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15 November 2024, Volume 21 Issue 11 Previous Issue   

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Contents 2024, 21(11): 0-0.  Abstract ( 48 )   PDF (461KB) ( 45 )   Related Articles | Metrics

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Risk Signal Mining and Experimental Observations of Febuxostat Cardiotoxicity WANG Xue, DING Xueli, LU Chengjin, CHEN Siying, ZHANG Xiaomeng, ZHANG Bing, LIN Zhijian 2024, 21(11): 1201-1208.  DOI: 10.19803/j.1672-8629.20240393 Abstract ( 79 )   PDF (2112KB) ( 63 )   Objective To evaluate the US spontaneous reporting system of cardiac adverse events of febuxostat, analyze the risks and provide data for safe use of uric acid-lowering drugs. Methods Based on the FAERS database reports of cardiac adverse events of febuxostat from Q1 2004 to Q3 2021, the risk signals were evaluated. In a rat model of hyperuricemia, high dose (7.2 mg·kg-1) and low dose (3.6 mg·kg-1) groups of febuxostat were set up to observe the uric acid level, related cardiac indexes and histopathology in biochemical tests. Results A total of 5 001 adverse reaction reports and 15 989 adverse reactions were retrieved from the FAERS database for febuxostat, and 992 of the adverse reactions with cardiac relevance had 18 cardiac risk signals. Febuxostat cardiotoxicity was more common in males and usually occurred among those over 65. In animal experiments, a significant reduction in uric acid levels was observed in rats administered with febuxostat in a hyperuricemic state, indicating a good uric acid-lowering effect. Such cardiac indicators as AST, CK and cTn-I increased, while LDH and CK-MB levels decreased. MASSON staining showed that the febuxostat groups appeared to have different degrees of fibrosis, with pronounced blue collagen deposition. Conclusion In the clinical use of febuxostat for the treatment of hyperuricemia, cardiac risks ought to be considered to ensure rational use of febuxostat in different clinical populations. References | Related Articles | Metrics

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Systematic Evaluation of Cardiotoxicity of Chinese Herbal Compounds for Breast Cancer Chemotherapy LIU Shujia, ZHANG Xiaomeng, CHEN Siying, CAI Haili, ZHANG Bing 2024, 21(11): 1209-1215.  DOI: 10.19803/j.1672-8629.20240449 Abstract ( 30 )   PDF (2979KB) ( 30 )   Objective To evaluate the applicability and therapeutic effect of Chinese herbal compounds in preventing and treating chemotherapy-induced cardiotoxicity in breast cancer patients. Methods Data on randomized controlled trials (RCTs) of Chinese herbal compounds for chemotherapy-induced cardiotoxicity in breast cancer patients published in domestic and foreign databases was collected and sortde from establishment of the tibrary to April 1, 2024. Excel sheet was used to analyze the related medications while RevMan 5.4 software was adopted to perform Meta-analysis on RCTs that met the inclusion criteria. Results A total of 42 RCTs were included, involving 2 847 subjects. The experimental group was treated with Chinese herbal compounds plus conventional chemotherapy to combat chemotherapy-induced cardiotoxicity. Compared with the control group treated with chemotherapy drugs alone, the incidence of abnormal electrocardiograms was significantly reduced in the experimental group OR=0.23[95%CI (0.19, 0.28), P<0.000 01]. In addition, the left ventricular ejection fraction was increased with an MD of 9.02[95%CI (6.45, 11.60), P=0.000 1], but the expressions of creatine kinase isoenzyme and troponin I were reduced. Conclusion Chinese herbal compounds capable of replenishing qi and nourishing yin, promoting blood circulation and unblocking meridians have prominent advantages in preventing and treating the cardiotoxicity induced by chemotherapy drugs. References | Supplementary Material | Related Articles | Metrics

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Cardiotoxicity of Euodia rutaecarpa(Juss.) Benth. Based on Network Pharmacology and Untargeted Metabolomics YIN Xiaoyang, ZHANG Xiaomeng, LIU Zeyu, LIU Yadi, WANG Yu, LIN Zhijian, ZHANG Bing 2024, 21(11): 1216-1223.  DOI: 10.19803/j.1672-8629.20240472 Abstract ( 25 )   PDF (2597KB) ( 29 )   Objective To explore the potential mechanisms of cardiotoxicity of Euodia rutaecarpa, a long-used traditional Chinese medicine, in order to contribute to clinical safety and risk prevention. Methods Network pharmacology was employed to analyze the target pathways of Euodia rutaecarpa that acted on the heart. In combination with untargeted metabolomics, the impact of Euodia rutaecarpa on cardiac metabolic pathways was investigated in order to find out about the potential mechanisms of cardiotoxicity. Results Network pharmacology identified 51 intersecting targets between Euodia rutaecarpa and cardiotoxicity, such as TNF, IL-6, IL-1β, TP53, and CASP3. These targets were involved in key signaling pathways such as the Advanced Glycation End Products-Receptor (AGE-RAGE) and Mitogen-Activated Protein Kinase (MAPK) pathways. Metabolomics analysis revealed metabolic pathways, including purine metabolism, biosynthesis of valine, leucine, and isoleucine, and the citric acid (TCA) cycle. The combination of network pharmacology and untargeted metabolomics suggested that the cardiotoxicity of Euodia rutaecarpa was related to myocardial energy metabolism, potentially via the disruption of the intracellular TCA cycle, purine metabolism, and protein synthesis and degradation. Conclusion The cardiotoxicity of Euodia rutaecarpa is closely related to its impact on myocardial energy metabolism and exhibits bidirectional effects on the heart. Clinicians should be cautious regarding dosage and symptoms while attaching importance to drug monitoring. References | Related Articles | Metrics

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Risk Analysis and Mechanism Discussion of Cardiovascular, Hepatic, or Nephrotoxicity Induced by Tripterygium Wilfordii CHEN Lijuan, ZHANG Xiaomeng, GAO Fujun, LIU Zeyu, WANG Yu, ZHANG Bing 2024, 21(11): 1224-1231.  DOI: 10.19803/j.1672-8629.20240498 Abstract ( 31 )   PDF (2212KB) ( 36 )   Objective To analyze the characteristics and potential mechanisms of adverse drug reactions/events (ADR/ADE) in the heart, liver, or kidney caused by Tripterygium wilfordii (Leigongteng), with the aim of providing reference for the rational use of medicine in clinical practice. Methods The ADR/ADE in the heart, liver, or kidneys caused by Leigongteng were collected retrospectively from the China National Knowledge Infrastructure (CNKI) from constrac tion to 1, Jan 2024. By using Apriori association analysis and decision tree CART algorithm, the influencing factors that caused by Leigonteng to the heart, liver, or kidneys damage were conducted. After collectting the compounds contained in Leigongteng and the action targets of the heart, liver, or kidneys based on the Traditional Chinese Medicine Systems Pharmacology Analysis Platform and GeneCards database, using network pharmacology to analyze the intrinsic mechanisms of Leigongteng’s multi-organ toxicity. Results A total of 50 cases ADR/ADE involved the heart, liver, or kidneys damage were collected, among which 20 cases involved two or more systems-organs. There was a strong correlation between the toxicity to the heart, liver, or kidneys and the dosage and duration of medication, and there was also a certain association with the patient’s original diseases. 51 compounds from Leigongteng and 153 effective action targets were screened out. Through the use of Venn diagrams, 987 common targets of toxicity to the heart, liver, and kidneys were identified. Protein-protein interaction network and Gene Ontology functional analysis revealed that TP53-mediated apoptosis, AKT1 and STAT3-mediated inflammatory responses may be associated with the multi-organ toxicity of Leigongteng to the heart, liver, and kidneys. Conclusion The multi-organ toxicity caused by Leigongteng has intrinsic correlations that require further in-depth research, and clinical prevention necessitates strict control over the dosage and duration of medication use. References | Related Articles | Metrics

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Research Progress on Wuzi Yanzong Pill in the Treatment of Oligoasthenospermia TAN Tianyang, TANG Tian, LIU Zhejun, BAI Xue 2024, 21(11): 1232-1237.  DOI: 10.19803/j.1672-8629.20240635 Abstract ( 34 )   PDF (1305KB) ( 31 )   Objective Oligoasthenospermia (OA) is a prevalent cause of male infertility, significantly impairing fertility and life quality. The traditional Chinese medicine formula, Wuzi Yanzong Pill, has demonstrated promising efficacy in treating this condition. This article explores the clinical efficacy and mechanism of action of Wuzhi Yanzong Pill in the treatment of oligoasthenozoospermia. Methods This article reviews the latest research progress on the treatment of oligoasthenozoospermia with Wuzhi Yanzong Pill in the past three years, encompassing its clinical effectiveness, mechanisms of action, and pharmacological investigations. Result Studies have shown that Wuzi Yanzong Pill enhances sperm quality and quantity through various targets and pathways. It is primarily achieved by reducing oxidative stress and cellular apoptosis, regulating endocrine functions, protecting the blood-testis barrier, and boosting mitochondrial function. Additionally, the pill is found to influence gut microbiota and affect gene expression. Clinical research supports the therapeutic benefits of Wuzi Yanzong Pill in individuals with oligoasthenospermia and examines its synergistic use with other treatments. Conclusion Wuzhi Yanzong Pill has shown good clinical efficacy in the treatment of oligoasthenozoospermia. However, more comprehensive research is needed to fully understand its mechanisms and refine its clinical application strategies. References | Related Articles | Metrics

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Research Progress of Epimedium in the Treatment of Male Infertility TANG Tian, TAN Tianyang, LIU Zhejun, BAI Xue 2024, 21(11): 1238-1242.  DOI: 10.19803/j.1672-8629.20240638 Abstract ( 20 )   PDF (1246KB) ( 31 )   Objective To assess the potential of Epimedium and its active components in the treatment of male infertility and to explore their prospects in traditional Chinese medicine therapy. Methods A systematic literature review was conducted to analyze the significant effects of Epimedium and its main active components on improving spermatogenesis, protecting the testicular microenvironment, regulating sex hormone levels, combating oxidative stress, and alleviating sexual dysfunction. Results Epimedium demonstrated the potential to protect germ cells by modulating key signaling pathways and improving apoptosis, and it also showed positive effects in improving sexual dysfunction. Conclusion The active components of Epimedium have significant potential in the treatment of male infertility. Future research should further verify their clinical efficacy to promote their application in the field of male reproductive health. References | Related Articles | Metrics

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Research Progress on the Potential Therapeutic Effect of Bushen Shengjing Prescription on Oligoasthenozoospermia BAI Xue, CHEN Yafei, TANG Tian, LIU Zhejun, TAN Tianyang, LIU Zhenquan 2024, 21(11): 1243-1249.  DOI: 10.19803/j.1672-8629.20240593 Abstract ( 24 )   PDF (1286KB) ( 31 )   Objective To explore the potential therapeutic effects of Bushen Shengjing prescription (BSP) on oligoasthenozoospermia (OA), providing theoretical references for subsequent research. Methods The pharmacological effects of the eight Chinese medicinal herbs in BSP and their synergistic effects in the treatment of OA were analyzed through literature review. The effect of BSP on improving sperm quality was evaluated combined with existing research data. Results BSP has shown good efficacy in the treatment of OA, possibly improving sperm quality through multiple pathways such as antioxidation, anti-inflammation, and anti-apoptosis. Preliminary clinical studies have indicated that BSP can significantly increase the sperm vitality and quantity of OA patients, thereby improving fertility. Conclusion BSP has significant therapeutic potential in the treatment of OA, and its multi-component, multi-target mechanism of action provides a new treatment strategy for OA. Future research should further verify and study the efficacy and mechanism of action of BSP to promote its widespread clinical application. References | Related Articles | Metrics

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Lujiao Formula Inhibiting Cardiac Hypertrophy Induced by Ang Ⅱ through Regulating the NF-κB Pathways ZHANG Jianwei, LIU Li, XU Guanglin, SHI Xiaoli 2024, 21(11): 1250-1255.  DOI: 10.19803/j.1672-8629.20240494 Abstract ( 18 )   PDF (1667KB) ( 24 )   Objective To investigate the effect of Lujiao formula on cardiac hypertrophy induced by angiotensin II (Ang II) through regulating the NF-κB signaling pathway. Methods Ang II was used to establish a cardiac hypertrophy model of neonatal rat cardiac myocytes (NRCMs). The cells were divided into normal group, Ang Ⅱ model group, Lujiao formula + Ang Ⅱ group, BAY11-7082 + Ang Ⅱ group and Lujiao formula + BAY11-7082 + Ang Ⅱ group. The effect of Lujiao formula with final concentrations of 0, 0.1, 0.3, 1, 3, and 10 μ g · mL-1 on the surface area of cardiomyocytes was detected. The level of tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and interleukin-2 (IL-2) in culture medium of cells treated with Lujiao formula at effective concentrations of 10 and 100 μ g · mL-1 were detected by enzyme-linked immunosorbent assay (ELISA). Quantitative real-time polymerase chain reaction (RT-qPCR) was used to quantify the gene expression of ANP and BNP. Protein expression of NF-κB p65, p-NF-κB p65 (Ser536), p-IKK (Ser176/180), IκBα and p-IκBα (Ser32) were detected by Western Blot. Results Compared with normal group, the surface area of cardiomyocytes in model group was significantly increased (P<0.01 or P<0.05), and the mRNA level of hypertrophy markers ANP and BNP were increased (P<0.01), and the levels of pro-inflammatory factors TNF-α, IL-1β and IL-6 were increased (P<0.01). The level of anti-inflammatory factor IL-2 was decreased (P<0.01), the protein expressions of p-NF-κBp65 (Ser536), p-IKK (Ser176/180) and p-IκBα (Ser32) were significantly increased (P<0.01), and the protein expressions of IκBα were decreased (P<0.01). Compared with the model group, Lujiao formula could significantly inhibit the increase of surface area of cardiomyocytes (P<0.01), and inhibit the expressions of ANP and BNP mRNA of cardiomyocytes (P<0.01), and reduce the levels of TNF-α, IL-1β and IL-6 in cardiomyocyte culture medium (P<0.01), and increase the level of IL-2 (P<0.01). Lujiao formula could significantly decrease the protein expressions of p-NF-κB p65 (Ser536), p-IKK (Ser176/180) and p-IκBα(Ser32), and increase the protein expressions of IκBα (P<0.01 or P<0.05), and the effect of Lujiao formula on these protein levels was comparable to that of BAY11-7082 (P>0.05). Conclusion Lujiao formula could significantly inhibit cardiac hypertrophy induced by angiotensin II through inhibiting the NF-κB signaling pathway. References | Related Articles | Metrics

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Determination of 15 Chemical Constituents in Dandelion Leaves from Different Areas of Production Based on UPLC-MS/MS LEI Jingqi, ZHANG Zezhao, REN Dong, WANG Xinguo, NIU Liying 2024, 21(11): 1256-1263.  DOI: 10.19803/j.1672-8629.20240470 Abstract ( 24 )   PDF (1184KB) ( 26 )   Objective To establish a UPLC-MS/MS method to determine the contents of 15 components in Dandelion leaves in order to provide a reference for quality evaluation. Methods The Waters Acquity UPLC® HSS T3 Column was used while acetonitrile-0.1% formic acid water served as the mobile phase. Negative electrospray ionization was performed in a multiple reaction monitoring (MRM) mode. Cluster analysis and least partial binary analysis were conducted for evaluation. Results The 15 components had a good linear relationship within their respective range (r≥0.997 7), with good precision and accuracy (RSD <5%). The samples could be divided into four categories by clustering and OPLS-DA analysis, and chichoric acid, cafftaric acid, rutin, esculetin, hyperoside, isoquercetin and cynaroside were used as reference for the selection of quality markers in Dandelion leaves. Conclusion This method is accurate enough to provide references for quality control of Dandelion leaves. References | Related Articles | Metrics

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Research on Polymers in the Raw Materials and Preparations of Cefmezole Sodium ZHANG Xia, LIU Hui, YAO Shangchen, LI Jin, NING Baoming, HU Changqin 2024, 21(11): 1264-1269.  DOI: 10.19803/j.1672-8629.20240745 Abstract ( 23 )   PDF (1866KB) ( 24 )   Objective To establish an analytical method for polymers in cefmetazole sodium raw materials and preparations, which can provide guidance for production quality control and effective supervision. Methods The reversed phase liquid chromatography system containing volatile buffer salt was used to separate the polymers in cefmetazole with gradient elution, and the polymers were quickly identified coupled with mass spectrometry. The location of the polymers under the chromatographic method of related substances in the Chinese Pharmacopoeia was obtained by two-dimensional liquid chromatography, and the specificity of the high performance gel chromatography and reverse-phase high performance liquid chromatography for the separation of polymers in cefmetazole was explored. Results There is one dimer present in the raw materials and preparations of cefmetazole, while the reference listed drugs and high concentration degradation samples do not contain polymers. The pharmacopoeial method can simultaneously control related substances and the polymer. Reversed-phase high performance liquid chromatography is superior to high performance gel chromatography in the specificity of separating polymers. Conclusion The adopted technical pathway can provide guidance for the research on polymers in other cephalosporin with low content and difficult identification. References | Related Articles | Metrics

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Mechanism of Xinmaitong Tablets against Resistant Hypertension Based on Untargeted Proteomic Analysis DU Jianmin, ZHANG Chenning, ZHANG Xinghai, ZHANG Wenyu, ZHAO Hengli, WEN Qing 2024, 21(11): 1270-1275.  DOI: 10.19803/j.1672-8629.20240474 Abstract ( 16 )   PDF (1858KB) ( 22 )   Objective To explore the potential mechanism by which the active ingredients of Xinmaitong tablets combat resistant hypertension using untargeted proteomic analysis methods. Methods Clinical samples were collected from patients with resistant hypertension (RH) and controlled hypertension (CH) respectively. Using untargeted proteomic technology, differential proteins in plasma from the two groups of patients were characterized. The active ingredients and targets of Xinmaitong tablets were retrieved from the TCMSP and PharmMapper databases. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed using the Metascape database. Intersection targets of the drug with differentially expressed proteins in RH patients were identified, and molecular docking validation was conducted using the MOE software. Results A total of 162 active ingredients from Xinmaitong tablets were obtained, and 2 intersection targets between the drug and differentially expressed proteins in resistant hypertension were identified. The key active ingredients of Xinmaitong tablets for treating hypertension were baicalin, spinasterol, luteolin, kaempferol, quercetin, stigmasterol, and β-sitosterol while the core targets were Peptidyl-prolyl cis-trans isomerase A (PPIA) and heat shock protein HSP 90-alpha (HSP90AA1). GO and KEGG enrichment analysis involved the top 20 signaling pathways, including platelet degranulation, neutrophil degranulation, and inflammatory response signaling pathways. Molecular docking showed good binding activity between the key active ingredients and the core targets. Conclusion Xinmaitong tablets may exert their therapeutic effect against resistant hypertension by acting on PPIA through baicalin. References | Supplementary Material | Related Articles | Metrics

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Correlations between Serum Concentrations of Risperidone and Serum Trace Elements in Patients with Schizophrenia LUO Jianchao, YANG Rong, FU Qiong, LI Jixian 2024, 21(11): 1276-1279.  DOI: 10.19803/j.1672-8629.20240306 Abstract ( 21 )   PDF (1388KB) ( 27 )   Objective To explore the correlations between the plasma concentrations of risperidone and the contents of serum trace elements in patients with schizophrenia. Methods Two hundred schizophrenia patients who were hospitalized in 2023 and used risperidone alone were selected as the subjects, whose risperidone blood concentrations were detected and divided into low (<20 ng·mL-1, 17), normal (20~60 ng·mL-1, 153) and high concentration groups (>60 ng·mL-1, 30). The contents of such serum trace elements as iron, zinc, copper, manganese and selenium were compared between the three groups while the correlations between blood drug concentrations and the contents of serum trace elements were analyzed. Results ① There was no significant difference in the contents of iron, zinc, copper, manganese and selenium between the normal concentration group and the low concentration group (p>0.05). Compared with the low concentration and normal concentration groups, the contents of iron and zinc were lower while that of selenium was higher in the high concentration group, and the difference was statistically significant (p<0.05).② The proportion of abnormal contents of iron and selenium in the high-concentration group was higher than in the low and concentration groups (p<0.05).③ The plasma concentration of risperidone was negatively correlated with the content of iron, positively with that of selenium, but had no correlations with other trace elements. Conclusion The plasma concentration of risperidone is correlated with the contents of such serum trace elements as iron and selenium. The risk of abnormal iron, zinc and selenium increases with the plasma concentration of risperidone. It is recommended that clinicians monitor the plasma concentration and contents of iron, zinc and selenium. References | Related Articles | Metrics

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Standards for Drug Safety Signal Detection Using Individual Case Safety Reports in Pharmacovigilance LIANG Jizhou, CHEN Chenxin, BAI Wangyang, GUO Xiaojing, XU Jinfang, HE Jia, YE Xiaofei 2024, 21(11): 1280-1283.  DOI: 10.19803/j.1672-8629.20240471 Abstract ( 119 )   PDF (1223KB) ( 137 )   Objective To analyze and interpret the READUS-PV standard for drug safety signal detection based on individual safety reports in pharmacovigilance so as to provide references for related research in China. Methods The reporting of a disproportionality analysis for drug safety signal detection using individual case safety reports in pharmacovigilance (READUS-PV) jointly delivered by experts in pharmacovigilance worldwide was analyzed and interpreted. Results READUS-PV included 14 items concerning the title, introduction, methods, results, discussion, declaration and abstracts. Conclusion In actual drug safety signal detection research, READUS-PV can be consulted to improve research quality. References | Related Articles | Metrics

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Common Risks from Implantable Cardioverter Defibrillators SHEN Xiaohua, ZHANG Longying, QIU Jingting, WU Zhengshan, ZHAO Yan 2024, 21(11): 1284-1287.  DOI: 10.19803/j.1672-8629.20240243 Abstract ( 24 )   PDF (1270KB) ( 32 )   Objective To analyze the common risks posed by implantable cardioverter defibrillators (ICD) and provide references for clinical safety. Methods The reports about ICD-related adverse events were retrieved from the medical device adverse event monitoring system database of one province between Jan 1, 2015 and Mar 15, 2024 and from Manufacturer and User Facility Device Experience of the US Food and Drug Administration. Combined with the domestic information on recalls, these reports were statistically analyzed. Results The device failures included inadequate shock, premature discharge of batteries and depletelectrode failure. The dominating injuries involved were secondary surgeries, infections, and arrhythmia. Conclusion Clinical medical personnel should have an intimate knowledge of the impact of adverse events of the product on patients, weigh the risk-benefit ratio of patients, select indications with caution, and standardize clinical use. Manufacturers should strengthen the post-marketing risk management of the product, analyze the possible causes of risks and use them as the pre-market risk factors, improve product design, enhance product performance, and reduce the inherent risk of products. References | Related Articles | Metrics

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Risks of Calcium Dobesilate Preparations to Safety MENG Kangkang, TANG Ren 2024, 21(11): 1288-1292.  DOI: 10.19803/j.1672-8629.20240539 Abstract ( 31 )   PDF (1384KB) ( 32 )   Objective To analyze the safety information of oral preparations of Calcium Dobesilate and provide reference for rational clinical 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 and international literature published from January 1, 2000 to March 31, 2023, domestic and international drug specifications were analyzed. Results From January 1, 2004 to March 31, 2023, there were a total of 3 815 ADR reports of Calcium Dobesilate preparations in the database, involving 182 serious cases.in the reports of severe cases, skin damage was reported more frequently; Toxic epidermal necrolysis is more prominent in the literature, and the patients were accompanied by renal impairment. Conclusion Calcium Dobesilate oral preparation may cause serious skin damage, especially in patients with renal impairment requiring dialysis, and Medical institutions should pay attention to this risk. Marketing authorization holders should strengthen the monitoring of adverse reactions and update the information on safety in drug labels in time. References | Related Articles | Metrics

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Rational Use of Traditional Chinese Medicine Decoction Pieces in Outpatient Clinic of a Hospital LI Yiwen, CAO Keming, LAN Yuze, SU Shuang, MA Hongliang, ZHANG Lili, CHANG Xiaohong, LI Bo 2024, 21(11): 1293-1298.  DOI: 10.19803/j.1672-8629.20240410 Abstract ( 33 )   PDF (1383KB) ( 36 )   Objective To investigate the applications of PDCA cycle management method in the review of prescriptions for traditional Chinese medicine decoction pieces and to analyze its role in improving the rate of standard prescriptions and promoting the rational use of medicines. Methods A total of 645 prescriptions for traditional Chinese medicine decoction pieces given by the outpatient clinic between October and December 2023 were selected as the control group while the prescriptions after the first and second rounds of PDCA cycle management from January to March 2024 (612 prescriptions) and from April to June 2024 (615 prescriptions) were selected for the intervention group. The results of review of prescriptions before and after the PDCA cycle was carried out were compared to evaluate the utility of the method in improving the qualified rate of Chinese medicine prescriptions. Results After two PDCA cycles, the qualified rate of prescriptions for traditional Chinese medicine decoction pieces was significantly improved. In the first stage study group, the qualified rate of outpatient Chinese medicine prescriptions was significantly increased from 70.54% to 81.69%(P<0.05), but it did not reach the intended goal. In the second stage study group, the qualified rate of outpatient Chinese medicine prescriptions was increased to 91.87% (P<0.05). In case of diagnostic absence, lack of Chinese medicine diagnosis, lack of labeling of special decoctions, and in terms of rational use of toxic sips, the qualified rate of the second stage study group was significantly higher than that of the control group and the first stage study group(P<0.05). Conclusion The PDCA cycle management method can effectively improve the quality and rationality of traditional Chinese medicine decoction pieces. References | Related Articles | Metrics

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Reminders of Addiction in Drug Labels of Dextromethorphan LIU Xiaohui, ZHOU Li, ZHAO Yiming, LI Ying, WU Xirong, WANG Xiaoling, XU Baoping 2024, 21(11): 1299-1302.  DOI: 10.19803/j.1672-8629.20240382 Abstract ( 39 )   PDF (1372KB) ( 33 )   Objective To investigate both the reminders of addiction in the instructions of Chinese listed drugs containing dextromethorphan and the reports of addiction cases at home and abroad so as to provide evidence for standardized use. Methods Labels of drugs containing dextromethorphan were retrieved while case reports of addiction induced by dextromethorphan in CNKI, Wan Fang and PUBMED database were searched for before statistical analysis. Results On December 16, 2021, the National Medical Products Administration changed dextromethorphan hydrobromide oral monotherapy from an over-the-counter drug to a prescription one, and revised the instructions of 11 dextromethorphan products by deleting such descriptions as “no addiction or tolerance after long-term use”. On April 30, 2024, the National Medical Products Administration, Ministry of Public Security and the National Health Commission jointly issued an announcement adjusting dextromethorphan monotherapy as the second category of psychotropic drugs. However, some dextromethorphan-containing compound preparations were still labeled as non-addictive after long-term use under the item of pharmacological actions in the instructions. A total of 21 reports about addiction to dextromethorphan after long-term use were retrieved, including 11 domestic ones and 10 foreign ones, all of which involved minors who were enticed by their peers. Obvious symptoms of withdrawal, feelings of euphoria, and even suicide were reported. Conclusion Labels of drugs containing dextromethorphan should be standardized, and clinicians ought to be better informed of the drug dependence caused by dextromethorphan to improve the public knowledge of dextromethorphan, especially among minors. References | Related Articles | Metrics

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Pharmacological Care of Hypertension Due to Glucocorticoid Drugs LIU Xin, WANG Guojun 2024, 21(11): 1303-1305.  DOI: 10.19803/j.1672-8629.20240283 Abstract ( 34 )   PDF (1276KB) ( 37 )   Objective To investigate the priorities of pharmacological care of patients with hypertension due to glucocorticoid drugs and the effectiveness of pharmacists’ intervention. Methods Clinical pharmacists explored the key to such care, clinical management measures and effectiveness of pharmacological care of two patients who developed pharmacogenetic hypertension after using glucocorticoid medications. Results and conclusion Clinical pharmacists can effectively assist clinicians in the rational use of clinical medications to ensure safety by providing effective pharmacological care for patients with pharmacogenetic hypertension. References | Related Articles | Metrics

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Two Cases of Ceftriaxone Sodium for Injection Induced Immune Hemolytic Anemia in Children DING Yiqiang, LYU Zhiying, LIU Canghai, WEN Qinqin, FANG Xiaoping 2024, 21(11): 1306-1308.  DOI: 10.19803/j.1672-8629.20240492 Abstract ( 84 )   PDF (1201KB) ( 47 )   Objective To explore the clinical characteristics and mechanism of adverse drug reactions caused by ceftriaxone in children with immune hemolytic anemia. Methods Two cases of ceftriaxone sodium induced adverse reactions in children with immune hemolytic anemia and the correlations with adverse reactions were analyzed. Results Correlation analysis showed that both cases of hemolytic anemia were caused by ceftriaxone sodium, which was immediately discontinued and the patients were discharged after blood transfusion and glucocorticoid treatment. Conclusion Clinicians should pay attention to the risk of adverse reactions of ceftriaxone-induced immune hemolytic anemia in clinical practice. Rapid identification and appropriate immunological diagnosis and treatment can facilitate the prognosis of patients. References | Related Articles | Metrics

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One Case of Anaphylaxis Caused by Magnesium Isoglycyrrhizinate Injection JIANG Nan, WANG Kun, ZHANG Gangping, XING Ruimin, WANG Haiye 2024, 21(11): 1309-1311.  DOI: 10.19803/j.1672-8629.20240482 Abstract ( 25 )   PDF (1154KB) ( 30 )   Objective To analyze the etiology and characteristics of anaphylaxis induced by magnesium isoglycyrrhizinate injection so as to provide references for clinical safe use. Methods One case of anaphylaxis caused by intravenous drip of magnesium isoglycyrrhizinate injection was analyzed. The adverse reactions of magnesium isoglycyrrhizinate injection and the pathogenesis of anaphylaxis were reviewed. Results The chances of anaphylaxis being induced by magnesium isoglycyrrhizinate injection were considered high. After active anti-allergic therapy and symptomatic support therapy, the symptoms of anaphylaxis gradually subsided and improved. Conclusion When magnesium isoglycyrrhizinate injection is used, clinicians ought to be alert to the risk of adverse reactions and severe allergic reactions, especially among patients with a history of allergy, and be ready to take precautions. References | Related Articles | Metrics

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One Case of Acute Respiratory Distress Syndrome Caused by Indapamide Tablets LUO Yuchen, GONG Qingmei, XU Yuhang, QIN Shuqin, ZHANG Jian 2024, 21(11): 1312-1314.  DOI: 10.19803/j.1672-8629.20240280 Abstract ( 26 )   PDF (1194KB) ( 32 )   Objective To call attention to rare complications caused by indapamide so as to provide references for clinical treatment. Methods One case of acute respiratory distress syndrome (ARDS) attributed to indapamide intake was reported. The pathogenesis, clinical manifestations, and treatment of this adverse reaction were analyzed bases on domestic and foreign literature. Results After symptomatic treatments including non-invasive ventilatory support, anti-infection therapy, vasopressor therapy, and hydration therapy, the patient’s oxygenation improved, and the chest CT scan showed favorable progression, leading to discharge. However, the underlying mechanism by which indapamide triggered ARDS had yet to be elucidated, so more research was needed to discern its pathogenesis. Conclusion While hypokalemia, hyponatremia, and electrolyte imbalances are commonly reported adverse reactions of indapamide, it is crucial to be vigilant to the rare but potential risks of ARDS associated with its use. References | Related Articles | Metrics

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Introduction and Quality Factors of Peucedanum Praeruptorum Dunn LI Yaolei, JIN Hongyu, WEI Feng, MA Shuangcheng 2024, 21(11): 1315-1320.  DOI: 10.19803/j.1672-8629.20240255 Abstract ( 27 )   PDF (1319KB) ( 28 )   Objective To describe the history of the medicinal use of Peucedanum Praeruptorum Dunn (PD), its chemical composition, efficacy, areas of production, market demands and quality control and to provide reference for its development, utilization and quality control. Methods Based on the reports available, the medicinal use of PD and its key chemical constituents were traced, and the traditional and modern pharmacology of PD was elaborated in terms of chemistry and pharmacology. The areas of production, chief planting areas, market demands and production of PD were analyzed. The current standard for PD and problems with the quality were discussed. Results PD had a long history of medicinal use and plenty of pharmacological activities, whose chemical components included simple coumarin, furan coumarin and pyranocoumarin. Zhejiang, Anhui and Jiangxi were important areas of production of PD. There was large-scale cultivation in Chongqing, Guizhou and elsewhere. The current market was dominated by domestic species and simulated wild products, and the wild resources were diminishing. The main reason for defects of the product was the presence of Praeruptorin B. Analysis of Praeruptorin A and Praeruptorin B suggested that environmental geography, extraction, and different morphologies made a huge difference to the quality of PD. Conclusion The basic profile and determinants of quality of PD have been explored. It is of great significance to promote the sustainable use and industrial development of the plant. References | Related Articles | Metrics