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OBJECTIVE To explore the role of clinical pharmacists participating in the standardized perioperative nutritional management process for pancreaticoduodenectomy （PD） on improving postoperative recovery in patients. METHODS The clinical data of 100 patients undergoing PD in the Department of Biliary and Pancreatic Surgery， Drum Tower Hospital Affiliated to Nanjing University School of Medicine from November 2019 to February 2021 were analyzed retrospectively. According to the different perioperative nutrition management plans， they were divided into clinical pharmacist intervention group （n＝51， clinical pharmacists intervened according to the standardized nutrition management process） and control group （n＝49， clinical pharmacists only performed preoperative nutrition evaluation， and clinical physicians took nutrition support according to the patient’s condition）. The differences in postoperative recovery index， economic evaluation index， hospitalization length， postoperative complications， and postoperative enteral nutrition support route were compared between 2 groups. RESULTS The time of postoperative diet， the first postoperative ventilation， the first postoperative defecation， and postoperative drainage time of abdominal drain were significantly earlier in the clinical pharmacist intervention group than in the control group （P＜0.05）； the hospitalization cost， medication cost， nutritional support cost， parenteral nutrition cost， albumin preparation cost， and the length of postoperative hospitalization were significantly lower/shorter in the clinical pharmacist intervention group than in the control group （P＜0.05）； there was no statistically significant difference in the incidence of postoperative complications between the two groups （P＞0.05）； there was statistically significant difference in the perioperative enteral nutrition support pathways between two groups （P＜0.05）. CONCLUSIONS Clinical pharmacists’ participation in perioperative nutritional management for PD can significantly reduce hospitalization costs and nutritional support costs， improve patients’ perioperative nutritional status， and shorten hospital stays. wanglina668@163.com
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With the acceleration of China′s economic and social development and aging process, the construction of the pharmacist team was increasingly valued.By combing and analyzing the status of pharmacist allocation in Japanese medical institutions, the path of pharmacist career development, and the content of pharmaceutical services and the training mode, the author proposed that China should learn from relevant mature experience to further strengthen the allocation of pharmacists in medical institutions, improve the Professional certification system of clinical pharmacists, establish a standardized pharmacist training mode, so as to provide a reference for building a standardized, professional and sustainable team of pharmacists in medical institutions.
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Objective:To analyze the worldwide development status and frontier hotspots in the field of critical care nutrition in recent 10 years, and to inform domestic future research direction.Methods:Publications on critical care nutrition researches between January 1, 2012 and December 31, 2021 were retrieved from Web of Science core database. CiteSpace and VOSviewer were used for visual analysis.Results:After screening, a total of 2,467 articles were included, with an overall increasing trend in the number of publications. A total of 11,301 authors devoted to critical care nutrition researches, among whom Daren K. Heyland (81) published the most globally and Academician Jieshou Li (9) published the most in China. The United States (812), China (221) and Canada (206) were the top 3 countries concerning numbers of publications in this field. The main research institutions were Harvard University, Queen's University and University of Leuven while Nanjing University ranked the highest domestically. Journal of Parenteral and Enteral Nutrition, Nutrition in Clinical Practice and Clinical Nutrition were the three most active journals in this field. Cluster analysis of keywords identified 11 representative cluster labels. Global focuses in critical care nutrition were influence of malnutrition, nutritional treatment pattern and energy and protein supplementation. Special interests were in the nutrition therapy in newborns, obese population and sepsis patients as well as intestinal microbial flora and coronavirus disease 2019.Conclusions:Critical care nutrition research is still under rapid development. Close collaboration between domestic core research circles and institutions should be emphasized while promoting international interactions. Researches on key issues such as energy and protein supplementation should be encouraged, so as to provide stronger evidence for better diagnosis and treatment standards in critical care nutrition.
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OBJECTIVE To analyze the research status and development trends of the use of sacubitril/valsartan. METHODS Related literature about the use of sacubitril/valsartan were retrieved from CNKI and the core database of Web of Science. CiteSpace 5.8.R3 software was used to analyze authors， countries/areas， institutions and keywords. RESULTS & CONCLUSIONS Totally 1 193 Chinese literature and 1 060 English literature were included. The number of literature increased， with numerous literature covering the United States （429）， the United Kingdom （185） and China （184）. ZHANG Jing （5） and Solomon S D （118） published the highest number of Chinese and English articles. The authors of Chinese literature had less cooperation while the authors of English literature were in close contact. Dept. of Cardiology in the First Affiliated Hospital of Zhengzhou University （9）， Dept. of Cardiology in the Affiliated Hospital of Xuzhou Medical University （9） and Novartis AG （134） had the highest quantity of publications of Chinese and English literature. The institutions of Chinese literature had a small number of overall publications and less cooperation while the institutions of English literature were closely connected. The clinical efficacy of sacubitril/valsartan for heart failure， hypertension and their complications were research hotspots in Chinese and English literature. Chinese scholars and research teams need to strengthen cooperation and communication in the future， as well as conduct research from the perspectives of sacubitril/valsartan in the treatment of heart failure， hypertension and related complication， the improvement of oxidative stress， and the evaluation of the efficacy of combination therapy with dapagliflozin.
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OBJECTIVE To evaluate the clinical effectiveness and safety of domestic generic and imported original clopidogrel for antiplatelet therapy in patients with acute coronary syndrome （ACS）. METHODS The clinical data of ACS patients in Nanjing Drum Tower Hospital of China Pharmaceutical University from January 2020 to June 2021 were retrospectively collected by using electronic medical record system， and the patients were divided into original drug group （321 cases） and generic drug group （328 cases） according to the drug use. Both groups were given dual antiplatelet therapy with clopidogrel and aspirin. The effectiveness and safety outcomes of the two groups were followed up for 12 months and compared， the related influential factors were analyzed. RESULTS Major adverse cardiovascular events （MACE） occurred in 16 and 22 patients in original drug group and generic drug group respectively， including nonfatal myocardial infarction （4 and 5 cases）， stroke （2 and 4 cases）， revascularization （8 and 3 cases）， cardiovascular related death （2 and 4 cases）， and all-cause death （4 and 6 cases）. There were 12 and 7 patients with major bleeding events， 38 and 29 patients with minor bleeding events， and 33 and 21 patients with non-bleeding adverse events. There was no statistically significant difference in the cumulative incidence of related events （P values of Log-Rank tests were all greater than 0.05）. Cox regression analysis showed that the use of generic clopidogrel did not increase the risk of MACE and major bleeding events in ACS patients [hazard ratio of 1.305 and 0.416， 95% confidence interval of （0.678， 2.512） and （0.155， 1.117）， respectively， P＞0.05]， and the combination of proton pump inhibitors （PPI） could reduce the risk of major bleeding events [hazard ratio of 0.196， 95% confidence interval of （0.063， 0.611）， P＜0.05]. CONCLUSIONS Compared with imported original drug， domestic generic clopidogrel has similar clinical effectiveness and good safety. Combined use of PPI may be a beneficial factor to reduce the occurrence of major bleeding events in patients.
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Objective:This study aimed to determinate ten phenols (polydatin, resveratrol, rhein, emodin, chrysophanol, physcion, oxyresveratrol, 2,3,5,4'-tetera-hydroxystilbene-2-O-β-D-glucoside, (＋)-catechin and (-)-epicatechin) in Polygoni Cuspidati Rhizoma simultaneously based on the high-resolution multiple reaction monitoring (MRMHR) mode of ultra- performance liquid chromatography- quadrupole/time-of-flight mass spectrometry. Methods:The assay was performed on Waters ACQUITY UPLC BEH C18 (2.1 mm× 100 mm, 1.7 μm) column using acetonitrile-0.1% formic acid as the mobile phase. The flow rate was 0.2 ml/min. The MRMHR mode was adopted for quantification.Results:The analyzed compounds showed good linearity relationships ( r2>0.999). The intra- and inter-batch relative standard deviations were all <5% and the recovery rate was between 96.28%-103.23%. The content of polydatin was the highest, followed by resveratrol and emodin. However, the contents of chrysophanol and oxyresveratrol were relatively low and some batches were unqualified. The contents of analyzed compounds varied significantly among the ten batches. Conclusion:The proposed UPLC-Q/TOF-MS method was successfully established to determinate ten phenols in Polygoni Cuspidati Rhizoma simultaneously, which could provide technical support for the quality evaluation of Polygonum cuspidatum.
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Stent-assisted coil embolization is a common endovascular treatment for ruptured/unruptured intracranial aneurysms. Stent implantation process can damage vascular endothelium, activate platelet and coagulation cascade, and then increase the risk of thrombosis. In order to reduce the risk of postoperative embolism, antiplatelet therapy is required. Among them, aspirin combined with clopidogrel dual antiplatelet therapy is a commonly used strategy. For patients with low response to clopidogrel, tigrelol or cilostazol can be used as an alternative drug. Although the scheme has been considered to be effective and safe, it is still controversial.
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OBJECTIVE To intr oduce multidisciplinary collaborative blood glucose management mode （hereinafter referred as to blood glucose management mode of the whole hospital ）of the whole hospital with the participation of clinical pharmacists ，and to evaluation it effects on the blood glucose management of perioperative diabetes patients. METHODS The process of blood glucose management mode of the whole hospital in Drum Tower Hospital Affiliated to Medical School of Nanjing University and the work content of clinical pharmacists were introduced. Three hundred patients with type 2 diabetes mellitus who underwent elective surgery were included and randomly divided into general consultation group （control group ）and hospital-wide glucose management group （intervention group ）. The effect of glucose management and indicators such as preoperative waiting time and total length of stay were compared between 2 groups. RESULTS In the blood glucose management team of the whole hospital ，the physicians，clinical pharmacists and nurses of blood glucose management in endocrinology department were the core members ，and the management process was divided into initial management ，daily management ，discharge management and follow-up. As the team secretary ，the clinical pharmacists were mainly responsible for daily summarizing and managing the blood glucose level and special conditions of patients ，regularly evaluating the management effect ，carrying out pharmaceutical ward rounds ，medical order review， pharmaceutical care ， timely assessing the blood glucose of patients and guiding the rational use of drugs. Compared with before intervention ， after 3 days ofintervention，the levels of fasting plasma glucose （FPG）and postprandial blood glucose （PBG） were decreased significantly in 2 groups（P＜0.05）；intervention group was significantly lower than control group （P＜0.05）. Compared with control group ， the fluctuation of blood glucose in intervention group was significantly reduced （P＜0.05），standard deviation of blood glucose had reached the targeted control level ， and the postprandial glucose excursion and the largest amplitude of glycemic excursion were close to the targeted control level ；the rate of bl ood glucose reaching the standard before operation and at discharge were significantly increased （P＜0.05）；the preoperative waiting time and hospitalization days were significantly shortened （P＜0.05）. CONCLUSIONS The multidisciplinary collaborative blood glucose management mode of the whole hospital with the participation of clinical pharmacists can control the blood glucose level of diabetic patients in the perioperative period more stably and effectively ，and has practical significance for the disease treatment and prognosis of patients.
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Objective To evaluate the effects of antihypertensive drugs on renal function after percutaneous transluminal coronary angioplasty. Methods A retrospective analysis was performed on 193 patients who underwent percutaneous transluminal coronary angioplasty and took antihypertensive drugs regularly. Those patients were admitted to Nanjing Drum Tower Hospital during January 2020 to December 2020. The patients were divided into ACEI/ARB group, β-blockers, calcium channel blockers and hydration control group. All patients received routine hydration during the perioperative period. The changes of serum creatinine (Scr), blood urea nitrogen (BUN), estimated glomerular filtration rate(eGFR) and endogenous creatinine clearance rate (Ccr) before and after operation were compared. Results The incidence of CIN was 0% in four groups. Compared with the preoperative, there was no significant change in Scr and Ccr in every group. Except for the hydration control group, the BUN levels in three treated groups were reduced after postoperative. Specifically, the BUN reduction in β-blockers group has statistically significant difference compared to the hydration control group and CCB group. In addition, eGFR levels were significantly reduced in the β-blockers group. Preoperative Scr and Ccr levels in patients with high blood pressure (SBP≥140 or DBP≥90) were significantly different from the patients with normal blood pressure (SBP<140 and DBP<90). Conclusion The use of ACEI/ARB and CCB before percutaneous transluminal coronary angioplasty had no effect on renal function in the short term. β-blockers can slightly reduce renal function, especially in patients with high blood pressure, who should receive special attention.
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Objective:To investigate the distribution of blood concentration of cyclosporine (CsA) in patients with autoimmune disease in China, and analyze the effect of genetic polymorphisms of CsA-metabolizing enzymes, transporters and target enzymes on CsA levels.Methods:Steady-state trough blood concentrations (CsA C 0) of 193 patients' were detected by enzyme multiplied immunoassay technique. The genotype of the following sites in the included patients were sequenced by reverse transcription-polymerase chain reaction (RT-PCR): cytochrome P450 (CYP) 3A420230C>T, CYP3A56986A>G, ATP binding cassette subfamily B member 1 (ABCB1)1236C>T, ABCB12677G>T/A, ABCB13435C>T, cytochrome P450 oxidoreductase (POR) 1508 C>T and formyl peptide receptor 1 (FPR1) C>G were sequenced by RT-PCR. The influence of the gene polymorphism of the above-mentioned sites on the blood concentration of CsA was analyzed by using One-way analysis of variance (ANOVA), LSD- t test, Chi-square test. Results:One hundred and ninety-three patients included took CsA. The doses ranged from 75-200 mg/d and the patients' blood concentration distribution span was wide (33.0-313.8 ng/ml). The daily dose ( χ2=21.908, P=0.001) and age( F=4.262, P=0.006) had significant effect on the plasma concentration of CsA. ABCB12677G>T/A (rs2032582) gene polymorphism impacted on the unit dose of CsA C 0 (CsA C 0/d), CsA C 0/d [(0.81±0.42) ng·ml -1·mg -1] in wild type (GG) was higher than heterozygous mutant [GT/GA, (0.65±0.30) ng·ml -1·mg -1, P=0.023) and homozygous mutant (TT/AA/TA, (0.66±0.34) ng·ml -1·mg -1, P=0.039). Conclusion:The blood concentration of patients varies greatly among individuals. The Cold of CsA in wild type patients with ABCB12677G>T/A gene is signifficantly higher than that in mutant patients.
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Rett syndrome (RTT) is a progressive neurodevelopmental disorder, mainly caused by mutations in MeCP2 and currently with no cure. We report here that neurons from R106W MeCP2 RTT human iPSCs as well as human embryonic stem cells after MeCP2 knockdown exhibit consistent and long-lasting impairment in maturation as indicated by impaired action potentials and passive membrane properties as well as reduced soma size and spine density. Moreover, RTT-inherent defects in neuronal maturation could be pan-neuronal and occurred in neurons with both dorsal and ventral forebrain features. Knockdown of MeCP2 led to more severe neuronal deficits as compared to RTT iPSC-derived neurons, which appeared to retain partial function. Strikingly, consistent deficits in nuclear size, dendritic complexity and circuitry-dependent spontaneous postsynaptic currents could only be observed in MeCP2 knockdown neurons but not RTT iPSC-derived neurons. Both neuron-intrinsic and circuitry-dependent deficits of MeCP2-deficient neurons could be fully or partially rescued by re-expression of wild type or T158M MeCP2, strengthening the dosage dependency of MeCP2 on disease phenotypes and also the partial function of the mutant. Our findings thus reveal stable neuronal maturation deficits and unexpectedly, graded sensitivities of neuron-inherent and neural transmission phenotypes towards the extent of MeCP2 deficiency, which is informative for future therapeutic development.
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Objective:To conduct a meta-analysis of clinical data to investigate the relationship between incretins and fracture in order to provide individualized hypoglycemic agents for type 2 diabetic patients with osteoporosis.Methods:PubMed, Embase, Web of Science, and Cochrane databases were searched up to January 1, 2018 for randomized controlled trials(RCTs)and the relationship between incretins and fracture was explored by meta-analysis.Results:The meta-analysis showed that the use of incretin was not associated with fracture risk compared with placebo or other positive hypoglycemic agents( OR 0.972, 95% CI 0.876-1.079). But in the subgroup analysis, 100 mg/d sitagliptin( OR 0.495, 95% CI 0.304-0.806)or 1.8 mg/d liraglutide( OR 0.621, 95% CI 0.413-0.933)reduced fracture risk. Conclusions:Meta-analysis shows no increase in the incidence of fracture events after the use of incretin. 100 mg/d sitagliptin or 1.8 mg/d liraglutide may exert protective effects on bone metabolism. However, the included data are from the reports of fracture adverse reactions in RCT studies, and large-scale clinical studies are needed to confirm these findings.
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Objective:To determine the concentration of hydroxychloroquine (HCQ) and its active metabolite deethylhydroxychloroquine (DHCQ) in breast milk of lactating patients with autoimmune disease. To observe the safety of hydroxychloroquine in lactation period, and to explore the factors that may affect HCQ and DHCQ concentration in the milk.Methods:Lactating patients with autoimmune disease who have taken HCQ for at least 6 months were included in our study. A new high performance liquid chromatography (HPLC) method was established to detect HCQ and DHCQ levels in breast milk. Milk samples were collected at different time points: before taking the drug (0 hours), and 2 hours, 4 hours, 6 hours after taking the drug. In addition, the genotype of cytochrome CYP3A4*1G, CYP3A5*3 and CYP2D6*10 which were related to HCQ metabolism were tested by dideoxy chain termination method. Visual acuity, hearing and growth status of the patients' infants were followed up on a regular basis. T-test, one-way ANOVA and Pearson's test were used for data analysis. Results:In 15 patients, the average concentration of HCQ and DHCQ in the milk of patients taking 200 mg/d were (520±261) ng/ml and (177±112) ng/ml, respectively. While the average concentration of HCQ and DHCQ in the milk of patients taking 400 mg/d were (1 036±374) ng/ml and (397±271) ng/ml, respectively. The peak of HCQ level for 11 patients was at 4 hour after taking the drug, while the others' were at 2 hour. The breast-fed infants did not show any abnormal symptoms of hearing, vision and growth. However, cytochrome gene polymorphism did not affect the peak of HCQ and DHCQ.Conclusion:The concentration of HCQ and DHCQ in breast milk is positively correlated to the dosage. The peak level of HCQ milk is 4 hours after taking the drug. The levels of HCQ and DHCQ at 6 hours are similar as those in the whole blood. It is suggested that patients who take HCQ can feed 4 hours after taking the drug to reduce the HCQ and its active metabolites being absorbed by infants. However, the impact of HCQ on infant safety and gene polymorphism of CYP on milk concentration among individuals needs to be further verified in large sample studies and long-term follow-up.
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The mammalian central nervous system (CNS) is considered an immune privileged system as it is separated from the periphery by the blood brain barrier (BBB). Yet, immune functions have been postulated to heavily influence the functional state of the CNS, especially after injury or during neurodegeneration. There is controversy regarding whether adaptive immune responses are beneficial or detrimental to CNS injury repair. In this study, we utilized immunocompromised SCID mice and subjected them to spinal cord injury (SCI). We analyzed motor function, electrophysiology, histochemistry, and performed unbiased RNA-sequencing. SCID mice displayed improved CNS functional recovery compared to WT mice after SCI. Weighted gene-coexpression network analysis (WGCNA) of spinal cord transcriptomes revealed that SCID mice had reduced expression of immune function-related genes and heightened expression of neural transmission-related genes after SCI, which was confirmed by immunohistochemical analysis and was consistent with better functional recovery. Transcriptomic analyses also indicated heightened expression of neurotransmission-related genes before injury in SCID mice, suggesting that a steady state of immune-deficiency potentially led to CNS hyper-connectivity. Consequently, SCID mice without injury demonstrated worse performance in Morris water maze test. Taken together, not only reduced inflammation after injury but also dampened steady-state immune function without injury heightened the neurotransmission program, resulting in better or worse behavioral outcomes respectively. This study revealed the intricate relationship between immune and nervous systems, raising the possibility for therapeutic manipulation of neural function via immune modulation.
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Objective To investigate the use of parenteral nutrition preparations in Jiangsu Province,and to provide reference for the standardized management of parenteral nutrition preparations.Methods 720 cases using parenteral nutrition preparations from January 2017 to June 2017 in the department of general surgery of 12 hospitals in Jiangsu province were selected.The rate of nutritional risk screening,the indications of parenteral nutrition,the way of infusion,the rationality and economy of the prescriptions were retrospectively evaluated.The calorie,amino acid content,non-protein calorie/nitrogen ratio,glycolipid ratio and cation concentration of the patients received total parenteral nutrition were calculated.Results The total costs of parenteral nutrition preparations of 720 cases were 1.614 1 millions,and 346 cases did not have the indications for parenteral nutrition.The results of prescription comment showed that only 16 patients were screened for nutritional risk by Nutritional Risk Screening 2002 tool at admission.544 cases were intravenous dripped with amino acid and fat emulsion from peripheral vein.In the 176 total parenteral nutrition prescriptions,there were 39 non-protein calorie/nitrogen ratio cases,15 glycolipid ratio cases,69 cation concentration cases,61 calorie cases and 32 amino acid content cases failing to comply with the recommendation of the guidelines.Only 31 total parenteral nutrition prescriptions were completely reasonable.Conclusion The costs of parenteral nutrition preparations used in hospitals of Jiangsu are high but the rate of rationality is low.Nutrition support team should be established to regulate the use of parenteral nutrition preparations and save medical resources.
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@#Adverse drug reaction(ADR)reports are acting as primary sources for post-marketing drug safety evaluation, which have important reference value for drug safety evaluation. In this article, bidirectional gated recurrent unit, a kind of deep learning method, was applied as the model for relation extraction of drugs and adverse reactions in free-text section of ADR descriptions in Chinese ADR reports, with attention as well as character embedding and word segmentation embedding added into the network. The experimental results showed that our model achieved good performance in the classification task of confirming the relationship of “Drug-ADR” pair(denial, likely, direct and post-therapy)in the ADR description, and the final model achieved an F-value of 87. 52%. The extracted information can assist in evaluating ADR reports and at the same time be utilized in tasks like statistical analysis of certain drugs and adverse events and ADR knowledge base construction to provide more research techniques for drug safety researches.
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OBJECTIVE： To construct prediction model for initial dose of levothyroxine （L-T4） in differentiated thyroid cancer （DTC） patients after surgery. METHODS： A total of 100 DTC patients underwent surgery were selected from thyroid and breast surgery department in Nanjing Drum Tower Hospital. General information of patients such as gender， age， height， body mass， body mass index （BMI） and regular follow-up information after discharge were collected. Related data of thyroid function and adjusted dose of L-T4 were recorded. Single factor variance analysis and t-test were used to analyze the predictors that had significant correlation with the initial dose of L-T4. The prediction model of L-T4 initial dose was established by linear regression analysis， and was verified by prospective experiments. RESULTS： The initial dose of L-T4 in DTC post-surgery patients were significantly correlated with age （P＝0.01，F＝3.993）， body weight （P＜0.001，F＝6.910） and BMI （P＜0.001，F＝7.698）. Linear regression analysis showed that prediction model of initial dose of L-T4 was L-T4（μg/kg）＝2.971-0.033×BMI-0.005×age. DTC post-operative patients were given L-T4 empirically， and only 16％ （16/100） of the patients met the criteriaat the first follow-up of thyroicl function. In the validation test， L-T4 was given at the initial dose calculated by the prediction model， and 63.7％ （44/69） of the patients reached the standard at the first follow-up. CONCLUSIONS： The established prediction model of L-T4 initial dose after DTC surgery has a certain practicality.
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Objective:To observe the effect of clinical pharmacists on the pain education in the patients with fracture. Methods:A total of 122 fracture patients with ASAⅠ/Ⅱaged 18-80 years were randomly divided into the intervention group (n=61) and the control group(n=61). The control group received the conventional orthopedic treatment..Flurbiprofen was injected for the postopera-tive analgesia,and if the pain VAS score was above 6,pethidine solution was given at the dose of 50 mg immediately. Based on the conventional treatment,the patients in the intervention group were educated by clinical pharmacist one day before the surgery,and then strengthened education was given after the surgery.The pain VAS score,and sleeping quality at 6h,24h,48h and 72h and satisfaction of pain management were compared between the groups.Results:The VAS score of the intervention group was significantly lower than that of the control group at 6 h,24 h,48 h and 72 h after the operation (P<0.05). The scores of sleeping quality in the intervention group at 6 h and 24 h after the operation were higher than those in the control group (P<0.05). The scores of patients' satisfaction were significantly higher in the intervention group than those of the control group (P<0.05). Conclusion: The clinical pharmacist's pain education can improve the degree of pain control and sleeping quality,increase the patients' satisfaction with pain control to a cer-tain extent.
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Objective To analyze the effect of leukotriene receptor antagonist on anti-inflammation and immune function in asthmatic patients .Methods 86 cases of asthma patients in our hospital from August to December 2014 were taken as the research objects ,they were randomly divided into the observation group with 43 cases and the control group with 43 cases ,the control group was treated with conventional therapy plus Seretide ,the observation group was given leukotriene receptor antago-nist-montelukast based on the control group ,two groups were treated for 14 d .The changes of inflammatory factors and im-mune function ,therapeutic effect ,adverse reaction were compared between the two groups after treatment .In the observation group after the treatment ,the IL-6 ,TNF-αand CRP were lower than that in the control group ,the difference was statistically significant (P<0 .05) .In the observation group after the treatment ,CD4+ and CD4+ /CD8+ were higher than that in the con-trol group ,CD8+ was lower than that in the control group ,the difference was statistically significant (P<0 .05) .After the treatment in the observation group ,the ACT score was higher than that in the control group ,the total effective rate was higher than that in the control group ,the difference was statistically significant (P<0 .05) .There was no obvious adverse reaction in the two groups .Conclusion Leukotriene antagonist (montelukast) could play an important role in improving the immune func-tion and anti-inflammation in asthma patients ,which might be an important mechanism to improve the therapeutic effect of asthma .
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Objective To explore the factors resulting in poor medication compliance in patients with cerebral infarction and study the effect of medication education by pharmacist on the compliance of patients .Methods 128 patients with cerebral infarction recurrence from January to June of 2016 were selected .Patient′s medication history and knowledge were evaluated . The compliance was compared before medication education ,3 days and 30 days after medication education .Results Only 36.7% of the patients took drugs every day before hospitalization .The patient′s medication knowledge was limited .The poor compliance was related to the absence of medication education .The compliance was improved significantly after medication edu-cation .Conclusion Pharmacists play an important role in patient′s care .Pharmacists should take responsibility in medication education to improve medication compliance and reduce the recurrence of cerebral infarction .