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Welcome to Chinese Journal of Clinical Pharmacology and Therapeutics,Today is Chinese

Table of Content

    Volume 25 Issue 9
    26 September 2020
    Protective effects of α-ketoglutarate dehydrogenase complex in adaptive reperfusion following ischemia stroke
    CHEN Zuoqian, LIN Guoshi, DAI Xuejun, WANG Mengying, CHEN Binghong, YANG Jian, QIU Yongming, LIN Ruisheng
    2020, 25(9):  961-967.  doi:10.12092/j.issn.1009-2501.2020.09.001
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    AIM: To investigate whether α-ketoglutarate dehydrogenase complex (α-KGDHC) has protective effects on adaptive reperfusion after ischemic stroke in rats, and whether its mechanism is related to inhibition of apoptotic pathways. METHODS: A model of middle cerebral artery occlusion (MCAO) ischemia/reperfusion (I/R) was established, and the volume of cerebral infarction was assessed by TTC staining following computer analysis. The α-KGDHC activity was detected based on chemical reaction, to evaluate the change trend of α-KGDHC activity with cerebral ischemia time, and compare the difference between normal reperfusion group and adaptive reperfusion group; treatment of B35 and SH-SY5Y with CoCl2 to mimic cell hypoxia, and inhibition of α-KGDHC activity with E1K siRNA to detect the expression of apoptosis-related proteins Bcl-2/Bax/Caspase 3 by Western blot. RESULTS: In vivo experiments: In MCAO model, adaptive reperfusion further reduced cerebral infarction volume compared with normal reperfusion (P<0.05), and the expression of Caspase 3 was the lowest; α-KGDHC activity in cerebral cortex and hippocampal brain tissue decreased as ischemic time prolonged (P<0.05), and adaptive reperfusion inhibited the rate of decrease in α-KGDHC activity (P<0.05). In vitro experiments: Inhibiting α-KGDHC activity by interfering E1K expression led to downregulation of Bcl-2 (P<0.05) and upregulation of Bax (P<0.05) and Caspase 3 (P<0.05). CONCLUSION: α-KGDHC is an important factor in the protection of adaptive reperfusion after cerebral ischemia, and it may exert protective effect by inhibiting the activation of apoptotic pathways.
    Resveratrol regulates miR-409-3p/FKBP14 to inhibit the malignant biological processes of gastric cancer BGC823 cells
    WU Yi, ZHU Akao, SHAN Yuqiang, YING Rongchao, JIN Huicheng
    2020, 25(9):  968-975.  doi:10.12092/j.issn.1009-2501.2020.09.002
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    AIM: To investigate the effect of resveratrol (RES) on the malignant biological processes of gastric cancer (GC) cells. METHODS: CCK-8 assay was used to study the effect of RES on the viability of BGC823 cells; qRT-PCR was used to detect the regulation of RES on the expression of miR-409-3p; EdU assay was used to study the effect of RES on the proliferation of BGC823 cells; transwell assay was used to study the effect of RES on the migration and invasion of BGC823 cells; luciferase reporter assay and western blot assay were used to study the regulation of miR-409-3p on the expression of FKBP14. RESULTS: RES (>200 μmol/L) significantly inhibited the viability of BGC823 cells. RES inhibited the proliferation, migration and invasion of gastric cancer cells by up-regulating miR-409-3p. FKBP14 was the target gene of miR-409-3p. Res could inhibit the expression of FKBP14 in gastric cancer cells by up-regulating miR-409-3p. Overexpression of FKBP14 attenuated the antitumor effect of RES. CONCLUSION: RES can suppress the tumor progression in gastric cancer by regulating miR-409-3p/FKBP14 signaling pathway, indicating the potential value of RES in clinical treatment of gastric cancer.
    NADPH oxidase NOX4 inhibitor regulates the formation and mechanism of hepatoma related fibroblasts
    ZHOU Xiaohong, SHENG Yongjia, GU Yanling, WANG Jin
    2020, 25(9):  976-983.  doi:10.12092/j.issn.1009-2501.2020.09.003
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    AIM: To study the effect and mechanism of glx351322, an inhibitor of NADPH oxidase (NOX4), on the formation of tumor associated fibroblasts (CAFs).  METHODS: NIH3T3 cells were co-cultured with H22 cells. 5 μm (IC50) GLX351322 cells were pretreated with NIH3T3. After PI staining, flow cytometry was used to detect the change of cell cycle, immunofluorescence staining was used to detect the expression of CAFs markers α-SMA and FAP, Western blot was used to detect the expression of CAFs markers α-SMA, Desmin, FAP, TSP-1, FSP, CyclinD, TGF-β1 and Smad1.After H22 was used to construct tumor bearing mice model, GLX351322 was used for treatment,Immunohistochemical staining was used to detect the expression of α-SMA and CAFs in tumor tissue. RESULTS:GLX351322 pretreatment could inhibit the proliferation of NIH3T3, decrease cell viability and change cell cycle. At the same time, it could down-regulate the expression of α-SMA, desmin, FAP, TSP-1, FSP, CyclinD, and TGF-β signal was inhibited. GLX351322 also significantly inhibited the expression of α-SMA and CAFs markers in tumor mice. CONCLUSION: GLX351322, a NOX4 inhibitor, can inhibit the formation of tumor-related fibroblasts, which is related to the inhibition of TGF-β signal.
    Development of tools for clinical trial information retrieval and Meta-analysis based on R-Shiny: Taking non-small cell lung cancer as an example
    YU Zhaolei, BAI Jianling, YU Hao, ZHAO Yang
    2020, 25(9):  984-991.  doi:10.12092/j.issn.1009-2501.2020.09.004
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    AIM: To develop a tool providing the graphical user interface (GUI), which can integrate Meta-analysis and information retrieval from clinical trials. METHODS: The Web application based on the Bootstrap framework was built with the Shiny package of R language, and the information retrieval and meta-analysis functions were implemented based on the R packages of DT, Meta, gemtc, etc. RESULTS: The tool could filter the articles and variables according to the user's requirements, and the information presented in the form of a table. Users can also select different experimental group drugs and control group drugs for classic meta-analysis, and add or subtract different studies to construct the network map between drugs for network meta-analysis. CONCLUSION: This tool has a friendly user interface, which is easy to use, accurate in analysis and drawing results, and can bring convenience to researchers.
    Population pharmacokinetics of Linezolid in Chinese adult infection patients#br#
    LIN Zhong, XIE Qunli, DAI Shuping, CHEN Jing, LIN Feiyang, ZHU Yanwu, YU Guoliang, ZHANG Yuanhuai, CUI Ke
    2020, 25(9):  992-999.  doi:10.12092/j.issn.1009-2501.2020.09.005
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    AIM: The population pharmacokinetic model (PKK) of linezolid was constructed with the retrospective data of linezolid therapeutic drug monitoring from the 3 hospitals of ENZE medical center, which could be used to predict individualized pharmacokinetic parameters with Bayesian feedback method based on single point trough concentration and support scientific experimental method for rational drug use of linezolid in the future. METHODS: A total of 115 monitoring serum concentration data of 72 patients from Mar. 2016. to Dec. 2018 were included in this study. Stepwise regression method was used to screen the concomitant variable (age, weight, blood routine examination, biochemical index and drug combination etc.) for Vd and K by kinetica software. The internal and external validation were analyzed with maximum likihood method and Bayesian feedback. RESULTS: As the final model Vd=25.864-0.034×Fur(mg) shown, combination use of furosemide has a significant effect on Vd of linezolid. The level of age, Scr and the burn status of the patients have a significant effect on K of linezolid and the final model was K=0.324-0.0003×Scr-0.003×age +0.04×burn. Finally, the population mean value of Vd and K were 29.719 L(5.32, 52.36), 0.160 h-1 (0.05, 0.23) and 25.322 L (2.50, 52.51), 0.193 h-1 (0.06, 0.32) in basic model and final model. The mean absolute prediction error rate of external validation was 0.620 (0.001, 4.153) in basic model and 0.588 (0.014, 3.942) in final model. CONCLUSION: The final PPK model from the present study could well response the heterogeneous PPK characteristic of the patients from ENZE medical center, which could support scientific experiment method for improving the linezolid therapeutic effect and reducing adverse reaction rate.
    Correlation of infliximab related genetic polymorphism, serum trough concentration and efficacy in patients with Crohn's disease
    LIN Rongfang, ZHENG Weiwei, LIU Yiwei, LIN Cuihong, WANG Changlian, HUANG Pinfang
    2020, 25(9):  1000-1006.  doi:10.12092/j.issn.1009-2501.2020.09.006
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    AIM: To investigate the correlations of genetic polymorphisms, infliximab(IFX) serum trough concentration, immunogenicity and clinical outcome in patients with Crohn's disease(CD) to provide reference for optimizing IFX treatment in CD patients. METHODS: The clinical data of CD patients treated with IFX in our hospital from September 2017 to September 2019 were prospectively collected. The genotypes TNF-α-308, TNF-α-238, TNF-α-857, TNFRSF1B, ABCB1, FCGR3A were detected by targeted sequencing using multiple PCR combined with high throughput sequencing before administration. The IFX steady-state concentration was determined by ELISA. SPSS 20.0 software was used for statistical analysis and ROC curve was drawn for clinical efficacy and antibody threshold. RESULTS: A total of 111 patients were included in the study, the IFX trough concentration of patients with TNF-α-238GA was significantly lower than that of GG (0.55±0.52) vs. (1.75±1.46) μg/mL (P=0.003), while there was no significant difference in IFX trough concentration among TNF-α-308, TNF-α-857, TNFRSF1B, ABCB1, FCGR3 Agenotypes. Clinical response rate of TNFRSF1B (TG+GG) was significantly higher than that of the wild type (TT) (75.0% vs. 42.3%) (P=0.001), and there was no statistically significant difference in clinical efficacy among patients with different genotypes of other genes (P>0.05). The efficacy of IFX in the treatment of CD and the production of antibody to IFX were significantly correlated with maintenance trough concentration (P<0.01). The optimal IFX trough concentration thresholds for predicting CPR≤5 mg/L and clinical response after treatment were 1.33, 0.85 μg/mL, respectively. Trough concentration ≤0.51 μg/mL was used as an indicator to predict the generation of antibody. CONCLUSION: Polymorphisms of TNF-α-238 and TNFRSF1B can affect the maintenance trough concentration and clinical response of IFX in CD patients, respectively. The trough concentration at IFX maintenance stage >1.33 μg/mL had certain predictive significance for biological response, while ≤0.51 μg/mL can be used as a predictor of antibody production.
    Statistical analysis of active extension trial
    XIE Mengsheng, ZHAO Yang, CHEN Feng
    2020, 25(9):  1007-1013.  doi:10.12092/j.issn.1009-2501.2020.09.007
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    AIM: To estimate the treatment effect before and after patients stopped taking the drug, based on the combination of withdrawal randomized study and active extension trial design. METHODS: The short term treatment effect was estimated separately by the traditional method of using first stage data and the method of taking second or third stage data into consideration. And the treatment difference between long term and short term, also the treatment difference after patients discontinued from treatment were further assessed. The robustness of the result was tested by simulation assumed different scenario. RESULTS: The standard error (0.17) of the treatment effect estimation used more stage data was less than that of only used the first stage (Standard error: 0.19), besides much powerful for those treatment effect could be stabilized in the short period. CONCLUSION: Compared with the method only utilized the data of the first stage, the method developed here utilized second or third stage data. The utilization of more information leaded to decreasing of standard deviation and increasing of validity for the estimation of treatment effect. But the results will be influenced by the time required for the stabilization of the treatment effect, since the method was based on certain assumptions.
    Effects of CYP2C19 gene polymorphism on the clinical prognosis of clopidogrel in elderly patients with acute cerebral infarction
    XU Honglei, XU Bingxin, ZU Qing, ZHAO Yan, GAO Pengfei, YU Yang
    2020, 25(9):  1014-1020.  doi:10.12092/j.issn.1009-2501.2020.09.008
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    AIM: To investigate the effect of CYP2C19 gene polymorphism on the clinical prognosis of elderly patients treated with clopidogrel who suffered acute cerebral infarction.  METHODS: A total of 226 elderly patients with acute cerebral infarction who received aspirin and clopidogrel were prospectively enrolled in this study. The CYP2C19 genotype was detected by DNA microarray chip method. Based on CYP2C19 genotypes, the patients were divided into fast metabolism group, medium metabolism group and slow metabolism group. The National Institutes of Health Stroke Scale (NIHSS) scores before and after treatment were recorded. The changes of NIHSS scores before and after treatment were studied by repeated measurement ANOVA (analysis of variance), the decrease of NIHSS scores before and after treatment was used as the standard to evaluate the prognosis of patients, and the difference of favorable prognosis rate was compared among the three groups. Binary logistic regression analysis was used to explore the prognosis influencing factors of acute cerebral infarction, and adverse drug reactions (ADR) were observed in the three groups. RESULTS: There were 81 patients (35.8%), 108 patients (47.8%) and 37 patients (16.4%) in fast metabolism group, medium metabolism group and slow metabolism group, respectively, with a favorable prognosis rate of 86.4%, 73.1% and 64.9% respectively. There was significant difference in the favorable prognosis rate among the three groups, and fast metabolism group was significantly higher than slow metabolism group (P<0.05). Repeated measurement ANOVA showed that the NIHSS scores of three groups varied with time, and the NIHSS scores of fast metabolism group after treatment were lower than those of medium metabolism group and slow metabolism group, the difference was statistically significant (P<0.05). Binary logistic regression analysis showed that patients in fast metabolism group had a favorable clinical prognosis 3.447 times as much as those in slow metabolism group (OR=3.447, 95% CI: 1.364-8.712, P=0.009). Patients with diabetes had a favorable clinical prognosis 62.7% as those without diabetes (OR=0.627, 95% CI: 0.268-1.331, P=0.001). There was no statistical difference in the total incidence of ADR among the three groups (P>0.05). CONCLUSION: CYP2C19 gene polymorphism has an effect on the clinical prognosis of elderly patients treated with clopidogrel who suffered acute cerebral infarction, and the therapeutic effect on rapid metabolizer is better than that of slow metabolizer.
    Effects of 25(OH)D on islet β-cells function in the elderly with type 2 diabetes
    XU Yongxia, XIE Mingzhu, GONG Muxue, HUANG Jiaying, ZHAO Li, ZHU Defa
    2020, 25(9):  1021-1026.  doi:10.12092/j.issn.1009-2501.2020.09.009
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    AIM: To investigate the effects of serum 25-hydroxyvitamin D (25(OH)D) on the blood glucose and islet β-cells function in the elderly with type 2 diabetes (T2DM). METHODS: Fifty-eight elderly patients with type 2 diabetes were recruited from June 2019 to January 2020, and all the patients were divided into three groups according to levels of serum 25(OH)D. Age, body mass index (BMI) and the levels of fasting blood glucose (FBG), hemoglobin A1c (HbA1c) were analyzed. Steamed bread meal test was performed in all patients, and the levels of blood glucose and C-peptide were compared among the three groups at the time points of 0, 30, 60, 120 and 180 min to investigate the effect of serum 25(OH)D on the islet β-cells function.RESULTS: Compared with the elderly T2DM patients with sufficient 25(OH)D, the HbA1c increased significantly in the elderly T2DM patients with deficiency of 25(OH)D (P<0.05). The levels of blood glucose were increased at the time points of 120 min and 180 min, while the levels of C-peptide at the time point of 60 min and 120 min, C peptide index and AUCCP180 in elder T2DM patients decreased significantly (P<0.05). Pearson correlation analysis showed that serum was negatively correlated with HbA1c, and positively correlated with the C peptide and C peptide index and AUCCP180 (P<0.05). And stepwise multiple regression analysis indicated that C peptide was a factor influencing 25(OH)D levels. CONCLUSION: Elderly T2DM patients with deficiency of 25(OH)D are more likely to suffer with severe dysfunction of islet β-cells.
    Application of levosimendan in severe patients after cardiac surgery
    HU Xiaoyan, XU Qiuping
    2020, 25(9):  1027-1032.  doi:10.12092/j.issn.1009-2501.2020.09.010
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    AIM: To explore the influence of levosimendan on cardiac function, pulmonary hypertensions, renal function of the patients after severe heart surgery. METHODS: A total of 320 cases of patients with severe disease who underwent surgery in cardiac surgery department in our hospital from January 2014 to June 2019 were selected and divided into experiment group and control group using random number table method, 160 cases in each group. The prosthetic heart valve replacement or non-extracorporeal bypass surgery were underwent based on the specific condition of patient, the experiment group received levosimendan during the perioperation at the same time. The changes of cardiac, renal function parameters and pulmonary artery systolic pressure (PASP) at different times before and after operation were compared between the 2 groups. RESULTS: There was no significant difference in HR, MAP and CVP between the two groups 24 h after operation. LAC of the experimental group was significantly lower than that of the control group 12 h and 24 h after operation (P<0.05 or P<0.01). LVEDV and LVESV of the 2 groups showed a decreasing trend from 1 to 14 days after operation (P<0.05 or P<0.01), and the experiment group was significantly less than the control group at the same time point (P<0.05 or P<0.01); the CI and LVEF of the 2 groups showed an increasing trend (P<0.05 or P<0.01), and the experiment group was significantly higher than the control group at the same time point (P<0.05 or P<0.01). The levels of plasma NT-proBNP and PASP showed a decreasing trend of the 2 groups from 3 to 14 days after operation, and the experiment group was significantly lower than the control group at the same time point (P<0.05 or P<0.01); the levels of serum BUN, 24Upro and Scr had no significant change in the experiment (P>0.05), the levels of serum BUN, 24Upro and Scr increased first and then decreased in the control group, and the experiment group was significantly lower than the control group at the same time point (P<0.05 or P<0.01). Compared with the control group, the postoperative mortality, ICU stay, ventilator and IABP support time in the experimental group were significantly lower than those in the control group (P<0.05). CONCLUSION: Levosimendan after cardiac surgery can effectively improve the postoperative cardiac function of severe patients, protect renal injury caused by low perfusion, and reduce the incidence of early postoperative pulmonary hypertension, which is worthy of clinical reference.
    Median effective plasma concentration of propofol inhibiting body movement when combined with butorphanol in patients undergoing hysteroscopic surgery 
    YANG Qinyan, HUANG Li, SHI Lan, OU Yuanyuan, LI Guoyuan, HUANG Chengyong
    2020, 25(9):  1033-1037.  doi:10.12092/j.issn.1009-2501.2020.09.011
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    AIM: To determine the median effective plasma concentration (Cp50) of propofol inhibiting body movement when combined with butorphanol in patients undergoing hysteroscopic surgery. METHODS: Twenty-one patients scheduled for elective hysteroscopic surgery under non-intubated intravenous anesthesia, age 20-55 years old, ASA physical status Ⅰ or Ⅱ, were enrolled in this study, and anesthesia was induced by target-controlled infusion of propofol. Hysteroscopy was performed only when the plasma concentration and the concentration of the effector chamber were balanced. Butorphanol 20 μg/kg was injected intravenously at 5 min before surgery. The depth of anesthesia and adverse reactions during anesthesia was monitored. The plasma target concentration (Cp) of propofol was determined by up-and-down method, the first patient was 2.5 μg/mL, each time Cp increased/decreased by 10% in the next patient depending on whether or not body movement occurred. The patients were divided into positive and negative groups according to the results. The Cp50 and 95% confidence inlerval (CI) of propofol inhibiting body movement were calculated by up-and-down formula when combined with butorphanol in patients undergoing hysteroscopic surgery. RESULTS: The Cp50(95%CI) of propofol required to inhibit body movement was 2.23(2.12-2.34) μg/mL when combined with butorphanol in patients undergoing hysteroscopic surgery. None of the patients had serious adverse reactions. CONCLUSION: The Cp50 of propofol required to inhibit body movement is 2.23 μg/mL when combined with 20 μg/kg butorphanol in patients undergoing hysteroscopic surgery. It provides a reference for safe dosage of anesthesia in hysteroscopic surgery.
    Analysis of the role of clinical pharmacist in the establishment of standardized cancer pain management ward
    ZHOU Haihui, ZHANG Haixia, GE Weihong
    2020, 25(9):  1038-1042.  doi:10.12092/j.issn.1009-2501.2020.09.012
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    AIM: To explore the role of clinical pharmacists in the establishment of standardized cancer pain management ward in our hospital. METHODS: Information of hospitalized patients with cancer pain admitted to the oncology department from January to June 2018 and from July to December 2018 was retrospectively collected and was allocated as the control group and the intervention group, respectively. A total of 114 patients were included in the study, including 58 in the control group and 56 in the intervention group. General information included gender, age, body mass index, tumor type, KPS score, NRS score, etc was collected. There was no statistical difference of the baseline value. The analgesic effect before and after clinical pharmacists' participation was compared. RESULTS: The pain score in the intervention group was significantly lower than that in the control group (P<0.05), the number of pain occurence in the intervention group was significantly lower than that in the control group (P<0.05), and the total incidence of adverse reactions in the intervention group was significantly lower than that in the control group (P<0.05), and KPS score in the intervention group was significantly higher than that in the control group (P<0.05). CONCLUSION: Participant of clinical pharmacists in the diagnosis and treatment of standardized cancer pain ward elevates the standardized treatment level of cancer pain and improves the life qualityof cancer patients.
    Recent updates on drug-resistance mechanisms in Mycobacterium tuberculosis and the role of PE/PPE proteins in drug resistance 
    WANG Qinglan
    2020, 25(9):  1043-1051.  doi:10.12092/j.issn.1009-2501.2020.09.013
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    Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis (M. tb) and mainly spread by airborne transmission, remains a global health problem. After the wide clinical utilization of antibiotics in treatment of TB, the drug resistance has become a major threat to global TB control and this threat has been heightened by the emergence and propagation of multi-drug resistant tuberculosis (MDR-TB), extensively drug-resistant tuberculosis (XDR-TB) and totally drug-resistant tuberculosis (TDR-TB). The research in the mode-of-action mechanisms of anti-TB drugs and the drug resistance mechanisms of M. tb will facilitate the novel anti-TB drugs development, the optimization of current anti-TB drugs and the development of new drug resistance diagnosis technologies. This review provides a comprehensive overview of mode-of-action mechanisms of new anti-TB drugs and mechanisms of resistance to these drugs in M. tb, with particular attention to the role of newly-identified mycobacterial outer-membrane channel proteins (PE/PPE proteins) in TB drug resistance.
    Application of MAO-A/B subtype activity detection in diagnosis and treatment of neurological diseases
    WANG Limin, FANG Bin, FANG Haixiao, BAI Hua, LI Lin
    2020, 25(9):  1052-1058.  doi:10.12092/j.issn.1009-2501.2020.09.014
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    The abnormal expression of monoamine oxidases (MAOs), which distributed on the outer mitochondrial membrane can cause the dysfunction of neurotransmitter delivery and related to mental and neurodegenerative diseases. Therefore, the specific detection of MAOs (MAO-A/B) and the regulation of their activities will contribute to the diagnosis and treatment of neurological diseases. In order to distinguish the two subtypes of MAO-A/B, fluorescence detection and imaging techniques with highly specific and sensitive properties have important biological relevance. Herein, our research group based on the concept of "spatial configuration conversion" have designed the two-photon small molecule fluorogenic probes of U1 and F1, which capable of specific fluorescence "Switch-ON" behaviour, and combined with two-photon fluorescence microscopic imaging technology to realize the activity detection of endogenous MAO-B/A in cells and tissues. It is hoped that this works will benefit the understanding of physiological function about MAOs and developing innovative inhibitors, as well as diagnosing and treating in neurological diseases.
    Research progress of mitochondrial toxicity evaluation model for nucleoside drugs
    ZHANG Pinghu, ZHANG Ling, LIU Changxiao
    2020, 25(9):  1059-1065.  doi:10.12092/j.issn.1009-2501.2020.09.015
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    Antiviral nucleoside drugs represented by zidovudine, lamivudine, telbivudine, ribavirin, etc. have become the first choice drugs for clinical treatment of viral diseases such as AIDS, hepatitis B, herpes. However, the above drugs not only can inhibit virus replication, they can also interfere with the host mitochondrial mtDNA replication through similar mechanisms, leading to mitochondrial toxicity-related adverse reactions. Therefore, both the routine safety evaluation and mitochondrial toxicity evaluation are required for the development of nucleoside drugs. The research progress of mitochondrial toxicity evaluation models of nucleoside drugs are summarized for reference.
    Effects of resveratrol on autophagy of tumor cells
    YUAN Lijialong, YUAN Ronghui, WANG Jin, DENG Ziwei, WANG Hongqiang, DENG Ye, GONG Lu, JIN Yuanxiang, SHI Zhihua
    2020, 25(9):  1066-1073.  doi:10.12092/j.issn.1009-2501.2020.09.016
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    Resveratrol, as a natural autophagy regulator, has good biological activity in anti-tumor. In the anti-tumor process of resveratrol or similar substances, autophagy not only plays an important role in tumor cell apoptosis, proliferation, senescence and metastasis, but also plays a sensitizing effect on clinical radiation therapy and chemotherapy. This paper reviews the role of autophagy in the anti-tumor effect of resveratrol and its research progress.
    Statins for primary prevention of atherosclerotic cardiovascular disease in people 75 years of age and older
    YANG Ming, DONG Xiaowen, HONG Huashan
    2020, 25(9):  1074-1080.  doi:10.12092/j.issn.1009-2501.2020.09.017
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    Statins are important drugs for the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD). The role and status of statins in ASCVD secondary prevention have been established, but the application of statins in ASCVD primary prevention in the elderly is controversial, especially in the elderly aged 75 years and older. The evidence for primary prevention with statins is not adequate. It should be cautious to initiate statins for primary prevention, because of the frailty, multicomobidity, polypharmacy and the limited life expectancy of the elderly may increase the risk of statins adverse reactions. The recent clinical studies and guidelines of statin primary prevention in the elderly population especially in aged 75 years and older have been reviewed in the paper. Making decisions based on fully evaluating the patients' ratio of benefits and risk with patients and implement statin individualized treatment strategies are emphasized.