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Feng J, Zhang Y. The potential benefits of polyphenols for corneal diseases. Biomed Pharmacother 2023; 169:115862. [PMID: 37979379 DOI: 10.1016/j.biopha.2023.115862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/30/2023] [Accepted: 11/05/2023] [Indexed: 11/20/2023] Open
Abstract
The cornea functions as the primary barrier of the ocular surface, regulating temperature and humidity while providing protection against oxidative stress, harmful stimuli and pathogenic microorganisms. Corneal diseases can affect the biomechanical and optical properties of the eye, resulting in visual impairment or even blindness. Due to their diverse origins and potent biological activities, plant secondary metabolites known as polyphenols offer potential advantages for treating corneal diseases owing to their anti-inflammatory, antioxidant, and antibacterial properties. Various polyphenols and their derivatives have demonstrated diverse mechanisms of action in vitro and in vivo, exhibiting efficacy against a range of corneal diseases including repair of tissue damage, treatment of keratitis, inhibition of neovascularization, alleviation of dry eye syndrome, among others. Therefore, this article presents a concise overview of corneal and related diseases, along with an update on the research progress of natural polyphenols in safeguarding corneal health. A more comprehensive understanding of natural polyphenols provides a novel perspective for secure treatment of corneal diseases.
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Affiliation(s)
- Jing Feng
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Yangyang Zhang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.
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2
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Stevens Barrón JC, Chapa González C, Álvarez Parrilla E, De la Rosa LA. Nanoparticle-Mediated Delivery of Flavonoids: Impact on Proinflammatory Cytokine Production: A Systematic Review. Biomolecules 2023; 13:1158. [PMID: 37509193 PMCID: PMC10377633 DOI: 10.3390/biom13071158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Flavonoids are a diverse group of plant-derived compounds that have been shown to have various health benefits, including anti-inflammatory effects. However, their use in the treatment of inflammatory diseases has been limited due to their low bioavailability. The nanoparticle-mediated delivery of flavonoids has been proposed as a potential solution to this issue, as it allows the sustained release of the flavonoids over time. There are several different nanoparticle systems that have been developed for flavonoid delivery, including polymeric nanoparticles, liposomes, and inorganic nanoparticles. This systematic review aims to evaluate the impact of nanoparticle-mediated delivery of flavonoids on pro-inflammatory cytokine production in various diseases. We analyzed the performance of flavonoid-encapsulated nanoparticles in regulating cytokine production in different in vitro and in vivo studies. To this end, we followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to conduct a comprehensive search of the literature and to assess the quality of the included studies. The results showed that flavonoid-encapsulated nanoparticles significantly downregulated pro-inflammatory cytokines, such as TNF-α, IL-1β, IL-6, and IL-18. In some cases, this effect was significantly greater than that observed with non-encapsulated flavonoids These findings suggest that nanoparticle-mediated delivery of flavonoids may have potential as a therapeutic approach for the treatment of inflammatory diseases.
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Affiliation(s)
| | - Christian Chapa González
- Instituto de Ingeniería y Tecnología, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez 32310, Mexico
| | - Emilio Álvarez Parrilla
- Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez 32310, Mexico
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3
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Bangar SP, Chaudhary V, Sharma N, Bansal V, Ozogul F, Lorenzo JM. Kaempferol: A flavonoid with wider biological activities and its applications. Crit Rev Food Sci Nutr 2022; 63:9580-9604. [PMID: 35468008 DOI: 10.1080/10408398.2022.2067121] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Kaempferol and its derivatives are naturally occurring phytochemicals with promising bioactivities. This flavonol can reduce the lipid oxidation in the human body, prevent the organs and cell structure from deterioration and protect their functional integrity. This review has extensively highlighted the antioxidant, antimicrobial, anticancer, neuroprotective, and hepatoprotective activity of kaempferol. However, poor water solubility and low bioavailability of kaempferol greatly limit its applications. The utilization of advanced delivery systems can improve its stability, efficacy, and bioavailability. This is the first review that aimed to comprehensively collate some of the vital information published on biosynthesis, mechanism of action, bioactivities, bioavailability, and toxicological potential of kaempferol. Besides, it provides insights into the future direction on the improvement of bioavailability of kaempferol for wide applications.
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Affiliation(s)
- Sneh Punia Bangar
- Department of Food, Nutrition and Packaging Sciences, Clemson University, Clemson, SC, USA
| | - Vandana Chaudhary
- College of Dairy Science and Technology, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - Nitya Sharma
- Food Customization Research Lab, Centre for Rural Development and Technology, Indian Institute of Technology, Delhi, New Delhi, India
| | - Vasudha Bansal
- Department of Foods and Nutrition, Government of Home Science College, Chandigarh, India
| | - Fatih Ozogul
- Department of Seafood Processing Technology, Faculty of Fisheries, University of Cukurova, Adana, Turkey
| | - Jose M Lorenzo
- Centro Tecnológico de la Carne de Galicia, Ourense, Spain
- Área de Tecnología de los Alimentos, Facultad de Ciencias de Ourense, Universidade de Vigo, Ourense, Spain
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4
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Yang W, Xie D, Liang Y, Chen N, Xiao B, Duan L, Wang M. Multi-responsive fibroin-based nanoparticles enhance anti-inflammatory activity of kaempferol. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2021.103025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Li Q, Xin M, Wu X, Lei B. A nano-phytochemical ophthalmic solution for marked improvement of corneal wound healing in healthy or diabetic mice. Nanomedicine (Lond) 2021; 17:151-165. [PMID: 34927467 DOI: 10.2217/nnm-2021-0417] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Aim: To formulate a novel nano-phytochemical ophthalmic solution to promote corneal wound healing. Methods: Dipotassium glycyrrhizinate (DG) and palmatine (PAL) were used to formulate this formulation marked as DG-PAL, and its efficacy and mechanisms for promoting corneal wound healing were evaluated in mice. Results: DG-PAL was easily fabricated with excellent physical profiles. In in vivo efficiency evaluations, DG-PAL demonstrated an excellent promoting effect on corneal epithelial/nerve wound healing in both healthy and diabetic mice. These effects were involved in the DG-PAL-induced decreased expression levels of HMGB1 and its signaling-related factors in the corneas and trigeminal neurons of the healthy or diabetic mice. Conclusion: DG-PAL possibly represents a promising ophthalmic solution for promoting corneal wound healing.
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Affiliation(s)
- Qiqi Li
- Henan Eye Institute, Henan Eye Hospital, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China.,College of Chemical Engineering, Qingdao University of Science & Technology, Qingdao, China
| | - Meng Xin
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Xianggen Wu
- College of Chemical Engineering, Qingdao University of Science & Technology, Qingdao, China
| | - Bo Lei
- Henan Eye Institute, Henan Eye Hospital, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China
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Yin C, Liu Y, Qi X, Guo C, Wu X. Kaempferol Incorporated Bovine Serum Albumin Fibrous Films for Ocular Drug Delivery. Macromol Biosci 2021; 21:e2100269. [PMID: 34528413 DOI: 10.1002/mabi.202100269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/26/2021] [Indexed: 11/09/2022]
Abstract
The possibility of using drug loaded bovine serum albumin (BSA) porous films as therapeutic contact lenses is investigated. Kaempferol (KAE), a hydrophobic antioxidant and anti-inflammatory agent, is incorporated into BSA porous films to form BSA/KAE films. The BSA/KAE films are transparent in the visible wavelength range of the human eye, possessing high water content and good cytocompatibility. A prolonged and sustained drug release is observed, and the in vivo efficacy of BSA/KAE films is better than the individual KAE. BSA/KAE films promoted the corneal re-epithelialization, inhibited neovascularization, and reduced the inflammation of an alkali burn induced corneal injury model. The study demonstrates the promising potential of BSA/KAE films as therapeutic contact lenses for the treatment of corneal injury, builds an available ocular drug delivery platform for ocular diseases.
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Affiliation(s)
- Chuanjin Yin
- Department of Pharmacy, Collegeof Chemical Engineering, Qingdao University of Science and Technology, Zhengzhou Road 53, Qingdao, 266042, China
| | - Yalu Liu
- Department of Ophthalmology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Daxue Road 269, Xuzhou, 221100, China
| | - Xueju Qi
- Department of Pharmacy, Collegeof Chemical Engineering, Qingdao University of Science and Technology, Zhengzhou Road 53, Qingdao, 266042, China
| | - Chuanlong Guo
- Department of Pharmacy, Collegeof Chemical Engineering, Qingdao University of Science and Technology, Zhengzhou Road 53, Qingdao, 266042, China
| | - Xiaochen Wu
- Department of Pharmacy, Collegeof Chemical Engineering, Qingdao University of Science and Technology, Zhengzhou Road 53, Qingdao, 266042, China
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Yin C, Qi X, Wu J, Guo C, Wu X. Therapeutic contact lenses fabricated by hyaluronic acid and silver incorporated bovine serum albumin porous films for the treatment of alkali-burned corneal wound. Int J Biol Macromol 2021; 184:713-720. [PMID: 34181997 DOI: 10.1016/j.ijbiomac.2021.06.155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/13/2021] [Accepted: 06/22/2021] [Indexed: 11/28/2022]
Abstract
Hyaluronic acid (HA) was covalently linked to the surface of bovine serum albumin/silver (BSA/Ag) porous films to fabricate a possible contact lens. The BSA/Ag/HA films showed favorable properties as contact lenses, including acceptable transparency, high water content, good hemocompatibility, non-cytotoxicity and antibacterial properties. The therapeutic potential of the BSA/Ag/HA films was evaluated on an alkali burn-induced corneal injury model on mice. The corneal healing rate was enhanced, the corneal opacification and neovascularization were lessened, and the inflammation response was reduced. The chemical cross-linking of HA on the films prolonged the retention time of HA on the corneal surface, thus enhanced the drug efficacy and improved the patient compliance, proving the high potential of BSA/Ag/HA films as contact lenses.
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Affiliation(s)
- Chuanjin Yin
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Zhengzhou Road 53, Qingdao 266042, China
| | - Xueju Qi
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Zhengzhou Road 53, Qingdao 266042, China
| | - Jing Wu
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Zhengzhou Road 53, Qingdao 266042, China
| | - Chuanlong Guo
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Zhengzhou Road 53, Qingdao 266042, China.
| | - Xiaochen Wu
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Zhengzhou Road 53, Qingdao 266042, China.
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Wang J, Li Q, Chen Z, Qi X, Wu X, Di G, Fan J, Guo C. Improved bioavailability and anticancer efficacy of Hesperetin on breast cancer via a self-assembled rebaudioside A nanomicelles system. Toxicol Appl Pharmacol 2021; 419:115511. [PMID: 33819459 DOI: 10.1016/j.taap.2021.115511] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 12/15/2022]
Abstract
Hesperetin (HSP) has excellent biological activities with poor water solubility which limits its clinical development. In this study, we successfully prepared a novel, self-assembled micelle based on Rebaudioside A (RA) for oral delivery of HSP with improved bioavailability and therapeutic effects. We found that RA and HSP could be formylated into nanomicelles with particle sizes of 4.541 nm ± 0.048 nm. HSP was readily encapsulated into RA micelles and this improved its water solubility (to 12.74 mg/mL ± 0.28 mg/mL). The MTT results showed that RA-HSP enhanced the cytotoxicity, the clonal formation inhibitory activity, and cell migration inhibitory activity of HSP in human breast cancer MDA-MB-231 cells. The mechanism results showed that RA-HSP induced cell apoptosis by inducing the production of reactive oxygen species (ROS), destroying the mitochondrial membrane potential (MMP), and inhibiting the PI3K/Akt signaling pathway. Moreover, RA-HSP enhanced the anticancer activity, increased the oral bioavailability and tissue distribution of HSP in vivo. Moreover, the mechanism studies in vivo found that HSP inhibited PI3K/Akt signaling pathway with low side effects. These findings indicate that RA micelle formulations have great potential in oral drug delivery systems for the delivery of hydrophobic drugs.
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Affiliation(s)
- Jun Wang
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao 266042, China
| | - Qiqi Li
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao 266042, China
| | - Zekun Chen
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao 266042, China
| | - Xueju Qi
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao 266042, China
| | - Xianggen Wu
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao 266042, China
| | - Guohu Di
- School of Basic Medicine, Qingdao University, Qingdao 266071, China
| | - Junting Fan
- Department of Pharmaceutical Analysis, School of Pharmacy, Nanjing Medical University, Nanjing 211166, China
| | - Chuanlong Guo
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao 266042, China.
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Zhang F, Jia D, Li Q, Zhang M, Liu H, Wu X. Preparation and Evaluation of a Xanthan Gum-Containing Linezolid Ophthalmic Solution for Topical Treatment of Experimental Bacterial Keratitis. Pharm Res 2021; 38:347-359. [PMID: 33469875 DOI: 10.1007/s11095-020-02982-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/22/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To formulate a xanthan gum-containing linezolid ophthalmic solution (LZD-XG) as a new antibiotic treatment against ocular bacterial infection. METHODS LZD-XG was prepared and evaluated for its in vitro/in vivo ocular tolerance, in vitro/in vivo antibacterial activity, and in vivo ocular penetration. RESULTS The optimized LZD-XG exhibited good in vitro/in vivo eye tolerance. A prolonged ocular surface residence time of LZD-XG was observed after topical instillation, and the ocular permeation was significantly better for LZD-XG than fora linezolid (LZD) ophthalmic solution. The in vitro antimicrobial activity was significantly better with LZD-XG than with LZD. In vivo evaluation also confirmed a strong therapeutic treatment effect of LZD-XG, as it significantly improved the clinical symptoms, ameliorated the damage of Staphylococcus aureus to ocular tissues, lowered the colony forming unit counts in the cornea, and decreased the myeloperoxidase activity in the cornea. CONCLUSION LZD-XG was deemed a viable ophthalmic solution against ocular bacterial infection due to its excellent in vitro and in vivo characterizations.
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Affiliation(s)
- Fan Zhang
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao, 266042, China
| | - Dongmei Jia
- Department of Pathology, Qingdao Municipal Hospital, Qingdao, 266011, China
| | - Qiqi Li
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao, 266042, China
| | - Mengmeng Zhang
- Department of Pathology, Qingdao Municipal Hospital, Qingdao, 266011, China
| | - Hongyun Liu
- Department of Pathology, Qingdao Municipal Hospital, Qingdao, 266011, China.
| | - Xianggen Wu
- Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao, 266042, China.
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Krstić L, González-García MJ, Diebold Y. Ocular Delivery of Polyphenols: Meeting the Unmet Needs. Molecules 2021; 26:molecules26020370. [PMID: 33445725 PMCID: PMC7828190 DOI: 10.3390/molecules26020370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 12/14/2022] Open
Abstract
Nature has become one of the main sources of exploration for researchers that search for new potential molecules to be used in therapy. Polyphenols are emerging as a class of compounds that have attracted the attention of pharmaceutical and biomedical scientists. Thanks to their structural peculiarities, polyphenolic compounds are characterized as good scavengers of free radical species. This, among other medicinal effects, permits them to interfere with different molecular pathways that are involved in the inflammatory process. Unfortunately, many compounds of this class possess low solubility in aqueous solvents and low stability. Ocular pathologies are spread worldwide. It is estimated that every individual at least once in their lifetime experiences some kind of eye disorder. Oxidative stress or inflammatory processes are the basic etiological mechanisms of many ocular pathologies. A variety of polyphenolic compounds have been proved to be efficient in suppressing some of the indicators of these pathologies in in vitro and in vivo models. Further application of polyphenolic compounds in ocular therapy lacks an adequate formulation approach. Therefore, more emphasis should be put in advanced delivery strategies that will overcome the limits of the delivery site as well as the ones related to the polyphenols in use. This review analyzes different drug delivery strategies that are employed for the formulation of polyphenolic compounds when used to treat ocular pathologies related to oxidative stress and inflammation.
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Affiliation(s)
- Luna Krstić
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; (L.K.); (M.J.G.-G.)
| | - María J. González-García
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; (L.K.); (M.J.G.-G.)
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Yolanda Diebold
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; (L.K.); (M.J.G.-G.)
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-883423274
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Novel nanomicelles based on rebaudioside A: A potential nanoplatform for oral delivery of honokiol with enhanced oral bioavailability and antitumor activity. Int J Pharm 2020; 590:119899. [DOI: 10.1016/j.ijpharm.2020.119899] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 12/28/2022]
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Li M, Zhang L, Li R, Yan M. New resveratrol micelle formulation for ocular delivery: characterization and in vitro/ in vivo evaluation. Drug Dev Ind Pharm 2020; 46:1960-1970. [PMID: 32985941 DOI: 10.1080/03639045.2020.1828909] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Many eye diseases, such as corneal wound healing after injury, involve oxidative stress and inflammatory responses; however, many efficient natural antioxidants (e.g. resveratrol) have limited application in ophthalmology due to their poor solubility, low stability and poor ocular bioavailability. In this work, the aim was to formulate resveratrol into a micelle ophthalmic solution for efficient delivery to the eye. A Soluplus micelle ophthalmic solution containing resveratrol (Sol-Res) was formulated and optimized with a small and uniform dispersion in an ophthalmic solution. Sol-Res did not show any cell toxicity but promoted cell proliferation in both the short- and long-term cytotoxicity tests. The in vivo eye irritation test also verified the well ocular tolerance of the Sol-Res ophthalmic solution. The chemical stability of resveratrol in micelles in an aqueous solution was greatly improved over the free resveratrol solution, and Sol-Res also showed a good storage stability in the short-term storage stability test. Sol-Res showed improved in vitro passive permeation, in vitro cellular uptake, and in vivo corneal permeation over the free Res suspension solution. Furthermore, Sol-Res favored in vivo corneal wound healing, and the inhibition of key anti-inflammation mediators and the production of antioxidant factors in mRNA expression was observed in the Sol-Res treated wound healing corneas, suggesting that the mechanisms that regulate proinflammatory cytokines and oxidative stress might be involved in its therapeutic effect. Therefore, Sol-Res might be a promising candidate for further clinical application.
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Affiliation(s)
- Mengshuang Li
- Department of Pharmacy, Qingdao Women and Children's Hospital, Qingdao, China.,Department of Pharmacy, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao, China
| | - Ling Zhang
- Department of Pharmacy, Qingdao Women and Children's Hospital, Qingdao, China
| | - Rong Li
- Department of Pharmacy, Qingdao Women and Children's Hospital, Qingdao, China
| | - Meixing Yan
- Department of Pharmacy, Qingdao Women and Children's Hospital, Qingdao, China
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