Latest ArticlesIn order to explore the influencing factors of the willingness of part-time drug inspectors.
Based on the psychological contract theory, the questionnaire survey was conducted with samples of part-time drug inspectors from 13 cities in Jiangsu Province, and the factors influencing the willingness of part-time drug inspectors to inspect were analyzed from three dimensions of transactional, relational and developmental psychological contract.
A total of 212 questionnaires were distributed and 212 valid questionnaires were recovered, with an effective recovery rate of 100%. There was a significant and positive correlation between the three dimensions of psychological contract and the willingness to inspection（P<0.05）. Among them, the relational dimension had the greatest influence, the developmental dimension was the second, and the transaction dimension was the smallest.
It is suggested that inspection agencies should establish the development path, strengthen the incentive and affirmation, establish and improve the system guarantee of part-time drug inspectors, so as to improve the willingness of part-time drug inspectors for inspection.
In recent years, many new drug treatment targets have been found, which provided the basis for the precise treatment of antipsychotic drugs and promoted the research and development of new antipsychotic drugs. The development of trace amine-associated receptor 1 agonist, glycine transporter-1 inhibitor, peripherally restricted muscarinic receptor antagonist, 5-hydroxytryptamine 2A/2C receptor inverse agonist and other new drugs have provided new possibilities for the treatment of psychotic symptoms and attracted much attention due to their significant efficacy and mild adverse reactions.
The difficulties in diagnosing rare diseases, seeking medical treatment, and low drug accessibility have become a public health governance challenge in China and even globally. The fragmentation of China’s rare disease prevention and protection system is evident, and relevant policies urgently require legal authorization and solidification.Research and development of rare disease drugs lack effective legal and policy incentives. Special legislation is an effective way to solve the dilemma of rare disease prevention and protection. Promoting special legislation for rare diseases in China at present is an inherent requirement for achieving social justice and protecting the right to health of patients. There is a broad social consensus and mature experience outside the region for reference. The functional positioning of special legislation for the prevention and protection of rare diseases should be clarified, a reasonable value orientation for differential treatment should be established, and the construction of special legislation for rare diseases should be promoted through adhering to the idea of central coordination and local pilot parallel promotion.
To observe the safety and efficacy of patient-controlled intravenous analgesia （PCIA） with low-dose esketamine combined with sufentanil after off-pump coronary artery bypass grafting （OPCABG）.
Sixty patients undergoing OPCABG under general anesthesia were randomly divided into group S and group ES, with 30 patients in each group. The anesthesia induction and maintenance programs of the two groups were the same. Immediately after the operation, the group ES was injected with esketamine 0.05 mg·kg-1 intravenously, followed by continuous infusion of esketamine 0.5 µg·kg-1·min-1 for 72 h with equal volume sodium chloride injection in the group S. Then PCIA（ sufentanil 1.8 µg·kg-1 in the group ES, sufentanil 3 µg·kg-1 in the group S） was performed immediately for 72 h. The opioid dosage,analgesia satisfaction, effective pressing times of analgesia pump, rescue analgesia rate, pain and sedation score and vital signs in the two groups within 72 h after operation were observed. The time of awakening, extubation and exhaust after operation was recorded, the level of serum troponin was detected on the 4th day after operation, and the adverse drug reactions were observed within 72 h after operation.
Compared with the group S, the dosage of sufentanil and morphine decreased, the satisfaction of analgesia was higher, the rate of rescue analgesia was lower, and the Prince-Henry pain score at 12, 24, 48 and 72 h after operation in the group ES was significantly lower than that in the group S（ P<0.05）.There was no significant difference in awakening time and Ramsay sedation score, heart rate, mean arterial pressure and central venous pressure between the two groups at 6, 12, 24, 48 and 72 h after operation. There was no significant difference in the level of serum troponin between the two groups on the 4th day after operation（ P>0.05）. Within 72 h after operation,the incidence of nausea, vomiting and hypoxemia in the group ES was significantly lower than that in the group S（ P<0.05）,and there was no significant difference in the incidence of hypertension and skin pruritus（ P>0.05）.
Low-dose esketamine combined with sufentanil PCIA can be safely used after OPCABG, and can significantly reduce the dosage of sufentanil and improve the analgesia satisfaction of patients.
To synthesize the available clinical evidence to evaluate the efficacy and safety of lanadelumab,avoralstat, berotralstat, garadacimab, donidalorsen and plasma-derived C1-esterase inhibitor for preventing the acute attack of hereditary angioedema （HAE） using network meta-analysis.
PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, and VIP databases were searched for randomized controlled trials that evaluated the efficacy and safety of these six drugs in the prevention of the acute attack of HAE from the establishment of the library to January 2024. A network meta-analysis （NMA） was performed by Stata 17.0 and R 4.3.2.
A total of 10 randomized controlled trials fulfilling the inclusion criteria were retrieved, including 619 patients. NMA showed that five kinds of drugs were superior to placebo in reducing the number of acute HAE attacks every 4 weeks （P<0.05）. The surface under the cumulative ranking sorting results showed that garadacimab was the most efficacious （MD=2.59, 95%CI: 1.38 to 3.79）. For the comparison between placebo and these drugs, there were no significant differences in the incidence of adverse events and serious adverse events. The SUCRA indicated that lanadelumab had the lowest incidence of adverse events and donidalorsen had the lowest incidence of serious adverse events.
Garadacimab is the most effective drug of all these first-line agents used to prevent acute attacks of HAE, while lanadelumab has better safety.
Recurrent vulvovaginal candidiasis （RVVC） is one of the common recurrent and refractory diseases that troubles women. Oteseconazole, the first drug for the treatment of RVVC, is an oral azole metallic enzyme inhibitor targeting fungal sterol 14α-demethylase （CYP51） developed by Mycovia Pharmaceuticals, Inc., and was approved for sale in the United States on April 26, 2022. Clinical trials have shown that oteseconazole has a significant therapeutic effect on RVVC with minimal adverse reactions.
Drug-induced cardiotoxicity is one of the important reasons for the failure of drug development, and it is urgent to establish methods to screen the impact of drugs on the heart in the early stage. However, the traditional drug safety evaluation models are unable to meet the requirements of drug development. Therefore, the development of efficient and inexpensive drug safety evaluation and mechanism study models are very important for the development of new drugs and rational clinical application of drugs. In recent years, in addition to traditional animal models, the zebrafish, Drosophila,and Caenorhabditis elegans have been used for drug safety research. Based on transgenic technology, humanized animal models with gene expression profiles and regulation similar to that of humans can be established, and the development and application of such models can be used to solve the problem of species differences in drug research. In addition, non-animal methods such as organ chips, organoids, and network toxicology have also been developed. The novel cardiac safety evaluation models would be helpful for drug cardiotoxicity prevention and treatment, as well as drug development.
To observe the effects of propofol combined with etomidate on pulmonary complications and quality of recovery after laparoscopic abdominal surgery in elderly patients.
Eighty patients undergoing elective laparoscopic abdominal surgery, aged 60 to 85 years, ASA physical status Ⅱ~Ⅲ, were randomly allocated into two groups with 40 cases in each group. Both groups received midazolam 0.02-0.05 mg·kg-1 + sufentanil 0.5 μg·kg-1 + rocuronium 0.6 mg·kg-1 for anesthesia induction, propofol 2.5 mg·kg-1 was added to the control group and etomidate 0.2 mg·kg-1 combined with propofol 1 mg·kg-1 were added to the experimental group. The control group was given propofol 6-8 mg·kg-1·h-1 and remifentanil 4-6 μg·kg-1·h-1 intravenous pump for maintenance,while the experimental group was given propofol 4-6 mg·kg-1·h-1 combined with etomidate 0.2-0.4 mg·kg-1·h-1 and remifentanil 4-6 μg·kg-1·h-1 for maintenance. Patients’ heart rate （HR） and mean arterial pressure （MAP）were observed and recorded, serum interleukin （IL）-6 and tumor necrosis factor （TNF）-α concentrations were measured, QoR-15 scale score and the incidence of postoperative pulmonary complications （PPCs） were assessed.
MAP and HR were significantly higher in the experimental group than those in the control group at 30 minutes of anesthesia induction and at the end of surgery （P<0.05）. The serum concentrations of IL-6 and TNF-α in the experimental group were significantly lower than those in the control group at the end of surgery and 24 hours after surgery （P<0.05）. There was no significant difference in recovery time and extubation time between the two groups（P>0.05）, and there was no significant difference in QoR-15 scale score 1 day before surgery （P>0.05）. The QoR-15 scale score in the experimental group was significantly higher than that in the control group 1 day after operation. The incidence of PPCs was 12% （5/40） in the experimental group, which was significantly lower than that 38% （15/40） in the control group （P<0.05）.
Combination of propofol and etomidate for anesthesia can alleviate the perioperative inflammatory response, reduce the incidence of PPCs and improve the quality of postoperative recovery in elderly patients undergoing laparoscopic abdominal surgery.
With the significant improvement of the internationalization level of drug supervision in China has been significantly improved, and the regulation of TCM has entered a new stage of global TCM regulatory coordination. Meanwhile,TCM regulatory science is an emerging frontier discipline in the application of TCM supervision and developing rapidly in recent years. This paper introduced in detail the development status of traditional medicine regulatory science in China and the world’s major developed countries and regions, and carefully sorted out the construction and cooperation of international platforms for traditional medicine at home and abroad, focusing on China’s practice in international sharing of traditional medicine regulatory science. Actively building an international platform for scientific and technological innovation exchanges and cooperation in traditional drug regulatory science under the new situation of international competition can fill the gaps in the construction of international platforms in this field and promote the development of substantive cooperation in the field of traditional drug regulatory science.
Signaling pathways such as PI3K/AKT/mTOR, Hippo/YAP, Notch, Wnt/β-catenin, and TGF-β play the critical role in the malignant biological behaviors of triple-negative breast cancer（TNBC）, including proliferation, invasion,metastasis, and drug resistance. However, conventional chemotherapy drugs often lead to severe adverse reactions, and the utilization of nanotechnology presents a promising solution to this issue. Nano-drug delivery system based on inhibiting signal transduction pathways can carry conventional chemotherapy drugs, block the proliferation of cancer cells, and impede the progression of TNBC. This approach not only offers advantages in targeted therapy but also reduces tissue damage significantly, giving patients more benefits in the future.
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