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??OBJECTIVE To study the chemical constituents of Fomes fomentarius (L.Ex.Fr.). METHODS The compounds were isolated by chromatography on silica gel column, Sephadex LH-20 column, and their structures were elucidated by spectral analysis. RESULTS Six compounds were obtained and identified as fomentarinin (1), 2-hydroxy hexacosanoic acid ethyl ester (2),syringic acid (3), syringyl alcohol (4), vanillin (5), and ergosta-7,22-diene-3,6-dione (6), respectively. CONCLUSION Compound 1 is a new compound, and compound 2-6 are isolated from the fungus for the first time.
     

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??OBJECTIVE To systematically evaluate the economics of saxagliptin for treatment of type 2 diabetes mellitus. METHODS PubMed, Embase, Cochrane Library, NHS EED, CNKI, Wanfang and CBM were systematically searched. Literatures were screened according to pre-defined inclusion criteria. The quality of included studies were evaluated by CHEERS statement and the economic RESULTS were systematically analyzed. RESULTS Eight cost-effectiveness analyses were included, one of which was conducted in China. Patients among the studies all had blood glucose non-adeguately controlled by monotherapy. When added on to metformin, saxagliptin was cost-effective compared with sulfonylureas (glipizide and glimepiride) and thiazolidinediones (pioglitazone and rosiglitazone). When added on to metformin or sulfonylureas, saxagliptin was cost-effective compared with NPH insulin. CONCLUSION Saxagliptin represents a cost-effective option in treatment of type 2 diabetes mellitus patients with non-adequately controlled blood glucose after monotherapy.     

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??OBJECTIVE To analyze the connotation and composition of the clinical value of drugs, and to build the index system for the evaluation of drug's clinical value, hence to provide references for its scientific evaluation. METHODS We designed the preliminary constructs index system referencingmedicine clinical evaluation indicatorsof German and French firstly. And then the expert interview and Delphi survey were used to analysis to determine the index system and index weight of medicine clinical evaluation. RESULTS The classified index system of the clinical value was established, which was composed of 2 first-grade indexes including clinical value and innovation value and 15 grade two indexes. Experts were invited to assess the value ranking according to the background information of rosuvastatin, atorvastatin and simvastatin statin drugs by their generic names. The expert's scoring results were summarized to determine the sequence. And it were compared with the average market prices in Germany, France, Britain, the United States, South Korea, Japan and analyzed. CONCLUSION The clinical value of drugs is an international standard for determining the reasonable price of drugs. This research method is feasible to determine the drug prices sequencing by the classified clinical value of drugs in the same kind of product. The price sequencing of some generic names of statin drugs did not correspond with its clinical value sequence, and the price can not reflect its value. The integrity and authenticity of the background data directly determine the classification of the clinical value. Various parties are needed to participate in providing detailed data and information.     

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??Polygonati Rhizoma as one of the most common Chinese herbal medicine and food was widely distributed in China. In TCM clinic, it was used for diabetes, hyperlipemia and rehabilitation therapy of cancer. Nowadays, with the rapid development of health industry, Polygonati Rhizoma shows excellent functions on healthcare, and then a surge of demands was coming. But there are so many species belongs to this genus and the classification criteria are not unified, so some important problems become urgently to be resolved, such as how to guarantee the quality and how to keep sustainable development. In this paper, the origin, distribution in China, chemical composition, pharmacological, and clinical application are reviewed. Its prospect is discussed to be helpful to promote the comprehensive development of Polygonatum.     

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??OBJECTIVE Blood tends to deposit in atrium to form thrombus in patients with atrial fibrillation. Patients with diabetes are in high coagulation state, for whom thrombosis is easy to occur. The number of diabetic patients with atrial fibrillation is large. Warfarin is one of the most widely used oral anticoagulants, which can cause major or fatal bleeding, so it is necessary to perform regular monitoring of international normalized ratio (INR) on all patients treated with warfarin. New kinds of antidiabetic drugs are widely used in clinic, among which a lot affect INR levels achieved with warfarin therapy. Clinical pharmacists should pay attention to drug interactions and monitor adverse drug reactions. As a new antidiabetic drug, exenatide has less reports of interaction with warfarin. The characteristic of the interaction between exenatide and warfarin was investigated, with the aim to optimize the rational and individualized medication. METHODS A case was introduced in which exenatide was administrated combined with warfarin, so that the possible mechanism of exenatide affecting to warfarin were analyzed. RESULTS INR declined from 2.13 to 1.57 after exenatide being added, and decreased further to 1.43 with concurrency of the increasing exenatide dose. On the contrary, INR was on rise as result of discontinuing exenatide. At last, INR returned to 1.78 when the patient discharged. CONCLUSION Exenatide inhibited the absorption of warfarin, which lead to INR decline attributed to its effect of slowing down the gastric emptying. When exenatide and warfarin are combined,the dose of warfarin must be adjusted based on INR under clinical monitoring.     

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??OBJECTIVE To study and collate the literature on rare diseases in domestic and abroad, and comparative analysis, provide a scientific basis for the domestic rare diseases research. METHODS Retrieved the Web of Science, China National Knowledge Infrastructure from January 2011 to June 2016 published literature about rare diseases. RESULTS Through the screening of literature, finally determine the 200 articles for analysis. It is divided into seven research directions:rare diseases policy research, rare diseases legal and regulatory research, rare diseases medical social security study, orphan drugs availability research, orphan drugs economic evaluation study, orphan drug development research, rare diseases defined standard research. CONCLUSION Rare diseases policy research is the focus of research both domestic and abroad. Compared with foreign countries, the domestic research on the availability and economic evaluation of orphan drug is less, especially the economic evaluation research is almost blank. It is suggested that the researchers study the multiple aspects of rare diseases and drugs, and to provide the basis and reference for build rare disease policy in China.In addition to the field of rare diseases research, rare diseases drugs face many difficulties in pharmaceutical research, production and supply.The precondition to solve these problems is the nation formulate specific policies and regulations for rare diseases,and then clear the official definition standards of rare diseases,establish relevant policies to encourage pharmaceutical companies to develop rare diseases drugs.     

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??OBJECTIVE To synthesize 5-substituted indole-3-deoxypodophyllotoxin derivatives and study their antitumor activity. METHODS The target compounds were synthesized through a series of reactions and their anti-tumor activity in vitro were evaluated against Hela, K562 and K562/A02 cell lines by MTT as assay. RESULTS Ten target compounds were synthesized and confirmed by ¹H-NMR, ¹³C-NMR, and HR-ESI-MS. All the target compounds had different degrees of cytotoxic activity in vitro. Most of the compounds had significant anti-MDR activity in vitro. CONCLUSION 5-Substituted indole-3-deoxypodophyllotoxin derivatives have good antitumor activity and worth of further study.     

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??OBJECTIVE To determine the effects of saxagliptin and exenatide on humerus cancellous bone of diabetes-induced osteopenia rats by histomorphometry. METHODS Thirty-five Cases of female SD rats were randomly divided into normal group (N group, n=7), control group (C group, n=7), and the remaining rats were used to establish the type 2 diabetic model by combination of high-fat&sugar-diet feeding for 4 weeks and then low-dose streptozotocin injection(STZ, 30 mg??kg^-1) . After 10 d, the oral glucose tolerance test and the fasting blood glucose were measured, rats with high OGTT(2 h) above 11.1 mmol??L^-1 and high FBG above 16.7 mmol??L^-1 were divided into model group (M group, n=5), saxagliptin group (G group, n=5) and exenatide group (D group, n=6), and continuously treated for 30 d. The left humerus (proximal humeru metaphometry, PHM) were fixed with 4% paraformaldehyde for 48 h, uncalcified embedded in methyl methacrylate after dehydrated and cleared, and sections were taken for bone histomorphometry after Masson-Goldner Trichrome stained. RESULTS In PHM, there was no statistical significance between N and C group, the trabecular bone area ratio( BV/TV) and trabecular quantity were significantly decreased (P??0.01) in M group, while the trabecular separation degree was increased, comparing with those in C group (P??0.01), and the trabecular bone area ratio( BV/TV) and trabecular quantity in G and D group were higher (P??0.01) than those of model rats, while the trabecular separation degree was decreased, comparing with those in M group (P??0.01). Cell parameters showed no statistical significance between N and C group, the osteocllast number and percentage of osteocllast surface perimeter were significantly reduced(P??0.05, P??0.01) in M group, while the osteoclast number and percent osteocllast surface perimeter were significantly increased (P??0.01) as compared with those in C group, saxagliptin and exenatide were found to significantly induce osteocllast number (P??0.01) and percentage of osteoblast surface perimeter (G group P??0.05, D group P??0.01), while reduce osteoclast number (P??0.01) and percent osteoblast surface perimeter (P??0.05) compared with M group. In growth-plate, there was no statistical significance between N and C group, the thickness of growth-plate and the diameter of the mast cells were reduced in M groups (P??0.01), while the thickness of growth-plate (P??0.01) and the diameter of the mast cells (P??0.05) were increased in G and D group,compared with M group. CONCLUSION Therapeutic effects of saxagliptin and exenatide on diabetes -induced osteopenia rats was showed, and the mechanism may be related to the improved growth rate of growth-plate and the changed bone turnover status.     

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??OBJECTIVE To determine simultaneously the contents of xanthotoxin,bergaptol, and bergapten in cultivated Changium smyrnioides Wollf and its in vitro cultures by HPLC.METHODS Agilent-C₁₈ column (4.6 mm??250 mm,5 ??m) was used for chromatographic separation and PAD was applied as detector. The flow rate was 1.0 mL??min^-1with a mobile phase of methanol-water in gradient elution mode. The detection wavelength was set at 314 nm while the injection volume was 10 ??L.RESULTS The linear regression equations of xanthotoxin, bergaptol, and bergapten were Y=17 057??-87.689 (r=1.000 0), Y=23 828??-380.44 (r=0.999 9) and Y=37 123??-441.16(r=0.999 9), respectively. The contents of xanthotoxin and bergapten in cultivated and regenerated specimens were obviously higher than those in calli and suspension cells, while bergaptol was only detected in the latter two samples. A larger amount of furanocoumarins accumulated in the cells from leaves and petioles. CONCLUSION The established method is simple and effective with high sensitivity and good repeatability. It can be adopted in studies on the utilization of Changium smyrnioides, especially the regulation and induction of furanocoumarins.     

水合氯醛保留灌肠在婴幼儿影像学检查中作为镇静剂的应用评价

目的:评价在婴幼儿行影像学检查中使用6%水合氯醛保留灌肠的安全性及镇静催眠效果。方法:回顾统计在我院行影像学检查前,应用6%水合氯醛保留灌肠作为镇静催眠的6岁以下婴幼儿共55例,进行影像图像质量、镇静催眠效果及不良反应的评价。结果:55例患儿中有54例顺利完成检查,50例效果良好,4例效果一般,1例效果较差未完成检查,55例患儿均未出现明显不良反应。结论:6%水合氯醛保留灌肠在影像学检查时作为不合作患儿的镇静催眠用药安全有效,无明显不良反应,操作简单,避免了小儿静脉穿刺的痛苦,值得临床推广使用。     

2016年某医院儿科门诊中成药处方点评与分析

目的:了解某医院儿科门诊中成药处方用药情况,为临床合理用药提供参考,以保障儿童用药安全.方法:从美康系统抽取某医院2016年儿科门诊中成药处方,每月抽取100张,共抽取1200张进行回顾性点评与分析.结果:该医院儿科门诊疾病多涉及中医肺脏(西医呼吸系统),不合理处方118张,占抽取处方总数的9.83%.结论:该医院儿科中成药处方存在不合理使用情况,需加强对《处方管理办法》和中医中药知识的学习,诊疗过程中要注意辨证论治,病、证、药相结合,加强临床中成药合理用药意识,确保临床安全、有效、经济用药.     

中药不合理用药处方分析

目的 了解我院中药处方书写质量和不合理用药情况,分析其原因,提出解决办法,以提高医院整体合理用药水平.方法 随机提取我院2008年4月至2009年4月的中药处方3000张.选出不合理用药处方、接方审方中不合理用药记录进行统计分炎分析.结果 抽查的3000张处方中不合理处方258张(8.6%),不合理用药633处,主要表现为剂量过大或过小、配伍失当、重复用药等.结论 我院存在一定的不合理用药现象,应加强处方管理,提高合理用药水平.     

中药不合理用药处方分析

目的 了解我院中药处方书写质量和不合理用药情况,分析其原因,提出解决办法,以提高医院整体合理用药水平.方法 随机提取我院2008年4月至2009年4月的中药处方3000张.选出不合理用药处方、接方审方中不合理用药记录进行统计分炎分析.结果 抽查的3000张处方中不合理处方258张(8.6%),不合理用药633处,主要表现为剂量过大或过小、配伍失当、重复用药等.结论 我院存在一定的不合理用药现象,应加强处方管理,提高合理用药水平.     

水合氯醛纳肛在新生儿MRI检查中的镇静效果及安全性评价

目的:评估水合氯醛纳肛镇静法在新生儿MRI检查中的可行性及安全性。方法:回顾性分析96例新生儿头颅MRI检查资料以及镇静监测记录资料。所有患儿检查前均采用水合氯醛纳肛法镇静,并记录监测患儿各项主要生命体征。结果:96名患儿接受水合氯醛纳肛镇静进行MRI检查,这些水合氯醛镇静的整体成功率为81%,没有患儿出现呼吸系统并发症。结论:水合氯醛纳肛镇静法是新生儿MRI检查安全可行的镇静方法。     

《小儿药证直诀》之特殊服药饮品探析

钱乙《小儿药证直诀》卷下载方120首,方后多处记载了配合使用的服药饮品及其使用方法。通过整理这些特殊服药饮品,如中药汤汁、乳汁、酒、特殊用水等,总结了它们的作用及特色。发现卷下所载特殊服药饮品的使用特色可归纳为三个方面:随证灵活配伍;因时制宜服用;尤重顾护脾胃。诸药与服药饮品的搭配,多根据病证、服药时令、患儿年龄及体质等不同,灵活变化,为儿科临床服药调护提供指导。     

水合氯醛糖浆生产工艺的研究

目的研究水合氯醛糖浆的生产工艺。方法通过优选蔗糖、防腐剂等的用量来保证本品的口味和稳定性,制定了严格的单糖浆、5%羟苯乙酯溶液、羧甲基纤维素钠的配制方法。结果糖浆剂的口感较好,在口腔黏膜和胃肠道中粘度增加,延长了其在口腔和胃肠道中的滞留时间,生物利用度高于水合氯醛溶液,适用于儿科临床的检查和治疗。结论实验证明生产工艺可行。     

我院中药的不合理用药分析

目的：分析近年来中药的不合理用药现状,探讨中药使用中不良反应发生的原因,为临床合理用药提供参考。方法：抽查我院2011年1～6月份的中药处方1000张,统计不合格处方的数量和比例,并查阅近年来中药不合理用药的相关文献资料,进行整理、归纳和分析。结果：中药的不合理用药主要与品种混乱、超剂量使用、药不对证、配伍不当、炮制不当、煎煮不当、用药时间过长、个体差异等八个方面有关。我院抽查的处方中不合格处方52张,不合格率为5．2％,不合格原因有：未注明炮制规格22例,未注明特殊煎煮方法28例,超剂量使用2例。结论：临床医师和药师在今后的中药使用过程中应注意以上八个方面的因素,做到合理用药,以造福广大患者,促进中医药事业的长远发展。     

已上市中成药治疗小儿上呼吸道感染的核心处方挖掘

目的 分析已上市治疗小儿上呼吸道感染中成药的用药特点与组方规律,挖掘核心处方.方法 收集中成药价值评估信息数据库中所有治疗小儿上呼吸道感染的中成药,建立规范化数据库,进行症状分类,运用频数统计与关联规则分析证型及主要症状的用药特点与组方规律,发现与挖掘核心处方.结果 筛选出138种中成药,含203味中药,涉及11个证型...