A preliminary study on the prevention of hemorrhage after laparoscopic pancreaticoduodenectomy by wrapping gastroduodenal artery stump in the left external liver lobe and the left caudate lobe / 中华外科杂志

Objective: To investigate the safety and efficacy of embedding the stump of gastroduodenal artery between the left lateral lobe of the liver and the left caudate lobe to prevent bleeding after laparoscopic pancreaticoduodenectomy. Methods: The clinical data of 41 patients who underwent laparoscopic pancreaticoduodenectomy at the second Hospital of Hebei Medical University from October 2021 to April 2022 were analyzed retrospectively.There were 27 males and 14 females, aged (63.0±9.2)years (range: 48 to 78 years), and the body mass index was (24.1±3.2)kg/m2 (range: 15.4 to 31.6 kg/m2). After routine laparoscopic pancreaticoduodenectomy, the stump of gastroduodenal artery was embedded between the left lateral lobe and the left caudate lobe of the liver, and the hepatic parenchyma of the left lateral lobe and the left caudate lobe were sutured with absorbable sutures.The occurrence and recovery of postoperative complications (pancreatic fistula, biliary fistula, postoperative abdominal bleeding, abdominal infection, liver abscess) were observed. Results: All the operations of 41 patients were completed successfully.The operation time was (277.5±52.0) minutes (range: 192 to 360 minutes). The entrapment time of gastroduodenal artery stump was (3.1±0.6) minutes (range: 2.3 to 4.2 minutes), and the intraoperative blood loss (M(IQR)) was 300 (200) ml (range: 50 to 800 ml).The results of ultrasound examination of hepatic artery on the first day after operation showed that the blood flows of hepatic artery were unobstructed.Postoperative pancreatic fistula occurred in 3 cases, including grade B pancreatic fistula in 2 cases (1 case with abdominal infection) and biochemical leakage in 1 case. Three patients with pancreatic fistula were discharged successfully after continuous abdominal drainage. There was no biliary fistula, abdominal bleeding, abdominal infection, liver abscess or postoperative liver dysfunction. Conclusion: The encasement of the gastroduodenal artery stump by the left outer and left caudate lobes of the liver may be an effective way to prevent bleeding from the rupture of the gastroduodenal artery stump after laparoscopic pancreatoduodenectomy, which is easy and safe to perform.

Suggestions on the development of rare disease drugs in China / 国际药学研究杂志

The accessibility of orphan drugs has been the focus of many countries. Many countries and regions have established special laws and regulations to promote the development of orphan drugs since 1980’s. The development of orphan drugs has now become to be an important strategy for the drug development of many large pharmaceutical companies. At present, China has not yet defined the rare diseases, and the orphan drugs used in China are almost dependent on imports. The domestic situation that the research and development, introduction, production and sales of orphan drugs lack the policy support has been the bottleneck restricting the development of related industries in China. This paper reviews the present status of worldwide development of the rare diseases and their therapeutic drugs, and put forward related suggestions for the development of orphan drugs in China.

Research progress on co-crystal of insoluble active ingredients of Chinese materia medica / 中草药

Co-crystal is a crystalline structure composed of at least two components, where the components may be active pharmaceutical ingredients (APIs) and co-formers in stoichiometric amounts. Co-crystal structure exhibits long range order and the components interact via non-covalent interaction such as hydrogen bonding, ionic interaction, vander-waals interaction, and π-π interaction. The intermolecular interaction and resulting crystal structure can generate physicochemical properties which differ from the properties of the individual components. Such properties include melting point, solubility, chemical stability, and mechanical properties. Meanwhile, co-crystal can break through patents protection of APIs. So co-crystal attracts more attention in pharmaceutical research and development field. With the development of pharmaceutical co-crystals, there may be an opportunity for improving the insoluble active ingredients of Chinese materia medica (CMM) in further development. This review has been organized around four categories: the co-crystals of flavonoids (I), alkaloids (II), terpenes (III), and polyphenols (IV) and their effects on physicochemical properties and bioavailability of those APIs, which provide a good reference for the application of pharmaceutical co-crystals in insoluble active ingredients of CMM.

Crystal structure and crystal form stability of trelagliptin succinate / 药学学报

In order to investigate trelagliptin succinate's stability in solution, recrystallization and suspension methods in polar solvent (mainly in water and 95% alcohol) were used to study the crystal form transformation of trelagliptin succinate. Single crystal X-ray diffraction, powder X-ray diffraction and thermalgravimetric analysis, and differential scanning calorimetry were used to characterize the structure of the solid state form before and after transformation. The results showed that trelagliptin succinate can easily convert to trelagliptin hemi-succinate mediated by solvent, especially by polar solvent, namely trelagliptin hemi-succinate is more stable than trelagliptin succinate in solution.