Meta-analysis of Effectiveness and Safety of Bromocriptine by Vaginal Delivery for Hyperprolactinemia in Chinese Female Patients / 中国药房

OBJECTIVE:To evaluate the effectiveness and safety of bromocriptine by vaginal delivery in the treatment of hyperprolactinemia in Chinese female patients,and to provide evidence-based reference for clinic.METHODS:Retrieved from PubMed,The Cochrane Liabmry,Excerpta Medica Database,Chinese Journal Full-text Database,Wanfang Database and China Bxdxiology Medicine disc,randomized controlled trials (RCTs) about bromocriptine oral tablets by vaginal delivery (trial group) vs.bromocriptine by oral administration (control group) in the treatment of bromocriptine in Chinese female patients were collected.After data extraction,quality evaluation of included studies with Cochrane system evaluator manual 5.1.0,Meta-analysis of serum level of Prolactin levels,the rate of menstruation improvement,the rate of pregnancy recovery,the rate of galactorrhea disappearance,the incidence of ADR in digestive tract and the incidence of ADR in nervous system was conducted by using Rev Man 5.1 statistical software.RESULTS:A total of 16 RCTs were included,involving 1 175 patients.The results of Meta-analysis showed that the incidence of ADR in digestive tract [OR=0.14,95％CI(0.09,0.23),P＜0.001] and ADR in nervous system [OR=0.32,95％CI(0.11,0.90),P=0.03] in trial group were significantly lower than control group,with statistical significance.There was no statistical significance in serum level of PRL [MD=0.24,95％ CI (-0.94,1.41),P=0.69],the rate of menstruation improvement [RD=0.04,95％CI (-0.04,0.11),P=0.32],the rate of pregnancy recovery [RD=0.01,95％CI (-0.08,0.10),P=0.84] or the rate of galactorrhea disappearance [RD=0.05,95％ CI (-0.03,0.13),P=0.20] between 2 groups.CONCLUSIONS:Compared with oral administration,bromocriptine by vaginal delivery has no significant difference in therapeutic efficacy but has obvious advantages in the incidence of ADR in digestive tract and in nervous system and better safety.It is suggested to development the special vaginal delivery preparation of bromocriptine.

The value of end -tidal carbon dioxide partial pressure in fluid resuscitation in severe acute pancreatitis patients / 中国基层医药

Objective To investigate the value of end-tidal carbon dioxide partial pressure (PET CO2 )in fluid resuscitation in severe acute pancreatitis(SAP)patients.Methods SAP patients under mechanical ventilation with the need of a fluid challenge test were included.Hemodynamic parameter cardiac index(CI)and PET CO2 were conducted before and after the fluid challenge test.The value of ΔPET CO2 was used to predict fluid responsiveness. Results Totally 43 patients with SAP were prospectively recruited.31 patients had volume responsiveness, 12 patients had no volume responsiveness.Compared with no volume responsiveness group,volume responsiveness group led to a greater increase in ΔCI[(0.9 ±0.3)vs.(0.2 ±0.3),t =3.24,P <0.05]and ΔPET CO2 [(4.1 ± 1.9)vs.(0.7 ±1.2),t =4.01,P <0.05].ΔPET CO2 and ΔCI were correlated(r =0.74,P <0.05).The area under ROC curve of ΔPET CO2 was 0.872(95% CI 0.754 ~0.923,P <0.05).An increase of 5% in ΔPET CO2 predicted fluid responsiveness with a sensitivity of 86.7%,and specificity of 89.5%.Conclusion The change of ΔPET CO2 induced by fluid challenge test is an effective way to predict fluid responsiveness in SAP patients.

Cloning, expression of gene SjOST48 from Schistosoma japonicum and evaluation of the immunoprotective efficacy of rSjOST48 in mice / 生物工程学报

To identify SJCHGC01743 gene of Schistosoma japonicum and evaluate the potential of the recombinant protein as a new vaccine candidate for schistosomiasis, polymerase chain reaction (PCR) technique was used to amplify the cDNA of the gene and real-time RT-PCR was used to analyze the transcription profiles of SJCHGC01743 at different development stages. Recombinant plasmid was successfully constructed and transformed into competent Escherichia coli BL21 (DE3). Then the recombinant protein was expressed, purified and emulsified with ISA206 adjuvant to immunize BALB/c mice for three times. The immunogenicity was confirmed by Western blotting and tissue localization was detected by indirect immunofluorescent assay. The specific antibody level was detected by ELISA. The immunoprotection of rSjOST48 was evaluated by the reduction in worm and egg counts in mice. A cDNA with 1 248 nucleotides was isolated from 28-day-old schistosomes cDNAs by PCR. Sequence analysis revealed that SJCHGC01743 was a 48-kDa subunit of the oligosaccharyltransferase complex (OST48) and named as SjOST48. Real-time PCR analysis indicated that this gene was expressed in all investigated stages and had the highest expression level in 28 d worms, the level of gene transcription in female worms was significantly higher than that of male worms. Then recombinant plasmid pET28a(+)-SjOST48 was successfully constructed and expressed in E. coli BL21 (DE3). Western blotting analysis showed that rSjOST48 had good immunogenicity. Indirect immunofluorescent analysis revealed that SjOST48 was mainly distributed on the tegument of the worms. The result of ELISA indicated that the rSjOST48 vaccinated group could induce a significant increase in the level of specific IgG, IgG1 and IgG2a. An immunoprotection experiment showed that the vaccination of rSjOST48 in mice induced 32.62% (P < 0.05) reduction in the numbers of worms and 57.61% (P < 0.01) in eggs in liver, compared with that of the control group. This study provides the foundation for proceeding further research on the biological function of SjOST48 and screening new vaccine candidates for schistosomiasis.

Role of M3 muscarinic acetylcholine receptor in glycinergic neurotransmitter release in spinal lamina Ⅰneurons in rats / 中华麻醉学杂志

Objective To evaluate the role of M3 muscarinic acetylcholine receptor (M3 mAChR) in the release of glycinergic neurotransmitter by using oxotremorine-M (Oxo-M: a nonselective mAChR agonist) and 4-diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP: a highly selective M3mAChR antagonist). Methods Twenty male 3-4 weeks old SD rats weighing 160-180 g after successful intrathecal catheterization were randomized into 2 groups (n = 10 each): normal saline group (group NS) and pertussis toxin (group PTX).Pertussis toxin 1.5 μg/10 μl was injected IT in group PTX, while in group NS normal saline 10 μl was injected IT instead. The animals were killed at day 7 after injection. The spinal cords were removed and sliced and placed in artificial CSF. Glycinergic spontaneous inhibitory postsynaptic currents (sIPSCs) were measured in spinal lamina Ⅱneurons using whole-cell voltage-clamp technique. Five minutes after sealing, Oxo-M (final concentration 3 μ mol/L) was added. Oxo-M was then completely washed out 3 min later and 4-DAMP (final concentration 25 nmol/L) was added after 5 min of stabilization. In the presence of 4-DAMP, Oxo-M (final concentration 3 μmol/L) was added again 3 min later. sIPSCs were recorded before addition of Oxo-M (T1), 3 min after addition of Oxo-M (T2), 3 min after addition of 4-DAMP (T3), 3 min after the second addition of Oxo-M (T4). Results Compared with the baseline value at T1 , Oxo-M significantly increased the frequency of glycinergic sIPSCs at T2without changing the amplitude at T2-4 in both groups. The frequency of sIPSCs was significantly lower at T4 than at T2 in both groups (P ＜ 0.05 or 0.01). There was no significant difference in both frequency and amplitude of glycinergic sIPSCs between the two groups. Conclusion M3 mAChR plays a predominant role in the release of glycinergic transmitter in the spinal lamina Ⅱ neurons in rats.

Expression of GABAB1 receptors in spinal dorsal horn neurons in rats with diabetic neuropathic pain / 中华麻醉学杂志

Objective To investigate the role of GABAB1 receptors in spinal dorsal horn neurons in the development of diabetic neuropathic pain (DNP). Methods Sixty pathogen free male SD rats aged 4 weeks weighing 150-170 g were randomly divided into 2 groups ( n = 30 each): control group and DNP group. Diabetes mellitus was induced by single intraperitoneal injection of streptozotocin 50 mg/kg. Blood glucose levels and paw withdrawal threshold to mechanical stimuli were measured at 3, 5 and 7 weeks (T1, T2, T3 ) after IP STZ/NS ( n = 10 each). The animals were sacrificed after PWL measurement. The lumbar segment of the spinal cord was removed for determination of the expression of GABAB1 receptors by immuno-histochemistry, RT-PCR and Western blot analysis. Results The blood glucose levels were significantly higher while the PWT was significantly lower at T1,T2 and T3 in group DNP than in control group. The expression of GABAB1 receptor mRNA and protein in spinal dorsal horn was significantly lower at T2 and T3 in DNP group than in control group. Conclusion The expression of GABAb1 receptors is down-regulated in spinal dorsal horn neurons in rats with DNP.

Advance of the treatment for chylothorax / 国际外科学杂志

The treatment for chylothorax depends on the underlying causes and the individual clinical cir-cumstances.It is difficult to select the best treatment measure.The main options include medium-chain tri-glyceride diet,total parenteral nutrition,drug therapy,thoracentcsis,pleurodesis,pleuroperitoneal shunting,embolization or ligation of the thoracic duct.This paper provides a brief review of the treatment for chylotho-rax.

Emergency Drug Supply Mechanism in Women and Children’s Special Hospital During Earthquake Disaster / 中国药房

OBJECTIVE:To explore an emergency drug supply mechanism for women and children’s special hospital during earthquake disaster. METHODS: The practice of drug supply in our hospital after "5?12" Wenchuan earthquake was analyzed. RESULTS: The daily and post-earthquake medicine supply of the hospital was guaranteed,including the drugs which supply to the medical treatment rescues team in the disaster area;and the principle and approach of emergency drug supply in women and children's special hospital during earthquake disaster has been established. CONCLUSIONS: The emer-gency drug supply in women and children’s special hospital should cover drugs used for wounded women and children in addition to those special drugs used for earthquake injuries. All the links including drug plan,drug purchase,quantity monitoring and drugs needed for rescue should be considered in detail to form a fast and smooth hospital emergency drug supply mechanism.

Scientific Optimizing of Flow of Drug Purchasing in Hospital / 中国药房

OBJECTIVE:To construct a high-efficiency, high-performance, low-cost flow of drug purchasing. METHODS: The defects involved in the current drug purchasing flowsheet prevalent in many hospitals were analyzed and the optimized flowsheet was put into practice by combining the actuality of our hospital. RESULTS & CONCLUSIONS: The traditional drug purchasing modality can not meet the requirement of current hospitals in that it involves large work load and high probability of error, and it is tedious and time-consuming. The establishment of drug catalog database and the online drug purchase by means of instant communication software can help simplify drug purchase flow, lessen work load, enhance work efficiency, and effectuate a high-efficiency, high-performance, low-cost flow of drug purchasing.

Calculation of Jobs Intensity for Optimization of Shift Schemes / 中国药房

OBJECTIVE:To explore and extend a reasonable scheduling mode suitable for outpatient pharmacy.METHODS:The traditional scheduling mode was studied,and the fluctuation of the job intensity of dispensing personnel was revealed by drawing charts.In view of the disadvantage of the traditional scheduling mode,a new scheduling mode using mathematical conversion was adopted.RESULTS:Due to the new scheduling mode,the fluctuation of job intensity and the total man-hours were significantly decreased.CONCLUSIONS:Computing work intensity can help reasonably distribute and utilize the present human resources.

Approach to Management of Hospital Drug Storehouse Basing on Joint Commission International Accreditation / 中国药房

OBJECTIVE:To strengthen management of hospital drug storehouse.METHODS:According to Joint Commission International (JCI) accreditation,management of drug storehouse was guided through perfecting working system,workflow,qualification confirmation of employees,reasonable management of drug stock and information management,etc.Related investigation and discussion were carried out.RESULTS & CONCLUSIONS:Management of hospital drug storehouse combining with JCI accreditation and quality assurance system of drug storehouse management can improve workflow and management of drug storehouse,guaranteeing efficiency and quality of drug supply.