PIC/S GMP无菌药品附录对我国无菌药品检查的影响

目的：通过分析PIC/S GMP附录《无菌药品的生产》，为我国无菌药品检查与国际化接轨提供借鉴。方法：通过对PIC/S GMP无菌药品附录的主要内容以及与我国现行版GMP无菌药品附录进行对比分析，结合我国无菌药品生产检查中的常见问题，为完善我国无菌药品GMP检查提供建议。结果与结论： 修订后的PIC/S GMP无菌药品附录对比我国现有的GMP无菌药品附录从概念和内容都有了相当大的更新，体现了药品监管的与时俱进，提示我们在规范检查、提升检查水平的同时，应引导企业主动了解国际先进的质量管理理念，向国际水平和国际标准靠拢，提升我国无菌药品生产行业的整体水平。     

河南省医用氧生产企业实施新版药品GMP缺陷分析

目的：研究分析河南省医用氧生产企业实施新版药品GMP存在的主要问题,为有效实施新版药品GMP提供建议。方法：对本省34家医用氧生产企业的45次GMP认证跟踪现场检查发现的缺陷进行统计和分析。结果与结论：本省医用氧生产企业在质量管理与质量控制、文件管理、设备管理、机构与人员、确认与验证、生产管理等方面还存在不足,企业应当持续不断的改进质量管理体系,从而确保产品质量。     

山东省无菌制剂生产质量风险分析与探讨

目的：发现山东省无菌制剂生产企业在生产质量管理方面存在的共性缺陷问题,探讨无菌制剂生产企业存在的主要风险点,为无菌制剂企业更加规范地实施GMP提供参考。方法：对2016-2017年山东省承担的无菌制剂认证检查情况进行统计分析。结果与结论：企业需要关注确认与验证、无菌药品附录、质量控制与质量保证、机构与人员等方面存在的质量风险,有针对性地改进提升。     

2017年山东省药品GMP认证检查缺陷项目分析

目的 发现2017年山东省药品生产企业在生产质量管理方面存在的共性缺陷问题,探讨药品生产企业存在的主要风险点,为企业更加规范地实施GMP提供参考。方法 对2017年山东省承担的药品GMP认证检查缺陷进行统计分析。结果与结论 企业需要关注机构与人员、确认与验证、质量控制与质量保证、数据可靠性等方面存在的质量风险,有针对性地改进提升。     

生化药品GMP附录实施情况的分析与探讨

目的：《药品生产质量管理规范》（2010年修订）生化药品附录的颁布和实施,对生化药品生产企业提出了新要求。本文对生化药品GMP附录的实施情况进行了分析,对如何进一步推进生化药附录的实施提出了建议。方法：通过对附录实施前后国内生化药品检查情况汇总分析,阐述部分生化药品生产企业还存在一些薄弱环节,建议从生化药品生产企业贯彻落实GMP附录和进一步加强生化药品生产监管工作两方面加以推进。结果与结论：生化药品生产企业的质量管理与生化药品附录的要求存在一定差距,尤其是在供应链管理方面。在药品监督检查中,必要时应进行延伸检查,从源头进行监管。     

2016—2019年被收回GMP证书的药品生产企业存在的缺陷分析及改进建议

目的 分析被收回药品生产质量管理规范（Good Manufacturing Practices，GMP）证书的药品生产企业存在缺陷的规律和特点，为药品生产企业更好地实施GMP，保证药品质量安全提供参考。方法 回顾和分析2016—2019年被收回GMP证书的中成药和化学药品制剂生产企业存在的缺陷及其逐年变化的趋势。结果 125家次收证企业累计缺陷项目频次为855次，涉及GMP正文及其附录17个章节。缺陷项目主要集中在数据可靠性存疑、擅自改变工艺规程、弄虚造假、物料管理混乱、偏差管理系统不能有效运行以及企业关键人员不能有效履职。2016—2018年，生产管理、设备、机构与人员以及厂房设施等章节缺陷项目的频次占比呈现逐年下降趋势，而质量控制与质量保证章节缺陷项目的频次占比大幅增加，确认与验证缺陷也存在上升趋势；除了计算机化系统涉及的数据可靠性问题和偏差处理方面的缺陷项目外，其他缺陷项目在收证企业中的频次占比都基本呈逐年下降趋势。结论 药品生产企业作为药品质量的责任主体，应将风险管理的理念贯穿在整个产品生命周期内，坚持诚实守信，不断加强数据完整性管理，注重对员工的针对性培训，提高全员质量意识，在产品风险评估的基础上建立质量管理体系并保证其有效实施和持续不断改进。     

符合《药品生产质量管理规范》的Excel电子表格系统研究

目的：探讨在《药品生产质量管理规范》（GMP）环境中如何建立Excel电子表格,并进行验证以及合规地使用。方法：通过对相关文件进行回顾分析,总结了建立、验证及合规使用Excel电子表格的方法。结果与结论：在正确使用的情况下,Excel电子表格满足了国内法规要求,可用于制药行业的数据分析与储存。     

PIC/S GMP先进治疗产品附录与我国细胞治疗产品生产质量管理指南的对比分析

目的：为我国申请加入药品检查合作计划(PIC/S),建立与国际统一的检查标准,提出细胞治疗产品GMP检查亟需关注的差异点。方法：对我国细胞治疗产品指南与PIC/S先进治疗产品GMP附录进行整体梳理和对比分析,并就一些关键问题进行了讨论。结果：我国与PIC/S GMP附录原则及考虑要素基本是一致的,但从法规体系、框架结构、适用范围、具体要求均有所区别。结论：分别从质量风险管理、起始生物材料的检查、与国际检查标准的统一三个方面提出了对此类产品GMP检查的启示。     

中药饮片GMP检查典型缺陷分析及对中药饮片质量监管的启示

目的：为中药饮片生产企业实施GMP提出改进措施,为加强中药饮片生产监管提供对策建议。 方法：采用回顾性研究分析方法,以2018年1月至2021年6月福建省开展的33家次中药饮片GMP检查结果为研究对象,对检查发现的缺陷项目进行统计分析。结果：共发现检查缺陷项408项,其中主要缺陷29 项,一般缺陷379项,主要集中在机构与人员、质量控制与质量保证、厂房设施与设备、确认与验证、文件管理等方面。结论：企业应从强化人员培训、提升检验能力、扎实开展自检等方面着手完善质量管理体系。建议药品监督管理部门加强共性问题研究,运用智慧监管手段提升中药饮片监督检查效能,保障公众用药安全有效。     

国外药品GMP检查员管理体系对我国药品检查员队伍专职化的启示

目的：分析我国目前药品GMP检查员制度的现状,对比分析美国、欧盟、英国的药品GMP检查员制度,探讨如何建立我国GMP药品专职检查员制度、建设专职检查员队伍。方法：从药品GMP检查员的编制、分级制度、工作内容及培训制度四个方面对比,分析国内外药品GMP检查员制度。结果与结论：与其他国家或组织相比,我国GMP检查员的专职化在各方面有明显差距。因此,解决专职检查员的编制、合理设置分级制度、细化专职检查员工作内容、科学系统化专职检查员的培训内容是建设我国专职药品GMP检查员队伍待解决的问题。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.