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    15 May 2024, Volume 21 Issue 5 Previous Issue    Next Issue

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    Current situation of conservation and utilization of medicinal fungal germplasm resources and reflection
    LIU Tianrui, GAO Haiyun, CHEN Yuxin, LI Yao, LI Hui, YUAN Yuan
    2024, 21(5): 481-488. 
    DOI: 10.19803/j.1672-8629.20240144

    Abstract ( 136 )   PDF (1448KB) ( 96 )  
    Objective To review the conservation and utilization of medicinal fungal germplasm resources in China, and promote the high-quality development of medicinal fungi. Methods Discuss the distribution of medicinal fungi resources, construction of germplasm resource banks, preservation of germplasm resources, and innovative utilization of germplasm resources in China. Based on the current development status and long-term positioning, it points out the problems in the development of medicinal fungal resources in China at the current stage and proposes targeted development suggestions. Results China has abundant medicinal fungal resources and a wide distribution, but 95.1% of fungal species remained to be discovered, researched, developed and utilized. The collection and preservation of medicinal fungal germplasm resources are not yet comprehensive, and large-scale and systematic preservation centers and management platforms have not been formed, which restricts the development of the mycomedicine industry; The breeding process of improved and new varieties of medicinal fungi is relatively slow. Conclusion Medicinal fungal resources are a unique advantage in China, but there is still a long way to explore the development and utilization of medicinal fungal resources. It is urgent to increase the collection and protection of germplasm resources of edible and medicinal fungi, conduct research on material basis and efficacy evaluation, establish a national technical system for the medicinal fungi industry, and accelerate the selection and breeding of excellent and new varieties of medicinal fungi.
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    Toxicity analysis and safe application of 7 common fungi prone to adverse reactions
    LIU Tianrui, LI Yao, CHEN Yuxin, LI Hui, GAO Haiyun, YUAN Yuan
    2024, 21(5): 489-495. 
    DOI: 10.19803/j.1672-8629.20240143

    Abstract ( 207 )   PDF (1359KB) ( 141 )  
    Objective To review of research status on seven common conditional fungi that are prone to adverse reactions, analyze their toxic components, and propose corresponding safety utilization suggestions, so as to provide reference for their resource development and sustainable utilization. Methods By reviewing domestic and foreign literature and relevant books, the current research status, efficacy, toxic components, adverse reactions, and other aspects of seven common fungi that are prone to adverse reactions were summarized. Results Seven types of common fungi that are prone to adverse reactions, including BoletusBulgaria inguinansAuricularia auriculaAmanitaGymnopilus spectabilisCoprinus comatusPaxillus involutus contain complex types of toxic components, including peptides, alkaloids, amino acids, oligoisoprene compounds, etc, which may cause adverse reactions such as neurotoxicity, photosensitivity, gastrointestinal irritation, disulfiram-like reaction, hemolytic poisoning, etc. It is important to pay attention to them.. At the same time, these fungi are rich in various bioactive components with significant pharmacological activity, and some toxic components have the potential to be developed into anti-inflammatory, analgesic, antidepressant drugs, etc, which is worthy of further research and rational utilization. Conclusion Fungi that are prone to adverse reactions are also important resources for medicinal fungi, with great development value. Currently, many studies on fungi that are prone to adverse reactions focus on pharmacological and toxicological effects. Their virulence factors and toxic mechanisms are not yet clear, and further in-depth research is needed to provide theoretical basis for their development and utilization.
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    Research on toxins, poisoning features and exploitation and utilization of Amanita
    CHEN Yuxin, LI Yao, GAO Haiyun, LI Hui, LIU Tianrui, YUAN Yuan
    2024, 21(5): 496-501. 
    DOI: 10.19803/j.1672-8629.20240123

    Abstract ( 87 )   PDF (1410KB) ( 83 )  
    Objective To explore types of toxins, poisoning features and future utilization in the areas of medicine and biology, provide a new perspective for an objective understanding of Amanita safety, as well as references for further rational development and security applications of Amanita. Methods Based on the relevant literature in China and abroad, the present study of poisoning features, exploitation and utilization of toxins in Amanita were categorized, analyzed and summarized. Results Amanita mainly contains toxic components such as peptides, amino acids, and alkaloids, which are affected by the species, the application site and a variety of factors, resulting in a great difference in the composition and content. Main poisoning features of Amanita are gastrointestinal symptomsand acute liver and kidney injury. Meantime, these toxic components also have development and utilization value in the development of antibacterial, anti-tumor, anti-inflammatory and other drugs and play important roles in life science researches. Conclusion Amanita has important development value, toxic compositions types and mechanisms and safe dosages of Amanita are clarified to provide reference for the development and safe clinical utility.
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    Herbal textual research and adverse reaction study of Coprinus comatus
    GAO Haiyun, CHEN Yuxin, LI Yao, LI Hui, LIU Tianrui, YUAN Yuan
    2024, 21(5): 502-506. 
    DOI: 10.19803/j.1672-8629.20240052

    Abstract ( 106 )   PDF (1478KB) ( 72 )  
    Objective Exploring the medication history and modern research progress of the medicinal fungus Coprinus comatus, providing reference for further research and application of C. comatus. Methods By consulting ancient herbal monographs, we conducted research on the name, origin, morphology, medicinal properties, and efficacy of C. comatus, and conducted in-depth exploration in combination with modern literature research. Results C. comatus has a long history of being used in medicine. The ancient names of C. comatus were Gui Gai, Di Gai, Gui Wu. C. comatus and shaggy mane were the modern names of C. comatus. C. comatus was sweet in properties, flat in tastes, and distributed to stomach and heart meridian tropisms. It is used in the treatment of children's cold and feverish epilepsy, boils and swollen poisons, malignant sores, and centipede, snake and scorpion injuries. Modern pharmacological studies had shown that C. comatus had pharmacological effects such as antioxidant, anticancer, hepatoprotective, anti-inflammatory, antidiabetic, antimicrobial, antiviral, and antinematode activity. Through a systematic review of ancient and modern literature, it was found that C. comatus may cause adverse reactions such as disulfiram-like reaction, gastroenteritis-type poisoning, skin reactions in atopic dermatitis patients, and heavy metal enrichment. Conclusion This article provides a basis for the safe utilization of C. comatus by summarizing the herbal research and adverse reactions of C. comatus.
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    Research progress in pharmacology and safe use of Boletus edulis
    GAO Haiyun, LI Yao, CHEN Yuxin, LI Hui, LIU Tianrui, YUAN Yuan
    2024, 21(5): 507-512. 
    DOI: 10.19803/j.1672-8629.20240069

    Abstract ( 77 )   PDF (1407KB) ( 87 )  
    Objective To summarize the research progress related to rare wild fungus, Boletus edulis, evaluate its safety, and give tips on safe use. Methods The morphological characteristics, phylogenetics, bioactive ingredients, pharmacological activity, and heavy metal enrichment of B. edulis were discussed. Results The fruiting body was rich in protein, amino acids, carbohydrates, dietary fiber, and mineral elements. The active ingredients such as polysaccharides, phenolic compounds, flavonoids, and new multifunctional proteins were the material basis for its pharmacological effects including antioxidant, anti-inflammatory, anti-tumor, and liver-protecting properties. B. edulis had superior pharmacological activity and was a candidate drug with broad clinical applications. However, B.edulis was likely to enrich heavy metals (Cd, Hg, As and Pb) and had potential risks so that never using wild B.edulis from land contaminated areas and choosing appropriate processing methods could effectively reduce the risk of heavy metal intake. Conclusion B.edulis is of superior medicinal value, but there are also potential safety risks that are to be avoided.
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    Supervision status and research progress of global abuse of opioids
    LI Wenpeng, LIU Mingyu, CAO Ying, ZHOU Huziwei, WANG Shengfeng
    2024, 21(5): 513-518. 
    DOI: 10.19803/j.1672-8629.20240196

    Abstract ( 251 )   PDF (1416KB) ( 202 )  
    Objective To sort out the supervision status and research progress of global opioids abuse,and to promote the rational use of drugs and improve the treatment of abusers. Methods The related literature and documents from CNKI, Wanfang Data, PubMed, International Narcotics Control Board, United Nations Office on Drugs and Crime were searched and analysed. Result At present, the situation of global opioids abuse is still not optimistic.International institutions led by the INCB have put forward effective recommendations and launched relevant actions from four dimensions: policy legislation, regional cooperation, production transactions and prevention and treatment. In addition, researchers have also carried out relevant studies from different dimensions, such as related policies, abuse risk prediction, and treatment of abusers. Conclusion Current opioid supervision and research cannot meet the current needs of opioids regulation. In the future, in-depth research is still needed from the aspects of strengthening effective drug regulation, predicting drug abuse risk, improving addiction treatment programs, etc., to further improve the current situation of opioid abuse.
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    Applications and progress of methods for estimating opioids requirements
    LI Wenpeng, ZHOU Huziwei, ZHU Lan, WANG Shengfeng
    2024, 21(5): 519-523. 
    DOI: 10.19803/j.1672-8629.20230607

    Abstract ( 63 )   PDF (1234KB) ( 86 )  
    Objective To sort out the current status and existing problems in the application of estimation methods for opioid requirements, and to make suggestions for promoting the rational use of medication and improving estimation methods. Methods The related literature and documents from CNKI, Wanfang Data, PubMed, International Narcotics Control Boardwere were searched and analysed. Results There are three main methods for estimating opioid demand in the international arena, which have different data requirements and their own advantages and disadvantages. Conclusion In the context of existing problems, it is recommended that the regulator invest more resources to continuously improve the development of rules for estimation methods and the quality of drug data records and improve the drug estimation system in order to promote the rational use of opioids.
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    Research progress on the influencing factors and intervention measures of opioid requirements
    QIU Jinghui, ZHOU Huziwei, CAO Ying, LI Wenpeng, WANG Shengfeng
    2024, 21(5): 524-528. 
    DOI: 10.19803/j.1672-8629.20240145

    Abstract ( 65 )   PDF (1424KB) ( 74 )  
    Objective To summarize the existing literature on the influencing factors of opioid drugs, as well as the intervention measures for increasing the supply of legitimate opioid drugs in recent years. Methods The research progress on the influencing factors and intervention measures of opioid drug demand were analyzed by retrieving and screening data from PubMed, CNKI, Wan Fang, and relevant documents, Existing research experience and shortcomings are summarised. Results The influencing factors of clinical measures, patients, and society were summarized at three levels, but currently, relevant research only focuses on one possible influencing factor and lacks exploration of inconsistent results, correlation research, detailed research, and potential factor research; Summarize the intervention measures at each stage of the opioid drug supply process, but there is still a lack of specific research on a specific intervention measure. Conclusion In the future, research on the influencing factors of opioid drug demand can further explore the reasons for inconsistent results, from the perspectives of multi factor joint analysis, refining the measurement dimensions of factors, and exploring new influences; In terms of intervention measures, attention can be paid to the evaluation of their effectiveness and the study of their applicability.
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    Management of compound glycyrrhiza oral solution and recommendations
    CAO Ying, ZHOU Huziwei, ZHU Lan, WANG Shengfeng
    2024, 21(5): 529-534. 
    DOI: 10.19803/j.1672-8629.20230558

    Abstract ( 166 )   PDF (1599KB) ( 140 )  
    Objective To investigate the current management level of compound glycyrrhiza oral solution, and to offer recommendations for improvement. Methods Related literature was retrieved from CNKI, Wanfang, VIP, the website of the FDA of the United States, and the official websites of NMPA and provincial drug regulatory agencies of China before being summarized and analyzed. Results There were some problems with this solution, such as unstable preparation processes, incomplete standards for content determination, ambiguous instructions, and complicated ADRs during the use of compound glycyrrhiza oral solution in China. Conclusion It is recommended that ways to regulate similar drugs at home and abroad be referred to to optimize the regulations of CGOS, the targets of marketing and processes be standardized for enterprises, health care providers be better trained and related knowledge be made more accessible.
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    Mechanisms of extracts of Pith-nodecayed and Pith-decayed of Scutellariae Radix against Th17/Treg immune imbalance in damp-heat ulcerative colitis rats
    HUANG Wei, LUO Yaqin, YU Xinyang, DONG Hongjing, WANG Xiao
    2024, 21(5): 535-539. 
    DOI: 10.19803/j.1672-8629.20230566

    Abstract ( 40 )   PDF (1680KB) ( 59 )  
    Objective To compare the effects of extracts from Pith-decayed and Pith-nodecayed products of Scutellariae Radix on expressions of helper T cell 17 (Th17)/regulatory T cell (Treg) cytokines and the transcription factor ROR-γt/ Foxp3 in rats with damp-heat ulcerative colitis (UC). Methods Fifty healthy SD rats were randomly divided into five groups: the normal group, model group, Pith-decayed products of Scutellariae Radix group, Pith-nodecayed products of Scutellariae Radix group and mesalazine group, with 10 rats in each. A damp-heat UC rat model was established via the combination of high-fat and high-sugar diet+high-liquor administration+5% dextran sodium sulfate (DSS). Each group was given intragastric administration on the first day of modeling, respectively. The dosage was 5.25 g·kg-1·d-1 for the Pith-decayed products group and Pith-nodecayed products group, but 0.266 g·kg-1·d-1 for the mesalazine group. The normal group and model group were given an equal volume of normal saline. The drug was administered for 28 consecutive days. After administration, the rats were anesthetized, blood was collected from the abdominal aorta, serum was separated, and serum levels of interleukin-6(IL-6), IL-17A, IL-10 and transforming growth factor-β1(TGF-β1) were detected by Elisa. Spleen and colon tissues were separated, the proportion of Th17 and Treg cells in spleens was detected by flow cytometry, and the Th17/Treg ratio was calculated. Real-time quantitative fluorescent polymerase chain reaction (qRT-PCR) was used to detect the mRNA expression levels of ROR-γt and Foxp3 in colon tissues. The expression levels of ROR-γt and Foxp3 in colon tissues were detected by Western blot. Results Compared with the normal group, serum levels of IL-6 and IL-17A, the proportion of Th17 cells in spleens, Th17/Treg, and mRNA and protein expression levels of ROR-γt in colon tissues of the model group were significantly increased (P<0.01) while serum levels of IL-10, IL-35, TGF-β1, the proportion of Treg cells in spleens and the expression of Foxp3 mRNA and protein in colon tissues were significantly decreased (P<0.01). After 28 days of administration, serum levels of IL-6, IL-17A, the Th17 cell ratio in spleens, Th17/Treg, and ROR-γt mRNA and protein expression levels in colon tissues of rats in each administration group were decreased to varying degrees compared with the model group (P<0.05 or P<0.01), while serum levels of IL-10, IL-35, TGF-β1, the proportion of Treg cells in spleens, and the expression of Foxp3 mRNA and protein in colon tissues were increased to different extents (P<0.05 or P<0.01). Compared with the Pith-decayed products of Scutellariae Radix group, Pith-nodecayed products of Scutellariae Radix group and mesalazine group were more effective in reducing levels of IL-6 and IL-17A, increasing levels of IL-10, IL-35 and TGF-β1, and regulating mRNA and protein expressions of ROR-γt (P<0.05 or P<0.01). Conclusion Pith-decayed and Pith-nodecayed products of Scutellariae Radix may help regulate the expressions of transcription factors ROR-γt and Foxp3, restore Th17 /Treg immune imbalance, inhibit inflammatory response, protect against intestinal mucosal barrier damage, and facilitate the treatment of damp-heat UC.
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    Effect of Tianlongjie stage interventions on lung tissue remodeling and lung function of pulmonary fibrosis rats
    CHEN Bing, YUAN Dezheng, FU Yi
    2024, 21(5): 540-546. 
    DOI: 10.19803/j.1672-8629.20230506

    Abstract ( 31 )   PDF (3774KB) ( 49 )  
    Objective To observe the effects of Tianlongjie (a Yunnan ethnic medicine) stage interventions on lung tissue remodeling and lung function of pulmonary fibrosis (PF) rats and explore the possible mechanism of Tianlongjie against pulmonary fibrosis. Methods A pulmonary fibrosis model of rats was established via intratracheal bleomycin infusion. Ninety male Wistar rats were randomized into nine groups: the control group(C), model early group(ME) and model late group(ML), Tianlongjie early intervention group at a medium dose(TEM), Tianlongjie late intervention group at a low dose(TLL), Tianlongjie late intervention group at a medium dose(TLM) , Tianlongjie late intervention group at a high dose(TLH)(0.51,1.01,2.02 g·kg-1·d-1), pirfenidone early intervention group(PFDE) and pirfenidone late intervention group(PFDL). Rats in the early intervention group was given drugs from the 7th day after modeling while the late intervention group was given drugs from the 14th day. The survival of rats was observed and materials were selected on the 28th day. The protein expressions of CD31 and CD34 in lung tissue were detected by SABC. The content of Hyp in lung tissue was determined with colorimetry. The lungs were stripped before the lung coefficient was calculated. Pulmonary function was measured by an animal pulmonary function instrument. Blood samples were taken from the abdominal aorta for blood gas analysis. Results Compared with the model control group, CD31 and CD34 protein expressions in lung tissue of PF rats were inhibited in early and late intervention with Tianlongjie groups (P<0.01, P<0.001), and there was significant difference between TEM and TLM (P<0.05). Compared with TLL, TLM and TLH were more effective (P<0.05). Early and late intervention with pirfenidone inhibited CD31 and CD34 protein expressions in lung tissue of PF rats (P<0.01). There was no statistically significant difference between TEM and PFDE(P>0.05), and the same was true of TLM and PFDL. Compared with the model control group, the level of Hyp in lung tissue of PF rats decreased in each of the intervention groups (P<0.05,P<0.01). There was no statistically significant difference between TEM and PFDE(P>0.05), as in the case of TLM and PFDL. Compared with the model control group, intervention with Tianlongjie reduced lung weight and lung coefficients (P<0.05, P<0.01). There was no significant difference between Tianlongjie intervention and pirfenidone intervention (P>0.05). Compared with the model control group, intervention with Tianlongjie increased levels of FVC, FEV200 and FEV200/FVC (P<0.05, P<0.01, P<0.001), but decreased FRC levels(P<0.001). Conclusion Early and late intervention with Tianlongjie can effectively inhibit CD31 and CD34 protein expressions, and early intervention is more effective. Intervention with Tianlongjie can decrease Hyp contents in lung tissue of PF rats before reducing the lung coefficient, improve lung ventilation function, but there is no significant difference between Tianlongjie and pirfenidone, indicating that Tianlongjie could effectively regulate lung tissue remodeling of PF rats and inhibit the progress of pulmonary fibrosis.
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    Roles of Yangxue Antai prescription in improving endometrial epithelial-mesenchymal transformation and decidualization in recurrent spontaneous abortion mice by regulating autophagy
    YAO Weijie, YAN Shiqi, YUAN Sisi, GONG Leilei, FENG Xin
    2024, 21(5): 547-552. 
    DOI: 10.19803/j.1672-8629.20240061

    Abstract ( 36 )   PDF (1861KB) ( 51 )  
    Objective To explore the role of Yangxue Antai prescription in improving endometrial epithelial-mesenchymal transformation (EMT) and decidualization in mice with recurrent spontaneous abortion (RSA) by regulating autophagy. Methods An RSA mouse model with kidney deficiency and blood stasis was established before the normal pregnant mice were intraperitoneally injected 2 mg·kg-1 rapamycin (Rapa) solution or 15 mg·kg-1 3-methyladenine (3-MA) solution, respectively; RSA mice, Rapa mice and 3-MA mice treated with the same method were also set up, and the concentration of 28.08 g·kg-1 of Yangxue Antai Prescription was given at the same time for intervention, then the endometrium of the mice was collected. The expressions of EMT-related proteins E-cadherin, Vimentin, N-cadherin, and Fibronectin, as well as deciduation-related proteins BMP2, HOXA10, PRL, and IGFBP1 were measured by Western blot. Results Compared with the normal pregnancy group, the expression of E-cadherin in the endometrium of mice in the RSA group was significantly increased, while the expressions of Vimentin, N-cadherin, Fibronectin, BMP2, HOXA10, PRL and IGFBP1 were significantly decreased. The expression of E-cadherin in the endometrium of the Rapa group was significantly increased, while those of Vimentin, N-cadherin, Fibronectin, BMP2, HOXA10, PRL and IGFBP1 were significantly decreased. The protein expression of E-cadherin in the endometrium of the 3-MA group was significantly decreased while that of HOXA10 was significantly increased. Compared with the RSA group, the expression of E-cadherin in the the endometrium of mice in the RSA+ YXAT group was significantly decreased, while the expressions of Vimentin, N-cadherin, Fibronectin, BMP2, HOXA10, PRL and IGFBP1 were significantly increased. Compared with the Rapa group, the expression of E-cadherin in the endometrium of mice in the Rapa+ YXAT group was significantly decreased, while those of Vimentin, N-cadherin, Fibronectin, BMP2, HOXA10, PRL and IGFBP1 were significantly increased. Conclusion Yangxue Antai prescription can inhibit autophagy, promote EMT and decidualization process of the endometrium of pregnant mice, and reduce abortion rate.
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    Analysis of prescription rules for Omphalia lapidescens based on the Dictionary of Chinese Traditional Medicine Prescriptions
    LI Yao, CHEN Yuxin, GAO Haiyun, LI Hui, LIU Tianrui, YUAN Yuan
    2024, 21(5): 553-558. 
    DOI: 10.19803/j.1672-8629.20240030

    Abstract ( 47 )   PDF (1702KB) ( 72 )  
    Objective To explore the prescription and medication rules of Omphalia lapidescens in the Dictionary of Chinese Traditional Medicine Prescriptions based on data mining method. Methods With the Dictionary of Chinese Traditional Medicine Prescriptions as the information source, the prescriptions containing O. lapidescens were identified, and a prescription database for O. lapidescens was created. The methods of enhancing the efficacy and reducing the toxicity of O. lapidescens, the types of symptoms and the compatibility of O. lapidescens were discussed by using literature data mining methods. The compatibility characteristics of O. lapidescens in common diseases were explored by association rule analysis. Pearson correlation analysis was used to uncover drug- disease correlations and summarize medication patterns. Results The main dosage forms of O. lapidescens prescription were pill and powder, the high frequency drugs were Areca catechu, Rheum officinale, and Aucklandia lappa. The compatibility of O. lapidescens was anthelmintics, purgatives, and drugs for regulating Qi flow with the flavors of bitter or spicy. Meridian tropism is mainly distributed in the spleen and stomach meridian. Among them, “A. catechu-O. lapidescens” had the highest frequency of drug pair compatibility, followed by “R. officinale-O. lapidescens”, and then “A. lappa-O. lapidescens”. The O. lapidescens formula has the highest frequency of treating the main condition of worm accumulation, followed by malnutrition and stagnation. The results of Pearson correlation analysis showed that the treatment of worm accumulation was compatible with A. catechu, A. lappa, Quisqualis indica, Ulmus macrocarpa, and Carpesium abrotano; Treatment malnutrition was compatible with picrorhiza scrophulariiflora, Coptis chinensis, and Citrus reticulata; Treatment malnutrition stagnation was compatible with Massa fermentata, Citrus reticulata, Pharbitis nil, and Sparganium stoloni. Conclusion The combination of O. lapidescens (Lei Wan) and A. catechu (Bing Lang) can enhance the efficacy of killing worms and eliminating stagnation; The combination of O. lapidescens (Lei Wan), P. scrophulariiflora (Hu Huanglian), and R. officinale (Da Huang) may increase the effect of diarrhea and attack the accumulation, which may cause mild gastrointestinal adverse reactions; The combination of O. lapidescens (Lei Wan), A. Citrus reticulata Blanco (Chen Pi) and M. Fermentata (Shen Qu) can protect gastric mucosa and reduce gastrointestinal adverse reactions. However, the basic research on the toxic substances of O. lapidescens has not been reported, and further research is still needed to provide a more accurate basis for the clinical use of O. lapidescens.
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    Correlation of the efficacy, safety and plasma concentration of lacosamide in the treatment of children with epilepsy under 4 years of age
    YU Jing, PALATI Reheman, ZHAO Ting, FENG Jirong, SUN Yan, HE Lei
    2024, 21(5): 559-562. 
    DOI: 10.19803/j.1672-8629.20240018

    Abstract ( 59 )   PDF (1485KB) ( 72 )  
    Objective To assess the correlation of efficacy, safety and serum concentrations of lacosamide (LCM) in children with epilepsy under 4 years of age. Methods A total of 190 children with epilepsy treated with LCM from January 1, 2019 to December 31, 2023 in the Children's Hospital of Xinjiang Uygur Autonomous Region were retrospectively enrolled, and personal data were collected, and blood concentrations, efficacy, and adverse drug reactions of LCM were recorded. The correlation between efficacy, safety, and plasma concentrations was analyzed. Results The response rate of LCM treatment in children with epilepsy was 77.37%, and the incidence of adverse reactions was 31.58%. The accuracy of the LCM plasma concentration in predicting efficacy [AUC (95%CI)=0.532 (0.440~0.623)] was higher than that of the administered dose [AUC (95%CI)=0.525 (0.422~0.628)]. The reference intervals of LCM steady-state plasma concentration in children with epilepsy were 1.50~14.65 μg·mL-1, respectively. The plasma concentration of LCM in the children with adverse reactions was significantly higher than that in the children without adverse reactions [(7.93±3.90) μg·mL-1 and (6.44±3.10) μg·mL-1, P < 0.05]. Conclusion LCM has well efficacy and safety in the treatment of Childern with epicepsy under 4 years, and can be used for clinical epicepsy treatment.
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    Risks of piracetam preparations to safety
    LIU Cuili, WU Chen, WANG Tao
    2024, 21(5): 563-566. 
    DOI: 10.19803/j.1672-8629.20230381

    Abstract ( 152 )   PDF (1414KB) ( 151 )  
    Objective To analyze the risk of piracetam preparations in order to provide reference for clinical rational drug use. Methods Individual cases of adverse drug reactions reported in China adverse drug reaction (ADR) database between January 1, 2004 and March 31, 2023, domestic literature published from January 1, 2000 to March 31, 2023 and risk control measures taken in China were analyzed. Results Between January 1, 2004 and March 31, 2023, there were a total of 40 675 ADR reports of piracetam preparations in the database, involving 1 922 serious cases (4.7%). There were 5 360 ADR reports of oral preparations, including 55 serious adverse reactions and 429 unexpected adverse reactions. There were 35 315 cases of ADR reports of injection preparations, including 1 865 serious cases (5.3%). Conclusion Piracetam preparations can cause serious adverse reactions such as anaphylactic shock. Clinicians should be alert to these serious adverse reactions and take preventions when prescribing piracetam preparations. Marketing authorization holders should assume more responsibility for monitoring and evaluation of adverse drug reactions and update the information on safety in drug labels in time.
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    A model for prediction of risk factors of acute kidney injury induced by voriconazole for injection based on real-world data
    WANG Shubo, JIAO Tingting, DONG Hongliang, WANG Bailing, LI Hui
    2024, 21(5): 567-571. 
    DOI: 10.19803/j.1672-8629.20230530

    Abstract ( 75 )   PDF (1564KB) ( 86 )  
    Objective To establish a prediction model for risk factors of acute kidney injury (AKI) indued by voriconazole for injection and carry out internal and external validation to ensure clinical safety of medication based on real-world data. Methods The medical records of patients who were treated with voriconazole for injection for a minimum of 3 days in our hospital and aged 18 or older between January 1, 2020 and June 30, 2023 were collected. Among them, patients who were discharged before January 1, 2023 were used as the modeling group, and the rest as the validation group. The basic information of patients and such data as the indicators of experimental examinations, results of clinical diagnosis and combined medications was retrieved. Patients were divided into the AKI group and non-AKI group according to the occurrence of AKI. Multivariate logistic regression was used to analyze the risk factors for AKI induced by voriconazole for injection, and a prediction model was established. Discrimination and calibration were evaluated based on the receiver operating characteristic (Receiver Operating Characteristic, ROC) area under the curve (Area Under Curve, AUC) and H-L test (Hosmerand Lemeshow Test). The applicability of the model was evaluated both internally and externally. Results A total of 625 patients (371 males, 254 females) were included in the study. Among them, there were 489 cases in the modeling group (296 males and 193 females), with 87 cases of AKI, compared with 136 cases in the verification group (75 males, 61 females), with 32 cases of AKI. Multivariate logistic regression analysis of the modeling group showed that bloodstream infections, kidney diseases, cardiovascular diseases, and the use of diuretics were risk factors for AKI, while CrCl (Creatinine Clearance) and Alb(Albumin) were protective factors. The AUC of the model group was 0.750 (95%CI: 0.692~0.808, P<0.001) while the H-L test χ2 value was 7.535, P=0.480, compared with 0.821(95%CI: 0.749~0.893, P<0.001) and 13.924, P=0.084 in the verification group was, suggesting that the model had good discrimination. The maximum value of the Youden index of the model was 0.389, and the best value corresponding to the tangent point of the ROC curve was -0.976, the sensitivity was 56.3%, and the specificity was 82.6%. k-fold cross-validation suggested that the accuracy of the model was better (0.823) and the consistency was lower (0.191). Conclusion CrCl, Alb, bloodstream infections, kidney diseases, cardiovascular diseases, and diuretics are independent factors for AKI induced by voriconazole for injection. The prediction model of AKI established based on these 6 variables has some discrimination, which can assist clinical treatment and contribute to safe drug use.
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    Adverse events of COVID-19 vaccination in recipients of liver and kidney transplant based on US VAERS database
    WU Yi, HE Jinyang, WANG Xiaojian, ZhOU Xiaozhu, LIU Ranjia, GUO Mingxing, ZHAO Ying, DAI Wendi, CUI Xiangli
    2024, 21(5): 572-579. 
    DOI: 10.19803/j.1672-8629.20230771

    Abstract ( 79 )   PDF (1466KB) ( 92 )  
    Objective To mine and analyze data on adverse events among liver or kidney transplant recipients following COVID-19 vaccination based on the Vaccine Adverse Event Reporting System (VAERS). Methods The data on adverse events related to COVID-19 vaccines among liver or kidney transplant patients and collected between December 18, 2020 and May 24, 2023 was retrieved before being analyzed using disproportionality methods. Adverse events involving more than 3 cases were screened and analyzed via system organ classification. Results 253 and 817 adverse events related to COVID-19 vaccines were respectively collected among recipients of liver and kidney transplant. The common adverse reactions were headache, fatigue, fever, chills, limb pain, dizziness, cough and diarrhea, involving 13 system organ classifications of both liver and kidney transplant recipients. New adverse event signals that deserved clinical attention included deterioration of conditions, acute renal injury, elevated serum creatinine, atrial fibrillation, elevated alanine aminotransferase, transplant rejection, and decrease of blood oxygen saturation. Conclusion A number of new adverse event signals have been detected, which can provide reference for subsequent development of COVID-19 vaccines for liver and kidney transplant patients.
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    Adverse events of abemaciclib in breast cancer patients based on US FAERS database
    SU Xiaohan, ZENG Jiao, LI Xue, LIU Lixin, HOU Lingmi, LI Jinsui
    2024, 21(5): 580-586. 
    DOI: 10.19803/j.1672-8629.20240131

    Abstract ( 122 )   PDF (1492KB) ( 141 )  
    Objective To analyze adverse drug events (ADE) of abemaciclib used in breast cancer patients that were reported in FAERS (FDA Adverse Event Reporting System) database in order to provide clinical data for rational use of this drug among breast cancer patients. Methods Adverse event reports of breast cancer patients using abemaciclib between October 1, 2017 and September 30, 2023 were retrieved from the FAERS before being categorized based on the Medical Dictionary for Regulatory Activities (MedDRA), System Organ Class (SOC), and Preferred Term (PT). Suspected risk signals were analyzed using the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence interval neural propagation network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS). Results After duplicates were excluded, a total of 5 579 ADE of abemaciclib were retrieved. Following screening and analysis, 46 valid signals were identified that were of 16 SOC. The top three ADE were diarrhea, drug ineffectiveness, and dehydration. The top three signal strengths were treatment response loss, milk intolerance, and subcutaneous emphysema. Additionally, 19 suspicious signals, including renal tubular necrosis, kidney injury, sleep disorders (insomnia type), mediastinal emphysema, erythema multiforme, disseminated intravascular coagulation, and transient ischemic attack not mentioned in the product label deserved attention. Conclusion When this medication is adopted, clinicians should also watch for potential ADEs such as renal tubular necrosis and kidney injury that are not listed in the instructions to ensure the safety of the patients.
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    Literature research on ancient and modern literature of Dichroae Radix and Shu lacquer
    HU Xiaozhen, MA Lina, HE Ting, GU Yuanyuan, ZHAO Wei, ZHENG Changhui, YE Zuguang, CAO Junling
    2024, 21(5): 587-593. 
    DOI: 10.19803/j.1672-8629.20240070

    Abstract ( 63 )   PDF (1492KB) ( 63 )  
    Objective To study the source, areas of production, taste, efficacy and toxicity of Dichroae Radix and Shu lacquer in order to provide reference for research and rational application of Dichroae Radix and Shu lacquer. Methods Using the 5th edition of Chinese Medical Classics Database, Duxiu Database and Chinese Medicine Think Tank Online Ancient Book Database as the subject, the origin, areas of production, flavor, meridian tropism, efficacy and toxicity of Dichroae Radix and Shu lacquer were studied. At the same time, in-depth exploration was carried out in combination with modern literature research. Results It was found that Dichroae Radix and Shu lacquer were called differently and were widely distributed. They preferred cool and humid environments. The yield was the largest and the quality highest in Sichuan. The taste and meridian tropism of Dichroae Radix were found to change little in the records of ancient books, but there were differences in the records of Shu lacquer taste. In ancient books, the efficacy of Dichroae Radix and Shu lacquer was mostly to cure malaria and stop vomiting. Modern pharmacological studies found that they also had anticoccidial, anti-tumor, antipyretic, antihypertensive, anti-influenza and other pharmacological effects. However, because of toxicity, they used to be made less toxic and more effective via processing and compatibility, but now via structural modification and toxicity mechanism of their active ingredients. Conclusion Dichroae Radix and Shu lacquer not only have a variety of pharmacological activities such as anti-tumor and anti-malaria properties, but promise good prospects. However, their toxicity poses an obstacle to clinical applications. As processing and compatibility were adopted in the past, modern scholars have attempted to reduce toxicity and increase efficiency through structural modification and change of administration routes. This study is expected to offer a new line of thought for related research.
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    Research progress in drug-pair compatibility principles of Psoraleae Fructus based on theories of seven features of compatibility
    WANG Xiaoyan, CHEN Xiaofei, ZHANG Hui, ZHANG Mingliang, WU Yali, YANG Liuqing, TANG Jinfa, LI Weixia
    2024, 21(5): 594-600. 
    DOI: 10.19803/j.1672-8629.20230758

    Abstract ( 90 )   PDF (1454KB) ( 88 )  
    Objective To summarize the research progress related to Psoraleae Fructus drug pairs based on the theory of seven features of compatibility, and provide data for rational clinical applications of Psoraleae Fructus. Methods Through literature research and analysis, the research progress concerning Psoraleae Fructus drug pairs was summarized in terms of mutual reinforcement/assistnce, synergistic effect enhancement, mutual restraint/suppression, reduction of toxicity and side effects, and compatibility contraindications. Results Based on theories of seven features of compatibility and on studies of clinical medication principle of Psoraleae Fructus drug pairs, it was found that the mutually-reinforcing and mutually-assisting herb pairs of Psoraleae Fructus included Myristicae Semen, Cnidh Fructus, Foeniculi Fructus, Alpiniae Oxyphyllae Fructus, Cinnamomi Cortex, Euodiae Fructus, Morindae Officinalis Radix, Eucommiae Cortex, Drynariae Rhizoma and Curculiginis Rhizoma while the mutually-restricting and mutually-suppressing herb pairs included Juglandis Semen, Rehmanniae Radix, Schisandrae Chinensis Fructus, Paeoniae Radix Rubra. The mutually-inhibiting and mutually-antagonizing herb pairs included Glycyrrhizae Radix Et Rhizoma and Epimedii Folium. Conclusion This article summarizes the drug pairs that are often compatible with Psoraleae Fructus, providing ideas for clinical prescriptions.
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