ABSTRACT
OBJECTIVE:To understand the formulation method of medication index in clinical departments of the local hospital and the improvement of hospital medication index after the formulation of medication index. METHODS:Retrospective analysis was used to summarize and analyze the formulation,revision and application of 5 medication indexes(the proportion of drug cost in medical income,utilization rate of antibiotics in the inpatients,AUD of inpatients,the proportion of antibiotics cost in drug income,the proportion of national essential medicine cost in drug income)in clinical departments of 4 general hospitals of Nanyang. RESULTS:The medication indexes of clinical departments in 4 hospitals were formulated primarily during 2009-2014. The formulation of medication indexes in clinical departments was passed and implemented by Pharmaceutical Administration and Drug Treatment Committee/Antibiotics Management Group on the basis of the previous indicators of clinical departments. Till 2017,the times of medication indexes revision were 0.42-0.58 time/year. Before the formulation of medication indexes in clinical departments,5 indexes of each hospital were mostly not in line with the regulation of health administration department. During Jul. 2016-Jun. 2017,5 medication indexes of 4 hospitals ranged 32%-41%,47%-53%,30-37 DDD,13%-20%,21%-32%, respectively. Rational drug indexes conformed to the provisions of the administrative department of health basically. The author provided related suggestions about departments in charge of formulating and adjusting medication indexes,methods for the primary formulation and modification of medication indexes,formulation of medication indexes in special department,management measures after the formulation of medication indexes. CONCLUSIONS:At present,the formulation and management of medication indicators in 4 hospitals of local area develop well,and effectively promote the level of clinical rational drug use.
ABSTRACT
AIM: To explore the effects of exendin-4 (EX-4) on endoplasmic reticulum stress (ERS)-mediated insulin resistance in the 3T3-L1 adipocytes.METHODS: In vitro 3T3-L1 pre-adipocytes were differentiated into adipocytes, and the cells were treated with tunicamycin (TM), tauroursodeoxycholic acid (TUDCA) or EX-4, respectively.The cell viability was measured by MTT assay.The glucose consumption was determined by glucose oxidase assay to evaluate insulin sensitivity of the 3T3-L1 adipocytes with different interventions.The protein levels of p-Akt, Akt and endoplasmic reticulum stress markers, including inositol requiring enzyme-1 (IRE1), p-IRE1, JNK, p-JNK, protein kinase R-like endoplasmic reticulum kinase (PERK), p-PERK, eukaryotic initation factor 2 alpha (eIF2a), p-eIF2a, activating transcription factor-6(ATF-6) were detected by Western blot.RESULTS: The insulin-stimulated glucose consumption and the protein level of p-Akt were inhibited by TM at 5 mg/L for 5 h (P<0.05), while they were increased when the cells were treated with TUDCA at 1 mmol/L or EX-4 at 100 nmol/L for 24 h (P<0.05).The effects above induced by TM (5 mg/L for 5 h) were also blunted by pretreating with TUDCA at 1 mmol/L or EX-4 at 100 nmol/L for 24 h (P<0.05).The protein levels of ERS markers such as p-IRE1, p-JNK, p-PERK, p-eIF2a and ATF-6 were significantly increased by treating with TM at 5 mg/L for 5 h, whereas 24 h pre-treatment with TUDCA or Ex-4 alleviated the ERS of the 3T3-L1 adipocytes induced by TM.The expression of total IRE1, JNK, PERK and eIF2a was not changed in different groups.CONCLUSION: Exendin-4 improves endoplasmic reticulum stress mediated insulin resistance in 3T3-L1 adipocytes.