Progress and prospect of inhaled biological agents in asthma / 中国临床药理学与治疗学

More than 300 million people worldwide suffer from asthma, and the incidence is increasing year by year. As one of the most common chronic diseases, asthma is an immune-mediated inflammatory disease with complex triggering mechanisms and strong heterogeneity. With the in-depth study of physiological and pathological mechanisms, therapeutic small molecule and hormone drugs have been introduced to control and treat most patients, but about 5% - 10% of patients still suffer from various subtypes of difficult to control and treat asthma, that is, severe asthma. In the past decade, with the rapid development of bio-pharmaceutical research, protein and antibody have become the key drugs for the treatment of severe asthma with high efficacy, high specificity and high safety. However, biological drugs are usually administered by injection, they cannot be noninvasive and directly delivered into the lung to quickly absorb and take effect. Therefore, there is an urgent need for the introduction of inhaled biologics with quick effectiveness, convenience, economy and safety in clinical. The review summarizes the existing small molecule, hormone and biological therapy drugs, and summarizes the development of inhalable biological agents of asthma, and analyzes the future prospects of the inhalable biological drugs, which is designed to deepen the perception of the direction of the inhalable biological drugs research, and update the information of the field, in order to provide reference for the development of more inhalable biologics.

Research progress in the route of administration and corresponding dosage form of triamcinolone acetonide / 中国药房

As a glucocorticoid drug with wide clinical application， triamcinolone acetonide can be administered by multiple routes， such as eye， nose， joint cavity， and skin， for the treatment of various local diseases such as arthritis， macular edema， rhinitis， and urticaria. As a drug with extremely low solubility in water， the dose form of triamcinolone acetonide is closely correlated with administration route and site. The dosage form of triamcinolone acetonide administered via injection（including joint cavity injection， vitreous injection， suprachoroidal injection， intramuscular injection） is mainly suspension， and the representative drugs include Kenalog-40®， Zilretta®， Triesence®， Xipere®， etc.； the dosage forms of nasal mucosal administration are mostly sprays， and the representative drug is Nasacort®； the dosage forms of oral mucosal administration are mostly patches， ointments and creams， and the representative drug is Oracort®； the dosage forms for transdermal administration are mostly ointments， creams and lotions， and the representative drugs include Trianex®， Teva-Triacomb®， etc. At present， the research on dosage forms of triamcinolone acetonide by various administration routes mainly focuses on the construction of delivery carriers， the addition of cosolvents or the use of new delivery tools.

Research progress on new dosage forms of progesterone and its preparation methods / 药学学报

Progesterone is currently the first-line drug for the treatment and prevention of threatened abortion and habitual abortion. With the gradual liberalization of China's childbirth policy, the number of elderly parturients has increased significantly. As a result, the market demand for progesterone and the individual requirements have been continuously improved. Clinical studies have found that the indications of progesterone are not limited to gynecological diseases, but can also be used for the treatment of renal colic, traumatic brain injury and other diseases. Existing progesterone preparations include oral capsules, intramuscular injections, vaginal gels, etc., but they can no longer meet the current market situation and the increase of indications. Improving existing preparations, developing new preparations, and opening up new routes of administration have become one of the directions of progesterone drug research. This article will review the research progress of new dosage forms in existing administration, new routes of administration and related preparation methods of progesterone.

Application Analysis of Tranexamic Acid in the Orthopedic Inpatients from 4 Third-grade Class-A Hospitals in Chongqing / 中国药房

OBJECTIVE：To investig ate the application and trend o f tranexamic acid in the orthopedic inpatient ，and to provide reference for rational drug use. METHODS ：The consumption of tranexamic acid ，the distribution of orthopedics diseases using tranexamic acid and route of administration were analyzed in 3 sub-departments （joint surgery department ，spinal surgery department，orthopedic trauma department ）from 4 third-grade class-A hospitals of Chongqing during 2017 to 2020. RESULTS ： The total consumption of tranexamic acid used in orthopaedic department had increased year by year in the past 4 years，with increase of 6.2％-52.2％，and the consumption of tranexamic acid in various departments also increased year by year ；from 2017 to 􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂 书辅料标明情况及风险控制建议 [J].中国药师，2018，21 中华中医药杂志，2018，33（6）：2225-2229. （18）：2020-2022. [10] 孟菲，李学林.中成药说明书中规格项存在的问题与探 [ 7 ] 国家药典委员会.中华人民共和国药典：二部[S]. 2010年 讨[J].当代医学，2015，21（12）：14-15. 版.北京：中国医药科技出版社，2010：1014. [11] 国家食品药品监督管理局 .中成药规格表述技术指导原 [ 8 ] 孟菲，李学林.中成药说明书中功能主治项表述方法的探 则：征求意见稿 [EB/OL].（2017-10-11）[2020-12-20]. 讨[J].中医药临床杂志，2015，27（1）：111-112. https：//www.nmpa.gov.cn/xxgk/zhqyj/zhqyjyp/20171011- [ 9 ] 田硕，郭晖，苗明三.中成药说明书完善的思考及实践[J]. 151401184.html. [12] 王裴芳.我国中成药说明书中老年人用药项的调查分 Δ基金项目：重庆市科技计划项目-技术预见与制度创新项目（No. 析[J].中国药房，2015，26（29）：4055-4057. cstc2018jsyj-zdcxX0052）；重庆市社会科学规划项目（No.2019QNGL31） [13] 林志健，周伟龙，张冰，等.中成药说明书中儿童用药信息 ＊硕士研究生 。研究方向 ：社会医学 、卫生事业管理 。电话： 023-68485178。E-mail：351389583@qq.com 的修订完善思考 [J].药物流行病学杂志 ，2018，27（4）： # 通信作者：教授，硕士生导师，硕士。研究方向：医事法学、卫生 244-248. 政策、卫生事业管理。电话：023-68485178。E-mail：puchuan68@sina. （收稿日期：2021-01-07 修回日期：2021-05-26） com （编辑：罗 瑞） ·1622· China Pharmacy 2021Vol. 32 No. 13 中国药房 2021年第32卷第13期 2019，joint surgery department accounted for the largest prop ortion（59.2％ ，53.5％ ，47.2％）to use tranexamic acid ，and orthopedic trauma department accounted for the largest proportion （39.2％）in 2020. On the whole ，top 4 orthopedic diseases in the list of the consumption of tranexamic acid were joint replacement （25.5％-29.6％），hip fracture （19.3％-23.6％），diaphysis fracture （13.5％-18.6％）and pelvic and acetabular fracture （8.2％-14.0％）. The route of administration for tranexamic acid in spinal surgery department ，joint surgery department and orthopedic trauma department was mainly intravenous application every year （accounting for 55.1％-81.0％，46.9％-77.1％，49.3％-73.3％，44.9％-71.5％）. CONCLUSIONS ：The consumption of tranexamic acid in orthopedic inpatients is increased year by year ，and is dominated by joint surgery department and orthopedic trauma department. The route of tranexamic acid is still mainly intravenous administration ，which is safe and reliable.

Preferencias del tratamiento en pacientes con Espondiloartritis axial / Treatment preferences in patients with axial spondyloarthritis

Introducción: Una de las premisas del Treat to Target (T2T) es la decisión conjunta del tratamiento entre el reumatólogo y el paciente. Por esta razón las preferencias del paciente juegan un rol fundamental en el éxito del tratamiento a corto y largo plazo. El objetivo de este estudio fue evaluar las preferencias de tratamiento de los pacientes con Espondiloartritis axial (EsPax) e identificar factores asociados a su elección. Material y métodos: Estudio de corte transversal de la cohorte ESPAXIA de pacientes ≥18 años de edad con EsPax (según criterios ASAS 2009). Se consignaron datos sociodemográficos, comorbilidades, características de la enfermedad, y tratamientos recibidos. Se administró un cuestionario especialmente diseñado, en modalidad de elección múltiple y/o respuesta categorizada según orden de importancia de los enunciados. Análisis estadístico: Estadística descriptiva. Test T de Student, test de Chi2 y análisis de regresión logística múltiple. Se consideró significativo un valor de p<0,05. Resultados: Se incluyeron 70 pacientes con una edad mediana (m) de 46,5 años (RIC: 38-57) y un tiempo m de evolución de 13,5 años (RIC: 7,75-23,25). Los aspectos más importantes en la elección del tratamiento fueron: la capacidad de mejoría en la calidad de vida, seguido por mejoría en la inflamación articular, el dolor y la función física. Las vías de administración elegidas en orden decreciente de frecuencia fueron: vía oral (VO) 51,4%, subcutánea (SC) 41,4%, intramuscular (IM) 4,3% y endovenosa (EV) 2,9%. El intervalo entre dosis más votado en la VO fue 1 comprimido semanal (61,1%), y en la SC, 1 aplicación mensual (34,5%). La elección de la VO, se asoció con: preferencia por la autoaplicación, preferencia de aplicación en el hogar y mayor nivel de escolaridad. La elección de la vía SC, fue más frecuente en los pacientes con EA. Los pacientes que recibían tratamiento biológico por vía SC, así como aquellos que tenían la actividad de su enfermedad más controlada, tuvieron mayor conformidad con el tratamiento. Conclusión: La vía de administración de la medicación preferida en nuestra cohorte de pacientes con EsPax fue la oral. Los pacientes con mayor conformidad de tratamiento fueron aquellos que recibían el tratamiento biológico por vía SC y los que tenían menor actividad de la enfermedad.

Background: One of the premises of the Treat to Target (T2T) is the shared treatment decision between the rheumatologist and the patient. For this reason, patient preferences play a fundamental role in the success of treatment in the short and long term. The aims of this study were to evaluate the treatment preferences of patients with Axial Spondyloarthritis (axSpA) and to identify the factors associated with their choice. Material and methods: Cross sectional study. Patients ≥18 years old that fulfilled the ASAS 2009 criteria for axSpA were included. Sociodemographic data, comorbidities, disease characteristics, and treatments received were recorded. A specially designed questionnaire in both, multiple choice modality and response mode listed in order of priority of the statements was administered. Statistical analysis: Descriptive statistics. Student's T-test, Chi2 test and multiple logistic regression analysis. A value of p <0.05 was considered significant. Results: Seventy patients were included with a median age (m) of 46.5 years (IQR: 38-57), 55 males (78.6%) and a median disease duration of 13.5 years (IQR: 7.75-23.25). The relevant aspects for choosing a treatment were: the ability to improve the quality of life (32.9%), followed by improvement in joint inflammation (22.9%), pain (21.4%) and physical function (14.3%). The chosen administration routes in decreasing order of frequency were: oral (51.4%), subcutaneous (SC) (41.4%), intramuscular (IM) 4.3% and intravenous (IV) 2.9%. The preferred frequency of oral administration was one tablet per week (61.1%) and SC administration, once a month (34.5%). The choice of oral route was associated with: preference for self-administration, preference for receiving the medication at home and higher level of education. The choice of the SC route was independently associated with the type of axSpA (AS) and a lower educational level. The patients under biological SC treatment and with lower disease activity, showed higher level of treatment satisfaction. Conclusion: The most preferred way of administration by patients with axSpA was the oral route. Lower disease activity and SC biological treatment were associated with treatment greater compliance.

Research progress of anti-neovascularization drugs in the relationship between ophthalmology and oncology / 国际眼科杂志(Guoji Yanke Zazhi)

@#The formation of neovascularization is not only the common pathological change of many important eye diseases, but also the basis of tumor growth and metastasis. this article introduced the relationship, application and related research of anti-angiogenic drugs in the field of ophthalmology and oncology, it also introduced the new ways of administration, facing problems and challenges now, as well as the benefits and side effects of neovascularization drugs in ophthalmology application. Through the discussion of this article, we should strengthen the communication and cooperation between ophthalmologists and oncologists in basic and clinical aspects.

mRNA vaccine delivery system based on liposome: research advances / 国际药学研究杂志

mRNA vaccines are a new class of nucleic acid vaccines. Compared with DNA vaccines, mRNA vaccines do not need to enter the nucleus, and there is no risk of integration into the genome, which makes them relatively safer. However, the poor stability of mRNA vaccines and the facile degradation by nuclease in vitro and in vivo are the bottlenecks restricting its development. Therefore, mRNA vaccines need to have a suitable delivery vehicle to deliver them to the body in order to have a better immune effect. Currently, mRNA delivery vectors include viral vectors and non-viral vectors. In this paper, a brief overview of non-viral vector liposome is presented, mainly focusing on the mRNA vaccines, liposome, endosomal escape and enhancing liposome delivery, and the research prospects of mRNA and liposome delivery vectors are also commented.

Whether Combinedly Administered Tranexamic Acid In Tkr Is More Effective Than Only Intravenous Administration?

Introduction: The aim of our study is to compare efficacy of 3 doses of intravenous (IV) Tranexamic acid (TXA) versus combined IV and intraarticular TXA in reducing blood loss and transfusion requirement in patients who underwent primary total knee arthroplasty. Methods: Group A patients were administered 3 IV doses of TXA. Group B patients were administered 1 gram of IV and 2 grams of IA dose. Results: The mean 48 hrs drain collection was 238.33 ml in group A and 149 ml in group B. Mean hemoglobin drop is 2.39 gm% in group A and 1.74 gm% in group B. Post operative blood transfusion was required in 12 patients (40%) of group A and 5 patients (16.67%) of group B. Conclusion: IA with IV TXA is more beneficial than IV TXA in reducing blood loss in primary total knee arthroplasty.

Efficacy of High-dose Morphine with Different Continuous Administration Routes:a Prospective Study in Pa-tients with Advanced Cancer Pain / 中国药师

Objective:To compare the efficacy of morphine with intravenous injection and subcutaneous injection in the treatment of advanced cancer,and explore the indications of different drug delivery methods for high-dose morphine. Methods: A prospective study was performed,and 46 cases of patients with advanced cancer pain were collected and divided into intravenous group and subcutaneous group according to the administration route. Pain was assessed during the administration,and the analgesic efficiency and the incidence of adverse reactions were observed to compare the efficacy and safety of two different ways to give high-dose morphine. Results:No statisti-cally significant differences were found in the number of outbreaks needed to be rescued,the frequency of morphine-induced drug deliver-y,the efficiency of analgesia after opioid transfer,and the incidence of opioid-related side effects between the groups (P>0.05). The dose of morphine in the subcutaneous group was higher than that of the intravenous group(P<0.05). Conclusion:The continuous ad-ministration of morphine with intravenous injection and subcutaneous injection can quickly,safely and effectively relieve pain. With the same analgesic efficacy,patients can choose appropriate administration route according to the dose of morphine, the influence degree of primary diseases and the individual will.

Comparison of Therapeutic Efficacy of Different Administration Routes of Ambroxol in the Treatment of Pediatric Respiratory Disease / 中国药房

OBJECTIVE:To investigate the optimal administration route of ambroxol in the treatment of pediatric respiratory disease. METHODS:Totally 120 children with respiratory disease in pediatric department of our hospital during Jun. 2014-Jun. 2016 were divided into intravenous dripping group and atomization inhalation group according to even and odd-numbered admission order,with 60 cases in each group. Intravenous drip group was given Ambroxol hydrochloride injection 7.5 mg dissolved in 5%glucose solution 50 mL,ivgtt,bid;aerosol inhalation group was given aerosol inhalation of Ambroxol hydrochloride injection 7.5 mg,for 15 min each time,bid. The two groups were treated with 7 d. Clinical efficacies,p(O2)and p(CO2)level,the times of sputum absorption,clinical indexes and the occurrence of ADR were compared between 2 groups. RESULTS:Total response rate of atomization inhalation group(96.67%)was significantly higher than intravenous dripping group(78.33%);p(O2)level was sig-nificantly higher than intravenous dripping group,while the times of sputum absorption,fever disappearance time,asthma disap-pearance time,oxygen therapy time,pulmonary rales disappearance time,cough disappearance time and average hospitalization time were significantly less or shorter intravenous dripping group,with statistical significance (P0.05). CONCLUSIONS:Ambroxol is effective in the treatment of pediatric respiratory disease,and clinical efficacy of atomization inhalation is better than intravenous drop.

Clinical effects of oxytocin induced labor route / 中国生化药物杂志

Objective To study and analyze the clinical effects of different oxytocin induced labor routes. Methods From March 2015 to September 2016, 100 pregnant women who needed induced labor or induced oxytocin were selected in our hospital. They were randomly divided into the control group and the study group, with 50 patients in each group. The control group with traditional infusion method, given intravenous indwelling needle puncture method in patients with the study group, select the vein elastic and straight, thick, pay attention to the reasonable sealing, adjust the dropping speed according to the patients with uterine contraction. The infusion speed, safety and accuracy of the patients in the study group and the control group were compared and analyzed. Results After the corresponding administration route, there were 0 patients with drop velocity errors in the study group, and 12 patients in the control group. In the control group, the rate of drop error was 24％, which was significantly higher than that of the study group (0％), with statistical difference (P<0.05). Among the patients in the study group, the number of blocked tubes was 1, the probability was 2％, the rate of subcutaneous infiltration was 4％, and the incidence of needle prolapse was 0％. In the control group, the rate of subcutaneous exudate was 10％, the probability of blockage was 8％, and the incidence of needle prolapse was 6％. The average time spent by the study group on regulation of drip speed was (8.09 ±2.10) s, significantly shorter than that of the control group (78.90 ± 9.20) s, with statistical difference (P<0.05). Conclusion Intravenous catheter infusion of oxytocin administered with traditional delivery mode, simple operation, can significantly reduce the drop speed error probability, the clinical effect is ideal, has the meaning of promotion.

Effects of Standardization of Clinical Research on Results of Evidence-based Medicine Analysis for Yao-tongning Capsules / 中国药房

OBJECTIVE:To investigate influential factors of standardization of clinical research on therapeutic efficacy of Yao-tongning capsules,and to provide direction for reasonable and standard development of clinical research. METHODS:Retrieved from CJFD,VIP and Wanfang database,RCTs about Yaotongning capsules in the treatment of related disease were collected. After data extraction and quality evaluation,Meta-analysis was conducted by using Rev Man 5.3 statistical software. The effects of the di-alectical situation,treatment course and route of administration on the evaluation of therapeutic efficacy of Yaotongning capsules were compared;based on this,the concepts of index evidence-based value which reflected clinical standardization were put for-ward,and its effects on Yaotongning capsules were investigated. RESULTS:A total of 71 RCTs were included,involving 11009 patients. Results of Meta-analysis showed therapeutic efficacy of Yaotongning capsules was better than that of other drugs in dialecti-cal case(P=0.02),while therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs in non-dialectical case(P<0.01);therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs when treatment course was shorter than 30 days(P<0.05),while treatment course was longer than 30 days,there was no difference in therapeutic efficacy between Yaotongn-ing capsules and other drugs(P=0.99). When did not take medicine according to the instruction,therapeutic efficacy of Yaotongn-ing capsule was inferior to that of other drugs(P<0.05);when taking medicine according to the instruction,there was no differ-ence in therapeutic efficacy between Yaotongning capsules and other drugs(P=0.94). When evidence-based value was ≥5,thera-peutic efficacy of Yaotongning capsules was better than that of other drugs(P=0.03);when evidence-based value was equal to 4, there was no difference in therapeutic efficacy between Yaotongning capsules and other drugs(P=0.56);when evidence-based val-ue was ≤3,therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs(P<0.05),with statistical significance. CONCLUSIONS:It is an important guarantee of playing therapeutic efficacy of Yaotongning capsules to regularly use drugs strictly according to the principle of dialectical treatment,and take drugs according to treatment course and instructions. Clinical trials should be standardized strictly in accordance with the instructions,so as to provide objective and fair clinical findings.

Phlebitis Induced by Alprostadil Injection with Different Administration Routes:A Systematic Review / 中国药房

OBJECTIVE:To systematically review the difference of phlebitis induced by Alprostadil injection with different ad-ministration routes,and to provide evidence-based reference for clinical rational use. METHODS:Retrieved from PubMed,EM-Base,Cochrane Library,CBM,CJFD,VIP and Wanfang database,RCTs about phlebitis induced by Alprostadil injection with dif-ferent administration routes were collected. Meta-analysis was conducted by Rev Man 5.2 statistical software after literature screen-ing,data extraction and quality evaluation according to Cochrane System Evaluator's Manual 5.1.0. RESULTS:A total of 20 RCTs were included,involving 2562 patients. The results of Meta-analysis showed that the incidence of phlebitis induced by intravenous injection was significantly higher than that induced by intravenous dripping [OR=4.11,95%CI(1.59,10.67),P=0.004] and intrave-nous pump [OR=3.50,95%CI(1.50,8.16),P=0.004]. The incidence of phlebitis induced by general apparatus infusion was signifi-cantly higher than that induced by fine filtering infusion [OR=0.03,95%CI(0.01,0.08),P<0.001],with statistical significance. CONCLUSIONS:The incidence of phlebitis induced by low-concentration of Alprostadil injection or fine filtering infusion is low-er,and that of intravenous injection is higher.

Current trend of utilization of new generation proton pump inhibitors in gastric disorders among people in Jessore city, Bangladesh.

Proton pump inhibitors (PPIs) are the most widely prescribed class of gastrointestinal drugs as they have minimal side effects and few significant drug interactions, and are generally considered safe for long-term treatment. The proton pump inhibitors such as omeprazole, esomeprazole, pantoprazole, lansoprazole and rabeprazole have quite similar efficacy and potency. Current study was carried out at Jessore district in Bangladesh to investigate the current status of most commonly prescribed PPIs in terms of their generation, gender variation, age categorization and their preferred route of administration as well. However, esomeprazole was used by top most 70% patients, followed by 20%, 6%, 3% and 1% for omeprazole, pantoprazole, rabeprazole and dexlansoprazole respectively. 75% prescriptions were prescribed for oral route of administration. 55% male and 35% of 35-50 years aged patients are suffering from peptic ulcer diseases and uses PPIs for healing process. During proton pump inhibitor therapy, it was observed to have nausea of 30% and vomiting for 28% patients as a major side effect. This study reveals that the new generation PPIs becomes more popular for the treatment of gastric disorders among people of Jessore city, Bangladesh.

Application of Different Routes of Administration of Tranexamic Acid in One Stage Posterior Surgery of Thoracic Tuberculosis / 中国药房

OBJECTIVE:To observe the effects of different routes of administration of tranexamic acid on coagulation function and amount of bleeding in patients with one stage posterior surgery of thoracic tuberculosis. METHODS:40 patients suffered from thoracic tuberculosis in our hospital from Jan. 2011 to Dec. 2013 were randomly divided into intravenous group(5% Glucose injec-tion 100 ml+tranexamic acid 10 mg/kg,through an intravenous drip at 30 min before closing the wound) and topical application group(5% Glucose injection 10 ml and tranexamic acid 10 mg/kg,through soaking the wound before closing the wound)with 20 cases in each group. Other 15 cases suffered from the thoracic tuberculosis in our hospital from Jan. 2009 to Dec. 2010 were includ-ed in control group. 3 groups received one stage posterior surgery of thoracic tuberculosis,interbody fusion and internal fixation. The difference of hemoglobin,coagulation function and the amount of suction drainage were observed before and after surgery, and followed up. Bone graft fusion and therapeutic condition of tuberculosis were observed in the study. RESULTS:There was no statistical significance in postoperative suction drainage between intravenous group and topical application group (P>0.05),but their decrease was more significant than control group,with statistical significance(P0.05). The difference value of he-moglobin in control group before and after operation was significantly higher than in intravenous group and topical application group,with statistical significance (P0.05). 55 patients were all followed up and bone graft of all cases were fused,and all patients were cured and no case recurred. CONCLUSIONS:Tranexamic acid by intravenous application or topical application can reduce hemorrhage and ane-mia after operation of thoracic tuberculosis,and has no effect on blood coagulative system.

Efficacy Comparison of Misoprostol Administrated with Two Routes in the Prevention of Postpartum Hem-orrhage / 中国药师

Objective:To compare the effect of misoprostol respectively with sublingual administration and rectal administration in the treatment of postpartum hemorrhage. Methods:Totally 72 pregnant women were randomly divided into two groups with 36 cases in each. The sublingual group was given misoprostol 600 μg under the tongue immediately after the front shoulder of baby was delivered, while the rectal group was given misoprostol 600μg into rectum deeply. The amount of blood loss in 2 hours and 24 hours after the de-livery and the adverse reactions were compared between the two groups. Results: The postpartum hemorrhageon in 2 hours and 24 hours of the sublingual group was significantly less than that of the rectal group, and the incidence of postpartum hemorrhage in the sub-lingual group was significantly lower than that of the rectal group, and the difference was statistically significant (P0. 05). However, the incidence of shiver in the sublingual group was significantly higher than that in the rectal group, and the difference was statistically significant ( P<0. 05). Conclusion:The preventive effect of misoprostol with sublingual administration on postpartum hemorrhage after natural vagi-nal delivery is better than that with rectal administration, which is safe and convenient, and worthy of promoted application in clinics.

Role of personality traits in cocaine craving throughout an outpatient psychosocial treatment program

Objective: Cocaine dependence is a major international public health concern. Its chronically relapsing nature is possibly related to craving intensity, which can be influenced by diverse biological and psychological aspects. This study aimed to evaluate the role of different personality traits in craving measured throughout a psychosocial treatment program. Method: The sample comprised 66 cocaine-dependent outpatients who were enrolled in an individual and manualized cognitive-behavioral therapy program. The influence of personality traits on craving intensity, frequency, and duration was analyzed using a generalized estimating equations model with an autoregressive correlation structure. Results: Craving varied during treatment. The personality traits of novelty seeking, reward dependence, and harm avoidance interacted with craving intensity, and the personality trait of persistence interacted with craving duration throughout the treatment period. Furthermore, there were significant interactions between drug use and craving intensity, and between different routes of administration and craving intensity. Participants who used cocaine/crack while in treatment and concurrent users of crack (i.e., freebase) cocaine and powder cocaine also had a higher craving intensity. Conclusion: The extent of craving variation can depend on certain personality styles. This study shows that craving is influenced by personality traits, and this may presumably change clinical expression involved in disease. .

Terapêutica hormonal da pós-menopausa: consequências da via de administração do estrogênio / Postmenopausal hormone therapy: consequences of the estrogen route of administration

A terapêutica hormonal da pós-menopausa é considerada a forma mais eficaz de tratamento das manifestações do climatério, Entretanto a via de administração do estrogênio pode ter influência em vários aspectos metabólicos e de segurança, tais como risco de trombose venosa profunda e efeitos nos níveis séricos de lipídios, entre outros. Esta revisão procura abordar as diferenças de efeitos dos estrogênios em diversos parâmetros metabólicos, conforme a via de administração.A terapêutica hormonal da pós-menopausa (TH) é considerada o tratamento mais eficaz para os sintomas vasomotores do climatério, entretanto é importante notar que sob esse título se agrupam várias formas de tratamento. A depender das estruturas moleculares do estrogênio e dos progestagênios empregados, suas doses, regimes e vias de administração, os efeitos desejados e os adversos podem ser significativamente diferentes.A via de administração do estrogênio é, sem dúvida, aspecto de grande relevância para a segurança e a tolerabilidade da TH, pois as vias não orais, especialmente quando o estrogênio é administrado através da pele, não fazem o assim conhecido efeito de primeira passagem hepática(1)...

Comparative study of intravenous medication and pelvic perfusion on patients with gynecological pelvic inflammatory disease / 中国基层医药

Objective To investigate the effects of intravenous medication and pelvic perfusion in the treatment of gynecological acute and chronic pelvic inflammatory disease.Methods 120 cases with pelvic inflammatory disease were randomly divided into two groups.The control group(60 cases) received intravenous drugs.The observation group(60 cases) were given pelvic infusion therapy.The treatment efficacy of the two groups was compared after treatment for 14 days.Results The obvious effective rate of the observation group was 80.00％,which was significantly higher than 50.00％ in the control group(x2 =11.58,P ＜ 0.05).The total effective rate in the observation group was 90.00％,which was significantly higher than 68.33％ in the the control group(x2 =13.72,P ＜ 0.05).The incidence rate of adverse reactions in the control group was 38.33％,that in the observation group was 20.00％,the difference between the two groups was significant(x2 =4.18,P ＜ 0.05).Conclusion Pelvic perfusion therapy can improve the clinical efficacy of pelvic inflammatory disease,improve the symptoms of patients,reduce side effects,which is worthy of clinical application.

Diabetes mellitus: A journey of insulin.

Diabetes mellitus is a chronic ailment that impairs the production of or response to insulin, a hormone that helps to convert food into energy. Its complications are responsible for excess morbidity and mortality, loss of independence and reduce quality of life. Among the major cause of disablement and early death are ischemic heart disease, retinopathy, nephropathy, peripheral vascular disease and neuropathy. Insulin replacement therapy has been used in the clinical management of diabetes mellitus for more than 85 years. As subcutaneous injection is a painful episode so various approaches like transdermal, pulmonary, intranasal, colon targeted delivery, oral delivery is tried as an alternative way. Among them oral delivery is the challenging one because insulin cannot administered orally due to rapid enzymatic digestion in stomach. For oral delivery various technology, formulation and various modification approaches are going on. It is high time to invent an acceptable non-invasive insulin delivery for the diabetes to improve patient compliance and decrease the morbidity.