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    Research progress in the treatment of early Alzheimer's disease with lecanemab
    JIN Panpan, LIU Yang, QIU Bo, WU Huizhen
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 207-214.   DOI: 10.12092/j.issn.1009-2501.2024.02.011
    Abstract493)      PDF (672KB)(1076)       Save
    Lecanemab is a new drug used to treat early Alzheimer's disease (AD) with mild cognitive impairment or mild dementia. It is a human anti-Aβ fibril monoclonal IgG1 antibody, which is injected intravenously into the patient, through the blood-brain barrier into the brain, clearing amyloid plaque, thereby slowing the rate of cognitive decline in patients and delaying disease progression. This article reviews the pharmacological studies, clinical studies, safety and limitations of lecanemab, in order to help clinical understand the current research status and existing achievements of this drug.
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    Research progress of pharmacologic therapy in obstructive sleep apnea
    WU Xingdong, YUE Hongmei, ZHU Haobin, LIU Miaomiao, LI Yating, XU Jinhui
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 215-229.   DOI: 10.12092/j.issn.1009-2501.2024.02.012
    Abstract464)      PDF (1349KB)(270)       Save
    Obstructive sleep apnea (OSA) is a common sleep disordered breathing disorder. As a major global public health problem, untreated OSA can lead to a variety of adverse health outcomes, including various cardiovascular and cerebrovascular diseases, metabolic disorders, and psychiatric disorders such as anxiety and depression. Traditional OSA therapies such as positive airway pressure (PAP), weight loss, oral?appliance, upper airway surgery, and postural therapy focus on the anatomical factors of OSA. However, the pathogenesis of OSA is heterogeneous, and non-anatomical factors also play an important role in most patients. Although there is no drug with exact efficacy for the treatment of OSA, with the deepening understanding of the pathophysiological mechanism of OSA, more and more clinical studies are devoted to the study of drug treatment of OSA and its complications, and a series of results have been achieved. The following is a review of the relevant studies on drug treatment of OSA in recent years, hoping to provide literature support and theoretical basis for future research on drug treatment of OSA.
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    Progress and prospect of inhaled biological agents in asthma
    LI Guanghui, HUANG Jing, ZHU Min, ZHAO Rui, WAN Yakun, CHEN Zhihong
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 406-414.   DOI: 10.12092/j.issn.1009-2501.2024.04.007
    Abstract379)      PDF (904KB)(450)       Save
    More than 300 million people worldwide suffer from asthma, and the incidence is increasing year by year. As one of the most common chronic diseases, asthma is an immune-mediated inflammatory disease with complex triggering mechanisms and strong heterogeneity. With the in-depth study of physiological and pathological mechanisms, therapeutic small molecule and hormone drugs have been introduced to control and treat most patients, but about 5%-10% of patients still suffer from various subtypes of difficult to control and treat asthma, that is, severe asthma. In the past decade, with the rapid development of biopharmaceutical research, protein and antibody have become the key drugs for the treatment of severe asthma with high efficacy, high specificity and high safety. However, biological drugs are usually administered by injection, they cannot be noninvasive and directly delivered into the lung to quickly absorb and take effect. Therefore, there is an urgent need for the introduction of inhaled biologics with quick effectiveness, convenience, economy and safety in clinical. The review summarizes the existing small molecule, hormone and biological therapy drugs, and summarizes the development of inhalable biological agents of asthma, and analyzes the future prospects of the inhalable biological drugs, which is designed to deepen the perception of the direction of the inhalable biological drugs research, and update the information of the field, in order to provide reference for the development of more inhalable biologics.
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    Comparison of clinical effectiveness and safety between generic and branded dienogest tablets in the treatment of endometriosis
    LIU Qian, ZHANG Jianing, ZHANG Shuang, LIU Qinglan, ZHANG Baoyin, SUN Nan
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 527-534.   DOI: 10.12092/j.issn.1009-2501.2024.05.007
    Abstract366)      PDF (1781KB)(81)       Save
    AIM: To evaluate the clinical effectiveness and safety of generic and branded dienogest in the treatment of endometriosis. so as to provide the basis for clinical use of dienogest. MEHTODS: The data of patients admitted to Third Affiliated Hospital of Zhengzhou University from August 2022 to August 2023 who received dienogest (2 mg/d, orally, for 6 months) for treatment of endometriosis were collected. The clinical efficacy and adverse reactions of generic drugs and original drugs in the treatment of endometriosis-related pain were compared through follow-up surveys of the two groups of patients at 3 months and 6 months respectively. RESULTS: There was highly significant reduction in pelvic pain in both groups with mean of similar in generic group (34.0±3.0) mm and branded group (34.5±3.9) mm. The most frequent drug-related adverse effects in generic dienogest was vaginal bleeding (93%) which was no statistical difference with branded dienogest (90%). CONCLUSION: The generic and branded dienogest have the same clinical effectiveness and similar safety.
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    Recent progress of targeting Nrf2-ferroptosis to treat brain injury after ischemic stroke
    LI Mei, LI Qiang
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 188-197.   DOI: 10.12092/j.issn.1009-2501.2024.02.009
    Abstract366)      PDF (973KB)(350)       Save
    Emerging evidences suggest that ferroptosis plays a vital role in the pathophysiological process of brain injury after Ischemic stroke. Accumulating evidence supports  pharmacological inhibition of ferroptosis as a therapeutic target for brain injury after Ischemic stroke through activating nuclear factor erythroid 2-related factor 2 (Nrf2), which transcriptionally controls many key components of the ferroptosis pathway. In this review, briefly describe ferroptosis processes and the roles they play in contributing to brain injury after ischemic stroke in the brain. We then provide a critical overview of the relationship between Nrf2 signalling and ferroptosis. With a focus on discuss how therapeutic modulation of the Nrf2 pathway is a viable strategy to explore in the treatment of ferroptosis-driven brain injury after Ischemic stroke.
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    Research progress of uterine endometrial epithelial cell organoids in the field of reproduction
    CAO Zhiwen, YAN Guijun
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 576-582.   DOI: 10.12092/j.issn.1009-2501.2024.05.013
    Abstract352)      PDF (829KB)(665)       Save
    In recent years, significant progress has been made in the study of endometrial epithelial organoids in the field of reproduction. Traditional two-dimensional cell culture models and animal experiments fail to accurately replicate the three-dimensional structure and physiological functions of the endometrium, limiting the in-depth exploration of its normal physiological mechanisms and related disease mechanisms. Emerging organoid technologies have provided new avenues for research. These organoids, formed by self-organization of stem cells or progenitor cells in a three-dimensional culture system, faithfully recapitulate the characteristics of endometrial glands in situ. Not only can these organoid models mimic the changes in the endometrium at different stages of the menstrual cycle, but they can also simulate the interaction between the fertilized embryo and the endometrium. Moreover, organoid systems have become essential tools for fundamental research in the field of reproduction and for disease research, including studies related to reproductive biology, drug screening and development, disease mechanism exploration, drug action mechanisms, drug combination therapies, and targeted therapies. These studies have provided novel insights and methods for a deeper understanding of the biological properties of the endometrium, its disease mechanisms, and the development of therapeutic strategies for related disorders.
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    Practice of model-informed drug development in pharmaceutical industry in China
    LI Jian, WANG Yuzhu, WANG Jun
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 596-600.   DOI: 10.12092/j.issn.1009-2501.2024.05.016
    Abstract314)      PDF (932KB)(196)       Save
    Guideline of model-informed drug development was published by National Medical Products Administration in 2020, which provided technical guidance for the application of modeling and simulation in the process of new drug development. In July 2022, Center of Drug Evaluation conducted a questionnaire survey on the practical ability of pharmaceutical industry to apply model-informed drug development (MIDD) in the process of new drug development, in order to investigate the practice of MIDD in China. Based on the feedback data collected from enterprises, this paper analyzes the practice of MIDD in domestic pharmaceutical industry, and briefly discusses several problems that still exist at present.
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    Mechanism of action and research progress of vaccine adjuvants
    ZHANG Li, LU Chang, AN Minghui, WANG Mengmeng, ZONG Xiaoyu, YU Lin, RAN Zhuo-ling, SONG Jing, LI Huijie, GONG Jian
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (7): 785-791.   DOI: 10.12092/j.issn.1009-2501.2024.07.008
    Abstract301)      PDF (831KB)(494)       Save
    Vaccines are among the most effective measures for preventing infectious diseases and play a crucial role in controlling the spread of these diseases. Adjuvants, serving as auxiliary components in vaccines, are indispensable in the vaccine development process. Ideal adjuvants not only enhance the immune response, enabling the body to achieve optimal protective immunity but also play important roles in reducing the dosage of immunogens and lowering vaccine production costs. To meet the demands of novel vaccines, many new types of adjuvants have been developed. However, there is still a lack of adjuvants that are safe, effective, easy to prepare, highly pure, and suitable for a variety of vaccines in clinical settings. This article categorizes adjuvants and summarizes their mechanisms of action and characteristics, focusing on traditional aluminum salt adjuvants and more modern lipid-based and nucleic acid-based adjuvants. The summary is based on a computer search of databases including PubMed, Embase, The Cochrane Library, CNKI (China National Knowledge Infrastructure), VIP Database, and Wanfang Database, using English search keywords such as Adjuvants, Vaccine, Vaccine Adjuvant, aluminum salts, MF59, AS03, Toll-like receptor agonist, etc., and corresponding Chinese search terms. The aim is to provide references for the development and application of adjuvants.
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    Targeted biotherapy for chronic obstructive pulmonary disease
    BAI Haodong, SHA Bingxian, Ambedkar Kumar Yadav, XU Xianghuai, YU Li
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 377-382.   DOI: 10.12092/j.issn.1009-2501.2024.04.003
    Abstract298)      PDF (640KB)(218)       Save
    Chronic obstructive pulmonary disease (COPD) is the most common chronic airway disease. The current status of treatment based mainly on bronchodilators and ICS is not sufficient for all of COPD patients. Various studies have attempted to use biologics targeting specific cytokines and their receptors in COPD patients to alleviate respiratory symptoms or reduce the risk of acute exacerbations. However, they failed to bring significant clinical benefits. More studies are needed to further determine the efficacy of targeted biotherapy for COPD.
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    Effects of remimazolam on early postoperative cognitive function in elderly patients with hip fracture
    DUAN Gongchen, WU Jimin, XU Qiaomin, JIANG Jianxin, LAN Haiyan, ZHANG Xutong, YUAN Kaiming, LI Jun
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 146-153.   DOI: 10.12092/j.issn.1009-2501.2024.02.004
    Abstract285)      PDF (749KB)(241)       Save
    AIM: To evaluate the effect of remimazolam on early postoperative cognitive function in elderly patients with hip fracture based on a randomized controlled trial. METHODS: A total of 106 elderly patients, aged 65-90 years, ASA grade Ⅱ or Ⅲ, who underwent hip fracture surgery under combined spinal-epidural anesthesia in the Sixth Affiliated Hospital of Wenzhou Medical University from December 2022 to June 2023 and met the inclusion criteria, were selected and randomized into remimazolam group (group R) and propofol group (group P) according to the random number table, with 53 cases in each group. Patients in group P received a slow intravenous injection of propofol at a dose of 0.3-0.5 mg/kg (injection time of 1min), followed by a pump infusion at 0.5-3 mg·kg-1·h-1 for maintenance. In group R, intraoperative sedation was maintained by remimazolam at 0.1-0.3 mg·kg-1·h-1 after a loading dose of 0.05 mg/kg (injection time of 1min). The pump infusion rate were adjusted by maintaining MOAA/S score at 3-4 and BIS value at 75-85, and stopped administering sedatives while suturing the incision. MOAA/S score, MAP, HR, RR, SpO2 and BIS values were recorded before sedation (T0), 5 (T1), 10 (T2), 15 (T3), 30 (T4) and 60 (T5) min after sedation and at the end of surgery. The emergence time, intraoperative amnesia, the incidence of postoperative delirium (POD) and delayed neurocognitive recovery (DNR) within 7 days after operation, and the occurrence of adverse events during perioperative observation were recorded. RESULTS: Compared with T0, the BIS and MOAA/S scores of the two groups at T1-T5 were significantly decreased, and the MAP and HR of the two groups at T1-T6 were significantly lower (P<0.05). Compared with group P, group R showed higher MAP at all time points from T1 to T6 (all P<0.05), shorter emergence time (6.6±1.8 vs. 7.7±2.2 min, P<0.05), less decline in Hopkins Verbal Learning Test scores on postoperative day 7 (3.9±3.9 vs. 6.2±4.6, P<0.05), lower incidence of postoperative delirium and DNR (7.5% vs. 28.3%,5.7% vs. 20.8%, P<0.05), higher incidence of intraoperative amnesia (52.8% vs. 28.3%, P<0.05) lower incidence of hypotension and bradycardia (15.1% vs. 37.7%, 5.6% vs. 22.6%, P<0.05), and fewer frequent use of vasoactive drugs (P<0.05). CONCLUSION: Application of remimazolam for perioperative sedation in elderly patients with hip fracture can provide effective sedation and stable hemodynamic, with little effect on early neurocognitive function, and overall safety higher than propofol.
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    Analysis of clinical characteristics of tramadol induced hypoglycemia
    LIU Wei, HE Qin, HE Yiran
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (7): 819-825.   DOI: 10.12092/j.issn.1009-2501.2024.07.012
    Abstract283)      PDF (556KB)(149)       Save
    AIM: To investigate the clinical characteristics of tramadol-induced hypoglycemia. METHODS: Case reports of tramadol-induced hypoglycemia were collected by searching Chinese and English data from the database establishment to April 28, 2023. RESULTS: Twenty patients were included, with a median age of 50 years (4, 88). Hypoglycemia occurred 1 h-23 d after tramadol administration, with a median blood glucose of 2.25 mmol/L  (0.22, 3.3) and a median daily dose of 300 mg (1.53, 14 000). The main clinical manifestations were unconscious (12 cases), multiple organ failure (7 cases), asystole and/or apnea (7 cases), seizures (4 cases), somnolence (3 cases) and sweating (3 cases).Tramadol concentrations were reported in 6 patients, with a median of 3.56 mg/L (0.47, 9.4). After stopping tramadol in 20 patients and giving symptomatic supportive treatment, 16 patients recovered, 1 patient had moderate brain dysfunction, and 3 patients died. CONCLUSION: Tramadol induced hypoglycemia can occur from 1 h to 23 d after administration, and can be clinically manifested as autonomic nervous system symptoms and neurohypoglycemia symptoms, mainly neurohypoglycemia symptoms. After stopping tramadol, most patients with hypoglycemia returned to normal, and severe patients can die.
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    Mechanism and treatment of mucous hypersecretion in chronic obstructive pulmonary disease
    ZHANG Ting, SUN Rong, YANG Yong, LIU Weichun, YUAN Yuping, JU Xu, WANG Qian
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 383-391.   DOI: 10.12092/j.issn.1009-2501.2024.04.004
    Abstract279)      PDF (719KB)(348)       Save
    Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease. It has been reported in the literature that COPD patients with chronic airway mucus hypersecretion have more frequent acute exacerbations, more severe lung function decline, and higher hospitalizations and mortality. Therefore, it is particularly critical to understand the pathogenesis of hypersecretion of mucus in chronic obstructive pulmonary disease and find out effective treatment. This article focuses on the structure, significance of airway mucus and the mechanism of hypersecretion of mucus in chronic obstructive pulmonary disease (COPD). In addition, we also summarized drug and non-drug therapy for chronic airway mucus hypersecretion in this article. Drug therapy includes traditional drug therapy, some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy, and non-drug therapy includes smoking cessation, physical therapy and bronchoscopy therapy. We hope that it will provide new ideas and directions for the treatment of mucus hypersecretion in COPD patients.
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    Progress in the application of non-peptide gonadotropin-releasing hormone antagonist in the treatment of uterine fibroid
    ZHENG Yunxi, YI Xiaofang, XU Congjian
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 482-487.   DOI: 10.12092/j.issn.1009-2501.2024.05.001
    Abstract263)      PDF (603KB)(255)       Save
    Non-peptide gonadotropin-releasing hormone antagonist (GnRH-antagonist) is a highly efficient and selective antagonist of GnRH receptor. The oral preparations (Elagolix, Relugolix and Linzagolix) had been approved for listing abroad. It shows efficacy in reducing the size of uterine fibroid and controlling heavy bleeding. Appropriate combination of‘add-back’therapy could improve the safety in medical application and patient compliance. Compared with other hormonal pharmaceuticals, oral GnRH-antagonists showed promising prospects in the treatment of uterine fibroid.
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    Progress in perioperative application of tranexamic acid
    WANG Wenli, YAO Yiting, YANG Chun
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 198-206.   DOI: 10.12092/j.issn.1009-2501.2024.02.010
    Abstract257)      PDF (649KB)(392)       Save
    Perioperative bleeding is closely related to the prognosis of patients, and massive blood loss can lead to serious adverse events. Tranexamic acid, a lysine derivative, exerts anti-fibrinolytic effects by competitively blocking lysine binding sites on plasminogen to achieve hemostasis. Perioperative use of tranexamic acid can effectively reduce the risk of bleeding and the need for blood transfusion, and reduce the risk of bleeding related complications and death. At present, the use of tranexamic acid for perioperative hemostasis is increasingly widespread, and it is gradually entering the consensus and guidelines in more surgical fields. In this paper, the mechanism of action, perioperative application and adverse reactions of tranexamic acid were reviewed, and the effectiveness and safety of tranexamic acid in different surgical types were discussed, so as to provide reference for the application and research of tranexamic acid in China.
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    Research advance in progesterone therapy for endometrial cancer
    ZHANG Liyi, GUO Zifen
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 230-235.   DOI: 10.12092/j.issn.1009-2501.2024.02.013
    Abstract250)      PDF (631KB)(462)       Save
    Endometrial cancer originates from the endometrium and is one of the common gynecologic malignancies, with its incidence and mortality rate increasing year by year. Although endometrial cancer is more prevalent in the peri- and post-menopausal female population, it has been an evident trend in recent years towards younger patients. For young patients who have not yet given birth but intend to do so, the application of progestins in endometrial cancer treatment has made significant progress in clinical practice. Considering the existence of large individual differences and unclear mechanisms of action in the clinical application of progestins, this paper aims to provide an overview of the current clinical application status, efficacy, hormone resistance, and its mechanisms in the context of hormone therapy.
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    Can adalimumab biosimilars be clinically interchanged: evidence based on a systematic review and Meta-analysis
    HU Yang, SONG Zaiwei, GAO Yuan, RAN Yiwen, JIANG Dan, ZHAO Rongsheng
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (7): 722-734.   DOI: 10.12092/j.issn.1009-2501.2024.07.001
    Abstract250)      PDF (1571KB)(181)       Save
    AIM: To systematically evaluate the clinical interchangeability of adalimumab biosimilars in terms of efficacy, safety, and immunogenicity, and to provide evidence-based reference for clinical interchangeability. METHODS: Randomized Controlled Trials (RCTs) on the interchangeability of adalimumab biosimilars were systematically searched in PubMed, Embase, Cochrane Library, CNKI, WANFANG and SinoMed from inceptions to October 2023. Data were extracted from the literature that met the inclusion criteria, risk of bias was assessed using the Cochrane Handbook for Systematic Reviews of Interventions 5.0 bias risk assessment tool. Meta-analysis was performed using Revman 5.4 software. The certainty of evidence was graded using the GRADE tool recommended by the Cochrane Collaboration. This study was conducted according to the PRISMA guideline. RESULTS: Eighteen studies were included, with 7 focusing on psoriasis and 11 on rheumatoid arthritis. Regarding efficacy, for psoriasis, there were no statistical differences in PASI 75 response rates and sPGA scores of ≤1 after 1-4 switches between biosimilars and the reference drug (P>0.05, moderate-quality evidence). For rheumatoid arthritis, there were no statistical differences in ACR 20/50/70 response rates after 1-3 switches (P>0.05, moderate-quality evidence). Regarding safety, there were no statistical differences in the risk of adverse events after single or multiple switches for both diseases (P>0.05, moderate-quality evidence). Regarding immunogenicity, there were no statistical differences in the rate of anti-drug antibody production after single or multiple switches (P>0.05, moderate-quality evidence). High-quality evidence is still lacking for the interchangeability of adalimumab biosimilars in other indications.CONCLUSION:The switches between adalimumab biosimilars and the reference drug have no significant impact on clinical efficacy, safety and immunogenicity for psoriasis and rheumatoid arthritis patients.
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    Progress in the clinical application of the biased μ-opioid agonist oliceridine
    ZHU Changmao, XIE Li, WU Zifeng, WANG Sen, ZHANG Qi, XU Xiangqing, YANG Chun
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (9): 1057-1061.   DOI: 10.12092/j.issn.1009-2501.2024.09.012
    Abstract248)      PDF (596KB)(663)       Save
    Opioid receptors μOR, δOR, κOR and NOPR are all G protein-coupled receptors (GPCRs), which mainly function through G protein and β-arrestin. Recent studies have found that G protein mediates analgesia, while β-arrestin reduces analgesia and is related to the side effects of opioids. Oliceridine is the first biased μOR agonist approved for commerce. It mainly exerts analgesic effect by activating G protein. It has rapid onset of action and reliable analgesic effect. Due to its low activity on β-arrestin, the incidence of side effects is low, comparing to the classic opioid morphine. Oliceridine can be safely used in patients with liver or kidney insufficiency and its metabolite is inactive. This article summarizes the current progress of pharmacological research and clinical application of oliceridine, aiming to provide reference for the clinical practice of oliceridine.
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    Stains: recent research progress for endometriosis
    QIN Xian, WANG Qian, HOU Jia, XU Dongmei
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 488-494.   DOI: 10.12092/j.issn.1009-2501.2024.05.002
    Abstract248)      PDF (580KB)(249)       Save
    Defined as a common gynecologic endocrine disease, endometriosis is characterized by the presence of endometrium outside of the uterus cavity, affecting about 10% to 15% of reproductive-aged women worldwide.Moreover, Asian women tend to have a nine-fold increased risk of endometriosis compared with their white counterparts in Europe and the United States. Endometriosis not only causes chronic pelvic pain, dysmenorrhea, painful sex and other pain symptoms, but also leads to infertility, pushing the patients into a state of fatigue, high sensitivity and anxiety, thus reducing their quality of life. As the aging of Chinese population intensifies and the women's childbearing age delays, it is highly urgent to find solutions to those gynecological endocrine diseases such as endometriosis, which hamper women's fertility. In recent years, studies have shown that patients with endometriosis have abnormal serum lipid metabolism and an increased risk of cardiovascular diseases. At the same time, as a type of cholesterol-lowering drug, statins can inhibit the progression of endometriosis at the cellular and animal levels. Also, a few clinical studies have exhibited that statins exert a positive effect on the treatment of endometriosis. Therefore, this article aims to review the researches regarding the relationship between endometriosis and the cardiovascular disease, as well as the research progress of statin therapy on endometriosis based on the level of cells, animals and human beings. 
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    Progress in the potential therapeutic mechanism of mesenchymal stem cell-derived exosomes for liver fibrosis
    ZHAO Tingting, LI Junfeng, ZHANG Liting
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 475-480.   DOI: 10.12092/j.issn.1009-2501.2024.04.017
    Abstract248)      PDF (888KB)(255)       Save
    Liver fibrosis is pathological in most chronic liver diseases. Exosomes secreted by mesenchymal stem cells (MSCs) can regulate liver fibrosis through mechanisms such as inhibition of inflammatory response and proliferation of activated hepatic stellate cells, regulation of immune cells and metabolism. Therefore, MSC-derived exosomes can be used as a cell-free therapy for chronic liver disease, expanding new ideas for the treatment of chronic liver disease. Recent researches on MSC-derived exosomes in the treatment of liver fibrosis are reviewed in this article.
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    Progress in researches for perampanel in the treatment of comorbidities of epilepsy
    CHEN Sirui, LI Junqiang, DANG Xiaoli, WANG Tiancheng
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (3): 354-360.   DOI: 10.12092/j.issn.1009-2501.2024.03.015
    Abstract242)      PDF (575KB)(222)       Save
    Sleep disorder, migraine, cognitive and behavioral disorders, anxiety and depression are common comorbidities of epilepsy. The comorbidity rate of epilepsy patients is eight times that of the general population, which affects the prognosis and quality of life of epilepsy patients. Perampanel (PER), as a third-generation antiseizure medication, has shown promising clinical research and application in the treatment of comorbidities in epilepsy. PER can improve the total sleep time, sleep latency and sleep efficiency of patients with epilepsy comorbid sleep disorder. PER also shows good efficacy in reducing seizure and migraine attacks of patients with epilepsy comorbid migraine. Meanwhile, the impact of PER on overall cognitive characteristics is neutral, with no systematic cognitive deterioration or improvement, but behavioral changes are one of the most common adverse events related to PER. For patients with comorbid anxiety and depression, PER does not exacerbate the anxiety and depression of epilepsy patients, and the severity of anxiety and depression in some patients will improve. This article will review the mechanism of action and clinical treatment research progress of PER on comorbidities of epilepsy.
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    Novel mechanisms driving renal tubulointerstitial fibrosis
    ZHANG Yanni, DUAN Yuxin, BAI Yi, YU Jinyao, SUN Jiayi, WANG Zejie, LI Ling, YE Qifa
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (3): 348-353.   DOI: 10.12092/j.issn.1009-2501.2024.03.014
    Abstract240)      PDF (1252KB)(111)       Save
    Renal fibrosis, especially tubulointerstitial fibrosis, is the most common pathway of all chronic kidney diseases progressing to end-stage renal diseases. Several adaptive reactions occur in renal tubular epithelial cells after chronic injury, such as changes in glycolipid metabolism, unfolded protein response, autophagy and senescence, epithelial-to-mesenchymal transition and G2/M cell cycle arrest. Maladaptive repair mechanisms can induce tubulointerstitial fibrosis. This article will discuss the molecular mechanism of these adaptive responses of renal tubular epithelial cells driving renal tubulointerstitial fibrosis, and provide a basis for exploring new drug targets for renal tubulointerstitial fibrosis.
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    Progress on anti-tumor mechanisms of Ganoderma lucidum active ingredients
    LV Yujiao, ZHOU Shuting, WANG Lina, SHEN Mingmei, LIU Yongchao
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (8): 947-954.   DOI: 10.12092/j.issn.1009-2501.2024.08.012
    Abstract240)      PDF (712KB)(557)       Save
    Malignant tumors are one of the main causes of death from chronic diseases in China, and their incidence and mortality rates show an increasing trend year by year. Advanced non-surgical treatment of malignant tumors is an important means of improving patients' prognosis and enhancing their quality of life. The traditional Chinese medicine Ganoderma lucidum has anti-tumor effects and plays a role in the treatment of many malignant tumors. In this paper, a systematic review of the effects of Ganoderma lucidum active ingredients on tumors has been conducted at home and abroad in the past five years to explore the anti-tumor mechanism of Ganoderma lucidum active ingredients and to lay a theoretical foundation for the application of Ganoderma lucidum active ingredients in clinical practice.
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    Investigation and analysis of the current status of clinical research nurses
    CHEN Liming, ZHANG Haiyan, HUANG Fan, ZHAO Wenyan, DING Rui, CAO Cai, FANG Yi
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 455-459.   DOI: 10.12092/j.issn.1009-2501.2024.04.014
    Abstract237)      PDF (509KB)(89)       Save
    AIM: To investigate and analyze the current situation and needs of clinical research nurses in China, in order to provide scientific basis for constructing a training system for research nurses, promoting standardized training, and achieving standardized management for them. METHODS: A self-made questionnaire was used to investigate 102 research nurses from nearly 70 well-known clinical trial institutions in China. The contents of the questionnaire mainly included the general information, professional experience and work content of the research nurses, the sense of accomplishment and training needs of clinical trial work. RESULTS: Among the 102 research nurses surveyed, 92.15% have a bachelor's degree or above; 53.92% of those have intermediate or higher professional titles; 74.51% of them are part-time research nurse. Among professional experiences, 19.61% have more than 10 years of clinical trial experience; 47.06%, 40.20%, and 21.17% of surveyed research nurses were authorized to participate in clinical trial drug management, sample management, and quality control; 70.59% of research nurses have a high sense of achievement in their daily work. In terms of education and training needs, clinical trial related laws and regulations, standardized training for clinical trial protocol implementation, and good clinical practice (GCP) are the three most important aspects. CONCLUSION: Clinical research nurses in China have a relatively high level of education and nursing experience, but there is still a large gap in the amount of professional full-time clinical research nurses in China. Due to the rapid development of innovative drugs and devices, as well as the urgent need to improve the clinical research system, it is necessary to establish a training, assessment, and evaluation system for research nurses that is in line with China's national conditions in order to improve the professional level of research nurses, and improve the quantity and quality of clinical trial research on innovative drugs and devices in China.
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    Clinical features, risk factors and treatment of type 2 diabetes mellitus in patients with acute exacerbation of chronic obstructive pulmonary disease
    WANG Xiaochuan, WANG Hanchao, YAO Yu, LI Li, HE Gaoyan, LI Bo, ZHU Tao
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 392-400.   DOI: 10.12092/j.issn.1009-2501.2024.04.005
    Abstract233)      PDF (707KB)(239)       Save
    AIM: To investigate the clinical features of acute exacerbation chronic obstructive pulmonary disease (AECOPD) of complicated with type 2 diabetes mellitus (T2DM) , and analyze the related clinical features and risk factors. METHODS: This was a single-center cross-sectional study. From March 2020 to January 2023, 479 hospitalized patients with AECOPD in the department of respiratory and critical care medicine, Suining Central Hospital were included. There were 215 patients in AECOPD group and 60 patients in AECOPD with T2DM group. The collected variables included demographic data, complications, blood routine, infection index, random blood glucose, blood gas analysis and lung function. The adoption rate and constituent ratio of the basic description classification data were expressed as mean standard deviation for the normal distribution measurement data and median interquartile range for the skew distribution measurement data. T-test was used for normal distribution and non-parameter test was used for non-normal distribution. The categorical variables were tested by chi-square test. Rank sum test was used for rank variable data. Binary logistic regression model was used to investigate the independent factors associated with T2DM in patients with AECOPD. Finally, the results of logistic regression were verified and visualized by nomogram, validation curve, ROC curve and DCA curve. P<0.05 was a significant statistical difference. RESULTS: Univariate analysis showed that there were significant differences in body mass index (BMI), essential hypertension, coronary heart disease, atrial fibrillation (AF), pulmonary function (GOLD stage), blood neutrophil (NS), blood lymphocyte (LYM), arterial blood gas PaCO2, Alanine transaminase (ALT) and random blood glucose (RBG) between the two groups (P<0.05). The binary logistic regression model (C-index=0.847) was constructed with the above 10 variables, the results showed that BMI (OR=1.309), Af (OR=8.188), LYM counts (OR=0.474), PaCO2 (OR=1.082) and RBG (OR=1.434) were independently associated with type 2 diabetes in patients with AECOPD (all P>0.05). The results of logistic regression were verified and visualized by Nomogram and its-associated ccurves. The MAE and AUC curves were 0.021 and 0.847 respectively, indicating that the model had good prediction consistency and accuracy. The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99, suggesting that nomogram's model had better clinical predictive value. CONCLUSION: Our results showed that increased BMI, PaCO2 and random glucose, decreased blood lymphocyte, and atrial fibrillation is an independent clinical feature of AECOPD with T2DM. These results suggest that the immune function of patients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation, which is a potential cause of poor prognosis in these patients. Meanwhile, this conclusion needs to be further verified in multicenter study with large sample size.
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    Rapid health technology assessment of dienogest in the treatment of endometriosis
    GUO Hua, LIU Lanlan, HUANG Chunzhi, SUN Nan, REN Yanli
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 512-519.   DOI: 10.12092/j.issn.1009-2501.2024.05.005
    Abstract231)      PDF (616KB)(224)       Save
    AIM: To rapidly evaluate the effectiveness, safety and economy of dienogest in the treatment of endometriosis so as to provide evidence-based reference for clinical drug selection and decision. METHODS: Retrieved from PubMed, Embase, Cochrane Library, CNKI, SinoMed, Wanfang and health technology assessment (HTA) organization websites, HTA report, systematic review/Meta-analysis and pharmacoeconomic study were included during the inception to Sep 2023. Data extraction and quality evaluation were carried out for the literature that met the inclusion and exclusion criteria, and the research results were summarized and analyzed qualitatively. RESULTS: Nine systematic review/Meta-analyses, and 2 pharmacoeconomic studies were included. The quality of Meta-analysis literatures was low, and the quality of economic research was good. In terms of effectiveness, compared with no treatment, dienogest can significantly reduce postoperative recurrence rate, VAS score, and improve pregnancy rate and effective rate; Dienogest has similar therapeutic effects in terms of recurrence rate as GnRHa and COC; With regard to recurrence rate and pregnancy rate, dienogest is superior to danazol, gestrinone, and mifepristone. In terms of safety, compared with placebo, the incidence of vaginal bleeding and headache was significantly increased with dienogest, and there was no difference in bone loss; The incidence of vaginal bleeding caused by dienogest was significantly higher than that of GnRHa, but the incidence of hot flashes and bone loss was lower. In terms of economy, dienogest has a more cost-effective advantage comparing with GnRHa, but does not have economic benefits comparing with COC. CONCLUSION: Dienogest has good effectiveness and safety in the treatment of endometriosis, and economically superior to GnRHa, but inferior to COC.
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    Immunologic characteristics and management and prospects of targeted biological therapy in adults with severe asthma
    SUN Ao, WANG Jingluan, LIU Wenjuan, REN Dunqiang, LIU Xiaojing
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 415-422.   DOI: 10.12092/j.issn.1009-2501.2024.04.008
    Abstract230)      PDF (645KB)(268)       Save
    Severe asthma stands as a formidable contributor to both mortality and morbidity of patients suffering asthma, casting substantial social and economic shadows on communities. As our understanding of asthma's pathophysiology deepens, a beacon of hope emerges in the form of biological targeted therapies, offering a promising avenue for the management of this challenging condition. These therapies, by precisely inhibiting or modulating pivotal molecules in the inflammatory cascade, offer potential benefits in symptom alleviation, lung function enhancement, and risk reduction of acute exacerbations. They signify a paradigm shift in severe asthma treatment. Within the confines of this article, we embark on a systematic exploration of the immunological underpinnings that define severe asthma. By delving into the intricacies of the immune system's role in exacerbating this condition, we aim to offer a comprehensive assessment of both the current landscape and the future prospects of biological therapies. Our objective is to provide a scientifically robust and valuable reference that can guide the individualized treatment of patients grappling with severe asthma.
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    The attenuating and potentiating effects of traditional Chinese medicine in immune checkpoint therapy
    ZHANG Zhipeng, CHEN Ziqi, TIAN Jianhui
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (3): 339-347.   DOI: 10.12092/j.issn.1009-2501.2024.03.013
    Abstract225)      PDF (649KB)(305)       Save
    Immunotherapy has become a global focus in cancer clinical practice and scientific research.In the past two years, PD-1\PD-L1 and CTLA-4 inhibitors, especially Nivolumab, Pembrolizumab, Atezolizumab and Lpilimumab, have been used in non-small cell lung cancer, colon cancer. Promising results have been obtained in malignancies such as melanoma and urinary tract cancer. Traditional Chinese medicine has a long history in China. Modulating immune checkpoints has certain advantages in treating malignant tumors, and it has shown good efficacy in improving its adverse events. This article reviews the role of traditional Chinese medicine in regulating immune checkpoints and improving adverse reactions and its application prospects in immunomodulatory treatment.
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    Efficacy and safety analysis of tigecycline and polymyxin B in the treatment of carbapenem-resistant enterobacteriaceae pneumonia in critically ill patients
    ZHA Xian, CHEN Dayu, SHAO Hua
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 154-163.   DOI: 10.12092/j.issn.1009-2501.2024.02.005
    Abstract221)      PDF (1012KB)(154)       Save
    AIM: To compare the efficacy and safety of tigecycline with polymyxin B in the treatment of carbapenem resistant enterobacteriaceae (CRE) pneumonia in critically ill patients. METHODS: A retrospective analysis was performed on the clinical data of patients with CRE pneumonia who received tigecycline or polymyxin B therapy from January 1,2018 to Jun 30,2023 in the Intensive Care Unit (ICU). Primary outcomes included the 28-day all-cause mortality and clinical cure rate within 28days. Secondary outcomes included the ICU mortality, in-hospital mortality, the length of hospital stay and ICU stay, microbial eradication, duration of mechanical ventilation. Independent predictors affecting 28-day clinical cure rate were tested using Cox regression analyses. RESULTS: A total of 83 eligible patients were included in the final analysis after propensity score matching, 54 in the tigecycline group and 29 in the polymyxin B group. The 28-day all-cause mortality was 31.5% (17/54) in the tigecycline group and 37.9% (11/29) in the polymyxin B group, the difference was not statistically significant (P=0.554); the clinical cure rate was 63% (34/54) in the tigecycline group, which was significantly higher than that of the polymyxin B group of 34.5% (10/29) (P = 0.013). There were no statistical differences between the two groups in terms of secondary outcomes. Multivariate logistic regression analysis found that the use of tigecycline was an independent predictor of the 28-day clinical cure rate (HR 2.083, 95%CI 1.018-4.263, P = 0.045). However, activated partial thromboplastin time (APTT) and prothrombin time (PT) were significantly prolonged in the tigecycline group compared with the polymyxin B group (P=0.047; P=0.027), and fibrinogen (FIB) was significantly decreased (P < 0.001) after drug administration. CONCLUSION: There was no significant difference in 28-day all-cause mortality between the tigecycline and polymyxin groups; tigecycline might be associated with a higher 28-day clinical cure rate compared with polymyxin B. It should be noted that tigecycline may increase the risk of coagulation abnormalities.
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    Effects of short-term intensive insulin pump treatment on type 2 diabetes and its influencing factors
    SHEN Jizhong, TANG Jifa
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 171-176.   DOI: 10.12092/j.issn.1009-2501.2024.02.007
    Abstract220)      PDF (656KB)(168)       Save
    AIM: To observe the real world efficacy of continuous subcutaneous insulin infusion (CSII) with insulin pump in short-term intensive treatment of patients with type 2 diabetes (T2DM) and explore the influencing factors associated with efficacy. METHODS: A total of 369 hospitalized T2DM patients were treated with CSII short-term intensive therapy. Based on the blood glucose levels on the 5th day of treatment, they were divided into two groups, namely the qualified blood glucose control group and the non-qualified blood glucose control group. The differences of glucose metabolism, physiology, biochemistry and other indicators between the two groups were compared, and the influencing factors of insulin pump efficacy were analyzed by regression statistics. RESULTS: After 4 days of CSII short-term treatment, 225 patients (61%) achieved blood glucose control standards, while 144 patients (39%) did not achieve blood glucose control standards. Compared with the qualified blood glucose control group, the non-qualified blood glucose control group was older and with higher levels of total daily insulin dose per kilogram of body weight (TDD), fasting blood glucose (FBG), fasting insulin, fasting C-peptide, and insulin resistance index (HOMA-IR), while lower levels of blood phosphorus, insulin growth factor 1 (IGF1). In terms of biochemical indicators, there was no significant difference between the two groups as a whole, including blood lipid levels, liver function, and kidney function. The results of univariate regression and multivariate stepwise regression analysis showed that 2-hour postprandial insulin, TDD and blood phosphorus were the key factors influencing the efficacy of Insulin pump. Among them, qualified blood glucose control was positively correlated with blood phosphorus, and negatively correlated with 2-hour postprandial insulin and TDD. CONCLUSION: CSII with insulin pump is an ideal method for short-term intensive treatment of type 2 diabetes. In order to achieve a more satisfactory rate of qualified blood glucose control, more attention should be paid to the patient's blood phosphorus, 2-hour postprandial insulin and TDD in clinical use. 
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    Low-dose rituximab improves progression in early-stage medium-to-high-risk membranous nephropathy: an exploratory study
    XU Qiuyu, AI Sanxi, WANG Gangan, JIA Chunyu, WANG Jiahui, ZHENG Ke, QIN Yan, CHEN Gang, LI Xuemei
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (7): 744-751.   DOI: 10.12092/j.issn.1009-2501.2024.07.003
    Abstract217)      PDF (1117KB)(80)       Save
    Membranous nephropathy (MN) is the predominant cause of primary nephrotic syndrome (NS) among adults. The identification of PLA2R as target antigen has brought about a profound transformation in the management of MN, offering a basis for the utilization of B-cell depleting agents such as rituximab (RTX). The question of whether early intervention targeting antibodies can effectively impede the progression of MN, contributing to enhanced disease control and long-term renal outcomes for patients, remains further exploration. We analyzed demographic data, laboratory parameters, and renal involvement in 13 patients with PLA2R antibody-related MN who received at least one RTX treatment at our center from October 2019 to March 2023. Early-stage medium-to-high-risk MN was defined as baseline or admission anti-PLA2R antibody levels exceeding 50 RU/mL, excluding patients who already presented with nephrotic syndrome at baseline. The median duration of MN at the initiation of the first RTX treatment was 4.1 months (IQR 1-7.7), and the median follow-up time after RTX therapy was 27 months (IQR 23-45). All patients had commenced renin-angiotensin system inhibitors before receiving RTX. Following RTX therapy, none of the 13 patients progressed to NS during the follow-up period, and 12 patients achieved complete or partial remission at the 2-year follow-up or the last visit. No deaths, severe infections, or other serious adverse reactions occurred during the follow-up period. In conclusion, RTX demonstrates favorable efficacy and safety in early-stage, medium-to-high-risk MN patients. Initiating antibody clearance therapy in these patients may be beneficial for long-term disease control and distant renal outcomes.
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    Lymphoma risk in the treatment of Crohn's disease with four biological agents: a real world analysis of post-marketing surveillance data 
    SONG Yao, PAN Chen, ZHAO Xiaohong, YANG Hongge, LI Ze, CUI Xiangli
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (7): 768-774.   DOI: 10.12092/j.issn.1009-2501.2024.07.006
    Abstract214)      PDF (626KB)(77)       Save
    AIM:To determine the link between infliximab, adalimumab, vedolizumab, ustekinumab and risk of lymphoma in order to provide reference for the safety of clinical application. METHODS: Disproportionality analysis and Bayesian analysis were used in data mining to screen the suspected lymphoma after the use of four biological agents based on the FAERS data from October 2012 to June 2023. The fatality and hospitalization rates of this four biological agents associated lymphoma were also investigated. RESULTS: Totally 705 cases of four biological agents associated lymphoma were collected. Four biological agents associated lymphoma appeared to influent more young patients and middle-aged patients than elderly patients (25.11% vs. 22.41% vs. 12.2%). There were slightly more male than females (42.84% vs. 35.60%). Infliximab has the highest reporting odds ratio [ROR3.40, 95%CI=(3.03, 3.82)], proportional ratio [PRR3.38, 95%CI=(3.01, 3.79)], information component (IC1.14, IC-2SD=1.02) and empirical Bayes geometric mean (EBGM2.21, EBGM05=2.01). Significant difference in the fatality rate and hospitalization rate among four biological agents were not found. CONCLUSION: Infliximab showed a strongest lymphoma association than the other three biological agents. Lymphoma risk should be vigilant when using infliximab.
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    Expert consensus on the diagnosis and treatment of insomnia in specified populations
    CHEN Guihai, DENG Liying, DU Yijie, HUANG Zhili, JIANG Fan, JIN Furui, LI Yanpeng, LIU Chunfeng, PAN Jiyang, PENG Yanhui, SU Changjun, TANG Jiyou, WANG Tao, WANG Zan, WU Huijuan, XUE Rong, YANG Yuechang, YU Fengchun, YU Huan, ZHAN Shuqin, ZHANG Hongju, ZHANG Lin, ZHAO Zhengqing, ZHAO Zhongxin
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (8): 841-852.   DOI: 10.12092/j.issn.1009-2501.2024.08.001
    Abstract212)      PDF (795KB)(292)       Save
    Clinicians need to focus on various points in the diagnosis and treatment of insomnia. This article prescribed the treatment protocol based on the unique features, such as insomnia in the elderly, women experiencing specific physiological periods, children insomnia, insomnia in sleep-breathing disorder patients, insomnia in patients with chronic liver and kidney dysfunction. It provides some reference for clinicians while they make decision on diagnosis, differentiation and treatment methods.
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    Di'ao Xinxuekang activates IRS-1/PI3K/Akt signal pathway to improve insulin resistance in nonalcoholic fatty hepatitis mice
    WANG Xin, WANG Yifan, SHANG Muhong, LIU Yuyan, CHEN Guangliang
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 121-129.   DOI: 10.12092/j.issn.1009-2501.2024.02.001
    Abstract211)      PDF (2222KB)(179)       Save
    AIM: To study the effect and mechanism of Di'ao Xinxuekang (DXXK) on insulin resistance in nonalcoholic steatohepatitis (NASH) mice. METHODS: C57BL/6J mice were randomly divided into normal group and model group. After 16 weeks of high-fat diet, the model group was randomly divided into model group and Pioglitazone group (6.0 mg·kg-1·d-1), DXXK high, medium, and low (200, 60, 20 mg·kg-1·d-1) dose groups, with 8 animals in each group, and were administered by gavage for 8 consecutive weeks. The body weight, activity, fat mass, fasting blood sugar (FBG), serum insulin (FINS), total cholesterol (TC), triglyceride (TG), aspartic acid transaminase (AST), alanine amino transferase (ALT), and the contents of TC and TG in the liver were measured; oral glucose tolerance test (OGTT), intraperitoneal insulin tolerance test (IPITT), calculate insulin resistance index (HOMA-IR), insulin sensitivity index (ISI), area under curve (AUC) of OGTT and IPITT. HE staining was used to observe liver pathology, and Oil Red O staining was used to observe liver lipid accumulation. Western blot was used to detect the related proteins and downstream target SREBP-1c protein in the IRS-1/PI3K/Akt signaling pathway in liver tissue. RESULTS: Compared with the model group, the body weight, fat mass, FBG, FINS, HOMA-IR, ISI, TC, TG, AST, ALT levels, AUC of OGTT and IPITT in DXXK group and pioglitazone group were significantly reduced, significant increase in activity, liver lipid deposition and liver function abnormalities were significantly improved, hepatocyte steatosis and ballooning were significantly reduced, and liver p-IRS-1/IRS-1, PI3K, p-AKT/AKT protein expression was significantly increased, SREBP-1c protein expression was significant decrease. CONCLUTION: DXXK can improve insulin resistance in NASH mice, and its mechanism of action may be related to the activation of the IRS-1/PI3K/Akt signaling pathway.
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    Application of single-cell multi-omics sequencing technology in the study of ischemic stroke
    MENG Qian, WANG Yiwen, CUI Na, BAI Min, YANG Le, DING Yi
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (6): 690-699.   DOI: 10.12092/j.issn.1009-2501.2024.06.011
    Abstract210)      PDF (810KB)(446)       Save
    Ischemic stroke is an acute cerebrovascular disease with high disability and mortality, is the most common cause of death in China. Despite years of research, there are still no biomarkers for stroke, and the molecular mechanisms remain largely unknown. In the past decade, single-cell sequencing technology, as a rapidly developing emerging technology, can conduct high-throughput sequencing of multiple omics including genome, transcriptome, epigenome and proteome at the level of a single cell, providing a new way to discover biomarkers and analyze pathological mechanisms. In this paper, the progress of single-cell multi-omics sequencing technology and its application in the discovery of biomarkers, pathological mechanisms and drug development of ischemic stroke are introduced in detail, in order to provide valuable reference for precision medicine of ischemic stroke.
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    Research progresses of nonsense-mediated mRNA decay in tumorigenesis and cancer therapy
    WANG Yuhui, WANG Jingpeng, CHEN Bei, WANG Yaru, LI Tangliang
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (8): 930-936.   DOI: 10.12092/j.issn.1009-2501.2024.08.010
    Abstract210)      PDF (815KB)(274)       Save
    Nonsense-mediated mRNA decay (NMD) is a highly conserved post-transcriptional regulatory mechanism in eukaryotic cells. NMD can recognize and degrade abnormal transcripts containing premature termination codons (PTC) to prevent the translation of C-terminal truncated proteins. Furthermore, NMD could degrade a subset of normal gene transcripts and thus fine-tune gene expression. NMD is essential for cell fate determination, stress response, as well as animal development. In this review, we briefly discussed the functional and molecular mechanisms of NMD pathway activation and inhibition in tumorigenesis, cancer progression and therapy. Current studies indicate that NMD factor mutations can lead to a variety of human tumors. Interestingly, inhibition of NMD factors can activate DNA damage response and inhibit the expression of oncogenic factors, thereby killing cancer cells. This review may provide new perspectives for the biological mechanism and therapeutic strategy of human tumors.
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    Analysis of hyperglycaemia adverse drug reactions of PCSK9 inhibitors and statins based on FAERS database
    Analysis of hyperglycaemia adverse drug reactions of PCSK inhibitors and statins based on FAERS database
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (7): 762-767.   DOI: 10.12092/j.issn.1009-2501.2024.07.005
    Abstract209)      PDF (554KB)(142)       Save
    AIM: To compare the risk of hyperglycaemia with PCSK9 inhibitors versus statins, based on U.S. Food and Drug Administration Adverse Events Reporting System (FAERS). METHODS: The hyperglycaemia reports induced by "alirocumab", "evolocumab", "atorvastatin" and "rosuvastatin" were utilized as the first suspected drugs from the database of FAERS from 2016 to the third quarter of 2023. The report odd ratio (ROR) method was employed. RESULTS: Based on the FAERS database, the ROR (95% CI) for hyperglycaemia due to Alirocumab versus Atorvastatin and Rosuvastatin were 0.628(0.545, 0.724) and 0.307 (0.263, 0.357) , the ROR (95% CI) for hyperglycaemia due to Evolocumab were 0.817 (0.750, 0.889) and 0.399 (0.361, 0.441) , all generated no adverse reaction signals. The ROR (95% CI) for hyperglycaemia due to Alirocumab and Evolocumab versus all other drugs in FAERS were 1.488(1.315,1.682) and 1.934(1.845, 2.027), all generated adverse reaction signals, respectively. CONCLUSION: Based on the FAERS database, PCSK9 inhibitors have a lower risk of hyperglycemia than statins and deserve clinical attention.
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    Advances in clinical research of CAR-T immunotherapy for systemic rheumatic diseases
    LI Zhi, ZHANG Mengying, ZHU Chuanmiao, MAO Li, PENG Hui
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (8): 937-946.   DOI: 10.12092/j.issn.1009-2501.2024.08.011
    Abstract207)      PDF (743KB)(233)       Save
    Systemic rheumatic disease is a kind of autoimmune disease which is caused by the dysfunction of autoimmune cells and the damage of multiple systems and organs. Traditional immunosuppressants play an important role in the treatment of systemic rheumatic diseases, but there are still a considerable number of refractory systemic rheumatic diseases that do not respond well to traditional immunosuppressant therapy, and new therapeutic methods need to be explored. Chimeric antigen receptor T cell therapy (CAR-T) immunotherapy was initially used for the treatment of malignant hematological diseases and has shown good efficacy. Recently,CAR-T immunotherapy has also achieved remarkable efficacy in refractory systemic lupus erythematosus. It brings new hope for the treatment of systemic rheumatic diseases. This article summarizes the progress of clinical application of CAR-T immunotherapy in systemic rheumatic diseases in recent years, aiming to enhance clinicians' cognition of CAR-T immunotherapy and promote the further development of CAR-T immunotherapy in systemic rheumatic diseases.
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    Umbrella review of the efficacy and safety of monoclonal antibodies in the treatment of thyroid-associated ophthalmopathy
    LIU Shuang, JIANG Hanchun, WU Jingjing, ZHAO Rongsheng
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (7): 735-743.   DOI: 10.12092/j.issn.1009-2501.2024.07.002
    Abstract203)      PDF (623KB)(182)       Save
    AIM:To comprehensively evaluate the efficacy and safety of rituximab (RTX), tocilizumab (TCZ), and teprotumumab (TMB) in the treatment of thyroid-associated ophthalmopathy (TAO). METHODS: A systematic search was conducted in PubMed, Embase and Cochrane Library databases for systematic reviews/meta-analyses on TAO treatment, with the search time limited to January 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, Assessment of Multiple Systematic Reviews (AMSTAR) 2 tool, and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) were used to assess the reporting quality, methodological quality, and evidence quality of the included studies. RESULTS: The current systematic reviews on the three monoclonal antibodies in TAO treatment exhibited deficiencies in reporting quality, methodological quality, and evidence quality. Direct comparative evidence between the three monoclonal antibodies is still lacking. Based on indirect comparative evidence, TCZ appears to be the most promising treatment option, followed by TMB and RTX. In terms of efficacy, TCZ and TMB significantly reduced the Clinical Activity Score (CAS), proptosis, and improved quality of life. TCZ also significantly reduced the incidence of diplopia. RTX significantly reduced disease response, while RTX and TCZ both significantly improved disease inactivation rates. RTX showed no significant difference in diplopia, lid fissure changes, NOSPECS score and quality of life. The conclusions regarding safety are inconsistent, with TCZ and TMB potentially increasing the incidence of adverse events, while RTX showed no significant difference in safety compared to glucocorticoids or placebo.CONCLUSION: This study provides evidence-based insights for the selection of three monoclonal antibodies in the treatment of TAO. While TCZ may have advantages in efficacy, considering the limitations of existing evidence, more high-quality studies are needed to further verify and compare the efficacy and safety of different monoclonal antibodies in TAO treatment.
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    Advances of VEGF signalling pathway in hepatocellular carcinomar invasion and metastasis and therapy
    LAN Xueling, HUANG Yanni, ZHU Minmin, MA Ping, DONG Min
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (6): 707-714.   DOI: 10.12092/j.issn.1009-2501.2024.05.013
    Abstract202)      PDF (664KB)(448)       Save
    The development of hepatocellular carcinoma (HCC) is closely related to the formation of tumour blood vessels. VEGF-mediated angiogenesis is a major driver of the immune escape response in tumours. VEGF binds to vascular endothelial growth factor receptor2 (VEGFR2) on endothelial cells, promoting endothelial cell proliferation and migration, inducing vascular changes in HCC, and thus promote the growth of hepatocellular carcinoma cells. Anti-VEGF and its receptor-targeted molecular drugs are currently effective new treatments for HCC. Monoclonal antibodies against VEGF and small-molecule tyrosine kinase inhibitors targeting VEGF have been shown to block its angiogenic activity, alleviate the inhibitory effect of the tumour microenvironment, and ultimately achieve tumour regression. This article provides a review of the research progress of VEGF/VEGFR inhibitors in HCC treatment.
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    Multidimensional analysis of endometriosis clinical trials based on the ClinicalTrials.gov database
    ZHANG Baoyin, YANG Wenhui, LIU Qinglan, WANG Chen, WU Jing, LIU Qian, SUN Nan
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 520-526.   DOI: 10.12092/j.issn.1009-2501.2024.05.006
    Abstract198)      PDF (845KB)(108)       Save
    AIM: To perform a multidimensional analysis of the clinical study characteristics of endometriosis based on the ClinicalTrials.gov, providing comprehensive and objective information for researchers, clinicians, and clinical pharmacists. METHODS: A thorough investigation was conducted on clinical trials related to endometriosis, registered on the ClinicalTrials.gov from its inception to October 20, 2023. Relevant trial data were extracted and statistically analyzed using bibliometrics and comparative research methods. RESULTS: A total of 667 endometriosis clinical studies were registered globally, showing an annual increase. The United States (127 trials), France (70 trials), and Italy (57 trials) had the highest number of registered trials. Interventional studies were predominant (416 trials, 62.4%), followed by observational studies (251 trials, 37.6%). Within interventional studies, drug therapy was the primary intervention (223 trials, 53.6%). Despite endometriosis being a female condition, male subjects were also considered, with 6 trials specifically requiring male participants and 37 trials not restricting gender. Companies/corporations were the main funding sources, while public and governmental organizations provided relatively less funding. CONCLUSION: Clinical trial research on endometriosis is in a phase of growth, with drug therapy being the main treatment approach. However, there is a relative lack of investment and attention from public funds and governmental organizations.
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