CHINA PHARMACY Volume 33，Number 18，September 30，2022 Semimonthly Table of Contents Study on the availability of essential medicines for children at 18 tertiary children ’s hospitals / 中国药房

OBJECTIVE To provide emp irical evidence for relevant decision makers in China to formulate and improve policies related to children ’s medicine use . METHODS Based on the purchase data （Jul. 2016-Jun. 2019）of 18 tertiary children ’s hospitals，the availability of medicines included in the 7th edition of WHO Model List of Essential Medicines for Children （WHO EMLc）and their influential factors were investigated according to standard medicine investigation method recommended by the WHO and Health Action International . RESULTS A totally 189 active ingredients listed in the 7th edition of WHO EMLc were available at 18 tertiary children ’s hospitals in China ，which referred to 229 medicines. The availability of Budesonide inhalation suspension，oral rehydration salt ，Immunoglobulin for injection and Water for injection was 100%. In each quarter from Jul . 2016 to Jun . 2019，the availability of more than half of the medicines exceeded 50%，and the availability of the medicines remained basically stable in each quarter . The overall availability of cardiovascular system medicines and blood system medicines was the highest，while that of antiparasitic medicines and dermatology medicines was lower . There were 28 medicines（12.2%）that were not approved for use in children in China ，the use of which were off -label. The medicines which had been approved for children and which were included in national essential medicine list had a significantly higher availability （P＜0.05）. CONCLUSIONS The availability of essential medicines for children is generally better at tertiary children ’s hospitals in China . But the use of some essential medicines in children are off -label. In order to ensure the safety and the availability of essential medicines for children ，it is suggested to introduce China ’s essential medicines list for children ，to promote clinical trials in children for commonly used medicines，and to updete the drug manual in time .

Analysis of 240 Cases of Medical Damage Liability Disputes Caused by Medication Error / 中国药房

OBJECTIVE：To study general chara cteristics and medication of medical damage liability disputes cases caused by medication error ， and to provide references for related departments and medical staff for preventing and reducing medication-induced medical disputes. METHODS ：A total of 240 cases of medical damage liability disputes cases caused by medication error were collected from Peking University ’s Fabao Law Database during Jan. 2001 to Feb. 2020，and analyzed in terms of general situation ，damage outcome ，level of the hospital involved ，liability judgment and compensation ，types of medication error and drug types. RESULTS ：medication-related medical damage liability disputes accounted for 25.3％ of overall medical damage disputes ；the most damage result of patients was death （68.3％）；medical negligence forensic appraisal was conducted as the main appraisal pattern with a proportion of 57.9％；the average case compensation was 203，000 yuan；the hospitals involved were mainly tertiary hospitals （48.8％）；the main type of medication error involved was prescription error ； chemical medicine was mainly involved ，of which the top three categories were systemic antibacterial ，systemic corticosteroids and antipsychotics. CONCLUSIONS ：ADR caused by medication errors are the common causes of medical disputes. Medical institutions should focus on improving the relevant systems and processes ，strengthen the construction of pharmaceutical information and automation system ，and reduce the probability of medication errors ；at the same time ，great importance should be paid to the cultivation of pharmaceutical talents in hospital ，give full play to the role of pharmacists ，and strengthen the monitoring and intervention of medication errors. Finally ，the relevant national judicial departments should constantly improve the settlement mechanism of medical damage liability disputes to provide reasonable protection for both doctors and patients.

Chinese herbal medicine reduces mortality in patients with severe and critical Coronavirus disease 2019: a retrospective cohort study / 医学前沿

This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) in patients with severe/critical coronavirus disease 2019 (COVID-19). In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who were admitted to a designated hospital to treat patients with severe COVID-19 in Wuhan before March 20, 2020. All patients were divided into an exposed group (CHM users) and a control group (non-users). After propensity score matching in a 1:1 ratio, 156 CHM users were matched by propensity score to 156 non-users. No significant differences in seven baseline clinical variables were found between the two groups of patients. All-cause mortality was reported in 13 CHM users who died and 36 non-users who died. After multivariate adjustment, the mortality risk of CHM users was reduced by 82.2% (odds ratio 0.178, 95% CI 0.076-0.418; P < 0.001) compared with the non-users. Secondly, age (odds ratio 1.053, 95% CI 1.023-1.084; P < 0.001) and the proportion of severe/critical patients (odds ratio 0.063, 95% CI 0.028-0.143; P < 0.001) were the risk factors of mortality. These results show that the use of CHM may reduce the mortality of patients with severe/critical COVID-19.

Study on Binding Characteristics of Aminocarboxyl Chelating Ligands for Metal Ions / 分析化学

The feasibility of frontal chromatography for determining the complexation stability constant KML and total mole of binding site Λo was demonstrated by the accuracy and precision binding experiments between metal ions (Cu2+, Ni2+ and Co2+) and chelating ligand (IDA), in which R2>0.98 and RSD Asp>Glu;binding strength of metal ions for chelate ligands followed Cu2+>Ni2+>Co2+;and the binding effect with NaAc-HAc buffer was the best.In aqueous solution, quantum computing of binding energy (ΔE) and gibbs free energy (ΔG) between chelating ligand and metal ion was performed at the M06/6-311++G (d, p) level.According to ΔE and ΔG, the binding rules between chelating ligand and metal ion were predicted theoretically.These rules were basically in agreement with above experimental results.The present work provided effective method for studying on binding characteristics of metal ions for aminocarboxyl chelating ligands, thus exhibited a good foundation for improving the stability of immobilized metal affinity chromatographic column and solving the leakage of metal ions from the column in the process of competitive elution.

K-ras gene mutation status in 454 Chinese patients with colorectal cancer / 肿瘤

Objective: To analyze the mutation status of K-ras gene in CRC (colorectal cancer) tissues and plasma samples of CRC patients, ultimately to promote the targeted agents against EGFR (epidermal growth factor receptor) (such as cetuximab and panitumumab, etc.) used in personalized treatment for CRC patients. Methods: The sequence of K-ras gene at specific sites was investigated in 431 CRC tissues and 23 plasma samples collected from 454 CRC patients, respectively. To improve the detection sensitivity, a combinatory approach was chosen which included the COLD-PCR (coamplification at lower denaturation temperature PCR) method, followed by DNA sequencing. Chi-square test was employed to analyze K-ras mutation frequencies in various sample types or subgroups of CRC patients according to age, and the difference was considered statistically significant if P value was less than 0.05. Results: The overall K-ras mutation rate was 25.29% in 431 CRC tissue samples. The two major forms of K-ras mutation were Gl 2D (mutation of glycine to an aspartate residue at codon 12) and Gl 3D (mutation of glycine to an aspartate residue at codon 13), and their occurrence frequencies were 12.99% and 6.26%, respectively. Interestingly, the overall K-ras mutation rate was 21.74% in blood samples from additional 23 CRC patients, without a significant difference from the mutation rate in the tumor samples (P > 0.05). Moreover, the occurrence frequency of anyone form of K-ras mutation was 37.94% in CRC patients aged 60 and over, which was significantly higher than the detection rate (7.30%) of the patients under the age of 60 (P < 0.01). Conclusion: COLD-PCR amplification combined with DNA sequencing method can be used to detect the mutation status of K-ras gene, and plasma samples can be used insteadly if CRC tumor tissues are unavailable. In addition, for elderly patients aged of 60 and over, it is suggested that K-ras mutation status should be routinely detected before treatment. Copyright © 2013 by TUMOR.

Dynamic analysis of major active ingredients of Cortex Moutan cultivated in Dianjiang county of Chongqing / 中国中药杂志

<p><b>OBJECTIVE</b>To study the change of paeonol and paeoniflorin, the two major active ingredients contained in Cortex Moutan cultivated in Dianjiang county of Chongqing, due to the change of some influence factors, and explore suitable plant conditions and quality cotrol methods of Cortex Moutan.</p><p><b>METHOD</b>Paeonol and paeoniflorin were determined by HPLC in samples from Dianjiang.</p><p><b>RESULT AND CONCLUSION</b>The ratio of paeonol and paeoniflorin in Cortex Moutan was regularly influenced by altitude, the growth years and harvest time. Cortex could be cultivated at altitude of 400 m to 800 m but 600 m is the best aria because of the peak of the percentage composition of paeonol and paeoniflorin at 600 m. The first and middle third of October in the fifth year is the best picking time of Cortex Moutan because of the maximum of the percentage composition of paeonol and paeoniflorin.</p>

Orthogonal experiments on cultivation of Phyllanthus urinaria / 中国中药杂志

<p><b>OBJECTIVE</b>To study the growth rules, the output and the influence factors of cultivated Phyllanthus urinaria, and provide basis for standardized cultivation.</p><p><b>METHOD</b>Orthogonally designed field experiments with three factors and three levels, comparing the characters of cultivated plants and the wild ones of P. urinaria.</p><p><b>RESULT AND CONCLUSION</b>Under the manual planter condition, the characters, such as branching number, single dry weight, single output etc, enhanced enormously, and the increase of single output reaches 3.27 times. The sowing time was the most sensitive factor, which affected the single character and the yield per unit of area, whereas the different levels of sowing thickness and fertilizer also remarkably influenced the output. When the seeds were sowed at the mid-April earlier period, drilling with the 20 cm row spacing, they started to emerge about 1 week later, the growth flush period was from June to August, the growth slowed down in September, and the output per hectare could reach to 5.750 kilograms at harvest in late October.</p>

A comparison of tissue formation and the content of polysaccharide between wild and cultured Dendrobium candidum / 中国中药杂志

<p><b>OBJECTIVE</b>To compare the tissue formation and the content of polysaccharide between the wild Dendrobium candidum and the cultured ones and to find any existed differences.</p><p><b>METHOD</b>Bare-handed microtomy and photomicrography; The content of polysaccharide is determined by phenol-sulphuric acid method.</p><p><b>RESULT AND CONCLUSION</b>There are no marked noticeable differences between the wild D. candidum and the cultured ones in terms of the tissure formation and the content of polysaccharide.</p>

The relationship between haplotypes of multilocus markers and ankylosing spondylitis / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between haplotypes of multilocus markers and ankylosing spondylitis (AS).</p><p><b>METHODS</b>Five families with AS were recruited from Shanghai area. Eleven microsatellite markers around D6S276 were analyzed by Linkage package and by Cyrillic package.</p><p><b>RESULTS</b>Fine linkage analysis showed the significant Lod score values with D6S276 was 3.8821, Lod score values with D6S1691 and D6S1618 near D6S276 were larger than 1.5. The crossover value in 5 pedigrees was 14%. The haplotype analysis showed that the regions between D6S1691 and D6S1618 were associated with AS.</p><p><b>CONCLUSION</b>The regions of D6S1691-D6S276-D6S1618 may harbor a susceptible gene of AS. The specific haplotypes of different pedigrees may play an important role in the presymptomatic diagnosis for AS.</p>

Analysis on HLA-E polymorphism in Guangdong Han population / 中国实验血液学杂志

To investigate the distribution of HLA-E alleles and linkage between HLA-E and HLA-A or -B loci in Chinese Han in Guangdong area, HLA-E alleles were detected by using PCR-SSP in 150 unrelated healthy individuals from Guangzhou area; HLA-A, -B antigens typing in 106 individuals was carried out with NIH standard microlymphocytoxic method. Analysis of linkage was performed between HLA-E and HLA-A, -B. The results showed that three alleles of HLA-E could be detected in this population. They are E * 0101, E * 01031, E * 01032, with the frequency of 45.33%, 32.33%, 22.33% respectively. No E * 0102 and E * 0104 could be detected in all of these individuals. The analysis of linkage on two loci between HLA-E and HLA-A or -B showed that no significant difference could be found between expected frequencies and observed frequencies except B15/E * 01032 and A2/E * 01032. In conclusion, the high conservative polymorphism of HLA-E suggests that it's biological characteristic is different from that of classical HLA class Ia molecules.

Genome-wide scanning for susceptibility genes in researches on six HLA-associated diseases / 中华医学遗传学杂志

Six human leucocytic antigen(HLA)-associated diseases, including ankylosing spondylitis, rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, type 1 diabetes mellitus and psoriasis, were selected as objects of this review. The characteristics of these diseases in whole-genome scans on susceptibility genes or loci undertaken to date were analyzed and compared. Meanwhile, the potential proposals for dealing with the existing problems were put forward.

Killer Ig-like receptor gene content diversity and haplotype analysis in Chinese Han population in Shanghai / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect the diversity of killer Ig-like receptor(KIR) gene content and the combination of haplotypes in Chinese Han population in Shanghai area.</p><p><b>METHODS</b>DNA samples from 87 randomly unrelated healthy individuals in Shanghai Han population were genotyped with SSP/PCR method.</p><p><b>RESULTS</b>(1) Frequencies of KIR genes: All of 18 known KIRs genes, such as 2DL1-5, 2DS1-5, 3DL1-3, 3DS1, KIR1D and the pseudogenes X, Xv and Z(KIR2DP1) were observed in Shanghai Hans. All individuals contain 3DL3, 2DL4, 3DL2 and 3DL1; the most common genes were 2DL3, Z, 2DL1 and X; the following were 2DS4, 1D, 2DL5, 2DS1, 3DS1 and 2DS5; the next were 2DS2, 2DL2, 2DS3 and Xv. (2) Frequencies of KIR gene haplotypes; there were 13 haplotypes detected in 87 Han individuals, among them, the most frequent one was type 2 (haplotypeA-2DS4). (3) Frequencies of KIR genotypes: 18 kinds of the combinations of the haplotypes were observed; the most frequent ones were AJ(2,2), AF (1,2). Also, In this study were identified five new genotypes FZ1 2 9 , FZ2 1 16 , FZ3 6 17 , FZ4 4 13 and FZ5 2 6 ,which had not been observed in Caucasians so far.</p><p><b>CONCLUSION</b>These findings suggest that there are distinctive frequencies of KIR gene content, haplotype as well as genotype in Chinese Han population in Shanghai area.</p>

Analysis on polymorphism in exons 2,3 and 4 of the MICA gene in three different Chinese populations / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect genetic polymorphism in the exons 2 to 4 of the MICA gene in Chinese Han population in Shanghai, Dai population in Yunnan province and Uygur population in Xinjiang province respectively.</p><p><b>METHODS</b>DNA samples from 183 random healthy individuals in Han population, 41 in Dai population and 66 in Uygur population were genotyped by using the polymerase chain reaction (PCR) and sequence-specific oligonucleotide probing (SSOP) method.</p><p><b>RESULTS</b>In total, 10, 7 and 9 alleles of MICA were observed in Han, Dai and Uygur population respectively. MICA*008 was the most common allele in the population of both Han and Uygur, whereas MICA*010 was the most popular one in Dai population. Han and Dai had a bit similar distribution pattern (Chi-square=12.809 P=0.046), in contrast with Han to Uygur (Chi-square=58.499 P=0) and Dai to Uygur (Chi-square=49.273 P=0).</p><p><b>CONCLUSION</b>MICA gene displayed different allele distributions in different populations.</p>