ABSTRACT
OBJECTIVE To explore the characteristics and regulations of adverse drug reactions （ADR） caused by apatinib， and to provide a reference for the safe use of apatinib in clinic. METHODS Case and group reports on ADR and safety evaluation of apatinib were retrieved from Chinese and English databases such as CNKI， Wanfang medical network， VIP and PubMed since its listing in 2014， literature data were extracted and statistically analyzed after screening. RESULTS Totally 101 cases were included， involving 221 ADR. In the above cases， the male-to-female ratio was 1.24∶1， with the highest proportion of patients aged 51 to 70 years， most of the patients were given a dose of 500 mg or more， and the patients given low dose of apatinib combined with other antitumor drugs were also likely to have ADR. One to two types of adverse reaction were the most common， while the types could reach up to six. Most ADR occurred within 30 days after medication， and the systems/organs involved were mainly the cardiovascular system damage，skin and its accessories damage， gastrointestinal system damage and urinary system damage； the main clinical manifestations were hypertension/aggravation，hand-foot syndrome，abdominal pain diarrhea and albuminuria， etc. Hypertension/aggravation， hand-foot syndrome and myelosuppression were the most common serious ADR. Most ADR could be improved/cured by suspension of administration， dose downregulation and symptomatic treatment. All 4 patients who died had underlying diseases， and their ECOG scores all ≥2 points. Special ADR （such as reversible posterior encephalopathy syndrome， psychiatric disorders， and cognitive impairment） were mostly caused by apatinib itself， or may be caused by apatinib in combination with the primary or underlying disease. CONCLUSIONS Advanced age， large dose， combination medication， underlying diseases and poor physical condition might be the high risks for ADR caused by apatinib. It is recommended to monitor the blood pressure，urine protein and skin of hands and feet of all patients with medication on a daily basis，pay attention to the occurrence of special ADR， and timely detect abnormal states and give effective intervention，so as to avoid the aggravation of ADR and other secondary ADR.
ABSTRACT
Objective:To study the antibacterial activity of sanguisorba tannin extract in vitro and its mechanism in the antibacterial effect on staphylococcus aureus. Methods:The antibacterial effect of sanguisorba tannin extract was studied by an Oxford-cup method and a tube double dilution method. With staphylococcus aureus as the tested bacteria, extracellular alkaline phosphatase (AKP), potassium ion, soluble protein and T-ATPase were determined. The changes in protein bands and the cell ultrastructure were respectively observed by SDS-PAGE and TEM to illustrate the antibacterial mechanism. Results:The results showed that sanguisorba tannin extract was effec-tive against the gram-positive bacteria, while the effect against the gram-negative bacteria was weak. After staphylococcus aureus was trea-ted with sanguisorba tannin extract, the contents of alkaline phosphatase (AKP), potassium ion, soluble protein, DNA, RNA and the other large molecules were increased obviously when compared with those in the control group. The concentrations of intracellular and ex-tracellular ATP were significant changed. DS-PAGE showed that staphylococcus aureus treated with sanguisorba tannin extract had no pro-tein band formation. TEM showed that the cell integrity was damaged. Conclusion:Sanguisorba tannin extract shows strong antibacterial activity, which can change the cell membrane permeability and damage the cell integrity.