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Vaccination has been proved to be the most effective strategy to prevent the Corona Virus Disease 2019 (COVID-19). The mRNA vaccine based on nano drug delivery system (NDDS) - lipid nanoparticles (LNP) has been widely used because of its high effectiveness and safety. Although there have been reports of severe allergic reactions caused by mRNA-LNP vaccines, the mechanism and components of anaphylaxis have not been completely clarified yet. This review focuses on two mRNA-LNP vaccines, BNT162b2 and mRNA-1273. After summarizing the structural characteristics, potential allergens, possible allergic reaction mechanism, and pharmacokinetics of mRNA and LNP in vivo, this article then reviews the evaluation methods for patients with allergic history, as well as the regulations of different countries and regions on people who should not be vaccinated, in order to promote more safe injection of vaccines. LNP has become a recognized highly customizable nucleic acid delivery vector, which not only shows its value in mRNA vaccines, but also has great potential in treating rare diseases, cancers and other broad fields in the future. At the moment when mRNA-LNP vaccines open a new era of nano medicine, it is expected to provide some inspiration for safety research in the process of research, development and evaluation of more nano delivery drugs, and promote more nano drugs successfully to market.
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AIM:To evaluate the correlation between axial lengths and anterior segment parameters using swept-source optical coherence tomography(SS-OCT).METHODS:For the cross-sectional clinical study, a total of 109 adult volunteers with different degrees of myopia recruited from January 1, 2022, to March 31, 2022, at the ophthalmology clinic of the First Affiliated Hospital of Zhengzhou University were included. Participants were divided into 4 groups based on axial length(AL): group A(AL≤24.0mm), group B(24.0mm<AL≤25.0mm), group C(25.0mm<AL≤26.0mm)and group D(AL>26.0mm). Anterior segment examinations were performed using SS-OCT, including: central corneal thickness(CCT), lens thickness(LT), anterior chamber depth(ACD), anterior chamber width(ACW), angle opening distance(AOD500), angle recess area(ARA500), trabecular iris space area(TISA500), trabecular iris angle(TIA500), crystalline lens rise(CLR). The relationships between these data and AL, spherical equivalent(SE)were analyzed.RESULTS:There was no difference in the comparison of CCT among the four groups(P>0.05). There were differences in SE, LT, ACD, ACW, AOD500, ARA500, TISA500, TIA500 and CLR among the four groups(all P<0.01). SE and LT were negatively correlated with AL(r=-0.75, -0.41, all P<0.01); ACD, ACW and CLR were positively correlated with AL(r=0.58, 0.45, 0.54, all P<0.01); AOD500, ARA500, TISA500 and TIA500(temporal and nasal side)were positively correlated with AL(all P<0.01). ACD and CLR were negatively correlated with SE(r=-0.21,-0.25, all P<0.01), and LT was positively correlated with SE(r=0.21, P<0.05).CONCLUSION:As AL increases, CCT remains unchanged while the ACD and ACW increase. The position of the crystalline lens moves backward and LT decreases.
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Oral anticoagulants play an important role in the prevention and treatment of thromboembolic diseases.Warfarin,a traditional oral anticoagulant,is limited in clinical use due to its limitations such as narrow therapeutic window and requirements on frequent monitoring and dose adjustment.Direct oral anticoagulants(DOACs)such as dabigatran,rivaroxaban,apixaban,and edoxaban are increasingly used to prevent and treat venous thrombosis or thrombus formation.However,recent studies have documented inter-individual variability in plasma drug levels of DOACs.This article summarizes the recent advances in the pharmacogenomics of DOACs.
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Administration, Oral , Anticoagulants , Therapeutic Uses , Atrial Fibrillation , Drug Therapy , Dabigatran , Pharmacogenetics , RivaroxabanABSTRACT
OBJECTIVE: To analyse current situation of clinical drug use in diabetic retinopathy and provide reference for clinical rational drug use. METHODS: Two-stage sampling method was adopted which combines stratified sampling and holistic sampling, and conducted statistical analysis was conducted of with the clinical medication related data of diabetic retinopathy in 2018, which including 135 hospitals in 9 cities in “the cooperation project of hospital prescription analysis”. RESULTS: Seventeen Drugs for diabetic retinopathy were used in 135 hospitals in 2018, endocrinology contributed the most, and followed by ophthalmology, and outpatients accounted for 73.2%. The top 3 most frequently used drugs for diabetic retinopathy are calcium dobesilate, mecobalamin and pancreatic kininogenase, which accounted for 81.8% of the total 17 drugs prescription volume. It is lack of evidence for most drugs except for calcium dobesilate, and off-label use of DR drugs is common. CONCLUSION: The standardization of clinical medication for diabetic retinopathy needs to be further improved.
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OBJECTIVE: To evaluate the effects of clinical pharmacy services in patients with warfarin and highlight the important role of clinical pharmacists. METHODS: Patients in need of warfarin were enrolled as intervention group during 2016.9-2017.9 to receive standard anticoagulation management and follow-up provided by clinical pharmacists, and clinical data of patients who meet the inclusion criteria during 2013.7-2015.7 as control group was analyzed retrospectively. International normalized ratio(INR) values, maintenance doses, time to achieve therapeutic range, and etc. were recorded and TTRs (time in therapeutic range) were calculated to compare the outcomes of each group. RESULTS: TTRs in intervention group were significantly higher than those in control group, and so was the percentage of patients with the best quality of warfarin therapy(47.89% vs. 20.09%,P<0.001).Time to achieve therapeutic range was shorter and the frequency of INR test was higher in intervention group compared with those in control group. Patients′ cognitive scores of warfarin therapy were substantially increased after pharmacist′s education. CONCLUSION: Anticoagulation therapy management provided by clinical pharmacists could significantly improve the quality of warfarin therapy.
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OBJECTIVE: To evaluate the effectiveness and safety of metaraminol in maintaining hemodynamics during anaesthesia. METHODS: Cochrane library, Pubmed, Embase, CBM, CNKI, VIP and Wanfang Database were searched. Randomized controlled trials (RCT) of metaraminol vs placebo or ephedrine in maintaining hemodynamics during anaesthesia were selected, and quality evaluation and Meta analysis were performed. RESULTS Ten RCTs were selected. The efficacy of metaraminol in maintaining hemodynamics during anaesthesia was better than placebo, it showed significant differences between the two groups in the incidence of hypotension [RR 0.23, 95%CI(0.12, 0.41), P < 0.01] and in the reduction of SAP [MD-10.22, 95% CI(-12.55, -7.89), P < 0.01], but no significant difference in the change of heart rate [MD 3.35, 95% CI (-11.88, 18.58), P=0.67]. There were no significant difference between metaraminol and ephedrine in the incidence of hypotension [RR 0.79, 95%CI(0.45, 1.39), P=0.42], the reduction of SAP [MD 1.47, 95%CI(-0.39, 3.34), P=0.12] and the change of heart rate [MD-12.11, 95% CI(-34.56, 10.34), P=0.29]. CONCLUSION The effect of metaraminol on maintaining hemodynamics during anaesthesia is equivalent to that of ephedrine; meanwhile metaraminol has fewer adverse effects than ephedrine.