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Objective:To explore the efficacy of mecobalamin combined with insulin in the treatment of patients with gestational diabetes (GDM) and its effect on Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88) signaling pathway and maternal and infant outcomes.Methods:A total of 132 patients with GDM in the Fourth Central Hospital of Baoding City were selected and they were randomly grouped according to the principles of stratified random design and controlled design trials, with 66 cases in each group. The control group was treated with insulin, and the observation group was treated with mecobalamin combined with insulin. The curative effect, fasting blood glucose (FBG) and 2 h postprandial blood glucose (2 h PBG), TLR4, MyD88, tumor necrosis factor-α (TNF-α), white blood cells interleukin 1β (IL-1β) before and after treatment and infant outcomes were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 95.45%(63/66) vs. 84.85%(56/66), and the difference was statistically significant ( χ2 = 4.181, P<0.05). After 1, 2, 3 weeks of treatment, the levels of FBG and 2 h PBG in the observation group were lower than those in the control group: after 1week of treatment, the differences were statistically significant ( P<0.05). After 1, 2, 3 weeks of treatment, the levels of serum TLR4, MyD88, TNF-α, IL-1β in the observation group were lower than those in the control group: after 1 week of treatment, the differences were statistically significant ( P<0.05). The incidence of cesarean section, polyhydramnios, macrosomia and premature birth in the observation group were lower than those in the control group: 7.58%(5/66) vs. 21.21%(14/66), 4.55%(3/66) vs. 16.67%(11/66), 1.52%(1/66) vs. 13.64%(9/66), 3.03%(2/66) vs. 7.58%(5/66), the differences were statistically significant ( P<0.05). Conclusions:Mecobalamin combined with insulin can regulate the TLR4/MyD88 signaling pathway, which can help to control blood sugar and improve the maternal and infant outcomes.
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Objective:To analyze the correlation between serum ferritin (SF), perilipin, leptin and the outcome of patients with gestational diabetes mellitus (GDM).Methods:From October 2017 to December 2019, 126 patients with GDM who underwent maternity checkups in Baoding Fourth Central Hospital and gave birth were selected as the GDM group, and 82 normal pregnant women during the same period were selected as the control group for retrospective analysis. The levels of serum SF, perilipin, and leptin in the GDM group and the control group were measured and compared, and the expressions of serum indexes of patients with different blood glucose control and different pregnancy outcomes in the GDM group were measured. Pearson correlation analysis was used to explore the correlation between the expression of serum indexes in GDM patients and fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h PG), and insulin resistance index (HOMA-IR). Logistic regression was used to analyze the relationship between the expression of serum indicators and adverse pregnancy outcomes in GDM patients. The receiver operating characteristic (ROC) curve was used to observe the value of single serum indexes and to predict the pregnancy outcome of GDM patients.Results:The levels of SF, perilipin and leptin in GDM group were higher than those in control group: (152.48 ± 37.64) μg/L vs. (109.27 ± 32.16) μg/L, (857.06 ± 192.35) ng/L vs. (262.83 ± 104.7) ng/L, (23.54 ± 2.28) μg/L vs.(14.62 ± 1.83) μg/L, the differences were statistically significant ( P<0.05). The levels of SF, perilipin and leptin in patients with good blood glucose control in GDM group were lower than those in patients with poor blood glucose control: (132.10 ± 36.52) μg/L vs. (176.37 ± 40.06) μg/L, (176.37 ± 40.06) ng/L vs. (946.42 ± 205.37) ng/L, (21.49 ± 2.16) μg/L vs. (25.94 ± 2.40) μg/L, the differences were statistically significant ( P<0.05). The levels of serum SF, perilipin and leptin in GDM patients were positively correlated with FPG, 2 h PG and HOMA-IR levels ( P<0.05). The levels of serum SF, perilipin and leptin in GDM patients with adverse pregnancy outcomes were higher than those in patients without occurrence: (182.86 ± 42.29) μg/L vs. (138.86 ± 35.47) μg/L, (1 013.35 ± 216.07) ng/L vs. (787.00 ± 183.49) ng/L, (27.04 ± 2.5) μg/L vs. (21.97 ± 2.07) μg/L, the differences were statistically significant ( P<0.05). Logistic regression analysis showed that serum SF, perilipin and leptin were closely related to the adverse pregnancy outcomes in GDM patients ( P<0.05). ROC curve analysis showed that the sensitivity and the specificity of SF, perilipin, leptin combined detection to predict GDM patients with adverse pregnancy outcomes was 76.92% and 83.91%. Conclusions:The serum SF, perilipin and leptin are abnormally high expression in GDM patients, and it is positively correlated with blood glucose level and HOMA-IR. Joint detection can improve the predictive value of adverse pregnancy outcomes and provide a basis for early intervention.
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Objective:To establish an HPLC fingerprint and determine five compounds in Zhengtian pills to provide reference for the effective quality control.Methods:The analysis was carried out on an Agilent XDB-C18analytical column (250 mm × 4.6 mm,5 μm) with gradient elution by acetonitrile (A) -0.19% phosphoric acid solution (B) (0-8 min,10 % A→15% A;10-23 min,15 % A→45 % A;23-50 min,45 % A;50-60 min,45 % A→70 % A;60-70 min,70 % A),the detection wavelength was 310 nm and the flow rate was 1.0 ml/min. The column temperature was 30 ℃. Similarity evaluation was used to evaluate the fingerprints of 12 batches of Zhengtian pills,and five marker components were quantified. Results:There were 33 common peaks in the fingerprints of twelve batches of Zhengtian pills, and five of them (ferulic acid, prim-O-glucosylcimifugin, 5-O-methylvisammioside,imperatorin and isoimperatorin) were identified by comparison with the reference. The similarity of the 12 batches of samples was over 0.99. The linear ranges were 0.050-0.605 μg(r = 0.999 8),0.008-0.100 μg(r = 0.999 2), 0.013-0.150 μg(r = 0.998 6), 0.171- 2.049 μg(r = 0.999 7)and 0.113- 1.352 μg(r = 0.999 6) for ferulic acid, prim-O-glucosylcimifugin,5-O-methylvisammioside, imperatorin and isoimperatorin, respectively. The content of ferulic acid, prim-O-glucosylcimifugin,5-O-methylvisammioside,imperatorin and isoimperatorin was 0.78-0.84 mg/g,0.10-0.13 mg·g-1, 0.18-0.20 mg·g-1,2.44-2.51 mg·g-1and 1.70-1.78 mg·g-1in the 12 batches of samples, respectively. Conclusion:The established method has high sensitivity and specificity,which can be used for the quality control of Zhengtian pills.
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OBJECTIVE:To provide reference for the clinical pharmacists to determine their work orientation,and improve their work mode and pharmaceutical care level. METHODS:The questionnaire survey was conducted among doctors,nurses, patients and pharmacists from 65 third grade class A hospitals of 18 provinces(regions,cities)in China. The collected data were analyzed statistically and suggestions were presented. RESULTS:Totally 3 840 questionnaires were sent out,3 045 were effectively received with a recovery of 79.30%[involving 56 third grade class A hospitals of 17 provinces(regions,cities)]. Of 3 045 valid questionnaires,1 001 questionnaires were filled out by the doctors and nurses,1 013 questionnaires were filled by the pharmacists and 1 031 questionnaires were filled out by the patients. 88.45% of the survey doctors and nurses thought that clinical pharmacists were needed in their wards. The major clinical pharmaceutical care they needed were the participation of clinical pharmacists in the clinical ward round,patients management,difficult case discussions,consultation(77.32%),etc. 64.54% of the survey doctors and nurses thought that clinical pharmacists could participate the clinical work and solve some simple medicine-related problems, and 27.17% of the survey doctors and nurses thought that clinical pharmacists could resolve clinical medicine-related problems. 14.59% of the survey doctors and nurses believed that clinical pharmacists lacked clinical thinking and could not communicate with medical staff. The most common problems the survey medical staff met were as follows:ADR (78.02%),usage and dosage(72.83%),contraindications(72.63%),drug indication(63.14%)and solvent selection (61.74%),etc. As regards the ratio of working time which clinical pharmacists spent on their clinical work,over 50%(35.55%)and 30%(23.46%)were most chosen by the survey pharmacists,while 13.19% of the survey pharmacists thought clinical pharmacists almost did not participate in clinical work. The survey pharmacists thought that there were some deficiencies in the knowledge structure of clinical pharmacists, such as clinical medical science and therapeutics(92.50%), communication skills(47.19%),professional knowledge of pharmacy(46.10%),etc. 87.90% of the survey patients were willing to accept the medication guidance provided by clinical pharmacists. The services they required were as follows:medication guidance(79.92%),observation and discovery of medication problem(71.00%),etc. CONCLUSIONS:Medical staff and patients have demands in many ways associated with clinical work and rational drug use provided by clinical pharmacists,while the clinical pharmacists have yet not reached the demands of medical staff and patients in regard to their evaluation. It is suggested that the clinical pharmacists should ascertain their work orientation,improve their work mode,participate the clinical work in full-time, complete their knowledge structure and ascent their pharmaceutical service level.
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OBJECTIVE:To provide reference for rational use of antineoplastic agents. METHODS:The utilization of antineo-plastic agents in 34 hospitals from Chongqing area during 2011-2013 was analyzed retrospectively in terms of consumption sum, DDDs and DDC,etc. RESULTS:The consumption sum of antineoplastic agents increased by 23.74%in 2012 compared with 2011, and increased by 36.89% in 2013 compared with 2012. DDDs of antineoplastic agents increased year by year except that of botanic antineoplastic agents decreased slightly in 3 years. The DDDs of Chinese patent medicines remained at the first place over the three years;the consumption sum of it took up the first place over the three years too. CONCLUSIONS:The consumption of antineoplas-tic agents in Chongqing is in line with the general tendency of drug consumption in China. Chinese patent medicines which have lit-tle side effect and low price occupy an important place among all antineoplastic agents in Chongqing area.
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OBJECTIVE:To evaluate the status quo and tendency of the clinical utilization of antihypertensive drugs in Chongqing.METHODS:The utilization of antihypertensive drugs in Chongqing from 2005 to 2007 was analyzed statistically in respect of consumption sum,DDDs and DDC(daily drug cost),etc.RESULTS:The consumption sum of antihypertensive drugs in Chongqing during the period 2005～2007 increased year by year.The consumption sum of calcium antagonists accounted for 43.08% and that of angiotensin Ⅱreceptor antagonists accounted for 23.86%.Nifedipine occupied the first place on both DDDs list and consumption sum list.CONCLUSION:The utilization of antihypertensive drugs in Chongqing is basically in line with the general medication situation either at home or abroad and it also conforms to the current medication principle of antihypertensive drugs.
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OBJECTIVE: To analyze the status quo and developing trend of the use of antihyperlipidemics drugs in Chongqing so as to provide information for the research,production,marketing and clinical application of these drugs.METHODS: The consumption sum,DDDs and the defined daily cost(DDC) of Antihyperlipidemics in 18 hospitals in Chongqing city from 2004 to 2006 were analyzed statistically.RESULTS: Both the DDDs and the consumption sum of the antihyperlipidemics showed uptrend over the 3 years,with statins dominating the first place over the 3 consecutive years,making up 48.37%,47.74%,and 61.79% respectively,followed by Chinese patent medicines and fibrates.Xuezhikang and simvastatin ranked among the first two places in terms of DDDs.CONCLUSION: Statins and Chinese patent medicines occupied a predominant role among all the antihyperlipidemic drugs in Chongqing,and their use had a bright prospect.
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OBJECTIVE:To evaluate the present situation and tendency of antihypertensive drug use in the southwestern districts of China.METHODS:The sales volume,drug types,DDDs,DDDc of antihypertensive drugs from 2002 to 2004 in 62 hospitals in the southwestern districts of China were statistically analyzed.RESULTS:The sales volume of antihypertensive drugs counted 18%to 20%of total sales volume of cardiovascular drugs,with the mean annual increasing rate of 20%.The sales volumes of amlodipine and enalapril ranked the first,and the second in 2004.Among the 10 manufacturers,the sales volume of antihypertensive drugs produced by multinational companies reached 81.9%of total sales volume.CONCLUSION:The sale volumes of antihypertensive drugs and cardiovascular drugs have gone on increasing sharply,calcium antagonists and angiotensin-converting enzyme inhibitor drugs dominate in the antihypertensive drug market in the southwestern district.
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OBJECTIVE:To review the situation of antihypertensives used in hospitals of Chongqing City METHODS:The sum of money,DDDs and daily cost of antihypertensives consumed during the past three years were analysed RESULTS:Consumption sum of antihypertensives in the period 1999～2001 was increasing year by year During this period,the costs of calcium antagonists and ACEI accounted for 44 59% and 33 55% of the consumption sum,respectively,while the domestic drugs showed an increasing tendency,the drugs produced by joint ventures and the imported drugs decreased steadily Among this kind of drugs,Nifedipine and Captopril were much more frequently used than others,and Felodipine occupied the first place in the cost list CONCLUSION:It is necessary to develop the long-effect antihypertensives that fulfill the domestic need
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OBJECTIVE:To survey and evaluate the present situation and trends of antidiabetic agents used in hospitals of southwest China so as to provide information for the production,sale and consumption units.METHODS:To investigate the antidiabetic agents used in60hospitals of southwest China during the period2000～2002in respect to the sum of money of consumption,Kinds of drugs,DDDs and DDC.RESULTS:In recent3years,the annual increasing rates of consumption of oral antidiabetic agents and insulin injection were14.12%and42.09%,the proportions of costs for the oral antidiabetic agents and insulin injections in total consumption of antidiabetic agents were67.20%and32.78%respectively.CONCLUSION:The use of insulin is increasing quickly and the new dosage has developmental future.The Metformin and Glipizide are the important oral antidiabetic agents.