中国科技论文统计源期刊 中文核心期刊
美国《化学文摘》《国际药学文摘》
《乌利希期刊指南》
WHO《西太平洋地区医学索引》来源期刊
日本科学技术振兴机构数据库（JST）
第七届湖北十大名刊提名奖
美国《化学文摘》《国际药学文摘》
《乌利希期刊指南》
WHO《西太平洋地区医学索引》来源期刊
日本科学技术振兴机构数据库（JST）
第七届湖北十大名刊提名奖
Opioids are widely used in the treatment of moderate to severe pain.However,there are wide inter-individual variabilities in analgesic efficacy and adverse reactions.Pharmacogenetics study shows that gene polymorphism was closely related to the above interindividual variabilities,and more research was focused on CYP2D6 (cytochrome P450 2D6),μ opioid receptor (OPRM1),and catechol-O-methyltransferase (COMT).In February 2021,the Clinical Pharmacogenetics Implementation Consortium (CPIC) issued Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6,OPRM1,and COMT Genotypes and Select Opioid Therapy.Therefore,to provide the basis for individualized clinical medication,this paper interprets the guidelines,including summarizing CYP2D6,OPRM1,and COMT gene polymorphism of opioid analgesic effect and adverse reactions and putting forward treatment suggestions based on CYP2D6 genotype to guide clinical use codeine,tramadol,and hydrocodone.
Objective To explore the protective effect and mechanism of fosfomycin on vancomycin-induced renal injury of model rats. Methods A total of 60 healthy SD rats were randomly divided into the normal control group,model control group,vancomycin with high,medium,and low dose fosfomycin groups (recorded as combined-L,combined-M,and combined-H group),10 animals in each group.Each rat in the normal control group was injected intraperitoneally (IP) with the same dose of 0.9% sodium chloride solution. The rats in the model control group were injected with vancomycin (0.2 g·kg-1 ),in the fosfomycin group was injected with fosfomycin (0.25 g·kg-1 ). In combination regimens, rats were injected with fosfomycin at a dose of 0.125,0.25,and 0.5 g·kg-1 respectively in combined-L,combined-M,and combined-H group,and 30 minutes later rats were injected with vancomycin (0.2 g·kg-1 ).The drug was administered for 21 days continuously.The contents of NAG and KIM-1 in urine were determined by enzyme-linked immunosorbent assay (ELISA),proteinuria (Upro/24 h) by Coomassie brilliant blue staining method,and the expressions of Nrf2,Keap1,and the target protein glutathione peroxidase1 (GPX-1) downstream of the Keap1-Nrf2/ARE pathway were detected by RT-PCR. Results Compared with the model control group,the levels of Upro / 24h,NAG,and KIM-1 in the urine of the model control group were significantly higher (P<0.05),the mRNA expression of Nrf2 was significantly increased (P<0.01),Keap1 was almost unchanged,and the mRNA expression of GPX-1 was decreased (P<0.01) in model group.Expressions of Nrf2 and Keap1 mRNA in the combined-L and the combined -M were significantly increased (P<0.01),and the expression of GPX-1 mRNA in three groups of the combination regimen was significantly increased (P<0.01).Compared with the model control group,the level of Upro/24 h,NAG,and KIM-1 in combined-M and combined-H groups decreased significantly (P<0.01).With the increase in fosfomycin dose,it showed a certain dose dependence. Conclusion Vancomycin may cause renal injury by affecting the expression of Nrf2 in renal tissues,and fosfomycin may alleviate vancomycin-induced kidney injury by activating the Keap1- Nrf2 /ARE signaling pathway,which is defensive transduction against external oxidative stimulation.
Objective To observe the effect of magnoflorine on NF-κB signaling pathway and NLRP3 inflammasome activity,and to explore the possible mechanism of magnoflorine on ulcerative colitis in rats. Methods Sixty SD rats were randomly divided into normal control group,model control group,5-aminosalicylic acid group (100 mg·kg-1) and magnoflorine low-dose,medium-dose and high-dose groups (25,50,100 mg·kg-1),with 10 rats in each group.The normal control group was given purified water by gavage,and the other 5 groups were given corresponding drugs by gavage,once a day for 10 days.After the administration,the colonic tissue of rats was collected,stained by hematoxylin and eosin (HE) and observed under microscope.The contents of pro-inflammatory cytokines (IL-1β,IL-18 and TNF-α) in colon tissues were detected by the ELISA method.The number of CD11b+ macrophages was detected by the immunofluorescence method.The effect of magnoflorine on the express of NF-κB/NLRP3 inflammasome signaling pathway related protein was detected by western blotting and immunohistochemistry method. Results Magnoflorine could reduce the disease activity index,histopathological score,the expression levels of pro-inflammatory cytokines and the number of CD11b+ macrophages in colon tissue of UC rats.Magnoflorine decreased the expressions of p-IκBα and p-IKKβ protein in the colon tissue of UC rats and p-NF-κB p65 protein in the cell nucleus,and increased the expression of p-NF-κB p65 protein in the cytoplasm.Magnoflorine significantly decreased the levels of NLRP3 inflammasome-related proteins (NLRP3,ASC,Cleaved caspase-1). Conclusion Magnoflorine has an obvious therapeutic effect on the rats with UC,the mechanism of which may be closely related to the regulation of NF-κB/NLRP3 inflammasome signaling pathway.
Real-world evidence (RWE) based on real-world data (RWD) can better reflect the effectiveness of medical products in a real-world setting.This paper introduces the background of RWE research,highlights the relevant measures of various countries to improve the standardization and transparency of RWE research design,and summarizes the current international representative randomized controlled trial(RCT) simulation research to promote the domestic scholars to better understand the scope and application value of RWE.
Objective To describe the research hotspots and authors’ cooperative relationships in the field of pharmacoepidemiology mentioned in the 37th International Conference on Pharmacoepidemiology & Therapeutic Risk Management (ICPE) abstracts. Methods Taking the 37th ICPE documents as the data source,we used Python to extract the literature information. The network D3 package of R software was used to draw network diagrams of cooperative relationships among authors and organizations.The Tidytext package was used to split the literature text into tokens.TF-IDF value,a weighted statistic,was used to identify the key words that represent the research hotspots. Results A total of 806 ICPE abstracts were included.192 core authors (including 10 from China) constitute 33 groups (including 2 from China).149 core research organizations (including 8 in China) constitute 22 groups (including 1 in China).Top 3 hotspot study designs are cohort study,systematic review and Meta-analysis and cross-sectional study.Top 3 hotspot diseases are COVID-19,rheumatoid arthritis and type 2 diabetes.The top 3 hotspot drugs are opioids,antipsychotics and rivaroxaban.Top 3 hotspot databases are FAERS,CPRD,and IBM MarketScan CCAE. Conclusion The number of foreign core authors and organizations is large and their cooperative relationships are close and extensive,while the number of domestic core authors and organizations is small and the cooperative relationships are relatively loose.This study describes the research hotspots mentioned in ICPE,which has a certain reference value for future research and cooperation partner selection of domestic pharmacoepidemiologists.
Objective To explore the current situation and quality of drug treatment guidelines for bacterial meningitis in children and to provide a reference for the standardization of drug treatment programs for bacterial meningitis in children. Methods Systematic retrieval of PubMed,Embase,CNKI,WanFang,and CBM databases were conducted from the establishment of the database to April 2021,and relevant guidelines for drug treatment of bacterial meningitis in children were collected.The Appraisal of Guidelines for Research & Evaluation(AGREE) Ⅱ instrument was used to evaluate the quality of the included guide and analysis. Results A total of 9 guidelines were included from five countries and one region.An overall medium grade of agreement among reviewers to each domain was observed (ICC ranged from 0.700 to 0.766).The results of the AGREE II evaluation showed that the inclusion guidelines were in "Scope and Purpose" (Mean score of domain scores was 86.11%±7.12%),"Participant" (80.56%±5.68%),"The rigor of formulation"(78.01%±10.46%),"Clarity" (77.30%±9.64%) and "Editorial independence" (72.69%±18.00%) score were good,both over 70%.The recommendations of the guidelines are similar in diagnosing diseases and the selecting of treatment regimens,but there is still controversy in the field of neonatal drug use and glucocorticoid adjunctive drug use due to lack of evidence. Conclusion The overall quality of the evidence-based guidelines for neonatal bacterial meningitis is above average,and the evidence in the area of neonatal medication needs to be improved.
Objective The clinical use of human albumin in inpatients was investigated and analyzed in combination with guidelines and clinical evidence,in order to provide a reference for follow-up evaluation of the rational use of human albumin and promote further rational use. Methods Data on the use of human albumin in inpatients from 120 hospitals in 9 regions of China from January 2016 to December 2020 were randomly selected,and the prescription quantity,drug quantity,consumption,department distribution,and indications were analyzed. Results A total of 756 055 prescriptions were selected in the study,and most human albumin products were imported.From 2016 to 2020,the use of human albumin showed a steady increasing trend.Compare to the average annual prescription quantity,drug quantity,and prescription amount of each hospital in 9 regions,the top three regions were Hangzhou,Guangzhou,and Chengdu,and Harbin was the lowest.The consumption of human albumin was huge,with an average annual consumption of 207 695-2 213 604 yuan per hospital.The top departments in terms of prescription quantity and prescription amount in 9 regions were the ICU and surgical system.The tumor prescriptions accounted for the largest proportion,followed by heart and liver diseases. Conclusion Human albumin was widely used,and some indications were still controversial,which required further evidence-based evaluation.It was necessary to carry out special comments by pharmacists in departments and disease fields where human albumin was used more frequently,in order to reduce the unreasonable use rate,reduce medical costs,and promote rational clinical use.
Objective To compare and analyze the occurrence and clinical characteristics of acute kidney injury (AKI) caused by amphotericin B and its liposomes in hospitalized patients, and to provide a reference for clinically safe and rational drug use. Methods Based on the Adverse Drug Events Active Surveillance and Assessment System (ADE-ASAS), we retrospectively monitored all inpatients using amphotericin B deoxycholate (AmB-D), and liposomal amphotericin B (L-AmB) in the Chinese PLA General Hospital from Jan 1st, 2010 to Jan 1st, 2020,and AmB-D was divided into two subgroups according to the route of administration.The positive cases of AKI caused by AmB-D and L-AmB were confirmed by system alarm, double-blind evaluation and expert review. Results The numbers of AmB-D and L-AmB patients were 2139 and 717, respectively.There were 53 (6.92%), 45 (3.28%), and 27 (3.77%) positive cases of AKI by the AmB-D intravenous route, other routes, and L-AmB, respectively, and the difference in incidence was statistically significant (P<0.01).The median time to AKI by the AmB-D intravenous route was 4 (2-6) days, 3 (2-6) days by other routes, and 5 (3-6) days by L-AmB, all with predominantly stage 1 AKI (77.4%, 73.3%, and 55.6%).Both dosage forms had the highest proportion of AKI in patients with hematology and hematologic disorders.After intravenous administration, serum creatinine (SCr) and peak SCr were slightly higher in L-AmB than in AmB-D. Conclusion ADE-ASAS can accurately and efficiently obtain real-world drug safety data;the incidence of AKI is higher with intravenous AmB-D than with other routes and higher with L-AmB.All clinical applications should monitor changes in renal function in the drug-using population in key departments, especially SCr levels 3-5 days after drug administration.
To explore the safety of antidepressant use during pregnancy and to provide a reference for antidepressant use during pregnancy.Based on clinical evidence such as guidelines,literature,and database search,the teratogenicity,maternal and infant pregnancy outcomes,and long-term effects of antidepressants in pregnancy were reviewed to evaluate their safety.The use of antidepressants during pregnancy may lead to teratogenesis,spontaneous abortion,neonatal withdrawal syndrome,preeclampsia and postpartum bleeding,and may have some long-term effects on offspring.Current evidence shows that serotonin reuptake inhibitors (SSRIs) are safe to be used in pregnancy,among which sertraline and citalopram are recommended as first-line drugs.It is necessary to carry out studies on the use of SSRIs in pregnancy to obtain more clinical evidence support.
Objective To observe the effects of fixed-dose administration and administration by body mass on the anesthesia effect and recovery effect of a painless gastroscopy, and to explore the optimal dose of remifentanil combined with remimazolam mesylate in painless gastroscope. Methods A total of 200 patients who underwent painless gastroscopy in the endoscopy center of the Affiliated Hospital of Yangzhou University were selected and randomly divided into four groups(W1, W2, F, and C groups): ideal body mass remimazolam mesylate 0.2 mg·kg-1 (group W1), ideal body mass remimazolam mesylate 0.3 mg·kg-1 (group W2), a fixed dose of 5 mg remimazolam mesylate (group F), ideal body mass propofol 1.5 mg·kg-1 (group C), 50 cases in each group. All patients were given low-dose remifentanil 0.25 μg·kg-1 (ideal body weight) for analgesic pretreatment and then intravenous bolus injection of the corresponding dose of remimazolam mesylate or propofol. Anesthesia effect, resuscitation quality, heart rate, blood pressure, pulse oxygen saturation, and perioperative adverse events were recorded; temporal changes in the modified observer's assessment of alert (MOAA/S) were recorded. Results In terms of the anesthetic effect of the first dose of the drug, group W2 had the highest success rate (96.0%), group C was 86.0%, group W1 was 72.0%, and group F was 10.0%, group F sedation is clearly lacking. In terms of changes in vital signs, the blood pressure of group F was higher than that of group W2 and group C after the first administration (P<0.05), and the blood pressure of group F was higher than that of the other three groups at two minutes after administration (P<0.05). The blood pressure in group W1 was higher than that in group C after the first administration (P<0.05). After the first administration and four minutes after administration, the MOAA/S score of group F was higher than that of group W2 and group C (P<0.05). The MOAA/S score of group C was significantly lower than that of group W1 four minutes after administration (P<0.05). There were no significant differences in heart rate changes, wake-up time, and discharge time among the four groups (P>0.05). In terms of adverse reactions, the incidence of choking in group F was 60.0%, which was significantly higher than that in the other three groups (P<0.01); the incidence of injection pain in group C was 36.0%, which was significantly higher than that in the other three groups (P<0.01). Conclusion Remimazolam mesylate combined with remifentanil can be safely used for painless gastroscopy, and the ideal body mass is 0.3 mg·kg-1 remimazolam combined with 0.25 μg·kg-1 remifentanil combination better.
Sepsis,characterized by excessive inflammation in response to infection,often leads to multiple organ failure.However,the molecular mechanisms remain to be fully elucidated.In recent years,dexmedetomidine(DEX),a novel α2 adrenergic receptor agonist with high selectivity,has gained great attention for its anti-inflammatory,sedative and organ protective effects in the treatment of sepsis,not limited to be used as an anesthetic adjuvant.Accumulating evidence have proved that DEX has beneficial effects on multiple organs of sepsis patients,including the lungs,kidneys,liver,and central nervous system.Here,we reviewed the pharmacokinetics,pharmacodynamics and organ protective effects of DEX,in order to provide clinical evidence and reference for DEX treatment of sepsis.
Neuroglioma is the main relative death reason for brain tumors.Although the scheme of operation with chemoradiotherapy can significantly improve the survival quality of the patients, the high death rate and recurrence rate of glioma lead to the general low survival rate of the patients on account of drug resistance.It is well known that, as the inherited key regulatory factor of tumor surface appearance, microRNA(miRNA) has a network of interlaced interactional influence with the drug resistance of glioma proved by a large amount of research.The pity is that these regulatory networks of drug resistance are extremely complicated, which has not been illustrated completely.Therefore, this paper summarizes the effects and molecular mechanism of miRNA in the drug resistance of various anti-tumor medicines (temozolomide, cisplatinum, antitumor agents of plant origin, molecular targeting drug, and immunotherapy agent), and mainly discusses the potential function of miRNA as the glioma drug therapeutic target, and the potential value of using nanometer materials as the carrier of miRNA to treat glioma. It will provide references for the study of reversal of glioma drug resistance and nano-medicine in clinical diagnosis and treatment.
Objective To optimize the processing technology of soil-stir-baked Angelica sinensis by Box-Behnken response surface method. Methods Taking appearance character, ferulic acid, and volatile oil content as evaluation indexes, the processing technology of soil-stir-baked Angelica sinensis was designed and optimized by the response surface method based on a single factor experiment. Results The regression model predicted that the optimal processing technology of soil-stir-baked Angelica sinensis was as follows: the amount of furnace soil was 0.3 times the weight of Chinese herbal pieces, the baking temperature was 140.16 ℃, and baking time was 9.44 min. Conclusion The optimized processing technology was stable, simple, feasible, and suitable for industrial production of Soil-stir-baked Angelica sinensis.
Objective To explore the effects of different packaging on the quality of Ying'er Jianpi powder, and to provide reference for the selection of suitable packaging. Methods The combustion experiment quickly identified the composition of the middle layer of laminated films. In the accelerated testing(temperature 40 ℃, relative humidity 75%), the changes in moisture content, and volatile components content(costunolide and dehydrocostuslactone) in different packaged samples, were investigated by HPLC after 0,10,20 and 30 days. Results For the samples packed with a laminated film of Class Ⅳ and Class Ⅲ, the RSD of water content were 2.9%-7.9% and 2.9%-21.8%; the average content of costunolide decreased by 21.3% and 42.2%, the average content of dehydrocostuslactone decreased 18.2% and 42.3%, respectively. Conclusion The laminated film significantly impacted the contents of water and volatile components. The laminated film of class Ⅳ is the most suitable packaging form. Packed with a laminated film combination of class Ⅳ and class Ⅲ, the quality of the product can be well guaranteed.
Objective To collect and summarize the package inserts of cephalosporins,to put forward specific revision comments in combination with relevant literatures,and to provide reference for the revision and update of package inserts and the specification of cephalosporin skin test. Methods A total of 3938 package inserts of 38 cephalosporins were collected and collated,and the skin test requirements and allergic warnings in the package inserts were summarized and analyzed by Excel. Results A total of 450 package inserts of 12 cephalosporin antibiotics required skin allergy test before medication.There were differences in the requirements for skin test,allergic precautions and contraindications of drugs by different manufacturers.Most of the package inserts requiring skin test lacked specific skin test solution preparation,skin test operation and interpretation of skin test results. Conclusion At present,there is still a lack of scientificity and standardization in the relevant contents of skin test and allergy in the package inserts of cephalosporins.The manufacturers of cephalosporins should generally cancel the requirements for routine skin test in the package inserts.For the drugs with relatively high incidence of allergic reactions such as third-generation cephalosporins,supplementary items should be added to focus on warning the possibility of allergic reactions,as well as the need to inquire the history of allergy in detail and prepare for the rescue of anaphylactic shock at any time.
Objective To determine the existence of correlation between tigecycline-induced hypofibrinogenemia and concentration, and to define thresholds of toxicity. Methods Patients received tigecycline from April 2019 to April 2021 were retrospectively analyzed,and the concentration of tigecycline,fibrinogen(FIB)values and other clinical indicators were recorded before and after treatment,and the patients were classified into adverse drug reaction(ADR)group (n=49) and control group (n=74) according to the criteria.The difference in tigecycline concentration between the two groups was analyzed and the cut-off of ADR was obtained by ROC curve. Results There was no statistical difference in age,gender,dose,course of treatment,and other clinical characteristics between ADR group and control group.There were significant differences in tigecycline trough concentration(Cmin),peak concentration(Cmax) and 24 h AUC(AUC0-24 h),all P<0.001.According to ROC curve,the cut-off of tigecycline-induced hypofibrinogenemia was Cmin=0.775 μg·mL-1 and AUC0-24 h=28.38 μg·h·mL-1. Conclusion This study revealed the correlation between tigecycline-induced hypofibrinogenemia and concentration. When clinical using of tigecycline in the treatment of severe infection we should not just consider the effect but also should pay attention to the adverse reactions caused by tigecycline.It is necessary to monitor the blood drug concentration regularly.
Objective To discuss the implementation effect of the pharmaceutical care model based on the knowledge-attitude-practice (KAP) intervention theory among systemic lupus erythematosus (SLE) patients,and to provide a reference for developing therapy management services for SLE patients. Methods A total of 350 patients were included in the study.The correlations of their KAP levels with risk perception, disease activity, and organ damage were analyzed through the questionnaire survey and clinical test indexes.The patients were randomly divided into the intervention group and control group.The patient in the intervention group was given pharmaceutical care based on the KAP intervention theory until discontinued or followed up for nine months.The KAP levels before the intervention and those at pre-designed time points after the intervention were analyzed.Then, SLE disease activity and SLE-related organ damage were evaluated. Results Excluding 26 patients with incomplete data, the KAP levels were positively correlated with risk perception and negatively correlated with disease activity and organ damage in 324 SLE patients.After nine months of intervention, 302 patients were included in the analysis, including 148 patients (14 excluded) in the intervention group and 154 patients (8 excluded) in the control group.After 3, 6, and 9 months of the intervention, the scores of each KAP dimension at pre-designed time points in the intervention group were all significantly higher than those of the control group(P<0.01).The time and grouping effects were statistically significant (P<0.01).After nine months of intervention, the incidence of acute attacks and adverse reactions in the intervention group were significantly reduced, and the level of risk perception, disease activity, and organ injury was all significantly improved compared with the control group (P<0.05). Conclusion Providing the SLE patients with proper pharmaceutical care based on the KAP theory was instrumental in changing their behavioral tendency and contributed to facilitating their disease self-management to improve the pharmaceutical care quality and disease control effect.
Objective To analysis the adverse drug event (ADE) of evolocumab and alirocumab by signal mining using large sample scale data, and to provide a reference for rational and safe drug use in clinic. Methods ADE reports of evolocumab and alirocumab from the 3rd quarter of 2015 to the 2nd quarter of 2021 were collected from the FDA adverse event reporting system (FAERS), and data mining was performed by reported odds ratio (ROR) and proportional reporting ratio (PRR) methods.The Medical Dictionary for Drug Regulatory Activities (MedDRA) was used for the standardized analysis of adverse drug event signals. Results Among 8024 207 adverse reaction reports collected, 73 797 ADE reports were screened out,including 61 883 cases of evolocumab and 11 914 cases of alirocumab, with a male to female ratio of 0.74 to 1, aged from 45 to 74 years old.It was found that ADE signals related to evolocumab and alirocumab were mainly concentrated on injection site reaction, skeletal muscle disease, and respiratory disease.Evolocumab had a higher risk of skeletal muscle disease and respiratory disease-related ADE.The signals were normalized and compared;ADE signals with a strong correlation which have not been included in drug instructions, such as neurological diseases, were also discovered. Conclusion FAERS database can be used to excavate and analyze safety warning signals of evolocumab and alirocumab, providing a reference for clinical safety and rational drug selection.
Objective To investigate of the current status and career development needs of clinical pharmacists in China,and to provide a reference for improving the quality of pharmaceutical services of clinical pharmacists. Methods The questionnaire was designed by the “wjx.cn” website,and promoted in WeChat,Dingxiangyuan,and other network platforms.The questionnaire was filled anonymously and collected for statistical analysis after 15 days. Results A total of 403 questionnaires were collected,and the Cronbach.α coefficient was 0.975.In all respondents,males accounted for 34.99% and females accounted for 65.01%;and 72.95% of them comes from Third-level hospitals.There were 39.95% of clinical pharmacists who had participated in one-year standardized training.There were 38.46% of hospital information systems(HIS) introduced prescription software,and 26.05% of the hospitals opened pharmacist-managed clinics.Clinical pharmacists mainly engaged in the anti-infective specialty(48.64%),cardiology specialty(9.43%),and oncology specialty(8.44%).There were 57.57% of clinical pharmacists believed that clinical departments had a good recognition of clinical pharmacists.The competency scores of clinical pharmacists ranged from 5.93 to 7.05(full score is 10 points).The personal development expectation of clinical pharmacists was supported by the following aspects:the emphasis on hospital leadership(87.34%),improvement of salary(80.89%),increasement of academic exchange opportunity(75.43%),and scientific research fund(57.82%). Conclusion Clinical pharmacy is in a rapid development period in China at present,and clinical pharmacists are gradually expanding from anti-infective specialty to other specialties.The software and hardware facilities for clinical pharmacy work are continually improved,and the recognition of clinical pharmacists by clinical departments is increasing.It will be beneficial for the current professional development of clinical pharmacists to improve the leadership's attention to the development of clinical pharmacy,increase the support of scientific research funds and academic exchange opportunities,and improve the salary.
