Which Severe Mental Illnesses Most Increase the Risk of Developing Dementia? Comparing the Risk of Dementia in Patients with Schizophrenia, Major Depressive Disorder and Bipolar Disorder

Objective@#Previous studies have shown that certain severe mental illnesses (SMIs) increase the risk of dementia, but those that increase the risk to a greater degree in comparison with other SMIs are unknown. Furthermore, physical illnesses may alter the risk of developing dementia, but these cannot be well-controlled. @*Methods@#Using the Taiwan National Health Insurance Research Database, patients with schizophrenia, bipolar disorder and major depressive disorder (MDD) were recruited. We also recruited normal healthy subjects as the control group.All subjects were aged over 60 years, and the duration of follow-up was from 2008 to 2015. Multiple confounders were adjusted, including physical illnesses and other variables. Use of medications, especially benzodiazepines, was analyzed in a sensitivity analysis. @*Results@#36,029 subjects (MDD: 23,371, bipolar disorder: 4,883, schizophrenia: 7,775) and 108,084 control subjects were recruited after matching according to age and sex. The results showed that bipolar disorder had the highest hazard ratio (HR) (HR: 2.14, 95% confidence interval [CI]: 1.99−2.30), followed by schizophrenia (HR: 2.06, 95% CI: 1.93−2.19) and MDD (HR: 1.60, 95% CI: 1.51−1.69). The results remained robust after adjusting for covariates, and sensitivity analysis showed similar results. Anxiolytics use did not increase the risk of dementia in any of the three groups of SMI patients. @*Conclusion@#SMIs increase the risk of dementia, and among them, bipolar disorder confers the greatest risk of developing dementia. Anxiolytics may not increase the risk of developing dementia in patients with an SMI, but still need to be used with caution in clinical practices.

Real-world research of vonoprazan and amoxicillin dual therapy for Helicobacter pylori eradication / 中国药房

OBJECTIVE To explore the efficacy， safety and economics of a dual therapy consisting of conventional dose of vonoprazan combined with conventional dose of amoxicillin in patients with primary treatment of Helicobacter pylori （HP） infection. METHODS Using a prospective cohort study， the patients diagnosed with HP infection and receiving initial treatment in Chengdu Xinhua Hospital from July 2021 to July 2022 were collected according to inclusion and exclusion criteria. The patients were given vonoprazan/amoxicillin dual therapy （i.e. VA group， Vonoprazan fumarate tablets 20 mg， once a day+Amoxicillin capsules 1.0 g， twice a day， 14 days） and bismuth-containing quadruple therapy （i.e. LJAF group， Rabeprazole sodium enteric- coated tablets 20 mg， twice a day+Colloidal bismuth pectin capsules 200 mg， twice a day+Amoxicillin capsules 1.0 g， twice a day+ Furazolidone tablets 100 mg， twice a day， for 14 days） according to the patient’s medication willingness. Four weeks after the end of the treatment， HP eradication rates of the two groups were compared by using intention-to-treat （ITT）， modified intention-to- treat （MITT） and per-protocol （PP） analysis. The occurrence of adverse drug reactions （ADR） was recorded， and an economic evaluation was performed for them. RESULTS Among the 58 patients in VA group， 55 completed the trial， 2 were lost to follow- up and one withdrew due to rash； among the 62 patients in LJAF group， 57 completed the trial， 3 were lost to follow-up and 2 withdrew due to rash. Results of ITT， MITT and PP analysis showed that HP eradication rates of VA group were 86.2%， 89.3% and 90.9%， and those of LJAF group were 87.1%，91.5% and 94.7%， respectively； there was no statistical significance among different groups （P＞0.05）. The incidences of ADR in VA group and LJAF group were 6.9% and 14.5%，which were not significantly different （P＞0.05）. The result of cost minimization analysis showed that the treatment cost of VA group was 340.9 yuan， which was lower than 373.5 yuan of LJAF group. CONCLUSIONS In patients with primary treatment of HP infection， the efficacy and safety of dual therapy of conventional dose of vonoprazan combined with conventional dose of amoxicillin is equivalent to the bismuth-containing quadruplex therapy with low cost.

Neonatal Exposure to Propofol Interferes with the Proliferation and Differentiation of Hippocampal Neural Stem Cells and the Neurocognitive Function of Rats in Adulthood via the Akt/p27 Signaling Pathway / 生物医学与环境科学（英文）

Objective@#Neonatal exposure to propofol has been reported to cause neurotoxicity and neurocognitive decline in adulthood; however, the underlying mechanism has not been established.@*Methods@#SD rats were exposed to propofol on postnatal day 7 (PND-7). Double-immunofluorescence staining was used to assess neurogenesis in the hippocampal dentate gyrus (DG). The expression of p-Akt and p27 were measured by western blotting. The Morris water maze, novel object recognition test, and object location test were used to evaluate neurocognitive function 2-month-old rats.@*Results@#Phosphorylation of Akt was inhibited, while p27 expression was enhanced after neonatal exposure to propofol. Propofol also inhibited proliferation of neural stem cells (NSCs) and decreased differentiation to neurons and astroglia. Moreover, the neurocognitive function in 2-month-old rats was weakened. Of significance, intra-hippocampal injection of the Akt activator, SC79, attenuated the inhibition of p-AKT and increase of p27 expression. SC79 also rescued the propofol-induced inhibition of NSC proliferation and differentiation. The propofol-induced neurocognition deficit was also partially reversed by SC79.@*Conclusion@#Taken together, these results suggest that neurogenesis is hindered by neonatal propofol exposure. Specifically, neonatal propofol exposure was shown to suppress the proliferation and differentiation of NSCs by inhibiting Akt/p27 signaling pathway.

Research Progress on Pharmacological Mechanism of Danhong Injection in Treatment of Cardiovascular and Cerebrovascular Diseases / 中国实验方剂学杂志

Cardiovascular and cerebrovascular diseases are one of the major diseases endangering human health， and its morbidity and mortality are still in the rising stage in our country. Traditional Chinese medicine （TCM） injections play an important role in the prevention and treatment of cardiovascular and cerebrovascular diseases due to their advantages of rapid onset， remarkable curative effect， and convenient use. Among them， Danhong injection （DHI）， a Chinese medicine injection for promoting blood circulation and removing blood stasis， is widely used in the clinical treatment of cardio-cerebrovascular diseases. DHI is composed of Salviae Miltiorrhizae Radix et Rhizoma （Danshen in Chinese） and Carthami Flos （Honghua in Chinese）， and mainly contains phenolic acids， tanshinones and flavonoids. A large number of studies have shown that DHI has a significant effect in the treatment of ischemic cardio-cerebrovascular diseases， is a representative drug of co-therapy of brain and heart of TCM， its pharmacological effects related to many aspects such as anti-inflammatory， anti-oxidation， anti-coagulation. At the same time， Other studies have also explained the protective effects of DHI on cardiovascular and cerebrovascular diseases through the overall regulation and intervention of multiple targets and pathways. However， DHI has a wide range of clinical applications， there are still many unknown pharmacological effects to be further explored. Therefore， this article summarizes the current researches on the chemical components of DHI， the multi-target and multi-path pharmacological mechanisms of DHI in the treatment of cardiovascular and cerebrovascular diseases， and introduces the latest pharmacological research progress， so as to provide theoretical guidance for clinical rational drug use and subsequent in-depth research.

Analysis of Modular Network Mechanism of Danhong Injection in Treatment of Coronary Angina Pectoris / 中国实验方剂学杂志

Objective:To explore the pharmacological mechanism of Danhong injection (DHI) in the treatment of coronary heart disease with angina pectoris from the level of functional modules by modular pharmacological analysis framework. Method:The targets of drug components in the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and the angina-related genes in DisGeNET, OMIM and CTD databases were combined to construct the target network of DHI for the treatment of coronary angina pectoris by STRING version 11.0. Functional modules were identified by the molecular complex detection (MCODE), Markov cluster (MCL) and GLay algorithms, and the results were optimized by the minimum network structure entropy algorithm. The Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis was performed on the modules by DAVID version 6.8 bioinformatics analysis platform. Result:By integrating 262 genes related to DHI and 192 genes related to angina pectoris, the target network of DHI for angina pectoris was constructed, including 414 nodes and 6 621 edges. After optimization of the minimum network structure entropy, 12 functional modules (number of nodes>3) were identified by MCODE algorithm, of which the largest module (module 1) has 47 nodes and 962 edges, MCODE score=41.826. KEGG pathway enrichment analysis was conducted on the gene network of DHI for angina pectoris and the modules divided by MCODE, and 37 and 58 KEGG signaling pathways were obtained respectively, with the coverage rate of 86.5%. The pathways enriched by the modules could be roughly divided into 11 categories, among which human diseases (45%), signal transduction (17%), and amino acid metabolism (14%) were involved in a large proportion. Module 1 was enriched into 39 pathways, which was signal transduction-related module. Module 3 was amino acid metabolism-related module. Conclusion:The therapeutic effect of DHI on coronary heart disease with angina pectoris is achieved through multiple modules, multiple pathways and multiple functions, mainly by regulating modules related to signal transduction, amino acid metabolism, neuroactive ligand-receptor interaction, Ca2+ and p53 signaling.

Guilu Erxian Glue () Inhibits Chemotherapy-Induced Bone Marrow Hematopoietic Stem Cell Senescence in Mice May via p16 / 中国结合医学杂志

OBJECTIVE@#To evaluate the effect of Guilu Erxian Glue (, GEG) on cyclophosphamide (CTX)-induced bone marrow hematopoietic stem cells (HSCs) senescence in mice and explore the underlying mechanism.@*METHODS@#The H@*RESULTS@#Compared with the model group, GEG increased cell viability as well as proliferation (P<0.05 or P<0.01) and reduced β -gal expression. Furthermore, GEG significantly decreased the expressions of p16@*CONCLUSION@#GEG can alleviate CTX-induced HSCs senescence in mice, and the p16

Treatment analysis and pharmaceutical care for one infant with purulent meningi-tis and renal insufficiency / 药学实践杂志

Objective To discuss how the clinical pharmacists participated in the treatment of pediatric purulent meningi-tis and conducted drug monitoring.Methods Clinical pharmacists involved the whole process of treatment for a purulent men-ingitis infant with renal insufficiency,evaluated medication history,conducted therapeutic drug monitoring and designed an in-dividualized medication treatment plan with clinical physicians.Results Clinical pharmacists assisted clinicians with their phar-macy expertise,and developed individualized drug dosing regimen to achieve effective therapy and medication safety.Conclusion Clinical pharmacists play an important role in providing individualized pharmaceutical care for patients,optimizing the treat-ment plan and improving the rational drug use.

Identify metabolites of Piper longum alkaloids in feces and urine of rat by HPLC-FT-MS / 中国中药杂志

The metabolites were detected in feces and urine of rats orally administrated alkaloids of Piper longum by using high performance liquid chromatography coupled with a Fourier Transform ion cyclotron resonance mass spectrometer (HPLC-FT-MS). According to the mass spectrometric data and reported literature, the structures of metabolites were identified. Several metabolites were analyzed and belonged to piperine, piperanine, piperlonguminine, Δα,β-dihydropiperlonguminine and pellitorine, respectively. The metabolites of alkaloids from P. longum alkaloids were produced through Ⅰ phase and Ⅱ phase metabolism reaction, and were excreted with urination and defecation. The approach provided a rapid method for characterizing the metabolites of P. longum alkaloids and gave the truly active structures and the action mechanism of their neuroprotective effects.

Medication analysis and pharmaceutical care for a Parkinson′s disease patient with mental disorders / 药学实践杂志

Objective To investigate the role of clinical pharmacists in the treatment of a Parkinson′s disease patient with mental disorders.Methods Clinical pharmacists provided appropriate pharmaceutical care and optimized the treatment program based on patient′s symptom, medication history, drug interactions,and adverse drug reactions etc.Results Clinical pharmacists improved rational drug use by participating in the development of patient′s treatment program, giving patient with proper medication instruction and discharge education.Conclusion With their professional knowledge, clinical pharmacists play an important role in rational drug use and helping physicians to optimize the medication regimen.

Meta-analysis of 10 mg policosanol versus an equal dose of atorvastatin on the lipid-lowering efficacy in patients with dyslipidemia / 药学实践杂志

Objective To evaluate the lipid-lowering effect of 10 mg policosanol versus an equal dose of atorvastatinin patients with dyslipidemia.Method Databases such as VIP,Wanfang,CNKI,Cochrance Library,PubMed,Web of Science and EMBASE were searched for random control trials(RCT) and controlled clinical trials (CCT) of 10 mg policosanol versus an equal dose of atorvastatinin their lipid-lowering effects.The quality was assessed by Cochrance Handbook 5.1.0 or Newcastle-Ottawa scale (NOS).The study related data were analyzed statistically with RevMan 5.2 software.4 RCTs were selected.257 patients were included in the trials.130 cases were in 10 mg policosanol group and 127 cases belonged to 10 mg atorvastatin group.Results Results of Meta-analysis show that TC[SMD=0.84,95%CI(0.41,1.27),P=0.000 1] and LDL-C[SMD=0.68,95%CI(0.28,1.09),P=0.001] were reduced more effectively in 10 mg atorvastatin group than in 10 mg policosanol group.HDL-C[SMD=0.27,95%CI(0.02,0.51),P=0.03] was elevated more in 10 mg policosanol group than 10 mg atorvastatin group.Both groups showed no statistic difference(P=0.42) in TG [SMD=0.10,95% CI:(-0.41,0.35),P=0.42].Conclusion The lipid-lowering efficacy of 10 mg atorvastatin is better than equal dose of policosanolin patients with dyslipidemia.Dose increase of policosanol should be considered to ensure the efficacy when policosanol was used tore place atorvastatin therapy.This study had some shortcomings, such as limited study numbers and small sample size.The reliability of this study should be verified from high-quality,multi-center RCTS with large samples.

Analysis of the Hierarchical Diagnosis and Treatment System in China Based on Game Theory and the Principle of Incentive Compatibility / 中国医院管理

Objective To understand the interests of the government,large general hospitals,higher medical institutions and primary health care institutions to promote the establishment of hierarchical diagnosis and treatment system.Methods The game theory is used to analyze the contradictions and interests of the stakeholders.Results The lack of government investment,the higher medical institutions not wanting to sink medical resources,lack of capacity for primary health care institutions and other issues hinder the smooth implementation of the classification system.Conclusion The role of government should be played,and government investment be increased;the division of labor among medical institutions be strengthened,and medical resources be reasonably allocated;and the strength of primary health care institutions be improved.

Sensitivity of AML Cells with FLT3to PKC412 In Vitro / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the clinical value of PKC412 (midostaurin) in treatment of AML patients with FLT3.</p><p><b>METHODS</b>The bone marrow or peripheral blood were collected and heparinized from 21 newly diagnosed FLT3AML patients, then the mononuclear cells from bone marrow or peripheral blood were isolated by density-gradient method. The sensitivity of leukemia cells to PKC412 of 8 concentration in vitro was detected by ATP-bioluminescence-tumor chemosensitivity assay (ATP-TCA), and the relationship among sensitivity results in vitro, risk stratification and therapeutic efficacy was analyzed.</p><p><b>RESULTS</b>The leukemia cells of 21 patients with AML displayed different sensitivities to PKC412 in vitro. The rate of sensitivity in vitro was 42.9%, and sensitive concentration in vitro were between 1 µmol/L and 5 µmol/L. There was no significant relationship between risk stratification and sensitivity results of PKC412 in vitro. There was also no significant relationship between clinical efficacy and sensitivity results of PKC412 in vitro. The survival of patients in low-risk and intermediate-risk groups was better than that of patients in high-risk groups (P=0.015).</p><p><b>CONCLUSION</b>PKC412 can be one of the effective therapeutic method for AML patients without FLT3 mutation. The sensitivity of leukemia cells to PKC412 may become a prognostic marker for evaluating clinical efficacy of PKC412, which is independent of other factors.</p>

Advance in Studies on Anti-inflammatory Mechanism of Flavonoids / 中国药师

Flavonoids are the secondary metabolites of plants , which are found in many plants .Flavonoids have extensive phar-macological actions , such as anti-inflammation, anti-tumor, anti-bacteria and anti-virus, scavenging free radicals , osteoporosis preven-tion and cardiovascular protection .Based on the analysis of relative literatures published at home and abroad in recent years , the mech-anisms of anti-inflammatory effects of flavonoids were reviewed , including arachidonic acid metabolism pathway , cytokine and its recep-tor, cell second messenger, active oxygen, nitrogen monoxide, platelet activating factor and its receptor , nuclear factor, intercellular adhesion molecule and so on .The review aimed to provide theoretical basis for the further development and research .

Three-dimensional finite element analysis of a newly designed onplant miniplate anchorage system / 华中科技大学学报（医学）（英德文版）

The purpose of this research was to evaluate the structural stress and deformation of a newly designed onplant miniplate anchorage system compared to a standard anchorage system. A bone block integrated with a novel miniplate and fixation screw system was simulated in a three-dimensional model and subjected to force at different directions. The stress distribution and deformation of the miniplate system and cortical bone were evaluated using the three-dimensional finite element method. The results showed that the stress on the plate system and bone was linearly proportional to the force magnitude and was higher when the force was in a vertical direction (Y-axis). Stress and deformation values of the two screws (screw 1 and 2) were asymmetric when the force was added along Y-axis and was greater in screw 1. The highest deformation value of the screws was 7.5148 μm, much smaller than the limit value. The load was decreased for each single miniscrew, and the ability of the new anchorage system to bear the load was also enhanced to some degree. It was suggested that the newly designed onplant miniplate anchorage system is effective, easily implanted and minimally invasive.

Research Progress on Treating Acute Myeloid Leukemia by Midostaurin / 中国实验血液学杂志

FLT3 gene mutations occurred in approximately 30% of acute myeloid leukemia (AML) patients, which is closely associated with the occurrence, development and poor prognosis of AML. The therapy targeting at FLT3 mutations might be a promising treatment for AML. Midostaurin can inhibit the activities of III receptor tyrosine kinase encoded by FLT3 gene, induce cell cycle arrest and has a apoptotic effect on primitive AML cells of FLT3 -mutant, FLT3 wild-type and the expression of FLT3 mutated receptor. In view of this, the association between FLT3 mutations and AML, and research advances and clinical applications of midostaurin on the treatment of AML especially for FLT3 mutated AML, are reviewed.

Module-based analysis: deciphering pathological and pharmacological mechanisms of complex diseases and multi-target drugs / 中国中药杂志

A complex disease is rarely a consequence of abnormality in a single gene. It is known that many drugs exhibit a therapeutic effect by acting on multiple targets, produce synergies to intervene the occurrence and development of diseases. Unlike the traditional methods which act on single molecule or pathway, this disease-drug target network constructed with high throughput data vividly showed the complex relationship between drugs, their targets and diseases. However, the networks are usually extremely complex. In order to reduce the complexity, it is necessary to deconstruct the network and identify module structures. In this study, framework of module analysis was summarized from four aspects: module concept, structure and identification methods, importance of disease-drug module identification, and its application. Module-based analysis provides a new perspective for deciphering the drug intervention mechanisms for complex diseases, and provides new ideas and pathways to reveal the mechanisms of multi-target and multi-component drugs.

Protective effect of alkaloids from Piper longum in rat dopaminergic neuron injury of 6-OHDA-induced Parkinson's disease / 中国中药杂志

<p><b>OBJECTIVE</b>To discuss the protective effect of alkaloids from Piper longum (PLA) in rat dopaminergic neuron injury of 6-OHDA-induced Parkinson's disease and its possible mechanism.</p><p><b>METHOD</b>The rat PD model was established by injecting 6-OHDA into the unilateral striatum with a brain solid positioner. The PD rats were divided into the PLA group (50 mg x kg(-1) x d(-1)), the madorpa group (50 mg x kg(-1) x d(-1)) and the model group, with 15 rats in each group. All of the rats were orally given drugs once a day for 6 weeks. Meanwhile, other 15 rats were randomly selected as the sham operation group, and only injected with normal saline in the unilateral striatum. The behavioral changes were observed with the apomorphine (APO)-induced rotation and rotary rod tests. The number of tyrosine hydroxylase (TH)-positive cells in rat substantia nigra and the density of TH-positive fibers in striatum were detected by tyrosine hydroxylase immunohistochemistry. The content of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione (GSH), catalase (CAT), malondialdehyde (MDA), nitric oxide (NO) and nitric oxide synthase (NOS) in rat substantia nigra and striatum were measured by the spectrophotometric method.</p><p><b>RESULT</b>After being induced by APO, PD rats showed obvious rotation behaviors, with decreased time stay on rotary rod and significant reduction in the number of TH-positive cells in sustantia nigra and the density of TH-positive fibers in striatum. The activities of SOD, GSH-Px, CAT, the content of GSH and the total antioxidant capacity significantly decreased, whereas the activities of NOS and the content of MDA, NO significantly increased. PLA could significantly improve the behavioral abnormality of PD rats and increase the number of TH-positive cells in sustantia nigra and the density of TH-positive fibers in striatum. It could up-regulate the activities of SOD, GSH-Px, CAT, the content of GSH and the total antioxidant capacity, and decrease the content of NOS and the content of MDA, NO.</p><p><b>CONCLUSION</b>Alkaloids from P. longum shows the protective effect in substantia nigra cells of 6-OHDA-induced PD model rats. Its mechanism may be related with their antioxidant activity.</p>

Situation analysis for drug clinical trial institutions / 中国中药杂志

Drug clinical trial is an important link in the chain of new drug research and development. The results of drug discovery and development directly depend on the extent of standardization of clinical trials. Therefore, improving the quality of drug clinical trials is of great importance, and drug clinical trial institutions play a crucial role in the quality management of drug clinical trials. After years of development, the overall level of drug clinical trials has advanced rapidly in China, and a large number of clinical trials of traditional Chinese medicine have also been carried out. However, there is still a big gap between our country and developed countries. Therefore, for the construction and management of Chinese drug clinical trial institutions, there is still a long way to go. This study aims to analyze the current development of drug clinical trial institutions in China and explore the existing problems from three aspects, including current situations of institutional organization and management, regional and professional distributions, and quality control. And some suggestions are put forward finally, including support of traditional Chinese medicine, introduction of drug-risk management system, and construction of information management.

Comparison of the effects of sevoflurane and disoprofol to inflammatory factors in patients received abdominal surgeries / 中国基层医药

Objective To explore and compare the effect of sevoflurane and disoprofol to inflammatory factors in patients received abdominal surgeries.Methods Patients with sevoflurane and disoprofol respectively were anaesthetized and detected IL-6,IL-8,IL-10 and TNF-α in their serum at T1 (when anesthesia induction),T2 (after anesthesia induction),T3 (30min after beginning of operations) and T4 (after operations).Results Compared with T1,the serum level of IL-6,IL-8,IL-10 and TNF-α increased significantly in all patients(all P ＜ 0.05) ; Compared with disoprofol group,the serum level of IL-6,IL-8 and TNF-α increased significantly (all P ＜ 0.05) ; Compared with sevoflurane group,the serum level of IL-10 increased significantly(all P ＜ 0.05).Conclusion Intravenous anesthesia with disoprofol in patients receiving abdominal operations is proper for maintenance of inflammatory balance.

Application of network analysis in diseases and drug studies / 中国中药杂志

A disease is rarely caused by a single virulence gene, but by an imbalanced regulatory network arising from dysfunction of multiple genes or their products. However, drugs intervene the occurrence and development of a disease by acting on multiple target points in the disease network and making a synergy effect on each target point, in order to achieve the therapeutic effect. Unlike traditional approaches focusing on a single molecule or pathway, network analysis with high-throughput data provides a new perspective for studying disease pathobiology and pharmacological mechanisms, and brings forth new ideas for multi-component and multi-target-point pharmacologic mechanisms of traditional Chinese medicines, in three aspects-establishment of relevant disease and drug network, network decomposition, and biological significant of sub-network.