Therapeutic effects of the extract of Sancao Formula, a Chinese herbal compound, on imiquimod-induced psoriasis via cysteine-rich protein 61 / 中西医结合学报

OBJECTIVE@#Psoriasis is a common chronic inflammatory skin disease that is prone to recurrence, and the proinflammatory factor, cysteine-rich protein 61 (Cyr61), is important in its pathophysiology. Long-term clinical practice has shown that Sancao Formula (SC), a Chinese herbal compound, is effective in the treatment of psoriasis, but the precise mechanism remains unknown. In this study, we investigate the mechanism by which SC extract alleviates imiquimod (IMQ)-induced psoriasis.@*METHODS@#The expression of Cyr61 in psoriatic lesions and normal healthy skin was detected using immunohistochemical analysis to investigate the biological role of Cyr61 in models of psoriatic inflammation. A psoriatic mouse model was established by topical application of IMQ, and the effect of topical application of SC extract was evaluated using the psoriasis area and severity index (PASI) score, hematoxylin-eosin staining, and histopathological features of the skin. Next, a HaCaT cell inflammation model was established using interferon-γ (IFN-γ), and the effect of SC extract on the mRNA and protein levels of Cyr61 and intercellular cell adhesion molecule-1 (ICAM-1) was confirmed using Western blot and quantitative real-time polymerase chain reaction analyses.@*RESULTS@#Immunohistochemical staining showed that the expression of Cyr61 in psoriatic lesions was higher than that in normal skin samples (78.26% vs 41.18%, P < 0.05), and the number of Cyr61-positive cells in psoriatic lesions was also significantly higher than in normal skin (18.66 ± 2.51 vs 4.33 ± 1.52, P < 0.05). Treatment in mice with IMQ-induced psoriasis showed that SC extract could significantly improve the inflammatory phenotype, PASI score (10.875 ± 0.744 vs 3.875 ± 0.582, P < 0.05), and pathological features compared with those in IMQ model group; SC treatment was also associated with decreased levels of Cyr61 and ICAM-1. In the IFN-γ-induced inflammatory cell model, the mRNA and protein levels of Cyr61 and ICAM-1 were upregulated, while the SC extract downregulated the levels of Cyr61 and ICAM-1.@*CONCLUSION@#The results provide a theoretical basis for the involvement of Cyr61 in the pathogenesis of psoriasis, and suggest that SC should be used to target Cyr61 for the prevention of psoriasis recurrence.

Cross Sectional Survey on Therapeutic Drug Monitoring of Imipenem in Critically Ill Patients of the Real World / 中国药学杂志

OBJECTIVE: To explore the application of therapy drug monitoring of imipenem in ICU, and to provide evidence for the use of imipenem in critically ill patients. METHODS: A cross-sectional survey was conducted to collect clinical data of 67 patients receiving therapeutic drug monitoring of imipenem in ICU from January 1, 2016 to December 31, 2018. Using SPSS21.0 statistical software, 71 cases of therapeutic drug monitoring data (blood drug concentration, f%T>MIC) and related clinical data were analyzed. RESULTS: Of all 71 cases of therapeutic drug monitoring, there are 37 cases (52.11%) f%TMIC≥40%,26 cases(36.62%)f%TMIC70%,and 10 cases(14.08%) f%TMIC=100%. f%TMIC of all cases with 0.25 g q6h were 70%. Among other dosage regimens, the highest proportion of f%T>MIC>40% was 1 g q12h (66.67%) and the highest proportion of f%T>MIC>70% was 0.5 g q8h(43.59%). According to different f%T>MIC, those patients were divided into ≤40% group, >40%-70% group and>70%group. Only group>70% showed a downward trend in the infection index of patients before and after medication. The body temperature decreased significantly (P=0.004), while the average PCT level of group MIC>70% group showed a downward trend in serum creatinine after treatment, but there was no significant difference (P=0.285). The serum drug concentration in CRRT group was slightly higher than that in non-CRRT group, and there was no significant difference in f%T>MIC (P=0.376, P=0.209, P=0.988). CONCLUSION: The level of f%T>MIC of imipenem in ICU is unsatisfactory. For critically ill patients, when imipenem f%T>MIC>70%, the antimicrobial effect is better.

Analysis of the improvement of perioperative antibiotic prophylaxis in our hospital / 中国药学杂志

OBJECTIVE: To analysis the improvement of perioperative antibiotic prophylaxis in 3 kinds of surgical incisions after we strengthened the management of antibiotics in our hospital and provide reference for clinical rational use of antibiotics. METHODS: Random selected 139 medical records from January to October in 2011as the control group, and random selected 150 medical records from January to October in 2012 as the monitoring group. Compared the surgical site infection rates, antimicrobial utilization rate, the average number of medication days, the cost of antimicrobial drugs and the rationality of the antibiotics, etc. between the two groups in order to investigate if the monitoring group significantly improved. RESULTS: There was no significant difference (p=1.00) in Surgical site infection rates between the two groups. The antimicrobial utilization rate (P<0.001), the average number of medication days (P=0.001), the average cost of hospitalization (P=0.006), the average drug costs (P<0.001), the average antibacterial drug costs (P<0.001), the average antibacterial drug cost/the average cost of hospitalization (P<0.001), the reasonable rate for the choice of the drug (P=0.003), the reasonable rate for the intraoperative medication time (P=0.007) in the monitoring group were significantly better than the control group in type 1incision operation; in type 2incision operation the average number of medication days (P=0.05), the average antibacterial drug costs (P=0.015), the average antibacterial drug costs/the average inpatient costs (P=0.03), the reasonable rate for the preoperative medication time (P<0.001), thereasonable rate for the postoperative medication (P=0.001) in the monitoring group were significantly better than the control group; and in type 3 incision operation only the average antibacterial drug costs/the average inpatient costs (P=0.046) and the reasonable rate for the intraoperative medication time (P=0.057) in the monitoring group were significantly better than the control group. COMCLUSION The Measures to strengthen the management of antimicrobial drugs in our hospital can improve the rational use of antimicrobial agents in type 1incision operation. However, we need to further strengthen the management of preventive antibacterial drugs in type 2and type 3 incision operation.