中国科技论文统计源期刊 中文核心期刊  
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  • 01 February 2021 Volume 40 Issue 2
      

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  • Zhuozhi WANG,Qiuyue CHEN,Yong HAN,Yongzi CHEN,Yifei HUANG,Weijing GONG,Shuangbing XU,Juyi LI,Aiping DENG,Yani LIU,Fang ZENG,Yongning LYU,Yu ZHANG
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    Objective The concordance correlation coefficient (CCC) method of bioinformatics is used to predict the drug sensitivity genes of the NP scheme(vinorelbine and cisplatin) in the first-line chemotherapy regimen for non-small cell lung cancer. Methods Five statistical methods (Pearson correlation analysis,Spearman correlation analysis,Welch's t-test,ANCOVA and rank-based ANCOVA) were used to screen drug sensitivity genes from the NCI 60 database,and screened biomarkers of chemotherapeutic drug sensitivity in patients with non-small cell lung cancer by concordance correlation coefficient (CCC).The online database DAVID was used for enrichment analysis of KEGG pathway. Results The selection of genes that may be used to predict the sensitivity of chemotherapy drugs of non-small cell lung cancer chemotherapy drugs:the drug sensitivity genes of cisplatin were mainly enriched in proteoglycans and bacterial invasion of epithelial cells;The drug sensitivity genes of vinorelbine were mainly related to cancer pathways,and proteoglycans. Conclusion The CCC method of bioinformatics can be applied to screen out genes that predict the sensitivity of non-small cell lung cancer chemotherapy drugs,which can provide a research foundation for the construction of the NP scheme precision chemotherapy prediction model in the future.

  • Xiaomeng YUE,Yuxiang LI,Feili ZHAO,Fanghong JIA,Jiuhong WU
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    Two main policy documents:“Interim Measures for the Administration of Drugs Used in Basic Medical Insurance” and “Work Plan for the Adjustment of the National List of Drugs For Medical Insurance in 2020 ” that were recently issued by the National Healthcare Security Administration recently for the first time clarified the conditions of adjusting payment criteria and delisting medicines from the national reimbursement drug list (NRDL).The adjustment of drug listing was classified into four categories:newly added items,direct delisting,ready for delisting and payment criteria adjustment.The establishment of dynamic adjustment of NRDL reflects the further advancement of China's medical insurance management.This study reviewed the international experiences and procedure of dynamic adjustment of drug reimbursement formulary,in particular the delisting procedure.The focus of this study is the representative countries in Europe and the United State of America.The domains that were analyzed include decision-making mechanism,the frequency and procedure of adjustment,evaluation method and criteria,as well as the impact and result of the adjustment.Based on the analyses and summary of the international experiences,we further provided the policy recommendations on the establishment of adjustment and delisting mechanism in China with the aim of facilitating the management of NRDL and improving the efficiency of medicine insurance scheme in China.

  • Chen PANG,Xiliu ZHANG,Xiuling ZHANG,Xingjiang YE,Min HUANG
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    Objective To explore the inhibition of fresh Dendrobium officinalis on transplanted tumor tissues and its related mechanism. Methods A total of 30 of nude mice were randomly divided into 6 groups,including blank control group,model control group,cyclophosphamide group,Dendrobium officinalis low,medium and high-dose group.Except for blank control group,nude mice of the other group were establishment of A549 lung adenocarcinoma xenograft model.Nude mice in blank control group and model control group were given 0.9% sodium chloride solution (30 mL·kg-1),those of cyclophosphamide group were given intraperitoneal injection of cyclophosphamide (every other day,0.025 g·kg-1),those of Dendrobium officinalis low,medium and high-dose group were given Dendrobium officinalis 6.25,12.5,25 g·kg-1.The time lasted 4 weeks, after the drug was stopped,the nude mice were sacrificed,and the tumor body was weighed and measured before use.Immunohistochemistry was used to observe the protein expression of autophagy related factor Beclin1 and proliferation index Ki67 in transplanted tumor tissues of nude mice.RT-PCR was used to detect the expression of tumor suppressor genes p53,p16 and EGFR in transplanted tumor tissues of nude mice. Results Compare with the model control group,the expression rate of Beclin1 in cyclophosphamide group,Dendrobium officinalis medium,high-dose group increased.Compared with the model control group,the positive expression rate of Ki67 in cyclophosphamide group and Dendrobium officinalis high-dose group decreased.Compared with the model control group,the expression of EGFR in the cyclophosphamide group and Dendrobium officinalis high-dose group were decreased (P<0.05).Compared with the model control group,the expression of p16 mRNA in the cyclophosphamide group,the Dendrobium officinalis medium,high-dose group were increased,and the difference were statistically significant (P<0.05).Compared with the model control group,p53 mRNA expression was increased in the cyclophosphamide group,Dendrobium officinalis low,medium and high-dose group,and the difference were statistically significant (P<0.05). Conclusion Dendrobium officinalis can inhibit the growth of transplanted tumor tissues in nude mice with lung adenocarcinoma,and the mechanism of action may be related to autophagy related factor Beclin1.Through the synergistic effect of Beclin1-p53 and p16-Ki67 and the regulation of tumor angiogenesis related factor EGFR expression,the growth of transplanted tumor tissues can be inhibited.

  • Nan GOU,Xingchen WANG,Jianyi GAO,Yongzhi LI,Juan JING,Xueying LIU,Qingwei WANG
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    Objective To compare effects of different compatibility ratios of Radix Paeoniae Rubra-Peach Kernel on blood flow changes in rats with acute blood stasis. Methods The effects of different ratio of Radix Paeoniae Rubra - Peach Kernel (1:0,1:1,1:2,2:1,0:1) on hemorheology in rats with acute blood stasis were studied by measuring whole blood viscosity (WBV),plasma viscosity (PV),hematocrit (HCT),and erythrocyte sedimentation rate (ESR).The effects of different compatibility ratios of Radix Paeoniae Rubra and Peach Kernel on coagulation function were investigated by proenzyme time (PT),fibrinogen (FIB) and thrombin time (TT). Results Compared with the blank control group,WBV,PV,HCT,ESR in the model control group increased significantly (P<0.05),suggesting that the model was successful.Compared with the model control group,the hemorheology and coagulation function of the single drug group of Radix Paeoniae Rubra and Peach Kernel had no significant changes.WBV,PV,HCT,ESR,FIB of Radix Paeoniae Rubra-Peach Kernel (1:1) decreased significantly (P<0.05),and PT and TT were significantly prolonged (P<0.05).WBV,ESR,FIB of Radix Paeoniae Rubra-Peach Kernel (1:2) decreased significantly (P<0.05),and TT was prolonged significantly (P<0.05).Radix Paeoniae Rubra-Peach Kernel (2:1) increased ESR significantly (P<0.05),and TT was prolonged significantly (P<0.01). Conclusion Different ratios of Radix Paeoniae Rubra-Peach Kernel can improve the hemorheology of acute blood stasis rat model in different degrees,and the 1:1 ratio has a very significant effect,revealing that the compatibility of the two may have synergistic effect.

  • Yanwu HU,Wenxin YANG,Xiaoxue BAO,Shuai YU,Zijing WU,Ruili LI
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    Objective To observe the effects of puerarin on blood lipid metabolism,serum inflammatory factors TNF-α,IL-6,IL-1β,and mitogen-activated kinase (MAPK) signaling pathway in atherosclerotic rats,and to explore the mechanism of puerarin against atherosclersis (AS). Methods Sixty adult male Wistar rats were randomly divided into normal control group (n=15) and model group (n=45).Rats in the model group were given high-fat diet and injected with vitamin D3 to duplicate AS model.After confirming the success of the modeling,the rats in the model group were randomly divided into model control group,simvastatin group (4 mg·kg-1·d-1,ig),high-dose puerarin(60 mg·kg-1·d-1,ig),and low-dose puerarin (30 mg·kg-1·d-1,ig) groups,with 10 rats in each group.Serum lipids and levels of TNF-α,IL-6 and IL-1β in rats were measured. Results Compared with the model control group,the levels of TC,TG,LDL-C,TNF-α,IL-6,and IL-1β in serum of rats in simvastatin group,high-dose and low-dose puerarin groups were significantly lower (P<0.05),while the levels of HDL-C in serum were significantly higher (P<0.05).The expression levels of p-ERK1/2,p-p38 and p-JNK in thoracic aorta were significantly decreased (P<0.05). Conclusion Puerarin can significantly regulate the level of serum lipids and inflammatory factors in AS rats.The mechanism may be related to the inhibition of activation of MAPK signaling pathway.

  • Tianmu HE,Qihong CHEN,Sha YANG,Jianyong ZHANG,Xiaofei LI
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    Objective To analysis the molecular mechanism of cantharidin induced nephrotoxicity based on the network pharmacology. Methods The potential targets of cantharidin were collected from the databases of TCMSP,CTD,Pubchem,and Uniprot,while the potential targets of nephrotoxicity were collected from Digsee,Genecards,and CTD.The common targets were then imported into CTD database to get related diseases.Meanwhile,the gene relation,gene function,and pathway enrichment of the targets were analyzed by STRING and DAVID databases.Visible target-disease network,PPI,and target-pathway network were constructed by Cytoscape software.Finally,the targets of cantharidin and cantharidin were validated by Systems Dock Web Site. Results A total of 41 targets were collected from cantharidin and 5619 targets were collected from nephrotoxicity.They have 32 common targets,which mainly act on PTGS2/COX-2,TP53/p53,BCL-2,CASP3,and AKT1 in analysis of PPI.And cantharidin further regulates the apoptosis,TNF signaling pathway,and MAPK signaling pathway to induce nephrotoxicity. Conclusion This study reveals the multi-target and multi-pathway action of cantharidin in nephrotoxicity,and provides a new method for further research on the molecular mechanism of cantharidin in nephrotoxicity.

  • Yudan ZHU,Zhongkun LI,Yueqin LIANG,Hongying XIA,Cuihong LI,Zhongjuan WANG
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    Objective To study the immunoregulatory activity of Herba schizonepetae polysaccharide (HSP) on Raw264.7 cells and immunosuppressive mice. Methods HSP was extracted by hot water and then precipitated in alcohol.Total sugar content was determined by phenol-sulfuric acid method.Uronic acid content was determined by sulfuric acid-sodium tetraborate method.Protein content was determined by Coomassie bright blue staining method,and monosaccharide composition was analyzed by HPLC.The effects of HSP on the proliferation and phagocytosis of Raw264.7 cells were detected by MTT and flow cytometry,respectively.The immunosuppressive mice model were induced by cyclophosphamide to investigate the effects of HSP on weight gain,thymus index,spleen index and PPs. Results There were 1.73% of D-mannose (Man),4.36% of L-rhamnose (Rha),1.38% of D-glucuronic acid (GlcA),6.67% of L-galacturonic acid (GalA),0.40% of D-glucose (Glc),2.03% of D-galactose (Gal),and 92.26% of L-arabinose (Ara) in HSP.HSP at the concentrations of 200,400,and 800 μg·mL-1 could promote the proliferation and phagocytosis of Raw264.7 cells (P<0.05 or P<0.01).It also could significantly affect the morphology of macrophages,and regulate the spleen and thymus index of immunosuppressed mice (P<0.05). Conclusion HSP has immunomodulatory effects on immune system.

  • Yongzi CHEN,Liwen YANG,Qiang LI,Jun CHEN,Dongyuan WANG,Qiuyue CHEN,Zhuozhi WANG,Juyi LI,Aiping DENG,Yong HAN,Yongning LYU,Yu ZHANG
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    The rapid progress of new generation sequencing technology has provided great potential for personalized medicine. Biomedicine and cancer genomics have also undergone great changes in the era of big data.With the continuous improvement of biological science and technology and the ability of computer processing data,high-throughput sequencing plays a key role in the acquisition and mining of multi-omics biological data.Currently,it has become an important tool for biologists to conduct scientific research and has made valuable contributions to the field of anticancer drug discovery.This review will focus on the application of different sequencing methods in drug discovery,and provides beneficial suggestions for new generation sequencing techniques in it.

  • Changkai ZHOU,Long XU,Bin ZHANG,Hongyan JI,Xiaomin XING,Qie GUO,Shasha ZHANG,Wenxiao WANG,Yanlin SHAO,Hongxia YU,Jing LI,Fanbo JING
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    Selective serotonin reuptake inhibitors (SSRIs) are the first-line drugs in the treatment of depression.CYP2D6 and CYP2C19 gene polymorphisms may influence the metabolism of SSRIs.Thereby,they could affect drug safety and efficacy.At present,clinicians have few individualized SSRIs treatment practices for depression patients based on pharmacogenomics.This paper reviews the genotypes of CYP2D6 and CYP2C19 and their effects on SSRIs treatment,in order to provide a useful reference of individualized SSRIs for patients with depression.

  • Yao SUN,Yuanyuan FU,Suming ZHOU,Can LUO
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    Objective To explore the permeability of vancomycin into epithelial lining fluid (ELF) of patients with severe pneumonia,and to understand the distribution of vancomycin in lung tissue.The study is to provide references for studying the correlation between vancomycin tissue concentration and therapeutic effect and formulating more accurate drug treatment plan. Methods Patients admitted to ICU from May 2016 to January 2017,who needed vancomycin for pulmonary infection,mechanical ventilation for respiratory failure and bronchoalveolar lavage therapy during treatment,were selected.Vancomycin was given 0.5 g,q8h for continuously intravenous infusion for 1 h. Bronchoalveolar lavage was performed 3 days after the administration,and lavage fluid and blood samples from the same period were collected.Vancomycin concentration was determined by LC-MS/MS.The apparent volume of ELF recovered by bronchoalveolar lavage was determined by using urea as an endogenous marker.The permeability of the drug in the lung tissue was calculated by Renard formula,expressed as the ratio of ELF / plasma. Results Sixteen patients were included,including 12 males (75%) and 4 females (25%).The average age was 60.94 years old,and the average APACHE II score was 30.31.The main diagnosis was pulmonary infection,and the mortality rate during hospitalization was 12.5% with the main cause of death of multi-organ failure.White blood cell (WBC) count and procalcitonin (PCT) were statistically different before and after the treatment (P<0.05).The recovery rate of lavage fluid was 38.83%,and the dilution rate of urea in lavage fluid was 37.34 times (17.8-79 times) to average.Vancomycin levels in ELF ranged from 1.48 to 10.15 μg·mL-1,while the mean simultaneous level of the drug in serum was from 8.71 to 61.96 μg·mL-1.The ratio ELF/plasma of drug penetration was 23.12%. Conclusion Vancomycin has a low pulmonary permeability in critically ill patients.When the concentration of vancomycin reaches the standard,the actual concentration in ELF may not reach the optimal target value,which may lead to treatment failure.

  • Na LI,Ximing YAN,Jinbing CHEN,Guilan JIN
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    Objective To investigate the distribution of MTHFR and ABCB1 alleles in patients with rheumatoid arthritis (RA) in Yichang and their relationship with MTX correlation. Methods A retrospective study was conducted to collect patients cases of RA detected by gene polymorphism of MTHFR 677 C>T,MTHFR 1298 A>C ,ABCB1 3435 T>C,from January 2016 to June 2019 in the gene testing laboratory of a third-class hospital of Yichang. Retrospectively analyze the distribution of related genotypes and the impact of gene polymorphisms and curative effects. Results Among the 64 patients,MTHFR C677T CC,CT,TT type distribution frequency of 46.88%,40.62%,12.50%;MTHFR A1298C AA,AC,CC Distribution frequency of 78.13%,18.75%,3.12%;ABCB1 C3435T CC,CT,TT type distribution frequency of 51.56%,34.38%,14.06%,all of which were in line with Hardy-Weinberg genetic equilibrium (P>0.05).No significant correlation was observed between the drug efficacy and MTHFR C677T,MTHFR A1298C,ABCB1 C3435T gene polymorphisms.Among the 64 patients with RA,at least one gene locus was changed in 51 cases,with a gene mutation rate of 79.69%.The occurrence of gene mutation may affect the changes of ESR and ALT values. Conclusion There are obvious individual differences in genetic polymorphisms among patients with the same disease in the same region.The changes in MTHFR and ABCB1 gene polymorphisms may be related to the treatment effect or toxic side effects of low-dose MTX.

  • Yamei LIU,Yuchun CAO
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    Objective To investigate the effect of high-dose intravenous immunoglobulin on glucocorticoid use and disease progression in the treatment of severe drug eruptions. Methods We collected retrospective data on 49 cases of severe drug eruptions from July 2012 to July 2017 and prospective data on 16 cases of severe drug eruptions admitted to our department from September 2017 to August 2019,and the patients were divided into glucocorticoid-treated group and combined treatment group.All patients were given 1-2 mg·kg-1·d-1 of glucocorticoid,and patients in the combined treatment group were given additional 400 mg·kg-1·d-1 of immunoglobulin,which were lasted for 3-5 days.Initial glucocorticoid dose,glucocorticoid reduction time,rash improvement time,and length of hospital stay were statistically analyzed. Results Compared with glucocorticoid-treated group,patients in the combined treatment group did not shorten the glucocorticoid reduction time,the rash improvement time,and the length of hospital stay,and the cost was more than the glucocorticoid-treated group. Conclusion The data in this study suggest that the use of immunoglobulin in Stevens-Johnson syndrome and toxic epidermal necrosis may not shorten the time of glucocorticoid use and the course of the disease.

  • Yunjie CHENG,Xiaoli WANG,Peipei ZHANG,Xiangyun CHANG
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    Objective To explore the clinical characteristics of patients with exogenous insulin-induced antibody syndrome (EIAS) and the clinical outcome after 24 weeks follow-up. Methods A total of 16 cases with EIAS after insulin therapy from January 2015 to June 2018 were enrolled.Laboratory data such as general clinical data,fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS),2-hour insulin (2hINS),and insulin antibody (IA) were observed at 12 and 24 weeks after the adjustment of drug treatment. Results Serum FINS and 2hINS levels of 16 EIAS patients were significantly increased,and the separation of insulin and C-peptide was observed,and insulin antibodies of these cases were positive.Twelve weeks after the withdrawal of insulin or change of insulin dosage form,FINS and 2hINS levels decreased significantly (in all cases) or returned to normal (in 2 cases).At the 24th week,insulin levels of 12 patients became to the normal range,and 9 patients had negative IA,and no hypoglycemia occurred in all patients. Conclusion When diabetic patients treated with exogenous insulin,the insulin level and insulin antibody should be detected to avoid missed diagnosis or misdiagnosis of EIAs when hypoglycemia,large fluctuation of blood glucose and,difficulty in glucose control occur.In most patients with EIAS,insulin level can significantly decrease within 24 weeks after insulin withdrawal or dosage change,while the time for IA to turn negative is relatively lag.

  • Chunfang YI
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    Proton pump inhibitors(PPI)are the first choice for the treatment of acid-related diseases currently.However,in recent years,more and more studies have found that long-term use of PPI may be associated with gastric mucosal lesions,which even lead to the occurrence of gastric cancer.This article describes the pharmacological effects,carcinogenic mechanisms,and related clinical research results of PPI by investigating domestic and international literatures.This paper is to provide a reference for the rational selection and use of PPI,to identify high-risk groups of gastric cancer,and to reduce the incidences of PPI-related gastric cancer.

  • Liken ZHENG,Shiyun YE,Shaowen YIN,Wei WANG
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    Objective To screen the main active component indexes of Kushen mo and establish HPLC fingerprint analysis method,and to investigate the influence of production equipment changes on the main active components of Kushen mo. Methods Fingerprints of 30 batches of samples before and after the change of production equipment were established.Fingerprint map similarity evaluation software was used to process fingerprint map data.SPSS 22.0 was used for system cluster analysis and principal component factor analysis,and then re-cluster analysis according to the results of principal component factor analysis.Based on the class analysis,the difference of the index components in the quality of the Kushen mo was screened out.The content of index components of the samples before and after the 30 batches of equipment were measured.The independent sample T test was performed using SPSS 22.0 to discuss the influence of equipment changes on the content of the components of Kushen mo. Results There were 8 common peaks in the fingerprint.According to the results of cluster analysis,the samples could be clustered into two groups.The reason for the difference might be related to the production year and whether the samples were overdued or not.Five different components of Kushen mo were screened out from the results of principal component factor analysis.Cluster analysis based on the different components was consistent with the previous results.Sophocarpine,matrine,sophoridine,and oxymatrine were initially identified as the indicators of Kushen mo.The contents of four known components in 30 batches of Kushen mo were determined.The results showed that the content of Kushen mo was higher in batches after the equipment was changed,and the difference was significant (P<0.05). Conclusion The fingerprints,cluster analysis,and principal component analysis of the established HPLC fingerprints can provide references for the quality control of Kushen mo.

  • Xiaowen ZHANG,Jingmeng SUN,Zhuoming WANG,Jintao NING,Dan WANG,Weiyu ZHANG
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    Objective Preparation and evaluation of cinepazide maleate liposomes (CM-Lip). Methods The CM-Lip was prepared by reverse evaporation method.The encapsulation efficiency was measured.The fishbone diagram analysis method and Plackett-Burman (PBD) design were used to screen the key factors affecting the encapsulation efficiency.The Box-Behnken response surface method was used.The key factors affecting the encapsulation efficiency of CM-Lip were optimized by the ratio of drug to phospholipid,hydration time,oil phase (ether:ethanol) and water phase.Based on the regression model,the design space of CM-Lip preparation process was established and verified to determine the best formulation and process parameters of CM lip;the formation of CM-Lip was verified by differential scanning calorimetry (DSC) and infrared spectroscopy.The CM-Lip was characterized by transmission electron microscopy,particle size measurement and zeta potential. Results The best prescription for determining CM-Lip was as follows:drug to phospholipid ratio was 1:110;hydration time was 1.5 hours;oil phase (ether:ethanol) was 3:1 compared with water.Transmission electron microscopy proves that CM-Lip was spherical or ellipsoid,and DSC test and infrared spectroscopy verified the CM-Lip.The particle size of CM-Lip was (114.5±10.3) nm,and the PDI was 0.208,and the Zeta potential was -17.85 mV.The encapsulation efficiency was 83.12%,and the average drug loading was 30.17 mg·g-1. Conclusion CM-Lip has a simple preparation process,high encapsulation efficiency,and sustained release effect.Its quality is in line with the requirements of the 2015 edition of the Chinese Pharmacopoeia,which provides a basis for the development of new drugs.

  • Shuyan LAI,Hui JIN,Chunnuan YU,Guangyao MEI,Haibo WANG,Zhaoxia ZHANG,Guoqing ZHANG
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    Objective To develop the preparation methods for the amorphous of empagliflozin. Methods Amorphous of empagliflozin was prepared by rotating steaming technology.The raw material was dissolved in ethanol at 65 ℃ and then was evaporated at 70 ℃ until the solvent was completely removed.The obtained amorphous structure was determined by PXRD and its thermodynamic properties were analyzed by DSC. Results The amorphous had good stability at low temperatures and humility,and would transform slowly into crystalline A at higher temperatures and humidity.The apparent solubility test showed that the amorphous apparent solubility reached 0.054 mg·mL-1,which was significantly higher than that of the crystalline A (0.026 mg·mL-1). Conclusion A simple,effective method for the preparation of amorphous of empagliflozin is established.

  • Bin KONG,Xiaoxia LIU
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    Objective To evaluate the similarity of dissolution curves between domestic-made and imported nimodipine tablets by optical fiber dissolution analysis. Methods The gastrointestinal environment was simulated at different pHs.The dissolution curves of domestic-made and imported nimodipine tablets were examined by a real-time optic fiber dissolution process monitoring system at the wavelength of 238 nm.The similarity of dissolution curves was compared by a similarity factor method. Results The dissolution curves of nimodipine tablets from 7 manufacturers determined at different pHs were significantly different by f2 factor comparison. Conclusion The optic fiber dissolution process monitoring system can accurately measure the data and truly describe the dissolution curve,which can provide reliable reference data for improving pharmaceutical preparations and drug quality testing.

  • Lihui OUYANG,Shunzhi ZHANG,Gefei HE,Xiaohui LIU,Xiaohui ZENG,Ren GUO,Liubao PENG
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    Objective To evaluate the cost-effectiveness of gemcitabine plus cisplatin (GP) vs fluorouracil plus cisplatin (FP) in the treatment of advanced nasopharyngeal carcinoma patients from the perspective of Chinese medical and health system. Methods Based on the outcome from a phase III randomized clinical trial,a Markov model was developed to compare the cost and effectiveness of gemcitabine plus cisplatin vs fluorouracil plus cisplatin in the treatment of advanced nasopharyngeal carcinoma.And one-way sensitivity analyses and probabilistic sensitivity analyses were performed to evaluate the uncertainty of the model. Results Compared with FP regimen,GP regimen prolonged 0.3 quality adjusted life years (QALYs),but increased the cost by 34 292.68 yuan.The incremental cost-effectiveness ratio (ICER) was 98 180.97 yuan / QALYs,which was lower than the WTP value of 193 932 yuan / QALYs in China.Thus,GP regimen is cost-effective. Conclusion Gemcitabine plus cisplatin regimen was estimated to be more cost-effective than fluorouracil plus cisplatin regimen for advanced nasopharyngeal carcinoma based on the results of the model.

  • Jinfang SONG,Xia LI,Wenjin HUA,Yiqing ZHAO
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    Objective To explore the effectiveness of clinical pharmacists in developing pharmaceutical care by establishing doctor-pharmacist joint pharmacy clinic for outpatients and joining the diagnostic and therapeutic team of the National Metabolic Management Center (MMC). Methods A total of 160 patients with type 2 diabetes mellitus were enrolled and randomly divided into control group and intervention group.The study period was 3 months.Both groups received standardized MMC diagnosis and treatment,and clinical pharmacists provided pharmaceutical care for the intervention group.Observation indicators include:drug compliance,fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1c),blood pressure,blood lipid,and other comprehensive management indicators. Results The baseline characteristics of the two groups were similar,and there was no significant difference (all P>0.05).After 3 months of follow-up,drug compliance,HbA1c,FPG,LDL-C,and diastolic blood pressure in the intervention group were significantly improved compared with those in the control group (all P<0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05). Conclusion Clinical pharmacists can improve the comprehensive management of diabetes mellitus and provide new ideas for the development of pharmaceutical outpatient service by establishing the doctor-pharmacist joint pharmacy clinic for outpatients and improving the MMC integrated diagnosis and treatment system.

  • Shengyuan LIU,Kangkang YAN,Dan YE,Yucheng ZHANG,Yue CHEN,Ningsheng WANG,Huaixia YUAN,Bianling FENG
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    Objective To analyze the impact of abolishing the ceiling price policy on the price of low-cost drugs before and after the implementation based on the evaluation of policy implementation effect,in order to provide evidence support for optimizing drug price reform and exploring the mechanism of drug price formation. Methods The low-cost drug purchase data was collected from January 1st,2015 to September 30th,2019 through the hospital information management system of a Class 3 first level general hospital to analyze the change trend of low-cost drug price after the implementation of low-cost drug policy. Results After the implementation of the low-price drug policy,the price of these drugs increased significantly.There were 71 of the 92 low-cost drugs having experienced price increase,accounting for 77.17%.In particular,the price of injectable drugs of low-cost drugs increased even more,with the maximum price increase of 10 929.41%.The reasons for the rise in prices of low-cost drugs include the rising prices of pharmaceutical raw materials,labor,transportation,and packaging materials,as well as the implementation of the "two-vote" policy for drugs. Conclusion The price of drugs increased significantly after the implementation of the low-price drugs policy,and this upward trend has been continuing.It is suggested that the drug bidding and procurement system should be improved,and a reasonable drug pricing mechanism and regulatory system should be formulated.Meanwhile,penalties for the illegal behavior of malicious increase of drug price should be imposed stronger.For the drugs with small dosage and clinical necessity,relevant measures such as fixed-point production and national reserve could be applied,so as to stabilize the drug price and protect the rights and interests of patients.