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Objective:To describe the incidence, diagnosis rate, treatment rate and treatment pattern of hyperkalemia, and serum potassium retesting rate among hyperkalemia patients in the emergency department.Methods:Data were derived from Military Data Center for Rational Use of Drugs. Patients who accessed emergency medical services (≥18 years old) with record(s) of serum potassium between 2015 and 2017 were included. The data of laboratory test, diagnosis, and treatment were analyzed. The main outcomes included the incidence of hyperkalemia, the diagnosis rate, the treatment rate, treatment pattern and the 7-day retesting rate.Results:A total of 1 039 245 patients who met the above criteria were included, of whom, 36 615 (3.52%) had at least one hyperkalemia event. Among the emergency patients with chronic kidney disease, heart failure, diabetes mellitus and hypertension, the proportions of patients who experienced hyperkalemia were 47.69%, 29.13%, 21.69% and 10.16%, respectively. The diagnosis rate of emergency hyperkalemia patients was 9.23%. The overall hyperkalemia treatment rate was 42.1%. Insulin + glucose injection was the most commonly used therapy for emergency hyperkalemia patients. The overall serum potassium retesting rate within 7 days was 28.8%.Conclusions:Hyperkaliemia is more common and more severe in patients with chronic kidney disease, heart failure, diabetes and hypertension. The diagnosis rate and retesting rate of hyperkalemia are low, suggesting that the identification and management of hyperkaliemia in emergency patients should be strengthened.
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OBJECTIVE： To evaluate the effects of clinical pharmacist-led ischemic stroke management， and to provide reference for chronic disease management. METHODS： Totally 184 patients with ischemic stroke who were hospitalized in neurology department of the First Hospital of Hebei Medical University from May to August 2018 were included prospectively， and then divided into control group （92 cases） and intervention group （92 cases） by random number method. Control group did not receive clinical pharmacist intervention. In the intervention group， clinical pharmacists were the leader in the pharmaceutical care during the hospitalization， the medication education at discharge， and pharmacy follow-up after discharge. The rate of medication compliance （antiplatelet drugs， antihypertensive drugs， hypoglycemic drugs and lipid-lowering drugs） and the rate of secondary prevention and control indicators of ischemic stroke， such as blood pressure， blood glucose [glycated hemoglobin （HbA1c）] and blood lipid [low-density lipoprotein cholesterol （LDL-C）] were investigated between 2 groups at 6 months after discharge. The incidence of adverse drug reaction and the rate of rehospitalization were compared between 2 groups at 6 months after discharge. RESULTS： The number of patients in the intervention group and the control group was 84 and 82， respectively. At 6 months after discharge， the compliance rate of antiplatelet drugs in the intervention group was 96.43％， which was higher than 95.13％ of control group， but the difference was not statistically significant. The good compliance rates of antihypertensive drugs， hypoglycemic drugs and lipid-lowering drugs in the intervention group were 92.86％， 91.67％ and 77.38％， which were higher than 78.57％， 69.70％ and 60.98％ of control group， with statistical significance （P＜0.05）. The qualified rate of index of blood pressure was 89.29％ in intervention group， which was higher than 76.79％ of control group， but the difference was not statistically significant. The qualified rates of HbA1c and LDL-C in the intervention group were 80.56％ and 66.67％， which were higher than 57.58％ and 48.785 of control group， with statistical significance （P＜0.05）. The incidence of total adverse drug reactions in the intervention group was 15.48％， which was lower than 20.73％ of control group， but the difference was not statistically significant. The total rehospitalization rate in the intervention group was 7.14％， which was lower than 17.86％ of control group， the difference was statistically significant （P＜0.05）. CONCLUSIONS： The management of ischemic stroke patients with clinical pharmacists as the leading factor can improve the patient’s medication compliance， improve the qualified rate of secondary prevention and control indicators of ischemic stroke， and reduce the rate of rehospitalization.
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Objective To investigate the utilization of antibiotics in emergency departments (EDs) of class Ⅲ general hospitals in China.Methods Data from a national monitoring network for rational use of drugs was used.The data included prescriptions of EDs from 114 class Ⅲ general hospitals in 30 provinces (autonomous regions,municipalities) of China.A total of 10 260 595 prescriptions from October 1,2014 to December 31,2016 were extracted.The Anatomical Therapeutic Chemical Classification/Defined Daily Dose (DDD) system was used for the classification of antibiotics and calculation of antibiotic use intensity.An auto-regression model was used to analyze the trend over time and seasonal variation of antibiotic use in EDs.Results The rate of antibiotic prescriptions was 27.82％ in EDs,among the antibiotics prescribed,25.58％ were for the combination therapy with 2 or more antibiotic agents,and injectable antibiotic prescriptions accounted for 60.59％.Besides,the number of DDDs per 100 patient visits was 81.84.Broad-spectrum agents were the most commonly used antibiotics,among which the second and third generation cephalosporins,quinolones and macrolides accounted for 23.83％,21.68％,19.17％ and 7.89％ of all prescribed antibiotics,respectively.The use of antibiotics,including prescription frequency and use intensity,in EDs had a slight but significant increase tendency (P＜0.05),and the seasonal variation of antibiotic use in EDs was obvious,characterized by the highest frequency and intensity of antibiotic use in winter,the differences were significant (P＜0.05).Conclusion The antibiotic prescription rate in EDs of class Ⅲ general hospitals in China was controlled at a low level,but the proportions of broad-spectrum antibiotics and injectable antibiotics were high,and a significant increase trend in antibiotic use in EDs was found.
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Objective To investigate the utilization of antibiotics in emergency departments (EDs) of class Ⅲ general hospitals in China.Methods Data from a national monitoring network for rational use of drugs was used.The data included prescriptions of EDs from 114 class Ⅲ general hospitals in 30 provinces (autonomous regions,municipalities) of China.A total of 10 260 595 prescriptions from October 1,2014 to December 31,2016 were extracted.The Anatomical Therapeutic Chemical Classification/Defined Daily Dose (DDD) system was used for the classification of antibiotics and calculation of antibiotic use intensity.An auto-regression model was used to analyze the trend over time and seasonal variation of antibiotic use in EDs.Results The rate of antibiotic prescriptions was 27.82％ in EDs,among the antibiotics prescribed,25.58％ were for the combination therapy with 2 or more antibiotic agents,and injectable antibiotic prescriptions accounted for 60.59％.Besides,the number of DDDs per 100 patient visits was 81.84.Broad-spectrum agents were the most commonly used antibiotics,among which the second and third generation cephalosporins,quinolones and macrolides accounted for 23.83％,21.68％,19.17％ and 7.89％ of all prescribed antibiotics,respectively.The use of antibiotics,including prescription frequency and use intensity,in EDs had a slight but significant increase tendency (P＜0.05),and the seasonal variation of antibiotic use in EDs was obvious,characterized by the highest frequency and intensity of antibiotic use in winter,the differences were significant (P＜0.05).Conclusion The antibiotic prescription rate in EDs of class Ⅲ general hospitals in China was controlled at a low level,but the proportions of broad-spectrum antibiotics and injectable antibiotics were high,and a significant increase trend in antibiotic use in EDs was found.
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Aim To analyze the expression of phosphatidylethanolamine-binding protein(PEBP) and ERK in critical brain regions of psychological dependence rats.Methods Morphine-induced rats conditioned place preference(CPP) model was established to mimic different stages of morphine psychological dependence, during which PEBP expression and ERK activity were assayed in different brain regions.Results PEBP expression in hippocampus, prefrontal cortex, striatum and nucleus accumbens showed no change at three stages of psychological dependence.However, ERK activity increased notably in prefrontal cortex on CPP formation, and decreased remarkably in hippocampus on CPP reinstatement.Conclusions The formation and retrieval of associated memory between morphine effects and environment involve different neural circuits, in which ERK activity is critical, and PEBP might not be involved in such a memory-related ERK regulation.
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Objective To study the phosphorylation mode of extracellular regulated kinase( ERK)induced by acute and chronic morphine treatment on Chinese hamster ovary( CHO)cells expressed withμopioid receptors. Methods The time course of ERK phosphorylation 1 h and 36 h after morphine exposure as well as naloxone-precipitated withdrawal was detected by immunobloting. Results A transient enhancement of ERK phosphorylation was induced by 1 μmol · L-1 morphine with the peak effect at 5 min(P〈0. 01),and the effect was dose-dependent. No difference in ERK phosphorylation was found after 36h of treatment with 10 μmol · L-1 morphine compared with the control. However,5 or 10 min-naloxone precipitation induced remarkable decrease in ERK phosphorylation compared with the control(P〈0. 01). Conclusion Different changes of ERK phosphorylation were found under acute and chronic morphine treatment and naloxone precipitation,indicating a compensation of ERK related pathway induced byμ opioid receptors.
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OBJECTIVE: To study in vitro percutaneous permeability of methylphenidate cream. METHODS: Isolated rat skin was taken as permeable barrier. The influence of different concentrations of azone(0%, 2%. 5% ) in methylphenidate cream on drug permeation was observed. RESULTS: Steady-state percutaneous flow(J ) of methylphenidate cream with 2% and 5% azone increased 27. 80% and 49. 05%. respectively. CONCLUSION: Methylphenidate cream will be a safe. effective and conve- nient new preparation.
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OBJECTIVE:To observe the preventive and therapeutic effect of Keshu on acute alcoholism mice.METHODS:Acute alcoholism mice model was established,and randomly divided mice into model group and high,middle,low dosage of Keshu group;the tolerance time,lasting time and the concentration of alcohol in blood were compared among each group.RE-SULTS:Compared with the model group,the tolerance time has been prolonged,the lasting time has been shortened and the blood concentration of alcohol has been lowered in Keshu group.CONCLUSION:Keshu has an obvious preventive and thera-peutic effect on acute alcoholism,the preventive effect of which outweighs the therapeutic effect.
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OBJECTIVE:To establish a HPLC method for determination of the concentration of Buspirone in serum.MET_ HODS:The chromatographic system consisted of ZORBA SB-C 18 column and mobile phase of methanol-acetonitrile-water-0.1mol/L NaAC buffer solution(pH4.5)(10∶38∶51∶1),with a detection wavelength of237nm,and the content was calcu?lated by peak area internal standard method.RESULTS:The linear range of Buspirone was1～80ng/ml,r=0.9979.CONCL_ USION:This method is simple and accurate for determination of Buspirone in serum.
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OBJECTIVE:To study the in vitro percutaneous permeability of galanthamine cream.METHODS:Using iso?lated mouse's skin as barrier to permeation,the promoting effect of azone in different concentrations on permeation of galanth_ amine was studied.RESULTS:Azone could obviously enhence the permeability of galanthamine through skin.The steady flux of galanthamine cream containing2%and5%azone increased56.12%and23.29%respectively.CONCLUSION:Galanthamine cream has good percutaneous permeability and2%azone promotes the permeability best.
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OBJECTIVE:To study the in vitro percutaneous absorption of neostigmine cream.METHODS:Using isolated mouse skin as permeation barrier,the influence of different concentrations of azone on percutaneous permeation of neostigmine was studied.RESULTS:Azone could obviously enhance the percutaneous permeation of neostigmine,and the accumulative permeation quantity of neostigmine cream containing2%and5%azone increased7.17%and11.87%respectively compared with that of cream without azone.CONCLUSION:The percutaneous permeability of neostigmine cream is satisfactory and the best concentration of azone in enhancing permeation seems to be5%.