Estimated Manipulation of Tablets and Capsules to Meet Dose Requirements for Chinese Children: A Cross-Sectional Study.

Objectives: To estimate the frequency of manipulations of all tablets and capsules prescribed for children in a teaching and tertiary children's hospital in China over the course of 1 month. Moreover, hypothetical reduction of manipulation according to the availability of low-strength tablets/capsules licensed by the Chinese National Medical Products Administration (CNMPA) was evaluated. Methods: Information on all tablets and capsules prescribed in the hospital from March 17 to April 16, 2019 was collected. It was assumed that tablets or capsules were manipulated if the prescribed dose would have required only a proportion of the intact dose form. Manipulation typically includes splitting or crushing tablets, opening capsules and dispersing in water, or combinations of these method. Moreover, we defined an "avoidable manipulation," when the dose could be rounded and/or when alternative products with a reduced strength or in liquid formulation were available in the hospital, and a "inappropriate manipulation," which involved manipulated medications with a direct contraindication for any manipulation, such as those with a narrow therapeutic index or hazardous ingredients, or modified release dosage-forms. The frequencies of total, avoidable, and inappropriate manipulation were estimated, along with the hypothetical reduction of manipulation according to the availability of CNMPA-approved drug doses. Results: A total of 17,123 prescriptions for 142 medications were identified to have required a manipulation among 78,366 prescriptions administered during the study period, with 43 different proportions of subdivisions, ranging from a 19/20 to 1/180 product strength reduction. Half, quarter, and trisection were the most common subdivisions administered. Overall, 19% of the manipulated prescriptions were determined to be avoidable, and 19% of the manipulations involved medications with a clear recommendation to not manipulate. In addition, 21% of the manipulated prescriptions could have been potentially avoided if all of the approved preparations with the lowest strength would have been available at the hospital. Any manipulations undertaken were carried out by pharmacists and family care givers. Conclusions: More than 20% of tablets and capsules prescriptions need manipulated, included a high incidence of avoidable and inappropriate manipulation.

Screening Antitumor Compounds Psoralen and Isopsoralen from Psoralea corylifolia L. Seeds.

Psoralea corylifolia L. (Fabaceae) is a widely used medical plant in China. This study was designed to screen and identify bioactive compounds with anticancer activity from the seeds of Psoralea corylifolia L. One volatile fraction (fraction I) and three other fractions (fraction II, III, IV) from methanol extraction of P. corylifolia L. were obtained. Bioactivities of these fractions were evaluated by the cytotoxicity on KB, KBv200, K562, K562/ADM cancer cells with MTT assay. Major components in the active fraction were identified by HPLC/MS(n). Fraction IV significantly inhibits the growth of cancer cells in a dose-dependent manner. The IC(50) values were 21.6, 24.4, 10.0 and 26.9, respectively. Psoralen and isopsoralen, isolated from fraction IV, were subject to bioactive assay and presented a dose-dependent anticancer activity in four cancer cell lines (KB, KBv200, K562 and K562/ADM). The IC(50) values of psoralen were 88.1, 86.6, 24.4 and 62.6, which of isopsoralen were 61.9, 49.4, 49.6 and 72.0, respectively. Apoptosis of tumor cell significantly increased after treated with psoralen and isopsoralen. Induction of apoptotic activity was confirmed by flow cytometry after staining with Annexin V/PI. These results suggested psoralen and isopsoralen contribute to anticancer effect of P. corylifolia L.

[Analysis of myocardial proteomic alteration after Qishenyiqi formula treatment in acute infarcted rat hearts].

OBJECTIVE: Use proteomic technique to research the effects of Qishenyiqi formula in acute myocardial infarcted rats, and further explore its protein-level mechanism. METHOD: The rat hearts of sham, myocardial infarcted and Qishenyiqi formula treated groups were collected. Analyzing and comparing the differences of protein expressions in each groups with two-dimensional electrophoresis, computer-assisted image analysis and matrix-assisted laser desorption/ionization mass spectrometry. RESULT: Compared with myocardial infarcted group, there were 14 protein expressions changed in Qishenyiqi formula treated group. The result showed that 9 protein expressions were up-regulated, and 5 ones were down-regulated significantly. These proteins are associated with energy metabolism, mitochondrial function, oxidative stress, cytoskeleton and others. CONCLUSION: Myocardial protective effects of Qishenyiqi formula in myocardial infarcted procedure might be closely related to the recovery of energy supply, the reduction of oxidative stress, as well as the promotion of cell recovery.

Cytotoxic properties of thiophenes from Echinops grijissi Hance.

The dichloromethane fraction of the crude ethanol extract of Echinops grijissi Hance roots exhibited different cytotoxicity against a panel of four human tumor cell lines, HepG2, K562, HL60 and MCF-7. By a bioassay-guided fractionation, eight thiophenes were isolated from the dichloromethane fraction, one of them was isolated from the plant for the first time. And they were assayed for their toxicity against the cell lines in order to compare their relative anti-tumor activity and find candidates of potential anti-tumor drugs. The dichloromethane fraction and isolated thiophenes showed different activity against the cell lines, and the anti-tumor activity of the dichloromethane fraction was also studied in vivo in S180 implanted ICR mice, however, it exhibited no anti-tumor activity at dosage of 20 or 40 mg/kg/d. There were also deaths recorded and the animals showed signs of toxicity when the dosage is 200 mg/kg/d.