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  • 01 May 2019 Volume 38 Issue 5
      

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  • Anhua WEI,Juan LI
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    Heart failure is a serious or advanced stage of various heart diseases,which is identified as the final battleground in the cardiovascular field. The 2018 guidelines for the diagnosis and treatment of heart failure, which are based on the 2014 guidelines in China with new evidence and clinical status,aimed to provide practical,evidence-based guidelines for the diagnosis,classification,prevention,treatment and management of heart failure.This study reviewed updates of pharmacologic therapy in the guideline.

  • Tingting XIAO,Yonghong XIAO
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    Tigecycline,a broad-spectrum antibiotic known as the last resort for the treatment of multiple drug resistance bacterial infections,has been widely used in clinic since its approval in China in 2011. It is currently approved for complicated intra-abdominal infections,complicated skin and skin structure infections,and community-acquired pneumonia.However,numerous clinical studies and meta-analyses have raised concerns about its clinical efficacy and safety.Therefore,in this review,we objectively analyze the researches of tigecycline in recent years,including the mechanism of action and clinical application,which may provide references for clinical application.

  • Jidong CHEN,Wenqi OUYANG,Li ZHANG,Fei FANG
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    The occurrence of thyroid malignancy was considered a rare event in hyperthyroid patients.Recent studies have found an increased risk of thyroid cancer in patients of hyperthyroidism with thyroid nodules.Thyroid cancer is closely related to the early period of hyperthyroidism.However,there were significant differences among the results.In order to provide the basis for clinical diagnosis and treatment,it is necessary to clarify the relationship between hyperthyroidism and thyroid cancer. Although surgery is the preferred treatment,there is still no consensus on the choice of surgical approach.We believe that total thyroidectomy can not only cure hyperthyroidism but also effectively treat thyroid cancer.And targeted drug treatment provides a new method for some radioactive iodine-refractory differentiated thyroid cancer.The traditional Chinese meclicine therapy plays a supplementary role to make up for the lack of medicine.

  • Yadan ZHANG
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    Objective To investigate the effect of apigenin-loaded nanoliposomes on myocardial cells apoptosis induced by diabetic cardiomyopathy. Methods The apigenin-loaded nanoliposomes were prepared by film hydration and ultrasonic dispersion technology and their quality inspections were also investigated. Sixty SD rats were randomly divided into normal control group, model control group, blank and apigenin-loaded nano-liposomes group. Rat model of typeⅠdiabetes was induced by single intraperitoneal injection of STZ. After two weeks of STZ injection, the model rats were used for this study. The rats of apigenin loaded nano-liposomes treatment group were treated with apigenin loaded nano-liposomes via caudal vein administration for 12 weeks (three times a week). And the rats of normal control group and model control group were administrated equivalent volume of 0.9% sodium chloride solution. After treatment for 12 weeks, the experimental animals were sacrificed and their hearts were harvested after 0.9% sodium chloride solution perfusion. The myocardial cell apoptosis index was detected by TUNEL staining and the expressions of Bcl-2 and Bax, which were related to the cell apoptosis, were examined by Western blotting analysis. Results TUNEL staining showed the apoptosis index in the rats of diabetes and blank nano-liposomes groups were significant higher than the normal control group (P<0.05). However, there was significant decrease of apoptosis index in the diabetes rats after the treatment of apigenin loaded nano-lipsomes (P<0.05). Moreover, Western blotting analysis confirmed that there was significant lower expression of Bcl-2 and higher expression of Bax in the hearts of model control group and blank nano-liposomes treated rats compared with normal control rats (P<0.01). Compared with the diabetes and blank nano-liposomes group, the apigenin loaded nano-liposomes treated groups showed higher expression of anti-apoptosis protein Bcl-2 (P<0.01) and lower expression of pro-apoptosis protein Bax (P<0.01). Conclusion Apigenin loaded nano-liposomes have reduced the apoptosis of myocardial cells in diabetic cardiomyopathy rats via the Bcl-2/Bax pathway.

  • Zhixiu CAO,Yipeng LIU,Chuanhua ZHANG,Jingdong YUAN
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    Objective To observe the protective effect of green tea polyphenols on ischemia/reperfusion injury of rat kidney. Methods A total 30 male Sprague Dawley rats were randomly divided into sham group (n=10), I/R group (n=10) and I/R+G group (n=10), respectively. Both sham group and I/R group were gavaged with 0.9% sodium chloride solution 60 mg·kg-1·d-1 per day for 4 weeks. I/R+G group were gavaged with green tea polyphenols 60 mg·kg-1 ·d-1 for 4 weeks. Then, the ischemia/reperfusion injury model was established. The left kidneys of I/R group and I/R+G group were underwent ischemia/reperfusion for 50 min. Sixty min after operation, left kidneys were harvested for detection of MDA, SOD, KIM-1 and apoptosis index. Results The SOD of Sham group [(510.67±16.91) U·mg-1] and I/R+G group [(439.17±8.27) U·mg-1]were higher than that of I/R group[(174.02±9.62) U·mg-1, P<0.05]. The MDA of Sham group [(0.02±0.03) nmol·mg-1] and I/R+G group [(1.78±0.08) nmol·mg-1] were significantly lower than that of I/R group [(4.10±0.09) nmol·mg-1, P<0.05]. The score of KIM-1 expression in I/R group (4.52±0.11) was higher than that of Sham group (0.02±0.02) and I/R+G group (1.98±0.09)(P<0.05).The apoptosis index in Sham group (0.08±0.08) and I/R+G group (14.86±1.19) were much lower than that of I/R group (53.39±2.95, P<0.05). Conclusion Green tea polyphenols has exerted protective effect on ischemia/reperfusion injury of rat kidney.

  • Lingling SHEN,Guang DU
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    Objective To observe the effect of the extract of Jiawei Xuanmai Ganjie on pharyngitis of anti-inflammatory, expectorant and antibacterial. Methods The LD50 was determined by Sun's modified Karber's method. To study the anti-inflammatory effects of the extract, dimethylbenzene on ear swelling and cotton granulomatous model in mice was established. The phlegm removing activity in mice was observed with phenolic red excretion. The antibacterial effect on Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus pneumoniae, the common pathogenic bacteria in throat and upper respiratory tract, was evaluated by in vitro antimicrobial test. At the same time, the routine blood test and the levels of tumor necrosis factor (TNF) and interleukin-1 (IL-1) in serum were measured in rat acute pharyngitis model. Results The LD50 value of extract was 30.71 g·kg-1. The extract had obvious anti-inflammatory effects on acute and chronic inflammation models in a dose-dependent manner (0.77, 1.54 and 3.07 g·kg-1). In the phenolphthalein expectorant test, the extract of different doses could enhance the excretion of phenol red in trachea. In rat acute pharyngitis model, the percentage of white blood cells, neutrophils and lymphocytes in plasma and the levels of TNF and IL-1 in serum significantly decreased in the extract-treated group. Conclusion The extract of Jiawei Xuanmai Ganjie has significant anti-inflammatory, expectorant and bacteriostasis effects on pharyngitis, which may exert its effect by inhibiting TNF and IL-1 pathways.

  • Danping YAN,Pin MA
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    Objective To explore the effect and mechanism of Akt inhibitor MK2206 on proliferation and apoptosis of T24 cells. Methods The CCK-8 method was used to detect the cell proliferation. Then the effects of different concentrations (0,1,5,10,20 μmol·L-1) MK2206 on T24 cell apoptosis were tested by flow cytometry. Mealwhile, Western blotting was used to detect the phosphorylation of Akt protein and GSK-3β/β-catenin pathway proteins. Results The result of CCK-8 assay showed that MK2206 had a significant inhibitory effect on the proliferation activity of T24 cells (P<0.05), and the effect was in time-dose dependence manner arranged 0-20 μmol· L-1 concentration. Flow cytometry results showed that the MK2206 could promote apoptosis of T24 cells in 24 h. Comparing to control group, the level of p-Akt (ser347) protein significantly decreased (P<0.01). There was a significantly inhibitory effect on the GSK-3β/β-catenin signaling pathway, which showed the expression of p-GSK-3β and β-catenin proteins was significantly reduced (P<0.05) in the premise of no influence on the expression of GSK-3β. Conclusion MK2206 has inhibited T24 cell proliferation and promoted cell apoptosis via restraining Akt phosphorylation (ser473) and inhibiting the GSK-3β/β-catenin signaling pathway. MK2206 may relieve the tumor development process.

  • Xingyu HE,Peng BIAN,Yi ZHANG
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    Objective To investigate the effects of recombinant human erythropoietin(rh-EPO) on neurobehavioral development and peripheral monocyte interleukin-17(IL-17) and interleukin-23(IL-23) expression in infants with premature anemia. Methods A total of 64 cases of anemia premature infants were randomly assigned to the treatment group and the control group (32 infants in each group).The control group were given routine treatment, on the basis of treatment,iron was given 10 days after birth. The treatment group was given subcutaneous injection of rh-EPO on the besides the treatment of control group.Treatment time was 5 weeks. The neonatal behavioral neurological assessment (NBNA) was performed before and 4 weeks after treatment in both groups.The Gesell developmental schedules was assessed 12 weeks after treatment. The levels of IL-17 mRNA and IL-23 mRNA in peripheral blood of the two groups were also measured. Results The NBNA scores of the treatment group and the control group at 4 weeks after treatment were higher than the pre-treatment,and the difference was statistically significant(P<0.05).The NBNA score of the treatment group was higher than that of the control group at 4 weeks after treatment(P<0.05). The Gesell's assessment showed that the gross weight,fine motor,adaptive behavior,language,and individual-social behavior scores of the treatment group were higher than those of the control group(P<0.05).The relative expressions of IL-17 mRNA and IL-23 mRNA in the treatment group and the control group were lower than those before treatment at 4 weeks after treatment,and the difference was statistically significant(P<0.05).The levels of IL-17 mRNA and IL-23 mRNA were measured in the treatment group 4 weeks after treatment.The relative expression levels were lower than the control group,and the difference was statistically significant(P<0.05). Conclusion rh-EPO contributes to the development of neurobehavior in premature infants with anemia,and has a protective effect on brain injury,which can reduce the expression of IL-17 and IL-23 proinflammatory cytokines.

  • Bangni WEI,Hua LU,Daohai CHENG
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    Objective To collect blood trough concentrations of vancomycin and analyze its clinical treatment in severely infected neonates, so as to provide a reference for clinical rational use. Methods Retrospectively analyzing clinical data of 45 severely infected neonates who had been treated with vancomycin in a comprehensive hospital with the rank of “Grade 3, Class A”, was collected from January 2013 to May 2017. The data including basic information, disease distribution, etiological examination, PCT test, vancomycin use, vancomycin blood trough concentration, drug combination, clinical efficacy, liver and renal function indexes, and ototoxicity were analyzed statistically. Results Pneumonia and septicemia were the most common diseases in neonatal patients. All patients received etiological examination, and 75.6% patients received PCT test. The effective rate of therapy was 84.4%. The average course of vancomycin was (16.96±8.96) d, main dose of 10-15 mg·kg-1 had been given every 8 or 12 hours. Forty-three cases received combination use of two or more antibiotics. There were 91 vancomycin trough concentrations in steady-state with an average value of (11.90±10.08) μg·mL-1. After taking vancomycin, neonates' liver and renal function indexes decreased than before, but the renal function index of trough concentrations which greater than 20 μg·mL-1 were higher;no ototoxicity was observed in all neonates. Conclusion Monitoring steady-state trough concentrations of vancomycin can improve the therapeutic effect of vancomycin in treatment of neonatal infections. It helps to guarantee vancomycin safely use.

  • Yali ZHENG,Peng ZHANG,Zhengchuang FU,Kai YU,Jianjuan REN
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    Objective To observe the clinical effect and safety of topiramate on mania in children and adolescents. Methods A total of 97 children and adolescent patients diagnosed with mania were recruited and randomly divided into two groups: treatment group (49 cases) and control group (48 cases). The treatment group was treated with oral topiramate 100-400 mg·d-1 twice a day for 12 weeks, with an average dose of (211.25±67.21) mg·d-1. And control group was treated with oral sodium valproate 1000-2000 mg·d-1 twice a day for 12 weeks, with an average dose of (1171.05±240.39) mg·d-1. The clinical effects was evaluated by scores of Young Manic Rating Scale (YMRS ), Clinical Global Impression (CGI) and Treatment Emergent Symptom Scale (TESS), and the variations of related laboratory results were compared between these two groups before and after 2, 4, 8 and 12 weeks of treatment. Results The treatment response rates of treatment group and control group were 80.00% and 78.95%, respectively (P>0.05). The YMRS scores in both groups were significantly decreased after treatment (P<0.05) when compared to pre-treatment, but there was no crucial difference between the two groups (P>0.05). After treatment for 12 weeks, the side effects, especially in lethargy and elevated transaminase, were more noticeable in control group than that in treatment group (P<0.05). However, body mass and body mass index in treatment group were remarkably lower than control group with a statistically significant difference (P<0.05). Conclusion Topiramate has a curative effect similar to valproate in treatment of in children and adolescents with mania. Moreover, the incidence of adverse reactions happened less frequently and thus the medicine is safe to use.

  • Weizhen QIAN,Weifeng ZHANG
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    Objective To investigate the effects of Shenlingbaizhu powder combined with mesalazine on inflammatory factors and immune function in children and adolescents with ulcerative colitis. Methods Sixty-two children with ulcerative colitis were randomly divided into control group and treatment group (31 children each) according to random number table method. The control group received oral Mesal amine, 20 mg·kg-1 each time, 4 times a day. The treatment group was given Shenlingbaizhu powder on the basis of the control group, 3.0 or 6.0 g each time, 3 times a day. Both groups were treated for 2 months. The levels of inflammatory factors, T cell subsets(CD3+,CD4+,CD8+ and CD4+/CD8+), immunoglobulin levels, Traditional Chinese Medicine (TCM) syndrome scores and treatment effectiveness were compared between the two groups. Results After treatment, the levels of interleukin (IL)-6, IL-17 and tumor necrosis factor-α (TNF-α) in the treatment group were lower than those in the control group, and the level of IL-10 was higher than the control group (P<0.05). The levels of CD3+ and CD8+ in the treatment group were significantly lower than those in the control group, and the ratio of CD4+ and CD4+/CD8+ was significantly higher than the control group (P<0.05). The level of IgA and IgM in the treatment group was significantly lower than the control group(P < 0.05). After treatment, abdominal pain, diarrhea, pus and bloody stool, tenesmus points and total scores in the treatment group were significantly lower than the control group (P<0.05). The efficacy of the treatment group and the control group were 93.55% and 74.19%, respectively(P<0.05). Conclusion Shenlingbaizhu powder combined with mesalamine in the treatment of in children and adolescents with ulcerative colitis is beneficial to improve clinical efficacy, which regulate the level of inflammatory factors, reduce the inflammatory response, balance the number of T cells, reduce the level of immunoglobulin, improve the immune function of intestinal mucosa, promote ulcer healing, and improve TCM syndromes.

  • Haozheng YUAN,Ning WANG,Feng XU,Yimeng YANG,Shan LEI,Pengbo ZHANG
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    Objective To observe the effect of small dose of dexamethasone on the immunological cell changing and inflammatory response after the section resection of mammary gland. Methods Forty female patients scheduled for mammary gland section resection under general anesthesia were randomly divided into control group and treatment group. The two groups were subjected to general anesthesia under laryngeal mask ventilation. The treatment group was received dexamethasone 4 mg by intravenous before surgery. Blood cell classification count, blood glucose, CRP, IL-6, IL-8 level, CD4+ and CD8+ proportion and their ratios were detected before operation (t1), 24 h after operation (t2) and 48 h after operation (t3). Results Compared with the treatment group, the leucocyte count, neutrophil count and eosinophil count level at t1decreased significantly in the control group, but CRP level was higher (P<0.05), and the lymphocyte count decreased especially significant (P<0.01). Compared with t1 and t3, the proportion of CD4+, CD8+ and CD4+/CD8+ at t2 in the control group decreased significantly (P<0.05). Conclusion Intravenous injection of dexamethasone before operation can reduce the inflammatory reaction 24 h after operation via changing the number of immune cells after operation, which shows an effect on the postoperative immune system.

  • Yumei ZHU
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    Objective To observe the effect of dexmedetomidine combined with dyclonine mucilage on preventing the restlessness in patients with endoscopic nasal surgery after general anesthesia. Methods A total of 90 patients with endoscopic nasal surgery were randomly divided into three groups:control group(group C,n=30), dyclonine group (group D,n=30) and dexmedetomidine combined with dyclonine group (group DD,n=30). The systolic blood pressure(SBP), diastolic blood pressure(DBP), and heart rate(HR) were recorded at the time before induction (t0), before extubation (t1), during extubation (t2), 10 minutes after extubation(t3) and 20 minutes after extubation(t4). RS and RSS were recorded at t1, t2, t3and t4,respectively. In addition, adverse reaction of the three groups was recorded. Results The SBP, DBP and HR at t1 and t2 in group C and group D were significantly increased comparing with those at t0, while those of group DD were steady(P<0.05). At t2, the RS of group C and group D were significantly higher than group DD, while the RSS of group DD were significantly higher group C and group D (P<0.05). The rate of adverse reactions of group DD were significantly lower than those of group C and group D. There were no significant differences between the three groups in the time of extubation. Conclusion Dexmedetomidine combined with dyclonine mucilage prevent the restlessness in patients with endoscopic nasal surgery during emergence after general anesthesia. In addition, that would not prolong the extubation time.

  • Xifang REN,Lijing ZHANG
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    Objective To observe the therapeutic efficacy of probiotics in the treatment of intestinal dysfunction in patients with non-alcoholic fatty liver disease (NAFLD), and to explore the relationship and interaction between NAFLD and intestinal environment. Methods A total of 122 patients with modest to severe NAFLD complicated by intestinal dysfunction were randomly divided into group A (n=34), group B (n=48), group C (n=40). All patients received a basic treatment of calorie control diet and exercise. Moreover, group A was given polyene phosphatidylcholine (PP) capsule 456 mg; group B was given PP capsule 456 mg + pancreatin enteric-coated (PC) capsule 0.3 g; and group C was given PP capsules 456 mg + PC capsules 0.3 g + bifidobacterium, lactobacillus and enterococcus (BLE) capsule 420 mg. All medications were taken orally 3 times a day, and the course of treatment was 1 month. The routine blood test and symptoms of intestinal dysfunction were evaluated and monitored. Results Comparing to group A, the symptoms of intestinal dysfunction were significantly improved in group B and group C. The effective rate of diarrhea in group B and group C was 50.0% and 65.0%, respectively (P<0.05). The efficiency of tenesmus in group B and group C was 20.8% and 30.0% (P<0.05); and the anal exhaust efficiency in group B and group C was 22.9% and 37.5% (P<0.05). Conclusion The PP capsule + PC capsules + BLE capsule combination therapy has good curative effect on intestinal dysfunction in patients with NAFLD. The intestinal environment is closely related to liver, thus intestinal flora imbalance in NAFLD may play an important role in the disease development.

  • Ting FAN,Xingang LI,Zhigang ZHAO
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    Objective To conduct an objective and comprehensive analysis of the international research status, research hotspots and development trends of herpes zoster vaccine based on visual analysis software, and provide useful guidance and reference for the research of herpes zoster. Methods The Web of Science database was used as the search object, and the articles related to the herpes zoster vaccine published from 1980 to 2017 were included. Visualizing analysis of the authors, institutions, countries, key words and cited documents was conducted based on CiteSpace 5.2.R2. Results A total of 2155 articles were eventually included, and the number of a publication increased year by year. The international research on the herpes zoster vaccine continues to heat up. The USA has the largest number of publications. The leading institutions were Center for Disease Control and Prevention (USA), the University of Colorado, Stanford University, and Columbia University. Japan and Europe also have conducted in-depth research in this field. The leading authors and agencies have a relatively close relationship. Conclusion The study of herpes zoster vaccine is still under development, which has strong potential. The researches on herpes zoster in USA, Europe, and Japan ranks among the top in the world;China still lags behind its international peers.

  • Hui HU,Hongwei ZHAI,Yuancai LIU
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    Objective To establish the quality standards of Kochia Scoparia. Methods The marker component momordin Ic in the samples were identified by qualitative TLC. The determination of momordin Ic were conducted by HPLC, and on the basis of that, the HPLC fingerprints were established.The content of moisture, particle size, and solubility of Kochia Scoparia dispensing granules were determined. Results The TLC showed the spots developed clearly, with good resolution. The alcohol soluble extractive moisture from 10 batches of Kochia Scoparia dispensing granules were 27.44%-30.95 %. The concentration of momordin Ic showed a good linear relationship in the range of 18.768 2-600.582 4 mg·L-1 (R2=0.999 5), and the average recovery was 102.04 %, with RSD was 0.98% (n=9), the similarity coefficient of fingerprint was greater than 0.95. The moisture, particle size, and solubility were conformed according to the China Pharmacopoeia (2015) requirement. Conclusion The established methods are accurate, with strong specificity and good reproducibility, which can be used for the quality control of Kochia Scoparia dispensing granules.

  • Jun CHEN,Xin XIONG,Nancai YU
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    Objective To establish HPLC fingerprint and control the quality of chitosan Shanling Quban gels. Methods HPLC was applied to analyze the constituents of chitosan Shanling Quban gels. Using Agilent C18 Columns (4.6 mm×200 mm,5 μm). According to the National Pharmacopoeia Commission "HPLC Chromatographic Fingerprint Similarity Evaluation System" (2010 Edition), the chromatography was performed with methanol -0.1% phosphoric acid as mobile phase in gradient elution. The detection wavelength was 286 nm and the flow rate and column temperature was seted at 1.0 mL·min-1 and 30 ℃, respectively. Results The HPLC fingerprints of chitosan Shanling Quban gels were established, and 10 common characteristic peaks were labeled. The similarity of HPLC fingerprint was 0.9 for 10 batches of samples. Conclusion The HPLC fingerprint profile established in this experiment is highly specific and the method is simple and reliable which could reflect the quality of chitosan Shanling Quban gels.

  • Jinshuang ZOU,Xi WANG,Hong JIANG,Qian ZHOU,Chunyan SUN
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    Objective To analyze and investigate the use and administration condition of bacteriostatic agents in ophthalmic preparations in Hubei province, provide suggestions for the quality control and supervision, and promote the quality of the ophthalmic preparations. Methods Eighty prescriptions of 50 ophthalmic preparations from all ophthalmic preparation manufacturing enterprise in Hubei province were included in the investigation. Twenty-two representative batches were tested and evaluated according to the types and contents of bacteriostatic agents. Results The bacteriostatic agents added to the prescription included hydroxyphenyl esters, quaternary ammonium salts, organic mercury, chlorobutanol and other alcohols. Only 20% quality standards of the 50 preparations evaluated bacteriostatic agents, and there are inconsistencies between control types and prescription types. About 40.9% of ophthalmic preparations have a bacteriostatic agent content lower than 80% of the prescription amount. Conclusion In a part of ophthalmic preparations in Hubei province, there is a lack of quality control in bacteriostatic agents, and some products have lower bacteriostatic agent content than prescriptions. In order to improve the quality of ophthalmic preparations, hard work is needed from the aspects of standard setting, prescription rationality and manufacturing technique.

  • Xingli WANG,Lihan SUN,Lei ZHANG,Huajing WU,Junying ZHANG,Chunyong WU
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    Objective To establish a reversed-phase high performance liquid chromatographic (RP-HPLC) method with pre-column derivatization for determination of dianhydrogalactitol. Methods After dianhydrogalactitol was derivatized with sodium diethyldithiocarbamate, the RP-HPLC separation was performed on a Welch Ultimate XB-CN column (250 mm×4.6 mm,5 μm) with the mixture of acetonitrile-water (50:50) as the mobile phase. The flow rate was 1.0 mL?min-1 and the detection wavelength was set at 278 nm. Results The derivatization reaction could be finished within 30 min at 40 ℃ and the derivative was stable within 10 h. The calibration curve was linear over the range of 0.100-20.0 μg·mL-1 (r=0.999 8). The limit of detection (LOD) and limit of quantification (LOQ) was 30 and 100 ng·mL-1, respectively. The method showed good specificity, accuracy and precision. Conclusion The proposed method was fast, accurate and sensitive with high specific and repeatability. The study provides a new approach for the quality control of dianhydrogalactitol.

  • Jun JIANG,Zongling XIA
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    Objective To establish the metoprolol drug use evaluation (DUE) criteria, so as to evaluate the use of metoprolol and provide reference for clinical rational use. Methods According with the reference of establishing DUE, the evaluation criteria of metoprolol drug utilization were established. The retrospective study was conducted to evaluate and analysis the medical prescriptions of 91 patients with acute coronary syndrome in the First People's Hospital of Changzhou City. Interventions and improvements were concluded based on the analyze. Results According to the established metoprolol DUE criteria, the analysis were conducted from 3 aspects: the drug indications, medication process and the treatment outcome.The result showed our hospital did good job on the rational use of metoprolol in the fields of medication timing, dose interval and adjustment, combination therapy and pharmaceutical care. Conclusion The DUE of metoprolol can effectively assist clinical pharmacists to monitor the use of metoprolol before and during the course of treatment. It can be an effective method for clinical pharmacists to evaluate the effect of treatment and rationality.

  • Ailing ZHANG,Duolu LI,Yubing ZHOU,Chengcheng SHI,Jian KANG,Xiaojian ZHANG
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    Objective To evaluate the correlation between the dapagliflozin and urinary tract and genital infection in patients with type 2 diabetes mellitus (T2DM) and provide reference for clinical safe use. Methods Randomized, placebo-controlled, double-blinded clinical trials reported the association between dapagliflozin and urinary tract or genital infection were collected in electronic databases, including PubMed, EMbase, the Cochrane Library and Clinical Trials until January 8th 2018. Two authors assessed, extracted and crosschecked data according to the literature inclusion and exclusion criteria independently. Data were analyzed by Stata 12.0. Results Twenty-five clinical trials (n=11 199) were included.Comparing to placebo group, the risk of urinary tract infection and genital infection were significant higher (P<0.05). Besides, the incidence rate was higher in female patients than male patients (P<0.05). Conclusion The patients with T2DM who received dapagliflozin should regularly monitor urine routine and reproductive system. If urinary tract infection or genital infection occurred, T2DM patients should switch to other medications to avoid severe infections.

  • Yu WANG,Youyi RAO,Hong NING,Guoxian KOU,Yong YANG
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    Objective To provide reference for clinical rational drug use via signal mining of the side effects of sofosbuvir. Methods The warning signals of sofosbuvir-induced neuropsychic adverse drug reaction (ADR) were mined by proportional reporting ratio(ROR)method from Adverse Event Reporting System in the United States from 2014 to the second quarter of 2015 were mined by proportional repoting ratio (ROR) method. The distribution characteristic of signals, such as gender, age and dosage, were analyzed. Results A total of 52 relevant ADR signals were detected, and 49 were not recorded in the drug label. The ROR of ADR signals which were higher than others were mental disorders (13.49), hangover (11.36), irritability (12.40), homicidal ideation (13.93), violence-related symptom (13.37). The strengths of signals were all weak. There was no significant difference in the distribution of gender (P = 0.227), however, there were significant differences in the in the distribution of patient age (P<0.001) and sofosbuvir dosage (P=0.001). Conclusion Mining and analysis of ADR signals induced by sofosbuvir can provide preliminary references to evaluate the safety.

  • Hui ZHU,Sijia CHEN,Jian JIN
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    Objective To introduce the experience of pharmaceutical care based on Wechat platform. Methods To provide pharmaceutical care by “Pharmacists in Shanghai Ninth Hospital” Wechat platform,a platform maintenance team were formed. The “Pharmacists in Shanghai Ninth Hospital” Wechat platform contained three modules which were menu, pharmaceutical information and pharmaceutical consultation. The menu module contained three parts: program information,chronic disease management and training for pharmacist. The content of the menu module updated irregularly. However, the pharmaceutical information module updated regularly which contains original articles about popular science. The pharmaceutical consultation was running in a real-time online mode. Results The original articles had been forwarded 904 times since the platform launched three months ago. The platform had received and 354 consultations from 109 counselees which involve all aspects of rational use of drugs, such as drug selection, usage and dosage of drug, ADR and drug combination. The counselees are very satisfied with our replies. Conclusion The pharmaceutical service on Wechat platform contributes to upgrade the professional image of pharmacists which helps them to play an important role in rational use of drugs and improve the level of pharmaceutical care of our hospital.