2024 Vol. 42, No. 6
Display Method:
2024, 42(6): 227-230, 243.
doi: 10.12206/j.issn.2097-2024.202310007
Abstract:
Tacrolimus is a commonly used medication for the treatment of nephrotic syndrome. Due to its narrow therapeutic window and significant pharmacokinetic differences among individuals, therapeutic drug monitoring is required during its clinical use. In the process of therapeutic drug monitoring, machine learning-based personalized dosing prediction models for tacrolimus can excavate medication patterns from a large amount of clinical data, assist in clinical decision-making, and achieve individualized precise medication. Machine learning models, the application progress of machine learning in personalized administration of tacrolimus for patients with nephrotic syndrome, modeling points of machine learning prediction models, and the limitations of current prediction models were reviewed in this paper, which could provide references for future research in this field.
Tacrolimus is a commonly used medication for the treatment of nephrotic syndrome. Due to its narrow therapeutic window and significant pharmacokinetic differences among individuals, therapeutic drug monitoring is required during its clinical use. In the process of therapeutic drug monitoring, machine learning-based personalized dosing prediction models for tacrolimus can excavate medication patterns from a large amount of clinical data, assist in clinical decision-making, and achieve individualized precise medication. Machine learning models, the application progress of machine learning in personalized administration of tacrolimus for patients with nephrotic syndrome, modeling points of machine learning prediction models, and the limitations of current prediction models were reviewed in this paper, which could provide references for future research in this field.
2024, 42(6): 231-237.
doi: 10.12206/j.issn.2097-2024.202306008
Abstract:
Esophageal cancer is a malignant tumor with high incidence and mortality rate in the world and its pathogenic factors are complex and diverse. There are no obvious symptoms in the early stage, and most patients are in the middle to late stage at the initial diagnosis. The prognosis of esophageal cancer is poor. The treatment mode of conventional surgical resection combined with chemoradiotherapy can no longer meet the current treatment needs of disease, and new treatment strategies are urgently needed. Molecular targeted therapy and immunotherapy are new treatment methods that have emerged in recent years, which have broken the therapeutic bottleneck and have been proven to play important roles in the treatment of esophageal cancer. The current research progress of the main targets and their related targeted drugs in molecular targeted therapy and immunotherapy for esophageal cancer were reviewed in this article, which provided reference for the application of precision medicine in the field of esophageal cancer.
Esophageal cancer is a malignant tumor with high incidence and mortality rate in the world and its pathogenic factors are complex and diverse. There are no obvious symptoms in the early stage, and most patients are in the middle to late stage at the initial diagnosis. The prognosis of esophageal cancer is poor. The treatment mode of conventional surgical resection combined with chemoradiotherapy can no longer meet the current treatment needs of disease, and new treatment strategies are urgently needed. Molecular targeted therapy and immunotherapy are new treatment methods that have emerged in recent years, which have broken the therapeutic bottleneck and have been proven to play important roles in the treatment of esophageal cancer. The current research progress of the main targets and their related targeted drugs in molecular targeted therapy and immunotherapy for esophageal cancer were reviewed in this article, which provided reference for the application of precision medicine in the field of esophageal cancer.
2024, 42(6): 238-243.
doi: 10.12206/j.issn.2097-2024.202312010
Abstract:
In recent years, the rapid development of medical information technology has made it critical to analyze large-scale diagnosis and therapeutic data and extract rules based on real medical environment. This has become an essential approach for marketing evaluation and regulatory decision-making of drugs and devices both domestically and internationally. Real world study （RWS）, as a novel methodology for clinical evaluation of drugs in the field of drug utilization research （DUR）, have presented opportunities and challenges for observational studies in assessing actual efficacy or effectiveness. However, despite being a popular methodological approach among scholars in the field, there are still limitations and deficiencies when analyzing population medication characteristics in RWS. Systematic evaluation research methods have not yet been established, leading to inadequate generation of real-world evidence （RWE）. The research design, methodological pathways, evaluation indicators, confounding factors, and bias management involved in DUR based on real-world data （RWD） were reviewed in this artical with the intention of providing guidance for further exploration into DUR.
In recent years, the rapid development of medical information technology has made it critical to analyze large-scale diagnosis and therapeutic data and extract rules based on real medical environment. This has become an essential approach for marketing evaluation and regulatory decision-making of drugs and devices both domestically and internationally. Real world study （RWS）, as a novel methodology for clinical evaluation of drugs in the field of drug utilization research （DUR）, have presented opportunities and challenges for observational studies in assessing actual efficacy or effectiveness. However, despite being a popular methodological approach among scholars in the field, there are still limitations and deficiencies when analyzing population medication characteristics in RWS. Systematic evaluation research methods have not yet been established, leading to inadequate generation of real-world evidence （RWE）. The research design, methodological pathways, evaluation indicators, confounding factors, and bias management involved in DUR based on real-world data （RWD） were reviewed in this artical with the intention of providing guidance for further exploration into DUR.
2024, 42(6): 244-247.
doi: 10.12206/j.issn.2097-2024.202310027
Abstract:
Objective To investigate the effects and possible mechanism of electret and 5-fluorouracil（5-FU）on the growth of scar fibroblasts. Methods The effect of +5000 V electret combined with different concentrations of 5-FU on the proliferation of scar fibroblasts was detected by automatic enzyme labeling instrument. The apoptosis of scar fibroblasts and the mRNA expression of p53 and other apoptotic genes were studied by fluorescence microscopy and RT-PCR technology under the action of electrostatic field. Results ① After the treatment of positive electret and different concentrations of 5-FU for 72 h, the cell proliferation rate decreased, and the inhibition rate of scar cells in the +5000 V electret+160 μg/ml 5-FU group was (0.15±0.051)%. ②+5000 V electret group could promote the apoptosis of scar fibroblasts; The number of apoptotic cells in +5000 V electret and 5-FU group was higher than that in 5-FU group. ③The mRNA expression levels of four apoptotic genes in the +5000 V electret group were increased, and the expression levels of four signature genes in the +5000 V electret and 5-FU group were increased compared with those in the 5-FU group. Conclusion The combination of positive electret and 5-FU had a synergistic effect on inhibiting cell growth. The mechanism of positive electret inhibiting scar cell growth may be through promoting the expression of apoptosis gene, and then affecting the growth state of cells to inhibit cell growth.
2024, 42(6): 248-252, 266.
doi: 10.12206/j.issn.2097-2024.202305007
Abstract:
Objective To establish the method of simultaneous determination of four main components of Danggui Liuhuang Decoction, including phellodendrine, palmatine, calycosin, and ferulic acid and provide reference for the quality control of Danggui Liuhuang Decoction. Methods Based on the HPLC-MS/MS analysis method, the positive ion data acquisition mode were adopted for the mass spectrometry detection and the four main components were quantified with multiple reaction monitoring mode (MRM) by ESI source. The chromatographic column was Agilent Extend-C18 (5 μm, 4.6 mm×250 mm), and gradient elution was performed with methanol and 0.5% formic acid in water. Results The linear range of phellodendrine was from 2-200 nmol/ml, and the linear range of palmatine, calycosin and ferulic acid was from 20-2 000 nmol/ml. The contents of the four components in the seven batches of Danggui Liuhuang Decoction were relatively stable, among which ferulic acid was mainly found in Phellodendrine and Coptidis; Phellodendrine was only detected in cortex phellodendri; the content of calycosin in Scutellaria baicalensis and Astragalus was higher; palmatine was detected in both Phellodendron and Astragalus. Conclusion The method had high sensitivity, good specificity and sample stability, which could meet the requirements of quantitative analysis of Traditional Chinese Medicine compounds, and could provide reference for further pharmacokinetics study on the content changes of traditional Chinese medicine compounds in biological samples.
2024, 42(6): 253-259.
doi: 10.12206/j.issn.2097-2024.202311055
Abstract:
Objective To investigate the effect of the petroleum ether extract of Sageretia thea on the proliferation and apoptosis of breast cancer cells. Methods After breast cancer cells were incubated with the petroleum ether extract for different times, cell viability was analyzed by CCK8 assay, cell proliferation was detected by plate cloning test, nuclear morphology was observed by DAPI staining, mitochondrial membrane potential（MMP）and reactive oxygen species（ROS）were determined by immunofluorescence, and the cell cycle and apoptosis were detected by flow cytometry. After incubating with the extract for 24 h, the CCK8 assay was used to observe the toxicity to normal human vascular endothelial cells. Results The IC50 of BT549 and MDA-MB-231 breast cancer cell lines treated with the petroleum ether extract for 24 h were 45.40 μg/ml and 12.23 μg/ml, respectively. The extract time and dose dependently inhibited breast cancer cell viability and clonal formation, induced cell apoptosis and cycle arrest in G1/S phase, decreased MMP and increased ROS levels. There was no toxic effect on normal endothelial cells. Conclusion The petroleum ether extract of Sageretia thea may induce apoptosis by increasing ROS to cause MMP collapse, followed by activating mitochondrial pathway, thereby hindering the growth of breast cancer cells. These results could support the application of Sageretia thea to anti-breast tumor in the folk.
2024, 42(6): 260-262, 272.
doi: 10.12206/j.issn.2097-2024.202304014
Abstract:
Objective To investigate the pathogenic distribution characteristics and drug resistance of opportunistic Candida in patients with pulmonary tuberculosis on the Qinghai-Tibet Plateau. Methods 3 012 hospitalized cases of pulmonary tuberculosis at Qinghai Province Fourth People’s Hospital from March 1, 2020 to December 31, 2020 were analyzed, sputum samples were collected, Candida identification was carried by VITEK-32-YBC automatic bacterial analysis system, and the detected Candida was tested for drug sensitivity. Results Among the 3 012 cases of pulmonary tuberculosis in this investigation, 283 cases of pulmonary tuberculosis patients with Candida infection, accounting for 9.40%. Among them, Candida albicans was the main type of Candida, accounting for 79.86% of the total. Conclusion The prevalence rate of pulmonary tuberculosis complicated with Candida infection was high in Qinghai-Tibet Plateau. Therefore, the selection of antimicrobial drugs should be based on a comprehensive analysis of the patient's condition, in order to select the best and most effective drugs for treatment.
2024, 42(6): 263-266.
doi: 10.12206/j.issn.2097-2024.202309050
Abstract:
Objective To explore the role of clinical pharmacists involved in the case of a patient with acute myeloid leukemia whose QTc interval prolongation was induced by gilteritinib, and to provide reference for drug treatment and monitoring of those patients. Methods The abnormal electrocardiogram （ECG） of a patient with acute myeloid leukemia was found in time by clinical pharmacists, who participated in clinical diagnosis and treatment by analyzing the patient’s underlying diseases, diagnosis and treatment process, therapeutic drugs and their potential interactions. Results Clinical pharmacists suspected that the prolonged QTc interval was likely to be an adverse reaction caused by gilteritinib, and recommended immediate discontinuation of the drug and re-examination of the electrocardiogram.The physician took the suggestion to stop the suspected drug therapy with gilteritinib promptly, and ECG was rechecked 3 d later, and the QTc value returned to the normal range. Conclusion Clinical pharmacists participating in clinical diagnosis and treatment could provide better pharmaceutical care for patients.
2024, 42(6): 267-272.
doi: 10.12206/j.issn.2097-2024.202302039
Abstract:
Objective To analyze the clinical characteristics of pyogenic liver abscess（PLA）and explore the rationality and the duration of antibacterial treatment. Methods The clinical data of patients diagnosed as pyogenic liver abscess in our hospital from January 1, 2020 to December 31, 2022 were analyzed to explore their clinical characteristics. The rationality of antibacterial treatment was evaluated by setting evaluation criteria. The duration of antibacterial use in different treatment outcomes was counted. Results A total of 89 patients were included in the analysis. The average age was （62.0±15.6） years old, with the male accounting for 61.80%. Diabetes for 53.9% was the most common complication. Among 59 patients （66.3%）with positive culture of pos or blood, 51 cases （57.3%） were Klebsiella Pneumoniaes. Among the empirical and target treatment, 45 cases （50.6%） and 17 cases （28.8%）of antibacterial regimens were evaluated as unreasonable, respectively. Recovery treatment time was （17.0±7.6）d, and actual treatment time was （21.1±7.3） d. Conclusion Diabetes was the most common high-risk factor of PLA, and Klebsiella Pneumoniae was the main pathogenic bacteria. It is necessary to strengthen the management of antibacterial drugs, explore the appropriate duration of antibacterial treatment, and reduce the overuse of antibacterial drugs.
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