Recommendations and guidance for providing pharmaceutical care services during COVID-19 pandemic: A China perspective.

BACKGROUND: The novel coronavirus pneumonia (COVID-19), which was first detected in Wuhan City, has now became a pandemic that affecting patients around the world. Particularly, the community patient population are at high risk of infection and are facing potential failure of proper medication use during the pandemic. OBJECTIVE: To discuss community pharmacists' role and the content of pharmaceutical care (PC) during the novel coronavirus pandemic to promote effective prevention and control and safe drug use of the community patient population. METHOD: Collect and summarize the experience Chinese community pharmacies gained from providing pharmacy services during the COVID-19 outbreak, and taking patients' PC needs into consideration, analyze and discuss the methods and strategies that community pharmacies and pharmacists shall use to provide PC during the pandemic. RESULTS: Community pharmacy management teams shall support PC services by providing adequate supply of COVID-19 related medications and preventative products, following environment regulations, and providing sufficient staff trainings. Pharmacists shall use various approaches to provide PC services in drug dispensing, consulting and referrals, chronic disease management, safe use of infusions, patient education, home care guidance and psychological support to promote the COVID-19 pandemic control and ensure safe medication use of community patients during the pandemic. CONCLUSION: PC services in communities during the COVID-19 shall possess different properties due to disease characteristics and related change in patients' need. Community pharmacies shall work as a strong supporter of patient's medication and protective equipment supply. Community pharmacists shall be prepared to provide skilled and effective PC services for community patient population to ensure medication safety and promote the overall COVID-19 pandemic control.

Study on the graft modification mechanism of macroporous silica gel surface based on silane coupling agent vinyl triethoxysilane.

In this research, the graft modification mechanism of coupling agent vinyl triethoxysilane (KH-151) to macroporous silica gel was studied using a combination of multiple methods. SEM, FTIR, RAMAN, NMR and XPS were used to characterize the silica gel before and after grafting, determining the mechanism of the grafting reaction of the silane coupling agent. On this basis, the grafting rate of the coupling agent was accurately calculated by TGA weight loss. From the results of characterization, it can be seen that the coupling agent molecules have two connection types on the surface of silica gel, and the ratio of the two types is 43.51% and 56.49% respectively. The influences of hydration degree of the silica gel, coupling agent dosage and reaction temperature on the grafting rate were explored, and the optimal reaction conditions for the modification of macroporous silica gel were determined by the coupling agent through orthogonal experiments, that is, the hydration degree of silica gel of 10%, a coupling agent dosage of 12 mL, and a reaction temperature of 80 °C. Under optimal reaction conditions, the average grafting rate of the coupling agent vinyl triethoxysilane (KH-151) on macroporous silica gel is as high as 91.03%.

Switching Xe/Kr adsorption selectivity in modified SBMOF-1: a theoretical study.

The separation of Xe/Kr mixtures in used nuclear fuel (UNF) has attracted lots of attention, but no report on the adsorption and separation of Kr from mixed Kr/Xe at room temperature can be found. From grand canonical Monte Carlo (GCMC) simulation, it is found that by replacing the metal center Ca of SBMOF-1 with Mg, due to the appropriate pore size, the adsorption selectivity (S Kr/Xe) was extremely high (250 000) and the adsorption capacity for Kr on Mg-SBMOF-1 modified with -NH2 was increased by 300% to 1.020 from 0.248 mmol g-1. Based on the calculations of density functional theory (DFT), we found that the stronger electron-donating ability of a functional group will increase the polarizability of the ligand, and thus increase the adsorption capacity to Kr. In addition, the analysis of electronic structures with independent gradient model (IGM) and energy decomposition analysis (EDA) indicates that van der Waals forces will be responsible for the interaction of Mg-SBMOF-1 and Kr gas. Among them, the interaction of Mg-SBMOF-1 and Kr gas is mainly an induction force, while that of modifications with -CH3 and -NH2 is mainly a dispersion force. The present theoretical study represents the first report of the separation of Kr from Xe with MOF adsorption at room temperature. We hope this work may promote the experimental synthesis of Mg-SBMOF-1 for efficient separation of Kr and Xe.

Association between the AUC0-24/MIC Ratio of Vancomycin and Its Clinical Effectiveness: A Systematic Review and Meta-Analysis.

BACKGROUND: A target AUC0-24/MIC ratio of 400 has been associated with its clinical success when treating Staphylococcus aureus infections but is not currently supported by state-of-the-art evidence-based research. OBJECTIVE: This current systematic review aimed to evaluate the available evidence for the association between the AUC0-24/MIC ratio of vancomycin and its clinical effectiveness on hospitalized patients and to confirm the existing target value of 400. METHODS: PubMed, Embase, Web of Sciences, the Cochrane Library and two Chinese literature databases (CNKI, CBM) were systematically searched. Manual searching was also applied. Both RCTs and observational studies comparing the clinical outcomes of high AUC0-24/MIC groups versus low AUC0-24/MIC groups were eligible. Two reviewers independently extracted the data. The primary outcomes were mortality and infection treatment failure. Risk ratios (RRs) with 95% confidence intervals (95%CIs) were calculated. RESULTS: No RCTs were retrieved. Nine cohort studies were included in the meta-analysis. Mortality rates were significantly lower in high AUC0-24/MIC groups (RR = 0.47, 95%CI = 0.31-0.70, p<0.001). The rates of infection treatment failure were also significantly lower in high AUC/MIC groups and were consistent after correcting for heterogeneity (RR = 0.39, 95%CI = 0.28-0.55, p = 0.001). Subgroup analyses showed that results were consistent whether MIC values were determined by broth microdilution (BMD) method or Etest method. In studies using the BMD method, breakpoints of AUC0-24/MIC all fell within 85% to 115% of 400. CONCLUSIONS: This meta-analysis demonstrated that achieving a high AUC0-24/MIC of vancomycin could significantly decrease mortality rates by 53% and rates of infection treatment failure by 61%, with 400 being a reasonable target.

miRNA-149* promotes cell proliferation and suppresses apoptosis by mediating JunB in T-cell acute lymphoblastic leukemia.

MicroRNA-149* (miRNA-149*) functions as an oncogenic regulator in human melanoma. However, the effect of miRNA-149* on T-cell acute lymphoblastic leukemia (T-ALL) is unclear. Here we aimed to analyze the effects of miRNA-149* on in vitro T-ALL cells and to uncover the target for miRNA-149* in these cells. The miRNA-149* level was determined in multiple cell lines and bone marrow cells derived from patients with T-ALL, B acute lymphoblastic leukemia (B-ALL), acute myelocytic leukemia (AML), and healthy donors. We found that miRNA-149* was highly expressed in T-ALL cell lines and T-ALL patients' bone marrow samples. JunB was identified as a direct target of miR-149*. miRNA-149* mimics downregulated JunB levels in Molt-4 and Jurkat cells, while miRNA-149* inhibitors dramatically upregulated JunB expression in these cells. miRNA-149* mimics promoted proliferation, decreased the proportion of cells in G1 phase, and reduced cell apoptosis in T-ALL cells, while miRNA-149* inhibitors prevented these effects. miRNA-149* mimics downregulated p21 and upregulated cyclinD1, 4EBP1, and p70s6k in Molt-4 and Jurkat cells. Again, inhibitors prevented these effects. Our findings demonstrate that miRNA-149* may serve as an oncogenic regulator in T-ALL by negatively regulating JunB.

Comparative study between original and traditional method in establishing a chronic sinus node damage model in rabbit.

Sick Sinus Syndrome is a common and refractory arrhythmia, needing further study in which setting up a credible sinus node damage model is important. To explore the feasibility and superiority of an original formaldehyde pinpoint pressing permeation (FPPP) method for building a chronic sinus node damage (CSND) model, 5 rabbits were chosen from 35 as a sham-operation group, and the remaining were randomly divided into two groups: the formaldehyde wet compressing (FWC) group, in which models were established by applying a cotton bud dipped in 20% formaldehyde onto the sinus node (SN) area, and the FPPP group, in which models were established by injecting formaldehyde into the SN area through a self-made pinpointing and injecting electrode. We found that in both groups, the HR at 2 h, 24 h, 1 wk, and 2 wk after modeling decreased compared with premodeling; sinoatrial conduction time, sinus node recovery time, and corrected sinus node recovery time were prolonged compared with premodeling. The indexes mentioned shortened by 2 wk after modeling compared with 2 h in the FWC group, whereas they were stable after modeling in the FPPP group. The modeling achievement ratio in the FPPP group was higher and the death rate was lower. Under light microscope, paraffin sections of the SN tissue and cells showed severe injury in both groups. The results indicate that the CSND models in rabbits can be successfully established by the FPPP method, with higher achievement ratio, lower death rate, better stabilization effect, and less damaging comparing with the traditional method.

[Effect of kangxin fulu recipe on electrophysiological functions of the sinoatrial node in rabbits with sick sinus syndrome].

OBJECTIVE: To study the effect of Kangxin Fulu Recipe (KFR) on electrophysiological functions of the sinoatrial node in rabbits with sick sinus syndrome (SSS). METHODS: Sixty big ears white rabbits were randomly divided into six groups, i.e., the normal group, the model group, the atropine group, the high dose KFR group, the middle dose KFR group, and the low dose KFR group, ten in each group. SSS model was established by injecting formaldehyde to the sinoatrial node except those in the normal group. Changes in AA interval, the sinoatrial conduction time (SACT), the sinus node recovery time (SNRT), and the corrected sinus node recovery time (CSNRT) were measured before and after modeling, seven days before and after gastrogavage. RESULTS: (1) The AA interval and SACT could be significantly shortened in the high dose KFR group, the middle-dose KFR group, and the atropine group (P<0.05, P<0.01). Better effects were obtained in the former two groups (P<0.05). (2) SNRT and CSNRT could be shortened in the high dose KFR group and the atropine group, with no statistical difference between the two groups (P>0.05). CONCLUSION: The electrophysiological mechanism of KFR might possibly be correlated with accelerating the recovery of sinus node autorhythmicity and conduction functions.