OBJECTIVE:To study the adsorption of disposable transfusion connective tube and infusion needle for single use only to nitroglycerin in intravenous injection via minipump.METHODS:The intravenous injection via minipump was im-itated;the concentration change of nitroglycerin during the injection process was determined by the high performance liquid chromatography(HPLC)and ultraviolet spectrophotometry.RESULTS:Disposable transfusion connective tube and infusion needle for single use only had significant adsorption to nitroglycerin with an mean adsorption rate at(73.88?2.05)%within8hours.CONCLUSION:It is unsuitable to use those disposable transfusion connective tubes and infusion needles for single use only that have strong adsorption to nitroglycerin in the intravenous injection of nitroglycerin via minipump.

OBEJECTIVE:To study quality differences of compound danshen injections of different batch numbers from different manufactures.METHODS:The fingerprints of compound danshen injections were obtained through gradient elution by HPLC;The contents of danshensu,protocatechualdehyde and savianolic acid B in samples of different batch numbers and different manufactures were determined,and the insoluble fine particle,protein,tannin,resin etc.in samples were studied ac-cording to the specification of China Pharmacopoeia2005.RESULTS:The fingerprints of compound danshen injections were specific;Great differences were found in the contents of danshensu,protocatechualdehyde and salvianolic acid B of the samples from different manufactures,quality discrepancies were found between some of the related substances in some of the prepara-tions and the specifications.CONCLUSION:Quality differences were found in compound danshen injections from different manufactures,therefore,the quality control standards of compound danshen injections should be enhanced and unified,and with regard to the controlling of the insoluble fine particles,the technics and techniques of which should be improved and given a further study.

Objective To evaluate the current clinical application of domestic tirofiban in patients with acute coronary syndrome (ACS) and to explore its safety profile focused on the common causes and correlation factors for the hemorrhagic events.Methods The patients diagnosed as ST-elevation myocardial infarction (STEMI) and medium to high risk non-ST-elevation myocardial infarction (NSTEMI)/ unstable angina(UA) in 15 hospitals from September 2009 to December 2011 and given domestic tirofiban,were enrolled in this study.The following data were carefully collected:demographic data,comorbidities,concomitant medications,laboratory data,interventional treatment,application of tirofiban,hemorrhagic events and major adverse cardiac events(MACE) in hospital and at day 30 after discharge.Results (1) A total of 927 patients were enrolled in the study.The domestic tirofiban was given to 241 subjects (26.0％) before the intervention,567 subjects (61.2％) during the intervention and 89 subjects (9.6％) after the intervention.The standardized application was performed in 737 subjects (79.5％) with the loading dose of 10 μg/kg and the maintenance dose of 0.15 μg · kg-1 · min-1 In all the subjects,the average maintenance time was (30.4 ± 14.2) hours with the average dose of (339.3 ± 182.9)ml.(2)During hospitalization,major bleeding happened in 4 cases(0.4％) and major adverse cardiac events (MACE) in 37 cases (4.0％).(3)At day 30 after discharge,1 cases (0.1％)was reported with major bleeding and 9 cases (1.0％) with MACE.(3)The least MACE was showed in the preoperative tirofiban group (2.5％) and followed by the intraoperative group (4.1％) and the postopcrative group (9.0％).Compared with the non-standardized application group,MACE was significantly decreased in the standardized application group (2.44％ vs 10.00％,P ＜ 0.05).Conclusions The standardized application of the domestic tirofiban could decrease the incidence of MACE.Taken into account the combination therapy of clopidogrel and aspirin in the vast majority of patients,the domestic tirofiban exhibits a good safety profile with a relatively lower incidence of bleeding than the similar clinical studies.

OBJECTIVE:To evaluate the quality of levofloxacin tablets produced by 6 different factories.METHODS:To investigate the quality of 17 batches of levofloxacin tablets produced by 6 factories according to related standards and to evaluate the drug dissolubilities using paddle method.RESULTS:17 products from six factories were all proved qualified.Significant differences of dissolution parameters and treatment costs were found among the different products.CONCLUSION:There are difference in quality of levofloxacin tablets.The tablets produced by the factory holding the patent right are more expensive,however the qualiity is more stable.

Objective: To investigate the awareness of HIV non-occupational post-exposure prophylaxis (nPEP) among residents in Yangzhou City, Jiangsu Province, so as to provide basis for further publicity and application of nPEP in genenral population. Methods: Community residents at ages of 18 years and older in Yangzhou City were sampled using the multi-stage random sampling method from January to June, 2022, and a cross-sectional survey was conducted to collect their demographic information, acquired immune deficiency syndrome (AIDS)-related knowledge, attitude and behaviors and awareness of nPEP. A multivariable logistic regression model was used to identify factors affecting awareness of nPEP. Results: Totally 1 488 questionnaires were allocated, and 1 447 valid questionnaires were recovered, with an effective recovery rate of 97.24%. There were 644 males and 803 females, with mean age of (36.33±11.90) years. There were 585 residents (40.43%) employed by government agencies, enterprises and public institutions; 750 residents (51.83%) with awareness of AIDS; 413 (28.54%), 651 (44.99%) and 383 residents (26.47%) had low, medium and high levels of AIDS discrimination, respectively; 201 residents (13.89%) with HIV detection experience; and 792 residents (54.73%) with regular health checkup. The awareness rate of nPEP was 47.89%. Multivariable logistic regression analysis identified career (government agencies, enterprises and public institutions, OR=1.530, 95%CI: 1.170-1.999; students, OR=1.450, 95%CI: 1.027-2.047), awareness of AIDS (OR=3.201, 95%CI: 2.495-4.106), having HIV detection experience (OR=1.908, 95%CI: 1.339-2.719), regular health checkup (OR=2.308, 95%CI:1.807-2.949) and discrimination against AIDS (medium, OR=0.703, 95%CI: 0.532-0.928; high, OR=0.699, 95%CI: 0.502-0.974) as factors affecting awareness of nPEP. Conclusions The awareness of nPEP among residents in Yangzhou City needs to be improved. Employees in government agencies, enterprises and public institutions and students have higher awareness of nPEP.

OBJECTIVETo evaluate the effects of ALT, HBsAg and HBV DNA at the baseline, 4 and 12 weeks after lamivudine treatment on the long term (104 weeks) response in e antigen-negative chronic hepatitis B patients.

METHODS127 adult e antigen-negative chronic hepatitis B patients were enrolled in this study. All patients received treatment on LAM 100 mg/d for at least 104 weeks. The liver function, serum HBV markers and HBV viral load were regularly checked during the treatment. The effects of ALT, HBsAg and HBV DNA at the baseline, 4 and 12 weeks after lamivudine treatment on the response at 104 weeks were statistically analyzed.

RESULTSThe proportion of patients with serum HBV DNA less than 1000 copies / ml at 104 weeks after LAM treatment was 50.0% and 86.8% in patients with baseline ALT less than 5 ULN and ALT is more than or equal to 5 ULN, respectively (P less than 0.01). In patients with baseline HBsAg less than 2000 COI and HBsAg is more than or equal to 2000 COI, the proportion of patients with serum HBsAg less than 500 COI at 104 weeks after LAM treatment was 19.1% and 17.5%, respectively (P more than 0.05). the HBsAg serological conversion rates were respectively 2.1% and 2.5% , respectively (P more than 0.05), the proportion of patients with serum HBV DNA less than 1000 copies/ml was 61.7% and 67.5%, respectively (P more than 0.05). In patients with baseline HBV DNA less than 10(6) copies/ml and HBV DNA is more than or equal to 10(6) copies/ml, the proportion of patients with HBV DNA less than 1000 copies/ml were statistically different at 4 weeks and 12 weeks after treatment, however, the proportion of patients with HBV DNA less than 1000 copies/ml at 104 weeks after LAM treatment was 62.7% and 67.1%, respectively (P more than 0.05). In patients with HBV DNA less than 1000 copies/ml and HBV DNA is more than or equal to 1000 copies/ml at 4 weeks after treatment, the proportion of patients with HBV DNA less than 1000 copies/ml at 104 weeks after LAM treatment was 70.7% and 60.9%, respectively (P more than 0.05). In patients with HBV DNA less than 1000 copies/ml and HBV DNA is more than or equal to 1000 copies/ml at 12 weeks after treatment, the proportion of patients with HBV DNA less than 1000 copies/ml at 104 weeks after treatment was 78.8% and 38.1%, respectively (P less than 0.01).

CONCLUSIONe antigen negative chronic hepatitis B patients with baseline ALT is more than or equal to 5 ULN and HBV DNA less than 1000 copies/ml at 12 weeks after treatment have better virological response at 104 weeks after LAM treatment. The baseline HBsAg and HBV DNA load are associated with the virological response at 104 weeks after LAM treatment.

Administration, Oral ; Adult ; Aged ; Alanine Transaminase ; blood ; Antiviral Agents ; pharmacology ; therapeutic use ; DNA, Viral ; blood ; Female ; Follow-Up Studies ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; virology ; Humans ; Lamivudine ; pharmacology ; therapeutic use ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Viral Load ; Young Adult

Objective:To explore the effect of small dose of low molecular weight heparin on the prognosis of elderly patients with severe pneumonia using systematic evaluation method.Methods:Databases including Wanfang data, VIP, CNKI, SinoMed, PubMed, Embase and Cochrane Library were searched for randomized controlled trial (RCT) studies about the comparison of conventional therapy and low molecular weight heparin on prognosis of elderly patients with severe pneumonia from the time of database establishment to August 2019. The patients in conventional treatment group were treated by improving ventilation, anti-infection, eliminating phlegm, relieving asthma and maintaining homeostasis while those in low molecular weight heparin group were subcutaneously injected with low molecular weight heparin of 4 000 U, once a day for 7 days. The patients' main outcomes included the oxygenation index (PaO 2/FiO 2) after 7 days of treatment, duration of mechanical ventilation, mortality in hospital, and secondary outcomes included acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score and coagulation function after 7 days of treatment, the length of intensive care unit (ICU) stay, and incidence of bleeding. Data extraction and quality evaluation were conducted. The Meta-analysis of included studies that met the quality standards was performed using RevMan 5.3 software. Funnel diagram analysis was used to analyze the parameters with no less than 10 studies enrolled. Results:A total of 14 RCT studies were enrolled involving 1 173 elderly patients with severe pneumonia, among whom 590 received low molecular weight heparin while the other 583 received conventional therapy. All the included studies were well designed and of high quality. The results of Meta-analysis showed that compared with conventional therapy, small dose of low molecular weight heparin significantly elevated PaO 2/FiO 2 after 7 days of treatment [mean difference ( MD) = 19.25, 95% confidence interval (95% CI) was 16.88 to 21.61, P < 0.000 01], shortened the duration of mechanical ventilation ( MD = -48.88, 95% CI was -67.42 to -30.33, P < 0.000 01), and decreased mortality in hospital [odds ratio ( OR) = 0.40, 95% CI was 0.22 to 0.73, P = 0.003] and APACHEⅡ score after 7 days of treatment ( MD = -3.38, 95% CI was -3.94 to -2.83, P < 0.000 01), and shortened the length of ICU stay ( MD = -4.51, 95% CI was -5.75 to -3.27, P < 0.000 01). There was no significant difference in the changes of coagulation parameters after 7 days of treatment or the incidence of bleeding between low molecular weight heparin group and conventional therapy group [7-day thrombin time (TT): MD = 0.57, 95% CI was -0.15 to 1.28, P = 0.12; 7-day prothrombin time (PT): MD = 0.32, 95% CI was -0.35 to 0.98, P = 0.35; 7-day fibrinogen (FIB): MD = -0.17, 95% CI was -0.45 to 0.10, P = 0.22; incidence of bleeding: OR = 0.86, 95% CI was 0.36 to 2.07, P = 0.74]. The funnel diagram showed that there was publication bias of included 10 studies about APACHEⅡ score after 7 days of treatment. Conclusion:Small dose of low molecular weight heparin can improve the prognosis of elderly patients with severe pneumonia and it has no obvious side-effect on coagulation function.

The treatment of patients with diabetes mellitus, which is characterized by defective insulin secretion and/or the inability of tissues to respond to insulin, has been studied for decades. Many studies have focused on the use of incretin-based hypoglycemic agents in treating type 2 diabetes mellitus (T2DM). These drugs are classified as GLP-1 receptor agonists, which mimic the function of GLP-1, and DPP-4 inhibitors, which avoid GLP-1 degradation. Many incretin-based hypoglycemic agents have been approved and are widely used, and their physiological disposition and structural characteristics are crucial in the discovery of more effective drugs and provide guidance for clinical treatment of T2DM. Here, we summarize the functional mechanisms and other information of the drugs that are currently approved or under research for T2DM treatment. In addition, their physiological disposition, including metabolism, excretion, and potential drug-drug interactions, is thoroughly reviewed. We also discuss similarities and differences in metabolism and excretion between GLP-1 receptor agonists and DPP-4 inhibitors. This review may facilitate clinical decision making based on patients' physical conditions and the avoidance of drug-drug interactions. Moreover, the identification and development of novel drugs with appropriate physiological dispositions might be inspired.

Sepsis is one of the common severe diseases caused by the dysregulated host response to infection， which seriously threatens the life and health of human beings all over the world. The incidence and mortality of the disease are extremely high， and it has always been an urgent problem to be solved in the field of acute and critical diseases. At present， anti-infection， fluid resuscitation， mechanical ventilation and other programs are most used in clinic to treat sepsis， but their poor prognosis and high cost and other issues remain to be resolved. Therefore， it is necessary to explore a new， efficient， safe and inexpensive drug and treatment model at this stage. The treatment of traditional Chinese medicine （TCM） is based on syndrome differentiation and holistic concept. It can effectively regulate the progression of sepsis， maintain the homeostasis of the body， and has fewer adverse reactions. It has achieved good clinical results. In recent years， a large number of studies have shown that TCM can reduce the inflammatory response by regulating the Toll-like receptor 4（TLR4） signaling pathway， thereby reducing the severity and mortality of sepsis patients. However， there is still a lack of systematic exposition of TCM regulating TLR4 signaling pathway in the treatment of sepsis. Therefore， this article summarizes the relationship between TLR4 signaling pathway and sepsis and the mechanism of TCM in the disease by searching and consulting relevant literature in recent years. It is found that some Chinese medicine monomers and active ingredients， Chinese medicine compounds and Chinese medicine preparations can effectively reduce systemic inflammatory response， repair organ damage and improve the prognosis of sepsis by inhibiting the activation of TLR4 signaling pathway. However， due to various limitations， some studies have directly focused on the differential expression and function of TLR4， ignoring the downstream molecular expression and phenotypic effects of TLR4. The alternative mechanism， relationship and specific molecular mechanism of the pathway are still unclear. There are problems such as unclear pharmacokinetics and unclear mechanism in the pro- and anti-inflammatory balance， which need to be further studied and explored in order to provide new ideas for the potential treatment and drug development for sepsis.

Objective: To explore the therapeutic effect of Xuebijing on patients with acute paraquat poisoning (APP) by using systematic evaluation method. Methods: PubMed, Cochrane Library, Embase, Wanfang database, China National Knowledge Infrastructure (CNKI), VIP database (VIP) and China Biology Medicine (CBM) were searched using the computers to find the literatures published about the Xuebijing injection for the treatment of APP. Randomized controlled trials (RCT) were retrieved from the establishment of the database to August 2019. Patients in experimental group were treated with Xuebijing injection combined with conventional treatment, while the patients in control group were only given conventional treatment. The patients' outcome included the 14-day mortality, arterial oxygen saturation (SaO₂) and incidence of pulmonary fibrosis. In addition, the 6-month survival rate, alanine aminotransferase (ALT), serum creatinine (SCr), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA) and superoxide dismutase (SOD) between the two groups were compared. The literature data were extracted by two researchers independently, and the quality of the literatures was evaluated according to the Cochrane 5.1 handbook. The Meta-analysis was performed by using RevMan 5.3 software. The results stability of Meta-analysis was tested by sensitivity analysis. The publication bias was analyzed through drawing of funnel diagram. Results: Twenty-seven RCT studies in total were enrolled, of which 26 were in Chinese and 1 was in English. A total of 1 429 patients were enrolled, among whom 726 were in experimental group and another 703 were in control group. Meta-analysis showed that compared with the control group, the 14-day mortality [relative risk (RR) = 0.62, 95% confidence interval (95%CI) was 0.54 to 0.72, P < 0.000 01] and incidence of pulmonary fibrosis (RR = 0.67, 95%CI was 0.53 to 0.85, P = 0.000 9) of patients in the experimental group were significantly lowered, while SaO₂ at 7 days and 14 days were significantly increased [7 days: mean difference (MD) = 16.86, 95%CI was 9.89 to 23.83, P < 0.000 01; 14 days: MD = 16.51, 95%CI was 10.22 to 22.80, P < 0.000 01]. Compared with the control group, the survival rate within 6 months (RR = 1.55, 95%CI was 1.41 to 1.71, P < 0.000 01) and SOD (MD = 13.88, 95%CI was 7.43 to 20.33, P < 0.000 1) of patients in the experimental group were significantly increased, ALT at 14 days (MD = -78.35, 95%CI was -127.35 to -29.34, P = 0.000 5), SCr at 7 days and 14 days (7 days: MD = -135.13, 95%CI was -219.09 to -51.17, P = 0.002; 14 days: MD = -206.05, 95%CI = -290.13 to -121.96, P < 0.000 01), CRP (MD = -11.55, 95%CI was -17.77 to -5.33, P = 0.000 3), TNF-α (MD = -9.27, 95%CI was -15.48 to -3.96, P = 0.000 9) and MDA (MD = -1.27, 95%CI was -1.57 to -0.96, P < 0.000 01) were significantly lowered. The overall effect value of the parameters with high heterogeneity was not significantly changed after furtherMeta-analysis excluding any one of the studies, suggesting that the result was relatively stable. Funnel chart analysis was used to analyze the parameters from more than 10 articles enrolled, and it showed that there was publication bias. Conclusion Xuebijing injection can reduce the mortality of patients with APP, which may because that it can improve liver and kidney function, reduce inflammation and oxidative stress damage, inhibit pulmonary fibrosis and increase oxygenation level.