1.Effectiveness and safety of nab-paclitaxel and platinum as first-line chemotherapy for ovarian cancer: a retrospective study
Liangliang WANG ; Shuangying LI ; Da ZHU ; Yu QIN ; Xiaoli WANG ; Zhenya HONG ; Zhiqiang HAN
Journal of Gynecologic Oncology 2023;34(4):e44-
Objective:
To evaluate the effectiveness and safety of nab-paclitaxel plus platinum as first-line chemotherapy for ovarian cancer (OC).
Methods:
Patients administered platinum combined with nab-paclitaxel as first-line chemotherapy for epithelial OC, fallopian tube cancer, or primary peritoneal cancer from July 2018 to December 2021 were retrospectively evaluated. The primary outcome was progression-free survival (PFS). Adverse events (AEs) were examined. Subgroup analysis was performed.
Results:
Seventy-two patients (median age, 54.5 years; range, 20.0–79.0 years) were evaluated, including 12 and 60 administered neoadjuvant therapy and primary surgery with subsequent chemotherapy, respectively. The median follow-up duration was 25.6 months, and the median PFS was 26.7 (95% confidence interval [CI]=24.0–29.3) months in the whole patient population. In the neoadjuvant subgroup, the median PFS was 26.7 (95% CI=22.9–30.5) months vs. 30.1 (95% CI=23.1–37.1) months in the primary surgery subgroup. Twenty-seven patients were administered nab-paclitaxel plus carboplatin and had a median PFS of 30.3 (95% CI=not available [NA]–NA) months. The commonest grade 3–4 AEs included anemia (15.3%), white blood cell decreased (11.1%), and neutrophil count decreased (20.8%). No drug-related hypersensitivity reactions occurred.
Conclusion
Nab-paclitaxel plus platinum as first-line treatment in OC was associated with a favorable prognosis and was tolerable in patients with OC.
2.Effect of renal failure on docetaxel exposure and adverse reactions in breast cancer patients
Juxiang ZHOU ; Shuangying WANG ; Jiantao SHE ; Xianliang ZENG ; Jihong ZHANG
Journal of Pharmaceutical Practice and Service 2022;40(6):571-575
Objective To investigate the influence of renal failure on the area under curve (AUC) and adverse reactions of docetaxel in breast cancer patients, and provide evidence for the dosage of docetaxel in renal failure patients. Methods A retrospective study was conducted on 24 patients with breast cancer who had undergone radical mastectomy and received AC-T adjuvant chemotherapy in our hospital from January 2019 to November 2021. According to renal function cases, the patients were divided into two groups: renal failure group (n=5) and normal renal function group (n=19). The clinical characteristics such as gender, age, body weight and body surface area of patients in two groups, docetaxel dose, blood concentration, area under the curve, liver and kidney function, white blood cell count and absolute value of neutrophil before chemotherapy were collected. Single factor linear regression was used to analyze the influencing factors of the AUC of docetaxel. Adverse reactions after chemotherapy with docetaxel including nausea and vomiting, bone marrow suppression, constipation and liver function injury were collected. CTCAE 4.0 evaluation standard was used to evaluate adverse reactions. Results The clinical characteristics of creatinine [908.0 (819.0, 1018.0) μmol/L vs 54.8 (52.0, 65.0) μmol/L] and creatinine clearance rate [4.9 (4.3, 5.4) ml /min vs 86.3 (59.3, 92.5) ml/min] of the renal failure group and the normal renal function group have significant difference (P<0.001), while no significant difference (P>0.05) were found in the body surface area [1.4 (1.4, 1.5) m2 vs 1. 6 (1.5, 1.6) m2], docetaxel dose [70.4 (69.4, 73.0) mg/m2 vs 74.4 (72.3, 91.2) mg/m2], body weight [(51.4±3.8) kg vs (51.5±5.5) kg]. Liver function, white blood cells and neutrophils were within the normal range before chemotherapy with docetaxel. There was no significant difference in AUC value [(1.6±0.6) mg·h/L vs (1.8±0.8) mg·h/L] between the two groups after chemotherapy with docetaxel (P>0.05). Linear univariate regression analysis indicated that the blood concentration at the end of docetaxel infusion was significantly associated with AUC of docetaxel (P<0.001), while the body surface area, dose of docetaxel, body weight, liver and kidney function were not correlated with AUC of docetaxel (P>0.05). After chemotherapy with docetaxel, adverse reactions of patients in the two groups: nausea and vomiting (grade I incidence: 40% vs. 57.9%, grade II incidence: 60% vs. 42.1%), myelosuppression (grade I incidence: 60% vs. 84.2%, grade II incidence: 20% vs 15.8%) and constipation (all mild constipation) had no significant difference (P>0.05). Conclusion Renal failure did not affect the exposure of docetaxel and the adverse reactions after chemotherapy with docetaxel in breast cancer patients.
3.Simultaneous improvement to solubility and bioavailability of active natural compound isosteviol using cyclodextrin metal-organic frameworks.
Xiaojin CHEN ; Tao GUO ; Kaikai ZHANG ; Jiacai CHEN ; Caifen WANG ; Xiaohong REN ; Qin WANG ; Yingchao YANG ; Chongjing LIU ; Wen TAN ; Shuangying GUI ; Li WU ; Jiwen ZHANG
Acta Pharmaceutica Sinica B 2021;11(9):2914-2923
Cyclodextrin metal-organic framework (CD-MOF) as a highly porous supramolecular carrier could be one of the solutions to the insolubility of isosteviol (STV). The solubility of STV was lower than 20.00 ng/mL at pH 1.0 and pH 4.5, whilst its solubility increased to 20,074.30 ng/mL at pH 6.8 and 129.58 ng/mL in water with a significant pH-dependence. The
4. The operational status of Qinghai provincial measles laboratory network in 2012—2017
Lixia FAN ; Haotao TANG ; Zhuoma BA ; Shengcang ZHAO ; Chonghai LI ; Shuangying JIANG ; Zhen ZHU ; Huiling WANG
Chinese Journal of Experimental and Clinical Virology 2018;32(2):166-168
Objective:
To evaluate the running status of Qinghai provincial measles laboratory network during 2012—2017.
Methods:
To analyze serological and virological surveillance database developed in Qinghai provincial measles laboratory network in 2012—2017, and evaluate the indicators for the running status of measles laboratory network in Qinghai Province.
Results:
It was shown that 5 763 suspected measles cases were reported in Qinghai Province during 2012—2017, and 4 167 serum samples were collected from suspected measles cases, the collection rate is 72.31%; among them, 3 697 were IgM positive for measles and the positive rate was 88.72%; 68 were IgM positive for rubella and the positive rate was 1.63%. And 515 throat swab specimens were collected from suspected measles cases, 82 measles virus isolates were obtained and the positive rate was 15.92%. The result of sequencing and analysis showed that all the measles viruses belonged to genotype H1 and subgenotype H1a, which were predominant genotype circulated in China in recent years. In addition, Qinghai provincial measles network labs passed all the serological confirmatory test and proficiency test, and on-site review held by national or provincial measles laboratory and WHO during 2012—2017, respectively.
Conclusions
Qinghai provincial measles laboratory network has been established and running well. It provided important scientific basis for measles elimination in Qinghai province.
5. Genetic characteristics of human enterovirus A type 71 in Qinghai province during 2016-2017
Lixia FAN ; Weijun WANG ; Zhuoma BA ; Shengcang ZHAO ; Chonghai LI ; Shuangying JIANG ; Dongmei YAN ; Tianjiao JI
Chinese Journal of Experimental and Clinical Virology 2018;32(5):501-504
Objective:
To investigate the genetic characteristics of enterovirus A 71 (EV-A71) and etiological features of hand, foot and mouth disease (HFMD) in Qinghai province from 2016 to 2017.
Methods:
Specimens were collected from HFMD patients in Qinghai province, and detected by real-time reverse transcription-polymerase chain reaction (RT-PCR). For EV-A71 positive samples, virus was isolated and RNA was extracted, and then VP1 coding region was amplified by RT-PCR. The phylogenetic tree was constructed by comparing with other genotypes and sub-genotypes strains of EV-A71.
Results:
It was shown that 114 strains of EV-A71 were isolated in Qinghai province from 2016 to 2017, which all belonged to genotype C4a, and could be divided to two different lineages by phylogenetic analysis. From 2016 to 2017, the epidemic strains of EV-A71 in the different transmission chains of Qinghai province was closely related to other provinces of China.
Conclusions
C4a was the dominant genotype of EV-A71 in Qinghai province from 2016 to 2017, and no other genotype was detected. In addition, EV-A71 isolated from Qinghai province co-evolved with EV-A71 in other provinces of China.
6.Risk factors for healthcare-associated infection in patients with aneurysmal subarachnoid hemorrhage
Shuangying HE ; Hongyu TANG ; Aimin WANG
Chinese Journal of Infection Control 2016;15(6):408-411
Objective To investigate risk factors for healthcare-associated infection (HAI) in patients with aneurysmal subarachnoid hemorrhage(aSAH)in the department of neurology of a hospital.Methods Clinical data of 47 patients with aSAH who were admitted to a hospital from January 2014 to January 2015 were retrospectively analyzed.Results Of 47 patients with aSAH,17 developed 19 times of HAI,HAI rate was 36.17%,case infection rate was 40.43%.The main infection site was lower respiratory tract (n = 17,89.47%),followed by urinary tract (n=2,10.53%);2 patients had both lower respiratory tract infection and urinary tract infection.17 patients were performed pathogenic detection,13 pathogenic isolates were isolated from 9 patients.Multivariate non-conditional logistic regression analysis revealed that risk factors for HAI in patients with aSAH were disturbance of consciousness (OR,24.878 [95%CI ,3.996 - 156.040])and intensive care unit admission(OR, 8.645 [95%CI ,1.419-52.670]).The prognosis of patients with HAI was poorer than those without HAI(Z =4.108,P < 0.001 ).Conclusion Patients with aSAH are at high risk of HAI,it is necessary to take targeted prevention and control measures for reducing the occurrence of HAI and promoting good prognosis.
7.Preparation and evaluation of intra-articular injectable sinomenine hydrochloride-loaded in situ liquid crystals.
Yulin CHEN ; Shuangying GUI ; Xin LIANG ; Shengmei WANG ; Xiaojing JIANG
Acta Pharmaceutica Sinica 2016;51(1):132-9
Phytantriol (PT), ethanol (ET) and water were used to prepare in situ cubic liquid crystal (ISV2). The pseudo-ternary phase diagram of PT-ET-water was constructed and isotropic solution formulations were chosen for further optimization. The physicochemical properties of isotropic solution formulations were evaluated to optimize the composition of ISV2. In situ hexagonal liquid crystals (ISH2) were prepared based on the composition of ISV2 with the addition of vitamin E acetate (VitEA) and the amount of VitEA was optimized by in vitro release behavior. The phase structures of liquid crystalline gels formed by ISV2 and ISH2 in excess water were confirmed by crossed polarized light microscopy and small angle X-ray scattering, respectively. Rheological properties of ISV2 and ISH2 were studied by a DHR-2 rheometer. In vitro drug release studies were conducted by using a dialysis membrane diffusion method. Pharmacokinetics was investigated by determination of sinomenine hydrochloride (SMH) concentration in synovial membrane after intra-articular injection of SMH-loaded ISH2 in adjuvant-induced arthritis rats. The optimal ISV2 (PT/ET/water, 64 : 16 : 20, w/w/w) loaded with 6 mg x g(-1) of SMH showed a suitable pH, injectable and formed a cubic liquid crystalline gel in situ with minimum water absorption in the shortest time. The optimal ISV2 was able to sustain the drug release for 144 h. The optimal ISH2 system was prepared by addition of 5% VitEA into PT in the optimal ISV2 system. This ISH2 (PT/VitEA/ET/water, 60.8 : 3.2 : 16 : 20, w/w/w/w) was an injectable isotropic solution with suitable pH. The new ISH2 was able to sustain the drug release for more than 240 h. Local pharmacokinetics study indicated that the retention time and AUC(0-∞) of ISH2 group were increased significantly compared with that of SMH solution group and the AUC(0-∞) of ISH2 group was 6.01 times higher than that of SMH solution group. The developed ISH2 was suitable for intra-articular injection that may apply to patients in the treatment of rheumatoid arthritis.
8.The relation of cationic trypsinogen gene G191R mutation and pathogenesis of pancreatitis
Lu LI ; Hui DING ; Yuxiu YANG ; Shuangying HAN ; Chunrong WANG
Chinese Journal of Pancreatology 2014;14(2):110-113
Objective To observe the prevalence of anionic trypsinogen (PRSS2) gene G191R mutation in patients with acute pancreatitis (AP) and chronic pancreatitis (CP),and to investigate the effect of PRSS2 gene G191R mutation on susceptibility to pancreatitis.Methods The blood samples of 82 patients with acute pancreatitis,73 patients with chronic pancreatitis and 138 healthy subjects were collected,and genomic DNA was extracted.Nest PCR were performed to amplify PRSS2 gene and restriction fragment length polymorphism (RFLP) was followed by using Hpy188Ⅲ to distinguish the G191R mutation.DNA sequencing analysis was performed to confirm the mutation status.Results The size of nest PCR products was 436 bp.RFLP2 produced 309 bp and 127 bp fragments,which were resulted from PRSS2 gene G191R mutation (GGA →AGA).DNA sequencing analysis of the PCR products further confirmed the PRSS2 gene G191R mutation.Five of eighty-two(6.1%) patients with acute pancreatitis had PRSS2 gene G191R mutation (OR=0.682,95% CI 0.231 ~ 2.010); one of seventy-three (1.4%) patients with chronic pancreatitis had the mutation (OR =0.145,95% CI 0.019 ~ 1.145),and the corresponding value in healthy group was 8.7% (12/138).The G191R mutation rate in patients with chronic pancreatitis was significantly lower than that in healthy group (x2 =0.432,P =0.035),but the G191R mutation rates were not significantly different between AP group and healthy group (x2 =0.487,P =0.485).Conclusions PRSS2 gene G191R mutation facilitates the degradation of anionic trypsin,and may reduce the incidence of chronic pancreatitis.
9.Bio-mimetic drug delivery systems designed to help the senior population reconstruct melatonin plasma profiles similar to those of the healthy younger population.
Ying LI ; Liuyi WANG ; Li WU ; Xueju ZHANG ; Xue LI ; Zhen GUO ; Haiyan LI ; Peter YORK ; Shuangying GUI ; Jiwen ZHANG ;
Acta Pharmaceutica Sinica B 2014;4(1):60-66
The secretion of melatonin (MT) is obviously different in the younger and the senior sectors of the population, and the maximum plasma concentration of seniors is only half of that in the younger population group. If exogenous MT can be supplied to senior citizens based on the secretion rate and amount of endogenous MT in the younger population by a bio-mimetic drug delivery system (DDS), an improved therapeutic effect and reduced side effects can be expected. Based upon this hypothesis, the pharmacokinetic parameters of MT, namely, the absorption rate constant (k a), the elimination rate constant (k e), and the ratio of absorption rate (F) to the apparent volume of distribution (V) were obtained by a residual method depending on the plasma concentration curve of immediate release preparations in the healthy younger population. The dose-division method was applied to calculate the cumulative release profiles of MT achieved by oral administration of a controlled release drug delivery system (DDS) to generate plasma MT profiles similar to the physiological level-time profiles. The in vivo release of MT deduced from the healthy younger population physiological MT profiles as the pharmacokinetic output of the bio-mimetic DDS showed a two-phase profile with two different zero order release rates, namely, 4.919 μg/h during 0-4 h (r=0.9992), and 11.097 μg/h during 4-12 h (r=0.9886), respectively. Since the osmotic pump type of DDS generally exhibits a good correlation between in vivo and in vitro release behaviors, an osmotic pump controlled delivery system was designed in combination with dry coating technology targeting on the cumulative release characteristics to mimic the physiological MT profiles in the healthy younger population. The high similarity between the experimental drug release profiles and the theoretical profiles (similarity factor f 2>50) and the high correlation between the predicted plasma concentration profiles and the theoretical plasma concentration profiles (r=0.9366, 0.9163, 0.9264) indicated that a prototype bio-mimetic drug delivery system of MT was established. The similarity factors between the experimental drug release profiles and the theoretical release profile were all larger than 50 both in periods of 0-4 h and 4-12 h, namely, 68.8 and 57.3 for the first batch (Batch No. 20131031), 76.7 and 50.2 for the second batch (Batch No. 20131101), and 73.7 and 51.1 for the third batch (Batch No. 20131126), respectively. The correlation coefficients between the predicted plasma concentration profiles based on the release profiles of the bio-mimetic DDS and physiological profiles were 0.9366 (Batch No. 20131031), 0.9163 (Batch No. 20131101), 0.9264 (Batch No. 20131126), respectively. Since the pharmacokinetic profile of MT in any kind of animal differs markedly from that of human beings, it is impossible to test the bio-mimetic DDS in animals directly. Therefore, the predicted pharmacokinetic profile based upon the in vitro release kinetics is an acceptable surrogate for the conventional animal test. In this research, a bio-mimetic DDS for replacement of MT was designed with in silico evaluation.
10.Absorption transport mechanism of puerarin oil-in-oil nanoemulsion.
Enyuan PAN ; Hongfei WU ; Chuanhua LU ; Shuangying GUI ; Lei WANG
China Journal of Chinese Materia Medica 2010;35(20):2674-2678
OBJECTIVETo investigate the mechanisms of the oil-in-oil nanoemulsions transport through the gastrointestinal tract and the transport efficiency changed with its different particle size in the lymphatic channels.
METHODThe behavior of nanoemulsions in vivo and their absorption via lymph after oral administration was investigated, with the transport efficiency and absorption pathway of nanoemulsions clarified by lymph duct cannulation in rats.
RESULTIt suggested about 36.8% of puerarin nanoemulsions was transported into systematic circulation via lymph. Nanoparticles with different size absorbed by the lymphatic channels varied as the degree of transportion.
CONCLUSIONThe degree of absorption and particle transport is inversely proportional to the size.
Absorption ; Animals ; Biological Transport ; Emulsions ; Female ; Isoflavones ; administration & dosage ; pharmacokinetics ; Lymph ; metabolism ; Male ; Nanoparticles ; Particle Size ; Rats ; Rats, Sprague-Dawley

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