OBJECTIVE To improve the efficiency and quality of dispensed oral drug management in the inpatient pharmacy， and ensure the safety of drug use in patients. METHODS SWOT （strength， weakness， opportunity， threat） analysis method was used to analyze the internal strengths and weaknesses， as well as the external opportunities and threats in the construction of a closed-loop management system for dispensed oral drugs in the inpatient pharmacy of our hospital， and propose improvement strategies. RESULTS & CONCLUSIONS A refined， full-process， closed-loop traceability management system for dispensed oral drugs in the inpatient pharmacies was successfully established， which is traceable in origin， trackable in destination， and accountable in responsibility. After the application of this system， the registration rate of dispensed drug information and the correctness rate of registration content both reached 100%. The proportion of overdue drug varieties in the same period of 2024 decreased by 77.78% compared to March 2020， the inventory volume decreased by 29.50% compared to the first quarter of 2020， the per-bed medication volume decreased by 32.14% compared to the first quarter of 2020； the average workload per post in the same period of 2023 increased by 49.09% compared to 2019， the dispensing accuracy rate reached 100%， and the improvement rate of quality control problem increased by 25.25% compared to 2021. This system effectively improves the safety and accuracy of dispensed oral drug management in the inpatient pharmacy.

Cancer multidrug resistance (MDR) impairs the therapeutic efficacy of various chemotherapeutics. Novel approaches, particularly the development of MDR reversal agents, are critically needed to address this challenge. This study demonstrates that tenacissoside I (TI), a compound isolated from Marsdenia tenacissima (Roxb.) Wight et Arn, traditionally used in clinical practice as an ethnic medicine for cancer treatment, exhibits significant MDR reversal effects in ABCB1-mediated MDR cancer cells. TI reversed the resistance of SW620/AD300 and KBV200 cells to doxorubicin (DOX) and paclitaxel (PAC) by downregulating ABCB1 expression and reducing ABCB1 drug transport function. Mechanistically, protein arginine methyltransferase 1 (PRMT1), whose expression correlates with poor prognosis and shows positive association with both ABCB1 and EGFR expressions in tumor tissues, was differentially expressed in TI-treated SW620/AD300 cells. SW620/AD300 and KBV200 cells exhibited elevated levels of EGFR asymmetric dimethylarginine (aDMA) and enhanced PRMT1-EGFR interaction compared to their parental cells. Moreover, TI-induced PRMT1 downregulation impaired PRMT1-mediated aDMA of EGFR, PRMT1-EGFR interaction, and EGFR downstream signaling in SW620/AD300 and KBV200 cells. These effects were significantly reversed by PRMT1 overexpression. Additionally, TI demonstrated resistance reversal to PAC in xenograft models without detectable toxicities. This study establishes TI's MDR reversal effect in ABCB1-mediated MDR human cancer cells through inhibition of PRMT1-mediated aDMA of EGFR, suggesting TI's potential as an MDR modulator for improving chemotherapy outcomes.
Humans ; Protein-Arginine N-Methyltransferases/antagonists & inhibitors* ; Drug Resistance, Neoplasm/drug effects* ; ErbB Receptors/genetics* ; Animals ; Cell Line, Tumor ; Drug Resistance, Multiple/drug effects* ; Methylation/drug effects* ; Saponins/administration & dosage* ; Mice ; Mice, Nude ; Mice, Inbred BALB C ; ATP Binding Cassette Transporter, Subfamily B/genetics* ; Doxorubicin/pharmacology* ; Paclitaxel/pharmacology* ; Female ; Repressor Proteins

OBJECTIVE To analyze the use and distribution characteristics of toxic traditional Chinese medicine decoction pieces in oncology outpatient department, and to provide data reference for the safe and rational use of toxic traditional Chinese medicine decoction pieces in clinical applications. METHODS The 838 prescriptions data of toxic traditional Chinese medicine from the Oncology Outpatient Department of The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine in 2022 were collected and made retrospective statistical analysis of patient gender, age, clinical diagnosis, variety of toxic traditional Chinese medicine, frequency of use, frequency of overdose, and combination use of toxic traditional Chinese medicine. RESULTS Among the 838 prescriptions of toxic Chinese herbal medicines, 22 toxic Chinese herbal medicines were involved, accounting for 81.48% of the hospital's toxic Chinese herbal medicines. The majority of prescriptions (217 cases, accounting for 25.89%) aged 50 to 60 years old. Most of the single prescriptions were concentrated in 11 to 15, and the toxic Chinese herbal decoction pieces were mainly used in various tumor diseases, digestive system diseases and gynecological diseases, etc. In addition to golden larch bank, ginkgo and centipede, the other toxic traditional Chinese medicines all had the overdose problem. 231 prescriptions of toxic traditional Chinese medicine were used in combination with≥2 , with 190 prescriptions of 2 ingredients being the most commonly used (accounting for 22.67%). There were 78 incompatibilities, most of which were the combination of Aconiti Lateralis Radix Praeparata and Pinelliae Rhizoma. It was used to treat chronic Atrophic gastritis, insomnia and depression. CONCLUSION Toxic traditional Chinese medicine decoction pieces are widely used in oncology department. However, the overdose phenomenon is serious, it is necessary to be aware of the potential risks of overdose and combination of toxic traditional Chinese medicine. Therefore, it is necessary to further strengthen drug management, promote rational application, and ensure patient medication safety.

Objective To investigate the effect of the aqueous extract of Chuan Xiong Rhizoma(CR)on brain metastasis of melanoma B16F10 cells in mice.Methods C57BL/6J mouse models of brain metastasis of melanoma were established by ultrasound-guided intraventricular injection of Luc-labeled B16F10 cells,and brain tumor growth was monitored by in vivo imaging.The mouse models were then randomized for daily gavage of saline or aqueous extract of CR(equivalent crude drug concentration of 1 mg/g).Behavioral tests were used to evaluate the neuroprotective effects of CR in the tumor-bearing mice,and the changes in proteins associated with blood-brain barrier integrity,neuronal cell proliferation and apoptosis,and microglial cell apoptosis and activation were observed using immunofluorescence assay.The efficacy of CR combined with temozolomide(25 mg/kg)against brain metastases of B16F10 cells was observed by in vivo imaging.Results CR-treated mouse models did not show obvious progression of brain metastases and had a reduced rate of body weight loss and lowered protein expressions of ZO-1,claudin-5,occludin,P-gp,TNF-α,AQP4 and PDGFRβ.In the behavioral tests,the CR-treated mice showed prolonged stay on the wooden stick with a shortened time of sticky stick removal.Immunofluorescence assay showed increased proliferation and decreased apoptosis of neuronal cells and microglia in CR-treated mice.CR treatment significantly increased the levels of CD86,CD206,IL-4 and IL-10 and decreased the levels of CD163 and IL-1β in the microenvironment of brain metastases.The mice receiving combined treatments with CR and temozolomide showed significantly lower intensity of fluorescent signals in the brain than those treated with temozolomide alone.Conclusion CR does not promote brain metastasis of melanoma while inducing opening of the blood-brain barrier,and its combined use with TMZ results in enhanced inhibition against brain metastasis of melanoma B16F10 cells in mice.

Objective To investigate the effect of the aqueous extract of Chuan Xiong Rhizoma(CR)on brain metastasis of melanoma B16F10 cells in mice.Methods C57BL/6J mouse models of brain metastasis of melanoma were established by ultrasound-guided intraventricular injection of Luc-labeled B16F10 cells,and brain tumor growth was monitored by in vivo imaging.The mouse models were then randomized for daily gavage of saline or aqueous extract of CR(equivalent crude drug concentration of 1 mg/g).Behavioral tests were used to evaluate the neuroprotective effects of CR in the tumor-bearing mice,and the changes in proteins associated with blood-brain barrier integrity,neuronal cell proliferation and apoptosis,and microglial cell apoptosis and activation were observed using immunofluorescence assay.The efficacy of CR combined with temozolomide(25 mg/kg)against brain metastases of B16F10 cells was observed by in vivo imaging.Results CR-treated mouse models did not show obvious progression of brain metastases and had a reduced rate of body weight loss and lowered protein expressions of ZO-1,claudin-5,occludin,P-gp,TNF-α,AQP4 and PDGFRβ.In the behavioral tests,the CR-treated mice showed prolonged stay on the wooden stick with a shortened time of sticky stick removal.Immunofluorescence assay showed increased proliferation and decreased apoptosis of neuronal cells and microglia in CR-treated mice.CR treatment significantly increased the levels of CD86,CD206,IL-4 and IL-10 and decreased the levels of CD163 and IL-1β in the microenvironment of brain metastases.The mice receiving combined treatments with CR and temozolomide showed significantly lower intensity of fluorescent signals in the brain than those treated with temozolomide alone.Conclusion CR does not promote brain metastasis of melanoma while inducing opening of the blood-brain barrier,and its combined use with TMZ results in enhanced inhibition against brain metastasis of melanoma B16F10 cells in mice.

Background::Non-alcoholic fatty liver disease (NAFLD) and inflammatory bowel disease (IBD) have shown similar worsening epidemic patterns globally and shared various overlapping pathophysiological mechanisms. However, evidence on the relationship between NAFLD and IBD risk is lacking. We aimed to investigate the associations between long-term risk of incident IBD and NAFLD in a large prospective cohort.Methods::Participants from the United Kingdom Biobank cohort (https://biobank.ndph.ox.ac.uk/) who were free of IBD and alcoholic liver disease at baseline were enrolled. Baseline non-alcoholic fatty liver degree was measured by the well-established fatty liver index (FLI). The outcomes of interest included incident IBD, ulcerative colitis (UC), and Crohn’s disease (CD). Multivariable Cox proportional hazard regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).Results::Among 418,721 participants (mean FLI: 48.11 ± 30.11), 160,807 (38.40%) participants were diagnosed as NAFLD at baseline. During a median of 12.4 years’ follow-up, 2346 incident IBD cases (1545 UC, 653 CD, and 148 IBD-unclassified) were identified. Due to limited events, those IBD-unclassified were combined in UC or CD when examining the associated risk of UC or CD, separately. Compared with the lowest quartile of FLI, the highest quartile showed a separately 36.00%, 25.00%, and 58.00% higher risk of incident IBD (HR Q4 vs. Q1 =1.36, 95% CI: 1.19-1.55, Ptrend <0.001), UC (HR Q4 vs. Q1 =1.25, 95% CI: 1.07-1.46, Ptrend=0.047), and CD (HR Q4 vs. Q1 =1.58, 95% CI: 1.26-1.97, Ptrend <0.001) after multivariable adjustment. Compared with non-NAFLD, NAFLD participants had a significantly higher risk of incident IBD (HR=1.13, 95% CI: 1.04-1.24) and CD (HR =1.36, 95% CI: 1.17-1.58). Conclusions::Higher degree of non-alcoholic fatty liver is associated with increased risk of incident IBD. Interventions aimed at improving NAFLD may be a potential targeted strategy for the detection and treatment of IBD.

Objective To explore the effects of optimized nutrition intervention scheme on nutritional status and clinical outcome during transplantation in the patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods Seventy inpatients with allo-HSCT in this hospital from January to December 2022 were selected as the study subjects and divided into the control group and intervention group by the random number table method,35 cases in each group.The control group conducted the conventional nutritional intervention and the intervention group conducted the optimized nutritional intervention.The nutri-tional indicators[body weight,patient-generated subjective global assessment (PG-SGA),energy and protein intake],levels of total protein (TP),albumin (ALB) and prealbumin (PA),hospitalization duration,hospitali-zation costs and adverse reactions occurrence were compared between the two groups.The differences in the nutritional status and clinical outcomes in the tow groups were comprehensively evaluated.Results Compared with the control group,the body weight decrease ranges in entering the laminar flow ward and on 60 d of transplantation in the intervention group were much less[3.10(1.10,4.80)kg vs. 4.30(3.10,6.70)kg;3.20 (1.00,5.50)kg vs. 4.15(3.33,7.88)kg],the PG-SGA score was lower[(10.43±3.25)points vs. (13.00±3.05) points],the PA level was higher[(189.63±51.29)mg/L vs. (163.83±48.03)mg/L],the energy and protein oral intakes were much more[(753.99±350.66)kcal vs. (539.96±247.65)kcal;(33.87±15.87)g vs. (20.43±12.57)g],the diarrhea occurrence rate was lower (14.3％ vs. 37.1％),and the differences were statistically significant (P<0.05).Conclusion Optimizing the nutritional intervention during allo-HSCT pe-riod is beneficial to improve the nutritional status of the patients,and reduce the incidence rate of adverse reac-tions.

Objective:To investigate the effect of dexamethasone mixed with ropivacaine for cervical nerve pathway blockade on the postoperative swallowing function in patients undergoing thyroid surgery.Methods:This was a prospective randomized controlled trial. One hundred twenty-four patients, regardless of gender, aged 18-60 yr, of American Society of Anesthesiologists Physical Status classification Ⅰor Ⅱ, who underwent elective thyroidectomy at Xuzhou Cancer Hospital from March to December 2023, were selected and divided into test group (DR group, n=62) and control group (R group, n=62)using a random number table method. After induction of total intravenous anesthesia, bilateral cervical nerve pathway blockade was performed, dexamethasone 5 mg and 0.25% ropivacaine 10 ml were injected in DR group, and 0.25% ropivacaine 10 ml was injected in group R. Main outcome measures: The swallowing function was assessed using Standard Swallowing Assessment scale at 1 and 6 days postoperatively, and the occurrence of swallowing dysfunction (abnormal in any indicator) was recorded. Secondary outcome measures: numerical rating scale scores were recorded immediately after tracheal extubation and at 4, 8, 12, 24 and 48 h after tracheal extubation in both static and swallowing states. Voice function was evaluated using the Voice Handicap Index-10 at 1 and 6 days postoperatively. The use of ketorolac tromethamine and occurrence of adverse reactions after surgery were recorded. Results:Sixty-one patients were finally included in DR group and 60 patients in R group. Compared with R group, the Standard Swallowing Assessment scale scores at 1 and 6 days after operation and incidence of swallowing disorders at 1 day after operation were significantly decreased, the numerical rating scale scores at 8 and 12 h after tracheal extubation in the static state and at 4-24 h after tracheal extubation in the swallowing state were decreased, the incidence of postoperative nausea and vomiting and Voice Handicap Index-10 scores at 1 day after operation were decreased, and the number of patients who used ketorolac tromethamine was reduced in DR group ( P<0.05). Conclusions:Dexamethasone mixed with ropivacaine for cervical nerve pathway blockade can improve the postoperative swallowing function in patients undergoing thyroid surgery.

The construction of experimental animal models plays an important supporting role in research into the mechanisms of action of Chinese medicines.There have been increasing reports of the construction and evaluation of animal models of spleen deficiency;however,the construction method have involved different standards and there has been insufficient objectification of the evaluation indexes.In this review,we summarize the construction and evaluation method of animal models of spleen deficiency from the aspects of animal selection,model establishment,macroscopic characterization,behavioral experiments,and objective indexes of spleen deficiency,with a view to providing theoretical guidance for the construction of experimental animal models of spleen deficiency and references for the selection of animal model platforms for spleen deficiency.

Tumor metastasis is closely related to high mortality rate of cancer.It is well known that glutamine plays an important role in the malignant progression of cancer.Notably,as an important carbon and nitrogen donor,glutamine has been found to be closely related to tumor metastasis in recent years.Glutamine is not only involved in regulating the proliferation of tumor cells,but is also closely related to the migration and invasion of tumor cells.Furthermore,various enzymes along with transporters in the metabolism of glutamine are involved in the process of tumor metastasis through different signaling pathways.This review provided a summary of the role of glutamine in tumor metastasis in recent years and proposed therapeutic targets to provide new strategies for the clinical treatment of tumor metastases.