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  • 01 February 2022 Volume 41 Issue 2
      

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  • YIN Qinan,HAN Lizhu,BIAN Yuan,HUANG Xuefei,LEI Yang,SONG Yujie,TONG Rongsheng
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    In July 2021, the ESC Working Group on aorta and peripheral vascular diseases and the ESC Working Group on pulmonary circulation and right ventricular function published the Second consensus document on diagnosis and management of acute deep vein thrombosis, as an update to the 2017 consensus document and a companion document to the 2019 ESC Guidelines on the Management of Pulmonary Embolism (PE).The objective is to provide comprehensive therapeutic management of venous thromboembolic disease (VTE).In order to provide references for the clinical application, this paper gives a comprehensive interpretation for prolonging the time of anticoagulant therapy, management of cancer patients, prevention and management of post-thrombotic syndrome, management of bleeding during anticoagulation and treatment of deep vein thrombosis in pregnant patients.

  • WANG Zengsi,GAO Wen,CHEN Dan,CHEN Jin,HUANG Dan
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    Objective To explore the mechanism of astragaloside IV (AS-IV) in treatment of diabetic nephropathy by effects of apoptosis on mesangial cells induced with tunicamycin,expression of protein of endoplasmic reticulum stress and CHOP pathway. Methods The mesangial cells were respectively cultured in DMEM medium of inactivated fetal bovine serum (normal control group), plus 5 μg·mL-1 tunicamycin (model control group), 5 μg·mL-1 tunicamycin+AS-IV 50 μg·mL-1 (AS-IVL group), 5 μg·mL-1tunicamycin+AS-IV 100 μg·mL-1 (AS-IVH group), or 5 μg·mL-1 tunicamycin+PBA10 mmol·L-1 (PBA group).Apoptosis of mesangial cells were measured with flow cytometric analysis.The signaling pathways in UPR of phosphorylation of eIF2α, PERK and IRE1α, the apoptotic related factors including GRP78, CHOP, BAX, Bcl-2 and cleaved caspase-3 were determined by Western blotting. Results Compared to the normal control group, the mesangial cells in model control group showed significant increase of apoptosis, and the phosphorylations of eIF2α, IRE1α and PERK were upregulated, and the expressions of CHOP, Bax and cleaved caspase-3 were significantly increased (all P<0.05).Both concentrations of AS-IV treatment significantly inhibited the apoptosis of mesangial cells induced with tunicamycin, inhibited the phosphorylation of IRE1α,PERK and eIF2α, decreased the expression of CHOP, and inhibited the expression of Bax and cleaved caspase-3 (all P<0.05). Conclusion AS-IV significantly down-regulated the CHOP pathway, and reduced mesangial cells apoptosis induced by endoplasmic reticulum stress.

  • BIAN Hongsheng,YUE Lili,SHAWULIEXI Mulatibieke,MAO Dengxuan,GUO Hongli,HUANG Lili
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    Objective To observe the effect of Acanthopanax Senticosus extract on the sleep deprivation of Drosophila melanogaster by mobile phone radiation. Methods The experiment was randomly divided into five groups: blank control group, model control group, and low-, medium-, and high dose group, with 32 Drosophila melanogaster in each group.The average sleep time and sleep-wake rhythm were used as the observation indexes by using the DAMS.The seven-day-old Drosophila melanogaster were tested for 24 hours in the blank control group and the model control group, and the Drosophila melanogaster were exposed to mobile phone radiation [30-190 μW·(cm2)-1, intervention point: 20:00-22:00 every 30 minutes to make phone call for 10 minutes] in the model control group.The low-,medium-and high dose group were treated with different concentrations (2%, 4%, and 8%) of Acanthopanax Senticosus extract for three days with the four-year-old, and also irradiated by mobile phone for 24 hours at the age of seven days. Results Compared with the blank control group, Drosophila melanogaster in the model control group which was intervened in the night by mobile phone radiation showed an alternate change on sleeping and awakening (fragmentation sleep), and the sleep duration of 12 hours was shortened (P<0.01).This phenomenon indicates that mobile phone radiation has a negative effect on Drosophila’s sleep.Compared with the model control group, Acanthopanax Senticosus could improve the sleep-wake rhythm of Drosophila melanogaster by reducing the fragmented sleep and increasing the sleep duration.The results showed that the daytime, night and all-day sleep time of male Drosophila melanogaster at 2% dosage were significantly prolonged (P<0.01), and the daytime and all-day sleep time of 8% dosage were significantly prolonged (P<0.01 or P<0.05).The sleep-wake rhythm of 2% dosed drosophila melanogaster was the most obvious and similar to that of the blank control group, and the sleep time of 4% dosed Drosophila melanogaster was obviously shortened during the day, and the sleep time at night was significantly prolonged in 8% dosages (P<0.01).The sleep-wake rhythm of 8% dosed group was the most obvious and the most similar to that of the blank control group. Conclusion Acanthopanax Senticosus extract has a positive effect on the negative effects of sleep time and sleep-wake rhythm of Drosophila melanogaster by mobile phone radiation.

  • ZHU Zhendong,PI Na,HE Qin,ZHONG Yan,ZHANG Xuan
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    Objective To investigate the protective effect of Gentiana rigescens Franch against bleomycin (BLM) induced pulmonary fibrosis in mice and its influence on mitogen activated protein kinase (MAPK) signaling pathway. Methods The mice were randomly divided into six groups: normal control group, model control group, pirfenidone group,low-, medium-, and high-dose Gentiana rigescens Franch group, with ten mice in each group.Except for normal control group, the mouse model of pulmonary fibrosis was established by intratracheal instillation of bleomycin (5 mg·kg-1).Mice in the low-, medium-, and high-dose Gentiana rigescens Franch group were administered intragastrically with 50, 100, 200 mg·kg-1of Gentiana rigescens Franch.Mice in the pirfenidone group were administered 50 mg·kg-1 of pirfenidone intragastrically.The normal control group and the model control group were given the same amount 0.5% of sodium carboxylmethyl cellulose solution once a day.On the 28th day after modeling, lung tissues were taken for investigation.HE staining was used to observe the inflammation degree of lung tissue in mice.Masson staining was used to observe the degree of pulmonary fibrosis.Western blotting was used to detect the protein expression of p38, JNK, Erk1/2, IL-13, and Collagen I in lung tissues. Results Compared with the normal control group, the lung tissue structure of mice in the model control group was damaged, and the alveolar wall was thickening.A large amount of fibrous tissue hyperplasia and collagen deposition were found in lung interstitium, and the protein expression levels of Collagen I, IL-13, JNK, P38 and Erk1/2 in the model group were significantly increased (P<0.05).Compared with the model control group, the collagen deposition was significantly reduced, and the lung tissue lesions were alleviated in different doses groups of Gentiana rigescens Franch and pirfenidone group.And the protein expression levels of collagen I, IL-13, JNK, P38, and Erk1/2 in lung tissue were significantly down-regulated (P<0.05). Conclusion Gentiana rigescens Franch can ameliorate bleomycin-induced pulmonary fibrosis in mice, and the mechanism is related to the inhibition of MAPK signaling pathway and down-regulating IL-13 expression.

  • CAI Fenglin,WANG Meifang,CHEN Xueqin,YUN Leyong,HE Jinjuan,HU Wenwen,TANG Yijun
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    Objective To explore the role and possible mechanism of Isoliquiritigenin (ISL) on the pulmonary fibrosis by observing the effect of ISL on pulmonary fibrosis model induced by transforming growth factor β1 (TGF-β1) on human alveolar type II epithelial A549 cells in vitro. Methods TGF-β1 was used to stimulate A549 cells to undergo epithelial-mesenchymal transition (EMT) to construct a pulmonary fibrosis model in vitro.After the intervention by adding ISL, MTT method was used to detect effect of ISL on cell proliferating activity after TGF-β1 stimulating A549 cells. Cell scratch test was used to detect cell migration ability. Inverted phase contrast microscope was used to observe cell morphology. Real-time PCR (RT-PCR) was used to detect the expression levels of EMT-related mRNA (E-cadherin, Vimentin, α-SMA, and FN) and EMT related transcription factors (Snail, Slug, Twist, ZEB1, and ZEB2). Western blotting was used to detection the expression levels of EMT-related proteins (E-cadherin, N-cadherin, Vimentin, α-SMA, FN) and Erk phosphorylated protein in MAPK/Erk signaling pathway. Results TGF-β1 could change the morphology of A549 cells from epithelial cells to fibroblasts, enhance the ability of cell proliferation and migration (P<0.05 or P<0.01), decrease the expression of E-cadherin, increase the expressions of N-cadherin, Vimentin, α-SMA, FN, and increase the expressions of EMT-related transcription factors and phosphorylated Erk (P<0.05 or P<0.01).ISL could effectively inhibit the proliferation, migration and cell morphology changes of A549 cells induced by TGF-β1 (P<0.05 or P<0.01).It could also increase the expression levels of E-cadherin, and decrease N-cadherin, Vimentin, α-SMA, FN, EMT-related transcription factors and phosphorylated Erk (P<0.05 or P<0.01). Conclusion ISL could inhibit TGF-β1 induced EMT process of A549 cells by interfering the MAPK/Erk signaling pathway.It could maintain the epithelial morphology of the cells, and reduce the production of lung fibroblasts.Thus, it could be used as a potential treatment for pulmonary fibrosis.

  • WU Le,WU Qiang,CHEN Yong
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    Objective To observe the effects of LXA4(Lipoxin A4) on the activity of cysteinyl aspartate-specific proteases 1 (Caspase-1) in the peripheral area of the ischemic cortex tissue in rats with middle cerebral artery occlusion/reperfusion (MCAO/R). Methods Adult male Sprague-Dawley rats were randomly divided into sham group, model control group, and LXA4 group, 8 rats in each group. For rats of model control group and LXA4 group, the model rats of cerebral ischemia were made by occlusion of middle cerebral artery using an intraluminal filament method, and rats in LXA4 group were injected 1 nmol of LXA4.The infarct volume, the neurological deficit scores, the activity of Caspase-1, Caspase-1 protein expression, concentrations of interleukin-1β (IL-1β) and interleukin-18 (IL-18) in three groups were observed. Results LXA4 effectively reduced infarct volume and neurological scores in MCAO/R rat (P<0.01).The activity and protein expression of Caspase-1 were significantly reduced by LXA4.(P<0.01) The concentrations of IL-1β and IL-18 were also significantly inhibited by LXA4 (P<0.01). Conclusion These results suggest that the neuroprotective effects of LXA4 were likely achieved by inhibiting the activity of Caspase-1.

  • YU Hengyi,OU Shuyun,LIU Dong,LIANG Biaozhi,GAO Yongjian,REN Xiuhua
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    Objective To study the pharmacokinetic characteristics of nifedipine sustained-release tablets in Chinese healthy subjects and evaluate the bioequivalence. Methods This was a randomized,open-lable,three period,three-way crossover bioequivalence study.30 healthy subjects were enrolled in fasting study and 30 in fed study.Each subject received a single dose of test preparation T1 10 mg,test preparation T2 10 mg,or reference preparation R 10 mg with a washout period of seven days.The concentrations of nifedipine in human plasma were determined by LC-MS/MS and calculated through DAS 2.1 software to evaluate the bioequivalence. Results The main pharmacokinetic parameters of the test preparations T1,T2,and reference preparation R were as follows:under fasting condition (n=28),Cmax were (44.10±17.41),(25.94±13.53),(28.90±16.05) ng·mL-1;AUC0-t were (264.65±106.88),(208.02±107.85),(219.48±113.46) ng·h·mL-1;AUC0-∞ were (276.95±109.24),(251.74±136.25),(289.03±162.06) ng·h·mL-1.Under fed condition (n=29),Cmax were (43.80±18.42),(30.30±8.88),(27.72±9.82) ng·mL-1;AUC0-t were (183.10±70.63),(179.06±68.38),(170.80±65.44) ng·h·mL-1;AUC0-∞ were (191.51±72.43),(190.56±77.03),(190.30±94.02) ng·h·mL-1.In fasting study,the 90% confidence inerval of Cmax,AUC0-t,AUC0-∞ between T1 and R were 140.5%-189.2%,113.1%-136.7%,91.5%-114.0%;the 90% confidence inerval of Cmax,AUC0-t,AUC0-∞ between T2 and R were 80.5%-108.5%,86.7%-104.8%,80.0%-99.7%.In fed study,the 90% confidence inerval of Cmax,AUC0-t,AUC0-∞ between T1 and R were 138.4%-171.4%,99.7%-117.0%,95.3%-113.7%;the 90% confidence inerval of Cmax,AUC0-t,AUC0-∞ between T2 and R were 100.0%-123.8%,96.8%-113.5%,93.6%-111.7%. Conclusion AUC0-t,Cmax of nifedipine sustained-release tablets T1 and R are not bioequivalent in fasting conditions, and Cmax are not bioequivalent in fed conditions, while Cmax、AUC0-t、AUC0-∞ of nifedipine sustained-release tablets T2 and R are bioequivalent in fasting and fed conditions.

  • WEN Yufa,DING Yajun,WANG Hubin,QIAO Hongqun
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    Objective To evaluate the potential effects of 19F-magnetic resonance imaging tracer LL02 on cardiovascular and respiratory system in conscious Beagle dogs. Methods Four Beagle dogs, which had been successfully implanted DSI telemetry transmitters, were ramdonly designed into four groups, vehicle control group (0.9% sodium chloride injection), low-dose group (3 μg·kg-1), medium-dose group (6 μg·kg-1), and high-dose group (12 μg·kg-1).The ECG (heart rate, QRS interval, PR interval, QT interval, and QTcB), blood pressure (systolic pressure, diastolic pressure, and mean arterial pressure), respiration (tidal volume and respiratory rate), and other indicators were continuously monitored and recorded from 2 h before administration to 2 h after administration, and the data of each detection point at 1h before administration, 5, 10, 15, 30, 60, 90, and 120 min after administration (according to the end time point of administration)were analyzed. Results Compared with the vehicle control group at the same time point, there was no significant differences in ECG, blood pressure, and respiratory indexes in each treatment group at 2h after administration (P>0.05). Conclusion No significant changes of cardiovascular and respiratory system in conscious Beagle dogs are observed after intravenous injection of LL02 at the doses of 3, 6, and 12 μg·kg-1.

  • LI Zilu,LI Jiang
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    Pulmonary arterial hypertension (PAH) is a type of chronic,progressive,and malignant disease with pulmonary arteriole remodeling as the main pathology.It is manifested by increased pulmonary vascular resistance and pulmonary artery pressure,which eventually leads to right heart failure and death.The current drugs for the treatment of PAH mainly target the endothelin pathway,the nitric oxide pathway,and the prostacyclin pathway.The treatment strategy of PAH is to develop an individualized treatment plan based on the risk stratification of the PAH patient,so that the patient can reach and maintain a low-risk status as soon as possible.Recent guidelines have shown that initial dual drug therapy is the drug treatment option for most of low-and intermediate-risk patients.However,in the real world,most patients cannot achieve a low-risk status under the initial dual drug therapy.Triple drug therapy may be the main option in the future.This article reviews the evidence-based medicine evidence of PAH combined drug therapy in recent years,focusing on the officacy and timing of triple drug therapy in PAH.

  • CHEN Yusi,LI Jiang
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    Pulmonary arterial hypertension (PAH) is a malignant pulmonary vascular disease characterized by abnormal shrinkage and reconstruction of small pulmonary vessels. The progressive development of PAH usually leads to the increased pulmonary vascular resistance and pulmonary artery pressure, resulting in right ventricle failure and even death.Studies have shown that the decline of endogenous prostacyclin is related to the occurrence of pulmonary arterial hypertension, and drugs targeting prostacyclin pathway can not only improve the symptoms of patients with PAH but also slow down or reverse the progress of the disease and improve the long-term prognosis.This review discusses the mechanism of action, clinical application, evidence-based medicine, new therapeutic strategy, and future prospect of prostacyclin in pulmonary arterial hypertension.

  • LI Zhiqin,FAN Yuan,WEI Anhua
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    Pulmonary arterial hypertension (PAH) is a chronic and severe disease of cardiopulmonary dysfunction associated with high mortality and complex etiology, which is characterized by pulmonary vascular remodeling and increased pulmonary vascular resistance.Over the past few decades, the emergence of targeted drugs, such as nitric oxide activators, endothelin receptor antagonists, and prostacyclin analogues, has significantly improved the outcomes of PAH patients, but the current treatments are still difficult to halt or reverse the progression of PAH.Therefore, the development of new drug therapeutic targets is particularly important.Recently, more evidences indicate that immune factors and immunologic mechanism may play important roles in the pathogenesis of PAH.Thus, the immunotherapy of PAH as a new direction is reviewed in this paper.

  • GUO Sitong,GU Zhichun,CHEN Xiaoyu,SU Henghai
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    Objective To evaluate the effectiveness and safety of the monotherapy of endothelin receptor antagonists in the pulmonary arterial hypertension. Methods Retrieved from Pubmed,Embase,Chochrane Library,the US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov,and the World Health Organization International Clinical Trials Registry Platform,randomized controlled trials (RCT) about monotherapy of endothelin receptor antagonists versus placebo in the treatment of pulmonary arterial hypertension were collected.The assessment of methodological bias risk and meta-analysis of each outcome were carried out by RevMan5.3 software.The sensitivity analysis,meta-regression analysis,trial sequential analysis,and publish bias analysis were carried out by STATA14.0 software. Results A total of 9 RCTs involving 1919 PAH patients were included in this meta-analysis.Compared with placebo,ambrisentan,bosentan,and macitentan had no significant difference in mortality rate [OR=0.81,95%CI(0.47,1.40),P=0.45],and they improved 6 minutes walking distance significantly [MD=23.06,95%CI(15.35,30.77),P<0.000 01]Compared with the placebo,ERA increased the risk of headache and anemia,and had no signifi cant difference in causing abnormal liver function,dyspnea,and peripheral edema.The evaluation results of the evidence ranged from moderate to low. Conclusion ERA can improve exercise capacity,but cannot reduce the incidence of mortality,and it may increase the risk of headache and anemia.

  • TIAN Jinghui,GUO Shanshan,CHEN Jingjing,XU Bingxin,ZHAO Liang
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    Objective To observe the therapeutic effect of eleutheroside E on monocrotaline (MCT) induced pulmonary arterial hypertension (PAH) rats and to explore its possible mechanism. Methods Forty-eight male Sprague-Dawley rats were randomly divided into 4 groups.For the intervention group, rats received intraperitoneal injection of eleutheroside E (10 mg·kg-1, once daily) at day 7 after one-dose subcutaneous injection of MCT.After intervention for 2 weeks, the right heart catheter was adopted to evaluate the hemodynamics.Fulton’s index was used to calculate the right heart hypertrophy.HE staining and immunofluorescence staining were used to evaluate the pulmonary vascular remodeling, and Western blotting was used to assess the phosphorylation of PI3K and Akt in lung tissue of SD rats. Results After intraperitoneal administration of eleutheroside E, the hemodynamics of PAH rats were significantly improved, with a mark decrease in right ventricular systolic pressure (33.18±4.85 v.s.44.95±3.59 mmHg, P<0.01) and mean pulmonary artery pressure (31.77±5.41 v.s.42.20±3.18 mmHg, P<0.01) compared to MCT group.Eleutheroside E also significantly improved right heart hypertrophy index in PAH rats (0.29±0.03 v.s.0.41±0.07, P<0.01).Pathological staining showed that eleutheroside E effectively inhibited pulmonary artery media thickness (34.88±3.24) % v.s.(47.67±2.88) % (P<0.01), and muscuralization (38.8±3.42) v.s.(53.80±6.76)% (P<0.05) in PAH rats.Western blotting indicated that eleutheroside E significantly inhibited the phosphorylation of PI3K and Akt in the lungs of PAH rats. Conclusion Eleutheroside E exerts a therapeutic effect on PAH by regulating the PI3K/Akt pathway.

  • WEI Yan,HUANG Jiangbiao,ZHANG Zhimin,RAO Zhiguo,YANG Bo,HU Meng,LIU Jian
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    Objective To evaluate the effects of reduced glutathione and docetaxel combined with cisplatin (TP) chemotherapy on efficacy, immune function, and adverse reactions in patients with advanced malignant tumor. Methods A total of 90 patients with advanced malignant tumor who recruited TP chemotherapy from 2017 to 2019, were collected and randomly divided into control group (n=30) and treatment group (n=60).Patients in the control group were treated with TP regimen, and patients in the treatment group were treated with reduced glutathione injection (0.9-1.8 g added to 100 mL of 0.9% sodium chloride injection, intravenous drip, once a day, at least one week before and after chemotherapy), with 21 days as a cycle.After two cycles of chemotherapy, the differences of chemotherapy efficacy, immune function index changes, and adverse reactions between the two groups were compared. Results After 2 cycles of TP chemotherapy, there was no significant difference in efficacy and disease control rate between the two groups (P>0.05).In the aspect of immune function, compared with the control group, there were no significant differences in the number of C D 3 + T cells and C D 4 +T cells (P>0.05), but there were significant differences in the number of C D 8 +T cells and NK cells and the ratio of C D 4 +/ C D 8 + in the treatment group after chemotherapy (all P<0.01).In terms of adverse reactions, compared with the control group, there were no significant statistical differences in myelosuppression and gastrointestinal reactions in the treatment group, and the incidences of neurotoxicity and abnormal liver and kidney function in the treatment group were significantly reduced (P<0.05). Conclusion Combined with reduced glutathione and TP chemotherapy in patients with advanced cancer can improve the immune function and reduce the occurrence of chemotherapy-related adverse reactions.

  • YIN Xueyan,HU Yixin,JIANG Xin,LI Dan,HUANG Jiangeng,ZHANG Yongjun,ZHANG Wenting
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    Hyperbilirubinemia is one of the common adverse drug reactions, and severe hyperbilirubinemia can lead to the interruption or change of drug treatment, which is one of the important factors affecting the treatment effect or outcome of patients.Elevated serum bilirubin concentrations can be due to the overproduction of bilirubin, impaired uptake, conjugation, excretion of bilirubin, or backward leakage from damaged hepatocytes or bile ducts.This paper presents a review of studies of drug-induced hyperbilirubinemia mediated by transporters and metabolic enzymes, aiming to provide references for research and the development of new chemical entity and drug treatment in clinical practice.

  • YAN Jujiao,WANG Jing,ZHANG Yichang,YU Yue,ZHOU Chaohui,LI Heng
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    Objective To establish a method to determine the content of isoaspartic acid (isoAsp) in the mixture of recombinant human insulin injection. Methods The isoAsp content in the mixture of recombinant human insulin injection was determined by ISOQUANT® (Isoaspartic Acid or isoAsp) Detection kit coupled with high performance liquid chromatography (HPLC).The method was verified by a standard recovery rate test, and used to quantify isoAsp in samples from different manufacturers. Results There was a good linear relationship between the injection amount of S-adenosyl-L-homocysteine (SAH, the enzymatic product from the IsoQuant assay) and its peak area integral in the range from 5 to 75 pmol (r=0.999 3).The recovery yields for the reference substances in three concentrations were all in the range from 96% to 116%.The percentages of isoAsp in samples from different manufacturers and batches ranged from 0.07% to 0.31%. Conclusion The quantification method for isoAsp is robust for the mixture of recombinant human insulin injection, and will also be useful for other peptide-and protein-pharmaceuticals in both quality control and development.

  • TAN Zhongchuan,YANG Desen,GAN GuoPing,ZHOU Qi
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    Objective To investigate and develop new crystal forms and co-crystals of olanzapine, and analyze their intermolecular interactions. Methods The crystals were obtained by recrystallization and determined by single crystal X-ray diffraction (SXRD), and their intermolecular interactions were analyzed by a Hirshfeld surface method. Results An olanzapine solvate was obtained upon attempted co-crystallization with saccharin.It belongs to the monoclinic system with space group P21/c.The asymmetric unit contains 1 molecule of olanzapine, 0.5 molecule of methanol, and two 0.5 molecules of water.The solvent molecules acted as bridges and linked with the centrosymmetric dimers of olanzapine through hydrogen-bonding interactions.The H…H interaction was the predominate type of intermolecular interactions according to Hirshfeld surface analysis. Conclusion In this paper, a new olanzapine methanol hemisolvate dihemihydrate was successfully obtained, and it provides new ideas and data support for the research of polymorphism of olanzapine.

  • LIU Anping,BU Chenchen,MA Jieqiong,SU Yuan,LI Weiye,MA Xiuling,REN Donghai,YANG Zengliang
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    Objective To improve the quality standard of Tibetan Qiwei Tuercao San. Methods Microscopic identification of Cinnabaris, Curcumae longae rhizoma, Carthami flos, and Gymnadenia R.Br were set up.TLC was set up for the qualitative identification of Lagotis brachystachya Maxim, Chebulae fructus, Carthami flos, Bear bile powder and Curcumae longae rhizoma.An HPLC method was used to determine the contents of gallic acid and luteolin. Results The new established microscopic identification and TLC identification have obvious characteristics resolution and good feasibility.Gallic acid in the range of 0.002 023-0.020 23 μg showed good linear relationship (r=0.999 6), and luteolin in the range of 0.197-1.97 μg showed good linear relationship (r=0.999 6). Conclusion The new analysis methods established in this study was scientific, accurate and reliable. It can further improving the quality standard of the preparation and can better control the quality of Tibetan Qiwei Tuercao San.

  • MENG Qianlin,LING Baodong
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    Objective To research the homology of Extensively Drug-resistant Acinetobacter baumanii (XDRAB) and its biofilm formation ability, which will provide a basis for the clinical infection prevention and control. Methods Thirty-seven XDRAB isolates were collected from January 2018 to July 2020, which from the First Affiliated Hospital of Chengdu Medical College.The minimum inhibitory concentration (MIC) of 16 antibacterial agents against 37 strains of XDRAB were determined by the microdilution broth method, and the crystal violet staining method was used to quantitatively analyze their biofilm formation ability. The multilocus sequence typing (MLST) and the enterobacterial intergenic repeat consensus sequence PCR (ERIC-PCR) were used to test 37 XDRAB strains. Results The 37 strains of XDRAB were only sensitive to polymyxins and tigecycline, but were resistant to the other antibacterial agents.Compared with the negative control group, the biofilm formation ability of XDRAB was more than 81%.For the results of MLST typing, 37 strains of XDRAB belonged to the international cloning group IC2 cloning complex (CC92), of which 34 strains were ST208, followed by ST195 and ST368.ERIC-PCR typing results showed that 37 strains of XDRAB were divided into two types, of which type I contained 22 strains and type II contained 15 strains. Conclusion The clinically isolated XDRAB biofilm formation ability was strong.CC92 was the main clonal complex of XDRAB nosocomial infection.MLST and ERIC-PCR can be used as effective methods for XDRAB homology analysis.

  • CHENG Xiaohua,SHU Zhan,XU Wenwei,WEN Jinhua,HU Jinfang
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    With the vigorous development of investigator initiated trials and the continuous improvement of the national requirements for the management of clinical research, the enthusiasm of medical institutions to carry out clinical research is also growing.According to clinical research relevant laws and regulations, combined with access to relevant documents and previous clinical studies of management experience, common problems existing in the project management process, management mode, and the main responsibility were explored.And the management department and team, formal examination, academic and ethical review, contract review and other key links in the possible risk points of the clinical research are analyzed and elaborated.Through the establishment of a dynamic project approval management system under the risk mode, the strengthening of the capacity building and management functions of the management department, and the standardized project approval review process and the support of the information platform are the important guarantees for the implementation of project approval review and management, which will contribute to the sustainable development of investigator initiated trials.

  • QIAO Zelin, HUANG Zhe
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    Objective To explore the drug procurement strategy of medical institutions under the mode of procurement with target quantity, and improve the operational efficiency of the drug supply chain under the risk of supply disruption. Methods Based on the supply chain risk management theory, combined with the public welfare of Chinese medical institutions, a drug procurement model derived from expected cost function was established, and the influence of factors such as drug supply interruption probability and the proportion of order distribution on drug procurement strategy were analyzed.Matlab 2018b was used for the numerical simulation. Results The research results showed that the mode of procurement with target quantity can effectively reduce the cost with lower risk, while dual-source procurement or completely reliable supplier procurement can avoid greater losses with higher risk.In addition, the expected cost function was not always positively correlated with the order proportion of alternative suppliers. Conclusion Under the macro background of the continuous deepening reform of the centralized drug procurement system, the drug procurement strategy should not only be focused on the level of the drug price itself, but also pay attention to the stability of the continuous supply of drug.Therefore, suggestions such as optimizing the mode of procurement with target quantity and increasing the audit mechanism of bid enterprises are proposed.