With the gradual promotion of drug selection and evaluation in some provinces and cities in China,it is urgent for medical institutions to establish a complete and quantifiable drug selection and evaluation system. Based on the development of pharmacy and the adjustment of national drug policies in recent years,this guideline has revised and refined the evaluation indicators of drug evaluation and selection in medical institutions on the basis of the first version,so that the quantitative scoring can better reflect the priority of drugs in medical institutions,and also more fulfill the requirements of the national policy. Moreover,the scoring items are more detailed,clear and easy to use. In this guideline,five dimensions of pharmaceutical properties (28 points),effectiveness (27 points),safety (25 points),economy (10 points) and others (10 points) were quantified and scored,so as to objectively conduct selection and evaluation of drugs in medical institutions.
Objective To explore the effects of trelagliptin succinate on the expression levels of 2 major CYP450 enzymes (CYP3A4,CYP2D6) and three drug transporters (GLUT2,MRP2,NTCP) in liver tissues of the db/db mice. Methods Eighteen db/db mice were randomly divided into model control group,trelagliptin succinate group,sitagliptin phosphate group,and six C57 mice were set as a normal control group.The trelagliptin succinate group was intragastrically administered with trelagliptin succinate 17.29 mg·kg-1·w-1,and the sitagliptin phosphate group was intragastrically administered with sitagliptin phosphate 16.71 mg·kg-1·d-1 for eight weeks.HE staining was used to observe whether trelagliptin succinate could improve liver histopathology in db/db mice;ELISA assay was used to measure the glycated hemoglobin levels in each group to evaluate whether the glycated hemoglobin of db/db mice was higher than that of C57 healthy mice.The mRNA and protein expression levels of CYP3A4,CYP2D6,GLUT2,MRP2,and NTCP in the liver tissues of each mouse were detected by Real-time PCR and Western blotting. Results Compared with the model control group,trelagliptin succinate could improve the pathological state of liver tissue,and attenuate vacuolar degeneration of hepatocytes;there was no significant difference in the expression level of CYP3A4 mRNA (P>0.05),while the protein expression level of CYP3A4 was significantly increased (P<0.01);CYP2D6 mRNA and protein expression levels had no significant difference (P>0.05);GLUT2 mRNA and protein expression levels were significantly increased (P<0.01);MRP2 mRNA and protein expression levels had no significant difference (P>0.05);NTCP showed no significant difference in mRNA expression level (P>0.05),while NTCP protein expression level was significantly increased (P<0.01). Conclusion Trelagliptin succinate can increase the expressions of CYP3A4,GLUT2 and NTCP,but does not affect on the expressions of CYP2D6 and MRP2.
The “Tangye Jingfa map” of Fuxingjue contains a complete syndrome differentiation and treatment system,including disease diagnosis and herbal treatment.In terms of disease diagnosis,“Tangye Jingfa map” respects the syndrome differentiation on deficiency and excess syndrome of Five Zang only,and determines the disease nature based on the deficiency and excess syndrome of liver,heart,spleen,lungs,and kidneys.The 20 prescriptions for tonifying or reducing Five Zang included in Fuxingjue,which clearly records the clinical manifestations of deficiency and excess syndrome of Five Zang.This paper summarizes and analyzes the records of the main symptoms of the prescriptions for tonifying and reducing Five Zang in Fuxingjue,standardizes and equivalently converts the description of syndromes,and unifies the description of different syndromes,such as “pain leads to less abdominal urgency” and “less abdominal fullness and pain”,“irritability” and “heart deficiency”.At the same time,the diagnosis information database of deficiency and excess syndromes of Five Zang was constructed.It was found that there were overlaps of indications between the syndrome of small Decoction and large Decoction in the same Zang (such as the small Decoction of tonifying liver and the large Decoction of tonifying liver),and between the syndrome of large tonifying Decoctions in the adjacent Zang (such as the large Decoction of tonifying spleen and the large Decoction of tonifying lung).Using C4.5 algorithm and random tree algorithm of the decision tree discrimination model,we can also get the diagnosis discrimination model of the deficiency and excess syndrome of Five Zang,and identify the key symptom nodes.Through the above research,it provides academic support for the clinical application of syndrome differentiation and treatment theory shown in “ Tangye Jingfa map ”.
The“Tangye Jingfa map” preserved in “Fuxingjue”,a Dunhuang's posthumous book,has profound and rigorous five-flavor matching formulary prescription rules.According to Tao Hongjing's points in “Fuxingjue”,“Tangye Jingfa map” is probably derived from the contents of Yi Yin's book named “Tangye Jingfa map”.Therefore,it may be the general source of the compatibility of TCM prescriptions,and can be used to explain the compatibility rules of various prescriptions,including classic prescriptions of Zhongjing,time prescriptions,modern Chinese prescriptions,and various medical cases.Taking the heart diseases as the example,this paper determines syndrome differentiation ideas and treatment principles of heart diseases in the light of the system of “Tangye Jingfa map”.It analyzes the Xiaobuxiexinbao decoction,Gualou Xiebai Baijiu decoction,Huanglian Ejiao decoction,Anshen Dingzhi pills,Wenxin granules,and medical cases of the treatment of palpitation,and clarifies the compatibility of prescription structure and the consistency of medicine and syndrome.It also discusses the applicability of "Tangye Jingfa map" in different types of prescriptions,and shows the original and profound meaning of the principles of fomulating prescription of the five flavors for laxative formulas,which provides a certain reference for the further study and application of classical prescriptions and clinical application of this theory.
The "“Tangye Jingfa map” is the key principle of “Tangye Jingfa map” written by Yi Yin in the Shang Dynasty.It has been inherited and passed down by the citation in Dunhuang book Fuxingjue.It is called the key to uncover the mystery of the compatibility of prescriptions by the academic community.“Tangye Jingfa map” depicts a theory system of syndrome differentiation based on the deficiency and excess of five Zang organs,and the treatment based on the reinforcing and reducing on five flavors,which contains many new contents and new understandings about the medicinal properties of traditional Chinese medicine.Firstly,“Tangye Jingfa map” breaks the one-to-one relationship between five flavors and five Zang organs,while it takes tonifying flavor,purging flavor and transforming flavor as the framework to express the relationship between multiple herbal flavors and the five Zang organs in different roles.Secondly,“Tangye Jingfa map” describes a new compatibility transformation relationship among five flavors.For example,a pungent flavor which combines with a sour flavor can turn into a sweet flavor;A salty flavor which combines with a bitter flavor can turn into a sour flavor;A sweet flavor which combines with a pungent flavor can turn into a bitter flavor;A sour flavor which combines with a salty flavor can turn into a pungent flavor;A bitter flavor which combines with a sweet flavor can turn into a salty flavor.This transformation relationship is the key to understand the compatibility of complex prescriptions,and has also been preliminarily proved from the perspective of mathematics.Thirdly,“Tangye Jingfa map” restores the cognitive system of the five elements of Traditional Chinese Medicine,and uses the five elements to determine the herbal properties,which has important inspiration for exploring the essential relationship between the natural attributes and efficacy attributes of traditional Chinese medicines.Lastly,the theoretical and practical system of “Tangye Jingfa map” shows the primacy of the five flavors in the theory of medicinal properties of Chinese medicine.The above contents provide support for the future development and in-depth thinking of the theoretical research and application of traditional Chinese medicine.
Morinda officinalis is the dried root of Morinda officinalis How of the Rubiaceae plant family,whose traditional efficacy is “Tonifying Kidney Yang,strengthening muscles and bones,and dispelling wind and dampness".Its medicinal property is sweet and pungent in flavor,slightly warm in property,and distributing to liver and kidney channel".From the perspective of the theoretical system of “Tangye Jingfa map” in Fuxingjue,the function of kidneys governs firming and dominates the bones of the body,which is supplemented by bitter flavor;the function of liver governs ascending and determines the tendons of the body,which is supplemented by pungent flavor.Thus,the property of five elements of Morinda officinalis should be “wood in water”,and the main medicinal flavor is bitter and pungent.In this paper,according to the summarized tropism of taste and medicinal image of Morinda officinalis in the herbal records of successive dynasties,combined with the efficacy of Morinda officinalis and 25 traditional Chinese medicines with “water” attribute,the compatability strcutrue of Tiaogan Decoction and Bajitian pill which are representative prescriptions was analyzed,and the bitter and pungent flavor of Morinda officinalis was determined.This paper would provide a basis for the compatibility of Morinda officinalis in prescriptions.
Objective Based on the theoretical system of the “Tangye Jingfa map”,the study aims to explore the common characteristics of allergic rhinitis of different syndromes in the compatibility of medicine and taste in this paper. Methods The traditional Chinese medicines diagnosis and treatment guidelines for allergic rhinitis,clinical pathways,and the traditional Chinese medicine treatment prescriptions covered by the systematic review and the proprietary traditional Chinese medicines for the treatment of allergic rhinitis were collected.The prescription compatibility structure and efficacy characteristics were clarified,and the distribution of herbal tastes was statistically analyzed.Compared with the tonification flavor (sour),purgation flavor (salty),and harmonization flavor (pungent) in the treatment of lung diseases in the “Tangye Jingfa map”,the proportion of medicinal taste was calculated,and the characteristics of the combination was analyzed. Results A total of 33 prescriptions were collected for different syndrome types of allergic rhinitis,including Xiaoqinglong decoction,Buzhong Yiqi decoction,Xinyiqingfei decoction,Magnolia Biyan Pills,and Tongqiao Biyan granules.Among them,"sour and salty" herbs account for a proportion above 80% in 24 prescriptions,six prescriptions account for a proportion between 60% and 80%,and three prescriptions account for a proportion between 40% and 60%,and 0 prescription accounts for a proportion below 40%.Among them,bitter and sweet herbs are mainly concentrated in the lung and spleen or lung and kidney prescriptions. Conclusion From the “Tangye Jingfa map” perspective,the treatment of simple allergic rhinitis is mainly to treat the lungs,and the medicinal taste is mainly "bitter and salty".Traditional Chinese medicine with bitter-sweet flavor is often used in complex situations where the lungs and spleen are treated together,or the lungs and kidneys are treated together.
Objective In this case,the theoretical system of the “Tangye Jingfa map” in Fuxingjue was used to carry out pharmaceutical care of one diabetic case with the coexistence of multiple diseases using Traditional Chinese Medicine Decoction. Methods The patient is an elderly woman with diabetes,hypertension,coronary heart disease and other diseases.The patient was presented with dry mouth and thirst for 15 years,and high nocturnal blood pressure for 10 days.The patient was brought into pharmaceutical care since the admission,the patient's etiology,pathogenesis,and treatments were determined by the theoretical system of the viscera deficiency and excess dialectic and five-flavor tonification and purgation therapy which presented in “Tangye Jingfa map”,and the rationality of each clinical prescription was analyzed.Pharmaceutical inquiry was carried out.The effectiveness and safety of clinical treatment were monitored,and the timely pharmaceutical advice was provided. After the admission,she was identified as the "diabetes,lung and stomach congestion heat syndrome" caused by spleen deficiency and phlegm accumulation.Patient was treated with Banxia Baizhu Tianma Decoction and Chaige Jieji Decoction,and part of symptoms was improved after taking the medicine for nine days (adjusting the prescription once during the period).However,the main symptoms were not improved,and there was a new problem of insufficient qi when coughing.The clinical pharmacist analysed that the patient was mainly lung deficiency combined with liver excess,and the deficiency and excess were mixed by using “Tangye Jingfa map” theoretical system.The treatment should be based on the sour medicine of invigorating lungs and purging liver.The first two prescriptions of drug structure were “six bitter,three pungent,three salty,and three gan acid”,“seven bitter,four salty,two gan,two pungent,one acid”,and these two prescriptions were mainly bitter,but rarely sour.However,the main clinical symptoms did not relief.After the communication with the clinical pharmacist,doctor adjusted the prescription structure in the third prescription as “four acid,four salty,three bitter,three sweet,and two acrid”,and the main effect of the prescription become invigorating lungs and purging liver.After taking the medicine for five days,dry mouth,bitter mouth,sweating,cough,dizziness,numbness,lower limbs,cramps. Results The clinical symptoms of the patients were obviously improved,and there were no adverse reactions. Conclusion This case suggests that using the theoretical system of “Tangye Jingfa map” in Fuxingjue to carry out pharmaceutical intervention with the dominant medicinal taste of Chinese medicine compound as the starting point is a feasible way for pharmaceutical care of traditional Chinese Medicine Decoction.
Hepatic fibrosis (HF) is a leading pathological process of chronic liver injury.Extensive cells necrosis in hepatic DNA and connective tissue hyperplasia can induce cirrhosis,eventually leading to organ failure,cancer proliferation or even death.Poly(ADP-ribose) polymerase (PARPs) are key enzymes implicated in hepatocyte DNA repair processes (especially PARP-1).In this paper,through the structural and functional analysis of PARP-1 gene,it was found that it can regulate mitochondrial homeostasis,modulate NF-κB inflammatory signaling pathway,activate transcriptional activator protein 1(AP-1),and inhibit AMPK-mTOR pathway through NAD+ and energy metabolism in cellular DNA injury and repair in hepatic cells,thereby promoting HF.This suggests that PARP inhibition (PAPRI) is a promising therapeutic strategy in anti-HF.
Parkinson's disease (PD) is a common neurodegenerative disorder.In recent years,there are more and more surgeries for PD patients,while PD symptom has an important influence on surgery.In addition,sudden withdrawal or reduction of anti-PD drugs before surgery may lead to serious complications,increasing the risk of surgery for PD patients.On the other hand,other commonly used perioperative drugs may also affect PD symptoms or have adverse interactions with anti-PD drugs.In view of the above reasons,perioperative drug therapy management of PD patients is particularly important.However,there is still a lack of unified standards for perioperative drug management of PD.Therefore,in order to provide references for perioperative clinical drug therapy for PD patients and reduce postoperative complications,this paper reviews perioperative drug therapy management for PD patients,mainly including anti-PD drug management,perioperative management of common drugs,and pharmaceutical care.
Ivabredine is the first selective,specific sinoatrial node If channel blocker that slows heart rate without affecting myocardial contractility and cardiac conduction.In China and abroad,it is mainly approved for the treatment of chronic heart failure,which can effectively control sinus rhythm,delay the progression of the disease,and change the prognosis of patients with heart failure.It is also approved for stable angina pectoris and stable heart failure due to dilated cardiomyopathy in children.A number of studies have shown that ivabradine also plays a certain role in the treatment of arrhythmia.Here is a review of the research progress of ivabradine in arrhythmia as follows in the paper.
Myocardial ischemia-reperfusion injury (MIRI) is an unavoidable risk event for acute myocardial infarction.Ferroptosis was an iron dependent,peroxide-driven,nonapoptotic form of regulatory cell death.Accumulating evidences have suggested that ferroptosis may play a vital role in the pathogenic progression of MIRI.Notably,targeted inhibitors can alleviate MIRI by blocking the ferroptosis pathway.Despite these advances,a systematical review summarizing the intervention of ferroptosis inhibitors in modulating ferroptosis in MIRI is still lacking to date.Herein,this review summarizes the emerging data from different models that have studied in mitigating MIRI through pharmacologically inducing ferroptosis.Therefore,this paper classifies and organizes drugs that inhibit ferroptosis in the treatment of MIRI according to three mechanisms: regulating GPX4,regulating iron,and inhibiting lipid peroxidation.This review suggests that the pharmacological inhibition of ferroptosis by bioactive compounds can be used as a therapeutic target for MIRI.
Trimethylamine N-oxide (TMAO),a product produced from trimethylamine oxide (TMA) in the liver by the hepatic enzymes,is a common metabolite of intestinal flora and is closely associated with cardiovascular diseases.In recent years,domestic and international studies have found a strong clinical correlation between plasma TMAO levels and myocardial infarction (MI) and the reoccurrence of late adverse cardiovascular events,which can be used as a newly identified risk factor for cardiovascular diseases.This review summarizes the relevant literatures and finds that high levels of TMAO increase the incidence of MI through mechanisms such as increased platelet activity,promoting foam cell formation,affecting bile acid synthesis,and causing endothelial cell dysfunction.Meanwhile,plasma TMAO levels are influenced by diet,drugs [antibacterial drugs,3,3-dimethyl-1-butanol (DMB)],and exercise,etc.. It can provide new clinical ideas for the treatment of MI.
Objective To identify the chemical constituents of the leaves of Mallotus apelta using ultra high performance liquid chromatography coupled with quadruple time of flight mass spectrometry (UHPLC-Q-TOF-MS/MS). Methods The fragmentation information was obtained by UHPLC-Q-TOF-MS/MS,combined with secondary mass spectrometry database,Scifinder database,etc.Combined with Progenesis SDF Studio software,Progenesis QI software and literature search,MS and MS/ MS fragment analysis were carried out. Results A total of 63 chemical components were identified,including 21 organic acids,19 flavonoids,6 phenols,4 esters,4 alcohols,3 alkaloids,2 sugars,2 aldehydes,1 choline,and 1 quinoline,and the accurate mass measurement results of the identified components are all ±5 ppm error. Conclusion This method provides a comprehensive analysis of the chemical constituents of the leaves of Mallotus apelta,which provides a basis of the analysis for the chemical constituents of medicinal materials of the Mallotus apelta.
Objective To prepare a kind of traditional Chinese medicine cream for the treatment of fungal infection using oregano oil,Schizonepeta oil and other compound essential oil as the raw materials,and to study the preparation process of the prescription,and to investigate its rheological properties. Methods Using the rheological parameters to investigate the matrix of the cream,the ratio of essential oil to the matrix and the molding process parameters were optimized by an orthogonal test. Results The ointment substrate was an oil-in-water type,and the best forming process was as follows: the shear speed was at 10 k (r·min-1),the shear time was at 5 min,and the two-phase mixing temperature was at 65 ℃,and with the 6% essential oil,the rheological property is good. Conclusion The cream prepared in this study has good quality,good bacteriostatic properties,and excellent rheological parameters,which can be further developed and applied.
Objective Identification and quantification of eight pyrrolizidine alkaloids (PAs) in Qingre Sanjie Tablets and Qingre Sanjie capsules were performed using HPLC-MS/MS. Methods The sample was ultrasonically extracted by 0.1% formic acid aqueous solution-methanol (6:4) mixed solution,and then monocrotaline was added as the internal standard.After gradient elution by methanol and an aqueous solution containing 0.1% formic acid and 5 mmol·L-1 ammonium formate via a C18 column,the PAs were subsequently identified by a mass spectrometer with electro-spray ionization (ESI) in a positive mode using dynamic multiple reaction monitoring,while the quantification was achieved using an internal standard calibration method. Results The 8 PAs exhibited good linear regression ranged 1-100 ng·mL-1 with the correlation coefficient (r) ≥0.999.The limits of detection of the 8 PAs ranged in 0.04-0.39 ng·mL-1.The average recoveries of the 8 PAs were 89.9%-107.7% with the relative standard deviations ranged 1.6%-4.7%.Satisfactory results of methodological investigation were achieved.Four types of PAs (adonifoline,senecionine,seneciphylline and senkirkine) were identified in the samples.Senkirkine,senecionine and seneciphylline were identified and reported in these samples for the first time.The total PA content varies from 8.48-61.82 μg per capsule/tablet,which was equivalent to the daily PA intake between 96.2 μg and 1 483.7 μg following the administration instructions. Conclusion Since several PAs were identified in Qingre Sanjie tablets and Qingre Sanjie capsules. The total amount of PAs and the equivalent daily PA intake were found so high,it is necessary to conduct a systematic and comprehensive study of PAs in Qingre Sanjie preparations in order to reduce the risk of clinical medication.
Objective To study the preparation process of peppermint oil dripping pills and establish a quality evaluation method to screen the optimal formulation process. Methods Taking drop pill appearance,weight difference,friability weight loss percentage,hardness,and hardness difference as evaluation indicators,the L9(34) orthogonal design experiment method was used to screen the formulation process of dropping pills. Results The optimal preparation process of peppermint oil dripping pills was screened out: the percentage of peppermint oil content was 45%,and the dripping temperature was 85 ℃,and the height of the condensate was 8 cm,and the dripping distance was 6cm.The content of peppermint oil in the dripping pills prepared by the optimal process was 37.37% (RSD=1.45%,n=3);the linear range of peppermint oil concentration was 0.092 45-0.369 8 mg·mL-1 (R2=0.999 8);the average sample recovery rate was 97.98% (RSD=0.63%,n=3). Conclusion The peppermint oil dripping pills prepared under the optimal process have a round and smooth shape,and the weight difference meets the requirements of the 2020 edition of the Chinese Pharmacopoeia.The optimal process for preparing dripping pills is stable and feasible.
Objective To establish quality standards for Sheshang capsules. Methods The Cissus assamica and Lobelia chinensis in Sheshang capsules were identified by a microscopic identification method;Thin layer chromatography (TLC) was used to identify Desmodium microphyllum,Cissus assamica,Lobelia chinensis,and Aristolochia fordiana;The contents of bergenin and isoorientin,as well as aristolochic acid A,which was both effective and toxic,were determined by high performance liquid chromatography (HPLC). Results In the microscopic identification,the calcium oxalate needle crystal of Cissus assamica and the stomata and inulin of Lobelia chinensis had obvious and specific characteristics;TLC had strong specificity,clear spots,and good resolution;Bergenin,isoorientin,and aristolochic acid showed a good linear relationship within the range of 0.030 4~0.607 2 mg·mL-1 (r=0.999 9),0.010 1~0.202 8 mg·mL-1 (r=0.999 8),and 0.013 9~0.278 4 mg·mL-1 (r=0.999 9).The average recoveries were 95.75%,99.05%,and 100.61% respectively,with RSD of 1.84%,2.89% and 2.57% respectively;The contents of bergenin,isoorientin and aristolochic acid A in 11 batches of Sheshang capsules ranged from 4.74 to 5.93,0.26 to 0.34,and 0.27 to 0.32 mg·g-1 respectively. Conclusion The identification method is highly specific,and the content determination method is stable,repeatable and accurate.The quality standard can be used for the quality control of Sheshang Capsules.
Objective To evaluate the clinical efficacy and safety of tralokinumab and dupilumab in treating moderate to severe atopic dermatitis. Methods All randomized controlled studies using tralokinumab or dupilumab VS placebo published by November 2021 were collected using a computer searches of PubMed and other databases.Topical glucocorticoids were allowed to be used as needed in both groups.For the meta-analysis,the Numerical Rating Scale (NRS) score,the Investigator's Global Assessment (IGA),the Eczema area,and the Severity Index (EASI) were employed as evaluation indexes.The efficacy and adverse effects of tralokinumab and dupilumab were compared using the GEMTC package of R.4.2.0 software with placebo as an intermediate variable.The publication bias was evaluated by using the funnel plot of Review Manager 5.4.1 software.If the funnel plot was symmetrical,the publication bias was considered to be small. Results The meta-analysis includes a total of 14 trials.Tralokinumab and dupilumab were both effective in treating moderate to severe specific dermatitis on all indicators when compared to placebo,but dupilumab outperformed tralokinumab on the same index.Between the two groups,there was no significant difference in the incidence of severe adverse responses or overall adverse reactions. Conclusion In the treatment of moderate and severe atopic dermatitis,dupilumab is more effective than Tralokinumab.In terms of safety,dupilumab is comparable to tralokinumab.
Objective To evaluate the preventive effect and safety of novel oral anticoagulants (NOACs) on thrombosis in patients ≥80 years of age with non-valvular atrial fibrillation (NVAF). Methods The literature searches were up to May 2021 in the Cochrane Library,PubMed,Embase,CNKI,WANFANG DATA,Chongqing Whip (VIP),Chinese Biomedical Literature Database (CBM),including randomized controlled trials of NOACs and warfarin in the treatment of elderly patients with NVAF.The quality of the included literatures was evaluated,and relevant information from the literature was extracted.Revman 5.3 was used for analysis,and GRAD Eprofiler 3.6 was used to evaluate the quality of the evidence. Results A total of 7 RCTs with 2235 cases were included in the study.The results showed that compared with warfarin,NOACs can reduce the incidence of major bleeding in ≥80-year-old NVAF patients [RR=0.65,95%CI(0.46,0.92),P=0.02] and the incidence of non-major bleeding [RR=0.42,95%CI(0.26,0.68),P=0.000 5].There was no statistically significant difference in reducing the incidence of stroke and non-central nervous system thromboembolism.The results of GRADE evidence quality classification showed that the incidence of non-central nervous system thromboembolism and major bleeding were moderate-quality evidence,and the incidence of stroke and non-major bleeding were low-quality evidence. Conclusion The efficacy of the application of NOACs in elderly patients with NVAF is not inferior to warfarin,while the risk of bleeding is lower and the safety is better.Dabigatran etexilate is more effective in reducing the incidence of major bleeding,and rivaroxaban is more effective in reducing the incidence of non-major bleeding.
Objective To provide a reference for the use and improvement of global trigger tool (GTT) in Chinese medical institutions by analyzing the research and application progress of GTT at home and abroad in recent 5 years (2017-2021). Methods The databases of PubMed and CNKI were searched,and the literature related to GTT were collected. The research and application status of this tool in medical adverse event monitoring were summarized and analyzed. Results A total of 50 relevant valid studies from 21 countries were included.The study subjects covered 11 categories,including ordinary inpatients,children and elderly patients.The research scope has been gradually expanded from a single center to a multi-center cooperation.The research contents mainly involve the detection of adverse medical events by GTT,the optimization measures,and application evaluation of GTT. Conclusion GTT is a feasible and effective method for monitoring medical adverse events that has been applied in many countries and regions,and it can be popularized and applied in the monitoring of adverse events in Chinese medical institutions.
Objective To carry out data mining study of glucocorticoids (GCs) related osteoporosis and osteonecrosis based on the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database in order to provide a reference for the safe clinical use of GCs. Methods Seventy-two FAERS reports from the first quarter of 2004 to the fourth quarter of 2021 were downloaded.After duplication removal and data cleaning,GCs-related osteoporosis and osteonecrosis event reports were extracted,and reported odds ratio (ROR),proportional reported odds ratio (PRR),and information component method (IC) were used for signal detection. Results A total of 12,040 cases of adverse events were reported with 16 GCs as the primary suspected drugs,including 2675 cases of osteoporosis related adverse events and 8 GCs drugs were detected with osteoporosis related events.A total of 2479 osteonecrose-related adverse events were reported,and 8 GCs drugs were associated with osteonecrose-related events.The results of this study showed that prednisone,a medium-potency GCs drug,showed a strong signal in osteoporosis events (ROR=10.98,95%CI(9.95,12.01),PRR=10.60,χ2= (7565.53);IC=3.40,E(IC)-2SD=3.15).In addition,the signal value was also the highest in osteonecrosis events with prednisone (ROR=8.79,95%CI (7.76,9.83),PRR=8.58,χ2=4 138.02;IC=3.10,E (IC) - 2SD=2.81).In the analysis of GCs related death reports,there were 104 (5.40%) osteoporosis event-related death reports and 93 (4.37%) osteonecrosis event-related death reports. Conclusion Attention should be paid to the risk of GCs drug-related osteoporosis and osteonecrosis events,and clinical medication monitoring should be strengthened to reduce the impact of adverse reactions on patients' prognosis and quality of life.
By analyzing a case of serum sickness-like adverse reactions caused by infliximab for inflammatory bowel disease and performing a literature review,the mechanism and prevention measures of the adverse reactions caused by infliximab were discussed,and the recognition of rare serological sick-like adverse reactions caused by Infliximab was enhanced.Clinicians should pay attention to this adverse reaction and improve the safety and effectiveness of drug therapy.
Objective This paper studies the scientific and technological innovation policy of Fujian pharmaceutical industry and analyzes possible problems in order to put forward the policy recommendations to improve the scientific and technological innovation ability of Fujian pharmaceutical industry. Methods Through the search of websites of government departments,policy texts which are relevant to pharmaceutical science and technology innovation from 2010 to 2020 were collected.A two-dimensional analytical framework based on the theory of policy tools and the technological innovation process of pharmaceutical industry was established. Results A total of 28 policy texts are related to medical science and technology innovation in Fujian province selected.From the X dimension,environment-oriented policy tools are the the core policy tools to promote scientific and technological innovation in Fujian pharmaceutical industry,which account for 63.19%.Supply-oriented and demand-oriented policy tools are auxiliary tools,accounting for 25.77% and 11.04% respectively.From Y dimension,the proportion of policies in research and development,industrialization and market stage account for 28.53%,58.28%,and 13.19%,respectively. Conclusion The research shows that the scientific and technological innovation policies of pharmaceutical industry in Fujian province are dominated by environmental policy tools and industrialization policies.And the joint force of policy issuing entities is insufficient.Finally,according to the existing problems,some suggestions are put forward to balance the portfolio structure of policy tools,give full play to the combination effect,increase the diversity of policy forms,the synergistic effect of policy release subjects,and strengthen the supervision and evaluation of policy implementation effect.
Objective The situation of centralized procurement of the first batch of drugs in Wuhan in 2019 was summarized to provide a reference for further effective promotion of procurement with volume. Methods Through the documents and materials related to the centralized procurement of the first batch of drugs in Wuhan in 2019,combined with relevant data analysis and interviews,this paper summarized the establishment of relevant systems,the range of procurement varieties,enterprise qualification evaluation,determination of selected enterprises,distribution of contract quantity,and advance payment and other perspectives. Results The Wuhan city with quantity procurement has a certain innovation,through the establishment of scientific quality stratification and enterprise scoring system.On the premise of ensuring drug quality,combined with the characteristics of medical alliance institutions in Wuhan,a special account page for drugs is set up,and the platform supervision mechanism guarantees the effective operation of the purchase with quantity through prepayment for drug purchase. Conclusion Technical means and platform construction are needed as the foundation and functional departments with unified authority were formed as the guarantee to realize the procurement of drugs with quantity.Only by promoting the linkage of joint reformation for public health services,medical insurance,and medical production-circulation,the procurement of drugs can be further promoted effectively.
In recent years,chimeric antigen receptor T cell (CAR-T) immunotherapy has been paid more and more attention in clinic,especially in hematological tumors.Currently,two domestic CAR-T products have been approved as drugs for marketing in China.Since it is as a drug for pharmaceutical management,pharmacists must participate in the work.However,CAR-T immunotherapy is still a new technology in China,and there is no clear standard on how pharmacists play the role in the clinical treatment of CAR-T immunotherapy.Based on the detailed process of CAR-T immunotherapy in clinical application,this study analyzes the work that pharmacists can participate in the CAR-T and explores the responsibilities and work of pharmacists in this process,hoping to improve the management level of CAR-T products in medical institutions and standardize the clinical application of CAR-T products to serve the clinic further.