OBJECTIVE To explore the inhibitory effects and mechanisms of Sanwu Huangqin Decoction （SWHD） on acute inflammation based upon zebrafish inflammatory models. METHODS CuSO4 immersion， tail transection and lipopolysaccharide （LPS） yolk injection zebrafish models were set up for evaluating the acute anti-inflammatory effects of SWHD. Zebrafish larvae were divided into four groups of control， model， positive （10 μg·mL–1 dexamethasone） and SWHD treatment （100/200/300 μg·mL–1）. Aggregation of neutrophils in injured area of zebrafish was observed by fluorescence. In LPS-induced inflammation model， hematoxylin-eosin （HE） stain was utilized for observing the changes in the number of inflammatory cells in zebrafish. Quantitative reverse-transcription polymerase chain reaction （qRT-PCR） was employed for measuring the transcript mRNA levels of inflammation-related genes and lactate kit for detecting lactate concentration in zebrafish. RESULTS As compared with model group， SWHD dosing blunted abnormal neutrophil recruitment to inflamed sites. The survival rate of LPS-induced zebrafish was significantly elevated after dosing of SWHD. Significantly elevated lactate level， up-regulated mRNA expressions of lactate dehydrogenase A （LDHA） and interleukin-10 （IL-10） and down-regulated mRNA expressions of NF-κB， IL-6 and TNF-α were also observed. CONCLUSION SWHD may effectively suppress neutrophil aggregation to alleviate acute inflammatory process through regulating the LDHA-mediated NF-κB signaling pathway.
OBJECTIVE To explore the protective mechanism of Jiawei Simiao Yong’an Decoction （JSY） on human retinal vascular endothelial cells （HRCEC） through endoplasmic reticulum stress （ERS） signaling pathway. METHODS The cells were assigned into four groups of negative control （LG）， high glucose induction （HG）， positive control （metformin， MET） and JSY. CCK-8 method was employed for screening the optimal concentration of JSY on HRCEC cells. Annexin Ⅴ-FITC/PI method was utilized for detecting cell apoptosis in each group. The mRNA expression levels of eIF2α， CHOP， VEGF， IL-1β， IL-6 and TNF-α were determined by reverse transcription-polymerase chain reaction （RT-qPCR）. And the levels of IL-6， IL-1β， TNF-α and AGE in supernatant were detected by enzyme-linked immunosorbent assay （ELISA）. Protein levels of eIF2α， CHOP， JNK， caspase12 and NF-κB were detected by Western blot. RESULTS As compared with LG group， apoptotic rate rose markedly in HG group （P<0.05）. The mRNA expression levels of eIF2α， CHOP， VEGF， IL-1β， IL-6 and TNF-α were significantly up-regulated （P<0.05）. The contents of IL-6， IL-1β， TNF-α and AGE spiked markedly （P<0.05）. The relative expression levels of eIF2α， CHOP， JNK， caspase12 and NF-κB increased markedly （P<0.05）. As compared with HG group， apoptotic rate declined markedly in MET/JSY group （P<0.05）. The mRNA expressions of eIF2α， CHOP， VEGF， IL-1β， IL-6 and TNF-α dropped sharply （P<0.05）. The contents of IL-6， IL-1β， TNF-α and AGE were markedly elevated （P<0.05）. The relative expression levels of eIF2α， CHOP， JNK， caspase12 and NF-κB dropped markedly （P<0.05）. CONCLUSION JSY may arrest ERS signaling pathway and downstream NF-κB pathway， down-regulate the expressions of related mRNA and protein， lower the levels of HG-induced HRCEC inflammatory factors and stunt cell apoptosis. It play some roles in protecting HRCEC.
OBJECTIVE The fingerprint of Senden-4 was established by HPLC， and the quality difference of different batches of samples was compared by chemical pattern recognition analysis to provide basis for quality evaluation. METHODS The chromatography column was Agilent Eclipse XDB C18 （4.6 mm×250 mm， 5 μm）， with methanol （A）-0.2 % phosphoric acid （B） solution as a mobile phase for gradient elution. Flow rate was 1 mL·min–1， column temperature 35 ℃， injection volume 10 μL and detection wavelength 254 nm. The Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine （Edition 2012） was employed for evaluating the similarity of 17 batches of Sendeng-4. Bioinformatic platform was utilized for cluster analysis （CA） and SIMCA 14.1 software for principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA）. Variable importance in projection （VIP） value >1.0 was utilized as an index for screening the differential components and Graph Pad Prism 8.0 software for examining variance of different components. RESULTS There were a total of 24 common peaks in fingerprints of 17 batches of Sendeng-4 and the similarities surpassed 0.992； nine common peaks were identified， including gallic acid （peak 2）， geniposide acid （peak 4）， dihydromyricetin （peak 11）， geniposide （peak 12）， corilatin （peak 13）， chebulic acid （peak 18）， ellagic acid （peak 20）， myricetin （peak 21） and crocin I （peak 22）. According to the results of CA/PCA， 17 batches of samples could be clustered into two categories of S1， S3–S14， S16 and S2， S15， S17. Under the OPLS-DA model， 10 differential biomarkers were screened based upon VIP value >1 and the differences were significant （P<0.01）. CONCLUSION In conjunctions with chemical pattern recognition techniques， HPLC fingerprinting of Sendeng-4 may be employed for quality evaluations of Sendeng-4. Ten components such as Corilagin are differential markers affecting the quality of Sendeng-4.
OBJECTIVE To explore the efficacy and mechanism of Sanren Granules （SG） on damp-heat gastritis （DHG） based upon network pharmacology and in vivo animal experiments. METHODS The key active components and their corresponding targets of SG were screened by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and PubMed. And the related therapeutic targets for DHG were collected by disease databases of OMIM and GeneCards. Protein-protein interaction （PPI） network was constructed by STRING and Cytoscape 3.9.0. DAVID database was employed for performing gene ontology （GO） function and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis on the target genes related to the treatment of DHG. And a “component-target-pathway” network was established. DHG rat model was established by an intragastric injection of 2% sodium salicylate solution and feeding with a high-fat， high-sugar and high-heat diet. The animals were randomized into six groups of control， model， positive drug （omeprazole， 4 mg·mL–1） and low/medium/high-dose SG （2 250/4 500/9 000 mg kg–1）. The changes of body weight， body temperature and fecal water content pre/post-dosing were evaluated. Hematoxylin-eosin （HE） stain was utilized for observing the morphologies of gastric mucosa. The serum levels of interleukin-1β （IL-1β）， interleukin-6 （IL-6）， tumor necrosis factor-alpha （TNF-α）， HSP60 and HSP-70 were quantified by enzyme-linked immunosorbent assay （ELISA） and real-time fluorescent quantitative method. Western blot was utilized for detecting the expressions of NF-κB/MAPK signaling pathway-related proteins in gastric tissue. RESULTS A total of 62 potential active components were screened in SG and 44 intersection targets obtained. Among them， TP53， IL-6， IL-1β， JUN and VEGFA were the key targets. Through the analysis of GO/KEGG， NF-κB/MAPK signaling pathway might be an important way for SG for treating DHG. Animal experiments indicated that body weight of rats gained and body temperature dropped markedly in middle/high-dose SG groups. And infiltration of inflammatory cells improved. The serum levels of IL-1β， IL-6， TNF-α， HSP-60 and HSP-70 declined significantly （P<0.05） while the expression levels of MAPK and NF-κB proteins were down-regulated （P<0.01）. CONCLUSION SG may stunt inflammation through the NF-κB/MAPK pathway for treating damp-heat gastritis， providing theoretical rationales for clinical application of SG.
OBJECTIVE To optimize formulations of liquiritin gastric floating tablets （Liq-GFT） and explore its protective effects on gastric mucosa injury of rabbits. METHODS Liq-GFT was prepared by powder compression. Amounts of HPMC K15M， stearic acid and NaHCO3 were employed as independent variables. And comprehensive score of cumulative release at 2/6/12 h was selected as evaluation parameters. The formulations of Liq-GFT were optimized by Box-Behnken response surface method and release mechanisms also elucidated. Rabbits were randomized into four groups of normal， model， Liq-GFT and cimetidine. Acute gastric mucosal injury model in rabbits was established by an intragastric injection of ethanol. And the protective effects of Liq-GFT on gastric mucosal injury were evaluated. RESULTS Optimal formulation of Liq-GFT： amounts of HPMC K15M， stearic acid and NaHCO3 were 26.4%， 6.6% and 9.0%， respectively. Average floating time of Liq-GFT was up to 12 h， floating lag time 58 s， and cumulative release rate 91.3%. The release process of Liq-GFT in vitro accorded with the first-order model and the release mechanism was through synergistic effects of diffusion and dissolution. Pharmacodynamic results indicated that gastric mucosal injury index of high-dose Liq-GFT group （40 mg·kg–1·d–1） decreased markedly as compared with model group （P<0.01） and ulcer inhibition rate was 48.92%. CONCLUSION Liq-GFT has obvious characteristics of sustained release in vitro. Its cumulative release rate is high and there are evident protective effects on gastric mucosa injury in rabbits.
OBJECTIVE To explore the structural characteristics of water-soluble protein of velvet antler and examine its anti-fatigue effect. METHODS Water-soluble protein of velvet antler was extracted with sika deer antler as raw material through alkaline extraction and acid precipitation. Molecular weight distribution was detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis （SDS-PAGE） and Coomassie blue stain. Amino acid composition was detected by high performance liquid chromatography （HPLC）. And structural characteristics and micro-molecular morphologies were detected by ultraviolet （UV） spectroscopy， circular dichroism （CD） spectroscopy， Fourier transform infrared spectroscopy （FTIR）， endogenous fluorescent spectroscopy and scanning electron microscopy （SEM）. Anti-fatigue activity was evaluated by exhaustive swimming experiments in mice. RESULTS Molecular weight distribution of water-soluble protein ranged from （43-80）×103 and it was less than 14.4×103. It contained an abundant supply of glutamic acid， lysine， aspartic acid and leucine， as well as essential amino acids. Water-soluble protein of velvet antler possessed distinct protein characteristic structures， including abundant alpha helix and excellent protein stabilities. It prolonged exhausted swimming time， reduced the blood levels of urea nitrogen and lactated， caused an accumulation of liver glycogen and muscle glycogen， boosted the activities of lactate dehydrogenase （LDH） and superoxide dismutase （SOD） and lowered the content of malondialdehyde （MDA）. CONCLUSION The molecular characteristics of water-soluble proteins of velvet antler may serve as a structural basis for their excellent anti-fatigue properties.
OBJECTIVE To perform digital characterization of color of perilla leaf with both surfaces purple （PP）， perilla leaf with upper surface green and lower surface purple （GP） and white perilla leaf with both surfaces purple green （GG） for establishing determination method of anthocyanin and explore the differences between different samples and the correlation between colorimetric value and anthocyanin content. METHODS Fluorescent microscope was utilized for measuring seven colorimetric values of R， G， B， L*， a*， b* and E*ab. The sample was extracted with a 60% ethanol solution containing 2.5% hydrochloric acid. Contents of anthocyanin were determined by spectrophotometry with oxidized cyanidin as a reference substance. Partial least squares-discriminant analysis （PLS-DA） was employed for examining the difference between samples with different colors. Pearson’s correlation analysis and stepwise multiple linear regression were performed on 7 colorimetric values and anthocyanin content. RESULTS The relative standard deviations for precision， repeatability and stability tests of leaf color were all below 3.0%. Calibration curve of anthocyanin displayed a decent linearity within its test ranges. Its relative standard deviations for precision， repeatability and stability were all below 3.0%. Average recovery was 99.8%. R value and anthocyanin content of PP， GP and GG declined sequentially while E*ab value spiked sequentially. No significant difference existed in values of R， G， B， L*， a*， b* or E*ab among three kinds of samples. PLS-DA could classify 30 batches of samples into 3 categories based upon leaf color and a positive correlation existed between R value and anthocyanin content. CONCLUSION The proposed methods are sensitive， accurate， simple and fast. Digital expression of color of perilla leaf and white perilla leaf has been achieved in this study， revealing the correlation between leaf color and internal component and providing rationales for “quality evaluation based upon color” of medicinal perilla leaf.
OBJECTIVE To analyze the alcohol-soluble and volatile constituents of Jingfuzhiyang Granules by ultra-high performance liquid chromatography-quadrupole/orbitrap high resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） and headspace solid-phase microextraction-gas chromatography-mass spectrometry （HS-SPME-GC-MS） for analyzing the cleavage pattern of the compounds， reveal the attribution of the constituents in the preparation and improve the quality standard of Chinese medicinal preparations. METHODS UPLC-Q-Orbitrap HRMS analysis was performed on a Thermo Scientific AccucoreTM C18 （3 mm×100 mm， 2.6 μm） ultra-performance liquid column. The mobile phase was a gradient elution of 0.1% formic acid aqueous solution （A）-methanol （B）. MS data were collected in positive and negative ion modes. The alcohol-soluble constituents of Jingfuzhiyang Granules were identified on the basis of accurate mass charge ratios and secondary fragmentation ion information and in conjunctions with the literature data. HS-SPME-GC-MS analysis was utilized for identifying the volatile constituents in Jingfuzhiyang Granules and chromatographic peak information was acquired and compared with the standard database for a rapid identification of volatile constituents. RESULTS Totally 162 chemical constituents were identified in Jingfuzhiyang Granules， among which 129 alcohol-soluble compounds were identified from the results of UPLC-Q-Orbitrap HRMS， including 35 flavonoids， 10 coumarins， 3 alkaloids， 39 organic acids， 12 amino acids， 6 amides， 6 nucleosides and 18 others； 33 volatile compounds were identified from the results of HS-SPME-GC-MS， including 7 hydrocarbons， 12 aldehydes， 3 ketones， 3 esters， 4 organic acids， 2 alcohols and 2 heterocycles. CONCLUSION The analytical protocol of UPLC-Q-Orbitrap HRMS and HS-SPME-GC-MS has been formulated for elucidating pharmacological substance basis of compound preparation， providing references for further improving the quality， optimizing the process and stabilizing the pharmacological effect.
OBJECTIVE To systematically evaluate the risk of virus and/or symptom rebound after Nirmatrelvir/Ritonavir （NMV/r） treatment in patients with coronavirus disease 2019 （COVID-19）. METHODS From January 1， 2018 to November 2， 2023， the databases of PubMed， Embase， Cochrane Library， Clinical Trials， Wanfang and China National Knowledge Infrastructure （CNKI） were searched for the related literature of COVID-19 rebound in patients treated with NMV/r （observation group） and molnupiravir or no antiviral drugs （control group）. After information collection and quality evaluation， meta-analysis was performed by STATA 12.0 software. RESULTS A total of 12 cohort studies and 1 randomized controlled trial were included. Rate of viral rebound， symptom rebound， viral and/or symptom rebound after NMV/r treatment were 4.72%， 3.75% and 7.24%， respectively. Meta-analysis results revealed no significant differences in viral rebound ［OR=1.46， 95%CI（0.91， 2.33）， P=0.116］， symptom rebound ［OR=0.85， 95%CI（0.58， 1.25）， P=0.093］ and virus and/or symptom rebound ［OR=0.76， 95%CI（0.37， 1.55）， P=0.452］ between NMV/r and control groups. Subgroup analysis indicated that symptom rebound rate was significantly lower in NMV/r group than that in molnupiravir group ［OR=0.67， 95%CI（0.48， 0.92）， P=0.015］. It was comparable to that in group without antiviral drugs ［OR=1.43， 95%CI（0.45， 4.57）， P=0.684］. CONCLUSION COVID-19 rebound may appear in patients treated with NMV/r， molnupiravir and no antiviral drugs. The risk of COVID-19 rebound does not differ between NMV/r group and group without antiviral drugs. Symptom rebound rate of NMV/r is lower than that of molnupiravir and viral rebound rate is similar between them. However， due to the limitations of the included studies， these results should be further verified by more large-sample clinical trials.
OBJECTIVE To analyze the incidence of immune-associated pneumonia caused by tislelizumab to provide a pharmaceutical supervision for clinical pharmacists on immune-associated pneumonia occurring in actual clinical treatment of tislelizumab. METHODS The databases of PubMed， Elsevier Science Direct， SpringerLink， Wiley Online Library， China National Knowledge Infrastructure （CNKI） and Wanfang were searched for immune-associated pneumonia induced by tislelizumab were searched as of June 2023. RESULTS A total of 12 cases of pneumonia induced by tislelizumab were included. There were 11 males and 1 female with a mean age of 61 years. Time of onset of pneumonia predominated at 1-6 months after an initial drug dosing. The major clinical manifestations included dyspnea， cough and fever and imaging feature was ground-glass opacity. Nine patients were cured after symptomatic treatment. Four patients were retreated with tislelizumab and two relapsed. CONCLUSION Clinical symptoms and lung imaging characteristics of patients with immune-related pneumonia should be closely monitored during a treatment of tislelizumab by clinical pharmacists. And the pharmaceutical care should be strengthened to ensure the safety of drug dosing.
OBJECTIVE To explore the risk factors for myelosuppression associated with AC-T chemotherapy regimens for breast cancer， develop a risk prediction model and evaluate its predictive performance. METHODS From January 2018 to October 2023， medical records were retrospectively reviewed for 309 female breast cancer patients on chemotherapy of AC-T regimen at Xinjiang Uygur Autonomous Region People’s Hospital. According to the WHO grading criteria for acute/subacute toxic reactions to anticancer drugs， they were assigned into two groups of control （0-Ⅰ degree， n=163） and case （Ⅱ-Ⅳ degree， n=146）. Independent risk factors were screened by univariate and multifactorial Logistic regression analyses. The validation methods were random forest and extreme gradient boosting feature selection. Machine learning method was applied for establishing five prediction models. And the best model was selected by comparing the prediction performance among the models. RESULTS The incidence of myelosuppression was 47.25%. Ethnicity， body mass index （BMI） <24 kg·m–2， previous history of diabetes mellitus， chemotherapeutic cycle <5 sessions， non-preventive use of colony-stimulating factors， low lymphocyte count， low monocyte count and low serum albumin level were independent risk factors for myelosuppression with AC-T chemotherapy regimens. Extreme gradient boosting （XGB） model was the best model with an AUROC of 0.944， denoting good predictive performance， stability and clinical utility. CONCLUSION XGB model built by machine learning method may better predict the risk of myelosuppression caused by AC-T chemotherapeutic regimen. It provides references for formulating clinical treatment protocols and implementing individualized preventive drug strategies.
OBJECTIVE Vonoprazan is a novel potassium competitive acid blocker. Due to its novelty， its long-term safety and adverse events still need to be further confirmed. METHODS From 2015 to 2023， the relevant adverse event reports were searched and extracted through the FDA Adverse Event Reporting System （FAERS） and the Japanese Adverse Drug Event Reporting System （JADER） and the adverse event system was classified using the Medical Dictionary for Regularly Activities terminology set. Data processing and analysis of drug-related reports were performed by reporting odds ratio （ROR） and proportional reporting ratio （PRR）. RESULTS In the analysis of preferred terms， the important signals in the FAERS database were deficiency of luteinizing hormone （ROR=2 066.06，PRR=2 065.82）， gallbladder torsion （ROR=2 065.94， PRR=2 065.82） and esophageal anastomosis （ROR=1 377.37， PRR=1 377.21）. The important signal orders of JADER database were as follows： elevated blood gastrin （ROR=1 535.76， PRR=1 525.05）， gastrinoma （ROR=930.27， PRR=928.29） and duodenal polyps （ROR=398.20， PRR=397.84）. In the analysis of system organ classification， the important signals of FAERS database were arranged in the following order： endocrine disorders （ROR=5.36， PRR=5.31）， hepatobiliary disorders （ROR=5.14， PRR=4.98） and blood/lymphatic system disorders （ROR=2.96， PRR 2.87）. The important signals of JADER database were ranked as follows： social circumstances （ROR=4.54， PRR=4.53）， pregnancy， puerperium & perinatal conditions （ROR=3.81， PRR=3.81） and skin/subcutaneous tissue disorders （ROR=3.16， PRR=3.15）. CONCLUSION The signal mining results based upon FAERS and JADER databases suggest that pharmacists should pay greater attention to the risk of venolazone related adverse events. And clinical medication monitoring should be strengthened for minimizing the impact of adverse reactions on patient prognosis and quality-of-life.
OBJECTIVE To mine the data of adverse event to hyperglycemia caused by immune checkpoint inhibitors （ICIs） and provide references for rational clinical use of drugs. METHODS From January 1， 2004 to June 30， 2023， OpenVigil platform was utilized for collecting reports of adverse event to hyperglycemic caused by ICIs （including nivolumab， pembrolizumab， atezolizumab & durvalumab） from the FAERS database. Signal detection and data analysis were performed with reporting odds ratio （ROR）， proportional reporting ratio （PRR） and Bayesian confidence propagation neural network （BCPNN）. RESULTS A total of 1020 reports of adverse event for hyperglycemia caused by ICIs were collected， including nivolumab （n=648）， pembrolizumab （n=287）， atezolizumab （n=72） and durvalumab （n=13）； there were 595 males and 347 females； two major reporting countries were Japan and the United States. The adverse events reported by FAERS were mostly type 1 diabetes mellitus （T1DM）， fulminant type 1 diabetes （FT1D） and diabetic ketoacidosis （DKA）； The major adverse consequences of hyperglycemia were “life-threatening” and “prolonged hospitalization stay”. CONCLUSION ICIs are associated with the occurrence of hyperglycemia. Navurizumab carries the highest risk of hyperglycemia. When dosing ICIs， clinicians should watch out for the occurrence of type 1 diabetes mellitus （T1DM）， fulminant type 1 diabetes mellitus （FTlD） and ketoacidosis （DKA）. ICIs treatment may lead to such serious consequences of hyperglycemia as “life-threatening” and “prolonged hospitalization stay”.
OBJECTIVE To systematically evaluate the pharmacoeconomic researches on durvalumab as a first-line treatment for extensive-stage small cell lung cancer （ES-SCLC） so as to optimize clinical treatment plans， improve health decisions and provide references for subsequent pharmacoeconomic researches. METHODS A systematic review was conducted by accessing the databases of PubMed， Embase， Cochrane Library， Web of Science， China National Knowledge Infrastructure （CNKI）， SinoMed， VIP and WANFANG DATA. And the relevant literature items were up to March 2024. The qualities of included studies were assessed by the CHEERS 2022 checklist and followed by a descriptive summary analysis. RESULTS Ten studies of high overall quality were included. All were model-based cost-effectiveness analyses from the perspectives of health system and payers. Utility values were derived from prior researches and expenses focused upon direct medical costs. Survival data were projected by standard parametric and risk-adjusted models. Durvalumab plus chemotherapy （etoposide plus platinum） failed to demonstrate cost-effectiveness over chemotherapy alone or atezolizumab plus chemotherapy. However， in ES-SCLC patients with brain metastases or receiving patient assistance， durvalumab plus chemotherapy was economically favorable and more cost-effective than atezolizumab plus chemotherapy and yet not over chemotherapy alone. As compared with such checkpoint inhibitors as pembrolizumab and ipilimumab， durvalumab offered a significant cost-effectiveness advantage. CONCLUSION This study has preliminarily clarified the economic viability of durvalumab as compared with other drug dosing regimens. Future researches should utilize head-to-head trial data or real-world data to provide further evidence for treating ES-SCLC.
OBJECTIVE Through questionnaire survey， understand the current status and influencing factors of home medication safety for urban elders in Shandong Province and provide references for pharmacists providing home pharmaceutical care. METHODS Pharmacists provided home pharmaceutical care for elders and completed a questionnaire survey to obtain basic profiles and managed family medicine chest and drug safety. Binary logistic regression or multiple linear regression was utilized for examining the influencing factors of drug safety. RESULTS A total of 294 valid questionnaires， covering families of elders in 14 cities in Shandong Province， were obtained finally. The prevalence of multiple chronic conditions in urban elders was 61.22% and 27.21% of urban elders received polypharmacy treatment. There were still many problems of family medicine chest， such as non-classification， similar drugs and lacking package. And 70.07% of elders had poor medication compliance. Binary Logistic regression indicated that education level was an influencing factor of medication compliance. Medication literacy and common sense， including medication cognition and behavior， were rated as good. The results of multiple linear regression revealed that the influencing factors of score of medication cognition and behavior were education level and monthly income. CONCLUSION Due to the existence of multiple chronic conditions， dosing of various drugs， poor management of family medicine chest and low medication compliance have elevated， the risks of home medication for elders. It is necessary to provide home pharmaceutical care for elders.
OBJECTIVE To summarize pharmaceutical care researches published in top medical journals to provide references for pharmacists to carry out researches of pharmaceutical care. METHODS PubMed database was searched by journal and contents of pharmaceutical care as search terms. Pharmaceutical care researches published in top four medical journals from January 1， 2000 to August 21， 2023 were extracted. RESULTS A total of 18 articles were included， among which 9 articles were published in BMJ， 5 in JAMA， 3 in LANCET and 1 in NEJM. The participants， study design， contents of pharmaceutical care and outcome parameters were analyzed. CONCLUSION Pharmaceutical care researches published in top medical journals have outstanding characteristics in terms of population representation， targeted intervention measures， diversity of settings， appropriateness of epidemiological study design and rationality of outcome parameters. It may provide practical references for planning researches in pharmacy practice in China and offering high-quality pharmaceutical care.
Elevated low-density lipoprotein cholesterol （LDL-C） is a significant risk factor for atherosclerotic cardiovascular disease （ASCVD）. In recent lipid management guidelines， LDL-C has been recommended as a primary target for lipid-lowering therapy in most countries or regions. And target levels are based upon risk stratification. Extensive evidence indicates that statins could effectively decrease the incidence of cardiovascular events in ASCVD patients through a marked reduction of serum LDL-C level. However， the current rate of LDL-C target attaining in high-risk ASCVD populations remains low， indicating numerous unmet needs in lipid-lowering therapy. To address this challenge， researchers have identified several LDL-C-targeting drugs with potentially innovative mechanisms of action. These include proprotein convertase subtilisin/kexin type 9 （PCSK9） inhibitors （e.g. monoclonal antibodies of evolocumab， alirocumab and torcetrapib， as well as small interfering RNA molecule of inclisiran）， ATP-citrate lyase inhibitor （e.g. bempedoic acid） and angiopoietin-like protein 3 inhibitor （e.g. evinacumab）. Additionally many emerging LDL-C-targeting drugs are currently under evaluations. Focusing upon clinical pharmacology and cardiovascular benefits of these drugs， this review summarized the evidence-based management protocols of innovative LDL-C-targeting therapies.
Amomum kravanh has a long history of medicinal use in China. Containing volatile oils， flavonoids， diarylheptane and other chemical components， A. kravanh has pharmacological functions of renohepatic protection and anti-tumor. Here chemical compositions and pharmacological effects of A. kravanh were reviewed and Q-Markers of A. kravanh were predicted from the aspects of plant genealogy， specificity of chemical components， correlation between components， traditional medicinal properties， compound compatibility， chemical composition measurability and different origins. It was preliminarily predicted that 1，8-eucalyptol， β-pinene， α-pinene， α-terpineol， α-caryophyllene， α-cubebene and eugenol could be used as Q-Markers for A. kravanh， providing rationales for optimizing the quality standards of A. kravanh.
