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OBJECTIVE:To evaluate the effects of clinical pharmacists'intervention on prophylactic use of antibiotics in re-moval of internal fixation device for fracture. METHODS:Totally 117 patients underwent removal of internal fixation device for fracture were selected from some on third grade class A hospital during Mar.-Jul. 2015 as pre-intervention group. Totally of 266 pa-tients underwent removal of internal fixation device for fracture were selected during Aug. 2015-May 2016 as post-intervention group. Clinical pharmacists performed interventions based on Rationality Evaluation Criteria for Prophylactic Use of Antibiotics in Removal of Internal Fixation Device for Fracture. The prophylactic use of antibiotics was compared between 2 groups before and af-ter intervention. RESULTS:No unreasonable single dose or additional drug during surgery was found before and after intervention. After intervention,utilization rate of antibiotics for prophylactic use,the proportion of patients receiving antibiotics without indica-tions,the proportion of medication duration more than 24 h decreased from 84.6%,71.8%,48.7% to 17.3%,9.8%,4.9%,re-spectively. Average antibiotics cost,the proportion of total drug cost in hospitalization cost,the proportion of antibiotics cost in to-tal drug cost were all decreased significantly compared to before intervention,with statistical significance(P0.05). CONCLUSIONS:Clinical pharmacists'interventions significantly reduce the utilization rate of antibiotics for pro-phylactic use in patients underwent removal of internal fixation device for fracture,improve drug use without indications and ratio-nality of prophylactic use of antibiotics. There still are problems,such as unreasonable medication timing,continuous use time of more than 24 h,etc. It is necessary to continuous follow-up intervention.
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OBJECTIVE:To study anti-inflammatory,analgesic and anti-fatigue effects of polysaccharides from Acanthopanan trifoliatus (ATMP) in rats and mice. METHODS:In hot plate experiment,150 mice were randomly divided into normal control group (constant volume of normal saline),aspirin group [200 mg/(kg·d)],and ATMP high-dose,medium-dose and low-dose groups [400,200,100 mg(gross polysaccharide)/(kg·d)];the threshold of pain was determined,and analgesic effect of ATMP was investigated. 150 mice were included in exhaustive swimming test and then randomly divided into normal control group(con-stant volume of normal saline),Chongcao yangshen jijing group [400 mg/(kg·d)by total saponins],and ATMP high-dose,medi-um-dose and low-dose groups [200,100,50 mg(gross polysaccharide)/(kg·d)];the body weight and exhaustive swimming time of mice were determined,and biochemical process was used to determine the contents of hepatic glycogen and muscle glycogen, and serum levels of BUN,LDH and CK in mice. The anti-fatigue effect of ATMP was investigated. In carrageenan-induced paw swelling experiment,40 rats were divided into normal control group (constant volume of normal saline),dexamethasone acetate group [5 mg/(kg·d)],ATMP high-dose,medium-dose and low-dose groups [100,50,25 mg(gross polysaccharide)/(kg·d)];the degree of paw swelling was recorded,and anti-inflammatory of ATMP was investigated. RESULTS:Compared with normal control group,the threshold of pain in mice were increased in ATMP 400,200,100 mg(gross polysaccharide)/(kg·d)groups;the exhaus-tive swimming time of mice were prolonged significantly,and the contents of hepatic glycogen in mice were increased significant-ly,while serum contents of CK decreased in ATMP 200,100 mg(gross polysaccharide)/(kg·d)groups;the content of muscle gly-cogen in mice was increased significantly in ATMP 200 mg (gross polysaccharide)/(kg·d) group,while serum contents of BUN and LDH were decreased;the degree of paw swelling in rats was decreased in ATMP 100,50,25 mg(gross polysaccharide)/(kg·d) groups,with statistical significance (P<0.01 or P<0.05). There was no significant difference in body weight of mice before and after medication. CONCLUSIONS:ATMP has significant analgesic and anti-fatigue effects on mice and anti-inflammatory effect on rats.
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Objective To investigate MR findings and analyze the misdiagnosed cases of pituitary macroadenoma.Methods MR features of 1 90 patients of pituitary macroadenoma confirmed by operation and pathology were reviewed.Results 1 6 cases were mis-diagnosed as craniopharyngioma,chordoma,or meningioma.Among the sixteen cases,eight cases with cyst degeneration and hemor-rhage were misdiagnosed as craniopharyngioma;five cases with clival and sphenoid sinus destruction were misdiagnosed as chordo-mas;three cases with suprasellar and anterior cranial fossa extension were misdiagnosed as meningiomas.Conclusion Craniophar-yngioma,chordoma and meningioma should be considered in the differential diagnosis of atypical pituitary macroadenoma.The com-prehensive analysis should be based on a variety of signs.
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Objective To explore the value of pretargeting technology in vitro MRI of L5 peptide guided streptavidin-conjugated and polyethylene glycol modification protected ultra-small superparamagnetic iron oxide(SA-PEG-USPIO) to hepatocellular carcinoma(HCC) via glypican-3(GPC3) receptor.Methods Direct immumofluorescence assay with carboxyfluorescein(FAM) labeled L5 and competitive inhibition was performed in HepG2 and HL-7702 cells.Imaging was obtained from fluorescent microscope.Immunoassay fluorescence images were carried out to determine the expression of GPC3 in HepG2 cell.PEG-USPIO conjugated with streptavidin was made by carbodiimide reaction,and the hydrodynamic diameters,Zeta potential and magnetic relaxivity of SA-PEG-USPIO and PEG-USPIO were measured.HL7702 cells were used for evaluate cells viability of SA-PEG-USPIO and PEG-USPIO.HepG2 and HL-7702 cells were used as experimental and control group respectively.Each of the two cell lines were further divided into three groups:L5-BT united SA-PEG-USPIO group,SA-PEG-USPIO group and control group.Prussian blue staining and MRI was preformed to observe the targeting efficacy of SA-PEG-USPIO respectively,and normalized T2 signal was recorded.The significant changes of normalized T2 signal intensity among groups was deterumine by using One-way analysis of variance.Results There were much more fluorescences on the membrane and cytoplasm of HepG2 cells than those on HL-7702 cells and cells of competition group.And indirect immunofluorescence images show the obvious expression of GPC3 in HepG2 cell.The SA-PEG-USPIO and PEG-USPIO nanoparticles had hydrodynamic diameters of (22.73 ± 3.31) and (35.97±5.19)nm,Zeta potential of them were (4.22±0.53) and (-7.91± 1.22)mV and magnetic relaxivity were 0.139 4× 103 and 0.103 9 × 103 mM-1s1.Although the highest concentration of SA-PEG-USPIO and PEG-USPIO was 2.4 mmol/L,cells viability was greater than 80％.The most iron particle was observed in L5-BT united SA-PEG-USPIO group of HepG2 cells.In vitro MR,the normalized T2 signal intensity of HepG2 cells in L5-BT united SA-PEG-USPIO group,SA-PEG-USPIO group and control group were 39±7,77 ± 12 and 93 ± 4.There was significant difference among those three groups (F=23.96,P＜0.01).The normalized T2 signal intensity of HL-7702 cells in each of three groups were 69± 11,78±8 and 95±5.There was no significant difference among those three groups (F=2.86,P＞0.05).Conclusion By the pretargeting method,L5 peptide guided SA-PEG-USPIO has effective targeting ability to HepG2 cells in vitro.