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Additional file 1: Figure S1. 1H-NMR study showing the existence of Ang conjugated to DSPE-PEG. Figure S2. Size distribution of exosomes derived from U87-MG cells by nanoparticle tracking analysis. Figure S3. DTX release profiles for different nanoformulations. Figure S4. Storage stability of different nanoparticles. Figure S5. Serum levels of ALT, AST, BUN and Cr in mice with GBM after treatment. Figure S6. H&E staining of major organs of mice with GBM after treatment. Scale bar = 200 ��m. Table S1. Drug loading properties of nanoparticles.

Ping Xu,1 Yi Yun Hu,1 Hai Yan Yuan,1 Da Xiong Xiang,1 Yan Gang Zhou,1 Andrew J Cave,2 Hoan Linh Banh2 1Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410008, People’s Republic of China; 2Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, CanadaCorrespondence: Ping XuDepartment of Pharmacy, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, Hunan 410008, People’s Republic of ChinaTel +86-138-7488-2504Email xuping1109@163.comHoan Linh BanhDepartment of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-10 University Terrace, Edmonton, AB, CanadaTel +1 780-248-1835Email hoan@ualberta.caBackground: Prior to 2015, clinical consultation was the only clinical service provided by clinical pharmacists in Changsha Second Hospital. Between 2015 and 2017, a train-the-trainer program was implemented to train clinical pharmacists to provide pharmaceutical care and to conduct clinical research. The objective of the study is to examine the impact on the clinical services provided by pharmacists after the implementation of the train-the-trainer program.Patients and methods: Between 2004 and 2014, all completed clinical consultation activities were tallied and summarized. The results from the tallied consultation activities were used as a baseline for clinical activities provided by pharmacists prior to the training. A structured training program was implemented between 2015 and 2017 to train clinical pharmacists to provide pharmaceutical care. After the implementation of the training program was completed, all clinical activities provided by pharmacists between January 2017 and December 2017 were documented in the clinical workload form. The clinical activities completed by each pharmacist were tallied and summarized.Results: Between 2004 and 2014, a total of 6569 (average 657 per year) pharmacy consultations were requested and completed from a total of 44 departments. In 2017, a total of 15,078 hrs of clinical activities were logged. The pharmacists completed 3481 consultations in 2017 (an increase of 430%), averaging 316 consultations for each pharmacist and 271.8 hr per pharmacist. Over 2000 hrs (of the 15,078 hrs) were spent on direct patient care by the pharmacists.Conclusion: This study shows that there was a 430% increase in clinical pharmacy consultation services provided by the clinical pharmacists after the implementation of the training program. This is directly related to the number of well-trained pharmacists available. After the implementation of the train-the-trainer program, the range of services as well as the number of clinical services and clinical hours spent on providing pharmaceutical care have significantly increased.Keywords: clinical pharmacy, pharmacy consultation, pharmacy services, pharmaceutical care

Jun-Yong Wu,1–3* Yong-Jiang Li,1–3* Xin-Yi Liu,1–3 Jia-Xin Cai,1–3 Xiong-Bin Hu,1–3 Jie-Min Wang,1–3 Tian-Tian Tang,1–3 Da-Xiong Xiang1–3 1Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, People’s Republic of China; 2Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan, People’s Republic of China; 3Hunan Provincial Engineering Research Center of Translational Medicine and Innovative Drug, Changsha, Hunan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Da-Xiong XiangDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, People’s Republic of ChinaEmail xiangdaxiong@csu.edu.cnBackground: 3,5,4′-trimethoxy-trans-stilbene (BTM) is a methylated derivative of resveratrol. To improve the pharmaceutical properties of BTM, BTM loaded PEG-PE micelles (BTM@PEG-PE) were fabricated and its anti-cancer efficacy against colon cancer was evaluated.Methods: BTM@PEG-PE micelles were prepared by the solvent evaporation method and were characterized by nuclear magnetic resonance (NMR), size, zeta potential, polymer disperse index (PDI) and transmission electron microscopy (TEM). Cellular uptake, cell viability assay, caspase-3 activity assay and flow cytometry were performed to evaluate the cell internalization and anti-cancer efficacy of BTM@PEG-PE micelles in vitro. Pharmacokinetic profiles of BTM and BTM@PEG-PE micelles were compared and in vivo anti-cancer therapeutic efficacy and safety of BTM@PEG-PE micelles on CT26 xenograft mice were evaluated.Results: BTM was successfully embedded in the core of PEG-PE micelles, with a drug loading capacity of 5.62±0.80%. PEG-PE micelles facilitated BTM entering to the CT26 cells and BTM@PEG-PE micelles exerted enhanced anti-cancer efficacy against CT26 cells. BTM@PEG-PE micelles showed prolonged half-life and increased bioavailability. More importantly, BTM@PEG-PE micelles treatment suppressed tumor growth in tumor-bearing mice and prolonged survival with minimal damage to normal tissues.Conclusion: Altogether, the BTM@PEG-PE micelles might be a promising strategy to enhance the pharmacokinetic and pharmacodynamic potentials of BTM for colon cancer therapy.Keywords: 3,5,4′-trimethoxy-trans-stilbene, bioavailability, colon cancer, drug delivery, micelles

Xiong-Bin Hu,1–3 Tian-Tian Tang,1–3 Yong-Jiang Li,1–3 Jun-Yong Wu,1–3 Jie-Min Wang,1–3 Xin-Yi Liu,1–3 Da-Xiong Xiang1–31Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 2Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan, People’s Republic of China; 3Hunan Provincial Engineering Research Center of Translational Medicine and Innovative Drug, Changsha, Hunan Province, 410011, People’s Republic of ChinaPurpose: The aim of this research was to develop a phospholipid complex based nanoemulsion system for oral insulin delivery.Methods: Insulin-phospholipid complex (IPC) was firstly prepared by an anhydrous co-solvent lyophilization method, and then encapsulated into the oil phase of nanoemulsion to obtain the IPC-based nanoemulsion (IPC-NE). Both water-in-oil (W/O) IPC-NE and oil-in-water (O/W) IPC-NE were formulated and evaluated for comparison.Results: The obtained W/O IPC-NE and O/W IPC-NE were both spherical in shape with a mean particle size of 18.6±0.79 nm and 27.3±1.25 nm, respectively. While both IPC-NEs exhibited enhanced Caco-2 cell monolayers permeability than IPC and insulin solution, W/O IPC-NE showed relatively greater protective effects against enzymatic degradation than O/W IPC-NE. Moreover, oral administration of W/O IPC-NE exhibited significant hypoglycemic effects, with 12.4-fold and 1.5-fold higher oral bioavailability compared with insulin solution and O/W IPC-NE, respectively.Conclusion: IPC-NEs, especially the W/O IPC-NE showed promising efficiency in vitro and in vivo, thus could be a potential strategy for oral insulin delivery.Keywords: insulin, phospholipid complex, oral drug delivery, nanoemulsion, hypoglycemic effect

Jun-Yong Wu,1–3,* Yong-Jiang Li,1–3,* Ting-Ting Liu,1–3 Ge Ou,1–3 Xiong-Bin Hu,1–3 Tian-Tian Tang,1–3 Jie-Min Wang,1–3 Xin-Yi Liu,1–3 Da-Xiong Xiang1–3 1Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People’s Republic of China; 2Institute of Clinical Pharmacy, Central South University, Changsha, Hunan 410011, People’s Republic of China; 3Hunan Provincial Engineering Research Center of Translational Medicine and Innovative Drugs, Changsha, Hunan, People’s Republic of China *These authors contributed equally to this work Background: 8-methoxypsoralen (8-MOP) is one of the most commonly utilized drugs in psoralen-ultraviolet A therapy for treatment of vitiligo. However, poor skin retention and systemic side effects limit the clinical application of 8-MOP. Methods: Microemulsions (MEs) and chitosan derivative-coated 8-MOP MEs were developed and compared for dermal delivery of 8-MOP. Ex vivo skin retention/permeation study was performed to select the ME formulation with the highest retention:permeation ratio. Four different chitosan-coated MEs were prepared and compared with the ME formulation for their ability to distribute 8-MOP in the skin.Results: Among various ME formulations developed, a formulation containing 2.9% ethyl oleate, 17.2% Cromophor EL35, 8.6% ethanol and 71.3% water showed the highest ex vivo skin retention:permeation ratio (1.98). Of four chitosan-coated MEs prepared, carboxymethyl chitosan-coated MEs (CC-MEs) and hydroxypropyl chitosan-coated MEs (HC-MEs) showed higher ex vivo skin retention:permeation ratio (1.46 and 1.84). and were selected for in vivo pharmacokinetic study. AUCskin (0–12 h) for 8-MOP MEs (4578.56 h·ng·mL-1) was higher than HC-MEs (3422.47 h·ng·mL-1), CC-MEs (2808.51 h·ng·mL-1) and tincture (1500.16 h·ng·mL-1). Also, AUCplasma (0–12 h) for MEs (39.35±13.90 h·ng·mL-1) was significantly lower than HC-MEs (66.32 h·ng·mL-1), CC-MEs (59.70 h·ng·mL-1) and tincture (73.02 h·ng·mL-1).Conclusion: These combined results suggested that the MEs developed could be a promising and safe alternative for targeted skin delivery of 8-MOP. Keywords: 8-methoxypsoralen, microemulsion, chitosan-coated microemulsion, ex vivo permeation, microdialysis, pharmacokinetics