Application of metagenomics next-generation sequencing in the diagnosis and treatment of spinal infection / 实用医学杂志

The incidence of spinal infections,a relatively rare infectious disease,is on the rise due to the empirical use of antibiotics that increases the chances of infection with drug-resistant bacteria,as well as advances in testing technology that have led to an increase in detection rates.Identifying the type of pathogen to target antibi-otics is the key to treatment.However,conventionaldetection methods have low detection rates and are time-consum-ing,which are not conducive to the rapid and accurate diagnosis of spinal infection.Metagenomics next-generation sequencing(mNGS)is a detection technique that can sequence all nucleic acid fragments in samples,the emer-gence of which subverts traditional detection methods and plays an important role in the diagnosis and treatment of spinal infections.This article summarizes the application of mNGS in the diagnosis and treatment of spinal infection.

Interactions and clinical significance of gut microbiota and levothyroxine / 中国临床药理学与治疗学

Levothyroxine is a class of thyroid hormone medication mainly used in the clinical treatment of thyroid hormone replacement therapy and thyrotropin suppression therapy. In recent years, studies have found a close correlation between the human gut microbiota and the occurrence and development of thyroid diseases, as well as changes in thyroid hormone levels. Therefore, understanding the impact of levothyroxine on the gut microbiota, as well as the effects of the gut microbiota on the metabolism and absorption of levothyroxine, is of great significance for the treatment of thyroid diseases and the rational use of clinical medication. This article explores the interaction between the gut microbiota and levothyroxine and summarizes the current clinical findings of the gut microbiota in levothyroxine therapy.

Clinical application characteristics of Ciwujia Injection in treatment of 5 904 cases with cardiovascular disease in real world / 中国中药杂志

To investigate the clinical characteristics and the rule of administration of Ciwujia Injection in patients with cardiovascular disease by correlation analysis and frequency analysis. The information of 5 904 patients who used Ciwujia Injection to treat cardiovascular disease for at least three times in the hospital information system(HIS) of 19 comprehensive tertiary hospitals nationwide. The frequency analysis method was used to analyze the higher frequency variables, and the algorithm of Apriori correlation analysis method was used to analyze the clinical characteristics and medication laws of Ciwujia Injection in treating patients with cardiovascular disease. Among the 5 904 patients, the median age of the patients was 70 years, and the number of patients between 65-75 years old was up to 2 096(35.5%). There were more women than men in terms of diagnosis and treatment, and the women at age of 45-65 and 65-75 years old were more than men. The top three diagnoses by Western medicine were coronary heart disease in 8 104 cases(65.66%), dyslipidemia in 2 515 cases(20.38%), and cardiac function grade Ⅱ-Ⅲ in 581 cases(4.71%), while the largest number of syndromes in traditional Chinese medicine(TCM) at discharge was 1 109(21.37%) in other type, followed by 739 cases(14.24%) of Qi deficiency and blood stasis syndrome, and 698(13.46%) of liver and kidney Yin deficiency syndrome. The most frequently used Western medicine in combined use was Nifedipine in 2 567 cases(7.21%), and most frequently used TCM was Compound Xianzhuli Liquid leachate in 766 cases(3.53%). From the results of pharmacological analysis, the frequency of using Ciwujia Injection + stasi-seliminating agent + calcium channel blocking drugs was highest when using 1 Chinese medicine combined with 1 or 2 Western medicines. In the use of 2 Chinese medicines combined with 1 Western medicine, Ciwujia Injection + heat-clearing agent + stasis-eliminating agent + calcium channel blocker was the most common. This study demonstrated that Ciwujia Injection was more common in middle-aged and elderly patients and more in women than men. Treatment should be based on different cardiovascular disease treatment guidelines to reduce complications caused by underlying diseases, and attention should be paid to the prevention and treatment of cardio-vascular disease risk factors such as hypertension, diabetes and abnormal lipid metabolism. According to the analysis of frequency distribution and association rules, it was concluded that Ciwujia Injection was mainly used in combination with calcium channel blockers and stasis-eliminating agents in the treatment of cardiovascular disease. In the treatment of cardiovascular diseases by Ciwujia Injection in combination with other Chinese and Western medicines, in order to avoid pharmacological changes and avoid affecting the efficacy of the drug, it is necessary to closely observe whether adverse reactions occur and ensure that the medication is safe and effective. This study provides a good reference for the follow-up clinical guidance of Ciwujia Injection.

Intension research on influencing factors of medicinal properties formation of Lonicera japonica and cause hypothesis in explaining medicinal properties of Chinese materia medica single herb / 中草药

The four natures are the basic properties of Chinese materia medica (CMM). At present, it is one of the research hotspots to reveal the scientific connotation of CMM property theory. Clarifying the formation process and influencing factors of the medicinal properties of each single herb in a long historical period is the basic condition for the induction and summary of common characteristics of TCM property theory. Through the textual research of ancient books and documents, combined with the research results of modern Chinese medicine science, this paper combs the influence factors in the formation of the medicinal properties of Lonicera japonica, and reveals its scientific connotation. That is to say, the formation of the medicinal properties of each single herb of TCM is the result of its efficacy material base, the efficacy reflected in the process of clinical treatment and the tendency of clinical medication in previous dynasties. Based on the above research, the cause hypothesis of single herb property is put forward for the first time. The hypothesis provides a reference for the theoretical study of medicine property of TCM.

Clinical Significance of Human Cytochrome P450 1A2 Ontogeny and Its Gene Polymorphism / 中国药学杂志

The change of human cytochrome P450 1A2 ontogeny and the effect of its gene polymorphism on clinical medication were reviewed. The relevant literatures from various databases were searched, collected, analyzed and summarized. CYP1A2 is one of the major subfamilies in human liver enzyme. It is involved in metabolism of about 8%-10% of drugs in clinic, which has important pharmacological and toxicological implications.The expression and activity of CYP1A2 enzymes were different during development, which had a significant effect on clinical medication in human. Studies can see clearance rates and elimination half-lives differences by using caffeine as a probe substrate.Gene polymorphisms cause activity differences of CYP1A2. Gene polymorphisms of CYP1A2*1C and CYP1A2*1F, have been extensively studied show significant effects on clinical medication in adults.There are very few studies on medication between CYP1A2 gene polymorphism and enzyme activity in premature infants, infants and children. The effect of CYP1A2 enzyme activity is unknown between gene polymorphism and ontogeny interaction during human development.It is very necessary to further study the ontogeny changes of CYP1A2 and its gene polymorphism on drug metabolism for improving the safety and efficacy medication in children.

Formulation of Criterion for Clinical Application of Shuxuetong Injection by Clinical Pharmacists in Our Hospital Based on Evidence Quality Evaluation Method / 中国药房

OBJECTIVE： To provide reference for strengthening clinical application of key monitoring drugs and promoting rational drug use in clinic. METHODS： Based on evidence-based medicine， taking key monitoring drugs Shuxuetong injection as example， clinical evidence of domestic and foreign clinical studies were collected. The included literatures were graded according to the quality of GRADE evidence and recommended strength system. Evidence-based medicine evidence for the indications of Shuxuetong injection were evaluated， and criterion for clinical use of Shuxuetong injection was formulated in Huaihua First People’s Hospital （our hospital）. RESULTS： The main content of criterion for clinical application of Shuxuetong injection formulated by our hospital was that there was A-level evidence support for acute ischemic cerebral infarction， but it was weakly recommended and only used for adjuvant therapy； there was B-level evidence support for anticoagulation （for preventing DVT）， diabetic peripheral nerve lesion， but it was weakly recommended； there was only C-level or D-level evidence support for other indications， it was strongly recommendation against use. CONCLUSIONS： Clinical pharmacists formulate the criterion for clinical application of Shuxuetong injection by evidence quality evaluation method， provide reference for clinical application management of key monitoring drug and play an important effect on rational drug use in clinic.

Multiple measures to improve the rationality of medication :practice and experience / 中华医院管理杂志

The hospital improved its rationality of medication by means of better pharmaceutical management ,full-course supervision of drug use ,and clarified responsibility system. It holds that IT means can play an early warning role for the rational medication ,while orchestrated work of section , departments and measured can improve the rationality and ensure patient safety .

Mechanism and clinical application of sodium-glucose co-transportor 2 inhibitors:research advances / 国际药学研究杂志

Sodium-glucose co-transportor 2(SGLT2)exerts an important role in the reabsorption of renal glucose,and SGLT2 inhibitors could reduce the blood glucose level in type 2 diabetes mellitus patients by decreasing renal glucose reabsorption and in-creasing urine glucose excretion. This paper briefly reviews the renal regulation of glucose homeostasis and the regulatory mechanism of SGLT2 inhibitors,then summarized the administration,clinical pharmacology,adverse reaction and other aspect of clinical applica-tion of three most representive SGLT2 inhibitors:dapagliflozin,canagliflozin and empagliflozin,in hope of providing reference for clinical use of SGLT2 inhibitors in the future.

Investigation and Analysis of the Application of Analogical Thought Situational Teaching Method in Clini-cal Medication Nursing Teaching / 中国药房

OBJECTIVE:To provide reference for improving the teaching quality of clinical medication nursing teaching. METHODS:The cluster sampling method was adopted to collect 8 classes of full-time undergraduate nursing students from 2011 and 2012 grade of our university(each 4 classes in each grade). They were randomly divide into trial group(analogical thought sit-uational teaching method) and control group (traditional teaching method). Horizontal comparison was conducted for multi-station comprehensive examination result evaluation and questionnaire survey. RESULTS:A total of 102 questionnaires were issued to full-time undergraduate nursing students of 2011 grade in our university,and 102 effective questionnaires were collected with recov-ery rate of 100%. A total of 102 questionnaires were issued to full-time undergraduate nursing students of 2012 grade,and 110 ef-fective questionnaires were collected with recovery rate of 100%. The average score and skill score of the students in the 2011 and 2012 grades test groups was significantly better than that in the control group,with statistical significance(P<0.05). The other items were significantly better than the students of control groupin the 2011 grades,with statistical significance(P<0.05),except for the item of"improving collaboration and organizational skills"(P>0.05). And all the students of the 2012 grade nursing profes-sional test group were significantly better than the control group, with statistical significance(P<0.05). CONCLUSIONS:It can fully embody the teaching idea of"taking students as the main body",improve students'awareness of clinical medication,nursing safety and innovation,cultivate students'clinical thinking and practical ability,and improve clinical comprehensive ability as inde-pendent thinking and autonomous learning to use analogical thought situational teaching in clinical medication nursing teaching be-fore nursing students entering the production practice.

Analysis of clinical medication rules in 48 398 patients with limb fractures based on hospital information system / 中国中药杂志

To explore the clinical medication rules in the patients with limb fractures, and provide guidance for clinical practice. Data of 48 398 patients with limb fractures from 2001 to 2011 was extracted from the hospital information system(HIS) established by the institute of basic research in clinical medicine, China academy of Chinese medical sciences. The gender and age distribution of patients and clinical medication characteristics were described. Apriori algorithm was adopted to analyze the common drug combinations of Chinese medicine(CM) and western medicine(WM). The study results showed that the ratio of included males and females was 1.83∶1. There was a high peak of incidence for the patients from 18 to 44 years. Apriori algorithm showed that the usage of WM was more frequent than that of CM. The most commonly used CM was Lugua polypeptide and sodium aescinate injection. Blood-activating and stasis-resolving medicines, as well as tendons and bones-strengthening medicines were the commonly used CM types. In addition, WM antibiotics plus blood-activating and stasis-resolving CM, or antibiotics plus tendons and bones-strengthening CM was the most commonly used drug combination. Based on the analysis of available data, the prevalence of limb fracture was higher in men than in women; more in young and middle-aged patients; the common drug combination was antibiotics plus blood-activating and stasis-resolving CM, or antibiotics plus tendons and bones-strengthening CM. More prospective and high-quality clinical trials are necessary to evaluate the effect of CM or integrative medicine treatment for limb fracture in the future research.

Rationality and normativity of the package insert of dexamethasone injection related to medication safety / 中国药学杂志

OBJECTIVE: To evaluatethe rationality and normativity of the contents of thepackage insert of dexamethasoneinjectionrelated to medicationsafety, thus to facilitate the rational use of dexamethasoneinjection. METHODS: The contentsof dosage and administration, adverse drug reaction, and precautionsin the package insert of dexamethasoneinjectionwere reviewed, and the rationality and normativity of the contents were discussed according tothe published papers and the clinical medication practice in our hospital. RESULTS: The contents of the package insert of dexamethasone injectionwere simple, some of the expressionswereambiguousor not standard. Dexamethasone is a long-acting glucocorticoid drug, which has a great influence on human glucose metabolism, while the effect of water and sodium retention is weak. Using 5% glucose injection as the solvent of dexamethasone as stated in the package insertmay exacerbate hyperglycemia, and 0.9% sodium chloride injection should generally be used as the dilution solvent. Besides, when the stock solution is directly injected intravenously, the adverse reactionsof gastrointestinal tract and nervous system may be aggravated. Additionally, there was no precaution statement in the package insert that dexamethasonemay induce hypokalemia in a minority of patients even at single low dose. CONCLUSION: Package insertsof drugs are legal instruments and the most important evidence to guide the rational use of medications. Therefore, it is suggested that the package insert of dexamethasoneinjection should be further improved and revised, which will be of great significance in the implementation of clinical guidelines of glucocorticoids applicationand the rational use of glucocorticoids.

Change of cytochrome P450 2C in the process of development and its clinical significance / 中国药学杂志

This paper presents a review of the change of cytochrome P450 2C (CYP2C) in human development process and the effect of its gene polymorphism on clinical medication. The relevant literature at home and abroad was reviewed, analyzed, and summarized. The expression and activity of CYP2C9 and CYP2C19 enzymes are different at different ages, which has a direct effect on clinical drug use in pediatric patients. It has vital significance to further research the change rules of CYP2C9 and CYP2C19 and the influence of gene polymorphism on drug metabolism in the process of development for improving the efficacy and rationality of pediatric medication.

Metrological Study on Clinical Prescription Characteristics of Four Famous Doctors of School of Integrative Medicine / 世界科学技术-中医药现代化

This article was aimed to compare similarities and differences of medication rules of clinical prescriptions from nine doctors in order to analyze and discuss the clinical medication features of four doctors of the School of Integrative Medicine, who were Zhang Xichun, Tang Rongchuan, Y un Tieqiao, and Lu Y uanlei. The clinical medical records of Dr. Zhang Xichun and eight other doctors were selected in this study. The traditional literature metrology methods and formula metrology were used in the comparative analysis of indicators on four qi, five flavours, channel tropism, supplementation and drainage of commonly used herbal medicine. The results showed that the top five herbs used by doctors of the School of Integrative Medicine were prepared licorice, bighead atractylodes rhizome, Poria, Radix Paeoniae Alba, Angelica, which had the effect of nourishing qi and blood, supplementation and drainage at the same time. Most of the herbs were used to nourishing qi and yang. Dr. Y un Tieqiao preferred to nourish yin and blood. Medications used by doctors of the School of Integrative Medicine were mostly cold and cool in nature as well as acrid and sweet in flavour. Dr. Zhang Xichun had significant correlation with Dr. Tang Rongchuan and Dr. Lu Y uanlei of the School of Integrative Medicine. The correlation coefficients were 0.826 and 0.701, respectively (P <0.05). There were no significant correlation between Dr. Zhang Xichun and other doctors. The cluster analysis revealed that Dr. Zhang Xichun, Dr. Tang Rongchuan and Dr. Lu Y uanlei, who were of the School of Integrative Medicine, can be classified in one category. And Dr. Y un Tieqiao can be classified in a separate category. Doctors who were not of the School of Integrative Medicine were not in the same category. It was concluded that there were similarities in the medication rules of four doctors of the School of Integrative Medicine. However, they also had their own characteristics.

On Evidence-based Pharmacy and the Emergency Management of Pharmaceutical Affair Safety / 中国药房

OBJECTIVE:To provide reference for upgrading emergency management of pharmaceutical affairs and enhancing the safety and effectiveness of clinical medication.METHODS:The guiding effect of evidence-based parmacy(EBP)on emergency management of pharmaceutical affair security especially on the choice of drugs in clinical medication were discussed by elaborating the example of seeking sovereign remedy for tetramine acute poisoning.RESULTS & CONCLUSIONS:Emplying the principle of EBP to guide clinical medication can help to choose more effective and safe drugs and to find the best emergency treatment scheme.

Clinical Efficacy of Fasudil Hydrochloride Injections (Administered at Different Time) for Acute Cerebral Infarction / 中国药房

OBJECTIVE:To evaluate the efficacy and safety of hydrochloric fasudil(administered at different time after onset)for acute cerebral infarction(ACI).METHODS:90 patients developed ACI within 72 h were randomly divided into trial group and control group of 45 each.The trial group was subdivided into trial group 1(developed ACI within 24 h)and trial group 2(developed ACI for more than 24 h).The control group received Compound Radix Salviae Miltiorrhizae injection for 15 days while the trial groups received Fasudil Hydrochloride for 15 days.Improvement of neurological function was evaluated using China Stroke Scales(CSS).RESULTS:The CSS of trial group 1 and trial group 2 was significantly decreased as compared with that of control group,and the CSS in trial group 1 was markedly decreased than in trial group 2,all showing significant differences(P