Objective To evaluate the effects of dipeptidyl peptidase-4 inhibitors on serum lipids in patients with type 2 diabetes mellitus. Methods Randomized controlled trials of related articles from inception to February 2017 were searched from PubMed,Cochrane Library,CBM,CNKI and Wangfang by computer.Meta-analysis was performed using RevMan 5.0 and Stata12.0 software. Results A total of 38 randomized controlled trials were identified.The results showed that as compared with controls, dipeptidyl peptidase-4 inhibitors alone or in combination significantly improved serum total cholesterol [WMD=-0.13 mmol·L-1,95%CI (-0.19,-0.07) mmol·L-1,P<0.000 1],triglycerides [WMD=-0.17 mmol·L-1,95%CI (-0.25,-0.09) mmol·L-1,P<0.000 1] and low-density lipoprotein cholesterol [WMD=-0.08 mmol·L-1,95%CI (-0.13,-0.03) mmol·L-1,P=0.003 0].However,no statistical significances were observed in high-density lipoprotein cholesterol [WMD=-0.01 mmol·L-1,95%CI (-0.04,0.01) mmol·L-1,P=0.280 0].Subgroup analysis revealed that dipeptidyl peptidase-4 inhibitors in combination achieved greater improvement in serum total cholesterol,triglycerides and low-density lipoprotein cholesterol levels. Conclusion Dipeptidyl peptidase-4 inhibitors alone or in combination significantly improve serum total cholesterol,triglycerides and low-density lipoprotein cholesterol in patients with type 2 diabetes mellitus.
Objective To investigate the effect of fisetin on myocardial ischemia reperfusion (I/R) injury in isolated rats and its mechanism. Methods The myocardial I/R injury model was established through Langendorff system. A total of 32 SPF grade SD rats were randomly divided into 4 groups (n=8): normal control group, model control group, low dose fisetin group (0.5 μmol·L-1) and high dose fisetin group (5 μmol·L-1). The myocardial function was measured by TTC staining. The content of CK-MB was measured by enzyme-linked immunosorbent assay (ELISA). The levels of SOD, MDA, GSH, GSSG, TNF-α and IL-6 in the myocardium were measured by ELISA. The changes of myocardial tissue were observed by HE staining. The degree of apoptosis was detected by TUNEL staining. Results Compared with the normal control group, the cardiac function parameters of the model control group were decreased significantly, serious infarction and necrosis developed in myocardium, and the leaking amount of CK-MB was significantly increased. The contents of MDA, GSSG, IL-6 and TNF-α in myocardium were significantly increased, and the activities of SOD and GSH significantly decreased. Severe apoptosis appeared in the cardiomyocytes of the model control group. Compared with the model control group, the pretreatment of fisetin could significantly reverse the changes of myocardial injury induced by I/R, and the protective effect of high dose of fisetin was more obvious. Conclusion Fisetin can significantly alleviate I/R-induced myocardial injury and exerts a dose-dependent effect. The protective effect of fisetin may be related to its anti-oxidation, anti-inflammatory and anti-apoptotic effects.
Objective To investigate the difference of osmotic kinetic parameters of magnolol and honokiol on different permeation enhancers. Methods Isolatedrat abdominal skins were served as transdermal barrier. Improved Franz diffusion cell method was applied. Ethanol-0.9%sodium chloride solution (30:70) was served as a receiving solution transdermal absorption system, different concentrations of menthol, azone, transcutol.P as penetration enhancer. Magnolol and honokiol concentration in the receiving solution were determined by RP-HPLC. Results Magnolol and honokiol have significant differences under the action of different transdermal enhancers. When Azone served as permeation enhancer, magnolol had better transdermal property than honokiol. Menthol had a similar permeability effect on magnolol and honokiol. However, transderol.P exerted a significant inhibitory effect on magnolol while a potent permeation enhancing effect on honokiol. Conclusion Different transdermal enhancers exert different transdermal effects on magnolol and honokiol, which may be related to the different molecular structures.
Objective To explore cluster analysis in the evaluation of drug safety. Methods Totally, 12 batches of lansoprazole for injection produced by 12 manufacturers (code A-L) were subjected to hemolysis test, muscle stimulation test, in vitro cytotoxicity test, and 12 manufacturers were classified by cluster analysis according to the above three variables. Results The 12 manufacturers can be divided into three classes: production enterprise K in a class; A, C, D, E, F, I in a class; B, G, H, J, L in a class. Conclusion The safety of lansoprazole for injection produced by the 12 enterprises was obviously different. Cluster analysis could be used in drug safety evaluation.
Objective To encapsulate PLGA nanoparticles modified with folic acid conjuncted chitosan (F-CS-PLGA-NPs) and to study its in vitro inhibitory effect on SKOV-3 and SKOV-3/TAX. Methods Folic acid conjuncted chitosan oligosaccharide was synthesized using carbodiimide as the catalys, which was used as nanoparticles materials to obtain the paclitaxel loaded nanoparticles. MTT experiment was adopted to evaluate the inhibitory effect of F-CS-PLGA-NPs on SKOV-3 and SKOV-3/TAX cells. Results The in vitro experiments showed that the inhibitory effect of PLGA-NPs and F-CS-PLGA-NPs on proliferation of SKOV-3/TAX was less sensitive than that on the proliferation of SKOV-3. The IC50 of F-CS-PLGA-NPs on SKOV-3 and SKOV-3/TAX cells were (23.17±2.45) nmol·L-1 and (88.81±10.69) nmol·L-1. Conclusion Folic acid conjuncted chitosan oligosaccharide modification could increase the targeting efficiency of nanoparticles on drug-resistant tumor cell, which might be a potential formulation for treating drug-resistant cancer cells.
With high internal and external surface area and pore volume,adjustable pore size,colloidal stability,favorable biocompatibility,diverse surface chemistry,scientists in nanomedicine field pay intensive attention on porous silica spheres.In this review,at first,the fabrication strategy of porous silica spheres with different structure,such as hierarchical solid sphere,core shell spheres and porous hollow spheres was discussed;then explore the various responsive strategy used for controllable drug delivery system;and lastly review the application of porous silica carriers in controlled drug delivery.
Nanocarriers of skin functional ingredients have wide applicable prospects in transdermal drug delivery and cosmetics,with good effects of diseases treatment and skin care.This article introduces the characteristics of nanocarriers for skin functional ingredients and reviews the research progress on the nanocarriers for skin diseases treatment,barrier repairing,melanin inhibition,antioxidation,and anti-acne etc.
With excellent water solubility, biocompatibility and safety, hydroxyethyl starch (HES) has been widely used as clinical plasma volume expander for over 50 years. Because of the unique biological properties, HES can be used for in-vivo tumor-targeted delivery of anti-tumor drugs. Via conjugation or encapsulation, HES can increase the aqueous solubility and stability of the drug, thereby extending the half-life time, improving drug tumor accumulation, and reducing the toxicity and side effects of the drug. Abundant hydroxyl groups on the surface of HES can also be used for surface modification to achieve combinational therapies. Therefore, HES possesses significant potential for anti-tumor nanomedicine and clinical translation.
Radiation therapy has been one of the most widely used and most effective therapies for clinical treatment of malignant tumor. However, the high doses of ionizing radiations and severe damages to normal tissues adjacent to tumors limit the therapy effects of radiation therapy. Therefore, how to enhance radiation therapy sensitivity and specificity of tumor cells, and increase the local radiation dose of tumor tissues has been the hot spot and focus of the current tumor radiation therapy research. In recent years, due to the fascinating physicochemical properties, nanomaterials have played an increasingly important role in tumor radiation therapy, providing significant opportunities for tumor radiotherapy sensitization. This paper briefly reviews the research progress of nanomaterials in enhanced tumor radiation therapy and combined radiation therapy, expecting to provide new ideas and strategies for clinical tumor radiation therapy.
The oral delivery of peptides and proteins is still a hot research in pharmacy field despite the numerous challenges.The design of oral peptides and proteins delivery have three keys:protecting the macromolecules from degradation in the gastrointestinal tract,successfully permeating through the intestinal barrier and promoting drug absorption into the systemic circulation.Currently,oral formulations have been developed in clinical application.Nanotechnology shows good prospects of clinical application in oral delivery of peptide and protein drugs.This articles introduced the types,characteristics and carrier materials of nano drug delivery systems for oral administration of peptides and proteins,and mechanisms of oral uptake of nanoparticles. Several kinds of new nano drug delivery systems for oral administration and its mechanism in recent years was reviewed.
Oral delivery of insulin has always been a research highlight in the field of pharmaceutics.The key issue is to improve the bioavailability of orally delivered insulin by overcoming the multiple barriers to absorption of insulin simultaneously.Rapid breakthroughs in formulation technique of nanomedicine shed a light on effective oral delivery of insulin.In this publication,the current status of insulin-loaded nanoparticles was reviewed.The efficiency and shortcomings of insulin nanoparticles in overcoming the multiple barriers to absorption are discussed.The review ends with some prospects and challenges for the success of administering insulin-loaded nanoparticle orally in diabetes treatment.
Objective To study the effect of levosimendan on QT dispersion (QTd) and ventricular arrhythmia in patients with acute ST segment elevation myocardial infarction (STEMI) complicated with acute heart failure (AHF). Methods A total of 92 patients with STEMI complicated with AHF were randomly divided into treatment group (46 cases) and control group (46 cases).Each group underwent intravenous thrombolytic therapy and conventional therapy,on this basis,the treatment group received leosimendan by micro pump,and the control group received dobutamine by micro pump.Two groups had been given continuing dripping with micro-infusion pump for 24 h.N terminal B type natriuretic peptide (NT-proBNP),left ventricular ejection fraction (LVEF),QT dispersion (QTd),corrected QT dispersion (QTcd) and ventricular arrhythmias before and after treatment were detected. Results After the treatment,the NT-proBNP and LVEF of the two groups were significantly improved (all P=0.000),the improvement was more significant in the treatment group (all P=0.000).There were no statistically significant differences in QTd,QTcd,premature ventricualar contraction (PVC) and short paroxysmal ventricular tachycardia (SPVT) in the treatment group before and after the treatment (P>0.05);The QTd,QTcd,PVC and SPVT of the control group after treatment were significantly increased compared with those before treatment (P<0.05 or P<0.01).After treatment,QTd,QTcd,PVC and SPVT in the treatment group were lower than those in the control group (P<0.05 or P<0.01).The incidence of adverse reactions in the treatment group was lower than that in the control group (P<0.05). Conclusion Levosimendan is better than dobutamine in treating STEMI complicated with AHF,and does not increase QTd,QTcd and the incidence of ventricular arrhythmia,with less adverse reaction.
Cerebral hemorrhage occurs and progresses quickly, and has high morbidity and mortality. At present, the research on its mechanism of progress, especially secondary injury mechanism and its intervention has become a hotspot. In recent years, the experimental study has shown that Buyanghuanwu decoction has the effect of promoting angiogenesis, alleviating brain edema, inhibiting cell apoptosis and protecting brain function, which provides the experimental basis for the early use of this method in the treatment of acute cerebral hemorrhage.
Objective To rapidly identify Fructus Lycii in different planting areas. Methods Fourier transform infrared spectroscopy (FTIR) and two-dimensional correlation spectroscopy (2DIR) were used to analyze and evaluate the medicinal powder, water extract and alcohol extract of Fructus Lycii in different planting areas. Results The result of single-dimensional FTIR of Fructus Lycii in different planting areas were very similar, and the similarity coefficients were more than 0.950. In the two order derivative spectrum, the peak position and the peak intensity of crude medicinal herbs and water extracts of Fructus Lycii were obviously different at 1 500-1 800 cm-1. At the 800-1 160 cm-1 band in the two-dimensional correlation spectrum, the relative peak intensity of Ningxia wolfberry was the highest. It indicated that the polysaccharides and glycosides of Fructus Lycii in Ningxia were higher than those in other three areas. In the 1 520-1 800 cm-1 band, there were 2 groups of obvious automatic absorption peaks in Ningxia wolfberry. There were 4 groups of obvious automatic absorption peaks in Inner Mongolia, Gansu and Qinghai wolfberry, which reflected the difference of Fructus Lycii in different area. Through analysis of water extracts and alcohol extracts of Fructus Lycii from different planting areas, it further indicated that there were obvious differences in the amino acids, proteins, amides, polysaccharides and glycosides in Fructus Lycii from different planting area. Conclusion FTIR with 2DIR provided a rapid and comprehensive evaluation method for identification and analysis of Fructus Lycii in different planting areas.
Objective To optimize preparation process of butylphthalide sulfobutyl ether-β-cyclodextrin inclusion complex. Methods Freeze-drying method was adopted to prepare butylphthalide sulfobutyl ether-β-cyclodextrin inclusion complex. Inclusion ratio was served as index, the effects of inclusion temperature, inclusion time and the ratio of sulfobutyl ether-β-cyclodextrin to butylphthalide on the inclusion process were investigated by using response surface method. The optimal inclusion process was predicted according to the formulation which was established and fitted by multi-linear equation, second-order polynomial equation and the third-order polynomial equation. Results The optimum inclusion technology of butylphthalide sulfobutyl ether-β-cyclodextrin inclusion complex was as follows: inclusion temperature was 67 ℃, inclusion time was 2.09 h, the input ratio of sulfobutyl ether-β-cyclodextrin to butylphthalide was 2.6:1. The deviation of inclusion ratio between actual value and predicted value was 2.4%. Conclusion Mathematical model established by central composite design and response surface method has a good prediction, which can be used to optimize the preparation process of butylphthalide sulfobutyl ether-β-cyclodextrin inclusion complex.
Objective To establish a HPLC method for simultaneous determination of puerarin, ferulic acid and salvianolic acid B in Tongmai dropping pills. Methods The Kromasil C18 chromatographic column (250 mm×4.6 mm, 5 μm) was used, and the Column temperature was set at 30 ℃. The mobile phase was methanol-0.1%phosphoric acid with a gradient elution. The flow rate was 1.1 mL·min-1. The injection volume was 20 μL. The UV detection wavelength was set at 250 nm, 321 nm and 286 nm. Results The linear ranges of puerarin, ferulic acid and salvianolic acid B were 41.6-416 μg·mL-1 (r = 0.999 9), 3.84-38.4 μg·mL-1 (r=0.999 8), 36.8-368 μg.mL-1 (r=0.999 8), respectively. The average recovery rates were 99.49%, 99.73%and 100.18%, and RSDs were 1.11%, 1.22%and 0.94%, respectively. Conclusion The method is simple, accurate, reproducible, and proper for simultaneous determination of puerarin, ferulic acid and salvianolic acid B in Tongmai dropping pills.
Objective To prepare the artesunate self-microemulsion and evaluate its quality. Methods The equilibrium solubility of artesunate in oils, emulsifier and co-emulsifier was investigated, respectively. The prescription composition of artesunate self-microemulsion was screened by using the pseudo-ternary phase diagrams. The stability and quality of artesunate self-microemulsion were studied. Results The optimal artesunate self-microemulsion formula was composed of Cremophor EL: n-buty alcohol: ethyl oleate (54:36:10), and the quality fraction of artesunate was 50 mg·g-1. The average particle size was (15.48±0.66) nm, while the Zeta potential was (-5.78±0.34) mV. The result of drug release showed that artesunate self-microemulsion could improve the drug dissolution rate significantly in vitro, and the preliminary stability was good. Conclusion The self-microemulsion with small particle size is stable, the drug release in vitro was significantly improved as compared with artesunate API, and has a good stability.
Objective To investigate the clinical distribution and drug resistance of common pathogenic bacteria in central nervous system infection and provide reference for rational use of antibiotics in clinic. Methods Retrospective analysis of pathogenic bacteria isolated from cerebrospinal fluid specimens in our hospital from 2012 to 2016 was carried out. Drug susceptibility was tested by K-B method except for Cryptococcus neoformans by the ATB method of MIC value. Results A total of 643 strains of pathogenic bacteria were isolated from cerebrospinal fluid specimens, and the top five pathogens were as following: 101 batches were Staphylococcus epidermidis (15.7%), 59 batches were Acinetobacter Bauman (9.2%), 52 batches were Staphylococcus aureus (8.1%), 49 batches were Cryptococcus neoformans (7.6%) and 40 batches were Staphylococcus haemolyticus (6.2%). The results of drug sensitivity showed that the sensitivity of Acinetobacter baumannii to common antibiotics was less than 25%, the sensitive rate of Staphylococcus aureus to cotrimoxazole, vancomycin, teicoplanin and linezolid were more than 98%, the sensitive rate of fluconazole, amphotericin , 5-fluorine cytosineand voriconazole to Cryptococcus neoformans was more than 95%. Conclusion The main pathogenic bacterias isolated from the central nervous system infection in hospital were Acinetobacter Bauman, Staphylococcus aureus and Cryptococcus neoformans. Drug resistance was serious for Acinetobacter Bauman. Clinicians should select antibiotics according to the results of drug sensitivity.
Objective To investigate the serum trough concentration and pharmacokinetics of vancomycin in patients with severe sepsis. Methods Trough concentrations of vancomycin from 128 patients with severe sepsis were collected. All eligible patients were divided into lung infection group(n=45), abdominal infection group(n=37), bloodstream infection group(n=33) and mixed infection group(n=13) according to the different infection site. According to the age, patients were divided into elderly group(n=54) and adult group(n=74). The trough concentration of vancomycin was measured by fluorescence polarization immunoassay. The pharmacokinetic parameters of vancomycin were calculated by Bayesian feedback method. Results The trough concentrations of vancomycin varied from 1.7 to 36.8 mg·L-1. Only 46.9%of the samples could reach 10-20 mg·L-1. The standard-reaching rate in adult group was 43.2%, that of elderly group was 51.9%. The mean vancomycin trough concentration of the elderly was higher than that of the adults. Regression analysis indicated that vancomycin trough concentrations had a good correlation with age, creatinine clearance, acute physiology and chronic health score. The Vd of vancomycin was (1.00±0.12) L·kg-1, and the CL was (78.80±44.51) mL·min-1, significantly increased (P<0.01). The Vd increased significantly, which is compared with the mean Vd of vancomycin, and the CL of the adult group was significantly higher than that of the elderly group. Conclusion The stand reaching rate of vancomycin serum trough concentration is low in patients with severe sepsis. Both the trough concentration and pharmacokinetic parameters had significant individual differences. The age, CL and APACHEⅡ of the patients obviously influenced the trough concentration. Vancomycin should be used based on the patient’s own pathophysiological conditions, the dosing regimen could be optimized with the help of therapeutic drug mornitoring, and clinical individualization should be implemented.
Objective To investigate and analyze the effect of clinical pharmacist participating in the operation mode of medication management in patients with idiopathic membranous nephrology. Methods A total of 88 patients hospititalized in the First Hospital of Jiaxing City from October 2010 to October 2015 were divided into guardianship group (n=48) and control group (n=40). All patients received conventional therapy combined with glucocorticoid and cyclophosphamide. Clinical pharmacists participated in drug management in patients with idiopathic membranous nephropathy. Clinical pharmacists participated in management of drug use in patients with idiopathic membranous nephrology. They carried out patient management, electronic health records, drug guidance and prevention of adverse reactions. The drugs included glucocorticoid, anticoagulants, blood-pressure medications, and lipid-lowering drugs mainly. Clinical efficacy, 24 h urinary protein, albumin, serum creatinine, eGFR, fibrinogen, total cholesterol (TC), triglyceride (TG) before and after treatment and adverse reactions in all groups were observed. Results There were no significant differences in basic data of 24 h urine protein, serum albumin, serum creatinine and eGFR between the two groups pre-treatment. The levels of 24 h urine protein, serum albumin, serum creatinine and eGFR were significantly different between the two groups (P<0.01). The levels of TC and TG in the guardianship group were significantly decreased after the treatment (P<0.05). The prothrombin time in the control group was significantly shortened after the treatment (P<0.05). The total effective rate in the guardianship group was significantly higher than that in the control group (P<0.05). During the treatment period, impaired glucose tolerance, gastrointestinal symptoms and respiratory tract infection were the most common complications. The difference was not statistically significant between the two groups. Conclusion It is beneficial for patients with idiopathic membranous nephropathy to conduct pharmacy guardianship with the participation of clinical pharmacists.
Objective To investigate the breakthrough points of pharmaceutical care for patients with pulmonary embolism complicated with heart failure. Methods Through the treatment and pharmaceutical care for three patients with pulmonary embolism complicated with heart failure,analysis and summarization were performed. Results Based on factors such as the patients' condition and co-administered drugs,clinical pharmacists proposed optimization suggestions on medication,and successfully relieved symptoms of the patients. Conclusion Clinical pharmacists develop individual pharmaceutical care plan according to pharmaceutical knowledge,which have positive influence on improving the compliance of patients and reducing the incidence of adverse drug reactions.
Objective To investigate the status of implemention and the relevant influential factors of the outpatient special diagnosis and treatment project on rheumatoid arthritis and ankylosing spondylitis (RA/AS) in Xi'an city, and to provide suggestions for the further improvement of this project. Methods With questionnaire survey, the relevant data of patients with RA/AS were collected and analyzed by descriptive statistics and chi-square test. Results Patients of rheumatoid arthritis or ankylosing spondylitis had some differences in the morbidity, history and distribution of disease degree. The main of the patients were farmers with New Rural Co-operative Medical System. 45.3% patients had been treated with biological agents, 70.6% patients had not been applied for reimbursement for the treatment with biological agents, 22.1% patients had been applied for that, and 7.3% patients had participated in clinical trial of biological agents. The patient’s acceptance of this project was not high. Only 40.7% patients knew the project. The main factors that affected the patient’s awareness of the project were the type of disease, gender, occupation type, type of health insurance, insured areas, using biological agents or not and being applied for reimbursement or not, etc. Conclusion By standardizing the process of disease diagnosis and carrying out relevant research, which could further improve reimbursement ratio and expand the scope and objects of reimbursement appropriately to improve the acceptance of the policy. Through carrying out the systematic training for medical insurance staff and patient education, expanding the methods and the innovating ways of propaganda and other aspects to increase publicity efforts, thus increasing the awareness rate of this policy.
Objective To understand the current situation of methcathinone abuse in Changzhi district of Shanxi Province, and explore the characteristics of methcathinone abusers. Methods A questionnaire survey was conducted and analyzed among 261 male methcathinone abusers at a compulsory isolated detoxification center in Changzhi city, Shanxi province. Results The abuse of methcathinone was mainly among people between 25 and 45 years of age. The majority of the abusers came from rural areas and abusers with educational backgrounds over junior high school accounted for 49.4%. Most abusers were peasants and workers. Intranasal administration was the most common way for the intake of methcathinone. The abuse duration was 3 years and the abuse dosage was 0.1-0.5 g per time in the majority of the cases. The major reasons for drug abuses were curiosity, stress and impacts of family and friends. The physical symptoms of methcathinone abuse involved the autonomic nervous system, the cardiovascular system, the digestive system and the reproductive system. The psychological and behavioral symptoms mainly included increased speech speed, behavior paranoia and abnormal excitement. Conclusion Methcathinone is highly addictive and harmful to physical and mental health. Therefore, methcathinone must be strictly controlled so as to prevent a wider range of abuse and greater social harm.