A Review of the Surgical Procedures for the Treatment of Drug-Resistant Epilepsy and Their Seizure Control Outcomes

Background: Drug-resistant epilepsy can be defined as the existence of seizures within 6 months, despite adequate therapy regimens with one or more antiepileptic drugs. Epilepsy surgery has been the standard therapy to help those patients who suffer from drug-resistant epilepsy. The goal of this surgery is to halt or reduce the intensity of seizures. This literature review aims to provide an overview of existing surgical procedures for the treatment of drug-resistant epilepsy and the degree of seizure control they provide based on available literature. Methods: Data were collected from medical journal databases, aggregators, and individual publications. The most used databases were PubMed, Medline and NCBI. Some of the keywords used to search these databases include: “drug resistant epilepsy”, “seizure control”, and “neurosurgery”. Results: Epileptic surgery is divided into resective and non-resective procedures. Studies have shown that a full resection of the epileptogenic brain area increases the probability of seizure eradication, however, the risks of postoperative impairments grow as the resection area is extended. On the other hand, patients who are unsuitable for seizure focus removal by resective surgery, such as those with multifocal seizures or overlapping epileptogenic zone with a functional cortex, may benefit from non-resective surgical options such as Vagus Nerve Stimulation and Responsive Neurostimulation. Conclusion: This literature review discusses the comprehensive treatment of epilepsy, especially the surgical treatment of drug-resistant epilepsy. The reviewed studies have shown that epilepsy surgery has promising outcomes in achieving seizure freedom/reducing seizure frequency with minimal adverse effects when performed correctly with the appropriate choice of surgical candidates.

pH-responsive mesoporous silica nanoparticles employed in controlled drug delivery systems for cancer treatment

In the fight against cancer, controlled drug delivery systems have emerged to enhance the therapeutic efficacy and safety of anti-cancer drugs. Among these systems, mesoporous silica nanoparticles （MSNs） with a functional surface possess obvious advantages and were thus rapidly developed for cancer treatment. Many stimuli-responsive materials, such as nanopartides, polymers, and inorganic materials, have been applied as caps and gatekeepers to control drug release from MSNs. This review presents an overview of the recent progress in the production of pH-responsive MSNs based on the pH gradient between normal tissues and the tumor microenvironment. Four main categories of gatekeepers can respond to acidic conditions. These categories will be described in detail.

BIODEGRADABLE POLYMERS WITH A PHOSPHORYL-CONTAINING BACKBONE:TISSUE ENGINEERING AND CONTROLLED DRUG DELIVERY APPLICATIONS

This review provides a glimpse of the potential of the biodegradable phos-phoryl-containing polymers in medical applications. Undoubtedly these polymerspossess unique properties that are yet to be fully understood. Many areas warrantfurther investigation and much optimization remains to be done. The fascinatingchemistry of phosphorus poses interesting hurdles but at the same time leavesample room for polymer scientists to exercise their creativity in designinginteresting biomaterials. As the mutual understanding between basic and clinicalscientists on the need of medical devices and the capabilities of these newbiomaterials expands, imaginative application of new biomaterials to other medi-cal applications can be expected.

A Concise Review of Gold Nanoparticles-Based Photo-Responsive Liposomes for Controlled Drug Delivery

The focus of drug delivery is shifting toward smart drug carriers that release the cargo in response to a change in the microenvironment due to an internal or external trigger. As the most clinically successful nanosystem, liposomes naturally come under the spotlight of this trend. This review summarizes the latest development about the design and construction of photo-responsive liposomes with gold nanoparticles for the controlled drug release. Alongside, we overview the mechanism involved in this process and the representative applications.

Synthesis of the Core-Shell Structure Materials as the Controlled-Release Drug Carrier

We have developed a controlled-release drug carrier. Smartly controlled-release polymer nanoparticles were firstly synthesized through RAFT polymerization as the controlled-release core. The structural and particle properties of polymer nanoparticles were characterized by nuclear magnetic resonance spectroscopy (1H-NMR), scanning electron microscope (SEM) and X-ray spectroscopy (EDX). Mesoporous materials were selected as the shell materials to encapsulate the smart core as the stable shell. The mesoporous shell was characterized by transmission electron microscopy (TEM) and scanning electron microscope (SEM). All the results showed that a well-defined core-shell structure with mesoporous structure was obtained, and this controllable delivery system will have the great potential in nanomedicine.

运输毒品罪的存在空间与合理界定

《全国法院毒品案件审判工作会议纪要》对于运输毒品行为司法认定与刑罚适用的相关完善,进一步彰显出运输毒品罪的独立属性与存在价值。作为连接制毒源头与贩毒中端、贩毒中端与贩毒中端以及贩毒中端与消费终端的重要流通环节,运输毒品行为独立成罪的本质在于运输者对于流通中毒品的事实占有或观念占有,以及由此形成的对于毒品流通过程的排他性控制。根据“空间转移”与“占有关系”这两个变量,可以更为合理地确定运输毒品行为的实行着手、停止形态与犯罪既遂,更为科学地厘定运输毒品罪与走私、贩卖、制造毒品罪,非法持有毒品罪的区别与联系,更为正当地适用包括死刑在内的法定刑罚。

Preparation and Characterization of Chitosan-Insulin-Tripolyphosphate Membrane for Controlled Drug Release: Effect of Cross Linking Agent

The term Diabetes Mellitus (DM) comprises a group of metabolic disorders characterized by chronic hyperglycemia resulting from defects in the secretion and/or action of insulin. The Insulin therapy constitutes the preferred treatment for DM, consisting of daily subcutaneous insulin injections to control blood glucose levels. The chitosan studied for Biomedicine is a biomaterial that can be used for controlled release of drugs whose release rate can be controlled by Sodium Tripolyphosphate (TPP), which is an ionic cross linker of the chitosan. Present study, therefore, was aimed to develop and evaluate membranes of chitosan and chitosan cross linked by TPP for use in controlled release of insulin system, with the purpose of obtaining an alternative to the injectable administration of this drug. The developed membranes were characterized by the techniques of Fourier Transform Infrared spectroscopy (FTIR), Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDX), High Performance Liquid Chromatography (HPLC) and Evaluation of Cell Viability of Macrophages (MTT). With the FTIR technique the interaction between chitosan, tripolyphosphate and insulin was identified. Chemical elements present in chitosan, insulin and sodium tripolyphosphate membranes were detected by EDX technique. By SEM technique, the changes in the morphology of the membrane containing insulin, with the presence of granular particles of varying sizes, could be observed when compared to pure chitosan. With HPLC assay insulin was identified and it was shown that it gets separated from chitosan membrane even when the membrane was cross linked by the TPP, though at a reduced rate. The crosslinking agent was effective to control the rate of insulin release. The biocompatibility of the prepared membranes was confirmed by cell viability of macrophages using the MTT assay. The developed membranes, therefore, have potential for use as a biomaterial in controlled release systems for insulin.

基于天然多糖的刺激响应型药物控释系统研究进展

刺激响应型药物控释系统一般以天然多糖生物大分子或其衍生物作为载体,通过化学结合或物理吸附等方式负载药物分子。具有刺激响应功能的天然多糖生物大分子或其衍生物能够感知其所处环境的变化,并由于其物理或化学性质的变化而做出应激响应,因此可在不同环境或条件的刺激下,通过药物与载体之间化学键断裂或载体自身降解等方式将药物从载体中释放,从而实现药物的控制释放。结合课题组的研究工作,介绍了常用的刺激方式,包括单一刺激和多重刺激、外源性刺激和内源性刺激,为开发新型刺激响应型药物控释系统提供了思路。

Doping Control Analysis of 16 Non-Steroidal Anti-Inflammatory Drugs in Equine Plasma Using Liquid Chromatography-Tandem Mass Spectrometry

Non-steroidal anti-inflammatory drugs (NSAIDs) are classified as Class 4 agents by the Association of Racing Commissioners International and are banned in racehorses during competition in Pennsylvania (PA). To control the abuse of these agents in racehorses competing in PA, a forensic method for screening and confirmation of the presence of these agents is needed. Equine plasma (0.5 mL) was acidified with 75 μL 1M H3PO4 to increase recovery of the analytes by liquid-liquid extraction using methyl tert-butyl ether (MTBE). Extracted analytes were separated by reversed-phase liquid chromatography using a C8 column under gradient condition. All 16 analytes were detected, quantified and confirmed using a triple quadrupole tandem mass spectrometry with selected reaction monitoring (SRM) in both negative and positive electrospray ionization modes. The limit of detection, quantification and confirmation of the analytes were 1.0 - 5.0 ng/mL, 1.0 - 5.0 ng/mL and 1.0 - 20 ng/mL, respectively. The linear dynamic range of quantification was 5.0 - 200 ng/mL. The method is routinely used in anti-doping analysis to control the abuse of NSAIDs in racehorses competing in PA.

负载胰岛素的透明质酸温敏水凝胶的制备及体外释放评价

目的:制备负载胰岛素的透明质酸温敏水凝胶并对其进行初步评价。方法:通过酰肼交联反应得到己二酰肼/透明质酸,再利用自由基聚合法合成透明质酸温敏水凝胶;采用核磁共振氢谱对其进行结构确认,扫描电子显微镜观察其微观形态结构;采用紫外分光光度法测定最低临界温度;以牛胰岛素作为模型药物,透明质酸温敏水凝胶作为递送载体,对其药物体外释放行为进行考察。结果:成功合成并制备了胰岛素装载的透明质酸温敏水凝胶。该水凝胶呈现三维网络类蜂窝结构,最低临界温度在30℃左右。体外释放结果显示,载药水凝胶在72 h内药物累积释放不到50%,而对照组在24 h内药物累积释放率几乎达到100%。结论:本研究所制备的透明质酸温敏水凝胶对胰岛素有一定的缓释作用,可作为大分子药物的递送载体。

New botanical drug, HL tablet, reduces hepatic fat as measured by magnetic resonance spectroscopy in patients with nonalcoholic fatty liver disease: A placebo-controlled, randomized, phase Ⅱ trial

AIM To evaluate the efficacy and safety of HL tablet extracted from magnolia officinalis for treating patients with nonalcoholic fatty liver disease(NAFLD).METHODS Seventy-four patients with NAFLD diagnosed by ultrasonography were randomly assigned to 3 groups given high dose(400 mg) HL tablet, low dose(133.4 mg) HL tablet and placebo, respectively, daily for 12 wk. The primary endpoint was post-treatment change of hepatic fat content(HFC) measured by magnetic resonance spectroscopy. Secondary endpoints included changes of serum aspartate aminotransferase, alanine aminotransferase(ALT), cholesterol, triglyceride, free fatty acid, homeostasis model assessment-estimated insulin resistance, and body mass index(BMI).RESULTS The mean HFC of the high dose HL group, but not of the low dose group, declined significantly after 12 wk of treatment(high dose vs placebo, P = 0.033; low dose vs placebo, P = 0.386). The mean changes of HFC from baseline at week 12 were-1.7% ± 3.1% in the high dose group(P = 0.018),-1.21% ± 4.97% in the low dose group(P = 0.254) and 0.61% ± 3.87% in the placebo group(relative changes compared to baseline, high dose were:-12.1% ± 23.5%, low dose:-3.2% ± 32.0%, and placebo: 7.6% ± 44.0%). Serum ALT levels also tended to decrease in the groups receiving HL tablet while other factors were unaffected. There were no moderate or severe treatment-related safety issues during the study.CONCLUSION HL tablet is effective in reducing HFC without any negative lipid profiles, BMI changes and adverse effects.

分析多角度光散射在药物质量控制中的应用价值

多角度光散射技术在药物质量控制中有着广泛的应用,该检测技术能够直接针对大分子药物相对分子质量与分布情况进行测定,具有测定范围广以及准确度高等特点,能够为药物质量控制以及标准建立、修订等提供技术参考和指导。本文就多角度光散射技术的特点、原理及在药物质量控制中应用情况进行分析。

药食同源理论及其在航天营养健康研究中的应用

载人航天飞行中面临的重力场变化、辐射、狭小空间孤闭隔离、噪声及生物节律变化等航天特因环境给维持航天员机体营养健康带来了挑战。根据载人航天实践,综述了航天特因环境下机体适应性变化,阐述了药食同源在航天营养健康保障中的应用预先研究现状,分析并提出了药食同源在支持未来载人深空探测方面的潜在应用价值。

临床药师对住院高血压患者实施标准化管理的实践

高血压是一种常见慢性病,若未及时有效治疗,可损伤心、脑、肾这些重要脏器的结构和功能,其导致的临床并发症不仅致残、致死率高,且消耗很多的医疗和社会资源,给家庭和社会造成巨大的负担。高血压患者通常需要长时间的标准化治疗方能达到控制血压,延缓、降低靶器官损害及临床并发症发生等目的;但由于患者难以得到科学、系统、标准化的药学服务,因此该类患者对疾病、药物治疗知识认知不足,不合理用药情况多见,存在大量误区,导致药物治疗的依从性差,最终无法达到降压目标,影响整体治疗效果。基于以上原因,笔者在住院高血压患者标准化管理方面进行了研究并进行总结,旨在探索建立针对高血压患者的药学服务模式,为今后临床药师开展慢病管理工作提供参考。

Studies on the in Vitro Dissolution of Insoluble Volatile Drug from Su-Anxin Nasal Inhalant and Its Correlation on the Nose Steady Self-Controllable Expiration and Inspiration at Night

In the paper, the in vitro dissolution of borneol in 12 hours from 6 batches of optimized inhalant samples were investigated. As a new dosage form, the in vitro release apparatus of nasal inhalant was invented and a pushing bump was used according to the simulation of the nose expiration and inspiration. Based on the data of r2 in the profile and similar factor f2 from 6 linear release tendencies, a good controlled release and a zero order tendency were observed. It can be suggested that there is a good correlation between the in vitro controlled release and the nose steady self-controllable expiration and inspiration, which will contribute to the trend of insoluble volatile drug controlled release and the effect of quick absorption in nasal pulmonary delivery to cure severe or acute cardiovascular or lung diseases at patients' sleeping, such as angina or breathing obstruction. Also, it was concluded that the prescription composed of insoluble volatile drugs can be prepared to be nasal inhalant from which drugs can be absorbed through nose steady self-controllable inspiration to the lung then into the blood and have a great effectiveness improvement of bioavailability at night timing drug delivery system.

全院性医院感染防控文化活动作用评价

目的为评价全院性的感控文化建设在医院感染防控中的作用。方法回顾性分析2021—2023年某肿瘤专科医院举办的个人防护用品操作视频大赛、“手卫生之星”活动、“火眼金睛”——图说感控活动、感控微视频大赛等全院性感控文化相关活动,并统计2020—2023年各项院感监测指标变化情况,评价活动效果。结果2023年院感防控监测指标均较2021年有显著提升。其中,手卫生依从率从84.13%提高至94.46%,医院感染发生率由1.53%降低至0.70%,多重耐药菌感染率由0.21%降低至0.11%,多重耐药菌防控措施正确实施率由52.50%提高至88.19%,差异均有统计学意义(均P<0.05);个人防护用品穿脱考核通过3000余人次。结论适当举行全院性的感控宣传活动,能有效提高医院感染防控能力。

静脉用质子泵抑制剂使用合理性分析及院内管控

目的:探讨我院静脉用质子泵抑制剂(PPIs)使用的合理性。方法:收集2022年度我院使用PPI的病例,共226份病历资料符合要求。结果:进入季度使用金额排名前五名次数最多的PPIs依次是注射用艾司奥美拉唑、注射用艾普拉唑、注射用雷贝拉唑、注射用奥美拉唑;病历不合理率为64.16%,无适应证用药53例(36.55%),用法用量不适宜46例(31.72%),疗程不适宜21例(14.48%),遴选药品不适宜17例(11.72%),联合用药不适宜5例(3.45%),溶媒不适宜3例(2.07%)。结论:对PPI使用不合理的现象需要加强重点品种管控,提升医师的合理用药水平,促进合理用药。

分子生物学方法在提高综合医院传染性肺结核发现率中的作用

目的 了解综合医院使用Xpert技术诊断传染性肺结核和耐药肺结核的现状和问题,以便更好地发挥综合医院在肺结核发现中的前哨作用。方法 采用自身前后对照的研究方法,对比分析综合医院使用Xpert检查和未使用Xpert检查患者2组之间的病原学阳性患者比例、利福平耐药肺结核患者发现、肺结核和利福平耐药肺结核患者诊断时间等指标。共有171例肺结核患者纳入本次研究,其中研究组为使用Xpert检查的52例患者,对照组为未使用Xpert检查的119例患者。采用Wilcoxon秩和检验和χ^(2)检验(Fisher精确检验)分析组间差异。结果 研究组中综合医院诊断的病原阳性肺结核比例(41/52,78.85%)明显高于对照组(65/119,54.62%),差异有统计学意义(P<0.05)。研究组中综合医院诊断的疑似病例比例(2/52,3.85%)明显低于对照组(24/119,20.17%)。研究组中肺结核诊断时间为1 d,明显短于对照组(4 d)差异有统计学意义(P<0.05)。研究组共有3例利福平耐药肺结核患者,在综合医院就诊时全部得到明确诊断,利福平耐药诊断时间为1 d;对照组中有1例利福平耐药患者,综合医院未能发现。研究组同时接受痰涂片和Xpert检查的52例患者中,Xpert检出结核分枝杆菌比例(40/52,76.92%)明显高于痰涂片检查(25/52,48.07%),差异有统计学意义(P<0.05)。结论 Xpert技术能够显著提高肺结核病的诊断率、早期发现传染性肺结核和利福平耐药肺结核患者,建议将其纳入医保报销范围,加快在综合医院推广应用。

质量控制和精细化管理在PIVAS的应用效果分析

目的探究质量控制和精细化管理在医院静脉用药调配中心(Pharmacy Intravenous Admixture Service,PIVAS)应用中的效果。方法济南市第三人民医院于2020年1月—2022年12月实施质量控制和精细化管理方案,将此时段内设定为研究组,与2018年1月—2019年12月采用传统输液管理方式的对照组进行对比。两个阶段的医护人员均为同一批,共计20名医护人员,记录两组医护人员的正负性情绪评分、情绪智力以及工作质量。结果研究组正性情绪评分高于对照组,研究组管理后的负性情绪评分低于对照组,差异有统计学意义(P均<0.05);研究组各项情绪智力高于对照组,差异有统计学意义(P均<0.05);与对照组相比,研究组医护人员审方排药、核对、配置操作、环境卫生、清场、设备使用及维护评分更高,差异有统计学意义(P均<0.05)。结论质量控制和精细化管理的引入,使得PIVAS在患者用药过程中更加安全可靠,医护人员的情绪得到改善,并且护理质量大大提升,在提高医疗质量方面具有显著优势。

体重控制药物临床试验的现状分析

目的:分析中国在2018至2023年间的体重控制药物临床试验的研究现况和发展趋势,为体重控制药物临床试验研究方向提供参考。方法:检索并收集我国药物临床研究注册与信息公开平台上注册的体重控制药物临床试验的详细信息。对体重控制药物临床试验发展趋势、注册特点、作用机制及主导单位的地理位置进行了分析。结果:2023年体重控制药物临床试验注册数量达到了近年来的最高点。临床Ⅰ期、Ⅱ期和Ⅲ期临床试验占87.9%(51/58),试验设计以平行、随机化和双盲试验为主。在作用靶点方面,胰高血糖素样肽-1(Glucagon-likepeptide-1,GLP-1)受体激动剂单靶点试验数量居首(27/58)。药物临床试验主导单位主要分布在北京市(27/58)、上海市(6/58)和长沙市(5/58)。结论:体重控制药物的临床试验数量呈现出上升趋势,特别是在基于GLP-1受体激动剂的单靶点及多靶点联合治疗领域的临床试验发展尤为迅猛。