ABSTRACT
OBJECTIVE To explore and establis h a general pharmacist system suitable for China ’s national conditions ，and to improve the rational use of drugs in primary medical institutions . METHODS Under the leadership of Tianhe District Health Bureau of Guangzhou ，relying on the regional pharmaceutical specialty alliance ，general pharmacist system of medical consortium was established ，and the general pharmacist was responsible for the overall planning of pharmaceutical care in the medical consortium. The joint management office of pharmaceutical care was established ，and the training of the pharmacists in the medical consortium was organized. A regional audit center was established to realize the prescription review of 13 community health service centers in the medical consortium. “Internet plus ”home pharmaceutical care was carried out ，and science popularization education was provided for communities ，schools，enterprises and institutions. RESULTS After systematic training and assessment ，three pharmacist teams had been successfully established in the medical consortium to provide prescription review ，science popularization and education and family pharmacist services for community residents ；the regional audit center successfully intercepted 17.17％ of unreasonable prescriptions ，reducing the amount of unreasonable drug use by a total of 6.56 million yuan. After the intervention of prescription review system ，the qualified rate of outpatient prescriptions in community health service centers was ≥95％，and the qualified rate increased by an average of 6％. The department of pharmaceutical science popularization and education held 35 science popularization and free clinic activities ，of which 71.20％ of the residents believed that the activities had improved their understanding of drugs. In addition ，111 cases patients serviced by home pharmaceutical care were carried out successfully by pharmacist team ，and the patients ’acceptance of pharmacist intervention was 91.89％ . CONCLUSIONS Under the new medical reform ，it is feasible to implement a regional general pharmacist system within the medical consortium ， which improves the pharmaceutical administration and pharmaceuticalcare capabilities of m edical institutions in the medical consortium，as well as the level of rational drug use ，and reduces the me dical burden.
ABSTRACT
Objective To study the effects of wedelolactone on the expression of P-glycoprotein (P-gp) and to explore the multi-drug resistance reversing mechanism of wedelolactone in K562/A02 cells in vitro.Methods The half maximal inhibitory concentration of ADM in K562/A02 was determined by MTT method.The protein expression level of P-gp was determined by Western blot after wedelolactone pretreatment.Results Wedelolactone remarkably enhanced chemo-sensitivity to ADM of K562/A02 cells.After 0.2, 2, 20 μmol/L different concentration of wedelolactone treatment in 24 h, the relative reversal efficiency of K562/A02 to ADM was 23.5％, 47.1％ and 67.7％, respectively.according to the results of Western blot, wedelolactone was shown to efficiently inhibit the expression of P-gp (P＜0.05).The relative efficiency of K562/A02 to ADM was 25.4％,46％ and 55.6％, respectively.Conclusion Wedelolactone could modulate P-gp expression, and P-gp expression down regulation may be one of the MDR reversal mechanisms in K562/A02 cells by wedelolactone.