Knowledge-Based Design of Multifunctional Polymeric Nanoparticles.

Conventional drug delivery systems (DDS) today still face several drawbacks and obstacles. High total doses of active pharmaceutical ingredients (API) are often difficult or impossible to deliver due to poor solubility of the API or undesired clearance from the body caused by strong interactions with plasma proteins. In addition, high doses lead to a high overall body burden, in particular if they cannot be delivered specifically to the target site. Therefore, modern DDS must not only be able to deliver a dose into the body, but should also overcome the hurdles mentioned above as examples. One of these promising devices are polymeric nanoparticles, which can encapsulate a wide range of APIs despite having different physicochemical properties. Most importantly, polymeric nanoparticles are tunable to obtain tailored systems for each application. This can already be achieved via the starting material, the polymer, by incorporating, e.g., functional groups. This enables the particle properties to be influenced not only specifically in terms of their interactions with APIs, but also in terms of their general properties such as size, degradability, and surface properties. In particular, the combination of size, shape, and surface modification allows polymeric nanoparticles to be used not only as a simple drug delivery device, but also to achieve targeting. This chapter discusses to what extent polymers can be designed to form defined nanoparticles and how their properties affect their performance.

[Formulation of expert consensus on clinical application of external ethnic medicine: taking Baimai Ointment as an example].

The concept of ethnic medicine is divided into a broad sense and a narrow sense. The broad concept refers to the traditional medicine of the Chinese nation, and the narrow concept refers to the traditional medicine of Chinese ethnic minorities. The external medicine is one of the main forms of ethnic medicine, and it is also the important content of ethnic medicine for external use, which is widely used in clinical practice. As the theory of ethnic medicine is unique, the application methods have certain characteristics, which are the key technical parts of clinical practice. However, the existing traditional Chinese medicine consensus formulation me-thods cannot meet the needs of the consensus formulation of the external ethnic medicine. Therefore, the methods suitable for expert consensus on external ethnic medicine are required. This article took Expert opinion on clinical application of Baimai Ointment as an exa-mple, and explorde a reasonable, effective, multi-dimensional, and multi-stage method to formulate expert consensus on the external ethnic medicine. In this research, three-dimensional sources of information, including ancient classics, clinical research evidence, and expert application experiences, were systematically and scientifically collected. After organization and analysis, the information was formed into comprehensive evidence. In a formal consensus meeting, part of the recommendations reached consensus. As to the issues that did not reach agreement, in-depth interviews were used to explore the reasons for the differences and resolve the disagreements. Finally, unanimous recommendations were reached. There are common problems during the formulation process of Expert opinion on clinical application of Baimai Ointment. This study is expected to provide references for the formulation of expert consensus on other external ethnic medicine.

Formulation of expert consensus on clinical application of external ethnic medicine: taking Baimai Ointment as an example / 中国中药杂志

The concept of ethnic medicine is divided into a broad sense and a narrow sense. The broad concept refers to the traditional medicine of the Chinese nation, and the narrow concept refers to the traditional medicine of Chinese ethnic minorities. The external medicine is one of the main forms of ethnic medicine, and it is also the important content of ethnic medicine for external use, which is widely used in clinical practice. As the theory of ethnic medicine is unique, the application methods have certain characteristics, which are the key technical parts of clinical practice. However, the existing traditional Chinese medicine consensus formulation me-thods cannot meet the needs of the consensus formulation of the external ethnic medicine. Therefore, the methods suitable for expert consensus on external ethnic medicine are required. This article took Expert opinion on clinical application of Baimai Ointment as an exa-mple, and explorde a reasonable, effective, multi-dimensional, and multi-stage method to formulate expert consensus on the external ethnic medicine. In this research, three-dimensional sources of information, including ancient classics, clinical research evidence, and expert application experiences, were systematically and scientifically collected. After organization and analysis, the information was formed into comprehensive evidence. In a formal consensus meeting, part of the recommendations reached consensus. As to the issues that did not reach agreement, in-depth interviews were used to explore the reasons for the differences and resolve the disagreements. Finally, unanimous recommendations were reached. There are common problems during the formulation process of Expert opinion on clinical application of Baimai Ointment. This study is expected to provide references for the formulation of expert consensus on other external ethnic medicine.

The Plan Formulation Method from Control Mastery Theory and Management of Countertransference.

The aim of this article is to show how the plan formulation method (PFM), an empirically validated method for case formulation based on control mastery theory (CMT), can help clinicians make sense of and use what they feel during sessions to better understand and treat their patients. We give a brief overview of the main psychoanalytic conceptions about countertransference, provide a brief introduction to CMT, and describe the concept of the plan and the PFM. We then show, using several brief clinical examples, how the components of the plan (patient's goals, pathogenic beliefs, traumas, tests, and insights) may help understand clinicians' in-session feelings.

Grain Legume Yield Responses to Rhizobia Inoculants and Phosphorus Supplementation Under Ghana Soils: A Meta-Synthesis.

A discrete number of studies have been conducted on the effects of rhizobia (Rhz) inoculants, phosphorus (P) management, and combined application of Rhz and P fertilizer on the enhancement of grain legume yield across soils of Ghana and elsewhere. However, the extent to which the various inoculated Rhz strains, P application, and combined application of Rhz + P studies contribute to improving yield, performed on a comprehensive analysis approach, and profit farmers are yet to be understood. This study reviewed different experimental studies conducted on soybean (Glycine max (L.) Merr.), cowpea (Vigna unguiculata [L.] Walp), and groundnut (Arachis hypogaea [L.]) to which Rhz inoculants, P supplements, or Rhz + P combination were applied to improve the yield in Ghana. Multiple-step search combinations of published articles and multivariate analysis computing approaches were used to assess the effects of Rhz inoculation, P application, or both application of Rhz and P on yield variation. The random forest (RF) regression model was further employed to quantify the relative importance of various predictor variables on yield. The meta-analysis results showed that cowpea exhibited the highest (61.7%) and groundnut (19.8%) the lowest average yield change. The RF regression model revealed that the combined application of Rhz and P fertilizer (10.5%) and Rhz inoculation alone (7.8%) were the highest explanatory variables to predict yield variation in soybean. The Rhz + P combination, Rhz inoculation, and genotype wang-Kae explained 11.6, 10.02, and 8.04% of yield variability for cowpea, respectively. The yield in the inoculated plants increased by 1.48-, 1.26-, and 1.16-fold when compared to that in the non-inoculated cowpea plants following inoculation with BR 3299, KNUST 1002, and KNUST 1006 strains, respectively. KNUST 1006 strain exhibited the highest yield increase ratio (1.3-fold) in groundnut plants. Inoculants formulation with a viable concentration of 109 cells g-1 and a minimum inoculum rate of 1.0 × 106 cells seed-1 achieved the highest average yield change for soybean but not for cowpea and groundnut. The meta-analysis calls for prospective studies to investigate the minimum rate of bacterial cells required for optimum inoculation responses in cowpea and groundnut.

The plan formulation method: An empirically validated and clinically useful procedure applied to a clinical case of a patient with a severe personality disorder.

The plan formulation method (PFM) is an empirically validated procedure for identifying a patient's goals for therapy, what is hindering the patient from attaining those goals, and how the patient is likely to work in therapy. In this paper, we employ the PFM to analyze the initial psychotherapy sessions of Geena, a 30-year-old outpatient with borderline personality disorder and relational and substance abuse problems. Employing the PFM, we identify a family of pathogenic beliefs (e.g., that she is unlovable and unworthy; that her parents will be hurt if she has satisfying intimate relationships) that Geena sought to disprove in her therapy and explain how she worked with the therapist to do so. We illustrate how the PFM can help the therapist identify what information and what types of interventions will be helpful for a given patient.

Discussion on Formulation Strategy of Medication Indexes in Clinical Departments of Hospital / 中国药房

OBJECTIVE:To understand the formulation method of medication index in clinical departments of the local hospital and the improvement of hospital medication index after the formulation of medication index. METHODS:Retrospective analysis was used to summarize and analyze the formulation,revision and application of 5 medication indexes(the proportion of drug cost in medical income,utilization rate of antibiotics in the inpatients,AUD of inpatients,the proportion of antibiotics cost in drug income,the proportion of national essential medicine cost in drug income)in clinical departments of 4 general hospitals of Nanyang. RESULTS:The medication indexes of clinical departments in 4 hospitals were formulated primarily during 2009-2014. The formulation of medication indexes in clinical departments was passed and implemented by Pharmaceutical Administration and Drug Treatment Committee/Antibiotics Management Group on the basis of the previous indicators of clinical departments. Till 2017,the times of medication indexes revision were 0.42-0.58 time/year. Before the formulation of medication indexes in clinical departments,5 indexes of each hospital were mostly not in line with the regulation of health administration department. During Jul. 2016-Jun. 2017,5 medication indexes of 4 hospitals ranged 32%-41%,47%-53%,30-37 DDD,13%-20%,21%-32%, respectively. Rational drug indexes conformed to the provisions of the administrative department of health basically. The author provided related suggestions about departments in charge of formulating and adjusting medication indexes,methods for the primary formulation and modification of medication indexes,formulation of medication indexes in special department,management measures after the formulation of medication indexes. CONCLUSIONS:At present,the formulation and management of medication indicators in 4 hospitals of local area develop well,and effectively promote the level of clinical rational drug use.

Investigation of in vitro absorption, distribution, metabolism, and excretion and in vivo pharmacokinetics of paromomycin: Influence on oral bioavailability.

OBJECTIVE: The objective of this study is to investigate in vitro Caco2 permeability, metabolism and in vivo pharmacokinetic (PK) properties of paromomycin to develop an efficient dosage form with improved oral bioavailability. MATERIALS AND METHODS: For the purpose, Caco2 permeability assay, mouse microsomal stability assay and in vivo PKs in male BALB/c mice were performed. RESULTS: In Caco-2 permeability assay, paromomycin showed negligible permeability in the apical to basolateral (A-to-B) direction and vice versa (B-to-A). Marginal increase in permeability with the use of P-glycoprotein (P-gp) inhibitor, namely, verapamil suggesting paromomycin could be a P-gp substrate. Paromomycin was unstable in liver microsomes of mouse. Paromomycin showed good PK properties after intravenous dose in male BALB/c mice which included low plasma clearance, i.e., <10% of hepatic blood flow in mice, high volume of distribution (Vd), and half-life (T½) of 2.6 h. Following per oral dose, it exhibits low oral bioavailability (0.3%) with carboxymethyl cellulose formulation. Oral plasma exposure increased in mice by 10% and 15% after pretreatment with P-gp inhibitor verapamil and CYP inhibitor 1-Aminobenztriazole, respectively. CONCLUSION: Comparatively significant increase in oral plasma exposure of paromomycin was observed with an alternative oral formulation approach, use of P-gp and CYP inhibitors resulting in improved oral bioavailability up to 16%.