主办单位：上海医药行业协会
10 June 2025, Volume 46 Issue 6
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 3-6.
Acromegaly is a chronic, progressive endocrine disorder that is primarily caused by pituitary growth hormone adenoma. This condition results in excessive synthesis and secretion of growth hormone (GH), which subsequently leads to the increased release of insulin-like growth factor-1 (IGF-1) from the liver. The overproduction of GH and IGF-1 causes significant alterations in appearance, as well as comorbidities such as cardiovascular, metabolic, and skeletal issues. The therapeutic goals for acromegaly include normalizing blood levels of GH and IGF-1 through medication, resecting tumor by surgery and management of comorbidities. Medical therapy remains a critical component in the treatment of acromegaly. This article summarizes the current available drugs for its treatment and the potential drugs that is being investigated in late-stage clinical trials and may be marketed in the future.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 7-10.
Diabetic nephropathy is the leading cause of end-stage renal disease, and the existing drugs are limited in both variety and efficacy. Basic and clinical studies have found that mineralocorticoid receptor antagonists exert a renal protective effect on diabetic nephropathy. The underlying mechanisms may be related to inhibiting inflammation, reducing fibrosis, and correcting oxidative stress imbalances. This article reviews and summarizes these findings.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 11-15.
Intravascular large B-cell lymphoma (IVLBCL) is a rare and highly aggressive extranodal non-Hodgkin lymphoma. A case of IVLBCL who initially presented with central nervous system symptoms was reported. His diagnosis and treatment process were long and challenging, during which he was initially diagnosed with central nervous system demyelinating disease and vasculitis. After failed treatments with corticosteroids and immunosuppressants, the diagnosis was ultimately confirmed through two separate surgical pathological biopsies. Following diagnosis, he underwent four cycles of high-dose methotrexate combined with R-CHOP therapy, followed by six cycles of R-DHAP therapy. Although imaging showed lesion regression and symptoms improved, neurological function had been never recovered. He remains unable to perform daily activities independently and is currently under regular follow-up.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 16-22.
Scars are fibrous tissues formed during the healing process after skin injury. They may affect patients’ appearance, limit joint mobility, and be associated with discomfort such as pain, thereby reducing quality of life. Accurate assessment of the clinical symptoms and severity of scars is essential for formulating effective treatment strategies. This study systematically reviews recent advances in scar assessment scales based on a comprehensive literature review. It focuses on patient-reported outcome measures, such as the 36-item short-form health survey, dermatology life quality index, Bock quality of life questionnaire, and the patient scar assessment questionnaire, as well as clinician-reported scales, including the Vancouver scar scale, Manchester scar scale, and the patient and observer scar assessment scale. The advantages and limitations of these tools are compared to provide clinical guidance for evaluating scar severity and adjusting treatment plans accordingly, aiming to promote individualized and precise scar management.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 23-26.
Objective: To investigate the clinical efficacy of alfentanil combined with propofol for anesthesia in pediatric bronchoscopic foreign body removal. Methods: Sixty children scheduled for bronchoscopic foreign body removal were divided into a control group (n=30) and an observation group (n=30) based on the anesthesia induction regimen. The control group received sufentanil+propofol, while the observation group received alfentanil+propofol. Perioperative parameters were compared, including mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), number of scope insertion/removal attempts, operation time, recovery time, Riker sedation-agitation scale (RSAS) score, staff satisfaction, and incidence of adverse reactions. Results: When inserting a bronchoscope and removing foreign bodies, MAP and HR in the observation group were significantly lower than in the control group (P<0.05). The observation group had shorter recovery time, lower RSAS scores, and fewer cases of breath holding and SpO2<90% compared to the control group (all P<0.05). Conclusion: Alfentanil combined with propofol for pediatric bronchoscopic foreign body removal provides effective anesthesia, resulting in more stable hemodynamics, faster recovery, and lower incidence of adverse reactions such as breath holding and respiratory depression.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 27-30.
Objective: To assess the impact of clozapine on myocardial enzyme levels and electrocardiogram in patients with maintenance chronic schizophrenia. Methods: Forty-eight patients with chronic schizophrenia were treated with clozapine only and the plasma concentrations of clozapine, myocardial enzymes and serum potassium and electrocardiogram were determined at baseline, the ends of 3 months, 6 months and 9 months. The data were analyzed by repeated measures ANOVA and Pearson correlation analysis. Results: Pearson correlation analysis showed that the plasma concentration of clozapine was not correlated with QTc interval at baseline, at the ends of 3 months and 6 months (P<0.05). There were significant statistical differences in plasma concentrations of clozapine and serum potassium, CK-MB, heart rate and QTc interval between male and female patients (P<0.05). Conclusion: The fixed dose taken during maintenance therapy with clozapine has little effect on myocardial enzyme levels and electrocardiogram. There are gender differences in the degree of influence of clozapine. Therefore, it is necessary to follow up the relevant indicators regularly and establish an individualized diagnosis and treatment plan.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 31-34.
Objective: To investigate the efficacy of oral nutritional supplements (ONS) in the treatment of patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) complicated with sarcopenia. Methods: A total of 100 cases of the patients were divided into a control group (n=50) and an observation group (n=50) based on treatment regimens. Both groups were treated with conventional therapy and dietary guidance, while the observation group was additionally given ONS. Serum albumin (ALB), prealbumin (PA), forced expiratory volume in one second as a percentage of predicted value (FEV1%Pred), 6-minute walking distance (6MWD), COPD assessment test (CAT) score, body mass index (BMI), fat-free mass index (FFMI), and skeletal muscle mass index (SMI) were compared between the two groups. Results: After treatment, the observation group showed significantly higher levels of serum ALB, PA, FEV1%Pred, 6-MWD, BMI, FFMI, and SMI, along with a lower CAT score compared to the control group (all P<0.05). Conclusion: ONS can effectively improve nutritional status and cardiopulmonary function, as well as promote muscle mass gain in these patients.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 35-38.
Damp-constipation is a special type of constipation that is clinically common but often overlooked. This article reviews the understanding of dampness-related constipation by ancient physicians and emphasizes the significance of dampness as a pathogenic factor. The core pathogenesis is characterized by spleen deficiency leading to dampness accumulation, and subsequent obstruction of Qi movement. The treatment strategy focuses on strengthening the spleen, resolving dampness to eliminate its source, and promoting Qi transformation using pungent and aromatic herbs, with sweet and neutral agents to harmonize the middle burner. Additionally, the therapeutic approach involves regulating the functional interaction of the spleen with the lung, heart, liver, and kidney based on their physiological and pathological characteristics. In cases of damp-heat accumulation, treatment should aim at dispersing and eliminating the pathogenic factors while regulating Qi and dampness. Depending on the location of damp-heat accumulation within the triple burner (San Jiao), appropriate methods are applied. For cases with impacted fecal matter obstructing the colon, purgative methods are combined to eliminate turbidity and relieve stagnation.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 39-42.
Objective: To compare the efficacy of transvaginal specimen radical rectal cancer resection with traditional laparoscopic surgery. Methods: A total of 60 women with rectal cancer admitted to our hospital were divided into a transvaginal group (radical rectal cancer resection with vaginal specimens) and a traditional group (traditional laparoscopic surgery), with 30 cases each. Their outcomes were compared. Results: The transvaginal group had a smaller surgical incision, shorter time for gas, eating and first getting out bed for activity than the traditional group (P<0.05), a lighter pain score, and a lower complication rate than the traditional group (P<0.05). Conclusion: The effect of transvaginal specimen radical rectal cancer surgery is better than that of traditional laparoscopic surgery, which is conducive to relieving postoperative pain, promoting postoperative recovery and enhancing prognosis.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 43-46.
Objective: To investigate the effects of high-intensity interval training combined with elastic band resistance training in post-PCI patients with coronary heart disease. Methods: Ninety-four cases of the patients were randomly assigned to a control group (n=47) receiving conventional rehabilitation exercise and an observation group (n=47) receiving additional high-intensity interval training combined with elastic band resistance training. Cardiopulmonary function, activities of daily living (ADL), exercise endurance, and quality of life were compared between the two groups. Results: After intervention, the observation group exhibited lower right ventricular anterior wall thickness (RVAWT), right ventricular end-diastolic dimension (RVEDD), and pulmonary artery systolic pressure (PASP), along with higher forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC ratio compared to the control group. Additionally, the observation group showed higher ADL and GQOLI-74 scores, as well as greater 6-minute walk test (6MWT) distance (all P<0.05). Conclusion: High-intensity interval training combined with elastic band resistance training can significantly improve cardiopulmonary function, enhance activities of daily living and exercise endurance and elevate quality of life in post-PCI patients with coronary heart disease.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 47-50.
Objective: To standardize the water-added amount for decoction of traditional Chinese medicine (TCM) and improve the quality of decoction of TCM. Methods: Different numbers of outpatient TCM prescriptions were selected, and the amount of decoction loss (Vloss) was determined in the empirical decoction with water, and the water-added amount was calculated according to the measured water absorption coefficient, packing volume, and loss. Results: Vwater addition volume = (K1×M1+K2×M2+K3×M3+……+Kn×Mn)×P+300+(300×number of dosage)/7+(number of dosage×number of times per day+1)×dose per dose. Conclusion: The error in the water-added amount is within the normal range.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 51-55.
Objective: To provide a basis for the amount of water added during the decoction process in the decoction machine by determining the water absorption coefficient of single Chinese medicine decoction piece under actual decoction conditions. Methods: The water absorption coefficients of 629 different categories of Chinese medicine decoction piece were determined under actual decoction conditions and the difference between the actual measured water absorption under machine decoction conditions and the water absorption calculated according to the absorption coefficient was verified by determination of ten sets of compound Chinese medicine decoction piece. Results: There was a significant difference in the water absorption coefficients among different categories of Chinese medicine decoction piece, and the error between the actual liquid volume obtained by adding water according to the absorption coefficient and the required liquid volume was relatively small. Conclusion: The water absorption coefficient of Chinese medicine decoction piece determined by experiments can guide enterprises to standardize the amount of water added when decoction.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 56-60.
Objective: To improve the transformation and upgrading capabilities of China’s pharmaceutical industry, and provide decision-making suggestions for its high-quality development. Methods: An evaluation model for the upgrading capability of the pharmaceutical industry was constructed based on the entropy TOPSIS method, and empirical analysis was conducted using relevant data from four regions in China from 2009 to 2020 as samples. Results: The four indicators of output capacity, input capacity, industrial structure optimization, and environmental support capacity showed an almost linear upward trend in the four regions, growth rate was relatively stable, and the evaluation indices of various subsystem indicators in each region showed a trend in the eastern>central>western>northeast regions. Conclusion: The upgrading level of China’s pharmaceutical industry has been constantly improving, and its development has been gradually getting better. However, there is uneven development in various regions. Therefore, policies should be formulated based on the development stages and characteristics of the transformation and upgrading capabilities of China’s pharmaceutical industry.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 61-64.
This article compares and analyzes the overall framework and key content of the Good Distribution Practice for Medicinal Products (GDP) issued by the Pharmaceutical Inspection Co-operation Scheme (PIC/S) with the current version of Good Supply Practice (GSP) in China. Based on common issues observed in drug market inspections in China, it provides suggestions for improving regulatory practices. It aims to provide a reference for enhancing China’s regulatory system for drug market inspections and accelerating alignment with international standards. The GDP issued by PIC/S differs significantly from China’s current GSP in both concept and content, reflecting emerging trends in drug market regulation. It suggests that while standardizing inspections and improving their quality, efforts should also be made to guide enterprises to actively adopt advanced international quality management concepts, align with global standards, and enhance the overall development of China’s drug distribution sector.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 65-66.
To discuss a new approach to the improvement of the teaching effect of the course Basis of Surgical Operations in view of its practical and operational characteristics. The modern information technologies such as multimedia technology, network technology and virtual simulation technology, together with the use of small group teaching method was widely applicated in the stages of pre-class learning, classroom teaching and after-class review, which could more effectively transform teachers’ operational ability into students’ own ability, improve students’ self-directed learning ability, and also close the connection between teachers and students, so as to achieve mutual learning in teaching.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 67-70.
Objective: To explore the pharmaceutical treatment plan and pharmaceutical care for a pregnant patient with Sjögren’s syndrome (SS) complicated with gestational hypertension and gestational diabetes mellitus. Methods: The clinical pharmacist participated in the patient’s medication therapy, assisted physicians in evaluating the treatment regimen, and provided medication monitoring and counseling for the patient. Results: Her SS was stable after treated with hydroxychloroquine and low-dose glucocorticoids, blood pressure was controlled using nifedipine controlled-release tablets and blood glucose level was managed with recombinant human insulin injections. Thus, both of her blood pressure and blood glucose level were remained within acceptable ranges and no significant adverse reactions occurred. Conclusion: Clinical pharmacists, as integral members of the clinical treatment team, can assist physicians in evaluating therapeutic plans, and improve patient compliance through medication counseling.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 71-72.
Objective: To explore the relevant risk factors of drug-induced Reye’s syndrome (RS) and provide references for clinical rational drug use. Methods: Clinical pharmacists participated in the discussion of the diagnosis and treatment process of a patient with suspected RS and provided pharmaceutical advice and monitoring. Results: The relevant factors that induced the patient’s mental abnormality were gradually excluded through electroencephalogram monitoring, cerebrospinal fluid examination and other measures, and the patient’s repeated medication was considered to induce RS. The pharmacist recommended medication, and the patient was recovered and discharged from the hospital after treatment. There was no recurrence of the disease on the 20th and 90th days of follow-up after discharge. Conclusion: Clinical pharmacists can play an important role in the diagnosis and treatment process by participating in the analysis of clinical difficult RS cases and providing pharmaceutical guidance.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 73-76.
The origin, structural framework, and application of the information-motivation-behavioral skills (IMB) model are elucidated, while reviewing its current applications in pharmaceutical therapy interventions, medication adherence, medication management for chronic diseases, extended pharmaceutical services, and internet-based pharmacy so as to to provide theoretical references for the development and improvement of the IMB model in pharmaceutical practice.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 77-79.
Objective: To optimize the synthesis process of brivaracetam (1). Methods: (R)-4-propyl-dihydrofuran-2-one (2) underwent ring-opening with HBr in acetic acid to yield (R)-3-bromomethylhexanoic acid (3), which is then esterified with ethanol to obtain the intermediate (R)-3-bromomethylhexanoate (4). Subsequently, 4 was reacted with (S)-2-aminobutanamide hydrochloride (5) in the presence of sodium carbonate and tetrabutylammonium iodide (TBAI) to obtain 1. Results: The yield of 3 was increased from 81% to near 100%; the yield of the reaction between 4 and 5 was improved from 32.0% to 40.7%; the overall yield was increased from 23.1% to 38.8%. Conclusion: The improved process is easier to be operated, and can increase the yield and reduce the production cost.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 80-83.
To validate a microbial limit test method for Burkholderia cepaci complex (Bcc) and establish a detection protocol for Bcc in oral solutions. A sample of 1 mL oral solution was inoculated into tryptic soy broth (TSB) for non-selective enrichment. The enriched culture was then streaked onto Burkholderia cepacia selective agar (BCSA) to isolate Bcc colonies. Single colonies were subjected to Gram staining (revealing Gram-negative rods) and confirmed via 16S rDNA gene sequencing. This study successfully established a detection method for Bcc in oral magnesium-sodium-potassium sulfate concentrated solutions. The validated method provides a reliable framework for monitoring Bcc contamination in oral liquid formulations, thereby mitigating potential patient medication safety risks.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 84-87.
Objective: To establish HPLC quantitative analysis method for dopamine citrate in dopamine hydrochloride injection and provide a basis for quality control of dopamine hydrochloride injection. Methods: Dopamine citrate contents in dopamine hydrochloride injection were determined by HPLC via gradient elution using disodium hydrogen phosphate solution-acetonitrile 900 : 20 and 650 : 350 as mobile phase A and B. Results: This method had good specificity precision and durability; each dopamine citrate impurity showed a good linear relationship in their respective concentration ranges (r≥0.990). The average recovery rates of 3 impurities were 101.6%, 100.0% and 102.9%, respectively. Conclusion: The method has good sensitivity and specificity, and can be used for the determination of dopamine citrate in dopamine hydrochloride injection and the quality control of dopamine hydrochloride injection.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 88-91.
Pyrogens originate from microbial components and excessive pyrogens can induce complex inflammatory responses, cause shock and even death, posing serious risks to human health. Therefore, development of sensitive, accurate and fast detection methods is crucial. At present, there are two main examination methods: the rabbit pyrogen test and the bacterial endotoxin detection method—the limulus amoebocyte lysate test, but neither can meet the market needs. Therefore, with a deeper understanding of pyrogens, it is feasible to develop some low-cost, easy-to-operate and rapid pyrogen detection techniques based on their pathogenic mechanisms. This article reviews the progress of pyrogen detection methods and focuses on future pyrogen detection technologies.
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Shanghai Medical & Pharmaceutical Journal. 2025, 46(6): 92-95.
Objective: To study the self-degradation of trypsin solution for injection in the production process. Methods: The changes of titer and trypsin content of trypsin solution under different time, temperature and pH conditions were compared to reflect their effects on trypsin stability in the solution. Results: With the increase of time and the rise of temperature and pH, the titer and trypsin content of trypsin solution was gradually decreased. Conclusion: In the conventional production process, it is necessary to control the whole process within 6 h, the pH of the solution at 5.8 and the temperature at 4 ℃, so as to ensure that the content of trypsin for injection meets the pharmacopoeia standard.
