Mechanism of Qizhenziyin mixture in the treatment of hypogonadism based on network pharmacology analysis and molecular docking / 药学实践杂志

Objective To investigate the mechanism of Qizhenziyin mixture in the treatment of hypogonadism by using the network pharmacology approach. Methods The active components of Qizhenziyin mixture were obtained by searching TCMSP ，TCMID and HIT databases.The related targets of candidate compounds were obtained by searching STITCH databases. The potential targets of Qizhenziyin mixture in the treatment of hypogonadism were obtained by mapping the disease genes of hypogonadism with Genecards and DisGeNet databases. The protein interaction platform database (STRING) was used to construct the interaction relationship between action targets. The target protein interaction （PPI） network was constructed by introducing Cytoscape software. The mechanism of Qizhenziyin mixture in the treatment of hypogonadism was explained through the enrichment analysis of GO, KEGG and molecular docking technology. Results A total of 148 drug-disease chemical compounds, 96 drug-disease intersection targets, 1085 disease targets were obtained；the components for treating diseases are: quercetin，kaempferol, luteolin, etc; enrichment analysis of GO revealed 1792 biological processes （BP）, 31 cellular components (CC) and 79 molecular functions (MF)；the results of KEGG pathway enrichment analysis indicated such as FOXO signaling pathway, prostate cancer, AGE-RAGE signaling pathway in diabetic complications, HIF-1 signaling pathway, etc.The results of molecular docking showed that kaempferol and LEP had the best and stable binding energy. Conclusion The active components of Qizhenziyin mixture may play a role of the treatment of hypogonadism by improving insulin resistance and the expression of testosterone synthetase of Leydig cells.

Determination of camphor residue and borneol content in Qingchang suppository by GC / 药学实践杂志

Objective To establish a gas chromatography for simultaneous determination of camphor residue and borneolum content in Qingchang Suppository. Methods Gas chromatograph method was used. The chromatographic column was Agilent capillary column(30 m×0.25 mm×0.25 µm). The column temperature was 140 ℃. The sample injection temperature was 250 ℃. The FID detector temperature was 250 ℃. Results Camphor，borneol and isoborneol content showed good linear in the extent of 0.0299~1.497(r=1.000), 0.0205~1.025(r=1.000), 0.0097~0.4830 µg (r=1.000). RSDs of precision，stability and repeatability test results were less than 2%. The recovery was 99.7%, 101.0%, 102.5%. Conclusion This method is simple and quick with accurate result, which could be used for the content determination of Borneol in Qingchang Suppository.

Clinical pharmacists in promoting the rational use of angiotensin-converting enzyme inhibitors in the CCU / 药学实践杂志

Objective To improve the rational use of angiotensin-converting enzyme inhibitors (ACEI).Methods Clinical pharmacists reviewed ACEI use for the patients admitted into coronary heart disease care unit (CCU) during May 2012 to May 2013 to analyze the rational use of ACEI according to the expert consensus standards, guidelines and drug instructions of ACEI without any interventions.Clinical pharmacists intervened the irrational use of ACEI based on the same standard from June 2013 to May 2015.Results By comparing the data before and after intervention, it was found that the percentage of ACEI use increased from 80.1％ to 98.9％.The percentage of initial ACEI overdose was dropped from 21.4％ to 0.9％, and the percentage of under dose was decreased from 4.7％ to 0.5％, which was statistically significant.Conclusion Clinical pharmacists can play a leading role in promoting the rational use of ACEI.

Treatment optimization for dermatitis medicamentosa in a patient with abnormal liver function associated with infection / 药学实践杂志

Objective To optimize the treatment plan for dermatitis medicamentosa in a patient with abnormal liver function associated with infection.Methods The culprit medication for drug eruption was identified by reviewing the patient′s liver and kidney function, routine blood count, therapeutic drugs, allergic history, by analyzing the characteristics of the compounding medication, combined with literature search on drug eruption diagnosis and treatments.Following the antihistamines and glucocorticoid use guidelines, the treatment plan was optimized by selecting appropriate antihistamines and glucocorticoids based on their metabolism and excretion pathway.Results The rash was poorly controlled after clinical pharmacist′s initial recommendation to use chlorpheniramine (intramuscular injection) and cetirizine (oral).The clinical pharmacist further suggested dexamethasone intravenous drip.The patient recovered well with the combination therapy of antihistamines and glucocorticoid.Conclusion When drug eruption occurred, clinical pharmacists should evaluate patient′s disease and medications comprehensively, provide timely and accurate pharmaceutical care to patients.

Meta-analysis on treatment of lower respiratory tract infection of azatreonam or ceftazidime / 药学实践杂志

Objective The aim of the study is to evaluate clinical efficacy and safety of azatreonam or ceftazidime on treatment of lower respiratory tract infection .Methods Four English databases (MEDLINE、EMBASE、Pubmed、Cochrane li‐brary) and three Chinese databases (CNKI、VIP、WANFANG) were searched .Meta‐analysis was performed using Review Manager 5 .2 .Results The Meta‐analysis revealed azatreonam was superior to ceftazidime in total efficiency (RR=1 .15 ,95%CI is 1 .09‐1 .21) .No significant differences are seen between azatreonam and ceftazidime (RR=1 .03 ,95% CI is 0 .98‐1 .09) on the bacterial eradication rates or the incidence of adverse reactions (RR=0 .66 ,95% CI is 0 .39‐1 .12) .Conclusion Azatreonam is more effective than ceftazidime on the treatment of lower respiratory tract infection in the clinical practice .

Study on the Effects of Total Cost Prospective Payment System on the Consumption of Drugs / 中国药房

OBJECTIVE:To investigate the consumption of drugs after the inplementation of total cost prospective payment sys-tem(PPS),and to provide reference for hospital drug cost control. METHODS:The data of prescriptions collected from 9 hospital during 2007-2014 were divided into group A,B and C according to PPS,and then summarized statistically in respects of increase rate of total consumption sum,consumption sum ratio of major category;the drug cost per time of outpatient department,emergen-cy department and inpatient department were calculated as well as consumption sum ratio of self-paid drugs;the dosage per time of drugs in blood pressure and diabetes prescription were also calculated. RESULTS:The total consumption sum of drug increased slowly after the implementation of total cost PPS;the consumption sum ratio of major category kept stable,while that of anti-infec-tive agent decreased;the emergency drug cost per time achieved a negative growth,and outpatient and inpatient drug cost per time increased slightly. The proportion of self-paid drugs was relatively stable. The dosage per time of drugs in hypertension and diabetes prescriptions was stable,too. CONCLUSIONS:Total cost PPS is useful in controlling the rapid growth of drug costs,and promote the reasonable drug use. The consumption sum of self-paid drugs are well controlled. The increase of drug cost per time in outpa-tient and inpatient should arouse the attention of the relevant departments. In addition,it has no effect on drug dosage for the pa-tients with hypertension and diabetes.

Intervention Effect of “Intelligent Interactive Software for Drug Monitoring Warning” / 中国药师

Objective:To analyze the intervention effect of a successfully created platform“intelligent interactive software for drug monitoring warning” on the decrease of medication errors and adverse drug events,and the increase of the drug treatment level. Meth-ods:The intensive care unit ( ICU) of our hospital was selected as the experiment group, and the ICU of the other two hospitals was used as the contrast group. During the first 18 months, both groups were without intervention. During the latter 18 months, the plat-form was used in the experiment group, and the clinical pharmacists employed alerts of the system in the practice of interaction with doctors to correct the medication errors. No intervention was performed in the contrast group. In addition, all adverse drug events in both groups were surveyed. Results:During the first period, 50 preventable adverse drug events were discovered with the incidence of 6. 8% in the experimental group. During the second period, the correct rate of the alerts was 97. 7%. Through the effective interven-tion,the alerts and their percentage in the prescriptions were from the maximum of 68 and 1. 1% to the minimum of 6 and 0. 1%. To-tally 17 preventable adverse drug events were found with the incidence of 2. 4% after the intervention. The decline was significant, 848 991 yuan of hospitalization expenses was saved, and 294 days of the length of stay were shortened. There was no change in the contrast group, and there was no change in unpreventable adverse drug events in the two groups before and after the intervention. Conclusion:The intelligent interactive software for drug monitoring warning can examine many sorts of medication errors,and decline the inci-dence rate of preventable adverse drug events in ICU. However, it needs to continuously improve the intelligence. Clinical pharmacists need to master the relevant conditions of patients to detect the irrational drug use based on the clinical practice for each patient.

Changes of coagulation and lung injury in response to leukocytapheresis in endotoxemia dog / 中华创伤杂志

Objective To observe the effect of leukocytapheresis(LCAP)on the coagulation,fibrinolysis system and lung injury in the endotoxemia dog and explore the mechanism in the endotoxin-induced lung injury dog. Methods Endotoxemia-induced model in dogs was established by administration of lipopolysaccharide(LPS,2 mg/kg).Separation of the leucocytes wag performed with the automated continuous flow blood cell separators.A total of 30 male mongrel dogs were randomly divided into LPS group(group L,only injected with LPS,with no LCAP),sham LCAP group(group S,received sham LCAP at 12-14 hours after administration of LPS)and LCAP treatment group(group T,received LCAP at 12-14 hours after administration of LPS),10 dogs per group.The dynamic changes of the activated protein C(APC),soluble thrombomodulin and plagminogen activator inhibitor-1 in the serum were measured at 0 hour before LPS administration,at 2,6,12,14,16,24 and 36 hours after administration of LPS.Results Through LCAP,there found the following four results:(1) the APC level in the serum of the group T wag(50.805±4.422)μg/ml and(40.480±2.993)μg/ml at 14 hours and 16 hours respectively,which were significantly higher than(45.881±4.024)μml and(35.935±4.057)μg/ml in the group L(P<0.05).(2)The expressions of soluble thrombomadulin in the group T was (9.688±O.914)μml and(10.492±O.865)μg/ml at 14 hours and 16 hours respectively,which was statistically lower than(11.005±0.854)μg/ml and(12.04±0.954)ug/ml in the group L(P<0.05).(3)Thelevel of plagminogen activatorinhibitor-1 in the group T was lower than that in the group the group T Wag statistically lower than that in the group L(ALI/ARDS occurred in 2 and 7 dogs of the groups T and L respectively within 36 hours after infusion of LPS.P<0.05). Conclusions At the decrease the incidence of acute lung injury partly due to its role in improving the function of coagulation and fibrinolysis.

Intelligentized Prescription-Monitoring System on the Dosage and Medication Frequency of Antibiotics / 中国药房

OBJECTIVE:To introduce the function and operation of "Intelligentized prescription-monitoring system on the dosage and medication frequency of antibiotics" in order to reduce adverse drug events and increase therapeutic efficacy. METHODS: The monitoring system was evaluated and analyzed from aspects of the tools used for the research and development,software and hardware platforms,functional modules,characteristics,technical difficulties,and effectiveness of the monitoring system. Meanwhile,599 prescriptions sampled randomly were examined online. RESULTS: For the total 599 prescriptions,50 warnings appeared in the system,and which had been confirmed to be correct by experts. CONCLUSIONS: The discrepancy between the dosage and (or) medication frequency and the drug package inserts can be detected with the use of monitoring system,which thus meets our expected goal.

Experience of Research & Development of the Intelligent Prescription Screening System / 中国药房

OBJECTIVE:To reduce the incidence of the preventable adverse drug events by using information technology. METHODS:The intelligent prescription screening system was developed and the hospital information system-based link between "contraindications" and diagnosis of patients,their laboratory results and creatinine clearances were realized. RESULTS:Of the total 5 546 prescriptions selected randomly within one day,46 laboratory results-related,28 diagnosis-related and 32 creatinine clearance-related contraindications were detected by the system. CONCLUSION:This link mode is practical in that those prescriptions that violating the contraindications can be found out by the system; however,the clinical effect of the intelligent prescription screening system remains to be proved.

Influence of Time and Costs of Hospitalization by Severe Adverse Drug Events / 药物流行病学杂志

Objective:To study the relations between the length and costs of hospitalization and the severe ad- verse drug events which took place in the gastroenterologic and pulmonary wards.Method:Pharmacists surveyed ADEs in- cluding their existence and preventability in the wards,and found out the quantity of excessive length and extra costs of hos- pitalization.Result:There were totally 20 identified severe ADEs in which 11 were preventable in the pulmonary wards during 8 months and in the gastroenterologic wards during 5 months.The mean attribute length of stay was 17.8 days and mean attribute extra cost of hospitalization was 16,869 yuan for each ADE.The mean attribute length of stay was 19.3 days and mean attribute extra cost of hospitalization was 12,578 yuan for each preventable ADE.Conclusion:The attribute length of stay and extra costs of hospitalization were substantial.Since many severe ADEs were preventable,the effective measure must be taken to decrease their incidence.

Survey of Antibiotics in Emergency Department of Oriental Hospital and Analysis of Rational Use During 2007 / 药物流行病学杂志

Objective:To understand the use of antibiotics in our hospital to provide clinical drug reference. Method:The hospital outpatient and emergency prescriptions in 2007 were randomly selected and according to clinical pharmacology knowledge and literature material,sorting of the antibiotics use frequency and category was carried out,and the statistics and rationality about the antibiotics prescriptions were classified and analyzed.Result:According to the use frequency(DDDs),the top 3 kinds were ornidazole,levofloxacuin and azithromycin.Cephalosorins,quinolones and macrolides were most frequently used in clinic.In the total 10,800 prescriptions audited,3842 antibiotic prescriptions and 409 irrational prescriptions were used respectively in the drug solvent which presented problems in the dosage regimen,pharmacological effects and rational drug use.Conclusion:The use of antibiotics in the hospital was basically reasonable,but there were still some problems and the need to further improve the prescription audit would be helpful for the rational use of antibiotics.

Correlation Between in vitro Chemosensitivity of Antineoplastic Drugs and its Clinical Response and Prognosis in Human Colorectal Cancers / 药物流行病学杂志

Objective:To study the correlation between in vitro chemosensitivity of Fluorouraci(5-Fu) + Mitomycia (MMC) and its clinical response and prognosis in human colorectal cancers. Method:The chemosensitivity of 5-Fu + MMC was tested in 169 Dukes B and C colorectal cancers with the MTT method,and the progression-free internal and prognosis in 4 years following the surgery were observed. Result:Based on the in vitro chemosensitivity of 5-Fu + MMC, 100 patients were divided into an antagonistic group(28 patients) in which their relapse rates were 57. 1% and a synergistic-additive group(72 patients) in which their relapse rates were 22.2% (P

Key to Medical Reform:Rational Use of Health Resources / 中国药房

OBJECTIVE:To provide reference for the implementation of new"Medical Reform"in China. METHODS:The effectiveness of performed health policy was analyzed. The advantages and disadvantages of new"Medical Reform"were analyzed systematically according to the condition of China. RESULTS&CONCLUSION:Rational use of health resource is the key to"Medical Reform". Effective methods for rational use of health resource are charging for single disease and total cost repaid.

Analysis on Application of Intelligent Monitoring System for Dosage and Frequency of Drugs in the Monitoring of Non-antimicrobials / 中国药房

OBJECTIVE: To promote rational use of non-antimicrobials based on Intelligent Monitoring System for Dosage and Frequency of Drugs.METHODS: Base on the information system of hospital,dosage and frequency of drugs were collected from Intelligent Monitoring System for Dosage and Frequency of Drugs and connected with patients’ ages,weights,body surface areas and renal functions.1 315 hospitalized prescriptions of non-antimicrobials were randomly collected from our hospital one day.RESULTS: There were 200 warnings of overdosage each time and moderate frequency,91 warnings of overdosage each time and inadequate frequency,43 warnings of moderate dosage each time and inadequate frequency,41 warnings of moderate dosage each time and excessive frequency,15 warnings of inadequate dosage each time and moderate or inadequate frequency for drugs that needn’t be adjusted according to age and renal functions.There were 11 warnings of overdosage and excessive frequency for drugs that should be adjusted according to patients’ age and renal function.CONCLUSION: This kind of connection is practical,when prescriptions of non-antimicrobials which violate the rules of dose and (or) frequency are identified by system.But the significance of Intelligent Monitoring System for Dosage and Frequency of Drugs should be proved by practice.

Meta-analysis of Oxaliplatin or Irinotecan Combined with 5-FU/LV for Advanced Colorectal Cancer / 中国药房

OBJECTIVE:To evaluate clinical efficacy and toxicities of oxaliplatin or irinotecan combined with 5-FU/LV for advanced colorectal cancer. METHODS:RCTs were retrieved from PubMed database and CHKD and Metaanalysis was carried out using Review Manager version 4.2.2 software. RESULTS:Six studies were enrolled. The oxaliplatin group was superior to irinotecan group in the overall response rate(RR=0.82,95%CI ranged from 0.74 to 0.91). The incidence rate of neutropenia in irinote-can group was lower than in oxaliplatin group(RR=0.79,95%CI ranged from 0.69 to 0.90)while the incidence of nausea/vomiting and diarrhea in irinotecan group was higher than in oxaliplatin group(RR=1.85,95%CI ranged from 1.42 to 2.40;RR=1.75, 95%CI ranged from 1.41 to 2.17). CONCLUSION:The scheme oxaliplatin combined with 5-FU/LV in the treatment of advanced colorectal cancer is superior to the scheme irinotecan combined with 5-FU/LV.

Rational Thinking on Current Policy of Containing Rapid Rise of Drug Expenditure in Our Country / 中国药房

OBJECTIVE:To discuss countermeasures to effective contain the rapid rise of drug expenditure.METHODS:Reasons of the rapid rise of drug expenditure and its countermeasure were analyzed in detail.RESULT &CONCLUSION:There were a lot of factors that contributed to the rapid rise of drug expenditure,the current containing policy has both advantages and disadvantages,a systematic method should be adopted to make it improved and perfected,meanwhile,supervision on which should be strengthened.

Study on the Drug Utilization for Lower Respiratory Tract Diseases / 药物流行病学杂志

To study the status and patterns of the drug utilization in the diseases of lower respiratory tract, the drug utilization for 290 inpatients with respiratory tract diseases in a Shanghai hospital druing 1993-1997 was analyzed by using Acute Physiology, Age, Chronic Health Evaluation(APACHE) and index of defined daily dose numbers(DDDs). The relativity between APACHE and DDDs was studied. It was found that most common drugs was anti-infection agents and expectorants, accounting for 39.06% and 38.38 %, respectively. The quantitative relationship between drug consumption and disease severity was not observed. It is concluded that the status of the drug utilization can't be demonstrated by analyzing the frequency of drug use by using DDDs.

Current Situation of Overseas Research on Pharmacoeconomics and Existing Problems in Its Application at Home / 中国药房

OBJECTIVE:To promote the research and level of application of pharmacoeconomics in China.METHODS:To expound the current situation of overseas research on pharmacoeconomics and existing problem in its application at home.RE_SULTS & CONCLUSION:Many countries in the world are attaching importance to pharmacoeconomics day by day,however,there exist unclear viewpoints and improper design and data source in pharmacoeconomic research at home.

Comparison of Cost-minimization Analyses between Metformin and Acarbose Combined with Insulin in Treating Type2Diabetes Mellitus / 中国药房

OBJECTIVE:To compare the effects and costs between metformin and acarbose when combined with insulin in treating type2diabetes mellitus.METHODS:Cost-minimization analysis in medical economy was applied to analyze the therapeutic effects,costs and cost related factors with the respect for the patients.RESULTS:There was no statistically sig?nificant difference in effects of the2therapeutic regimens.Total cost and drug cost per head in metformin group were1941.46yuan and138.86yuan respectively as compared with2308.37yuan and229.82yuan respectively in acarbose group.The analysis on cost related factors showed no statistical significance.CONCLUSION:Metformin combined with insulin is a preferable therapeutic regimen.