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OBJECTIVE To evaluate the effects of pharmaceutical interventio n led by clinical pharmacists on medication appropriateness of elderly inpatients. METHODS A non-randomized concurrent controlled trial was carried out. Elderly patients admitted to two treatment groups in the geriatric department of Yancheng First People ’s Hospital since June 2021 were selected as the research objects. According to the inclusion and exclusion criteria ，the first 40 patients were selected from each of the two treatment groups （according to the order of admission time ）and set as the control group or the intervention group. The control group received routine treatment and nursing services ，and the intervention group additionally received pharmaceutical intervention led by clinical pharmacists on the basis control group. Clinical pharmacists found potential inappropriate medication （PIM）and put forward suggestions on optimization of medication regimen. American Geriatrics Society 2019 Updated AGS Beers Criteria ® for PIM Use in Older Adults （hereinafter referred to as “Beers criteria ”）and the Criteria of PIMs for Older Adults in China 2017 Edition （hereinafter referred to as “Chinese criteria ”）were used as reference tools for drug use review. The medication appropriateness index （MAI）total scores （main evaluation indicator ），the number of PIMs ，the number of drugs used ，the length of hospital stay ，the number of drug-related adverse events during hospital stay ，the number of drug regimen optimization suggestions by pharmacists ， and implementation rate of E-mail：zhihuadou@163.com optimization suggestions adopted by clinicians were compared between 2 groups at admission and at discharge. RESULTS At admission ，there were no statistically differences in MAI total scores，the number of PIMs based on Beers criteria ，the number of PIMs based on Chinese criteria or the number of drugs used between 2 groups（P＞0.05）. At discharge ，there were no statistically differences in the number of PIMs based on Chinese criteria and the length of hospital stay between 2 groups（P＞0.05），but the MAI total scores ，the number of PIMs based on Beers criteria and the number of drugs used in the intervention group were lower than those in the control group （P＜0.05）. In the intervention group，the proportion of drugs recorded as “inappropriate medication ”at admission （34.5％）was significantly higher than that at discharge（19.5％）（P＜0.05）. The difference between the number of drugs discharged from hospital and the number of drugs admitted to hospital in the control group [ 3（1-4.8)] was significantly higher than that in the intervention group [ 1（0-2.8)]（P＝ 0.012）. Compared with admission ，the proportion of drugs recorded as “inappropriate medication ”in the intervention group at discharge was significantly decreased on the basis of “effectiveness”dimension and “course”dimension （P＜0.05）. During hospitalization，clinical pharmacists put forward 70 optimization suggestions of drug regimen for the intervention group ，among which 39 suggestions were adopted and implemented by clinicians ，with an implementation rate of 55.7％. CONCLUSIONS The pharmaceutical intervention led by clinical pharmacists can improve overall appropriateness of drug use in the elderly inpatients using MAI as main evaluation indicator.
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Objective:To improve the determination method for the total anthraquinone of the Rhei Radix et Rhizoma in the Pharmacopoeia of the People’s Republic of China, and compare this method with the method in the pharmacopoeia to determine the feasibility of such method. Methods:By changing the determination of total anthraquinone from biphasic hydrolysis to monophase hydrolysis, the method included in the pharmacopoeia was improved to determine the total anthraquinone content in Rhei Radix et Rhizoma. Chromatographic conditions were Symmetry C18 (4.6 mm × 250 mm, 5 μm) chromatographic column; the mobile phase is methanol-0.1% phosphoric acid water (85:15); the flow rate was 1 ml/min; the column temperature is 30 ℃; the detection wavelength is 254 nm. Results:The concentrations of aloe-emodin, rhein, emodin, chrysophanol, physcion in the range of 0.003 3-0.332 0 μg, 0.006 9-0.668 0 μg, 0.002 3-0.232 0 μg, 0.010 4-1.040 0 μg, 0.008 4-0.836 0 μg have good linear relationship with the peak area; RSDs of precision, stability and repeatability were less than 2%; the recovery rates of aloe-emodin, rhein, emodin, chrysophanol and physcion were 101.50%, 99.30%, 99.62%, 101.57%, and 103.11%, and the RSDs were less than 2%. Conclusion:The improvement method is simple, accurate, reliable and reproducible, which could be used for the quality control of Rhei Radix et Rhizoma.
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OBJECTIVE： To establish a method for simultaneous determination of 8 non-anthraquinone constituents in Rheum palmatum. METHODS： HPLC method was adopted. The determination was performed on Symmetry C18 column with mobile phase consisted of methanol-0.1％ phosphoric acid （gradient elution） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃ and detection wavelength was 280 nm. Sample size was 30 μL. RESULTS： The linear range of gallic acid， catechin， epicatechin， resveratrol 4′-O-glucopyranoside， epicatechin gallate， resveratrol 4′-O-β-D-（6″-O-galloyl）-glucopyranoside， sennoside A， 4′-hydroxyphenyl-2-butanone-4′-O-β-D-（2″-O-galloyl-6″-O-p-hydroxy cinnamyl）-glucopyranoside were 6.16-2 464 ng（r＝0.999 9）， 37.4-14 960 ng（r＝0.999 9）， 7.635-3 054 ng（r＝0.999 7）， 7.63-3 052 ng（r＝0.999 9）， 8.32-3 328 ng（r＝0.999 9）， 11.5-4 600 ng（r＝0.999 9）， 16.08-6 432 ng（r＝0.999 9）， 29.3-11 720 ng（r＝0.999 9）， respectively. The limits of quantitation were 3.48， 4.30， 6.40， 4.40， 3.39， 2.87， 8.40 and 4.95 ng， respectively. The limits of detection were 2.32， 2.58， 2.40， 2.64， 2.26， 1.23， 4.20， 2.97 ng， respectively. RSDs of precision， stability and reproducibility tests were all lower than 5％. Recoveries were 94.32％- 100.54％（RSD＝2.78％，n＝6）， 91.15％-99.36％（RSD＝3.72％，n＝6）， 92.16％-98.04％（RSD＝2.39％，n＝6）， 93.41％-100.73％（RSD＝3.17％，n＝6）， 93.89％-98.40％（RSD＝1.99％，n＝6）， 92.61％-101.74％（RSD＝3.71％，n＝6）， 92.66％-103.40％（RSD＝3.76％，n＝6）， 95.45％-102.70％（RSD＝3.06％，n＝6）， respectively. CONCLUSIONS： The established method is simple， accurate and specific， and can be used for the simultaneous determination of 8 non-anthraquinone constituents in R. palmatum.
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Objective To study the protective effect of Rhein on the kidney of type 2 diabetic rats induced by high fat diet.Methods A rat model of type 2 diabetes was induced by high fat diet combined with low dose streptozotocin 35 mg/kg.The diabetic rats were randomly divided into diabetes group, Low, middle and high rhein dose groups (50,100,150 mg/kg), metformin group (300 mg/kg) and normal control group.Blood glucose and urine micro albumin were measured at 0, 2, 4 and 8 weeks respectively.Serum creatinine, urea nitrogen, total cholesterol and triglyceride were measured at 8 weeks.HE staining was used to observe the pathological changes of renal tissue.Effects of rhein on the expression of transforming growth factor-β1 and Smad3 protein in renal tissue of diabetic rats were detected with Western Blot.Results The blood glucose and urine micro albumin in model group were significantly higher than those in normal control group.Each rhein dose group exhibited reduced blood glucose and urinary micro albumin in diabetic rats.The high rhein dose group showed significant reduction of blood glucose and urine micro albumin in diabetic rats (P<0.05).Compared with model group, rhein reduced the serum Cr, BUN, TC and TG values in each dose group, most significantly in the high rhein dose group (P<0.05).The obvious pathological changes of renal tissue in model group were observed with most improved changes in the high rhein dose group.The expression of TGF-β1 and Smad3 protein in renal tissue of diabetic rats decreased significantly (P<0.05).Conclusion Rhein has preventive effect on diabetic nephropathy.The mechanism may relate to the improvement of renal function, regulation of blood lipid and down regulation of TGF-β1 and Smad3 protein expression in renal tissue.
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OBJECTIVE:To establish a method for content determination of schizantherin E,gomisin J,angeloylgomisin H,schisantherin A,schisantherin B,schisanhenol,anwuligan,schizandrin A,schizandrin B and schizandrin C in Wuzhi tablets.METHODS:RP-HPLC method was adopted.The determination was performed on Symmetry C18 column with acetonitrile-0.1％ phosphoric acid solution (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set 225 rm,and the column temperature was 30 ℃.The sample size was 10 μL.RESULTS:The linear ranges of schizantherin E,gomisin J,angeloylgomisin H,schisantherin A,schisantherin B,schisanhenol,anwuligan,schizandrin A,schizandrin B and schizandrin C were 2.25-67.5ng(r=0.999 6),2.1-63 ng(r=0.999 8),28-840 ng(r=0.999 9),124.6-3 738 ng(r=0.999 9),22.7-681 ng(r=0.999 9),32.7-981 ng(r=0.999 9),47-1 410 ng(r=0.999 9),208-6 240 ng(r=0.999 9),5.36-160.8 rig(r=0.999 9),4.48-134.4 ng(r=0.999 8).The limits of quantitation were 14.17,13.32,9.33,11.37,14.62,19.88,14.66,12.50,16.40,13.55 rg.The limits of detection were 4.62,4.60,3.08,3.76,4.81,6.74,4.93,4.16,5.86,5.03 ng.RSDs of precision,stability and reproducibility tests were less than 3.0％;the recoveries were 96.36％-100.00％(RSD=1.83％,n=6),95.00％-100.00％(RSD=2.07％,n=6),95.00％-98.00％(RSD=1.22％,n=6),95.37％-98.91％ (RSD=1.29％,n=6),95.62 ％-103.71％ (RSD=2.85％,n=6),97.33％-102.67％ (RSD=2.00％,n=6),95.00％-99.33％ (RSD=1.75％,n=6),97.24％-104.93％ (RSD=2.63％,n=6),95.00％-97.50％ (RSD=1.42％,n=6),96.00％-102.00％ (RSD=2.45％,n=6),respectively.CONCLUSIONS:The developed method is accurate,sensitive and reproducible,and it can be used for content determination of 10 lignanoids in Wuzhi tablets.
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Objective To develop a method for simultaneous determination of three hydrophilic components and two lipophilic components in Radix et Rhizoma Salviae Miltiorrhizae. Methods The RP-HPLC method was performed by using a Welchrom C18 column(250 mm×4.6 mm,5 μm)with a mobile phase of acetonitrile (A)-0.1%phosphoric acid(B). The gradient elution program was as follows:0-15 min,10%→12%A;-35 min,12%→20%A;-45 min,20%→60%A;-65 min,60%→65%A;-80 min,65%→80%A;-90 min,10%A. The flow rate was kept at 1.0 mL?min-1 . The detection wavelength was set at 280 nm. The column temperature was 30 ℃ . Results A good linearity was obtained over 0.059 5-2.380 0 μg for tanshinol, 0.346 0-13. 840 0 μg for rosmarinic acid, 0. 656 0 - 26. 240 0 μg for salviamolic acid B, 0. 420 0 - 16.800 0 μg for cryptotanshinone and 0.414 0- 16.560 0 μg for tanshinoneIIA, respectively ( r = 0.999 9). The average recovery rates were between 98.69%-100.91% with RSD less than 1.2%(n = 6). Conclusion The method is rapid, accurate, credible and repeatable, and can provide basis for the quality control of Radix et Rhizoma Salviae Miltiorrhiza.
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Aim To discuss the effects and mechanism of Ganoderma lucidum polysaccharides and metformin on myocardial structure and hemodynamics in type 2 diabetic rats.Methods High fat diet combined with intraperitoneal injection of low dose streptozotocin 30 mg· kg -1 was applied to establish rat model of type 2 diabetes mellitus .The diabetic rats were randomly into normal control group ,diabetes group , ganoderma lucid-um polysaccharides group (600 mg· kg -1 ) , metformin group ( 600 mg · kg -1 ) , combination group ( ganoder-ma lucidum polysaccharides 300 mg · kg -1 +metform-in 300 mg· kg -1 ) .After 12 weeks′treatment,the lev-els of fasting serum glucose were determined and the hemodynamic parameters (LVSP,LVEDP,dp/dtmax,-dp/dtmax ) were determined.Collagen volume fraction ( CVF ) was detected by Van Gieson . Immunohisto-chemical method and Western blot were used to detect myocardial tissue MMP-2 protein expression .Results The fasting blood glucose was significantly decreased in the combined treatment group .Combined medication could significantly improve hemodynamic parameters in diabetic rats: reduced LVEP and raised LVEDP , dp/dtmax and -dp/dtmax .CVF was significantly decreased in combination group .The expression of MMP-2 in my-ocardial tissue was significantly inhibited .Conclusions The combination of Ganoderma lucidum polysaccha-ride and metformin can significantly improve the hemo-dynamic parameters in type 2 diabetic rats, and have a preventive effect on diabetic cardiomyopathy . The mechanism may be related to the down regulation of the expression of MMP-2.
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OBJECTIVE:To provide reference for improving the application ability of professional English for students major-ing in pharmacy in higher vocational education. METHODS:The career-oriented practical pharmaceutical English course and teach-ing system were constructed through the way of formulation of curriculum standards,establishment of teachers’team,development of school-based teaching material,application of CBI theme teaching mode and variety teaching methods,and it was carried out among students majoring in pharmacy in 2011-2014 grades in our school. Besides,experimental and survey research were used for the evaluation of Proctical Pharmaceutical English. RESULTS:There was no significant difference in the academic achievement and questionnaire evaluation between 2 class before teaching(P>0.05);however,academic achievement and questionnaire evaluation were higher than 2 class after teaching,experimemal class higher than control class,the difference was statistically significant(P<0.05). CONCLUSIONS:The career-oriented Practical Pharmaceutical English course and teaching system is feasible and effective;compared with traditional teaching,it can inspire students' interest in English learning,improve the ability to use English in the work and motivate their comprehensive qualities.
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Objective To study the effect of ganoderma lucidum polysaccharides combined with metformin on oxidative stress of type 2 diabetic rats. Methods SD rats were fed with high fat diet for 4 weeks and injected with streptozotocin (30 mg·kg-1 ) to produce type 2 diabetic model. The diabetic rats were randomly divided into diabetes model group, ganoderma lucidum polysaccharides group (600 mg·kg-1 ), metformin group (600 mg·kg-1 ), combination group (ganoderma lucidum polysaccharides 300 mg·kg-1+ metformin 300 mg·kg-1 ), After 12 weeks of treatment, the level of fasting blood glucose was determined, and the activity of superoxide dismutase ( SOD), malondialdehyde ( MDA), catalase ( CAT), glutathione peroxidase (GSH-Px), total cholesterol (TC) and triglyceride (TG) were detected. Results The levels of fasting blood glucose in the treatment groups were significantly lower than that in the diabetes model group (P<0. 01). Furthermore, fasting blood glucose in the combination group was significantly lower than that in ganoderma lucidum polysaccharides group and metformin group (P<0. 01). Compared with diabetes model group, serum TC and TG in the treatment groups were significantly lower (P<0. 05, P<0. 01). Serum TC and TG were significantly lower in the combination group than in ganoderma lucidum polysaccharides group and metformin group (P<0. 05, P<0. 01). Compared with diabetes model group, serum SOD levels in the treatment groups were significantly higher (P<0. 01). Compared with ganoderma lucidum polysaccharides group and metformin group, serum SOD levels in the combination group was significantly higher (P<0. 05). Compared with diabetes group, serum MDA levels in the treatment groups were significantly lower (P<0. 01). Serum MDA in the combination group was significantly lower than that in ganoderma lucidum polysaccharides group and metformin group ( P<0. 05). Compared with diabetes model group, serum CAT and GSH-Px in the treatment groups were significantly higher (P<0. 05, P<0. 01). Serum CAT and GSH-Px in the combination group were significantly higher than those in ganoderma lucidum polysaccharides group and metformin group (P<0. 05). Conclusion Ganoderma lucidum polysaccharides combined with metformin could effectively inhibit oxidantion stress in type 2 diabetic rats. The effect was better than ganoderma lucidum polysaccharides or metformin used alone. The possible mechanism may be related to increased activity of SOD, CAT, GSH-Px in vivo and regulation of dyslipidemia.
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Aim To study the effects of ganoderma lu-cidum polysaccharides and metformin on myocardial fi-brosis of type 2 diabetic rats and its mechanism. Methods SD rats were fed with high fat diet for 4 weeks, and then were injected with streptozotocin (30mg·kg-1 ) to replicate type 2 diabetic model. The diabetic rats were randomized into normal control group,diabetes group, ganoderma lucidum polysaccha-rides group ( 600 mg · kg-1 ) , metformin group ( 600 mg·kg-1 ) , and combination group( ganoderma lucid-um polysaccharides 300 mg·kg-1 +metformin 300 mg ·kg-1 ) . After 12 weeks’ treatment,the levels of fast-ing serum glucose were determined and the extent of myocardial fibrosis was observed by Picro-sirius red staining. The contents of AGEs in serum were deter-mined by fluorescence spectrophotometer. The activities of CAT and GSH-Px in myocardium were detected. Im-munohistochemical method and Western blot were used to detect myocardial tissue AGEs and CTGF protein ex-pression. Results Combination group could repress patho-proceeding of myocardial fibrosis efficiently, im-prove the activity of CAT and GSH-Px in myocardium and lower the concentration of AGEs in serum, as well as reduce the expression of AGEs and CTGF in myo-cardium. Conclusions Ganoderma lucidum polysac-charides and metformin could prevent myocardial fibro-sis. The possible mechanism may be related to repress-ing oxidative stress of myocardium, lowering serum AGEs and down regulating AGEs and CTGF of myocar-dium.
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Aim To investigate the effects and mecha of ganoderma lucidum polysaccharides and metformin on pathological changes of thoracic aorta in diabetic ratsandthemechanisms.Methods SDratswerefed with high fat diet for 4 weeks and injected with strepto-zotocin ( 30 mg · kg-1 ) to replicate type 2 diabetic model. The diabetic rats were randomly into diabetes group, ganoderma lucidum polysaccharides group ( 600 mg·kg-1 ) ,metformin group(600 mg·kg-1 ) ,combi-nation group ( ganoderma lucidum polysaccharides 300 mg· kg-1 + metformin 300 mg · kg-1 ) and normal control group. After 12 weeksˊ treatment, the levels of fasting serum glucose, the activity of catalase(CAT), glutathione peroxidase ( GSH-Px ) , total cholesterol (TC)and triglyceride(TG) in serum were detected. Pathological changes of thoracic aorta were observed by HE staining. Immunohistochemy and Western blot were used to detect thoracic aorta VEGF protein expression. Results Combination group could lower fasting serum glucose and blood fat significantly, meanwhile the ac-tivity of CAT and GSH-Px in serum was improved. The expression of VEGF in thoracic aorta was repressed. The result of HE staining suggested that the lipid de-posits in aortic endothelium in combination group were lessthanthoseinthemodelgroup.Conclusions Ga-noderma lucidum polysaccharides combined with met-formin has an obvious prevention on pathological chan-ges of thoracic aorta in diabetic rats. The possible mechanism may be related to repressing oxidative stress of thoracic aorta, regulating the dyslipidemia, and the down regulation of the expression of VEGF in thoracic aorta.
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Objective To determine schisandrin,schisandrol B,deoxyschizandrin,and schisandrin B in serum containing drug of Compound Wurenchun Capsula.Methods An HPLC method was set up.Li-chrosphere C18 column(250 mm ?4.6 mm,5 ?m) and Phenomenex Description C18(4.0 mm?3.0 mm)protective column were used.Acetonitrile-water was used as gradient mobile phase.The flow rate was 1.0 mL/min.The column temperature was 30 ℃ and the detection wavelength was 210 nm.Results The linear ranges of schisandrin,schisandrol B,deoxyschizandrin,and schisandrin B were within 0.051 2-0.768 0 ?g(r=0.999 5),0.054 0-0.810 0 ?g(r=0.999 6),0.012 3-0.184 5 ?g(r=0.999 8),and 0.039 8-0.597 0 ?g(r=0.999 6),respectively.The average concentration of these four lignans in serum containing drug were 8.021 1,6.231 0,0.530 8,and 5.851 0 ?g/mL,respectively.Conclusion This method is easy,sensitive,specific,and accurate for the assaying of the four lignans in serum containing drug of Compound Wurenchun Capsula.
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Objective To identify the drug-induced constituents in rat serum containing drug of Compound Wurenchun Capsula and determine the content of these constituents. Methods Identification of the drug-induced constituents in serum has been carried out by combinative method of HPLC-DAD and UPLC-MS/MS. The content of four lignans in serum has been detected by HPLC-UV. Results Seven of eight original form compounds in serum have been identified as schisandrin,gomisin J,schisandrol B,deoxyschizandrin,gomisin N,schisandrin B,and schisandrin C. The UV spectrogram of five metabolites showed the absorption character of dibenzocyclooctadiene lignans. Eight lignans were identified by UPLC-MS/MS,besides schisantherin,there are seven lignan-like ones detected by HPLC-DAD. The content of schisandrin,schisandrol B,deoxyschizandrin,and schisandrin B in serum was (8.145 3?1.020 2),(6.604 5?1.341 4),(0.560 1?0.137 5),and (5.933 0?0.966 6) ?g/mL,respectively. ConclusionLignans and their metabolites are composed of the main drug-induced constituents in rat serum.
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Objective To compare the content of main constituents of Compound Wurenchun Capsules dissolved in serum and plasma of rats. Methods Serum and plasma containing drug were prepared after ig the preparation to rats. Lichrosphere C_ 18 (250 mm?4.6 mm, 5 ?m) column and Phenomenex Description C_ 18 (4.0 mm?3.0 mm) protective column were used. The mobile phase consisted of methanol-water, eluted in gradient mode. The flow rate was 1.0 mL/min. The column temperature was 30 ℃ and detection wavelength was 254 nm. Results The linear ranges of schisandrin and schisandrin B were 0.051 2 .614 4 and 0.039 8—0.477 6 ?g. The average relative recoveries of schinsandrin and schisandrin B were 96.72%, 101.06%, 102.05%, and 99.03%, 100.18%, 100.28% in low, middle, and high concentrations, respectively. The average contents of schisandrin in serum and plasma were 11.063 2 and 12.883 7 ?g/mL, schisandrin B were 7.490 9 and 12.590 8 ?g/mL, respectively. Conclusion The main constitu-ents of Compound Wurenchun Capsules contained in plasma account for higher than the ones in serum.
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AIM: To illuminate the therapeutic basis of Compound Wurenchun Capsules in combination with serum pharmacology,the lignans of this preparation migrating to blood of rats after oral administration having been accomplished. METHODS: By UPLC-MS/MS method, lignans migrating to blood were affirmed by comparing the extracted ion chromatography (EIC) of the serum containing drug with the ones of Compound Wurenchun Capsules, the control serum and control articles, correlated ion peak in mass-spectrogram were analyzed at the same time. RESULTS: Five lignans migrating to blood have been found, they are schisandrin, schisandrol B, schisantherin, deoxyschizandrin and schisandrin B. CONCLUSION: Five lignans above mentioned are likely the effective substances of Compound Wurenchun Capsules in human body. More study by means of combining with serum pharmacology will illuminate the therapeutic basis of this preparation.
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OBJECTIVE:To establish a method for content determination of schisandrin and schisandrin B in compound wurenchun capsule by RP-HPLC.METHODS:Column lichrosphere C18 was used,mobile phase of water and MeOH(gradient elution)was set up,the flow rate was 1.0mL?min-1,the column temperature was 30℃and the detection wavelength was 254nm.RESULTS:The linear ranges of schizandrin and schisandrin B were within 0.182 4～1.641 6?g(r=1.000 3)and 0.189 6～ 1.706 4?g(r=0 .999 9),respectively.The average recoveries were 98.32%(RSD=1.02%)and 97.22 %(RSD=0.94%),respectively.CONCLUSION:The established method is convenient,accurate and highly specific,and it can be used for the quality control of compound wurenchun capsule.