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OBJECTIVE：To investigate the effects of integrated su pervision mode by doctors ，pharmacists and nurses on the whole-process implementation of therapeutic drug monitoring （TDM）. METHODS ：The patients monitored with TDM in our hospital admitted from Jan. to Dec. 2018 were selected as control group ，treated with the traditional drug supervision mode （i.e. the work of doctors ，nurses and pharmacists was relatively independent ）. Treatment group was composed of inpatients monitored with TDM from Jan. to Dec. 2019，treated with the integrated supervision mode of doctors ，nurses and pharmacists （i.e. doctors ，nurses and pharmacists cooperated with each other ，taking the patients and sample as the center ，pharmacists as the key link formulated the implementation standards of each link ，and clarified their respective responsibilities ）. The concentration compliance rate ，the incidence of incorrect samples ，critical value notification rate ，clinical satisfaction ，drug recommendation feedback and adoption ， compliance rates of 6 kinds of monitored drugs （sodium valproate ，digoxin，tacrolimus，cyclosporin，methotrexate，vancomycin） were compared between two groups. RESULTS ：The overall compliance rate ，critical value notification rate and clinical satisfaction rate of the observation group were respectively 64.57％，99.39％ and 97.22％，which were significantly higher than 57.86％， 96.80％ and 92.22％ of control group （P＜0.05）. The incidence of incorrect samples in observation group was 0.72％，which was significantly lower than 3.09％ of control group （P＜0.001）. The feedback rate of individual pharmacists （89.19％），the feedback rate of doctors （80.50％）and the adoption rate of medication suggestions （69.98％）in the observation group were significantly higher than control group （50.34％ ，71.46％ and 55.36％ ，P＜0.001）. The compliance rate of tacrolimus concentration in observation group was slightly lower than control group （73.40％ vs 75.77％，P＞0.05）. The concentration compliance rate of other 5 varieties was higher than control group ，and the differences of valproate sodium ，digoxin and vancomycin concentrations between two groups were statistically significant （P＜0.05）. CONCLUSIONS ：The implementation of integrated doctors ，nurses and pharmacists supervision mode in TDM can effectively improve the drug concentration compliance rate ，realize the . dynamic supervision and feedback of individualized drug use ， which is conducive to ensure the safety of clinical medication.
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Objective:To optimize the water extraction process of traditional Chinese medicine ( TMC) Qubai granule. Methods:The orthogonal test was used to study four influencing factors including water amount, soaking time, extraction time and extraction times with dry extract yielding rate and the content of ferulic acid as the evaluation indices. Results:The optimum extraction process was as follows:A2 B1 C2 D2 , namely adding 10-fold amount of water, without soaking in advance, extracting twice with 2 h for each time. Con-clusion:The process is simple, stable and reproducible, which provides basis for the industrial production.
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Objective:To study the anti-inflammatory activity of total alkaloids from Solanum lyratum.Methods:Human umbili-cal vein endothelial cells ( HUVECs) were cultured and induced by H 2 O2 (200 μmol· L-1 ) , and RAW 264.7 cells were cultured and induced by lipopolysaccharide ( LPS ) .The two inflammatory cell models were randomly divided into the normal group , model group, positive control group, and total alkaloids group respectively at low , medium and high dose.After the treatment, the cells were continued to be cultured , and CCK-8 method was applied to observe the cell survival rate .SD rats were randomly divided into the nor-mal group, model group, positive control group, total alkaloid group respectively at low, medium and high dose,and then the rats re-ceived subplantar injection of carrageenan in the paw .After the treatment , inflammation was analyzed by the swelling degree of acute ankle joint injury, and the contents of prostaglandin E2 (PGE2) and cyclooxygenase-2 (cox2-) were detected.Results:The effect of total alkaloids from Solanum lyratum at medium dose on H 2O 2-induced HUVECs and that of total alkaloids from Sola num lyratum at high dose on LPS-stimulated macrophages were similar to that of the positive control group without statistical significance (P>0.05), and the total alkaloids from Solanum lyratum at medium and high dose could significantly reduce the swelling degree of the acute ankle model in rats (P<0.01), and decrease the content of PGE2 in the toe exudate of rats and that of COX-2 in serum (P<0.01) with statistical significance when compared with that in the model group (P<0.01).Conclusion:The total alkaloids from Solanum lyra-tum have significant anti-inflammatory activity , and it is necessary to further study the efficacy and action mechanisms .
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Objective:To optimize the alcohol precipitation technology of Qingmai granules. Methods:The relative density of liq-uor,the concentration and time of alcohol precipitation were chosen as the factors,the yield of dry extract and content of diosgenin as the indices,the alcohol precipitation technology was optimized by orthogonal test. Results:The optimal alcohol precipitation technology was as follows:the extraction liquid was concentrated till the relative density was 1. 13-1. 18 g·ml-1 ,ethanol was added until the concen-tration was up to 60% with the alcohol precipitation time of 24h. Conclusion:The optimized technology is stable,reasonable and feasi-ble,which can provide experimental basis for the clinical application of Qingmai granules.
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Objective:To study the optimum extraction conditions for Yaotong granules. Methods:An orthogonal test was adopted to optimize the percolation extraction process of total alkaloids by orthogonal experiment with the yield of dry extract and total extraction rate of tetrandrine and fangchinoline as the indices. Results:The optimal extraction conditions were as follows:the medicinal materials were soaked with crude powder in 60% ethanol for 48h,then percolated at the rate of 2 ml·min-1 ·kg-1 . Conclusion:The extraction technology for Yaotong granules is simple and rapid with stable results,which can provide theoretical basis for the production of Yaotong granules.