Archive

15 October 2024, Volume 21 Issue 10 Previous Issue    Next Issue

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Research progress in mechanisms of acquired drug resistance and EGFR-targeted therapy tolerance in non-small cell lung cancer XIE Sihua, GAO Zhichao, ZHANG Wei, XING Jiahui, LIANG Jingwei, MENG Fanhao 2024, 21(10): 1081-1086.  DOI: 10.19803/j.1672-8629.20240287 Abstract ( 170 )   PDF (1192KB) ( 131 )   Objective To summarize the progress in treatment of non-small cell lung cancer (NSCLC) with mutations by specific tyrosine kinase inhibitors (EGFR-Tkis) that target the epidermal growth factor receptor (EGFR). Methods Targeted therapies with EGFR currently available were highlighted. The common mechanisms of EGFR-TKIs resistance were elaborated. The characteristics of drug-tolerant persister (DTP) cells and the mechanism of EGFR mutation leading to drug resistance in NSCLC were discussed. Results EGFR-targeted therapies could cause drug-resistance or drug-resistant cells, ultimately leading to tumor recurrence. Conclusion Insights into drug tolerance and underlying causes of resistance can help improve the effectiveness of cancer treatment. References | Related Articles | Metrics

Select

Effect of long-term oral administration of Asari Radix et Rhizoma decoction and its main aristolochic acid analogs to mice main organs LIU Meiting, MENG Jing, TIAN Jingzhuo, ZHAO Yong, YI Yan, LI Chunying, LIU Chenyue, CUI Shuang, ZHANG Yushi, WANG Lianmei, LIANG Aihua 2024, 21(10): 1087-1094.  DOI: 10.19803/j.1672-8629.20240200 Abstract ( 113 )   PDF (2356KB) ( 102 )   Objective To investigate the toxicological effect of single-dose intragastric administration of Asari Radix et Rhizoma powder and Asari Radix et Rhizoma decoction, and 24-week continuous intragastric administration of Asari Radix et Rhizoma decoction and the equal amount of its major aristolochic acid analogs (AAs) to mice main organs, so as to provide reference for the clinical drug safety application. Methods Acute toxicity experiment: mice were intragastric administrated with Asari Radix et Rhizoma powder (692 times the clinical dose, 11.54 g·kg-1), or Asari Radix et Rhizoma decoction (500 times the clinical dose, 25 g·kg-1; 1 000 times the clinical dose, 50 g·kg-1), then the toxicity to mice were observed within 14 days since administration. Long-term toxicity experiment: Mice were randomly divided into a blank control group, a media control group (0.02% CMC-Na), a positive drug group of aristolochic acid-Ⅰ group (AA-Ⅰ, 27.2 μg·kg-1), an aristolochic acid-Ⅳa group (AA-Ⅳa, 27.2 μg·kg-1), an aristolactam-Ⅰ group (AL-I, 13.5 μg·kg-1), a low-dose group of Asari Radix et Rhizoma decoction (10-time the clinical dose, 0.5 g·kg-1), a middle-dose group of Asari Radix et Rhizoma decoction (31.6-time the clinical dose, 1.6 g·kg-1) and a high-dose group of Asari Radix et Rhizoma decoction (100-time the clinical dose, 5 g·kg-1). Organs were weighed and pathologically examined at 12, 24 weeks and 24 weeks followed by 8 weeks withdraw since drug administration. Results Acute toxicity experiment: All mice died within 5~30 minutes after administration of the Asari Radix et Rhizoma powder. No deaths or abnormalities present in Asari Radix et Rhizoma decoction treated mice during the 14-day observation period. Long-term toxicity experiment: After 24 weeks of continuous administration of Asari Radix et Rhizoma decoction and its major aristolochic acid analogs (AA-Ⅳa, AL-I), mice showed no significant abnormalities in contrast to control cohort. And there were no drug-induced pathological changes in heart, lungs, spleen, adrenal glands, brain and testes in the drug treated mice compared with the control mice. In addition, no delayed toxicity was observed after 8 weeks of drug withdrawal. Conclusion The Asari Radix et Rhizoma decoction is relatively safe, in addition, the equivalent amount of AA-Ⅳa, AL-I contained in the high dose of Asari Radix et Rhizoma decoction is relatively safe in this study. However, taking into account the limited data in this study, it is still not recommended to use Asari Radix et Rhizoma decoction in continuous overdose. References | Related Articles | Metrics

Select

Effect of blood-activating and stasis resolution therapy on hematoma volume and neurological deficit in rats with acute cerebral hemorrhage across different time points XING Yichao, LIU Ruofan, WANG Yue, ZHANG Genming 2024, 21(10): 1095-1102.  DOI: 10.19803/j.1672-8629.20240281 Abstract ( 70 )   PDF (1688KB) ( 75 )   Objective To observe the effect of activating blood circulation and resolving stasis at different time points on the volume of hematoma and the degree of neurological deficit in rats with acute intracerebral hemorrhage, explore whether the adoption of this method during the acute phase increases the risk of hematoma expansion, compare the effects of medication at different timing, and to explore its mechanism of action. Methods Forty SPF-grade SD rats were randomly divided into three groups: the sham operation group, model group, experimental group. The experimental group was divided into pre-administration group, 6 h group and 24 h group according to the time of first administration. Intracerebral hemorrhage in rats was induced by injection of type Ⅶ collagenase into the caudate nucleus. Before modeling, the pre-administration group was given Naoxueshu oral liquid daily by intragastric administration for 7 consecutive days, and the other groups were given the same amount of normal saline daily. After the modeling was successful, the pre-administration group and the 6 h group were given the first dose at 6 h after the modeling, the 24 h group was given the first dose at 24 h after the modeling, and the sham operation group and the model group were given the same amount of normal saline until 72 h after the modeling. Magnetic resonance imaging was used to assess hematoma volumes 24 and 72 hours after modeling, and the behavioral neurology of rats was recorded and evaluated using the modified Neurological Deficit Score. Finally, the expression level of CD36 in rat brain tissue was determined using Western blot. Results Evaluation of hematoma volumes: Compared with 24 hours after modeling, the hematoma volumes in the pre-administration group, 6-hour group, and 24-hour group were significantly reduced at 72 hours after modeling (P<0.05). Intergroup comparison showed that the hematoma clearance rate in each experimental group was lower than that of the model group (P<0.01). Neurological deficit score: At 72 hours after modeling, the neurological deficit scores in the experimental groups were significantly lower than those in the model group (P<0.05). CD36 expression: At 72 hours after modeling, the expressions of CD36 in the pre-administration group and 6-hour group were significantly higher than that of the model group (P<0.05). Conclusion The method of activating blood and resolving stasis during the acute phase does not increase the risk of bleeding, and the effect of early medication on hematoma clearance is stronger. The mechanism of action may be related to promotion of the phagocytic function of microglia after mediation by CD36, unlike anticoagulant or antiplatelet drugs. References | Related Articles | Metrics

Select

Effect of targeting c-Met/CD47 CAR-T cells on ovarian cancer cells WANG Rumeng, SI Qin 2024, 21(10): 1103-1112.  DOI: 10.19803/j.1672-8629.20240339 Abstract ( 63 )   PDF (3599KB) ( 89 )   Objective To investigate the effect of knocking down the expression of mesenchymal-epithelial transition factor (c-Met) on proliferation, invasion, migration and apoptosis of ovarian cancer cells in vitro, prepare chimeric antigen receptor T (CAR-T) targeting c-Met and observe its ability to kill ovarian cancer cells. Methods The expression of c-Met in three ovarian cancer cell lines was detected by real-time fluorescence quantitative polymerase chain reaction and Western blotting. The c-Met was knocked down by transfection, and cell proliferation was detected by cell counting kit-8 (CCK-8) and cell cloning. Cell invasion and cell scratch were used to detect cell invasion and migration ability. The cell cycle, apoptosis and the positive rate of lentivirus infected cells were detected by flow cytometry. CCK-8 was used to detect the proliferation of CAR-T cells stimulated by target cells. Lactate dehydrogenase assay was used to detect the killing rate of cells while the release of interferon-γ (IFN-γ) and interleukin-2 (IL-2) was detected by enzyme-linked immunosorbent assay. A subcutaneous xenograft model of nude mice was established before T, CAR-T, c-Met CAR-T, c-Met/CD47 CAR-T effector cell groups were injected. The tumor weight was measured. Hematoxylin-eosin staining and immunohistochemistry were used to study the therapeutic effect of CAR-T cells against ovarian cancer. Results The expression of c-Met in SKOV3 cell line was high. Compared with the control group, the cell proliferation, invasion, migration ability of the c-Met knockdown group decreased while the apoptosis rate increased. G1 and S phase decreased while G2 phase increased. Flow cytometry showed that the infection efficiency of CAR-T, c-Met CAR-T and c-Met/CD47 CAR-T cells was 97.42%, 97.39% and 97.35%, respectively. CCK-8 assay indicated that the proliferation potential of c-Met/CD47 CAR-T cells to target cells was significantly enhanced. LDH assay suggested that the killing rate of c-Met/CD47 CAR-T cells to target cells was significantly increased. ELISA showed that SKOV3 induced c-Met/CD47 CAR-T cells to release more IFN-γ and IL-2. The weight of transplanted tumor in the c-Met/CD47 CAR-T cell group was lighter than in T, CAR-T and c-Met CAR-T cell groups when SKOV3 cells were injected subcutaneously. HE results showed that there was no physiological structure damage in the tissues and organs of each cell treatment group. Conclusion c-Met/CD47 can be used as a molecular target for CAR-T cell therapy for ovarian cancer, which can target and recognize ovarian cancer cells with higher c-Met expression. The stronger the killing ability, the better the proliferation ability and cytokine release level. References | Related Articles | Metrics

Select

Comparative study of bacterial endotoxin capability verification project at China and abroad XU Meibao, PEI Yusheng, Liu Yadan, CHEN Chen, DU Ying, LI Wenlong, LIU Tao, CAI Tong 2024, 21(10): 1113-1117.  DOI: 10.19803/j.1672-8629.20240352 Abstract ( 114 )   PDF (1178KB) ( 101 )   Objective To improve the quality control of bacterial endotoxin detection in laboratories by comparing and analyzing domestic and international bacterial endotoxin proficiency testing schemes and results, and summarizing the experience in designing proficiency testing schemes. Methods Introduce the contents and characteristics of the bacterial endotoxin proficiency testing program organized by the EDQM, Charles River and NIFDC, the correlation between the source of the sample to be tested and the satisfaction rates and result evaluation methods were analyzed. Results Each organization's proficiency testing has its own characteristics and it was found that the satisfaction rates of proficiency testing using real samples and multiple test samples were significantly lower than those using standard samples. Conclusion It is suggested that multiple modes of proficiency testing should be adopted for bacterial endotoxin detection. Proficiency testing schemes should emphasize the use of real samples and strengthen research on the uncertainty of bacterial endotoxin detection. This will further improve the level of domestic bacterial endotoxin detection proficiency testing and ensure the quality and safety of injectable drugs. References | Related Articles | Metrics

Select

Research on pharmacovigilance of traditional Chinese medicine based on knowledge graphs analysis ZHANG Xiaomeng, HE Xin, YANG Ying, ZHANG Bing, LIN Zhijian 2024, 21(10): 1118-1124.  DOI: 10.19803/j.1672-8629.20240391 Abstract ( 172 )   PDF (2882KB) ( 168 )   Objective To construct a knowledge graph for pharmacovigilance research in traditional Chinese medicine (TCM) by analyzing publicly published journal literature from both domestic and international sources, which is to identify research hotspots and future development directions in the field. Methods Relevant literatures published by academic and research institutions on “pharmacovigilance of TCM” published during the previous decade was searched using the National Knowledge Infrastructure of China and Web of Science databases. The knowledge graph was analyzed using CiteSpace software to explore author distribution, keyword co-occurrence, keywords clustering, and keywords burst. Results Three primary research teams and institutions were highlighted in a total of 2 785 Chinese and 229 English articles. The three main areas of research concentration were risk avoidance, rational medication, identification of adverse reactions to TCM, and understanding the processes of TCM toxicity. The study material had consistently been expanded and improved. Hotspots for publications, both domestically and internationally, have distinct focuses. There had been a continuous emphasis on safety concerns related to injections used in TCM. A mental map of TCM pharmacovigilance research and development was created by integrating the current knowledge of the field with future development prospects. Conclusion To establish pharmacovigilance, it is essential to honor the principles of TCM, while effectively utilizing modern technology, which will also contribute to the advancement of international pharmacovigilance of botanical medicines. References | Related Articles | Metrics

Select

Real-world data on medications with vitamin injections SUN Xuelin, DU Jiao, TAN Qin, ZHANG Yatong, HU Xin 2024, 21(10): 1125-1129.  DOI: 10.19803/j.1672-8629.20240546 Abstract ( 101 )   PDF (1331KB) ( 102 )   Objective To analyze the usage of vitamin injections among inpatients so as to provide references for clinical medications and monitoring of drug use. Methods The data was collected from 10 A-class hospitals. Inpatients who had been treated with vitamin injections between 2020 and 2022 were selected as the subjects. The baseline information of the patients, departments, diagnosis, and medications was collected. MySQL 5.7 and Stata 17 software were used for data governance and statistical analysis. The counting data was statistically described by the number of cases and composition ratio. Results Vitamin injections were used 31 307 times, 17 860 of which involved males (57.05%). The percentage of people over 60 years old was 52.23%. Most of the patients paid via medical insurance (92.51%). The top five departments in terms of usage were the Department of General Surgery (23.43%), Department of Intensive Care Medicine (9.90%), Anorectal Department (8.15%), Department of Oncology (7.75%), and Department of Urology (7.52%). The top five diseases involved were pneumonia (the pathogens not specified) (5.14%), gastric malignant tumor (4.64%), other medical care (3.72%), colon malignant tumor (3.56%), malignant tumor in unspecified locations (3.40%). Potassium chloride (4.48%), insulin (2.40%), human albumin (1.43%), furosemide (1.09%), calcium gluconate (1.08%), heparin (1.04%), compound amino acids (18AA-II) (1.00%) were the combined medications most frequently used. Conclusion The real-world data suggests that the usage of vitamin injections is the highest among patients under general surgery, and among patients with pneumonia (pathogens not specified). The analysis of medications with vitamin injections has revealed the characteristics of patients involved, which can benefit medications and patients. References | Related Articles | Metrics

Select

Identification and clinical characteristics of potential suspicious traditional Chinese medicines in traditional Chinese medicine-related liver injury WANG Hengxin, DUN Wenliang, HU Jinwen, LI Qing, ZHAO Zeyu, LUO Tianjiong 2024, 21(10): 1130-1136.  DOI: 10.19803/j.1672-8629.20240246 Abstract ( 165 )   PDF (1466KB) ( 157 )   Objective To study ways to discover risk signals of drug-induced liver injury by using the big data platform of the hospital, to screen out the related traditional Chinese medicines that may induce liver injury, and to analyze the risk factors for liver injury. Methods The diagnosis of DILI started with confirmation of liver injury with the data from June 1, 2019 to June 1, 2023, followed by the exclusion of other liver diseases before the causal relationship between drugs and liver injury was quantitatively evaluated using the Roussel-Uclaf causality assessment method (RUCAM). Experienced experts were consulted to exclude inpatients who used chemical drugs (mostly class A and class B drugs) for drug-induced liver injury caused by drug combination before suspicious Chinese medicine varieties were found and sorted out, which were divided into four categories: possible, probable, unlikely and impossible. Results A total of 2 056 patients with abnormal liver function were collected, 142 of whom with possible Chinese medicine-related liver injury were screened out. The types of possible and probable drugs included antidepressants, herbal medicines for removing heat and toxins, activating blood circulation and reducing blood stasis, and for dispelling winddampness. Conclusion There is a wide range of suspected traditional Chinese medicines. The occurrence of drug-induced liver injury may be related to the state of the human body and the drug itself. The mechanism of drug-induced liver injury may be related to immune inflammation. References | Related Articles | Metrics

Select

Adverse drug reaction reports in 141 cases of orally administered targeted anti-tumor drugs GUO Yijun, CHEN Xia, MENG Ping 2024, 21(10): 1137-1142.  DOI: 10.19803/j.1672-8629.20240139 Abstract ( 124 )   PDF (1469KB) ( 131 )   Objective To study the characteristics and number of reports of oral adverse drug reaction (ADR), and to explore suspicious ADR signals, so as to provide references for clinical safe drug use. Methods Due to the research needs of the project, statistical analysis was conducted on 141 ADR reports caused by oral targeted anti-tumor drugs received by a drug adverse reaction monitoring center in a certain city from January 1, 2018 to December 31, 2022, including patient age, gender, underlying disease, ADR occurrence time, Severity and outcome of ADR, ADR involvement of system organs, ADR clinical manifestations, and occurrence cases. The reporting odds ratio (ROR) method was used to mine ADR signals. Results The 141 cases of ADR involved a total of 23 drugs, with a total of 164 ADR symptoms affecting 13 systemic organs. The top three ADR occurrences were rash (28 cases, 17.07%), hypertension (16 cases, 9.76%), and diarrhea (14 cases, 8.54%). A total of 8 suspected ADR signals related to drugs were identified. Three signals of hypertension, oral ulcers, and hand foot syndrome were identified from anlotinib. Three signals of hypertension, hand foot syndrome, and proteinuria were identified from Apatinib. Two signals of rash and diarrhea were identified from osimertinib. One signal of rash was detected from afatinib, one signal of rash was detected from dacotinib, and one signal of rash was detected from gefitinib. One signal of rash was identified from imatinib. Dig out one signal of diarrhea from Regorafenib. Conclusion During the use of oral targeted anti-tumor drugs by patients, special groups such as the elderly should be closely monitored. Focus on patients within the first month of taking medication. Focus on monitoring ADR such as rash, hypertension, diarrhea, hand foot syndrome, oral ulcers, proteinuria, and take preventive and treatment measures. References | Related Articles | Metrics

Select

Ninety-seven cases of adverse drug reaction caused by urinary kininogenase for injection CHEN Chunyan, TANG Yingjie, ZHAO Haixia, PAN Huimin, ZHU Qingmei 2024, 21(10): 1143-1147.  DOI: 10.19803/j.1672-8629.20240064 Abstract ( 97 )   PDF (1346KB) ( 102 )   Objective To analyze the characteristics and patterns of adverse drug reaction (ADR) caused by urinary kininogenase for injection so as to provide reference for rational use of this drug. Methods A total of 97 cases of ADR related to urinary kininogenase for injection reported between 2020 and 2023 were collected. The basic data, types of ADR, clinical manifestations, involved systems-organs, and rationality of medication were analyzed. Results Among the 97 cases of ADR related to urinary kininogenase for injection, male patients outnumbered female ones (64 cases, 65.98%). The course of treatment ranged from one day to thirteen days. There were 85 patients treated with antihypertensive drugs or other cerebral infarction drugs. Most of these ADR occurred within 24 hours of the first use of drugs, and involved the cardiovascular, neurological/psychiatric, and digestive systems, with such clinical manifestations as decreased blood pressure, sweating, nausea and vomiting, most of them improved after drug withdrawal or symptomatic treatment. There were 29 cases of new ADR, 2 cases of severe ADR, and 1 case of new and severe ADR. In total, there were 14 cases of irrational medication. Conclusion There is the need to improve the ADR monitoring of urinany kininogenase for injection to ensure the safety of medications. References | Related Articles | Metrics

Select

Seventy-nine cases of tislelizumab-related adverse reactions WANG Ying, HUANG Shan, SHENG Qinyong, LIAN Xia, CHANG Ying, JIANG Yan, LIN Bing, HUANG Aiwen 2024, 21(10): 1148-1153.  DOI: 10.19803/j.1672-8629.20240261 Abstract ( 119 )   PDF (1306KB) ( 130 )   Objective To analyze the regularity and clinical characteristics of adverse drug reactions (ADR) induced by tislelizumab in order to provide references for safe and rational drug use. Methods Seventy-nine reports of adverse reactions related to tislelizumab submitted by our hospital to the national ADR Monitoring System from January 1, 2020 to March 31, 2024 were retrospectively analyzed, involving patients' demographics, types of drugs used, times of adverse reactions, clinical presentations, organs and/or systems involved, severity, management and outcomes, causality assessment, and off-label use. Results Among these cases of tislelizumab-related adverse reactions, 88.61% occurred after one to five medication cycles. Affecting multiple organs and systems, the main manifestations included bone marrow suppression, skin toxicity, thyroid dysfunction, and liver function abnormalities. Myasthenic syndrome and anaphylactic shock were serious ADR not specified in drug instructions. After discontinuation of the drug and symptomatic treatment, most of the cases improved. Conclusion A few severe adverse reactions of tislelizumab can lead to life-threatening consequences. Close monitoring during clinical use is recommended, with timely symptomatic treatment to reduce severe adverse reactions. References | Related Articles | Metrics

Select

Mining of adverse event signals of lamivudine in the kidney and urinary system based on FAERS LI Jinyang 2024, 21(10): 1154-1158.  DOI: 10.19803/j.1672-8629.20230666 Abstract ( 104 )   PDF (1349KB) ( 104 )   Objective To mine the risk signals related to lamivudine-caused adverse events (AE) of the kidney and urinary system based on the Food and Drug Administration Adverse Event Reporting System (FAERS), and provide references for clinical safe drug use. Methods AE in the FAERS database collected between the first quarter of 2004 and the second quarter of 2023 were retrieved. According to the primary suspected drugs, the method of the reporting odds ratio (ROR) and compression estimation algorithm were used to identify the risk signals of AE associated with lamivudine in the kidney and urinary system by taking tenofovirdisoproxil, nevirapine, zidovudine and adefovirdipivoxil as control. Subgroup signal mining was performed on HIV and HBV patients respectively. Results There were 1 165 AE related to the kidney and the urinary system with lamivudine as the primary suspected drug and 2 713 cases in the control group. The risk of renal impairment by lamivudine was higher than in the control group, so was the risk of renal failure in the HIV group and toxic nephropathy in the HBV group. HIV complicated with HBV infection was a risk factor for renal impairment by lamivudine. Conclusion The AE signals of the kidney and urinary system based on FAERS point to the risk of lamivudine-caused damage to the kidney and urinary system, which could provide references for long-term use of lamivudine. References | Supplementary Material | Related Articles | Metrics

Select

Mining of adverse event signals of polatuzumab vedotin based on FAERS GU Chenchen, ZONG Liuliu, YAO Yamin, SHEN Jie 2024, 21(10): 1159-1165.  DOI: 10.19803/j.1672-8629.20240215 Abstract ( 79 )   PDF (1408KB) ( 99 )   Objective To mine information from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database to analyze adverse reaction signals of polatuzumab vedotin for clinical use. Methods The reports in the FAERS database collected between January 1, 2004 and June 30, 2023 were screened using SAS 9.4, and the signal values of the screened data were calculated by using the reporting odds ratio (ROR) and information component (IC) before being assessed according to the signal detection criteria. Results The number of reports that screened polatuzumab vedotin as the primary suspect drug (PS) was 636. After such signals were excluded as product defects, surgical and medical procedures and primary disease, 233 cases of positive polatuzumab vedotin-related AD signals were recorded. The ADE signals that ranked high in terms of the number of reported cases included off-label use, COVID-19, pyrexia, platelet count decreases and cytopenia. Among them, such signals as COVID-19, renal impairment and cardiac failure were not included in the labels. ADE signals with higher strength included subclavian vein stenosis, cytomegalovirus gastrointestinal ulcer and olfactory dysfunction, but subclavian vein stenosis and olfactory dysfunction were not included in the labels. Conclusion The suspicious signals for polatuzumab vedotin mined so far are generally consistent with those specified in the instructions. The use of polatuzumab vedotin requires not only close attention to such adverse reactions mentioned in the label as neutropenia, thrombocytopenia and peripheral neuropathy, but vigilance to potential ADE, such as renal failure, cardiac failure, thromboembolism, and COVID-19 infection. Blood test, cardiac and renal function should be closely monitored. Abnormalities of sensory nerves, motor nerves and autonomic nerves have to be observed. Immediate preventive and curative measures are needed to reduce the risk of clinical medications when necessary. References | Related Articles | Metrics

Select

Pharmaceutical care of a case with vertebral osteomyelitis of Coxiella burnetiid SHEN Jianghua, KONG Chao, PAN Fumin, CHU Yanqi 2024, 21(10): 1166-1168.  DOI: 10.19803/j.1672-8629.20240221 Abstract ( 65 )   PDF (1141KB) ( 79 )   Objective To explore the starting point where clinical pharmacists can carry out pharmaceutical care for patients with special infections by studying one case of Coxiella burnetii vertebral osteomyelitis. Methods Clinical pharmacists participated in the treatment of one case of lumbar spine infection caused by Coxiella burnetii, assisted clinicians in analyzing the patient's history and etiology, proposed medications with sensitive drugs, provided sustainable pharmaceutical care for the patient, got involved in evaluating the therapeutic effect, and kept adjusting the drug treatment plans. Results and Conclusion Clinical pharmacists assisted doctors in opting for medications and ensuring stable improvement of the patient' conditions. Clinical pharmacists can do much to ensure the safety of medications by participating in a treatment team and starting with rare site infections caused by special pathogens. References | Related Articles | Metrics

Select

One case of severe allergic reactions caused by oxytocin injection JU Kanglu, CHANG Ying, LIU Zhenguo 2024, 21(10): 1169-1171.  DOI: 10.19803/j.1672-8629.20240316 Abstract ( 133 )   PDF (1157KB) ( 128 )   Objective To analyze severe allergic reactions caused by oxytocin injection so as to provide references for safe and rational drug use. Methods One rare case of severe allergic reactions in a patient with missed abortion was reported, who had manifested critical symptoms after two minutes of intravenous infusion of oxytocin on the second day of continuous injection. Related literature was retrospectively analyzed. The causes and preventive measures were studied. Results The severe allergic reactions were likely related to oxytocin injection, and such cases were very rare. The symptoms were relieved after effective anti-allergic treatment. Conclusion Clinicians need to prevent severe allergic reactions caused by oxytocin injection, and early detection and treatment are crucial. References | Related Articles | Metrics

Select

One case of anaphylactic shock caused by pamidronate disodium glucose injection LIU Meng, FANG Ke, YAN Jiaju, LIU Meng, HE Manyun, WEI Liangbing 2024, 21(10): 1172-1174.  DOI: 10.19803/j.1672-8629.20240106 Abstract ( 77 )   PDF (1255KB) ( 92 )   Objective To investigate the characteristics of anaphylactic shock triggered by pamidronate disodium in order to provide data for the prevention and treatment of adverse reactions and ensure safe medications. Methods One case of anaphylactic shock induced by pamidronate disodium was reported, with the correlations assessed using the evaluation method recommended by the National Adverse Drug Reaction Monitoring Center. Additionally, literature on the common adverse reactions and pathogenesis related to pamidronate disodium was reviewed to explore the potential causes and preventive strategies. Results The patient's clinical conditions and the timing of drug administration strongly suggested that pamidronate disodium was the likely cause of anaphylactic shock,so immediate and effective treatment was offered to alleviate the symptoms. Conclusion Clinicians who prescribe pamidronate disodium should be alert to the risk of anaphylaxis. It is crucial to enhance monitoring of adverse reactions and ensure the availability of emergency medications and equipment during treatment. References | Related Articles | Metrics

Select

One case of severe allergic shock caused by misoprostol tablets JIANG Renjun, QIN Shuyong, WANG Yuan, LUO Sui 2024, 21(10): 1175-1177.  DOI: 10.19803/j.1672-8629.20240201 Abstract ( 109 )   PDF (1186KB) ( 84 )   Objective To study one case of allergic shock caused by misoprostol tablets and the effects of different administration routes so as to provide references for safe use. Methods The clinical data of a 29-year-old patient with medical abortion due to 400 μg of misoprostol tablets sublingually was reviewed and the cause of allergic shock leading to cardiac arrest was analyzed. Medications were recommended after related literature was consulted. Results Allergic shock and cardiac arrest occurred in the patient who had received misoprostol tablets sublingually. The analysis of medications time of delivery pointed to severe adverse drug reactions (ADR). By analyzing relevant literature and cases, it was found that ADR might occur through different administration routes. Conclusion Misoprostol tablets may increase the risk of cardiac arrest, so clinical vigilance is required. References | Related Articles | Metrics

Select

One case of neuromuscular block caused by clindamycin phosphate for injection ZHANG Hao, CAO Shugang, HE Jun, XU Wenan, XIA Mingwu 2024, 21(10): 1178-1180.  DOI: 10.19803/j.1672-8629.20240295 Abstract ( 96 )   PDF (1173KB) ( 92 )   Objective To investigate such adverse reactions as neuromuscular blockade caused by clindamycin phosphate for injection so as to provide references for clinical safe use. Methods Based on related literature, one case of myasthenia gravis in a 51-year-old patient with periodontal abscess after receiving clindamycin phosphate for injection was analyzed. Results The patient experienced muscle weakness after taking tinidazole and clindamycin phosphate for injection. The symptoms were considered to be adverse reactions related to clindamycin phosphate for injection. After symptomatic treatment, the patient's muscle strength was largely normalized. Conclusion In case of myasthenia gravis, the possibility of the symptoms being caused by clindamycin phosphate for injection should be considered. Clindamycin phosphate for injection should be used with caution in patients who are taking neuromuscular blocking drugs concurrently. References | Related Articles | Metrics

Select

One case of secondary amenorrhea caused by thalidomide tablets in a β-thalassemia patient YIN Chunyan, KONG Wenqiang, YANG Kun 2024, 21(10): 1181-1183.  DOI: 10.19803/j.1672-8629.20240468 Abstract ( 80 )   PDF (1360KB) ( 86 )   Objective To explore the clinical characteristics and mechanism of secondary amenorrhea caused by thalidomide in a β-thalassemia patient. Methods Secondary amenorrhea caused by thalidomide in a β-thalassemia patient was analyzed, while the manifestations and pathogenesis were summarized based on literature review. Results The patient developed amenorrhea after 5 months of thalidomide treatment. Four months later, spontaneous menses returned and her hormonal profile returned to normal. The adverse reaction was believed to have been caused by thalidomide. Conclusion Thalidomide can cause hypergonadotropin amenorrhea, so clinicians should be alert to the risk during treatment. References | Related Articles | Metrics

Select

Research progress on the mechanism of action and drugs of FXR in the treatment of cholestatic liver diseases HU Li, YANG Weifeng, LIU Ting, FENG Weihong, LU Chenna, LI Chun 2024, 21(10): 1184-1191.  DOI: 10.19803/j.1672-8629.20240531 Abstract ( 64 )   PDF (1504KB) ( 80 )   Objective To review the mechanism of action of farnesoid X receptor (FXR) in the treatment of cholestatic liver disease and the research progress of drugs targeting FXR. Methods The mechanism of FXR in improving cholestasis by regulating bile acid production, metabolism, transport and enterohepatic circulation was expounded. The anti-inflammatory, antioxidant and anti-fibrosis effects and mechanisms of FXR were discussed. The therapeutic effects of steroid and non-steroid FXR agonists and FXR antagonists and the progress of clinical trials were reviewed. Results and Conclusion Cholestatic liver disease is a group of common clinical diseases with cholestasis as the main manifestation. Its pathogenic mechanism is complex, which also determines the complexity of medication to a certain extent. Nuclear receptors can regulate the homeostasis of bile acid and are currently a hot research topic for drug targets for the treatment of cholestasis. FXR plays a vital role in maintaining bile acid balance. It is a physiological bile acid nuclear receptor and is regarded as the main therapeutic target for cholestasis and related diseases. With the continuous deepening of research on FXR, it was found that it plays a core regulatory role in regulating bile acid homeostasis, anti-inflammation, anti-oxidation and anti-fibrosis aspects. FXR agonists and FXR antagonists are constantly being developed to treat cholestatic liver diseases. References | Related Articles | Metrics

Select

Research progress in reproductive and hepatorenal toxicological mechanisms of Tripterygium wilfordii BAI Xue, TAN Tianyang 2024, 21(10): 1192-1199.  DOI: 10.19803/j.1672-8629.20240116 Abstract ( 91 )   PDF (1821KB) ( 125 )   Tripterygium wilfordii (TW) is a traditional Chinese medicine for treating rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome, and urinary system diseases. TW has such effects as dispelling wind and dampness, promoting blood circulation and unblocking collaterals, reducing swelling and pain, killing insects and detoxification. However, the toxic reactions to the reproductive system, liver, and kidney pose a huge obstacle to TW's clinical applications. Based on literature published over the past 3 to 5 years, the toxicological mechanisms of TW and its active ingredients (Tripterygium glycosides and Triptolide) were analyzed. TW was found to induce mitochondrial defects and apoptosis, promote oxidative stress and inflammatory reactions, activate autophagy and ferroptosis, induce metabolic disorders, and cause toxic reactions to the reproductive system, liver, and kidney. This article is expected to provide references for the toxicological research and clinical applications of TW. References | Related Articles | Metrics