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2022 Vol. 40, No. 4

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Mechanisms and therapeutic drugs of high-altitude lung diseases
HUANG Yueqi, HU Jinglu, LI Qi, LI Miao, XIE Fei, DU Lina, JIN Yiguang
2022, 40(4): 289-295. doi: 10.12206/j.issn.1006-0111.202111025
Abstract(5917) HTML (1804) PDF (1257KB)(96)
Abstract:
The heavily harsh plateau environment including low pressure, hypoxia, cold, dryness and strong ultraviolet radiation, seriously threatens the physical and mental health of those who quickly enter the plateau area. Lungs are the sensitive organs for high altitude injury. High-altitude lung diseases include the acute high-altitude lung disease (i.e., high-altitude pulmonary edema), the chronic high-altitude lung disease (i.e., high-altitude pulmonary artery hypertension) and the high-altitude de-adapted reaction. This review summarizes the pathogenic mechanisms and the main therapeutic drugs of high-altitude lung diseases based on the recent research. Moreover, the related formulations and administration routes are also reviewed here. It will provide support and counsel for the diagnosis and treatment of high-altitude lung diseases.
Progress and perspective of gene therapy
SHI Tong, LI Jizong
2022, 40(4): 296-301, 313. doi: 10.12206/j.issn.1006-0111.202112015
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Gene therapy is generally referred as a therapeutic method through modifying or manipulating gene expression and accordingly changing biological characteristics of living cells. With the substantial progress of vector delivery, gene editing and other relevant technologies, gene therapy has been widely applied in the research of genetic disorder, cancer and other refractory diseases. Gene therapy products have been approved in many countries and exhibited amazing therapeutic effectiveness. Big pharmaceutical companies have strategically entered this field along with many innovative entrepreneurs. Gene therapy has showed great market potential and prospect. In this review, research progresses, industrial developments, administration policies, as well as future expectations of the gene therapy were discussed.
Research progress and coping strategy of the drug resistant mechanism of platinum anti-tumor drugs
WANG Dongbo, NIE Jing, WU Huina, SUN Lei, LIU Lihui, WU Jiyong
2022, 40(4): 302-308. doi: 10.12206/j.issn.1006-0111.202204046
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Platinum anti-tumor drugs are currently the most widely used first-line chemotherapeutic drugs in clinical practice, and their curative effects are remarkable. However, the problems of platinum drug resistance in non-small cell lung cancer, breast cancer, ovarian cancer and others seriously limit effectiveness and clinical application of platinum drugs. The occurrence of platinum drug resistance is caused by many factors. At present, the resistance mechanism of platinum drugs mainly includes the following aspects: decreasing the accumulation of platinum in cells, increasing the inactivation of platinum in cells, repairing DNA damage and tumor cell apoptosis inactivation. This article reviews the drug resistance mechanism and coping strategy of platinum anti-tumor drugs, providing ideas for the development of platinum anti-tumor drugs and references for overcoming clinical platinum drug resistance.
The role of SDH2 gene in the environmental adaptability of Candida albicans
WANG Xinrong, LU Renyi, WANG Yan
2022, 40(4): 309-313. doi: 10.12206/j.issn.1006-0111.202201096
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  Objective  To investigate the role of SDH2 gene in the environmental adaptability of Candida albicans.   Methods  Wild-type C. albicans strain SC5314, SDH2 gene knockout mutant sdh2 Δ/Δ and reintegrated strain sdh2 Δ /SDH2 were used as experimental objects. Spot assay was conducted to assess the sensitivity of the WT C. albicans strain SC5314, SDH2 gene knockout mutant sdh2 Δ/Δ and reintegrated strain sdh2 Δ /SDH2 to external stress stimulants and antifungal drugs. The effect of SDH2 gene deletion on drug efflux ability of C. albicans was determined by rhodamine 6G efflux assay.   Results  After SDH2 gene deletion, C. albicans showed slight tolerance to cell wall stress stimulants caffeine, oxidative stress stimulators diamide and menadione. Notably, the sensitivity of SDH2 gene knockout mutant sdh2 Δ/Δ to azole antifungal drugs was significantly increased. The drug efflux capacity of C. albicans was decreased due to the deletion of SDH2 gene.   Conclusion  SDH2 gene deletion lead to changes in environmental adaptability of C. albicans, including changes in response to external environmental stress and increased sensitivity to azole antifungal drugs. The development of fungal-specific inhibitor targeting SDH2 gene may lead to the discovery of new antifungal drugs which have synergistic effect with azole drugs.
Protective effects of the total bakkenolides from Petasites tricholobus on hypoxia mice under normobaric pressure
LI Bingfeng, DUAN Yaqian, WANG Xu, GUO Meili, GAO Yue
2022, 40(4): 314-319. doi: 10.12206/j.issn.1006-0111.202111085
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  Objective   To investigate the protective effects of the total bakkenolides from P.tricholobus on improving hypoxia tolerance in mice.   Methods  Mice normobaric pressure hypoxia model and oxygen glucose deprivation model in PC12 cells were established, and the effects of PTB on survival time, serum lactate dehydrogenase (LDH) activity and malondialdehyde (MDA) content, brain and heart superoxide dismutase (SOD) and reduced glutathione (GSH) activities, brain tissue pathological changes and cell survival were observed.   Results  The total bakkenolides from P.tricholobus had prolonged the survival time of mice in confined spaces, increased the activity of SOD and GSH, reduced the production of lipid peroxidation, decreased the degree of anaerobic glycolysis, protected the structure and function of neural cells, and improved the survival rate of OGD-treated cells.   Conclusion  The total bakkenolides from P.tricholobus could promote the hypoxia tolerance in mice which might be related to scavenging oxygen free radicals, inhibiting lipid peroxidation reaction and protecting the structures and functions of nerve cells.
Effect and mechanism of estrogen on EPCs function in diabetic rats
DONG Yafen, WANG Jian, LI Li, LI Shushu, LIU Helong, QIU Yan
2022, 40(4): 320-325. doi: 10.12206/j.issn.1006-0111.202106121
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  Objective  To explore the effect and mechanism of estrogen on endothelial progenitor cells(EPCs)function in diabetic rats.   Methods  EPCs were isolated from bone marrow of rats and characterized by fluorescence microscopy and flow cytometry. Rat diabetic model was established via streptozotocin induction. The bone marrow was taken to culture EPCs. EPCs of diabetes were incubated with Estrogen 10 nmol/L for 24h. The functions and proliferation of EPCs in vitro were detected. The levels of MnSOD and NO in EPCs and TSP-1 in supernatant were assayed.   Results  Compared with control group, EPCs proliferation, adhesion and angiogenesis functions were impaired in diabetic rats. The level of MnSOD and NO in diabetic EPCs were significantly decreased, while TSP-1 protein level in the supernatant increased. The above changes can be reversed with estrogen incubation.   Conclusion  Estrogen improved the EPCs migration and tubule formation in diabetic rats. The mechanism may be related to the reduction of oxidative stress and downregulation of TSP-1 expression in diabetic EPCs.
Role of intercellular junctions in the biological behavior of SP cells of multiple myeloma
WANG Ziyan, ZHANG Xiaohui, RUI Mingzhong, ZHOU Min, FU Jinxiang
2022, 40(4): 326-334. doi: 10.12206/j.issn.1006-0111.202105104
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  Objective  To observe the effects of the intercellular gap junction (GJIC) composed of connexin 43(Cx43) in mesenchymal stem cells (MSCs) from different sources and their signals on the biological behavior of multiple myeloma (MM) lateral population cells (SP cells), and to explore its possible mechanism.   Methods  Mesenchymal stem cells (MSCs) from different sources were isolated and cultured. SP cells of MM cell line RPMI 8266 were sorted by flow cytometry. RT-PCR and Western blot were used to detect the expression of Cx43 gene and protein in MSCs, RPMI 8266 and SP cells from different sources. The effects of MSCs from different sources on SP cell cycle, Cx43 protein expression, colony formation ability in vitro, stem cell related gene expression, cytokine secretion and drug resistance were observed.   Results  There was no significant difference in morphology and phenotype between MM-MSCs and ND-MSCs. Both MM-MSCs and RPMI 8266 cells expressed a higher level of Cx43. Co-culture with MM-MSCs induced more SP cells to enter G0 phase (P<0.001). The expressions of c-myc, Kif4 and Sox2 genes in SP cells were significantly up-regulated, while the expression of Oct-4 gene was down-regulated. After adding α-GA, c-myc, Kif4 and Sox2 were down-regulated in varying degrees, but there was no significant difference. The expression of Cx43 was up-regulated by (31.00±2)% and (39.00±2)%, respectively. The colony formation ability in vitro was up-regulated, and the addition of α-GA could partially inhibit this effect. A small amount of c-myc, Kif4, Sox2 and Oct-4 genes were expressed in RPMI 8266. These genes were significantly up-regulated in SP cell subpopulation. MM-MSCs secreted high levels of interleukin (IL)-6. After co-culture with SP cells, the expressions of IL-6, IL-10 and TGF-β in the supernatant of MM-MSCs were up-regulated (P=0.0072, P=0.037). bFGF and IL-17 had no significant change. After adding α-GA, the levels of IL-6, IL-10 and TGF-β in the supernatant decreased. MM cells were sensitive to bortezomib (BTZ) induced apoptosis, but SP cells were less sensitive. Co-culture with MM-MSCs significantly reduced BTZ-mediated apoptosis. The addition of α-GA partially restored the sensitivity of MM cells to bortezomib.   Conclusion  MM-MSCs and multiple myeloma SP cells up-regulate the expression of Cx43 protein, form more GJIC, and promote the proliferation and drug resistance of SP cells by changing the cytokine secretion profile of MSCs, which may be one of the reasons for the recurrence of MM.
Investigation of medication adherence for superficial mycoses among students in a college based on Morisky Medication Adherence Scale
TANG Renjie, LI Zhiyong, WANG Ruina, LIU Jiacun, WANG Zhi, LIU Haiyan, LI Honglei, WANG Xu, ZHANG Dazhi, YAN Lan
2022, 40(4): 335-338. doi: 10.12206/j.issn.1006-0111.202107016
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Abstract:
  Objective  To investigate the medication adherence of military academy students with superficial mycoses.   Methods  A 8-item Morisky medication adherence scale (MMAS) was modified into 7-item scale to evaluate the compliance of antifungal drugs in the sick students. The reliability and validity of the scale were analyzed.   Results  A total of 243 questionnaires were collected, of which 242 were valid questionnaires. 90.08% of the students took topical medication and 8.68% were treated both with topical and systematic combination. High, medium and low medication adherence rates as assessed by the modified MMAS were 9.09%, 23.97% and 66.94%, respectively. The reliability analysis showed that the internal consistency coefficient (Cronbach’s α ) was 0.781, and the adjusted Cronbach’s α was 0.790, indicating the high reliability of the scale. The KMO value was 0.798, and the Bartlett’s spherical test value was 440.866, P=0.000. One factor was extracted by exploratory factor analysis. The factor loadings of the items were all above 0.5. Therefore, the high convergent validity was good.   Conclusion  The modified MMAS has good reliability and validity and is applicable for the evaluation of medication compliance for superficial mycoses. In this study, the military students have a low level of medication adherence for superficial mycoses. Effective measures should be taken to help students strengthen their daily medication management and improve compliance.
Rapid analysis of chemical components of Xiaotan Tongfu formula based on UHPLC-Q-TOF/MS
QIN Ye, HUANG Wei, GU Yufang, ZHANG Ci’an, XIU Lijuan, TANG Jigui, ZHANG Feng, LIU Xuan
2022, 40(4): 339-346. doi: 10.12206/j.issn.1006-0111.202109029
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  Objective  To rapidly explore the chemical components of Xiaotan Tongfu formula, and to provide scientific basis for the basic research and clinical treatment of the formula.   Methods  Analysis was performed on an Agilent 1290 ultra-performance liquid chromatography system coupled with an Agilent 6530 accurate quality Q-TOF/MS system, by using a Waters ACQUITY UPLC BEH C18 column (2.1 mm × 100 mm, 1.7 μm), with a gradient elution applying 0.1% aqueous formic acid solution and acetonitrile as a mobile phase. The flow rate was 0.3 ml/min. The column temperature was 30°C. The injection volume was 1 μl, and the detection wavelength was 254 nm. Mass spectrometry (MS) data were collected in both positive and negative ESI ion modes. Components in the formula were identified by using the in-house compound database, and comparing the retention time (tR), MS1 and MS2 data with the standard compounds, and the online compound MS database.   Results  A total of 55 compounds were identified from Coptis coptidis, Pseudomonas solani, Rhubarb, Araceae artemisiae and Pinellia chinensis.   Conclusion  The established UHPLC-Q-TOF/MS method could systematically and accurately identify the chemical components from Xiaotan Tongfu formula, and provided a reference for the quality marker selection and the research on the active ingredient.
Study on quality standard for Xuanxi Rongjin powder
HU Dan, LIU Chunguang, CAO Hong, ZHANG Guiying, MA Zihui, ZHENG Mingming
2022, 40(4): 347-349, 363. doi: 10.12206/j.issn.1006-0111.202109078
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  Objective  To revise the qualitative and quantitative determination methods of Xuanxi Rongjin powder.   Methods  TLC was used to qualitatively identify Chuanxiong and Chuanshanlong. The content of cinnamaldehyde in the preparation was determined by HPLC with KR100-5C18 column (250 mm×4.6 mm, 5μm). The mobile phase was acetonitrile-water (35:65) and the detection wavelength was 290 nm.   Results  TLC can qualitatively identify Chuanxiong and Chuanshanlong. Cinnamaldehyde has a good linear relationship in the range of 0.0489~0.3260 µg/ml (r=1.00), The average recovery was 95.71% (RSD=1.78%).   Conclusion  The method has high sensitivity, good specificity, simple operation and good reproducibility.
Determination of sodium valproate and vancomycin in human serum by HPLC-MS/MS
DUAN Jingjing, JI Guowen, GUO Zhijun, XU Feng
2022, 40(4): 350-353, 378. doi: 10.12206/j.issn.1006-0111.202108087
Abstract(3582) HTML (1181) PDF (970KB)(48)
Abstract:
  Objective  To establish a high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for simultaneous determination of sodium valproate and vancomycin in human serum.   Methods  Valproic acid-d6 and kanamycin B were used as the internal standard of sodium valproate and vancomycin, the serum samples were treated by acetonitrile precipitation protein method. The mobile phase was 0.1% formic acid aqueous solution-acetonitrile for gradient elution. The flow rate was 0.5 ml/min, with column temperature at 25 ℃. The sample volume was 4 μl and total analysis time was 12 min. The positive and negative ion mode was monitored by electrospray ion source and the multiple reaction monitoring mode was used for quantitative analysis. The specificity, standard curve, lower limit of quantification, precision, recovery, matrix effect, and stability of the method were examined.   Results  Sodium valproate and vancomycin had good linear relationships in the range of 1 - 200 μg/ml and 0.5 - 100 μg/ml, respectively. The quantitative lower limits were 1 μg/ml and 0.5 μg/ml, respectively. The extraction recoveries were above 70%. The inter- and intra-batch precision RSD values were less than 10%. The stability was good and there was no obvious matrix effect.   Conclusion  This method is simple, quick, sensitive, specific and accurate, which could be used to simultaneously determine the concentration of sodium valproate and vancomycin in human serum.
Cardiovascular benefits of SGLT-2 inhibitors and GLP-1 receptor agonists in type 2 diabetes: a systematic review and network meta-analysis
LAI Yanlan, HUANG Aiwen, CHEN Guanxu, CHEN Tingting, ZHAO Lijun, LIAO Xiaolan, GUO Xiuqiang, WU Gang, SONG Hongtao
2022, 40(4): 354-358. doi: 10.12206/j.issn.1006-0111.202109108
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  Objective  To evaluate cardiovascular benefits in patients with type 2 diabetes mellitus treated with the marketed 11 sodium-glucose co-transporter-2 (SGLT-2) inhibitors and glucagon-like polypeptide-1 (GLP-1) receptor agonism by Bayesian network meta-analysis system.   Methods  MEDLINE, Embase and Cochrane Library were searched from the establishment of the database to 18 July 2020. The endpoint of the study was adverse cardiovascular events. The effect measures were hazard ratios (HR) and 95% credible intervals (CI).   Results  Compared with placebo, empagliflozin, canagliflozin, dapagliflozin, albiglutide, dulaglutide, exenatide, liraglutide, semaglutide reduced the risk of major adverse cardiovascular events in patients with type 2 diabetes with HR and 95% CI ranging between 0.75(0.60-0.95)~0.90(0.82-0.99); The risk of heart failure was reduced by empagliflozin, canagliflozin, dapagliflozin and ertugliflozin, with HR and 95%CI ranging between 0.64(0.49-0.82)~0.74(0.65-0.85); Empagliflozin, canagliflozin, dapagliflozin, exenatide, liraglutide and oral semaglutide reduced the incidence of all-cause mortality with HR and 95%CI ranging between 0.52(0.33-0.84)~0.89(0.80-0.99); Empagliflozin, canagliflozin, liraglutide and oral semaglutide can reduce the risk of cardiovascular death events, with HR and 95% CI ranging between 0.54(0.30-0.95)~0.83(0.71-0.96) .  Conclusion  The order of the cardiovascular benefits of SGLT-2 inhibitors or GLP-1 receptor agonists in patients with type 2 diabetes mellitus complicated with atherosclerotic cardiovascular disease are canagliflozin (the best), empagliflozin, dulaglutide, liraglutide; for patients with type 2 diabetes and heart failure. The order of the cardiovascular benefits for patients with type 2 diabetes and heart failure are empagliflozin, canagliflozin, ertugliflozin, and dapagliflozin.
Study on the relationship between blood concentration and efficacy of voriconazole in the treatment of pediatric invasive fungal infection
GUI Mingzhu, LI Jing, XIE Xiaotian, LI Zhiling
2022, 40(4): 359-363. doi: 10.12206/j.issn.1006-0111.202106075
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  Objective  To explore the correlation between dose, blood concentration and efficacy of voriconazole in the treatment of invasive fungal infection in children.   Methods  68 children treated with voriconazole during January 2019 to December 2019 were collected. The plasma concentration of voriconazole was assayed by high performance liquid chromatography (HPLC). The correlation between blood concentration and clinical efficacy was statistically analyzed.   Results  Different drug blood concentrations were obtained with different dosages: <4.0 mg/kg (6 cases) with the trough concentration ranged from 0.4 to 3.31 μg/ml (r=0.613, P=0.195). (4.0 - 7.0) mg/kg (44 cases), ranged from 0.35 to 7.02 μg/ml (r=0.325, P=0.018); >7.0 mg/kg (18 cases), ranged from 1.46 to 12.45 μg/ml (r=0.584, P<0.023). There was a difference between the three groups (F=7.270, P=0.026). The relationship between the drug blood concentration and the therapeutic effect was obvious. In the <1.0 μg/ml group of 14 cases, 10 cases (71.4%) were effective, and 4 cases were ineffective. In the 1.0 - 5.5 μg/ml group of 48 cases, 44 cases (91.7%) were effective, and 4 cases were ineffective. In the >5.5 μg/ml group of 6 cases, 4 cases (66.7%) were effective and 2 cases ineffective. The difference among the three groups was obvious (χ2=5.360, P=0.039). Among the 68 cases, 58 cases (85.3%) were effective, and 10 cases (14.7%) were ineffective. Adverse reactions occurred in 10 cases (14.7%) with mild liver function injury, which did not affect the treatment and recovered with liver protection treatment.   Conclusion  This study showed that voriconazole was generally safe and effective in the treatment of invasive fungal infections in children. There was a significant dose-blood concentration and efficacy correlation. Further studies on pharmacokinetics and efficacy should be carried out to optimize the individualized treatment.
Case analysis of acute eosinophilic pneumonia caused by recombinant human granulocyte stimulating factor (rhG-CSF)
QU Runan, FAN Jialong, LIU Hui, ZHANG He, MAO Junqin
2022, 40(4): 364-367. doi: 10.12206/j.issn.1006-0111.202202029
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  Objective  To investigate the role of clinical pharmacists in identifying adverse drug reactions (ADR), to draw clinical attention to the possibility of drug-induced lung injury caused by rhG-CSF, and distinguish them from infectious diseases.   Methods  A case of rhG-CSF induced acute lung injury was analyzed. After analyzing the relationship between rhG-CSF and acute eosinophilic pneumonia, exploring the possible mechanism, in combination with the patient's condition, the clinical pharmacist put forward the suggestion for the treatment of the disease.   Results  After receiving rhG-CSF, the patient's eosinophils increased, the pneumonia was aggravated, and the effect of anti-infection treatment was poor. Eosinophils pneumonia associated with rhG-CSF was considered. The patient's pulmonary symptoms improved after treatment with glucocorticoid in combination with withdrawal of antibiotics and antiviral drugs, and eosinophil returned to normal.   Conclusion  rhG- can cause rare eosinophilic pneumonia. The clinical pharmacist's participation in clinical treatment can help to identify drug-induced diseases, reorient the direction of treatment and ensure the success of clinical therapy.
Drug monitoring of omalizumab in treatment of 2 children with high level IgE allergic asthma
ZENG Na, WANG Chao, SUN Huajun, MA Liping, DONG Xiaoyan
2022, 40(4): 368-371. doi: 10.12206/j.issn.1006-0111.202205109
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  Objective  To explore the clinical efficacy and safety of the omalizumab treatment in children with high level IgE allergic asthma.   Methods  The clinical data of 2 children with allergic asthma treated with omalizumab in the Departemnt of Respiratory Medicine of Shanghai Children’s Hospital from August 2020 to May 2021 were retrospectively analyzed, and they had regular follow-up after end of treatment. The dosage and course of treatment, therapeutic effect and adverse drug reactions of omalizumab were analyzed.   Results  After receiving omalizumab treatment, asthma symptoms were well controlled, the dosage of inhaled corticosteroids during asthma treatment were reduced and nasal symptoms were relieved. 20 subcutaneous injections were received by 2 children, and no adverse reactions were found. After the treatment, regular pharmaceutical follow-up showed that the children were in good health.   Conclusion  Omalizumab is suitable for high level IgE allergic asthma and can improve asthma control symptoms with good long-term safety. However, the appropriate dosage and course of treatment still need further experience accumulation.
Perioperative antithrombotic therapy in the patient undergoing revision total hip arthroplasty after coronary stent implantation: a case report and literature review
LI Ying, CAO Ailin, BAO Leilei, WANG Zhankun, QIAN Jiao
2022, 40(4): 372-373, 386. doi: 10.12206/j.issn.1006-0111.202103074
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  Objective  To explore the strategies of perioperative antithrombotic therapy in the patient undergoing revision total hip arthroplasty after coronary stent implantation.   Methods  The antithrombotic therapy in one patient undergoing revision total hip arthroplasty after coronary stent implantation was analyzed with the review of related literatures.   Results  The patient developed non-ST segment elevated myocardial infarction due to the stop of aspirin three days before operation and no low molecular weight heparin was used. The antithrombotic treatment and prevention of venous thromboembolism were analyzed.   Conclusion  Antithrombotic therapy should be selected reasonably in patients undergoing revision total hip arthroplasty after coronary stent implantation.
Implementation and exploration of administration of anesthesia and psychotropic drugs by electronic account books
GE Jiyun, ZHANG Jing, WANG Liling, YAO Chen, BAO Leilei, HUANG Yufeng
2022, 40(4): 374-378. doi: 10.12206/j.issn.1006-0111.202109089
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  Objective  To explore the effect and significance of electronic account books on the management of anesthesia and psychotropic drugs.  Methods  The data of electronic account books from January 2020 to June 2020 in the inpatient pharmacy of the hospital (observation group), and manual account books from July 2019 to December 2019 (control group) were collected respectively. The data of daily accounting time, monthly settlement accounting time and accounting accuracy between the two groups were compared and analyzed.  Results  The daily average time for pharmacists to manually accounting was (162.8±22.5) min, and the daily average time for pharmacists to make accounts electronically was (33.2±7.0) min. It took (245.5±7.2) min for manual accounting of monthly settlement and (46.8±2.5) min for electronic accounting of monthly settlement. The accuracy rate of daily counting records, special account books, special register and empty ampoule waste paste recovery records included in electronic accounting is up to 100%.  Conclusion  The implementation of electronic account books not only significantly improved the work efficiency of pharmacists, but also strengthened drug supervision, formed a comprehensive traceability system, which could ensure the safety of clinical medication, and make the management of narcotic psychotropic drugs more efficient and standardized.
Retrospective analysis of the pre-audit results for prescriptions of Chinese patent medicines in a second-level hospital
XU Shanshan, FU Xiang
2022, 40(4): 379-382. doi: 10.12206/j.issn.1006-0111.202111089
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  Objective  Analyze the pre-audit results of Chinese patent medicine prescriptions in a second-level hospital, suggest the risks of taking Chinese patent medicines and promote the safe and standardized use of Chinese patent medicines.   Methods  A total of 31542 outpatient and emergency prescriptions of Kongjiang hospital in April 2021 were collected, combined with the review of the instructions and relevant data, classify the toxic components of Chinese patent medicines, and summarize and analyze the problems of drug use.   Results  The types of problems in the prescription of Chinese patent medicine and chemical medicines were different, mainly including repeated medication and wrong usage and dosage. Insufficient warnings on toxic medicinal ingredients in the instructions of Chinese patent medicines and the imperfect knowledge base of audit software increased the risk of using Chinese patent medicines.   Conclusion  It is necessary to improve the knowledge base of the prescription audit system, strengthen the high-alarm management of Chinese patent medicines containing toxic ingredients, and improve the public's understanding of the rational use of Chinese patent medicines.
Suggestions on the revision of pharmacist examination outline for national professional qualification examination of licensed pharmacists
WEN Ruirui, XU Long, ZHU Wenjing
2022, 40(4): 383-386. doi: 10.12206/j.issn.1006-0111.202202025
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This paper summarized the implementation of the pharmacist examination outline of the seventh edition of the national professional qualification examination for licensed pharmacists, and pointed out the existing problems and deficiencies: unclear definition between disciplines, insufficient organic integration of knowledge, lack of practicability in the content selection of professional basic disciplines and so on. At the same time, corresponding revision suggestions are put forward for the revision ideas and contents of the syllabus of pharmaceutical examination: increase the degree of professional integration between disciplines and the breadth of relevant professional knowledge, start with clinical medication, emphasize people-centered pharmacy services, and pay attention to comprehensiveness and practicability. It is hoped to provide references for further improving the outline of the national licensed pharmacist qualification examination.
2022, 40(4): 387-388. doi: 10.12206/j.issn.1006-0111.202109137
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Abstract: