Preparation and in vivo Distribution of Essential Oil from Alpinia zerumbet Fructus Encapsulated Nanoemulsions / 中国实验方剂学杂志

ObjectiveTo prepare oral nanoemulsions encapsulating essential oil from Alpinia zerumbet fructus（EOFAZ） and to investigate its pro-absorption effect in vitro and distribution in vivo. MethodThe proteoglycan conjugate polysaccharides of vinegar-processed Bupleuri Radix-bovine serum albumin（VBCP-BSA） was prepared by Maillard reaction of VBCP and BSA. Taking VBCP-BSA as emulsifier， vitamin B12（VB12） as absorption enhancer， and medium chain triglycerides mixed with EOFAZ as oil phase， the nanoemulsions loaded with EOFAZ was prepared by high energy emulsification method. The particle size， particle size distribution， surface Zeta potential， EOFAZ content and appearance and morphology of the nanoemulsions were characterized， and fluorescein tracer method was used to investigate the absorption effect of fluorescein-labeled EOFAZ nanoemulsions in vitro and their distribution in vivo. ResultVBCP-BSA was formed by Maillard reaction for 48 h with high grafting rate. Using VBCP-BSA as emulsifier， the homogeneous pink nanoemulsions was prepared and denoted as EOFAZ@VBCP-BSA/VB12. The particle size of the nanoemulsions was less than 100 nm and the particle size distribution was uniform. The surface of the nanoemulsions was a weak negative charge， and the shape was spherical. The encapsulation rate of the nanoemulsions for EOFAZ was greater than 80%， which had a good absorption effect in vitro and could enhance liver accumulation after oral administration. ConclusionThe designed proteoglycan nanoemulsions can effectively load EOFAZ， promote oral absorption and enhance liver distribution， which can provide experimental basis for the development of oral EOFAZ liver protection preparations.

Research progress of sustained-release drug delivery system for uveitis / 国际眼科杂志(Guoji Yanke Zazhi)

Uveitis, a complex ocular disorder with numerous etiologies, can result from infection, autoimmune, and various physicochemical and mechanical injury factors. The treatment of this disease is difficult, and failure to receive timely and effective treatment can often lead to blindness. With the deepening of people's understanding of uveitis and its related mechanisms, various new sustained-release drug delivery systems for uveitis have been studied. However, due to the existence of various anatomical and physiological barriers in the eye, there are multiple obstacles to the sustained release treatment of uveitis. In this paper, the main research results in this field in recent years are reviewed, and the innovations and limitations of various new sustained-release drug delivery systems are discussed in order to provide new ideas for the sustained-release drug delivery treatment of uveitis in the future. These new sustained-release drug delivery systems will help to completely change the traditional treatment mode of uveitis with side effects and poor compliance in the future, bringing longer targeted sustained release and less toxic reactions.

Usage and Dosage Analysis and Countermeasures for Development of Compound Preparations of Han Dynasty Famous Classical Formulas / 中国实验方剂学杂志

In order to provide a reference basis for the development of relevant compound preparations， this article takes a comprehensive analysis of the usage and dosage of famous classical formulas in Han dynasty from various perspectives， and gives corresponding countermeasures on this basis. Through the comprehensive analysis of the classification and statistics of Zhongjing's medication characteristics， decoction methods， administration and dosage， and combining conversion methods of weights and measures by ancient medical practitioners， along with the dosage and administration of the listed Han dynasty famous classical formulas， it was found that the "Jiangxi method" served as a general guideline for administration according to Zhongjing's original text. This method allowed for flexible dosing based on the conversion of the ancient measurements to modern equivalents［13.8 g per Liang（两）］， ensuring the safe and effective medication of these formulas. After combing， it is found that although the dosage of single medicine is large in famous classical formulas from Han dynasty， the administration is flexible. The crude drug amount per administration serves as the foundational dose， with the frequency of administration adjusted flexibly according to the condition. This dosing approach becomes the key for the rational development of compound formulations of famous classical formulas. Based on the conclusions of the study， it is recommended that when developing compound formulations of famous classical formulas in Han dynasty， the original administration method and dosage should be respected. The original crude drug amount per administration should be considered as the daily foundational dose， with the frequency of administration described within a range（1 to N times per day， where N is the maximum number of administrations as per the original text）. The specific frequency of administration can be adjusted flexibly by clinical practitioners based on the individual condition. This approach should also be adopted in toxicological studies， where the dosage per administration serves as the basis for toxicity research， and the toxicity profile at the maximum administration frequency should be observed， providing guidance on the clinical safety range. Corresponding drug labels should provide information within a range to indicate toxicological risk intervals.

Comparison of the efficacy of latanoprost versus dorzolamide/timolol fixed combination therapy in patients with pseudoexfoliative glaucoma according to glaucoma stage / Comparação da eficácia da terapia de combinação fixa latanoprosta versus dorzolamida/timolol em pacientes com glaucoma pseudoesfoliativo de acordo com o estágio de glaucoma

ABSTRACT Purpose: Only a few trials have compared the intraocular pressure-lowering effects of prostaglandin analogs to carbonic anhydrase inhibitor plus beta-blocker fixed-dose combination therapy in patients with pseudoexfoliative glaucoma. Furthermore, the influence of the glaucoma stage on the intraocular pressure-lowering effects of these drug types has not been studied. The purpose of this study was to compare the IOP-lowering efficacy of latanoprost, a prostaglandin analog versus dorzolamide/timolol fixed combination, a carbonic anhydrase inhibitor plus beta-blocker fixed-dose combination therapy, in patients with pseudoexfoliative glaucoma based on glaucoma stage. Methods: The data of 32 eyes (32 patients) diagnosed with uniocular pseudoexfoliative glaucoma and treated with topical latanoprost (Group 1) or dorzolamide/timolol fixed combination (Group 2) were retrospectively assessed. The groups were subdivided into early and moderate-advanced stages. Patients' demographics, baseline intraocular pressure, final intraocular pressure, and intraocular pressure difference (the difference between the baseline and final intraocular pressure) were determined from medical records and compared between groups and according to glaucoma stage. Results: The mean drug use duration was 17.7 ± 13.5 months. No significant differences in mean baseline intraocular pressure, mean final intraocular pressure and mean intraocular pressure difference between Groups 1 and 2. In Group 2, the mean intraocular pressure difference was significantly greater in patients with early versus moderate-advanced stage glaucoma (p=0.015). The difference, however, was not detected in Group 1. The mean intraocular pressure difference in early-stage glaucoma was significantly greater in Group 2 versus 1 (p=0.033). Conclusions: Latanoprost and dorzolamide/timolol fixed combination are effective treatments for newly diagnosed pseudoexfoliative glaucoma. In early-stage pseudoexfoliative glaucoma, greater intraocular pressure reduction was noted with dorzolamide/timolol fixed combination than with latanoprost; thus, dorzolamide/timolol fixed combination should be considered when a significant decrease in intraocular pressure is desired in early-stage glaucoma.

RESUMO Objetivo: Estudos limitados examinaram os efeitos de redução de pressão intraocular de análogos de prostaglandina versus inibidor de anidrase carbônica mais terapia de combinação de dose fixa beta-bloqueador em pacientes com glaucoma pseudoesfoliativo. Além disso, a influência do estágio de glaucoma nos efeitos de redução da pressão intraocular desses tipos de drogas não foi avaliada. Este estudo teve como objetivo comparar a eficácia de redução do IOP do latanoprosta, uma combinação fixa análoga de prostaglandina versus dorzolamida/timolol, um inibidor de anidrase carbônica mais terapia de combinação de dose fixa beta-bloqueador, em pacientes com glaucoma pseudoesfoliativo de acordo com o estágio de glaucoma. Métodos: Os dados de 32 olhos (32 pacientes) diagnosticados com glaucoma pseudoesfoliativo monocular e tratados com latanoprosta tópica (Grupo 1) ou combinação fixa de dorzolamida/timolol (Grupo 2) foram avaliados retrospectivamente. Os grupos foram subdivididos em estágios inicial e moderado-avançado. A demografia dos pacientes, a pressão intraocular da linha de base, a pressão intraocular final e a diferença de pressão intraocular (a diferença entre a pressão intraocular da linha de base e a pressão intraocular final) foram determinadas a partir dos prontuários médicos e comparadas entre os dois grupos e de acordo com o estágio de glaucoma. Resultados: A duração média do uso de drogas foi de 17,7 ± 13,5 meses. Nenhuma diferença significativa foi observada entre os grupos 1 e 2 para a média da pressão intraocularda linha de base, média da pressão intraocular final e média da diferença da pressão intraocular. No Grupo 2, a média da diferença da pressão intraocular foi significativamente maior em pacientes com glaucoma de estágio precoce versus moderado-avançado (p=0,015). No entanto, essa diferença não foi observada no Grupo 1. A média da diferença da pressão intraocular em glaucoma de estágio inicial foi significativamente maior no Grupo 2 versus 1 (p=0,033). Conclusões: Terapias com Latanoprosta e dorzolamida/timolol são tratamentos eficazes para glaucoma pseudoesfoliativo recém-diagnosticado. Observou-se em glaucoma pseudoesfoliativo de estágio inicial, uma maior redução da pressão intraocular com combinação fixa de dorzolamida/timolol do que com latanoprosta; assim, a combinação fixa de dorzolamida/timolol deve ser considerada quando uma diminuição significativa da pressão intraocular é almejada em glaucoma de estágio inicial.

Medicamentos intercambiables en Perú. Un estudio de revisión

La intercambiabilidad de medicamentos representa una necesidad en países en vías de desarrollo, porque brinda la posibilidad de acceder a productos de menor costo, además, permite asegurar eficacia y seguridad en los tratamientos farmacoterapéuticos. El estudio recolectó investigaciones realizadas en el estado peruano, publicadas en bases de datos de alto impacto como Scielo, Sciencedirect, Scopus y Pubmed. De las 553 investigaciones encontradas, sólo diez artículos cumplieron con los criterios de inclusión y exclusión, se identificaron medicamentos como diazepam, prednisona, amoxicilina, doxiciclina, fluconazol, fenitoína sódica, alprazolam, amlodipino, carbamazepina sódica, glibenclamida, moxifloxacino y ácido acetilsalicílico. Todos los artículos analizaron el perfil de disolución mediante el cálculo del factor de similitud f2, mientras, en otros casos, estimaron parámetros como variación de peso, friabilidad, dureza, cuantificación, uniformidad de contenido y perfil de disolución. Los resultados evidencian que nueve medicamentos incluidos en el estudio fueron analizados mediante estudios in vitro a diferentes pH (1,2; 4,5 y 6,8), y cumplieron con presentar un factor de similitud f2 mayor a 50. Se concluye que aún se encuentra en proceso la intercambiabilidad de medicamentos en el estado peruano, y que, mediante alianzas estratégicas con el sector privado, se podría tener una mayor cantidad de alternativas farmacéuticas en la recuperación del paciente.

The medicines' interchangeability represents a necessity in developing countries, because it offers the possibility of accessing lower cost products, it allows to ensure efficacy and safety in pharmacotherapeutic treatments. The study gather researches carried out in the Peruvian state published in high-impact databases such as Scielo, Sciencedirect, Scopus and Pubmed. Of the 553 researches found, only 10 articles met the inclusion and exclusion criteria, drugs such as diazepam, prednisone, amoxicillin, doxycycline, fluconazole, phenytoin sodium, alprazolam, amlodipine, carbamazepine sodium, glibenclamide, moxifloxacin and acetylsalicylic acid were identified. All the articles analyzed the dissolution profile by calculating the similarity factor f2, while, in other cases, they estimated parameters such as weight variation, friability, hardness, quantification, content uniformity, and dissolution profile. The results show that 9 drugs included in the study were analyzed by in vitro studies at different pH (1.2; 4.5 and 6.8), and complied with presenting a similarity factor f2 greater than 50. It is concluded that, the interchangeability of medicines in the Peruvian state is still in process, and that, through strategic alliances with the private sector, a greater number of pharmaceutical alternatives could be had in the patient's recovery.

Avaliação qualitativa das preparações servidas em um restaurante popular e os impactos do cenário pandêmico da covid-19 / Qualitative assessment of preparations served in a popular restaurant and the impacts of the COVID-19 pandemic scenario / Evaluación cualitativa de las preparaciones servidas en un restaurante popular y los impactos del escenario de pandemia COVID-19

Introdução:A chegadadapandemia da COVID-19 afetou diretamente o planejamento alimentar de instituições municipais, estaduais e de demais âmbitos, dentre eles as refeiçõesofertadas peloprograma restaurante popular, importante na garantia da segurança alimentarda população mais vulnerável.Objetivo:Avaliar de forma qualitativa as preparações do cardápio do almoço do Restaurante Popular do município de Santa Cruz-Rio Grande do Nortee os impactos do cenário pandêmico da COVID-19.Metodologia:Para tanto, avaliou-se os cardápios referentes aos meses de março, abril, maio, agosto e setembro de 2021, pelo método avaliação qualitativa das preparações do cardápio. Além disso, por meio da adaptação dométodosupracitado, designou-se as preparações de acordo com as recomendações do tipo de processamento segundo o Guia Alimentar para população Brasileira. Resultados:Identificou-se uma baixa oferta de frutas e folhosos, alta de carnes gordurosas e doce, regular de preparações ricas em enxofre e as cores iguais, todavia, quanto à fritura e ao conjunto de fritura + doce apresentou-se em apenas umdiada semana (n=109). Além disso, nos dois últimos meses de análisehouve aumento na oferta de folhosos, diminuição da monotonia, alimentos ricos em enxofre e doces, e ainda, as preparações com alimentos in natura ou minimamente processados + processados fizeram-se presentestodos os dias. Conclusões:Com a utilizaçãodométodo estudadofoipossível identificar ajustesno cardápiopara o período analisado, a fim de ofertar qualidade para os comensais.Ressalta-se que foi observadoque com a adaptação e redução dos casos da COVID-19, houve aumento na oferta de in natura e minimamente processados. Espera-se que melhorias e ajustes sejam realizadosnos cardápios, visto a necessidadede ser mais enfático em seu princípiode garantir a segurança alimentar (AU).

Introduction:The arrival of the COVID-19 pandemic affected directly the food planning of municipal, state and other institutions, including the meals offered by the popular restaurant program, which is important in guaranteeing the food security of the vulnerablepopulation. Objective: To qualitatively evaluate the preparations of the lunch menu at Restaurante Popular in the municipality of Santa Cruz-Rio Grande do Norteand the impacts of the COVID-19 pandemic scenario.Methodology:To this, the menus for the months of March, April, May, August and September 2021 were evaluated by the methodqualitative evaluation of menu preparations. Furthermore, through the adaptation of the methodaformentioned, preparations were designated according to the recommendations for type of processing following the Food Guide for the Brazilian population.Results:A low supply of fruits and leafy vegetables was identified, high supply of fatty and sweet meats, regular supply of preparations rich in sulfur and the same colors. However, regarding the frying and the frying + sweet combination, it was presented in just one daythe week(n=109).Moreover, in the last two months of analysis there was an increase in the supply of hardwoods, decrease in monotony,foods rich in sulfur and sweets, and even, preparations in natura or minimally processed + processed foods were presentsevery day. Conclusions:With the use of the method studied it waspossible to adjust the menufor the analyzed periodto offer qualityto diners. It should the increase in the supply of in natura and minimally processed foods stands out with the adaptation and progression of the reduction of COVID-19cases.It is expected that improvements and adjustments will be madethe menus,given the need to be more emphatic in its principleof ensuring food safety (AU).

ntroducción: La llegada de la pandemia del COVID-19 afectó directamente la planificación alimentaria de las instituciones municipales, estatales y otras, incluyendo las comidas que ofrece el programa de restaurantes populares, importante para garantizar la seguridad alimentaria de la población más vulnerable. Objetivo:Evaluar cualitativamente las preparaciones del menú del almuerzo en el Restaurante Popular del municipio de Santa Cruz-Rio Grande do Nortey los impactos del escenario de pandemia del COVID-19.Metodología:Para ello, se evaluaron los menús de los meses de marzo, abril, mayo, agosto y septiembre de 2021 por el método evaluación cualitativa de la elaboración de menús. Además, al adaptar el métodocitado, las preparaciones fueron designadas de acuerdo con las recomendaciones del tipo de procesamiento según la Guía de Alimentos para la población brasileña.Resultados: Se identificó una baja oferta de frutas y hortalizas de hoja, alta oferta de carnes grasas y dulces, regular oferta de preparaciones ricasen azufre y los mismos colores,aún,en cuanto a la fritura y la combinación fritura + dulce, se presentó en un solo díade lasemana(n=109). Además, en los últimos dos meses de análisishubo un aumento en la oferta de maderas duras, una disminución de la monotonía, alimentos ricos en azufre y dulces, y aun, las preparaciones con alimentos in natura o mínimamente procesados + procesados presentes todos los días. Conclusiones: Con el uso del método estudió fueposible identificar ajustes en el menúpara el período analizado, con el fin de ofrecer calidad a los comensales. Cabe señalar que se observó que con la adaptación y reducción delcasosCOVID-19, hubo un aumento en la oferta de productos in natura y mínimamente procesados. Se espera que se realicenmejoras y ajustesa los menús, dada las necesidades más enfáticasen su principiode garantizar la seguridad alimentaria (AU).

Avaliação da rotulagem de cosméticos clareadores de pele comercializados em Juazeiro, Bahia, Brasil / Evaluation of the labeling of skin lightening cosmetics marketed in Juazeiro, Bahia, Brazil

A hiperpigmentação da pele, principalmente na região facial, resulta em um incômodo estético que afeta a qualidade de vida do indivíduo, levando a busca por produtos clareadores. Este estudo avaliou a conformidade dos rótulos de cosméticos comercializados como "produtos clareadores de pele", bem como a existência de substâncias clareadoras proibidas neste tipo de produto. Foi realizada uma análise transversal descritiva qualitativa no período de abril a maio de 2022, em busca por cosméticos comercializados em estabelecimentos farmacêuticos e lojas de produtos cosméticos localizadas no município de Juazeiro/BA. Foram selecionados 18 produtos e os desvios de rotulagem identificados com base na legislação utilizada vigente à época do estudo, foram: ausência de informações sobre advertências/restrições de uso e número de registro incompleto, equivalente a 16,7% (n = 3) das amostras. A hidroquinona, proibida nesse tipo de produto, foi encontrada em um cosmético (5,5%). Embora a maioria das amostras analisadas esteja em conformidade com as exigências legais, os resultados evidenciam descumprimentos, indicando a necessidade de uma fiscalização mais rigorosa a fim de evitar possíveis danos à saúde do usuário.

Skin hyperpigmentation, particularly in the facial region, can be an aesthetic nuisance that affects an individual's quality of life, leading them to seek out whitening products. This study evaluated the compliance of cosmetics labels marketed as "skin lightening products", and assessed the presence of whitening substances prohibited in this type of product. A qualitative, descriptive, cross-sectional analysis was conducted between April and May 2022 in Juazeiro, Bahia, Brazil, focusing on cosmetics sold in pharmaceutical establishments and cosmetic product stores. Eighteen products were selected, and labeling deviations identified based on the legislation in force at the time of the study. These included a lack of information on warnings/use restrictions and incomplete registration numbers, affecting 16.7% (n = 3) of the samples. Hydroquinone, prohibited in this type of product by the legislation, was detected in one cosmetic (5.5%). Although most of the analyzed samples comply with legal requirements, the observed non-compliance highlights the need for more stringent inspection to prevent potential harm to user's health.

Risco ambiental provocado por resíduos de medicamentos na cidade do Rio de Janeiro, Brasil, durante a pandemia por SARS-Cov19 / Environmental risk caused by drug waste in the city of Rio de Janeiro, Brazil, during the SARS-Cov19 pandemic

Resumo Foi avaliada a relação entre a distribuição de medicamentos usados na pandemia por SARS-COV-19 no município do Rio de Janeiro e o nível de risco ambiental estimado provocado por seus resíduos. Foi coletada a quantidade de medicamentos distribuídos pelas unidades de atenção primária à saúde (APS) entre 2019 e 2021. O quociente de risco (QR) correspondeu à razão entre a concentração ambiental preditiva estimada (PECest), obtida pelo consumo e excreção de cada fármaco, e a sua concentração preditiva não efetiva (PNEC). Os PECest da azitromicina e da ivermectina aumentaram entre 2019 e 2020, tendo uma queda em 2021 provavelmente devido ao desabastecimento. Já o da dexclorfeniramina (DEX) e da fluoxetina (FLU) tiveram uma queda, retornando o crescimento em 2021. Enquanto o PECest do diazepam (DIA) aumentou ao longo desses três anos, o etinilestradiol (EE2) diminuiu, possivelmente pela priorização da APS no tratamento da COVID-19. Os maiores QR foram de FLU, EE2 e AZI. O padrão de consumo desses medicamentos não refletiu seu risco ambiental, pois os mais consumidos possuem baixa toxicidade. Vale destacar que alguns dados podem estar subestimados devido ao incentivo que foi dado durante a pandemia para o consumo de determinados grupos de fármacos.

Abstract The relationship between the distribution of medicines used in the Pandemic by SARS-COV-19 in the municipality of Rio de Janeiro and the estimated level of environmental risk caused by their residues was evaluated. The amount of medicines distributed by primary health care (PHC) units between 2019 and 2021 were collected. The risk quotient (RQ) corresponded to the ratio between the estimated predictive environmental concentration (PECest) obtained by the consumption and excretion of each drug and its non-effective predictive concentration (PNEC). Between 2019 and 2020, the PECest of azithromycin (AZI) and ivermectin (IVE) increased between 2019 and 2020, with a decrease in 2021 probably due to shortages. Dexchlorpheniramine (DEX) and fluoxetine (FLU) fell, returning to growth in 2021. While the PECest of diazepam (DIA) increased over these 3 years, ethinylestradiol (EE2) decreased possibly due to the prioritization of PHC in the treatment of COVID-19. The largest QR were from FLU, EE2 and AZI. The consumption pattern of these drugs did not reflect their environmental risk because the most consumed ones have low toxicity. It is worth noting that some data may be underestimated due to the incentive given during the pandemic to the consumption of certain groups of drugs.

Análisis de la heterogeneidad en revisiones sistemáticas de cardiología publicadas entre 2000-2005 y 2011-2016 / Analysis of heterogeneity in cardiology systematic reviews published be-tween 2000-2005 and 2011-2016 / Análise da heterogeneidade em revisões sistemáticas de cardiologia publicadas entre 2000-2005 e 2011-2016

Introducción: la cardiología es una de las especialidades médicas que cuenta con más revisiones sistemáticas y metanálisis. Estudiar la metodología de las revisiones y anali­zar su heterogeneidad estadística es fundamental para garantizar su validez científica. Objetivo: describir la comparación de medidas de asociación, modelos estadísticos y grado de heterogeneidad en metanálisis de revisiones sistemáticas de intervenciones farmacológicas en cardiología, publicadas entre 2000-2005 y 2011-2016. Metodología: estudio analítico basado en la descripción y comparación de métodos estadísticos de revisiones sistemáticas de intervenciones farmacológicas en cardiología, publicadas en la biblioteca Cochrane. Para las variables cualitativas se estimaron frecuen­cias absolutas y relativas, mientras que para las cuantitativas se determinaron medias y desviaciones estándar, o medianas y rangos intercuartílicos, según su distribución. Para establecer la diferencia de medias se realizó la prueba t de Student y para la diferencia de proporciones el Chi cuadrado. Resultados: se incluyeron 54 revisiones sistemáticas, con un total de 1053 metanálisis, 6 revisiones con 240 metanálisis entre 2000-2005 y 48 revisiones con 813 metanálisis entre 2011-2016. La mayoría de metanálisis utilizaron el tratamiento estándar como grupo de comparación (56.6%), midieron desenlaces cualitativos nominales (86.3%), determinaron riesgos relativos (63.3%) y aplicaron modelos de efectos fijos (57.8%). En 2011-2016 se encontró una media del Índice de Higgins 17.5 menor que en 2000-2005 (p<0.05). Conclusión: se evidenció una disminución de la heterogeneidad estadística y un aumento en la implementación de modelos de efectos aleatorios, lo que da cuenta de una mayor rigurosidad a la hora de demostrar resultados verdaderamente significativos.

Introduction: cardiology is one of the medical specialties with the most systematic reviews and meta-analyses. Studying the methodology of the reviews and analyzing their statistical heterogeneity is essential to guarantee their scientific validity. Objective: to describe the comparison of association measures, statistical models and degree of heterogeneity in meta-analyses of systematic reviews of pharmacological interventions in cardiology, published between 2000-2005 and 2011-2016. Methodology: analytical study based on the description and comparison of statistical methods of systematic reviews of pharmacological interventions in cardiology, published in the Cochrane library. For the qualitative variables, absolute and relative frequencies were estimated, while for the quantitative ones, means and standard deviations, or medians and interquartile ranges, were determined, depending on their distribution. The Student's t test was used to establish the difference in means and the Chi square for the difference in proportions. Results: 54 systematic reviews were included, with a total of 1.053 meta-analyses, 6 reviews with 240 meta-analyses between 2000-2005, and 48 reviews with 813 meta-analyses between 2011-2016. Most meta-analyses used standard treatment as the comparison group (56.6%), measured nominal qualitative outcomes (86.3%), determined relative risks (63.3%), and applied fixed-effect models (57.8%). In the 2011-2016 period, an average of the Higgins Index was found to be 17.5 lower than in the 2000-2005 (p<0.05). Conclusion: there was evidence of a decrease in statistical heterogeneity and an increase in the implementation of random effects models, which accounts for greater rigor when it comes to demonstrating truly significant results.

Introdução: a cardiologia é uma das especialidades médicas com mais revisões sistemáticas e metanálises. Estudar a metodologia das revisões e analisar sua heterogeneidade estatística é essencial para garantir sua validade científica. Objetivo: descrever a comparação de medidas de associação, modelos estatísticos e grau de heterogeneidade em metanálises de revisões sistemáticas de intervenções farmacológicas em cardiologia, publicadas entre 2000-2005 e 2011-2016. Metodologia: estudo analítico baseado na descrição e comparação de métodos estatísticos de revisões sistemáticas de intervenções farmacológicas em cardiologia, publicadas na biblioteca Cochrane. Para as variáveis qualitativas foram estimadas frequências absolutas e relativas, enquanto para as quantitativas foram determinadas médias e desvios padrão, ou medianas e intervalos interquartis, dependendo de sua distribuição. O teste t de Student foi utilizado para estabelecer a diferença de médias e o qui-quadrado para a diferença de proporções. Resultados: foram incluídas 54 revisões sistemáticas, com um total de 1053 meta-análises, 6 revisões com 240 meta-análises entre 2000-2005 e 48 revisões com 813 meta-análises entre 2011-2016. A maioria das metanálises usou tratamento padrão como grupo de comparação (56.6%), mediu resultados qualitativos nominais (86.3%), determinou riscos relativos (63.3%) e aplicou modelos de efeito fixo (57.8%). Em 2011-2016, a média do Índice de Higgins foi 17.5 menor do que em 2000-2005 (p<0.05). Conclusão: evidenciou-se uma diminuição da heterogeneidade estatística e um aumento da implementação de modelos de efeitos aleatórios, o que confere maior rigor na demonstração de resultados verdadeiramente significativos.

Preparaciones culinarias ¿cómo determinar cuándo forman parte de una dieta sustentable?

La adopción de formas de consumo y producción sostenibles de alimentos es una necesidad imperiosa, debido a las consecuencias adversas que los sistemas alimentarios actuales tienen para la salud y el planeta. A pesar de que estudios muestran que las personas valoran un menor efecto de la dieta en el ambiente, desconocen cómo evaluar su impacto en este sentido. Esta revisión cualitativa buscó la existencia de indicadores o herramientas que permitan evaluar la sustentabilidad de preparaciones culinarias como parte de una dieta sostenible. Se incluyen definiciones, abordajes y formas de medir y evaluar tanto la dieta como la gastronomía sustentable a nivel mundial y nacional. La búsqueda de artículos científicos se realizó en las bases de datos Medline/PubMed, Scopus, Web of Science y SciELO utilizando como palabras claves "dietas sustentables", "dietas sostenibles", "ecogastronomía", "sustainability assessment", "out of home meals", "sustainable gastronomy", "sustainable diet", "sustainable healthy diets", "sustainability indicators", "sustainable indicators", "sustainability index", "sustainable diets index", "dietas sustentáveis". Toda dieta tiene un impacto en el medio ambiente, sin embargo, factores como su composición y formas de producción determinan la magnitud de dicho impacto. Un tema central gira en torno a las metodologías para medir, analizar y evaluar los diferentes aspectos que componen la sostenibilidad de las dietas, existiendo escasa evidencia respecto de herramientas que permitan calificar las preparaciones culinarias según su nivel de sustentabilidad. Por esto, se requiere mayor investigación en la materia con el propósito de contribuir en la adopción de dietas saludables y sostenibles por parte de la población.

The adoption of sustainable forms of consumption and production is an imminent need due to the adverse consequences that current food systems have on health and the planet. Although studies show that people value a lesser effect of diet on the environment, they do not know how to evaluate its impact in this sense. This qualitative literature review investigated the existence of indicators or tools to assess the sustainability of culinary preparations as part of a sustainable diet. Definitions, approaches, and ways of measuring and evaluating sustainable diets and sustainable gastronomy at the global and national levels were included. The search for scientific articles was carried out in the Medline/PubMed, Scopus, Web of Science and SciELO databases using as keywords "sustainable diets", "sustainable diets", "ecogastronomy", "sustainability assessment", "out of home meals", "sustainable gastronomy", "sustainable diet", "sustainable healthy diets", "sustainability indicators", "sustainable indicators", "sustainability index", "sustainable diets index", "dietas sustentáveis". Every diet has an impact on the environment, however, factors such as its composition and forms of production determine the magnitude of this impact. A central issue revolves around the methodologies to measure, analyze and evaluate the different aspects that make up the sustainability of diets, and there is little evidence regarding tools to qualify culinary preparations according to their level of sustainability. Therefore, further research is required in this area in order to contribute to the adoption of healthy and sustainable diets by the population.

Simultaneous determination of five active ingredients including gallic acid in different dosage forms of Sana preparation by reverse-phase high-performance liquid chromatography / 中国基层医药

Objective:To establish reverse-phase high-performance liquid chromatography and simultaneously determine gallic acid, methyl gallate, corilagin, Sennoside B, and Sennoside A levels in Sana preparations.Methods:From January to December 2021, Phenomenex Hydro-RP 80A column (4.60 mm × 250 mm, 4 μm) was used. Elution was conducted using mobile phases methanol (A)-0.2% formic acid (B). The following gradients were applied: 1%-3%A for 0-18 minutes, 3%-15%A for 18-19 minutes, 15%-17%A for 19-40 minutes, 17%-25%A for 40-45 minutes, 25%-35%A for 45-65 minutes, 35%-60%A for 65-95 minutes, 60%-90%A for 95-96 minutes, 90%-1%A for 96-97 minutes. The flow rate was 1.0 mL/minute. The column temperature was 35 ℃. The detection wavelength was 270 nm.Results:The linear ranges of gallic acid, methyl gallate, corilagin, Sennoside B and Sennoside A were 0.182-1.099 μg ( r = 0.999 9), 0.046-0.278 μg ( r = 0.999 2), 0.266-1.598 μg ( r = 0.999 4), 0.172-1.036 μg ( r = 0.999 2), and 0.176-1.056 μg ( r = 0.999 9). The average dosing recovery rates were 100.02%, 99.14%, 99.38%, 101.77%, and 100.92%, respectively. Conclusion:Reverse-phase high-performance liquid chromatography can be used for quality control of Sana preparations because of high accuracy, sensitivity, reliability, and reproduction.

Application of interpenetrating polymer network enamel-like teeth in the dental practice teaching of crown preparations / 中华医学教育探索杂志

Objective:To explore a type of teaching teeth that can highly simulate natural teeth, and to investigate its application in the practice teaching of crown preparations.Methods:A total of 44 senior students majoring in stomatology Fourth Military Medical University were selected, and each student received the training of crown preparations using interpenetrating polymer network (IPN) enamel-like teaching teeth, extracted natural teeth, and traditional composite resin teeth. Operation assessment was performed, and the operation time of each crown preparation was recorded. According to the requirements for crown preparations, scores were determined from the five aspects of axial converging, space for repair, line angle, shoulder quality, and posture, with 10 points for each aspect and 50 points in total, and the total score was calculated. A questionnaire survey on IPN enamel-like teeth was performed for each student after assessment, and SPSS 23.0 was used to perform the least significant difference t-test and the Tambane's T2 test. Results:There was no significant difference in total assessment score between the IPN enamel-like teeth group and the natural teeth group (37.15±1.17 vs. 37.20±1.20, P>0.05), and both groups had a significantly higher total score than the resin teeth group (31.53±1.41) ( P<0.05). The IPN enamel-like teeth group and the natural teeth group had significantly higher scores than the traditional composite resin teeth group in terms of axial converging, space for repair, and shoulder quality ( P<0.05). The questionnaire survey of the students showed a relatively high score of 3.7-4.9 for each item. Conclusion:Compared with traditional composite resin teeth, IPN enamel-like teeth can more comprehensively and effectively simulate the operation and experience of natural teeth for crown preparations and thus have potential advantages in the practice teaching of crown preparations.

Textual research classic decoction Danggui Yinzi by ancient and modern literatures / 国际中医中药杂志

The Danggui Yinzi, as one of the classic prescriptions, was first recorded in Yan's Jisheng Prescription and is mainly used to treat various skin diseases with blood deficiency and wind dryness. By referring to ancient books and modern literature researches, this study analyzed and summarized the literature of Danggui Yinzi from the aspects of prescription origin, composition, addition and subtractive changes of flavor, dosage and decocting and taking method, discrimination of prescription and efficacy, raw material and processing of medicinal materials, and modern clinical application. Textual researches explored more than 80 ancient literature and 170 modern literature and showed its content included Angelicae Sinensis Radix, Paeoniae Radix Alba, Chuanxiong Rhizoma, Rehmannia Radix, Tribuli Fructus, Saposhnikoviae Radix, Schizonepetae Spica, Polygoni Multiflora Radix, Astragali Radix, Glycyrrhizae Radix et Rhizoma. It was cooked by water. It was used for the patients with skin diseases and Chinese pattern of blood deficiency wind drying. It has showed a wide range of applications, and similar application in ancient and modern time. This paper provides a more comprehensive reference for the research and development of compound preparation of Danggui Yinzi.

Research advances in signaling pathways associated with potential anti-liver fibrosis drugs and targets / 临床肝胆病杂志

Liver fibrosis is a key step in the progression of chronic liver diseases to liver cirrhosis and even liver cancer. In recent years， a large number of studies have shown the necessity of intervening in the process of liver fibrosis， and various anti-liver fibrosis drugs and active ingredients have been discovered. Non-coding RNAs also play an important role in the process of liver fibrosis， and searching for upstream non-coding RNAs that can regulate signaling pathways can provide new insights for anti-liver fibrosis treatment. This article introduces the process of liver fibrosis mediated by the TGF-β， Wnt/β-catenin， PI3K/Akt/mTOR， NF-κβ， Hippo， and MAPK signaling pathways， lists the latest anti-liver fibrosis drugs or active components in each signaling pathway， and summarizes the research advances in anti-liver fibrosis targets and drugs mediated by related non-coding RNAs， so as to provide new research ideas and treatment methods for anti-liver fibrosis treatment.

Thinking on Clinical Key Problems During Transformation of Preparations in Medical Institutions to Innovative Chinese Medicines / 中国实验方剂学杂志

Under the national policy background of traditional Chinese medicine（TCM）registration review and approval reform， TCM preparations in medical institutions（hereinafter referred to as medical institution preparations） have human use experience， conform to the characteristics of TCM clinical practice， and have advantages in the research and development of innovative Chinese medicines. Therefore， the research and development mode based on clinical experience prescription-medical institution preparations-innovative Chinese medicines has attracted widespread attention from the industry. However， in the process of development and use of medical institution preparations， there are generally clinical problems that restrict their transformation into innovative Chinese medicines， resulting in a relatively weak collection basis of human use experience and insufficient clinical evidence for supporting the research and development of new TCM medicines. In this paper， on the basis of sorting out the supporting regulations and relevant technical requirements of human use experience， and analyzing the clinical problems restricting the transformation of medical institution preparations， it provides suggestions for medical institutions to carry out high-quality research on human use experience of preparations in the process of TCM clinical practice from the aspects of continuously exploring clinical value， improving the construction of information system， focusing on the TCM clinical practice and giving full play to the advantages of discipline cooperation. By realizing the whole life cycle management of medical institution preparations based on three-combination evaluation evidence system， we can promote the transformation of medical institution preparations into innovative Chinese medicines.

Systematic Review on Safety of Chinese Medicines Combined with Tripterygium wilfordii Preparations in Treatment of Rheumatoid Arthritis and Exploration on Underlying Network Regulatory Mechanisms of Enhancing Efficacy and Reducing Toxicity / 中国实验方剂学杂志

ObjectiveTo systematically evaluate the safety of Chinese medicines combined with Tripterygium wilfordii polyglycoside tablets/Tripterygium wilfordii tablets （TWPT/TWT） in the treatment of rheumatoid arthritis （RA）， and to explore the network regulatory mechanisms of enhancing efficacy and reducing toxicity of commonly used combination regimes. MethodThe literature involving the adverse reactions of TWPT/TWT in treating RA was searched and collected from three Chinese databases （CNKI， Wanfang Data， VIP） and three English databases （PubMed， Cochrane Library， Embase） from the inception of the databases to July 2021. All studies were assessed by the Cochrane risk of bias tool， and the data were extracted and analyzed by Stata 15.0. Furthermore， Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine 2.0 （TCMIP v2.0，http：//www.tcmip.cn/） was used to construct a "drug target-symptom gene of efficacy and toxicity" interaction network， to explore the underlying network regulatory mechanisms of enhancing efficacy and reducing toxicity of common T. wilfordii preparation combinations. ResultA total of 2 132 articles on Chinese medicines combined with TWPT/TWT in the treatment of RA were retrieved， and 18 of them were finally included. The systematic review showed that the adverse reactions of TWPT/TWT against RA mainly occurred in the digestive system， blood system， and reproductive system， of which digestive system had the highest incidence of damages. However， the combination with Chinese medicines effectively alleviated the adverse reactions caused by TWPT/TWT ［RR （95% CI）=0.45 （0.30， 0.66）， P<0.01］. In addition， the subgroup analysis indicated that the age of RA patients， course of disease， combination regimen， medication dosage and duration of treatment all affected the occurrence of adverse reactions of TWPT/TWT. It was found in clinical studies that total glucosides of paeony （TGP） and TWPT/TWT was most widely combined， and the effect of TGP in reducing TWPT/TWT-induced hepatotoxicity was also more significant than that of other Chinese medicines. Moreover， taking this combination regime as an example， this paper explored the "efficacy-toxicity" association mechanisms of TGP-TWPT/TWT against RA. The "drug target-symptom gene of efficacy and toxicity" interaction network revealed that the core network targets of TGP-TWPT/TWT enhanced efficacy and reduced toxicity mainly through regulating immunity-inflammation-related pathways， metabolic pathways and cell signal transduction. Especially， interleukin-4 （IL-4） and interleukin-13 （IL-13）， which were involved in the "immunity-inflammation" module， were the common targets of TGP-TWPT/TWT to enhance efficacy and reduce toxicity. The endogenous sterols， bile acids and bile salts， insulin secretion and other metabolic pathways in the "body metabolism" module were closely associated with the mechanisms of TWPT/TWT inducing hepatotoxicity and TGP reducing hepatotoxicity. While cell function regulation pathways， such as stem cell factor （SCF）/tyrosine kinase receptor （KIT） signaling pathway and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）signaling pathway were involved in both anti-RA effects and hepatotoxicity of TWPT/TWT. ConclusionClinical application of suitable Chinese medicines combined with TWPT/TWT in the treatment of RA can effectively improve the rheumatism and reduce the adverse reactions of TWPT/TWT， and TGP-TWPT/TWT has the most significant toxicity-reducing effect. Further biological network-based investigation indicates that the toxicity-reducing mechanism of TGP-TWPT/TWT may be related to the regulation of interleukin signaling pathway and bile acid metabolism pathway， and the synergistic efficacy-enhancing effect of the combination may be achieved by acting on interleukin signaling pathway and cell function regulation pathway.

Preliminary Discussion on Post-marketing Comprehensive Evaluation Indicator System of Ancient Famous Classical Formula Preparations / 中国实验方剂学杂志

The construction of the comprehensive evaluation index system of the famous classical formula preparations after the marketing has both theoretical and practical significance. In this study， literature related to the post-marketing comprehensive evaluation of traditional Chinese medicine（TCM） compound preparations was retrieved from China National Knowledge Infrastructure（CNKI）， China Science and Technology Journal Database（VIP）， Wanfang Data Knowledge Service Platform（WanFang） and SinoMed from January 1， 2000 to April 30， 2022. CiteSpace 6.1.R2， a scientometrics software， was used to visualize the keywords involved， and to analyze the dynamic evolution trend and research hotspots in this field. Then， the existing comprehensive post-marketing evaluation index system of TCM compound preparations was screened and extracted， and the research status was systematically analyzed by mathematical statistics. It was found that there were problems such as the generalized boundaries between assessment dimensions and assessment elements， the lack of data sources for individual evaluation indexes， unset weight of some index system and insufficient application degree. In addition， according to the characteristics of famous classical formulas， the authors discuss the importance of evidence evaluation based on combination of disease and syndrome， pharmacovigilance of famous classical formulas preparations， and whole-process quality control of famous classical formulas， and put forward the construction strategy of comprehensive post-marketing evaluation of the famous classical formula preparations， which is oriented by clinical value， centered on evidence evaluation， and guaranteed by the whole-process quality control.

Research progress of traditional external preparations and novel nanoformulations of Arnebiae Radix / 中国药房

Arnebiae Radix is used widely in TCM external treatment. It has obvious curative effect on skin diseases， wound infection and local inflammation， and is used to treat water and fire burns， skin ulcers， eczema， psoriasis， vitiligo and atopic dermatitis， etc. The clinical and commercial preparations mainly include ointment， liniment and suppository. Modern research has proved that microcapsules， nano-micelles， nanofiber membranes， nanogels and other novel nanoformulations can significantly improve the stability of drug-effective substances， improve local drug concentration and targeting， and perform sound drug release properties in vitro. This paper reviews the variety and application of Arnebiae Radix traditional preparations for external use and the research progress of novel nanoformulations of Arnebiae Radix， from which we prospect to provide some valuable references for the future application and development of Arnebiae Radix external preparations.

Technique optimization of intravenous or intraperitoneal injection of Evans blue combined with retinal preparations in mice / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To optimize the technique of intravenous injection of Evans blue and retinal preparations in mice, improving the accuracy and repeatability of staining experiment of retinal preparations.METHODS: C57BL/6 male mice were intravenous injected with 10g/L(1%)Evans Blue 0.3mL and circulated in vivo for 10 or 20min, and the eyes were removed after sacrificed and fixed in 4% paraformaldehyde for 20, 40 or 60min. When failure of intravenous injection, the experiment was remediated by intraperitoneal injection of 1% Evans Blue 0.3mL, circulated in vivo for 3h and fixed for 60min to observe morphology, distribution and leakage of the retinal vessels. Besides, we compared the morphology, distribution and leakage of the retinal vessels after intravenous injection with those after intraperitoneal injection to determine the optimal conditions for in vivo circulation time and retinal preparations.RESULTS: After intravenous injection, compared to the retinal vascular condition under 20min in vivo circulation time of Evans blue and 20 or 40min of fixation, with 10min of in vivo Evans blue circulation and 60min of fixation, the morphology of retinal vascular was more intact with less retinal vascular leakage, and the vascular branches are clear. When intravenous injection failed, remediated results from intraperitoneal injection showed that the morphology and distribution of retinal vessels were intact. There was no significant difference in morphology, distribution and leakage of the retinal vessels after 3h of intraperitoneal Evans blue circulation compared to 10min intravenous Evans blue circulation.CONCLUSION: This experiment optimizes the protocol, improves the accuracy and reproducibility of retinal preparations, and provides a reference for the study of related retinal vascular diseases.

Anti-tumor Effect of Alkaloids of Chinese Medicine： A Review / 中国实验方剂学杂志

Malignant tumors， with the increasing crude morbidity and mortality year by year， have become the major diseases threatening human health. The conventional therapeutic drugs against tumors have serious adverse reactions， which can cause a heavy burden on patients. The active components of Chinese medicine can effectively inhibit tumor growth， improve the quality of life of patients， and have few toxic and side effects. Alkaloids of Chinese medicine are natural organic compounds widely existing in a variety of Chinese herbal medicines. In recent years， they have attracted more and more attention because of their anti-tumor effect. The anti-tumor mechanisms of alkaloids of Chinese medicine mainly include the induction of apoptosis， inhibition of tumor cell migration and invasion， suppression of proliferation， induction of autophagy of tumor cells， cell cycle arrest， inhibition of tumor angiogenesis， regulation of microRNA， and modulation of immunity. In addition， Chinese medicine alkaloids can also reverse tumor drug resistance and reduce the stemness of tumor stem cells. Alkaloids of Chinese medicine can regulate the phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， c-Jun N-terminal kinase （JNK）， p38 mitogen-activated protein kinase （p38 MAPK）， mammalian target of rapamycin （mTOR）， Notch， Hedgehog， Wnt/β-catenin， and other signaling pathways to participate in the processes of tumor proliferation， invasion and metastasis， autophagy and apoptosis， and affect the occurrence and development of tumors in multiple links and ways. The derivatives and nano-preparations of alkaloids can improve the solubility， utilization， and anti-tumor activity of alkaloids， bringing a broader prospect for the clinical application of alkaloids. This review summarized the recent anti-tumor research on alkaloids， their representative derivatives， and nano-preparations to provide references for the in-depth research on the anti-tumor effect of alkaloids.