Objective To systematically evaluate whether taking calcium channel blockers(CCB)increases the risk of fractures. Methods Data were collected from Cochrane, PubMed, EMbase (OVID), CBM, VIP, CNKI and Wanfang databases.The Meta analysis was performed using RevMan5.2 software after evaluating the data quality. Results A total of 499 454 cases were included from 2 casecontrol studies and 2 cohort studies.Meta analysis showed no significant risk of fracture in patients taking CCB (OR＝1.23, 95% CI, 0.84-1.81, P＝0.29).Subgroup analysis showed that longterm treatment with CCB significantly decreased the risk of fractures (OR＝0.94, 95% CI, 0.92-0.96, P＝0.00), even though a trend of increased fracture risk existed in patients exposed to shortterm treatment (OR＝1.30, 95% CI, 0.83-2.03, P＝0.25). Conclusion Current evidence show that CCB administration does not increase the risk of fractures.The higher risk of fractures from short term use of CCB may result from the higher risk of falls,which remind us to improve the quality of nursing and strengthen selfawareness during the initial use of CCB.Restricted to the quantity and quality of literatures included, the Conclusion s are to be verified by more highquality studies.

Objective To study clinical application and safety of quetiapine fumarate in treating Alzheimer’s disease (AD). Methods A total of 74 patients with AD were randomly divided into treatment group(n=48)and control group(n=26).Patients in the control group were given 5 mg·d^-1 of donepezil chloride,patients in the treatment group were given 5 mg·d^-1 of donepezil chloride and 12.5 mg·d^-1 of quetiapine fumarate.Before and 1,2,4,8 and 12 weeks after the treatment,the patients were evaluated by mini-mental state examination(MMSE),the brief psychiatric rating scale(BPRS),neuropsychiatric inventory(NPI),NPI distress factor and activity of daily life(ADL). Results After 1 week of treatment,total NPI score of treatment group and control group was(72.830±10.45) and(78.057±10.97),respectively;NPI distress factor was(30.532±5.82) and(34.208±6.50),respectively(all P<0.05).After 4 weeks of treatment,BPRS scores of treatment group and control group was(30.277±6.43) and(35.01±7.38),respectively(P<0.05).After 8 weeks of treatment,NPI distress factor of treatment group and control group was(23.021±5.74) and(28.618±6.08)(P<0.05).After 12 weeks,MMSE score of treatment group and control group was(7.83±3.02) and(7.116±2.67),which was increased compared with that before treatment(all P>0.05). Conclusion Short-term use of quetiapine fumarate can reduce anguish of AD tender,and relieve psychological and behavioral symptoms of AD patients,and may have positive effects on cognitive function.

Quality control of biotech drugs has attracted increasing attentions in recent years. Deamidation reaction is one of the major concerns in quality control of biotech drugs, due to the generation of isoaspartic acid(isoAsp). This paper describes the deamidation of asparagine(Asn) residues and its effects on the biological drugs. The detection methods currently used in China and overeas for this reaction, including pretreatment protocols and instrumental analysis were described. The identification and determination of isoaspartyl sites were also described in detail, along with the positive impact on the development of biotech drugs in China by the studies on deamidation reactions.

由美国辉瑞制药有限公司研制的劳拉替尼(lorlatinib)是第三代非小细胞肺癌(NSCLC)治疗新药,具有间变性淋巴瘤激酶(ALK)和c-ros原癌基因1(ROS1)双重受体酪氨酸激酶(RTK)抑制作用,用于治疗既往接受过至少一种ALK抑制药治疗,但病情进展的ALK阳性和(或)ROS1阳性转移性NSCLC患者。美国食品药品管理局(FDA)于2015年10月授予lorlatinib罕用药(orphan drug)认定,2017年4月27日获得FDA突破性治疗药资格和优先审评的待遇,并于2018年11月2日加速批准上市,制剂商品名为Lorbrena ^®;日本医药品医疗器械综合机构(PMDA)于2018年9月21日批准该药上市,片剂商品名为ロルラチニブ^®;欧洲药品管理局(EMA)人用药品委员会(CHMP)2019年2月底财政年度会议纪要中,对lorlatinib的安全性和有效性持正面意见,建议EMA批准上市,制剂商品名将命名为Lorviqua^®。该文对lorlatinib非临床和临床药理毒理学、临床研究、不良反应、适应证、剂量与用法、用药注意事项及知识产权状态和国内外研究进展等进行介绍。

摘要目的分析双氯芬酸钠所致不良反应，为临床安全、合理用药提供参考。 方法检索《中国医院数字图书馆》中有关双氯芬酸钠引起不良反应的文献资料（1994～2011年），按年龄、性别、剂量、合用药物、给药方法、药品不良反应发生时间分布、临床表现症状、治疗与转归进行统计分析。 结果双氯芬酸钠引起的不良反应与性别关系不大，年龄分布以41～60岁为主。所致的不良反应类型以泌尿系统损害（26.1%）和消化系统损害（23.9%）为主；前3位的表现形式为急性肾衰竭、血尿、消化道出血；发生时间以第1天发生不良反应为主，占58.7%。 结论要严密观察患者使用双氯芬酸钠时的异常反应，发现问题及时停药、及时处理，警惕严重不良反应（急性肾衰竭、血尿、过敏性休克）的发生，确保患者的用药安全。

Bupivacaine is a long-acting local anesthetic widely used clinically,but its 6-8 hours duration is insufficient for postoperative analgesia.Designing drug dosage forms to prolong the action time of local anesthetics is the research content of local anesthetics.In 2011,the FDA approved a bupivacaine liposome preparation based on DepoFoam TM technology:Exparel,which can be used for more than 72 hours.This article reviewed the clinical safety research of Exparel and the research progress of its application in clinical postoperative analgesia.

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 study the preparation process of compound Xiecao shuxin dropping pills. Methods Dropping pills were prepared by dropping method.The effects of PEG4000/6000 matrix, drug-matrix ratio, dropping acceleration and liquid temperature on the preparation of the dropping pills were studied.Orthogonal test was conducted with the total scores of appearance, weight difference, and dissolution time as the factors to optimize the best preparation process of compound Xiecao shuxin dropping pills. Results The optimal preparation process of compound Xiecao shuxin dropping pill was as follows: PEG4000/6000 (1:1) was as the matrix, and the ratio of drug to matrix was 1:3.The temperature of the feeding liquid was 90 ℃, and the dropping acceleration was 35 drops per minute, and the temperature range of condensate liquid paraffin was from 5 to 15 ℃. Conclusion The optimized preparation technology is stable and feasible, which can provide necessary reference for the preparation of compound Xiecao shuxin dropping pills.

Nanocarriers of skin functional ingredients have wide applicable prospects in transdermal drug delivery and cosmetics,with good effects of diseases treatment and skin care.This article introduces the characteristics of nanocarriers for skin functional ingredients and reviews the research progress on the nanocarriers for skin diseases treatment,barrier repairing,melanin inhibition,antioxidation,and anti-acne etc.

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.

ObjectiveTo provide evidence for clinical trial and to evaluate the safety of total flavonoids from rhizome of drynariae MethodsThe maximum tolerance of gastrogavage in mice: twenty mice were fed 30 mL·kg^-1 with the total flavonoids solution (0.40 g·mL^-1 ) by gastrogavage， the bite and sup， activity， psychosis， coat and skin， urine and faeces， and body weight were observed The maximum tolerance of gastrogavage in rats: twenty rats were given the same dose total flavonoids solution， and the same observation were done The acute toxicity trial in mice, LD50 was carried out by abdominal injection with 7 dosage groups， and the mice were observed for 7 days after one injection ResultsThe mice and rats had no abnormal changes in bite and sup， activity， psychosis， coat and skin， urine and faeces， and body weight There were no significant changes(P＞0.05) Only a little remain of the fed sample was found in the abdomen anatomizing And there were no remarkable pathological changes in all organs The median lethal dose of the total flavonoids was 5.99 g·kg^-1 ConclusionThere are no abnormal changes in the acute toxicity trial with total flavonoids from rhizome of drynariae, and the flavonoids are safe in clinical use

To determine whether mirtazapinne is clinically effective on the treatment of chronic insomnia and to compare the clinical effects between mirtazapine and alpazolam on chronic insomnia. MethodsSeventynine patients were randomly divided into two groups (38 and 41 for each), which received the treatments of mirtazapine and alprazolam respectively for 12 weeks as a course. The patients in mirtazapine group took 10－15 mg 0.5 hour before sleeping, while the patients in alpazolam group took 0.4－0.8 mg 0.5 hour before sleeping. The curative effects were evaluated with Pittsburgh Sleep Quality Index (PSQI) and sleeping dairy before and after the 4th, 8th, and 12th weeks of treatment. ResultsThe effective rate and significantly effective rate of mirtazapine on chronic insomnia were 96.9% and 90.6%, respectively, whereas those of alprazolam, 78.8% and 51.5% respectively. Mirtazapine played significantly better role in the treatment of chronic insomnia than alprazolam did(P＜0.05). The side effects of mirtazapine included sleepy, dizzy and getting weight, all of which were acceptable. ConclusionMirtazapine is surely effective on clinical treatment of chronic insomnia with mild side effects . For using mirtazapine, starting with the small dosage is suggested.

To assess the therapeutic effectiveness and safety rate of gatifloxacin hydrochloride in the treatment of infections of the respiratory or urinary system. Methods225 patients with infections of the respiratory or urinary system were randomly divided into 2 groups: the trial group (n＝114) and control group (n＝111). Patients of the trial group were given each 0.4 g of gatifloxacin hydrochloride tablets PO,q.d. while those of the control group were given each 0.2 g of levofloxacin, PO, b.i.d.. The course of treatment in both groups lasted 7－14 days. The therapeutic effectiveness and adverse reactions of the drugs were kept under observation. ResultsIn patients of the trial group and control group, the clinical effective rates were 88.60% and 92.79%, the bacteria elimination rates were 94.32% and 96.63% and the incidences of adverse reactions were 9.32% and 11.97%, respectively. Differences between the 2 groups with respect to the above mentioned data were insignificant (P＞0.05). ConclusionGatifloxcin hydrochloride was shown to be effective and safe in the treatment of infections of the respiratory or urinary system.

L-carnitine is a carrier that assist in transport of long-chain fatty acids into mitochondria and an effective drug for treating primary carnitine deficiency (PCD).Starting supplementation as early as possible before irreversible organ damage occured can alleviate organ damage,reduce the risk of sudden death,and improve the quality of life.However,in recent years,some studies have suggested that long-term oral L-carnitine has potential risks,the metabolism of L-carnitine through intestinal flora results in the production of trimethylamine oxide (TMAO),which can increase the risk of cardiovascular disease (CVD).Therefore,this paper summarizes the clinical research progress of L-carnitine in treating PCD to provide a theoretical basis for the clinical application of L-carnitine in PCD.

恩格列净(empagliflozin)由美国礼来公司和德国勃林格殷格翰公司合作研发,是钠葡萄糖共转运蛋白2(SGLT2)抑制药,用于改善2型糖尿病成年患者的血糖控制,对二甲双胍耐受性差、靠调节饮食与锻炼不能有效控制血糖的成年患者,可单药治疗或与其他降血糖药物联合用药. 该文对恩格列净的非临床和临床药理毒理学、临床研究、适应证、剂量与用法、用药注意事项、不良反应及知识产权状态和国内外研究进展等进行介绍.

The “Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions” was developed by standards-based process from WHO.The guideline was referenced to the WHO Essential Medicines List,WHO Medicines and Health Products Programme Strategic Framework (2016—2030),and the relevant policy and system documents of developed countries and regions,including the United States, Europe, Japan and so on.Experts reached consensus on the scoring system for drug evaluation and selection were reached through the Delphi method in this guideline.In the end, to develop this guideline, we also took the actual conditions of Chinese medical institutions into account.

［摘要］综述治疗泌尿系统结石（石淋）的10种基本中成药，介绍祖国医学对石淋的认识和研究，并归纳和总结现代医学对中药治疗泌尿系统结石的化学、药理和临床疗效研究。由经验方制成的中成药因具有疗效确切、价格低廉及使用方便的特点，具有良好的临床应用前景。但部分单味中药治疗结石的有效成分和药理至今尚不明确，少数中成药的临床研究报道较少，需加强国家基本药物的研究和应用。

目的 建立测定参附注射液中人参皂苷Rg1、Re和Rb1含量的高效液相色谱法。方法 采用反相高效液相色谱法进行梯度洗脱，固定相： Lichrospher C18色谱柱；流动相A：水；流动相B：乙腈；流速：1.2 mL·min1；检测波长：203 nm；柱温：35℃。结果 人参皂苷Rg1、Re和Rb1分别在4～400，4～400和8～800 μg·mL1 范围内峰面积与浓度呈良好的线性关系。平均加样回收率分别为101.92%～106.79%(人参皂苷Rg1)，94.78%～100.65%(人参皂苷Re)，和 103.04%～106.62%(人参皂苷Rb1)。结论该方法简便、快速、准确，可同时测定参附注射液中人参皂苷Rg1、Re、Rb1的含量。

ObjectiveTo evaluate the efficacy and safety of lianhuaqingwen capsule for treating acute upper respiratory tract infection. MethodsThe clinical randomizedcontrolledtrails were conducted. VitC yinqiao tablets was used as control. A total of 206 subjects with acute upper respiratory tract infection were enrolled in our study, in which 102 patients randomly assigned in the treatment group were orally given lianhuaqingwen capsule (4 capsules, tid) for 3 d, and the other 104 patients were orally administered with VitC yinqiao tablets (2 pills,tid) for 3 d. ResultsThe clinical efficacy rates were 91.2% and 73.1% in lianhuaqingwen capsule group, and VitC yinqiao tablets group, respectively. Compared with control group, lianhuaqingwen capsule was more effective for improving main symptoms including fever, chill, headache and myalgia, with the therapeutic rates for whjch were 90.2%,85.4%,89.5%,91.0%, respectively. No significant difference on incidence of side effects in both groups was found (P＞0.05). ConclusionThe results suggest that lianhuaqingwen capsule is an effective and safe agent for treating acute upper respiratory tract infection, and is superior to VitC yinqiao tablets.

In recent years, nano-silica has been widely used in the field of biomedicine due to its high specific surface area, high biocompatibility, and targeting properties. This review focuses on the preparation methods of mesoporous silica nano (MSN) materials, the research progress of MSNs in the diagnosis and treatment of various diseases, and the drug isolationand delivery, aiming at providing are ference for the further application of mesoporous nano-silica in the field of medicine.

Cancer is a severe threat to human life and health.The over-activation of oncogenes is the main reason for poor treatment and prognosis of cancer patients.Most of these over-activated oncogenes are protein tyrosine kinase (PTK).Among many PTKs,non-receptor tyrosine kinase (NRTK) is an important signaling molecule that regulates cell proliferation and migration as the primary driver of intracellular signaling pathway transduction. Targeting NRTK has become the focus and difficulty in developing anti-tumor drugs.Traditional Chinese medicine (TCM),with its characteristics of multi-channel,multi-link,multi-target,and low toxicity,plays a significant advantage in treating adjuvant tumors.So far,it has been found various traditional TCM monomers can inhibit NRTK from playing an anti-tumor role.This review summarized the part of Src,Jak,Abl,Fak families,the prominent members of NRTK in tumor progression,as well as the TCM monomers acting on these members. We aimed to provide a theoretical basis for the anti-tumor therapy targeting NRTK and a reference for the search for TCM monomer inhibitors of NRTK.

Red sage root (Radix salviae miltiorrhizae) is one of the common traditional Chinese medicines clinically used to treat cardiovascular diseases for thousands of years. Indications of red sage root documented in the ancient Chinese pharmacopoeia or monographs are to promote blood circulation and remove blood stasis in the treatment of dysmenorrhea, amenorrhea, abdominal masses due to stasis of blood, carbuncles and ulcers. Red sage root has also been used in the treatment of coronary heart disease. Major progress has been achieved in the recent research of red sage root with respect to its biological features, chemical constituents, pharmacological effects, mechanisms of action, clinical preparation and clinical application. It has been shown that red sage roots from different growing areas may have distinct differences in their chemical constituents, and this is the main reason why their clinical therapeutic effects vary. Red sage root contains many kinds of chemical constituents, which may be classified into 2 major groups of chemical compounds, namely tashinones and salvionolic acids. Most of the tashinone compounds are provided with a diterpine struclure. More than 30 kinds of tashinone compounds have so far been separated and identified. Different salvionolic acids are mostly provided with a phenolic acid structure. More than 20 kinds of salvionolic acids with identified structures have been demonstrated. These chemical compounds compose the active principles of red sage root and the material basis for the drug to exert its therapeutic effects. The major pharmacological effects of the active principles of red sage root are manifested in many aspects. The main effects of tanshinone compounds are to promote blood circulation, combat bacteria and counteract inflammation, while the most prominent effects of salvionolic acid compounds have been shown to be antioxidation, antiblood coagulation and cell protection. Many drugs derived from red sage root have been developed for clinical application. These include more than 20 kinds of injections and oral medicines separately used in the treatment of cardiovascular diseases, skin diseases and diseases of the liver and kindney with promising therapeutic effects.

ObjectiveTo analyze the contents of amino acids in Dendrobium crystallinum Tchb. F. by using precolumn derivatization method. MethodsThe amino acids in Dendrobium devonianum were pretreated with 2，4dinitrofluorobenzene and their derivatives were analyzed on Waters 600 HPLC using Symmetry C18 column. Gradient eluent consisted of sodium acetate solution (pH=6.4) with 1% N，Ndimethylformamide， acetonitrile and water (1：1) was taken. The detection wavelength was 360 nm and column temperature was 35 ℃ and loading volume was 20 μL. ResultsThe calibration curves for amino acids showed good linearity(r=0. 999 5－1.000 0，n=5). The mean recoveries of amino acids were 99.34%－101.93% with RSD as 0.54%－1.91%(n=6). And the average content of amino acids was 3.79%. ConclusionThe method is quick，simple with minimum loss of amino acids, which provides a theoretical basis for the Dendrobium crystallinum development.

Objective To analyze the development status of intelligent pharmaceutical services for traditional Chinese medicine,to summarize the practical experience of intelligent pharmaceutical services for traditional Chinese medicine,and to explore its technical requirements and development direction. Methods The Affiliated Hospital of Chengdu University of traditional Chinese medicine launched the Smart Traditional Chinese Medicine Room project in January 2018 and established a Smart Traditional Chinese Medicine Pharmacy to undertake pharmaceutical services such as outpatient dispensing,decoction,and distribution of traditional Chinese medicine decoction pieces. Results A total of 5.572 million pairs of traditional Chinese medicine decoction pieces were delivered until May 2023,and 231 400 patients were served in 2022.The service process was more straightforward;there was no need to wait for medication or go to the hospital again.The service efficiency was high,improving the patient's medical experience. Conclusions Intelligent pharmaceutical services for traditional Chinese medicine are developing rapidly.A comprehensive intelligent service system will be established based on technological progress in the future.

Medication-related harm poses a severe threat to patient safety.To address the challenges of medication safety,the World Health Organization (WHO) has launched a global initiative with the theme "Medication without Harm" and adopted "Medication without Harm" as the slogan for this year's World Patient Safety Day.Since 2016,WHO has focused on medication safety and developed strategic frameworks and action plans to address medication safety challenges.The International Pharmaceutical Federation (FIP) has worked closely with WHO on patient safety issues,advocated for the active role of pharmacists in the medication use process,and assisted WHO in publishing technical reports on three key areas to identify priority areas for action.This paper reviews the key measures of WHO and FIP in addressing medication safety challenges to provide a reference for the development of medication safety practices in China.

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.

The high incidence of schizophrenia causes a greater burden on society and family.In the past of half century, with the widespread use of schizophrenic drugs,the prognosis of clinical schizophrenia has been substantially improved after following the principles of early, effective and maintenance therapy.In this overview,the clinical characteristics at different stages of disease progression with the recent advances in drug therapy of schizophrenia was combined,to introduce clinical selection of schizophrenic drugs.