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RESUMEN: La osteonecrosis mandibular asociada a medicamentos (MRONJ) es una enfermedad grave, pero de baja prevalencia en la cual los márgenes quirúrgicos de la resección ósea son determinados clínicamente por el cirujano basado en parámetros subjetivos. Debido a esto, se ha propuesto la resección ósea guiada por fluorescencia. Describir el conocimiento act ual sobre la resección ósea guiada por fluorescencia en pacientes con MRONJ. Se realizó Scoping Review, buscando en las bases de datos de Pubmed, ScienceDirect y Web of Science, utilizando los operadores booleanos AND y OR. Se aplicaron criterios de inclusión y exclusión. De 66 artículos iniciales, se seleccionaron 13 que cumplieron con los criterios de elegibilidad. Actualm ente se utiliza la técnica de fluorescencia con tetraciclinas (FT) y autofluorescencia (AF), describiéndose un éxito del 85 a 100 % y 7 7,3 a 100 % en un tiempo de seguimiento 1 a 12,9 y 4 a 13,1 meses respectivamente. Hubo 100 % de correlación Clínico-Histopatológica para tejido óseo vital y necrótico. La resección ósea guiada por fluorescencia logra discriminar clínicamente entre tejido óseo vital y necrótico, delimitando los márgenes quirúrgicos de la resección y/o desbridamiento basado en parámetros objetivos y reproducibl es que permiten estandarizar el procedimiento quirúrgico.
ABSTRACT: Medication-related Osteonecrosis of the jaw (MRONJ) is a serious but low prevalence disease in which the surgical margins of bone resection are clinically determinated by the surgeon based on subjetive parameters. Because of this, fluorescence-guided bone resection has been proposed. The objetive of this study is to describe the current knowledge of fluorescence-guided bone resection in patients with MRONJ. Scoping Review was carried out, searching the databases of PubMed, ScienceDirect and Web of Science, using the boolean operator AND and OR. Inclusion and exclusion criteria were applied. Of 66 articles, 13 were selected that met the eligibility criteriaThe technique of fluorescence with tetracyclines (FT) and autofluorescence (AF) is used, describing a success of 85 to 100 % and 77.3 to 100 % in 1 to 12.9 and 4 to 13.1 months respectively. There was 100 % Clinical-Histopathological correlation for vital and necrotic bone tissue. Fluorescence-guided bone resection is able to clinically discriminate between vital and necrotic bone tissue, allowing the delimitation of surgical margins based on objective and reproducible parameters. In addition, it allows to standardize the surgical procedure.
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Etudier l'ampleur et les caractéristiques de l'automédication en consultation ORL. Méthode: Etude descriptive du 1er juin 2020 au 1er février 2021 dans le service d'ORL-CCF/ Hôpital d'Instruction des Armées. Ont été inclus tous les patients reçus en consultation ORL ayant déclaré avoir utilisé des substances actives sans prescription médicale pour soulager leur plainte actuelle. 6 Résultats: L'automédication a été retrouvée chez 373 patients soit une prévalence de 47,88%. La moyenne d'âge était 32,26 ans (02 mois et 80 ans). Les sujets âgés 0 à 20 étaient plus représenté (68,4%). La sex-ratio était de 0,86. Les professions libérales étaient plus représentées (30%). La quasi-totalité des patients (98%) a pu énumérer au moins deux effets nocifs de l'automédication. Les médicaments en cause étaient les médicament en vente libre OTC (80%). Les principales raisons ayant motivé l'automédication ont été le coût élevé des prestations médicales (41,3%) et le manque de temps (33,2%). Conclusion: L'automédication a été retrouvée chez des patients volontiers jeunes, de sexe féminin, porteurs d'affections rhinologiques. Les OTC étaient en cause dans huit cas sur dix. Les principales motivations à l'automédication ont été le coût élevé des prestations médicales et le manque de temps
Subject(s)
Humans , Pharmaceutical Preparations , Self Medication , Pharyngitis , EarABSTRACT
A inclusão dos cuidados em Saúde Mental na Atenção Primária tem ocorrido em diversos países, incluindo o Brasil, para suprir a existência de uma lacuna assistencial. A integração dos serviços é apontada como necessária, mas ao mesmo tempo um grande desafio. O objetivo deste estudo foi realizar a análise exploratória das práticas discursivas sobre o uso dos medicamentos psicotrópicos e das abordagens não farmacológicas para superação de eventos negativos da vida. As entrevistas realizadas com médicos que trabalham na saúde da família, sobre a prática clínica nos cuidados primários em saúde mental, compuseram o corpus da pesquisa. Os dados foram tratados a partir dos pressupostos da análise do discurso. As descrições analíticas foram construídas a partir dos enunciados identificados na formação discursiva da medicalização da vida. Os resultados da análise evidenciaram o pluralismo terapêutico dos psicotrópicos e seus efeitos, com o uso menos frequente das abordagens não farmacológicas; a prescrição exclui tramas sociais mais amplas, captura a potência da vida modulando os comportamentos individuais e coletivos, para que a convivência seja assegurada e legitimada, para garantir o pretenso bem comum.
Inclusion of mental health care into primary care has occurred in several countries, including Brazil, to tackle the lack of assistance. The integration of services is seen as necessary, but at the same time a major challenge. The aim of this study was to conduct an exploratory analysis of discursive practices on the use of psychotropic drugs and non-pharmacological approaches to overcome negative life events. Interviews conducted with physicians working in family health on the clinical practice of primary mental health care made up our research corpus. Data were analyzed based on the assumptions of discourse analysis. The analytical descriptions were built based on the statements identified in the discursive formation of the medicalization of life. The results of the analysis showed the therapeutic pluralism of psychotropics and their effects, less frequently using non-pharmacological approaches. Prescription excludes broader social plots, captures the power of life by modulating individual and collective behavior, so that social life is assured and legitimized, thus ensuring the alleged common good.
L'inclusion des soins de santé mentale dans l'attention primaire se développe dans divers pays, y compris au Brésil, pour combler l'existence d'une lacune assistancielle. L'intégration des services est considérée comme nécessaire, mais également comme un défi. L'objectif de cette étude a été de réaliser l'analyse exploratoire des pratiques discursives sur l'usage des médicaments psychotropes et des approches non pharmacologiques pour surmonter les événements négatifs de la vie. Les entretiens réalisés avec les médecins travaillant en santé familiale à propos de la pratique clinique dans les soins primaires de santé mentale ont composé le corpus de la recherche. Les résultats de l'analyse ont mis en évidence le pluralisme thérapeutique des psychotropes et leurs effets, avec l'usage moins fréquent des approches non pharmacologiques. La prescription exclut des trames sociales plus amples, capture la puissance de la vie en modulant les comportements individuels et collectifs pour que la vie sociale soit assurée et légitimée, pour garantir le prétendu bien commun.
La inclusión de la atención en salud mental en el ámbito de la atención primaria se ha dado en varios países, entre ellos Brasil, para suplir la existencia de un vacío asistencial. La integración de los servicios se considera como necesaria y, al mismo tiempo, como un gran desafío. El objetivo de este estudio fue realizar un análisis exploratorio de las prácticas discursivas sobre el uso de medicamentos psicotrópicos y sobre los abordajes no farmacológicos para superar los eventos negativos de la vida. Las entrevistas a médicos, que trabajan en salud familiar, sobre la práctica clínica en salud mental dentro de la atención primaria, constituyeron el corpus de la investigación. Los datos fueron tratados a partir de los postulados del análisis del discurso. Las descripciones analíticas se construyeron a partir de las declaraciones identificadas en la formación discursiva de la medicalización de la vida. Los resultados del análisis mostraron el pluralismo terapéutico de los psicotrópicos y sus efectos, con un uso menos frecuente de abordajes no farmacológicos, la prescripción excluye tramas sociales más amplias, capta la potencia de la vida modulando os comportamientos individuales y colectivos, para garantizar y legitimar la coexistencia y garantizar el supuesto bien común.
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One of the most important objectives of root canal treatment is elimination of microorganisms in the root canals. The use of intra-canal medicament may be helpful in eliminating remaining bacteria that survived inside the root canals after complete chemo-mechanical preparation. This study aims to evaluate and compare the antimicrobial activity of Septilin, chlorhexidine and calcium hydroxide against Enterococcus faecalis and Streptococcus mutans. Intra-canal medicament helps in eliminating remaining bacteria that survived inside root canals after complete chemo-mechanical preparation. MethodsThe well variant of agar diffusion test using brain heart infusion agar was used for evaluating the antimicrobial activity of the intra-canal medicaments. McFarland 0.5 turbidity standard was taken as reference to adjust the turbidity of bacterial suspensions. The wells were prepared and filled with of Septilin, chlorhexidine and calcium hydroxide. This was done for both the test organisms and plates were incubated in an incubator for 24 hrs. at 37 °C. After incubation, antimicrobial effectiveness was determined using digital caliper (mm) by measuring zone of inhibition. ResultsThe mean zone of inhibition for chlorhexidine, calcium hydroxide, and Septilin were 29.50 ± 0.58, 25.00 ± 0.00, 20.00 ± 0.82 for E. faecalis and 28.50 ± 1.00, 24.25 ± 0.96, 19.50 ± 1.29 for S. mutans respectively. ConclusionsSeptilin showed significant inhibition against E. faecalis and S. mutans but its antibacterial activity is less compared to that of calcium hydroxide and chlorhexidine. Moreover, the dark colour of the material might cause tooth discoloration.
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Resumen Objetivo Identificar la prescripción de benzodizepinas y barbitúricos psicotrópicos: Clobazam, Tiopental, Clonazepam, Lorazepam, Fenobarbital y Diazepam en la Caja Costarricense del Seguro Social (CCSS) en Costa Rica en el periodo 2011-2015. Materiales y métodos La población estuvo constituida por 1 488 989 prescripciones de psicotrópicos dentro de la CCSS en Costa Rica en el periodo de enero del 2011 a diciembre del 2015. El estudio es de tipo descriptivo retrospectivo. Resultados Del total analizado, casi la mitad (un 47,15%) corresponden a Clonazepam. Le siguen el Lorazepam y el Diazepam con un 22,80% y un 22,53%, respectivamente. Finalmente, Fenobarbital, Clobazam y Tiopental son las menos prescritas con un 7,07%, 0,24% y 0,22% respectivamente. En cuanto a la distribución por sexo las mujeres recibieron el 62,65% de las prescripciones, el restante 37,35% fueron para hombres. Conclusión Existe un aumento exponencial en el consumo de estos fármacos en el quinquenio en estudio. Las personas al final de su ciclo productivo (40 años o más) alcanzan los mayores porcentajes de consumo que luego decrecen alrededor de los 70 años o más; las mujeres son a quienes más se les prescriben este tipo de medicamentos. Por tanto, es necesaria una monitorización continúa que favorezca un uso adecuado de estos fármacos y evite generar potenciales problemas a la salud de la población especialmente a los adultos mayores.
Abstract Objective To identify the prescription of benzodiazepines and psychotropic barbiturates: Clobazam, Thiop ental, Clonazepam, Lorazepam, Phenobarbital and Diazepam at the Costa Rican Social Security Fund (CCSS) in Costa Rica in the period 2011-2015. Materials and methods The population was constituted by 1 488 989 prescriptions of psychotropics within the CCSS in Costa Rica in the period from January 2011 to December 2015. The study is of a retrospective descriptive type. Results Of the total analyzed, almost half (47.15%) corresponded to Clonazepam. It is followed by Lorazepam and Diazepam with 22.80% and 22.53%, respectively. Finally, Phenobarbital, Clobazam and Thiopental are the least prescribed with 7.07%, 0.24% and 0.22% respectively. In terms of gender distribution, women received 62.65% of prescriptions, while the remaining 37.35% were for men. Conclusion There is an exponential increase in the consumption of these drugs in the five-year period under study. People at the end of their productive cycle (40 years or more) reached the highest percentages of consumption, which then fell to around 70 years or more; women were prescribed this type of drug the most. Therefore, continuous monitoring is necessary in order to promote the adequate use of these drugs and avoid generating potential health problems in the population, especially among the elderly.
Resumo Objectivo Identificar a prescrição de benzodiazepinas e barbitúricos psicotrópicos: Clobazam, Thiopental, Clonazepam, Lorazepam, Phenobarbital e Diazepam no Fundo de Seguraba Social da Costa Rica (CCSS), na Costa Rica, no período 2011-2015. Materiais e métodos A população foi constituida por 1 488 989 prescribes de psicotrópicos dentro do CCSS na Costa Rica, no período de Janeiro de 2011 a Dezembro de 2015. O estudo é de tipo descritivo retrospectivo. Resultados Do total analisado, quase metade (47,15%) correspondia ão Clonazepam. Segue-se Lorazepam e Diazepam com 22,80% e 22,53%, respectivamente. Finalmente, Phenobarbital, Clobazam e Thiopental são os menos prescritos com 7,07%, 0,24% e 0,22%, respectivamente. Em termos de distribuição por género, as mulheres receberam 62,65% das receitas, enquanto os restantes 37,35% foram para os homens. Conclusão Verifica-se um aumento exponencial do consumo destes medicamentos no periodo de cinco anos em estudo. As pessoas no final do seu ciclo produtivo (40 anos ou mais) atingiram as percentagens mais elevadas de consumo, que depois diminuíram para cerca de 70 anos ou mais; as mulheres foram as que mais receitaram este tipo de medicamentos. Por conseguinte, é necessário um acompanhamento continuo a fim de promover o uso adequado destes medicamentos e evitar a criação de potenciais problemas de saúde na população, especialmente entre os idosos.
Résumé Objectif Identifier la prescription de benzodiazépines et de barbituriques psychotropes : Clobazam, Thiopental, Clonazepam, Lorazepam, Phenobarbital et Diazepam, dans les établissements de la Caisse Costaricienne de Sécurité Sociale (CCSS), au Costa Rica, durant la période 2011-2015. Matériels et méthodes La population a été constituée de 1 488 989 prescriptions de psychotropes au sein de la CCSS au Costa Rica durant la période de janvier 2011 a décembre 2015. L'étude est de type descriptif rétrospectif. Résultats Sur le total des prescriptions analysées, pres de la moitié (47,15 %) correspondent au Clonazépam. Viennent ensuite le Lorazépam et le Diazépam (22,80 % et 22,53 % respectivement). Enfin, le Phénobarbital, le Clobazam et le Thiopental sont les moins prescrits (7,07%, 0,24% et 0,22% respectivement). En termes de distribution par sexe, les femmes ont reçu 62,65 % des prescriptions, les 37,35 % restants ont été destinés aux hommes. Conclusion On observe une augmentation exponentielle de la consommation de ces substances au cours des cinq années a l'étude. Les pourcentages de consommation les plus élevés correspondent aux personnes arrivant a la fin de l'étape du cycle de vie généralement la plus productive (40 ans ou plus) ; ils diminuent ensuite aux alentours de 70 ans ou plus. Les femmes reçoivent plus fréquemment ce type de prescriptions. Une surveillance continue est donc nécessaire afin de promouvoir l'utilisation adéquate de ces substances et d'éviter de générer d'éventuels problemes de santé dans la population, en particulier chez les personnes âgées.
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Background: Dental erosion is a complex pathology of multifactorial etiology in which chemical, biological and behavioural factors influence the erosive process. The etiology has been related to the regular use of products with low endogenous pH and high acidity including liquid medicaments. Aim: To investigate the endogenous erosive potential of commonly used pediatric liquid medicaments. Methods: Endogenous pH and titratable acidity of eight commonly used pediatric liquid medicaments were measured using a digital pHmeter. 54 exfoliated or extracted primary and permanent teeth without any carious lesion, maintained in pediatric liquid medicaments were observed under SEM after 1 minute and 10 minutes of time intervals. Results: Most of the medicaments showed etched prism pattern on primary teeth and crater formation whereas etched prism pattern was seen on all permanent enamel surfaces. Conclusion: Evidence of dental erosion was observed on both primary and permanent enamel.
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Resumen Objetivo: Efectuar una revisión de los conocimientos sobre la Farmacovigilancia, el suministro de información sobre sospechas de RAM, que es tanto un deber moral para el médico y otros profesionales de salud como un aspecto de la atención al paciente y la infranotificación de estos reportes. Material y métodos: La revisión fue realizada en las bases de datos LILACS, PAHO, SciELO, EMBASE, PubMed e Infomed, los motores de búsqueda Google y Google Scholar donde se colocaron palabras claves para la búsqueda de la información en artículos originales, tesis, otros artículos de revisión bibliográfica y revistas de elevado índice de citación publicados desde 1937 a 2017, en los idiomas español o inglés. Resultados: Se identificaron 100 artículos, de los cuales 30 fueron seleccionados como útiles verificados para actualizar los conceptos relacionados con las disciplinas de Farmacovigilancia. En la práctica clínica existen varios factores que pueden dificultar la detección de las RAM y como consecuencia contribuir a la infranotificación. Conclusiones: La infranotificación en Farmacovigilancia es una realidad mundial, observándose que la mayoría de las publicaciones analizadas que proceden de Europa (Alemania, España y Reino Unido) y en países de América Latina como Colombia, reconocen bajos índices de notificación.
Abstract Object: The article proposes a pharmacovigilance knowledge review, the provisión of information on suspicion of AMR, which is both a moral duty for the doctor and other health professionals and an aspect of patient care and the underreporting of them. Materials and methods: The review was carried out in the databases LILACS, PAHO, SciELO, EMBASE, PubMed and Infomed, the Google search engines and Google Scholar where keywords were placed for the search of the information in original articles, theses, other articles of bibliographic review and high citation index journals published from 1937 to 2017, in Spanish or English. Results: Consequently 100 articles were identified, 30 of which were selected as verified tools to update the concepts related to Pharmacovigilance discipline. There are several factors in clinical practice that can hinder the detection of ADR and it could contribute to under-reporting. Conclusión: In pharmacovigilance the under-reporting is a global reality, noting that most of the analyzed publications come from Europe (Germany, Spain and the United Kingdom) and in Latin American countries such as Colombia, recognize low reporting rates.
Resumo Objetivo: O artigo propõe uma revisao de literatura sobre farmacovigilancia, fornecendo informações sobre suspeitas de RAM, que é um dever moral para os médicos e outros profissionais de saúde como um aspecto da assistencia ao doente e subnotificação desses relatórios. Materiais e métodos: A pesquisa foi realizada nas bases de dados LILACS, PAHO, SciELO, EMBASE, PubMed e Infomed, nos motores de busca Google e Google Scholar, onde foram colocadas as palavras-chave para encontrar as informações em artigos originais, teses, outros artigos de revisão bibliográfica e de revistas de alto índice de citação publicados de 1937 a 2017, em espanhol ou inglês. Resultados: Foram identificados 100 artigos, dos quais 30 foram selecionados como instrumentos importantes para atualização dos conceitos relacionados á disciplina de farmacovigilancia. Na prática clínica, existem vários fatores que podem dificultar a detecção de RAM e, consequentemente, contribuir para uma subnotificação Conclusão: Na farmacovigilãncia, a subnotificação é uma realidade mundial, observando que a maioria das publicações analisadas provenientes da Europa (Alemanha, Espanha e Reino Unido) e dos países latino-americanos como a Colõmbia, reconhecem baixos índices de notificação.
Résumé Objectif: Procéder á une revue de littérature des connaissances sur la pharmacovigilance et la fourniture d'informations sur la suspicion de Réactions Indésirables aux Médicaments (RIM), qui est autant un devoir moral pour le médecin et pour d'autres professionnels de la santé qu'un aspect des soins aux patients, ainsi que sur la sous-déclaration. Matériaux et méthodes: La revue a été réalisée á l'aide des bases de données LILACS, PAHO, SciELO, EMBASE, PubMed et INFOMED, et des moteurs de recherche Google et Google Scholar, en utilisant des mots clés pour chercher des informations dans des articles originaux, théses, articles de revue de littérature et revues ayant des indices de citations élevés, publiés entre 1937 et 2017, en espagnol ou en anglais. Résultats: 100 articles ont été identifiés, dont 30 ont été sélectionnés comme utiles pour actualiser les concepts en relation avec les disciplines impliquées dans la pharmacovigilance. Dans la pratique clinique, plusieurs facteurs peuvent entraver la détection des RIM et, par conséquent, contribuer á la sous-déclaration. Conclusions: La sous-déclaration en pharmacovigilance est une réalité mondiale. Dans la plupart des publications analysées provenant d'Europe (Allemagne, Espagne et Royaume-Uni) et des pays d'Amérique latine comme la Colombie, on a pu observer la reconnaissance d'un faible taux de déclaration.
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The “eighteen incompatible medicaments” is an important content of Chinese materia medica (CMM) compatibility contraindication, involving the key basic problem of safe and effective clinical use of CMM. Based on the rule of the automatic action of supramolecular “imprinting template” previously proposed, the current research basis of “eighteen incompatible medicaments” were integrated and analyzed. Firstly, the history of “eighteen incompatible medicaments” were summarized, then the theory of Chinese materia medica (CMM) compatibility was interpreted by supramolecular “imprinting template”: the compatibility of CMM are that two or more than two kinds of CMM effective components group of molecules (object) are combined by non-covalent bonds, and the new formed supramolecular system and the human body (subject) are interacted with each other according to “imprinting template”, and then the toxicity and efficacy were generated, while the compatibility law of CMM is displayed macroscopically. Based on this, three groups of “eighteen incompatible medicaments” were discussed from the perspective of supramolecular chemistry, and the supramolecular method integrating toxicity with efficacy was put forward, including “chemicalkinetics”, “network kinetics” and “spectrum toxicity and efficacy kinetics” methods, thereby providing the ideas and reference for the research on the mechanism of “eighteen incompatible medicaments” and providing reference for clinical application.
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“Incompatibility” is the focus of the “Eighteen Incompatible Medicaments” in Chinese materia medica. At present, most experts in traditional Chinese medicine supported that “incompatibility” is relative, that is, the conversion between incompatibility and appropriate compatibility can occur under certain conditions. Genkwa Flos and Glycyrrhizae Radix et Rhizoma are one of the representative of incompatible pairs in “Eighteen Incompatible Medicaments”, which had been well studied. This paper summarized the research progress of the incompatible pairs of Genkwa Flos and Glycyrrhizae Radix et Rhizoma from seven aspects of material basis, pharmacological toxicology, drug metabolism and metabolomics, incompatibility mechanism, gut microbiota, clinical application and compatibility conditions. Combined with the author’s previous systematic study on the chemical components of Daphne genkwa, the connotation of the material base of Genkwa Flos and Glycyrrhizae Radix et Rhizoma was discussed from the perspective of the weak bond between the active components in this paper, so as to provide reference for further research of the incompatible pair.
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OBJECTIVE： To investigate the historical evolution and clinical application of “eighteen incompatible medicaments” and “nineteen medicaments of mutual restraint” of TCM， and to provide reference for enriching the contents of rational use of TCM. METHODS： Through the methods of literature mining， using “eighteen incompatible medicaments” “nineteen medicaments of mutual restraint” “incompatible medicaments” “clinical use” “ADR” “ADE” as keywords， retrieved from CNKI， Wanfang， VIP database （from the date of database establishment to August 2018） and library of Henan University of TCM， related literatures about “eighteen incompatible medicaments” and “nineteen medicaments of mutual restraint” were extracted and combed， and the history and clinical application of them were summarized and analyzed. RESULTS & CONCLUSIONS： “Eighteen incompatible medicaments” is one of the main contents of TCM basic theory. The word is first published in Shubencao， which is the concrete embodiment of the “opposite” in the “seven compatibility regularities” of TCM， and the number of “eighteen incompatible medicaments” of TCM recorded in the medical books of TCM is different from each other in the past dynasties. “Nineteen medicaments of mutual restraint” is one of the taboos of TCM compatibility， which is first found in Shennong’s Herbal. There are mixed use of “mutual inhibition” “incompatible” and “mutual restraint” in all dynasties， and there is still controversy about the attribution of “seven compatibility regularities” of “nineteen medicaments of mutual restraint” among physicians. Regardless of ancient medical books， modern medical books， various editions of Chinese Pharmacopeia， literature reports and clinical applications， there are compatibility usage of drug pairs of “eighteen incompatible medicaments” and “nineteen medicaments of mutual restraint”. Among them， 8 kinds of set prescription preparations containing drug pair of “eighteen incompatible medicaments” were involved in 2015 edition of Chinese Pharmacopoeia （part Ⅰ）， most of which were Aconitum carmichaelii/Aconitum kusnezoffii-Bletilla striata/Ampelopsis japonica； 9 kinds of set prescription preparations containing drug pair of “nineteen medicaments of mutual restraint” were also involved， most of which were Syringa oblate-Curcuma rcenyujin， Cinnamomum cassia-Halloysitum rubrum. Although there are medical records or literature pointing out that it can be used to treat critical and difficult diseases， and some studies have preliminarily confirmed the compatibility rationality of individual incompatibility medicaments/medicaments of mutual restraint， the conclusions of relevant studies are not entirely consistent， and the intensity of research evidence is not high， and the research evidence is insufficient. Basic researches should be strengthened and large-scle， multiple-center and high-quality clinical studies are needed to confirm this conclusion so as to guaratetee the rationality and safety of drug use in clinic.
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OBJECTIVES: The objective of this study was to assess coronal discoloration induced by the following intracanal medicaments: calcium hydroxide (CH), a mixture of CH paste and chlorhexidine gel (CH/CHX), and triple antibiotic paste (3Mix). MATERIALS AND METHODS: Seventy extracted single-canal teeth were selected. Access cavities were prepared and each canal was instrumented with a rotary ProTaper system. The specimens were randomly assigned to CH, CH/CHX, and 3Mix paste experimental groups (n = 20 each) or a control group (n = 10). Each experimental group was randomly divided into 2 subgroups (A and B). In subgroup A, medicaments were only applied to the root canals, while in subgroup B, the root canals were completely filled with medicaments and a cotton pellet dipped in medicament was also placed in the pulp chamber. Spectrophotometric readings were obtained from the mid-buccal surface of the tooth crowns immediately after placing the medicaments (T1) and at 1 week (T2), 1 month (T3), and 3 months (T4) after filling. The ∆E was then calculated. Data were analyzed using 2-way analysis of variance (ANOVA), 3-way ANOVA, and the Scheffé post hoc test. RESULTS: The greatest color change (ΔE) was observed at 3 months (p < 0.0001) and in 3Mix subgroup B (p = 0.0057). No significant color change occurred in the CH (p = 0.7865) or CH/CHX (p = 0.1367) groups over time, but the 3Mix group showed a significant ΔE (p = 0.0164). CONCLUSION: Intracanal medicaments may induce tooth discoloration. Use of 3Mix must be short and it must be carefully applied only to the root canals; the access cavity should be thoroughly cleaned afterwards.
Subject(s)
Calcium Hydroxide , Chlorhexidine , Dental Pulp Cavity , Reading , Tooth Crown , Tooth Discoloration , ToothABSTRACT
Removal of the microbial organisms from the root canal system is a prerequisite for the successful outcome of any root canal treatment. Use of an effective intracanal medicament will assist in the disinfection of the root canal system. Intracanal medicaments have been used to disinfect root canals between appointments and reduce interappointment pain. Materials and Methods: A questionnaire survey was conducted to evaluate the knowledge, attitude, and awareness about the principal choice of intracanal medicaments among general dental practitioners and nonendodontic specialists. The questionnaire consisted of 11 questions related to intracanal medicaments in Endodontics. It was distributed to 75 general dental practitioners and 75 other specialists (nonendodontists). Results: In the present study, the authors observed that the knowledge level among the study participants was moderately satisfying. However, the need for more education of the dentists with regard to the intracanal medicaments was perceived. Discussion: Correct knowledge of intracanal medicaments would help the practitioners to decide the apt material of choice as intracanal medicaments in different clinical situations. Conclusion: The present study highlighted the need for more continuing dental education programs with active participation of general practitioners and nonendodontic specialists to update themselves.
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Resumen Objetivo: Caracterizar el patrón de consumo de los antineoplásicos utilizados para el tratamiento de los pacientes con neoplasias en la provincia La Habana durante el período 2011-2015. Materiales y métodos: Estudio descriptivo, de utilización de medicamentos de consumo con elementos de consecuencias prácticas expresadas en unidades vendidas. Los datos se obtuvieron de la base de datos de la Droguería, según el Formulario Nacional de Medicamentos presente cada año en el Cuadro Básico, durante el período 2011-2015, pertenecientes al Cuadro Básico de Medicamentos de la provincia. Los datos de consumo en unidades físicas de los antineoplásicos se obtuvieron a partir de las ventas por productos de la Unidad Empresarial de Base Mayorista de Medicamentos La Habana. Los precios se obtuvieron del listado oficial de precios: PRECIOS1, del Ministerio de Finanzas y Precios. Se consideró consumo ideal a lo planificado según la demanda de las instituciones de salud y real a la cantidad de unidades vendidas a dichas instituciones. Resultados: El consumo de manera general se mostró ascendente en cada año de estudio de (488578) a (753587). El mayor consumo se concentró en las mostazas nitrogenadas (116709), análogos del ácido fólico (113333), platinos (70336), derivados de la podofilotoxina (61551) y anticuerpos monoclonales (38294). El costo del consumo de medicamentos fue de $51.403.612,75. Conclusiones: El patrón de consumo según unidades vendidas se caracterizó por un incremento del mismo por años de estudio en los diferentes subgrupos con independencia del cumplimiento o no de las solicitudes demandadas por las unidades de salud. El valor económico del consumo de antineoplásicos se incrementó. Los anticuerpos monoclonales fueron el grupo de mayor costo identificado en el estudio.
Abstract Objective: To characterize the consumption pattern of the antineoplastic drugs used for the treatment of patients with neoplastic in the province of La Habana during the period 2011-2015. Materials and methods: Descriptive study of the use of consumer drugs with elements of practical consequences expressed in units sold. The data were obtained from the database of drugstore, according to National Formulary of Medications, present each year in the Basic Chart, during the period 2011-2015, belonging to the Basic Chart of Medicines of the province. The consumption data in physical units of the antineoplastic ones were obtained from the sales by products of the Business Unit of Base Wholesale of Medicine Havana. The prices were obtained from the oficial price list: PRECIOS1, from the Ministry of Finance and Prices. Ideal consumption was considered as planned according to the demand of health institutions and real to the number of units sold to these institutions. Results: Consumption in general was upward in each year of study from (488578) to (753587). The highest consumption was concentrated on nitrogen mustards (116709), folic acid analogues (113333), platines (70336), podophyllotoxin derivatives (61551) and monoclonal antibodies (38294). The cost of drug consumption was $ 51,403,612.75. Conclusions: The pattern of consumption according to units sold was characterized by an increase of the same by years of study in the different subgroups independently of the compliance or not of the requests demanded by the health units. The economic value of antineoplastic consumption increased. Monoclonal antibodies were the highest cost group identified in the study.
Resumo Objetivo: Caracterizar o padrão de consumo de agentes antineoplásicos utilizados no tratamento em utentes com neoplasia na provincia de Havana durante o período de 2011 a 2015. Materiais e métodos: Estudo descritivo, com a utilização de medicamentos, com elementos de consequências prácticas expressas em unidades vendidas. Os dados foram obtidos através do banco de dados de medicação, obtida do Formulário Nacional de Medicamentos em cada ano e representados no Gráfico Básico durante o período 2011-2015. Os dados relativos ao consumo dos antineoplásicos foram obtidos a partir das vendas da Unidade de Negócios da Wholesale Drug Base de Havana. Os preços foram obtidos pela lista de preços oficiais: PREçOS1, do Ministério das Finaças e Preços. Considerou-se que o consumo ideal o planeado de acordo com a procura das Instituiçoes de Saúde e o real as quantidades de unidades vendidas nestas Instituiçoes. Resultado: O consumo geral tem vindo a aumentar em cada ano de estudo, passe de 488578 para 753587. O principal produto consumido foi a mostarda de nitrogenio (116709), análogos de ácido fólico (113333), platinas (70336), derivados de podofilotoxina (61551) e os anticorpos monoclonais (38294). O valor do consumo dos medicamentos foi de US $ 51.403.612,75. Conclusões: O padrão de consumo, de acordo com as unidades vendidas, foi caracterizado por um aumento de acordo com as unidades acrescidas pelos anos de estudos nos diferentes subgrupos, independentemente da conformidade ou não dos pedidos exigidos pelas unidades de saúde. Os gastos com o consumo de antineoplásicos aumentou. Os anticorpos monoclonais foi o grupo identificado no estudo com maior custo.
Résumé Objectif: Caractériser le profil de consommation des antinéoplasiques utilisés pour le traitement des patients atteints de néoplasies dans la province de La Habana pendant la période 2011-2015. Matériaux et méthode: étude descriptive de l'utilisation de médicaments incluant des éléments de conséquences pratiques exprimés en unités vendues. Les données ont été obtenues a partir de la base de données de la Pharmacie pour la période 2011-2015, selon le Formulaire National de Médicaments représenté chaque année dans la Liste des Médicaments Essentiels de cette province. Les données de consommation en unités physiques d'antinéoplastiques ont été obtenues a partir des ventes de chaque produit par l' «Unidad Empresarial de Base Mayorista de Medicamentos La Habana¼ (Unité de base de commerce en gros de médicaments La Havane). Les prix ont été obtenus a partir de la liste des tarifs officiels PRECIOS1, du Ministere des Finances et des Prix. La consommation idéale considérée correspond a la planification réalisée a partir de la demande des institutions de santé et la consommation réelle a la quantité d'unités vendues dans ces institutions. Résultats: Globalement, la consommation a augmenté chaque année étudiée, passant de 488578 a 753587 unités. La consommation la plus importante s'est concentrée sur les moutardes azotées (116709), les analogues d'acide folique (113333), les platines (70336), les dérivés de la podophyllotoxine (61551) et les anticorps monoclonaux (38294). Le cout de la consommation de médicaments a été de 51.403.612,75$. Conclusions: Le modele de consommation selon les unités vendues s'est caractérisé chaque année par une augmentation dans les différents sous- groupes, indépendamment de la satisfaction ou non des demandes réalisées par les unités de santé. La valeur économique de l'utilisation antinéoplasique a augmenté. Le groupe des anticorps monoclonaux a représenté le cout le plus élevé.
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Aims: To evaluate the use of various gingival displacement techniques prior to impression making in fixed partial dentures by the Prosthodontists in Vadodara. Settings and Design: Questionnaire based survey among prosthodontists in Vadodara city. Methods and Material: All the prosthodontists practitioners and those prosthodontists in academic institutes in Vadodara City, Gujarat, were surveyed through a questionnaire regarding their usage of gingival displacement technique and their reasons and methods of using gingival displacement technique for fixed partial denture. The results were analysed through discriminant statistical analysis. Results: Among all the Prosthodontists in Vadodara city, 62% prefer the use of gingival displacement technique for successful clinical practice while 38 % of them do not follow the procedure believing it does not make major difference in clinical practice. Conclusions: Those Prosthodontists who preferred the use of gingival displacement technique were able to detect many advantages of using it in their daily fixed partial denture practice and the percentage of prosthodontists not following gingival displacement technique blamed it as a time consuming affair and was not feasible on economic grounds for the class of patient they treated.
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Objectives: This study was designed to evaluate postoperative pain after endodontic retreatment. Material and Methods: Asymptomatic, multirooted molar & premolar teeth requiring retreatment with 25 mm periapical lesions were included. Seventy-eight teeth were randomly placed in four groups (n=20): single-visit (control, group 1), Ledermix (group 2), metronidazole, ciprofloxacin, minocycline mixture (group 3), calcium hydroxide (group 4). The postoperative pain was recorded using a VAS at 6, 12, 24, and 48 h after retreatment. Statistical evaluation was performed using TwoWay Repeated Measures ANOVA and Tukey test. Results: Mild pain occurred in 67.5%, moderate in 30%, and flare-ups in 2.5%, and there was a significant difference between the groups (p <0.01). Significantly lower postoperative pain was observed in TAP and CaOH2 groups (p <0.05). In the 6, 12, and 24 h intervals, there was a significant difference in the pain levels (p <0.05). Conclusion: TAP and CaOH2 are effective for reducing postoperative pain after retreatment. (AU)
Objetivo: Este estudo foi projetado para avaliar a dor pós-operatória após o retratamento endodôntico. Material e Métodos: Foram incluídos dentes molares e pré-molares multirradiculados e assintomáticos que necessitavam de retratamento com lesões periapicais de 2-5 mm. Setenta e oito dentes foram distribuídos aleatoriamente em quatro grupos (n = 20): sessão única (controle, grupo I), Ledermix (grupo II), metronidazol, ciprofloxacina, mistura de minociclina (grupo III), hidróxido de cálcio (grupo IV). A dor pós-operatória foi registrada usando um VAS às 6, 12, 24 e 48 h após o retratamento. A análise estatística foi realizada utilizando ANOVA de dois fatores para medidas repetidas e teste de Tukey. Resultados: Ocorreu dor leve em 67,5%, moderada em 30% e agudizações 2,5%, e houve diferença significativa entre os grupos (p <0,01). Foi observada dor pós-operatória significativamente menor nos grupos TAP e hidróxido de cálcio (p <0,05). Nos intervalos de 6, 12 e 24 h, houve diferença significativa nos níveis de dor (p <0,05). Conclusão: TAP e hidróxido de cálcio são eficazes para reduzir a dor pós-operatória após o retratamento.(AU)
Subject(s)
Pain, Postoperative , Pharmaceutical Preparations , RetreatmentABSTRACT
Resumen Objetivo: Actualizar los conocimientos acerca de los transportadores de la superfamilia ABC vinculados con la resistencia farmacológica. Materiales y métodos: Se realizó un estudio donde se aplicó el método cualitativo, mediante una revisión bibliográfica y documental sobre el tema en fuentes de datos digitales. Se usaron los descriptores DeCs-MeSH: transportadores ABC, superfamilia ABC, resistencia farmacológica, ATP binding- cassette. Se revisaron artículos publicados sobre el tema, a través de los buscadores habituales (Google, PubMed, Cochrane, Future Medicine, Scielo, entre otros), teniendo en cuenta la calidad y la actualidad de ellos. Resultados: Se destaca la importancia clínica de estos transportadores que se relacionan con la aterosclerosis, enfermedades hepáticas, enfermedad de Alzheimer, entre otras. Esto los convierte en dianas atractivas para el diseño de nuevos medicamentos; pero al mismo tiempo, pueden expulsarlos de la célula, haciéndola resistente como a los antitumorales, antimicrobianos y antivirales. Conclusiones: Los transportadores ABC tienen una función central en los efectos adversos que diferentes sustancias, entre ellas los fármacos, tienen sobre la célula. Además, el polimorfismo genético en esta superfamilia se asocia con alteraciones farmacocinéticas que pueden desencadenar resistencia farmacológica; el impacto de estas modificaciones es el centro de recientes investigaciones que las sitúan como posible blanco terapéutico.
Abstract Objective: To update the knowledge about the ABC transporters superfamily linked to drug resistance. Materials and methods: A qualitative study where the method was applied, using a bibliographical and documentary review on the subject of digital data sources was conducted. ABC transporters, ABC superfamily, and drug resistance, binding- ATP cassette: the DECS-MeSH descriptors were using published articles on the subject through the usual search engines (Google, PubMed, Cochrane, Future Medicine, Scielo, among others), counting on the quality and timeliness of them were review. Results: The clinical significance of these transporters is stress as they relate to atherosclerosis, liver disease, Alzheimer's disease, among other conditions. This makes them attractive targets for new drug design; but at the same time, they can expel the cell making it resistant as antitumor, antimicrobial and antiviral. Conclusions: ABC transporters have central role in the adverse effects of different substances, including drugs, have on the cell. In addition, the genetic polymorphism in this superfamily is associated with pharmacokinetic changes that can trigger drug resistance; the impact of these changes is the focus of recent research that place them as a possible therapeutic target.
Resumo Objectivo: Atualizar o conhecimento sobre os transportadores de superfamilia ABC ligada a resistência a drogas. Materiais e métodos: Foi realizado um estudo qualitativo, através de uma revisão da literatura e documental sobre o tema em fontes de dados digitais. Foram utilizados os descritores DeCs-MeSH: transportadores ABC, superfamilia ABC, resistência farmacológica, ATP binding- cassette. Foram pesquisados artigos sobre o tema, através dos motores de busca (Google, PubMed, Cochrane, Future Medicine, Scielo, entre outros), tendo em conta a qualidade e a sua atualidade. Resultados: Destacou-se a importãncia clínica destes transportadores que se relacionam com a aterosclerose, doen9as hepáticas, de Alzheimer, entre outras. Isso os torna alvos atraentes para o design de novos fármacos, mas ao mesmo tempo, os fármacos podem ser expulsos da célula, tornando-a resistente aos antitumorais, antimicrobianos e antivirais. Conclusões: Os transportadores ABC têm uma função central nos efeitos adversos que diferentes substãncias, tais como os fármacos, possuem sobre a célula. Além disso, o polimorfismo genético desta superfamilia está associado as alterações farmacocinéticas que podem desencadear a resistência aos medicamentos; o impacto dessas mudanças é o centro de pesquisas recentes que os coloca como um possível alvo terapéutico.
Résumé Objectif: Actualiser les connaissances sur les transporteurs de la superfamille ABC liés a la résistance pharmacologique. Matériaux et méthodes: Une étude qualitative a été réalisée au moyen d'une recherche bibliographique et documentaire dans différentes sources de données numériques avec les moteurs de recherche habituels (Google, PubMed, Cochrane, Medicine Future, Scielo, entre autres). Les descripteurs DeCs-MeSH utilisés ont été: transporteurs ABC, superfamille ABC, résistance pharmacologique, ATP binding- cassette. Un certain nombre d'articles relatifs au sujet ont été sélectionnés en fonction de leur qualité et de leur actualité. Résultats: Les résultats mettent en avant l'importance clinique de ces transporteurs du fait de leur relation avec l'athérosclérose, certaines maladies hépatiques, la maladie d'Alzheimer, et d'autres affections. Cela en fait des cibles attrayantes pour la conception de nouveaux médicaments; mais en meme temps, ils peuvent expulser des médicaments de la cellule et la rendre résistante aux antitumoraux, antimicrobiens et antiviraux, par exemple. Conclusions: Les transporteurs ABC jouent un role central dans les conséquences néfastes de différentes substances, y compris les médicaments, sur la cellule. En outre, le polymorphisme génétique dans cette superfamille est associé a des modifications pharmacocinétiques qui peuvent déclencher une résistance aux médicaments; l'impact de ces modifications est l'objet de recherches récentes qui les placent comme cible thérapeutique possible.
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The applications of prescriptions including Ginseng Radix et Rhizoma and Trogopterus Dung in contemporary literatures from 1949 to 2016 are compiled and the data mining techniques containing scale-free complex network method are utilized to explore its practical characteristics, with comparison between modern and ancient ones. The results indicate that malignant neoplasms, coronary heart disease which present Qi deficiency and blood stasis type are the main diseases treated by prescriptions including Ginseng Radix et Rhizoma and Trogopterus Dung according to the reports during 1949 to 2016. The complex network connection shows that Glycyrrhizae Radixet Rhizoma, Angelicae Sinensis Radix, Astragali Radix, Typhae Pollen, Salviae Miltiorrhizae Radix et Rhizoma are the primary drugs related to Ginseng Radix et Rhizoma and Trogopterus Dung. The next are Paeoniae Radix Alba, Atractylodis Macrocephalae Rhizoma, Persicae Semen, Foria, et al. Carthami Flos, Notoginseng Radix et Rhizoma, Cyperi Rhizoma, Bupleuri Radix are the peripheral ones. Also, Ginseng Radix et Rhizoma-Glycyrrhizae Radixet Rhizoma, Trogopterus Dung-Glycyrrhizae Radixet Rhizoma, Ginseng Radix et Rhizoma-Angelicae Sinensis Radix, Trogopterus Dung-Angelicae Sinensis Radix, Ginseng Radix et Rhizoma-Astragali Radix, Trogopterus Dung-Astragali Radix are the main paired drugs. The paired drugs including Ginseng Radix et Rhizoma-Trogopterus Dung-Glycyrrhizae Radixet Rhizoma, Ginseng Radix et Rhizoma-Trogopterus Dung-Angelicae Sinensis Radix, Ginseng Radix et Rhizoma-Trogopterus Dung-Astragali Radix, Ginseng Radix et Rhizoma-Trogopterus Dung-Typhae Pollen have a higher support degree. The main compatible drugs are different in ancient and modern prescriptions including Ginseng Radix et Rhizoma and Trogopterus Dung. Notoginseng Radix et Rhizoma, Typhae Pollen, Salviae Miltiorrhizae Radix et Rhizoma, Astragali Radix are utilized frequently in modern prescriptions while less used in ancient ones. It is also shown that more attentions are paid to the drugs contributing to invigorating Qi and promoting blood circulation in modern times with comparative results between modern and ancient prescriptions.
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Aim: The present study evaluated the antimicrobial efficacy of Chlorhexidine, Nisin and Linezolid and a control group (Normal saline ) against Enterococcus faecalis (EF). Methods: Human single rooted premolars with type I canal anatomy were instrumented with ProTaper using NaOCl as an irrigant. Supension of EF was inoculated into each root specimen and incubated. The medicaments were syringed into each root and incubated. After 24 hours, 8 samples per group (among the 4 groups) were retrieved. A hole was drilled on each root, and the dentinal shavings obtained were allowed to fall in brain-heart infusion (BHI) broth. Dilutions from the broth were plated and spread over blood agar. Colony-forming units (CFU) of EF was counted. The procedure was repeated after 72 hrs and 1 week. Results: In group Nisin, the mean CFU was 10.6250 at 24 hrs, 6.6250 at 72 hrs and 6.2500 after 1 week respectively (statistically significant). In group Chlorhexidine, mean CFU was found to be the lowest of 10.5000 at 24 hrs, with further gradual increase to 13.7500 at 72 hrs and further increase to 15.8750 by 1 week. Similarly, in group linezolid , the mean CFU was found to decrease from 49.0000 at 24 hrs to 29.8750 at 72hrs and then increase to 34.8750 in 1 week.
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Aims: This in vitro study was designed to investigate the exogenous erosive potential of most commonly used pediatric syrup medicaments on primary teeth. Place and Duration of Study: Department of Pediatric Dentistry, Vishnu Dental College, Bhimavaram, India, 2012 to 2013. Methodology: The erosive potential of 17 syrups was assessed by measuring their inherent pH, titratable acidity, viscosity and ability to erode enamel. The inherent pH and titratable acidity of syrups were measured using digital pH meter and viscosity was determined using Brookfield viscometer. Enamel surface changes were evaluated using optical 3D profilometer. Results: Api –up (appetizer) showed the least pH and Azee (Azithromycin) exhibited the highest pH. The titratable acidity was greater for Api-up (5.40ml) and least for Tonoferron (0.20ml). Asthalin exhibited highest viscosity and Ondem showed least viscosity. All the test syrups caused some degree of enamel loss, however, Api – up caused the greatest and Azee caused the least degree of enamel loss at three time intervals. Conclusion: The medicated syrups with low inherent pH and high viscosity showed to cause a greater dissolution of enamel. However, certain syrups with low viscosity had shown higher degree of enamel loss due to their inherent acidic pH and those with high viscosity Showed lesser degree of enamel loss due to their basic pH. Hence, these results proved that inherent pH is the most critical factor for erosion.
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Currently,the toxicity study of traditional Chinese medicine is faced with the following problems. Firstly,the evaluation in vitro cannot fully reflect the true state of the body. Secondly,the traditional method is not sensitive enough to the early toxicity. Lastly,the toxicity evaluation indexes cannot determine whether the compatibility of traditional Chinese medicine produces toxicity or increases toxicity systematically. The paper proposed a synthesized early evaluation research method for target organ toxicity induced by traditional Chinese medicine:screening,validation,optimization and application. This method mainly inoolves early target organ toxicity biomarkers in screening,optimi?zation,validation,biological significance explanation,and application to the traditional Chinese medicine incompatibility based on the metabolic dynamic fingerprint spectrum in order to obtain biomarkers of target organ toxicity that are sensitive and precede conventional biochemical indices for early evaluation . We attempted to analyze the pattern of chang of the biomarkers for animals acted by″18 incompatible medicaments″compatibility combination. We found that Radix Aconiti Lateralis Preparata with cardiotoxicity were compatible with Rhizoma Pinelliae,and that Trichosanthes kirilowii Maxim,Fritillaria,Ampelopsis Radix and Bletilla striata without non-cardiotoxicity produced and increased cardiotoxicity systematically.