Calculus Bovis(CB) is one of the precious traditional Chinese medicines (TCM) and has been widely used in oriental countries over 2000 years. It possesses a broad spectrum of pharmacological properties such as relieving fever, analgesic, diminishing inflammation, sedation, reducing blood pressure, recovering gallbladder functions, antioxygenation, and anti-tumor and improving immunity, et al.Due to the scarce resource and high price of natural CB, its substitutes, artificially synthesized CB and C. Bovis Sativus (CBS), also called in vitro cultured C. Bovis, have already been developed and widely used in medicine preparation. By using the literature material method, the current article explored literatures regard to pharmacological activities and clinical application of CB and its substitute, and the compound preparations were also included, from 1949 to 2016 in journals of domestic and foreign. All documents are summarized to provide a valuable reference for further basic or clinical research about CB and its substitute.
Objective To make suggestions for China's drug safety supervision through an introduction of the status of pharmacovigilance system in the United States (US). Methods Through legal research and document research, the author introduced and analyzed the current situation of pharmacovigilance system in the US from the organization and responsibilities of Food and Drug Adminis tration, system of laws and regulations, risk management and evaluation methods of post-marketing drugs etc. Results The US has now established a relatively mature pharmacovigilance system. This system has a perfect drug safety supervision organization structure, a sound system of laws and regulations and a scientific evaluation system of drug risk management. Conclusion The relevant experience of the US can be learned by China, such as the communication & collaboration between pre- and post-market drug regulatory agencies, instillation of drug risk management and establishment of guidance for industry to promote the development and improvement of China's drug safety supervision.
During percutaneous coronary intervention, thrombotic storm which is mediated by hypercoagulable state, mechanical distension induced-plaque rupture, platelet activation and adhesion is still the main cause of cardiovascular adverse events. The mortality rate is extremely high if not treated properly. Thrombotic storm can be diagnosed quickly through coronary artery angiography and myocardial blush grades. Once coronary thrombosis occurs, medicine including platelet Ⅱb/Ⅲa receptor antagonist tirofiban or vasodilators can rapidly improve coronary flow and effectively treat it.
Objective To investigate the effects of Siwu decoction on the learning and memory abilities in mice with blood deficiency and the related mechanism. Methods The mice were randomly divided into five groups: normal control group, model control group, high-, medium-, and low-dose group of Siwu decoction. Blood deficiency mouse model was established by continuously cuttingtailand bleedingin model control group, high-, medium-, and low-dose group of Siwu decoction. The mice in high-, medium-, and low-dose group were intragastrically administrated with Siwu decoction of 2.5, 5.0, 10.0 g·kg-1 for 14 days, respectively. The erythrocyte counts (RBC), hemoglobin (HGB), red blood cell hematocrit (HCT) were detected before modeling, 7 and 14 days after administration. The spatial learning and memory abilities were assessed using the T maze test. The spontaneous activities were assessed using locomotors activity detector. The levels of erythropoietin (EPO) content in serum and acetylcholinesterase (AChE) in hippocampal tissue were detected by enzyme-linked immunousorbent assay. Results 5.0 and 10.0 g·kg-1Siwu decoction could increase RBC, HGB, HCT on the 7th and 14th day, 2.5 g·kg-1Siwu decoction could increase RBC, HCT on 14th day, and each dosage of Siwu decoction could significantly increase the spontaneous activities of model mice with blood deficiency on the 7th and 14th day as compared with model control group (P<0.05 or P<0.01). Compared with model control group, the number of errorsin T Maze test were decreased significantly in high-, medium-, and low-dose groups (P<0.01). And the Siwu decoction had a tendency to reduce the hippocampal AChE levels, but when compared with the model control group there were no statistical differences (P>0.05). Conclusion Siwu decoction is benefit formemory and spatial learning in mice with blood deficiency, which may be related with higher serum EPO and lower hippocampal AChE expression.
Objective To probe into the influence of Jiannao Anshen Capsule of Miao medicine on the behavioral performance, content of cytokine interleukin-1 (IL-1), neuroendocrine hormone melatonin (MT) and monoamine neurotransmitter 5-hydroxytryptamine (5-HT) of rats with sleep deprival. Methods All of the 60 rats were evenly and randomly divided into 5 groups: the normal control group, model control group, estazolam group, Zaoren Anshen group, and Jiannao Anshen of Miao medicine group, respectively. Every group had 12 rats.Sleep deprivation rat model was established by intraperitoneal injection of para-chlorophenyla lanice(PCPA). After successful modeling, the rats were intragastrically administrated with corresponding medicines. The contents of serum 5-HT, IL-1 and MT and the contents of 5-HT, MT in brain tissue were determined. Results Behavioral score, the contents of 5-HT, MT and IL-1 in serum and the contents of 5-HT, MT in brain tissue in insomnia rats caused by PCPA were significantly decreased as compared with normal control group (P<0.05). In the Jiannao Anshen group, estazolam group and Zaoren Anshen group, the behavioral score, the content of 5-HT, MT and IL-1 in serum and the content of 5-HT and MT in brain tissue of insomnia rats were significantly increased as compared with model control group (P<0.05). The behavioral score, the content of 5-HT, MT and IL-1 in serum and the content of 5-HT and MT in brain tissue of insomnia rats were not statistically significant different among Jiannao Anshen group, estazolam group and Zaoren Anshen group (P>0.05). Conclusion Jiannao Anshen capsule of Miao medicine could obviously improve the sleep quality of rats with sleep deprival. The mechanism may be related to improving the content of IL-1, MT and 5-HT.
Objective To study the antitumor activity of Xerophilusin G on S180 cells,and Its mechanism. Methods Modified MTT assay was used to test the effect of Xerophilusin G on the proliferation of S180 tumor cell strain. The influences on tumor growth and immune organs of mice with transplanted sarcoma (S180) were observed. The cell cycle of S180 cell lines and mouse sarcoma (S180) was analyzed by flow cytometry. The lymphocyte proliferation activity of spleen stimulating was tested. The level of IL-2 in serum of mice with transplanted sarcoma (S180) was measured by ELISA. Results The IC50 of Xerophilusin G in S180 cell lines was 19.80 μg·mL-1, the LD50 in mouse for Xerophilusin G was 121.11 mg·kg-1 through intraperitoneal injection. The tumor inhibition rate of Xerophilusin G was 32.11% and 41.60%, respectively at the doses of 3 and 6 mg·kg-1 (P<0.05). Compared with the control, the thymus, kidney and cardiac index were decreased. The cell proportion at G0/G1 phase of mouse sarcoma (S180) was increased. T and B cell proliferation activities in tumor-bearing mice were enhanced (P<0.05). As compared with control group, the serum level of IL-2 was decreased 90.9% and 77.1% in low- and medium-dose groups, respectively (P<0.05). Conclusion Xerophilusin G has remarkable effects in sarcoma (S180) bearing mice. The antitumor mechanism of Xerophilusin G might be related with G0/G1 phase arrest of mouse sarcoma (S180) cells and enhancing the activity of T and B cell but not related with increasing the secreting of IL-2.
Objective To investigate the influence of inhalation anesthestic desfluran (Des) on the learning and memory abilities of rats and the protective role of chrysophanol. Methods Totally, 50 male and 50 female rats, aging 24 months and weighing (500±10) g, were randomly divided into five groups: normal control group, Des group, low-, medium- and high-dose Chr group (0.1, 1.0 and 10.0 mg·kg-1), with 20 rats in each group. After anesthetization for 24 h, the Morris water maze was used to investigate the abilities of learning and memory of rats. The amount of Aβ1-42 was determined by ELISA assay, and the apoptosis of rat hippocampal neurons in five group was observed by TUNEL assay. Furthermore, the expression levels of Bcl-2, Bax and Caspase-3 were examined by Western blotting. The activity of acetylcholinesterase in each rats hippocampus was determined using iron trichloride chromogenic spectrophotometer colorimetric analysis method. Results Compared with the normal control group, the mean escape latency of the rats in Des group was significantly prolonged; the spatial exploring time (29.85±4.51) s was reduced; the apoptotic rate of neurons (0.742±0.052)%, the amount of Aβ1-42 peptide (9 618.72±1 076.43) pmol·g-1 , the expression levels of Caspase-3 (1.132±0.217), and Bax (1.298±0.209) were increased; the expression of Bcl-2 (0.318±0.038) were reduced; the activity of acetylcholinesterase (96.38±7.62) U·mL-1 was increased. Compared with the Des group, the rats in all Chr groups obtained shorter escape latency and longer spatial exploring time; the amount of Aβ1-42 peptide and the expression levels of Caspase-3 and Bax were down-regulated; the activity of acetylcholinesterase was reduced. In addition, chrysophanol improved the abilities of learning and memory of anesthetic rats in a dose-dependent manner. Conclusion Chrysophanol could improve the abilities of the learning and memory of rats after desflurane anesthesia, along with inhibition of Aβ deposition.
Objective To investigate the influence of ligustrazine hydrochloride on cytochrome P450 and nuclear receptor in hepatocyte of mice. Methods Mice were randomly divided into blank control group, phenobarbital group, and ligustrazine hydrochloride low-, medium- and high-dose groups (13.0,19.5 and 26.0 mg·kg-1·d-1). Then the mice were sacrificed after were administered medicines once daily for consecutive 7 days. Liver microsomes were prepared to determine the enzyme activities. Quantitative real-time PCR and Western blotting was employed to examine the expression of these four CYP450 enzymes and nuclear receptor in liver tissue of mice. Results Compared with the blank control group, CYP1A2 activity, mRNA and protein expression were increased by 1.43,1.44 and 1.40 times (P<0.05) respectively in the ligustrazine hydrochloride dose group.Ligustrazine hydrochloride was found to have no impact on the activities of CYP2E1, CYP3A and CYP2D22.AhR mRNA was increased by 1.6 times (P<0.05) in the ligustrazine hydrochloride dose group.Ligustrazine hydrochloride was found to have no impact on the expression of HNF-4α,PXR and PPARα. Conclusion Ligustrazine hydrochloride is found to have no impact on the expression of CYP2E1,CYP2D22,CYP3A,HNF-4α,PXR and PPARα,but induces the activity of CYP1A2. This effect is likely to be related toin creasing AhR level to promote the expression of CYP1A2.
Objective To evaluate the application effect of clinical pharmacy services in the secondary prevention of stroke. Methods Hospitalized stroke patients were selected in Taihe Hospital from June 2013 to August 2014. The patients meeting the inclusion criteria were paired and sequentially numbered, and randomly divided into observation group (n=100) and control group (n=102). The patients were treated routinely during the hospitalization. The clinical pharmacists conducted the drug education. The control group implemented the telephone follow-up for guiding compliance behavior one month after discharge. The observation group continued to perform clinical pharmacist-leading service projects. The medication compliance (Morisky scale), systolic blood pressure (SBP), diastolic blood pressure (DBP), glycated hemoglobin (HbA1C), serum total cholesterol (TC), low density lipoprotein-C (LDL-C) and relapse rate were compared three months, six months and twelve months after the two groups discharged. Results The medication compliance, SBP, DBP, HbA1C, TC, LDL-C and recurrence rate after hospital discharge were no statistically significant (P>0.05) three months after the two groups discharged, but statistically significant between the two groups (P<0.05 or P<0.01) six months and twelve months after the two groups discharged. Levels of SBP, DBP, HbA1C, TC and LDL-C in the two groups were both significantly lower than before (P<0.05 or P<0.01). The relapse rate of the observation group three months, six months and twelve months after they discharged was 2.00%, 5.00% and 15.00%, respectively, and that of the control group was 2.94%, 13.72% and 28.43%, respectively. Conclusion The pharmacy services in the secondary prevention of stroke can improve the patient medication compliance and better control the blood pressure, blood glucose and blood lipid levels, and reduce the relapse rate. It should be recommended in the clinical practice work.
Objective To investigate the role of clinical pharmacist in medical therapy for a patient with cerebrovascular disease and epilepsy. Methods One patient was hospitalized due to headache and twitch. Clinical diagnosis was cerebral venous sinus thrombosis and epilepsy. During the treatment, the clinical pharmacist gave suggestion on drug selection of anti-infection and anti-epileptic therapy, assessed drug interaction between omeprazole-escitalopram and mannitol-dexamethasone, monitored the adverse drug reaction of valproate, and provided medication education to the patient. Results Physician adopted clinical pharmacist's suggestion. The patient discharged with stable condition. Conclusion The participation of clinical pharmacists in the medication therapy of patients with cerebrovascular disease can reduce the risk of drug use and promote the efficacy and safety of medication.
Objective To explore the role of clinical pharmacist in individualized treatment of hypertension. Methods A patient with "H" hypertension receiving pharmaceutical care from clinical pharmacists was retrospectively analyzed. Results Patient's MTHFR (C677T) gene type was TT homozygous. Clinical pharmacist suggested doctor modify treatment, and then patient's plasma homocysteine dropped from 61.5 to 16.0 μmol·L-1, and blood pressure dropped from 173/111 mmHg(1 mmHg=0.133 kPa) to 130/80 mmHg. Conclusion Clinical pharmacist provides individualized treatment for patient with hypertension to ensure the safety and effectiveness of the drug by genotyping.
Objective To provide reference for clinical pharmacists participating in pharmacotherapy of low molecular weight heparin calium-induced thrombocytopenia. Methods Clinical pharmacists carried out pharmaceutical care for a patient with chronic cor pulmonale with acute exacerbation of chronic asthmatic bronchitis in the use of low molecular weight heparin calium, who developed progressive thrombocytopenia, and helped clinicians to manage adverse reaction and select subsequent treatment drug. Results The suggestions were adopted by clinicians. The platelets of patients gradually recovered without thrombosis events. Conclusion Participation of clinical pharmacists in the treatment of low molecular weight heparin calium induced-thrombocytopenia can effectively improve the prognosis of patients and ensure the safety in drug use.
Objective To investigate the effect of Dl-3-n-butylphthalide on acute cerebral infarction. Methods In Department of Neurology in the Fifth Hospital of Wuhan from March 2013 to June 2014, 100 cases of patients with first onset of acute cerebral infarction were recruited. The participants were divided into 2 groups (control group and treatment group) randomly, with 50 participants in each group. Besides general treatment, the patients of treatment group received intravenous injection of Dl-3-n-butylphthalide in acute phase and orally took soft capsule of Dl-3-n-butylphthalide in recovery phase. All the patients were followed up for 24 weeks. Neurological function and general cognition were assessed separately by national institute of health stroke scale (NIHSS), and mini mental state examination (MMSE) was applied to assess overall cognitive function. Results NHISS score was gradually decreased and MMSE score was increased in both groups. As compared with the control group, NIHSS score and MMSE score were changed significantly in the treatment group. From first onset to 24 weeks after treatment, NHISS score was decreased by 30% in the control group and 44% in the treatment group; MMSE score was increased by 17% in the control group and 32% in the treatment group. Conclusion Sequential therapy with Dl-3-n-butylphthalide improves neurological function and general cognition faster and more significant for patients with acute cerebral infarction.
Objective To observe curative effect of Ningdong granules on tourette syndrome (TS) concomitant with sleep disorder in children. Methods Eighty-three cases were diagnosed by diagnosis and statistics of mental-disorder (DSM-Ⅳ) TS criterion and diagnostic standard of traditional Chinese medicine, and then were divided into 3 groups: tiapride hydrochloride group (n=25), Ningdong granules group (n=30) and tiapride hydrochloride plus Ningdong granules group (n=28). Yale global tic severity scale (YGTSS) and Athens insomnia scale (Athens) were used for rating the clinical efficacy before and after treatment. The enrolled children were treated for a period of three months. Results The therapeutic effective rate of TS in tiapride hydrochloride group, Ningdong granules group and tiapride hydrochloride plus Ningdong granules group was 92.0%, 90.0% and 96.4%, respectively. The therapeutic effective rate of sleep disorder was 84.0%, 93.3% and 96.4%, respectively. After treatment, YGTSS and Athens scores were significantly changed in all three groups (P<0.05). Athens score was significantly different between tiapride hydrochloride plus Ningdong granules group and tiapride hydrochloride group (P<0.05). The total number of adverse reactions was 16, 1 and 8, with significant difference (P<0.01). Conclusion Curative effect of Ningdong granules is similar to that of tiapride hydrochloride on treating TS, but Ningdong granules is more effective than tiapride hydrochloride on treating sleep disorder with less adverse reactions. Combination therapy of Ningdong granules with tiapride hydrochloride is the better choice for treating TS with sleep disorder, and it can also reduce the incidence of adverse reactions of tiapride hydrochloride.
Objective To investigate the pre-emptive analgesia effects of hydromorphone on stress reaction in patients undergoing gynecological laparoscopic surgery. Methods Forty ASA Ⅰ or Ⅱ patients [age: 45-58 years, body mass index: 18-24 kg·(m2)-1] undergoing gynecological laparoscopic surgery were randomly divided into 2 groups (n=20 for each group): treatment group and control group. Hydromorphone (1 mg) was intravenously injected before anesthesia in treatment group. In the two groups, after routine induction and incubation, remifentanil (0.2 μg·min-1·kg-1) and propofol (0.1 mg·min-1·kg-1) were injected with micro perfusion pump, cisatracurium was injected intermittently. Injection of remifentanil and propofol was stopped when skin suture started. The concentrations of epinephrine(E) and norepinephrine(NE) were obtained before induction (t1), pneumoperitoneum (t2), 1 h after pneumoperitoneum (t3) and extubation (t4), respectively. The heart rate, blood pressure and the time of operation to extubation of the patients were recorded. Results There were no significant changes in extubation time after operation among the groups. Heart rate and systolic blood pressure were significantly lower in the treatment group than in the control group (P<0.05). Plasma E and NE levels at t1 were significantly lower than those at t2 ,t3 and t4. Plasma E and NE were significantly lower in treatment group than that of control group at t2, t3 and t4 (P<0.05). Conclusion Pre-emptive analgesia of hydromorphone can significantly decrease the release of epinephrine and norepinephrine during and after laparoscopic surgery, restrain the increase of heart rate and systolic blood pressure during extubation, without influence of revival time.
Objective To optimize enrichment and purification technology of total flavonoids from seed shell of Scutellaria baicalensis by macroporous resin. Methods Scutellarin was selected as the index, and its content was determined by HPLC.Types of macroporous resin were optimized by static adsorption elution tests.Enrichment and purification technology was investigated by orthogonal test and single-factor tests. Results AB-8 macroporous resin showed better effects than others.Optimum purification condition was as follows: sample concentration was 30.0 g·L-1, the best adsorption capacity was 0.3 g·g-1, adsorption velocity was 1.0 mL·min-1, diameter- height ratio was 1∶3, the eluting agent was 20 BV purified water, with the total polyphenols being desorbed by 5 BV of 70% ethanol. Conclusion The technology is scientific, simple and highly reproducible.It can be applied to enrich and purify total flavonoids from seed shell of Scutellaria baicalensis by macroporous resin.
Objective To establish an high perfermance liquid chromatography method for determination of five indole alkaloids in Rauvolfia. Methods The Diamonsil C18 column was used at 25 ℃ with methanol-water (gradient elution) as the mobile phase, the flow rate was 1.0 mL·min-1, the detective wavelength was 280 nm, and the injection volume was 5 μL. Results In the range of 1.56-200 μg·mL-1, the correlation coefficients of regression equations of sarpagine, yohimbine, ajmaline, ajmalicine, reserpine were higher than 0.999 0. The average recovery (n=9) of five indole alkaloids was between 95.0%-105.0%. Conclusion This method is simple with good accuracy and repeatability. It can be used for quality control of Rauvolfia.
Objective Evaluation of efficacy and safety of combination of Yinxin Damo injection and low molecular heparin for deep venous thrombosis (DVT) in orthopedics operation. Methods Randomized controlled trials of combination of Yinxin Damo injection and low molecular heparin intervention study of DVT in orthopedics operation were searched from the Cochrane Library, clinicaltrials.gov, PubMed, EMBASE, CNKI, Wanfang database, VIP database, and Chinese biomedical database (CBM). According to the Cochrane Handbook 5.1, Meta analysis was performed by Revman 5.3 software. Results A total of 4 studies included 358 patients. The results of Meta-analysis showed that, compared with control group, incidence of DVT was significantly reduced (P=0.01), value of D-D significantly decreased (P<0.000 01) and value of PT increased (P=0.04), and increased value of APTT (P=0.07) in combined group. Heterogeneous sources of PT and APTT were analyzed, and the results after excluding literature 7, as compared with the control group, APTT and PT were significantly increased in combined group (P<0.000 1). Conclusion Based on the current clinical evidence, combination of Yinxin Damo injection and low molecular heparin treatment for DVT of orthopedics operation patients is effective and safe, but there is certain heterogeneity between the studies, therefore it is necessary to design a randomized controlled trial of high quality, large scale and multicenter to research.
Objective To conduct a retrospective study about drug-induced hyperthermia (DIH) based on DIH data obtained in medical practice, and elucidate the relationship between DIH incidence and antibacterials overuse. Methods To investigate successively the medical records of inpatients from orthopaedics department in Fudan university affiliated Jinshan hospital at two different periods, and data of DIH cases were extracted to perform a comparative study. The period for 229 effective cases of group Ⅰ was from Feb. 1 to Apr. 30, 2011, before significant improvement on antibacterials use. The period for 342 effective cases of group Ⅱ was from Jul. 1 to Sep. 30, 2012, after the effective enforcements of regulation on antibacterials use. Inclusion criteria for DIH were: ①an oral temperature ≥37.6 ℃ since postoperative day 4, ②no evidence of infection,③a time relationship between fever and the administration of causative drugs: a fever occurring with drug administration and disappearing after drug cessation within 3 days,④no other causes for the fever,⑤oral temperature≤37.6 ℃ until leaving hospital. Exclusion criteria for DIH were listed below: ①possible pathological fever, e.g., in cancer, ②hospitalization within 3 days,③no surgery,④severe trauma, for example, visceral or central nervous system injury. Results All causative drugs were for injection. By comparison, duration of antibacterial administration is significantly shorter in group Ⅱ than in group Ⅰ (1.7±1.7 vs. 4.6±1.8 days, P<0.01), and total DIH incidence and antibacterials related DIH incidence were significantly lower in group Ⅱ than in group Ⅰ (7.3% vs. 30.1%, 1.5% vs. 25.3%, both P<0.01). Conclusion DIH incidence is related with drug type especially with antibacterials overuse, and changed with drug program. DIH was more serious for injection of antibacterials than injection of traditional Chinese medicine. Decrease of antibacterials usage is positively associated with the decreased DIH incidence. Safe medication should begin from safe usage of antibacterials.
Objective To investigate the role of clinical pharmacist in anti-infection therapy for patients with augmented renal clearance (ARC). Methods A case with multi-site severe infection after traffic accident was treated with anti-infection therapy. According to the characteristics of infection and pharmacokinetics, clinical pharmacist discussed the intervention by clinical pharmacist in terms of formulating anti-infection program and adjustment of individual dose. Results After consultation and evaluation by clinical pharmacist, the patient was diagnosed as ARC. According to pharmacokinetics characteristics reported by literature, vancomycin was adjusted to 1 g (once per 8 h). Based on detection result of pathogenic bacteria, meropenem was replaced by cefoperazone/sulbactam, and the dose was increased to 3 g (once per 6 h). And then, vancomycin concentration was detected again, and it reached >10 μg·mL-1; pathogenic bacteria culture result was negative. This patient obtained good therapeutic effect. Conclusion Clinical pharmacist could assist physician on anti-infection treatment and dose adjustment of ARC patient, and improve ARC patient's therapeutic effect.
Combined with the development of modern hospital pharmacy, in light of the present condition of the continuing education for the hospital pharmacists, based on the continuing education mode and method of the affiliated provincial hospital of Anhui medical university pharmacists, from the establishment of continuing education's goal and mode, the construction of "hierarchical" continuing education system, and education content integration aspects, this paper expounds the role and influence of the pharmacist professional skill contest. Through pharmacist professional skill contest, pharmacist can test and evaluate the hospital pharmacist professional ability, gradually improve pharmaceutical service level and quality of pharmacists. By introducing the pharmacist professional skill contest, pharmacist can not only timely adjust the continuing education's plan and ways, better coordinate with the development of hospital pharmacists, but also provide important technical support and talent reserves for the pharmacist professional skill contest.