Postoperative pulmonary complications (PPCs) are a major cause of postoperative morbidity, mortality, and longer hospital stays. Expectorants are widely used during the perioperative period to reduce PPCs. This study aimed to compare the clinical effectiveness between ambroxol (AMB) and N ‐acetylcysteine (NAC) in patients undergoing surgery. A multicenter, retrospective cohort study was conducted using deidentified medical records from hospital information system. Between July 1, 2015, and November 30, 2017, patients aged ≥18 years, who received intravenous AMB or nebulized NAC as the only expectorant therapy for >3 days during their hospitalization for thoracic, abdominal, and neurosurgery, were included in this study. The clinical outcomes were evaluated, and propensity score matching was used to adjust significant differences between 2 groups. A total of 4025 cases in the AMB group and 2062 in NAC group after propensity score matching were identified. The incidence of PPCs (13.9% vs 11.6%; P = .013), postoperative sputum suction (17.2% vs 8.0%; P < .001), intensive care unit admission after surgery (25.1% vs 22.5%; P = .024), and postoperative mechanical ventilation (22.3% versus 17.5%; P < .001) in the AMB group were all significantly higher than those in the NAC group. This study suggested that patients treated with NAC during the perioperative period had a significantly lower risk of PPCs. However, further prospective study is needed to ensure the replicability of our findings.

Objective:To describe the incidence, diagnosis rate, treatment rate and treatment pattern of hyperkalemia, and serum potassium retesting rate among hyperkalemia patients in the emergency department.Methods:Data were derived from Military Data Center for Rational Use of Drugs. Patients who accessed emergency medical services (≥18 years old) with record(s) of serum potassium between 2015 and 2017 were included. The data of laboratory test, diagnosis, and treatment were analyzed. The main outcomes included the incidence of hyperkalemia, the diagnosis rate, the treatment rate, treatment pattern and the 7-day retesting rate.Results:A total of 1 039 245 patients who met the above criteria were included, of whom, 36 615 (3.52%) had at least one hyperkalemia event. Among the emergency patients with chronic kidney disease, heart failure, diabetes mellitus and hypertension, the proportions of patients who experienced hyperkalemia were 47.69%, 29.13%, 21.69% and 10.16%, respectively. The diagnosis rate of emergency hyperkalemia patients was 9.23%. The overall hyperkalemia treatment rate was 42.1%. Insulin + glucose injection was the most commonly used therapy for emergency hyperkalemia patients. The overall serum potassium retesting rate within 7 days was 28.8%.Conclusions:Hyperkaliemia is more common and more severe in patients with chronic kidney disease, heart failure, diabetes and hypertension. The diagnosis rate and retesting rate of hyperkalemia are low, suggesting that the identification and management of hyperkaliemia in emergency patients should be strengthened.

目的:评估中国青光眼患者对抗青光眼药物的用药依从性,并确定其相关因素.方法:采用全军合理用药监测网处方数据(2015-2017).纳入2016年1月至2016年12月期间首次诊断为青光眼或高眼压症且在首次诊断日期前12个月(基线期)和后12个月(随访期)都在持续参保的成人患者.药物持有比例＞80％的患者和没有120 d的抗青光眼药物治疗间隔被认定为依从性良好.结果:共纳入8 593位青光眼患者,平均年龄为50.14岁,50.1％为女性.双眼患病患者占比为72％.患者的药物持有率均值为(0.167±0.11),持续用药时间均值为(61.48±46.47)d.本研究显示用药频率和患眼只数与用药依从性相关.与用药频率大于每日2次的患者相比,用药频率小于等于每日2次的患者可能有更高的药物持有率[校正OR(95％CI):3.51(1.39～8.84),P = 0.008]和更长的持续用药时间[校正HR(95％CI):0.86(0.81～0.92),P= 0.001].单眼患病组较双眼患者组可能倾向于更低的药物持有率[校正OR(95％CI):0.10(0.02～0.42),P = 0.001]和更长的持续用药时间[校正HR(95％CI):0.340(0.32～0.36),P＜0.001].结论:初次诊断的青光眼患者用药依从性普遍较低,临床可适当增加用药频次低的滴眼剂的使用比例,以增强青光眼患者的用药依从性.

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

BACKGROUND:Inappropriate antibiotic use greatly accelerates antimicrobial resistance. The appropriateness of antibiotic prescriptions is well evaluated, using big observational data, in some high-income countries, whereas the evidence of this appropriateness is scarce in China. We aimed to assess the appropriateness of antibiotic prescriptions in ambulatory care settings in China to inform future antimicrobial stewardship.METHODS:We used data from the Beijing Data Center for Rational Use of Drugs, which was a national database designed for monitoring rationality of drug use. 139 hospitals that uploaded diagnosis and prescription information were included from 28 provincial-level regions of mainland China. Outpatient prescriptions were classified as appropriate, potentially appropriate, inappropriate, or not linked to any diagnosis for antibiotic use by following a published classification scheme. Antibiotic prescription rates for various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Antibiotic prescribing patterns and proportions of individual antibiotics prescribed for different diagnosis categories were analysed and reported.FINDINGS:Between Oct 1, 2014, and April 30, 2018, 18 848 864 (10·9%) of 172 704 117 outpatient visits ended with antibiotic prescriptions. For conditions for which antibiotic use was appropriate, potentially appropriate, and inappropriate, 42·2%, 30·6%, and 7·6% of visits were associated with antibiotic prescriptions, respectively. Of all 18 848 864 antibiotic prescriptions, 9 689 937 (51·4%) were inappropriate, 5 354 224 (28·4%) were potentially appropriate, 2 893 102 (15·3%) were appropriate, and 911 601 (4·8%) could not be linked to any diagnosis. A total of 23 266 494 individual antibiotics were prescribed, of which 18 620 086 (80·0%) were broad-spectrum and the top four most prescribed antibiotics were third-generation cephalosporins (5 056 058 [21·7%]), second-generation cephalosporins (3 823 410 [16·4%]), macrolides (3 554 348 [15·3%]), and fluoroquinolones (3 285 765 [14·1%]).INTERPRETATION:Inappropriate antibiotic prescribing was highly prevalent nationwide in China. Over half of the antibiotic prescriptions were inappropriate in secondary-level and tertiary-level hospitals, suggesting an urgent need for outpatient antibiotic stewardship aimed at optimising antibiotic prescribing to achieve the goals set in China's 2016 national action plan to contain antimicrobial resistance.FUNDING:The National Natural Science Foundation of China.

目的:了解2015-2017年全国114家三级甲等医院青光眼治疗药物应用现状,旨在探讨我国青光眼药物治疗的发展趋势,同时为临床合理用药提供参考.方法:抽取114家医院门诊眼科和五官科诊断为青光眼或高眼压症患者的用药数据,对青光眼治疗药物应用情况、用药频度(defined daily dose system,DDDs)、限定日费用(defined daily cost,DDC)、年增长率以及青光眼禁忌慎用药物等进行分析评价.结果:中成药及β肾上腺素能受体拮抗剂使用量最大,临床信任度高;各类药物的DDDs及DDC相对稳定但有波动,其中复方制剂滴眼液的DDDs呈现逐年缓慢增加的趋势,而其DDC呈现逐年缓慢降低的趋势.真实世界中,青光眼患者存在使用青光眼禁忌慎用药物的情况.结论:临床青光眼治疗药物总体使用情况合理,但青光眼患者存在使用青光眼禁忌慎用药物的情况,还需进一步优化.

Background: The assessment of antibiotic use for acute upper respiratory infections (AURIs) is important to promote the appropriateness of antibiotic prescribing. Evaluation of antibiotic prescriptions for AURIs at a national level is very limited in China. Objective: To investigate outpatient antibiotic prescriptions for AURIs in Chinese hospitals. Methods: This study used data from over 10 million outpatient and emergency department visits for AURIs, which contained information on drug prescription and diagnosis, from 94 cities and 28 provinces of mainland China. Antibiotic prescription rates for various subgroups and potential predictors of antibiotic use were estimated. Patterns of antibiotic prescriptions and proportions of individual antibiotics prescribed for different types of AURIs were analysed and reported. Results: In total, 10 770 219 outpatient visits for AURIs were included in this study. Of these, 40.8% (95% confidence interval 40.7-40.8%) resulted in antibiotic prescriptions. Patient characteristics, including age, gender, payment type, AURI type, department and season of visit, were significantly associated with antibiotic prescriptions for AURIs. In total, 4 984 744 antibiotic agents were prescribed, of which 87.9% were broad-spectrum antibiotics and only 36.8% were prescribed in line with the guideline recommendations. Azithromycin (13.2%), cefdinir (11.7%), cefixime (8.3%) and cefaclor (8.2%) were the most commonly prescribed antibiotics for AURIs in China. Conclusions: Antibiotic prescribing for patients with AURIs in outpatient settings was prevalent nationwide in China. Antibiotic stewardship efforts targeting specific populations in outpatient settings are needed to reduce antibiotic use and promote appropriate antibiotic selection for AURIs in China. (C) 2020 The Author(s). Published by Elsevier Ltd.

目的:研究和评价不同地区10家医院锁骨骨折手术病人的医疗费用结构及合理用药情况.方法:从全军合理用药监测网数据库中筛选符合纳入条件的病例.对数据进行整合和分析,得到药费占比、材料费占比、药品用量和金额等指标,并对不合理用药情况进行分析.结果:例均医疗费用与医院所在地区经济的发展水平(或物价水平)成正比.不同医院间例均医疗费用、药费占比、药品选择等方面存在显著差异.材料费是锁骨骨折行切开内固定术病人最主要的经济负担(总体材料费占比为59.7％),药费居其次(总体药费占比为18.7％).骨科辅助用药、神经辅助用药和中药注射剂占总药费的35％,是不合理用药集中的领域.结论:体现医务人员价值的手术、麻醉、治疗、护理等费用占比较低.不同医院对同一病种的药品选择和用量差异显著,不合理用药问题比较突出.政府应通过改革医疗保险付费制度、医务人员薪酬制度,实施合理用药质控措施等逐步引导医疗机构合理用药,控制医疗费用过快增长.

Abstract Background and Aims At present, the clinical burden and treatment pattern of hyperkalaemia among outpatients in China is not well characterized. The aim of this study was to evaluate the disease distribution and treatment pattern of hyperkalaemia among outpatients in China. Method Data were derived from Beijing Data Center for Rational Use of Drugs, which contains primary records of 157 hospitals, covering 30 provinces in China. Patients who accessed outpatients (aged >=≥18 years old) with record(s) of serum potassium (S-K) between 2015.1.1- 2017.12.31 were included. The laboratory test, diagnoses, and treatments were analyzed. Hyperkalaemia defined as S-K > 5.0 mmol/L. A hyperkalaemia episode was defined as one or more consecutive S-K > 5.0mmol/L measurement(s) within 7 days. If there was a return to S-K <5.0mmol/L within 7 days, the subsequent measurement(s) will be recognized as another hyperkalaemia episode. The proportion of hyperkalaemia was defined as the proportion of patients who experienced at least one hyperkalaemia episode. The main outcomes, including the proportion of hyperkalaemia patients, the diagnosis rate, the treatment rate and the S-K retesting rate were analyzed. The geographic and seasonal distribution of the proportion was examined. The diagnosis rate was defined as the proportion of hyperkalaemia episodes that have diagnoses records of hyperkalaemia within the episode. Treatment rate was defined as the proportion of hyperkalaemia episodes that have records of any hyperkalaemia treatment including diuretics, glucose injection + insulin, calcium injection, sodium bicarbonate, potassium binder, transfer to emergency room or dialysis. Retesting rate was defined as the proportion of hyperkalaemia records that have potassium test record(s) within one day, two days or seven days. Results A total of 2,997,634 patients with at least one S-K record each were analysed. 115,826 patient (3.86%) experienced hyperkalaemia (S-K >5.0mmol/L), in which 28,254 patients (0.94%), experienced S-K ≥5.5mmol/L. In patients with chronic kidney disease, heart failure, hypertension, and diabetes mellitus, the proportions of patients who experienced hyperkalaemia were 22.89%, 12.54%, 7.11% and 6.51%, respectively. Composition proportion of who experienced S-K ≥ 5.5mmol/L, in the patients with CKD and HF, defined as the proportion of patients experienced S-K≥ 5.5mmol/L in all hyperkalaemia patients, were 39.27% and 32.16% respectively, higher than the general population (16.3%). Geographic analysis showed that provinces with higher proportions of hyperkalaemia were Jiangsu (9.22%), Hebei (8.31%), Tianjin (6.74%), Hunan (6.27%) and Liaoning (5.56%). In addition, the seasonal proportion varied as winter (4.18%), autumn (3.93%), spring (3.83%) and summer (3.57%). In patients with hyperkalaemia, the overall hyperkalaemia diagnosed rate within the episode was 2.53%. Diagnosed rates increased by the severity of hyperkalaemia, patients with S-K ≥7.0 mmol/L showed the highest diagnosed rate of 9.63%. The overall hyperkalaemia treated rate was 8.69%. The treated rate of patients with S-K 5.0 to 5.5mmol/L was much lower than that of patients with S-K 5.5 -6.0mmol/L (6.6% vs. 12.01%). The overall retesting rate within 7 days was 11.41%. Patients with S-K 5.0-5.5 mmol/L were retested less frequently (8.51%) than those with S-K ≥5.5 mmol/L (15.56-21.76%). Conclusion The proportions of hyperkalaemia in patients with chronic kidney disease, heart failure, hypertension and diabetes were higher than the proportion in overall outpatients. The severity of hyperkalaemia increased in patients with chronic kidney disease and heart failure. The diagnosed rate, treated rate and resting rate of hyperkalaemia in outpatients were low, showing a slight raise with increased severity.

目的:研究北京市2017年医药分开综合改革对医疗费用及其结构的影响.方法:从全军合理用药监测网数据库中提取位于北京市的军队三级甲等医疗机构门诊和住院医疗中产生的全部就诊和费用数据,计算就诊人次和费用并将费用划分为药品、诊疗、材料和其他等四类,采用成分数据分析方法结合分段线性回归模型对2017年北京市医药分开综合改革实施前后医疗费用及其结构的变化进行分析.结果:医药分开改革使样本医院门诊和住院次均费用分别降低了44.7和414.9元,但对次均医疗费用的变化趋势没有显著影响.医疗总费用中药占比下降了5.8％,相应的诊疗收入占比上升了6.1％.门诊和住院医疗费用中药占比分别下降4.8％和5.8％,诊疗费用占比则分别上升了3.9％和6.4％.医院药品收入损失主要由诊疗收入补偿.医药分开改革对医疗费用结构的变化趋势影响不显著,材料和其他费用的占比在改革实施后均没有显著的变化趋势.结论:北京市医药分开综合改革有效控制了医疗费用的过快增长,基本实现了以医事服务费补充药品收入损失的目标,但医疗收入中药占比仍然很高,需要继续深化改革,进一步降低药品费用占比.

Objective We aimed to evaluate the validity of an algorithm to classify diagnoses according to the appropriateness of outpatient antibiotic use in the context of Chinese free text. Setting and participants A random sample of 10 000 outpatient visits was selected between January and April 2018 from a national database for monitoring rational use of drugs, which included data from 194 secondary and tertiary hospitals in China. Research design Diagnoses for outpatient visits were classified as tier 1 if associated with at least one condition that 'always' justified antibiotic use; as tier 2 if associated with at least one condition that only 'sometimes' justified antibiotic use but no conditions that 'always' justified antibiotic use; or as tier 3 if associated with only conditions that never justified antibiotic use, using a tier-fashion method and regular expression (RE)-based algorithm. Measures Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the classification algorithm, using classification made by chart review as the standard reference, were calculated. Results The sensitivities of the algorithm for classifying tier 1, tier 2 and tier 3 diagnoses were 98.2% (95% CI 96.4% to 99.3%), 98.4% (95% CI 97.6% to 99.1%) and 100.0% (95% CI 100.0% to 100.0%), respectively. The specificities were 100.0% (95% CI 100.0% to 100.0%), 100.0% (95% CI 99.9% to 100.0%) and 98.6% (95% CI 97.9% to 99.1%), respectively. The PPVs for classifying tier 1, tier 2 and tier 3 diagnoses were 100.0% (95% CI 99.1% to 100.0%), 99.7% (95% CI 99.2% to 99.9%) and 99.7% (95% CI 99.6% to 99.8%), respectively. The NPVs were 99.9% (95% CI 99.8% to 100.0%), 99.8% (95% CI 99.7% to 99.9%) and 100.0% (95% CI 99.8% to 100.0%), respectively. Conclusions The RE-based classification algorithm in the context of Chinese free text had sufficiently high validity for further evaluating the appropriateness of outpatient antibiotic prescribing.

目的:评价临床药师主导的缺血性脑卒中患者管理的效果,为慢病管理提供参考.方法:前瞻性纳入2018年5-8月在河北医科大学第一医院神经内科住院治疗的184例缺血性脑卒中患者,采用随机数字表法分为对照组(92例)和干预组(92例),对照组不实施临床药师干预,干预组以临床药师为主导对患者进行住院期间药学监护、出院时用药教育、出院后药学随访等慢病管理措施;考察两组患者出院6个月时的用药(使用抗血小板药、降压药、降糖药和降脂药)依从性良好率及血压、血糖[糖化血红蛋白(HbA1c)]、血脂[低密度脂蛋白(LDL-C)]等缺血性脑卒中二级预防控制指标的达标率,考察两组患者出院6个月时的药品不良反应发生率及再住院率.结果:最终干预组与对照组统计患者数分别为84、82例.出院6个月时,干预组使用抗血小板药的用药依从性良好率为96.43％,高于对照组的95.13％,但差异无统计学意义;干预组使用降压药、降糖药和降脂药的用药依从性良好率分别为92.86％、91.67％和77.38％,高于对照组的78.57％、69.70％和60.98％,差异有统计学意义(P＜0.05);干预组血压指标的达标率为89.29％,高于对照组的76.79％,但差异无统计学意义;干预组HbA1c和LDL-C指标的达标率分别为80.56％和66.67％,高于对照组的57.58％和48.78％,差异有统计学意义(P＜0.05);干预组药品不良反应发生率为15.48％,低于对照组的20.73％,但差异无统计学意义;干预组再住院率为7.14％,低于对照组的17.86％,差异具有统计学意义(P＜0.05).结论:以临床药师为主导对缺血性脑卒中患者进行管理,可提高患者的用药依从性,提高缺血性脑卒中二级预防控制指标的达标率,降低再住院率.

Objective:To investigate the current situation of therapeutic drug monitoring (TDM ) and gene test for person-alized medication (GTPM ) delivered by hospitals in China .Methods:Questionnaire forms were designed ,issued ,submitted and analyzed by mobile Internet platform .Results:The distribution of retrieved valid questionnaires covered all the provinces of mainland China ,except Hainan .National tertiary hospitals involved in the survey accounted for 90% .About 71% of the hos-pitals carried out TDM ,in which sodium valproate ,cyclosporine and tacrolimus were predominant test drugs .About 48% of the hospitals performed GTPM ,in which clopidogel ,warfarin and folic acid-related gene polymorphism sites were predominant test genes .Only about 70% of the surveyed hospitals held inter-sectional laboratory test quality evaluations of TDM and GTPM .Conclusion:The questionnaire survey truly reflected the current situation of personalized medication test in Chinese hospitals ,revealed deficiency in awareness of quality control and incompliance of GTPM regulations ,and different charging standards of medical test items .Therefore ,the paper put forward recommendations for more strict management or supervision by related health administrations .

Aim To analyze the expression of phosphatidylethanolamine-binding protein(PEBP) and ERK in critical brain regions of psychological dependence rats.Methods Morphine-induced rats conditioned place preference(CPP) model was established to mimic different stages of morphine psychological dependence, during which PEBP expression and ERK activity were assayed in different brain regions.Results PEBP expression in hippocampus, prefrontal cortex, striatum and nucleus accumbens showed no change at three stages of psychological dependence.However, ERK activity increased notably in prefrontal cortex on CPP formation, and decreased remarkably in hippocampus on CPP reinstatement.Conclusions The formation and retrieval of associated memory between morphine effects and environment involve different neural circuits, in which ERK activity is critical, and PEBP might not be involved in such a memory-related ERK regulation.

目的:基于医院信息系统(HIS)研究住院病例质子泵抑制剂(proton pump inhibitors,PPIs)使用情况并分析其合理性.方法:抽取陆军总医院2014年使用PPIs的出院病例,通过整理其费用、诊断、手术、医嘱、检验结果等资料,设计指标、确定算法,对PPIs使用情况进行分析.结果:纳入研究的病例共14 310例,其中26.31％为适应证治疗用药,16.79％为预防药物相关胃肠黏膜损害用药,19.47％为预防手术应激性溃疡用药,37.44％为无适应证用药.此外也发现0～～5岁患儿PPIs日剂量变异大,同时使用氯吡格雷和奥美拉唑的比例高等问题.结论:本研究利用HIS数据库实现对住院病例PPIs使用情况和合理性进行快速全面分析,临床药师应进一步结合循证依据实施PPIs合理用药点评.

Objective To evaluate the effectiveness and safety of salvianolate injection (SI) on motor and cognitive function of patients with acute cerebral infarction (ACI).Methods We electronically searched databases including PubMed, The Cochrane Library, EMBASE, ClinicalTrail.gov, CBM, CNKI and WanFang Data to collect randomized controlled trials (RCTs) focused on SI treating ACI up to February 29th, 2016. Two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 and R 3.2.3 software.Results A total of 19 RCTs involving 2383 patients were included. The results of meta-analysis showed that compared with the conventional treatment (CT) group, the total effective rate of SI treatment group was higher (RR=1.23,95%CI:1.17~1.29,P<0.00001) in 10 RCTs;NIHSS score of SI treatment group was lower (MD=-2.42,95%CI:-2.86~-1.98,P<0.00001) and Barthel score of SI treatment group was higher (MD=7.68,95%CI:5.15~10.21) in 15 RCTs; and CRP level of SI treatment group was lower (MD=-2.14,95%CI:-2.63~-1.65,P<0.00001). There was no significant difference in adverse reaction rates between the two groups (P>0.05).Conclusion Salvianolate can promote recovery of the motor and cognitive function of patients with acute cerebral infarction. However, due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.

Stimulation of the µ‑opioid receptor activates extracellular signal‑regulated kinase (ERK), however, the mechanism by which this occurs remains to be elucidated. Phosphatidylethanolamine‑binding protein (PEBP) has been reported to act as a negative regulator of the ERK cascade (Raf‑MEK‑ERK) by binding to Raf‑1 kinase. In the present study, the role of PEBP in µ‑opioid receptor‑mediated ERK activation was investigated in Chinese hamster ovary/µ cells and SH‑SY5Y cells, as well as in human embryonic kidney 293 cells expressing other types of G protein‑coupled receptors. The acute activation of µ‑opioid receptors by morphine or (D‑Ala2, MePhe4, Gly5‑ol) enkephalin induced a rapid activation of ERK. Prolonged morphine treatment did not affect the phosphorylation level of ERK compared with control cells, but the phosphorylation level of ERK decreased markedly when cells were precipitated with naloxone following chronic morphine treatment. For the phosphorylation of PEBP, no change was identified under the designated drug treatment and exposure duration. A total of two other types of G protein‑coupled receptors, including Gs‑coupled dopamine D1 receptors and Gq‑coupled adrenergic α1A receptors were also investigated and only the activation of adrenergic α1A receptors induced an upregulated phosphorylation of PEBP, which was protein kinase C activity dependent. Thus, PEBP did not have a significant role in µ‑opioid receptor‑mediated regulation of ERK.