Effects of pre-existing antibody on seroconversion rate after influenza vaccination / 中华微生物学和免疫学杂志

Objective:To investigate the effects of pre-existing antibody on seroconversion rate after influenza vaccination.Methods:This study recruited 1 900 healthy volunteers to receive influenza split vaccines in Xinjiang Uygur Autonomous region and Yunnan Province from September 2009 to October 2018. Hemagglutinin agglutination inhibition assay was used to detect the titers of specific antibodies in blood samples collected before vaccination and 28 d after vaccination and the effects of pre-existing antibody on the seroconversion to different influenza vaccine components were analyzed.Results:Trend analysis showed that with the increasing titer of pre-existing antibody, the seroconversion rates to A/H1N1, A/H3N2, B/Victoria and B/Yamagata vaccine components were gradually decreased (χ 2=121.76, P<0.001; χ 2=67.58, P<0.001; χ 2=45.25, P<0.001; χ 2=54.55, P<0.001). After adjusting for factors such as region, gender and age, multivariate logistic regression showed that pre-existing antibody titer equal to or higher than 40 was an independent factor that affected the seroconversion to A/H1N1, A/H3N2 and B/Victoria vaccine components, and the adjusted OR (95%CI) values were 2.50(2.00-3.13)、1.64(1.35-2.00) and 2.50(1.79-3.45), respectively. Conclusions:The seroconversion rate to each vaccine component was negatively correlated with the pre-existing antibody titer. The factor that pre-existing antibody titer equal to or higher than 40 was detrimental to the seroconversion to A/H1N1, A/H3N2 and B/Victoria vaccine components, but had no significant influence on B/Yamagata seroconversion.

Preparation and identification of influenza H1N1 subtype vaccine candidate strain in China / 中华实验和临床病毒学杂志

Objective@#Influenza H1N1 subtype vaccine candidate strains from a 2015—2016 year epidemic strain in China were prepared and identified by themethod of classical reassortment.@*Methods@#The influenza H1N1 epidemic strain and H3N2 high-yield reassortant parental strain (X-157) were mixed and inoculated into embryonated chicken eggs by the classical reassortmentmethod . The negative selection of mixed culture virus was carried out with the antiserum of H3 protein and the antiserum of X-157 strain. Real-time PCRmethod was used to test the HA and NA genes. Restriction enzyme digestionmethod was used to identify the internal genes. HA and NA genes of selected strains were sequenced. The strain which HA and NA genes possessed the same amino acid constitution with the wild type virus was selected and immunized to ferret. Two-way test was carried out.@*Results@#Five strains with expected HA and NA genes were selected by real-time PCR. Internal genes were identified, with 4 strains had 6+ 2 constitution, 1 strain had 5+ 3 constitution. Comparing with the wild type virus, HA and NA genes of the 5 strains had no mutation. HA titer of reassortant strains was above 1 024. HI titer of the selected NO.12 reassortment strain reached 5 120, and two-way test was passed. The yield of reassortant strain was 64 times that of the wild type strain.@*Conclusions@#A circulating influenza A (H1N1) strain of influenza A (2015—2016) was successfully prepared in China and laid the foundation for vaccine storage and disease prevention and control.

Simultaneous Determination of 6 Residual Organic Solvents in Xingnaojing Injection by Headspace GC / 中国药房

OBJECTIVE:To establish the method for simultaneous determination of 6 residual organic solvents in Xingnaojing injection,such as methanol,ethanol,isopropanol,n-butanol,ethyl acetate and acetonitrile.METHODS:Headspace GC method was adopted.The determination was performed on DB-624 capillary column by temperature programming with the injector temperature of 200 ℃;flame ionization detector was adopted with the temperature of 250 ℃;carrier gas was nitrogen with flow rate of 25 mL/min and split ratio of 35 ∶ 1;headspace sampling size was 1 mL,and heating temperature of headspace sampling was 80 ℃;equilibrium time was 15 min.RESULTS:The linear ranges of methanol,ethanol,isopropanol,n-butanol,ethyl acetate and acetonitrile were 15.00-240.00 μg/mL (r =0.999 9),25.00-400.00 μg/mL (r =0.999 9),25.00-400.00 μg/mL (r =0.999 9),25.00-399.99 μg/mL(r=0.999 9),25.00-399.99 μg/mL(r=0.999 8) and 5.00-80.00 μg/mL(r=0.999 9).The LOQ were 5.98,3.94,2.05,2.13,1.39,1.24 μg/mL,and the LOD were 2.01,2.11,1.18,1.56,1.15,0.01 μg/mL,respectively.RSDs of precision tests were all less than 2.0％,stability and repetitive tests only ethyl acetate was detected,RSD＜2.0％;the recoveries were 93.59％-99.02％ (RSD=2.62％,n=6),92.42％-98.40％ (RSD=2.43％,n=6),94.81％-104.64％ (RSD=3.47 ％,n=6),94.56％-106.73％ (RSD=4.21％,n=6),97.04％-106.33％(RSD=3.50％,n=6)and 98.40％-107.97％ (RSD=3.37％,n=6).CONCLUSIONS:The method is specific,rapid,simple and accurate,and can be used for simultaneous determination of 6 residual organic solvents in Xingnaojing injection.

Simultaneous Determination of 6 Residual Organic Solvents in Xingnaojing Injection by Headspace GC / 中国药房

OBJECTIVE:To establish the method for simultaneous determination of 6 residual organic solvents in Xingnaojing injection,such as methanol,ethanol,isopropanol,n-butanol,ethyl acetate and acetonitrile.METHODS:Headspace GC method was adopted.The determination was performed on DB-624 capillary column by temperature programming with the injector temperature of 200 ℃;flame ionization detector was adopted with the temperature of 250 ℃;carrier gas was nitrogen with flow rate of 25 mL/min and split ratio of 35 ∶ 1;headspace sampling size was 1 mL,and heating temperature of headspace sampling was 80 ℃;equilibrium time was 15 min.RESULTS:The linear ranges of methanol,ethanol,isopropanol,n-butanol,ethyl acetate and acetonitrile were 15.00-240.00 μg/mL (r =0.999 9),25.00-400.00 μg/mL (r =0.999 9),25.00-400.00 μg/mL (r =0.999 9),25.00-399.99 μg/mL(r=0.999 9),25.00-399.99 μg/mL(r=0.999 8) and 5.00-80.00 μg/mL(r=0.999 9).The LOQ were 5.98,3.94,2.05,2.13,1.39,1.24 μg/mL,and the LOD were 2.01,2.11,1.18,1.56,1.15,0.01 μg/mL,respectively.RSDs of precision tests were all less than 2.0％,stability and repetitive tests only ethyl acetate was detected,RSD＜2.0％;the recoveries were 93.59％-99.02％ (RSD=2.62％,n=6),92.42％-98.40％ (RSD=2.43％,n=6),94.81％-104.64％ (RSD=3.47 ％,n=6),94.56％-106.73％ (RSD=4.21％,n=6),97.04％-106.33％(RSD=3.50％,n=6)and 98.40％-107.97％ (RSD=3.37％,n=6).CONCLUSIONS:The method is specific,rapid,simple and accurate,and can be used for simultaneous determination of 6 residual organic solvents in Xingnaojing injection.

Content Determination of Paeoniflorin in Bazhen Pill(Concentrated Pill)by HPLC / 中国药房

OBJECTIVE:To establish a method for the content determination of paeoniflorin in Bazhen pill(concentrated pill). METHODS:HPLC was performed on the column of wondasil C18 with mobile phase of acetonitrile-1% phosphoric acid(15∶85, V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 230 nm,and column temperature was 30 ℃. RESULTS:The lin-ear range of paeoniflorin was 0219-1.32 μg(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 1%;recovery was 95.82%-101.82%(RSD=2.13%,n=6). CONCLUSIONS:The method is simple,stable and reproducible, and can be used for the content determination of Bazhen pill(concentrated pill).

Discussion on Reasonable Medication Work Mode in Pharmacy Intravenous Admixture Service (PIVAS) / 中国药师

Objective:To discuss the effect and significance of reasonable medication review mode for intravenous medical advice on the platform of pharmacy intravenous admixture service( PIVAS) . Methods:The effect of prescription review interference in intrave-nous drugs on the platform of PIVAS was studied through analyzing irrational prescriptions before and after the performance of PIVAS for 25 departments in our hospital. Results:The real-time review and interference procedure for intravenous transfusion was established, which could significantly increase the percentage of reviewed medical advice and the correction rate of irrational medical advice, and re-duce the percentage of irrational medical advice. The medical advice review quality was also increased, which could guarantee the med-ication safety in patients. Conclusion:The real-time review and interference procedure for intravenous transfusion on the platform of PIVAS can significantly improve the rational medication level of intravenous drugs and avoid the hidden danger of irrational medical ad-vice to the maximum extent to ensure the medication safety in patients, which is also beneficial to the provision of medication service and new platform establishment for the development of clinical pharmacy in hospitals.

Susceptibility of influenza B viruses to neuraminidase inhibitors during 2014 to 2015 in mainland China / 中华微生物学和免疫学杂志

Objective To analyze the phenotypic characteristics of antiviral-resistant influenza B viruses circulating in mainland China and to analyze the susceptibility of influenza B viruses to neuraminidase inhibitors ( NAIs) . Methods Antiviral-resistant phenotyping test was performed to analyze the NAI suscep-tibility of 1 386 influenza B viruses isolated in mainland China from April 2014 to March 2015, including the test of susceptibility to oseltamivir and zanamivir. Results All of the 94 B-Victoria lineage viruses were sensitive to oseltamivir and zanamivir. Of all 1 292 B-Yamagata lineage viruses tested, 1 virus showed re-duced sensitivity to oseltamivir with NA gene containing I221T amino acid mutation, 10 viruses showed re-duced sensitivity to zanamivir with 4 having D197N amino acid mutation in NA gene, 3 viruses showed re-duced sensitivity to both oseltamivir and zanamivir with NA gene possessing D197N amino acid mutation and 1 virus carrying the A245T amino acid mutation in NA gene showed reduced sensitivity to oseltamivir and highly reduced sensitivity to zanamivir. Conclusion The majority of influenza B viruses circulating in main-land China during 2014 to 2015 were sensitive to NAIs, which indicated that NAIs could be used continually for clinical treatment of patients with influenza. Sustained monitoring of antiviral susceptibility of influenza B viruses should be emphasized for timely detection of antiviral resistant viruses and more attention should be paid to the D197N mutations in NA gene of influenza B viruses.

Comparison of Efficacy of Salmeterol-flutiacasone Alone versus Fluticasone Propionate Combined with Mon-telukast Sodium in the Treatment of Children with Moderate Persistent Asthma / 中国药房

OBJECTIVE:To compare the clinical efficacy and safety of salmeterol-fluticasone alone versus fluticasone propio-nate combined with montelukast sodium in the treatment of children with moderate persistent asthma. METHODS:275 children with moderate persistent asthma were randomly divided into inhaled corticosteroids(ICS)+ long acting β2 receptor agonist(LABA) group (139 cases) and ICS+ leukotriene receptor antagonists (LTRA) group (136 cases). ICS+LABA group was given Salmeter-ol-fluticasone powder inhalant,1 inhalation,bid;ICS+LTRA was given Fluticasone propionate inhalation aerosol,bid+Montelu-kast sodium chewable tablet 5 mg,before bedtime,qd. Both groups received more than 12 weeks of treatment. Body indexes of 2 groups were observed after treatment,such as asthma control degree,asthma score,the percentage of peak expiratory flow(PEF) in estimated value,aberration rate of PEF,the levels of eosinophi cationic protein(ECP)and leukotrienes E4(LTE4)in peripheral blood,the times of taking short acting β2 receptor agonist (SABA) during treatment,asymptomatic days,compliance,the inci-dence of ADR,etc. RESULTS:Total effective rate of ICS+LABA group(86.33%)after 4 weeks treatment was higher than that of ICS+LTRA group(58.09%),with statistical significance(P0.05). The day and night asthma score of 2 groups decreased significantly and the percentage of PEF in estimated value increased significantly after treatment,there was statisti-cal significance compared to before treatment(P0.05). The levels of ECP and LTE4 decreased significantly in 2 groups after treatment,there was statistical signif-icance compared to before treatment(P0.05). CONCLUSIONS:Salmeterol-fluticasone alone versus fluticasone propionate combined with montelukast sodi-um in the treatment of children with moderate persistent asth-ma both have good therapeutic efficacy and safety,while thelatter one has stronger inhibition effect on ECP and LTE4,and to control asthma symptoms more rapidly.

Virological characteristics of influenza A (H3N2) virus in mainland China during 2013-2014 / 病毒学报

To analyze the antigenic and genetic characteristics of the influenza A (H3N2) virus in mainland China during the surveillance year of 2013-2014, the antigenic characteristics of H3N2 virus were analyzed using reference ferret anti-sera. The nucleotide sequences of the viruses were determined by Sanger dideoxy sequencing, phylogenetic trees were constructed with the neighbor-joining method, and the genetic characteristics of the viruses were determined in comparison to current vaccine strains. The results showed that most of the H3N2 viruses were antigenically closely related to the A/Victoria/361/2011 vaccine strain cell-propagated prototype virus (99.6%). Using the A/Texas/50/2012 egg isolate as the reference antigen, 15.1% of the viruses were found to be closely antigenically related to it, while 11.9% of strains were closely antigenically related to the egg-propagated epidemic strain, A/Shanghai-Changning/1507/2012. Phylogenetic analysis of HA genes indicated that the A(H3N2) viruses in this surveillance year were in the same clade, but no drug resistant mutation was identified in the NA genes. During the 2013-2014 influenza surveillance year, no significant genetic change was detected in either the HA or NA genes of the A(H3N2) viruses, while significant mutations were found in egg isolates resulting from their adaptation during propagation in eggs. The antigenic and genetic changes should be investigated in a timely manner to enable the selection of an appropriate vaccine strain in China.

Susceptibility of human influenza A (H3N2) viruses to neuraminidase inhibitors isolated during 2011-2012 in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the susceptibility of influenza A (H3N2) viruses to neuraminidase inhibitors during 2011-2012 in Mainland China.</p><p><b>METHODS</b>All the tested viruses were obtained from the Chinese National Influenza Surveillance Network, which covers 31 provinces in mainland China, including 408 network laboratories and 554 sentinel hospitals. In total 1 903 viruses were selected with isolation date from January 1, 2011 to December 31, 2012 in Mainland China, among these viruses, 721 were confirmed to be influenza A (H3N2) virus by Chinese National Influenza Center and tested for the susceptibility to oseltamivir and zanamivir using chemiluminescence-based assay. The neuraminidase inhibitor sensitive reference virus A/Washington/01/2007 (119E) and oseltamivir resistant virus A/Texas/12/2007 (E119V) were used as control in this study. The t -test was used to compare the difference of NAI susceptibility of viruses isolated from different years.</p><p><b>RESULTS</b>The half maximal inhibitory concentration (IC₅₀) of A/Washington/01/2007 for oseltamivir and zanamivir was (0.10 ± 0.02) and (0.30 ± 0.05) nmol/L, respectively. The IC₅₀ of A/Texas/12/2007 for oseltamivir and zanamivir was (4.27 ± 1.60) and (0.20 ± 0.03) nmol/L, respectively. Among the 721 influenza A (H3N2) viruses, 132 influenza A (H3N2) viruses were isolated in 2011 and 589 influenza A (H3N2) viruses were isolated in 2012. The IC50 for oseltamivir ranged from 0.04 to 0.62 nmol/L for viruses isolated in 2011 and ranged from 0.02 to 0.95 nmol/L for viruses in 2012, and the IC₅₀ of all the viruses tested was within 10-fold IC₅₀ (1.0 nmol/L) of the neuraminidase inhibitor sensitive reference virus A/Washington/01/2007. The IC50 of zanamivir ranged from 0.12 to 0.80 nmol/L for viruses in 2011 and ranged from 0.04 to 0.72 nmol/L for viruses in 2012, and was within 10-fold IC₅₀ (3.0 nmol/L) of the neuraminidase inhibitor sensitive reference virus A/Washington/01/2007.</p><p><b>CONCLUSION</b>The influenza A(H3N2) viruses isolated during 2011-2012 in Mainland China were tested to be sensitive to oseltamivir and zanamivir.</p>

Scientific Management in Outpatient Chemical Drug Pharmacy / 中国药房

OBJECTIVE:To explore a fair,reasonable and legal management for outpatient chemical drug pharmacy.METHODS:By combining our experiences in outpatient chemical drug pharmacy of our hospital reviewing a considerable literature,the problems occurred in daily pharmacy management were analyzed,and the coping strategies such as flexible shift arrangement system,comprehensive drug control and sustained improvement etc were applied.RESULTS:The scientific management contributed to a reasonable pharmacy management,reduced error rate,ensured the drug quality,greatly shortened the dispensing time,and due to which,high-quality service was available and the allocation of human resources was optimized to some degree.Patients' satisfaction degree raised to 97.8% of Mar.2008 from 80% of Apr.2006.CONCLUSI-ON:A fair,reasonable and legal pharmacy management was achieved by means of scientific,human and standard management,accordingly,the hardware and software in pharmacy brought about a maximal efficiency and effectiveness of management.