Comparison of Cultivated and Wild-simulated Astragali Radix Based on Traditional Quality Evaluation / 中国实验方剂学杂志

ObjectiveBased on the traditional quality evaluation methods summarized in previous dynasties， this paper systematically contrasted cultivated Astragali Radix（CA） and wild-simulated Astragali Radix（WA） from the aspects of character， microstructure and chemical composition by modern technological means. MethodThe collected CA and WA were compared in characters and microscopic characteristics in cross section， and comparative analysis were performed on the contents of cellulose， extracts， carbohydrate， total flavonoids， total saponins， etc. Then ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometer（UPLC-Q-TOF-MS） and desorption electrospray ionization mass spectrometry imaging（DESI-MSI） were used to comparatively analyze the secondary metabolites and their spatial distributions in the xylem and phloem of CA and WA. ResultIn terms of characters， the characters and sectional features of WA was consistent with the characteristics of high-quality Astragali Radix， while the CA was quite different from the traditional high-quality Astragali Radix. In terms of microscopy， the phellem layer of CA was thin， and the section fissures were mostly distributed through the cambium in a long strip shape without obvious growth ring characteristics. The cork layer of WA was thick， and the cracks in the section were distributed in the center of the xylem and the outer edge of the phloem in an irregular cavity shape. The cambium was tight without cracks， and had obvious characteristics of a growth ring. In terms of chemical composition， the contents of water-soluble extract， 80% ethanol extract and sucrose of CA was significantly higher than those of WA， while the contents of total saponins， lignin and hemicellulose were significantly lower than those of WA. And the contents of 100% ethanol extract， total polysaccharides and total flavonoids in both of them were generally similar， but slightly higher in WA. The contents of 2 kinds of monoacyl-substituted flavonoid glycosides in the xylem of WA was significantly higher than those of CA， while the contents of 2 kinds of flavonoid aglycones and one flavonoid glycoside were on the contrary. The contents of 7 saponins in phloem of WA were significantly higher than those of CA. ConclusionThere are significant differences between CA and WA in characters， microstructure and chemical components， in which CA has a fast growth rate and a short planting period， and the primary metabolites such as water-soluble extracts and sucrose are more enriched， which is the reason for its firm texture and sweetness being significantly higher than those of WA. However， the contents of lignin， hemicellulose and some secondary metabolites in WA are significantly higher than those in the CA， which are close to the traditional description of characters and quality. Based on the results of this study， it is suggested to strengthen the production of WA， improve the supply capacity of WA， and gradually upgrade the current standard. It is recommended to increase the contents of monoacyl-substituted flavonoid glycosides， total saponins and other indicators that can characterize different production methods， so as to guide the high-quality production of Astragali Radix.

Clinical outcomes of COVID-19 cases and influencing factors in Guangdong province / 中华流行病学杂志

Objective To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days ( P 25 - P 75 : 18-31 days) and the median length of hospitalization were 20 days ( P 25 - P 75 : 15-27 days). For severe cases, the median time of showing severe manifestations was on the 12th day after onset ( P 25 - P 75 : 9th to 15th days), and the median time of severe manifestation lasted for 8 days P 25 - P 75 : 4-14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (a HR =1.87, 95% CI : 1.43-2.46), older age (a HR =1.67, 95% CI : 1.51-1.85), seeking medical care on day 2-3 after onset (a HR =1.73, 95% CI : 1.20-2.50) pre-existing diabetes (a HR =1.75, 95% CI : 1.12-2.73) and hypertension (a HR =1.49, 95% CI : 1.06-2.09). Conclusions The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.

Efficacy and Safety of Jianpi Shengxue Granule Alone or Combined with Iron Supplement versus Iron Supplement Alone in the Treatment of Iron Deficiency Anemia in Children ：A Meta-analysis / 中国药房

OBJECTIVE： To systematically review the efficacy and safety of Jianpi shengxue granule alone or combined with iron supplement versus iron supplement alone in the treatment of iron deficiency anemia in children， and to provide evidence-based reference for iron deficiency anemia in children. METHODS： Retrieved from PubMed， Embase， Medline， Scifinder， Cochrane library， CJFD， VIP and Wanfang database during database establishment to Nov. 2018， RCT about efficacy and safety of Jianpi shengxue granule alone or combined with iron supplement （trial group） versus iron supplement alone （control group） in the treatment of iron deficiency anemia in children were collected. After the data were extracted from clinical studies that met the inclusion criteria， and the quality was evaluated with Cochrane System Evaluator Manual 5.1.0， Meta-analysis was conducted by using Rev Man 5.3 statistical software for total response rate， cure rate， the levels of hemoglobin （HB）， mean corpuscular volume （MCV）， mean corpuscular hemoglobin （MCH）， serum iron （SI）， serum ferritin （SF） elevation， the incidence of ADR. RESULTS： Totally 19 RCTs were enrolled， involving 2 259 patients. Results of Meta-analysis showed that total response rate [OR＝6.73， 95％CI （4.68， 9.68）， P＜0.001]， cure rate [OR＝2.51， 95％CI （2.06，3.06）， P＜0.001]， HB increased levels [MD＝8.91， 95％CI （6.13，11.68）， P＜0.001]， MCV increased levels [MD＝9.13， 95％CI （5.32，12.95）， P＜0.001]， MCH increased levels [MD＝2.95， 95％CI （1.75，4.15）， P＜0.001]， SI increased levels [MD＝3.66， 95％CI （2.77， 4.55）， P＜0.001]， SF increased levels [MD＝10.82， 95％CI （9.18，12.45）， P＜0.001] and the incidence of ADR [OR＝0.49， 95％CI （0.33，0.71）， P＝0.000 2] in trial group were all better than control group， with statistical significance. CONCLUSIONS： Jianpi shengxue granule alone or combined with iron supplement versus iron supplement alone can improve total response rate， cure rate， the levels of HB， MCV， MCH， SI and SF in children with iron deficiency anemia， and also decrease the incidence of ADR.

Working Mode Exploration for Antineoplastic Clinical Pharmacists Participating in Clinical Rational Drug Use / 中国药师

Objective:To explore the ideas and techniques of antineoplastic clinical pharmacists in clinical practice. Methods:Antineoplastic clinical pharmacists studied the pharmacology, pharmacokinetics and pharmacodynamics of common antineoplastic a-gents,mastered clinical practice guidelines and expert consensus for common tumors and their complications, dealt with and summa-rized the participation in clinical practice. Results:Pharmacists preliminarily set out the antitumor adjuvant directory,and participated in the clinical rational drug use through the following aspects as the breakthrough points: reforming the doctor's advice, reconsidering wisely on health care,evaluating medicine temporary purchase and formulating clinical pathways. Conclusion:Antineoplastic clinical pharmacists can better promote the control of drug proportion and ensure the safety of patients.

Protective Effect of Liraglutide on Hypoxia and High Glucose-induced Oxidative Stress Injury in Cardiomyocyte / 中国药师

Objective:To explore the effects and possible mechanism of liraglutide on hypoxia and high glucose-induced oxidative stress injury in cardiomyocytes. Methods:The neonatal rat cardiomyocytes were separated and cultured in vitro. The hypoxia and high glucose-induced injury model was established in neonatal rat cardiomyocytes. The cells were divided into six groups:the normal control group, liraglutide control group, hypoxia and high glucose model group, liraglutide treatment group, GLP-1R antagonist group and hyperosmotic control group. The metabolic ability of the cells was detected by MTT assay, the activities of LDH and CK-MB were detected by colorimetric method,SOD activity and MDA content were determined by xanthine oxidase method and thiobarbituric acid method,ROS level was measured by chemiluminescence method. The mRNA and protein expression of adaptor protein p66Shc was detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot. Results:Compared with those in the normal control group, the cells in hypoxia and high glucose model group had poorly metabolic ability,the content of LDH, CK-MB, MDA and ROS increased (P < 0.01), the activity of SOD decreased (P <0.01), and the expression of adaptor protein p66Shc greatly increased(P <0.01). After the treatment with liraglutide,the above mentioned parameters were all improved(P < 0.01). Exendin(9-39),an antagonist of GLP-1R,attenuated the protective effect of liraglutide. Conclusion:Liraglutide has a protective effect on cardiomyocytes by down-regulating adaptor protein p66Shc expression and reducing ROS formation.

TaqMan Real-time PCR,pyrosequencing and GeneChip microarray using the SNP protocol for rapid determination of ALDH2*2 in a Chinese population / 西安交通大学学报(医学版)

ABSTRACT:Objective To establish a rapid molecular method for the detection of aldehyde dehydrogenase-2 (ALDH2)and investigate the gene polymorphisms of ALDH2?2 and determine whether the polymorphic ALDH2 gene is associated with drinking behavior in a Chinese population.Methods The gene polymorphisms of ALDH2?2 were detected using pyrosequencing,TaqMan Real-time PCR and GeneChip microarray technologies;genotyping of 302 volunteers was performed to assess their genetic associations with alcohol use behavior.Results We developed pyrosequencing,TaqMan Real-time PCR and GeneChip microarray methods to identify ALDH2? 2 polymorphisms.The allele frequency of ALDH2?2 was 20.36% in the Chinese population:16.33% in the alcoholic group and 27.83% in non-drinkers (P=0.001).In contrast,the genotype frequency of heterozygous ALDH2?1/?2 plus homozygous ALDH2?2/?2 was 45.28% in non-drinkers and 32.65% in the alcoholics group (P=0.030). Allele frequency of ALDH2 genotypes differed significantly between our Chinese sample and other ethnic groups in Asia,and it was significantly higher than that in European and American countries.Conclusion The developed pyrosequencing,TaqMan Real-time PCR and GeneChip microarray methods are rapid,accurate,high-throughput, convenient,and reliable for detecting ALDH2 polymorphisms.ALDH2?2 gene can protect against the development of alcoholism.The allele frequency of ALDH2 in this Chinese population differs from that in other ethnic groups.

Causes Analysis of Acute Upper Gastrointestinal Bleeding in One Case of Postoperative Patients with PCI / 中国药师

Objective:To explore the role of clinical pharmacists in the use of antiplatelet drugs in the patients with PCI in periop-erative period in order to improve the clinical treatment effect and reduce the incidence of adverse drug reactions. Methods:According to the latest antiplatelet drug treatment guidelines and the related literatures, the causes of acute upper gastrointestinal bleeding induced by triple antiplatelet drugs were analyzed in one case of postoperative patients with PCI, and the rationality of the drug use and the treatment of bleeding were discussed, and the related suggestions were put forward for clinics. Results:In order to ensure the clinical safety and the rational use of drugs, the patients with high risk of bleeding and high thrombosis events should carefully select new anti-platelet drugs, and anti ischemic drugs with good efficacy and low bleeding risk were the first choices. Conclusion:In order to ensure medication safety and effectiveness, clinical pharmacists should actively participate in clinical rational drug use through giving relative suggestions and playing active roles in the rational use of antiplatelet drugs.

Pharmaceutical Care for One Patient with Early Stage Breast Cancer Secondary Osteoporosis Treated with Letrozole / 中国药师

Objective:To explore the pharmaceutical care approaches for the patients with early breast cancer secondary osteoporo-sis treated with letrozole. Methods:A patient with early breast cancer treated with letrozole in long-term faced the high risk of second-ary osteoporosis and led to fracture. How to reduce the risk of fractures by using drugs was the breakthrough point of clinical pharma-cists, and then, individualized pharmaceutical care was performed. Results: The patient was assessed at high risk of fractures in 10 years, and clinical pharmacists assisted doctors to optimize drug therapy, and carried out long-term follow-up education to the patient. The waist pain of the patient disappeared in six months. Conclusion: For early breast cancer patients treated with letrozole, clinical pharmacists should consider the diet and living habits of the patients, assess the fracture risk in 10 years, adjust individual dose of cal-cium and vitamin D3 , choose appropriate bone absorption inhibitors and endocrine treatment, and perform follow-up for the long-term treatment compliance of the patients.

Introduction of the Training Mode for Specialized Clinical Pharmacists in the United States / 中国药师

Objective:To introduce the working mode and training process of specialized clinical pharmacists in the United States. Methods:By visiting and learning the experience of specialized clinical pharmacist training in the United States, the process and re-quirements of specialized clinical pharmacy were illustrated. Through the content analysis on pharmaceutical care of specialized clinical pharmacists in the United States, the work patterns and responsibilities were understood. Results and Conclusion:The duties of spe-cialized clinical pharmacists in USA are more refining. A three-step pattern is clearly presented in the training system of clincial phar-macists in USA, and specialized clinical pharmacists can play important roles in pharmaceutical care.

Formula Screening and in vitro Drug Release of Tegafur Thermo-sensitive Gel for Intratumor Injection / 中国药师

Objective:To screen the best formula of tegafur temperature-sensitive gel for intratumor injection and investigate the in vitro drug release behavior. Methods:The drug dose was determined by cytotoxicity experiment. The thermo-sensitive gel was prepared with PLGA-PEG-PLGA and HPMC as the matrix. With the in vitro release as the index, the effects of PLGA-PEG-PLGA and HPMC at different concentrations on gel were investigated. The gelation temperature, viscosity and pH were detected. Results:The best formula was as follows:25% PLGA-PEG-PLGA, 1% HPMC, and tegafur dose of 1 mg·ml-1 . The average gelation temperature was 36. 7℃, the average viscosity was 7550 mPa·s, and the average pH was 7. 2. Conclusion:Tegafur thermo-sensitive gel for intratumor in-jection shows temperature sensitivity and obvious sustained-release property, which provides experimental basis for the further clinical research.

Effect of group psychotherapy on the alleviation of psychiatric nurses' compassion fatigue / 中国实用护理杂志

Objective To explore the influence of group psychotherapy on the alleviation of psychiatric nurses' compassion fatigue.Methods A total of 190 psychiatric nurses were investigated by compassion fatigue scale.Forty psychiatric nurses were selected to accept group psychotherapy for 10 times.The scores of compassion fatigue scale were compared before and after group psychotherapy and the influencing factors of therapeutic effect were analyzed.Results Thirty-eight psychiatric nurses had accomplished the intervention and follow-up.Compared with before group psychotherapy,the total scores of compassion fatigue scale and the scores of mental tension,passive behavior,doubtful ability and loss of morale among 6 dimensions after group psychotherapy were improved:(83.28±7.01) scores vs.(102.60±7.24) scores,(2.66±0.42) scores vs.(3.11±0.49) scores,(2.02±0.36) scores vs.(2.55±0.41) scores,(1.99±0.33)scores vs.(2.65±0.38) scores,(1.69±0.34) scores vs.(2.76±0.44) scores,and there were significant differences,P＜0.05.Regression analysis found that the work life,education level were correlated with the deduction rate of the total scores of compassion fatigue scale,t=2.858,3.099,P＜0.01.Conclusion Group psychotherapy can help psychiatric nurses to alleviate their compassion fatigue.

Study on Active Fractions of Macrothelypteris Oligophlebia for Chronic Non-bacterial Prostatitis in Rats / 中国药师

Objective:To explore the effect of the methanol extract of Macrothelypteris oligophlebia on chronic non-bacterial prosta-titis ( CNP) in rats to confirm the active fractions. Methods:The powdered rhizomes of M. oligophlebia were soaked in methanol. The methanol extract was suspended in water and then extracted successively with chloroform and ethyl acetate to obtain chloroform fraction, ethyl acetate fraction and water fraction. Carrageenan-induced CNP in rats was established. The rats were randomly divided into the sham-operated control group, model group, positive control group, methanol extract group, ethyl acetate fraction group, chloroform fraction group and water fraction group. The anti-prostatitis effect was evaluated by the prostate index, and the pathological examination of prostate was performed using HE staining. The levels of interleukin-10 (IL-10), tumor necrosis factor alpha (TNF-α), cyclooxyge-nase-2 (COX-2) and prostaglandin E2(PGE2) were analyzed using ELISA kits. Results:The ethyl acetate fraction group and metha-nol extract group with high flavonoid content could significantly decrease prostate index (P<0. 01) and the levels of IL-10, TNF-α, COX-2 and PGE2(P<0. 05 or P<0. 01), and improve the prostate morphology when compared with the model group, especially with the ethyl acetate fraction group. Conclusion:The rhizomes of M. oligophlebia show promising therapeutic effect on CNP, and the ethyl acetate fraction is the active fraction.

In Vitro Release and Inhibiting Effects on the Proliferation of SKOV-3 of Paclitaxel PLGA Nanoparticles Modified with Folic Acid Conjugated Chitosan Oligosaccharide / 中国药师

Objective:To prepare PLGA nanoparticles modified with folic acid conjugated chitosan oligosaccharide containing pa-clitaxel (F-CS-PLGA-NPs) and study the inhibitory effect on SKOV-3. Methods:F-CS-PLGA-NPs were prepared by an interface dep-osition method, 30% ethanol was used as the release medium for the in vitro release profiles of nanoparticles, and MTT was adopted to evaluate the inhibitory effect of paclitaxel with different formulations and concentrations on SKOV-3. Results:The particle size and zeta potential of F-CS-PLGA-NPs was (321 ± 0. 76) nm and (22. 6 ± 0. 26) mV, respectively, the drug loading was (5. 1 ± 0. 25)%, and the encapsulation efficiency was (41. 96 ± 1. 96)%. F-CS-PLGA-NPs had a similar in vitro release profiles with the ordinary nanoparti-cles ( PLGA-NPs) . About 35% of paclitaxel was released from the nanoparticles in the initial 24 h, and then a near zero order release at a relative slow rate was shown, and the cumulative release rate in 144 h was about 75%. The results of cell experiments suggested that at the same paclitaxel concentration, the inhibition effect of F-CS-PLGA-NPs group was stronger than that of the PLGA-NPs group and the solution group. The inhibition effect of F-CS-PLGA-NPs could be reduced by free folic acid. Conclusion:PLGA nanoparticles modified with folic acid conjugated chitosan oligosaccharide can increase the targeting efficiency in SKOVS-3 tumor cells.

Study on enterovirus infection in family close contacts of patients with hand, foot and mouth disease and the contamination of environment / 中华传染病杂志

Objective To understand the enterovirus infection in family close contacts of patients with hand,foot and mouth disease (HFMD) and the contamination of environment.Methods Forty-one HFMD cases confirmed by laboratory from web-based surveillance system during July to August 2010 in Guangdong Province were selected.All members of the cases′ family were investigated by collecting their information on demography,habit of domestic hygiene and hygiene status in household.The stool samples of all members and the smear samples from the surface of family belongings from 16 families were collected and the enterovirus was detected by real time quantitative polymerase chain reaction.The data were analyzed by chi square teat and t test.ResultsForty-one HFMD cases′ families and 135 close contacts were included in this survey.The infection rate of the enterovirus was 39.2％ (53/135) in all close contacts.Of all the investigated families,the infectionrate was 58.5％ (24/41) in family with one or more close contacts and 9.8％ (4/41) in family with all close contacts.The differences of infection rates of enterovirus among the members of parents (32.5％,25/77),grandparents/aunts/ uncles (43.3％,13/30) and cousins (53.6％,15/28) didn′t show statistical significance (χ2 =4.07,P=0.131).The infection rate of enterovirus in close contacts from family with more than 5 members was higher than that from family with 4 or less members (OR=1.4,95％CI 1.1-1.9).Among 135 close contacts,27.4％ (37/135) were infected with the same types of entervirus as that of HFMD case in the family and 11.9％ (16/135) were infected with the different virus types.In 33 family belongings samples from 16 families,the positive rate of enterovirus detection was 6.1％ (2/33).Between 17 families with enterovirus testing negative and 23 families with enterovirus testing positive in close contacts,there were no statistical differences of the family hygiene status,hand-washing of babysitter,disinfection of tableware and drinking,sharing towels,airing bedding articles and toy cleaning (P＞0.05).ConclusionsThe infection rate of enterovirus in close contacts of HFMD cases is high and the enterovirus contamination exists in case family environment.Management of close contacts of HFMD cases and disinfection of the family environment are important in HFMD controls.

Preparation and Quality Control of Doxycycline Hydrochloride Microspheres / 中国药房

OBJECTIVE: To prepare doxycycline hydrochloride microspheres and to establish a method for its quality control.METHODS: O/O emulsion solvent evaporation method was adopted to prepare doxycycline hydrochloride microspheres with poly (lactic-co-glycolic acid) (PLGA) as carrier.Light microscope was used to detect appearance and particle size of microspheres and UV spectrophotometry was applied to determine the loading rate and release rate of drug in vitro.RESULTS: Prepared microspheres are smooth and round with mean particle size of (49?6.9) ?m and span of 0.9.Average drug loading rate was (3.3?0.2) % and encapsulation efficiency was (52.4?3.2) % (n=3).Accumulative drug release reached 28% within 0.5 h with constant drug release lasting more than 30 days.CONCLUSION: Doxycycline hydrochloride microspheres preparation process is available and controllable in quality.