Study on the medication law and mechanism of treatment of lumbar disc herniation by national Traditional Chinese Medicine master Liu Bailing based on data mining and network pharmacology / 国际中医中药杂志

Objective:To explore the core prescriptions and mechanism of national TCM master Liu Bailing in the treatment of lumbar disc herniation (LDH) based on data mining and network pharmacology methods; To provide the clinical reference for the treatment of LDH.Methods:The cases of LDH treated by Professor Liu in Affiliated Hospital of Changchun University of Chinese Medicine, from January 1, 2011 to December 31, 2019 were collected and analyzed. Hierarchical clustering and association rules were used to analyze the medication rules and core prescriptions. TCMSP, GeneCards, ETCM, SymMap, DAVID, etc. were used to analyze the network pharmacology of the core compounds in treating LDH and symptoms, and reveal the mechanism.Results:A total of 1 334 prescriptions were included, involving 201 kinds of Chinese materia medica, among which the medicinal property was mainly warm, the flavor was mainly sweet and the meridians were mainly liver meridian and kidney meridian; the core medicines for the treatment of LDH included Aconiti Lateralis Radix Praeparata, Spatholobi Caulis, Cinnamomi Cortex, Corydalis Rhizoma, Eucommiae Cortex, Paederia Foetida and Amomi Fructus, reflecting that Professor Liu Bailing often treats LDH from the perspective of kidney deficiency, and commonly uses the treatment methods of dispelling wind, relieving pain, warming yang and benefiting the kidney. The core prescriptions mainly participated in three pathways of cancer, immunity and cell metabolism, including PI3K-Akt signaling pathway, TNF signaling pathway and FoxO signaling pathway. Conclusion:Professor Liu Bailing's treatment of LDH focuses on overall dialectical treatment, which mainly dispels wind, relieves pain, warms yang and benefits the kidney and the mechanism of the core prescriptions may lie in diminishing the inflammatory response. The core prescriptions may treat LDH by regulating the immune response and cellular physiological functions.

Development of the modified medication regimen complexity index of Chinese version(mMRCI-C)and its validation in elderly diabetic patients / 中华全科医师杂志

Objective:To develop the modified medication regimen complexity index of Chinese version (mMRCI-C)and test its reliability and validity.Method:The Chinese version of MRCI was developed by modification,translation and back translation. The MRCI was interculturally adapted by 2-rounds of expert consultation and pilot study to ensure the semantics, content and conceptual equivalence. The validation of the mMRCI-C scale was tested among 420 community-dwelling elderly patients with type 2 diabetes mellitus(T2DM) in Shanghai Changfeng Community Health Service Center from October to December 2020. SPSS 23.0 was used to analyze the reliability and validity of the scale.Results:The mMRCI-C scale included 3 dimensions, namely drug dosage form (14 entries), medication frequency (5 entries), and additional instructions (6 entries), with a total of 25 entries. Among 420 valid questionnaires collected,the respondents were 212 males (50.4%) and 208 females (49.6%) with a mean age of (71.4±8.1) years. The test-retest reliability was 0.999 and internal consistency reliability was 0.849. The content validity exceeded 0.80,the convergent validity was 0.932; and discriminant validity P<0.001. Conclusion:The preliminary testing results show that the reliability and validity of the mMRCI-C scale are satisfactory.

Risk factors associated with drug therapy among elderly people with Alzheimers disease: a cross-sectional study

ABSTRACT BACKGROUND: Improving knowledge and establishing strategies and policies for better patient safety are worldwide priorities. OBJECTIVE: To evaluate drug safety among elderly people with Alzheimer's disease (AD). DESIGN AND SETTING: Cross-sectional study among elderly people within the National AD Assistance Protocol (PCDTDA/MS) who were living in the municipality of Araraquara, Brazil, in 2017. METHODS: Through interviews conducted with relatives/caregivers of elderly people with diagnoses of AD, the following variables were evaluated: comorbidities, drug therapy used, use of potentially inappropriate medications for the elderly (PIMs), presence of potentially inappropriate interactions (PIIs) and medication regimen complexity index. Factors associated with AD severity were also evaluated. Multivariate and simple logistic regressions were applied. RESULTS: 143 elderly people enrolled in PCDTDA/MS were analyzed. The majority were women (67.1%); assisted only through the public healthcare system (75.5%); polymedicated (57.4%); using at least one PIM (63.6%); presenting at least one PII (63.6%); and under drug therapy of low to medium complexity (92.2%). No semi-annual monitoring of the effectiveness of PCDTDA/MS drugs was identified. The proportion using AD drug therapy at daily doses differing from those recommended by the World Health Organization was 75.6%. However, these doses were not associated with drug risk. CONCLUSION: The data from this study raise the hypothesis that use of polypharmacy might show a correlation with severity of AD. The drug safety risk may be associated with comorbidities of the metabolic syndrome, anxiety and off-label use of PIMs, such as risperidone and quetiapine, and benzodiazepines (i.e. clonazepam and flunitrazepam).

Analysis on diagnosis and treatment scheme of traditional Chinese medicine in treatment of COVID-19 in Chinese provinces and regions / 中草药

Since December 2019, a novel coronavirus-infected pneumonia was first detected in Wuhan, such cases had been subsequently discovered in other cities. The disease caused by the novel coronavirus was officially named COVID -19 (coronavirus disease 2019) by the world health organization. National Health Commission of China and other provinces and cities have successively performed syndrome differentiation of COVID-19 and provided corresponding Chinese medicine treatment programs. In this epidemic, the disease is a “dampness toxin”. The best principle for treatment is early detection and early treatment. Both Chinese and Western medicine have their own advantages. The advantages could be complementary and could not be replaced each other. Therefore, we collected the Chinese medicine treatment programs for the treatment of COVID-19 comprehensively, conducted a systematic analysis, and especially analyzed the pharmacological basis of traditional Chinese medicine for the treatment of COVID-19, which provided a basis for the rationality of Chinese medicine prescription for the treatment of COVID-19, and provided a reference of updating the diagnosis and treatment plan for provinces and cities.

Application of Monte Carlo Simulation Method in the Formulation of Primary Medication Regimen for Antibacterial Drug Treatment of ICU Patients with Escherichia coli Infection / 中国药房

OBJECTIVE： To provide reference for the formulation of primary medication regimen for antibacterial drug treatment of ICU patients with Escherichia coli infection. METHODS： Based on the surveillance report on E. coli resistance in hospitals issued by CHINET China bacterial drug resistance surveillance network in 2016， 19 third class A hospitals in China were collected as E. coli clinically isolated from ICU wards. Antibiotics with resistance rate of less than 40％ to E. coli and with high utilization rate in clinical practice were selected as the research objects， and a simulated drug delivery scheme was formulated. Monte Carlo simulation method was used to simulate the clinical effect of different dosage regimens on 10 000 cases among “patients with E. coli infection” in ICU wards. The target thresholds were ％fT＞MIC＞50％ （piperacillin/tazobactam， cefoperazone/sulbactam），％fT＞MIC＞40％ （meropenem）， fcmax/MIC＞10 （amikacin）. The cumulative response percentage （CFR） to the target threshold requires that CFR be greater than 90％ for the optimal regimen. The results were compared with those of 275 clinical ICU pationts. RESULTS： Four antibiotics were identified， namely cefoperazone/sulbactam， piperacillin/tazobactam， meropenem and amikacin； sixteen medication regimen were simulated， including 1 kind of cefoperazone/sulbactam “3.0 g， q8 h”； 3 kinds of piperacillin/tazobactam “2.25 g，  q6 h” “3.375 g， q8 h” and “3.375 g， q6 h”； 2 kinds of meropenem “0.5 g， q8 h” “1.0 g， q8 h”； 3 kinds of amikacin “0.4 g， q24 h” “0.6 g， q24 h” and “0.8 g， q24 h”. Their CFR values were higher than 90％， all of them could be regarded as primary medication regimen. The clinical results were basically consistent with the simulation results. CONCLUSIONS： Above medication regimen of piperacillin/tazobactam， cefoperazone/sulbactam， meropenem and amikacin can be used as initial empirical drug selection for patients with E. coli infection in ICU.

Description of the complexity of prescribed medication regimens in primary health care of Ribeirão Preto - SP

Introduction: Pharmacotherapy is the main therapeutic resource for the management of diseases. However, the number of drugs prescribed, dose frequency, and mode of administration can make the treatment more complex and influence treatment outcomes. The aim of this study was to measure the complexity of prescribed medication regimens in primary health care (PHC) services in Ribeirão Preto, Brazil. Methods: This cross-sectional study included 1,009 participants: 889 from primary health units and 120 from family health units in Ribeirão Preto, Brazil. Treatment complexity was assessed using the Medication Regimen Complexity Index (MRCI). Results: MRCI mean scores were 12.5 points (SD = 9.3) and dose frequency was the major contributor to increase the score. The complexity of pharmacotherapy showed a significant correlation with the number of prescribed medications (r = 0.93, p < 0.01), but not with patients' age (r = 0.28, p < 0.01). There is also no difference in complexity between the sexes (p = 0.83) and the types of primary health care service (p = 0.31). An analysis of variance revealed that patients with lower levels of education receive more complex prescriptions (p < 0.01). Conclusions: The pharmacotherapy prescribed in PHC services from Ribeirão Preto, Brazil is complex, and there is a need to concentrate efforts and adopt strategies to simplify drug prescription without compromising patient's clinical status.

ADHERENCE TO MEDICATION REGIMEN IN PATIENT WITH GRAND MAL SEIZURE: ASSESSED BY MORISKY MEDICATION ADHERENCE SCALES / Шинэ санаа Шинэ нээлт

Grand mal is the main characteristic of epileptic isorder. Other seizures that caused by non-epileptic disorders are called symptomatic epilepsy, epilepsy-like seizure and symptomatic seizure. The primary treatment of seizure patient is anticonvulsive medication. Therefore, adherence to medication regimen is important to reducing seizure incidence and preventing complications. Accreditation processes to study that how influence on the institution and individual development The survey was conducted by descriptive cross-sectional design in outpatient clinic of NCMH. Morisky Medication Adherence Scales are used to assess adherence to medication regimen of seizure patient’s. Folstein rapid test is used to assess dementia. Overall, 70 patients, aged 20-71 years, 36 males and 34 females were participated our survey. 81.4% of total participants were patients with seizure syndrome caused by brain injure; 14.3% were patients suffering from congenital epilepsy and 4.3% of them could not described causes of their disease. 29.9% of all participants assessed as mild and moderate dementia, 34.3% of participants assessed non-adherent to medication regimen by scale 4 item and 77.1% of participants assessed non-adherent to medication regimen by scale 8 item. 29.9% of all participants have dementia, and 34.3%-77.1% of patients are non-adherent to medication regimen. Thus, our study suggests that there is a direct correlation between dementia and an adherence to medication regimen.

ADHERENCE TO MEDICATION REGIMEN IN PATIENT WITH GRAND MAL SEIZURE: ASSESSED BY MORISKY MEDICATION ADHERENCE SCALES / Шинэ санаа Шинэ нээлт

Grand mal is the main characteristic of epileptic isorder. Other seizures that caused by non-epileptic disorders are called symptomatic epilepsy, epilepsy-like seizure and symptomatic seizure. The primary treatment of seizure patient is anticonvulsive medication. Therefore, adherence to medication regimen is important to reducing seizure incidence and preventing complications.Accreditation processes to study that how influence on the institution and individual developmentThe survey was conducted by descriptive cross-sectional design in outpatient clinic of NCMH. Morisky Medication Adherence Scales are used to assess adherence to medication regimen of seizure patient’s. Folstein rapid test is used to assess dementia. Overall, 70 patients, aged 20-71 years, 36 males and 34 females were participated our survey. 81.4% of total participants were patients with seizure syndrome caused by brain injure; 14.3% were patients suffering from congenital epilepsy and 4.3% of them could not described causes of their disease. 29.9% of all participants assessed as mild and moderate dementia, 34.3% of participants assessed non-adherent to medication regimen by scale 4 item and 77.1% ofparticipants assessed non-adherent to medication regimen by scale 8 item.29.9% of all participants have dementia, and 34.3%-77.1% of patients are non-adherent to medication regimen. Thus, our study suggests that there is a direct correlation between dementia and an adherence to medication regimen.