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Objective To explore the mechanism and management of acute kidney injury induced by the interaction be-tween voriconazole and nifedipine.Methods A patient with acute kidney injury was treated with nifedipine controlled-release tablets and voriconazole tablets at the same time.Pharmacists analyzed drug interactions and drug characteristics during diagnosis and treatment and proposed treatment recommendations,discontinued suspected drugs(cefotaxime and voriconazole),and deter-mined subsequent treatment based on the analysis results.Results The doctor accepted the advice and the patient gradually re-covered from acute kidney injury.Conclusion Drug-drug interactions,especially those based on the interaction of liver drug enzyme CYP450,should be paid attention to in clinical diagnosis and treatment,to improve efficacy and reduce adverse reactions.
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This study investigated the characteristics and frequency of perioperative anaphylactic shock induced by cefuroxime, so as to provide a reference for the safe and rational use of cefuroxime in the perioperative period. Cases of perioperative anaphylactic shock caused by cefuroxime in our hospital from 2011 to 2021 were extracted from the Adverse Drug Reaction Monitoring System. Literature reporting adverse drug reactions (ADR) including cefuroxime-induced anaphylactic shock in perioperative settings was collected from the CNKI, VIP, Wanfang, PubMed, and Web of Science databases from their respective inception to May 2022. Statistical analysis was performed for all cases of cefuroxime-induced perioperative anaphylactic shock. A total of 31 patients were included [13 men (48.1%) and 14 women (51.9%)], most of whom were over 60 years old ( n=16, 59.3%); 9 (29.0%) patients had a history of drug allergy; 5 (16.1%) patients had received skin tests, but with negative results; 28 (90.3%) patients received treatment intravenously; 22 (71.0%) patients were treated after anesthesia. For 20 (64.5%) patients the ADR occurred within 10 minutes after anesthesia. The main manifestations were hypotension, dyspnea, rash, and tachycardia. For all patients, symptoms resolved after withdrawal of the drug and active rescue, and there were no deaths. A history of allergy and skin test findings may have limitations in predicting perioperative anaphylactic shock caused by cefuroxime; greater vigilance should be exercised when using cefuroxime in the perioperative period. Close monitoring is recommended for patients undergoing treatment with cefuroxime. Rescue therapy should be administered for allergic shock, and suitable response measures must be taken in a timely manner to ensure the safety of patients.
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BACKGROUND@#Highly expressed in various human cancers, circular RNA Protein Kinase C Iota (circPRKCI) has been reported to play an important role in cancer development and progression. Herein, we sought to reveal the prognostic and clinical value of circPRKCI expression in diverse human cancers.@*METHODS@#We searched the Pubmed, Web of Science, and the Cochrane Library databases from inception until May 16, 2021. The relationship between circPRKCI expression and cancer patients' survival, including overall survival (OS) and disease-free survival (DFS), was assessed by pooled hazard ratios (HR) with corresponding 95% confidence interval (CI). The correlation between circPRKCI expression and clinical outcomes was evaluated using odds ratios (OR) with corresponding 95% CI. The data were analyzed by STATA software (version 12.0) or Review Manager (RevMan 5.3).@*RESULTS@#A total of 15 studies with 1109 patients were incorporated into our meta-analysis. The results demonstrated that high circPRKCI expression was significantly related to poor OS (HR = 1.96, 95% CI: 1.61, 2.39, P <0.001) when compared with low circPRKCI expression in diverse human cancers. However, elevated circPRKCI expression was not associated with DFS (HR = 1.34, 95% CI: 0.93, 1.95, P = 0.121). Furthermore, the patient with a higher circPRKCI expression was prone to have a larger tumor size, advanced clinical stage, and lymph node metastasis, but it was not significantly correlated with age, gender, and distant metastasis.@*CONCLUSION@#Elevated circPRKCI expression was correlated with worse OS and unfavorable clinical features, suggesting a novel prognostic and predictive role of circPRKCI in diverse human cancers.
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Humans , Prognosis , RNA, Long Noncoding/genetics , Neoplasms/metabolism , Disease-Free Survival , Progression-Free Survival , Lymphatic Metastasis , Biomarkers, Tumor/metabolismABSTRACT
OBJECTIVE:To i nvestigate the clini cal ch aracteristics of anaphylactic shock induced by piperacillin and its compound preparation ,and to provide reference for prevention and treatment of the severe ADR. METHODS :A case of anaphylactic shock induced by piperacillin and sulbactam were analyzed in our hospital ,meanwhile ADR literatures about piperacillin alone and its compound preparation-induced anaphylactic shock were collected from Medline ,CNKI,Wanfang database and VIP during the inception to Jul. 2020. Gender and age of patients ,allergic history ,primary disease and treatment ,skin test , administration route and dosage of piperacillin and its compound preparation ,occurrence time and main manifestations of anaphylactic shock ,treatment measure and prognosis were analyzed ,then prevention and treatment suggestions were put forward. RESULTS:The patient in this case was transferred to the ICU after partial hepatectomy. The use of piperacillin and sulbactam to prevent postoperative infection caused anaphylactic shock. A total of 28 literatures about anaphylactic shock induced by piperacillin and its compound preparations were collected from the database (involving 28 patients). Among totally 29 patients,there were 12 male and 17 female;the majority of patients were 50-59 years old (6 cases,20.69%). Three patients had allergic history (food, latex gloves ,etc.),and most of the primary diseases were infectious diseases or the drug used in perioperative period. Skin tests were carried out in 22 patients(75.86%)before medication and the results were negative. The possible allergenic drugs of 27 cases which were administered by intravenous route included piperacillin ,piperacillin sulbactam and piperacillin tazobactam. The dosage was different according to the primary disease and severity. 14 patients(55.56%)developed anaphylactic shock within 5 minutes after drug exposure. The main symptoms were systemic allergic reaction ,mainly involving the circulatory system. Except for two death cases ,the other patients ’symptoms were relieved after treatment. CONCLUSIONS :Allergic history and skin test results may have limitation in predicting anaphylactic shock induced by piperacillin and its compound preparation. Close monitoring needs to be taken in patients during these medications. Rescue therapy should be prepared in advance and countermeasures need to be carried out promptly in case of anaphylactic shock.
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OBJECTIVE:To rapidly evaluate the effectiveness ,safety and economics of Ginkgo biloba extract(EGb)in the treatment of Alzheimer ’s disease (AD)patients,and to provide evidence-based reference for clinical drug selection and decision. METHODS:Retrieved from PubMed ,Embase,Cochrane Library ,Web of Science ,CNKI,CBM,Wanfang database ,health technology assessment (HTA)organization websites and database during the inception to Aug. 10,2020,HTA reports ,systematic reviews/Meta-analysis,and pharmacoeconomic studies of EGb versus placebo in the treatment of AD were collected. After literature screening and data extration ,HTA checklist ,AMSTAR-2 scale and CHEERS scale were used respectively to evaluate the literature quality of the included HTA report ,systematic review/Meta-analysis and pharmacoeconomics studies. The conclusion of the included studies were summarized by using qualitative description. RESULTS :A total of 9 literatures were included ,involving 8 systematic reviews and 1 economic studies. In terms of effectiveness ,there was no statistical significance in MMSE score of EGb group,ADAS-Cog score of 120 mg EGb group ,compared with placebo group (P>0.05). Dementia Quality of Life (DQoL)score of EGb group was significantly higher than that of placebo group. The scores of short cognitive aptitude tests ,neuropsychiatric inventory(NPI),NPI caregiver version score ,ADAS-Cog score of 160 mg EGb group and 240 mg EGb group were significantly lower than those of control group (P<0.05). ADL scores of patients were inconsistent ;ADL scores of EGb group were significantly lower than those o f placebo group (P<0.05),or there was no significant diff erence between 2 groups(P>0.05); . subgroup analysis by dose showed that there was no RDY2019-39) significant difference in ADL score between 120 mg EGb group and placebo group (P>0.05);ADL score of 240 mg E-mail:renxiaolei83@126.com EGb group were signicantly lower than that of placebo group (P<0.05). Subgroup analysis of clinical global impression 010-88325751。E-mail:lyi1267@126.com change (CGIC) score showed that there was no significant difference in CGIC score between EGb group and placebo group after receiving <200 mg EGb and 26 weeks of treatment (P> 0.05);CGIC score of EGb group was significantly higher than that of placebo group after receiving >200 mg EGb and 24 weeks of treatment (P<0.05). In terms of safety ,there was no statistical significance in the incidence of ADR or the incidence of severe ADR between EGb group and placebo group (P>0.05). Subgroup analysis by dose showed that the incidence of ADR in 240 mg EGb group was significantly higher than placebo group (P<0.05). Economically ,EGb treatment for AD is cost-effective ,which could indirectly save the nursing costs of AD patients. CONCLUSIONS :The efficacy of EGb in the treatment of AD is uncertain , and the safety and economy are good.
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OBJECTIVE: To analyze chemical components as coumarin in Saposhnikovia divaricata, and to provide reference for comprehensive analysis of pharmacodynamic material base in S. divaricata. METHODS: UPLC-Q-TOF-MS method was adopted. Chromatographic condition: the determination was performed on ACQUITY UPLC BEH C18 column with mobile phase consisted of 0.1% formic acid water-0.1% formic acid acetonitrile (gradient elution) at the flow rate of 0.3 mL/min. The column temperature was 35 ℃, and sample size was 3 μL. MS condition: ESI, in positive and negative ion mode, ESI+/ESI- 5 500 V/-4 500 V, declustering potential of 80--80 V, auxiliary heating gas pressure of 55.00 psi, atomizing gas pressure of -55 psi, curtain gas pressure of -35.00 psi, desolvent temperature of 550 ℃, collision activation scanning energy of 15 eV, collision voltage of 35 psi. Component analysis was performed by comparing with the related literature data and the standard chromatogram control combined with accurate relative molecular mass of compounds provided by UPLC-Q-TOF-MS. RESULTS: Totally 135 chemical components were analyzed in ESI+ mode, and the 105 chemical components were analyzed in ESI- mode. 11 chemical components as coumarin were identified in ESI+ mode, such as isoimperatorin, umbelliferone, scopolamine, xanthotoxin, psoralen, Ostenol, fraxidin, isoimperatorin, 5-hydroxyl-8-methoxypsoralen, phellopterin, decursin. CONCLUSIONS: The method is accurate and rapid, and can be used for the analysis of chemical components as coumarin in S. divaricata.
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Objective To investigate the influence of zoledronic acid injection on body temperature of patients with primary osteoporosis.Methods A total of 142 patients with primary osteoporosis who received intravenous zoledronic acid treatment in Peking university people's hospital during 2013-2014 were enrolled in this study.The body temperature before and after intravenous zoledronic acid treatment were recorded and analyzed with SPSS 17.0 software.Results The patients'body temperature at different time points after intravenous zoledronic acid treatment was significantly different (P =0.000).Prophylactic use of NSAIDs could significantly reduce patients' body temperature at the second day after intravenous zoledronic acid.Conclusion NSAIDs can be given orally on the same day of intravenous injection of zoledronic acid,and continued for three days.
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Objective To establish ovarian cancer cell line SKVO3 that can stably express human ADP ribosylation factor-4 (ARF4). Methods A eukaryotic expression vector pCDH-CMV-MCS-EF1-Puro/ARF4 was constructed and transfected into SKOV3 cells after verifying by DNA sequencing. The expression of ARF4 mRNA was verified by real-time quantitative PCR (qRT-PCR). Then, the recombinant plasmid with lentiviral packaging plasmids were co-transfected into SKOV3 cells for packaging. The recombinant lentiviral particles LV-ARF4 were collected and transfected into SKOV3 cells, and the stable transfected SKOV3 cell line was screening by culture with puromycin. The expression of ARF4 gene was detected by qRT-PCR and Western Blot. Results A eukaryotic expression vector pCDH-CMV-MCS-EF1-Puro/ARF4 was successfully constructed. The vector could significantly up-regulate the expression of ARF4 mRNA in SKOV3 cells and be successfully packaged into recombinant lentiviral particles in HEK-293T cells. Compared with the control group, the relative expression level of ARF4 mRNA and protein in SKOV3 cells was significantly increased after the infection with LV-ARF4 (all P<0.001). Conclusion The recombinant plasmid pCDH-CMV-MCS-EF1-Puro/ARF4 and lentiviral vector LV-ARF4 were successfully constructed. The establishment of stably infected SKOV3 cell line with LV-ARF4 provides an experimental foundation for further studies on the biological function of ARF4 in ovarian cancer.
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Objective To systematically evaluate the efficacy and safety of alprostadil injection in patients with viral hepatitis.Methods Medline,Embase,The Cochrane Library,CBMdisc,CNKI,Wanfang Database and VIP were searched.The quality of included studies such as randomization,blinding,allocation concealment and loss of follow-up were evaluated and meta-analysis was performed by RevMan5.1 software.Results In total,14 RCTs and 1 232 patients were included.Meta-analysis showed that in patients with viral hepatitis,the total effective rate of alprostadil injection treatment was significantly superior to that of conventional therapy (P<0.000 01).Serious adverse drug reactions (ADRs) induced by alprostadil injection were not reported.Conclusion Alprostadil injection is effective and safe for treating viral hepatitis.However,the evidence is not strong due to the generally low methodological quality of RCTs.Further high quality and large sample-sized randomized controlled trials and more pharmacoeconomics studies should be carried out.
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Objective To explore how clinical pharmacists exert their effects in drug therapy.Methods The pharmaceutical practice of clinical pharmacist participating in the treatment of one case of warfarin related nephropathy (WRN) was reported.Early identification of warfarin associated nephropathy and early treatment were necessary and the anticoagulant regimen was optimized.Pharmaceutical education was conducted by clinical pharmacist.Results With guidance by clinical pharmacist,the psychological burden of the patient was reduced,the patient compliance was improved,and the patient understanding of adverse drug reactions was increased.Conclusion Clinical pharmacists involved in clinical treatment practice is conducive to timely detecting and treating patients with adverse drug reactions,and improving the level of drug treatment.
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OBJECTIVE:To systematically review the effect of CYP2C19 genetic polymorphism on lansoprazole pharmacoki-netics,and provide evidence-based reference for clinical individualized medication of lansoprazole. METHODS:Retrieved from PubMed,EMBase,Web of science,Cochrane Library and CJFD,retrospective studies about the effect of CYP2C19 genetic poly-morphism on lansoprazole pharmacokinetics were collected,Meta-analysis was performed by Rev Man 5.2 software after data ex-tract and quality evaluation. RESULTS:Totally 11 retrospective studies were included,involving 200 patients. The gene type in-cluded homozygote express metabolizers (EM),heterozygous express metabolizers (HEM) and slow metabolizers (PM). Results of Meta-analysis showed CYP2C19 polymorphism significantly affected cmax,AUC,t1/2,tmax and CL/F. The cmax and AUC in group PM were higher than group HEM and group EM;CL/F in group EM was higher than group HEM and group PM;t1/2 in group PM was higher than group HEM and group EM,while there was no significant difference in the t1/2 between group HEM and group EM;tmax in HEM and group PM were higher than group EM,while there was no significant difference in the tmax between group PM and group HEM. CONCLUSIONS:CYP2C19 genetic polymorphism shows obvious effect on lansoprazole pharmacokinetics, which is the key factor for causing efficacy of lansoprazole and individual differences among adverse reactions,and clinic should take into account individualized dose regimen of lansoprazole.
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OBJECTIVE:To investigate the characteristics and related factors of drug-induced hyperkalemia,present preven-tive measures and provide reference for the rational drug use. METHODS:46 literatures of individual cases and group cases of drug-induced hyperkalemia publicly reported in domestic medical journals from 1979 to 2014 were collected and analyzed statistical-ly,including 66 cases. RESULTS:66 cases with drug-induced hyperkalemia were mainly involved in cardiovascular drugs and im-munosuppressants. Most of them were improved after drug withdrawal and symptomatic treatment,and 2 cases died. CONCLU-SIONS:Drug-induced hyperkalemia are potentially dangerous. It is necessary to be vigilant,prevent and control timely and reduce the incidence of severe adverse reactions.
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Central South University began to implement the eight-year medical education in 2004, and has accumulated rich experience in the pre-medical education through continuous reform and improvement. Since 2012, Central South University has made a series of reformation, which is more conducive to the all-round development of medical students , on the pre-medical education . Through adding freshman courses, humanities courses, bilingual teaching courses, and applying aca-demic adviser institution, early scientific research training and open courses during the pre-medical education, Central South University has exercised and strengthened students' scientific research ability, the humanistic quality, English level, and made the pre-medical comprehensive examination for the shunt selection of students. Thus Central South University has improved the eight-year medical students' comprehensive quality, and provided an example of the reformation for medical education.
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OBJECTIVE: To evaluate the efficacy and safety of huperzine A for patients with mild and moderate Alzheimer disease(AD). METHODS: The randomized controlled trials (RCTs) comparing huperzine A with placebo retrieved from Medline, Embase, the Cochrane Library, CBMdisc and CNKI were enrolled. The methodology quality of the included studies was evaluated and a Meta-analysis was performed using RevMan4.2 software. RESULTS: A total of five RCTs were included. The Meta-analysis results showed that as compared with placebo, huperzine A treatment significantly increased the scores of MMSE, decreased the scores of ADL(activities of daily living), moreover, the associated therapeutic effect increased gradually with the prolonging of the treatment time yet with small publication bias; huperzine A treatment significantly increased the scores of MQ(memory quotient), but some publication bias might be existed because of the small number of RCTs included. The sensitivity analysis on the comparison of HDS score changes showed that the influence of the quality of the RCTs could reverse the results. The comparison on effective rate showed that huperzine A was more effective than placebo. The comparison on safety showed that huperzine A was more likely to induced side effects than placebo, but the publication bias was big because there was only a few literature included. CONCLUSION: According to the Meta-analysis’s results, we think huperzine A is effective in improving memory and cognitive function of AD patients, and there is significant difference in clinical efficacy as compared with placebo, and there is small publication bias. In terms of safety, huperzine A has higher incidence of side effects than placebo, but the side effects are mostly mild and have little impact on the treatment. The above conclusion may serve as reference for clinical medication.
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AIM:To investigate pharmacokinetics of cinnamon acid and paeonol in Jinkui Shenqi Pill(Radix Rehmanniae Praeparata,Cortex Cinnamomi,Radix Aconiti Lateralis praeparata,Rhizoma Alismatis,etc.)in rabbit.METHODS:RP-HPLC was used to examine blood concentration of cinnamon acid and paeonol in rabbit which was administred Jinkui Shenqi Pill.Chromatographic condition consisted of Symmetry C_ 18(5?m,3.9 mm ?150 mm)chromato graphic column,mobile phase(methanol-1%glacial acetic acid water-solution(45∶55)),flow rate(0.8 mL/min),column temperature(35 ℃),detection wavelength of cinnamon acid(285 nm),detection wave length of paeonol(274 nm).The serum pharmacokinetic parameters were calculated with 3p87 program.RESULTS:Linear range of cinnamon acid ranged from 0.06 ?g/mL to 15 ?g/mL(r=0.999 7),the lowest detectability was 0.054 ?g/mL.Pharmacokinetic process of paeonol in rabbit could be fitted to two-compartment model;Linear range of paeonol ranged from 0.2 ?g/mL to 10 ?g/mL(r=0.999 9),the lowest detectability was 0.02 ?g/mL.Pharmacokinetic process of cinnamon acid in rabbit could be fitted to one-compartment model.CONCLUSION:HPLC detection of serum concentration of cinnamon acid and paeonol is simple,rapid,highly accurate and sensitive.Pharmacokinetic parameters can reveal pharmacokinetics of cinnamon acid and paeonol of Jinkui Shenqi Pill in rabbit.