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2023 Vol. 41, No. 11

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Research progress on therapeutic DC vaccine against melanoma
ZHANG Xinyue, TAI Zongguang, ZHU Quangang, CHEN Zhongjian, BAO Leilei
2023, 41(11): 643-647. doi: 10.12206/j.issn.2097-2024.202211043
Abstract(912) HTML (270) PDF (853KB)(18)
Abstract:
Melanoma is the most aggressive skin malignant tumor, which is prone to early metastasis and relapse after treatment. Therapeutic tumor vaccines are new immunotherapies, which have the advantages of low toxicity and inhibiting tumor metastasis. Melanoma has a high mutation load and a large number of specific antigens. Currently, various types of tumor vaccines have been developed for melanoma, especially those based on dendritic cells (DC). Although the efficacy of therapeutic DC vaccines in melanoma has been confirmed by a number of studies, these vaccines still have problems such as insufficient immune effect and poor efficacy when used alone, and there is still a large room for improvement. In this paper, the current research status of therapeutic DC vaccines for melanoma was reviewed, and the research key points and optimization strategy of therapeutic DC tumor were prospected.
Progress on factors affecting gastrointestinal function and drug protection in high altitude hypoxia environment
CHENG Junfei, ZHAO Anpeng, ZHAO Yilan, WANG Zihan, LI Wenbin, WANG Rong
2023, 41(11): 648-653. doi: 10.12206/j.issn.2097-2024.202111018
Abstract(1646) HTML (785) PDF (1243KB)(67)
Abstract:
Due to factors such as low pressure, low oxygen and cold in the plateau environment, people who enter the plateau rapidly are susceptible to digestive system diseases, such as upper abdominal pain, loss of appetite, nausea and vomiting and other gastrointestinal dysfunction, which seriously affect the health and work ability of people who enter the plateau rapidly. The gastrointestinal dysfunction caused by the rapid advance to the plateau is mainly reflected in three aspects: gastrointestinal motility dysfunction, impaired mucosal barrier function, and intestinal flora imbalance. At present, the pathogenesis of gastrointestinal dysfunction is still not very clear, and there are fewer drugs for targeted prevention and treatment. Gastrointestinal hormones, oxygen free radicals, inflammatory factors, intestinal flora and other factors, as well as the protective effects of related drugs were reviewed in this paper to provide treatment options and theoretical basis for the prevention and treatment of the gastrointestinal emergency response caused by entering the plateau.
Effect of intestinal Metrnl gene knockout on intestinal microbiota and ulcerative colitis
CHEN Simin, LING Qisheng, ZHANG Sailong, MIAO Chaoyu
2023, 41(11): 654-661. doi: 10.12206/j.issn.2097-2024.202211050
Abstract(1110) HTML (352) PDF (2729KB)(12)
Abstract:
  Objective  To investigate the effect of intestinal Metrnl on dextran sodium sulfate (DSS)-induced ulcerative colitis mouse model and the regulation mechanism of intestinal microbiota.   Methods  Different concentrations of DSS (3% DSS and 1% DSS) were used to induce ulcerative colitis on C57 mice to determine the experimental conditions. Intestinal epithelial Metrnl specific knockout mice (Metrnl(-/-)) and its control mice (Metrnl(+/+)) were administrated with 3% DSS for 5 d. Then the survival time, body weight, DAI (disease activity index), colon length and pathological changes in colon tissues were observed. 16S ribosomal RNA gene sequencing was used to detect the composition of intestinal microbiota.   Results  Compared with 1% DSS, 3% DSS could significantly aggravate ulcerative colitis on C57 mice, such as lower survival rate (P<0.05), more weight loss (P<0.05), higher DAI score (P<0.05), shorter colon length (P<0.05) and higher pathology score (P<0.05). After administrated to 3% DSS for 5 d, comparing with Metrnl(+/+) mice, Metrnl(-/-) mice showed more weight loss (P<0.05), higher DAI score (P<0.05), shorter colon length (P<0.05) and higher pathology score (P<0.05). The 16S ribosomal RNA results showed that the diversity of intestinal microbiota in Metrnl(-/-) mice significantly decreased. Furthermore, Bacteroidetes and Proteobacteria significantly decreased, while Firmicutes increased.   Conclusion  Metrnl could protect the DSS-induced ulcerative colitis mouse through regulating intestinal microbiota.
TLC identification and quantitative determination of Shipi Xiaoshui gel plaster
MA Bingzhi, LIANG Yingying, WANG Haiyang, TANG Yonghe, LI Dong, HE Jun
2023, 41(11): 662-665, 679. doi: 10.12206/j.issn.2097-2024.202205054
Abstract(1276) HTML (333) PDF (1780KB)(12)
Abstract:
  Objective   To establish the method of thin layer chromatography (TLC) for identification and quantitative determination of Shipi Xiaoshui gel plaster.   Methods  TLC was adopted to qualitatively identify astragalus radix, plantaginis semen, curcumae rhizome, cinnamomi ramulus, polyporus umbellatus and akebia quinata. UPLC-MS was used to determine the content of astragaloside Ⅳ.   Results  TLC spots were clear and well-separated; RSDs of precision, reproducibility and stability tests were all lower than 3%, the linear range of astragaloside Ⅳ was 2.75-33 μg/ml (r=0.999 9, n=6), and the average recovery was 100.49% (RSD=1.98%, n=6).   Conclusion  The established method in this study is accurate, reliable and specific, which could be used for the quality control of Shipi Xiaoshui gel plaster.
Protective effect of Shenmajing formula on ischemic brain injury in mice
LIU Jingxue, HE Ruihua, TAO Xia, HUANG Jin
2023, 41(11): 666-671, 685. doi: 10.12206/j.issn.2097-2024.202208066
Abstract(816) HTML (283) PDF (2968KB)(9)
Abstract:
  Objective   To observe the protective effect of Shenmajing formula on brain tissue of mice with cerebral ischemic injury and explore the possible mechanism.   Methods  Thirty SPF-grade C57 BL/6 male mice were randomly divided into model control group, Shenmajing group and nimodipine group, and the animal models of cerebral ischemic injury in mice were prepared by electrocoagulation. The protein expression level in endothelial progenitor cells were detected by Western blot.   Results  Compared with the model control group, the infarct volume of mice in the Shenmajing group was significantly reduced, and the migration, adhesion and tubule formation ability of endothelial progenitor cells were significantly improved, and the expression level of BDNF protein in endothelial progenitor cells was significantly increased.   Conclusion  The protective effect of Shenmajing granules on brain tissue of mice with cerebral ischemic injury could be closely related to the regulation of BDNF expression in endothelial progenitor cells and improvement of endothelial progenitor cell function of bone marrow origin.
Mechanism of Artemisia annua L. in GIOP with kidney-yin deficiency based on network pharmacology
LAI Liyong, XIA Tianshuang, YUE Xiaoqiang, XIN Hailiang
2023, 41(11): 672-679. doi: 10.12206/j.issn.2097-2024.202204115
Abstract(722) HTML (407) PDF (3112KB)(14)
Abstract:
  Objective  To predict and preliminarily verify the potential targets and related signaling pathways of Artemisia annua L. in treating glucocorticoid-induced osteoporosis (GIOP) with kidney-yin deficiency by network pharmacology and in vitro experiments.   Methods  The pharmacological targets of Artemisia annua L. were obtained from TCMSP database and were converted to gene names through Uniprot database. The target genes of GIOP with kidney-yin deficiency were obtained from GeneCards database, OMIM database and Drugbank database, and the common target genes were obtained by cross analysis with drug target gene. Protein-protein interaction (PPI) network was constructed by String database, and visualization analysis and core targets screening were performed by Cytoscape 3.9.0. All common targets were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analysis through Metascape database. Finally, the prediction results were verified by in vitro experiments.   Results  Ninety-eight targets of Artemisia annua L. to GIOP with kidney-yin deficiency were screened, including 17 core genes. The results of GO and KEGG functional enrichment analysis indicated that Artemisia annua L. treating GIOP with kidney-yin deficiency was related to biological processes such as hormonal response, positive regulation of cell death and extracellular stimulation response, et al, as well as signaling pathways such as PI3K/AKT, AGE/RAGE, MAPK and IL-17 et al. The number of genes enriched in PI3K/AKT signaling pathway was the largest. In vitro experiment results showed that Artemisia annua L. promoted the proliferation of osteoblasts damaged by dexamethasone (DEX), increased alkaline phosphatase activity, activated PI3K/AKT pathway, and promoted the phosphorylation of AKT.   Conclusion  Artemisia annua L. treating GIOP with kidney-yin deficiency has the characteristics of multi-targets and multi-pathway, which could promote the proliferation and differentiation of osteoblasts through multiple pathways. The PI3K/AKT signaling pathway is an important pathway. Artemisia annua L. treating GIOP with kidney-yin deficiency might be related to its ability to promote the PI3K/AKT signaling pathway and promote the phosphorylation of AKT.
Review of clinical use of Dingqing Tablets in a Tertiary A Hospital of Integrated Traditional Chinese and Western Medicine
XU Yi, YANG Yuehong, HUANG Jin, WANG Jie, LIU Jing, WU Tiejun
2023, 41(11): 680-685. doi: 10.12206/j.issn.2097-2024.202208034
Abstract(742) HTML (258) PDF (1110KB)(12)
Abstract:
  Objective  To improve the quality of prescriptions and promote the rational drug application of Dingqing Tablets by investigating the outpatient prescriptions in a tertiary A hospital.   Methods  A total of 4 796 prescriptions of outpatient pharmacy patients from August 1, 2020 to August 1, 2021 were extracted from the hospital information system by the hospital information software, focusing on the analysis of indications, usage and dosage, drug interaction, etc.   Results  10 departments including hematology department and geriatrics department were used Dingqing Tablets, and the irrationality was mainly manifested in the superposition of drug flavors and drug interactions.   Conclusion  Dingqing tablets were widely used in clinic and had remarkable curative effect. However, there are certain risks in the use of Dingqing tablets. It is necessary to add medication education and supervision to promote the safe and rational use of drugs in clinic.
Effect evaluation of the clinical pharmacists participating in the treatment of patients with diabetic foot
YANG Zhihui, ZHANG Lili, ZHAO Yan, HUANG Jinghui, LIU Yuan, YUAN Hailong
2023, 41(11): 686-688, 699. doi: 10.12206/j.issn.2097-2024.202209087
Abstract(779) HTML (218) PDF (1185KB)(10)
Abstract:
  Objective  To evaluate the effect of clinical pharmacists participating in the treatment of hospitalized patients with diabetic foot by antibiotics management index and health economics index.   Methods  40 hospitalized patients with diabetic foot of Wagner Grade 4 in the Endocrine Department of Air Force Medical Center from April to September 2017 were selected as control group, and 40 hospitalized patients with diabetic foot of Wagner Grade 4 in the Endocrine Department from April to September 2019 were selected as interventional group. No clinical pharmacists were involved in drug treatment of patients in the control group, while the clinical pharmacists in the interventional group participated in drug treatment, and implemented antimicrobial stewardship, medication reconciliation, pharmaceutical care and medication education. Antibiotics management indexes (use intensity of antibiotics, use rate of special class antibiotics) and health economics indexes (medicine expenses, hospitalization expenses) of the two groups were compared.   Results  The efficacy of the two groups was similar. The use intensity of antibiotics and use rate of special class antibiotics of the interventional group in which clinical pharmacists participated were significantly lower than the control group (P<0.01), so were the medicine expenses and hospitalization expenses (P<0.01).   Conclusion  Clinical pharmacists participating in the treatment of hospitalized patients with diabetic foot could reduce antibiotics administration index and health economics index, promote rational medicine use and save medical expenses.
Practice and exploration of physician-pharmacist joint outpatient service mode of chronic obstructive pulmonary disease (COPD) and asthma
CHEN Dan, LIU Guodong, LIU Yu, TONG Shaohua, LIU Shengjun
2023, 41(11): 689-693. doi: 10.12206/j.issn.2097-2024.202209034
Abstract(1086) HTML (311) PDF (1016KB)(21)
Abstract:
  Objective   To explore the physician-pharmacist joint outpatient service mode of chronic obstructive pulmonary disease ( COPD) and asthma.   Methods  Cases of COPD or asthma patients who visited the joint outpatient department from June 2021 to December 2021 were collected in our hospital, the inhaler usage score, compliance ( MMAS-8) score, clinical control efficacy, incidence of adverse reactions and patient satisfaction were evaluated before and after pharmaceutical care intervention and statistically analyzed.  Results  The inhaler usage score, MMAS-8 score, and the Asthma Control Test(ACT)/COPD Assessment Test(CAT) score had been changed significantly after the intervention (P<0.05). Patient satisfaction with pharmaceutical care was basically above 94.75%.  Conclusion  Pharmaceutical care provided by joint outpatient department in our hospital could help COPD and asthma patients to use inhaler device correctly, resulting in improving compliance of inhaler usage, better disease control, and reducing the occurrence of adverse drug reactions, which could be a positive attempt and exploration of standardized pharmaceutical care model for patients with COPD and asthma.
Risk factors of linezolid-related thrombocytopenia in patients in the department of hepatobiliary surgery
SHAN Xuechun, LI Xu, DU Hongli, BAO Leilei, WANG Hui
2023, 41(11): 694-699. doi: 10.12206/j.issn.2097-2024.202210061
Abstract(881) HTML (342) PDF (957KB)(9)
Abstract:
  Objective  To provide the evidence for clinical medication safety by the investigation of the risk factors of linezolid-related thrombocytopenia in cancer patients in the department of hepatobiliary surgery.   Methods  Patients who received linezolid for anti-infective treatment from January 2017 to December 2021 were selected. The patients were divided into thrombocytopenia group and non-thrombocytopenia group according to whether thrombocytopenia occurred or not after administration of linezolid. The general data and laboratory indicators of the two groups were compared, and the risk factors of linezolid-related thrombocytopenia were screened by multivariate logistic regression analysis.   Results  A total of 104 patients were included in the study, including 84 patients who underwent surgery and 20 patients who did not. The incidence of linezolid-related thrombocytopenia was 24.0%. There were significant differences in gender, age, duration of linezolid use, platelet count, white blood cell count, alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin, creatinine, estimated glomerular filtration rate between the two groups (P<0.05); logistic regression analysis suggested that age ≥60 years (OR=7.093; P=0.017), duration of linezolid use ≥12 days (OR=4.399; P=0.035), baseline platelet count ≤200×109/L (OR=8.470; P=0.004), baseline AST≥50 U/L (OR=15.465; P<0.001), and baseline white blood cell count ≥11×109/L (OR=11.436; P=0.001) were the risk factors for linezolid-related thrombocytopenia in cancer patients.   Conclusion  During the treatment of linezolid in cancer patients, attention should be paid to the adverse reactions of thrombocytopenia in the patients, especially those with old age, long-term treatment, low baseline platelets, poor baseline liver function, and high baseline white blood cell counts.
Risk factors of poor early prognosis in the treatment of COVID-19 with nematevir and ritonavir tablets and the establishment of prediction model
HUANG Wenhui, XU Yanyu, HAO Xiaowei, LIN Guan, OUYANG Shandan, WANG Jiakun, CHEN Jinshan
2023, 41(11): 700-704. doi: 10.12206/j.issn.2097-2024.202303038
Abstract(851) HTML (299) PDF (971KB)(13)
Abstract:
  Objective  To explore risk factors of poor early prognosis in the treatment of COVID-19 by nematevir and ritonavir tablets Paxlovid and establish the prediction model to provide reference for improving the effect of such patients.   Methods  92 inpatients of COVID-19 treated with Paxlovid in three military tertiary hospital in southern Fujian from January 2023 to March 2023 were retrospectively analyzed. The clinical indicators of 92 inpatients were collected for univariate and multivariate analysis by single factor and multiple factors and the independent risk factors of poor early prognosis in Paxlovid were screened out. Logistic model equation was transformed to construct the combined predictors, and ROC curve was used to determine the area under the curve (AUC) and the optimal critical value of the combined predictors.   Results  Among 92 patients, 31 (33.70%) developed poor early prognosis, including 11 deaths (35.48%), 17 critical cases (54.84%) and 3 severe cases (9.68%). Multi-factor Logistic regression analysis showed that the disease days, lymphocyte count, aspartate aminotransferase(AST), C reactive protein(CRP) and ventilator-assisted ventilation were independent risk factors for poor early prognosis in Paxlovid. A formula for calculating the combined predictors (Y) was established as Ycombinedpredictors=7.875Xdisease days+126.188Xlymphocyte count+1.438XAST+XCRP+220.500Xventilator-assisted ventilation based on the above independent risk factors, and the ROC curve was drawn. With the maximum area under the ROC curve of the combined predictors being 0.939, the prediction value was best, and the optimal critical value of the ROC curve corresponding to the maximum Youden index (0.756) was 447.920.Theoretical accuracy of the model was 89.10%.  Conclusion  The disease days, lymphocyte count, AST, CRP and ventilator-assisted ventilation were independent risk factors for poor early prognosis in Paxlovid. Combined predictors could be calculated by the above risk factors before medication. The efficiency should be improved by taking more active treatment, including combining with other anti-COVID-19 drugs when the prediction result exceeds 447.920.