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Objective:To investigate the effect of botulinum toxin type A on children with odorihidrosis.Methods:From March 2017 to February 2021, 121 children with odorihidrosis, including 48 males and 73 females, aged 13 to 17 (15.9±1.2) years, were admitted to the Burn and Plastic Surgery Department of the 980 Hospital of PLA. There were 24 cases in mild group, 50 cases in moderate group and 47 cases in severe group. Botulinum toxin A was injected into 20-50 points on each side, and 1 U was injected into each point. The total amount of botulinum toxin A was 50-100 U on both sides.Results:Three groups of children were evaluated for efficacy, 24 cases of mild group was significantly effective in 23 cases, accounting for 95.8%. In the moderate group, 46 (92.0%) of 50 cases showed obvious effect. 49 cases (98.0%) were effective; In the severe group, 40 cases (85.1%) showed obvious effect and 45 cases (95.7%) were effective. Three groups of children with different efficacy had no statistical significance ( P>0.05). The significant efficiency in mild and moderate groups was higher than that in severe group, and the difference was statistically significant ( P<0.05). Conclusions:Botulinum toxin type A is effective in the treatment of children with mild and moderate bromhidrosis, and is worthy of clinical application.
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OBJECTIVES@#Thoracoabdominal aortic aneurysm (TAAA) prosthetic vessel replacement is one of the most complex operations in the field of cardiovascular surgery. The key to success of this operation is to prevent and avoid ischemia of important organs while repairing TAAA. This study aims to summarize and analyze the effect of prosthetic vessel replacement under left heart bypass in the treatment of TAAA.@*METHODS@#Data of 15 patients with TAAA who underwent prosthetic vessel replacement under left heart bypass in Xiangya Hospital of Central South University were retrospectively analyzed. According to Crawford classification, there were 2 cases of type I, 8 cases of type II, 3 cases of type III, and 2 cases of type V. There were 14 cases of selective operation and 1 case of emergency operation. All operations were performed under left heart bypass, and cerebrospinal fluid drainage was performed before operation. Left heart bypass was established by intubation of left inferior pulmonary vein and distal abdominal aorta or left femoral artery. The thoracoabdominal aorta was replaced segment by segment. After aortic dissection, the kidneys were perfused with cold crystalloid renal protective solution, and the celiac trunk and superior mesenteric artery were perfused with warm blood.@*RESULTS@#One patient with TAAA after aortic dissection of type A died. During the operation, straight blood vessels were used to repair TAAA, and the celiac artery branches were trimmed into island shape and anastomosed with prosthetic vessels. After the operation, massive bleeding occurred at the anastomotic stoma, then anaphylactic reaction occurred during massive blood transfusion, resulting in death. One patient suffered from paraplegia due to ischemic injury of spinal cord. The other patients recovered well and were discharged. The postoperative ventilation time was (16.5±13.8) h and the postoperative hospital stay was (10±4) d. The amount of red blood cell transfusion was (13±9) U. The patients were followed up for 2 months to 2 years, and the recovery was satisfactory.@*CONCLUSIONS@#The effect of prosthetic vessel replacement under left heart bypass in the treatment of TAAA is good, which is worthy of clinical promotion.
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Humans , Aortic Dissection/surgery , Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation , Heart Bypass, Left , Postoperative Complications , Retrospective Studies , Treatment OutcomeABSTRACT
To explore the role of P2X4 receptor in opioid-induced hyperalgesia (OIH).
Methods: A total of 30 Sprague-Dawley (SD) male rats were randomly divided into 5 groups: a saline (N0) group, a remifentanil at 0.5 μg/(kg.min) (R1) group, a remifentanil at 1.0 μg/(kg.min) (R2) group, a remifentanil at 1.5 μg/(kg.min) (R3) group, and a remifentanil at 5.0 μg/(kg.min) (R4) group. The paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were measured at follow time points to optimize the dosages: the day before treatment (T1), 30 min after tail intravenous catheterization (T2), and 30 min (T3), 1 h (T4), 2 h (T5), 24 h (T6) after withdrawal from remifentanil. Then, the rats were randomly divided into 2 groups: a saline group (N group), a remifentanil at 1.0 μg/(kg.min) group (R group). The PWMT and PWTL were measured at follow time points: T1, T2, and T4. The lumbar enlargement of spine was selected at 1 h after withdrawal from remifentanil, and the expression of P2X4 receptor mRNA and protein was examined in OIH. Additional male rats were selected and randomly divided into 2 groups: a plantar incision surgery followed by saline treatment group (I+N group), a plantar incision surgery followed by remifentanil treatment group (I+R group). The PWMT and PWTL were measured at follow time points: T1, T2, T3, T4, T5, T6, 48 h (T7) and 72 h (T8) after withdrawal from remifentanil. The lumbar enlargement of spine was selected at 1 h after withdrawal from remifentanil, the expression of P2X4 receptor mRNA and protein was examined by PCR and Western blotting, and the microglial activation in spine 1 h after withdrawal from remifentanil were assessed by immunofluorescence.
Results: The pain thresholds including PWMT and PWTL in different groups were as follows: R4 groupSubject(s)
Animals
, Male
, Rats
, Hyperalgesia
, Pain, Postoperative
, Rats, Sprague-Dawley
, Receptors, Purinergic P2X4
, Remifentanil
, Spinal Cord
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Objective: To investigate the application characteristics of proton pump inhibitors (PPIs) in 31 hospitals in Wuhan ar-ea from 2014 to 2016 to provide reference for the clinical rational use. Methods: The utilization of PPIs in 31 hospitals in Wuhan area from 2014 to 2016 was statistically analyzed by drug types and dosage form in terms of consumption sum, DDDs, DDC, and consump-tion ranking (B)/DDDs ranking (A), etc. Results: The consumption sum and DDDs of PPIs were rising year by year. As for the dos-age form, the most commonly used one was oral preparation, however, the percent of injection kept high level. Among the different PPIs, oral poptolazole and lansorazole for injection were with the fastest increase in consumption sum and DDDs, while the consumption sum and DDDs of omeprazole for injection significantly decreased. The DDDs of oral poptolazole ranked first in the continuous three years with the B/A value much higher than 1. 0. The synchronicity was good for most of PPIs and the DDC was decreasing year by year. Moreover, PPIs were dominated by domestic products except for esomeprazole. Conclusion: The use of PPIs in 31 hospitals in Wuhan area from 2014 to 2016 was basically reasonable. However, some potential irrational application in clinic may still exist. There-fore, the application monitoring for PPIs should be further strengthened to promote rational drug use in clinics.
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Objective:To investigate the current situation and trend of the utilization of antihypertensive drugs in Wuhan city. Methods:The utilization data including varieties,consumption sum and DDDs of antihypertensive drugs in 34 hospitals in Wuhan city from 2013 to 2015 were analyzed.Results:The annual consumption sum of antihypertensive drugs increased year by year,and the val-ue was 20 896.67,23 527.19 and 24 033.44 million yuan, respectively. The calcium-channel blockers (CCB), angiotensin Ⅱ re-ceptor antagonist (ARB),adrenergic receptor blockers and angiotensin converting enzyme inhibitors (ACEIs) ranked the top four in consumption sum of antihypertensive drugs. Their constituent ratio was not changed during 2013 and 2015. The consumption amount and DDDs of new compound preparations increased. Top two drugs in terms of consumption amount and DDDs were amlodipine and le-vamlodipine. Conclusion:CCB,ARB,ACEI,adrenergic receptor blockers and diuretics occupy the predominant places among all the antihypertensive drugs in Wuhan city,which is accordance with the current treatment guideline of antihypertensive drugs.
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According to the mechanism , reasons, clinical characteristics and treatment principle of oxaliplatin-induced allergic re-actions ( DHRs) and combined with the specific situation of the patient , clinical pharmacists provided suggestions for the reuse of oxali-platin in one case of DHRs patient .The causes of allergic reactions were confirmed through the analysis , and the comprehensive drug prevention and pretreatment and pharmaceutical care were provided for doctors resulting in successful completion of oxaliplatin chemo -therapy without drug withdrawal .
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Calculus bovis(CB) exerts potencial pharmacological effects through anti-oxidation, anti-inflammatory, and anti-hypoxic injury. We reviewed the published literature about CB and its substitutes in the treatment of central nervous system diseases, in order to provide a reference for the deeper application and study in the future.
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Objective: To analyze the clinical characteristics of allergic reactions in patients with colorectal cancer after routine premed-ication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regimen and to provide a reference for reduc-ing the risk of oxaliplatin allergy. Methods: Retrospective analysis of 242 patients with colorectal cancer who received chemotherapy with an oxaliplatin-containing regimen at the Changzhou Cancer Hospital of Soochow University from January 2014 to October 2017 was performed, and the incidence of allergic reactions was calculated. The associations between multiple factors and allergic reactions were then assessed using univariate analysis. The independent factors of allergic reactions were assessed using multivariate Logistic analysis, and the treatment outcome of oxaliplatin rechallenge in allergic patients was discussed. Results: A total of 242 patients were studied. They received routine premedication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regi-men. Twelve (4.9%) patients had type I allergic reactions, with a median onset time of 6 (5.5-10.5) cycles and a median cumulative dose of 895 (716.5-1 075.0) mg. Multivariate analysis identified undergoing an oxaliplatin-free interval as an independent risk factor (P=0.04). Rechallenging patients with prophylactic agents was successful in 1 (33.3%) of 3 patients who completed their treatment. Conclusions: Routine low-dose dexamethasone premedication before oxaliplatin administration is safe and exhibited a lower inci-dence of hypersensitivity reactions than that reported in literature. An oxaliplatin-free interval may increase the risk of hypersensitivity reactions. Caution should be exercised while rechallenging allergic patients with oxaliplatin.
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To investigate the incidence of postoperative abnormal liver function test (aLFT) for the children with heart surgery, and to analyze the clinical characteristics and risk factors. Methods: A total of 143 children younger than 18 years old who underwent heart surgery in 2017 were enrolled in this study. The liver function were examined one day preoperation and consecutive 5 days after operation. The clinical data of perioperative period were recorded and the risk factors for aLFT were analyzed. Results: There were 43/143 (30%) cases had aLFT, including 5/143 (3.5%) acute liver injury (ALI). In the 6 liver function tests, total bilirubin, and glutamic-oxalacetic aminotransferase and glutamic-pyruvic aminotransferase increased to the peak at the first day and the second day after operation, respectively, and albumin declined to the lowest level at the fourth day after operation. aLFT happened most common at the first day after operation(22/43, 51.2%). The patients in the aLFT(+) group had smaller body size, more proportion of the risk adjustment for congenital heart sugery-1 (RACHS-1) score ≥ 3 and cyanosis, longer cardiopulmonary bypass (CPB) time, higher postoperative cardiac troponin (cTnI) value, higher inotropic score (IS), more transfusion, and longer mechanical ventilation time than those in the aLFT(-) group. The aLFT(+) group had longer ICU and hospital time, higher morbidity and mortality than those in the aLFT(-) group (P<0.05). Logistic regression showed that RACHS-1≥3, cyanosis, CPB time, cTnI, IS, transfusion, and mechanical ventilation time were the risk factors for aLFT. Multiple factor analysis showed the mechanical ventilation time was an independent risk factor for aLFT (P<0.05). Conclusion: aLFT is common in children after congenital heart operation, which could deteriorate to poor outcome. The mechanical ventilation time is an independent risk factor for aLFT.
Subject(s)
Adolescent , Child , Child, Preschool , Humans , Cardiac Surgical Procedures , Heart Defects, Congenital , General Surgery , Liver , Wounds and Injuries , Pathology , Logistic Models , Postoperative Complications , Respiration, Artificial , Retrospective Studies , Risk Factors , Treatment OutcomeABSTRACT
Objective:To explore the pharmaceutical care approaches for the patients with early breast cancer secondary osteoporo-sis treated with letrozole. Methods:A patient with early breast cancer treated with letrozole in long-term faced the high risk of second-ary osteoporosis and led to fracture. How to reduce the risk of fractures by using drugs was the breakthrough point of clinical pharma-cists, and then, individualized pharmaceutical care was performed. Results: The patient was assessed at high risk of fractures in 10 years, and clinical pharmacists assisted doctors to optimize drug therapy, and carried out long-term follow-up education to the patient. The waist pain of the patient disappeared in six months. Conclusion: For early breast cancer patients treated with letrozole, clinical pharmacists should consider the diet and living habits of the patients, assess the fracture risk in 10 years, adjust individual dose of cal-cium and vitamin D3 , choose appropriate bone absorption inhibitors and endocrine treatment, and perform follow-up for the long-term treatment compliance of the patients.
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Calculus Bovis (CB) is one of the precious traditional Chinese medicines (TCM) and has been widely used in oriental countries over 2000 years.It possesses a broad spectrum of pharmacological properties such as relieving fever,analgesic,diminishing inflammation,sedation,reducing blood pressure,recovering gallbladder functions,antioxygenation,and anti-tumor and improving immunity,et al.Due to the scarce resource and high price of natural CB,its substitutes,artificially synthesized CB and C.Bovis Sativus (CBS),also called in vitro cultured C.Bovis,have already been developed and widely used in medicine preparation.By using the literature material method,the current article explored literatures regard to pharmacological activities and clinical application of CB and its substitute,and the compound preparations were also included,from 1949 to 2016 in journals of domestic and foreign.All documents are summarized to provide a valuable reference for further basic or clinical research about CB and its substitute.
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Objective:To discuss the anti-rheumatoid arthritis activity and mechanism of hospital preparation Erteng Tongbi gran-ule ( ETTB) . Methods:The collagen-induced arthritis ( CIA) animal model in DBA/1 mice was established and treated with high, medium and low dosage of ETTB. Blank control, model control and methotrexate group were also established. The influences of ETTB on BMI, arthritis index, ankle joint destruction and expression of serum cytokine TNF-α and IL-6 in CIA mice were observed. Re-sults:Compared with the control group, ETTB at high dose (6g?kg-1) could significantly decrease the arthritis index of CIA mice (P<0. 05), and the joint damage on the 14th day was also significantly improved. ELISA results showed that ETTB at high dose could significantly inhibit the secretion of cytokine TNF-αand IL-6 when compared with the model group (P<0. 01). Conclusion:Hospital preparation ETTB has anti-rheumatoid arthritis activity, and its mechanism may be related with the inhibition of cytokine secretion.
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Objective: To provide the methods and evidence for the treatment of patients with renal insufficiency and hyperuricemia, and explore the key points of work for clinical pharmacists.Methods: By participating in the treatment of one case of cervical cancer complicated with renal insufficiency and hyperuricemia, clinical pharmacist helped physician choose appropriate drugs and dosage, and monitored the patient with pharmaceutical care.Results: After the treatment, the blood uric acid decreased and renal function returned to normal, and the chemotherapy was completed successfully without obvious side effects.Conclusion: Clinical pharmacists participating in making individual therapeutic scheme can provide safe and effective medication care for patients and reduce adverse reactions.
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Natural Calculus Bovis,one of the precious traditional Chinese medicines,is the dried gallstone in bovine gallbladder,bile duct or hepatic duct.It is one of the essential components of the formulation of a variety of traditional Chinese medicines.Due to high price and rareness of natural Calculus Bovis,Chinese researchers have developed artificial Calculus Bovis,cultured Calculus Bovis and Calculus Bovis Sativus as substitutes of it.They are mainly composed of bilirubin,bile acids,amino acids and inorganic elements.Due to the co-existence of natural Calculus Bovisa and its substitutes in the market,and the complex composition of them,identification,quality control and material basis study of them are important issues in recent years.Currently,the quality control of them mainly focus on cholic acid and bilirubin.In order to fully solve the quality control problem of natural Calculus Bovis and its substitutes,researches on testing techniques of other bile acids or other components have already started.In this paper,research progress on the chemical compositions,quality control and the test technology of bilirubin,bile acids,amino acids and other components of Calculus Bovis are reviewed,in order to provide reference for further research of Calculus Bovis.
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Objective:To establish a liquid chromatography tandem mass spectrometry ( LC-MS/MS) method for the determination of 5-fluorouracil (5-Fu) in patient’s plasma and apply it in clinics patients validation. Methods:5-Fu was analyzed on an Agela Inno-val NH2 (2. 1 mm × 50 mm, 5 μm) column. Methanol:ultra pure water (2 ∶98) was used as the mobile phase with isocratic elution. The flow rate was 0. 3 ml ·min-1 and the column temperature was set at 40℃. The ion transitions with electrospray ionization negative model were m/z 128. 8→42. 1 and m/z 188. 6→42. 1 for 5-Fu and 5-bromouracil (the internal standard), respectively. The LC-MS/MS method was verified according to the guideline of quantitative analysis validation of biological samples ( Chinese Pharmacopoeia, 2015 edition, the fourth part) . Results:The calibration curve of 5-Fu was linear within the range of 10-1 000 ng · ml-1 . The lower limit of quantification was 10 ng · ml-1 . The precision, accuracy, matrix effect and stability within the linear range were all in line with the requirements of method validation. Conclusion:The LC-MS/MS method developed in the study for the determination of 5-Fu is simple, rapid, accurate and reproducible, which can be used for the plasma concentration detection of 5-Fu in patients.
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Calculus Bovis is a valuable traditional Chinese medicine and has been used for more than two thousand years in clinic with the effects of puring heart, sweeping phlegm, resuscitation, extinguishing wind and detoxification. Since the founding of the People's Republic of China, modern methods have been utilized by traditional Chinese medicine researchers in the resource identification, chemical components, pharmacodynamics, pharmacokinetics, pharmacy, clinical application, etc. It is their continually exploration that makes significant achievements for the modern research of Calculus Bovis. This article statistically analysed the literatures from 1949 to December 2015 in Pubmed, CNKI, Wanfang, Vip database etc. to review Calculus Bovis and its compound formulas, as well as its substitutes, quality control, formulation study, compound prescription, pharmacological mechanism and clinical research. The aim of this article is to provide a valuable reference for future developments and studies of Calculus Bovis.
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The preparation of Calculus bovis and its compounding preparations have been used widely in clinical practice.Traditionally,the forms of medicine were in raw material medicine way,preparing tablet,pill,powder or directly taking its powder.The main active ingredient of Calculus bovi were considered to be bilirubin and bile acids.However,the traditional formulations caused low bioavailability and wasted expensive herbs because its main component were insoluble in water.In recent years,many researchers have tried to use modern preparation technology to prepare its compounding formulations,such as solid dispersion technology,ultrafine grinding technology,powder coating technology,liposome encapsulation technology,or simplifying the prescription by using of known pharmacological effects of soluble components as substitutes.These methods were considered to be feasible to develop new formulations of Calculus bovis.In this paper,in order to provide reference of method and technology for the improvement of Calculus bovis compounding preparation and the development of new dosage form,ultramicrostructure,chemical composition,improvement methods and techniques of compounding preparation were analyzed.In addition,the relevant techniques and method of improving the formulation Calculus bovis compounding preparation in recent years were reviewed.
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OBJECTIVE:To establish a method for the simultaneous determination of ornidazole and dexamethasone sodium phosphate in Compound ornidazole film. METHODS:HPLC was performed on the column of Inertsil ODS-3 with mobile phase of methanol-20 mmol/L phosphate buffer(pH was adjusted to 7.40 with glacial acetic acid)(55∶45,V/V)at a flow rate of 1.0 ml/min, column temperature was 30 ℃,detection wavelength was 242 nm and volume injection was 10 μl. RESULTS:The linear range were 1-100μg/ml for both ornidazole(r=0.999 7)and dexamethasone sodium phosphate(r=0.999 9);RSDs of precision,stabili-ty and reproducibility tests were lower than 2.0%;recoveries were 96.50%-99.80%(RSD=1.02%,n=9) and 96.50%-99.60%(RSD=0.99%,n=9). CONCLUSIONS:The method is specific with good precision and stability and high accuracy,and can be used for the simultaneous determination of ornidazole and dexamethasone sodium phosphate in Compound ornidazole film.
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Objective To explore the pharmaceutical care approaches for patients with lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy. Methods An elderly patient with lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy faced inevitable safety risks.Clinical pharmacists considered it as an intervention point, and provided individual pharmaceutical care. Results Clinical pharmacists fully assessed the safety risks of the case receiving pemetrexed chemotherapy with clinicians, assisted in improving the therapeutic regimen, and carried out medication education for the patient. No serious adverse drug reactions occurred in the patient, and anti-tumor efficacy was obtained. Conclusion For patients of lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy, clinical pharmacists should focus on creatinine clearance rate, and decide whether the combined use of platinum anti-tumor drugs, non steroidal anti-inflammatory drugs and zoledronic acid can be adopted, and follow-up on adverse drug reactions and anti-tumor efficacy.
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Objective:To analyze the anti-infection therapy for one lung cancer patient with agranulocytosis and fever after chemo-therapy to provide pharmaceutical care and support for the rational anti-infection drug use in the patient. Methods: Clinical pharma-cists analyzed the drugs used in the patient and provided pharmaceutical care for doctors according to the examination results and diag-nosis of the patient. Results:By participating in the treatment plan, clinical pharmacists ensured the treatment for the patient was safe and effective. Conclusion:Clinical pharmacists should assist doctors in making out the treatment plan according to patients’ situation in order to promote rational drug use in clinics and reflect the value of pharmaceutical care.