Objective To investigate the role and related molecular mechanisms of Rhizoma reed polysaccharide in inhibiting the proliferation of non-small cell lung cancer(NSCLC). Methods A549 cell model in vitro was established. CCK-8 method was used to detect cell activity, and flow cytometry was used to detect apoptosis of A549 cells. Western blotting was used to detect LC3-Ⅱ/Ⅰ, AKT, p-AKT, PI3K, and p-PI3K protein expressions in A549 cells. Tumor model in mice was established, and the efficacy of Rhizoma reed polysaccharide on the growth of tumors in mice was observed and compared with the positive control cisplatin. The expressions of apoptotic proteins Bax, Bcl-2, and Caspase-3 in A549 cells were detected by immunohistochemistry. Results The proliferation of A549 cells was significantly inhibited by 100 μg·mL-1 of Rhizoma reed polysaccharide at 48 and 72 h(P<0.05); Rhizoma reed polysaccharide could significantly increase the apoptotic rate of A549 cells(P<0.05), and the LC3-Ⅱ/Ⅰ, p-AKT/AKT, p-PI3K/PI3K ratio of A549 cells increased significantly(P<0.05), while the expression levels of AKT and PI3K protein did not change significantly(P<0.05). Seven days after transplantation of A549 cells in nude mice, tumor mass began to grow in axilla. On the 13th day, the volume of tumors reached 90 mm3, and the success rate of the modeling was 90.0%. From the 9th day of administration, the growth curves of tumors in the cisplatin group and the Rhizoma reed polysaccharide group were smooth, and the volumes of tumors were significantly lower than those in the control group(P<0.05). On the 18th day of administration, compared with the control group, the inhibition rates of cisplatin and Rhizoma reed Polysaccharide were 39.1% and 35.9% respectively(P<0.05). The expressions of apoptotic proteins Bax and Casepes-3 were significantly increased(P<0.05), while the expression of Bcl-2 was significantly decreased(P<0.05). Conclusion Rhizoma reed polysaccharide may inhibit the proliferation of A549 cells by activating autophagy and promoting apoptosis, and thus can be used as a potential therapeutic drug for non-small cell lung cancer.
Cancer patients were susceptible to COVID-19, which brought great challenges to the oncologists under COVID-19 epidemic situation. The oncologists should focus on the epidemic characteristics and clinical manifestations of COVID-19 infection, identify the condition of cancer patients complicated with COVID-19 infection, and strictly grasp the indications of anticancer treatment for cancer patients. By using the Internet medical platform, we should strengthen the whole-process management mode of tumor diseases, and advocate individualized and precise treatment, and give a full play to the advantages of traditional Chinese medicine in anti-epidemic and anti-cancer therapy. This paper aimed to discuss the problems of integrated Chinese and Western medicine in the prevention and treatment of tumor diseases under the epidemic situationand to provide new strategies for the treatment of tumor diseases.
In order to provide reference for the standardized management of narcotic drugs in the situation of sudden respiratory infectious diseases, we analyzed the problems in the management of narcotic drugs during the popularity of COVID-19, formulated countermeasures and implemented them. We made statistics on the varieties and uses of narcotic drugs during the epidemic,analyzed the problems in the actual management of narcotic drugs and worked out countermeasures which not only meet the clinical requirements of timeliness, but also ensure the safe and reasonable use of narcotic drugs. The implemented countermeasures could ensure the safe and reasonable use of narcotic drugs while meeting the clinical timeliness. During the epidemic period of COVID-19, the implementation of the temporary plan for the management of narcotic drugs in optical valley hospital, Tongji Hospital of Huazhong University of Science and Technology, was feasible, which could minimize the hidden dangers of the management of narcotic drugs, ensure the drug safety of patients and reduce the cross infection of medical staff in the hospital.
Under the coronavirus disease 2019 (COVID-19) pandemic, this study is to make a preliminary analysis of the current problems and the measures to be improved in conducting phase I clinical trials.From the aspects of preventive measures, reasonable adjustment of clinical trial scheme design, subject managements for clinical trials under the COVID-19 epidemic situation, and control countermeasures were put forward to prevent and control the pandemic situation, ensure the health and safety of volunteers and relevant practitioners of clinical trials, avoid cross-infection, and minimize the risk of hospital infection and pandemic spread. This study provides a reference for the development of phase I clinical trials in the period of major infectious diseases.
Tumor biomarkers mainly include predictive and prognostic biomarkers. Researches of predictive biomarkers of immunotherapy mainly focuses on the positive biomarkers such as programmed cell death ligand 1 (PD-L1), tumor mutation burden (TMB) and microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR), among which the role of PD-L1 has the highest recognition in clinical practice. Meanwhile, the biomarkers of negative efficacy prediction mainly include mutations of specific genes, immunosuppressive molecules or cells. The existing researches suggest that only the T cells’ inflammatory gene expression profile (GEP) and somatic copy number alterations (SCNA) are the tumor prognostic biomarkers and the predictive biomarkers of immunotherapy.
In recent years, immunotherapies represented by immune checkpoint inhibitors have shown significant clinical efficacy in anti-tumor therapy, but some patients still cannot achieve the response. In order to improve the effect of immunotherapy and further expand the beneficiary population, a number of studies have been launched for the exploration of combined immunotherapies, including immuno-chemotherapy, targeted-immunotherapy, immuno-immunotherapy,etc. This paper summarizes the current clinical trials of immunotherapy in combination, and discusses the synergistic mechanism, curative effect, and application prospects of combined medication.
Immunotherapy represented by immune checkpoint inhibitors (ICIs) has been a great success. However, the efficacy of ICIs monotherapy is limited by the primary and acquired drug resistance. Immunotherapy combined with anti-angiogenesis therapy has emerged as a new regimen in recent years. In terms of the mechanism, anti-angiogenic agents can not only reverse the immunosuppressive effects stimulated by vascular endothelial growth factor (VEGF), but also induce the normalization of tumor vascular system and promote the transition of T cells and other immune effector molecules. On the other hand, ICIs can activate effector T cells and increase the infiltration and cytotoxicity of effector T cells to normalize tumor vasculature. A series of clinical trials have also demonstrated that this combination strategy impressively improved the therapeutic efficacy of advanced renal carcinoma, hepatocellular carcinoma, and non-small cell lung carcinoma and other malignant tumors. Notably, in the field of such combination therapy, there are still a lot of problems that need to be further explored and solved.
In recent years, immune checkpoint inhibitor represented by anti-PD-1, PD-L1 and CTLA-4 antibodies have been widely used in clinical tumor treatments. However, the overall efficacy of immunotherapy alone is low. To improve the efficacy, researchers try to combine it with other tumor treatment drugs/methods. This article mainly discusses the progress of immune checkpoint inhibitors combined with tumor vaccines, oncolytic viruses, modified immune cell therapies, and small molecule targeted therapies.
With the wide application of immune checkpoint inhibitors (ICIs), its combination with radiotherapy has been a focus in this field. Radiotherapy could increase the efficacy of immunotherapy by releasing vaccine in situ, improving antigen presentation, removing the inhibitory immune microenvironment, and increasing PD-L1 expression of tumor cells. However, there are still many hot issues to be solved in the clinical application of ICIs combined with radiotherapy, such as the time points between ICIs and radiotherapy delivery, different radiotherapy fractionation, the heterogeneity of various tumor types, and so on.This paper elaborates and analyzes these hot topics one by one in order to bring readers thinking and determine the future exploration directionin this field.
Chemotherapy can activate the immune response by directly stimulating the innate immune response and acquired immune cells, blocking the immunosuppressive pathways that promote tumor progression, improving the immunogenicity of tumor cells, or enhancing the sensitivity of immune response mechanism.Chemotherapy can also enhance the anti-tumor effect of immunotherapy, further improve the remission rate, and expand the beneficiary population of immunotherapy. The adverse reactions of the combined treatment can also be controlled. This article reviews the progress of the combination of immunotherapy and chemotherapy, the ongoing clinical research of immunochemotherapy, and discusses the existing problems and future directionof the combination.
Osteosarcoma (OS) is the most common primary malignant bone tumor.Surgery is the primary therapeutic approach in the treatment of early OS.With the benefits of neoadjuvant chemotherapy, the outcomes for the osteosarcoma treatments have improved significantly.However, the treatment and prognosis of metastatic or unresectable osteosarcomas were still unsatisfactory.Thus, the development of novel systemic therapies for osteosarcoma to improve the prognosis was needed.Since the 1980s, various immunotherapies have been utilized in patients with osteosarcoma and favorable response for some patients was observed after the treatment.However, the overall response rate was low.Immunotherapy has developed rapidly in recent years, and immunotherapy including immune checkpoint inhibitors and engineered T cells has been utilized in patients with many malignancies.Although there were limited reports of immunotherapies for osteosarcoma, immunotherapy was still thought to be a promising treatment option for osteosarcoma.In this review, an overview of various immunotherapies for osteosarcoma is provided and their potentials are discussed.
In recent years, nano-silica has been widely used in the field of biomedicine due to its high specific surface area, high biocompatibility, and targeting properties. This review focuses on the preparation methods of mesoporous silica nano (MSN) materials, the research progress of MSNs in the diagnosis and treatment of various diseases, and the drug isolationand delivery, aiming at providing are ference for the further application of mesoporous nano-silica in the field of medicine.
Nanocrystalline drugs,based on the combination of nanotechnology and crystal technology, are expected to improve the solubility and the druggability, and reduce side reactions. The stability control and the combination of nanocrystalline drugs and polymers have great application values in the field of sustained and controlled release preparations and targeted drug delivery. This paper introduces the related concepts, preparation methods, influencing factors of nanocrystalline drugs, and discusses the current research progress and the prospects by consulting relative domestic and foreign literatures.
Nanotechnology is a new technology with rapid development in recent years, which has a good application prospect in the field of pharmaceutical preparation. Nano-preparation technology is also widely used in progestational agent. By improving the water solubility of these drugs, nano-preparation technology can enhance the bioavailability and reduce the clinical toxic and side effects.
With the aging of the population and the development and application of new drugs, the prevalence of drug-induced parkinsonism (DIP) is increasing continuously, and it is close to the primary Parkinson's syndrome. In this paper, the clinical characteristics of DIP and the pathogenesis mechanism of DIP induced by different drugs are discussed. The aim is to improve clinical awareness of DIP, so as to develop reasonable prevention and control strategies to reduce the incidence rate of DIP.
Objective A new co-amorphous nanoparticles of imatinib-quercetinwas prepared in order to improve the solubility of imatinib and quercetin. Methods The co-amorphous material of imatinib-quercetin was obtained by heating and stirring, and the co-amorphous nanoparticles of imatinib-quercetinwas prepared by anti-solvent method using PVP K30 as a stabilizer. Then the characterization and analysis were carried out on the nanoparticles and co-amorphous substance, including powder X-ray diffraction(PXRD),differential scanning calorimetry(DSC),infrared spectroscopy(IR), andsaturation solubility. Results The nanoparticles with small particle size [(157.3±4.5)nm, PDI=0.135] was well distributed. The drug loading rates of imatinib and quercetin were 20.21% and 3.53%, respectively,which were significantly improved compared to co-amorphous substance and raw materials. Conclusion The nanoparticles of imatinib-quercetin can significantly improve the saturation solubility of theinsoluble imatinib and quercetin.
Objective To prepare and characterize a novel liposome which could be used for targeted synergistic chemo-photothermal cancer therapy. Methods Hydrophilic nano copper sulfide(PVP/CuS)was chosen as the near infrared photothermal agent, and doxorubicin hydrochloride(DOX)was used as the model chemo-therapeutic agent. DOX-PVP/CuS-Lip was successfully prepared by the membrane dispersion method. The zeta potential and particle size of DOX-PVP/CuS-Lip were determined by using Darwin laser particle size analyzer. The morphology was observed by TEM. The encapsulation efficiency was determined by the ultrafiltration centrifugation method. The characteristics of photothermal conversion were measured under near-infrared irradiation. And dialysis method was used for in vitro drug release test. Results DOX-PVP/CuS-Lip was spherical and uniform in size. The average particle size and zeta potential were 200.9 nm(PDI=0.43)and (-16.0±0.9) mV, respectively. The encapsulation efficiency and drug loading ratio were (91.0±2.0)% and (11.02±0.2)%, respectively. DOX-PVP/CuS-Lip had obvious photothermal conversion effect under near-infrared irradiation at 808 nm in a time-dependent manner. The in vitro drug release test showed that the formulation had obvious sustained release characteristics compared with DOX solution, and the release rate at 45 ℃ was significantly higher than that at 37 ℃. Conclusion The preparation process of DOX-PVP/CuS-Lip was stable and feasible. And the prepared DOX-PVP/CuS-Lip had obvious photo-thermal conversion efficiency and temperature dependent drug release characteristics.
Objective Compare the advantages and disadontages of two kinds Ganoderma lucidum powders and fromulate drying process optimization scheme. Methods The quality of two kinds of Ganoderma lucidum powders produced by vacuum belt drying and spray drying were compared. Results Compared with spray dry powder, vacuum belt dry powder has smaller repose angle, better fluidity, smaller particle size, lower water content, faster dissolution, and higher bulk density. Scanning electron microscopy showed that the shape of Ganoderma lucidum powder with dry powder was irregular, while the shape of spray powder was mostly spherical and vesicular. The results of the hygroscopic experiment showed that the time of approaching hygroscopic equilibrium was 36 and 72 h with dry powder and spray dry powder respectively, and the time of reaching equilibrium was 72 and 96 h, and the CRH with dry powder and spray dry powder were 67.34% and 75.40% respectively. Conclusion Compared with spray dry powder, the time for moisture absorption to reach equilibrium is shorter, and the moisture absorption is smaller, so it is easy to preserve. Therefore, the powder made by belt drying is not easy to absorb moisture and has good fluidity.
Objective To establish the HPLC fingerprint of Yinxing-Huonao capsule for quality control. Methods Inertsil ODS-SP C18 column (250 mm×4.6 mm, 5 μm) was utilized to establish the fingerprint with the mobile phase comprising methanol-0.1% phosphoric acid at the flow rate of 1 mL·min-1 in a gradient elution manner. The detection wavelength was set at 254nm and the column temperature was maintained between 25℃ and 30℃. Similarity for 6 sets of samples was analyzed by the Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine. The chemical components of the main characteristic peaks in the HPLC fingerprint of the Yinxing-Huonao capsule were identified by comparing the retention times of the reference substance, and the attribution of Chinese herbal medicines was preliminarily determined. Results The HPLC fingerprint of the Yinxing-Huonao capsule with good specificity, precision, repeatability, and stability was established. The similarity of six batches of preparations was 0.894-0.940.Thirty-three characteristic peaks were identified as common chromatographic peaks and nine of them were chemically identified. Conclusion The established HPLC fingerprint method of the Yinxing-Huonao capsule is feasible and can be included in the quality evaluation system of this prescription. The results of this research provided a reference for further research on the Yinxing-Huonao capsule.
Objective To co-load ascorbic acid with iron zirconium oxide, which was synthesized using pine needle extract as green solvent, to provide scientific basis for improving ascorbic acid bioavailability. Methods The influence of preparation condition of iron-zirconium oxide on ascorbic acid loading rate was studied by a single factor test, and acute toxicity of this material and the sustained-release property of ascorbic acid intercalated iron-zirconium oxide were evaluated by in vivo in vitro tests. Results When the molar ratio of ferric chloride and zirconium oxychloride was 8:1, 0.5 g cetyltrimethylammonium bromide was added, the reaction temperatures and drying time were 60 ℃ and 24 h, respectively, the maximum loading ratio of ascorbic acid on iron-zirconium oxide was achieved at 97.82%. The material had no obvious acute toxicity to experimental mice. The maximum release times of ascorbic acid intercalated iron zirconium oxide in both stimulated gastric juice and intestinal juice were 450 min. Conclusion The iron-zirconium oxide synthesized by this method was suitable as the sustained-release carrier for ascorbic acid.
Objective To establish an HPLC method for simultaneous determination of vanillic acid, isoquercetin, genistein, and kaempferol in the extract of Duchesnea indica(Andr.)Focke. Methods The HPLC analysis was carried out on Kromasiol-100 C18 column(4.6 mm×250 mm,5 μm)with acetonitrile(A)-0.05% phosphoric acid(B)for gradient elution: 0-10 min, 10%?42%A; 10-16 min, 42%?60%A; 16-30 min, 60%?80%A; 30-35 min, 80%?90%A at a flow rate of 1 mL·min-1. The detection wavelength was 350 nm and the column temperature was 30 ℃. Results The detection of the concentrations of vanillic acid, isoquercitrin, genistein, and kaempferol had good linear relationships in the ranges of 3.095-123.8, 7.06-282.4, 3.83-153.2 and 5.092 5-203.7 μg·mL-1 (r=0.999 9, 0.999 8, 0.999 7, 0.999 9), respectively. The RSD of precision experiment were 1.42%, 1.05%, 1.26% and 1.13%. The RSD of repetitive experiment were 1.37%, 1.21%, 1.44% and 1.16%. The RSD of stability experiment were 1.29%, 1.43%, 1.18% and 1.35%. All the above results were good. The average recoveries were 99.09%, 98.95%, 98.65% and 99.33%, and RSD were 1.25%, 1.42%, 1.44%, and 1.38%(n=6)respectively. The contents of vanillic acid, isoquercetin, genistein and kaempferol in the extract of Duchesnea indica(Andr.)Focke were 5.904, 17.535, 9.011 and 10.788 mg·g-1, respectively. Conclusion The method was simple, fast, accurate and reliable with high reproducibility. It could provide an experimental basis for the quality evaluation and control of the extract of Duchesnea indica(Andr.)Focke.
Objective To systematically evaluatethe influence of steroids inthe treatment of bronchopulmonary dysplasia on neuro-development in extremely low gestationalage neonates or low birth weight premature infants. Methods Retrieved from Pubmed,The Cochrane Library,EMbase,and CJFD database,the randomized controlled trials(RCT) about the effects of steroids for the prevention of bronchopulmonary dysplasia on neurodevelopment in extremely low gestationalage neonates or low birth weight premature infants were collected,with the supplemental search by manual retrieval..Quality evaluation and meta-analysis of included literatures were conducted. Results A total of 12 RCTs were included,involving 3341 cases.Results of meta-analysis showed that the number of patients with cerebral palsy[RR=1.04,95%CI=(0.74,1.48),P=0.81],cognitive delay[RR=0.77,95%CI=(0.40,1.50),P=0.44],visual impairment[RR=0.87,95%CI=(0.55,1.38),P=0.56],auditory impairment[RR=0.42,95%CI=(0.16,1.07),P=0.07],language impairment[RR=0.85,95%CI=(0.46,1.56),P=0.60],cystic periventricular leukomalacia[RR=1.07,95%CI=(0.66,1.75),P=0.78],severe intraventricular hemorrhage[RR=0.95,95%CI=(0.72,1.24),P=0.70],mental development index[SMD=-0.18,95%CI=(-0.67,0.31),P=0.48],psychomotor development index[SMD=-0.25,95%CI=(-0.84,0.35),P=0.42]in the test group(steroids intervention) had no statistically significant difference compared with control group(placebo). Conclusion The usage of low-dose corticosteroids for the treatment of bronchopulmonary dysplasia in very preterm or very low-weight infants had no significant adverse effects on neurodevelopment.
Objective To investigate and analyze the current cognitive status of clinicians for drug uses to patients with chronic disease during the peri-operation in the operation department of a third-class hospital in Wuhan, and to provide a reference for the effective management. Methods An anonymous questionnaire was designed according to the characteristics of drug use during peri-operation period.From two aspects of theoretical cognition and practical knowledge,the questionnaire survey was carried out among 56 clinicians in the relevant operation departments of the hospital. Results According to associate chief physicians,drug Instructions,references,medical guide,and their work experience were the equally important.And 80% of the attending physicians think that the drug instructions,references and guidelines were most reliable.Among the resident physicians,86.67% of them referred to the drug instructions,and 73.33% were willing to believe the recommendations of their superiors,but the application of references and guidelines was relatively low(66.67%).89.13% of clinicians thought the major risk was from adverse drug reactions.But in fact,only 60.87% of them would pay attention to drug interaction,followed by pharmacokinetics and pharmacodynamics of drugs(67.39%).Most of clinicians(95.65%) also thought the half-life of drugs decided when to stop using them.Some of clinicians do not understood the meaning of bioavailability(36.96%) and the peak concentration(19.56%). Conclusion It is clear that there still are many deficiencies in clinicians' understanding of perioperative medication for patients with chronic diseases.Then tt is necessary to strengthen the training,standardize medication and avoid the risk of clinical medication.
Objective To explore the influence of full course pharmaceutical care on the compliance of patients with rheumatic immune disease, and to analyze the influencing factors. Methods Patients in rheumatology and immunology department were given the full course pharmaceutical care from May 2017. Morisky scale was used to investigate the compliance of patients discharged from the hospital in April 2017 and December 2017, respectively. Risk factors affecting compliance were analyzed by the SPSS 18.0 statistic software. Results It was demonstrated that the proportion of patients with good compliance increased from 57.1% to 82.1% after receiving whole course pharmaceutical care. The compliance was positively correlated with the education background. There was no significant correlation between compliance and gender, age or types of medication. Among the non-compliance patients, 40.5% of the patients stopped medication because of improvement, and 18.9% of the patients stopped medication because of the fear of adverse effect. Conclusion Through the full course pharmaceutical care, clinical pharmacists could improve patients' understanding on diseases and drugs, so as to improve patients' compliance. In this process, pharmacists need to design individualized drug education programs according to patients' education background.
Objective To strengthen the administration of medication for the elderly in China, based on the functional advantages of foreign drug management systems and the existing medical and health systems in China. Methods The drug management systems used in Sweden and Germany for the irrational drug use by the elderly were compared and analyzed. Results Sweden's multi dose drug dispensing system was more suitable for medical institutions, and Germany's serior assistance medication systems was more suitable for family medication, respectively. They improved the current situation of irrational drug use for the elderly from different perspectives, but there were still shortcomings. Conclusion The improvement of Chinese medical and health systems and the establishment of drug management systems were helpful to improve the level of rational drug use for the elderly.