Efficacy and safety of different doses of zinc in the treatment of diarrhea in children：a systematic review / 中国药房

OBJECTIVE To investigate the efficacy and safety of different doses of zinc in the treatment of diarrhea in children， and to provide a reference for clinical safe and rational drug use. METHODS Retrieved from PubMed， Cochrane Library， Embase database， randomized controlled trials about zinc （zinc group） versus placebo or conventional treatment （control group） in the treatment of diarrhea in children were collected from the inception to October 2022. Then， the quality of the included literature was evaluated by the Cochrane Handbook 6.0， and meta-analysis and sensitivity analysis were performed by RevMan 5.3 software. RESULTS Finally， 25 RCTs were included， with a total of 8 618 children. The results of meta-analysis showed that in terms of duration of diarrhea， in zinc ＜20 mg group， the zinc group was significantly shorter than the control group [SMD＝ －0.39， 95%CI（－0.71， －0.08）， P＝0.01]， but in subgroups of ＜6 months old， there was no significant difference between the two groups [SMD＝0.01， 95%CI（－0.10， 0.11）， P＝0.88]. In zinc 20 mg group， the zinc group was significantly shorter than the control group [SMD＝－0.52， 95%CI（－0.80， －0.23）， P＝0.000 3]. In zinc ＞20 mg group， the zinc group was significantly shorter than the control group [SMD＝－0.83， 95%CI（－1.39， －0.27）， P＝0.004]. In zinc ＞10 mg （age ≤12 months） or zinc ＞ 20 mg （age ＞12 months） group （short for “constant dose group”）， the zinc group was significantly shorter than the control group [SMD＝－0.16， 95%CI（－0.27， －0.06）， P＝ 0.003]. In the aspect of diarrhea rate after 7 days of treatment，there was no significant difference in the diarrhea rate after 7 E-mail：lihuiying@etyy.cn days of treatment between the zinc group and the control group： in zinc ＜20 mg group[OR＝1.28，95%CI （0.96，1.70），P＝0.09]， in zinc 20 mg group [OR＝0.40， 95%CI （0.15，1.01），P＝ 0.05]， in constant dose group [OR＝0.64， 95%CI （0.28， 1.44）， P＝0.28]. In terms of vomiting rate， in zinc ＜20 mg group， the vomiting rate of zinc group was significantly higher than that of the control group [OR＝2.13， 95%CI （1.68， 2.70）， P＜0.001]； in constant dose group， vomiting rate of zinc group was significantly higher than that of the control group [OR＝1.84， 95%CI （1.44， 2.34）， P＜0.001]. CONCLUSIONS Zinc can significantly shorten the duration of diarrhea in children（6 months and above）， but low doses can increase the risk of vomiting， which should be taken attention in clinical.

Effects of ADRB2（rs1042713）Gene Polymorphism on Therapeutic Efficacy of Anticholinergic Drugs in the Treatment of Refractory Asthma Pediatric Patients / 中国药房

OBJECTIVE： To study the effects of ADRB2 （rs1042713） gene polymorphism on therapeutic efficacy of anticholinergic drug in the treatment for refractory asthma pediatric patients. METHODS： 171 children with refractory asthma were selected from outpatient department of Kunming Children’s Hospital during Nov. 2016 to Jul. 2019. The distribution of ADRB2 （rs1042713） genotype， the clinical efficacy [asthma control test （C-ACT） score， FEV1， FVC， PEF， maximal mid-expiratory flow （MMEF）] of anticholinergic drug were analyzed statistically； the response of different genotypes to the use of anticholinergic drug were also analyzed statistically. RESULTS： 148 of 171 refractory asthmatics pediatric patients were administered anticholinergic drug， among them 50 of the 71 AA genotype and 36 of the 77 GA genotype responded to anticholinergic drug treatment. Statistical analysis showed that 71 children with AA refractory asthma had improved C-ACT score， FEV1， FVC， PEF and MMEF， there was statistical significance， compared with GA genotype （P＜0.05）； the response rate of the AA genotype to anticholinergic drugs was 2.71 times that of the GA genotype [OR＝2.71， 95％CI （1.38， 5.34）， P＝0.005]. CONCLUSIONS： The detection of ADRB2 （rs1042713） gene polymorphism has some guiding significance in the treatment of refractory asthma with anticholinergic drugs， and the response of AA genotype is better.

Practice of ADRB2, GLCCIl, FCER2 Gene Detection in Individualized Medication of 2 Children with Refractory Asthma / 中国药房

OBJECTIVE: To study the value of ADRB2, GLCCI1, FCER2 gene detection in individualized medication of children with refractory asthma.METHODS: Clinical pharmacists participated in therapy for 2 cases of refractory asthma, and comprehensively analyzed risk factors as its pathogenic factors (allergens and pathogens of respiratory infections), lung function indexes and family history. It was suggested to conduct anti-asthmatic drugs gene [p2-adrenergic receptor (ADRB2), glucocorticoid induced transcriptional 1 gene (GLCCI1), low affinity IgE receptor (FCER2)] testing. According to detection results, the suggestions were put forward such as increasing the dose of Glucocorticoid for inhalation, stopping β2 receptor agonist, additionally using anticholinergic drug. RESULTS: The clinical physicians adopted the suggestions of clinical pharmacists. After optimizing refractory asthma therapy plan according to the results of gene testing and clinical factors, 2 patients were stable and the number of seizures decreased significanthy. CONCLUSIONS: Gene test can provide evidence for the formulation of individualized therapy in asthma children.

New drugs for gont:research advances / 国际药学研究杂志

Gout is a common disease in the elderly men. The prevalence rate of gout is rising worldwide in recent years,and gout has become a serious metabolic disease threatening human health. Moreover,gout is also closely related to incidence of many dis?eases and symptoms such as hypertension,hyperlipidemia,atherosclerosis,obesity and insulin resistance. Recently,investigation and development of new drugs have attracted increasing attention. This paper summarizes the research advances in new agents for treat?ment of gout,including the uric acid reduction drugs that target the key enzymes of purine metabolism,the drugs which target the re?nal tubular urate transporters to lower the uric acid level,the dual inhibitors of xanthine oxidoreductase(XOR)and renal tubular urate transporters,and the uricase.

Effects of 3,5,2 ’,4 ’-tetrahydroxychalcone on urate excretion in hyperuricemic mice / 中国药理学通报

Aim To investigate the effects of 3 ,5 ,2 ’ , 4’-tetrahydroxychalcone (P40) on urate excretion, as well as mRNA and protein expressions of renal URAT1 and GLUT9 in hyperuricemic mice. Methods Sixty Kunming mice were randomly divided into six groups:normal control group, hyperuricemic group ( model group), P40 2. 0, 4. 0, 8. 0 mg·kg-1 groups and positive control group. All drugs were administered in-tragastrically to mice for 5 doses. Hyperuricemic mice were induced by intraperitoneal injection of uric acid (0. 15 g·kg-1 body weight) for 3 times. The urate levels were assayed with the phosphotungstic acid method. The mRNA and protein expressions of GLUT9 and URAT1 were determined by RT-PCR and Western blot. Results P40 at a dose of 4. 0 and 8. 0 mg · kg-1 significantly reduced the serum urate levels in a dose-dependent manner, when compared with untreat-ed hyperuricemic mice ( P<0. 05 or 0. 01 ) . The he-patic urate contents decreased in untreated-and treated-hyperuricemic mice as compared with normal mice ( P<0. 01 ) . Furthermore, P40 had no influence on the renal URAT1 mRNA and protein expression levels, while it could down-regulate renal GLUT9 protein ex-pression but not mRNA expression in hyperuricemic mice. Conclusion P40 possesses potent uricosuric effects associated with urate reabsorption by down-regu-lating the protein expression of GLUT9 in kidney.

Effect of compound flumetasone ointment on transepidermal water loss and its clinical application in patients with atopic dermatitis / 中华皮肤科杂志

Objective To evaluate the effect of salicylic acid on skin barrier function and the efficacy of salicylic acid combined with flumetasone ointment for the treatment of atopic dermatitis (AD).Methods Sixtyfour patients with AD (including 31 males and 33 females) aged 18 to 58 years were recruited into the present study.Four lesional areas of similar size and severity were selected at the similar body sites of both sides of each patient,and randomly classified into four groups to be topically treated with compound flumetasone ointment (containing 0.02％ flumetasone and 3％ salicylic acid,compound flumetasone group),flumetasone 0.02％ ointment (flumetasone group),salicylic acid 3％ ointment (salicylic acid group) and vehicle (control group),respectively;two normal skin areas were chosen from apparently normal skin on the similar body sites of both sides of each patient and topically treated with salicylic acid 3％ ointment (salicylic acid group) and vehicle (control group) respectively.All of these preparations were applied twice a day for 3 weeks.Transepidermal water loss (TEWL) was measured by a Tewameter MPA580 (Courage & Khazaka,Germany) at the baseline as well as on week 1,2 and 3 after initiation of treatment.Symptom and sign scores were evaluated before and after the treatment.Meanwhile,two normal skin areas were selected on bilateral forearm of 30 healthy controls and treated with 3％ salicylic acid ointment (salicylic acid group) and vehicle (control group) respectively twice a day for 3 weeks,and TEWL was measured before treatment as well as on week 1 and 3 after initiation of treatment.Results In the healthy controls,TEWL value showed no significant difference between the salicylic acid group and control group at any of these time points.As far as the lesional skin was concerned,no statistical difference was observed in TEWL value at the baseline between the four groups ((34.26 ± 20.82) vs.(33.02 ±16.71) vs.(34.16 ± 18.03) vs.(33.81 ± 17.11) g· m-2· h-1,P ＞ 0.05),but significant difference was noted after treatment (repeated measurement data analysis of variance,F =39.57,P ＜0.01),with the TEWL value being (22.38 ± 16.16),(17.04 ± 12.74),and (15.34 ± 13.13) g·m-2·h-1 respectively in the compound flumetasone group on week 1,2 and 3,(24.63 ± 17.08),(20.37 ± 9.53),(19.06 ± 9.17) g·m-2·h-1 respectively in the flumetasone group,(26.49 ± 8.59),(21.91 ± 8.46),(21.20 ± 9.38) g·m-2·h-1 respectively in the salicylic acid group,and (29.80 ± 12.48),(26.16 ± 8.31),(25.52 ± 6.05) g·m-2·h-1 respectively in the control group.In detail,the decrease in TEWL value was stronger in the compound flumetasone group than in the flumetasone group on week 1,2,and 3 (all P ＜0.05),in the salicylic acid group than in the control group (P ＜0.05 or 0.01),but similar between the flumetasone group and salicylic acid group.In non-lesional skin,the salicylic acid group showed a more intense decrease in TEWL value compared with the control group on week 2 and 3 (both P ＜0.05).Both the cure rate and response rate were significantly higher in the compound flumetasone group than in the flumetasone group (53.1％ vs.34.4％,x2 =4.57,P＜0.05;83.1％ vs.64.1％,x2 =6.90,P＜0.01).Conclusions The salicylic acid 3％ ointment shows a reparative effect on skin barrier in patients with AD,and the compound flumetasone ointment is superior to the flumetasone ointment in the treatment of AD.

Effects of ginsenoside Rb1 on melanogenesis in human epidermal melanocytes / 中华皮肤科杂志

[Objective] To estimate the effects of ginsenoside Rb1 on melanogenesis in human melanocytes and underlying mechanisms.[Methods] Epidermal melanocytes were obtained from circumcision specimens of children,and subjected to primary culture.After 2 to 5 passages,the melanocytes were treated with different concentrations of ginsenoside Rb1,dimethyl sulfoxide (DMSO,vehicle control),forskolin at 10 μmol/L(positive control) or remained untreated (blank control).After additional culture for 72 hours,methyl thiazolyl tetrazolium (MTT) assay and NaOH lysis method were used to evaluate cell viability and melanin content in melanocytes respectively,spectrophotometer to determine dopa oxidase activity of tyrosinase,Western blot to quantify the protein level of tyrosinase,microphthalmia-associated transcription factor (MITF),phosphorylated and total cAMP response element binding protein (p-CREB and t-CREB) in melanocytes.[Results] After treatment with ginsenoside Rbl of 25,50 and 100 μmol/L for 72 hours,the melanocytes experienced no significant changes in viability (P ＞ 0.05 ),but a significant dose-dependent increase in melanin content (112.4％± 5.7％,155.7％ + 6.3％,217.2％ ± 11.7％ vs.100％,P＜ 0.05 or 0.01) and tyrosinase activity(117.9％ ± 5.7％,158.2％ ± 9.6％,182.6％ ± 10.0％ vs.100％,P＜ 0.05 or 0.01 ) compared with the vehicle control melanocytes.The protein expressions of tyrosinase,MITF and p-CREB were statistically higher in melanocytes treated with ginsenoside Rb1 of 100 μmol/L for 72 hours than in the vehicle control melanocytes (225.4％ ± 12.8％ vs.100％ ± 7.9％,313.5％ ± 16.7％ vs.100％ ± 9.8％,322.5％ ± 21.1％ vs.100％ ± 9.1％,all P＜ 0.01).The increase in MITF protein expression was inapparent in melanocytes at 8 hours after the treatment with ginsenoside Rb1 of 100 μmol/L,but statistically significant at 24 hours compared with the melanocytes at baseline (P＜ 0.01).The pretreatment with H-89 (a 8elective inhibitor of PKA) at 10 μmol/L,significantly suppressed the ginsenoside Rb1 (100 μmol/L for 72 hours) -induced phosphorylation of CREB,increase in MITF,tyrosinase expression,as well as tyrosinase activity and melanin content in melanocytes (all P ＜ 0.01 ).[Conclusion]s Ginsenoside Rb1could enhance the melanogenesis and tyrosinase activity in normal human melanocytes.The PKA/CREB/MITF/ tyrosinase signaling pathway may contribute to the pro-melanogenic effect of ginsenoside Rb1.

Clinical analysis of 890 cases of cosmetic dermatoses in Dalian region / 中华皮肤科杂志

Objective To investigate the clinical features of cosmetic dermatoses and causative cosmetics. Methods A total of 890 cases of cosmetic dermatosis were analyzed in this study. Patch test was performed to determine the causative cosmetics. Results The cosmetic dermatoses mainly manifested as contact dermatitis (90%), followed by hyperpigmentation (3.93%), acneiform lesions (3.37%), photosensitive dermatitis (2.24%), contact urticaria (0.56%). There were 2019 types of questionable cosmetics, which were predominated by skin care cosmetics (92%). Of the 890 patients, 346 (39%) were positive for patch test.Conclusions The causes of cosmetic dermatosis are various, and it is important to strengthen the promotion of cosmetic knowledge as well as to set up a complete monitoring system for cosmetic dermatoses.

Detection of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo / 中华皮肤科杂志

Objective To determine the level of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo at different stages and to study its relationship with the development of vitiligo. Methods Blood samples were collected from 34 outpatients with vitiligo, including 19 cases of progressive vitiligo and 15 cases of stable vitiligo, as well as from 20 normal human controls. Flow cytometry was used to detect the levels of peripheral CD4+ and CD4+CD25+ T lymphocytes in these samples. Results Compared with the controls, the percentage of CD4+CD25+ regulatory T lymphoeytes in peripheral lymphocytes was significantly lower in patients with progressive vitiligo than those in patients with stable vitiligo and normal human con-trois [(2.43±0.30)% vs (3.49±0.39)% and (3.34±0.24)%, both P <0.05], but no significant difference was found between patients with stable vitiligo and normal human controls (P＞0.05). A significantly nega-tive correlation was observed between the percentage of CD4+CD25+ regulatory T lymphocytes and lesion area in patients with progressive vitiligo (r = -0.48, P <0.05), but not in patients with stable vitiligo (P ＞0.05). There was no significant correlation between the course of disease and the percentage of peripheral CD4+CD25+ regulatory T lymphocytes in patients with progressive vitiligo or stable vitiligo (both P ＞ 0.05). Conclusion There is an abnormal proportion of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo, which may be related to the development of vitiligo.

Effects of N-acetylglucosamine on tyrosinase activity and melanogenesis in B16 melanoma cells / 中华皮肤科杂志

ibits tyrosinase activity and melanogenesis in murine B16 melanoma cells. Hence, N-acetylglucosamine may serve as a skin lightening agent in the future.

Levels of Nitric Oxide and Some Cytokines in Sera and Suction Blister Fluid in Patients with Vitiligo / 中华皮肤科杂志

Objective To study the relationship between nitric oxide(NO)and some cytokines and the pathogenesis of vitiligo.Methods Nitric acid reductase assay and ELISA were used to determine the serum levels of NO,and IFN-?,IL-10and IL-12in32patients with vitiligo,compared with18normal controls.The levels of these molecules in suction blister fluids,including involved skin and uninvolved skin from20patients,were also determined.Results The serum levels of NO and IFN-?in vitiligo patients were significantly higher than those in controls,and the serum level of IL-10in the patients was significantly lower than that in controls.The serum level of IFN-?in generalized type of vitiligo and the serum level of NO in localized type of vitiligo in active stage were higher than those in stable stage.The NO level in suction blister fluid of localized vitiligo of involved skin was significantly higher than that of uninvolved skin.Conclusion These findings suggest that NO,IFN-?and IL-10might be involved in the pathogenesis of vitiligo.

The Effects of 4 Traditional Chinese Medicinal Compounds on Murine DNFB Dermatitis / 中华皮肤科杂志

Objective To study the relationship between the therapeutic principle and prescription of traditional Chinese medicine and the experimental pharmacologic effects in relation to the treatment of eczema. Methods Murine DNFB allergic contact dermatitis was used as an animal model, and was treated with 4 traditional Chinese medicinal compounds which were composed of Chinese materia medica with activities to suppress type Ⅳ allergic reaction. Results The results showed that the effect of compound Ⅲ composed of Paeoniae obovata Maxim(赤芍), Fructus Gardeniae(栀子), Herba Schizonepetae(荆芥), Herba Spirodelae(浮萍) and Poria(茯苓), possessing multiple potencies of cooling and promoting blood, clearing heat, expelling wind and eliminating dampness, was strongest among the compounds tested, and the compound up regulated the serum level of calcitonin gene related peptide which was lowered in the mice with DNFB induced dermatitis. Conclusion It is suggested that the compounds with suppressive effect on type Ⅳ allergic reaction might improve the therapeutic effect in clinical practice.

Levels of Soluble Interleukin-2 Receptor in the Sera and Skin Tissue Fluids of Patients with Vitiligo / 中华皮肤科杂志

In order to study the possible role of soluble interleukin-2 receptor (slL-2R) in the pathogenesis of vitiligo, we measured the levels of slL-2R in the sera and the tissue fluids from skin lesions and uninvolved skin from 41 patients with vitiligo, using the method of sandwich ELISA with monoclonal and polyclonal antibodies. The results showed that the overall level of serum sIL-2R from patients with vitiligo was significantly higher, than that from normal control group (P0.05). The level of serum sIL-2R from patients with vitiligo in progressive stage was significantly higher than that in stable stage (P

Effects of Ethanol Extracts of Several Traditional Chinese Medicinal Herbs on Tyrosinase Expression and Melanogenesis in Guinea Pig Skin / 中华皮肤科杂志

Objective To explore the effects of traditional Chinese medicinal herbs (TCMHs) on the expression of tyrosinase gene, melanogenesis and proliferation of melanocytes and elucidate the mechanism of TCMHs in promoting melanogenesis. Methods Seven TCMHs including Herba Ecliptae, Spica Prunellae, Caulis Spatholob, etc, which were known to be effective in activating tyrosinase in vivo, were selected. Brownish guinea pigs were selected as the experimental model. The mRNA in situ hybridization (ISH), Schmorl-staining and dopa-oxygenase staining were performed to observe the effects of TCMHs on gene expression of tyrosinase, melanogenesis and melanocyte proliferation. Results The mRNA ISH showed that these seven drugs, especially Herba Ecliptae,Spica Prunellae and Tribulus terrestris could significantly increase the number of positive cells and the intensity of hybridization signal in the treated group as compared with that in the control group (P 0.1). Conclusions These results suggested that these 7 TCMHs including Herba Ecliptae can upregulate the gene expression of tyrosinase, enhance the melanogenesis and promote the proliferation of melanocytes.

Serum Level of Interleukin,Tumor Necrosis Factor Alpha and Granulocyte Macrophage-Colony Stimulating Factor in Patients with Vitiligo / 中华皮肤科杂志

Objective To study the possible role of cytokines interleukin-1beta(IL-1?),interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor alpha(TNF-?)and granulocyte macrophage colony stimulating factor(GM-CSF)in the pathogenesis of vitiligo.Methods The serum levels of IL-?,IL-6,IL-8,TNF-?,and GM-CSF were measured in50patients with vitiligo and20healthy volunteers with radioimmunoassay.Results The serum level of IL-6and GM-CSF in focal type and generalized type of vitiligo,and the serum level of IL-1?in generalized type were significantly higher than those in normal controls.In segmental type of vitiligo,the serum levels of all the cytokines tested were not significantly different from those in normal controls.The GM-CSF levels in focal type and generalized type,and the IL-6level in generalized type of the progressive stage were significantly higher than those in the stable stage.Conclusion IL-6and GM-CSF may be involved in the autoimmune mechanism of non-segmental type of vitiligo.

Plasma and Skin Tissue Fluid Levels of beta-endorphin in Patients with Vitiligo / 中华皮肤科杂志

Objective To study the role of beta endorphin (?-EP) in the pathogenesis of vitiligo. Methods Radioimmunoassay (RIA) was used to measure the levels of ?-EP in plasma from 40 patients and tissue fluid of lesional and non lesional skin from 33 patients with vitiligo. Results Plasma levels of ?-EP were significantly higher in patients with generalized(11.74?3.47 pmol/L), local(8.31?2.57) and segmental(8.61?2.61) vitiligo than those in normal controls(6.69?1.46). Tissue fluid levels of ?-EP were significantly higher in lesional skin (9.25?4.49 and 10.24?4.37) than those in non lesional skin (5.50?2.84 and 6.12?1.61) from patients with local and segmental vitiligo. Increased levels of ?-EP were observed in tissue fluid from both lesional and non lesional skin in patients with generalized vitiligo, however, no significant difference of ?-EP levels was found between the two kinds of skin tissue. Conclusion It is suggested that ?-EP might play a role in the pathogenesis of vitiligo.