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Objective To investigate a suspected outbreak of carbapenem-resistant Klebsiella pneumoniae(CRKP)healthcare-associated bloodstream infection(HA-BSI),provide reference for effective control of CRKP in-fection.Methods The characteristics of CRKP infected patients and the risk factors for the event transmission in an adult hematology department of a teaching hospital in June 2022 were obtained by field epidemiological investigation.The specimens of environmental target strains were co-llected by blood nutrient agar inoculation,the removal status of environmental microorganisms and the effect of infection control after implementing control measures were com-pared.Results There were a total of 6 cases of CRKP HA-BSI,with an attacking rate of 1.29%(6/464),which was significantly higher than 0 during the same period in 2021,and difference was statistically significant(P=0.011).In environmental hygiene monitoring,the detection rate of CRKP was 2.27%(1/44),which was from the surface of bed curtain in the living unit of infected patients,homology analysis with CRKP detected from 2 patients revealed that the 16s RNA of 3 CRKP strains was completely identical,with a similarity of 100%.Seven house-keeping genes of 3 CRKP strains were all identical and belonged to the ST11 type.Comprehensive control measures were taken:appropriate closure of the ward,centralized isolation of patients,terminal disinfection of the ward,reg-ular health care workers and relative restriction of their activity areas.After the measures were taken,the qualified rate of microbial colony count in the ward increased compared to before taking the measures(2.27%vs 68.89%,P<0.001),with a statistically significant difference,there were no more CRKP infected cases after the intervention,indicating that the control measures were effective.Conclusion This outbreak was caused by ST11 type of common CRKP in China,and laminar bed curtains are carriers of pathogen transmission.It is speculated that non-standard cleaning and disinfection,as well as inadequate implementation of hand hygiene are the main causes for transmis-sion.Adopting an appropriate strategy of closing the ward and concentrating patient isolation can quickly and effec-tively prevent the transmission of the event.
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Aim To investigate the effect of overexpression of silent information regulator 1 (Sirtl) on cardiac function in mice with myocardial ischemia. Methods Myocardial specific Sirtl overexpression transgenic mice (Sirtl-Tg) and littermate control mice (C57BL/6J), half male and half female, were randomly divided into control sham operation group (Con), control model group (Con +ISO), Sirtl overexpression sham operation group (Sirtl-Tg) and Sirtl overexpression model group (Sirtl-Tg + ISO). Isoproterenol (ISO) was injected subcutaneously into the back of the neck at 100 mg • kg
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OBJECTIVE@#To compare the clinical efficacy, survival, and prognosis of autologous hematopoietic stem cell transplantation (ASCT) with new drug chemotherapy in the treatment of newly diagnosed multiple myeloma (NDMM) in the new drug era.@*METHODS@#The clinical data of 149 patients with NDMM treated with new drug induction regimen in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2012 to December 2019 were retrospectively analyzed. Twenty-four patients who received ASCT were in ASCT group, and 125 patients who did not receive ASCT were in non-ASCT group. The median follow-up time was 43 (1-90) months. The propensity score matching (PSM) method was used to balance confounding factors, then depth of response, overall survival (OS), and progression-free survival (PFS) between the two groups were compared and subgroup analysis was performed.@*RESULTS@#After matching, the covariates were balanced between the two groups. Fifty-one patients (15 cases in ASCT group and 36 cases in non-ASCT group) were included. ASCT patients had a better complete response (CR) rate than non-ASCT patients receiving maintenance therapy (93.3% vs 42.3%, P=0.004), while there were no statistical differences in deep response rate and overall response rate (ORR) between the two groups (93.3% vs 65.4%, P=0.103; 93.3% vs 96.2%, P=1.000). Before matching, the 3 and 5-year PFS rate and median PFS (mPFS) in ASCT group and non-ASCT group were [89.6% vs 66.5%, P=0.024; 69.8% vs 42.7%; non-response (NR) vs 51.0 months], and the 3 and 5-year OS rate and median OS (mOS) were (100% vs 70.6%, P=0.002; 92.3% vs 49.6%; NR vs 54.0 months). After matching, the 3 and 5-year PFS rate and mPFS in ASCT group and non-ASCT group were (83.6% vs 61.7%, P=0.182; 62.7% vs 45.7%; NR vs 51.0 months), the 3 and 5-year OS rate and mOS were (100% vs 65.6%, P=0.018; 88.9% vs 46.9%; NR vs 51.0 months). Subgroup analysis showed that patients with mSMART 3.0 high risk stratification, the 3-year PFS rate and mPFS in ASCT group and non-ASCT group were (83.3% vs 41.5%, P=0.091; NR vs 34.0 months), and the 3-year OS rate and mOS were (100% vs 41.5%, P=0.034; NR vs 34.0 months). Patients with mSMART 3.0 standard risk stratification, the 3-year PFS rate and OS rate in ASCT group and non-ASCT group were (83.3% vs 76.8%, P=0.672; 100% vs 87.2%, P=0.155). The 3-year PFS and OS rate in MM patients who achieved deep response within 3 months after transplantation compared with non-ASCT patients who achieved deep response after receiving maintenance therapy were (83.1% vs 56.7%, P=0.323; 100% vs 60.5%, P=0.042), and the 3-year PFS and OS rate in patients who achieved overall response in both groups were (83.1% vs 62.5%, P=0.433; 100% vs 68.1%, P=0.082). After matching, Cox multivariate regression analysis showed that mSMART 3.0 risk stratification and ASCT were independent prognostic factors for OS.@*CONCLUSION@#In the new drug era, ASCT can increase CR rate and prolong OS of NDMM patients. ASCT patients who are mSMART 3.0 high risk stratification or achieved deep response within 3 months after transplantation have better OS than non-ASCT patients receiving new drug chemotherapy. ASCT and mSMART 3.0 risk stratification are independent prognostic factors for OS in NDMM patients.
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Humans , Antineoplastic Combined Chemotherapy Protocols , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Multiple Myeloma/drug therapy , Pharmaceutical Preparations , Propensity Score , Retrospective Studies , Stem Cell Transplantation , Transplantation, Autologous , Treatment OutcomeABSTRACT
To explore the action mechanism of Xuefu Zhuyu Decoction in treating myocardial infarction based on network pharmaco-logy and molecular docking. Active components and corresponding targets of Xuefu Zhuyu Decoction were obtained through Traditional Chinese Medicine Systems Pharmacology Database(TCMSP), and related targets of myocardial infarction were obtained through GeneCards, DisGeNET, and OMIM databases. Then the intersection targets were obtained by integrating the drug targets and disease targets. The "active component-target" network was constructed by Cytoscape software, and protein-protein interaction(PPI) network was drawn using STRING platform. Protein cluster analysis was carried out using MCODE. GO enrichment analysis and KEGG pathway analysis were carried out using DAVID database and ClueGO, and molecular docking was carried out using Autodock Vina and Pymol. Finally, 226 active components of Xuefu Zhuyu Decoction were obtained, 257 corresponding targets, 1 340 targets of myocardial infarction, and 109 drug and disease intersection targets were obtained. From GO enrichment analysis, 208 biological process terms, 38 molecular function terms, and 33 cellular component terms were obtained. From KEGG pathway analysis, NF-κB signaling pathway, IL-17 signaling pathway, HIF-1 signaling pathway, and other related pathways were obtained. The molecular docking results showed that the main active components(quercetin, kaempferol, β-sitosterol, luteolin, stigmasterol and baicalein) of Xuefu Zhuyu Decoction in the treatment of myocardial infarction had good binding properties with the core proteins IL6, ALB, VEGFA, TNF, MAPK3 and CASP3. The results suggested that Xuefu Zhuyu Decoction may play a role in the treatment of myocardial infarction by reducing the inflammatory response, reducing oxidative stress, inhibiting cell apoptosis, and promoting angiogenesis.
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Humans , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Molecular Docking Simulation , Myocardial Infarction/geneticsABSTRACT
OBJECTIVE@#To study whether there are differences in the resuscitation process and early outcomes between the extremely preterm infants delivered on off-hours (6 pm to 8 am of working days, weekends, and national holidays) and those delivered on working hours.@*METHODS@#A retrospective analysis was performed on the medical data of extremely preterm infants who were born in the Peking University Third Hospital from January 1, 2010 to December 31, 2020 and transferred to the neonatal intensive care unit (NICU). According to the time of birth, they were divided into two groups:working hours (@*RESULTS@#Compared with the working hours group, the off-hours group had a significantly lower proportion of infants with the use of full-dose dexamethasone before delivery (@*CONCLUSIONS@#Extremely preterm infants delivered on off-hours tend to have a low Apgar score at 1 minute after birth, with a higher proportion of infants requiring positive pressure ventilation or tracheal intubation during resuscitation than those delivered on working hours, and they tend to develop neonatal respiratory distress syndrome and intrauterine pneumonia. This suggests that it is important to make adequate preparations in terms of personnel and supplies for resuscitation of extremely preterm infants after birth and that NICUs should develop a detailed management plan for extremely preterm infants at each period of time before, during, and after birth.
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Humans , Infant , Infant, Newborn , Infant, Extremely Premature , Intensive Care Units, Neonatal , Respiratory Distress Syndrome, Newborn , Resuscitation , Retrospective StudiesABSTRACT
: Aim To explore the role and possible mechanism of forked transcription factor (FoxO1) in hepatocyte apoptosis induced by homocysteine (Hey) . Methods The male cbs
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Aim To discuss the mechanism of proteasome 26S subunit non-ATPase 10(PSMD10) activating hepatocyte autophagy and promoting liver injury by in homocysteine. Methods Wild mice and cystathionine β-synthase (CBS) gene knockout mice were used and divided into normal (cbs
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OBJECTIVE: To study the mechanism of flunarizine in the nitroglycerin-induced migraine model rats by metabonomics. METHODS: The nitroglycerin-induced migraine rat model was used and the brain samples and serum samples were obtained at 30, 60, and 90 min after model establishment or drug administration. After the isolation of TCC sites was performed,GC-TOF-MS was used to analyze the metabolic status of rat serum and TCC sites in different groups. RESULTS: The metabolic status of the model group and the flunarizine group differed from that of the control group at the same time point.The metabolic state that compared with the model group or the flunarizine group at different time points changes continuously with time. Compared with those in the model group, L-asparagine, 5-methoxytryptamine, α-lactose, ribitol, arachidonic acid, and glycerol in the serum samples and the phosphoglycolic acid, erythrose, inosine, glyceric acid, and D-glucose in the TCC samples were changed in the flunarizine group, indicating that the energy metabolism pathways and amino acid metabolic pathways were involved in the mechanism of flunarizine intervening migraine. CONCLUSION: Flunarizine may improve metabolic disorders in nitroglycerin-induced migraine model rats by affecting energy metabolism and amino acid metabolism.
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Evidence continues to grow on potential health risks associated with Ginkgo biloba and its constituents. While biflavonoid is a subclass of the flavonoid family in Ginkgo biloba with a plenty of pharmacological properties, the potential toxicological effects of biflavonoids remains largely unknown. Thus, the aim of this study was to investigate the in vitro and in vivo toxicological effects of the biflavonoids from Ginkgo biloba (i.e., amentoflavone, sciadopitysin, ginkgetin, isoginkgetin, and bilobetin). In the in vitro cytotoxicity test, the five biflavonoids all reduced cell viability in a dose-dependent manner in human renal tubular epithelial cells (HK-2) and human normal hepatocytes (L-02), indicating they might have potential liver and kidney toxicity. In the in vivo experiments, after intragastrical administration of these biflavonoids at 20 mg·kg·d for 7 days, serum biochemical analysis and histopathological examinations were performed. The activity of alkaline phosphatase was significantly increased after all the biflavonoid administrations and widespread hydropic degeneration of hepatocytes was observed in ginkgetin or bilobetin-treated mice. Moreover, the five biflavonoids all induced acute kidney injury in treated mice and the main pathological lesions were confirmed to the tubule, glomeruli, and interstitium injuries. As the in vitro and in vivo results suggested that these biflavonoids may be more toxic to the kidney than the liver, we further detected the mechanism of biflavonoids-induced nephrotoxicity. The increased TUNEL-positive cells were detected in kidney tissues of biflavonoids-treated mice, accompanied by elevated expression of proapoptotic protein BAX and unchanged levels of antiapoptotic protein BCL-2, indicating apoptosis was involved in biflavonoids-induced nephrotoxicity. Taken together, our results suggested that the five biflavonoids from Ginkgo biloba may have potential hepatic and renal toxicity and more attentions should be paid to ensure Ginkgo biloba preparations safety.
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Psoriasis is a common,chronic autoimmune/inflammatory disease directed by abnormal activation of skin immune system.It is characterized by erythematous plaques and slivery scales in the patients'lesional sites.Dendritic cells,macrophages,gamma delta T cells and group 3 innate lymphocytes are great contributors to the progress of the disease,as they are the main source of proin-flammatory cytokines like TNF-α,IL-1β,IL-6,IFN-α,IL-23 and IL-17.Particularly,as the initiator of the inflammation,DCs are indispensable of the progress.There are different subpopulations of dendritic cells in the skin,in this review,we are trying to elaborate their unique location and function based on the published articles.
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Hypoxia is a common pathophysiological state especially in the processing inflammatory tissues cells due to hypoxia partial pressure caused by excessive oxygen consumption or insufficient oxygen supply. Hypoxia inducible factor(HIF) that regulates the transcription of downstream target genes in order to cope with the hypoxia environments is induced by various mechanisms in hypoxic state. Studies have demonstrated that HIF-α plays essential roles in the inflammatory response. This paper reviews the recent research that the roles and mechanisms of HIF-α in inflammation-associated diseases mediated by innate immune cells.
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Objective To predict the antiviral and anti-inflammatory mechanisms of major compounds from the flowers of Trollius chinensis, namely, vitexin, orientin, 2"-O-β-L-galactopyranosylvitexin, 2"-O-β-L-galactopyranosylorientin, veratric acid, and trolline, by using the molecular docking technique. Methods Discovery Studio 2.5 software and Chinese Medicine Chemistry Database were employed for docking between the ligands including 6 compounds and the proteins including Toll-like receptors (TLRs) and neuraminidase (NA). The docking results and interactions of their functional domains were obtained by simulation analysis. Results Vitexin, orientin, 2"-O-β-L-galactopyranosylvitexin, veratric acid, and trolline were applied to one or more TLR, whereas 2"-O-β-L-galactopyranosylorientin could interact with neither of the proteins investigated. Flavonoids, namely vitexin, orientin, 2"-O-β-L-galactopyranosylvitexin and 2"-O-β-L-galactopyranosylorientin were applied to NA, whereas veratric acid and trolline could not interact with NA. Conclusion Five out of the 6 compounds have influence on the signaling pathways mediated by TLRs, and TLR3, 4, and 7 are their potential targets for antivirus and anti-inflammation. Four flavonoids can affect the activity of influenza virus by interacting with NA. This study can provide a basis for the investigation of the antiviral and anti-inflammatory effective compounds of the flowers of Trollius chinensis and the further development.
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Objective To evaluate the significance of liver biopsy and B ultrasonograpgy in the diagnosis of fatty liver. Methods The results of 62 patients with liver steatosis diagnosed by liver puncture biopsy but not by B-ultrasonograpgy were contrastively analyzed and combined with liver function, blood lipids, blood glucose, and body mass index. Results The 62 cases which were not diagnosed as fatty liver by B-ultrasonograpgy were proved to be 5%-33%liver steatosis after liver puncture biopsy. Among the 62 cases, 23 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo did not see abnormalities, 18 cases showed the liver parenchyma echo slightly was enlarged, 17 cases showed the liver parenchyma echo density was a bit enhanced and 4 cases were diffuse liver damage,which respectively were 37.01%、29.03%、27.42%and 6.45%. Pathologically it indicated that 45 cases were 5%≤liver steatosis≤19%. Among the 45 cases, 18 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo was not seen abnormalities, 8 cases showed the liver parenchyma echo slightly was enlarged, 17 cases showed the liver parenchyma echo density was a bit enhanced, and 2 cases were diffuse liver damage, and the change of ultrasound was mainly showed by the liver parenchyma echo not seen abnormalities and the enhanced liver parenchyma echo density. Pathologically it indicated that 17 cases were 20%≤liver steatosis≤33%, 6 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo did not see abnormalities, 5 cases showed the liver parenchyma echo slightly was enlarged, 5 cases showed the liver parenchyma echo density was a bit enhanced, and 1 case was diffuse liver damage, and the change of ultrasound was mainly showed by the liver parenchyma echo not seen abnormalities, the slightly enlarged liver parenchyma echo and the enhanced liver parenchyma echo density. By analyzing the influence to the ultrasound changes by patients' liver function, body mass index, blood fat and blood sugar, and with logistic regression analysis through a disorderly classification, it was found that the larger value of the glutamine transferase, alkaline phosphatase, body mass index, triglyceride and low density lipoprotein cholesterol, the higher possibility of diffuse liver damage, and the higher level of fatty degeneration, the higher possibility of diffuse liver damage. Conclusion In the diagnosis of fatty liver, when the fatty degeneration is below 1/3, B-ultrasonic examination can't show characteristic changes of fatty liver. It should be closely observed or take liver puncture biopsy to make a definite diagnosis of fatty liver.
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Objective By comparing the methylation status of imprinted gene H19 in three different quality spermatozoa and the methylation status of the embryos after the combination of spermatozoa, the sperm methylation status in the ART technique was preliminarily explored with the postnatal embryo methylation.Methods In this study, a total of 91 spermatozoa and 91 low-quality embryos were collected from IVF-ET in the First People's Hospital of Yunnan Province. Among them, sperm samples were divided into three groups according to the sperm concentration parameter in the WHO fourth edition,then the relationship between different quality spermatozoa and postnatal embryo methylation were analyzed.Results The abnormality rate of H19 methylation status in group B was significantly higher than that of the sperm group and the embryo group.Conclusions The abnormalities of H19 methylation mainly concentrated in the abnormal parameters of spermatozoa,suggesting that the abnormal state was related to the decrease of sperm quality;Through IVF, ICSI fertilized embryos have the same proportion of the corresponding abnormal state with no significant difference; Abnormal sperm embryos did not show abnormality, which may be related to the self-repair function of the embryo itself.
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AIM To study the effects of active components extracted from Dachuanxiong Decoction (DCXD,Chuanxiong Rhizoma,Gastrodiae Rhizoma) on the expressions of calcitonin gene-related peptide (CGRP) and its receptors in hypothalamus and periaqueductal gray (PAG) of rats with migraine.METHODS Seventy-two rats were evenly assigned to six groups at random,normal group,model group,positive drug group,groups of highdose,middle-dose and low-dose DCXD.Each group was then divided into Subgroup A and Subgroup B.The migraine rat model was established by subcutaneous nitroglycerin injection.The expressions of CGRP in Subgroup B's rat hypothalamus and PAG were observed by immunohistochemical staining,while the levels of CGRP in rat plasma,hypothalamus and PAG in Subgroup A were detected by ELISA.All the gene expressions of CGRP and its receptors (CRLR,RCP,RAMP1) in Subgroup A's rat hypothalamus and PAG were assessed by real-time PCR.RESULTS There was a more significant CGRP level increase in plasma,hypothalamus and PAG in the model group than that in the normal group (P < 0.01).The modelled rats found their up-regulated expressions of CGRP and RCP in hypothalamus (P < 0.05),up-regulated expressions of CGRP and CRLR in PAG,and down-regulated expression of RCP (P < 0.05).All low-dose,middle-dose,high-dose active components worked in decreasing the CGRP levels in plasma,hypothalamus and PAG.The middle-dose led to down-regulation of CGRP,RCP expressions in hypothalamus (P <0.05,P <0.01),down-regulation of CGRP,CRLR expressions in PAG (P <0.05),and up-regulation of RCP expression in PAG (P < 0.05).CONCLUSION The mechanism of active components extracted from DCXD in migraine management may associate with its capability in down-regulating CGRP expressions in hypothalamus and PAG,reducing CGRP synthesis and inhibiting neurogenic inflammation.
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A boy aged 2 months (born at 36 weeks of gestation) was admitted due to cough and dyspnea. After admission, he was found to have persistent hypertension, proteinuria, and persistent convulsion, and imaging examination showed extensive calcification of the aorta and major branches and stenosis of local lumens of the abdominal aorta and the right renal artery with increased blood flow velocity. The boy was admitted during the neonatal period due to wet lung and pulmonary arterial hypertension and was found to have hypertension and proteinuria. High-throughput whole-exome sequencing was performed and found two compound heterozygous mutations in the ENPP1 gene from his parents, c.130C>T (p.Q44X) and c.1112A>T (p.Y371F). c.130C>T was a nonsense mutation, which could cause partial deletion of protein from 44 amino acids, and was defined as a primary pathogenic mutation. c.1112A>T was a missense mutation which had been reported as a pathogenic mutation associated with idiopathic infantile arterial calcification (IIAC). Therefore, he was diagnosed with IIAC. He was given phosphonate drugs, antihypertensive drugs, anticonvulsion treatment, and respiratory support. Blood pressure was maintained at the upper limit of normal value. There was no deterioration of arterial calcification. It is concluded that IIAC should be considered for infants with persistent hypertension and extensive vascular calcification, and imaging and genetic examinations should be performed as early as possible to make a confirmed diagnosis.
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Humans , Infant , Male , Hypertension , Infant, Premature , Mutation , Vascular CalcificationABSTRACT
This study is designed to investigate the effect of triptolide on the function and expression of P-glycoprotein (P-gp) in HNE1 nasopharyngeal cancer cells. MTT assay was used to test cell viability. Intracellular doxorubicin content was evaluated with flow cytometry. Rhodamine 123 (Rh) was used to detect the excretion function of P-gp. The expression of P-gp was analyzed by Western blot. ATP levels were evaluated. JC-1 staining was used to determining mitochondrial membrane potential (MMP). Triptolide, doxorubicin and the combination treatment all had the inhibitory effect to HNE1 cells, and the combination treatment had the best effect. Triptolide increased intracellular concentration of doxorubicin and Rh (P P P < 0.05). JC-1 staining showed that triptolide mediated the down-regulation of MMP in HNE1 cells. Triptolide could increase intracellular drug content and enhance cytotoxicity of chemotherapeutics by inhibition of the expression and the excretion function of P-gp.
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Timolol maleate cubic nanoparticles (TM-LCNPs) were prepared via fragmentation of a bulk GMO/poloxamer 407 cubic phase gel by high-pressure homogenization. The optimal prescription was selected based on particle size and entrapment efficiency by orthogonal design method. Malvern particle sizer, polarized light microscopy, and differential scanning calorimetry were used to characterize the cubic nanoparticles. Commercial eye drops were used as a control for the release and corneal permeation experiment in vitro. Fluorescence imaging was used to observe the retention of Rhodamine B cubic nanoparticles (RhB-LCNPs) in rabbit cornea. The results indicated that the optimal prescription and preparation of TM-LCNPs was oil-water ratio (7:3), homogenous pressure (900 bar), the number of homogenizations (6) and drug loading (1%). Corneal permeability of TM-LCNPs was significantly higher than that of commercially available eye drops. The residence time in eyes was longer which suggested a sustained release behavior. The pathology result of rabbit corneal after multiple administration of TM-LCNPs showed that there was no apparent damage.
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<p><b>OBJECTIVE</b>To analyze the clinical significance of corrected serum calcium(CSCa) in patients with multiple myeloma.</p><p><b>METHODS</b>The serum calcium levels of 320 patients with initial multiple myeloma were measured and corrected by serum albumin and its levels measured simultaneously. The differences of serum calcium levels were analyzed before and after the correction by serum albumin.</p><p><b>RESULTS</b>There was a significant difference between serum calcium and CSCa in MM patients (2.34±0.15 vs 2.6±0.17 mmol/L). The constituent ratio of patients with hypercalcemia was from 11.3% to 23.1% after correction, the MM patients with hypocalcemia was decreased from 42.8% to 7.8% after correction, and the patients with normal calcium level were increased. There was a significant difference between serum calcium level and CSCa in I, II, III stages of MM patients respectively(P<0.05). In the 320 patients, the incidence of anemia was 80%, renal failure was 20.9%, and myeloma bone disease was 68.8%. Calcium concentration in both anemia and renal insufficiency was higher than the normal group, and the difference was more significant after correction. In 220 cases of MM receiving chemotherapy, the median progression-free survival (PFS) was 15 months, and overall survival(OS) time was 20 months. The PFS and OS time of the patients with hypercalcemia were shortened, and the difference was very significant after correction(P<0.01).</p><p><b>CONCLUSION</b>Corrected serum calcium can more sensitively to reflect the diseases serious extent, thus indicating prognosis has better effect.</p>
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In this paper, a design space approach was applied to optimize the dropping process of Ginkgo biloba dropping pills. Firstly, potential critical process parameters and potential process critical quality attributes were determined through literature research and pre-experiments. Secondly, experiments were carried out according to Box-Behnken design. Then the critical process parameters and critical quality attributes were determined based on the experimental results. Thirdly, second-order polynomial models were used to describe the quantitative relationships between critical process parameters and critical quality attributes. Finally, a probability-based design space was calculated and verified. The verification results showed that efficient production of Ginkgo biloba dropping pills can be guaranteed by operating within the design space parameters. The recommended operation ranges for the critical dropping process parameters of Ginkgo biloba dropping pills were as follows: dropping distance of 5.5-6.7 cm, and dropping speed of 59-60 drops per minute, providing a reference for industrial production of Ginkgo biloba dropping pills.