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ObjectiveTo evaluate the clinical effect of Silybum marianum preparation in the prophylactic treatment of antitubercular agent-induced liver injury (ATB-DILI), since there have always been controversies over the development of Silybum marianum preparation for the prophylactic treatment of ATB-DILI. MethodsMEDLINE, PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trials (RCTs) on Silybum marianum preparation versus placebo in preventing ATB-DILI published up to November 30, 2018. STATA 12.0 software was used for statistical analyses. Standardized mean difference (SMD) and risk ratio (RR) with 95% confidence intervals (CI) were used to evaluate the effect of Silybum marianum preparation. The Cochrane handbook was used to assess the quality of RCTs, and funnel plots and Egger’s tests were used to evaluate publication bias. A sensitivity analysis was conducted to assess the influence of each RCT on overall effect. ResultsA total of five RCTs with 1198 patients were included, and among these patients, 585 received Silybum marianum preparation and 613 received placebo. Silybum marianum preparation significantly reduced the risk of the onset of ATB-DILI at week 4 (RR=0.33, 95%CI: 0.15-0.75, P=0.008). In addition, Silybum marianum preparation had a protective effect on liver function in patients receiving antitubercular agents (alanine aminotransferase: SMD=-0.15, 95%CI: -0.24 to -0.07, P＜0.001; aspartate aminotransferase: SMD=-0.14, 95%CI: -0.23 to -0.06, P=0.001; alkaline phosphatase: SMD=-0.12, 95%CI: -0.20 to-0.03, P=0.008). Silybum marianum preparation had a similar risk of adverse events as placebo (RR=1.09, 95%CI: 0.86-1.39, P=0.47). ConclusionIn patients with tuberculosis, prophylactic treatment with Silybum marianum preparation can significantly reduce the risk of the onset of ATB-DILI after 4 weeks of treatment. In addition, Silybum marianum preparation can also improve the liver function of patients treated with antitubercular agents.
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Mogroside V is the most abundant [approximately 0.50%] cucurbitane-type triterpene glycoside in Siraitia grosvenorii and exhibits significant antitussive, expectorant, anti-carcinogenic, and anti-inflammatory effects. A sensitive, robust and selective liquid chromatography tandem with mass spectrometry [LC-MS/MS] was developed and validated for the determination and pharmacokinetic investigation of mogroside V in rat plasma. Samples were prepared through an one-step deproteinization procedure with 250 microL of methanol to a 75-microL plasma sample. Plasma samples were effectively separated on a Shiseido Capcell Pak UG120 C18 column [2.0 × 50mm, 3.0microm] using a mobile phase consisting of methanol: water [60:40, v/v] with an isocratic elution program. The running time for each sample was 7.0 min and the elution times of mogroside V and IS were 2.0 and 4.8 min, respectively. The detection relied on a triplequadrupole tandem with mass spectrometer equipped with negative-ion electrospray ionization interface by selectedreaction monitoring [SRM] of the transitions at m/z 1285.6 - 1123.7 for mogroside V and m/z 1089.6 - 649.6 for IS. The calibration curve was linear over the range of 96.0-96000 ng/mL with a limit of quantitation [LOQ] of 96.0ng/mL. Intra-day and inter-day precisions were both <10.1%. Mean recovery and matrix effect of mogroside V in plasma were in the range of 91.3-95.7% and 98.2-105.0%, respectively. This method was successfully applied in the pharmacokinetic study of mogroside V after intravenous or intraperitoneal administration of 1.12mg/kg mogroside V in rats
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OBJECTIVE:To provide reference for promoting rational use of vancomycin in the clinic. METHODS:Referring to vancomycin instruction,Guiding Principles for Clinical Use of Antibacterials (2015 edition) and Chinese Expert Consensus on Clinical Use of Vancomycin (2011 edition),720 inpatient medical records of vancomycin were collected from our hospital during Jan. 2013-Dec. 2014,and then drug use of those inpatients were analyzed retrospectively. RESULTS:Among 720 cases,male (428 cases)was more than female(292 cases),and most of them aged 41-65(45.83%). There were 50 cases of prophylactic drug use(6.94%)and 670 cases of therapeutic drug use(93.06%). The patients came from 36 departments. Among 720 cases,the dose of 19 cases were higher than 2 g/d,and there were 13 ADR cases(1.81%). Among 670 cases of therapeutic drug use,587 cases of microbiological samples (87.61%) were detected,and other antibacterials were used in 522 cases additionally (77.91%). DUI of vancomycin was equal to 0.96 in 549 cases no younger than 18 years old of herapeutic drug use. There were 240 cases of unsuit-able drug use (33.33%) in total,including 192 cases of unsuitable solvent (26.67%),28 cases of unsuitable usage and dosage (3.89%)and 20 cases of unsuitable drug combination(2.78%). CONCLUSIONS:The use of vancomycin in our hospital is basi-cally rational;vancomycin is widely used in departments;drug combination is a common phenomenon;the inspection rate of mi-crobiological samples is qualified;no drug abuse is found. However,there still is inappropriate use in the clinic. It is recommended to strengthen special evaluation and training about rational use of vancomycin,and further standardize monitoring for vancomycin use so as to guarantee the safety of drug use.
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OBJECTIVE:To provide reference for solving the shortage of national essential medicines in Changchun. METH-ODS:According to preliminary work,a questionnaire was conducted to investigate and statistically analyze the shortage situation of essential medicines in 22 higher than secondary and 50 basic medical and health institutions in Changchun;ABC analysis was used to analyze the national essential medicines in shortage;the bid results and shortage causes of the primary and secondary nation-al essential medicines in shortage were inquired. RESULTS:Totally 72 questionnaire were send out,and 72 were recycled with ef-fective recovery of 100%. The investigation results showed there were 19 shortage breeds(22 dosage forms),which lost the bid-ding,and 99 breeds(111 dosage forms)of national essential medicines in shortage,which won the bidding,including 85 kinds of chemical medicines and biological products,14 kinds of Chinese patent medicine in Changchun. Cardiovascular system drugs shows the largest number in the bid chemical medicines and biological products,and the Chinese patent medicine were mainly Fu-zheng agent and Quyu agent(internal medicine). Results of ABC analysis showed,among the 111 bid shortage dosage forms,17 were primary and 23 were secondary. The main causes for them were price raising in raw materials,lack of production,no produc-ing in manufacturers and purchase price higher than winning bids. CONCLUSIONS:Low accessibility of raw material drugs,low enthusiasm to production,lower drug price than a reasonable level,and small clinical requirements can lead to the shortage of na-tional essential medicines. It is suggested to intensify in supervising the raw materials’marketing,raising the enthusiasm of manu-facturers,perfecting the system of drug bidding,developing fixed-point production and building drug reserve system to guarantee the production and supply of national essential medicines,and satisfy clinical demands.
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Objective To investigate the epidemiologic features of infant rotavirus(RV) diarrhea in Guilin area .Methods The detection of group A rotavirus were performed on 1 300 patients from Guilin 181st hospital by using immune colloidal gold method , and the epidemiological analysis were done according to the detection results .Results In the 1 300 patients ,132 were found rotavir‐us positive ,the total positive rate was 10 .15% .The positive rate of >1-2 years old group was the highest(23 .08% ) ,compared with other age groups(P<0 .05) .In November ,December and January ,the positive rates were 24 .14% ,20 .00% ,23 .53% ,respec‐tively .Compared with the positive rate in other months ,there was statistically significant difference(P<0 .05) .Conclusion Infants of 6 months to less than 2 years old in Guilin have higher detection rate of RV infection ,and the infection peak appears in autumn and w inter .
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Objective To investigate the prevalence and attitude of smoking and its influencing factors among residents in Hongkou District of Shanghai, so as to provide evidence for tobacco control. Methods Nine hundred and sixty residents in Hongkou District of Shanghai aged 15 to 69 years were selected by multi-level random sampling, among whom 958 completed the investigations on smoking status. Results The smoking rate and standardized smoking rate were 20. 04% and 18. 73%, respectively. The smoking rate and standardized smoking rate of males were 41.05% and 30.07%, and those of females were 0. 80% and 1. 70% , respectively. The smoking rate of males was higher than that of females (RR = 0.02, 95% CI: 0.01 -0.03). The smoking rates of age groups of 25 years old and over were higher than those of 15 to 24 years old, and the smoking rate of subjects with or above junior college education was lower than that of subjects with or below middle school education (RR=0.45, 95% CI: 0.25 -0.79). Subjects who drank alcohol smoked more than those did not (RR = 2. 68, 95% CI: 1. 76 - 4.09). Lower annual per capita income and higher knowledge on smoking hazard led to more tendance to object to smoking and agree with anti-smoking. Conclusion The prevalence of smoking of residents aged 15 to 69 years in Hongkou District of Shanghai was relatively lower. Age, gender, education status and alcohol drinking were influencing factors of smoking. Education on tobacco control among subjects aged more than 35 years should be strengthened, and more attention should be paid to those with lower education. Besides, education on alcohol control should be managed together with tobacco control.