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

Table of Content

    Volume 26 Issue 12
    26 December 2021
    Current opinions and developments of non-pharmacological treatments of hypertension based on sympathetic nervous system
    YE Peng, TAN Xing, LENG Yueqi, WANG Yangkai, WANG Weizhong
    2021, 26(12):  1335-1343.  doi:10.12092/j.issn.1009-2501.2021.12.001
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    Hypertension is a serious disease that endangers human health. Although the clinical efficiency of anti-hypertensive drugs have achieved good results, there are still many different types of resistant hypertension such as drug tolerance, and the incidence of complications of hypertension such as heart failure and stroke is still high. Therefore, the development and application of non-pharmacological treatment strategies have become an important aspect of the treatment of hypertension. The sympathetic nervous system plays a key role in the pathogenesis of hypertension. At present, most non-pharmacological treatment technologies for the prevention and treatment of hypertension mainly target the sympathetic nerve function. These technologies mainly include deep brain stimulation and renal denervation. Central iliac arteriovenous anastomosis, baroreflex activation therapy, endovascular baroreflex amplification, carotid body ablation, etc. This review focuses on the application status and related advantages and disadvantages of the above-mentioned non-pharmacological treatment methods based on the sympathetic nervous system, and provides new ideas and multiple options for treatment of hypertension.
    Quercetin reverses adriamycin resistance by activating GSK-3β/β-catenin pathways through GAS5 in breast cancer cells
    JIN Le, JIANG Duochen, CHEN Hongxiao, LIU Su, CHEN Zhaolin, JU Jing
    2021, 26(12):  1344-1351.  doi:10.12092/j.issn.1009-2501.2021.12.002
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    AIM: To investigate the ability of quercetin to reverse acquire adriamycin (ADR) resistance and explored its probably mechanism. METHODS: The CCK-8 assay was used to detect the cytotoxicity of quercetin in MCF-7/ADR cells and the reversal effect of ADR. The colony formation assay and Hoechst 332582 staining were used to detect the cell proliferation, cell apoptosis and the accumulation of rhodamine 123 (Rh123) respectively. The RNA expression levels of GAS5 and ABCB1 were detected by qRT-PCR. The protein expression levels of GSK-3β, β-catenin, c-MYC, cyclin D1, and ABCB1 were detected by Western blot. RESULTS: Quercetin (10, 20, 40 μmol/L) significantly enhanced the sensitivity of MCF-7/ADR to ADR, inhibitd cell proliferation, and increased the intracellular accumulation of Rh123. Treatment with quercetin in MCF-7/ADR cells, the expression levels of GAS5 and GSK-3β were increased, whereas the expression levels of β-catenin, c-myc, cyclin D1 and ABCB1 were decreased. Further research revealed that reduction of GAS5 by RNA interference (si-GAS5) induced inhibitory effects on the expressions of GAS5 and GSK-3β, and enhanced the expressions of β-catenin, c-myc, cyclin D1, and ABCB1. Furthermore, treatment by quercetin combined with si-GAS5 in MCF-7/ADR cells, the expressions of these proteins were effectively reversed in comparison to quercetin combined with siRNA negative control (sncRNA). CONCLUSION: Quercetin increases the expression of GAS5by GSK-3β/β-catenin signaling pathway, which inhibits the expression of ABCB1, ultimately reversing ADR resistance in the MCF-7/ADR cells.
    Sorafenib induces mitochondrial dysfunction and activates oxidative damage in hepatocellular carcinoma cells
    HU Wanye, YUAN Chen, HU Jiayu, WANG Hairui, LI Huanjuan, WANG Ying
    2021, 26(12):  1352-1359.  doi:10.12092/j.issn.1009-2501.2021.12.003
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    AIM: To investigate the role of sorafenib in promoting ferroptosis in HCC, and whether cell death can be induced by activating mitochondrial oxidative stress and consequent mitochondrial dysfunction.  METHODS: Hepatocellular carcinoma cell lines Huh7 and HCC-LM3 were treated with different concentrations of sorafenib, the cell viability was determined by CCK-8 assay; mitochondrial membrane potential (MMP) was measured by Tetramethylrhodamine (TMRM) staining; The mitochondrial oxygen consumption rate was monitored by the Seahorse XF24 Analyzer; mitochondrial superoxide indicator (Mitosox) was used to determine the level of reactive oxygen species (ROS) in mitochondria; the formation of total ROS was determined by dichlorofluorescein diacetate (DCF-DA) staning. Finally, The recovery of oxidative damage and cell death induced by sorafenib was observed after pretreated by glutathione (GSH). RESULTS: With the increasing concentration of sorafenib, the survival of the Huh7 and HCC-LM3 was significantly decreased. Sorafenib also inhibited the oxygen consumption rate and decreased oxidative phosphorylation, which results in the depolarization of MMP, ROS accumulation and eventually ferroptosis of HCC cells. However, the occurrence of oxidative stress induced by sorafenib in HCC cells can be effectively reversed by the pretreatment of GSH. CONCLUSION: The ferroptosis can be induced by sorafenib through inducing mitochondrial dysfunction and ROS accumulation in HCC cells. However, the GSH can restore oxidative damage. Therefore, induction of the GSH deficiency in HCC may be a potential therapeutic option to enhance the efficacy of sorafenib.
    Huatanjiangqi capsule regulates Nrf2/HDAC2 and improves glucocorticoid resistance of 16HBE cells
    WANG Mengwen, GUO Yan, WANG Chongyang, TAO Fulin, ZHU Wentao, HAN Zhili, SUN Nianxia, LI Zegeng, WANG Dianlei
    2021, 26(12):  1360-1369.  doi:10.12092/j.issn.1009-2501.2021.12.004
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    AIM: To explore the effect of Huatanjiangqi capsule medicated serum (HTJQ) on the resistance of human bronchial epithelial cells (16HBE) to glucocorticoid (GC) stimulated by cigarette smoke extract (CSE).  METHODS: After 16HBE cells were treated with HTJQ, the effects of different concentrations of HTJQ on the viability of 16HBE cells were determined by CCK-8 method. 16HBE cells were pretreated with HTJQ, and then cultured with dexamethasone (DEX) and lipopolysaccharide (LPS) for 24 hours, the effect of HTJQ on glucocorticoid (GC) resistance of 16HBE cells was determined by Enzyme-linked immunosorbent assay (ELISA). The effects of HTJQ, sulforaphane (SFN) and glutathione (GSH) on the expression of NF-E2-related factors 2 (Nrf2), Heme oxygenase-1 (HO-1) and histone deacetylase 2 (HDAC2) in 16HBE cells stimulated by CSE were measured by Western blot, and the effects of HTJQ, SFN and GSH on interleukin-8 (IL-8) in 16HBE cells were measured by ELISA. RESULTS: HTJQ promoted the proliferation of 16HBE cells at 1 h, 2 h and 4 h, the results of ELISA and Western blot showed that CSE induced GC resistance and decreased the expression of Nrf2, HO-1 and HDAC2 in 16HBE cells, HTJQ significantly decreased IL-8 and improved GC sensitivity of 16HBE cells (P<0.01), and up-regulated the expression of Nrf2, HO-1 and HDAC2 (P<0.01). In addition, HTJQ significantly up-regulated the level of GSH in 16HBE cells (P<0.01). Nrf2 agonists SFN and GSH significantly improved the glucocorticoid sensitivity of 16HBE cells (P<0.01), and up-regulated the expression of Nrf2, HO-1 and HDAC2 (P<0.01). CONCLUSION: HTJQ improves the GC resistance of 16HBE cells by up-regulating the expression of Nrf2/HDAC2 protein and the level of intracellular GSH.
    Ethanol extract of costusroot protects gastric mucosal in gastric ulcer rats by regulating the protein expression of Bcl-2 and Bax
    LEI Na, CHEN Yun, ZHANG Kailing, ZHU Hao, XU Yuannan, GUO Peixin, XIE Yuhuan
    2021, 26(12):  1370-1378.  doi:10.12092/j.issn.1009-2501.2021.12.005
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    AIM: To explore the effect of ethanol extract of costusroot (EEC) on gastric mucosa in gastric ulcer rats and related mechanism. METHODS: The rats were randomly divided into 5 groups: normal group, model group, sucralfate group, low-EEC group and high-EEC group, and anhydrous alcohol was administrated intragastrically to replicate gastric ulcer model in groups other than the normal. Changes in the area of gastric ulcer were observed and the inhibition rate of ulcer was calculated. The pathological changes of gastric tissue were measured by HE staining, and the protein expression levels of Bax and Bcl-2 were tested by immunohistochemistry and Western blot. RESULTS: EEC inhibited the formation of ulcer area in model rats and alleviated the histopathological damage to the stomach caused by ethanol. While enhancing the expression of Bcl-2 protein (P<0.01), it effectively inhibited the overexpression of Bax (P<0.01). CONCLUSION: EEC has a strong function of anti-gastric ulcers, and its mechanism of action might be related to the regulation of the protein expression level of Bax and Bcl-2 to inhibit the apoptosis of gastri mucosal cells.
    Study on binding of 68Ga-PSMA-I&T to newly diagnosed prostate cancer foci
    XIE Yan, LI Cheng, ZHANG Lulu, YU Fei, ZANG Shiming, FU Jingjing, LIU Lu, WANG Feng
    2021, 26(12):  1379-1385.  doi:10.12092/j.issn.1009-2501.2021.12.006
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    AIM: To evaluate the combining ability of prostate-specific membrane antigen (PSMA) targeted radioactive drug 68Ga-PSMA-I&T for newly diagnosed prostate cancer.  METHODS: A retrospective study included 45 newly diagnosed patients with prostate disease who underwent 68Ga-PSMA-I&T PET/CT between June 2018 and June 2019. Thirty-two cases of prostate cancer and 13 cases of prostate hyperplasia were diagnosed by pathology, aged from 56 to 89 years, with an average age of (71.0±8.6) years. The standardized uptake values (SUVs) of normal tissues and lesions were measured, including maximum standardized uptake values (SUVmax), peak standardized uptake values (SUVpeak) and mean standardized uptake values (SUVmean), to evaluate the uptake of normal tissues and lesions. Nonparametric Kruskal-Wallis H test was used to compare the differences among the three groups. If the differences between the three groups were statistically significant, Bonferroni method was used for pairwise comparison. Spearman rank correlation was used to analyze the correlation between quantitative data. The area under the curve (AUC) was calculated by the receiver operating characteristic (ROC) curve, and the optimal cut-off value was calculated by the Youden index. RESULTS: 68Ga-PSMA-I&T was biologically well distributed in normal tissues. The accuracy, sensitivity, specificity, PPV (positive predictive value) and NPV (negative predictive value) of 68Ga-PSMA-I&T PET/CT in the diagnosis of prostate cancer were 86.7%, 87.5%, 84.6%, 93.3% and 73.3% respectively. The SUVmax of primary lesions, bone metastases, and lymph node metastases were 15.89 (10.87, 22.05), 12.88 (7.26, 28.26), and 7.88 (6.85, 8.87), respectively. SUVs in primary lesions were higher than lymph node metastases (all adjusted P<0.016 7), SUVmax of bone metastasis was also higher than that of lymph node metastasis (adjusted P<0.016 7). SUVmax, SUVpeak and SUVmean were significantly correlated in all prostate disease foci, prostate hyperplasia foci and prostate cancer foci (all r>0.95, all P<0.001). CONCLUSION: 68Ga-PSMA-I&T can be well combined with the primary and metastatic foci of PCa. 68Ga-PSMA-I&T PET/CT is more sensitive to the detection of primary lesions and bone metastases than lymph node metastases.
    Protection effect of dexmedetomidine against sepsis-induced intestinal mucosal barrier injury by up-regulating hypoxia inducible factor-1ɑ in rats
    LI Hui, LI Jun, HUAN Suqin, LI Yuhong, FAN Jun
    2021, 26(12):  1386-1392.  doi:10.12092/j.issn.1009-2501.2021.12.007
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    AIM: To explore the protective effect and mechanism of dexmedetomidine on intestinal mucosal barrier injury in septic rats.  METHODS: Forty eight SD rats were randomly divided into four groups (n=12): sham operation group (sham group), sepsis group (sepsis group), sepsis + dexmedetomidine group (DEX group), and sepsis + DEX + HIF-1ɑ inhibitor Bay87-2243 (Bay87-2243 group). Sepsis model was established by cecal ligation and perforation (CLP). The rats in both DEX and Bay87-2243 groups were given 30 μg/kg of DEX intraperitoneally 30 minutes before CLP and 2 hours after CLP; while the rats in Bay87-2243 group received oral gavage of Bay87-2243 (9 mg/kg) for 3 days before CLP. The other groups were intraperitoneally injected and orally with the same amount of normal saline. The HIF-1ɑ and the tight junction protein (tight junction protein, TJs) was detected by western blot; the plasma concentrations of diamine oxidase (DAO), intestinal fatty acid binding protein (FABP2) and D-lactic acid (D-LAC) were detected by ELISA; the morphological changes of intestinal mucosa were detected by HE staining. RESULTS: DEX significantly increased the expression level of HIF-1ɑ (P<0.05) on intestinal mucosa in rats with sepsis injury (P<0.05), thus ameliorated intestinal mucosal pathological injury, reduced Chiu's score (P<0.05), decreased intestinal mucosal permeability (P<0.05), and up-regulated TJS protein expression (P<0.05). Moreover, effect on sepsis induced intestinal mucosal injury of DEX was reversed by HIF-1ɑ Bay87-2243. CONCLUSION: DEX could protect against sepsis-induced intestinal mucosal injury by up-regulating HIF-1ɑ expression in rats.
    Bioequivalence of moxifloxacin hydrochloride tablets in healthy Chinese subjects
    LIU Chang, DENG Kunhong, HUANG Jie, YANG Shuang, YANG Xiaoyan, XIANG Yuxia, HUANG Lu, ZHANG Zeyu, LIANG Wenzhong, LAN Jing, YANG Guoping
    2021, 26(12):  1393-1399.  doi:10.12092/j.issn.1009-2501.2021.12.008
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    AIM: To study the pharmacokinetic characteristics of single-dose oral moxifloxacin hydrochloride tablets under fasting and fed conditions, and use moxifloxacin hydrochloride tablets produced by Bayer Pharma AG as a reference to compare the pharmacokinetic parameters of the two preparations, and evaluate the human bioequivalence of the two preparations.  METHODS: A single-center, randomized, open, two-period, and self-crossover design was adopted to conduct a fasting and fed bioequivalence study of 23 healthy subjects each. The 0.4 g dose preparations were taken orally per cycle on fasting or fed administration. The plasma concentrations of moxifloxacin at different times after administration were determined by HPLC-MS/MS. The main pharmacokinetic parameters were calculated, and the bioavailability of the test preparation relative to the reference preparation was evaluated. RESULTS: After subjects in the fasting group took the test preparation T and the reference preparation R, the main pharmacokinetic parameters of moxifloxacin hydrochloride were: Cmax (3 476.0±855.2), (3 632.6±1 011.3) ng/mL; Tmax 1.50 (0.25, 4.00), 2.50 (0.25, 4.00) h; AUC0-t (54 972.81±11 400.81), (56 757.41±12 670.53) h·ng·mL-1; AUC0-∞ (56 791.17±11 681.08), (58 574.37±13 072.17) h·ng·mL-1; T1/2 (14.13±2.40), (13.85±2.44) h. After the subjects in the fed group took the test parameter T and the reference parameter R, the main pharmacokinetic parameters of moxifloxacin hydrochloride were: Cmax (3 744.3±819.2), (3 569.1±653.8) ng/mL; Tmax 1.50 (0.50, 4.00), 1.50 (0.50, 4.00) h; AUC0-t (51 613.98±10 725.93), (52 322.70±10 189.50) h·ng·mL-1; AUC0-∞ (53 585.13±10 954.51), (54 207.13±10 313.28) h·ng·mL-1; T1/2 (14.47±3.71), (14.53±3.04) h. The 90%CI of Cmax, AUC0-t, AUC0-∞ geometric mean ratios of the fasting group and the fed group all fell between 80.00%-125.00%. CONCLUSION: The test preparation T and the reference preparation R under fasting and fed conditions are bioequivalent and safe.
    Application of Monte Carlo simulation to evaluate the changes of drug sensitivity in late-onset sepsis of gram-positive cocci in neonates
    KOU Chen, LI Zhaona, ZHANG Yanan, GAO zhengping, ZHANG Tuohui
    2021, 26(12):  1400-1406.  doi:10.12092/j.issn.1009-2501.2021.12.009
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    AIM: Through the Monte Carlo simulation to monitor the change of MIC in late-onset sepsis of gram-positive cocci in neonates, through the cumulative fraction of response to evaluate the changing trend of bacterial resistance in our center and analyze the possibility of inducing drug resistance of bacterial, to reduce the occurrence of bacterial drug resistance in clinical work.  METHODS: This study retrospectively investigated the basic information, pathogen species and drug sensitivity results of neonatal late-onset sepsis of gram-positive cocci in Neonatal Intensive Care Units of Beijing Maternity Hospital from 2016 to 2019, and divided them into four groups by year. Crystal ball software was used to calculate the annual CFR of sensitive antibiotics (Vancomycin) against the gram-positive cocci by Monte Carlo simulation. RESULTS: From 2016 to 2019, there were 58 cases of late-onset sepsis caused by gram-positive cocci in neonates, and the number of pathogens detected each year showed no significant change, and there was no statistical difference in the affected population each year. Among them, the top three were 31 strains of Staphylococcus epidermidis (53.5%), 9 strains of Enterococcus faecium (15.5%), and 6 strains of Enterococcus faecalis (10.3%). Drug sensitivity tests showed that the resistance rates of Staphylococcus epidermidis, Enterococcus faecium and Enterococcus faecalis to Vancomycin and Linezolid were 0%. The CFR of Vancomycin against gram-positive cocci from 2016 to 2019 calculated by Monte Carlo simulation were 82%, 88.72%, 81.73% and 78.53%, respectively, which showed a downward trend. CONCLUSION: By using Monte Carlo simulation method, CFR can reflect the change of bacterial drug resistance with drug sensitivity test as the standard, and evaluate the current treatment plan, which should be paid attention to in clinical work.
    Absorption and excretion of CT-707 in healthy male subjects studied by radioisotope tracer method
    HAN Guijuan, JIANG Ji, OUYANG Weiwei, LUO Hong, ZHANG Xiaojun, WANG Minghua
    2021, 26(12):  1407-1412.  doi:10.12092/j.issn.1009-2501.2021.12.010
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    AIM: To study the absorption and excretion of CT-707 in healthy male subjects. METHODS: Six healthy male subjects received a single 300 mg (120 μCi) oral dose of radio-labeled CT-707 as a suspension in a fasted state. Blood, urine and feces were collected. Radioactivity concentrations were measured by liquid scintillation counting (LSC). The pharmacokinetic parameters of total radioactivity in plasma were calculated by WinNonlin (Pharsight version 8.1) software according to the non-compartment model. The recovery rate of total radioactivity in urine and feces was calculated according to the weight and radioactivity concentration of urine and feces collected at each time interval. RESULTS: After a single 300 mg oral of radio-labeled CT-707 552 h (23 d) as a suspension in a fasted state, the mean AUC0-t, AUC0-∞, Cmax, Tmax and t1/2 values for CT-707 in plasma were (1 049.15±589.38) ng·Equ.g-1·h, (2 288.64±511.05) ng·Equ.g-1·h, (229.00±63.66) ng/Equ.g, (2.83±1.47) h and (6.17±2.43) h, respectively. Excretion test results showed that CT-707 was mainly excreted from feces with a mean cumulative recovery of about (76.24±3.43)%, and partial excreed from urine with a mean cumulative recovery of about (3.41±1.00)%, and a total mean cumulative recovery of about (79.65±3.26)%. CT-707 was well tolerated and no serious adverse events were reported. CONCLUSION: In healthy male subjects, CT-707 suspension preparation can be absorbed quickly and eliminated quickly after a single oral in a fasted state. Most of the suspension preparation can be recovered through feces, showing good safety and tolerated.
    Discussion of the necessity of placing vena cava filter in systemic thrombolytic therapy for patients with acute deep vein thrombosis
    SHI Can, CHEN Rong, CHEN Pengzi, WU Tian
    2021, 26(12):  1413-1418.  doi:10.12092/j.issn.1009-2501.2021.12.011
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    AIM: To investigate the necessity of placing inferior vena cava filter in systemic thrombolytic therapy for patients with acute deep vein thrombosis. METHODS: Retrospectively summarized the clinical data of patients who received urokinase for deep vein thrombosis in the Third Xiangya Hospital of Central South University from September 2006 to April 2020, and discussed the necessity of placing inferior vena cava filter. RESULTS: A total of 549 patients were enrolled, including 294 patients in the filter group (154 males, 140 females) and 255 patients in the non-filter group (126 males, 129 females). Among 268 cases of proximal DVT in the filter group, thirty-five cases were complicated with pulmonary embolism before thrombolysis; and there were 218 cases of proximal DVT in the non-filter group and 16 cases of pulmonary embolism before thrombolysis, with statistical difference between the two groups (P=0.038 and 0.023, respectively). The total amount of urokinase in the filter group was (1 636.3±910.0) thousand units, and that in the non-filter group was (1 490.2±777.2) thousand units, with statistical difference between the two groups (P=0.045). However, there were no statistical differences in the days of use of urokinase and the proportion of patients with adequate anticoagulation. In this study, among 255 patients in non-filter group underwent thrombolysis, only 1 patient developed pulmonary embolism after thrombolysis (P=0.282). CONCLUSION: Inferior vena cava filter is not always necessary for patients with acute deep vein thrombosis during systemic thrombolytic therapy.
    General considerations for bioequivalence studies with pharmacokinetic methods for anti-schizophrenic drugs
    LI Na, HAN Hongcan, WANG Jun
    2021, 26(12):  1419-1425.  doi:10.12092/j.issn.1009-2501.2021.12.012
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    On account of the characteristics of anti-schizophrenic drugs, combined with the technical guidelines for bioequivalence studies of anti-schizophrenic generic drugs in different regulatory institutions at home and abroad, taking some drugs as examples, this paper discusses the key points to be considered in carrying out bioequivalence studies from the perspective of experimental design, so as to provide certain reference for the research and development and evaluation of related products.
    Exploration of early food effect study of innovative drugs based on physiologically-based pharmacokinetic absorption model
    ZHANG Miao, LIU Qian, YAO Xueting, LIU Dongyang
    2021, 26(12):  1426-1429.  doi:10.12092/j.issn.1009-2501.2021.12.013
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    Since the impact of food on innovative drugs exposure will increase the risk of evaluation failures for safety and effectiveness, food effect study is routinely completed before multiple ascending dose (MAD) trials for innovative drugs. The prediction performance of physiologically-based pharmacokinetic absorption model (absorption PBPK model) in the application of food effect prediction has improved, we proposed a new strategy to explore food effect based on the absorption PBPK model. Based on the accurate prediction by absorption PBPK model, the food effect studies for qualified innovative drugs would be nested in MAD clinical trials to intend replacing the early independent food effect study. That would be promising to reduce costs and time for drug development, and also to provide the template for early food effect study in China.
    Research progress of glucose 6 phosphorus dehydrogenase in malignant tumor
    MA Yue, FAN Fangtian
    2021, 26(12):  1430-1436.  doi:10.12092/j.issn.1009-2501.2021.12.014
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    Glucose-6-phosphate dehydrogenase (Glucose-6-phosphate dehydrogenase, G6PD) is the rate-limiting enzyme of pentose phosphate pathway (PPP), which mainly maintains the balance of NADPH and intracellular redox reaction. Reducing G6PD activity or PPP dysfunction can prevent normal cell proliferation, and severe lack of G6PD can damage embryonic development and delay organ growth. At present, many studies have proved that abnormal activation of G6PD can lead to the enhancement of cell proliferation and adaptability of various types of cancer, and it is easy to cause drug resistance and increase the difficulty of clinical treatment. It has become an urgent need for clinical treatment to study the mechanism of G6PD in cancer cells and identify new potential drug therapeutic targets.
    Research progress on the role of pyroptosis in intestinal ischemia-reperfusion injury 
    LU Yapeng, LIU Yang, HAO Wei, ZHONG Hailian, XIE Jianqin, LIU Jieting, WANG Yingbin
    2021, 26(12):  1437-1443.  doi:10.12092/j.issn.1009-2501.2021.12.015
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    Pyroptosis is a newly discovered programmed cell death that can lead to inflammatory response, its occurrence depends on the sequential activation of inflammatory bodies and caspase, and then the pore-forming generated by the fragmentation of gasdermin D and its cell membrane polymerization. Pyroptosis is mainly comprised of the pathway that depends on caspase-1 activated by flammasomes and the non-classical pathway that depends on caspase-4/5/11 activated by cytoplasmic lipopolysaccharide. As an important mechanism mediating the inflammatory response of the body, pyroptosis plays an irreplaceable role in the body's response to noxious stimuli, which is closely related to many diseases such as nervous system diseases, cardiovascular system diseases and tumors. Recent studies have found that pyroptosis also plays a key role in the occurrence of intestinal ischemia-reperfusion (II/RI). This paper reviews the molecular characteristics, mechanism of pyroptosis and its relationship with II/RI in recent years, in order to provide theoretical basis for the prevention and treatment of II/RI.
    Clinical application and research progress of remimazolam
    JIN Baowei, JIANG Zongming, GUO Jianrong
    2021, 26(12):  1444-1448.  doi:10.12092/j.issn.1009-2501.2021.12.016
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    Remimazolam is a new ultra-short-acting sedative, with rapid onset and recovery, metabolism independent of liver and kidney function, light respiratory inhibition, stable hemodynamics, long time application without accumulation. Carboxylic acid metabolites have no pharmacological effects, and can be rapidly reversed by antagonist flumazenil, which is expected to become a new choice of clinical sedative. In this paper, pharmacological characteristics and recent research progress of remimazolam are reviewed, which can provide reference for clinical safe drug use.
    Advances in evidence-based medical research of GnRHa for fertility protection after chemotherapy
    ZHAO Quanfeng, FU Peishu, GU Wenrui, ZHEN Dan, LV Zongjie, YANG Yang
    2021, 26(12):  1449-1454.  doi:10.12092/j.issn.1009-2501.2021.12.017
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    With an improvement in the long-term survival rates of cancer patients,  the requirements for fertility protection of young cancer patients after chemotherapy are increasingly prominent. Early studies have shown that gonadotropin-releasing hormone agonist (GnRHa) has a protective effect on fertility. But in recenct year, relevant studies have shown that its protective effect is controversial. This article reviews the clinical researches of GnRHa for fertility protection in patients with common tumors, and explores its evidence-based medicine, in the hope of providing references for reasonable clinical application.
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    2021, 26(12):  1450. 
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