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  • 10 December 2019 Volume 38 Issue 12
      
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  • Clinical Application Status and Medication Mismanagement of Atomization Inhalation Therapy in China
    TANG Ying , DU Guang
    2019, 38(12): 1557-1561. https://doi.org/10.3870/j.issn.1004-0781.2019.12.002
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    Atomization inhalation therapy achieves the goal of treatment by inhaling tiny drug droplets or particles, which were transformed through an atomizer using the gas-jet stream principle, into the respiratory tract and lungs to deposit on the alveolar.It has the advantages of fast response, low dosage and high safety in the treatment of respiratory diseases.Therefore, the atomization inhalation therapy is generally favored by both doctors and patients.In China, due to the lack of the special devices for atomization dosage forms and varied levels of clinicians’ experience, atomization inhalation therapy was often involved in off-label drug uses.These empirical medications lacked the corresponding systematic evaluations in terms of drug stability, efficacy and safety, thus affecting the therapeutic effect on patients.This review discusses the choices of atomization devices, current application status and medication mismanagement of atomization inhalation therapy in China.

  • Effects of Rosiglitazone on Airway Inflammatory Factors and MUC5ac Protein Expression in Asthmatic Mice
    YANG Hongxia , ZHANG Jianyong , ZHAO Jianjun , CHEN Ling , ZHENG Feiyan , BI Hai , ZHANG Hong
    2019, 38(12): 1562-1566. https://doi.org/10.3870/j.issn.1004-0781.2019.12.003
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    Objective To study the effects of rosiglitazone on airway inflammatory factors and MUC5ac expression in asthmatic mice. Methods Thirty male BALB/c mice were randomly divided into normal control group, asthma group and rosiglitazone group(10 rats in each group). Airway inflammation was observed by HE staining in lung tissue of each group. The changes of goblet cells and mucus in airway epithelium were observed by Alxin blue-periodic acid Schiff (AB-PAS) staining. The inflammatoryfactors (IL-5,IL-13,TNF-α) in bronchoalveolar lavage fluid (BALF) were detected by ELISA method. The expression of MUC5ac in lung tissue was detected by immunohistochemistry (IHC) method. The expression of MUC5ac mRNA in lung tissue was detected by real-time fluorescence quantitative PCR (RT-qPCR). Results The pathological score of peribronchial inflammation, the positive relative staining area of goblet cells and mucus in airway epithelium were lower than those in asthma group, but still higher than those in normal control group (P<0.01). The levels of IL-5, IL-13 and TNF- α in BALF in rosiglitazone group were lower than those in asthma group, but still higher than those in normal control group (P<0.01). The content of MUC5ac protein and mRNA in lung tissue of rosiglitazone group was lower than that of asthma group, but still higher than that of normal control group (P<0.05). Conclusion Rosiglitazone can effectively attenuate the airway inflammatory reaction of asthmatic mice, regulate the expression of airway mucin MUC5ac and inhibit airway mucus hypersecretion.
  • Anti -inflammatory Effect of Compound Qixiong Granules on Adjuvant Arthritis Rats
    CHEN Lifeng , YANG Chenxi , WANG Huasong , LU Qiping , XIA Ying , DONG Wangmei
    2019, 38(12): 1567-1571. https://doi.org/10.3870/j.issn.1004-0781.2019.12.004
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    Objective To study the therapeutic effect of compound Qixiong granules on adjuvant arthritis (AA) rats and the effect on Toll-like Receptor 2 (TLR2) and myeloid differentiation factor 88 (MyD88) pathway. Methods Sixty Wistar rats were randomly divided into six groups: blank control group, model control group, low-, medium- and high -dose compound Qixiong granules groups and Tripterygium glycosides tablet group.Except for rats in blank control group, other rats were developed into arthritis rat model with the complete Freund's adjuvant.In the third week after the onset of inflammation, the rats were administrated with treatment solutions by gastrogavage.During the experiment, the thickness of the toe metatarsus was observed and measured regularly.At 24 h after the last administration, rats were anesthetized and the synovium of knee joint was collected.The expression of TLR2 and MyD88 protein in synovial tissue was detected by Western blot, and the expression of TLR2 mRNA was detected by real-time fluorescence quantitative PCR. Results Compared with the blank control group, the toe thickness was increased, and the expressions of TLR2, MyD88 protein and TLR2 mRNA were increased (P<0.05) in the treatment groups.The toe thickness of rats in each treatment group were decreased after 3 weeks, and the expressions of TLR2, MyD88 protein and TLR2 mRNA were decreased (P<0.05). Conclusion Compound Qixiong granules have therapeutic effects on arthritis rats, and the effect of middle and high doses group was better than that of the low dose compound Qixiong granules group and Tripterygium glycosides group.The mechanism may be related to the inhibition of TLR2 pathway.
  • Study on Transdermal Permeation of Compound Cultivated Calculus Bovis Microemulsion Gel in vitro
    CHENG Lu , HUANG Lei , LIU Xinguo
    2019, 38(12): 1572-1576. https://doi.org/10.3870/j.issn.1004-0781.2019.12.005
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    Objective To study the transdermal permeability of compound cultivated calculus bovis microemulsion gel prepared with different concentrations of drugs and the interaction among transdermal components. Methods In vitro transdermal permeation experiments were carried out to test compound cultivated calculus bovis microemulsion gels with different drug concentrations.The concentrations of berberine hydrochloride and paeonol in the transdermal receiving solution were determined by high performance liquid chromatography, and the results were fitted with zero order, first order, and Higuchi dynamic equations.The effect of drug loading amount on the transdermal rates and the differentiation pattern were elucidated.The same method was also used to examine the differences in transdermal behavior between the two single components alone and in combination. Results Within the range of testing drug concentrations, the permeation parameters of berberine hydrochloride in compound calculus bovis microemulsion gel were best fitted with zero-order kinetic equation, indicating that the component passed through the skin via a passive diffusion process.The amount of skin permeation per unit time was proportional to the concentration of the matrix drug, and the Q-t relationship could be described by the Ficks diffusion law.However, the transdermal permeation parameters of paeonol were best fitted by Higuchi kinetic equation, indicating that the release amount of paeonol per unit area from the gel matrix was proportional to the square root of the time.But the increase of matrix drug concentration was not proportional to the increase of transdermal amount per unit time.The cumulative transdermal amount of single component preparation of berberine hydrochloride in 16 hours was significantly higher than that of the compound preparation (P<0.05), while the cumulative transdermal amount of single component preparation of paeonol and the compound preparation had little difference in the examination period. Conclusion Although increasing the drugs concentration could increase the transdermal permeation rate of berberine hydrochloride and paeonol in calculus bovis microemulsion gel, there are still some adverse factors that may affect the release and penetration of berberine hydrochloride.Thus, further improvements are needed to overcome these problems.
  • Targeted Delivery of Doxorubicin by PEG/PEI co-Modified Superparamagnetic Nano-particles in Rats with Glioma
    HU Licong , WU Fenfei , BAO Huajian
    2019, 38(12): 1577-1583. https://doi.org/10.3870/j.issn.1004-0781.2019.12.006
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    Objective To investigate glioma-targeted therapeutic effect of doxorubicin loaded PEG/PEI co-modified superparamagnetic nanoparticles (SPIONs). Methods SPIONs core was prepared by a high temperature thermal decomposition method, and then doxorubicin was loaded on PEG/PEI modified surface to form multifunctional drug-loaded nanoparticles SPIONs-DOX.The characteristics of the nanoparticles were also investigated.After the establishment of in situ C6/SD rat glioma model, 48 rats were randomly divided into control group, doxorubicin solution treated group (DOX), SPIONs-DOX solution group, SPIONs-DOX solution with external magnetic field group (DOX-SPIONs+MF) for drug treatments.In vivo MRI imaging combined with HE, Prussian blue and TUNEL staining were used to evaluate the therapeutic effect of these formulations on rat model. Results The DOX-SPIONs prepared in this experiment were uniform in dispersion, spherical in shape, and have pH response and magnetic targeting properties with high encapsulation efficiency and stability.The in vivo MRI imaging showed that compared with other formulation groups, the volume of glioma in rats treated with DOX-SPIONs+MF was significantly reduced (P<0.05), and the survival time of rats was significantly prolonged (P<0.05).In addition, the results of HE, Prussian blue and TUNEL apoptosis staining showed that compared with the control group and other formulation groups, DOX-SPIONs+MF treatment group significantly increased the concentration of drugs in the tumor site, increased the apoptosis and decreased the number of tumor cells. Conclusion With the help of external magnetic field, the new PEG/PEI co-modified SPIONs can be used as delivery vectors of targeted drugs for brain glioma, which can significantly improve the therapeutic effect of drugs on brain glioma.
  • Efficacy of Low-dose Cyclophosphamide on Condyloma Acuminatum and Its Influencing Factors
    MA Menglan , LIU Yamei , CAO Yuchun
    2019, 38(12): 1584-1589. https://doi.org/10.3870/j.issn.1004-0781.2019.12.007
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    Objective To investigate the efficacy and influencing factors of intermittent, short-course, and low-dose cyclophosphamide therapy in the treatment of condyloma acuminatum. Methods The patients with condyloma acuminata who met the inclusion criteria were selected as the study subjects.The therapeutic effect was observed at different time points, and the influencing factors of the curative effect were statistically analyzed through comparative analysis and multivariate analysis. Results The results showed that 164 patients had an effective rate of 60.98% in one month of treatment.Eighty-one patients had an effective rate of 82.72% in 2 months, and the recurrence rate was 18.52% at the end of the third month.The clinical cure rate was 91.36% in follow-up to 6 months.Influencing factors were as follows: 1.After 1 month of treatment, patients in the female group with the ages ≤ 30 years old had better effect on the therapy (P<0.05); After the correction by multivariate analysis, the effect of the treatment was better in patients aged less than 30 years (P<0.05).2.After 2 months of treatment, female patients got better effects (P<0.05); before the treatment, the proportions of total T lymphocytes, NK cells and total NK cells were correlated with the therapeutic effects in 2 months (P<0.05); after a multi-factor correction, the effect was no longer significant.3.The effect of 2 months treatment was better than that of 1 month treatment (P<0.05).4.Correlation analysis showed that age was positively correlated with total NK cell ratio (P=0.01), and gender was correlated with NK cell ratio (P=0.01) and NK cell count (P=0.03). Conclusion The effect of 2 months treatment was better than that of 1 month.The inherent basic function of the NK cells in patients may play a key role in maintaining the relative balance of anti-HPV immunity, and the therapy can better coordinate or mobilize this function.
  • Experimental Study of Resveratrol Nanoparticles Combined with Silk Fibroin Hydrogel on the Treatment of Psoriasis
    MAO Yanfei , ZHOU Yuejuan , XU Jinghong
    2019, 38(12): 1590-1596. https://doi.org/10.3870/j.issn.1004-0781.2019.12.008
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    Objective To investigate the therapeutic effect and mechanism of resveratrol (RSV) nanoparticles combined with silk fibroin hydrogel on psoriasis. Methods The RSV-loaded nanoparticles (RVS-NPs) were prepared with a novel polymer vitamin E succinate grafted ε-polylysine conjugate.After the characterization, the RVS-NPs was mixed with silk fibroin solution by a sonication-induced gelation method to form the drug loaded nanoparticle silk fibroin gel (RVS-NPs-gel).Among 60 BALB/c mice, 15 mice were randomly selected as normal control group, and the rest of mice were subjected to imiquimod (IMQ) cream on their skins for eight consecutive days to establish psoriasis skin mice model.The psoriasis mice were then randomly divided into psoriasis control group, resveratrol solution gel group (RVS-gel) and RVS-NPs-gel group, respectively.Blank gel, RVS-gel and RVS-NPs-gel containing 20 mg resveratrol were given to the mice in each group once every other day for 5 times.PASI (Psoriasis Area and Severity Index) score, HE staining and enzyme-linked immunosorbent assay (ELISA) were used to study the therapeutic effect and mechanism of RVS-NPs-gel on psoriasis. Results The morphology of RVS-loaded nanoparticles was round in shape, and resveratrol encapsulation efficiency was as high as (85.54±3.21)%.The drug loaded nanoparticles as flocculant were adsorbed on 3D surface of Silk Fibroin Gel.In vitro drug release result showed that the cumulative release of RVS-NPs was about (46.0±4.1)% after 72 hours, while the cumulative release of RVS-NPs-gel was about (30.9±2.5)%, which decreased significantly (P<0.05).The proliferation of keratinocytes was observed in the skin of psoriatic mice after the successful IMQ modeling.The scores of skin PASI, including erythema, scaling and thickening in psoriatic mice were significantly increased, and the contents of TNF-α, IL-6 and IL-8 were also significantly increased (P < 0.05) compared with normal control group.However, compared with psoriasis control group and RVS-gel group, the skin PASI score and the contents of TNF-α, IL-6 and IL-8 in RVS-NPs-gel treatment group were significantly decreased (P<0.05). Conclusion Resveratrol nanoparticles combined with silk fibroin gel can treat psoriasis by inhibiting the release of inflammatory factors such as TNF-α, IL-6 and IL-8, which is expected to become a new method in the clinical psoriasis treatment.
  • Therapeutic Effect of Qubai Granules on Hydroquinone-induced Vitiligo Mice
    YANG Aixia , XU Lei , ZHANG Lifan
    2019, 38(12): 1596-1600. https://doi.org/10.3870/j.issn.1004-0781.2019.12.009
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    Objective To study the therapeutic effect of Qubai granules on hydroquinone-induced vitiligo mice. Methods Mice were subjected with 2.5% hydroquinone cream on the back skin for 20 days to establish the vitiligo mouse model.Then, different doses of Qubai granules were given for 40 days.At the end of the experiment, the effective rate was calculated by scoring; the back skin was evaluated by hematoxylin-eosin (HE) staining, and the number of melanin hair follicles, melanocytes in the basal layer and epidermal cells containing melanocytes were also counted.Blood samples were taken from the eyelids of mice, and the levels of tyrosinase (TYR), cholinesterase (ChE) and monoamine oxidase (MAO) in the serum were detected by enzyme linked immunosorbent assay (ELISA). Results After the treatment on vitiligo mice at the low, medium and high doses, the effective rates determined by HE staining were 44.4%, 66.7%, and 81.2% (P<0.01), respectively.Pathological section experiments showed that the number of melanin hair follicles, basal lamellar cells, and melanocyte-containing epidermal cells were increased in the skin of mice after the treatment when compared with the control group, and the numbers in the middle and high doses groups were statistically significant (P<0.05).The serum test of the mice showed that the Qubai granules could significantly up-regulate TYR (P<0.01) and down-regulate MAO and ChE levels (P<0.01). Conclusion Animal experiments have shown that Qubai granules has certain curative effect on the treatment of vitiligo.The mechanism of action of Qubai granules in the treatment of vitiligo may be related to the regulation of the content of MAO and TYR in serum.
  • Clinical Analysis of 65 Cases with Drug Eruptions Caused by Antibacterial Agents
    LIU Yamei , CAO Yuchun
    2019, 38(12): 1601-1604. https://doi.org/10.3870/j.issn.1004-0781.2019.12.010
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    Objective To investigate the clinical features of antibacterial agents-induced drug eruptions, and to explore the rationality of the systematic use of glucocorticoids in non-severe drug eruptions caused by antibacterial agents. Methods Clinical data of 65 patients with drug eruptions caused by antibacterial agents from April 2011 to April 2018 were retrospectively analyzed. Results Among 65 cases of drug eruptions, 29.2% of the cases were caused by penicillins, which accounted for the highest proportion.There were 10 cases of severe drug eruptions and 55 cases of non-severe drug eruptions.The rash type of drug eruptions accounted for 36.9% as the highest proportion.Fixed drug eruptions were the most common type caused by nitroimidazole antibiotics.The incubation period of antibacterial agents-induced drug eruptions was within 7 days.In the non-severe drug eruptions with relatively extensive lesion area, patients with systemic glucocorticoid therapy had the shorter rash time and hospitalization time than non-glucocorticoid patients had, and the difference was statistically significant. Conclusion In this study, we identified that the most common drug eruptions caused by penicillins, and rash-type eruption was the most common drug eruption.In non-severe drug eruptions with a relatively wide area of rash, early and moderate uses of glucocorticoids could provide benefits in reducing duration of drug eruption thus reducing costs.
  • Effect of Levocarnitine Assisted in the Intravenous Thrombolytic Therapy for 54 Patients with Acute Ischemic Stroke
    TAN Liduan , GAO Junwu , GENG Yongzhi , CHEN Zhiguo
    2019, 38(12): 1608-1611. https://doi.org/10.3870/j.issn.1004-0781.2019.12.013
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    Objective To investigate the effect of levocarnitine on the level of serum heart-type fatty acid binding protein (H-FABP) and brain function in patients with acute ischemic stroke after an intravenous thrombolytic therapy. Methods Ninety-six patients with acute ischemic stroke treated by intravenous thrombolytic therapy from January 2015 to January 2018 in the emergency department of Chengde Central Hospital of Hebei Province were enrolled as the study subjects.Patients were divided into the treatment group (54 cases) and the control group (42 cases) by a random number table method.Patients in the control group were treated with conventional drugs such as atorvastatin after the intravenous thrombolysis, while patients in the treatment group were treated with additional dose of levocarnitine once a day, 3 g each time, for 2 weeks on the basis of therapy in the control group.Serum H-FABP levels were monitored before treatment, and after treatment at 12, 48 and 72 h, and NIHSS scores and BI scores were recorded before treatment and 1, 7 and 90 d after treatment. Results The serum H-FABP levels had no statistical difference before treatment in both groups.The serum H-FABP levels of the treatment group were significantly lower than those in the control group after treatment at 12, 24 and 48 h (P<0.05). The NIHSS scores were significantly lower than those in the control group after treatment at 1, 7 and 90 d (P<0.05).Barthel index scores were significantly higher than those in the control group after treatment at 1, 7 and 90 d (P<0.05). Conclusion Levocarnitine could effectively reduce the serum H-FABP levels, prevent neurons from dying, and promote the recovery of brain function.
  • Effect of Oxcycodone on Postoperative Analgesia and Algogenic Substances in Patients Undergoing the Transurethral Resection of the Prostate
    CUI Xiaoyan , GAN Jianhui , TU Qing , HE Shuangliang , YU Hong
    2019, 38(12): 1611-1615. https://doi.org/10.3870/j.issn.1004-0781.2019.12.014
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    Objective To study the effect of oxycodone injection on postoperative pain in patients with self-controlled intravenous analgesia (PCIA) after transurethral resection of the prostate (TURP), and its effect on plasma levels of algogenic substances. Methods A total of 120 patients undergoing transurethral resection of the prostate was divided into three groups (group oxcycdone, group sufentanil and group hydromorphone).All patients were treated with PCIA for postoperative analgesia.The patients' general parameters, ASA classification, and operation time were recorded.The VAS scores and Ramsay sedation scores were documented at the end of surgery (t1), 6 h (t2), 12 h (t3), 24 h (t4), and 48 h (t5) postoperatively.The plasma concentrations of substance P and serotonin (5-hydroxytamine,5-HT) were measured before anesthesia (t0), at t1, t2, and t3.Adverse reactions, the cases of additional analgesic consuming, the incidences of bladder spasm, PCIA pressing times were also recorded respectively. Results There were no significant differences about the general parameters after surgery.The differences among three groups of HR, MAP, SpO2, VAS scores and Ramsay scores had no statistical significance.Plasma substance P and 5-HT increased at t1 and t3 after surgery compared with the time before anesthesia (P<0.05), and group oxcycdone had lower plasma substance P and 5-HT at t1 and t3 than group sufentanil and hydromorphone had (P<0.05).PCIA pumping times, the amounts of additional analgesic consuming, and the incidences of bladder spasm in group sufentanil and hydromorphone were increased compared with group oxcycdone (P<0.05).Group sufentanil and hydromorphone had higher incidences of nausea, vomiting, dizziness and drowsiness reactions than group oxcycdone had (P<0.05).No respiratory depression was observed in all groups. Conclusion Oxycodone may effectively relieve postoperative pain after TURP, and it had little effect to respiratory and circulatory system with less side effects.It also had an inhibitory effect on the levels of substance P and 5-HT.
  • Simultaneous Detection of 14 Hydrophilic Components in Salvia miltiorrhiza by UPLC
    LI Yao , YANG Dezhi , SU Bin , DU Guanhua , LYU Yang
    2019, 38(12): 1624-1629. https://doi.org/10.3870/j.issn.1004-0781.2019.12.018
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    Objective To establish a UPLC method for the simultaneous determination of 14 hydrophilic components, including danshensu, protocatechuic acid, protocatechuic aldehyde, caffeic acid, ferulic acid, isoferulic acid, rosmarinic acid, glucursoric acid, salvianolic acid B, salvianolic acid A, salvianolic acid C, ?-saltanoic acid B monomethyl ester, 9'-salvianolic acid B monomethyl ester and salvianolic acid B dimethyl ester, in different parts of Salvia miltiorrhiza, and to investigate the effects of diameter and parts of Salvia miltiorrhiza on the contents of 14 components above. Methods The UPLC analysis was performed on a Waters ACQUITY UPLC BEH C18 (2.1 mm×50 mm, 1.7 μm) column with the mobile phase of 0.5% acetic acid solution (A)-acetonitrile (B) at a flow rate of 0.6 mL·min-1.The separation was achieved using the following gradient: 0-1.02 min, 90% A-80% A; 1.02-4.08 min, 80% A-72% A; 4.08-4.76 min, 72% A-55% A; 4.76-5.50 min, 55% A-90% A; 5.50-8 min, 90% A-90% A.The injection volume was 1 μL and the detection wavelength was set at 286 nm.The column temperature was kept at 30 ℃. Results The above 14 hydrophilic components were completely separated within 8 min and each substance had a good linearity.The instrument and method had a good repeatability with RSD below 2.0%, thus accurate quantification was achieved.The diameter and parts of Salvia miltiorrhiza had significant influences on the contents of hydrophilic components. Conclusion The established UPLC chromatographic method had good resolution, high sensitivity and accurate quantitative determination.Roots of Salvia miltiorrhiza with diameters between 0.1 cm and 0.5 cm and periderms of Salvia miltiorrhiza had advantages over others in the content of the hydrophilic components.
  • Extraction, Purification Process and Antitumor Activity of Total Saponins from Trillium tschonoskii Maxim
    YAO Minna , LIU Libing , LI Xiaoming , BAI Hong
    2019, 38(12): 1635-1640. https://doi.org/10.3870/j.issn.1004-0781.2019.12.019
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    Objective To optimize the extraction and purification process of total saponins from Trillium tschonoskii Maxim and to evaluate its antitumor activity in vitro and in vivo. Methods The optimum paste-forming rate and extraction process of total saponins from Trillium tschonoskii Maxim were determined by a single factor and orthogonal experiment.Using macroporous adsorption resin technology, optimized purification process was developed through static and dynamic adsorption and desorption tests.MTT was used to determine the inhibitory effects of total saponins on MCF-7, Hela and A549 cell lines, and the antitumor efficacy of saponins from Trillium tschonoskii Maxim was studied on S180 tumor-bearing mice in vivo. Results The optimum extraction conditions were as follows: ethanol volume concentration 80%, sonication time 40 min, solid to liquid ratio 1:50 and extraction temperature at 60 ℃.The optimized method for purification of saponins was as follows: D101 macroporous absorption resin, maximum sample volume 80 mL, elution with 75% ethanol, the volume 4BV.Purity of total flavonoids reached 61.45%.The IC50 of antitumor activity of saponins from Trillium tschonoskii Maxim against different tumor cell lines were 7.89±1.13, 8.18±1.04, 28.5±3.16 μg·mL-1, respectively.Tumor growth inhibition ratio of total saponins from Trillium tschonoskii Maxim was between 12.6% and 58.0% in vivo. Conclusion This method was robust and feasible with good separation and purification.The total saponins from Trillium tschonoskii Maxim showed good antitumor effect.
  • Analysis of Clinical Use of Danhong Injection in 5183 Cases
    LIN Ling , LI Jianping , CHEN Jing , WANG Nan
    2019, 38(12): 1641-1645. https://doi.org/10.3870/j.issn.1004-0781.2019.12.020
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    Objective To develop the clinical medication rules and characteristics of Danhong injection (DHI) based on clinical data mining, to guide the rational use of DHI and improve the safety and effectiveness of DHI in clinical medication. Methods A total of 5183 cases of patients who used DHI in Nanjing General Hospital of the Eastern Theater of the People's Liberation Army were collected from July 2012 to July 2017.By using frequency statistics and correlation analysis, the basic information of patients, the condition of disease, the dosage and diluting solvent of DHI, drug combination of DHI with other medicines were analyzed.The rationality of clinical medication of DHI was also investigated. Results The age of DHI patients was mainly over 40 years old, accounting for 91.55%.The ratio of male to female was 1.86:1.The clinical diagnosis of DHI prescriptions mainly involved many kinds of cardiovascular and cerebrovascular diseases, such as hypertension, cerebral infarction and diabetes.The highest binomial correlation of diseases was hypertension-cerebral infarction, and the highest trinomial correlation was hypertension-cerebral infarction-diabetes.The administration route of DHI was intravenous drips, and the frequency of dosing was once a day with the daily dose of 10-80 mL.The range of DHI treatment time was from 1 to 48 days, and the majority of cases were in the range of 1-14 days, accounting for 95.23% of the total cases.The dilution media of DHI injection included glucose injection, sodium chloride injection, fructose injection, glucose and sodium chloride injection and fructose and sodium chloride injection.Among them, sodium chloride injection was the most commonly used dilution medium, accounting for 95.13%, followed by glucose injection, accounting for 2.97%.The most commonly used volume for dilution was 250 mL and 100 mL.The drug combination of DHI was complicated, involving 473 kinds of drugs.The highest binomial correlation of combinational drugs was DHI-aspirin-clopidogrel, and the highest trinomial correlation of combinational drugs was DHI-aspirin-clopidogrel-oxiracetam injection.The safety of clinical application of DHI was confirmed in our study with no adverse events or reactions occurred in 5183 cases of patients who used DHI. Conclusion Clinical application of DHI was rational in accordance with the specifications.Based on the clinical medication rules of DHI, the future study could be focused on the DHI application in old patients, the effects of DHI on diabetes and hypertension, and the interaction between DHI and other combinational drugs, in order to improve the safety and effectiveness of DHI.
  • Prescription Rules of Traditional Chinese Medicine Formulae Containing Pinellia ternata
    GAO Yue , LIU Shi , HUANG Zhengde , HU Xiaoxue , CHEN Shuhe
    2019, 38(12): 1645-1651. https://doi.org/10.3870/j.issn.1004-0781.2019.12.021
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    Objective To analyze the prescription rules of formulae containing Pinellia ternata in Pharmaceutical Standard of the Ministry of Health of the People’s Republic of China- Preparation of Traditional Chinese Medicine Prescription (Hereinafter referred to as Preparation of Traditional Chinese Medicine Prescription) based on Traditional Chinese Medicine Inheritance Support Platform (TCMISP). Methods Through TCMISP (V2.5), formulae containing Pinellia ternata in Preparation of Traditional Chinese Medicine Prescription were collected and organized to build the database.Data mining methods, such as frequency statistics, association rules and others, were used to analyze disease syndromes, compatibility with commonly used drugs and combination rules, and to conduct in-depth analysis of high-frequency medicine pairs and syndromes. Results There were a total of 360 prescriptions containing Pinellia ternata, involving 579 kinds of traditional Chinese medicines and 49 commonly used medicine pairs for 17 main diseases.According to the analysis for high-frequency medicine pairs of Pinellia ternate-pericarpium citri reticulatae, Pinellia ternate-Poria cocos, and Pinellia ternate-Atractylodes, Pinellia ternata is usually combined with aromatic damp-resolving drugs, apophlegmatisants, and digestant drugs to reinforce spleen and regulate the flow of Qi.In addition, according to the analysis for high-frequency diseases like cough, indigestion, asthma, megrim, Pinellia ternata has almost the same effect in different drug pairs. Conclusion The formulae containing Pinellia ternata in Preparation of Traditional Chinese Medicine Prescription have the effect of regulating Qi, reducing phlegm, resolving dampness, and promoting digestion.The results reflect the compatibility of Pinellia ternata for different diseases.The drug combinations provide theoretical basis for studying the Pinellia ternata.
  • Usage Analysis of Budesonide Inhalation Suspension in Outpatient and Emergency Departments of a Children's Hospital
    YANG Jue , LI Ling , LU Yanhong , CAO Dandan , WANG Yan , CHEN Yanhua
    2019, 38(12): 1656-1661. https://doi.org/10.3870/j.issn.1004-0781.2019.12.023
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    Objective To retrospectively investigate the clinical use of budesonide inhalation suspension in outpatient and emergency departments of a children's hospital, aiming at providing references for ensuring drug safety in children and promoting the appropriate use of inhaled glucocorticoid in clinic. Methods A total of 1000 prescriptions of budesonide suspension used in outpatient and emergency departments in April 2018 were randomly selected.The distribution patterns of the prescriptions in different clinical departments, age groups and clinical diagnosis were investigated.Indications, drug combinations, dosages, incompatibility and contraindication of the prescriptions were analyzed. Results The group aged 0-3 years accounted for 71.60% of cases who used the drug, which belongs to the population with high risk for the drug use.The inappropriate prescriptions accounted for 63.80%, of which unsuitable prescriptions and extraordinary prescriptions were the main types.The unsuitable prescriptions were mainly for the inappropriate compatibility of budesonide suspension and compound ipratropium bromide solution, accounting for 23.00%.And the extraordinary prescriptions were mainly for drug prescription without indication, accounting for 49.70%. Conclusion The drug prescription without indication of budesonide suspension in clinic was common.Clinicians should strictly follow the indication of budesonide suspension so as to reduce the economic burden of patients and the incidences of adverse reactions.
  • Investigation on Compliance of Outpatient Patients with Inhalation Medications
    CHEN Haili , ZHONG Han , CUI Min , LE Kejia , ZHAO Xuji
    2019, 38(12): 1661-1664. https://doi.org/10.3870/j.issn.1004-0781.2019.12.024
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    Objective To investigate the influence factors on the compliance of inhalation agents used in outpatients of respiratory department. Methods Consultation room in respiratory department of Renji Hospital was set up for medication guidance.According to drug instructions and the relevant guidelines, clinical pharmacists carried out consultation for the 124 outpatients from April 2017 to November 2017, and the factors associated with compliance to inhaled medications among the outpatients after 6 months were investigated. Results Among the 108 patients, 29 patients showed high compliance, and 59 patients showed medium compliance with 20 patients of low compliance.On the basis of multivariate analysis, complication with comorbid conditions, inhalation devices, gender and times of acute exacerbation were the influencing factors of compliance (P<0.05), and the compliance of tiotropium bromide powder inhalation device was higher. Conclusion Comorbid conditions, inhalation devices, gender and times of acute exacerbations affected compliances with inhaled medications among outpatients.
  • Pharmaceutical Cares for Cerebral Hemorrhage Patients During the Delivery
    ZHANG Zaili , WANG Yi , LI Lixia , ZHANG Yuyi , CUI Min
    2019, 38(12): 1665-1668. https://doi.org/10.3870/j.issn.1004-0781.2019.12.025
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    Objective To explore the role of clinical pharmacists for patients in severe conditions during childbirth, determine the entry point and summarize working experience in clinical pharmaceutical care. Methods Clinical pharmacist participated in the treatment of a patient with cerebral hemorrhage during the delivery, and involved in the selection of appropriate antihypertensive drugs for the cerebral hemorrhage patient with coagulation dysfunction and drug contraindication complications.The patient with eclampsia associated large area cerebral hemorrhage was given antiepileptic treatment for the potential epileptic adverse reactions induced by estradiol.The drug interaction between valproic acid and carbamazepine and an adverse reaction leading to a rash by carbamazepine were pharmaceutically monitored in the whole process to assist the doctor to adjust the drug treatment regimen. Results According to the patient's condition and drug characteristics, clinical pharmacist optimized the treatment regimen and provided good pharmaceutical services for the clinician by means of drug therapeutic concentration monitoring and gene detection. Conclusion Clinical pharmacists can use their professional expertise to carry out pharmaceutical care for patients with severe diseases from the viewpoints of drug interactions and adverse drug reactions to ensure reasonable and safe clinical use of medicines.
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