The 2019 edition of the "National Basic Medical Insurance,Employment Injury Insurance and Maternity Insurance Medicine List" is the first comprehensive adjustment of the medical insurance catalogue after the establishment of the National Healthcare Security Administration.It is also a comprehensive combing catalogue after the publication of four editions of the medical insurance catalogue since 2000.Among them,the 2019 edition contains a total of 2643 medicines,including 1322 chemicals and biological products and 1321 Chinese traditional patent medicine(including 93 ethno medicines).Chinese herbal pieces were managed by the admittance management,and a total of 892 were included.This article compares the catalog composition,variety increasement and decreasement,payment type and use restrictions between the 2019 edition and 2017 edition so as to provide reference for the majority of medical staff.
The spread of multidrug-resistant or pandrug-resistant gram-negative bacteria. Because of the slow development of new antibiotics, polymyxins are increasingly used as a last option for such infections.Therefore, this paper reviews the latest progress in the the pharmacological properties, pharmacokinetics/ pharmacodynamics, toxicity and clinical application of polymyxins to provide references the challenges for its optimal use.
Objective To explore the ADR signal of human papilloma virus(HPV) tetravalent vaccine, and to provide reference for clinical rational medication. Methods Reporting odds ratio(ROR) and proportional reporting ratio(PRR) were used to conduct data-mining in FDA Vaccine Adverse Event Reporting System,from the first quarter of 2006 to the fourth quarter of 2018, altogether 52 quarters. Results In total, 3885 signals were found with both ROR and PRR.Overall, 14 of the 47 ADR signals were not mentioned in the labels after the second screening. Conclusion Excavation to the HPV tetravalent vaccine signal is strong, new ADR signals are focused on central and peripheral nervous system diseases, systemic injury, musculoskeletal diseases and skin and adnexal diseases.Provide reference for follow-up clinical medication monitoring, and take corresponding risk prevention measures.
Objective To evaluate the effect and its mechanism of Angelica gigas(AG) extract on cerebral ischemia/reperfusion(I/R) injury in mice. Methods Male C57BL/6 mice were randomly divided into six groups(n=9): sham group,model control group and AG group (10, 25, 50, 100 mg·kg-1). I/R mice were subjected to transient middle cerebral artery occlusion(MCAO),resulting in transient ischemia of 90 min and reperfusion of 24 h.After 24 h reperfusion,infarction volume and the changes of blood-brain barrier permeability were measured by 2,3,5-triphenyltetrazolium chloride(TTC) and Evans blue(EB) staining.The expression of angiogenesis-induced proteins,angiopoietin-1(Ang-1) and vascular endothelial growth factor(VEGF),tight junction proteins,ZO-1 and Occludin,and the phosphorylation of phosphatidylinositol 3-kinase(PI3K)/AKT were determined in the ischemic brains by Western blotting,respectively. Results The treatment of AG significantly decreased the volumes of brain infarction in I/R mice(P<0.05).AG decreased the permeability of blood-brain barrier comparing to I/R group(P<0.05).AG also significantly increased the expression of Ang-1,VEGF,ZO-1 and Occludin through activation of the PI3K/Akt pathway(P<0.05). Conclusion AG may play a neuroprotective role in I/R injury against mice by reducing blood-brain barrier permeability and promoting angiogenesis.
Objective To explore the role of tumor necrosis factor superfamily member 14(LIGHT) in lipid metabolism, and to provide references for clinical treatment of hyperlipidemia-related diseases. Methods A total of 32 patients with coronary heart disease took part in the trial, including 16 patients in the unstable angina group and 16 patients in the stable angina group.Sixteen healthy people served as the control group.The expression of LIGHT in patients with coronary heart disease at different stages was examined.The expression of lipid metabolism-related enzymes and inflammation-related proteins in oxidized low density lipoprotein(oxLDL)-induced mononuclear macrophages(THP-1) was observed. Results The expression level of LIGHT in patients with coronary heart disease was significantly higher than that in healthy people(P<0.05).LIGHT enhanced the expression of scavenger receptor(SR-A), acetyl-CoA acetyltransferase 1(ACAT1), adipose gene(SREBP-1c, ACS),interleukin-6(IL-6), human monocyte chemotaxis protein-1(MCP-1), and nitric oxide synthase(iNOS)(P<0.05).These effects could be blocked by the lymphotoxin beta receptor(LTβR-Ig).The NF-κB translocation inhibitor SN50 significantly inhibited the expression of nuclear transcription factors(NF)-κB, p65, IL-6 and adipose genes(P<0.05). Conclusion LIGHT promotes inflammatory response and lipid accumulation by activating NF-κB signaling pathway, which providing a new potential target for the treatment of hyperlipidemia-related diseases.
Objective To establish a mouse model for local lymph node test to detect the sensitization of safflower injection, and to explore its feasibility for evaluating the sensitization of traditional Chinese medicine injection. Methods Ninety BALB/c mice were randomly divided into 9 groups(10 in each group): three positive control groups(2,4,6-trinitrobenzenesulfonic acid, streptozotocin, and D-penicillamine), one negative control group(phosphate buffered solution) and five test groups(5 batches of safflower injection).The mice were immunized with the test materials of at the left hind foot, 50 μL per mouse.The animals were sacrificed on the 7th day after injection.The weight index(WI) and cell index(CI) of bilateral popliteal lymph node were measured by local lymph node test(LLNA), and the lymphocyte subsets were detected by flow cytometry.The difference between each test group and the control group was observed.The guinea pig systemic active allergy test(ASA) was used to test the 5 batches of the test samples in parallel, and the results were compared with the mouse local lymph node assay. Results The results of local lymph node assay showed that only one batch of safflower injection had an increasing trend in WI and the proportion of T lymphocytes increased, which suggested that the test samples might cause the enlargement of lymph nodes and the proliferation of T lymphocyte.There was a potential risk of sensitization.The ASA results showed no allergic reactions in 5 batches of injections.The results of the two methods are basically the same. Conclusion Under the experimental conditions, the preliminary determination of mouse LLNA can be used as an alternative method of ASA to evaluate the sensitization potential of safflower injection.
Objective To investigate whether sevoflurane reduces the risk of reperfusion arrhythmias by stabilizing ERP/MAPD90. Methods Healthy adult male SD rats were used to prepare 24 langendorff isolated heart perfusion model, then the hearts were randomly divided into three groups(n=8 in each group).In control group(C group), the hearts were perfused with K-H solution for 120 min.In ischemia-reperfusion(IR) group, K-H solution was used to perfuse after 15 min perfusion with Thomas solution(4 ℃, 20 mL·kg-1) until heart arrested.The heart was protected in Thomas solution at low temperature(4 ℃).30 min when half the amount after filling and Thomas solution(4 ℃,10 mL·kg-1), 60 min reperfusion K-H solution for 30 min.In Sevoflurane group(group S), the K-H solution was containing saturated 1.0 MAC sevoflurane and other procedures were same as group IR.Four time points were set as followed: 15 min after balance perfusion(t0), another 15 min perfusion with Thomas solution(t1), reperfusion 15 min/continue perfusion 105 min(t2), reperfusion 30 min /continue perfusion 120 min(t3).The myocardial monophasic action potentials after a 90% of the schedule(MAPD90) and heart rate(HR) were recorded at different time points.The ventricular effective refractory period(ERP) at t3 was measured to calculate the ERP/MAPD90 ratio.Repetitive regular stimuli(S1) were followed by a single extra-stimulus(S2) and the occurrence of reperfusion arrhythmia(VA) was recorded during the whole perfusion. Results Compared with t0 and t1, the HR of IR group and S group was significantly decreased at t2 and t3(P<0.05).Compared with C group, the HR of IR group and S group was significantly decreased at t2 and t3(P<0.05).Compared with IR group, the HR of S group was significantly increased at t2 and t3(P<0.05).When compared with t0 and t1, MAPD90 in IR group and S group was significantly prolonged at t2 and t3(P<0.05), while there was no significant difference in MAPD90 between each group at t0 and t1(P>0.05).Compared with group C at t2 and t3, MAPD90 in IR group and S group was significantly prolonged(P<0.05).Compared with IR group at t2 and t3, MAPD90 in S group was significantly shortened(P<0.05).Compared with group C in t3, ERP was prolonged, ERP/MAPD90 ratio decreased and VA evoked rate increased in IR group and S group(P<0.05);compared with IR group in t3, ERP was shortened, ERP/MAPD90 ratio increased and VA evoked rate decreased in S group(P<0.05). Conclusion Sevoflurane can reduce the risk of ventricular arrhythmias after myocardial ischemia-reperfusion by stabilizing ERP/MAPD90.
Tigecycline is used as a special grade antibacterial drug in critically ill patients and/or other antibacterial drugs are ineffective.However,special populations, patients with special pathophysiological status may present different pharmacokinetic(PK) status about tigecycline, such as patients with continuous renal replacement therapy(CRRT) or extracorporeal membrane oxygenation(ECMO) which make PK changes more complex and affect the safety and efficacy of medication.This article focuses on and summarizes the pharmacokinetic study of tigecycline in special patients.
Mastitis is common in patients during breast-feeding, who is frequently accompanied by local or systemic symptoms affecting the daily life of patients severely.According to the recommendation of World Health Organization(WHO), babies should be exclusively breastfed within six months, toddlers under or even over 2 years old can be breastfeed on the basis of complementary foods.Refusal of medication, unreasonable use of drugs, or concerns about drug safety often lead to the premature cessation of breastfeeding, posing potential risks for infants.This paper reviewed the principle of drug use, evaluation of drug safety and drug selection of lactation mastitis, which provided some references to the treatment and breastfeeding of lactation mastitis.
Objective To analysis the efficacy and safety of guizhifuling capsule combined with xinshenghua granule for medical abortion at 10-16 weeks pregnancy. Methods A total of 285 patients with pregnancy of 10-16 weeks who voluntary requested for termination of pregnancy were randomly divided into three groups(group A, B and C, 95 cases in each group).All patients were treated with a medical abortion with mifepristone and misoprostol, group A was added xinshenghua granule(2 packs per time,tid,po) on the first day of drug flow,group B was added guizhifuling capsule(3 capsules per time,tid,po) on the first day of drug flow,and group C was added xinshenghua granule(2 packs per time,tid,po) and guizhifuling capsule(3 capsules per time,tid,po) on the first day of drug treatment, three groups were treated continuously for 7 days.The three groups were compared with complete abortion rate, incomplete abortion rate, abortion failure rate, ADR rate, embryo discharge time, vaginal bleeding time, vaginal bleeding, menstrual re-tidal time and hemoglobin change value. Results The rates of complete abortion in group A, B and C were 71.58%, 68.42% and 90.53%, respectively.The complete abortion rate of group C significantly greater than group A and group B.The incomplete abortion rate, abortion failure rate, hemoglobin decline, embryo discharge time, vaginal bleeding time, vaginal bleeding, menstrual re-tidal time, and vaginal bleeding of group C were significantly lower than group A and group B(P<0.05).However, there is no significant difference in those aspects between group A and B(P>0.05).No serious ADR occurred in all three groups, and there was no significant difference in ADR(P>0.05). Conclusion Guizhifuling capsule combined with xinshenghua granule is beneficial to improve the complete abortion rate of mifepristone and misoprostol medicinal abortion;shorten the discharge time of gestational sac, vaginal bleeding time, and menstrual rewet time;and reduce the amount of bleeding.and no increase the incidence of adverse reactions. It is worthy to clinical promotion.
Objective To investigate the effect of levetiracetam(LEV) and lamotrigine(LTG) monotherapy on P300 latency and cognitive function in children with benign epilepsy of childhood with centrotemporal spikes(BECTs). Methods A total of 130 BECTs children were divided into LEV group and LTG group(65 cases in each group) by random number table method.Children in LEV group were treated with LEV(500-1500 mg,bid,po), and the children in LTG group were treated with LTG(25-200 mg,qd or bid,po).Both groups received continuous treatment for 6 months.The clinical efficacy, P300 latency, cognitive function and adverse reactions of the two groups were compared. Results There was no statistically significant difference in the grade of clinical efficacy between the two groups(P>0.05).The cognitive function scores of the children in the two groups before treatment were similar(P>0.05), and the scores of both two groups significantly increased after treatment(P<0.05).There was no statistically significant difference in cognitive function score between the two groups after treatment(P>0.05).The P300 incubation period of children in the two groups before treatment was similar(P>0.05), and the P300 incubation period of children in the two groups after treatment was significantly lower than that before treatment(P<0.05).There was no statistically significant difference between the two groups(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups, such as drowsiness, rash, anorexia, nausea and vomiting, dizziness, memory loss or irritability(P>0.05). Conclusion LEV and LTG monotherapy have similar clinical efficacy in BECTS children.Both LEV and LTG monotherapy can effectively inhibit epileptic discharge, shorten P300 incubation period and improve cognitive function.In addition.Both LEV and LTG monotherapy have similar adverse reactions and show good safety.LTG is more affordable and the cost of treatment is relatively low.
Objective To study the effect of combination of levetiracetam and methylphenidate controlled release tablets on the short-term efficacy and PSQ score of children with benign epilepsy of childhood with centrotemporal spikes(BECTs) combined with attention deficit hyperactivity disorder(ADHD). Methods A total of 100 cases of BECTs with ADHD patients were selected.They were randomly divided into control group and treatment group, 50 cases in each group.Two groups of children were given levetiracetam(10-30 mg·kg-1,bid,po), continuous treatment for 6 months.The control group was given psychological intervention.The treatment group was treated with methylphenidate hydrochloride controlled-release tablets(18-54 mg·kg-1,qd,po) besides the treatments of control group.To compare the clinical effect, the Wechsler's intelligence scale and PSQ score were used in both two groups. Results The total effective rate of BECTs in the treatment group was 92.00%, and that of the control group was 90.00%(P>0.05).The total effective rate of ADHD in the treatment group was 88.00%, and that of the control group was 70.00%(P<0.05).Before the treatment, Wechsler intelligence scale for children in two groups were similar(P>0.05).After the treatment, the scores of Wechsler intelligence scale in both groups were significantly increased(P<0.05).The PIQ, VIQ, FIQ and C score of treatment group were higher than the control group(P<0.05).Before the treatment, the PSQ scores of two groups were similar(P>0.05).And the PSQ scores of two groups decreased significantly after the treatment. In the treatment group, the hyperactivity index, learning factor, behavior factor, anxiety factor, impulse factor and mental factor was significantly lower than those of the control group(P<0.05). Conclusion The combination use of levetiracetam and methylphenidate hydrochloride controlled-release tablets can significantly improve the clinical efficacy in BECTs patients with ADHD, improve the children's Wechsler intelligence scale score and reduce the PSQ score.It is a worthy clinical application to improve children's intelligence, learning ability, reduce attention deficit and hyperactivity.
Objective To evaluate the clinical application of propofol combined with nalbuphine in elderly patients undergoing endoscopic submucosal dissection(ESD) anesthesia. Methods A total of 116 elderly patients undergoing ESD surgery were enrolled.They were divided into two groups according to the random number table(58 cases in each group).The control group was given 1.5 mg·kg-1propofol intravenously.And 0.2 μg·kg-1·h-1 sufentanil was given by an intravenous infusion pump continuously.The treatment group was administrated with propofol 1.5 mg·kg-1and nabulphine 0.1 mg·kg-1intravenously.The anesthesia effect, respiratory rate, heart rate, blood pressure, oxygen saturation and the incidence of adverse reactions were compared between the two groups. Results There was no significant difference in general body movement, recovery time and pain score between the treatment group and the control group(P>0.05).The respiratory rate of the treatment group was significantly higher than that of the control group at 5, 10, 30 min and the end of the operation(P<0.05).There was no significant difference in heart rate, blood pressure and oxygen saturation between the treatment group at 5, 10, 30 min and the end of surgery(P>0.05).The incidence of adverse reactions in the treatment group was not significantly different from that in the control group(P>0.05). Conclusion Propofol combined with nalbuphine or sufentanil is equivalent anesthesia effect in elderly patients with intestinal ESD.However, from a security perspective, the regime of propofol combined with nalbuphine is recommended for application in elderly patients undergoing intestinal ESD.
The sodium-glucose cotransporter 2(SGLT-2) inhibitor is a new type of hypoglycemic agent.It plays a hypoglycemic role by inhibiting renal tubular SGLT-2 and inhibiting proximal tubular glucose reabsorption.Recently, more and more large clinical trials have shown that SGLT-2 inhibitors have renal protective effects independent of hypoglycemia.The protective mechanism of SGLT-2 inhibitors on diabetic kidney disease is mainly related to improving renal hemodynamics, improving hypoxia, reducing inflammation and some metabolic effects.This article reviews the SGLT-2 inhibitors and the protective mechanism of SGLT-2 inhibitors on diabetic kidney disease.
Postoperative ileus(POI) is defined as transient impairment of gastrointestinal motility.It is commonly occurred in both abdominal and non-abdominal surgeries.There are many causes of POI, including the surgical procedure and the medicine applied in and after surgery.All of these factors accelerate POI mainly through affecting the physiology, increasing the inflammatory factors and regulating the gut hormones.Various agents and medicines have been studied so far in order to decrease the occurrence and the duration of POI.In the last decade, conspicuous progress has been made in medication treatment for POI.This review is in order to elaborating the current medicine treatment of POI by summarizing the effect of the prokinetic drugs that are already on the market and the traditional medicine on POI.In addition, we also sort out and analyze the research direction of the medicine for POI to take references for the drug treatment of POI.
Objective To prepare nanoparticles of isoliquiritigenin polylactic acid, and study the effects on the bioavailability of isoliquiritigenin in rats. Methods Isoliquiritigenin polylactic acid nanoparticles were prepared by self-emulsifying solvent volatilization method.The particle size and Zeta potential were determined by laser particle size analyzer.The encapsulation efficiency, drug loading and drug release in vitro of isoliquiritigenin polylactic acid nanoparticles were also studied.The pharmacokinetics and bioavailability of isoliquiritigenin polylactic acid nanoparticles and isoliquiritigenin aqueous suspension after oral administration in rats were studied. Results The particle size, PDI, Zeta potential, encapsulation efficiency and drug loading of isoliquiritigenin polylactic acid nanoparticles were(190.22±3.09) nm, 0.149±0.039,(-12.5±0.27) mV,(74.94±1.18) % and(8.45±0.66) %, respectively.The in vivo dissolution experiments showed that isoliquiritigenin polylactic acid nanoparticles had obvious sustained release characterization, the drug release model accord with Weibull model: LnLn[1/(1-Mt/M∞)]= 0.519 4Lnt-1.3919(r=0.9728).The in vivo results of pharmacokinetics in rat model indicated that the relative bioavailability of polylactic acid nanoparticles was enhanced to 170.02% compared with isoliquiritigenin suspension. Conclusion The prepared isoliquiritigenin polylactic acid nanoparticles had obvious sustained release characterization in vitro.After oral administration, it could facilitate the absorption of isoliquiritigenin.
Objective To prepare lyophilized powder of genistein micellar nanoparticles. Methods The genistein polyethylene glycol-polylactic acid(PEG-PLA) micelles were synthesized by an improved emulsion-evaporation method, using PEG-PLA copolymer as a carrier.The lyophilized powder of genistein micellar nanoparticles were prepared by freeze-drying.The types and dosage of cryoprotectants were screened by the characterization of freeze-drying powder. Results The results indicated that 5% sucrose was chosen as an optimum cryoprotectant.The appearance was coincided with the requirements, and the genistein micellar nanoparticle size was (133.56±3.67) nm.The Zeta potential was (-12.60±2.26) mV.The optimized freeze-drying process was as followed: vacuum at 1 Pa, pre-cooled at -60 ℃ for 5 h, maintained at -35 ℃ for 2 h, maintained at -33 ℃ for 5 h, maintained -30 ℃ for 5 h, maintained at 0 ℃ for 2 h, maitained at 25 ℃ for 2 h.The freeze-drying powder had better dispersibility with 333.32 μg·mL-1 genistein in the system.The genistein micelles retained biological activity. The scavenging capacity against hydroxyl free radicals of genistein micellar freeze-drying powder was better than genistein in a range of 20-80 μg·mL-1. Conclusion Stable lyophilized powder of genistein micellar nanoparticles could be obtained by screening cryoprotectant during lyophilization and optimizing freeze-drying process parameters.
Objective To optimize the honey baking technology of Lonicera japonica, to establish a method for the determination of its content and to study the pharmacodynamics of acute pharyngitis. Methods Taking chlorogenic acid content as the evaluation index, the factors such as honey content, moistening time, baking temperature and baking time were selected as the investigation factors.A rat model of acute pharyngitis was established by means of ammonia spray.And the changes of animal blood routine indexes were investigated. Results The best procedure was as followed: honey content was 20%, moistening time was 1 h, baking temperature was 154 ℃ and baking time was 13 min.After using the optimized honey-stir-baked Lonicera japonica, the symptoms of pharyngitis in acute pharyngitis model were relieved.The results of blood routine assay returned to normal levels, it also significantly reduced the swelling of the ear of mice. Conclusion The quality of honey-stir-baked Lonicera japonica is stable and controllable, and its preparation procedure is simple and feasible, which provides a theoretical basis for practical production.It has good therapeutic effect on acute pharyngitis, which enlarges the clinical application scope of Lonicera japonica.