1.Correlation between Liver and Kidney Toxicity and Cyclosporin A Blood Concentration in 1236 Samples of Patients with Aplastic Anemia
China Pharmacist 2017;20(3):513-515
Objective:To analyze the correlation between cyclosporin A blood concentration and drug-induced liver and kidney in-jury in the patients with aplastic anemia, investigate the significance of cyclosporin A concentration in the monitoring of liver and kidney toxicity, and provide theoretical basis for clinical individualized drug use. Methods:A total of 149 patients with aplastic anemia trea-ted with cyclosporin A as the main therapeutic drug were selected, and after 3-day treatment, the blood concentration of cyclosporin A was detected by an HPLC-UV method 10 minutes before the administration and 2 hours after the administration. The liver and kidney function were measured at the same time. The correlation between the different concentration of cyclosporine A and the change of liver and kidney function was analyzed. Results:All the patients were monitored cyclosporine A blood concentration with 1236 samples, and 34 patients (22. 82%) were with drug-induced liver injury and 51 patients (34. 23%) showed drug-induced kidney toxicity. The average C0 of liver injury patients was (297. 92 ± 74. 14) μg·L-1 , and C2 was (944. 47 ± 148. 47) μg·L-1 , while the average C0 of kidney injury patients was (311. 41 ± 52. 80)μg·L-1, and C2 was (926. 25 ± 136. 02) μg·L-1. The function indices of liver (ALT, AST, TBIL) and kidney (SC, BUN, UA) were significantly higher than those in the normal group (P<0. 05), and the blood concentration of cyclosporin A was significantly correlated with the liver,and kidney function. Conclusion:There is a certain correla-tion between cyclosporine A -induced toxicity and its blood concentration and C2 may be a more valuable predictor for drug -induced liver injury.
2.Effects of combination of tolterodine and tamsulosin on BPH induced LUTS in rats
Yuping SHANG ; Yuguang DUAN ; Haipeng LIU
Chinese Journal of Primary Medicine and Pharmacy 2008;15(2):212-214
Objective To investigate the efficacy of tolterodine plus tamsulosin in rats with benign prostatic hyperplasia(BPH)induced low urinary tract syndrome(LUTS).Methods Male rats were castrated,then testosterone propionate were given by subcutaneous injection to induce BPH/LUTS model.Model rats were intragastrically administrated with 0.4mg/kg of tolterodine,0.04mg/kg of tamsulosin or(0.4+0.04)mg/kg of tolterodine plus tamsulosin for 14 days and urodynamics,residual urine volume and volume of bladder were mearsured.Results Tolterodine plus tamsulosin could simultaneously shorten the micturition duration,prolong the interval duration between micturition,decrease the threshold intravesical pressure at micturition and the max intravesical Pressure at micturition significantly.The combined-therapy method could also decrease the residual urine volume to a certein extent and had no obvious influence on enlarging the volume of bladder(P<0.05 or P<0.01).Conclusion Combination treatment with tolterodine and tamsulosin may efficiently ameliorate bladder outlet obstrution and overactive bladder simultaneously,with no extra danger of uroschesis.
3.Special Review of 66 Patients Treated with Vancomycin in a Cancer Hospital
Xiaodan ZHANG ; Jingjing SHAO ; Chunxiao PAN ; Yuping SHANG
China Pharmacist 2017;20(1):109-112
Objective:To evaluate the clinical application of vancomycin in a cancer hospital in order to promote the rational use of vancomycin. Methods:The records of 66 patients treated with vancomycin in 2015 were reviewed and analyzed in the respects of in-dications of medication, pathogenic examination, usage and dosage, course of treatment, drug combination, drug monitoring and drug utilization index(DUI). Results:Among the 66 cases, most drug use was rational, which accounted for 69. 70% with DUI of 0. 82. There were still several types of irrational drug use including no medication indications, irrational usage and dosage, too long or too short course of treatment, irrational combination and prophylactic use time. Conclusion:The application of vancomycin is basically ra-tional, while irrational phenomenon still exists. The management and supervision should be further strengthened in order to promote clinical rational drug use and ensure medication safety of patients.
4.Concurrent raltitrexed plus oxaliplatin and radiotherapy versus PF synchronous radio-therapy on advanced esophageal cancer
Cheng CHEN ; Jianhua MA ; Qun DING ; Yuping SHANG ; Zhongming WANG
Chinese Journal of Clinical Oncology 2016;43(16):718-722
Objective:To compare the therapeutic and adverse effects of concurrent raltitrexed plus oxaliplatin and radiotherapy with those of PF synchronous radiotherapy in the treatment of advanced esophageal cancer. Methods:A total of 84 pathologically con-firmed patients with advanced esophageal carcinoma were randomly distributed to the concurrent raltitrexed plus oxaliplatin and ra-diotherapy group (experimental group, n=40) and to the PF synchronous radiotherapy group (control group, n=44). All patients were treated with 3DCRT at a total dose of 60 Gy/30f. The chemotherapy in the experimental group consists of raltitrexed at 2.5 mg/m2, d1, plus oxaliplatin at 130 mg/m2, d2. The chemotherapy of the control group consists of DDP at 25 mg/m2, Dd1-3, plus 5-FU 500 mg/m2, d1-5. Two cycles of concurrent chemotherapy were administered during radiotherapy on d1 and d29. The comparison results were used to estimate the therapeutic and adverse effects of the two groups. Results:The rerponse rate, complete response, and one-year overall survival rate of the experimental group were higher than those of the control group [(87.50%vs. 79.54%, P=0.3293), (32.50%vs. 18.18%, P=0.13), and (82.50%vs. 79.50%, P=0.701)], but the difference was not statistically significant. The incidence rates of nau-sea and vomiting, appetite degression, leucopenia, radiation-induced esophagitis, and cardiotoxicity were significantly lower (P<0.05) in the experimental group than in the control group. Other adverse effects of the two groups were similar (P>0.05). Conclusion:Simi-lar to PF chemotherapy and radiotherapy, the concurrent raltitrexed plus oxaliplatin and radiotherapy achieved a similar short-term therapeutic effect but lower adverse effects on patients with esophageal cancer.
5.Discussion on the Training Mode of the Humanistic Quality of Applied Talents in Medical Colleges
Min SHI ; Yuping HU ; Congshan SHANG ; Tingting MENG
Chinese Medical Ethics 2017;30(5):642-646
Throughin-depth study and thinking ofthe current situation of medical education,this paper exploredtraining strategies of applied talents in medical colleges under the new situation.From the training ofapplication talents in medical colleges under new situation,we should focus on the current reality,learn experience.Combined with the characteristics of medical specialty,we should explore the model of strengthening the humanistic quality moral training of current medical application talents from the curriculum,teaching content selection,teachers' construction,environment shaping,teaching methods,assessment and evaluation,and thus to adapt to the medical mode conversion,alleviate the doctor-patient contradiction and promote medical students employments.
6.Determination of Paclitaxel and Docetaxel in Plasma by Crossing Internal Standard Method and its Clinical Application
Xinchen WANG ; Yuping SHANG ; Fang DENG ; Xiaodan ZHANG ; Chunxiao PAN
China Pharmacist 2015;18(10):1685-1688,1728
Objective:To establish an HPLC method for the determination of paclitaxel and docetaxel in plasma to provide refer-ence for the individualized treatment regimen and the evaluation of curative effect and adverse reactions. Methods:Paclitaxel and do-cetaxel were used as the internal standard for each other. The samples were precipitated by acetonitrile and separated on a DikMA Dia-monsil C18 column with a mixture of acetonitrile-water (55: 45) as the mobile phase. The flow rate was 1. 2 ml·min-1 . The column temperature was set at 25℃. Paclitaxel and docetaxel were detected by UV-detection (λ= 227 nm). Results: A linearity was ob-tained within the range of 0. 078-10. 0 mg·L-1 for paclitaxel and docetaxel. The limit of quantitation was 0. 039 mg·L-1 . The aver-age recovery of paclitaxel and docetaxel was 99. 85% and 100. 35%, respectively. The inter- and intra-day RSD were both less than 5% and the RSD for freeze-thaw stability was below 10%. The plasma concentration of paclitaxel in clinical samples was within the range of 0. 18-6. 16 mg·L-1 and obvious individual difference was shown. Conclusion:Therapeutic drug monitoring is very important due to the obvious differences in plasma concentration of paclitaxel and docetaxel. The established method is sensitive, accurate, con-venient and rapid in r the therapeutic drug monitoring, and is useful for the adverse drug reactions monitoring and pharmacokinetic study.
7.Review and Analysis of Antibiotics Prophylactic Used during Perioperative Period of 960 Cases of TypeⅠIncision Operation in a Cancer Hospital
Xiaodan ZHANG ; Feng YANG ; Chunxiao PAN ; Jingmo YANG ; Yuping SHANG
China Pharmacist 2015;(11):1922-1925
Objective:To analyze the prophylactic use of antibiotics during the perioperative period of typeⅠincision operation in a cancer hospital in order to promote the safe, effective and rational use of antibiotics. Methods:The rationality of 480 cases of typeⅠincision operation from January to December in 2013 and from January to December in 2014 was evaluated respectively, and the analy-sis and comparison were performed on the prophylactic use of antibiotics. Results: Through the pharmaceutical intervention including the special evaluation carried out by clinical pharmacists, the use of antibiotics gradually reached the rational level. Conclusion: The participation of clinical pharmacists in the use management of antibiotics in typeⅠincision operation can improve the rationality of the drugs used in clinic.
8.Metabolomic study of the action mechanism of nourishing blood effect of fo-shou-san on blood deficiency mice.
Weixia LI ; Meiyan HUANG ; Yuping TANG ; Jianming GUO ; Erxin SHANG ; Linyan WANG ; Dawei QIAN ; Jinao DUAN
Acta Pharmaceutica Sinica 2013;48(8):1301-6
The metabolic effect of Fo-Shou-San on blood deficiency mice was studied by using metabolomic method. UPLC-QTOF/MS was used to analyze the plasma metabolome in blood deficiency mice. MS data were processed by MarkerLynx software. With multivariate statistical analysis of plasma metabolite profiles, a clear separation among control, blood deficiency model, and Fo-Shou-San groups was achieved. Potential biomarkers were selected according to the parameters of variable importance in the projection (VIP) and identified according to MS information and database retrieval. The metabolic network of blood deficiency was predicted via MetPA database. Twenty-two potential biomarkers were identified and used to explain the thiamine metabolism, arachidonic acid metabolism, sphingolipid metabolism, glyoxylate and dicarboxylate metabolism, histidine metabolism, nicotinate and nicotinamide metabolism, cysteine and methionine metabolism, tryptophan metabolism, starch and sucrose metabolism, tyrosine metabolism and citrate cycle (TCA cycle). Those metabolic pathways were disturbed in blood deficiency mice, but which could be regulated nearly to normal state after Fo-Shou-San administration. In this study, the metabolomics of blood deficiency mice and the action mechanism of nourishing blood effect of Fo-Shou-San were evaluated. The physiological and metabolic state of the organism could be represented comprehensively by using metabolomics. And metabolomics can be used to evaluate the pharmacodynamics and related mechanisms of Chinese medicine and formulae.
9.Comparative analysis of the promoting blood effects of the combination of different proportions of danggui and honghua by the principal component analysis and multi-attribute comprehensive index methods.
Shujiao LI ; Weixia LI ; Yuping TANG ; Juan SHEN ; Erxin SHANG ; Jianming GUO ; Jinao DUAN
Acta Pharmaceutica Sinica 2014;49(9):1304-9
The combination of Danggui and Honghua (GH) is a popular herb pair commonly used in clinic for the treatment of blood stasis syndrome in China. To evaluate the activating blood circulation and dissipating blood stasis effects of the combination of different proportions of Danggui and Honghua on acute blood stasis rats, and optimize the proportion of GH to have the best activating blood circulation and dissipating blood stasis effect. Acute blood stasis rat model was induced by subcutaneous injection of adrenaline and ice water bath. The blood stasis rats were administrated intragastrically with GH (1 : 0, 4 : 1, 2 : 1, 3 : 2, 1 : 1, 2 : 3, 1: 2, 1 : 4 and 0 : 1) extracts. The whole blood viscosity (WBV), plasma viscosity (PV), and high shear whole blood relative index (HSWBRI), low shear whole blood relative index (LSWBRI), and erythrocyte aggregation index (EAI) were tested to observe the effects of GH on hemorheology of blood stasis rats. And the maximum aggregation induced by adenosine diphosphate (ADP) was tested to observe the effect of GH on platelet aggregation index of blood stasis rats. In addition, the prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) and plasma fibrinogen (FIB) were tested to observe the effects of GH on blood coagulation function of blood stasis rats. Then principal component analysis and multi-attribute comprehensive index methods were both used to comprehensively evaluate the total activating blood circulation and dissipating blood stasis effects of GH. The results showed that the hemorheological indexes and coagulation parameters of model group both had significant differences with normal group. Compared with model group, GH (1 : 0, 4 : 1, 2: 1, 3 : 2, 1 : 1, 2 : 3, 1 : 2, 1 : 4 and 0 : 1) could improve all the blood hemorheology indexes and regulate part indexes of blood coagulation function and platelet aggregation in acute blood stasis rats. Based on principal component analysis and multi-attribute comprehensive index methods, GH 1 : 1 and GH 3 : 2 both had the best effect of blood circulation and dissipating blood stasis, and the effect of GH 1 : 1 was slightly better than GH 3 : 2. These results suggest that GH could obviously ameliorate the abnormality of hemorheology and blood coagulation function in acute blood stasis rats. The optimized proportion of GH was consistent with regulations of medicine usage that GH 1 : 1 had the highest frequency used in traditional Chinese formulae. It could provide scientific basis for more effective application of the compatibility between Danggui and Honghua in modern clinic medicine.
10.Interaction of nourishing and tonifying blood effects of the combination of Angelicae sinensis Radix and Astragali Radix studied by response surface method.
Xuqin SHI ; Erxin SHANG ; Yuping TANG ; Huaxu ZHU ; Jianming GUO ; Meiyan HUANG ; Weixia LI ; Jinao DUAN
Acta Pharmaceutica Sinica 2012;47(10):1375-83
The combination of Angelicae sinensis Radix (Danggui, DG) and Astragali Radix (Huangqi, HQ) is a popular herb pair commonly used in clinic for the treatment of blood deficiency syndrome in China. The aim of this paper is to study the interaction of DG and HQ nourishing and tonifying blood effects by response surface method. The blood deficiency mice were induced by injecting N-acetylphenylhydrazine (sc) and cyclophosphamide (ip). The blood deficiency mice were administrated intragastrically with DG-HQ extracts (0:1, 1: 5, 2:5, 2:3, 1:1, 3:2, 5:2, 5:1, 1:0). The changes of the peripheral blood indexes and organ indexes were observed. The indexes were integrated by comprehensive index method; the interactions of DG and HQ were analyzed by the response surface diagram established with Matlab software. The results showed that DG and HQ at most of their combination ratios had synergic effect. Within the range of 1:5 - 5:1, all of the extracts of DG-HQ showed synergic effect, and among which, high-doses had better effects than low-doses. The highest value (-1) of the synergic effect was showed when DG was 10 - 40 g at the same time of HQ as 90 -180 g, and DG was 50 - 100 g at the same time of HQ as 20 - 100 g. DG-HQ at all combination dosages within Chinese Pharmacopeia (DG: 6 - 12 g, HQ: 9 - 30 g) had certain synergic effect, and Danggui Buxue Decoction (DG: 6 g, HQ: 30 g) also was at this range. The results provided scientific basis to the clinical application of DG and HQ. And the response surface method was firstly applied to quantitatively evaluate the bio-activity change of herb combination, which provided a novel way for modern basic research on the interaction of herbs.