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Effects of different harvest seasons on anthraquinone contents of Polygoni Multiflori Radix based on UPLC-MS/MS LI Yanyi, WANG Ying, ZHANG Nanping, YANG Jianbo, LIU Yue, WANG Qi, ZHANG Yujie, MA Shuangcheng 2022, 19(12): 1277-1284.  DOI: 10.19803/j.1672-8629.20220479 Abstract ( 116 )   PDF (2010KB) ( 106 )   Objective To explore the effects of different harvest seasons and years of growth on contents of anthraquinone in Polygoni Multiflori Radix (PM) grown in Deqing District, Zhaoqing, Guangdong Province. Methods The contents of nine types of anthraquinones, including emodin-1-O-glucoside, emodin-8-O-β-D-glucoside, emodin- 8-O-(6’-methylmalonyl)-glucopyranoside, emodin-6-O-glucoside, physcion-8-O-β-D-glucoside, physcion-8-O-(6’-methylmalonyl)-glucopyranoside, 1-methyl emodin, emodin, and physcion were determined while the data on seasons of harvest and years of growth of Polygoni Multiflori Radix was collected. Results The total amounts of nine anthraquinones in the samples collected in autumn ranged from 1 465.82 to 1 707.76 μg·g-1, which were much lower than those of the samples collected in spring (ranging from 2 826.56 to 3 100.61 μg·g-1) and summer (ranging from 3 616.38 to 5 777.23 μg·g-1). The contents of anthraquinone in physcion-8-O-β-D-glucoside and physcion-8-O-(6’-methylmalonyl)-glucopyranoside trended down with the season, while those of the other seven anthraquinons increased in spring and summer, but decreased sharply in autumn. The contents of emodin, emodin-8-O-β-D-glucoside and other components in PM that had grown for three to four years were low. The contents of emodin-8-O-β-D-glucoside and physcion-8-O-β-D-glucoside in the four-year-old samples collected in autumn were the highest. Conclusion The season of harvest has a more significant effect on the content of anthraquinones than years of growth. With anthraquinones as an index of liver toxicity, the content of anthraquinones collected in autumn is lower than that of samples collected in spring and summer, so autumn is a good season for harvest as is defined in the Pharmacopoeia. The contents of anthraquinones in PM grown for three to four years are relatively low. References | Related Articles | Metrics

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Dynamic changes of polysaccharide structure during a nine-time repeat of steaming and drying of Polygoni Multiflori Radix WANG Ying, GU Donglin, YANG Jianbo, LIU Jingjing, FAN Jing, LIU Yue, WANG Qi, JIN Hongyu, WEI Feng, MA Shuangcheng 2022, 19(12): 1285-1290.  DOI: 10.19803/j.1672-8629.20220482 Abstract ( 116 )   PDF (1765KB) ( 65 )   Objective To study the dynamic changes of the primary structure of polysaccharides in Polygoni Multiflori Radix（PM）after nine times of steamed and sun-bathed processing. Methods The polysaccharide components of raw PM and each steamed product were obtained by water extraction and alcohol precipitation. The monosaccharide composition was determined using the PMP derivatization HPLC-PDA method, the average molecular weight（Mw）was determined with the GPC-MALLS-RID method, and the functional group structure of polysaccharide was analyzed via infrared spectroscopy. Moreover, the structural differences were analyzed. Results From raw products to processed products, the polysaccharide yield was 3.93%, 12.65%, 17.08%, 18.62%, 18.78%, 18.88%, 19.59%, 15.23%, 16.32% and 24.07%, respectively, showing an upward-downward-upward trend. The polysaccharides in raw and processed products of PM were both composed of 7 monosaccharides: mannose, rhamnose, glucuronic acid, galacturonic acid, glucose, galactose and arabinose. Despite the consistent monosaccharide composition, there were some differences in the content of monosaccharide. With the increasing number of times of steaming, the content of galacturonic acid decreased while that of glucose increased. The results of relative molecular weight measurement showed that the Mw of raw products and processed products was 515.6×103,144.9×103,325.9×103,458.5×103,256.6×103,172.8×103,281.8×103,371.2×103,304.7×103 and 257.1×103, respectively, showing a downward trend. The results of infrared spectroscopy showed that there was no significant difference in the absorption spectra of polysaccharides from raw and processed PM. Conclusion Compared with the polysaccharide in raw products of PM, the polysaccharide in processed products during the nine-time steaming and sun-drying undergoes a significant change in the monosaccharide composition and relative molecular weight, and is related to the number of times of processing. The results provide data for exploring the processing mechanism and quality control standards of PM. References | Related Articles | Metrics

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Changes of content of 5-HMF and stilbene glycoside in Polygoni Multiflori Radix during nine-time repeat of steaming and sun-drying WANG Ying, GU Donglin, FAN Jing, YANG Jianbo, LIU Yue, WANG Xueting, WANG Qi, JIN Hongyu, WEI Feng, MA Shuangcheng 2022, 19(12): 1291-1294.  DOI: 10.19803/j.1672-8629.20220493 Abstract ( 72 )   PDF (1703KB) ( 60 )   Objective To explore the changes of contents of 5-hydroxymethylfurfural (5-HMF) and stilbene glycoside in Polygoni Multiflori Radix(PM)during nine-time repeat of steaming and sun-drying and to provide reference for quality evaluation of PM. Methods The samples were prepared using the nine-time repeat of steaming and sun-drying method. The contents of 5-HMF were determined on an Agilent SB-C18(4.6 mm×250 mm, 5 μm ) column with a mobile phase composed of methanol and water solution(8:92)at a flow rate of 1.0 mL·min-1 and at the column temperature of 30℃. The contents of stilbene glycoside were determined using the method for PM specified in Chinese Pharmacopoeia (2020 Edition). Results The established method for the determination of 5-HMF in PM proved to meet the requirements of sample determination according to methodological validation tests. 5-HMF was not detected in the raw PM. The content of 5-HMF increased gradually with the number to times of processing, but the content of stilbene glycoside from PM trended down. Conclusion In the process of nine-time repeat of the steaming and sun-drying, the contents of 5-HMF and stilbene glycoside from PM can change significantly. This study can provide reference for the study on the processing mechanism of PM and for improvement of quality evaluation methods. References | Related Articles | Metrics

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Effects of duration of steaming on 26 chemical compositions of Polygoni Multiflori Radix based on UPLC-MS/MS detection technology LI Yanyi, WANG Ying, ZHANG Nanping, YANG Jianbo, LIU Yue, WANG Qi, ZHANG Yujie, WEI Feng, MA Shuangcheng 2022, 19(12): 1295-1302.  DOI: 10.19803/j.1672-8629.20220458 Abstract ( 64 )   PDF (2413KB) ( 48 )   Objective To explore the effects of duration of steaming (0~48 h) and processing methods recorded in “Chinese Pharmacopoeia” on the contents of main chemical components of Polygoni Multiflori Radix（PM）. Methods Pharmacopoeia-defined steamed samples were prepared before an ultra-high performance liquid chromatography-triple quadrupole mass spectrometry (UPLC-MS/MS) analytical method was established for determination of the 26 components in PM. Results An accurate and reliable UPLC-MS/MS method was established for the determination of anthraquinone, stilbene glycosides, flavonoids and phenolic compounds in PM. With the extension of steaming time, the contents of 26 components changed significantly. The contents of free anthraquinone components (emodin, physcion) decreased before they increased, while those of combined anthraquinone components (emodin-8-O-β-D-glucoside, Physcion- -8-O-β-D-glucoside, emodin-1-O-glucoside, emodin-6-O-glucoside), rhein, hydroxyemodin, emodin-1-methyl, cis-THSG, polydatin, epicatechin and rutin increased first and then decreased. The contents of emodin dianthrone, emodin-8-O-(6’-methylmalonyl)-glucopyranoside, physcion-8-O-(6’- methylmalonyl)-glucopyranoside, trans-THSG, resveratrol, 2,3,5,4’-tetrahydroxystilbene-2-0-(2”-O-feruloyl)-β-D-glucopyranoside, catechin and torachrysone-8-O-β-D-glucopyranoside decreased, while those of phenolic components increased. Conclusion This method is simple, accurate and repeatable, which can be used for quantitative detection and analysis of 26 chemical components in PM. The contents of the 26 components in PM are closely related to the duration of steaming. Anthraquinones, stilbene glycosides, flavonoids and phenols undergo regular changes, which have an impact on the quality of PM. References | Related Articles | Metrics

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Histopathology of acute kidney injury in SD rats induced by three monomer components of Polygoni Multiflori Radix HUO Guitao, WEN Hairuo, YANG Yanwei, QIN Chao, WANG Qi, MA Shuangcheng 2022, 19(12): 1303-1308.  DOI: 10.19803/j.1672-8629.20220459 Abstract ( 73 )   PDF (2286KB) ( 52 )   Objective To study the morphology of acute renal injury caused by three Polygoni Multiflori Radix monomers in SD rats after 14 days of oral administration. Methods Fifty male SD rats were randomly divided into the control group, the 28 mg·kg-1, 280 mg·kg-1 and 1 120 mg·kg-1 dose of emodin-8-O-β-D-glucoside groups, the 6.5 mg·kg-1, 65 mg·kg-1 and 650 mg·kg-1 dose groups of emodin-type monoanthranone and the 6.5 mg·kg-1, 65 mg·kg-1 and 650 mg·kg-1 dose groups of physcion. All doses of emodin-8-O-β-D-glucoside, emodin-type monoanthranone and physcion were administered orally for 14 days, respectively. After administration, the animals were anesthetized and necropsied, the kidneys were examined for macroscopic observation and weighed before the fixed kidneys were subjected to section preparation and histopathological examination. Results Macroscopic observation showed white nodules in bilateral kidneys of one rat in the 650 mg·kg-1 dose group of emodin-type monoanthranone. There were no gross lesions in SD rats in the three dose groups of emodin-8-O-β-D-glucoside, the 6.5 mg·kg-1, 65 mg·kg-1 dose groups of emodin-type monoanthranone, or in the three dose groups of physcion. Compared with the control group, there were no statistically significant differences in the absolute kidney weight or organ/body weight ratio of emodin-8-O-β-D-glucoside, emodin-type monoanthranone and physcion in each dose group (P >0.05). Microscopic observation showed that emodin-8-O-β-D-glucoside could cause the formation of tubular hyaline droplets, emodin-type monoanthranone could induce tubular pigmentation and aggravate tubular basophilia, and that physcion did not cause obvious injury to the kidney. Conclusion Emodin-8-O-β-D-glucoside and emodin-type monoanthranone can lead to morphological changes in the kidney of SD rats, but physcion does not. References | Related Articles | Metrics

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Variations of chemical substances and toxic substances of Evodia rutaecarpa using different extraction methods JI Hainan, TONG Na, LIU Chang, ZHAO Chan, ZHOU Xiaojuan, SUI Feng, SHEN Guolin 2022, 19(12): 1309-1314.  DOI: 10.19803/j.1672-8629.20210518 Abstract ( 48 )   PDF (1908KB) ( 52 )   Objective To study the chemical substances of Evodia rutaecarpa extracted using different methods and the possible main material basis of hepatotoxicity. Methods The water extract, 30% ethanol extract, 50% ethanol extract and 80% ethanol extract of Evodia rutaecarpa were prepared respectively. The differential chemical substances were identified using the method of phytomics, and the toxicity of the main differential chemical substances was screened via software prediction. Results The results showed that there were 50 types of different chemical substances in water extraction and ethanol extraction of Evodia rutaecarpa, among which the most important one was Evodia alkaloids. The results of toxicity endpoint screening showed that there were safety risks in Evodia rutaecarpa alkaloids. The toxicity of Evodia rutaecarpa alcohol extract was higher than that of water extract. Conclusion Different extraction methods can make a difference to chemical substances of Evodia rutaecarpa, and Evodia alkaloids may be the basis of its toxic substances . References | Related Articles | Metrics

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Yi medicine Micromeria biflora (Buch.Ham.ex D.Don)Benth. standard decoction WANG Meng, ZHI Yajing, QIE Lanxia, GUO Jiahui, CAI Yuluo, NIU Liying 2022, 19(12): 1315-1320.  DOI: 10.19803/j.1672-8629.20210458 Abstract ( 55 )   PDF (2273KB) ( 59 )   Objective To prepare Yi Medicine Micromeria biflora(Buch.Ham.ex D.Don)Benth. standard decoction and to study the quality standard. Methods Fifteen batches of Micromeria biflora(Buch.Ham.ex D.Don)Benth. standard decoction were prepared using the standard method. With rosmarinic acid as the quantitative detection index, the transfer rate and extraction rate were calculated and an HPLC characteristic chromatogram analysis method was established. Results According to the measurement of 15 batches of Micromeria biflora(Buch.Ham.ex D.Don)Benth. standard decoction, the transfer rate ranged from 34.11% to 104.72% and extraction rate from 11.9 % to 15.1 %. Similarity Evaluation System for Chromatographic Fingerprint of TCM (2012) was used to analyze and compare the characteristic chromatograms so that 23 common peaks were determined and 3 of them were identified. Moreover, the similarities were all over 0.90. Conclusion This determination method displays good precision, stability and repeatability, which can provide reference for quality control of Micromeria biflora(Buch.Ham.ex D.Don)Benth. References | Related Articles | Metrics

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Acute toxicity and long toxicity of Mongolian medicine sea-buckthorn syrup on 14-day-old SD rats GAO Qinqin, LIANG Guodong, ZHOU Zexuan, SHENG Wei, XU Xiaoshuang, LIU Weidong, NA Heiya 2022, 19(12): 1321-1324.  DOI: 10.19803/j.1672-8629.20210621 Abstract ( 77 )   PDF (2133KB) ( 57 )   Objective To observe the acute toxicity and long-term toxicity that may occur in the body of 14-day-old SD rats after oral administration of different doses of sea-buckthorn syrup, and provide data on safety for a larger population that is eligible for sea-buckthorn syrup. Methods On the acute toxicity test, 14-day-old SD rats were given 30, 90, and 180 g·kg-1·d-1 sea-buckthorn syrup at a single oral dose, and the acute toxicity within 2 weeks of administration was observed. On the long-term toxicity test, 14-day-old SD rats were given 15 (low dose), 45 (medium dose), 90 (high dose)g·kg-1·d-1 sea-buckthorn syrup orally for 13 weeks before being allowed to recover for 4 weeks. The clinical symptoms, body weight, food intake, indicators of physiological development, indicators of FOB, learning and memory ability, organ weights and coefficients, hematology, coagulation, blood biochemistry, urine indicators, results of histopathological examinations were observed. Results On the acute toxicity test, the MTD of sea-buckthorn syrup for a single administration exceeded 180 g·kg-1. On the long-term toxicity test, the NOAEL level of sea-buckthorn syrup was 90 g·kg-1. Conclusion The decrease in weight and food intake of young rats is positively correlated with the dose of sea-buckthorn syrup, and large doses ( >180 g·kg-1) should be avoided in clinical use. References | Related Articles | Metrics

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Complex network analysis of combined medications of Danshen Ligustrazine injection in the treatment of coronary heart disease complicated with hypertension CHENG Xu, ZHANG Lidan, XIE Yanming, GAO Yang, YANG Yunyun 2022, 19(12): 1325-1331.  DOI: 10.19803/j.1672-8629.20210641 Abstract ( 60 )   PDF (2988KB) ( 56 )   Objective To analyze the complex network of combined medications of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection in the treatment of coronary heart disease complicated with hypertension in the real world so as to provide reference for the selection of clinically effective regimens. Methods From the large-scale electronic medical electronic data warehouse constructed by the Institute of Clinical Basic Medicine of Chinese Academy of Chinese Medical Sciences, the data of 1 930 patients with coronary heart disease and hypertension who had been treated with Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection between October 1, 2006 and December 30, 2015 was retrieved and analyzed based on the hospital information system(HIS). The Tabu search algorithm and complex network analysis method were used to conduct group module analysis. Results The average age of the 1 930 patients was (74.16±10.10) years old. Males patients outnumbered female ones. Most of them were manual laborers. Most of the inpatients were in mild condition. Other comorbidities were mostly type 2 diabetes and cerebral infarction. The route of administration was intravenous drips. The drugs were used in line with the instructions. The average single dose was (12.85±4.46) mL. The average duration of administration was (4.36±2.16) days. Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection were preferably combined with isosorbide mononitrate + nicardipine/valsartan and amlodipine tablets, metoprolol/heparins/acetylsalicylic acid, atorvastatin/levcarne Ting and other programs in the treatment of coronary heart disease complicated with hypertension. For traditional Chinese medicine, Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection were combined with Safflower Injection + compound Danshen dropping pills + Shexiang Baoxin pills/Suxiao Jiuxin pills, Tongxin luo capsules, compound Ganmaoling granules/VC Yinqiao tablets/Yinhuang Buccal tablets/compound Huangliansu tablets, the Simo decoction oral liquid/qi and yin nourishing agent. Conclusion By dividing the core combined drugs used by the clinically cured and improving populations into sub-structures, we can see more clearly the relationships between the sub-groups of the core combined medications with western and traditional Chinese medicine and between the sub-structures of each sub-group, which provide clues to the selection of clinically superior programs and pathways. References | Related Articles | Metrics

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Network pharmacology of bexarotene against cerebral ischemia-reperfusion injury SHI Qiang, LIU Shengwei, SHEN Zhengze, CHEN Chang, REN Zhongyang, LIU Jie, HU Yi 2022, 19(12): 1332-1337.  DOI: 10.19803/j.1672-8629.20210503 Abstract ( 42 )   PDF (2150KB) ( 45 )   Objective To explore the mechanism of bexarotene in the treatment of cerebral ischemia reperfusion injury (CIRI) via network pharmacology. Methods PharmMapper Server was used to predict the targets of bexarotene, GeneCards was applied to retrieve the targets of the disease, and VENNY 2.1.0 was adopted to map the targets of bexarotene on CIRI. PPI networks of potential targets were constructed with software Cytoscape 3.8.2 before the R language package clusterProfiler was used for GO enrichment analysis and KEGG pathway analysis of the potential targets of bexarotene against CIRI. Results After mapping the predicted 275 targets of bexarotene with the 513 targets of cerebral ischemia/reperfusion injury, a total of 73 intersection targets were obtained. In the PPI network of potential targets, the top 10 key target genes were ALB, AKT1, CASP3, JUN, MAPK1, MAPK8, MMP9, SRC, IGF1 and ESR1. A total of 138 pathways were enriched by KEGG pathway analysis, among which the MAPK signaling pathway, apoptosis signaling pathway, PI3K-Akt signaling pathway, fluid shear stress and atherosclerosis signaling pathway were most significantly related to CIRI. Conclusion Bexarotene protects against CIRI possibly by acting on multiple targets and through multiple pathways, exerting anti-apoptotic, anti-inflammatory, anti-oxidant, anti-coagulative effects. References | Related Articles | Metrics

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Comparison of the effects of carvedilol and metoprolol on myocardial infarction and cardiac function in hemodialysis patients FAN Leilei, YANG Jing, XIAO Qianqian, GAO Dongxue, QU Suping 2022, 19(12): 1338-1343.  DOI: 10.19803/j.1672-8629.20210660 Abstract ( 71 )   PDF (1567KB) ( 45 )   Objective To compare the effects of carvedilol and metoprolol on myocardial infarction and cardiac function in hemodialysis patients, so as to provide reference for clinical medications. Methods A total of 180 patients receiving maintenance hemodialysis in our hospital between December 10, 2019 and December 31, 2020 were selected, who were randomly divided into the carvedilol group (n=60), metoprolol group (n=60) and control group (n=60). The carvedilol group received maintenance hemodialysis + carvedilol (oral), the metoprolol group was given maintainenance hemodialysis + metoprolol succinate sustained-release tablets (oral), and the control group underwent twelve months of maintenance hemodialysis only. The incidence of acute myocardial infarction was compared between the three groups, while the differences in amino-terminal brain natropeptide precursor (NT-proBNP), high-sensitive cardiac troponin T (hs-cTNT), myoglobin (Mb) and serum creatine kinase isoenzyme (CK-MB) and LVEF among the three groups were recorded. Results It was found that the incidence of acute myocardial infarction was significantly lower in the carvecilol group and metoprolol group than in the control group (P<0.05). The levels of NT-proBNP were significantly lower in the control group, but the LVEF value was significantly higher than in the control group, and the difference was statistically significant (P<0.05). The levels of hs-cTNT, Mb and CK-MB were not significantly different from those of the control group (P>0.05). Compared with the metoprolol group, the incidence of acute myocardial infarction in the carvedilol group was slightly lower, but the difference was not statistically significant (P>0.05). There was no significant difference in NT-proBNP, hs-cTNT, Mb, CK-MB and LVEF values between the metoprolol group and the carvedilol group. Conclusion Both carvedilol and metoprolol can reduce the incidence of acute myocardial infarction and improve cardiac function in maintenance hemodialysis patients, but there is no significant difference between the two groups. References | Related Articles | Metrics

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Network pharmacology of Tibetan medicine Ponka against influenza BAI Siyu, CHEN Qianwen, YE Xiao, FENG Weihong, RONG Lixin, LI Chun 2022, 19(12): 1344-1351.  DOI: 10.19803/j.1672-8629.20210612 Abstract ( 42 )   PDF (2812KB) ( 31 )   Objective To explore the active components and mechanism of anti-influenza virus and anti-inflammatory activities of Ponka via network pharmacological analysis. Methods The compounds isolated and identified from Ponka between January 1, 1985 and May 31, 2021 were collected and sorted from CNKI and Pubmed databases, while the bioactive components were screened according to ADME parameters via the SIB database. The targets of these active components were predicted using Swiss StargetPrediction. Influenza virus and inflammation targets were found in OMim and GeneCards databases, and the Venny2.1.0 tool was used to obtain the intersection targets of Ponka and influenza virus as well as Ponka and inflammation targets. The protein interactions were analyzed in the String database. Cytoscape3.6.0 software was used to construct the component-disease-key target network and core target network. GO function analysis and KEGG pathway enrichment analysis were performed using David 6.8 database. Results A total of 73 active components, 17 core ingredients, 841 action targets, 94 intersection targets of Ponka and influenza virus, 142 intersection targets of Ponka and anti-inflammation were retrieved. GO functional analysis revealed 181 biological processes, 42 molecular functions and 25 cell components of Ponka against influenza virus. KEGG enrichment analysis obtained 84 anti-influenza virus signaling pathways, mainly involving TNF, Hepatitis C and cancer signaling pathways. Go functional analysis revealed 232 biological processes, 52 molecular functions and 27 cell components of Ponka against inflammation. KEGG enrichment analysis showed 86 anti-inflammatory signaling pathways, mainly involving NF-Kappa B, TNF and HIF-1 signaling pathways. Conclusion The anti-influenza activity of Ponka results from the synergistic action of multiple components by multiple targets and multiple pathways. This finding can offer novel ideas for subsequent experimental verification. References | Related Articles | Metrics

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Analysis of data elements in case reports of traditional Chinese medicine drug-induced liver injury ZHU Lan, ZHU Yan, YAO Keyu, CHEN Chao, LIU Lihong 2022, 19(12): 1352-1357.  DOI: 10.19803/j.1672-8629.20220209 Abstract ( 159 )   PDF (1795KB) ( 170 )   Objective To evaluate the reported cases of traditional Chinese medicine (TCM) drug-induced liver injury(DILI) in China and provide reference for the standardization of TCM DILI. Methods Comprehensive collection of the 3 databases of CNKI, Wanfang Data and China Biomedical Text Service System from the establishment of the database to May 31, 2021, set the basic data elements of TCM DILI literature reports and evaluate the reported cases of TCM DILI in China. Results 43 data elements of TCM DILI literature reports were set, and 451 literatures involving 549 cases were included. The information of data elements was extracted, of which the reporting rate of 16 data elements was less than 50%.The reporting rate of data elements related to Roussel Uclaf scoring method (RUCAM) was low, and there were some problems such as fuzzy element reporting and discontinuous description of numerical data. Conclusion Some important information was missing in the literature of TCM DILI, and it is difficult to support the diagnosis and cality evaluation of TCM DILI. It is suggested that a unified standard should be established by developing the basic data set of TCM DILI literature case reports, to improve the quality of case report and promote the in-depth analysis and utilization of literature. References | Related Articles | Metrics

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Efficacy and safety of insulin degludec vs other long-acting basal insulin analogues in the treatment of type 1 diabetes ZHANG Shuai, GENG Yue, WAN Liyan, JI Liwei 2022, 19(12): 1358-1361.  DOI: 10.19803/j.1672-8629.20210787 Abstract ( 73 )   PDF (1656KB) ( 91 )   Objective To evaluate the efficacy and safety of insulin degludec(IDeg) vs other long-acting basal insulin analogues in the treatment of type 1 diabetes(T1DM), and provide evidence-based reference for clinical treatment. Methods PubMed, Cochrane Library, Clinical Trails.gov, CNKI, Wangfang Database, VIP and Chinadrugtrials.org.cn from the inception to March 31, 2021 were searched for articles related to randomized controlled trials about IDeg in the treatment of T1DM. Studies that met the inclusion criteria were analyzed using Rev Man 5.4.1. Results Totally, 5 RCTs were enrolled in meta-analysis, involving 2 256 patients. Results of Meta-analysis showed that for adult T1DM patients, there was no significant difference between IDeg and other long-acting basal insulin analogues in the ability to lower HbA1c [MD=0.01, 95%CI (-0.05, 0.08), P=0.69] , and the former was more effective in reducing FPG[MD=-0.85, 95%CI (-1.15, -0.56),P<0.000 01]. Weight gain was greater with IDeg than with insulin detemir [MD=1.07, 95%CI (0.47, 1.67), P<0.000 01]. The overall confirmed hypoglycemia rates[RR=0.95, 95%CI (0.92, 0.97), P=0.000 3], severe hypoglycemia rates[RR=0.78, 95%CI (0.66, 0.93), P=0.005] and nocturnal hypoglycemia rates[RR=0.70, 95%CI（0.61,0.80）, P<0.000 01] were lower with IDeg. Literature review found that insulin IDeg was also suitable for children and teenagers with type 1 diabetes. The reduced blood glucose fluctuations and hypoglycemia made it more cost effective. Conclusion For adult T1DM patients, IDeg is not only as effective and safe as other long-acting basal insulin analogues, but also has advantages in reducing FPG and the incidence of hypoglycemia, especially nocturnal hypoglycemia. IDeg may be an option for T1DM patients with relatively high fasting glucose or at high risk of hypoglycemia. References | Related Articles | Metrics

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Automatic monitoring of thrombocytopenia caused by bevacizumab in 4 864 inpatients and related influencing factors LI Boyan, GUO Daihong, ZHU Yu, WANG Jiaxi, ZHANG Bo, GUO Haili 2022, 19(12): 1362-1367.  DOI: 10.19803/j.1672-8629.20210746 Abstract ( 146 )   PDF (1639KB) ( 144 )   Objective To find out about the incidence of thrombocytopenia in large samples of hospitalized patients using bevacizumab in the real world, and to identify the risk factors. Methods The electronic information of all inpatients who used bevacizumab in our hospital between 2010 and 2020 was retrospectively monitored with the help of Adverse Drug Events Active Surveillance and Assessment System-II (ADE-ASAS-II). After the positive cases were determined, the propensity score 1:1 was used to match the control group, and the related risk factors were identified using binary logistic regression. Results Among the 4 864 inpatients treated with bevacizumab, 455 developed thrombocytopenia, with an incidence of 10.00%. A platelet base value < 150 ×109·L-1（OR=11.896,95%CI：8.270~17.111）, low leukocyte base value（OR=1.801,95%CI：1.213~2.675）, low erythrocyte base value（OR=1.561,95%CI：1.085~2.246）, stage Ⅳtumor (TNM stage)（OR=1.814,95%CI：1.059~3.107）, total number of times of chemotherapy≥ 10（OR=2.537, 95%CI：1.675~3.842）, and combination with paclitaxel and platinum（OR=2.658,95%CI：1.267~5.578） were risk factors for thrombocytopenia after using bevacizumab while the combination of platinum and pemetrexed regimen （OR=0.289,95% CI：0.147~0.568）was a protective factor for thrombocytopenia. Conclusion When bevacizumab is used in clinic, close attention should be paid to inpatients with risk factors such as a low platelet base value, multiple courses of treatment, combined treatment with paclitaxel and platinum. References | Related Articles | Metrics

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Correlations between vancomycin administration regimen recommended by the guidelines and blood trough concentrations DUAN Xiaohong, ZHANG Jie, WANG Yingyan, LUO Yini, LAI Xiaoxiao, WANG Xiaohui, CHEN She, SHEN Yuqiao 2022, 19(12): 1368-1371.  DOI: 10.19803/j.1672-8629.20210812 Abstract ( 60 )   PDF (1538KB) ( 89 )   Objective To investigate the relationships between blood trough concentrations of vancomycin and medication regimens. Methods A total of 199 patients who received vancomycin and TDM services in our hospital between January 1, 2017 and February 28, 2020 were selected. According to the monitoring concentrations, they were divided into the low-trough concentration group (< 10 μg·mL-1), through concentration group (10~20 μg·mL-1) and high-through concentration group (>20 μg·mL-1). The treatment regimens of the patients were evaluated according to the drug instructions/guidelines. Results Among the 199 patients, 45 (22.6%) were in the low-trough concentration group, 95 (47.7%) were in the trough concentration group, and 59 (29.7%) were in the high trough concentration group. Fifty-two (42.6%) of the 122 patients with correct dosage were in the trough concentration group. The trough concentrations of females were significantly higher than those of males ( P<0.001), and the trough concentration of the group under 18 years old was significantly lower than that of other groups (P<0.05). Conclusion More detailed guidelines and recommendations need to be formulated for initial administration according to patients’ age, gender, weight, renal function, drug combinations and complications. More vigorous monitoring of trough concentrations of vancomycin and adjustment of medications can enhance drug safety of patients. References | Related Articles | Metrics

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Analysis and prevention of medication errors of dabigatran etexilate and rivaroxaban ZHANG Qingxia, DING Qian, YAN Suying, WANG Yuqin 2022, 19(12): 1372-1375.  DOI: 10.19803/j.1672-8629.20210674 Abstract ( 120 )   PDF (1583KB) ( 141 )   Objective To discuss the occurrence and influencing factors of medication errors (ME) of dabigatran etexilate and rivaroxaban, and provide evidence for formulating targeted preventive measures. Methods The ME reports of dabigatran axetil and rivaroxaban between January 1, 2016 and December 31, 2020 of the National Clinical Safety Drug Monitoring Network were collected, and the classification, error content, error causing personnel, error finding personnel and causing factors of ME were analyzed. Results A total of 100 ME reports of dabigatran etexilate and rivaroxaban accounted for 0.17% of the total ME reports (59 949 cases), of which 5 were severe ME reports , which accounted for 0.98% of the total severe ME reports (508 cases). After a case-by-case review, 98 cases finally met the requirements, including 65 males and 33 females, with an average age of 62.45 (29~92) years. Grade B errors were the most, 76 cases (77.55%); severe ME reports 4 cases (4.08%), manifested as bleeding and bleeding tendency, and the wrong factors were drug interaction and perioperative anticoagulant use. The top three errors caused by physicians (45 cases, 45.92%) were indications, dosage and quantity/frequency;the top three errors caused by pharmacists (43 cases, 43.88%) were the quantity, specification, and variety. The people who found the errors were mainly pharmacists (77 cases, 78.57%). The top three factors causing errors were lack of knowledge/inadequate training, fatigue, and look-alike /sound-alike medicine. Conclusion The proportion of severe ME of dabigatran etexilate / rivaroxaban is greater than of total ME. It is important to pay attention to the procedure of prescription and dispensing. Equally, it is necessary to strengthen the training of medical staff in rational drug use and adjust the work intensity to reduce and avoid lack of knowledge/fatigue. Clinical decision support system such as pre-review prescriptions and automated drug delivery systems can be introduced to assist in reducing ME according to conditions. References | Related Articles | Metrics

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Pharmaceutical care for a case of fulminant type 1 diabetes with insulin allergy and positive insulin autoantibodies TANG Yan, WANG Jialin, ZHOU Jingya, ZHAO Weigang, DU Boran, HU Dandan, YANG Liping, YANG Yingying, ZHAO Zhe, YUAN Tao 2022, 19(12): 1376-1379.  DOI: 10.19803/j.1672-8629.20210758 Abstract ( 92 )   PDF (1545KB) ( 69 )   Objective To investigate the importance of medication adjustment and pharmaceutical care for a case of fulminant type 1 diabetes with insulin allergy and positive insulin autoantibodies. Methods Clinical pharmacists participated in the whole process of treatment, reviewed the related literature and offered recommendations according to the fluctuations of the patient’s blood glucose. Results The physicians and patient took the advice of the clinical pharmacists. The blood glucose of the patient was brought under control. Conclusion By using the intimate knowledge of pharmacy, clinical pharmacists can assist physicians in establishing the therapeutic regimen and performing pharmaceutical monitoring of the patient, which can help ensure rational drug use. References | Related Articles | Metrics

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Pharmaceutical care for a case of voriconazole combined with micafungin in the treatment of chronic obstructive pulmonary disease patients with pulmonary aspergillus infection ZHANG Li, CHEN Haitao, CHEN Xueliang, GAO Xiurong 2022, 19(12): 1380-1383.  DOI: 10.19803/j.1672-8629.20210808 Abstract ( 87 )   PDF (1533KB) ( 71 )   Objective To analyze the process of treatment and priorities of pharmaceutical care during the treatment of chronic obstructive pulmonary disease (COPD) complicated with invasive aspergillosis with voriconazole combined with micafungin. Methods Clinical pharmacists participated in the treatment and monitoring of a patient, selected drugs according to the metabolic kinetic characteristics of different drugs in the body, and provided pharmaceutical care during the treatment based on the condition of the patient. Results Upon participation in the treatment, the pharmacists recommended voriconazole combined with micafungin to alleviate the condition and prevent serious adverse drug reactions. Conclusion Selection of the right antibiotics is crucial to the efficacy of treatment of COPD with invasive aspergillosis. Clinical pharmacists should actively participate in pharmaceutical care of patients in critical condition. References | Related Articles | Metrics

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Immunotoxicity of traditional Chinese medicine containing Polygoni Multiflori Radix based on clinical signals LEI Chao, WANG Zhifei, XIE Yanming 2022, 19(12): 1384-1387.  DOI: 10.19803/j.1672-8629.20220066 Abstract ( 89 )   PDF (1437KB) ( 88 )   Clinically, most of the liver injuries caused by Polygonum multiflorum Thunb. and its preparations are immune specific liver injuries. The clinical risk signal mining of this type of liver injury focuses on specific constitution, basic diseases, gene markers, immune group libraries and serum metabolites. The onset of immune specific liver injuries is hidden and difficult to identify. This tentative exploration and mining of the immunotoxicity of Chinese herbal medicine containing Polygonum multiflorum Thunb. is expected to help clarify the priorities of subsequent clinical trials and provide reference for mining of clinical risk signals and the establishment of an early warning model of liver injury caused by Polygonum multiflorum Thunb. References | Related Articles | Metrics

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Research progress on pharmacological effect and structure-activity relationship of common cannabinoid compounds WANG Chunqing, ZHANG Yuanyuan, LI Qian, DU Lina, JIN Yiguang 2022, 19(12): 1388-1392.  DOI: 10.19803/j.1672-8629.20210549 Abstract ( 70 )   PDF (1894KB) ( 80 )   Cannabis compounds have attracted extensive attention in recent years. Based on the current research globally, this review summarizes the pharmacological effects and the existing problems with several common cannabinoid compounds. Cannabinol, tetrahydrocannabinol and cannabinoid phenol have diverse pharmacological effects, such as anti-tumor, anti-inflammatory, antibacterial properties, immune regulation, mental regulation as well as neuroprotection. Cannabinoid compounds need to be monitored to prevent abuse. Therefore, the relationship between the chemical structure and the pharmacological activity should be clarified to reduce mental dependence and broaden clinical applications. References | Related Articles | Metrics