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Imipenem-cilastatin is a broad-spectrum carbapenem antibiotic drug that has been widely used in clinical practice ， but there is a lack of guidelines and expert consensus on the development of individualized regimens for special status populations [e.g. continuous renal replacement therapy （CRRT）patients，extracorporeal membrane oxygenation （ECMO）patients， critically ill burn patients ，neonates and children]. In this paper ，by searching population pharmacokinetics research of imipenem- cilastatin in special status populations ，it is recommended that imipenem-cilastatin is given 1 to 3 g/d for CRRT patients ；500 mg to 1 g，q6 h for burn patients ；750 mg to 1 g，q6 h for ECMO patients ；20 mg/kg or 25 mg/kg，q8 h for neonates ；and 25 mg/kg，q6 h for children.
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OBJECTIVE：To study the hepatotoxicity of main components of Polygonum multiflorum ，and investigate its toxic mechanism based on metabolic enzymes. METHODS ：ADMETlab 2.0 platform was used to forecast the toxic or carcinogenic effects of emodin ，physcion，rhein，stilbene glycoside and gallic acid on liver ，skin and heart. The effects of those components on cytochrome P 450 enzyme system （CYP1A2，CYP2C9，CYP2C19，CYP2D6，CYP3A4）were evaluated. The effects of different concentrations of emodin ，rhein，stilbene glycoside and gallic acid （10，20，40，80 μmol/L）on the survival rate of normal hepatocyte L 02 were detected. The effects of major components of P. multiflorum on the activity of UGT 1A1 enzyme were studied by in vitro reaction system ，using bilirubin as substrate. RESULTS ：Main components of P. multiflorum ，ie. emodin ，physcion， rhein and gallic acid ，showed strong toxic effects on the liver ，while stilbene glycosides possessed weak toxic effects on the liver. Emodin and physcion had strong inhibitory effects on CYP 1A2 and medium inhibitory effects on CYP 2C9，CYP2D6 and CYP3A4；rhein showed medium inhibitory effects on CYP 1A2 and CYP 2C9，while stilbene glycoside and gallic acid possessed weak inhibitory effects on the above enzymes. Emodin （40，80 μmol/L）and gallic acid （40，80 μmol/L）could significantly reduce the survival rate of L 02 cells（P＜0.01）. The inhibition rate of 5，10，20，40，80 μmol/L emodin and gallic acid（except for 5 μmol/L emodin）on UGT 1A1 enzyme increased significantly （P＜0.01），and the inhibition effect of emodin on UGT 1A1 enzyme was reversible competitive inhibition. CONCLUSIONS ：The main components of P. multiflorum ，ie. emodin ，rhein and physcion ， are hepatotoxic ；the mechanism of it may be associated with inhibiting the activity of CYP 1A2 and CYP 2C9 and competitively blocking rate-limiting enzyme UGT 1A1 in the process of bilirubin metabolism.
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OBJECTIVE：To syste matically evaluate the effects of non-selective β-blockers（NSBB）on mortality of patients with cirrhosis and ascites ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from PubMed ，the Cochrane Library ，Embase，Web of Science ，CNKI and Wanfang database ，randomized controlled trials （RCTs）and cohort studies about the effects of NSBB on mortality of patients with cirrhosis and ascites were collected from the date of database establishment to Sept. 30th，2019. The patients in the trial group were treated with NSBB ，the patients in the control group were treated with blank control or isosorbidemononitrate ，variceal ligation or other measures to prevent variceal bleeding. After literature screening and data extraction ，the quality of RCTs and cohort studies were evaluated by using bias risk evaluation tool recommended by Cochrane system evaluator manual 5.1.0 and Newcastle-Ottawa scale . Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：Totally 18 studies were included ，involving 8 649 patients，4 RCTs and 14 cohort studies. Results of Meta-analysis showed that ，there was no significant difference in all-cause mortality between the patients using NSBB of trial group [RR ＝0.85，95％ CI（0.65，1.11），P＝0.22]，severe ascites [RR ＝0.58，95％ CI（0.15，2.22），P＝0.42] or refractory ascites [RR ＝0.85，95％CI（0.61，1.20），P＝0.36] and the control group. Subgroup analysis showed that ，there was no significant difference in all-cause mortality between the patients using NSBB of trial group and control group according to the research method （RCT vs. cohort study ）and the type of drug use （P＞0.05）. CONCLUSIONS ：The use of NSBB does not increase the incidence of all-cause mortality in cirrhosis patients with ascites ，or even in those with severe ascites or refractory ascites.
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OBJECTIVE:To probe into the characteristics and the general pattern of adverse drug reactions(ADRs)induced by ritodrine and relevant factors. METHODS:26 literatures according with ADR diagnosis standard were retrieved from CNKI from 1999 to 2009. A total of 337 ADR cases induced by ritodrine were analyzed statistically. RESULTS:The incidence of ritodorine-inducing ADRs was 29.96%(337/1 125). Several clinical manifestations appeared simultaneously. ADR of cardiovascular system accounted for 76.55%(n=284). 5.93% of patients with ADR stop taking medicine because of poor drug tolerance. CONCLUSION: Great importance should be attached to ADR monitoring,adjustment of administration route to guarantee the safety of drug use.
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OBJECTIVE: To establish an RP-HPLC method for the determination of aminophylline,eyhedrine and guaifenesin in Xiaoer kechuan oral solution.METHODS: The determination was performed on Hypersil ODS column(150 mm?4.6 mm,5 ?m).The mobile phase consisted of acetonitrile-0.015 mol?L-1 KH2PO4(0.1% triethylamine and pH value of phosphoric acid adjusted to 2.7)(10 ∶ 90) with a flow rate of 1.6 mL?min-1 and detection wavelength of 254 nm and 209 nm.RESULTS: The linear ranges were 356.4～712.8 ?g?mL-1 for aminophylline,88～176 ?g?mL-1 for eyhedrine and 106～212 ?g?mL-1 for guaifenesin(r=0.999 9).The average recovery rates were 101.0%(RSD=0.73%,n=9),99.7%(RSD=1.00%,n=9),98.3%(RSD=0.44%,n=9),respectively.CONCLUSIONS:The method is simple and accurate for quality control of Xiaoer kechuan oral solution.