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Objective: This study conducted a survey of the status of medicine adoption and appropriate use in hospitals. We compared the findings with 2015 survey results to evaluate the changes over time. We also evaluated the impact of changes in the current health care environment, including local community collaboration and the COVID-19 pandemic.Methods: The survey included 500 randomly selected hospitals with more than 200 beds, over 50% of which are general ward beds, as well as 175 hospitals that were randomly selected from the respondents of the 2015 survey. The survey questionnaire included the number of medicines, availability of medication lists, adoption decisions, and impacts of local collaboration efforts and the COVID-19 pandemic on drug adoption and appropriate use.Results: A total of 260 responses were collected from 675 hospitals (39% response rate). Of the 260 respondents, 90 were regional medical care support hospitals, 23 were special functioning hospitals, 143 were general hospitals other than those specified, and 4 were other hospital types. The average number of adopted medicines was 644 for oral medicines, 234 for topical medicines, and 228 for injectable medicines. Ninety-five percent of the hospitals used package inserts or interview forms when adopting medicines, but 15% used original articles. About 36% of the hospitals used standardized methods (hospital formulary management or protocol-based pharmacotherapy management), indicating a lack of pharmacists with pharmaceutical evaluation skills. As for local community collaboration regarding adopted medicines, the most common example was providing information to community pharmacists’ associations, and the most common method was sending information by e-mail, regardless of the hospital type. Regional collaboration meetings were few. The COVID-19 pandemic changed the method of obtaining drug information from pharmaceutical companies.Conclusion: For hospital pharmacists, the selection of adopted medicines is one of the tasks of pharmaceutical management. There are urgent needs for the use of standardized methods and the training of pharmacists involved in the selection of adopted medicines. The establishment of a system to provide appropriate use of medicine to patients by standardizing the method of medicine adoption and information sharing is desirable.
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Patients who initiated peritoneal dialysis (PD) in Sichuan Provincial People's Hospital from January 1, 2001 to December 31, 2013 were enrolled in the single center and retrospective study. Clinical and laboratory data were collected to analyze the long-term survival rates, technique survival rates and associated influencing factors. Patients were followed up until December 31, 2021 or endpoints occurred (death or stopping PD treatment). Kaplan-Meier survival curves were used to estimate survival rates and technique survival rates. Cox proportional hazards regression model was used to analyze the risk factors of death and technique failure in PD patients. A total of 373 patients were enrolled in the study, with age of (52.1±15.8) years old and 199 (53.4%) males. During the follow-up, 154 (41.3%) patients died, 72 (19.3%) patients transferred to hemodialysis, and 40 (10.7%) patients received kidney transplant. Kaplan-Meier survival curves revealed that overall survival rates of PD patients at 1, 3, 5, 7, and 10 years were 92.2%, 76.6%, 66.0%, 52.4% and 38.6%, respectively. Technique survival rates were 93.5%, 84.8%, 74.2%, 62.8% and 44.5% at 1, 3, 5, 7, and 10 years, respectively. Multivariate Cox regression model results showed that age ( HR=1.055, 95% CI 1.039-1.073, P<0.001), transfer from hemodialysis ( HR=2.212, 95% CI 1.514-3.231, P<0.001), episodes of peritonitis ( HR=2.141, 95% CI 1.194-3.837, P=0.011), Charlson comorbidity index ( HR=1.525, 95% CI 1.305-1.783, P<0.001), and baseline albumin ( HR=0.951, 95% CI 0.925-0.978, P<0.001) were independent influencing factors of survival in PD patients. Episodes of peritonitis ( HR=2.327, 95% CI 1.274-4.250, P=0.006) and Charlson comorbidity index ( HR=1.244, 95% CI 1.035-1.496, P=0.020) were independent influencing factors of technique survival in PD patients. PD patients have good early survival rates and technical survival rates, but long-term outcomes need to be further improved. Peritonitis is a major risk factor for low long-term survival rates and technical survival rates in PD patients.
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Objective To analyze the relationship between the level of 25 (OH )D and mortality in maintenance hemodialysis (M HD) patients .Methods This study was a prospective cohort study .We enrolled 156 M HD patients of Sichuan people′s hospital dialysis center in July of 2010 .The patients were divided into three groups according to the level of 25(OH)D .The three groups were normal(25(OH)D>30 ng/mL) ,insufficient(15 ng/mL<25(OH)D≤30 ng/mL) and deficient(25(OH)D≤15 ng/mL) re‐spectively .All the patients were follow‐up 40 months ;the end point was all‐cause and cardiovascular death .Results After follow‐up 40 months ,there were 26 deaths (16 .7% ) and 13 cardiovascular deaths among the 156 cases .There were 15 deaths (30 .6% ) in in‐sufficient group ,among which there were nine cardiovascular deaths ;there were eight deaths (11 .6% ) in deficient group ,among which there were three cardiovascular deaths ;there were three deaths (7 .9% ) in normal group ,among which there was one cardio‐vascular death .There was statistically significance either between all‐cause and cardiovascular mortality of deficient and normal group or between deficient and insufficient group (P<0 .05) .The Kaplan‐Meier curve analysis showed 25(OH)D≤15 ng/mL was the independent risk factor of the all‐cause and cardiovascular mortality(P<0 .05) .Cox regression showed 25(OH)D≤15 ng/mL was the independent risk factor of the all‐cause mortality in crude analysis (RR=4 .43 ,95% CI:1 .28-15 .32 ,P<0 .05) and adjus‐ted analysis (RR=4 .92 ,95% CI 1 .23-19 .66 ,P<0 .05) .Cox regression showed 25(OH)D≤15 ng/mL was the risk factor of the cardiovascular mortality in crude analysis(RR=8 .12 ,95% CI:1 .04 -64 .15 ,P=0 .047) .Conclusion 25(OH)D≤15 ng/mL was the risk factor and predictor of the all‐cause and cardiovascular mortality in M HD patients .
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Objective To study the association of serum L-kynurenine changes with nutritional status and vascular stiffness in maintenance hemodialysis (MHD) patients. Methods Twenty gender- and age-matched healthy volunteers (healthy group) and 40 MHD patients,including 20 cases with α-keto aicd(α-keto acid group)and 20 cases without α-keto aicd(non-α-keto acid group)were enrolled in the study.Serum L-kynurenine was measured by high performance liquid chromatography.C-reactive protein (CRP)and interleukin 6 (IL-6)were detected.Subjective global assessment(SGA)and malnutrition inflammation score(MIS)were applied to evaluate the nutritional status.Pulse wave velocity(PWV)was used to evaluate arterial stiffness for both groups of MHD patients. Results Serum L-kynurenine was significantly higher in MHD patients than that in healthy subjects[(3.20±1.12)μmol/L vs (1.74±0.27)μmol/L,P0.05].IL-6 was significantly higher in MHD patients as compared to healthy subjects[(6.45±3.78)ng/L vs(1.38±1.59)ng/L,P<0.01],while such difference was found between α-keto aicd group and non-α-keto aicd group[(3.37±0.82)ng/L vs (9.62±2.48)ng/L,P<0.051.There was no difference of CRP concentration between two MHD groups.As compared to non-α-keto acid group,higher SGA score(26.00±1.75 vs 22.67±2.61,P=0.001),lower MIS score(5.82±2.27 vs 10.00±2.62,P=0.002),lower left side PWV[(21.11±8.21)m/s vs(24.57±5.45)m/s,P=0.244]and lower right side PWV[(19.27±3.22)m/s vs (24.19±5.41)m/s,P=0.015]were observed in α-keto aicd group.Pearson analysis showed positive correlation between serum L-kynurenine and IL-6(r=0.352,P=0.011)and negative correlation between L-kynurenine and pre-dialysis Scr(r=-0.412,P=0.019). Conclusions Inflammation is common in MHD patients.Tryptophan degeneration product L-kynurenine may indicate inflammation status.α-keto acid improves nutritional status,anemia and arterial stiffness maybe through the alleviation of inflammation in MHD patients.
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<p><b>OBJECTIVE</b>To investigate the quality and quantity changes of Flos Lonicerace during flowering stages in Hanzhong GAP base in order for properly harvesting and quality control.</p><p><b>METHOD</b>The yield index of Flos lonicerace in four flowering stages was determined, and the contents of chlorogenic acid and the total flavonoid in the samples were determined by HPLC and the colorimetry, respectively. The volatile oils were extracted by the SFE-CO2 and the constituents were analyzed by GC-MS.</p><p><b>RESULT</b>The yield in the first two flowering times was attributed to about more than 80% of total yield, and the number of flower buds for each plant in the first time was almost the same as the sum of the other three times. The drying rate of the three-site green flowers kept the highest during the first flowering time, and the drying rate of the two-site white flowers kept the highest during the second flowering time. The contents of chlorogenic acid and the total flavonoid in the first flowering time were higher than those in the second, and among them, the two-site white flowers kept the highest, about 3.5% and 13.2%, respectively. For the sample flowers in in the second flowering time, the three-site green flowers kept the highest level of chlorogenic acid and the total flavonoid, about 2.7% and 11.6%, respectively. From the volatile oil samples in the five periods of Flos lonicerace in the first flowering time, 19 components were identified by GC-MS. They were composed by three types of compounds, n-diolefines, fatty acids and steroids. Nonacosane and hentriacontane had the relatively higher amount with more than 40% and 20%, respectively. The relative contents of vitamine E were higher too, about 8.15% - 10.43%. And, gamma-5-sitostene-3-ol, stigmasta-5,2-diene-3-ol and campesterol were also detected. Among these steroids, the relative contents of the first two were 4.90% - 6.9%, 1.06%- 4.10%, respectively.</p><p><b>CONCLUSION</b>The flowering samples in the first two times were attributed to the most to the total yield. The samples of the two-site white flower and the whole-white flower had the higher comprehensive quality. The components of vitamine E and the steroids in the volatile oil need to be paid more attention.</p>
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Biomass , Flowers , Chemistry , Lonicera , Chemistry , Oils, Volatile , SeasonsABSTRACT
The changes of several oncogenes and suppressor genes in the specimens of cancerous and juxtacancerous tissues of 42 cases of gastric cancer were studied with Southern blot hybridization and PCR-RELP method.The probes used were c-Ha-ras,K-ras,N-ras,N-myc,c-myc,hst,EGFR,c-erbB-2,p53 and Rb.Amplification,rearrangement,and deletion of c-Ha-ras were detected in 8/33 (25.8%) cases of gastric cancer (amplification or rearrangement of hst and c-erbB-2 in 11/42 (26.6%) and 12/42 (29.2%) cases respectively (amplification of EGFR in 21.4% of cas-esideletion or rearrangement of p53 and Rb in S/30 (30%) and 2/15 (13%) cases respectively) and amplification or rearrangement of N-ras (0/33),K-ras (1/26),N-myc (1/26),and c-myc (1/ 35) was only rarely encounted.The point mutation in codon 248 and 249 of p53 in gastric cancer was analyzed.2 cases of the 42 harbored point mutation in codon 248 of p53.These findings suggest that e-Ha-ras,hst,c-erbB-2,EGFR and p53 may be the hot point genes in the occurrence and development of gastric cancer.
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The amplification,rearrangement and deletion of c-Ha-ras,K-ras and N-ras were studied in 33 cases of gastric cancerous and juxtacancerous tissues.It was found that the amplification rearangement,and deletion of c-Ha-ras were shown in 25.8% (8/33) of cases and the ampli-cation of K-ras in 3.8% (1/26).No such changes was found for N-ras.
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It is known that no restriction endonuclease cleavage site exists at 12 codon in N-ras gene and at 12 and 13 codon in K-ras gene.Amismatched base was incorporated at the 3' end primer to creat a kind of restriction endonuclease cleavage site.Then it was possible for us to analyze the point mutation of the above mentioned codons with the polymerase chain reaction-restriction fragment length polymorphism.In this paper,the study of the point mutation at 12 and 61 codon in c-Ha-ras,at 12 codon in N-ras,and at 12 and 13 codon in K-ras was reported.
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The intragastric changes especially the changes of nitrite level after the cimetidine treatment with or without concomitant administration of vitamin C were studied in 34 patients with peptic ulcer. The pH value, nitrite level, and bacterial count of the gastrie juice after cimetidine treatment were significantly higher than those prior to the treatment (P0.05). Besides,the reduction of BAO,PAO,and MAO was not influenced by vitamin C intake. It is believed that vitamin C can reduce the nitrite concentration which was elevated by cimetidine treatment, but it will not affect the acid-inhibitory function of cumetidine. This fact is of importance for the safe application of cimetidine
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The deletion and rearrangement of p53 and Rb genes were studied in gastric cancer with Southern blot hybridization and the point mutation in 248 and 249 codons of p53 was studied with PCR-RFLP.It was found that deletion or rearrangement of p53 was seen in 9 cases out of 30 cases of gastric cancer and point mutation at 248 codon of p53 in 2 cases out of 42 cases,and deletion and rearrangement of Rb gene were seen in 2 cases out of 15 cases.