To establish a qualitative analytical method for the chemical constituents in the root and vine of Actinidia chinensis Planch, and to systematically compare the similarities and differences between them.

LC-MS was performed in negative ion mode to acquire high-resolution mass-to-charge ratios and ion intensity data of the samples from the root and vine of Actinidia chinensis Planch. Principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) were applied to the preprocessed dataset to rapidly identify differential components between the two samples.

The chemical compositions of root and vine were similar, primarily consisting of triterpenoids, flavonoids and phenylpropanoids, but with certain differences in content. Multivariate analysis identified 31 differential components. The root showed higher contents of triterpenoids (e.g., asiatic acid) and flavonoids (e.g., catechin) than the vine, while five differential compounds, including fraxin and aesculetin, were relatively more abundant in the vine.

This study clarifies the similarities and differences in chemical composition between the root and vine of Actinidia chinensis Planch. The admixture of vine into the root was found to compromise its quality. This study provides significant implications for ensuring the quality of root of Actinidia chinensis Planch., guiding clinical medication, and facilitating the medicinal development of both root and vine resources.

To establish a supercritical fluid chromatography (SFC) method for the determination of chiral purity of palonosetron hydrochloride using two columns in series, and to determine the isomers in palonosetron hydrochloride bulk drug and injections.

Two columns, DAICEL CHIRALPAK AD-3 (150 mm×3.0 mm, SFC, 3 μm) and DAICEL CHIRALPAK IG-3 (150 mm×3.0 mm, SFC, 3 μm), were in series. The column temperature was at 37 ℃, the mobile phase was composed of CO₂ and a mixture of anhydrous ethanol, acetonitrile, and diethylamine at a ratio of 55∶45, the back pressure was at 12 MPa, the flow rate was 1.2 mL·min^-1, the injection volume was 20 μL, and the detection wavelength was at 240 nm.

The R,S isomer, R,R enantiomer, S,R isomer, and palonosetron were eluted sequentially within 10 min with resolutions of 1.7, 2.3, and 1.5, respectively. All four compounds exhibited good linearity between peak area and concentration in the range from 0.20 to 10.0 μg·mL^-1, with r all greater than 0.999 5. The detection limits (S/N=3) of the three isomers were all 0.10 μg·mL^-1; and the quantitation limits (S/N=10) were all 0.20 μg·mL^-1. The average recoveries of the three isomers in the bulk drug and injections ranged from 97.8% to 101.3%, with relative standard deviations (RSDs) ranged from 0.3% to 1.5% (n=9). Except for one batch of bulk drug in which no chiral impurity was detected, the R,S isomer was detected in all the other five batches, with contents ranging from 0.03% to 0.12%.

The developed SFC method can separate palonosetron and its three isomers in a short analysis time, and the use of two columns in series improves the separation efficiency, especially the resolution between the S,R isomer and palonosetron. The method is accurate, reliable, and can be used as an effective means for chiral purity determination and quality control of palonosetron hydrochloride bulk drug and related preparations.

To study the impurities in domestic piroxicam gel.

An HPLC method was established to study the impurities in piroxican gel. Waters XBridge C₁₈ (250 mm×4.6 mm, 5 μm) column was used with gradient elution of mobile phase consisting of 0.5% of glacial acetic acid in water (adjust with ammonium hydroxide to a pH of 6.2) and acetonitrile. The flow rate was 1.0 mL·min^-1, and the UV detection wavelength was 265 nm. Q-TOF technique was used to identify the structures of the main impurities in positive/negative ion modes with ESI as the ion resource.

Piroxicam peak was well separated from each impurity peak. A total of 4 major impurities (≥0.1%) were detected in 17 batches of domestic piroxicam gel: i.e., 2-hydroxy-benzoic acid 2-[bis(2-hydroxyethyl)amino] ethyl ester, 2-hydroxypropyl-4-hydroxybenzoate, 1-hydroxypropyl-2-yl-4-hydroxybenzoate, and 2-methyl-4-methoxy-N-(2-pyridyl)-2H-1,2-benzothiazin-3-formamide-1,1-dioxide, which were for the first time reported in piroxicam gel.

The established HPLC method can be used for impurity detection of piroxicam gel. Impurities in domestic piroxicam gel mainly come from raw materials and excipient ethyl hydroxybenzoate. The production process should be optimized to improve the quality.

To analyze the rationality and effectiveness of hepatoprotective drugs in clinical practice and explore the evidence-based basis for off-label use, as well as the clinical value of prophylactic use and combination therapies.

Clinical data of 732 hospitalized patients treated with hepatoprotective drugs from January 2023 to December 2024 were collected. Rationality was evaluated based on drug labels, domestic and international guidelines, and expert consensus. Effectiveness was assessed by comparing liver function indicators before and after treatment.

A total of 732 patients were included. Rational use of hepatoprotective drugs was observed in 592 cases (80.87%), while 140 cases (19.12%) were categorized as irrational use. Rational use was subcategorized into label-compliant use (252 cases, 34.43%) and off-label use (340 cases, 46.45%). Off-label use cases were further classified as guideline-supported (91 cases, 12.43%) and consensus-supported (249 cases, 34.02%). Irrational use primarily included non-indicated prescriptions (58 cases, 7.92%), prophylactic use (43 cases, 5.87%), and redundant combinations (20 cases, 2.73%). Significant reduction in alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) levels was observed after treatment (all P<0.001). The effective rate was significantly higher in the label-compliant group than in the inappropriate-use group (72.62% vs 53.57%, P<0.05). No statistically significant differences were found among monotherapy, dual therapy, and triple-or-more therapy groups (62.54% vs 69.31% vs 62.79%, P>0.05).

Clinical application of hepatoprotective drugs should strictly adhere to instructions and authoritative guidelines, and avoid non-indicated prescriptions or combination therapy. This study provides a reference for rational clinical medication use and clinical pharmacist interventions.

To evaluate the cost-effectiveness of imipenem/cilastatin/relebactam (IMI/REL) in patients with hospital-acquired bacterial pneumonia (HABP) and ventilator-associated pneumonia (VAP), using piperacillin/tazobactam (PIP/TAZ) as a comparator, and to assess its economic viability within the Chinese healthcare system.

From the perspective of the Chinese healthcare system, a hybrid decision tree-Markov model was constructed to simulate the long-term health outcomes of IMI/REL and PIP/TAZ from the mean age of disease onset until death. Efficacy and safety data were derived from a Phase Ⅲ clinical trial (NCT03583333), while cost and utility parameters were obtained based on literature reviews and expert interviews. Cost-utility analysis was performed, and one-way and probabilistic sensitivity analyses were conducted to validate the robustness of the results. The unit price of IMI/REL was set at 1 240 yuan per vial based on publicly available sales prices, and which both base-case and scenario analyses were conducted.

The base-case analysis showed that the total treatment cost in the IMI/REL group was 164 275.71 yuan with a quality-adjusted life year (QALY) of 4.32, while the total cost in the PIP/TAZ group was 143 946 yuan with a QALY of 4.13. The incremental cost-utility ratio (ICER) was 104 991.37 yuan per QALY, which was lower than the threshold of three times China's per capita gross domestic product (GDP). The scenario analysis indicated that under the assumption of partial survival among uncured patients, the cost-effectiveness conclusion of IMI/REL remained robust.

Under the currently available price setting, IMI/REL demonstrates favorable cost-effectiveness compared with PIP/TAZ, providing a reference for optimizing treatment strategies and informing medical insurance payment policies for HABP/VAP in China.

To investigate the relationship between potentially inappropriate medication (PIM) and falls among the elderly in the medical-nursing integration community, and to provide a basis for fall prevention in the elderly.

A retrospective study was conducted. General information of the participants was collected, including basic information, disease conditions, medication use, various assessment records, and records of fall events. PIM screening was performed using the criteria of potentially inappropriate medications for older adults in China (2017). Statistical analyses were performed using R 4.3.0. Depending on the data type, t-tests, non-parametric rank sum test, or chi-square test was used, and logistic regression was used to analyze the relationship between various risk factors and falls.

A total of 1 153 elderly individuals from the medical-nursing integration community were enralled and divided into two groups based on the presence of falls between January 2022 and June 2024: the fall group (n=290) and the non-fall group (n=863). Multivariate Logistic regression analysis showed that increased age, the presence of pain, anxiety and depression, and an increased number of psychotropic PIMs, endocrine PIMs, and NSAID PIMs were independent risk factors for falls (P<0.05), whereas a higher education level was a protective factor against falls (P<0.05).

An increased number of endocrine PIMs, NSAID PIMs, and psychotropic PIMs is closely associated with falls in the elderly. Clinicians should promote rational drug use, reduce the types and numbers of PIMs, and thus lower the risk of falls in this population.