1.Meta-analysis of the effects of SLCO1B1 gene polymorphisms on the efficacy and safety of rosuvastatin
Chunyun LU ; Song WANG ; Kefeng LIU ; Ying XUE ; Juanjuan CHEN ; Yuanxia ZHAO ; Shuzhang DU
China Pharmacy 2024;35(19):2397-2403
OBJECTIVE To study the correlation between SLCO1B1 (521T>C and 388A>G) gene polymorphisms and the efficacy and safety of rosuvastatin. METHODS Retrieved from PubMed, Embase, Cochrane Library, PharmGKB, CNKI database and Wanfang database, the studies about the effects of 521T>C and 388A>G gene polymorphisms on the efficacy and safety of rosuvastatin were collected during the inception to Dec. 2023. The included data were analyzed by using RevMan 5.3 software. RESULTS A total of 16 studies were included. The results of meta-analysis showed that 521T>C gene polymorphism was significantly correlated with the efficacy of rosuvastatin. In the dominant gene model, compared with TT genotype, CC+TC genotype significantly improved the efficacy of rosuvastatin in raising high-density lipoprotein cholesterol (HDL-C) [MD=2.38, 95%CI(0.61,4.16), P=0.009 0]. In the homozygous gene model, compared with TT genotype, CC genotype significantly improved the efficacy of rosuvastatin in reducing total cholesterol [MD=-7.50,95%CI(-13.05, -1.95), P=0.008 0]. In heterozygous gene model, compared with TT genotype, TC genotype significantly improved rosuvastatin in reducing low-density lipoprotein cholesterol (LDL-C) [MD=-5.14, 95%CI(-9.74, -0.53), P=0.03] and increasing HDL-C [MD=5.67, 95%CI 232102311200) (2.61, 8.73), P=0.000 3]. 388A>G gene polymorphism was also significantly correlated with the efficacy of rosuvastatin. In dominant or homozygous gene models, compared with AA E-mail:dushuzhang911@163.com genotype, GG+AG genotype [MD=-6.88, 95%CI (-7.46,-6.30),P<0.000 1] or GG genotype [MD=-9.23, 95%CI(-9.41, 9.04), P<0.000 1] significantly improved the efficacy of rosuvastatin in lowering LDL-C. In the heterozygous gene model, compared with AA genotype, AG genotype significantly improved the efficacy of rosuvastatin in lowering LDL-C [MD=-3.00, 95%CI(-3.19, -2.82), P<0.000 1], total cholesterol [MD=-5.80, 95%CI(-6.00, -5.59), P<0.000 1] and triglyceride [MD=-11.79, 95%CI(-19.57, -4.02), P=0.003 0]. In the recessive gene model, compared with AA+AG genotype, GG genotype significantly improved the therapeutic efficacy of rosuvastatin in reducing LDL-C[MD=-4.31, 95%CI(-8.47, -0.14), P=0.040 0] and elevating HDL-C [MD=4.49, 95%CI (2.20, 6.77), P=0.000 1]. Under 4 gene models, there was a significant correlation between 521T>C gene polymorphism and rosuvastatin-related ADR probability (P<0.05), but no significant correlation was found in 388A>G gene polymorphism (P>0.05). CONCLUSIONS The polymorphism of 521T>C gene is significantly related to the efficacy and safety of rosuvastatin in lowering lipid, and the C allele may be one of the factors leading to the increase of rosuvastatin in lipid-lowering efficacy and ADR. 388A> G gene polymorphism is significantly associated with the lipid-lowering efficacy of rosuvastatin, but not with its safety.
2.Establishment of evaluation index system for the effectiveness of cough and wheeze pharmaceutical care clinic among asthma patients
Juanjuan CHEN ; Song WANG ; Yanfang WANG ; Mingjie YAO ; Shuzhang DU ; Baozhan CHEN
China Pharmacy 2024;35(21):2684-2689
OBJECTIVE To construct an evaluation index system for the effectiveness of cough and wheeze pharmaceutical care clinic (CWPC) among asthma patients, and to provide assessment tools and a theoretical basis for improving the control level of asthma patients and standardizing pharmaceutical care. METHODS Literature analysis and semi-structured interviews were used to establish the evaluation index system for the effectiveness of CWPC among asthma patients. Delphi method was used to conduct two rounds of expert correspondence consultation, and the index weights were determined by the analytic hierarchy process. The reliability and validity of the constructed index system were analyzed by questionnaire. RESULTS Totally 29 experts from three disciplines of medicine, pharmacy and nursing were selected from the third-grade class A hospitals in Henan province. After two rounds of expert correspondence consultation, the effectiveness evaluation index system of CWPC asthma patients (including 9 sub- dimensions, such as lung function, symptoms; 35 measurement items, such as wheezing and respiratory rate) was finally determined from three core dimensions of structure level, function level and literacy management level, and the weight value of each dimension index was determined. The results of the reliability and validity analysis confirmed the scientific rationality of the index system. CONCLUSIONS The constructed CWPC effectiveness evaluation index system for asthma patients has a high degree of recognition, reliability and validity, and can be used as a measurement tool for the effectiveness evaluation of asthma patients.
3.Clinical observation of 9 cases of rituximab followed by belimumab in the treatment of severe systemic lupus erythematosus
Yuanxia ZHAO ; Guanmin GAO ; Xiaojing LU ; Yaojuan CHU ; Song WANG ; Xiangfen SHI ; Shuzhang DU ; Xiaojian ZHANG
China Pharmacy 2023;34(7):849-853
OBJECTIVE To investigate the clinical efficacy and safety of rituximab (RTX) followed by belimumab (BLM) in patients with severe systemic lupus erythematosus(SSLE). METHODS Nine SSLE patients, who were treated with RTX followed by BLM for more than 6 months in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Zhengzhou University from October 2020 to June 2021, were enrolled. Baseline clinical data of patients, laboratory examination results and basic treatment status at weeks 0, 4, 12, and 24 of medication were collected retrospectively. The patients’ systemic lupus erythematosus disease activity index (SLEDAI) score, glucocorticoid dosage and serological indicators (complement C3, complement C4, serum albumin, and 24-hour urine protein quantification) level were analyzed. At the same time, the occurrence of adverse drug reaction was collected. RESULTS All 9 patients completed more than 24 weeks of RTX followed by BLM therapy. All patients suffered from renal impairment, of which 7 (77.8%) had renal pathology support, 3(33.3%) had blood system damage and 2 (22.2%) had nervous system damage. During treatment, with the prolongation of treatment time, the SLEDAI score, 24- hour urinary protein quantification, and glucocorticoid dosage of patients showed a significant downward trend, and ultimately decreased to the normal index level (P<0.05); serum albumin, complement C3 and complement C4 all showed a significant upward trend, eventually rose to the normal index level (P<0.05). During treatment and follow-up, 1 patient developed herpes zoster, 1 patient developed upper respiratory tract virus infection, and 1 patient developed urinary system bacterial infection. All patients recovered after symptomatic treatment. CONCLUSIONS In sequential use of RTX followed by BLM for SSLE, early administration of RTX can quickly stabilizethe condition, significantly alleviate clinical symptoms, and gradually normalize specific serological indicators; subsequent administration of BLM can reduce the type and dosage of basic treatment drugs; there is no increase in the incidence of adverse drug reactions.
4.Construction of evaluation index system for scientific research ability of hospital pharmacists and analysis of its reliability and validity
Yanfang WANG ; Juanjuan CHEN ; Kelei GUAN ; Xiangfen SHI ; Kefeng LIU ; Jing WANG ; Song WANG ; Shuzhang DU
China Pharmacy 2023;34(2):242-245
OBJECTIVE To construct the evaluation index system for scientific research ability of hospital pharmacists, and provide reference for the improvement of hospital pharmacists’ scientific research ability and the formulation of relevant scientific research policies. METHODS The relevant indexes of scientific research evaluation of hospital pharmacists were extracted by literature analysis, and consultation questionnaire was designed according to Likert grade 5 scoring method. Delphi method was used to conduct two rounds of questionnaire consultation for 28 experts, and the weight of each index was determined by analytic hierarchy process. The reliability and validity of index system were analyzed by questionnaire survey. RESULTS After two rounds of expert correspondence, evaluation index system for scientific research ability of hospital pharmacists was finally determined from three core dimensions: basic scientific research ability, scientific research achievements and transformation ability, academic influence and personnel training (including 11 sub-dimensions and 34 measurement items). The weight value of each dimension index was determined. The result of reliability and validity analysis confirmed the scientific rationality of the index system. CONCLUSIONS The established evaluation index system for scientific research ability of hospital pharmacists is innovative, comprehensive and scientific. The index system model can provide reference for the improvement of hospital pharmacists’ scientific research ability and the formulation of relevant scientific research policies.
5.Research hotspots and trends on potentially inappropriate medication from 2012 to 2021
Gaoxing QIAO ; Yaojuan CHU ; Chong LIU ; Shujuan WANG ; Kefeng LIU ; Shuzhang DU
China Pharmacy 2023;34(3):370-375
OBJECTIVE To quantitatively and qualitatively analyze the progress of potentially inappropriate medication (PIM) research by means of bibliometrics, and to predict the hotspots and trends of PIM, so as to provide reference for PIM research in China. METHODS The research literature related to PIM were searched from Web of Science core database, and the publication trend of the literature was analyzed on the bibliometric online analysis platform and CiteSpace 5.8.R3 software. The research results were visualized and analyzed, and the research hotspots of PIM were summarized through gCLUTO. RESULTS About PIM research, the annual number of the literature issued from 2012 to 2021 showed a continuous growth trend totally; the United States had the largest number of literature (241 pieces); the University of Sydney in Australia was the research institution with the largest number of literature (59 pieces); O’Mahony D from University College Cork, Ireland, published the most literature (23 pieces); the research of PIM involved 57 disciplines, among which there was the largest number of literature about gerontology (384 pieces); International Journal of Clinical Pharmacy was the journal with the largest number of literature (61 pieces); Journal of the American Geriatrics Society was cited most frequently (1 197 times). The hotspots of PIM research mainly focused on seven aspects: the standard of PIM, the safety and economy research of PIM, the risk factors research of PIM, the PIM research of chronic patients, the PIM research of antipsychotics, the research of pharmacists’ participation in PIM management, and the PIM research about palliative care of tumor patients. CONCLUSIONS The heat of research on PIM has been on the rise, and there is little cooperation between countries and institutions, and more cooperation is needed. In the future, the focus of Chinese pharmacists’ research on PIM may be on the deep localization of PIM standards, PIM intervention and precise medication guidance, and PIM management of specific diseases and drugs.
6.Visual analysis of tyrosine kinase inhibitors in HER2 positive breast cancer
Jing ZOU ; Yaojuan CHU ; Qiuzheng DU ; Heying YUE ; Xiaobao WANG ; Shuzhang DU
China Pharmacy 2023;34(24):3036-3041
OBJECTIVE To analyze the research status, hotspot and development trend of tyrosine kinase inhibitors (TKIs) in the treatment of human epidermal growth factor receptor 2 (HER2) positive breast cancer. METHODS The literature related to TKIs in the treatment of HER2 positive breast cancer were searched from the Web of Science core collection database; the author, country/region, institution, subject field, journal and keywords was visualized by CiteSpace 6.1.R3 software. RESULTS A total of 732 pieces of literature were included, and the number of literature published showed an increasing trend year by year. The number of literature published in the United States was the largest (center degree 0.10), and the number of literature published in China ranked second (center degree 0.05). The most published and cited authors were Crown from St. Vincent’s University Hospital in Australia and Slamon from University of California, Los Angeles in the United States; the institution with the highest number of literature was the University of Texas MD Anderson Cancer Center, and the journal with the highest number of literature was the Journal of Clinical Oncology. The research mainly focused on five aspects: HER2 positive breast cancer treatment drugs, TKIs receptor, TKIs mechanism of action, HER2 positive breast cancer brain metastasis, and TKIs clinical trials. The main frontier areas and development trends were the combination of TKIs with other drugs or therapies to enhance targeting and reduce toxic side effects. CONCLUSIONS The study of TKIs in the treatment of HER2 positive breast cancer has attracted the attention of scholars at home and abroad. Chinese scholars and research teams need to strengthen cooperation and communication in the future, and cooperation with other countries should be strengthened in terms of the efficacy and safety of TKIs alone and combined with other drugs in the treatment of HER2 positive breast cancer.
7.Development of the index system of the quality evaluation standard for pharmacist training in cough and wheeze pharmaceutical care outpatient department
Yanhui GE ; Xiaoli CHEN ; Xiaoyu ZHAO ; Zhe CHEN ; Kelei GUAN ; Shuzhang DU
China Pharmacy 2023;34(21):2649-2653
OBJECTIVE To establish the index system of quality evaluation standard for pharmacist training in cough and wheeze pharmaceutical care (CWPC) outpatient department, and to provide a basis for the selection of CWPC pharmacist training teachers and the improvement of training plans. METHODS Based on Kirkpatrick model, using the Delphi method, a total of 15 experts from 13 tertiary hospitals in 10 provinces in China were consulted to establish the standard index system of the quality evaluation for CWPC pharmacists training. Analytic hierarchy process (AHP) was adopted to determine the weights of each indicator and quantify the index system according to the weights of indicators at all levels. RESULTS The coefficient of expert authority was 0.810, the judgment coefficient was 0.727, and the familiarity coefficient was 0.893. The Kendall coordination coefficient of each index was 0.308-0.687. The P values of χ2 test were all less than 0.05, which indicated that the degree of coordination of the experts was high. After two rounds of correspondence, Kirkpatrick model-based index system of quality evaluation standard for CWPC pharmacist training was determined. The index system included 4 first-level indexes (participants’ reaction layer, learning gain layer, behavior improvement layer, training outcome layer), 12 second-level indexes (such as training needs, teaching methods, theoretical knowledge, practical skills, job abilities, patient benefits, etc.) and 44 third-level indexes (such as clear training objectives, core system of CWPC, special device operation and evaluation, professional knowledge related to the treatment of cough and wheeze patients, promoting the construction of CWPC, improving patient compliance). CONCLUSIONS The constructed index system of quality evaluation standard for CWPC pharmacist training has a certain level of authority and scientificity, and provides a scientific theoretical basis for quality evaluation of CWPC pharmacist training.
8.Application of percutaneous curved kyphoplasty in treatment of old osteoporotic vertebral body with endplate fractures
Tonghao WANG ; Xiaobin HOU ; Zhi LIU ; Liqiang HAN ; Yonggang TIAN ; Shuzhang GUO
Chinese Journal of Orthopaedics 2022;42(22):1492-1498
Objective:To investigate the clinical effect of percutaneous curved kyphoplasty in the treatment of old osteoporotic vertebral body with endplate fracture.Methods:Clinical data of 58 patients suffering from old osteoporotic vertebral bodies with endplate fractures from January 2018 to January 2020 were analyzed retrospectively. All patients had a single vertebral body fracture and were treated with bilateral injection of bone cement with percutaneous kyphoplasty (PKP). According to the shape of the puncture device, the patients were divided into a curved needle group and a ordinary group. There were 28 cases in the curved needle group, including 7 males and 21 females, aged 60-84 years old, with an average age of 71.8±7.8 years. The distribution of vertebral bodies with fractures: T 11 3 cases, T 12 5 cases, L 1 6 cases, L 2 5 cases, L 3 3 cases, L 4 4 cases, and L 5 2 cases. In the ordinary group, there were 30 cases, 8 males and 22 females, with an average age of 73.2±8.4 years (range, 61-88 years). The vertebral body distribution of fracture: T 11 3 cases, T 12 5 cases, L 1 7 cases, L 2 4 cases, L 3 4 cases, L 4 5 cases, and L 5 2 cases. The surgery time, amount of bone cement injection, and bone cement leakage rate were compared between the two groups, as well as the visual analogue scale (VAS) and Oswestry disability index (ODI) at 1 week, 6 months, and 1 year after surgery. Preoperative and postoperative vertebral midpoint height and kyphosis Cobb angle were measured. Results:All patients were followed up for 12-24 months, with an average of 14.7±2.9 months. The bone cement leakage rate in curved needle group (18%, 5/28) was lower than that in ordinary group (23%, 7/30), but there was no significant statistical difference (χ 2=0.27, P=0.607). The amount of bone cement injection and surgery time in curved needle group (5.0±0.5 ml, 55.2±6.9 min) were significantly higher than those in ordinary group (3.4±0.6 ml, 42.9±3.6 min, P<0.05) . The scores of VAS (2.3±1.0, 2.6±1.5) and ODI (27.5%±9.7%, 28.7%±11.3%) in curved needle group were lower than those in ordinary group (2.7±1.0, 4.5±1.1 and 31.8%±10.5%, 43.1%±13.4%) at 6 months after surgery and at the last follow-up after surgery. In the curved needle group, the Cobb angle was 25.5°±3.5° preoperatively, 18.4°±1.6° postoperatively, and 20.5°±4.9°at the last follow-up. The height of the vertebral body was 14.2±1.9 mm before surgery, 21.5±2.2 mm after surgery, and 20.1±3.6 mm at the last follow-up. Compared with the preoperative results, the kyphosis Cobb angle decreased and the height of the fractured vertebral body increased at the last follow-up, and the differences were statistically significant ( P<0.05). In the ordinary group, the Cobb angle was 24.4°±3.6° preoperatively, 23.1°±4.0° postoperatively, and 27.8°±2.9° at the last follow-up. The height of the vertebral body was 14.5±1.8 mm before surgery, 15.4±2.0 mm after surgery, and 12.7±1.0 mm at the last follow-up. At the last follow-up, the kyphosis Cobb angle increased and the height of the fractured vertebral body decreased compared with preoperative and postoperative 1 week, and the differences were statistically significant ( P<0.05). At 1 week after surgery, 6 months after surgery and the last follow-up, the Cobb angle of curved needle group was lower than that of ordinary group ( P<0.05), the height of vertebral body was higher than that of ordinary group ( P<0.05). Conclusion:Flexible application of percutaneous curved kyphoplasty in the treatment of old osteoporotic vertebral body with endplate fractures can effectively increase the riveting force of bone cement in the vertebral body, restore the height of endplate, and reduce the occurrence of kyphosis and chronic low back pain.
9.Analysis of working pressure for return-working postpartum hospital pharmacists and its influential factors
Rui ZHANG ; Xiangde ZHAO ; Yaojuan CHU ; Jie HAO ; Xiaojuan WANG ; Shuzhang DU
China Pharmacy 2022;33(24):3059-3062
OBJECTIVE To investigate the working pressure of return-working postpartum hospital pharmacists, analyze the influential factors, and find the suitable strategy to relieve the working pressure of postpartum pharmacists. METHODS By the means of general information questionnaire, working pressure questionnaire and self-rating depression scale, the data of postpartum pharmacists were surveyed with sampling survey to investigate the working-pressure situation. The main influential factors of the postpartum working pressure were analyzed by multiple linear stepwise regression analysis. RESULTS A total of 281 valid questionnaires were collected from 84 different hospitals, with effective rate of 88.64%. The total score of working pressure for 281 postpartum pharmacists who were back to position was (79.80±23.06) (total score of 155). However, 51.60% of return-working postpartum pharmacists showed depressive state (≥53). The depression status was positively correlated with working pressure. Family support, frequency of physical exercise, and ideal personnel care were all negatively associated with working pressure. CONCLUSIONS The working pressure of return-working postpartum pharmacists is at a moderate level. Depression, family support, ideal personnel care, and frequency of physical exercise are the main influential factors.
10.Analysis on research status and hot spots of gabapentinoid drugs in the treatment of pain
Xiaojing LU ; Xiangfen SHI ; Fangying SI ; Yuanxia ZHAO ; Jinyuan XING ; Xufeng ZHANG ; Xiaoyu ZHAO ; Shuzhang DU
China Pharmacy 2022;33(8):996-1002
OBJECTIVE To analyze the si tuation and hot spots of gabapentinoid drugs in the treatment of pain. METHODS Related researches about gabapentinoid drugs in the treatment of pain were retrieved from Web of Science core collection database during Jan. 1st,2011-Dec. 31st,2020. VOSviewer 1.6.17,CiteSpace 5.8.R1 and Excel 2018 software were used to statistically analyze the key characteristics of relevant literature ,such as the annual publications ,countries/regions,institutions,authors, journals and research hot spots. RESULTS & CONCLUSIONS A total of 3 519 literatures were retrieved ,and the annual publication outputs showed an upward trend generally. Totally 86 countries/regions had conducted relevant studies ,of which the United States ranked first (up to 1 219),and had close cooperation with the United Kingdom ,Canada,China,Germany,Japan, etc;a total of 3 996 institutions had published relevant literatures ,and the Pfizer Inc. issued the most publications ;the most studies were devoted by Professor Parsons from the University of California San Diego ,and the highest co-citations author was Professor Gilron from the Queen ’s University. Among 1 185 journals,Pain ranked first not only in the high-productive journal ,but also in the co-cited journal. The main hot topics include abuse and misuse of gabapentinoid ,off-label use of gabapentinoid ,clinical application of gabapentinoid as a component of multimodal analgesia ,and the update of guidelines for pain based on systematic evaluation and meta-analysis.

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