Objective In order to provide a better reference and basis for the selection of reasonable hypoglycemic drugs for clinical treatment,the study conducted a comprehensive clinical evaluation of the innovator sodium-glucose transporters 2(SGLT-2)inhibitors,based on A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition).Methods The real-world studies,randomized controlled trials,Meta-analysis/systematic review,drug clinical use guidelines,expert consensus and drug description evaluation evidence were collected,and the included drugs were assigned and evaluated from five dimensions:pharmaceutical characteristics,efficacy,safety,economy and other attributes.Results All SGLT-2 inhibitors had evaluation scores above 75,with dagaglifloztin tablets having the highest score of 84.6,and canaglifloztin having the lowest score of 75.1.Conclusions All five original SGLT-2 inhibitors showed good clinical utility,the difference is that the participating original drugs have different advantageous intervals in clinical use.The results show that dagliflozin has the most ideal clinical utility,and its clinical use should be safer and more effective.Due to the short time on the market and insufficient evidence-based reasons,the advantages of clinical use of proline hemegliflozin are not obvious compared with other evaluated drugs.

Objective In order to provide a better reference and basis for the selection of reasonable hypoglycemic drugs for clinical treatment,the study conducted a comprehensive clinical evaluation of the innovator sodium-glucose transporters 2(SGLT-2)inhibitors,based on A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition).Methods The real-world studies,randomized controlled trials,Meta-analysis/systematic review,drug clinical use guidelines,expert consensus and drug description evaluation evidence were collected,and the included drugs were assigned and evaluated from five dimensions:pharmaceutical characteristics,efficacy,safety,economy and other attributes.Results All SGLT-2 inhibitors had evaluation scores above 75,with dagaglifloztin tablets having the highest score of 84.6,and canaglifloztin having the lowest score of 75.1.Conclusions All five original SGLT-2 inhibitors showed good clinical utility,the difference is that the participating original drugs have different advantageous intervals in clinical use.The results show that dagliflozin has the most ideal clinical utility,and its clinical use should be safer and more effective.Due to the short time on the market and insufficient evidence-based reasons,the advantages of clinical use of proline hemegliflozin are not obvious compared with other evaluated drugs.

OBJECTIVE To investigate the effects of individualized dosing regimen on blood trough concentration of vancomycin and renal function in critically ill patients. METHODS According to relevant guidelines and the results of Vancomycin Calculator， clinical pharmacists formulated an individualized dosing regimen of vancomycin including loading dose and maintenance dose for critically ill patients based on the two independent variables of body weight and creatinine clearance rate. Using the method of retrospective study， patients who were admitted to the department of intensive care unit （ICU） of the Second Affiliated Hospital of Guangzhou Medical University and used the regimen from July 2018 to December 2021 were selected as the trial group， and patients who were treated with vancomycin and received blood drug concentration monitoring in ICU from January 2015 to June 2018 were recruited in the control group. The difference in trough concentration distribution and the incidence of acute kidney injury （AKI） after medication were compared between the two groups， the change of serum creatinine before and after medication in the trial group was analyzed. RESULTS Totally 197 patients were included in the trial group and 144 patients were in the control group. There was no significant difference between the two groups in the clinical information （gender， age， body weight， acute physiology and chronic health evaluation Ⅱ score， the proportion of patients with renal insufficiency， etc.） （P＞0.05）. The proportions of major infection sites （including lung， urinary， abdominal， blood and central nervous system） and treatment type （target or empirical treatment） also had no significant difference between the two groups （P＞0.05）. There was no significant difference in the attainment rate of ideal trough concentration （15-20 μg/mL） and the proportion of patients with trough concentration　＞20 μg/mL between the two groups （P＞0.05）， while the attainment rate of target trough concentration （10-20 μg/mL） and the proportion of patients with trough concentration ＜10 μg/mL were significantly different between the two groups （P＜0.05）. The attainment rate of target trough concentration in patients with chronic renal insufficiency in trial group was significantly higher than that in control group （P＜0.05）. There was no significant difference in the incidence of AKI and vancomycin-associated AKI between the two groups （P＞0.05）. In the trial group with medication duration ≥7 days ， the level of serum creatinine on the 7th day of treatment was increased significantly， compared with that on the 3rd day of treatment （P＜0.05）. CONCLUSIONS This individualized dosing regimen can improve the attainment rate of target trough concentration of vancomycin in critically ill patients， especially those with chronic renal insufficiency， during the first standardized monitoring， and not increase the risk of renal injury compared with previous empirical medication.

OBJECTIVE：To provide reference for the participation of clinical pharm acists in outpatient antibiotics management so as to promote the rational use of antibiotics in outpatient department. METHODS ：The pharmacist reset medication rules ， classified irrational medication levels ，formulated warning contents ，and established a diagnosis database of mild to moderate non- complex infections ，according to the problems found in the post review of outpatient antibiotics prescription through sorting out the previous rules of antibiotics use in the Yiyao Rational Drug Use Management Software （called“review software ”for short ）in our hospital. The special pre-review was performed by using combination of system review and manual review. Pharmacists used the review saftware to count the data of outpatient antibiotics prescriptions before （the first quarter of 2020）and after （the second ， third and fourth quarters of 2020）the implementation of special pre-review. The post review for antibiotics prescriptions in Dec. 2019（before the implementation of special pre-review ）and Dec. 2020（after implementation of special pre-review ）were performed by pharmacists to evaluate the impact of the implementation of special pre-review on promoting rational use of outpatient antibitics. RESULTS：Comared with before the implementation of special pre-review in the first quarter of 2020，the prompt rate of the review software for antibiotics prescriptions was decreased ，and the interception rate was increased after the implementation of special pre-review in the second quarter of 2020（P＜0.05）. Compared with before the implementation of special pre-review in Dec. 2019，the proportion of outpatient antibiotics prescriptions in all outpatient prescriptions ，the ratio of bi-antibiotics prescriptions in all antibiotics prescriptions in the same month ，the ratio of prescriptions with unsuitable indications in all antibiotics prescriptions in the same month were all decreased E-mail：phdloveyou@163.com significantly （P＜0.01）， while the ratio of prescriptions with rational antibiotics use in all antibiotics prescriptions in the same month was increased significantly （P＜0.01）. CONCLUSIONS：Pharmacists establishing a rule for rational use of antibiotics in outpatient department b ased o n the hospital ’s situation，implementing a special pre-review for antibiotics prescriptions with the help of review software ，can promote the rational use of antibiotics in outpatient department.

Aim To explore the role of cardiac-specific overexpression of RIP140 in cardiac function and inflammation signaling pathway.Methods Direct intra-myocardial injection of adenovirus vector expressing RIP140 drove transgene expression in heart tissue.RIP140 overexpression was confirmed using immunofluorescence technique in heart.Cardiac function was assessed by echocardiographic and hemodynamic assessment.TNF-α,IL-2 and IL-1β inflammatory cytokines were detected by ELISA,and the protein levels of p65 and IκB-α were measured by Western blot.Results Adenovirus-mediated foreign gene of RIP140 was successfully transferred in cardiac tissue.RIP140 overexpression in heart induced ventricular dilation,decreased left ventricular ejection fraction and cardiac malfunction,as well as increased releases of TNF-α,IL-2 and IL-1β inflammatory cytokines,p65 protein translocation into the nucleus and IκB-α protein degradation in cytoplasm.Conclusion Adenovirus-mediated RIP140 overexpression in cardiac tissue impairs cardiac function,activates NF-κB/p65 inflammatory signaling pathway and induces the release of inflammatory cytokines.

A 50-year-old woman received surgical treatment because of severe gastrointestinal perforation and acute diffuse peritonitis. She received subcutaneous injection of recombinant human growth hormone 5 U once daily to promote the surgical wound healing. The patient′s serum calcium was 2. 51 mmol/L before treatment. On day 3 of drug administration, the serum calcium was 2. 62 mmol/L. On day 13, the serum calcium was 3. 17 mmol/L. Recombinant human growth hormone was stopped. One week later, the serum calcium was decreased to 2. 55 mmol/L.

A 50-year-old woman received surgical treatment because of severe gastrointestinal perforation and acute diffuse peritonitis. She received subcutaneous injection of recombinant human growth hormone 5 U once daily to promote the surgical wound healing. The patient′s serum calcium was 2. 51 mmol/L before treatment. On day 3 of drug administration, the serum calcium was 2. 62 mmol/L. On day 13, the serum calcium was 3. 17 mmol/L. Recombinant human growth hormone was stopped. One week later, the serum calcium was decreased to 2. 55 mmol/L.

Aim The limited transfection efficiency for plasmid in primary neonatal rat cardiomyocytes,which are terminal differentiated cells,and long foreign DNA (the RIP140 gene sequence are as long as 3.5 kb) cause us to choose a better system to study RIP140 gene expression in primary non-replicative cells. Methods Full-length of RIP140 was cloned into pAdTracker-CMV shuttle vector,and then recombined with virus backbone pAdEasy-1 vector in BJ5183 bac-teria.Positive recombinant plasmid was confirmed by sequence analysis and restriction enzyme determina-tion,and then transfected into AD293 cells for amplifi-cation.Titers of virus particles were determined by Tis-sue Culture Infectious Dose 50 (TCID50 )method and cell vitality was analyzed by CCK-8 kit in cardiomyo-cytes.RIP140 gene was identified by Western blot. Results Sequence analysis suggested that full-length RIP140 gene was cloned correctly into AdEasyTM sys-tem.Virus titers of Ad-RIP140 and Ad-GFP were 1011.3 and 1011.7 PFU·mL-1 ,respectively.Cell vitali-ty was not affected when the Multiplicity of Infection (MOI)was lower than 200.Green fluorescent protein (GFP)and Western blot analysis showed RIP140 gene was remarkably increased in cardiomyocytes for 12h in-fection by Ad-RIP140 (P<0.05 ).Conclusion Re-combinant adenovirus containing RIP140 gene was suc-cessfully constructed and effectively expressed in car-diomyocytes.These will be helpful for further research on the function of RIP140 in cardiomyocytes.

Objective To clone and efficiently express E6E7 proteins of human papilloma virus HPV33 in E.coli.The recombinant proteins were purified and immunized to mice, and polyclonal antibodies were purified.Methods E6 and E7 genes of HPV33 were amplified by PCR using HPV33 human papilloma virus as template, and were sub-cloned into pET28a and pCDNA3.1 /His C vectors.The recombinant plasmids pET28a-HPV33 E6 and pET28a-HPV33 E7 were transformed into Escherichia coli BL21 (DE3) strain.We purified the recombinant proteins and immunized mice for preparing antibodies, and the polyclonal antibodies were purified. Moreover the plasmids pCDNA3.1 /His C-HPV33 E6 and pCDNA3.1 /His C-HPV33 E7 were transfected into 293 cells.The cells were used in immunofluorescence and Western-Blot to detect antibody specificity. Results The recombinant proteins were successfully obtained, and the polyclonal antibody was prepared, which had good specificity. Conclusion The recombinant proteins and antibodies may be used in the clinical detection and pathogenesis research of HPV33 type human papilloma disease.

A 47-year-old man received an IV infusion of edaravone 30 mg twice daily for acute cerebral infarction. Three days later,the patient developed yellowish sclera. Laboratory examination showed the following levels:aspartate aminotransferase(AST)269 U/ L,alanine aminotransferase(ALT)1 944 U/ L,γ-glutamyl transpeptidase( γ-GT)133 U/ L,total bilirubin( TBil)100. 01 μmol/ L,and platelet count 70 × 109 / L. The patient was diagnosed as severe liver injury and thrombocytopenia due to edaravone injection. Edaravone was stopped and an IV infusion of polyene phosphatidylcholine 465 mg once daily was given. Seven days later,the patientˊs yellowish sclera disappeared. Laboratory examination showed AST 44 U/ L,ALT 187 U/ L,γ-GT 148 U/ L,TBil 25. 4 μmol/ L,and platelet count 121 × 109 / L. Twelve days later,reexaminations showed AST 39 U/ L,ALT 77 U/ L,and γ-GT 126 U/ L.