Traditional treatment for type 1 diabetes mellitus （T1DM） primarily involves insulin replacement， yet some patients encounter issues such as significant blood glucose fluctuations， high risk of hypoglycemia， and weight gain. In recent years， the adjuvant therapeutic role of non-insulin hypoglycemic drugs in T1DM has gradually gained attention. This article reviews the mechanisms of action and clinical research progress of five types of non-insulin hypoglycemic drugs in the treatment of T1DM： amylin analogues （pramlintide）， biguanides （metformin）， sodium-glucose co-transporter 2 inhibitor， dipeptidyl peptidase-4 inhibitor， and glucagon-like peptide-1 receptor agonist. It is found that these drugs can enhance clinical benefits for T1DM patients by improving insulin sensitivity， delaying gastric emptying， promoting urinary glucose excretion， and regulating incretin levels， thereby reducing glycated hemoglobin levels， decreasing insulin dosage， and managing body weight. Simultaneously， these drugs also present limitations such as low patient compliance due to complex dosing regimens， increased risk of diabetic ketoacidosis， and heterogeneity in glycemic control. Future research could focus on developing individualized treatment strategies， combining pharmacogenomics with novel biomarkers to precisely identify subpopulations of patients who may benefit， and delving into the potential value of these drugs in delaying diabetic vascular complications and improving patients’ quality of life.

Ceftazidime-avibactam （CAZ/AVI）is a novel β-lactam antibiotic with broad-spectrum antibacterial activity and good tolerability. However， the physiological and pathological differences in special populations [e.g. augmented renal clearance （ARC） patients， undergoing continuous renal replacement therapy （CRRT） patients， neonates and children， obese patients， undergoing extracorporeal membrane oxygenation （ECMO） patients， elderly patients and liver dysfunction patients] may affect the pharmacokinetic （PK） properties of CAZ/AVI， leading to treatment failure. At present， there is currently a lack of corresponding guidelines or consensus on dose adjustment of CAZ/AVI in special populations. This article summarizes the research on PK/ pharmacodynamic （PD） characteristics and dose adjustment of CAZ/AVI in special populations and recommends the following dosing regimens： for ARC patients， the recommended dose is 2.5 g， q8 h； for undergoing CRRT patients with infections caused by sensitive strains （i.e. MIC＜4 mg/L） and infections at sites where hydrophilic antibiotics distribute well， a dose of 1.25 g， q8 h may be used； for undergoing CRRT patients with less sensitive strains or sites with poorer drug distribution， a dose of 2.5 g， q8 h or continuous infusion may be considered； for children aged 6 months to ＜18 years with normal or mildly impaired renal function， a dose of 62.5 mg/kg， q8 h is infused for 2 h （maximum dose not exceeding 2.5 g per dose）； for infants aged 3～6 months with normal or mildly impaired renal function， a dose of 50 mg/kg， q8 h is infused for 2 h； for obese patients， the recommended dose is 2.5 g， q8 h， with therapeutic drug monitoring recommended；undergoing ECMO patients， elderly patients， and those with impaired liver function may also use the recommended dose of 179368757@qq.com 2.5 g， q8 h.

OBJECTIVE：To syste matically evaluate the effects of non-selective β-blockers（NSBB）on mortality of patients with cirrhosis and ascites ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from PubMed ，the Cochrane Library ，Embase，Web of Science ，CNKI and Wanfang database ，randomized controlled trials （RCTs）and cohort studies about the effects of NSBB on mortality of patients with cirrhosis and ascites were collected from the date of database establishment to Sept. 30th，2019. The patients in the trial group were treated with NSBB ，the patients in the control group were treated with blank control or isosorbidemononitrate ，variceal ligation or other measures to prevent variceal bleeding. After literature screening and data extraction ，the quality of RCTs and cohort studies were evaluated by using bias risk evaluation tool recommended by Cochrane system evaluator manual 5.1.0 and Newcastle-Ottawa scale . Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：Totally 18 studies were included ，involving 8 649 patients，4 RCTs and 14 cohort studies. Results of Meta-analysis showed that ，there was no significant difference in all-cause mortality between the patients using NSBB of trial group [RR ＝0.85，95％ CI（0.65，1.11），P＝0.22]，severe ascites [RR ＝0.58，95％ CI（0.15，2.22），P＝0.42] or refractory ascites [RR ＝0.85，95％CI（0.61，1.20），P＝0.36] and the control group. Subgroup analysis showed that ，there was no significant difference in all-cause mortality between the patients using NSBB of trial group and control group according to the research method （RCT vs. cohort study ）and the type of drug use （P＞0.05）. CONCLUSIONS ：The use of NSBB does not increase the incidence of all-cause mortality in cirrhosis patients with ascites ，or even in those with severe ascites or refractory ascites.

OBJECTIVE:To compare the effects of equilibrium amino acid and it rich in branched chain amino acid on nutrition metabolism after surgery and prognosis of severe abdominal trauma patients. METHODS:A total of 60 severe abdominal trauma patients selected from our hospital during Sept. 2016-Jun. 2017 were divided into group A and B according to block randomization,with 30 cases in each group. Both groups were all given iso nitrogenous and iso caloric parenteral nutrition support on the basis of surgery and routine treatment after surgery;group A was additionally given 8.5％ Compound amino acid injection (18AA-Ⅱ)1.2 g/(kg·d)for 12 h each day at least;group B was additionally given 10％ Compound amino acid injection(20AA) 1.2 g/(kg·d)for 12 h each day at least. Both groups were treated for 7 d. The levels of nitrogen balance and serum protein(total protein,albumin,prealbumin and transferrin),plasma amino spectrum were observed in 2 groups before and after treatment. Hospitalization time,survival rate,the occurrence of complication and ADR were compared between 2 groups. RESULTS:Two patients of group A and one patient of group B were discharged,and totally of 57 patients completed the study. Before treatment, there was no statistical significance in the levels of nitrogen balance,serum protein or plasma amino spectrum (P>0.05). After treatment,the cumulative nitrogen balance of group B was significantly better than that of group A. The level of nitrogen balance was increased significantly in observation group 3-7 d after treatment and control group 5-7 d after treatment. Since 4 d after treatment,the level of nitrogen balance in group B was significantly better than control group,with statistical significance (P<0.05). The levels of albumin,prealbumin and transferring in group A were decreased significantly,and were significantly lower than group B, with statistical significance (P<0.05). The levels of glycine and threonine in 2 groups were increased significantly. The level of arginine in group B was decreased significantly, while the levels of valine and branched chainaimino acid were increased significantly;those indexes of group B were significantly lower or higher than those of group A respectively,with statistical significance(P<0.05). The incidence of gastrointestinal complications and disruption of wound,total incidence of complications in group B were significantly lower than group A,with statistical significance(P<0.05). There was no statistical significance in hospitalization time,survival rate or the incidence of infection between 2 groups (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Compared to equilibrium amino acid,equilibrium amino acid rich in branched chain amino acid can further improve and maintain the nitrogen balance,the levels of serum protein and plasma amino acid of severe abdominal trauma patients after surgery with low incidence of complication.

OBJECTIVE:To optimize the water extraction technology for the medicinal materials in Compound gastritis cap-sule. METHODS:Orthogonal test was adopted. Using the comprehensive score of contents of paeoniflorin,salvianolic acid B and weight of dry extract as evaluation index,effects of adding water amount,decoction time and times on water extraction technology were investigated,and verification test was conducted. RESULTS:Optimized water extraction technology was as follows as decoct-ing for 3 times,120 min each time and adding 10-fold water each time. In verification test,average comprehensive score was 909.19(RSD=1.84%,n=3). CONCLUSIONS:Optimized water extraction technology is stable and feasible,and can be used for the water extraction for each medicinal material in Compound gastritis capsule.

Aim This study examined the uptake and transport of ecdysterone(EDS) using Caco-2 cell monolayers as a model of human intestinal mucosa.Methods Two kinds of Caco-2 cell monolayer model(Caco-2 cell monolayers;CYP3A4 expressing Caco-2 cell monolayers) were set up to study the uptake and transport of EDS.Results Compared bi-directional charaterizaton of Caco-2 cell,the apparent permeability coefficients(Papp) values of EDS were between 0.1?10-6 cm?s-1 and 1?10-6 cm?s-1.EDS absorption was 1%~10% for two kinds of Caco-2 models.The RPapp values were all less than 1.5 for 4 h.Conclusions The uptake and transport of EDS was a passive transcellular diffusion mechanism.Ecdysterone was not influenced by CYP3A4 mediate mechanism.