Current situation analysis and suggestions on clinical pharmacy undergraduate internship education in China / 中国药房

OBJECTIVE To provide a reference for the improvement of the clinical pharmacy undergraduate internship education in China. METHODS The status of clinical pharmacy undergraduate internship education in China was briefly summarized， and suggestions on its future development based on advanced methods of domestic and abroad were provided. RESULTS & CONCLUSIONS In China， undergraduate students of clinical pharmacy were required to undergo hospital internships for no less than 42 weeks. The internship took place in both pharmacy and clinical departments in hospitals. Students’ performance was usually assessed at the end of the internship. The mainstream teaching patterns included on-site teaching， simulation teaching， case-based discussion teaching， medical and pharmaceutical joint teaching， team-based teaching， academic exchange， and so on. The form of assessment had also shifted from final evaluations to more dynamic formats. The clinical pharmacy undergraduate internship education in China can adopt teaching models such as the layered teaching approach， establish pre-internship assessment or training， and encourage interns to participate in social pharmacy practice and directly interact with patients， etc.， so as to improve the effect of internship.

Network meta-analysis of triple therapy for the prevention and treatment of acute nausea and vomiting caused by emetogenic chemotherapy drugs with moderate and high risk / 中国药房

OBJECTIVE To evaluate the efficacy of the triple therapy of 5-HT3 receptor antagonists， neurokinin-1 receptor antagonists and dexamethasone （referred to as “triple therapy”） in the prevention and treatment of acute nausea and vomiting caused by moderately and highly emetogenic chemotherapy drugs. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI and Wanfang data， randomized controlled trials （RCTs） about triple therapy or 5-HT3 receptor antagonist combined with dexamethasone （referred to as “dual therapy”） were collected during the inception to May 2023. After literature screening， data extraction and literature evaluation， network meta-analysis was performed by using Stata 16.0 software. RESULTS A total of 59 RCTs were included， involving 23 418 patients and 15 interventions. Results of network meta-analysis showed that fosaprepitant + palonosetron + dexamethasone （FPD） was most effective in terms of acute nausea and vomiting control rate， followed by fosaprepitant + granisetron + dexamethasone （FGD） and aprepitant + ramosetron + dexamethasone （AMD）. In terms of acute nausea control rate， FPD was the most effective， followed by aprepitant + palonosetron + dexamethasone （APD） and FGD. In terms of acute vomiting control rate， FPD was the most effective， followed by FGD and APD. CONCLUSIONS Fosaprepitant + palonosetron + dexamethasone is better than other triple therapy or dual therapy in preventing acute nausea and vomiting caused by moderately and highly emetogenic chemotherapy drugs.

Network meta-analysis of the effectiveness and safety of 3 kinds of snake venom hemocoagulase drugs for hemostasis in abdominal surgery / 中国药房

OBJECTIVE To systematically evaluate the hemostatic effect and safety of snake venom hemocoagulase drugs in abdominal surgery， so as to provide evidence-based evidence for clinic. METHODS Retrieved from Embase， Cochrane Library， PubMed， China Biomedical Literature Database， CNKI and Wanfang database， randomized controlled trials （RCTs） about 3 kinds of snake venom hemocoagulase drugs （Hemocoagulase injection， Hemocoagulase Bothrops atrox for injection， Haemocoagulase Agkistrodon for injection） in abdominal surgery were collected from the establishment of the database to Aug. 2023. Screening， quality evaluation， and data extraction were conducted on literature according to the inclusion and exclusion criteria， and Cochrane 5.1 was used for literature quality evaluation. The risk bias diagram and network diagram were drawn by Stata 15.1 software， and the Bayesian network meta-analysis was carried out by using R 3.6.2 software and Markov chain-Monte Carlo method. RESULTS A total of 11 studies were included， involving 1 401 patients， 852 in the study group， and 549 in the control group. In terms of hemostatic effect， Hemocoagulase injection was significantly superior to Haemocoagulase Agkistrodon for injection [MD＝－2.45， 95%CI （－4.39，－0.24）， P＜0.05]， and the probability of reducing intraoperative bleeding was ranked as follows： Hemocoagulase injection＞hemocoagulase B. atrox for injection＞Haemocoagulase Agkistrodon for injection； in terms of safety， there was no statistically significant difference between the three snake venom hemocoagulase drugs and placebo （P＞0.05）. CONCLUSIONS The hemostatic effect of Hemocoagulase injection in abdominal surgery is significantly better than that of Haemocoagulase Agkistrodon for injection； all three snake venom hemocoagulase drugs have good safety.

Interpretation of expert consensus for the American Gastroenterological Association clinical practice update on de-prescribing of proton pump inhibitors / 中华老年医学杂志

In 2022, the American Gastroenterological Association(AGA)published an expert consensus on the AGA's clinical practice update on PPI prescription cancellation in the Journal of Gastroenterology.In view of the excessive and unreasonable use of proton pump inhibitors(PPIs), experts were organized to formulate a set of ten practical suggestions on how to guide outpatient patients to reduce and stop using PPI.Based on the current situation of PPI use in China and the needs of clinical practice, this paper interpreted the consensus from the perspective of pharmacists, so as to provide reference for further regulating the rational use of PPI and reducing the excessive use and adverse reactions of PPI.

Comparison of management models of chronic noncommunicable diseases in China and abroad / 中华老年医学杂志

The management model of chronic noncommunicable diseases(chronic diseases)in the elderly is related to the outcome and outcome of patients.The main advantages of chronic disease management in foreign countries are the burden of medical insurance, the interconnection of medical institutions in a limited scope, the primary health workers leading, and the active participation of patients.Although the form of chronic disease management in the community is also included in China and guidance documents have been issued, there is still a need for improvement in policy implementation, information system, community resources and patient education.

Efficacy and Safety of Xianling Gubao Capsule Combined with Glucosamine in the Treatment of Knee Osteoar- thritis：A Meta-analysis / 中国药房

OBJECTIVE：To systematically evaluate the efficacy and safety of Xianling gubao capsule combined with glucosamine in the treatment of knee osteoarthritis （KOA），and to provide evidence-based reference for clinical treatment of KOA. METHODS：Retrieved from Cochrane library ，PubMed，Embase，CNKI，Wanfang database ，CBM and VIP during the inception to Nov. 2020，randomized controlled trials （RCTs）about glucosamine （control group ）combined with Xianling gubao capsule （trial group）in the treatment of KOA were collected. After data extraction ，Cochrane 5.1.0 system evaluator manual was used to evaluate the quality of the included clinical studies met inclusion criteria ，and Rev Man 5.4 software was used for Meta-analysis. RESULTS ： A total of 11 RCTs with 970 patients were included in this study. Results of Meta-analysis showed that cure rate [OR ＝2.41，95％CI （1.48，3.93），P＜0.001]，marked effective rate [OR ＝1.95，95％CI（1.49，2.56），P＜0.001]，total effective rate [OR ＝4.00，95％CI （2.57，6.24），P＜0.001]，visual analogue scale （VAS）score [MD ＝－2.34，95％CI（－2.51，－2.17），P＜0.001]，knee function score [MD ＝31.32，95％CI（27.89，34.75），P＜0.001]，Japanese Orthopaedic Association （JOA）low back pain score [MD ＝ 12.22，95％CI（9.68，14.76），P＜0.001] and pain relief time [MD ＝－1.55，95％CI（－1.84，－1.25），P＜0.001] of trial group were all significantly better than those of control group. The incidence of ADR in trial group was significantly lower than control group [OR ＝0.04，95％CI（0.02，0.12），P＜0.001]. CONCLUSIONS ：Xianing gubao capsule combined with glucosamine in the treatment of KOA is significantly better in cure rate ，marked effective rate ，total effective rate ，VAS，score，knee function score，JOA low back pain score and pain relief time ，and could significantly reduce the incidence of ADR.

Meta-analysis on effectiveness of live attenuated influenza vaccine against seasonal influenza in children / 中华流行病学杂志

Objective@#To evaluate the effectiveness of live attenuated influenza vaccine (LAIV) in the prevention of seasonal influenza in children aged 2-17 years.@*Methods@#Literature retrieval of case-control studies on the effectiveness of LAIV against seasonal influenza in children published from January 2003 to November 2018 was conducted through Web of Science, PubMed, and ScienceDirect databases. The Stata 13.1 software was used for Meta-analysis.@*Results@#A total of 14 studies were included in this study, and all were test-negative design (TND) studies. Our Meta-analysis showed that the effectiveness of LAIV in children was 49% (95%CI: 40%-57%). Subgroup analysis found that the protection rate of LAIV was 35% against influenza A (H1N1) pdm09 (95%CI: 5%-56%), 35% against influenza A (H3N2) (95%CI: 21%-46%), and 71% against influenza B (95%CI: 55%-82%). The protection rates of trivalent LAIV and quadrivalent LAIV in children were 56% (95%CI: 48%-63%) and 44% (95%CI: 27%-57%), respectively. The protection rates of LAIV in Europe and North America were 65% (95%CI: 47%-77%) and 46% (95%CI: 36%-55%), respectively.@*Conclusion@#LAIV has a certain preventive effect on seasonal influenza in children aged 2-17 years.

Simultaneous Determination of 6 Flavonoids in the Roots of Tetrastigma hemsleyanum by HPLC / 中国药房

OBJECTIVE： To establish a method for simultaneous determination of rutin， isoquercitrin， kaempferol-3-O- rutinoside， daunorubicin， quercetin and kaempferol in the roots of Tetrastigma hemsleyanum.  METHODS： HPLC method was adopted. The determination was performed on Alliance SilGreen C18 column with mobile phase consisted of 0.2％ phosphoric acid solution-acetonitrile solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was 360 nm and the column temperature was at 35 ℃. The sample size was 15 μL. RESULTS： The linear range of rutin， isoquercitrin， kaempferol-3- O-rutinoside， daunorubicin， quercetin and kaempferol were 21.77-217.77， 12.37-123.75， 13.23-132.31， 4.63-46.30， 5.75-57.50， 3.36-33.66 μg/mL （all r＝0.999 9）， respectively. limit of detection of them were 0.217 8， 0.123 8， 0.066 2， 0.046 3， 0.191 7， 0.112 3 μg/mL， respectively. limit of quantitation of them were 0.435 6， 0.247 5， 0.165 4， 0.154 3， 0.575 0， 0.421 2 μg/mL， respectively. RSDs of precision （n＝6）， stability （24 h， n＝7） and reproducibility tests （n＝6） were lower than 3.20％. The average recoveries of them were 96.23％， 86.88％， 97.51％， 97.67％， 97.50％， 87.46％， RSDs were 1.85％， 1.90％， 1.84％， 1.87％， 1.25％， 2.01％ （n＝9）， respectively. CONCLUSIONS： The method is fast and simple， and could be applied for simultaneous determination of rutin， isoquercitrin， kaempferol-3-O-rutinoside， daunorubicin， quercetin and kaempferol in the roots of T. hemsleyanum.  

Correlation between fasting blood glucose and hepatocarcinogenesis: a multicentre retrospective study (A report of 94 264 cases) / 中华消化外科杂志

Objective To explore the correlation between fasting blood glucose (FBG) and hepatocarcinogenesis.Methods The retrospective cohort study was conducted.The data of 94 264 participants who participated health examination at the Kailuan General Hospital of North China University of Science and Technology,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital,Kailuan Tangjiazhuang Hospital,Kailuan Fan'gezhuang Hospital,Kailuan Jinggezhuang Hospital,Kailuan Lyujiatuo Hospital,Kailuan Linnancang Hospital,Kailuan Qianjiaying Hospital,Kailuan Majiagou Hospital and Kailuan Branch Hospital from July 2006 to December 2015 were collected.There were 75 134 males and 19 130 females,aged (51:±:12)years,with a range of 18-98 years.All the subjects were allocated into 3 groups according to tertiles of FBG,including 31 083 with FBG ＜ 4.82 mmol/L in the T1 group,31 594 with 4.82 mmol/L≤ FBG ＜5.49 mmol/L in the T2 group and 31 587 with FBG ≥5.49 mmol/L in the T3 group.All participants received the same-order health examinations by the fixed team of doctors in 2006,2008,2010,2012 and 2014 at the same place.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.Observation indicators:(1) comparisons of clinical characteristics among the 3 groups;(2) follow-up and incidence of liver cancer;(3) situations of non-liver cancer death;(4) risk factors analysis affecting new-onset liver cancer;(5) comparisons of the prognostic value of FBG on liver cancer model;(6) effects of FBG on new-onset liver cancer using competing risk model.Follow-up using physical examination was performed to detect new-onset liver cancer and survival up to December 31,2015.The start time of follow-up was the first health examination in 2016 and the terminal event was new-onset liver cancer,loss of follow-up and death.Measurement data with normal distribution were expressed as Mean±SD,and comparisons among groups were analyzed using the one-way ANOVA.Measurement data with skewed distribution were described as M (range),and comparisons among groups were analyzed using the Kruskal-Wallis rank sum test.Count data were described as absolute number and percentage,and comparisons among groups were analyzed using the chi-square test.The cumulative incidence and mortality of new-onset liver cancer were calculated and incidence curve was drawn by the Kaplan-Meier method,and comparisons of incidences among groups were done by the Log-rank test.The incidence of liver cancer in patients with different levels of FBG was calculated by person-year incidence (incidence density).The hazard ratio (HR) and 95％ confidence interval (CI) of different levels of FBG (classification variable and continuous variable) on new-onset liver cancer were estimated by the COX proportional hazards regression models.Restrictive cubic spline regression was used to calculate the dose-response relation between the continuous FBG and the risks of new-onset liver cancer.The fitting degree of FBG on new-onset liver cancer model was calculated by the likelihood ratio test and akaike information criterion (AIC).The predictive power of different models was calculated using the C-statistics.The net effects of FBG on incidence of liver cancer were analyzed using cause-specific hazard function (CS) and sub-distribution hazard function (SD).Results (1) Comparisons of clinical characteristics among the 3 groups:gender (male),age,systolic pressure,diastolic pressure,waistline,body mass index (BMI),total cholesterol (TC),alanine aminotransferase (ALT),triglyceride (TG),cases with drinking,smoking,physical exercise,positive HBsAg and fatty liver were 23 567,(51±13)years,(128±21)mmHg (1 mmHg=0.133 kPa),(82±12)mmHg,(86± 10) cm,(24±3) kg/m2,(4.8± 1.2) mmol/L,17.12 U/L (range,12.21-24.01 U/L),1.18 mmol/L (range,0.82-1.75 mmol/L),5 080,9 423,4 779,724,7 591 in the T1 group,24 870,(50±12)years,(129±:20)mmHg,(83±12)mmHg,(86±10)cm,(25±3)kg/m2,(4.9±l.1) mmol/L,18.31 U/L (range,13.01-24.31 U/L),1.23 mmol/L (range,0.88-1.83 mmol/L),5 448,9 397,4 570,619,9 009 in the T2 group and 26 697,(53±11)years,(135±22)mmHg,(86±12)mmHg,(89±10)cm,(26±3)kg/m2,(5.1± 1.2) mmol/L,19.00 U/L (range,13.79-26.61 U/L),1.44 mmol/L (range,1.00-2.21 mmol/L),6 354,10 292,5 369,608,13 397 in the T3 group,showing statistically significant differences among groups (x2 =761.68,F=417.84,1 010.71,747.64,702.73,1 075.06,703.83,x2=447.44,2 109.38,165.97,66.69,78.90,15.50,2 576.95,P＜0.05).(2) Follow-up and incidence of liver cancer:all 94 264 participants were followed up for 817 475 person-year,with a total person-year incidence of 3.71/10 000 person-year,1.13/10 000 person-year in the female participants and 4.37/10 000 person-year in the male participants.The incidence density of liver cancer was 2.84/10 000 person-year,3.64/10 000 person-year,4.64/10 000 person-year in the T1,T2,T3 groups,respectively.The cumulative incidence was 2.76‰,3.90‰,4.90‰ in the T1,T2,T3 groups,respectively,showing statistically significant differences among groups (x2=11.95,P ＜ 0.05),showing no statistically significant difference between T1 and T2 groups (x2 =2.73,P＞0.05),showing statistically significant differences between T1 and T3 groups,between T2 and T3 groups (x2=11.56,4.10,P＜0.05).(3) Situations of non-liver cancer death:during the follow-up,6 880 of 94 264 participants had of non-liver cancer related death,with a non-liver cancer death intensity of 84.16/10 000 person-year.The non-liver cancer death intensity was 79.19/10 000 person-year,68.17/10 000 person-year,105.32/10 000 person-year in the T1,T2,T3 groups.The accumulative mortality was 78.90‰,67.80‰,104.40‰ in the T1,T2,T3 groups,respectively,showing a statistically significant difference among groups (x2 =1 231.46,P ＜ 0.05),showing statistically significant differences between T1 and T2 groups,between T1 and T3 groups (x2 =5.29,4.36,P＜0.05),showing no statistically significant difference between T2 and T3 groups (x2 =0.09,P＞ 0.05).(4) Risk factors analysis affecting new-onset liver cancer.Results of COX proportional hazards regression model analysis showed that continuous FBG was a related factor affecting new-onset liver cancer after adjustment of gender,age,BMI,ALT,drinking,smoking,physical exercise,positive HBsAg,fatty liver,liver cirrhosis,malignant tumor in immediate family (HR =1.06,95％ CI:1.01-1.12,P＜0.05).After ln transformation of FBG,ln FBG was a related factor affecting new-onset liver cancer (HR=1.81,95％ CI:1.21-2.70,P＜0.05).Results of restrictive cubic spline regression showed that continous FBG and ln FBG were nonlinear correlated with incidence of liver cancer (RCS_ S1_x2 =7.21,4.36,P＜0.05).After adding FBG as classification variable in the COX model,risk of new-onset liver cancer in the T2 and T3 groups was increased compared with the T1 group (HR=1.45,1.67,95％ CI:1.07-1.95,1.25-2.22,P ＜ 0.05).(5) Comparisons of the prognostic value of FBG on liver cancer model:multivariate model was constructed after adding risk factors of gender,age,BMI,ALT,drinking,smoking,physical exercise,positive HBsAg,fatty liver,liver cirrhosis,malignant tumor in immediate family,and C-value,-2Log L and AIC were 0.79,6 313.30 and 6 345.30 for the multivariate model.Then FBG variable was added into the multivariate model,and the C-value,-2Log L and AIC of the multivariate model + FBG model were 0.80,6 300.48 and 6 336.48,respectively,showing statistically significant differences compared with the T1 group (x2 =12.82,P＜0.05).(6) Effects of FBG on new-onset liver cancer using competing risk model.Results of competing risk model showed that the risk of new-onset liver cancer in the T2 group was not affected compared with the T 1 group (HR =1.42,95％CI:0.98-1.97,P＞0.05) and risk of new-onset liver cancer in the T3 group was increased compared with the T1 group with the SD model (HR=1.63,95％ CI:1.16-2.26,P＜0.05),after adjustment of gender,age,BMI,ALT,drinking,smoking,physical exercise,positive HBsAg,fatty liver,liver cirrhosis,malignant tumor in immediate family.In the CS model,the risk of new-onset liver cancer in the T2 group was not affected compared with the T1 group (HR=1.43,95％ CI:0.99-1.97,P＞0.05) and risk of new-onset liver cancer in the T3 group was increased compared with the T1 group (HR=1.65,95％ CI:1.18-2.23,P＜ 0.05).Conclusions The elevated FBG is an independent risk factor for the incidence of liver cancer.After considering the competitive risk of death,the risk effect of high-level FBG on the liver cancer still exists.

Simultaneous Determination of Benzoic Acid and Salicylic Acid in Compound Benzoic Acid Embrocation by High Performance Liquid Chromatography / 医药导报

Objective To develope a high performance liquid chromatography ( HPLC) method for simultaneous determination of benzoic acid and salicylic acid in compound benzoic acid embrocation. Methods An Alltima C18 column (150 mm×4.6 mm,5 μm) was used for the separation, with methanol-0.1％ phosphoric acid (50:50) as the mobile phase at the flow rate of 1.0 mL?min-1 .The detection wavelength was set at 236 nm.The column temperature was 35 ℃ . Results The good linearity was obtained with the correlation coefficient (r) of 1.0000 for benzoic acid and salicylic acid;the precisions and stability were satisfactory, and the relative standard deviations (RSDs) were less than 0.3％.The average recoveries (n= 9) were 100.15％ and 99.85％ for benzoic acid and salicylic acid, respectively. Conclusion The established method is accurate, simple and rapid, and can be utilized for the simultaneous determination of benzoic acid and salicylic acid in compound benzoic acid embrocation.

Progress in assessment of vaccine on herd protection / 中华流行病学杂志

The importance of vaccine on public health is related to the herd protection related to the levels of vaccine coverage,which directly influences the vaccinated individuals as well as the unvaccinated community.Reaching the level of herd protection by increasing vaccine coverage is the basic strategy to eradicate related infectious diseases.Again,herd protection has played an important role in public health practices.With the increasing interests in estimating the vaccine herd protection,we however,have seen only few relevant papers including observational population-based and cluster-randomized clinical trials reported in China.We hope to discuss the study designs for evaluating the vaccine herd protection in order to generate evidence-based related research in this field.

Progress in assessment of vaccine on herd protection / 中华流行病学杂志

The importance of vaccine on public health is related to the herd protection related to the levels of vaccine coverage,which directly influences the vaccinated individuals as well as the unvaccinated community.Reaching the level of herd protection by increasing vaccine coverage is the basic strategy to eradicate related infectious diseases.Again,herd protection has played an important role in public health practices.With the increasing interests in estimating the vaccine herd protection,we however,have seen only few relevant papers including observational population-based and cluster-randomized clinical trials reported in China.We hope to discuss the study designs for evaluating the vaccine herd protection in order to generate evidence-based related research in this field.

Intraoperative obeservation of laparoscopic splenectomy assisted with splenic artery embolization in patients with hypersplenism secondary to portal hypertension and splenomegaly / 中国医师进修杂志

Objective To discuss introperative value of laparoscopic splenectomy (LS) treatment assisted with preoperative splenic artery embolization (SAE) in the patients with the hypersplenism secondary to portal hypertension and splenomegaly. Methods The clinical data of 38 patients with the hypersplenism secondary to portal hypertension and splenomegaly admitted to the First People′s Hospital of Wenling from April 2015 to April 2018 were analyzed. Among them, 21 patients underwent LS alone (alone group) and 17 patients underwent LS assisted with preoperative SAE (combined group). Including length of the spleen and liver function Child-Pugh grade, operative time, blood transfusion rate, intraoperative blood loss, intraoperative blood transfusion volume and conversion rate were compared between two groups. Then the clinical value of LS treatment assisted with preoperative splenic artery embolization was discussed. Results The splenic volume of combined group was significantly reduced after SAE: (627 ± 195) cm3vs. (998 ± 251) cm3, P＜0.05. The conversion rate was 23.8%(5/21) in alone group, while no patient required open surgery in the combined group. Compared with that in alone group, operative time of the combined group was shorter [(143 ± 27) min vs. (189 ± 33) min], the blood loss volume was less [(155 ± 49) ml vs. (302 ± 76) ml)], and the differences were statistically significant (P＜ 0.05). The blood transfusion rates of combined group was lower [2/17 vs. 33.3% (7/21)], and intraoperative blood transfusion volume was less [(192 ± 42) ml vs. (399 ± 87) ml] . The differences were statistically significant (P＜0.05). Conclusions LS treatment assisted with preoperative SAE has some advantages, such as shorter operative time, lower surgical laparotomy rate, less intraoperative blood transfusion, less bleeding and shorter length of stay.

Simultaneous Determination of Five Vitamins in Complex Vitamin B Tablets by HPLC / 中国药师

Objective:To develop an HPLC method for the simultaneous determination of vitamin B 1(thiamine), vitamin B2(ribo-flavin), vitamin B3(niacinamide), vitamin B5(pantothenic acid) and vitamin B6(pyridoxine) in complex vitamin B tablets.Meth-ods:An Alltima C18 column (250 mm ×4.6 mm, 5μm) was used for the separation , and 50 mmol· L-1 ammonium dihydrogen phos-phate ( adjusting pH to 3.0 with H3 PO4 ) and acetonitrile were used as the mobile phase with gradient elution at the flow rate of 0.5 ml · min-1 .The detection wavelength was set at 275 nm for vitamin B1 , vitamin B2 , vitamin B3 and vitamin B6 , and 210 nm for vitamin B5 .The column temperature was 30℃and the injection volume was 5μl.Results:The linear range of vitamin B 1 , B2 , B3 , B5 and B6 was 39.48-197.40, 40.16-200.80, 39.36-196.80, 38.80-194.00 and 41.76-208.80 μg · ml-1(r≥0.9999).The average recov-ery was 98.70％, 99.91％, 99.04％, 99.63％and 98.75％, and the RSDs were 0.40％, 0.27％, 0.40％, 0.92％ and 0.39％(n =9), respectively.Conclusion:The established method is accurate , simple and rapid, and can be utilized for the simultaneous determination of vitamin B 1 , B2 , B3 , B5 and B6 in complex vitamin B tablets .

Simultaneous Determination of Dihydralazine Sulfate and Three Vitamins in Compound Apocynum venetum Tablets I by HPLC / 中国药房

OBJECTIVE: To establish a method for simultaneous determination of vitamin B1, dihydralazine sulfate, vitamin B6 and vitamin B5 in Compound Apocynum venetum tablets I.METHODS: HPLC method was used for content determination of 8 batches of samples from 2 enterprises. The determination was performed on Waters XBridge C18 column with mobile phase consisted of acetonitrile-0. 2％ phosphoric acid (gradient elution) at the flow rate of 0. 5 mL/min. The detection wavelengths were set at 285 nm (vitamin Bi, dihydralazine sulfate, vitamin B6) and 210 nm (vitamin B5). The column temperature was 30 ℃, and sample size was 10 μL. RESULTS: The linear ranges of vitamin Bi, dihydralazine sulfate, vitamin B6 and vitamin B5 were 41. 66-208. 3 μg/mL (r=0. 999 9), 127. 0-635. 0 μg/mL (r=0. 999 9), 40. 74-203. 7 μg/mL (r=0. 999 9) and 22. 72-113. 6 μg/mL (r= 0. 999 9), respectively. The limits of quantitation were 0. 267, 0. 274, 0. 062, 0. 124 μg/mL, respectively. The limits of detection were 0. 095, 0. 088, 0. 021, 0. 039 μg/mL, respectively. RSDs of precision, stability and reproducibility tests were all lower than 2. 0％ (n=6). The average recoveries were 98. 70％ (RSD=0. 69％, n=9),99. 74％ (RSD=1. 2％, n=9), 99. 89％ (RSD= 1. 0％, n=9), 99. 25％ (RSD=1. 2％, n=9), respectively. Among 8 batches of samples, the contents of vitamin B1, dihydralazine sulfate, vitamin B6 and vitamin B5 were 91. 44％-98. 74％, 36. 68％-95. 23％, 92. 42％-97. 90％, 91. 36％-99. 48％ of labelled amount, respectively. The contents of dihydralazine sulfate were significantly different and differed by 2. 6 times between the lowest and the highest threshold value. CONCLUSIONS: The method is accurate, reliable, simple and can be used for simultaneous determination of the above 4 components in Compound A. venetum tablets I.

Clinical application of laparoscope combined with gastroscope surgery in patients with gastric stromal tumor / 中国医师进修杂志

Objective To study the clinical application of laparoscope combined with gastroscope surgery in patients with gastric stromal tumor. Methods The clinical data of 50 patients with gastric stromal tumor were retrospectively analyzed. Among them 20 cases were treated with traditional laparotomy (laparotomy group), and 30 cases were treated with laparoscope combined with gastroscope surgery (combination group). The intraoperative bleeding, operation time, postoperative recovery time, postoperative hospitalization time and complications were compared between 2 groups. Results One case in combination group received open surgery (3.33%, 1/30), mainly because of obesity, and tumor rupture occurred in 1 case during operation. All specimens of the 2 groups had no tumor residue. There were no statistical differences in tumor diameter and operation time between 2 groups (P>0.05); the intraoperative bleeding, postoperative recovery time and postoperative hospitalization time in combination group were significantly lower than those in laparotomy group:(26.33 ± 14.21) ml vs. (42.57 ± 15.67) ml, (37.96 ± 8.80) h vs. (60.14 ± 13.41) h and (6.42 ± 2.80) d vs. (12.04 ± 4.69) d, and there were statistical differences (P<0.05). The 2 groups had no death, stomach bleeding, anastomotic stenosis and anastomotic leakage. The laparotomy group had postoperative incision fat liquefaction in 3 cases and incision infection in 2 cases, and the combination group had pulmonary infection in 1 case. All were cured after symptomatic treatment. Conclusions Laparoscope combined with gastroscope surgery in the treatment of gastric stromal tumors has a short operation time, less blood loss, faster postoperative gastrointestinal function recovery, shorter hospitalization time, and no major complications. It is a more ideal and minimally invasive surgery.

Study Advances in the Analytical Methods for Teicoplanin / 中国药师

Teicoplanin is a kind of glycopeptide antibiotic extracted from actinomycetes after fermentation, which is mainly used for the treatment of multidrug-resistant gram-positive cocci infection. The domestic and overseas research literatures on the advances in the analytical methods for teicoplanin were consulted, reviewed and analyzed. The determination methods of teicoplanin mainly includ-ed in vivo and in vitro pharmaceutical analysis. The analytical methods involved high-performance liquid chromatography analysis, bio-assay determination, liquid chromatography-mass spectrometry analysis and micellar electrokinetic capillary chromatography, and a-mong them, HPLC technology was most commonly utilized in the determination of teicoplanin in biological samples and teicoplanin preparations. Much progress has been made in the analytical methods for teicoplanin, and further exploration of determination methods in vivo and in vitro will be beneficial to the quality control of the drug and guiding clinical rational administration.

Analysis of seroepidemiology of enterovirus 71 diseases in children in Jiangsu province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the dynamic pattern and the distributive characteristics of neutralizing antibody against enterovirus 71 (EV-A71 ) in children aged 6-35 months in Jiangsu province from 2012 to 2014.</p><p><b>METHODS</b>From March, 2012 to March, 2014, a total of 1 276 children aged between 6 and 35 months were regularly followed up on day 0, year 1 and year 2 for EV-A71 neutralizing antibody test based on the enterovirus surveillance system, with the method of reporting by their guardian or being visited in Ganyu Sheyang Taixing Donghai Pizhou and Baoying in Jiangsu province. At the same time, samples were taken from the suspected persons infected by enterovirus. The χ(2) test or variance analysis was used to compare the difference of the positive rates and the geometric mean titer(GMT) of EV-A71 neutralizing antibody in different subjects.</p><p><b>RESULTS</b>In 2 years follow-up, the positive rates of EV-A71 antibody increased as the growth of the age,and the positive rates on day 0, year 1 and year 2 were 22.57% (288/1 276), 37.72%(444/1 177) and 42.84%(422/985), respectively (χ(2) values were 39.33, 56.41, 32.25; P< 0.001).The GMTs were 9.95, 15.37 and 24.05, respectively (F values were 22.90,46.36,41.58;P<0.001). In 2 years, the annually new infection rates were 13.47%(158/1 173) and 20.73%(192/926),respectively, and the annually decay rates of EV-A71 antibody were 2.81%(33/1 173) and 8.10%(75/926).</p><p><b>CONCLUSIONS</b>In 2012 to 2014, the positive rates and the GMTs of EV-A71 antibody of children increased as the growth of the age in Jiangsu. The higher annually new infection rate was in children aged 3 to 4 years. The EV-A71 neutralizing antibody level could maintain at least two years after natural infection.</p>

Immunological surrogate endpoints to evaluate vaccine efficacy / 中华预防医学杂志

An immunological surrogate endpoints is a vaccine-induced immune response (either humoral or cellular immune) that predicts protection against clinical endpoints (infection or disease), and can be used to evaluate vaccine efficacy in clinical vaccine trials. Compared with field efficacy trials observing clinical endpoints, immunological vaccine trials could reduce the sample size or shorten the duration of a trial, which promote the license and development of new candidate vaccines. For these reasons, establishing immunological surrogate endpoints is one of 14 Grand Challenges of Global Health of the National Institutes of Health (NIH) and the Bill and Melinda Gates Foundation. From two parts of definition and statistical methods for evaluation of surrogate endpoints, this review provides a more comprehensive description.

Expression and clinical significance of PTEN in bladde r transitional carcinoma / 中国医师杂志

Objective Investigates expression of PTEN(Phosphatase and tensin homology deleted on chromosome ten , PTEN) in bladder transitional cell carcinoma (BTCC) and its clinical significance.Methods Fifty-one cases of bladder transitional carcino -ma, forty-two cases of Cystitis Glandularis(CG) and ten cases of normal bladder tissue 10 cases of normal bladder tissue were collect -ed.All samples were derived from cystoscopic biopsy and were subjected to histopathological examination to confirm the diagnosis .Im-munohistochemistry S-P methods is used to demonstrate the expression of PTEN .Results The positive rate of PTEN expression in BTCC, CG and normal bladder tissue are 58.8%, 81% 100%,and there is statistic significance ( P <0.01) among three groups.51 cases of BTCC are divided into group G Ⅰ ,GⅡ ,GⅢ and Tis -T1 ,T2-T4 ,and there is statistic significance among group G Ⅰ and GⅡ, GⅢ ( P <0.01),between group Tis -T1 and T2-T4 ( P <0.05).Conclusions The reduced expression or loss of PETN might play an important role in carcinogenesis and progression of bladder cancer .The positive rate of PTEN expression was negatively correlated to the clinical and grade staging of tumor .