Allergic reactions of COVID-19 vaccine based on mRNA-LNP and its pharmacokinetics in vivo / 药学学报

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.

Progress in the Treatment of Antisense Oligonucleotides in Duchenne Muscular Dystrophy / 罕见病研究

In recent years, antisense oligonucleotide (ASO) has been very active in the field of rare disease research and development, especially in Duchenne muscular dystrophy, where it made a major breakthrough. Duchenne muscular dystrophy (DMD) is a rare childhood myopathy caused by mutations in the dystrophin gene. Currently, the four ASO drugs approved internationally for DMD are all targeted at dystrophin, including eteplirsen, golodirsen, viltolarsen and casimersen. They all belong to phosphorodiamidate morpholino oligomers (PMO) antisense oligonucleotide drugs, so that their pharmacokinetic characteristics are similar. The drugs quickly spread to other tissues after intravenous administration. Because of the electrical neutrality of the PMO, they have a low binding rate to plasma proteins and are quickly metabolized by the kidney and excreted in the urine as archetypes. In addition, the likelihood of drug-drug interactions of ASO is low. Existing clinical studies have shown that they have certain clinical benefits and good tolerability, bringing new options for DMD treatment. This paper mainly discusses the pharmacological effects, pharmacokinetic characteristics, efficacy, and safety of ASO drugs for the treatment of DMD, hoping to provide scientific reference for the rational and safe clinical use of such drugs.

Semimonthly Table of Contents Nationwide investigation and problems analysis of pharmaceutical preparations in medical institutions / 中国药房

@#OBJECTIVE To investigate the situation of pharmaceutical pr eparations in medical institutions （hereinafter refer to hospital preparations ），and to promote the sustained and healthy development of hospital preparations. METHODS Under the organization of National Pharmacy Administration & Quality Control Center ，internet survey was adopted to statistically analyze the data of hospital preparations in 2019 that was completed and reported by the secondary general hospitals and above in provinces （cities，districts）and Xinjiang Production and Construction Corps. RESULTS Among the 4 639 hospitals，9.36％ had drug approval numbers and 8.15％ had preparation laboratories. The average ratio of the number of hospital preparations in production to the number of preparations approved was 0.72，and that of 41.52％ hospital was concentrated in 1-0.9. Self-produced by hospital was the main production mode of hospital preparations ；the higher hospital level was ，the higher the proportion of self-production combined with commissioned processing ，while the lower the proportion of commissioned processing only. In hospitals with preparation approval numbers ，the proportion of owning TCM preparations was the highest （73.66％），followed by common chemical preparations （69.93％）. From perspective of annual output value of hospital preparations ，tertiary hospitals were higher than secondary hospitals ，and private hospitals were higher than public hospitals ；it was related to the production mode ，varieties of hospital preparations and the establishment of the preparation laboratories. There was a trend that the development of hospital preparations in C entral China ，North China and South China was better than that in the Northeast China ，Northwest China and Southwest China. CONCLUSIONS At present ，hospital preparations in China are mainly made in medical institutions ， com and the types are relatively limited. The regional developmentis unbalanced and the scale of hospital preparations is reduced.It is suggested that medical institutions should pay attention to the innovation of hospital preparations ，especially to deve lopment of characteristic preparations with definite curative effect ，so as to give full play to their role of “shortage make-up ”. Great importance also should be paid to the policy support of dispensing and the establishment of regional dispensing centers.

Attitude and medical insurance coverage for off-label use in various countries / 中华医院管理杂志

Off-label drug use is a global problem in clinical practice. The management status, attitude and medical insurance coverage of off-label drug use are different in various countries. By analyzing the management and reimbursement policy of off-label drug use in other countries, the authors suggested that China should speed up the institutional arrangements of off-label drug use and establish relevant management systems, and strengthen the supervision of off-label drug use, so as to guarantee the rights of patients to the best treatment.

Clinical features of Kasabach-Merritt syndrome: an analysis of 16 neonates / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features, treatment, and prognosis of neonates with Kasabach-Merritt syndrome (KMS), and to provide a reference for optimizing the diagnosis and treatment of this disease.@*METHODS@#A retrospective analysis was performed for the clinical and follow-up data of 16 neonates with KMS who were admitted to the Anhui Children's Hospital, Anhui Medical University, from January 2016 to December 2020.@*RESULTS@#Of the 16 neonates, there were 13 boys (81%) and 3 girls (19%), with an age of 1 hour to 10 days on admission. Among these neonates, 13 (81%) had cutaneous hemangioma (2 in the head and face, 5 in the trunk, and 6 in the extremities) and 3 (19%) had liver hemangioma. The main clinical manifestations of bleeding tendency and scattered petechiae and ecchymosis were observed in 10 neonates (62%). All the 16 neonates had varying degrees of thrombocytopenia and coagulation disorders. They all received glucocorticoid treatment after admission and 7 (44%) of them had response, among whom 4 experienced recurrence. Among the neonates with no response to glucocorticoid treatment, 3 received sirolimus treatment, among whom 1 had the tumor volume reduced by 58.8% after 4 weeks of treatment, with platelet count and coagulation function returning to normal, while 2 had no significant reduction in tumor volume or significant increase in platelet count and achieved a tumor volume reduced by (43.7±0.4)% after 4 weeks of combined treatment with bleomycin arterial embolization, with platelet count and coagulation function returning to normal. After 4 weeks of bleomycin arterial embolization alone for 4 neonates, tumor volume was reduced by (52.0±3.4)%, and platelet count and coagulation function returned to normal. Blunt and sharp dissection was performed for 2 neonates. The tumor was removed completely during surgery in the 2 neonates, with no infection or recurrence after surgery, and platelet count and coagulation function returned to normal. The postoperative pathological examination showed Kaposiform hemangioendothelioma in 1 out of the 2 neonates.@*CONCLUSIONS@#KMS has characteristic clinical manifestations, histopathological features, and laboratory examination results. The KMS neonates who are not sensitive to glucocorticoids can achieve a good curative effect through arterial embolization and sirolimus treatment.

Status and Rationality of Opioid Use in Lung Cancer Patients: A Single Center Retrospective Study / 中国肺癌杂志

BACKGROUND@#Cancer pain affect the physical activity, psychological state and quality of life seriously, and even shortened the survival time of patients. Rational and standard application of opioids could control cancer pain effectively. Since the high incidence of cancer pain in lung cancer patients, the status of opioids application should be analyzed to evaluate the rationality of analgesic application in lung cancer patients.@*METHODS@#The clinical data of 305 patients with lung cancer who were hospitalized in Department of Respiratory and Critical Care Medicine of Peking Union Medical College Hospital from June 2018 to June 2019 were analyzed retrospectively.@*RESULTS@#In the analysis of factors affecting the use of opioids in lung cancer patients, age and drug kinds were the main influencing factors. The proportion of male patients was higher than female. Moreover, male patients used more kinds of opioids and were mostly between 60 and 69 years old. The variety and structure of opioids used in lung cancer patients in our hospital met the requirements. Oxycodone hydrochloride prolonged-release tablet has the highest frequency of application, and defined daily cost (DDC) ranked the first with a serial number ratio of 1, which showed good synchronization. The quantity of morphine tablet and morphine injection were low, and the overall breakthrough cancer pain (BTcP) in lung cancer patients was well controlled. The overall application of opioids were reasonable (93.4%), and the unreasonable items mainly included the disposal of BTcP and the unreasonable frequency of opioids, as well as overdose.@*CONCLUSIONS@#The majority of patients with lung cancer who take opioids are male, and the cancer pain in elderly men are more difficult to control, which needs to pay more attention. The overall application of opioids in the patients with lung cancer pain in our hospital are reasonable, but there are still some problems to focus, such as the disposal of BTcP, the dosage of opioids and the medication of special groups.

Comparative Study on the Collection of Nervous System Medicines in Essential Medicine List of WHO and China / 中国药房

OBJECTIVE：To o ptimize the t ype of nervous system medicines in National Essential Medicine List of China. METHODS：Various editions of WHO Essential Medicine Model List （WHO EML ）were consulted ，the collection of nervous system medicines was analyzed statistically ，and 2017 edition of WHO EML was compared with 2018 edition of National Essential Medicine List of China （NEML）. RESULTS ：During 1977-2017，the total number of nervous system medicines and disease coverage included in each edition of WHO EML had little change. Compared with 2017 edition of WHO EML ，2018 edition of NEML contained more medicines for nervous system disease （54 medicines vs. 30 medicines），and covered more disease types ， such as dementia （huperzine A ）and neuralgia （pregabalin），etc. However ，for the treatment of multiple sclerosis ，neuralgia， dementia and other diseases ，there were not many medicines to choose ，and some similar medicines （with the same or similar mechanism of action ）were collected repeatedly and some medicines had serious adverse reaction. CONCLUSIONS ：It is suggested that National Essential Medicine List should be continuously optimized and perfected ，the varieties of essential medicines for the treatment of nervous system diseases should be increased appropriately ，for improving the treatment effect of such diseases and reducing the cost burden of patients.

Analysis of the correlation between estrogen level and retinopathy in postmenopausal patients with type 2 diabetes / 中国综合临床

Objective To investigate the correlation between postmenopausal estrogen levels and diabetic retinopathy in patients with type 2 diabetes.Methods Two hundred cases of postmenopausal type 2 diabetes admitted to the Eighth Affiliated Hospital,Sun Yat-sen University from January 2015 to January 2017 were selected as the subjects and divided into the retinopathy group (93 cases) and the normal retina group (107 cases) according to the resuhs of fundus angiography.The general data of the two groups were compared,and the blood glucose index,blood lipid index and estrogen level were measured and compared.Logistic regression analysis was used to analyze the related factors of the patients with retinopathy.Results (1) The disease duration of patients in the retinopathy group was longer than that in the normal retina group ((14.67 ±3.48) years vs.(10.20±2.85) years;t=9.983,P＜0.05).The fasting blood glucose (FBG),glycosylated hemoglobin of patients in the retinopathy group were higher than those in the normal retina group (FBG:(8.01 ± 1.21) mmol/L vs.(6.93 ± 1.20) mmol/L,FBG:(8.32 ± 1.56) mmol/L vs.(7.39 ± 1.43) mmol/L;t =6.324,4.397,P＜0.05).The total cholesterol (TC),triglyceride (TG) and low density lipoprotein (LDL-C) of patients in the retinopathy group were higher than those in the normal retina group [TC:(4.93±0.87) mmol/ Lvs.(4.23± 0.69) mmol/L,TG:(1.91 ± 0.42) mmol/L vs.(1.63 ± 0.32) mmol/L,LDL-C:(2.61 ± 0.90) mmol/L vs.(1.78±0.53) mmol/L;t =6.340,5.340,8.067,P＜0.05],while high density lipoprotein (HDL-C) was lower than that in the normal retina group ((1.23±0.37) mmol/L vs.(1.76±0.45) mmol/L;t =9.014,P ＜0.05).The E2 level in the retinopathy group was lower than that in the normal retina group ((23.91 + 8.51) ng/L vs.(32.18 + 9.80) ng/L;t=6.325,P＜0.05).Logistic regression analysis showed that the duration of diabetes,FBG,HbAlc,TC,TG and LDL-C were risk factors of retinopathy (OR (95％ CI) =1.049 (1.011 ～ 1.056),1.071(1.061 ～ 1.093),1.092(0.984～ 1.275),1.099(1.661 ～ 1.993),1.863(1.661 ～ 1.993),1.652 (1.461 ～ 1.893),P＜ 0.05),while HDL-C and E2 were protective factors of retinopathy (OR (95 ％ CI) =0.172(0.061 ～ 0.293),0.955 (0.861 ～ 1.093),P＜0.0S).Conclusion Estrogen level is related to retinopathy in postmenopausal diabetic patients.It may be a protective factor for diabetic retinopathy.

Effects of Salidroside on Keap1-Nrf2 Signal Pathway in Acetaminophen-induced Liver Injury Model Mice / 中国药房

OBJECTIVE:To investigate the protection role and mechanisms of salidroside (SALD) on acetaminophen (APAP)-induced liver injury model mice. METHODS:60 mice were randomly divided into normal group(normal saline),model group (normal saline),positive group (acetylcysteine,150 mg/kg),SALD low-dose,medium-dose and high-dose groups (100, 200,300 mg/kg),with 10 mice in each group. Except for normal group,other groups were given APAP 500 mg/kg intragastrically to induce liver injury model. 1 h before modeling,mice were given relevant medicine intrgastrically for consecutive 5 d. After medication,the serum contents of ALT,AST,ALP and LDH were determined,and the pathohistological changes of the liver tissue were observed by HE staining. The protein expressions of Keap1 (in tranuclear), Nrf2 (in tranuclear), HO-1 (in tracytoplasm),NQO1 (in tracytoplasm) and GCLC (in tracytoplasm) in liver tissue were determined by Western blot assay. RESULTS:Compared with normal group, serum contents of ALT, AST, ALP and LDH in model group were increased significantly(P<0.01). The liver lobuli hepatis disorder and difficult to recognize,liver cell eosinophilic necrosis and other lesions were found in liver tissue. The protein expressions of Nrf2,Keap1,HO-1 and GCLC in liver tissue were decreased significantly (P<0.05). Compared with model group,above indexes of all groups were improved significantly (P<0.05 or P<0.01),except that the decrease of LDH content in serum of mice in SALD low-dose group and the expression improvement of Nrf2 and Keap1 in liver tissue were not significant in positive group. The expression of NQO1 protein in liver tissue of mice was increased significantly in administration groups (P<0.05 or P<0.01);pathohistological exchange of liver tissue in mice was improved in adminstration groups to different extent. CONCLUSIONS:SALD can protect APAP-induced liver injury;the mechanism of which may be associated with promoting Keap1,Nrf2 into the of nucleu and strengthening the protein expression HO-1,NQO1,GCLC in liver tissue.

Osteochondroprogenitor cells: isolation, identification and chondrogenesis under the induction of transforming growth factor beta3 / 中国组织工程研究

BACKGROUND: Precartilaginous stem cells exist in articular cartilage, which may become potential seed cells for cartilage tissue engineering. Transforming growth factor-β3 (TGF-β3) has positive regulation effect on the proliferation and chondrogenic differentiation of precartilagious stem cells. OBJECTIVE: To investigate the effect of TGF-β3 on the chondrogenesis of osteochondroprogenitor cells. METHODS: CD146+chondrocytes were isolated from the patients with advanced osteoarthritis, and were then identified. CD146+chondrocytes were cultured in the normal medium (blank control group), chondrogenic induced medium (control group), chondrogenic induced medium containing 2.5 and 10 μg/L recombinant human TGF-β3, respectively. The immunohistochemistry of collagen Ⅱ and aggrecan was performed, and the related gene expression was tested by real-time quantitative PCR after 4 weeks of culture. RESULTS AND CONCLUSION: When chondrogenic differentiation was performed, the number of cell pellets in the 10 μg/L TGF-β3 group was greater than that in the 2.5 μg/L TGF-β3 group, and the number of cell pellets in the 2.5 μg/L TGF-β3 group was greater than that in the control group. The expression levels of collagen Ⅱ and aggrecan in the 10 μg/L TGF-β3 group was significantly higher than that in the 2.5 μg/L TGF-β3 group (P＜ 0.05). The expression levels of collagen Ⅱ and aggrecan in the 2.5 μg/L TGF-β3 group were significantly higher than those in the control group (P＜ 0.05). Real-time quantitative PCR results showed that the expression levels of collagen Ⅱ and aggrecan mRNA in the 10 μg/L TGF-β3 group were significantly higher than those in the 2.5 μg/L TGF-β3 group (P＜ 0.05), but the expression level of SOX-9 showed insignificant difference between two groups (P ＞ 0.05), and the expression level of SOX-9 in the 10 and 2.5 μg/L TGF-β3 groups was significantly higher than that in the control group (P＜ 0.05); the expression levels of collagen Ⅱ and aggrecan mRNA in the 2.5 μg/L TGF-β3 group were higher than those in the control group (P＜ 0.05). Our findings suggest that osteochondroprogenitor cells with stem cell characteristics exist in the residual articular cartilage of the patients with advanced osteoarthritis. TGF-β3 has the ability of promoting chondrogenic differentiation of osteochondroprogenitor cells, which may be an ideal cytokine for cartilage tissue engineering.

Enhancement-perfusion therapy by extracorporeal circulation system ameliorates the blood supply of ischemic lower limbs / 中国组织工程研究

BACKGROUND: In the preliminary study, extracorporeal circulation system simulated physiological environment has been applied in limb preservation, significantly prolonging the severed limb preserving time. OBJECTIVE: To study the effect of enhancement-perfusion by extracorporeal circulation system on the blood supply of ischemic lower limbs. METHODS: Eighteen adult Bama mini pigs were equally randomized into three groups: group A (no intervention), groups B and C (establishing the ischemic model by arteria cruralis ligation at the right posterior lower limb). At 4 weeks after modeling, the model pigs in the group C received enhancement-perfusion therapy 1 hour per day. One week later, the situations of angiography were detected by digital radiography. The tibialis anterior separated from each pig was used to test the microvessel density by hematoxylin-eosin staining. The expression levels of vascular endothelial growth factor in the skeletal muscle and serum samples were monitored by western blot and ELISA, respectively. RESULTS AND CONCLUSION: Both diameter and distal collateral circulation of the arteria cruralis in the group C were much better than those in the group B. The microvessel density in the group C was significantly higher than that in the group B (P < 0.05), but the insignificant difference between groups A and C was found (P > 0.05). Both histionic and serum levels of vascular endothelial growth factor were significantly increased in the groups B and C compared with the group A, especially in the group C (P < 0.05). In summary, the enhancement-perfusion therapy by extracorporeal circulation system can considerably ameliorate blood supply of lower limbs, providing a promising method for treatment of ischemic lower limbs.

Clinical and radiographic evaluations of titanium trabecular metal components manufactured by 3D printing for primary total hip arthroplasty: a 5-year follow-up / 中华创伤骨科杂志

Objective To explore the mid-term efficacy of porous titanium trabecular metal ( TTM ) components manufactured by 3D printing for primary total hip arthroplasty ( THA ). Methods Enrolled for this prospective clinical trial were 19 patients ( 20 hips ) who were to receive primary THA from May 2012 to June 2013 at Department of Orthopaedics and Traumatology, Puai Hospital. Of them, 9 patients ( 10 hips) used 3D printing porous TTM for acetabular prosthesis in primary THA while the other 10 patients ( 10 hips ) used Pinnacle acetabular prosthesis. At 5 years after operation, clinical and radiographic evaluations were conducted to assess acetabular component stability, osseointegration in the acetabulum-bone interface, and osteolysis incidence. Harris scores were used to assess the hip functions. Results The follow-up duration for all the patients averaged 5 years. By the Harris scores, 8 cases were excellent and 2 good in the TTM group while 9 excellent and one good in the Pinnacle group. The Harris scores were significantly improved from preoperative 48.2+5.5 to 92.8+3.1 at 5 years after operation in the TTM group and significantly from 46.5 ± 8.7 to 94.6 ± 2.9 in the Pinnacle group ( P ＜0.05 ). There were no significant differences regarding the preoperative Harris scores and those 5 years after operation between the 2 groups ( P ＞ 0.05 ) . Radio-graphic evaluation showed stable acetabular components, fine osseointegration, and no implant loosening or osteolysis. Two hips in the TTM group had a postoperative radiolucent line which disappeared 6 months later. The 5-year survival rate of the acetabular components was 100% for both groups, taking prosthetic loosening or revision as the end point. Conclusion The 3D printing TTM has shown excellent mid-term efficacy but its long-term efficacy needs further follow-up study.

Regeneration of functional alveoli by adult human SOX9 airway basal cell transplantation

Irreversible destruction of bronchi and alveoli can lead to multiple incurable lung diseases. Identifying lung stem/progenitor cells with regenerative capacity and utilizing them to reconstruct functional tissue is one of the biggest hopes to reverse the damage and cure such diseases. Here we showed that a rare population of SOX9 basal cells (BCs) located at airway epithelium rugae can regenerate adult human lung. Human SOX9 BCs can be readily isolated by bronchoscopic brushing and indefinitely expanded in feeder-free condition. Expanded human SOX9 BCs can give rise to alveolar and bronchiolar epithelium after being transplanted into injured mouse lung, with air-blood exchange system reconstructed and recipient's lung function improved. Manipulation of lung microenvironment with Pirfenidone to suppress TGF-β signaling could further boost the transplantation efficiency. Moreover, we conducted the first autologous SOX9 BCs transplantation clinical trial in two bronchiectasis patients. Lung tissue repair and pulmonary function enhancement was observed in patients 3-12 months after cell transplantation. Altogether our current work indicated that functional adult human lung structure can be reconstituted by orthotopic transplantation of tissue-specific stem/progenitor cells, which could be translated into a mature regenerative therapeutic strategy in near future.

Effect of occipitocervical fusion for treatment of craniovertebral junction deformity combined with atlantoaxial instability / 中国医师进修杂志

Objective To investigate the effect of occipitocervical fusion in patients with craniovertebral junction deformity combined with atlantoaxial instability. Methods The clinical data of 59 patients with craniovertebral junction deformity combined with atlantoaxial instability from March 2013 to June 2017 were retrospectively analyzed. The patients were treated with occipitocervical fusion. The atlantoaxial distance (ADI), distance between the odontoid and Chamberlain line and cervicomedullary angle (CMA) were used to evaluate atlantoaxial dislocation, vertical displacement and spinal cord compression, and the Japan Orthopedic Association (JOA) score was used to evaluate the effect before operation and 7 days after operation. Results The operation time was 109 to 214 (148.5 ± 20.1) min, the transoperative bleeding was 55 to 210 (122.0 ± 16.7) ml, and no injury of spinal cord nerve and vertebral artery occurred during operation. The CMA and JOA score 7 d after operation were significantly higher than that before operation: (153.8 ± 5.4)° vs. (131.2 ± 7.1) ° and (12.7 ± 1.8) scores vs. (10.6 ± 1.4) scores, and the ADI and distance between the odontoid and Chamberlain line 7 d after operation were significantly lower than that before operation: (2.9 ± 0.7) mm vs. (8.3 ± 2.7) mm and (3.2 ± 1.4) mm vs. (8.2 ± 2.3) mm, and there were statistical difference (P＜0.05). One case (1.7%, 1/59) died of massive brainstem infarction 1 d after operation; 2 patients (3.4%, 2/59) had undergone a revision operation due to fusion failure 3 months after operation; other 56 patients in reduction, internal fixation and bone graft fusion. The patients were followed up for 6 to 38 (15.9 ± 7.2) months, and the symptom relief was in 56 cases. The rate of symptom relief was 94.9% (56/59). The JOA score at last follow-up was significantly higher than that before operation: (13.3 ± 1.8) scores vs. (10.6 ± 1.4) scores, and there was statistical difference (P＜0.05). Conclusions The occipitocervical fusion can effectively relieve spinal cord compression and atlantoaxial instability in patients with craniovertebral junction deformity combined with atlantoaxial instability.

Investigation and Analysis of Quality Control of Hospital Pharmaceutical Administration in China / 中国药房

OBJECTIVE:To investigate the situation of hospital pharmaceutical administration in China,and provide basis for developing measures in improving the quality and safety of medication in hospitals. METHODS:According to the organization of National Health and Family Planning Commission,National Quality Control Center of Pharmaceutical Administration drafted the re-search indicators,and adopted internet survey to screen,confirm and statistically analyze the data about pharmacy staffing and drug use management of hospitals in 2014 that was completed and reported as requested by the secondary general hospitals and above in each area selected by Health and Family Planning Commission in provinces (cities,districts). RESULTS:The rates of pharmacy technicians in secondary and tertiary general hospitals were 5.2% and 4.4%,the numbers of clinical pharmacists per hundred-bed were 0.42 and 0.44 person,the numbers of dispensing prescription per person in a day were 119 and 173 in pharmacist in outpa-tient;the monitoring rates for key patients were 1.8% and 6.9%,the rates of intravenous infusion in outpatients were 12.8% and 10.1%,and inpatient were 93.1% and 90.4%;the rates of intravenous infusion of antibiotics in inpatients were 51.8% and 44.3%,and the rates of intravenous infusion of TCM were 34.7% and 29.0%,respectively. CONCLUSIONS:The problems exist-ing in pharmaceutical quality administration in China include lacking of pharmacy technicians,large workload,lacking of clinical pharmacists,imperfect pharmaceutical care model,non-standardized choice and use of intravenous infusion,etc. For these prob-lems,it is suggested to increase the propaganda of health education and management efforts of intravenous drugs,equipped with ad-equate pharmacy technicians and clinical pharmacists,continuously improve the quality evaluation system of hospital pharmaceuti-cal administration in China.

Application of project-driven teaching methods in establishing new model of medical interdisciplinary inno-vative informationists training / 中华医学图书情报杂志

After the characteristics of project-driven teaching methods and traditional teaching methods were com-paratively analyzed,a new gradient and hierarchical "dual-driven" model of medical interdisciplinary innovative informationists training was established by embedding the general model of project-driven teaching methods into the traditional training model of medical interdisciplinary innovative informationists training in order to improve the teaching level and find a new way for medical informationists training.

Hyperglycemia aggravated cerebral ischemia/reperfusion injury by inhibiting mitophagy / 中国药理学通报

Aim Toinvestigatetheroleofhyperglyce-mia in cerebral ischemia/reperfusion(I/R)injury with a middle cerebral artery occlusion(MCAO)rat model anditsmechanism.Methods EightyhealthymaleSD rats were randomly assigned into sham group, I/R group (normoglycemia),hyperglycemic I/R groupⅠ(HG1 )and hyperglycemic I/R groupⅡ(HG2 ).The cerebral I/R model was established by occluding the middle cerebral artery(MCA)in rats.Hyperglycemia was induced by intraperitoneal injection of 50% glu-cose solution.Neurological deficit was determined by Ludmila Belayev test;infarct size and brain edema were measured by TTC staining;mitophagy was ob-served by double immunofluorescent staining and elec-tron microscope.The expressions of autophagy-related proteins(LC3 and Beclin-1 )and apoptosis-related pro-teins(Cyt-C,AIF,caspase-9 and caspase-3 )were ex-aminedbyWesternblotfurtherly.Results Bloodglu-cose level was controlled at 4 mmol·L-1 (normoglyce-mia),10 mmol · L-1 (HG1 ) and 20 mmol · L-1 (HG2)respectively.There were no significant differ-ences between model group and HG1 group in neuro-logical deficit scores,infarct volume and edema size(P>0. 05 ).However,these indications in HG2 group were significantly increased compared with model group (P<0. 05 ).After 3 days of reperfusion,the level of mitophagy was significantly reduced accompanied with increased mitochondria damages in HG 2 group (P <0. 05 ),and the expressions of mitochondrial related ap-optotic proteins(Cyt-C,AIF,caspase-9 and caspase-3 ) were significantly increased accordingly compared to modelgroup.Conclusions Mildhyperglycemiacan not intensify the cerebal ischemic injury.In contrast, severe hyperglycemia significantly aggravates the brain ischemic injury by inhibiting the removal of injured mi-tochondria in a manner of mitophagy,thus amplifying the mitochondrial mediated cascade damage responses.

Effects of external counterpulsation combined with laser photocoagulation for treatment of non - proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effects of external counterpulsation combined with laser photocoagulation for treatment of non-proliferative diabetic retinopathy. METHODS: A prospective study method were used from Aug. 2013 to Feb. 2016. A total of 104 cases in our hospital for treatment of non - proliferative stage of diabetic retinopathy patients were selected as the research object, and all the patients were equally divided into observation group and control group, 52 cases in each group according to the order of admission. Patients in control group were treated with panretinal laser photocoagulation treatment. The observation group were given external counterpulsation combined with laser photocoagulation for treatment, observed the prognosis in the two groups. RESULTS: The total efficiency in the observation group and the control group were 98. 1% and 84. 6%, the observation group was significantly higher than the control group (P0. 05). CONCLUSION: External counterpulsation combined with laser photocoagulation treatment has good safety in the treatment of non-proliferative diabetic retinopathy, it can promote eye artery blood flow speed, thereby improve the therapeutic effect.

The effect of zinc on inflammatory reaction in rats with focal cerebral ischemia/reperfusion / 药学学报

This study was conducted to investigate the effect of N, N-diethyldithiocarbamate (DEDTC) on the changes of inflammatory cytokines after focal cerebral ischemia-reperfusion injury in rats and to explore the potential mechanism. Two hundred Sprague Dawley male rats were randomly divided into sham group, middle cerebral artery occlusion (MCAO) group and DEDTC (Zn chelator) treated group. MCAO model was established by the suture method. Rats were sacrificed at 6, 12 and 24 h after reperfusion. 2, 3, 5-Triphenyltetrazolium chloride (TTC) was conducted to measure the brain infarct volume. Newport Green was adopted to detect the chelatable zinc in the cerebral penumbra. Enzyme linked immunosorbent assay (ELISA) was performed to determine the release of TNF-α and IL-6. Furthermore Western blot was used to analyze the expression of the PI3K/Akt/NF-κB signaling pathway. The results showed that DEDTC resulted in a significant reduction of brain infarct volume and an obvious improvement of neurological function compared to the model group. DEDTC also decreased the release of inflammatory cytokines such as TNF-α and IL-6. The activation of PI3K/Akt/NF-κB signaling pathway induced by I/R injury was drastically inhibited by the treatment with DEDTC. In conclusion, DEDTC could protect the brain against ischemic injury induced by MCAO, which might be relevant to the inhibition of PI3K/Akt/NF-κB signaling pathway, and the decreased release of inflammatory cytokines.

Efficacy of fast-track surgery combined with standard rehabilitation training in elderly patients after total hip arthroplasty / 中华创伤骨科杂志

Objective To explore the efficacy of fast-track surgery (FTS) combined with standard rehabilitation program (HSS) in elderly patients undergoing total hip arthroplasty (THA).Methods Ninety elderly patients with femoral neck fracture were randomly assigned to receive either FZS plus HSS Tehabilitation program (experimental group,n =45) or HSS rehabilitation program (control group,n =45) after THA from December 2013 to December 2014 in our hospital.The experimental group had 23 men and 22 women,with an average age of 68.2 ± 3.7 years.The control group had 22 men and 23 women,with an average age of 70.6 ± 4.1 years.Harris score and visual analogue scale (VAS) were used to assess the hip joint function before operation,4,8 and 14 weeks after operation.The complications were compared between the 2 groups at 14 weeks after operation.Results All the patients completed a 14-week follow-up.There were no significant differences in Harris and VAS scores at pre-operation between the 2 groups (P ＞ 0.05).At 4,8 and 14 weeks after operation,the Harris scores in the experimental group (67.2 ±3.5,88.3 ±2.5and 92.5±3.3) were significantly higher than those in the control group (52.5±7.8,65.8±4.9 and 72.2±4.9) and the VAS scores in the experimental group (3.4±0.8,2.2±0.8 and 1.3±0.5) were significantly lower than those in the control group (5.6 ±0.9,4.2 ±0.8 and 2.9 ±0.8) (P ＞ 0.05).There were no complications in the experiment group while there were 14 complications (31.1％) in the control group,showing a significant difference (P ＜ 0.05).Conclusion FTS combined with HSS standardized rehabilitation can effectively reduce the incidence of complications and accelerate the functional recovery of hip joint in elderly patients after THA.