2022 Vol. 40, No. 2
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2022, 40(2): 97-102.
doi: 10.12206/j.issn.1006-0111.202111059
Abstract:
Flavonoids are secondary metabolites that widely existing in traditional Chinese medicine. They have many biological activities and pharmacological effects. In recent years, studies have found that flavonoids can play an effective protective role in the treatments of ischemic stroke and ischemic heart disease through various ways. The mechanisms of their protective effects have been systematically explained in detail. For example, flavonoids can affect pathophysiological mechanisms such as antioxidant, inhibition of inflammatory response, apoptosis and autophagy pathway. This paper reviews the protective effect and mechanisms of the treatments of flavonoids on cardiovascular and cerebrovascular ischemic diseases by referring to relevant literatures. The purpose is to provide reference for future research and development of drugs for the treatments of cardiovascular and cerebrovascular diseases.
Flavonoids are secondary metabolites that widely existing in traditional Chinese medicine. They have many biological activities and pharmacological effects. In recent years, studies have found that flavonoids can play an effective protective role in the treatments of ischemic stroke and ischemic heart disease through various ways. The mechanisms of their protective effects have been systematically explained in detail. For example, flavonoids can affect pathophysiological mechanisms such as antioxidant, inhibition of inflammatory response, apoptosis and autophagy pathway. This paper reviews the protective effect and mechanisms of the treatments of flavonoids on cardiovascular and cerebrovascular ischemic diseases by referring to relevant literatures. The purpose is to provide reference for future research and development of drugs for the treatments of cardiovascular and cerebrovascular diseases.
2022, 40(2): 103-107, 131.
doi: 10.12206/j.issn.1006-0111.202108002
Abstract:
Hyaluronic acid is widely present in the human body. It is an important component of extracellular matrix. It has unique hydrodynamic properties, good viscoelasticity and strain properties. At present, hyaluronic acid has been widely used in biomaterials, targeted-drug preparations, cosmetics and prevention of adhesion after abdominal surgery. With the expansion of the application scope of hyaluronic acid and the continuous emergence of new medical materials, the research on hyaluronic acid has been increasing in recent years. This paper reviews the clinical application of hyaluronic acid and its mechanism, in order to provide reference for the further development and safe application of hyaluronic acid products.
Hyaluronic acid is widely present in the human body. It is an important component of extracellular matrix. It has unique hydrodynamic properties, good viscoelasticity and strain properties. At present, hyaluronic acid has been widely used in biomaterials, targeted-drug preparations, cosmetics and prevention of adhesion after abdominal surgery. With the expansion of the application scope of hyaluronic acid and the continuous emergence of new medical materials, the research on hyaluronic acid has been increasing in recent years. This paper reviews the clinical application of hyaluronic acid and its mechanism, in order to provide reference for the further development and safe application of hyaluronic acid products.
2022, 40(2): 108-112.
doi: 10.12206/j.issn.1006-0111.202105116
Abstract:
Objective To study the reversal effect of Shenfu decoction（SFD）on adriamycin-induced cardiomyopathy and explore its mechanism by using serum metabolomic technology. Methods The BALB/c mouse model of cardiomyopathy induced by adriamycin was established. The corresponding intervention was given. The serum lactate dehydrogenase（LDH）and creatine phosphatase isoenzyme MB（CK-MB）were measured. The ejection fraction (EF) and shortening fraction (FS) were measured by echocardiography. Mouse serum was collected for gas chromatography-mass spectrometry (GC-MS) analysis. The data obtained was analyzed by multivariate and univariate statistical analysis to compare the changes of endogenous metabolites in the serum of mice in the normal group, model group and Shenfu decoction treatment group, to find the potential biomarkers of Shenfu decoction to reverse the adriamycin-induced cardiomyopathy. Metabolic pathway analysis was used to explore the targeted metabolic pathway of Shenfu decoction. Results The levels of serum LDH and CK-MB in the model group were increased significantly, and the values of EF and FS decreased significantly, indicating that the model was successfully established. The above indicators were significantly improved after treatment with Shenfu decoction. 13 potential biomarkers of adriamycin-induced cardiomyopathy were identified by metabonomic analysis, and Shenfu decoction had significant reversal effect on 11 metabolites. Metabolic pathway analysis showed that the synthesis of phenylalanine, tyrosine and tryptophan, arachidonic acid metabolism, phenylalanine metabolism, tricarboxylic acid cycle and dicarboxylic acid metabolism were the main targeted metabolic pathways of Shenfu decoction. Conclusion Shenfu decoction can reverse adriamycin-induced cardiomyopathy by regulating the unbalanced synthesis of phenylalanine, tyrosine and tryptophan, as well as the metabolism of arachidonic acid, phenylalanine, dicarboxylic acid and tricarboxylic acid cycle.
2022, 40(2): 113-119.
doi: 10.12206/j.issn.1006-0111.202105106
Abstract:
Objective To explore the mechanism of motherwort in the treatment of nerve injury. Methods The active components of motherwort were obtained by searching TCMSP and BATMAN-TCM databases. The action targets of candidate compounds were collected and predicted from TCMSP and SwissTargetPrediction (STP) databases. The target genes corresponding to the active components of motherwort were obtained by using the standardized database of disease targets (Uniprot). The potential targets of motherwort in the treatment of nerve injury were obtained by mapping the disease genes of nerve injury with the three databases of Genecards, DisGenet and OMIM. The network topology analysis software Cytoscape 3.6.0 was used to construct the action target network of motherwort active components. The protein interaction platform database (STRING) was used to construct the interaction relationship between action targets. The target protein interaction (PPI) network was constructed by introducing Cytoscape 3.6.0 software. Through STRING database, GO enrichment analysis and KEGG pathway enrichment analysis were carried out to analyze the target points of motherwort in the treatment of nerve injury. Results 19 active components were screened from motherwort, involving 654 action targets, including 426 action targets related to nerve injury and 6 key targets. These target genes were mainly involved in biological regulation, oxidative stress response and cell communication and other biological processes. Molecular functions were mainly related to protein binding, ion binding and catalytic reduction. They were enriched outside the cell membrane. Its mechanism was related to signal pathways such as MAPK, Toll-like receptor, PI3K-Akt, TNF, IL-17, and apoptosis. Conclusion The active components of motherwort may play a protective role on nerve injury through anti-inflammation, anti-apoptosis and promoting cell growth.
2022, 40(2): 120-124.
doi: 10.12206/j.issn.1006-0111.202107019
Abstract:
Objective To study the chemical constituents of Aspergillus terreus from sponge epiphytic fungal. Methods Sephadex LH-20 column chromatography, silica gel column chromatography and high performance liquid chroma-tography were used to separate and purify the compounds. The structures of compounds were identified by spectroscopic data. The α-glucosidase inhibitory activity and antioxidant activity of the compounds were tested by PNPG and DPPH methods, respectively. Results Eight compounds were isolated from Aspergillus terreus and identified as methyl-3,4,5-trimethoxy-2-(2-(nicotinamido) benzamido) benzoate ( 1 ), terrelumamide A ( 2) , emeheterone ( 3 ), (8R,9S)-dihydroisoflavipucine ( 4 ), (8S,9S)-dihydroisoflavipucine ( 5 ), cyclo(S-Pro-S-Phe) ( 6 ), brevianamide F ( 7 ), terrein ( 8 ). Compound 3 showed strong inhibitory activity against α-glucosidase and the IC50 value was 14.28 μmol/L. Conclusion Compounds 3 , 4 , 5 , and 7 were obtained from Aspergillus terreus for the first time.
2022, 40(2): 125-131.
doi: 10.12206/j.issn.1006-0111.202111038
Abstract:
Objective To explore the expression of CRELD2 at the gene and protein levels of mouse tissues, and to provide a reference for studying the biological function of CRELD2 in various tissues. Methods The expression level of CRELD2 in the liver, pancreas, stomach, and lung of C57BL/6J mice was determined by real-time PCR and Western Blot. Results RT-PCR and WB showed that CRELD2 was expressed in mouse liver, pancreas, stomach, and lung. The relative expression levels of CRELD2 from high to low were pancreas, stomach, liver, and lung at the gene level, and pancreas, liver, stomach, and lung at protein level respectively. The result suggested that the relative expression levels of the CRELD2 gene and protein in different tissues were not completely consistent, suggesting that it is related to transcriptional regulation. Conclusion CRELD2 is expressed in mouse liver, pancreas, stomach, and lung, and the relative expression levels of CRELD2 are not completely parallel at the gene and protein level.
2022, 40(2): 132-135, 142.
doi: 10.12206/j.issn.1006-0111.202110082
Abstract:
Objective To test the cardiac toxicity of new compound HMS-01 and evaluate the safety profile for clinical trials. Methods Manualpatch clamp method was used to measure human Ether-a-go-go-Related Gene (hERG) potassium channel currents with different concentrations of HMS-01. Cisapride was selected as the positive control drug. HMS-01 was diluted to the concentration of 0.3, 1, 3, 10 and 30 µmol/L and applied to the cells. The changes in electrical currents were recorded and the inhibition rate was calculated. Results At the highest concentration of 30µmol/L, the inhibitory rate of HMS-01 on hERG channel was less than 30%. There was no obvious inhibitory effect compared with cisapride. Conclusion Compared with the cisapride, HMS-01 has no obvious inhibitory effect on hERG channel and has no cardiotoxicity.
2022, 40(2): 136-142.
doi: 10.12206/j.issn.1006-0111.202112035
Abstract:
Objective To study the effect and mechanism of epigallocatechol gallate (EGCG) combined with trastuzu-mab on the proliferation of human epidermal growth factor receptor 2 (HER2) overexpressing breast cancer cells. Methods Trastuzumab was expressed and purified. The cell proliferation of HER2 overexpressing breast cancer cells BT474 and SK-BR-3 treated with trastuzumab, EGCG, or trastuzumab plus EGCG was evaluated by CCK8 assay. The effects of EGCG and trastuzumab on the expression of HER2, epidermal growth factor receptor (EGFR), mitogen-activated protein kinase (MAPK), protein kinase B (Akt), and their phosphorylated proteins in BT474 breast cancer cells were detected by Western blot. Results The results of cell proliferation assay indicated that EGCG and trastuzumab, alone or in combination, effectively inhibited the proliferation of BT-474 and SK-BR-3 cells. And within a certain concentration range, EGCG and trastuzumab showed a synergistic proliferation inhibitory effect on HER2 overexpressing breast cancer cells. Consistent with these results, Western blot results showed that trastuzumab and EGCG, alone or in combination significantly reduced the phosphorylation levels of Akt, MAPK, EGFR, and HER2 in BT474 cells. Moreover, the inhibition effect of EGCG plus trastuzumab was significantly more potent than either EGCG or trastuzumab. Conclusion EGCG and trastuzumab could synergistically inhibit the proliferation of HER2 overexpressing breast cancer cells, which may be related to the regulation of Akt and MAPK signaling pathways.
2022, 40(2): 143-145.
doi: 10.12206/j.issn.1006-0111.202101017
Abstract:
Objective To investigate the anti-hyperuricemia effects of Bixie deacidification fang on hyperuricemia mice and its mechanism of renal protein transport. Methods The effects of Bixie deacidification fang were investigated on hyperuricemia mice induced by potassium oxonate. Bixie deacidification fang was administered to hyperuricemia mice daily at doses of 220, 440 and 880 mg/kg for 10 days, and allopurinol (5mg/kg) was given as positive control. Serum and urine levels of uric acid and creatinine were determined by colorimetric method. Simultaneously, protein levels of urate transporter 1 (URAT1) and organic anion transporter 1 (OAT1) in the kidney were analyzed by Western blot. Results Compared with the model group, high-dose of Bixie deacidification fang inhibited xanthine oxidase (XOD) activities in serum (18.12±1.33 u/L) and that in liver (70.15±5.20 u/g protein) (P<0.05), decrease levels of serum uric acid (2.04 ± 0.64mg/L) (P<0.05) and serum creatinine (0.35±0.18µmol/L) and blood urea nitrogen (BUN)(8.83±0.71mmol/L) (P<0.05), ncreased levels of urine uric acid (38.34±8.23mg/L), urine creatinine (34.38±1.98mmol/L), down-regulated of URAT1 and up-regulated of OAT1 protein expressions (P<0.05) in the renal tissue of hyperuricemia mice. Conclusion Bixie deacidification fang recipe may promote the excretion of uric acid in the kidney by up-regulating the expression of OAT1 protein to promote the excretion of uric acid, and down-regulating the expression of URAT1 protein to inhibit the reabsorption of uric acid.
2022, 40(2): 146-151, 156.
doi: 10.12206/j.issn.1006-0111.202105117
Abstract:
Objective To qualitatively analyze the main chemical components in compound Jinqiancao granules by ultra high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF/MS). Methods XBridge BEH C18 column (2.1 mm×100 mm, 2.5 µm) was used for chromatographic separation. The mobile phase was composed of 0.1% formic acid water and 0.1% formic acid-acetonitrile, gradient elution, and the flow rate was 0.4 ml/min. Mass spectrometry was characterized by Quadrupole time-of-flight mass spectrometry (Q-TOF/MS) and positive ion mode scanning. Results Under the optimized LC/MS condition, 47 components in compound Jinqiancao granules were identified. The isomers were distinguished by software calculation. The source of medicinal materials was assigned. Conclusion A rapid and efficient analytical method was established for the identification of chemical components in compound Jinqiancao granules by UHPLC-Q-TOF/MS.
2022, 40(2): 152-156.
doi: 10.12206/j.issn.1006-0111.202106102
Abstract:
Objective To improve the quality standards of Kunxian capsules (KC) and effectively control the product quality. Methods Triptolide, icariin and hypericin were used as the indicator components, to increase or improve the thin layer chromatography (TLC) identification methods of Kunming begonia, epimedium and dodder. Agilent ZORBA SB-C18 (4.6 mm×250 mm, 5 μm) as a chromatographic column, the HPLC method for the determination of triptolide was improved with acetonitrile-0.1% formic acid solution as the mobile phase and 220 nm as the detection wavelength. Results The spots in the TLC method of Kunming begonia, epimedium and dodder has strong specificity, good and clear separation of characteristic spots, negative and no interference. The quantitative analysis of the content of triptolide in KC showed that there is a good linear relationship (r=0.9995) between the mass concentration of triptolide and the peak area in the range of 40.16-502.00 μg/ml, the average recovery was 98.12%, RSD was 8.25%, and the accuracy was good. Conclusion The TLC identification method and HPLC method established in this experiment have strong specificity and good reproducibility, and can effectively control the quality of KC.
2022, 40(2): 157-160, 170.
doi: 10.12206/j.issn.1006-0111.202109050
Abstract:
Objective To revise the determination method in the quality standard of Jingtian Zhitong cream. Methods The total saponins of angelica sinensis, Ligusticum wallichii, Rhizoma corydalis, and Panax notoginseng saponins were qualitatively identified by thin-layer chromatography (TLC). The contents of notoginsenoside R1, ginsenoside Rg1, and ginsenoside Rb1 in the preparation were determined by high performance liquid chromatography (HPLC). Results TLC showed strong specificity and good resolution. The concentration of notoginsenoside R1 showed a good linear relationship in the range of 0.1604 and 2.0050μg (r=0. 999). The concentration of ginsenoside Rg1 showed a good linear relationship in the range of 0.8003 and 10.0035μg (r=1.000). The concentration of ginsenoside Rb1 showed good linearity in the range of 0.6182 and 7.7275μg (r=1.000). The sample recovery rates were 101.43%, 98.75% and 100.95%, respectively. The relative standard deviation (RSD) were 2.56%, 2.71% and 2.75%, respectively. Conclusion The developed method is accurate and reliable with high sensitivity, which can be used for the quality control of Jingtian Zhitong cream.
2022, 40(2): 161-164.
doi: 10.12206/j.issn.1006-0111.202008007
Abstract:
Objective To establish a high performance liquid chromatography(HPLC) method for simultaneous determination of the contents of 7 components of chlorogenic acid, caffeic acid, paeoniflorin, ammonium glycyrrhizinate, baicalin, baicalein, and wogonin in Piqin oral liquid. Methods A double-wavelength HPLC method was performed. The column was Agilent Zorbax SB-C18 (250 mm × 4.6 mm, 5 μm). The mobile phase was 0.02% phosphoric acid aqueous solution (A)-acetonitrile (B) gradient elution; Flow rate: 1.0 ml/min; Column temperature: 35℃; Injection volume: 20 μl; Detection wavelength: 0-18.0 min, 325 nm (detect chlorogenic acid, caffeic acid); 18.0-65.0 min, 280 nm (detect paeoniflorin, baicalin, baicalein, ammonium glycyrrhizinate, wogonin) . Results The chlorogenic acid, caffeic acid, paeoniflorin, ammonium glycyrrhizinate, baicalin, baicalein and wogonin were completely separated. Seven components have a good linear relationship between the peak area and concentration, with the recoveries between 96.41% and 99.70%. Conclusion This method is simple, accurate and reproducible, and can be used for the quality control of Piqin oral liquid.
2022, 40(2): 165-170.
doi: 10.12206/j.issn.1006-0111.202009087
Abstract:
Objective To investigate the effect of CYP3A5 and MDR1 gene polymorphisms on blood concentration of tacrolimus and creatinine level in uremic patients during the early phase after kidney transplantation in real clinical practice. Methods 131 patients who underwent kidney transplantation for the first time with triple immunotherapy based on tacrolimus in single-center from 2013 to 2017 were enrolled for retrospective study. Tacrolimus daily dose, blood concentration, blood concentration-to-dose ratio, and serum level were compared according to the various genotypes of CYP3A5 and MDR1 polymorphisms in renal transplantation recipients, respectively. Results The dosage of tacrolimus in CYP3A5*3/*3 (GG) kidney transplantation recipients within 4 weeks after kidney transplantation was lower than those of CYP3A5*1/*1 (AA) and CYP3A5*1/*3 (AG). The serum creatinine levels of patients whose tacrolimus concentration in the range of 10-13 ng/ml were close to the normal value. Conclusion CYP3A5 gene polymorphism affects the blood concentrations of tacrolimus in renal transplant recipients. No association has been found between the blood concentrations of tacrolimus and MDR1 gene polymorphism. Tacrolimus concentration in the range of 10-13 ng/ml might contribute to restore the early kidney graft function.
2022, 40(2): 171-174.
doi: 10.12206/j.issn.1006-0111.202107045
Abstract:
Objective To explore the role of pharmaceutical care in the treatment of patients with pulmonary infection secondary to suppurative thrombophlebitis. Methods The treatment of a patient diagnosed with pulmonary metastatic infection secondary to suppurative thrombophlebitis and the whole process of clinical pharmacists participating in the monitoring were analyzed retrospectively. The use of antibiotics was evaluated, and the experience of coagulation management in suppurative thrombophlebitis was explored. Results Based on the infection site, characteristics of septic thrombus, monitoring of vancomycin blood concentration, pharmacokinetics and pharmacodynamics characteristics of antibiotics, clinical pharmacists provided comprehensive pharmaceutical services for clinicians and patients in terms of anti-infection scheme adjustment, optimization of vancomycin individualized treatment, anticoagulant timing. Patient’s systemic infection and septic thrombus can be effectively controlled and which promotes the treatment of patients with suppurative thrombophlebitis. Conclusion Clinical pharmacists can play an important role in the treatment team of severe patients to improve the rational use of antibiotics.
2022, 40(2): 175-179.
doi: 10.12206/j.issn.1006-0111.202109126
Abstract:
Objective To better carries out the review of the interaction between triazole antifungal drugs and statins, ensure drug safety for patients and improve the efficiency of the manual review of pharmacists. Methods The advantageous combination with less interaction between the two kinds of drug was obtained by summarizing the interaction information of triazole antifungal drugs and statins. At the same time, optimizing the process of full manual reviews for drug interaction, and the advantageous combination of the two kinds of drug will be set up in advance on the doctor side of the review system. Doctors can adjust the drug in time according to the prompts of the information system when there is a significant interaction of the two kinds of drug in the prescription or medical order, which is issued by the doctors. Results After optimization, most doctors choose the drug combination of less interaction between the two kinds of drug according to the system prompts. The number of drug combinations of significant interaction which is manually reviewed by pharmacists is significantly reduced (P<0.05), and the review efficiency is improved, the drug safety risks brought by drug interactions to patients are reduced. Conclusion Refinement review of drug interactions between triazole antifungal agents and statins based on the optimization of the pre-audit system plays a positive role in improving the safety of patients’ medication and the efficiency of pharmacists' manual auditing.
2022, 40(2): 180-183.
doi: 10.12206/j.issn.1006-0111.202106009
Abstract:
Objective To observe the effect of applying PDCA cycle method to promote the management of key monitoring drug, and provide a basis for the management of key monitoring drug in medical institutions. Methods To compare the consumption of drugs and prescription reviews before and after the adoption of PDCA management in a hospital. The control group was the inpatients with traditional management method in 2019, and the observation group was the inpatients with PDCA method in 2020. Results After the implementation of PDCA cycle, the consumption amount of key monitoring drugs decreased significantly (P<0.001); The problems of irrational prescription such as drug use without indication, repeated drug use, inappropriate dosage and route of administration, and long course of treatment were effectively controlled (P<0.05). The qualified rate of prescription increased from 65.96% to 90.76% (χ2=27.010, P<0.001). The incidence of adverse reactions was significantly decreased (χ2 =37.044, P<0.001). Conclusion PDCA method aims at continuous closed-loop management of key monitoring drugs in medical institutions, which can control drug costs to the greatest extent, reduce the economic burden of patients, promote rational drug use, reduce the incidence of adverse reactions, and ensure the quality of medical care.
2022, 40(2): 184-187.
doi: 10.12206/j.issn.1006-0111.202110068
Abstract:
Objective To explore the needs of community pharmacy services in elderly hypertensive patients in the community, especially empty-nest elderly patients. Methods Elderly hypertensive patients living in Ouyang street were randomly selected and divided into empty-nest and non-empty-nest groups by cluster random sampling method. The basic information of the respondents, the frequency of hypertension monitoring, the taking of hypertensive drugs, and the taking of other drugs were compared and analyzed. Results In term of “blood pressure monitoring frequency”, the daily pressure measurement of the empty-nest group and the non-empty-nest group accounted for 33.6% and 19.3%, respectively. There was significant difference between the two groups (P<0.05).In term of “the varieties of hypertension drugs” and taking 3 kinds of hypertension drugs at the same times, the empty-nest group accounted for 28.8% and the non-empty-nest group accounted for 16.7%, and the difference between the two groups was significant (P<0.05); In term of “the varieties of drugs” and taking 1-2 kinds of Chinese patent drugs at the same time, the empty-nest group accounted for 39.6% and the non-empty-nest group accounted for 26.0% , and the difference between the two groups was significant (P<0.05). Conclusion Community elderly patients with hypertension, especially empty-nest elderly patients have an urgent need for community pharmacy services, Community pharmacy services personnel should provide personalized and targeted medication education and guidance to elderly patients, especially empty-nest elderly patients, to promote the rational drug use in elderly patients.
2022, 40(2): 188-192.
doi: 10.12206/j.issn.1006-0111.202105091
Abstract:
Objective To understand the current situation of dispensing errors and effective prevention and control measures in outpatient pharmacies in domestic hospitals, in order to further improve the quality of drug dispensing. Methods The Chinese journal database was retrieved from 2015 to 2020 for the literature on the dispensing errors of outpatient pharmacies and the continuous improvement of the quality after the measures were taken in secondary and tertiary hospitals. Results Of the 146 literatures retrieved, 13 were included in the analysis (11 in tertiary hospitals and 2 in secondary hospitals). Before the improvement, the median of the drug dispensing error rate was 5.1‰, and after the improvement it was 1.1‰. Before and after the improvement, the types of drug dispensing errors were mainly quantity errors (52.5% vs. 51.3%), variety errors (28.3% vs. 28.7%), specifications and dosage forms errors (6.2% vs. 6.7%), and labeling errors (2.1% vs. 2.9%). The improvement measures taken for the reasons of dispensing errors have a high overlap rate, and they are concentrated in two aspects: personnel factors and drug factors. Conclusion The use of continuous quality improvement tools in hospital outpatient pharmacy to control and prevent dispensing errors is still a hotspot of current research. The composition of the types of errors after improvement has basically not changed. The implemen-tation of standardized operating procedures and other continuous improvement comprehensive measures can effectively reduce the incidence of dispensing errors, and contribute to the implementation of the “Expert Consensus on Medication Error Management in China”.
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