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Recommendations for prevention and treatment of device-related pressure injuries during COVID-19 period

Yunchang ZHANG ; Chunquan SHENG ; Bingkai WANG ; Zhiqiang MA ; Feng YANG

Journal of Pharmaceutical Practice.2020;38(2):97-100. doi:10.3969/j.issn.1006-0111.202003018

With the outbreak of COVID-19, non-stop working medical staff need to wear protective equipment for a long time, which could easily cause device-related pressure injuries to nose, cheek, forehead or the back of auricle, and might even cause facial skin swelling and ulceration. The above problems reduce work efficiency and increase the infection risk for healthcare people. This article introduces the concept of device-related pressure injuries and summarizes the progress of the treatment for device-related pressure injuries at home and abroad in recent years, aiming at providing guidance for frontline medical staff to prevent device-related pressure injuries.

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Traditional Chinese medicine in the treatment and rehabilitation for Coronavirus Disease 2019

Benming YOU ; Zhongzhuang WANG

Journal of Pharmaceutical Practice.2020;38(2):101-104. doi:10.3969/j.issn.1006-0111.202003061

Based on national health insurance policy, traditional Chinese medicine (TCM) clinical practice and newly revealed pathological changes in Coronavirus Disease 2019 (COVID-19), the early TCM utilization was recommended to promote blood circulation and protect respiratory system. The fermented Ophiocordyceps powder preparations (Bailing tablets or capsules) are the top choice to inhibit the cytokine storm, relieve lung fibrosis and kidney damage.

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The mechanism study on Chaihudaxiong mixture in the treatment of coronavirus disease 2019 with network pharmacology approach

Zhijun XIAO ; Cuicui LIU ; Saihua LU ; Jian CAI ; Feng XU

Journal of Pharmaceutical Practice.2020;38(4):289-295. doi:10.12206/j.issn.1006-0111.202004023

Objective To investigate the pharmacological mechanism of Chaihudaxiong mixture in the treatment of coronavirus disease 2019 (COVID-19) based on a network pharmacology approach. Methods The effective ingredients and targets of Chaihudaxiong mixture were collected from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). The targets’ names were standardized by Uniprot database. Genes associated with coronavirus were obtained from the GeneCards and OMIM, which were intersected with effective therapeutic targets. A "herbs-ingredients-targets" network was compiled and analyzed by Cytoscape 3.7.2. The protein-protein interaction of the targets was analyzed by String. The GO gene annotation and KEGG signaling pathway analysis were performed using related packages of the R software. Results A total of 165 active ingredients and 51 targets were collected. Further analysis revealed that the main active ingredients were β-sitosterol and 11 flavonoids. The core targets were CASP3, MAPK3, IL-6, MAPK8, IL-10, CXCL8, MAPK1 and IL-1B. A total of 1722 GO entries were obtained from the GO gene annotation (P<0.05), including 1612 entries for biological processes, 30 entries for cell composition, and 80 entries for molecular functions. 156 signaling pathways (P<0.05) were obtained with KEGG signaling pathway screen. The important signaling pathways were AGE-RAGE signaling pathway in diabetic complication, Influenza A, IL-17 signaling pathway, TNF signaling pathway and hepatitis B. Conclusion This study revealed the synergistic features of multi-component, multi-target, and multi-pathway of Chaihudaxiong mixture in the treatment of COVID-19, which provided an important scientific basis for further understanding the mechanism of Chaihudaxiong mixture in the treatment of COVID-19.

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Mechanism of leflunomide in regulating pulmonary fibrosis by regulating miR-449a

Dong LIU ; Weinan LAI

Journal of Pharmaceutical Practice.2020;38(4):296-300. doi:10.12206/j.issn.1006-0111.201910073

Objective To investigate the mechanism of leflunomide (LEF) in regulating pulmonary fibrosis by regulating microRNA (miR)-449a. Methods Human lung fibroblasts MRC-5 were divided into 6 groups: control group, LEF group, LEF+mimic group, mimic group, LEF+inhibitor group and inhibitor group. MiR-449a was overexpressed or silenced by plasmid transfection with miR-449a mimic or inhibitor and ncubate for 48 h at 5 mg / L LEF. The cell viability, cell proliferation ability and apoptotic rate of each group were measured by CCK-8 method, clone formation experiment and flow cytometry. Immunofluorescent staining was used to detect α smooth muscle actin (α-SMA) and collagen I (col I). The levels of miRNA and protein were detected using qPCR and Western blot, respectively. Results The miR-449a level in the mimic group was significantly higher than that in the control group (P<0.05). The level of miR-449a in LEF group and inhibitor group was significantly lower than that in control group (P<0.05). The expression level of miR-449a in LEF+mimic group was significantly higher than that in LEF group, and the level of miR-449a in LEF+inhibitor group was significantly lower than that in LEF group (P<0.05). The cell viability and cell proliferation ability of the LEF group and inhibitor group were significantly higher than those of the control group (P<0.05). The cell viability and cell proliferation ability of the mimic group were significantly lower than those of the control group (P<0.05). The cell viability and cell proliferation ability of the LEF+mimic group were significantly lower than those of the LEF group, while the cell viability of the LEF+inhibitor group was significantly higher than that of the LEF group (P<0.05). The apoptosis rate of LEF group and inhibitor group was lower than that of control group (P<0.05). The apoptosis rate of mimic group was significantly higher than that of control group (P<0.05). The apoptosis rate of LEF+mimic group was significantly higher than that of LEF group, while the apoptosis rate of LEF+inhibitor group was significantly lower than that of LEF group (P<0.05). The fluorescence intensity of α-SMA and Col I proteins in LEF group and inhibitor group were significantly higher than those in control group (P<0.05). The relative fluorescence intensity of mimic group was lower than that of control group (P<0.05). The relative fluorescence intensities of α-SMA and Col I proteins in LEF+mimic group were significantly lower than those in LEF group, while the relative fluorescence intensities of α-SMA and Col I protein in LEF+inhibitor group were significantly higher than those in LEF group (P<0.05). The levels of p-JNK / JNK in LEF group and inhibitor group were higher than those in control group (P<0.05). The p-JNK / JNK level in the mimic group was significantly lower than that in the control group (P<0.05). The level of p-JNK / JNK in LEF+mimic group was significantly lower than that in LEF group, while the level of p-JNK / JNK in LEF+inhibitor group was significantly higher than that in LEF group (P<0.05). Conclusion LEF may activate the JNK pathway by inhibiting the expression of miR-449a in lung fibroblasts, thereby inducing fibroblast activation and proliferation, inhibiting apoptosis, and causing pulmonary fibrosis.

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Preparation and formulation optimization of wound dressings with nitrocellu-lose as membrane material

Lingna ZHANG ; Tianyu WANG ; Wanfeng HONG ; Chun TAO ; Hongtao SONG

Journal of Pharmaceutical Practice.2020;38(4):301-306. doi:10.12206/j.issn.1006-0111.201910082

Objective To prepare a wound dressing using nitrocellulose as a membrane and optimize its formulation. Methods Partial analysis was performed on commercial available products. The wound dressings were prepared by using nitrocellulose as a film-forming material, benzyl alcohol as a bacteriostatic agent, castor oil as a plasticizer, isopropyl palmitate as a skin emollient, camphor as a fragrance, and isopropyl alcohol, ethyl acetate and butyl acetate as volatile solvent. The tensile strength, breakpoint elongation percentage, breathability and waterproof performance were tested and evaluated. Results The film-forming performance of the prepared liquid wound dressing was good. The final use amount of nitrocellulose was determined to be 6%. The use amount of plasticizer castor oil was determined to be 4%. Conclusion The prepared liquid wound dressing has good film-forming property, good mechanical property, good waterproof and certain breathability.

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Preparation and in vitro release of tacrolimus-loaded cationic nanoemulsion-based in-situ gel

Xin LIN ; Jialiang ZHANG ; Hongtao SONG

Journal of Pharmaceutical Practice.2020;38(4):307-311. doi:10.12206/j.issn.1006-0111.201911075

Objective In order to improve the problems of poor water-solubility and low bioavailability of ocular tacrolimus, a cationic nanoemulsion in-situ gel of tacrolimus was developed and its drug release behavior in vitro was studied to provide a basis for further research. Methods Tacrolimus-loaded cationic nanoemulsion was prepared by high pressure homogenization and dispersed in poloxamer 407 and poloxamer 188 to prepare tacrolimus-loaded cationic nanoemulsion-based in-situ gel. The membraneless dissolution model was used to study the in vitro drug release behavior. Results The inverse glass bottle method was used to determine the gelation temperature. The optimal formulation of gel matrix was screened out as 26% poloxamer 407 and 12% poloxamer 188. The in vitro release results showed that the rate of gel dissolution determined the in vitro drug release. Conclusion Tacrolimus-loaded cationic nanoemulsion-based in-situ gel is successfully prepared. Its in vitro drug release is stable. It meets the requirement of ophthalmic formulation and shows good prospects for ocular application.

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Comparative of pharmacokinetic of moxifloxacin in the plasma and lung tissues of pneumonia rats and normal rats

Xi CHENG ; Yueying HUANG ; Yi LI

Journal of Pharmaceutical Practice.2020;38(4):312-317. doi:10.12206/j.issn.1006-0111.202002007

Objective To compare the pharmacokinetics of moxifloxacin (MXF) administered orally in the plasma and lung tissues of rats with pneumonia infected by Streptococcus pneumoniae (S.p) and normal rats. Methods To establish a model of Streptococcus pneumoniae pneumonia rats and normal rats. Moxifloxacin was administered by intragastric administration at 42 mg/kg. Microdialysis technique was used to sample the blood and lung tissues of pneumonia rats and normal rats to determine the free drug concentration of moxifloxacin in each sample, calculate the pharmacokinetic parameters, and compare the pharmacokinetics of oral moxifloxacin in pneumonia rats and normal rats. Results The t_1/2 of moxifloxacin in the blood of normal rats and pneumonia rats were (5.27±4.38) h, (2.15±0.07) h (P>0.05), and C_max were (4.94±0.98) μg/ml, respectively, (4.83±0.05) μg/ml (P>0.05), C_{last_obs}/C_max were 0.02±0.03, 0.27±0.04 (P<0.05), AUC_0-t were (22.33±2.02)μg/ml·h, (12.88±1.19)μg /ml·h (P<0.05), CL/F are (1.79±0.11)(mg/kg)/(μg/ml)·h, (2.49±0.26)(mg/kg)/(μg/ml)·h (P<0.05); C_max of lung tissue of normal rats and pneumonia rats were (1.42±0.05) μg/ml, (4.84±0.02) μg/ml (P<0.05), t_1/2 are (1.9±0.63)h, (3.39±0.79)h (P>0.05), AUMC are (11.93±5.14)μg/ml·h², (107.01±25.39)μg/ml·h² (P<0.05), AUC_0-t are (3.06±1.0) 7μg/ml·h, (13.16±0.53)μg/ml·h (P<0.01). Conclusions ① Under the 400 mg/d dose condition, after intragastric administration of moxifloxacin, the concentration of free drugs in the blood and lung tissues is higher, far exceeding the minimum inhibitory concentration (MIC) and anti-drug resistance concentration (MPC), can effectively remove Streptococcus pneumoniae. ②The free concentration of moxifloxacin in the lung tissue of rats infected with Streptococcus pneumoniae is always higher than that of normal rats, and the C_max is about 3.4 times that of normal rats. The penetration rate of moxifloxacin in lung tissue of pneumonia rats is significantly higher than that of normal rats.

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The metabolic analysis of ¹¹C-flumazenil in different specific radioactivity

Zongpeng ZHANG ; Zhiguo WANG ; Qingxue SHI ; Guoxu ZHANG ; Hua HUO

Journal of Pharmaceutical Practice.2020;38(4):318-321. doi:10.12206/j.issn.1006-0111.202003141

Objective To analyze the metabolic differences of ¹¹C-flumazenil (¹¹C-FMZ) with different specific radioactivity by detecting the percentage proportion of the main metabolites in vivo. Methods 5 male and 5 female volunteers with average age of (41.7±4.7) years and weight of (69.3±6.8) kg were selected from May to October 2019. ¹¹C-FMZ with high and low specific radioactivity (268.3±57.2)×10³ and (57.8±11.4)×10³ Ci/mol was injected successively. The percentage of injected dose/liter of ¹¹C-FMZ and its metabolites in the plasma at 1, 2, 3, 4, 5, 10, 15, 20, 30, 40 and 60 min after the injection was measured. Paired sample mean t test was used to calculate and compare the percentage of metabolites in the two groups. Results The percentage proportion of metabolites increased gradually with time, and reached the stable level after 15 min. The percentage proportion of low specific radioactivity group was higher than that of high specific radioactivity group with a significant statistical difference between 15 min and 60 min (P<0.05). Conclusion The metabolic rate of ¹¹C-FMZ with different specific radioactivity was significantly different after injection and the specific radioactivity difference should be avoided if possible in clinical application.

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Study on pharmacodynamics and safety of self-made compound ketoconazole ointment

Jia YAN ; Bo WU ; Chun TAO ; Hongtao SONG

Journal of Pharmaceutical Practice.2020;38(4):322-327. doi:10.12206/j.issn.1006-0111.201909078

Objective To evaluate the pharmacodynamics and safety of the self-made compound ketoconazole ointment. Methods Using the disk diffusion test, 6 kinds of fungi and 2 kinds of bacteria were selected to investigate the effect of the self-made ointment and 3 commercial products on the diameter of the bacteriostatic circle. In addition, the skin irritation and skin allergies of the single and multiple applications were used to evaluate the safety of the self-made ointment. Results The self-made ointment was similar to the commercial products containing ketoconazole. They all showed remarkable bacteriostatic circle against the 6 kinds of fungi. For pseudomonas aeruginosa, none of the preparations contributed to visible bacteriostatic circle. For staphylococcus aureus, the bacteriostatic circle of the self-made ointment was similar to that of commercial mupirocin ointment and was significantly larger than other commercial products. After the treatment with the self-made ointment, the score of the skin irritation was below 0.5 and the sensitization rate was 0. There was no difference in tissue structure between treated and normal skin. Conclusion The self-made compound ketoconazole ointment has better safety and better antibacterial property than the commercial products. It is expected to be used for the treatment of superficial skin fugle infections.

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Optimization of formulation process and in vitro evaluation of copper sulfide nanoparticles

Zhenzhen CHEN ; Chun TAO ; Xueting ZHANG ; Guizhi ZHOU ; Qian ZHANG ; Hongtao SONG

Journal of Pharmaceutical Practice.2020;38(4):328-333. doi:10.12206/j.issn.1006-0111.201912092

Objective To avoid the accumulation of copper sulfide (CuS) nanoparticles, prepare and optimize CuS nanoparticles, analyze the factors affecting the particle size and evaluate their photothermal properties. Methods Based on the single factor study, central composite design-response surface methodology was used to optimize the CuS nanoparticle formulation process. The morphology, particle size stability, photothermal conversion efficiency, photothermal stability of optimized CuS nanoparticles were characterized. The toxicity of CuS nanoparticles on 4T1 breast cancer cells and HK2 kidney cells was evaluated by CCK-8 method. In vitro photothermal experiment was used to investigate the ability of CuS nanoparticles on killing 4T1 breast cancer cells. Results The average hydration dynamic diameter of optimized CuS nanoparticles was (10.53±1.63)nm, the actual particle size of CuS nanoparticles showed by TEM image was (3.10±0.81)nm. It had good particle size stability, good photothermal conversion efficiency and photothermal stability. Within the concentration range of 100 μg/ml and 150 μg/ml，it showed no significant toxicity on 4T1 breast cancer cells and HK2 kidney cells, indicating the good stability of CuS nanoparticles. In vitro photothermal therapy showed that CuS nanoparticles had good ability to kill 4T1 breast cancer cells by photothermal. Conclusion The prepared CuS nanoparticles have a small particle size (less than 6nm) and a good photothermal effect, which is expected to solve the problem of CuS nanoparticles accumulation in vivo and make it better for tumor treatment.

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