搜索结果：pill

All healthcare professionals (HCPs), have a role in ensuring patient understanding and optimal medication use. Solid oral dosage forms (SODFs) or pills are commonly prescribed; however, some patients struggle to take these and there is minimal reference to this in HCP education. KidzMed is a validated training programme that can support this in children and adults. We explored student views on its application in undergraduate medical, nursing, physician assistant, and pharmacy programmes in the United Kingdom (UK), Malaysia, and Jordan. University ethical approval was granted. HCP students from four universities in Europe, the Middle East, and Asia participated. This involved completing the pre-work of the KidzMed e-learning followed by its application in a simulated 90-min workshop at their university. Students were invited to evaluate the training and its potential application in their future practice via completion of e-questionnaires. Data was analysed using descriptive statistics to infer findings. Free-text comments were thematically analysed. A total of 327 HCP students completed evaluation questionnaires. They viewed the training favourably describing the content and length as "about right". They described the interventions as 'edutainment' - a fun activity that was also educational. Participants felt comfortable to counsel parents or patients to swallow pills and saw the relevance of this skill to everyday lived experiences of using pills. They expressed a desire to do more activities like this. All HCPs will encounter patients using pills in their clinical practice. Training at the undergraduate level to seek information about SODF use will allow the identification and rectification of poor pill use. KidzMed is a useful training tool to teach undergraduate HCPs from various professional backgrounds across different global jurisdictions, providing them with a fun, practical and educationally relevant session that they can apply to patients of all ages in their future practice.

This randomized, double-blind, multicenter Phase III study evaluated the efficacy and safety profile of a single-pill triple combination of valsartan/amlodipine/chlorthalidone (KDF1901, Valdipine Plus) compared with a dual combination of valsartan/amlodipine (KDF1901-R) in patients with essential hypertension. Patients (n = 294) with inadequately controlled hypertension after a 4-week run-in phase with valsartan/amlodipine (80/5 mg) were randomized to receive KDF1901 (valsartan/amlodipine/chlorthalidone 160/10/25 mg, n = 147) or KDF1901-R (valsartan/amlodipine 160/10 mg, n = 147) for 8 weeks. The primary efficacy endpoint was the change in mean sitting systolic blood pressure (MSSBP) from baseline to week 8. Secondary endpoints included changes in mean sitting diastolic blood pressure (MSDBP), BP normalization rates, and response rates. Safety profile outcomes assessed treatment-emergent adverse events (TEAEs), laboratory parameters, and serious adverse events. At week 8, the KDF1901 group exhibited a significantly greater reduction in MSSBP (-22.8 &#xb1; 1.0 mmHg) compared with the dual therapy group (-16.7 &#xb1; 1.0 mmHg, P < 0.0001). Similarly, the mean MSDBP reduction was significantly greater with KDF1901 (P = 0.0006). BP normalization rates (75.9% vs 54.5%, P < .0001) and response rates (73.8% vs 51.7%, P < 0.0001) were significantly higher in the triple combination group. Overall, the incidence of TEAEs was similar between groups (24.7% vs 21.5%, P = 0.5783), with mild cases of dizziness were most commonly reported. Exploratory ad hoc analyses showed statistically greater changes in sodium, potassium, and uric acid levels with triple therapy, but clinically meaningful extreme electrolyte abnormalities were rare in both groups, and the overall laboratory profile remained acceptable. This trial reported that the single-pill triple combination KDF1901 significantly improved BP control compared with dual therapy without compromising tolerability. NCT07116863.

The Dual Prevention Pill (DPP) is a daily oral pill containing oral pre-exposure prophylaxis (PrEP) for protection against HIV and a combined oral contraceptive (COC) for the prevention of unintended pregnancy, currently under development. However, little is known about healthcare providers' (HCPs) perspectives on this potential new multipurpose prevention technology (MPT). A more granular understanding of HCP views about the DPP may support efforts to ensure equitable introduction of and access to this innovative technology. We conducted in-depth interviews with 17 HCPs working at family planning (FP) and HIV service sites in Johannesburg, South Africa. We used a qualitative framework analysis to examine HCP perspectives on potential end-users, the DPP concept and health system-related considerations. HCPs articulated that the DPP would meet the needs of their clients, contribute to more efficient and effective integrated sexual and reproductive health service delivery and meet broader community goals for the reduction in HIV infections and unintended pregnancies. HCPs noted concerns and potential challenges with the product's daily dosing regimen, potential for exacerbated side effects (compared to oral PrEP or COCs taken alone) and potential ethical considerations about offering the DPP to adolescents. HCPs felt the DPP should be available through public health care facilities to maximise outreach and ensure appropriate care, and discussed community-based delivery options for expanded outreach. They also noted the need to address provider biases, particularly when serving adolescents, as well as the accompanying demand creation efforts with end-users and educational campaigns in the community. Understanding providers' support for the DPP, as well as the potential challenges they foresee, should inform market introduction strategies, clinic counselling guidelines and provider training for the DPP. We underscore the need to engage with HCPs early (prior to product introduction) to understand local barriers and facilitators to ensure quality sustained rollout and support for MPTs.

Jiannao Bushen Pill (JNBSP) is a traditional Chinese medicine (TCM) preparation used for nourishing the brain and kidney, tonifying qi and spleen, calming the mind, and improving memory. Clinically, it has been widely applied for the treatment of amnesia and cognitive decline; however, its pharmacodynamic material basis remains largely unclear. In the present study, an ultra-high-performance liquid chromatography coupled with Q-Exactive Orbitrap high-resolution mass spectrometry (UHPLC-Q-Exactive Orbitrap-HRMS) strategy was established to systematically characterize the chemical constituents of JNBSP. A total of 181 compounds were identified, and their herbal origins were further assigned through comparison with the chemical profiles of the 25 individual medicinal materials comprising the formula. In addition, 40 prototype compounds absorbed into the bloodstream and 41 metabolites were tentatively characterized in rat plasma after oral administration of JNBSP. To further evaluate the in vivo exposure behavior of representative absorbed constituents, microdialysis sampling combined with ultra-high-performance liquid chromatography-triple quadrupole tandem mass spectrometry was employed to monitor the temporal concentration profiles of six prototype compounds. The results revealed comparable Tmax values but different systemic exposure levels and elimination characteristics among these constituents, suggesting potentially different temporal and quantitative contributions to the pharmacological effects of JNBSP. To the best of our knowledge, this is the first systematic study to integrate comprehensive chemical profiling, characterization of absorbed prototypes and metabolites, and dynamic in vivo monitoring of representative constituents for JNBSP. These findings provide an important foundation for subsequent pharmacokinetic-pharmacodynamic studies, target identification, and mechanistic investigations of JNBSP in the treatment of cognitive dysfunction.

Lower extremity peripheral artery disease (PAD) is a chronic ischemic disorder primarily driven by atherosclerosis (AS) and characterized by endothelial injury, lipid deposition, inflammation, oxidative stress, and hemorheological abnormalities. From the perspective of traditional Chinese medicine (TCM), its pathogenesis is commonly interpreted within the concept of "Tuoju", in which blood stasis obstructs the collaterals/meridians and may coexist with qi deficiency, blood heat, or phlegm-dampness. Dahuang Zhechong Pill (DHZCP), first recorded in the Jingui Yaolue, is traditionally prescribed to remove blood stasis, clear heat, and resolve masses, while also supporting vital qi and nourishing yin, which conceptually aligns with TCM pattern differentiation in PAD. Preclinical studies and limited clinical reports suggest that DHZCP may be associated with multi-domain effects relevant to PAD pathophysiology, including endothelial-related readouts, lipid metabolism, inflammation, oxidative stress, and hemorheological parameters. Clinical studies (mostly small-sample trials) indicate that DHZCP may be associated with improvements in ankle-brachial index (ABI), lipid profiles, blood viscosity, and microcirculatory perfusion, particularly when used as an adjunct to acupuncture, blood-activating prescriptions, or conventional therapies, with generally favorable short-term safety signals. This review summarizes the traditional rationale and modern evidence on DHZCP for PAD, critically appraises the current evidence base and its limitations, and proposes priorities for future research to support standardized clinical use and potential international application. This article is a structured narrative review based on a predefined literature search and study selection strategy. In silico findings (e.g., network approaches and molecular docking) are treated as hypothesis-generating evidence and are clearly distinguished from in vitro/in vivo and clinical studies.

To investigate how Huatuo Zaizao pill (HZP) enhances neurological function and to explore the underlying mechanism in acute phase of the middle cerebral artery occlusion (MCAO) ischemia-reperfusion model. MCAO ischemia-reperfusion models were established in rhesus monkeys and rats to evaluate cerebral infarct volume and neurological impairment. Additionally, immunofluorescence staining and Western blotting (WB) were utilized to determine the expression levels of glial fibrillary acidic protein (GFAP) and Bax proteins. In the rhesus monkey MCAO ischemia-reperfusion model, the HZP group exhibited a greater reduction in infarct volume than the model group. The NHPSS scores in the HZP group began to decrease at 16 hours after stroke; compared with the model group, the NHPSS scores were significantly lower from 48 hours to 14 days. Compared with the control group, the percentages of cerebral infarction volume in rats of the model group was significantly increased, while that in the HZP groups was significantly decreased. Additionally, the time in the adhesive removal test was significantly shortened in the HZP groups. Immunofluorescence and WB revealed that the expression of GFAP and Bax was increased in the model group, whereas this change could be reversed to a certain extent after HZP treatment. HZP significantly alleviates acute-phase symptoms in the rhesus macaque MCAO model, with these beneficial effects persisting into the recovery phase. This protective action may counteract cerebral ischemia-reperfusion injury by mitigating neuroinflammation and inhibiting neuronal apoptosis. Findings from both rhesus macaque and rat models in this study support the potential of HZP as an adjunctive therapeutic agent for acute cerebral infarction.

Hypercholesterolemia imposes a growing cardiovascular burden in China, yet low-density lipoprotein cholesterol (LDL-C) target attainment remains low. The single-pill combination (SPC) of ezetimibe and atorvastatin (E/A SPC) was approved in China in 2023 and added to the National Reimbursement Drug List (NRDL) in 2024. Compared with free combination therapy (E/A FCT), E/A SPC may improve adherence and LDL-C reduction, but its economic value has not been assessed in the Chinese context. To evaluate the cost-effectiveness of E/A SPC versus E/A FCT in Chinese adults with hypercholesterolemia inadequately controlled on statin monotherapy, and to estimate the 5-year budget impact of E/A SPC adoption. An 11-state Markov model was developed from the Chinese healthcare system perspective, projecting 20-year costs and health outcomes in patients aged 69&#x2009;years with uncontrolled LDL-C (>70&#x2009;mg/dL) after statin therapy. Clinical efficacy inputs were derived from a large real-world German head-to-head study (n&#x2009;=&#x2009;311,242). Subgroup analyses were conducted by age, sex, and cardiovascular risk. A 5-year budget impact analysis estimated the financial consequences of increasing E/A SPC uptake. Costs and outcomes were discounted at 5% annually. E/A SPC generated 0.06 additional quality-adjusted life years (QALYs) at an incremental cost of USD 250.12, yielding an incremental cost effectiveness ratio (ICER) of USD 4,070/QALY, well below the willingness-to-pay threshold of USD 14,423. The probability of cost-effectiveness was 91%. Subgroup analyses consistently favored E/A SPC, with the most favorable ICERs observed in very high-risk patients and middle-aged patients. Over 5&#x2009;years, E/A SPC was associated with incremental drug spending of USD 372.5 million, partly offset by USD 292.0 million in avoided cardiovascular event costs. E/A SPC is a cost-effective strategy for Chinese adults with hypercholesterolemia inadequately controlled on statin monotherapy, supporting its NRDL inclusion. The study findings should be further validated using larger-scale real-world data from China.

Ischemic stroke (IS) is a major global cause of mortality and long-term disability and is closely associated with cardiovascular disease (CVD). Its pathogenesis overlaps with cardiovascular disorders, particularly atherosclerosis and immune-inflammatory dysregulation. Shexiang Baoxin Pill (SBP), a traditional Chinese medicine used for coronary heart disease and angina pectoris, has been reported to improve microcirculation and alleviate inflammation; however, the mechanisms of SBP against IS remain unclear. Here, an integrated strategy combining network pharmacology, machine learning, molecular docking, and molecular dynamics simulation was applied to explore the potential mechanisms of SBP in IS. In total, 126 bioactive compounds and 796 potential targets of SBP were identified. Intersection analysis with IS-related differentially expressed genes from GEO datasets identified six candidate targets: CXCL8, IL1B, JUN, NR4A2, PTGS2, and TNF. Functional enrichment analysis suggested that these targets were mainly involved in cardiovascular and cerebrovascular processes, including inflammatory responses, immune regulation, and apoptosis. Combined protein-protein interaction network analysis and machine learning further identified TNF and JUN as hub genes related to IS. Molecular docking and molecular dynamics simulations suggested stable binding between representative active ingredients (e.g., bufalin and bufotalin) and the two hub targets, and the TNF-compound complexes remained structurally stable during the simulation. Collectively, this computational study suggests that SBP may exert therapeutic effects in IS through a multicomponent and multitarget regulatory network involving inflammation- and immunity-related pathways. These findings provide preliminary molecular evidence and a basis for further experimental validation of the cerebrovascular protective effects of SBP.

Prostatitis is a common urological disorder with limited treatment options. Yougui Pill (YGP) has shown potential therapeutic value, particularly in inflammation-related conditions. This study aimed to evaluate its effects and explore possible underlying mechanisms. Active components of YGP were screened from TCMSP using oral bioavailability (OB &#x2265; 30%) and drug-likeness (DL &#x2265; 0.18) criteria, and corresponding targets were collected. Prostatitis-related targets were obtained from GeneCards, and overlapping targets were analyzed using protein-protein interaction (PPI) networks and Kyoto encyclopedia of genes and genomes (KEGG) enrichment. A total of 126 active compounds and 208 potential targets were identified, with 180 overlapping targets associated with prostatitis. PPI analysis identified TP53, IL6, AKT1, TNF, and IL1B as key hub genes. KEGG enrichment suggested involvement of inflammation-related pathways, including IL-17, TNF, MAPK, and PI3K-Akt signaling pathways. A rat model of prostatitis was established by intraprostatic injection of carrageenan. Histological examination and measurement of tumor necrosis factor-alpha (TNF-&#x3b1;) and interleukin-6 (IL-6) were performed to assess therapeutic effects. YGP treatment improved prostatic histopathology and reduced TNF-&#x3b1; and IL-6 levels at both protein and mRNA levels. These findings suggest that YGP exerts anti-inflammatory effects in prostatitis, while the specific molecular mechanisms remain to be further validated.

Stroke is the second leading cause of death and the third leading cause of disability-adjusted life years lost. A narrow therapeutic window and the complex, dynamic nature of stroke pathophysiology limit current neuroprotective therapies. Angong Niuhuang Pill (ANP) is a traditional Chinese medicine emergency prescription used to treat acute conditions and is reported to have neuroprotective effects. The aim of this review was to evaluate the neuroprotection of ANP and to assess its efficacy and safety in the treatment of stroke. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched four databases and selected studies that met the inclusion criteria (n = 16). The methodological quality was assessed using SYRCLE risk of bias tool (for animal studies), the Cochrane Risk of Bias tool (for Randomised Controlled Trials (RCTs)), and AMSTAR 2 (for systematic reviews/meta-analyses). Data were integrated using a narrative synthesis method. 12 preclinical studies suggested that ANP may provide neuroprotection in stroke via multiple pathways, half of them indicating anti-cell death properties. Two high-quality preclinical studies examine the mechanism of ANP in ischemic stroke (IS), namely via the PI3K/AKT axis and microcirculation. One RCT showed that ANP increased the proportion of patients achieving an mRS score of 0-2 at six months in patients with basal ganglia haemorrhage (26.2% vs. 2.6%) and the other one, which exhibits high methodological quality, showed for patients with moderate-to-severe acute IS, ANP showed no overall benefit in day-14 infarct or oedema volumes, although a significant reduction was observed in the large artery atherosclerosis subgroup (-12.3 mL, P = 0.03). Two meta-analyses indicated that ANP was associated with higher GCS (MD = 2.01, 95% CI [1.04, 2.98], P < 0.00001) and lower NIHSS scores, but both had low methodological quality. There was no statistically significant difference in the incidence of adverse events between the two groups. This review found that ANP has a relatively definite neuroprotective effect and can improve the clinical efficacy of stroke patients. However, due to the limited number of included studies and significant differences in study design, study population, and outcome definition, the existing evidence shows considerable heterogeneity, resulting in relatively low study quality and making reliable quantitative meta-analysis difficult. Future research should use relevant quality assessment tools in study design and implementation to enhance the credibility of evidence and thereby promote the generation of high-quality evidence. This review synthesizes evidence of neuroprotective effect and clinical effectiveness, suggesting potential neuroprotective benefit with an overall favorable safety profile.

Those affected by Type 2 diabetes (T2DM) often encounter microvascular harm, and within this context, the kidneys are especially prone to damage. Among the approaches to manage such microvascular complications, Shenqi Tangluo Pill (SQTLW), a traditional Chinese herbal formulation, is commonly utilized in clinical settings for preventing and addressing microvascular issues linked to T2DM. Nonetheless, the detailed impacts and working principles of this herbal formulation in alleviating kidney damage caused by diabetes are still not clearly understood. The aim was to confirm the kidney-protective impacts of SQTLW on T2DM mice, as well as to clarify the fundamental mechanisms related to intestinal microbiota and the microbe-derived metabolite trimethylamine N-oxide (TMAO), especially under the condition of intestinal flora depletion induced by a combination of broad-spectrum antibiotics (ABx). Diabetic db/db mice received sustained SQTLW intervention over an 8-week period. Following the 8-week intervention, evaluations were performed on fasting blood glucose levels (FBG), body mass, kidney function, and histopathological changes in renal tissue. Additionally, the makeup of gut microbial communities and the circulating concentrations of metabolites linked to TMAO were assessed. To assess the integrity of the intestinal barrier, histopathological examination of colonic tissue and expression profiles of zonula occludens protein-1 (ZO-1) and Occludin were performed. Expression levels of NOD-like receptor pyrin domain-containing 3 (NLRP3), Smad family member 2/3 (Smad2/3), fibronectin (FN), and &#x3b1;-smooth muscle actin (&#x3b1;-SMA) in renal tissue were examined using immunodetection methods. Next, db/db mice were given a combination of ABx and SQTLW treatments to further examine if the therapeutic outcome is dependent on the regulation of gut microorganisms. SQTLW notably lowered FBG and body weight in db/db mice, ameliorated renal dysfunction, and alleviated histopathological injury of renal tissue, with a notable dose-response relationship. 16S rRNA gene sequencing-based profiling revealed that SQTLW substantially altered the compositional structure of distinct bacterial genera from the phyla Bacteroidota and Firmicutes, particularly Muribaculaceae and Lachnospiraceae. Colonic histopathology and molecular detection indicated that SQTLW effectively preserved intestinal barrier architecture. Targeted metabolomics via LC-MS/MS demonstrated that SQTLW significantly modulated TMAO-related plasma metabolites, including TMAO, choline, and creatinine. Moreover, SQTLW significantly downregulated renal expression of NLRP3 and Smad2/3, thereby attenuating fibrosis-related injury. Importantly, further experiments confirmed that depletion of gut microbiota by ABx partially attenuated the renoprotective effects of SQTLW in db/db mice. SQTLW confers protective effects against renal injury secondary to T2DM, potentially via modulation of gut microbial composition, preservation of intestinal barrier function, and regulation of TMAO-related metabolic pathways.

Informed consent is a cornerstone of patient autonomy, yet its implementation in medication abortion, especially in the context of rapidly expanding telehealth and online access, remains understudied. This study explores how informed consent is experienced by women who undergo medication abortion, focusing on the information they receive and the gaps they perceive. Using an exploratory sequential mixed methods design, we first conducted a thematic analysis of online narratives to examine how women described their experiences with information, support, and uncertainty. We then developed and administered a national survey informed by these findings to assess how women perceive the informed consent process. Thematic analysis of online narratives revealed four key patterns: women sought information about medication abortion symptoms and side effects; emotional support; urgent reassurance during the process; and clarification of the information provided. Survey results showed that concerns about fetal remains, emotional well-being, and the risk of an incomplete abortion (retained tissue) were strongly associated with women's sense of being informed. Emotional responses also shaped these perceptions, where women who felt stressed were less likely to feel adequately informed, while those women who felt happy were more likely to report receiving sufficient information. Integration of qualitative and quantitative findings revealed consistent concerns, particularly about unanticipated symptoms, emotional distress, and the need for clearer guidance. Our results suggest that some women experience uncertainty or unmet informational needs prior to taking abortion medications, regardless of care setting. This informational gap raises the possibility of preference misalignment, whereby patients' expectations may not fully reflect their lived experience. The findings highlight a pressing need for clearer, more comprehensive, and emotionally supportive consent practices, particularly as medication abortion becomes increasingly accessible and utilized by women. Addressing these gaps can strengthen patient-centered care and ensure that women's choices are informed, respected, and aligned with their values.

暂无摘要（点击查看详情）

暂无摘要（点击查看详情）

暂无摘要（点击查看详情）

Unprecedented trial aims to protect people exposed to Ebola in the DRC and Uganda.

暂无摘要（点击查看详情）

暂无摘要（点击查看详情）