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Objective:To investigate the application effect of kangaroo mother care on anxiety and parenting stress in premature mothers during hospitalization.Methods:From January to December 2018, 230 premature mothers were admitted to the neonatal intensive care unit of Ningxia Medical University General Hospital.They were randomly divided into the intervention group( n=114) and the control group( n=116). The premature infants in control group only implemented routine developmental support care.The premature infants in the intervention group was on the basis of routine developmental support care, 2 hours per day of kangaroo mother care was performed from the 2nd day incharge to discharge.Parental Stress Scale: Neonatal Intensive Care Unit and Parenting Stress Index-Short Form was performed using the 2nd day and the 14th day of hospitalization, and the two groups of premature mothers were evaluated for anxiety and parenting stress. Results:There were no significant differences in the scores of PSS: NICU((3.65±0.91) vs (3.63±0.91)) and PSI-SF((90.32±8.95) vs (90.12±7.17))(both P>0.05) between the two groups on the 2nd day of hospitalization (before intervention). On the 14th day of hospitalization (after intervention), the total scores ((2.57±0.80) vs (3.47±0.93))and each dimension scores of PSS: NICU in the intervention group were lower than those in the control group (first part (2.41±0.78) vs (3.81±0.73), second part (2.61±0.71) vs (3.14±0.83), third part (2.75±0.86) vs (3.57±1.06), fourth part(2.49±0.80) vs (3.35±0.94))( P<0.01). In addition, the total score of PSI-SF((79.09±8.02) vs (89.46±8.74)), parenting Distress((32.32±9.48) vs (37.15±9.67)), Parent-Child Dysfunctional Interaction((24.26±5.07) vs (27.34±5.26)), and Difficult Child scores((22.51±4.88) vs (24.97±5.05)) in the intervention group were lower than those in the control group( P<0.01). Conclusion:Kangaroo mother care can reduce the anxiety of premature mothers during hospitalization and help relieve the parenting stress of premature mothers.
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OBJECTIVE： To investigate and evaluate perioperative medication in elective surgery elderly patients， and to provide reference for perioperative medication management of clinical pharmacists for elderly patients. METHODS： Totally 210 elective surgery elderly patients were selected from Beijing Tsinghua Chang Gung Hospital during Oct. 2015 to Oct. 2016. Pharmacists carried out drug reconstitution， obtained information about their diseases and medication， analyzed and evaluated perioperative medication （indication， usage and dosage， interaction， drug selection， if these drugs should be stopped before surgery） according to Optimal Guidelines for Preoperative Evaluation of Elderly Patients so as to put forward related medication suggestions. RESULTS： Among 210 patients， there were 132 males （62.86％） and 78 females （37.14％） with an average age of （69.96±7.67） years； 43.81％ of patients had more than 3 kinds of diseases， and 13.33％ of patients suffered from more than 5 kinds of diseases； 31.43％ of patients took more than 5 kinds of drug for long term before surgery； 38.10％ patients had more than 2 drug-induced risks； The preoperative medication of 110 patients （52.38％） included drugs that should be avoided before surgery （such as antiplatelet aggregation agents）， 23 patients （10.95％） had potentially inappropriate medication （such as proton pump inhibitors）， 12 patients （5.71％） should use drugs （such as aspirin） cautiously， 35 patients （16.67％） should use drugs （β receptor blocker） continuously during perioperative period. The pharmacists provided 177 times of medication suggestions such as stopping some medications for patients and physicians through medication reconciliation and preoperative medication evaluation （71 times for patients， 106 times for physicians）； the final adoption rates were 100％ and 95.28％， respectively. CONCLUSIONS： The elderly patients have many preoperative complications， various risk factors， multiple medications， so it is vital for their preoperative medication management. The medication reconciliation is an effective way to evaluate preoperative medication in elderly patients， preoperative medication evaluation and analysis in elderly patients is of great significance to ensure the safety of clinical medication.
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Objective To explore the types and drug resistance of pathogens in patients with type Ⅰ incision surgical site infection in orthopedics department.Methods Patients with type Ⅰ incision surgical site infection in orthopedics department at Peking University Third Hospital from January 2005 to December 2013 were retrospectively collected.Clinical characteristics of patients,distribution and drug resistance of pathogens were analyzed.Results A total of 58.2 thousands patients with type Ⅰ incision surgical site were hospitalized from January 2005 to December 2013 in orthopedics department,and among them 442 patients had infection in the type Ⅰ incision surgical site.The infection rate was 0.8％.Infection was mainly observed in elderly patients.The most common diseases were lumbar canal stenosis (21.7％),cervical spondylosis (20.6％) and lumbar intervertebral disc herniation (14.0％).A total of 453 pathogenic strains were detected,of which 52.9％ were gram-positive bacteria,45.5％ were gramnegative bacteria and 1.6 ％ were fungi.The common pathogens were Staphylococcus aureus (25.2 ％),Staphylococcus epidermidis (14.1 ％),Escherichia coli (11.5 ％),Enterobacter cloacae (7.3 ％),Pseudomonas aeruginosa (6.2 ％) and Acinetobacter baumannii (6.0 ％).The percentage of Meticillinresistant Staphylococcus aureus (MRSA) was 23.7％ and the percentage of Meticillin-resistant Staphylococcus epidermidis (MRSE) was 43.8％.Vancomycin or linezolid-resistant Staphylococcus aureus or Staphylococcus epidermidis were not detected.Proportion of extended-spectrum beta-lactamases (ESBL) producing strains in Escherichia coli was 53.8％,and proportion of ESBL-producing strains in Klebesiella pneumonia was 50.0％.The resistance rates to impenem and meropenem of the three different species in Enterobacteriaceae,including Escherichia coli,Enterobacter cloacae and Klebsiella pneumonia,were 0.Resistance rates of Pseudomonas aeruginosa to cefoperazone-sulbactam,piperacillin-tazobactam were less than 10 ％.Resistance rate of Acinetobacter baumannii to minocyline was 11.1％ and resistance rates of it to other drugs were more than 20％.Conclusions The rate of type Ⅰ incision surgical site infection in orthopedics department is low.Gram-positive and gram-negative bacteria each account for half of the pathogens.The proportion of resistant pathogens is high and empirical treatment is needed to cover these pathogens.
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OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for patient with multiple pulmonary in-fection after renal transplantation. METHODS:Clinical pharmacists participated in drug therapy for a patient with multiple pulmo-nary infection after renal transplantation,and assisted physicians to formulate primary therapy plan:ganciclovir 250 mg,ivgtt,q12 h+ Cefoperazone sodium and sulbactam sodium 3 g,ivgtt,bid+ methylprednisolone 80 mg,ivgtt,qd+ Compound sulfamethoxazole tablet,2 piece,po,qd+Ciclosporin soft capsule 75 mg,po,q12 h+Sodium bicarbonate tablet 1 g,po,qd+Nifedipine controlled release tablet 30 mg,po,qd+Famotidine tablet 20 mg,po,bid. The dose of ganciclovir was adjusted twice because of complica-tion cytomegaloviral pneumonia;the dose of ganciclovir was adjusted twice because of complication pneumocystis pneumonia. Pre-vention and disposal of ADR,patient education were also conducted. RESULTS:Physicians adopted the suggestion of clinical phar-macists;the pulmonary infection had been controlled,and the patient was discharged from hospital. CONCLUSIONS:Clinical pharmacists identify the breakthrough point to promote rational drug use,indicating the value of pharmaceutical care in the clinical treatment.
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Objective To investigate the efficacy and safety of warfarin anticoagulation in Chinese elderly patients based on vitamin K epoxide reductase complex 1 (VKORC1) and cytochrome P450 2C9 (CYP2C9) genetic polymorphisms.Methods Clinical data of 41 elderly patients with initial anticoagulation therapy in our emergency department and respiratory department were collected.Patients were divided into observation group (n=20,patients treated with warfarin based on genetic polymorphisms) and control group (n =21,patients treated based on clinical experience).The international normalized ratio (INR),the time of INR stabilized within target range (2.0-3.0) and the incidence of bleeding episodes in 6-month follow up were compared between groups.Results INR within target range at day 3,4,5 and 7 were 0.0％,42.1％,52.6％,68.4％ in observation group and 0.0％,10.0％,25.0％,35.0％ in control group,respectively.There were significant differences in INR within target range at day 4,7 between the two groups (both P＜0.05),while no significant difference was found in INR within target range at day 5 (P＞0.05).The time of INR stabilized within target range was shorter in observation group than in control group [(9.5±2.4) d vs.(12.3± 4.8) d,P＜0.05].Bleeding complication occurred in 3 patients in observation group and 5 patients in control group,and there was no significant difference between the two groups.Conclusions Warfarin therapy based on VKORC1 and CYP2C9 gene polymorphisms may shorten the time of first INR reaching the target value and INR within target range in elderly patients.However,the risk of bleeding complications should be alerted.
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Exogenous gonadotropins are widely used in controlled ovarian stimulation (COH) for patients undergoing in-vitro fertilization (IVF),because of the effect of follicle maturation and ovulation.Except for environmental factors such as age and ovarian reserve,genetic variability seems also to be a key factor in determining the ovarian response to the exogenous gonadotropins.In this review, the reason for the interindividual difference in ovarian resoponse as well as the influence of the genetic polymorphisms of FSHR and ESR on COH and IVF outcome has been summarized.
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OBJECTIVE:To provide a pharmaceutical care model for the practice of patient-centered clinical pharmacy so as to ensure safe,effective and economical clinical medication.METHODS:The concept,desired therapeutic outcomes and the treatment method of hypertension after renal transplantation were expounded;the issue of the key points in pharmaceutical care were decided,and immunosuppressive agents and antihypertensive drugs were administered and the pharmaceutical care plan was made based on patients’ conditions.The therapeutic outcomes were evaluated;the patients were educated to elevate their compliances.RESULTS & CONCLUSION:It is feasible to provide clinical pharmacists with an effective pharmaceutical care mode and method so as to provide better services for patients,doctors and nurses.
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OBJECTIVE To study the expression of CSE1L gene sifted from the whole genome expression profiling in the aRNA from homogenous human nasopharyngeal carcinoma (NPC) and non-NPC biopsy tissue samples using semi-quantitative RT-PCR (sqRT-PCR). METHODS CSE1L gene was sifted from the whole genome expression profiling from homogenous NPC and non-NPC biopsy tissue samples. RNA later RNA Stabilization Reagent was used to preserve the tissue samples harvested from the nasopharynx of NPC and non-NPC patients. The samples were microdissected to get the homogenous tissue cells and then the total RNA was isolated from them. The antisense RNA (aRNA) was amplified from the total RNA by “in vitro transcription” (IVT). CSE1L gene expression in the homogenous tumor cells of NPC and the pure epithelial pillar cells of normal nasopharyngeal tissue was investigated by sqRT-PCR. RESULTS The high quality total RNA could be harvested from the microdissected homogenous tissue cells, and then the sufficient aRNA was amplified from it. The expression of CSE1L gene was identified using these aRNA by sqRT-PCR. There were significantdifference between the average expression value of CSE1L in NPC tissue (1.740?1.105) and in non-NPC tissue (0.618?0.183; df=30, t=3.159, P=0.004). The expression of CSE1L gene in the whole expression profiling were 1.056?0.296 in NPC tissue and 0.465?0.835 in non-NPC tissue respectively (df=16, t=4.317, P=0.001) . CONCLUSION The whole genome expression profiling with sqRT-PCR could be used to sift the marker genes from biopsy tissue samples. CSE1L may be as a candidate oncogene in NPC.
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OBJECTIVE: To evaluate three therapeutic schemes for sudden deafness with cost-effectiveness analysis for guiding rational use of drugs. METHODS:Using pharmacoeconomic cost-effectiveness analysis to evaluate 61 patients with 62ears of sudden deafness treated by Salvia Miltiorrhiza(groups A), Salvia Miltiorrhiza and cerebroprotein hydrolysate(groups B) or cerebroprotein hydrolysate(groups C) . RESULTS: The effective rates of three groups were 73.9%, 75.0% and 80.0% respectively without significant difference among them(P ＞ 0.05) . The average drug costs for one patient in three groups were 617.89 yuan, 2 651.29 yuan and 2 647.99 yuan respectively. The costs for 1% increase of effective rate in three groups were 8.36 yuan, 35.35 yuan and 33.10 yuan respectively. CONCLUSION: Salvia Miltiorrhiza scheme is the most rational one for sudden deafness.
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Objective To investigate the incidence of the newborn's clavicle fracture,the high risk factors related to the fracture,and the possible methods to prevent and treat the fracture. Methods Forty-four newborns with fractured clavicles in our department from Sept.1994 to Dec. 1997 were analysed retrospectively.Results There were 44 newborns suffered from clavicle frac- ture in 3 135 vaginal deliveries with an incidence of 1.4%.Thirty-four cases(77.26%,34/44)were diagnosed immediately after delivery or before discharge from the hospital.The risk factors for clav- icular fracture include:high birth weight,forceps delivery,shoulder dystocia,and prolonged second stage of labor and persistent occipital transverse or posterior.However,41%(18/44)of cases had no high risk factors.The right clavicle is more likely to be affected,which may be due to the fact that the anterior shoulder was over-pressed as the infant descended through the pelvic outlet under the symphysis pubis.Conclusions Newborn's clavicle fracture is one of the common injuries in vagi- nal delivery.Close attention should be paid during delivery when any of the above mentioned high risk factor is presented,and careful examination of the newborn can not be neglected.
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Object\ To provide a basis for the further development, proper utilization and formulation of a standard for the medicinal materials Methods\ By macro and microscopic studies in combination with physicochemical identification The possible therapeutic value of other parts of the plant was briefly discussed Results\ Four obvious distinctive features were observed: ① Stem tuber showed a curved kidney like shaped ② Parenchymatous cells were polygonal shaped and densely packed together with limited intercellular spaces ③ Rich in compound starch grains, and ④ Crystalline calcium oxalate Clusters can be seen. The tubers had an absorbance peak in UV specturm at ? 241 nm , but its adventitious root was devoid of such absorbance peak Conclusion\ The distinctive features are clear and can be mastered easily The adventitious roots must be discarded when the tubers were used as medicine
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Objective: To study the inclusion effect and rules of azalea oil (rhododendron anthopogonoides marxim) and ? cyclodextrin(? CYD) in different proportion. Methods: An optimal condition for the preparation of the azalea oil ? CYD was established by orthogonal test. Results: The optimal condition was that stiring, 30 ?C , 30min, ? CYD:oil=8g∶1mL Conclusion: This optimized process is simple, stable and efficient.
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OBJECTIVE: To discuss the mode of delivering pharmaceutical care to asthmatic patients.METHODS: Individualized pharmaceutical care plan was established for asthmatic patients by taking into consideration of the advancement in asthma therapy,and the main contents of the pharmaceutical care for asthmatic patients were introduced.RESULTS & CONCLUSION: By providing pharmaceutical care to asthmatic patients,the treatment related problems are able to be identified in time,and the serious consequence can be avoided and the incidence of asthma attack can be kept under control.
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Aim To evaluate retrospectively the effect of genetic polymorphisms in CYP3A4 and CYP3A5 on cyclosporine pharmacokinetics during the early period in renal transplant patients.Methods Polymerase chain reaction-restriction fragment length polymorphism was performed to genotype for CYP3A4*18B and CYP3A5*3.Cyclosporine whole blood levels were measured by fluorescence polarization immunoassay.Results The frequencies of CYP3A4*18B and CYP3A5*3 variant alleles were 0.235(95 CI:0.235~ 0.241)and 0.770(95 CI:0.767~0.773),respectively in 63 of renal transplantation patients, and these alleles exhibited incomplete linkage disequilibrium. The median (range) value of cyclosporine dose adjusted blood trough concentrations (C0/D) and C0 in CYP3A4*1/*1 genotype patients was higher than that in CYP3A4*1/*18B and CYP3A*18B/*18B patients, the same result was found in CYP3A5 expression (CYP3A5*3/*1 and CYP3A5*1/*3) (P
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Cyclosporine is an immunosuppressive drug largely used in organ transplantation.It is characterized by a narrow therapeutic index and wide interindividual variability in its pharmacokinetics. Cyclosporine is metabolized primarily by CYP3A4 and CYP3A5 in the liver and small intestine and also substrate for P-gp, encoded by MDR1. The interindividual heterogeneity in enzymatic activity of small intestine and liver CYP3A4 and CYP3A5, and intestine P-gp have contributed to oral cyclosporine pharmacokinetics in kidney, heart,liver and lung transplant patients. The differences in enzymatic activity of CYP3A and P-gp are believed to be due to CYP3A4, CYP3A5 and MDR1 genetic mutation. Therefore, a investigation which the effect of sequence variants in gene encoding drug-metabolizing enzymes and drug transporter to cyclosporine disposition may lead to individualized drug dosing and improved therapeutics.
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Multidrug resistance is a common form of drug resistance of tumors and one main reason for chemotherapy′s failure and recrudescence of acute leukemia. In recent years,substantial studies addressed the different aspects about MDR1,including MDR1 genetic polymorphism,mRNA/protein expression as well as the function of its coding protein (P-gp).This paper reviewed recent advances about the relation between MDR1 genetic polymorphism and acute leukemia prognosis with the aim to improve acute leukemia curing and chemotherapy outcome evaluating in China.