Current Issue http://www.yydbzz.com/yydb EN-US http://www.yydbzz.com/yydb/EN/current.shtml http://www.yydbzz.com/yydb 5 Objective To investigate the hypoglycemic effect of ethyl acetate extract of Cichorium glandulosum (CEE) on diabetic mice. Methods CEE was obtained from the root extract of Cichorium glandulosum by 95% ethanol extraction with ethyl acetate.Kunming mice were randomly divided into normal control group,model control group,CEE low-dose group (150 g·kg^-1),CEE medium-dose group (300 g·kg^-1),CEE high-dose group (600 g·kg^-1) and metformin group (300 mg·kg^-1).Except for the normal control group,which was given 0.9% of sodium chloride solution,the other groups were intraperitoneally injected with alloxan to establish the mouse diabetes model.The changes in body mass of mice were recorded and the blood glucose level was measured at 5 d intervals.At the end of the experiment,glucose tolerance and insulin tolerance of mice were tested.Serum total cholesterol (TC),triacylglycerol (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),insulin (INS),malondialdehyde (MDA),and nitric oxide (NO) levels were measured in mice.by test kits. Results The success rate of mouse modeling was 88.57%,and the mortality rate was 11.43%.The body mass of all groups except the normal control group showed a decreasing trend and tetracosactide had a significant effect on the body mass of mice;Compared with the model control group,CEE had a significant effect on the body mass of diabetic mice after drug intervention.According to the results of glucose tolerance experiment,the blood glucose value of mice could be significantly reduced by CEE (P<0.05 or P<0.01).The results of insulin tolerance test showed that high dose CEE significantly increased the glucose utilization ability of mice and reduced the insulin tolerance of diabetes mice.The blood glucose level of diabetes mice significantly inhibited by CEE (P<0.05 or P<0.01).The levels of INS and HDL-C in the serum of diabetes mice could be increased by all CEE dose treatment groups,and the levels of MDA,NO,TG,TC,and LDL-C in the serum of diabetes mice were reduced. Conclusion CEE has a significant hypoglycemic effect on alloxan-induced diabetes mice,and its mechanism may be that it significantly inhibits the activity of the α-glucosidase while regulating the disorders of glucose and lipid metabolism,and enhances the antioxidant capacity of the body.

]]> Objective To study the effects of the methanolic extract of Zanthoxylum armatum DC.(ZADCM) on autophagy levels and reactive oxygen species (ROS) production in BRL 3A cells. Methods BRL 3A cells were cultured in vitro and the cells were treated with ZADCM (70 μg·mL^-1) for 3,6,12 and 24 h or ZADCM at different concentrations (30,50 and 70 μg·mL^-1) for 24 h.The intervention was then carried out by using 3-methyladenine (10 mmol·L^-1) and metformin treatment (2.5 mmol·L^-1).The effect of ZADCM on the survival rate of BRL 3A cells was detected by CCK-8 assay,and ROS production in BRL 3A cells was detected by flow cytometry.The expression level of autophagy marker protein LC3B was detected by immunofluorescence,and the expression levels of p-mTOR,mTOR,p-ULK1,ULK1,Beclin-1 and LC3B proteins were detected by Western blotting. Results Compared with the normal control group,immunofluorescence results showed a decrease in LC3B fluorescence intensity after 24 h of treatment with different concentrations of ZADCM.Western Blotting results showed that the expression levels of autophagy related proteins LC3B and Beclin-1 were significantly decreased (P<0.05 or P<0.01) after 12 or 24 h of treatment with ZADCM (70 μg·mL^-1),and p-mTOR²⁴⁴⁸/mTOR and p-ULK1⁷⁵⁷/ULK1 were significantly increased (P<0.05). ROS focal points were decreased detected by confocal laser scanning,and ROS levels were significantly increased detected by flow cytometry (P<0.05 or P<0.01).In addition,after the intervention with 3-methyladenine or metformin,intracellular ROS increased or decreased,and the expression of autophagy related proteins decreased or increased compared with the drug treatment group. Conclusion ZADCM can activate the intracellular mTOR/ULK1 signaling pathway in BRL 3A cells and inhibit autophagy leading to decreased cell viability with ROS accumulation.

]]> Objective To evaluate the long-term toxicity of Yangyin Yiqi capsule on rats administered by gavage for six months. Methods Ninety SD rats were randomly divided into three groups:high dose group of Yangyin Yiqi capsule (daily gavage dosage of crude drug of 20 g·kg^-1),low dose group of Yangyin Yiqi capsule (daily gavage dosage of crude drug of 5 g·kg^-1),and blank control group (daily gavage of equal volume of distilled water). All animals were administered by gavage with volume of 5 mL·kg^-1 and lasted 180 days. The appearance,feeding,physical signs,behavioral activities,bowel movements,weight,hematological and biochemical indicators,and pathological examination of rats were observed and detected. Reversible observation for 2 weeks was conducted after drug withdrawal. Results The weight gain of two experimental groups of rats was slightly lower than that of the blank control group,but there was no statistically significant difference among all groups (P>0.05). The hematological indicators of two experimental groups were all within the normal range,and there were no statistically significant difference compared to the blank control group (P>0.05). Blood urea nitrogen of high-dose group was higher than that in blank control group (P<0.05),but was still within the normal range. There were no statistical significance in other blood biochemical indexes among all groups (P>0.05). No abnormality was found in system autopsy,histopathological examination and reversible observation of animals in each group. There were no statistically significant difference in organ coefficient and gonadal coefficient among all groups (P>0.05). Conclusion The safe dose of Yangyin Yiqi capsule administered by gavage to rats for six months is 20 g·kg^-1 (crude drug),which is equivalent to 60 times of the clinical dosage.

]]> Objective To explore the effect of trelagliptin succinate on bile acid metabolism in type 2 diabetes mellitus (T2DM). Methods Eighteen db/db mice were randomly divided into model control group (Mod),trelagliptin succinate group (Tre) and sitagliptin phosphate group (Sit) (n=6),and 6 C57 mice were in control group (Con).The doses of trelagliptin succinate and sitagliptin phosphate were 17.29 mg·kg^-1·w^-1 and 16.71 mg·kg^-1·d^-1,respectively,and were administered continuously for eight weeks.HE staining was used to observe the pathological status of the pancreas and kidney of the mice in each group;Real-time PCR and Western Blot assay were used to determine the mRNA and protein expression levels of CYP7A1,FXR and SHP in the liver of the mice;the content of bile acids in mouse ileum was detected based on targeted metabolomics. Results Compared with the Mod group,the pathological state of the pancreas and kidney were improved in the Tre group and the Sit group.The Tre group and the Sit group had no significant difference in the expression levels of CYP7A1 mRNA and protein (P>0.05);the expression levels of FXR mRNA and protein in Tre group were significantly increased (the former P<0.05,the latter P<0.01),while sitagliptin had no significant effect on the expression levels of the FXR mRNA and protein in Sit group (P>0.05);the Tre group showed a significant effect on expression levels of the SHP mRNA and protein,but there was no significant difference (P>0.05),and Sit group showed no significant difference in expression levels of the SHP mRNA and protein (P>0.05);the Tre could significantly down-regulate NCA,HDCA and αMCA,and significantly up-regulated TCDCA;Sit could significantly down-regulate NCA,HDCA,αMCA,THDCA,TDCA and TαMCA. Conclusion Trelagliptin succinate can increase the expression levels of FXR and SHP in db/db mice,possibly due to the up-regulation of TCDCA and the down-regulation of NCA and αMCA.

]]> Through literature review,questionnaire surveys,medical case analysis and other methods,Chinese Hospital Association Pharmaceutical Specialized Committee conducted research on the current status and development direction of pharmacy administration and pharmacy practice in healthcare institutions,summarized systematically the key issues in the fields of pharmacy practice,pharmaceutical supply services and pharmacy administration in healthcare institutions,studied relevant domestic and foreign literature in recent years,referenced existing domestic laws,regulations and rules,as well as domestic and foreign standards,and ultimately established a group standard system framework.The group standard system was named “Pharmacy administration and Pharmacy practice in Healthcare institutions”,and included 51 volumes in four parts,which were general principles,pharmacy practice,pharmaceutical supply services and pharmacy administration.

]]> Therapeutic drug monitoring (TDM) is one of the important contents of clinical pharmacy services,promoting individualized drug therapy.According to the requirements of hospital rank appraisal standards,problems in the process of TDM are sorted out,combined with the current TDM situation.Referring to relevant guidelines,consensus,and specifications published at home and abroad,the principles of scientificity,universality,guidance,and operability are followed.Multiple rounds of opinion collection have been conducted,including the internal opinion collection,demonstration meeting,external opinion collection and review meeting.Three aspects of basic requirements,service process,quality management and evaluation improvement are standardized,formulating the first group standard in China to standardize the entire process of TDM.This standard is the first group standard in China to standardize the entire TDM process.This paper elaborates on the process of formulating standard and analyzes its contents.This standard aims to guides the medical institutions at or above the second level to standardize and carry out TDM,which could promote the high-quality development of personalized pharmaceutical services.

]]> Pharmacy intravenous admixture is anessential component of pharmaceutical services and plays a positive role in standardizing pharmaceutical management in medical institutions.This paper introduces the standard for pharmacy intravenous admixture,which is part of the group standards formulated under the leadership of the Chinese Hospital Association Pharmaceutical Professional Committee.The standard covers fifteen elements related to the basic requirements,drug and consumable management,process management,quality management and evaluation and improvement of pharmacy intravenous admixture.This article provides an analysis of the formulation process and key content of the standard for pharmacy intravenous admixture.

]]> Drug quality management and control is an important part of hospital pharmacy administration.Strengthening drug quality management and control in medical institutions can help improve medical quality and provide strong guarantees for patient medication safety.In order to implement homogeneous drug quality management and control,we sorted out problems,solicited opinions,and convened expert argumentation meetings,finally formed the first group standard in China to regulate the entire process of drug quality management and control adhered to the principles of scientificity,universality,guidance,and operability.This article elaborates on the process of formulating drug quality management and control standards,and analyzes the content of the standards in order to provide suggestions and guidance for various medical institutions at all levels to carry out drug quality management and control.

]]> Objective To evaluate the affordability of antihypertensive drugs in Shaanxi province before and after the policies of the national centralized procurement. Methods A cross-sectional survey was conducted on the affordability of 10 bid-winning generic antihypertensive drugs in the national centralized procurement and originator brands that have same active ingredient with these generics supplied in Shaanxi province in 2018 and 2021,using the minimum daily wage standard and annual per capita disposable income as indicators. Results As shown in the results,since the implementation of the national centralized procurement policy,the affordability of 10 original brands as well as generic antihypertensive drugs in Shaanxi Province has improved significantly.The ratio of monthly drug expenditures of 10 original and generic drugs to the minimum daily wage standard decreased from 1.86-4.54 times and 0.09-2.19 times in 2018 to 0.61-3.21 times and 0.03-0.94 times in 2021,respectively.The affordability of antihypertensive drugs for urban residents in Shaanxi province is better than that for rural residents,and the affordability of generic drugs is better than that of original drugs.For uninsured rural residents in Shaanxi province,the proportion of original yearly drugs expenditure to annual per capita disposable income decreased from 10.29%-25.10% in 2018 to 3.12%-16.34% in 2021;and that of annual generic drugs expenditure decreased from 0.49%-12.11% in 2018 to 0.15%-4.78% in 2021.For insured rural residents,the proportion of annual original drugs expenditure decreased from 5.63%-10.81% in 2018 to 2.63%-7.26% in 2021;and that of annual generic drugs expenditure decreased from 0.49%-6.27% in 2018 to 0.15%-3.22% in 2021. Conclusion The implementation of national centralized drug procurement has positively impacted on the affordability of original and generic antihypertensive drugs in Shaanxi Province,and in particular,the affordability for rural residents has improved significantly. We should continuously optimize the drug procurement,increase medical security,and improve the affordability of drugs for people,especially low-income groups.

]]> Objective To evaluate pediatricians' understanding of the National Centralized Drug Procurement (NCDP) with quantity policy,and to explore the factors that affect their prescribing of generic drugs pooled from NCDP,and to provide recommendations for improving the implementation of the policy of promoting the children's generic medicines in China. Methods A questionnaire survey was conducted among pediatricians in Shaanxi Province.The questionnaire included basic demographic information and KAP for NCDP and generic drugs.The collected data were statistically analyzed by SPSS. Results A total of 160 questionnaires were received from pediatricians.The average knowledge score was 2.76 (1.983).Among them,34.4% of pediatricians had knowledge scores of 4 or more,there were significant differences in knowledge scores between paediatricians of different genders (P<0.05),ages,titles,and years of experience (P<0.001),and 18.13% of pediatricians agreed or strongly agreed that paediatric generic drugs could replace the originator drugs,and whether they were willing to prescribe generic drugs for their family members (P<0.01,OR=3.441),and whether they supported the implementation of the policy of generic drug NCDP in the field of children's drugs (P<0.01,OR=2.596) had a significant positive impact on this.Among them,13.76% of pediatricians often or frequently prescribe generic drugs.The age (P<0.05,OR=1.999),knowledge score (P<0.01,OR=1.941),and attitude toward family (P<0.05,OR=1.772) of pediatricians have significant positive effects on prescription frequency. Conclusion Pediatricians do not know enough about generic drugs and NCDP,and their attitudes and practices are lower than those of general physicians.it is still necessary to increase the publicity and education of policies and generic drug expertise,especially among less senior doctors and children's families and to actively conduct real-world research on children's generics,so as to improve doctors' attitudes and encourage doctors to prescribe appropriate centralized purchasing generic drugs for children in their work and promote the implementation of the NCDP.

]]> Objective To evaluate the cost-effectiveness of levosimendan combined with conventional treatment (the levosimendan group) versus conventional treatment (the conventional group) for patients with low cardiac output syndrome (LCOS) after coronary artery bypass grafting (CABG) from the perspective of the Chinese health-care system. Methods Based on a foreign multicentre randomised clinical trial,Basic case analysis was conducted with the cost referring to the bidding price of medicines and medical service charges in Xinjiang,and the utility value referring to the published literature in foreign countries,to analyze the cost-effectiveness of the two treatment protocols by developing a decision tree model using randomized control trail to estimate the clinical effects.One-way and probabilistic sensitivity analyses were performed to assess the robustness of the results.A scenario analysis was conducted with the same analytical approach using a cohort study for the Chinese population and their robustness. Results In the basic case analysis,the levosimendan group had an absolute cost-effectiveness advantage over the conventional group with a cost reduction of CNY 138.77 and an effect increase of 0.000 042 quality-adjusted life years (QALYs) as a dominant strategy compared with conventional treatment.Its sensitivity analysis indicated that changes in some cost and probability parameters might introduce deviations in the results of the base-case analysis.In the scenario analysis,the levosimendan group had a relatively lower cost (-2 702.88 CNY) and QALYs forgone (-0.000 143 QALYs) to the conventional group,which did not reverse the results of the base-case analysis.Its sensitivity analysis showed the robustness of the results. Conclusion Using the Chinese healthcare system as a study perspective,levosimendan combined with conventional treatment regimens has more cost-effectiveness advantages than conventional treatment regimens for patients with postoperative LCOS after CABG.It is recommended that clinical decision-making should give priority to the use of levosimendan in combination with conventional treatment regimens when considering affordability.

]]> Objective To evaluate the economic efficiency of duvalizumab combined with tremelimumab in the treatment of advanced hepatocellular carcinoma (HCC),and to provide a reference for the choice of clinical treatment options. Methods Tree AgePro2011 software was used to establish a three-state Markov model with progression-free survival (PFS),disease progression (PD) and death (D).The model period is one month,with a total of 120 cycles,and the research time frame is ten years.The survival curve of HIMALAYA clinical trial data was fitted and the transition probability was calculated.The total cost,total utility,incremental cost,incremental utility and incremental Incremental cost-utility ratio (ICUR) were calculated by combining the cost and health utility values.The uncertainty of parameters was analyzed by single factor sensitivity analysis (DSA) and probability sensitivity analysis (PSA) of the second-order Monte Carlo simulation. Results The results of basic analysis showed that the cost of the combination of duvalizumab and tremelimumab and single drug duvalizumab monoclonal antibody was 646 481.33 yuan and 598 386.95 yuan, respectively,and the QALY obtained was 7.77 years and 7.66, years respectively.Compared with the latter,the former gained 0.11 QALYs,while the cost increased by 48 094.37 yuan,and the ICUR value was 444 022.05 yuan/QALY,which was much higher than China's per capita GDP by three times.DSA analysis results show that PFS state utility value,PD state utility value,cycle cost of tremelimumab and cycle cost of duvalizumab had great impact on the results,while other parameters had little influence,and the basic analysis results were robust.When WTP was about 500 000 yuan,the two groups had the same economic probability;When WTP was ≥900 000 yuan,the financial possibility of duvalizumab combined with tremelimumab was 100%.The PSA was consistent with the basic analysis results. Conclusion Duvalizumab combined with tremelimumab as the first-line treatment for advanced hepatocellular carcinoma is not cost-effective.

]]> Objective To facilitate the implementation of the centralized procurement policy,we build a refined management platform for the national centralised drug procurement (NCDP) that can achieve efficient and automated data analysis based on Power BI. Methods Power BI software is used to build information management templates,and import NCDP data for an efficient analysis,and and ultimately present a convenient visual display of the usage data. Results Based on Power BI,the NCDP Refined Management Platform is able to provide standardised,homogenised and visualised analysis views,which significantly improves the efficiency of related work.Hospital managers can make decisions quickly and effectively,such as reporting and calculating the workload of volume-based NCDP in the whole hospital,assigning the workload of departments,monitoring the whole use situation and analyzing the completion situation. Conclusion The refined management platform for NCDP based on Power BI can provide standardized,homogeneous and visual analysis.

]]> Objective To preliminarily explore the effects of carboxyamidotriazole(CAI) on three kinds of interleukin (IL)-1β-mediated autoinflammatory diseases (AIDs) including NLRP12-associated autoinflammatory disease (NLRP12-AID), familial Mediterranean fever (FMF), and tumor necrosis factor receptor-associated periodic syndrome (TRAPS). Methods Peripheral blood mononuclear cells (PBMCs) were isolated from AIDs patients and treated with CAI, and the levels of IL-1β, IL-6 and tumour necrosis factor (TNF)-α in the culture supernatants were determined by enzyme linked immunosorbent assay (ELISA). Results CAI significantly reduced the level of IL-1β secretion from NLRP12-AID PBMCs (P<0.05 or P<0.01), and had a tendency to decrease IL-6 and TNF-α levels, but the difference was not statistically significant (P>0.05).Also, CAI lowered the levels of IL-1β, IL-6 and TNF-α secreted by FMF PBMCs to different degree (P<0.05 or P<0.01);and lessened IL-1β secretion levels from TRAPS PBMCs. Conclusion CAI might have a role in treating three IL-1β-mediated AIDs, including NLRP12-AID, FMF and TRAPS, by reducing the production of proinflammatory cytokines such as IL-1β.

]]> Objective To observe the effectiveness and safety of nimodipine in the treatment of high-altitude headache. Methods A total of 94 patients with high-altitude headache were randomly divided into two groups.47 patients in the control group were treated with rest and activity reduction.47 patients were assigned to the intervention group,and given nimodipine orally in addition to the same treatment.Dose of nimodipine tablets were 20 mg each time,tid,lasted for 3 d.Numerical Rating Scale (NRS) was used to evaluate the therapeutic effect on the 4th day.The incidence of hypotension of nimodipine was also counted. Results A total of 45 patients completed the evaluation in the intervention group and 46 patients in the control group.The efficiency in the intervention group was 84.44%,and in the control group was 41.30% (P<0.05).The ‘under control’ rate was 88.89% in the intervention group and in the control group was 58.70%(P<0.05).The incidence of hypotension was 4.3% in the intervention group and 2.1% in the control group,and there was no significant difference(P>0.05). Conclusion Nimodipine is shown a significant decrease in high-altitude headache and is safe.

]]> Objective To study the Yiqi Tongmai formula combined with atorvastatin in treating carotid atherosclerotic plaque of qi deficiency and blood stasis type in the recovery period of ischemic stroke. Methods Eighty patients with atherosclerotic cerebral infarction were randomly divided into treatment group and control group.The control group was given atorvastatin calcium tablets and other conventional treatments, while the treatment group was given Yiqi Tongmai formula based on the control group, and the course of treatment was 12 weeks.Clinical efficacy, NIHSS score, Barthel index score, TCM syndrome score, four items of blood lipid, serum APN, CTRP5, and carotid artery color Doppler ultrasound indexes were detected. Results After treatment, the total effective rate of the treatment group was higher than that of control group (P<0.05).The NIHSS score and TCM syndrome score of the two groups were decreased (P<0.05);Barthel score was elevated (P<0.05);The improvement of plaque was significantly better than that of the control group (P<0.05).The levels of four blood lipids and CTRP5 were all reduced (P<0.05).Serum APN was increased (P<0.05).The treatment group had a better regimen than the control group (P<0.05). Conclusion Yiqi Tongmai Formula combined with atorvastatin calcium tablets has a better therapeutic effect, which indicates that the combined drugs have a better co-action effect.

]]> Targeted radionuclide therapy has become a new method to treat cancer.Alpha particles have attracted much attention because of their high energy, short range and the ability to cause irreparable DNA fragmentation.Among them, the isotope ²²⁵Ac of actinium is considered one of the most potential radionuclides due to its long half-life and potent toxicity.Therefore, this article reviews the development of ²²⁵Ac in the field of research and development in tumour therapy.

]]> The two-component regulatory system (TCS) is the most important mechanism for bacteria to sense and respond to environmental signals and regulate physiological behaviors.It plays an important role in bacterial pathogenicity, drug resistance, biofilm formation, and regulation of virulence factors.This paper briefly describes the structure, function, classification, and relationship between drug resistance and TCS, and discusses the inhibitors targeting bacterial TCS, to provide a theoretical basis for controlling the spread of drug-resistant bacteria and developing new antibacterial drugs.

]]> Nasopharyngeal carcinoma is a common malignant tumor in clinic.Radiotherapy and chemotherapy are common methods for the treatment of nasopharyngeal carcinoma.Cisplatin-based combination chemotherapy is one of the basic treatment options for middle and advanced stage nasopharyngeal carcinoma.However,tumor cell drug resistance has become a significant bottleneck in treating nasopharyngeal carcinoma during the treatment process.Cisplatin,a cell cycle nonspecific blocker,induces apoptosis in nasopharyngealcarcinoma cells by disrupting DNA synthesis and mitosis.In this paper,the mechanism of cisplatin resistance in nasopharyngeal carcinoma was elaborated from the aspects of enhanced DNA damage repair ability,increased drug efflux and decreased uptake,drug inactivation in vivo,and uncontrolled expression of apoptosis-regulated genes.In addition,the strategies for reversing cisplatin resistance in nasopharyngeal carcinoma reported in recent years were collected and reviewed,to find effective intervention targets and target molecules to increase the sensitivity of tumor cells to cisplatin.

]]> Intracerebral hemorrhage (ICH) is a primary non-traumatic brain hemorrhage characterized by bleeding in the brain parenchyma and secondary brain injury due to a fiercely neuroinflammatory response to blood components.It is a leading cause of death and adult disability with high morbidity,disability,and mortality rates,which has seriously endangered social health and safety.Surgery and pharmacotherapy are common treatments for cerebral hemorrhage.However,the current clinical treatment for various injuries caused by cerebral hemorrhage is not ideal because of the lack of effective therapeutic drugs.The study of the molecular mechanism of brain injury caused by cerebral hemorrhage has advanced rapidly in recent years,which provides a theoretical foundation for the development of more effective therapeutic drugs for cerebral hemorrhage.This paper reviews the molecular mechanisms involved in the process of cerebral hemorrhage that has been discovered in recent years from four aspects: reducing neuronal cell damage,suppressing the inflammatory response,reducing immune damage,reducing edema,and clearing hematoma,in order to identify the direction for new drug research and provide new ideas for the treatment of cerebral hemorrhage at the molecular level.

]]> Drug abuse has become a major threat to the social development and stability.No new detoxification drugs have been launched in the past 20 years.The existing drugs have the problems of poor patient compliance and difficulty sticking to long-term drug use, which makes it difficult to meet the clinical needs.By optimizing the dosage form of the existing detoxification drugs, the long-acting sustained-release formulations have been successfully used in clinical settings to improve the compliance and the success rate of drug treatment.This study analyzes and summarizes the clinical application of long-acting sustained-release formulations of detoxification drugs in the past ten years.It is believed that the important role of the long-acting sustained-release formulations of detoxification drugs has not been fully exploited in drug addiction treatment.It is necessary to study new sustained and controlled release delivery systems, establish scientific evaluation systems, and develop better dosage forms of detoxification drugs.

]]> Objective To investigate the distribution of ABCB1 (2677T>G) and ABCB1 (3435C>T) gene polymorphisms in patients with perimenopausal hyperlipidemia and their correlation with the lipid-lowering efficacy of atorvastatin. Methods The genotypes distribution of ABCB1 (2677T> G) and ABCB1 (3435C>t) in 80 patients with perimenopausal hyperlipidemia were detected by fluorescence in situ hybridization;The enrolled patients took atorvastatin 20 mg every night.After continuous treatment for eight weeks, the blood lipid levels before and after the treatment were measured to evaluate the lipid-lowering effect. Results Among the 80 selected patients, the mutation frequencies of ABCB1 (2677T> G) and ABCB1 (3435C>T) genes were 62% and 60%, respectively.The gene distribution was consistent with Hardy Weinberg equilibrium.The regulation of LDL-C in patients with ABCB1 2677GG was significantly higher than that of other genotypes at the same locus, but there was no correlation between other blood lipid markers.There was no significant difference in blood lipid changes among patients with ABCB1 (3435C>T) genotypes. Conclusion Patients with ABCB1 2677GG genotype have better lipid-lowering effect when treated with atorvastatin, but ABCB1 (3435C>T) polymorphism may not be related to the lipid-lowering effect of atorvastatin.

]]> Objective To determine the potassium content of commonly used Chinese patent medicines (CPMs) and to provide a reference for the safe use of CPMs in patients with chronic kidney disease (CKD). Methods A total of 32 commonly used CPMs were selected and detected for potassium content by inductively coupled plasma-optical emission spectrometry after microwave ablation, and the daily drug-derived potassium intake was calculated.The effect on CKD patients was evaluated. Results Potassium was detected in all 32 CPMs with varying levels.Among them, the prescription preparation has the highest potassium content, followed by single flavor preparation, and the extract preparation has the lowest potassium content.Eight CPMs had a daily pharmacogenic potassium intake of more than 100mg, including uremic clearance granules, which are commonly used by CKD patients. Conclusion It is noteworthy that the potential potassium load of CPMs might cause the intake of potassium to exceed the standards in CKD patients to raise serum potassium and increase the risk of hyperkalemia.

]]> Objective To systematically analyze the application of hypoglycemic drugs in 33 medical institutions in Wuhan region from 2018 to 2021 and to provide a reference for the rational use of hypoglycemic drugs and establishing drug prices. Methods A retrospective analysis was used to statistically analyse the consumption sum, DDDs, DDC and B/A on the hypoglycemic drugs in 33 hospitals in the Wuhan region from 2018 to 2021 Results From 2018 to 2021, there were 54 kinds of hypoglycemic drugs in 10 categories for clinical use in medical institutions in Wuhan area.Insulin category ranks first in terms of consumption sum and DDDs among the 10 categories of glucose-lowering drugs for four consecutive years.Consumption sum and DDDs of new hypoglycemic drugs and compound hypoglycemic drugs in Wuhan regional medical institutions have been increasing yearly, while traditional hypoglycemic drugs have been decreasing in the opposite trend.In terms of consumption sum, insulins, compound hypoglycemic drugs and DPP-IV inhibitors were the top 3 in the 10 categories;Insulin glargine, acarbose, insulin aspart 30 injection, metformin and pioglitazone/metformin compound preparation were the top 10 among 54 drugs for 4 years.In terms of DDDs, insulins, a-glucosidase inhibitors and sulfonylureas were the top 3 in the 10 categories;acarbose, metformin, pioglitazone/metformin compound preparation, insulin aspart 30 injection, glimepiride, gliclazide and insulin glargine were the top 10 among 54 drugs for 4 years.In terms of DDC, liraglutide, benaglutide and insulin degludec were always in the top 4.B/A of insulin glargine were the smallest among 54 drugs for 4 years with only 0.1 in 2021. Conclusion The use of traditional hypoglycemic drugs is dominant in 33 medical institutions in the Wuhan area, but the development trends of various drugs were different.New hypoglycemic drugs are growing rapidly, and some hypoglycemic drugs have a heavier economic burden.

]]> Objective To establish the drug utilization evaluation (DUE) criteria of apixaban, and to evaluate the rationality of the clinical application of apixaban by retrospective analysis. Methods Based on the drug instructions of apixaban with reference to relevant guidelines and literature, the drug utilisation evaluation criteria for apixaban were established by the expert consultation.A retrospective study was evaluated the rationality of drug utilisation of apixaban in inpatients in a third grade class-A hospital in Hubei province from January to December 2021, including indications, usage and dosage, combination, contraindications, adverse reaction monitoring and drug switching. Results A total of 544 medical records were included and the rational rate was 77.2%.Irrational drug use was common in unsuitable indications (19.5%) and inappropriate dosage (3.3%), and there was a high risk drug-drug interaction of 3.1%. Conclusion The established DUE criteria for apixaban are highly scientific, practical, and feasible, which can be used to evaluate the rationality of its clinical application.

]]> Objective To observe the effect of evidence-based pharmacy (EBP) on the whole-process management for the patients with non-valvular atrial fibrillation using rivaroxaban by clinical pharmacists, and to provide a reference for improving pharmaceutical care mode. Methods A total of 270 inpatients diagnosed with non-valvular atrial fibrillation and treated with oral rivaroxaban in a hospital from July 2018 to June 2019 were selected as subjects, and randomly divided into control group (135 cases) and intervention group (135 cases).Patients in the control group received conventional clinical diagnosis and treatment, while clinical pharmacists managed the intervention group patients based on EBP mode.The incidence of embolic events and bleeding events were compared between the two groups, and the economics were evaluated through cost-benefit analysis method. Results During the intervention period, 13 patients in the control group and seven patients in the intervention group withdrew from the trial for financial reasons.The difference of embolic events and bleeding events after intervention between the two groups was statistically significant (P<0.05).The results of economic evaluation showed that compared with the control group, the per capita cost of the intervention group increased by 112.58 yuan, and the reduced medical insurance payment cost was 1 098.01 yuan, with the benefit-cost ratio of 9.75, which was economical.The results of cost- benefit analysis were supported by sensitivity analysis. Conclusion Compared with the conventional clinical diagnosis and treatment service mode, the evidence-based pharmacy on the whole-process management for the patients could improve the effectiveness and safety, and show the economic value.

]]> Objective To analyze the role of a loading dose of ibandronate sodium in treating metastatic bone pain,in order to provide a reference for the therapeutic practice of metastatic bone pain. Methods Taking a case of using a loading dose of ibandronate sodium in treating a patient with metastatic bone pain as a clue,combined with the patient's medication history,clinical manifestations,pain scores and literature review,the application of the loading dose of ibandronate sodium was analyzed. Results After a treatment with a loading dose of ibandronate sodium,the patient's pain score was reduced from 9 to 3 points,which effectively reduced the degree of pain and improved the life quality of the patient. Conclusion The loading dose of ibandronate sodium can quickly relieve patients'metastatic bone pain,providing a reference for metastatic bone pain's therapeutic practice.

]]> Objective To analyze the literature on the impact of gene polymorphisms on pharmacokinetics (PK) to identify the research status and hot spots, and to provide valuable references for researchers. Methods Articles related to the impact of gene polymorphisms on pharmacokinetics in the Web of Science Core Collection(WoSCC)up to 2021 were selected as the research objects.VOSviewer 1.8.18 and CiteSpace 5.8.R3 were used to analyze countries/regions, institutions, authors, co-cited authors, journals, and keywords, etc. Results The final included literature was 3 510 papers, and the annual number of papers was on upward trend;The most productive countries/regions, institutions and authors are the United States, Central South University, YUICHI SUGIYAMA;The most frequently cited author is JULIA KIRCHHEINER of the University of Ulm in Germany;Molecular biology, genetics, health, nursing and medicine play an important role in this field.Keywords cluster analysis results showed that cytochrome P₄₅₀ (CYP), population pharmacokinetics (pop-PK), and tacrolimus (TAC) were the three major research directions in this field.The emergent keywords indicate that the research hotspots in recent years are mainly focused on ABCB1 and ABCG2, sodium valproate (VPA) and Meta-analysis. Conclusion This study summarizes the overall situation in the field of gene polymorphism pharmacokinetics and provides guidance for the direction of further research.

]]> Objective To evaluate the performance of a constructed language model and neural network (NN) model in the information identification and classification of drug complaint cases to explore the feasibility of using artificial intelligence (AI) to assist in manual review and classification for the drug complaint cases. Methods A total of 3 090 feedback records collected online by Company X from August 2022 to October 2022 were imported into the constructed NN model.Multiple matrices evaluated the classification performance of AI.The consensus results of three senior pharmacovigilance specialists were used as the ground truth value to compare the sensitivity, specificity and AUC value of the AI model and those of manual detection;In addition, the kappa value was used to evaluate the consistency between the AI group and ground truth value group. Results Compared with the manual group, the F1 score and AUC value of the AI group were 90.48% and 95.20%, respectively, which indicates the high quality of the classification of AI.The sensitivity of AI was 90.48%, lower than that of the manual group (97.62%), the difference was not statistically significant (P=0.25);the specificity of the AI group and the manual group were 99.87% and 99.31%, respectively, with significant difference (P<0.001) by statistical analysis;the kappa value of AI group was 0.903, which demonstrates the excellent consistency between AI group and ground truth value group. Conclusion The classification efficacy of AI is of high quality and It exhibits high sensitivity and specificity in identifying complaint cases, which can provide a reference for the rapid identification and classification of complaint cases and non-complaint cases.

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