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A large number of gut flora communities have colonized in the intestine, which is crucial to the metabolism of foreign compounds such as drugs. In recent years, the gut flora has been widely regarded as the "invisible organ" of the body. By reviewing the pertinent literature at home and abroad, classifications and functions of intestinal flora and its influence on the chemical composition and chemical metabolism of Chinese medicine are analyzed in the article. Understanding the impact of intestinal flora on drug metabolism and the process of drug conversion has great significance in guiding clinical rational drug use and individual therapy, evaluating toxicity and promoting drug discovery and development, and providing theoretical guidance for the study of the effects of intestinal flora on drug metabolism in the plateau environment.
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In this study, the change of intestinal microflora in rat fecal samples after amoxicillin administration was observed. In vitro incubation experiments combined with LC-MS/MS assay were used to test the role of intestinal flora in the metabolism of nifedipine. The effect of changes of intestinal flora was determined after amoxicillin administration on the metabolism of nifedipine. We found that the number and types of intestinal flora decreased after taking amoxicillin. After incubation for 12 h, the results showed that the remaining amounts of nifedipine in the N1 group (nifedipine) and N2 group (amoxicillin + nifedipine) were 0.057 6 and 0.064 8 μmol·L-1, respectively, while the remaining amounts of nifedipine after 24 h of incubation were 0.039 6 and 0.050 4 μmol·L-1, respectively. These results show that the intestinal flora is involved in the metabolism of nifedipine. After administration of amoxicillin, the metabolism of nifedipine was slowed down, the AUC0-t was increased by 39.10%, tmax was advanced by 0.45 h, and the CL was reduced 34.71%. The data suggest that the combination may enhance the therapeutic effect of nifedipine. Therefore, drug-drug interactions mediated by gut microbiota cannot be ignored when combined with antibiotics and nifedipine, one of the important factors affecting drug efficacy.
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To evaluate the clinical value of gene chip technology (GCT) in detecting the mycoba-cteria,isoniazid and rifampin resistance of patients diagnosed tuberculous empyema.The 182 patients who met the inclusion criteria were enrolled to this study from January 2011 to December 2015,whose pus mycobacterial species were detected by GCT and MGIT,the simultaneous and sensitivity of them were compared.Meanwhile,36 patients diagnosed tuberculous empyema were selected to detect isoniazid and rifampin resistance.The simultaneous and sensitivity of GCT were evaluated base on the standard of MGIT.The 135 patients were diagnosed by tuberculous empyema.The specificity of GCT was same to MGIT (95.7％),the the sensitivity was 48.9％ (66/135)in GCT,26.7％ in MGIT,there was significant difference between them (x2=80.5,P＜ 0.05).The sensitivity,specificity and coincidence rate of GCT in rifampin resistance were 100％,the sensitivity,specificityand coincidence rate in INH were 50.0％(1/2),97.1％(33/34) and 94.4％.Gene chip technology for detection of mycobacteria has high sensitivity and specificity,which can identify non-tuberculous mycobacteria quickly.And it can also effectively detect the resistance of Mycobacterium tuberculosis to isoniazid and rifampicin.It has important significance in early diagnosis and treatment of tuberculous empyema.
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To evaluate the efficacy and safety of Choudongning (CDN)capsule in children with Tourette's syndrome of spleen deficiency and phlegm accumulation through a randomized double-blind three-arm controlled phase Ⅲ study in 588 patients from 8 hospitals. The included patients were randomly divided into test group, positive control group and placebo group at the ratio of 3∶1∶1. Patients in the test group orally took CDN capsules and simulated Tiapridal tablets; the patients in positive control group took Tiapridal tablets and simulated CDN capsules; whereas the patients in placebo group orally took the simulated agents of the above two drugs. The treatment course was 6 weeks for three groups. The global grading rates, YGTSS scores and its factor scores, the degree of social function damage, as well as traditional Chinese medicine syndrome efficacy were evaluated as the outcome measures on efficacy. The AEs/ADRs, vital signs and laboratory testing were observed as outcome measures on safety. The total effective rate of YGTSS was 75.92% in the test group, 72.65% in the positive control group, and 37.29% in the placebo group. Non inferiority test stands between the test group and the positive control group, and they were superior to placebo group in efficacy with statistical difference. Significant difference had also been found among the 3 groups in YGTSS tics score, motor tics score, vocal tics, degree of social function damage and traditional Chinese medicine syndrome efficacy. During the study, there were 5 (1.42%)ADRs in the test group, 10 (8.55%)in the positive control group and 3 (2.54%)in the placebo group. The incidence of ADRs in the test group was lower than that in the positive control group, with statistical difference. It is clear to say that CDN capsule can effectively treat the Tourette's syndrome of spleen deficiency and phlegm accumulation. Its efficacy is not inferior to the commonly used Tiapridal tablets, with even less adverse reactions, so it has clinical application value.
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<p><b>OBJECTIVE</b>To assess the efficacy and safety of Xifeng Zhidong Tablet (XZT) in treating tic disorder children patients of internal disturbance of Gan-wind with phlegm syndrome (IDGWPS).</p><p><b>METHODS</b>A stratified randomized, double-blinded, parallel control of placebo, multi-center trial was conducted in 160 subjects from 5 hospitals in China. They were randomly assigned to 2 groups, the test group and the control group, 80 in each group. Those in the test group were treated with XZT, while those in the control group were treated with placebos. The therapeutic course was 4 weeks for all. The effectiveness indicators covered main indicators and secondary indicators. Yale global tic severity scale (YGTSS) was taken as the main indicators. The amelioration of social function impairment, efficacy, single index of Chinese medical syndromes, Chinese medical syndrome efficacy as well as disappearance rate of single Chinese medical symptoms were evaluated as secondary indicators. The safety indicators included clinical adverse events, vital signs, blood/urine/stool routines, renal and liver functions, and electrocardiogram (ECG).</p><p><b>RESULTS</b>As for main indicators, the score of YGTSS decreased from 22.10 +/- 6.38 to 11.34 +/- 6.58 in the test group, while it decreased from 22.65 +/- 6.70 to 16.82 +/- 6.53 in the control group, showing statistical difference when compared with the same group before treatment (P < 0.01). Besides, the decrement was more significant in the test group after treatment (P < 0.05). As for secondary indicators, the total effective rate was 83.54% in the test group and 34.18% in the controlled group, showing statistical difference between the two groups (P < 0.05). As for social function impairment, 20,38, 16, 3, 1 case(s) in the test group were ranked as normal, minimal, mild, moderate, obvious degree, while 1, 24, 45, 7, and 0 case(s) in the control group were ranked as normal, minimal, mild, moderate, obvious degree. Better effect was obtained in the test group (P < 0.05).As for Chinese medical syndrome efficacy, it was 87.34% in the test group and 64.56% in the control group (P < 0.05). As for single index of Chinese medical syndromes, the disappearance rate of motor tics, irritability, dreaminess, abnormal tongue proper,abnormal tongue fur, and abnormal tongue pulse condition was 78.67%, 34.72%, 62.26%, 34.62%, 58.97%, and 39.74%, respectively in the test group, while they were 34.67%, 13.11%, 21.82%, 15.58%, 25.97%, and 19.48%, respectively in the control group. Better results were shown in the test group (P < 0.05). Totally 5 adverse events occurred. The incidence of adverse events was 3.75% in the test group and 2.53% in the control group.</p><p><b>CONCLUSIONS</b>After 4 weeks of XZT treatment, the integral of YGTSS could be obviously reduced, the degree of social function impairment ameliorated, and Chinese medical syndromes improved. In addition, no adverse reaction occurred in this study.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Double-Blind Method , Drugs, Chinese Herbal , Therapeutic Uses , Medicine, Chinese Traditional , Phytotherapy , Placebos , Tic Disorders , Diagnosis , Drug Therapy , Treatment OutcomeABSTRACT
Vancomycin was enlisted as a drug of the last resort for the treatment of resistant gram-positive bacterial infections. However, the emergence of vancomycin-resistant bacteria has created an urgent need for new active analogues of vancomycin. Summing up the last ten years work of this field, the review introduced the antibiotic mechanism of vancomycin and summarized the vancomycin derivatives based on the modifications of vancomycin, dimmer of vancomycin and the vancomycin mimetics. The connection of modified location and function with antibacterial activity was also discussed.
Subject(s)
Anti-Bacterial Agents , Chemistry , Pharmacology , Microbial Sensitivity Tests , Molecular Structure , Vancomycin , Chemistry , Pharmacology , Vancomycin ResistanceABSTRACT
<p><b>OBJECTIVE</b>To explore the effect of Jiangqian granule (JQG) in treating children attention deficit hyperactivity disorder (ADHD) and its mechanism.</p><p><b>METHODS</b>Eighty children with ADHD were randomly divided into two groups, the treated group treated with JQG and the control group treated with Ritalin. Blood lead concentration and Conners' scoring were measured before and after 3 months treatment and the therapeutic effects were assessed. Besides, blood lead concentration and Conners' scoring in 60 healthy children were also determined for control.</p><p><b>RESULTS</b>The total effective rate in the treated group and the control group was 92.5% and 72.5% respectively, significant difference existed between the two groups. Blood lead level and Conners' scores in ADHD patients were significantly higher than those in the healthy control (P < 0.01). The two parameters decreased after treatment in both groups, but the lowering was more significant in the treated group (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>Blood lead concentration raised in ADHD patients, JQG could enhance the clinical therapeutic effect by means of reducing the blood lead.</p>