1.Comparison of predictive accuracy and clinical applicability among four vancomycin individualized dosing tools
Shu CHEN ; Yanqin LU ; Yun SHEN ; Chang CAO ; Kunming PAN ; Xiaoyu LI ; Qianzhou LYU
China Pharmacy 2025;36(22):2822-2827
OBJECTIVE To compare the predictive accuracy and clinical applicability of four vancomycin individualized dosing tools (SmartDose, ClinCalc, Gulou, Pharmado) and provide a basis for rational clinical medication use. METHODS A retrospective cohort study was conducted, enrolling 479 adult patients who received vancomycin therapy and underwent steady-state trough concentration monitoring in Zhongshan Hospital, Fudan University (Xiamen Branch) from January 1, 2022, to June 30, 2024. The predictive accuracy of each tool was evaluated using indicators, such as mean error (ME), mean absolute error (MAE), mean percentage error (MPE), mean absolute percentage error (MAPE), the proportion of patients with an absolute percentage error (APE) of less than 30%, the 95% limits of agreement, and the overall relative percentage difference between predicted and measured values. Using indicators such as accessibility, patient management, and recommendation of multiple treatment options, the clinical panxso@163.com applicability of the tools for all patients was evaluated; using the discrepancy in accuracy between the predicted and actual measured blood drug concentrations as an indicator, the clinical applicability was assessed for patients in different renal function subgroups (hyperfunction, normal, mild impairment, moderate impairment, and severe impairment). RESULTS In terms of accuracy, SmartDose demonstrated the best overall performance with an MAPE of 46.40% and a proportion of APE <30% (46.56%). Bland-Altman analysis indicated that SmartDose had the smallest overall relative percentage difference (-7.25%), although the 95% limits of agreement were broad for all tools, with differences between the upper and lower limits exceeding 200%. In terms of applicability, all four dosing tools were freely accessible and demonstrated good availability; SmartDose and Pharmado provided the most comprehensive solutions, offering features such as patient management, multiple regimen recommendations, and drug concentration-time curve plotting. Stratified analysis based on renal function revealed that Pharmado showed optimal prediction for hyperfiltration patients (mean difference: 0.11 mg/L). SmartDose and ClinCalc showed relatively better performance in normal and mild renal impaiment (mean difference: 0.37, 0.51 mg/L and -1.13, -1.33 mg/L,respectively). SmartDose performed best in moderate renal impairment (mean difference: -2.60 mg/L). Pharmado and Gulou had smaller prediction biases in severe renal impairment (mean differences: 1.52 mg/L and -0.23 mg/L, respectively). CONCLUSIONS The four individualized dosing tools demonstrated limited accuracy in the initial prediction of vancomycin concentrations. Among them, SmartDose demonstrates the highest overall prediction accuracy and possesses comprehensive clinical management features. It is recommended that Pharmado be preferred for patients with renal hyperfiltration; SmartDose or ClinCalc can be used for patients with normal or mildly impaired renal function; SmartDose is recommended for patients with moderately impaired renal function; Pharmado or Gulou may be considered for patients with severely impaired renal function.
2.Identification and Expression Analysis of PP2C Gene Family Members in Cannabis sativa
Xiaoxue CAI ; Sifan WANG ; Yaolei MI ; Huihua WAN ; Xue CAO ; Wei SUN ; Chang SU ; Shilin CHEN ; Yanqin XU ; Weiqiang CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(19):162-172
ObjectiveThe type 2C protein phosphatases (PP2C) are involved in numerous plant signal transduction pathways. They mainly participate in plant stress response and regulate second metabolites biosynthesis via negatively regulating MAPK signaling pathway. Herein,we were to identify and analyze PP2C (CsPP2C) gene family from hemp genome,in hope of providing comprehensive insights for studying CsPP2C function during the development of hemp. MethodMolecular Evolutionary Genetics Analysis (MAGA)-X was used to construct phylogenetic tree. Expert Protein Analysis System (ExPASy),WoLF PSORT,Multiple EM for Motif Elicitation (MEME),Batch Conserved Domain Search (Batch-CD-Search),PlantCare,and TBtools were used,respectively,to predict CsPP2C physicochemical properties,subcellular localization,conserved motifs,protein structure,cis-element in promoter and collinearity with Arabidopsis PP2C. Cannabis sativa transcriptome and Real-time polymerase chain reaction(Real-time PCR) were used to analyze and verify gene expressions,respectively. ResultFifty-two CsPP2C with conserved domains were identified from the entire genome of hemp,encoding proteins ranging from 244 to 1 089 aa in length and with molecular weights ranging from 26.76 to 122.53 kDa. Those genes were mainly distributed in the nucleus,cytoplasm and chloroplast. The 47 CsPP2C were divided into 10 subfamilies,and the remaining 5 were not clustered. Seven pairs of homologous genes between hemp and Arabidopsis thaliana were identified according to collinear analysis. The light-responsive elements and abscisic acid elements are most abundant in the prediction. The gene expression heat map showed varied expression pattern of CsPP2C in different tissues. Real-time PCR results of three CsPP2C were consistent with transcriptome data. Moreover,alternative splicing analysis showed that some CsPP2C had alternative-splicing genes during evolution. ConclusionWe predicted and analyzed CsPP2C gene family in genomic scale and showed that CsPP2C are involved in many biological processes,whereby provides foundation for CsPP2C functional study.
3.Effects of Salvia miltiorrhiza on body mass and levels of blood lipids and malondialdehyde in ovariectomized obese rats
Jia YUE ; Yanqin CHANG ; Jiaen ZHU ; Meiling LIN ; Xiaoyu ZHANG ; Yuling WEI ; Tianzhen ZHENG
Chinese Journal of Tissue Engineering Research 2007;11(36):7314-7316
BACKGROUND: Salvia miltiorrhiza is widely used to treat angina cordis, ischemic stroke and other ischemic cardiovascular diseases. However, the effects of Salvia miltiorrhiza on ovariectomized rats remain unclear.OBJECTIVE: To observe the effects of Salvia miltiorrhiza on the body mass, food intake, and levels of blood lipids and malondialdehyde (MDA) in ovariectomized rats.DESIGN: A completely randomized and controlled experiment.SETTING: Institute of Physiology and Psychology, School of Basic Medical Sciences, Lanzhou University.MATERIALS: The experiment was performed in the Key Laboratory of Pre-clinical Study for New Drugs of Gansu Province and the laboratory of Institute of Physiology and Psychology, School of Basic Medical Sciences, Lanzhou University from November 2005 to December 2006. Twenty-four healthy female SD rats of 3 months old and (220±2) g were selected. Salvia miltiorrhiza water decoction (equal to 1 g/mL crude drug) was identified and extracted by Drug Control Institute of Gansu Province; MDA kit was purchased from Nanjing Jiancheng Institute of Bioengineering.METHODS: ①The rats were randomly divided into three groups with 8 rats in each group: sham-operated group,ovariectomized group and Salvia miltiorrhiza group. The rats were underwent a bilateral ovariectomy except those in the sham-operated group, which were subjected to a removal of bilateral fat as much as ovariectomized group with the ovaries remained. Rats in sham-operated group and ovariectomized group freely drank water; rats in Salvia miltiorrhiza group freely took 1% water extracts from Salvia miltiorrhiza postoperatively, and the concentration of Salvia miltiorrhiza gradually increased to 12% on the eighth day, which was lasted until the end of the experiment (55 days). ②The food intake of rats in each group was monitored daily, and the body mass was measured every five days. At the end of the experiment, femoral artery blood samples of rats were collected to determine the levels of blood lipids. At the same time,MDA was measured according to the kit.MAIN OUTCOME MEASURES: The body mass, food intake, levels of blood lipids and malondialdehyde in each group.RESULTS: Twenty-four rats all entered the result analysis. ①The body mass of rats in 3 groups was nearly the same before operation (P > 0.05). While the body mass in ovariectomized group on the postoperatively 10th, 20th, 25th, and 55th days was significantly higher than those in sham-operated group (P < 0.01). The body mass in Salvia miltiorrhiza group on the postoperatively 20th, 25th, and 55th days was significantly lower than those in ovariectomized group (P <0.05-0.01). ②The food intake in ovariectomized group on the postoperatively 15th, 40th, and 55th days was significantly higher than those in sham-operated group (P < 0.05-0.01), and that in Salvia miltiorrhiza group was significantly lower than those in ovariectomized group at those 3 time points (P < 0.05-0.01). ③At the end of the experiment, the levels of total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglyceride in ovariectomized group were significantly higher than those in sham-operated group (P < 0.05-0.01). The levels of triglyceride and MDA in Salvia miltiorrhiza group were significantly lower than those in ovariectomized group (P<0.01, 0.05).CONCLUSION: Salvia miltiorrhiza can significantly reduce the body mass and levels of triglyceride and MDA in ovariectomized rats.

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