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.
Objective To investigate the protective effects of GABA against experimental inflammatory bowel disease (IBD) by enhanced intestinal barrier function and explore its underlying mechanisms. Methods Forty SD rats were randomly divided into normal control group, TNBS-alcohol model control group, 200, 100, 50 mg·kg-1 GABA treatment group.After modeling for 14 days, the changes of body weight and disease activity indexes (DAI) were observed.On the 15th day after modeling, 5 rats in each group were subjected to Evans blue staining.For the remaining rats, colon was collected and evaluated with histological injury score; the length and weight of the colon was determined.The intestinal mucosal barrier connexin and LC3 expression in rats with experimental colitis were observed by WB method. Results The cell resistance of Caco-2 monolayer models was increased and the infiltration of FD4 and the monolayer permeability was reduced by GABA.GABA also improved body mass, increased DAI, and lowered colon index.In addition, GABA decreased the Evans blue permeability and pathological changes in rats with experimental colitis, and significantly increased the Occludin, Claudin-4 and ZO-1 protein expression in the rats.Intestinal autophagy appeared in experimental colitis rats, GABA inhibited excessive autophagy. Conclusion GABA could relieve TNBS-ethanol-induced experimental colitis, and the mechanism might be related to the improvement of intestinal mucosal barrier injury.
Objective To study the effects of tetramethylpyrazine (TMP) on ABR threshold and oxidative stress in gentamicin (GM)-induced toxicosis of ear and kidney in guinea pig. Methods Forty healthy white guinea pigs were randomly divided into four groups: 0.9% sodium chloride solution (NS) group, gentamicin (GM) group, tetramethylpyrazine (TMP) group, gentamicin and tetramethylpyrazine (GM +TMP) group. Each group was given TMP for continuous 10 days. The levels of superoxide dismutase (SOD), malondialdehyde (MDA) and glutathione peroxidase (GSH-PX) were measured in the cochlea and kidney of guinea pigs before and 10 days after dosing. Results There was no significant difference in ABR threshold between each group before administration. After 10 days of administration, the ABR threshold of GM group was significantly changed (t=2.56, P<0.05). The ABR threshold of GM+TMP group was significantly lower than that of GM group (t=3.86, P<0.05). The activity of GSH-PX decreased significantly (t=2.78, P<0.05). The activity of SOD, MDA and GSH-PX in renal tissue of guinea pigs were significantly different from those in cochlea (t=2.45, P<0.05). Conclusion TMP reverses the oxidative stress response by decreasing the production of reactive oxygen species, free radicals and, and reduces the toxicity in the ear and kidney. The reversing effect is stronger on renal toxicity than on ear toxicity.
Objective To study the cytotoxicity and insulin intracellular delivery of four kinds of phospholipid vesicles as liposome, ethanol liposome, propylene glycol liposome, and lipid microbubble in human lung adenocarcinoma cell line (A549). Methods A549 cells were treated with four kinds of insulin phospholipid vesicles. Methyl thiazolyl tetrazolium (MTT) chromatometry method was employed to determine the cytotoxicity of phospholipid vesicles. The content of intracellular insulin was detected by electrochemical luminescence method (ECLIA). Results MTT experimental results showed that when the insulin concentration was less than 0.2 U·mL-1, the cell survival rate was more than 95%. When concentration of insulin phospholipid vesicles was 50%, the highest cell survival rate was in insulin liposome group (62.48±2.46)%; the lowest cell survival rate in ethanol liposome group (16.85±5.05)%. The relative safety order was liposomes, microbubbles, propylene glycol liposomes, and ethanol liposomes. At the same concentration of phospholipid vesicles, the order of insulin intracellular contents was: lipid microbubbles>propylene glycol liposomes>ethanol liposomes>liposomes. Conclusion Liposomes and lipid microbubbles constructed with phospholipid membrane are of high safety. Lipid microbubbles have the strongest ability in insulin intracellular delivery.
Objective To compare the efficacy and safety of leflunomide (LEF) tablets alone or combined with methotrexate (MTX) in the treatment of rheumatoid arthritis (RA). Methods One hundred RA patients were randomly divided into treatment group (LEF+MTX group) (50 cases) and control group (LEF group) (50 cases). Patients in control group were orally given LEF 20 mg, once a day. Patients in treatment group were orally given LEF 20 mg, once a day, and MTX 5 mg, once a week. All patients were treated for 24 weeks. The clinical symptoms, laboratory index and adverse drug reaction (ADR) of patients in the two groups were observed. Results All 100 cases finished the 24-week treatment. The effective rate was 80.0% in control group and was 84.0% in treatment group after 12 weeks. After treatment for 24 weeks, the effective rate was 88.0%, and the obvious progress rate was 26.0% in control group. In treatment group, the effective rate was 92.0%, and the obvious progress rate was 30.0%. The symptoms of patients with RA in both of the two groups were significantly improved. After treatment for 12, 18, 24 weeks, two groups both improved joint pain, decreased the morning stiffness time, enhanced hand power, reduced swelling joints scores (SJC) and tendered joints scores (TJC), enhanced the function of joints, reduced health assessment questionnaire (HAQ) scores. There was no statistically significant difference in improvement of symptoms between the two groups. After treatment for 18 and 24 weeks, two groups both reduced C-reaction protein, but had no effect on rheumatoid factor (RF). After treatment for 18 and 24 weeks, treatment group decreased erythrocyte sedimentation rate (ESR). After treatment for 24 weeks, LEF decreased ESR. There was no statistically significant difference between the two groups. After treatment for 6 months, the adverse reaction rate was 14.0% in treatment group and 6.0% in control group, with a significantly significant difference between the two groups (P<0.05). Conclusion LEF tablets alone or combined with MTX have obvious therapeutic effect on RA, and there is no statistically significant difference between the two groups. The adverse reaction rate in LEF tablets combined with MTX is higher than that of LEF tablets alone.
Objective To investigate the characteristics of medical visits, fee per time, cost structure and the annual direct medical burden trends of hospitalized patients with ankylosing spondylitis, and to provide theoretic evidence and support for the policy formulation in related department. Methods The relevant data of hospitalized patients with ankylosing spondylitis with urban basic medical insurance were collected from 2012 to 2015. Results The age distribution of ankylosing spondylitis patients mainly concentrated in 15 to 44 years old, the ratio of male to female was 3.33:1. Visiting rate in tertiary hospital for patients with ankylosing spondylitis with the urban worker medical insurance and the urban residents medical insurance was 92.33% and 94.00%, respectively; The average length of stay was 14 and 15 days, respectively; The average cost was 7 364.42 yuan and 7 292.35 yuan, respectively. For average cost per year, the patients with the urban worker medical insurance showed a decreasing trend; However, the patients with the urban residents medical insurance was on the rise. In 2014 and 2015, the proportion of the cost of drug, treatment, and assay was in the top 3. The total direct medical costs of this two kinds of patients were on the rise. Conclusion This kind of disease is more likely to occur in young men. Visiting rate in tertiary hospital for patients with ankylosing spondylitis is higher. The economic burden is very heavy, which brings some bad influence on patients and health care insurance system. Therefore, hierarchical diagnosis and treatment should be actively improved, medical resource allocation reasonablly planned, the medical insurance payment improved, the cost of other projects reduced, and the fairness of health insurance and services improved, thus the patients’ disease burden reduced.
Objective To evaluate the clinical efficacy of platelet-rich plasma injection (PRP) in the treatment of advanced knee osteoarthritis (KOA) by intra-articular injection. Methods A total of 65 patients with symptomatic KOA (Kellgren-Lawrence grade Ⅲ to Ⅳ) were enrolled in this study between January 2014 and June 2016. The patients were randomized to treatment group (group PRP, 30 cases) and corticosteroid group (treated with local anesthetic intra-articular injection, group CSA, 35 cases). All the patients were evaluated respectively before the treatment and 1,3,6 months after the treatment by visual analog scale (VAS) score. Results Before the treatment, VAS score was not significantly different between the two groups (P>0.05). One, three, six months after the treatment, symptoms in both groups were improved, and VAS score was significantly decreased (P<0.05), but there were no significant differences between the two groups (P>0.05). Conclusion PRP intra-articular injection is effective for relieving pain, improving function of joint activities and living quality. But for the patients with late-stage KOA, there was no significant difference in clinical efficacy between PRP and CSA.
Objective To observe the influence of continuous infusion of dexmedetomidine in elderly patients on residual neuromuscular blockade after laparoscopic inguinal hernia repair. Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes, aged 65-85 years, body mass index 19-25 kg·(m2)-1, scheduled for laparoscopic inguinal hernia repair, were randomly divided into two groups (n=30 each) by using a random number table: control group (group C) and dexmedetomidine group (group M). In group M, dexmedetomidine 1 μg·kg-1·h-1 and 0.5 μg·kg-1·h-1 was infused intravenously after induction of anesthesia until 10 min before the end of operation, while the equal volume of 0.9% sodium chloride solution was given into the group C. Clinical effect, the index of recovery, the rate of residual neuromuscular blockade 30 min after extubation and 1 h after operation (TOFR<0.9 represents residual neuromuscular blockade) were recorded. Results Clinical time limit was (24.0±2.7) and (23.6±3.1) min in group C and group M, respectively. Recovery index was (63±6) and (60±5), respectively; postoperative residual curarization appeaved in 26 and 25 cases, respectively 30 min after extubation, and it appeared in 3 and 2 cases, respectively 3 h after the surgery in group C and group M.There were no significant differences in recovery index and the rate of residual neuromuscular blockade 30 min after extubation and 3 h after the operation (P>0.05). Conclusion Continuous infusion of dexmedetomidine in elderly patients has no effects on residual neuromuscular blockade.
Objective To study the effect of valsartan combined with rosuvastatin on maintenance of sinus rhythm in patients with non valvular paroxysmal atrial fibrillation after cardioversion (PAF). Methods Totally, 120 patients with PAF who converted into sinus rhythm by amiodarone were randomly assigned to three groups in accordance with the maintenance of sinus rhythm of different drugs: group A (40 cases), amiodarone alone; group B (40 cases), valsartan+rosuvastatin; group C (40 cases), valsartan+rosuvastatin+amiodarone.The changes in P wave maximum duration (Pmax), P wave dispersion (Pwd), and left atrial diameter (LADd) were compared among the three groups before treatment and 12 months after the treatment; the maintenance rate of sinus rhythm 3, 6, and 12 months after cardioversion was compared; adverse drug reactions of the three groups within12 months were recorded. Results The incidence of adverse reactions was lower in group B than in group A and group C (group B vs.group A,χ2=7.314, P=0.007; group B vs.group C,χ2=6.135, P=0.013).There was no significant difference in the incidence of adverse reactions between group A and group C (χ2=0.075, P=0.785); Hs-CRP, Pmax, Pwd, LADd in group C was lower than those in group A (all P<0.05), LVEF in group C was higher than that in group A (P<0.05), hs-CRP, Pmax, Pwd, LADd were lower in group B than in group A (all P<0.05).There were no statistically significant differences in LVEF between the two groups (P=0.032).Pmax was lower in group C than in group B (P=0.012), LVEF was higher in group C than in group B (P=0.002).There were no statistically significant differences of hs-CRP, Pwd, LADd between the two groups.After 12 months of treatment, the maintenance rate of sinus rhythm in group C was higher than that in group A and group B (group C vs.group A, χ2=6.134, P=0.013; group C vs.group B, χ2=9.869, P=0.002).There was no statistically significant difference in sinus rhythm maintenance rate between group A and group B (χ2=0.446, P=0.504). Conclusion For sinus rhythm maintenance in patients with nonvalvular atrial fibrillation after cardioversion, the efficacy of group C is the best, group B and group A showed similar efficacy, but the incidence of adverse reactions of group B was less than that of group A and group C. Group B and group C have anti-inflammatory effect and inhibit atrial remodeling.
Objective To assess application effect of ultrasound guided-guided ilioinguinal/iliohypogastric (IiN/IHN) nerve blocks combined with rectus sheath block (RSB) with local anesthetic (LA) in high ligation of pediatric hernia by using laparoscope. Methods Fifty children aged 4-8 years scheduled for surgery were included in the study. After induction of general anesthesia and prior to surgical incision, patients were prospectively randomized into one of two groups: Group U received US-guided IiN/IHN and RSB with 0.1 mL·kg-1 of 0.15% ropivacaine; Group C received a caudal block with 0.75 mL·kg-1 of 0.15% ropivacaine. CHEOPS was used for pain assessment of the patients at PACU and public ward. Number of cases using tramadol was recorded. Parental satisfaction was surveyed before discharge. Results The average pain scores during hospital stay were not significantly different between group U and group C (P>0.05). In recovery room, no patients required pain rescue medication in group C and group U. Seven patients in the group U and six patients in group C required pain rescue medication at stay unit (P>0.05). No other adverse reaction occurred in the two groups during and after the surgery. Conclusion US-guided IiN/IHN nerve block and rectus sheath block is an ideal postoperative analgesic for hernia repair surgery in children, and is as effective as caudal block.
With the extensive use of recombinant cytokine biologic drugs in hospitals, the reports of adverse reactions of such drugs are also increasing. In this paper, by searching adverse effects of several types of recombinant human interleukin, such as recombinant human granulocyte stimulating factor, recombinant human interleukin,recombinant human interleukin, and other recombinant cytokines through database, we may understand the rules and the occurrence characteristics of adverse drug reaction of these , in-depth analysis of the causes of adverse reactions, and provide a good reference for the clinical application of such drugs safely.
The impact of anesthetics on patients, especially in young people with rapid brain development, is the focus of attention. Currently, researches are focused on the self-renew, proliferation, differentiation and apoptosis of the neural stem (progenitor) cell. The impaction of some anesthetics is concentration-dependent and duration-dependent via some classics signal pathways, e.g. Wnt, Caspase, Sox2, as well as the MicroRNA which is in the upper of these pathways. The future research will concentrate on the mechanisms of these effects in vivo and in vitro as well as the high throughput evaluation by using the characteristics of anesthetics on neural stem (progenitor) cell.
Objective Using central composite design-response surface methodology (CCD-RSM) to optimize the formulation of buspirone (BUS) gastric-floating sustained release tablets. Methods Levels of HPMC (K4M), MCC, lactose and NaHCO3 served as the independent variables. And the cumulative release and flotation performance of 2, 4 and 8 h were used as evaluation indexes. Preparation formulation was optimized by CCD-RSM. Release mechanism of drug from tablets was investigated. Results Tablets containing BUS were prepared by direct powder compression method. The optimized formulation was as follows: HPMC 70 mg, MCC 25 mg, lactose 50 mg, NaHCO3 45 mg. Initial floating time was less than 1 min and duration of floating was longer than 8 h. The cumulative release of the drug for 8 h was over 75%. Sustained release tablets in vitro proved to be non-Fick diffusion after equation fitting process. It’s a two-stage diffusion, the first stage wass dominated by drug’s diffusion while the second one by matrix’s dissolution. Conclusion The optimized formulation shows advantages in floating performance and releasing sustainability by CCD-RSM.
Objective To establish a fingerprint and quality standard for Huiru Yizeng granules. Methods Fingerprint of Huiru Yizeng granules was established by high performance liquid chromatography (HPLC). The thin layer chromarography (TLC) was used for qualitative identification of Prunella vulgaris and Thunberg Fritillary Bulb. HPLC was applied for the determination of rosmarinic acid and hordenine. According to the “Chinese pharmacopoeia” 2015 version, character, granularity, dry weight loss and dissolubility were tested. Results TLC spots were clear and well-separated without negative interference. A good linear relationship was found at range of 18.0-450.8 mg·L-1 for rosmarinic acid (r=0.999 9), 3.00-150.02 mg·L-1 for hordenine (r=0.999 0). In addition, the average recoveries were 98.5% and 96.9%, respectively. The particle size test showed that about 10.48% particle can not through sieve of 1(diameter of 2 mm) and can pass the sieve of 5(diameter of 0.18 mm). Loss weight on drying was 2.85%. All was dissolved in 5 minutes. HPLC fingerprint of Huiru Yizeng granules was established with ten common peaks, and the similarity was between 0.963 to 0.998. Conclusion The method is simple, accurate and reproducible. It can be used for the quality control of Huiru Yizeng granules.
Objective To study the mobility between vitamin B6/sodium bicarbonate injection and low borosilicate glass ampoule Methods The translocation of element boron (B), aluminum (Al), arsenic (As), cadmium (Cd), antimony (Sb), barium (Ba) and lead (Pb), migrated from the glass ampoule to B6/sodium bicarbonate injection was respectively measured in 6 and 30 months using inductively coupled plasma mass spectrometry (ICP-MS). Results The linear ranges of B, Al, As, Cd, Sb, Ba, Pb were 2-1 000 ng·mL-1 (r=0.998 8), 25-1 000 ng·mL-1 (r=0.998 2), 0.2-1 000 ng·mL-1 (r=1.000 0), 0.04-1 000 ng·mL-1 (r=0.999 8), 0.02-10 000 ng·mL-1 (r=0.999 8), and 0.1-1 000 ng·mL-1 (r=0.999 9), respectively. Additionally, their respective detection limit were 0.391 ng·mL-1 (B), 7.482 ng·mL-1, 0.035 1 ng·mL-1(Al), 0.006 24 ng·mL-1 (As), 0.004 94 ng·mL-1 (Cd), 0.030 5 ng·mL-1 (Ba) and 0.025 4 ng·mL-1 (Pb). Conclusion The influence of acidic injection and basic injection on low-borosilicate glass ampoules is different and the influence increases in a time-dependent manner.
Objective To establish a high performance liquid chromatography (HPLC) method for simultaneous determination of six components (chlorogenic acid, paeoniflorin, liquiritin, ferulic acid, glycyrrhizic acid and ligustilide) in Xiaoyao pills. Methods A Kromasil C18 column(250 mm×4.6 mm, 5 μm)was used. The mobile phase was acetonitrile (A)-0.1% phosphoric acid solution (B) at the flow rate of 1.0 mL·min-1 for gradient elution : 0-10 min, 5%A; 10-25 min, 5%→20%A; 20-70 min, 15%→60%A and 40-60 min, 60%A. The determination wavelengths were 326 nm (0-27.0 min) for chlorogenic acid, 230 nm (27.0-30.5 min) for paeoniflorin, 280 nm (30.5-36.0 min) for liquiritin and ferulic acid, 276 nm (36.0-52.0 min) for glycyrrhizic acid, 350 nm (52.0-70.00 min) for ligustilide. The column temperature was 35 ℃ and injection volume was 10 μL. Results The six compounds were well separated. The linear ranges were 27.09-270.90, 30.22-302.23, 12.45-124.48, 9.79-97.92, 6.89-68.92 and 7.46-74.56 μg·mL-1 for chlorogenic acid, paeoniflorin, liquiritin, ferulic acid, glycyrrhizic acid and ligustilide, respectively, with the correlation r>0.999 0. The average recoveries were between 97.9% and 100.8% with RSD varied from 0.55% to 1.83%. The contents of chlorogenic acid, paeoniflorin, liquiritin, ferulic acid, glycyrrhizic acid and ligustilide were 12.25-12.30, 10.38-10.45, 5.58-5.64, 5.07-5.14, 2.01-2.08 and 2.67-2.74 mg·g-1 in six batches of samples, respectively. Conclusion This method is simple, reliable and accurate, and could be used for the quality control of Xiaoyao pills.
Objective To retrospectively investigate and analyze potential inappropriate medication in elderly hospitalized patients, so as to provide reference for the rational use of drugs in elderly patients. Methods Medical records of 240 elderly hospitalized patients (≥ 65 years old) in 2016 were randomly collected. Potential inappropriate medication was analyzed on the basis of the primary judgment criteria of potential inappropriate medication in Chinese elderly patients. Results In the 240 elderly hospitalized patients, 90 had potentially inappropriate medication, the incidence was 37.50%. A total of 19 patients developed abnormal condition in accordance with the criteria; 5 cases developed 2 kinds of abnormal condition; 1 case 3 kinds of abnormal condition. Conclusion The incidence of potential inappropriate medication in elderly hospitalized patients is high. Some measurement should be taken to reduce the incidence of potential inappropriate medication in hospital and to improve the overall level of medication.
Objective To discuss the interaction between carbapenems and sodium valproate among special populations and the possible mechanisms, and provide references to medical treatment for clinicians. Methods Articles on interaction between carbapenems and sodium valproate among patients with liver dysfunction, patients with kidney insufficiency and children from 1990 to 2017 were selected from the electronic databases. Results Drug interaction was not observed in patients with liver dysfunction. Kidney disease was an independent risk factor for this drug interaction; The interaction between carbapenems and sodium valproate resulted in a dramatic decrease of valproate acid concentrations in children. Conclusion More attention should be paid to the serious drug interaction between carbapenems and sodium valproate, especially under special physiological and pathological conditions. The plasma concentrations of sodium valproate should be monitored when both drugs are used.
Objective To investigate the approaches of developing clinical pharmaceutical care for clinical pharmacists in patients with liver diseases. Methods Through case studies on the basis of the actual work in hepatopathy department, the working contents and methods of clinical pharmacists participating in clinical drug treatment were introduced. Results Clinical pharmacists participated in clinical drug treatment in hepatopathy department through participating in pharmaceutical inquiry, monitoring therapeutic drug, providing treatment recommendations, observing adverse drug reaction and drug interaction, strengthening medication consultation and education, et al. Conclusion Clinical pharmacists can provide various pharmaceutical care to the drug therapy in patients with liver disease, and carry out medical and nursing services projects in various ways to promote safe and rational drug use in clinic..
Drug registration test includes drug test and quality standard review. The actual registration test often neglects or simplifies the drug quality standard review, thus failing to scientifically reflect the application of the quality standard and whether it meets the current technical requirements. This paper analyzes and discusses the related problems of quality standard review during the process of drug evaluation, and provides suggestions about how to carry out the standardized registration test, so that registration test can provide important technical support for drug evaluation.