested in clinical trials， including monoclonal antibodies， ligand traps， small molecule inhibitors， antisense oligonucleotides， bispecial antibodies， and tumor vaccines， but no related drugs are currently approved for cancer treatment clinically. Accurately screening potential benefit patients and combining it with immune checkpoint inhibitors are its future development directions.关键词：tumor microenvironment;targeted therapy
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发布时间：2024-10-11
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