The prevalence of osteoporosis in postmenopausal women in urban Tianjin, China and its related factors.

OBJECTIVES: The aims of the study are to understand the prevalence of osteoporosis in postmenopausal women in urban Tianjin, China and its related factors through a questionnaire and to assess the correlation between individual characteristics, physical mobility, psychological and emotional well-being, and prevalence, as well as people's awareness of osteoporosis. METHODS: We selected 240 postmenopausal women from 12 randomly selected streets in 6 administrative districts of Tianjin for bone mineral density measurement and a face-to-face questionnaire survey to obtain the relevant data. Female residents who had lived in the communities under the jurisdiction of the incorporated streets for more than 10 years and had been in menopause for 2 years were included. The women were made aware of the study, there were no communication barriers, and they were willing to undergo dual-energy absorptiometry and cooperate in completing the questionnaire. We used one-way analysis of variance, Fisher exact test, and Pearson correlation analysis for the statistical analysis. RESULTS: The overall prevalence of osteoporosis in postmenopausal women in the six districts of Tianjin was found to be 52.08%, and the χ 2 test for trend showed a clear trend of increasing with age ( P = 0.035). Body mass index was found to be the most significant personal characteristic affecting the prevalence of osteoporosis; the mean values of the nonosteoporosis and osteoporosis group were (25.45 ± 3.09) and (23.85 ± 3.16), respectively ( P < 0.001); previous fractures were closely associated with the prevalence of osteoporosis. Awareness about osteoporosis had not disseminated among the population, and 9.17% of the participants had never heard of the disease. While 75.42% and 72.92% of the participants, respectively, believe that the harm of osteoporosis cannot be compared with heart disease and cerebral infarction, 56.67% had never had an examination for osteoporosis and paid little to no attention to this disease. People still had major misconceptions about the hazards of osteoporosis and common-sense precautions that needed to be followed. CONCLUSIONS: Although osteoporosis is prevalent among postmenopausal women in urban Tianjin and is strongly linked to both history of fracture and body mass index, most women are only familiar with the disease's name and lack an understanding of the dangers it poses as well as the importance of early diagnosis and treatment. To ensure the prevention and control of osteoporosis, it is crucial to focus on increasing the examination and treatment rates and spreading awareness of the three-level diagnosis and treatment pattern among the public.

Development and application of drug-induced liver injury surveillance and assessment system / 中国药房

OBJECTIVE To establish the drug-induced liver injury （DILI） surveillance and assessment system （DILI-SAS）， and to improve the diagnostic efficiency of clinical DILI. METHODS The DILI-SAS was constructed by using natural language processing technology to mine and utilize all inpatient medical record data， and combined with Roussel Uclaf causality assessment method （RUCAM）. The medical records of 19 445 hospitalized patients from August 2022 to January 2023 were detected to verify the performance of the system and manually analyze the basic data of patients with DILI and the distribution of the first suspected drugs. RESULTS The overall accuracy rate of the DILI-SAS system was 91.95%， and the recall rate was 93.20%. Seventy-five DILI cases were detected， and the DILI incidence rate was 385.70/100 000 people. The efficiency of DILI monitoring by human- computer coupling was increased by about 60 times of manual monitoring； males （61.33%） and patients over 60 years old （56.00%） were the most common in the 75 cases of DILI. The clinical type of liver injury was hepatocyte injury （69.33%）， the incubation period was mainly 5-90 days after treatment （62.67%）， and the RUCAM score between 3 and 5 was the most common （66.67%）； pharmacological distribution of the first suspected drugs was mainly dihydropyridines， HMG CoA reductase inhibitors， proton pump inhibitors， etc. The specific drugs were atorvastatin， omeprazole， ceftriaxone， metronidazole and other drugs. CONCLUSIONS The establishment of DILI-SAS can improve the evaluation efficiency on the basis of ensuring the accuracy degree， and provide a solution for the early identification， diagnosis and evaluation of clinical DILI.

A phase III randomized, double-blind, placebo-controlled trial of the denosumab biosimilar QL1206 in postmenopausal Chinese women with osteoporosis and high fracture risk.

The current study evaluated the efficacy and safety of a denosumab biosimilar, QL1206 (60 mg), compared to placebo in postmenopausal Chinese women with osteoporosis and high fracture risk. At 31 study centers in China, a total of 455 postmenopausal women with osteoporosis and high fracture risk were randomly assigned to receive QL1206 (60 mg subcutaneously every 6 months) or placebo. From baseline to the 12-month follow-up, the participants who received QL1206 showed significantly increased bone mineral density (BMD) values (mean difference and 95% CI) in the lumbar spine: 4.780% (3.880%, 5.681%), total hip :3.930% (3.136%, 4.725%), femoral neck 2.733% (1.877%, 3.589%) and trochanter: 4.058% (2.791%, 5.325%) compared with the participants who received the placebo. In addition, QL1206 injection significantly decreased the serum levels of C-terminal crosslinked telopeptides of type 1 collagen (CTX): -77.352% (-87.080%, -66.844%), and N-terminal procollagen of type l collagen (P1NP): -50.867% (-57.184%, -45.217%) compared with the placebo over the period from baseline to 12 months. No new or unexpected adverse events were observed. We concluded that compared with placebo, QL1206 effectively increased the BMD of the lumbar spine, total hip, femoral neck and trochanter in postmenopausal Chinese women with osteoporosis and rapidly decreased bone turnover markers. This study demonstrated that QL1206 has beneficial effects on postmenopausal Chinese women with osteoporosis and high fracture risk.

Discovery of small molecule degraders for modulating cell cycle / 医学前沿

The cell cycle is a complex process that involves DNA replication, protein expression, and cell division. Dysregulation of the cell cycle is associated with various diseases. Cyclin-dependent kinases (CDKs) and their corresponding cyclins are major proteins that regulate the cell cycle. In contrast to inhibition, a new approach called proteolysis-targeting chimeras (PROTACs) and molecular glues can eliminate both enzymatic and scaffold functions of CDKs and cyclins, achieving targeted degradation. The field of PROTACs and molecular glues has developed rapidly in recent years. In this article, we aim to summarize the latest developments of CDKs and cyclin protein degraders. The selectivity, application, validation and the current state of each CDK degrader will be overviewed. Additionally, possible methods are discussed for the development of degraders for CDK members that still lack them. Overall, this article provides a comprehensive summary of the latest advancements in CDK and cyclin protein degraders, which will be helpful for researchers working on this topic.

Alterations in the composition of the gut microbiota affect absorption of cholecalciferol in severe osteoporosis.

INTRODUCTION: To evaluate the relationship between the gut microbial composition and intestinal cholecalciferol absorption in patients with severe osteoporosis (SOP). MATERIALS AND METHODS: Eighteen patients with primary osteoporosis (OP) and 18 with SOP were included. Their clinical data were collected and their circulating concentrations of cholecalciferol and 25(OH)D3 were measured. Fecal samples were collected and their microbial contents were analyzed using 16S rDNA sequencing. RESULTS: The age, sex, body mass index, and body mass of the participants did not differ between the groups. The prevalence of gastrointestinal symptoms in the participants with SOP was significantly higher than that in the participants with OP. There were significant differences in the 25(OH)D3 and cholecalciferol concentrations between participants with SOP or OP and there was a significant positive correlation between the concentrations of these substance. The diversity of the gut microbiota in participants with SOP was significantly higher than that in participants with OP. Firmicutes was more abundant in the SOP group and the ratio of Firmicutes/Bacteroidetes in participants with SOP was higher. Conversely, Bifidobacterium was significantly less abundant, as were the order and family it belongs to. At the species level, Bifidobacterium was the most significant difference between the two groups. CONCLUSION: Differences in the intestinal microecology, especially Bifidobacterium, are associated with differences in the absorption of cholecalciferol and in the circulating 25(OH)D3 concentration, which may influence the progression of OP to SOP.

Efficacy of Yigu® versus Aclasta® in Chinese postmenopausal women with osteoporosis: a multicenter prospective study.

Zoledronic acid (ZOL) is a therapy inhibiting bone resorption. In this study, generic ZOL (Yigu®) showed its clinical efficacy consistency with original ZOL (Aclasta®) in Chinese postmenopausal women with osteoporosis. This study provides a practical basis for the application of Yigu® in Chinese population. INTRODUCTION: Yigu® has been approved its bioequivalence to Aclasta®. However, the clinical efficacy and safety of Yigu® have not been evaluated yet. Here, we compared the effectiveness and safety between Yigu® and Aclasta® in Chinese postmenopausal women with osteoporosis and assessed the efficacy of intravenous infusion of ZOL. METHODS: This was a randomized open-label, active-controlled study in postmenopausal women with osteoporosis of 14 clinical centers in China. Postmenopausal women with osteoporosis were recruited and randomized to receive a single infusion of 5 mg Yigu® or Aclasta®. The primary endpoint was the percentage change in bone mineral density (BMD) at lumbar spine after 12 months of treatment and was assessed for equivalence. The secondary endpoint was the percentage change in BMD at proximal femur after 12 months. Additional secondary endpoints were percentage changes in BMD at the above sites after 6 months of treatment and changes in bone turnover biomarkers during ZOL treatment. Safety was also evaluated and compared between two groups. RESULTS: A total of 458 postmenopausal women with osteoporosis were enrolled (n = 227, Yigu®; n = 231, Aclasta®). The mean percentage change in the BMD had no statistical difference at the lumbar spine (5.32% vs 5.18%), total hip (2.72% vs 2.83%), and femoral neck (2.37% vs 2.81%) between Yigu® and Aclasta® groups after 12 months of treatment. The mean difference of BMD change at the lumbar spine after 12 months between two groups was 0.15% (95% CI: - 0.71 to 1.00, equivalence margin: - 1.5%, 1.5%), demonstrating the treatments were equivalent. Meanwhile, the decreases in the P1NP and ß-CTX showed no difference between two groups after 14 days and 6 and 12 months of treatment. As regards the whole sample, BMD significantly increased after 12 months of treatment. Also, serum C-terminal telopeptide of type 1 collagen (ß-CTX) and procollagen 1 N-terminal peptide (P1NP) significantly decreased at each visit period. The overall adverse events were comparable and quite well between two groups. CONCLUSION: Intravenous infusion of zoledronic acid achieved the potent anti-resorptive effects which led to significant increase in BMD of Chinese postmenopausal women with osteoporosis. Yigu® was equivalent to Aclasta® with respect to efficacy and safety.

Clinical significance of folic acid metabolic gene detection in methotrexate treatment of leukemia / 中国药房

OBJECTIVE To expl ore the clinical significance of folic acid metabolic gene detection in methotrexate （MTX） treatment of acute myeloid leukemia （AML）. METHODS Therapeutic drug monitoring （TDM）pharmacists participated in the treatment process of an AML patient who had neurotoxic side effects such as dizziness ，headache，and vomiting after intrathecal injection of MTX. According to the results of the test of the folic acid metabolic gene MTHFR C677T（rs1801133）（mutant homozygous）and the results of MTX blood concentration monitoring （＜0.05 μmol/L），combined with clinical manifestations ，it was recommended to stop MTX ，give intravenous drip of calcium folinate for rescue ，and consider using azacytidine for follow-up treatment. RESULTS The doctor took the advice of TDM pharmacist ，and the above symptoms were significantly relieved after the patient rescued for 2 times and successfully discharged from the hospital. CONCLUSIONS For AML patients who meet the indications and receive intrathecal injection of MTX ，drug metabolism genetics testing and MTX drug concentration monitoring can be performed before medication ，which helps doctors and pharmacists evaluate the feasibility of drug treatment options and reduce medical risks.

Application of Medication Therapy Management Combined with Medicine Gene Detection in Individualized Pharmaceutical Care of An Elderly Patient with Warfarin-induced Acute Upper Gastrointestinal Hemorrhage / 中国药房

OBJECTIVE： To investigate how pharmacists provide through individualized pharmaceutical care for patients medication therapy management（MTM） combined with medicine gene detection， and to promote rational drug use in clinic.METHODS： A case of elderly comorbidity with acute upper gastrointestinal hemorrhage caused by Warfarin sodium tablets was taken as an example. The patient had a history of type 2 diabetes mellitus and hypertension. Coronary artery bypass grafting was performed two months before admission， and urinary tract infection occurred half a month ago. Medication therapy course was analyzed retrospectively before and after hospitalization； based on gene typing detection of CYP2C9*3 and VKORC1-1639， the individualized dose of Warfarin sodium tablets was evaluated. MTM was perfomed for acute upper gastrointestinal hemorrhage and all medication of patient to formulate individualized medication scheme. RESULTS： The genotyping of warfarin CYP2C9*3 and VKORC1-1639 indicated that the patients were of super slow metabolic type. The recommended dosage of warfarin should be 0.86-1.86 mg/d. Based on MTM analysis of acute upper gastrointestinal hemorrhage， the main causes of acute upper gastrointestinal hemorrhage were Warfarin sodium tablets 3.0 mg/d， poor drug compliance， disease status and co-morbidity and multi-drug combination. Clinical gastrointestinal hemorrhage of the patients were improved after drug withdrawal， anticoagulant drugs was changed into Rivaroxaban tablet，10 mg/d. Through MTM for all drug use in the patient， results of medication reorganization showed that Diltiazem hydrochloride tablet， Amoxicillin/clavulanate potassium dispersible tablet， Compound vitamin tablet were stopped； hypoglycemic drug Glimepiride tablet was changed into Gliquidone tablet； Metoprolol tartrate tablet was changed into Bisoprolol tablet after coronary artery bypass graft； proton pump inhibitor Esomeprazole enteric-coated tablet was changed into Pantoprazole sodium enteric-coated capsule. CONCLUSIONS： The pharmaceutical care mode of MTM combined with medicine gene detection can guide rational drug use in clinic， realize individualized pharmaceutical care， improve patient compliance and prevent problems related to adverse drug reactions.

Robust Dehaze Algorithm for Degraded Image of CMOS Image Sensors.

The CMOS (Complementary Metal-Oxide-Semiconductor) is a new type of solid image sensor device widely used in object tracking, object recognition, intelligent navigation fields, and so on. However, images captured by outdoor CMOS sensor devices are usually affected by suspended atmospheric particles (such as haze), causing a reduction in image contrast, color distortion problems, and so on. In view of this, we propose a novel dehazing approach based on a local consistent Markov random field (MRF) framework. The neighboring clique in traditional MRF is extended to the non-neighboring clique, which is defined on local consistent blocks based on two clues, where both the atmospheric light and transmission map satisfy the character of local consistency. In this framework, our model can strengthen the restriction of the whole image while incorporating more sophisticated statistical priors, resulting in more expressive power of modeling, thus, solving inadequate detail recovery effectively and alleviating color distortion. Moreover, the local consistent MRF framework can obtain details while maintaining better results for dehazing, which effectively improves the image quality captured by the CMOS image sensor. Experimental results verified that the method proposed has the combined advantages of detail recovery and color preservation.

Determination of 7 Residual Organic Solvents in Shengxuening Tablets by Headspace Gas Chromatography / 中国药师

Objective:To establish a method for the determination of 7 residual organic solvents including acetone,2,3 -dimethyl-pentane,3-methylhexane,n-heptane,2,2-dimethylhexane,o-xylene and 2,4,6-trimethylpyridine in Shengxuening tablets. Methods: A headspace gas chromatography method was adopted. The determination was performed on a DB-5MS capillary column ( 30 m × 0. 25 mm,0. 25 μm) with programming temperature. Nitrogen was used as the carrier gas at the flow rate of 2. 5 ml·min-1 . The tem-perature of injector was 200℃,and a flame ionization detector was used as the temperature of 250℃. The containers of headspace in-jector were in equilibrium at 95℃ for 30min. DMF was used as the solvent and an external standard method was used for the determi-nation of the 7 residual solvents. The injection volume was 1 ml. Results:Under the chromatographic conditions, the 7 residual organic solvents could be well separated from each other . The concentration of each solvent showed a good linearity with the peak area within the investigated concentration range (r≥0. 994 4). The average recoveries were 98. 72%-99. 71% (RSD=0. 14%-0. 71%)(n=9). Conclusion:The established method is simple, rapid and sensitive, which can be used for the determination of multiple residual or-ganic solvents in Shengxuening tablets.

Impact of a noval PPARδ agonist on blood lipids in hyperlipidemic golden hamsters / 药学学报

The study was designed to explore the effects of HS060098 on activation of peroxisome proliferator-activated receptors (PPARα, γ and δ) and in the down-regulation of hyperlipidemia in golden hamster. Luciferase gene reporters of PPARα, PPARγ and PPARδ were constructed in HepG2 cells and the green fluorescent protein (GFP) was used as an internal reference. Transfected cells were then cultured with various concentrations of HS060098 for 24 h. The peroxisome proliferator-response element luciferase activity was determined by the dual-luciferase reporter gene assay system. To investigate the lipid-lowering effect of HS060098, hyperlipidemic golden hamsters fed by high-diet were administered orally with HS060098 through prophylactic and therapeutic approaches respectively. The levels of blood lipids such as total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and fat index in hamsters were evaluated. The results showed that HS060098 was a potent activator of PPAR δ with a good selectivity and the median effective concentration (EC 50) is 0.01 μmol·L-1, while no obvious PPARα and PPARγ activation was observed. In the golden hamster, oral administration of HS060098 (5, 10, 20 mg·kg-1·d-1) for 2 weeks, led to a significant decrease the concentrations of plasma TC, TG, LDL-C and fat index (PPPPδ agonist with a significant activity in the prevention and therapy of hyperlipemia in golden hamster.

In vivo pharmacokinetic study on active constituents in Danhong Injection against cerebral ischemia of rats / 中草药

Objective: To develop an HPLC-DAD method for the simultaneous determination of danshensu, protocatechuic acid, vanillic acid, salvianolic acid B, and hydroxysafflor yellow A (HYSA) in cerebral ischemic injury of rats, in order to provide an accurate and reliable analytical method to study the pharmacokinetics. Methods: The middle cerebral artery occlusion (MCAO) model was established, in which all the rats were iv injected with the active constituents in Danhong Injection simultaneously (danshensu, protocatechuic aldehyde, salvianolic acid B, and HYSA). The analysis of the measured components' plasma concentration was carried at 30℃ on the reversed-phase column of Agilent Eclipse XDB-C18 (150 mm×4.6 mm, 5 μm) and eluted with acetonitrile and water containing 0.4% phosphate acid as mobile phase in gradient mode. Detection wavelengths were 280 nm for danshensu, protocatechuic acid, vanillic acid, salvianolic acid B and 403 nm for HYSA. The propyl p-hydroxybenzoate was used as the internal standard (IS). Results: Protocatechuic aldehyde rapidly metabolized in MCAO rats, but its metabolites, protocatechuic acid and vanillic acid, were easily detected. The linear ranges of danshensu, protocatechuic acid, vanillic acid, salvianolic acid B, and HYSA were 0.35-140 (R2=0.9998), 0.15-60 (R2=0.9990), 0.05-20 (R2=0.9988), 0.25-100 (R2=0.9996), and 0.075-30 mg/L (R2=0.9985), respectively. The mean recoveries were between 80% and 120% and the RSD value of intra-day and inter-day was less than 10%. The results of stability meet the requirements for biopharmaceutical analysis. The main pharmacokinetic parameters of danshensu, protocatechuic acid, vanillic acid, salvianolic acid B and HYSA were as follows: AUC0~∞ were (1143.862±230.840), (427.024±59.293), (135.785±47.631), (418.631±66.242), (288.788±87.809) mg·min/L and t1/2z were (71.496±29.067), (82.379±26.279), (40.331±6.006), (125.164±59.709), (177.577±112.836) min. Conclusion: The method is simple, rapid, precise and stable, which can be used to the pharmacokinetic studies on the compatibilities of danshensu, protocatechuic aldehyde, salvianolic acid B, and HYSA in MCAO rats.

Study on pharmacokinetics-pharmacodynamics correlation of Danshensu in rats with focal cerebral ischemia / 中国中药杂志

To study the pharmacokinetic process of Danshensu in cerebal ischemia injury model rats and the correlation with its anti-cerebral ischemia effect. In this study, the middle cerebral artery occlusion (MCAO) model was established, in which all of the rats were intravenously injected of Danshensu at a single dose of 40 mg x kg(-1). The HPLC-DAD method was applied to determine the plasma concentration of Danshensu at different time points and draw the drug-time curve. Meanwhile, the superoxide dismutase (SOD) and the lactate dehydrogenase (LDH) activity were determined to draw the time-effect curve. The DAS 3.2. 6 software was used to process the data, analyze their correlation, compare the pharmacokinetic difference between model and normal rats after the administration of the same doses of Danshensu and the changes in pharmacodynamic indicators of model rats after the administration, and evaluate the effect of Danshensu in treating the cerebral ischemia disease. According to the results, the pharmacokinetic processes of Danshensu in the cerebral ischemia-reperfusion and normal rats were consistent to the two-compartment model. The main pharmacokinetic parameters were: t1/2alpha were (0.267 +/- 0.026), (0.148 +/- 0.020) h;t1/2beta were (1.226 +/- 0.032), (1.182 +/- 0.082) h; AUC0-infinity were (42.168 +/- 4.007), (26.881 +/- 1.625) mg x L(-1) x h. After the cerebral ischemia-reperfusion, the activity of SOD decreased and the activity of LDH increased. Danshensu could inhibit the decrease in the SOD activity and the increase in the LDH activity within a certain period of time. This indicated that Danshensu could stay longer in cerebral ischemia-reperfusion rats than in normal rats and eliminated more slowly, which reflected the rationality of Danshensu in the clinical treatment of cerebral ischemia diseases. Danshensu's effect against the cerebral ischemic injury may be related with its level in vivo. Its plasma concentration is positively related to the SOD activity and negatively related to the LDH activity.

[Effects of Jinlong Capsule on expressions of interleukin-2 and soluble interleukin-2 receptor in patients with primary liver cancer after transarterial chemoembolization therapy].

OBJECTIVE: To observe and discuss the dynamic changes of interleukin-2 (IL-2) and soluble interleukin-2 receptor (sIL-2R) and their significance in the patients with primary liver cancer after transarterial chemoembolization (TACE) therapy combined with Jinglong Capsule. METHODS: A total of 48 patients with primary liver cancer, who failed to be treated by major surgery, were randomly divided into two groups: Jinlong Capsule group (TACE therapy plus Jinlong Capsule) and control group (TACE therapy alone). There were 24 cases in each group. The levels of peripheral blood IL-2 and slL-2R were measured before the first TACE and 1, 7 and 15 days after the second TACE respectively by using double-antibody sandwich enzyme-linked immunosorbent assay. The data from Jinlong Capsule group were compared with those from the control group. RESULTS: The level of sIL-2R in Jinlong Capsule group was significantly lower than that in the control group (P<0.05), while the level of IL-2 was significantly higher than that in the control group (P<0.05). CONCLUSION: Jinlong Capsule can significantly improve the lymphocyte function of the patients with primary liver cancer after TACE. The levels of IL-2 and sIL-2R can be considered as the valuable parameters for evaluating the effects on primary liver cancer, and Jinlong Capsule is helpful for the patients with primary liver cancer.