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OBJECTIVE: To explore the key points of work for clinical pharmacists in individualized anticoagulant therapy in patients with atrial fibrillation. METHODS: The pharmacists participated in the development of the regimen of warfarin anticoagulation and its supervision for prevention of embolism complications in one case of aged patient with non valvular disease combined with diabetes. RESULTS: The anticoagulant intensity and the combination regiment of warfarin with heparin were determined according to the characteristics of the patient. Patient self-monitoring and awareness of influencing factors were improved through the medical education by clinical pharmacists. CONCLUSION: Design of individualized medication regimen and medication supervision should be the breakthrough point of clinical pharmacists.
ABSTRACT
<p><b>BACKGROUND</b>Clinical combination of some traditional Chinese medical herbs, including berberine, with irradiation is demonstrated to improve efficacy of tumor radiotherapy, yet the mechanisms for such effect remain largely unknown. The present study investigated the effect of berberine on apoptosis induced by X-rays irradiation and the relation between this effect and gap junction intercellular communication (GJIC).</p><p><b>METHODS</b>The role of gap junctions in the modulation of X-rays irradiation-induced apoptosis was explored by manipulation of connexin (Cx) expression, and gap junction function, using oleamide, a GJIC inhibitor, and berberine.</p><p><b>RESULTS</b>In transfected HeLa cells, Cx32 expression increased apoptosis induced by X-rays irradiation, while inhibition of gap junction by oleamide reduced the irradiation responses, indicating the dependence of X-rays irradiation-induced apoptosis on GJIC. Berberine, at the concentrations without cytotoxicity, enhanced apoptosis induced by irradiation only in the presence of functional gap junctions.</p><p><b>CONCLUSIONS</b>These results suggest that berberine potentizes cell apoptosis induced by X-rays irradiation, probably through enhancement of gap junction activity.</p>