1.Meta-analysis of the incidence and risk factors of anti-tuberculosis drug-induced liver injury
Qinqin XIE ; Huanhuan JI ; Meiling GONG ; Yuntao JIA
China Pharmacy 2024;35(24):3052-3058
OBJECTIVE To systematically evaluate the incidence of anti-tuberculosis drug-induced liver injury (ATB-DILI) and its risk factors. METHODS PubMed, Embase, the Cochrane Library, Web of Science, China Knowledge Network, VIP, Wanfang data and China Biomedical Literature Database were searched to collect cohort studies and case-control studies on the incidence and risk factors of ATB-DILI from the establishment of the database to 31 May 2024. After screening literature, extracting data and evaluating the quality of literature, meta-analysis was performed using Stata 17.0 and RevMan 5.3 software. RESULTS A total of 26 literature involving 38 971 patients were included, of which 4 106 patients suffered from ATB-DILI. Meta-analysis showed that the incidence of ATB-DILI was 12.94% [95%CI (10.82%,15.06%), P<0.001]; subgroup analysis showed that the incidence of ATB-DILI in cohort studies, Chinese studies and pediatric patients was higher (P<0.001). Age≥60 years, abnormal body mass index, alcoholism, smoking, history of liver disease, hepatitis B surface antigen positivity, extrapulmonary tuberculosis, malnutrition, hypoproteinemia, cardiovascular disease, diabetes mellitus, systemic lupus erythematosus, no prophylactic use of hepatoprotective drugs, and high baseline alanine transaminase levels were risk factors for developing ATB-DILI (P<0.05). Sensitivity analysis and publication bias analysis showed that the results obtained in this study were relatively robust. CONCLUSIONS The incidence of ATB-DILI in tuberculosis patients is 12.94%. Age≥60 years, abnormal body mass index, alcoholism, smoking, history of liver disease, hepatitis B surface antigen positivity, extrapulmonary tuberculosis, malnutrition, hypoproteinaemia, cardiovascular disease, diabetes mellitus, systemic lupus erythematosus, non-prophylactic use of hepatoprotective medications, and high baseline levels of alanine transaminase are the risk factors for developing ATB-DILI.
2.Consensus on prescription review of commonly used H 1-antihistamines in pediatrics
Lihua HU ; Lu LIU ; Huiying CHEN ; Heping CAI ; Wentong GE ; Zhiying HAN ; Huijie HUANG ; Xing JI ; Yuntao JIA ; Lingyan JIAN ; Nannan JIANG ; Zhong LI ; Li LI ; Hua LIANG ; Chuanhe LIU ; Qinghong LU ; Xu LU ; Jun′e MA ; Jing MIAO ; Yanli REN ; Yunxiao SHANG ; Kunling SHEN ; Huajun SUN ; Jinqiao SUN ; Yanyan SUN ; Jianping TANG ; Hong WANG ; Lianglu WANG ; Xiaochuan WANG ; Lei XI ; Hua XU ; Zigang XU ; Meixing YAN ; Yong YIN ; Shengnan ZHANG ; Zhongping ZHANG ; Xin ZHAO ; Deyu ZHAO ; Wei ZHOU ; Li XIANG ; Xiaoling WANG
Chinese Journal of Applied Clinical Pediatrics 2023;38(10):733-739
H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.
3.Analysis of the Efficacy and Safety of Pamidronate Disodium in the Treatment of Osteogenic Imperfecta in Children
ZHOU Ruiou ; JI Huanhuan ; JIA Yuntao
Chinese Journal of Modern Applied Pharmacy 2023;40(22):3124-3128
Abstract
OBJECTIVE To retrospectively analyze the efficacy and safety of pamidronate disodium(APD) in the treatment of osteogenic imperfecta(OI) in children. METHODS Children who first used APD at the Children's Hospital Affiliated to Chongqing Medical University from January 1, 2014 to June 30, 2023 were selected as the research subjects. The growth and development status, improvement of bone metabolism and biochemical indicators, changes in bone density(BMD) and fractures, and occurrence of adverse drug reactions(ADRs) before and after treatment were compared. RESULTS A total of 14 pediatric patients were included, with a median age of 5.16 years. All children, regardless of the duration of treatment(1, 2 years, 3 years or more), showed significant improvements in height, body mass, and lumbar BMD compared to before treatment, while the average number of fractures per year decreased significantly(P<0.05). After 1 year of treatment, the alkaline phosphatase significantly increased(P=0.024). After 2 years of treatment, the total 25-hydroxyvitamin D3(T-25OHD3) significantly improved(P=0.014). After 3 years of treatment, the Z-value of height significantly improved(P=0.036). The most common ADR were fever, skeletal muscle pain, asymptomatic hypocalcemia and hypophosphatemia. CONCLUSION Pediatric patients with OI have good tolerance to APD treatment, with increased lumbar BMD and BMD Z values, reduced fracture rates, and improved growth and development.
4.Analysis of the Efficacy and Safety of Pamidronate Disodium in the Treatment of Osteogenic Imperfecta in Children
ZHOU Ruiou ; JI Huanhuan ; JIA Yuntao
Chinese Journal of Modern Applied Pharmacy 2023;40(22):3124-3128
Abstract
OBJECTIVE To retrospectively analyze the efficacy and safety of pamidronate disodium(APD) in the treatment of osteogenic imperfecta(OI) in children. METHODS Children who first used APD at the Children's Hospital Affiliated to Chongqing Medical University from January 1, 2014 to June 30, 2023 were selected as the research subjects. The growth and development status, improvement of bone metabolism and biochemical indicators, changes in bone density(BMD) and fractures, and occurrence of adverse drug reactions(ADRs) before and after treatment were compared. RESULTS A total of 14 pediatric patients were included, with a median age of 5.16 years. All children, regardless of the duration of treatment(1, 2 years, 3 years or more), showed significant improvements in height, body mass, and lumbar BMD compared to before treatment, while the average number of fractures per year decreased significantly(P<0.05). After 1 year of treatment, the alkaline phosphatase significantly increased(P=0.024). After 2 years of treatment, the total 25-hydroxyvitamin D3(T-25OHD3) significantly improved(P=0.014). After 3 years of treatment, the Z-value of height significantly improved(P=0.036). The most common ADR were fever, skeletal muscle pain, asymptomatic hypocalcemia and hypophosphatemia. CONCLUSION Pediatric patients with OI have good tolerance to APD treatment, with increased lumbar BMD and BMD Z values, reduced fracture rates, and improved growth and development.
5.Analysis of β-blockers associated with acute renal failure signal based on data mining method
Hongli WANG ; Ni ZHANG ; Guizun ZHONG ; Siqi CHEN ; Huanhuan JI ; Li GONG ; Lingyun PAN ; Yuntao JIA
China Pharmacy 2022;33(11):1380-1385
OBJECTIVE To excavate and evaluate β-blockers associated with acute renal failure(ARF)signal. METHODS Using the report odds ratio (ROR)method and Bayesian confidence interval progressive neural network (BCPNN)method,signal detection and analysis were performed for 4 kinds of β-blockers(metoprolol,bisoprolol,atenolol,nebivolol)associated with ARF Δ 基金项目:重庆市临床药学重点专科建设项目 (No.渝卫办发 in FDA adverse event reporting system (FAERS)from the two 〔2020〕68号);重庆医科大学未来医学青年创新团队发展支持计划项 dimensions of Standard International Dictionary of Medical 目(No.W0081) Terms (MedDRA) analysis query (SMQ) term set and *药师,硕士研究生。研究方向:药物警戒。电话:023-68485161。 preferred term (PT) level terms. When the two methods E-mail:2020121624@stu.cqmu.edu.cn detected positive signals at the same time ,it indicated that # 通信作者:主任药师,硕士生导师。研究方向:临床药学、药物警 suspicious signals were detected. RESULTS Totally 14 328 戒。电话:023-63625666。E-mail:jiayuntaomail@hospital.cqmu.edu.cn ARF reports of 4 kinds of β-blockers were retrieved within the ·1380· China Pharmacy 2022Vol. 33 No. 11 中国药房 2022年第33卷第11期 narrow sense of “acute renal failure ”in SMQ term set ,of which men (6 964)were more than women (6 206). The age of patients was mainly concentrated in the middle-aged and elderly (≥45 years old ),and serious adverse events accounted for 77.23%. The results of signal retrieval based on SMQ term set showed that ROR values and 95% confidence intervals of metoprolol ,bisoprolol, atenolol and nebivolol detected by ROR method were 2.58(2.51,2.65),5.30(5.14,5.47),2.80(2.69,2.91)and 3.28(3.04, 3.53)respectively. The signal components (IC)detected by BCPNN method and the lower limit of IC were 1.29(1.25),2.26 (2.22),1.42(1.36)and 1.64(1.53)respectively,suggesting suspicious signals were detected in these four kinds of β-blockers associated ARF. The results of signal detection based on PT level terms showed that 37 positive signals were detected by ROR method,38 positive signals were detected by BCPNN method ,and 36 suspicious signals were detected by the two methods at the same time. For each drug ,12 suspicious signals of metoprolol were detected at the same time ,9 suspicious signals of bisoprolol and atenolol were detected at the same time ,and 6 suspicious signals of nebivolol were detected at the same time ;the number and type of signals were different among the 4 kinds of drug. CONCLUSIONS Four kinds of β-blockers may cause ARF. Compared with metoprolol and atenolol ,bisoprolol and nebivolol have strong statistical correlation with ARF ,suggesting that medical personnel should pay attention to the possible renal related adverse reactions of these drugs in the process of clinical use.
6.Recommendations for prescription review of antipyretic-analgesics in symptomatic treatment of children with fever
Xiaohui LIU ; Xing JI ; Lihua HU ; Yuntao JIA ; Huajun SUN ; Qinghong LU ; Shengnan ZHANG ; Ruiling ZHAO ; Shunguo ZHANG ; Yanyan SUN ; Meixing YAN ; Lina HAO ; Heping CAI ; Jing XU ; Zengyan ZHU ; Hua XU ; Jing MIAO ; Xiaotong LU ; Zebin CHEN ; Hua CHENG ; Yunzhu LIN ; Ruijie CHEN ; Xin ZHAO ; Zhenguo LIU ; Junli ZHANG ; Yuwu JIANG ; Chaomin WAN ; Gen LU ; Hengmiao GAO ; Ju YIN ; Kunling SHEN ; Baoping XU ; Xiaoling WANG
Chinese Journal of Applied Clinical Pediatrics 2022;37(9):653-659
Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.
7.Investigation on mental health of general practice students in a medical school in Jiangsu Province
Wen WANG ; Yuntao LI ; Ting OU ; Yongzhen CHEN ; Guozhong JI
Chinese Journal of General Practitioners 2022;21(11):1081-1084
A survey on mental health status was conducted during October 2021 to January 2022 among grade 2017—2021 medical students majored in general practice who received 3+2-year education integrated undergraduate study and residency training for assistant physicians in a medical school in Jiangsu province. The SCL-90 and the self-made scale were used to investigate the mental health status and the results were compared with the national norm, the norm of national physicians, and the norm of medical students in Jiangsu province. A total of 125 valid questionnaires were recovered, and the positive detection rate of SCL-90 scale was 17.6%. Compared with the national norm in 2015, the scores of forcing ( t=-2.47), the interpersonal sensitivity ( t=-2.00), the hostile ( t=-2.65), the paranoid( t=-3.14) and the psychiatric factor( t=-2.45) of the study group were significantly lower than those of the norm ( P<0.05). Compared with the norm of national physicians and the norm of medical students in Jiangsu province, the scores of all the items except the fear factor were lower than those of the norms ( P<0.05). In the study group there were no significant differences in the total score and all factors among students with different genders, different training stages, and different background. The total score of SCL-90 scale was negatively associated with the study performance and clinical skill mastery ( r=-0.18) and the sense of achievement ( r=-0.23, P<0.05). The study shows that the mental health status of this group of students is generally better than that of the several norms.
8. Survey on resident participation in community health management service
Ronghua WANG ; Yuntao LI ; Xiaomin ZHAO ; Jinyan WANG ; Yaoqi GE ; Jinhui AN ; Guozhong JI
Chinese Journal of General Practitioners 2019;18(9):837-841
Objective:
To survey the resident participation in community health management service and its influencing factors.
Methods:
A survey on the resident participation in community health management service with self-designed questionnaire was conducted during January to March 2018 among residents in one of the subdistricts in Nanjing Gulou district. The questionnaire includes basic information of residents, understanding health management service, and the participation in the health management.
Results:
Total 500 questionnaire were distributed, 449 copies were retrieved and 402 were valid. The rates of engagement in health archives, management of blood pressure, blood glucose and blood lipids, attending health education, regular health check-up, health follow-ups, and equipping family medicine kits were 62.2% (250/402), 71.0% (286/402), 49.5% (199/402), 59.9% (241/402), 72.6% (292/402), 66.9% (269/402), respectively. The rates of engagement of health archives, attending health education, regular health check-up and equipping family medicine kits for healthy residents were higher than those with chronic diseases (χ2=6.31, 4.09, 10.83, 10.83;
9.Demands and needs of patients signing family doctor service in Nanjing Gulou district
Ronghua WANG ; Yuntao LI ; Xiaomin ZHAO ; Jinyan WANG ; Jinhui AN ; Yaoqi GE ; Guozhong JI
Chinese Journal of General Practitioners 2018;17(12):987-991
Objective To investigate the demands and needs of patients contracting for family doctor service in Nanjing Gulou district. Methods A questionnaire survey was conducted between July and December 2017 among residents in Nanjing Gulou district. The questionnaire included basic information of residents, willingness to sign service contract with family doctors, annual outpatient needs, demands of service mode, expectation for family doctor service, and willingness to pay. Results A total of 420 questionnaires were distributed and 415 questionnaires were valid. Multivariate analysis of variance suggested that age, income, and understanding of signing family doctor service were independent factors influencing signing intention (P<0.05).The variance analysis trend test indicated that the healthy people had highest willingness of signing, followed by the patients and the pregnant women (F=6.82, P<0.01). The number of annual outpatient service needs for healthy population, hypertensive patients, diabetic patients and pregnant women was(2.64±3.48),(7.02±4.80),(9.98±5.37)and(11.20±4.33)respectively (F=77.94, P<0.01). The average need of outpatient visit for health males was higher than that for females (P<0.01). There were significant differences in outpatient needs between patients with non-complicated hypertensionand complicated hypertension (P<0.01). The most anticipated services for healthy people were health records (74.26%,101/136), medical appointments (56.62%,77/136), and physical check-up (56.62%,77/136);those were management of blood glucose, blood pressure and body weight (70.13%, 108/154), regular testing (66.88%,103/154), follow-up supervision (66.23%,102/154) for chronic patients;those were regular physical examination (80.26%, 61/76), follow-up supervision (50.00%, 38/76) and health records (46.05%, 35/76) for pregnant women. The most popular health communication channel is WeChat, accounting for 44.10%(183/415), followed by outpatient clinic, telephone and internet services, accounting for 37.11%(154/415), 31.57%(131/415)and 11.08%(46/415)respectively. Among those who chose WeChat, 81.4%(149/183) were under 45 years old. And 86.27%(358/415)of people were willing to pay for corresponding signing fees. Conclusion Age, income, and understanding of general practice will affect residents′ willingness to sign the service contract with family doctors. Gender, disease spectrum and number of illnesses affect residents′outpatient service needs. Individualized family doctor service should be provided for people with different health needs.
10.Excavation and Evaluation of Security Alert Signals of Linezolid Based on Reporting Odds Ratio Method
Xuewen TANG ; Yuntao JIA ; Xiaojiang TIAN ; Huanhuan JI ; Zhi DONG
China Pharmacy 2017;28(20):2779-2783
OBJECTIVE:To excavate and evaluate the security alert signals of linezolid after marketing,and to provide refer-ence for rational drug use in clinic. METHODS:The reporting odds ratio(ROR)method was used to excavate the security alert signals from the adverse drug events(ADE)data in the OpenFDA platform of FDA during second quarter of 2004-2016. The low-er limit of 95%CI >1 was regarded as suggestive of ADE alert signal. RESULTS:A total of 6828534 reports were extracted, among which there were 7224 reports mainly induced by linezolid. Top 10 ADE reports were thrombocytopenia,drug interac-tion,thrombocytopenia,nausea,anaemia,serotonin syndrome,diarrhoea,pyrexia,drug ineffective,vomiting. After the detec-tion of top 200 ADE reports by ROR method,120 signals related to 18 system organ class(SOC)were identified. Top 5 ADE sig-nals in turn by SOC were medical examination,nervous system disorders,blood and lymphatic system disorders,metabolism and nutrition disorders,cardiac disorders. The high risk signals with clinical reference value included 42 cases of optic neuropathy (ROR=56.33),350 cases of serotonin syndrome(ROR=52.86),162 cases of lactic acidosis(ROR=18.30),31 cases of endo-carditis (ROR=15.38),566 cases of thrombocytopenia (ROR=14.29),122 cases of bone marrow failure (ROR=14.20),261 cases of panhematopenia (ROR=11.92),86 cases of disseminated intravascular coagulation (ROR=10.91),58 cases of toxic epidermal necrolysis(ROR=9.06),etc. As for ADE reports,male was slightly higher than female,and the patients in age group of ≥45 reported evidently more compared to younger age group. CONCLUSIONS:By detecting and evaluating alert signals of li-nezolid through OpenFDA platform,we could effectively lay the foundation for further research of pharmacovigilance.


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