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OBJECTIVE:To compare the efficacy and safety of dabigatran and warfarin respectively used in atrial fibrillation patients after radiofrequency ablation(RFCA). METHODS:Data of 141 nonvalvular atrial fibrillation patients,who scheduled for RFCA,were retrospectively analyzed and divided into warfarin group(71 cases)and dabigatran group(70 cases)by different med-ication. Patients in warfarin group should stop warfarin if they took before,then changed to Low molecular weight heparin calcium injection 100 U/kg,subcutaneous injection,taking RFCA when INR was lower than 1.5,stopping low molecular weight heparin 12 h before surgery;Low molecular weight heparin calcium injection 100 U/kg was intravenously injected when surgery;orally tak-ing Warfarin sodium tablet 4.5 mg after 4-6 h,once a day,meanwhile bridged overlapping treated at least 3-5 d with low molecu-lar weight heparin;monitoring once INR every 3 d after surgery,maintaining INR 2.0-3.0,taking warfalin at least 3 months. Pa-tients in dabigatran group stopped taking the anticoagulant drugs when admission,then changed to Dabigatran etexilate capsule 110 mg(age≥70 years old or body mass0.05). CONCLUSIONS:Dabigatran has similar anticoagulant efficacy and safety with warfarin in atrial fibrillation pa-tients after RFCA.
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Objective:To evaluate the effectiveness and safety of anticoagulant therapy with rivaroxaban in atrial fibrillation( AF) pa-tients after radiofrequency catheter ablation( RFCA) . Methods:A retrospective analysis was performed in the study. Totally 141 AF pa-tients with RFCA in our hospital were enrolled from January 2014 to October 2015. The patients were divided into rivaroxaban group(70 patients)and warfarin group (71 patients). In rivaroxaban group,rivaroxaban(10 mg, po,qd)was given for at least 3 months after RFCA. In warfarin group,low molecular heparin (100 IU·kg-1,ih) was given before RFCA, and standard dose of warfarin (3-5 mg,po,qd) was given for at least 3 months by adjusting the INR within the range of 2. 0-3. 0 after RFCA as bridging therapy. The death rate, throm-boem bolism events and bleeding events between the groups were evaluated and companed groups. Results: There were no significant differences in baseline characteristics between the groups except the diastolic pressure. There were no significant differences in the death and thromboembolism events(transient cerebral ischemia , ischemic encephalopathy, 2/70 vs 4/71,P>0. 05)between the groups. There were no TIMI major bleeding events in both groups. There were no significant differences in minor bleeding events between the groups (3/70 vs 4/71,P>0. 05). Conclusion: Compared with those of warfarin,the effectiveness and safety of rivaroxaban show the similar effect in AF patients after RFCA. Rivaroxaban can be safely and effectively used in AF patients with low or middle risk of thromboembo-lism after RFCA.
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OBJECTIVE:To explore the effects of short-term application of atorvastatin combined with ezetimibe on efficacy and related indicators of patients with primary nephrotic syndrome with hyperlipidemia. METHODS:Data of 50 patients with prima-ry nephrotic syndrome with hyperlipidemia were retrospectively collected and divided into combination group and control group ac-cording different treatment,25 cases in each group. All patients received low-salt,low-fat ,high-quality protein,giving prednisone 1 mg/(kg·d),po,qd,combined with anticoagulation,diuretic,anti-infection,taking cytotoxic drugs if necessary. Based on it, control group received Atorvastatin calcium tablet 20 mg before going to bed,qd;combination group received Atorvastatin calcium tablet(the same dosage and usage with control group)+Ezetimibe tablet 10 mg,qd. They were treated for 2 weeks. Lipid-lowering efficacy and low-density lipoprotein(LDL-C),triglyceride(TG),cholesterol(TC),high-density lipoprotein(HDL-C),24 h uri-nary protein (M-TP),serum albumin,alanine aminotransferase (ALT),aspartate aminotransferase (AST),serum creatinine and blood urea nitrogen before and after treatment in 2 groups were observed and the incidence of adverse reaction was recorded. RE-SULTS:There was no significant differences in the total effective rate of Lipid-lowering in 2 groups(P>0.05). After treatment, LDL-C,TC and HDL-C in 2 groups were significantly lower than before,Alb in combination group and ALT in 2 groups were sig-nificantly higher than before,with statistical significance(P0.05). And there was no significant difference in the TG,M-TP,AST,serum creatinine and blood urea nitrogen before and after treatment(P>0.05). CONCLUSIONS:Atorvastatin combined with ezetimibe can improve the blood lipid of patients with primary nephrotic syndrome with hyperlipidemia,while showing similar efficacy and safety with atorvastatin alone in a short term.
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Objective:To evaluate the curative effect and safety of fasudil hydrochloride injection in the prevention and treatment of aneurysm postoperative cerebral vasospasm by meta-analysis. Methods: The randomized controlled trials were retrieved from PubMed, EMBASE, Cochrane Library, VIP, Wangfang, CNKI and so on. Meta-analysis was conducted using RevMan 5. 0 software. Results:Totally 418 reference studies were screened, from which 11 ones were chosen including 786 patients in all. In the treatment of cerebral vasospasm (CVS), there was no significant difference between the groups (OR=1. 56, 95%CI:0. 95-2. 58, P>0. 05). While in the prevention of CVS, the incidence rate of CVS in fasudil group was significantly lower than that in nimodipine group ( OR=0. 43, 95%CI:0. 23-0. 81, P=0. 008). However, the incidence rate of ADR in fasudile group was higher than that in nimodipine group (OR=0. 43, 95%CI:0. 25-0. 75,P=0. 003). Conclusion:In the prevention of CVS, fasudil may be better than nimodipine, while the incidence of ADR is higher.
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Objective To establish the quality standard for Yanyan syrup. Methods Thin layer chromatography ( TLC) was used for the qualitative identification of Puerariae Lobatae Radix and Scrophulariae Radix. High performance liquid chromatography (HPLC) was used to determine the content of puerarin on Diamonsil C18(200 mm×4.6 mm,5μm) column with mobile phase consisting of methanol-0.5% acetic acid (25:75) at a flow rate of 1.0 mL?min-1.The detection wavelength was set at 250 nm. Results TLC spots were clear and well-separated without negative interference.The linear range of puerarin was 3-120μg?mL-1( r=0.999 7) with an average recovery of 97.44% ( RSD=2.07%,n=6) . Conclusion The method for quality and quantity of Yanyan syrup is simple, specific, accurate and reliable.It can be used for the quality control of Yanyan syrup.
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Objective To establish a quality standard and in vivo efficacy system for Mingmu Guben granule. Methods Chrysanthemi flos and Lycii fructus were identified by thin layer chromatography(TLC)method. The content of chlorogenic acid in Mingmu Guben granule was determined by HPLC. The Welchrom C18(200 mm×4.6 mm,5μm)column was used. The mobile phase consisted of acetonitrile-0.4%phosphoric acid of water(10∶90,V/V)at a flow rate of 1.0 ml/min. The detection wavelength was at 327 nm under 25℃. The in vivo efficacy of Mingnu Guben granule was measured by cataract,retinal ischemia and renal dysfunction rat model. Results The spots in the were clear. The chlorogenic acid showed a good linear relationship within the range of 2.5-90μg/min(r=0.9998). The average recovery was 96.93%,and the RSD was 2.65%. Moreover,the in vivo efficacy of Mingnu Guben granule was measured. The results indicated that orally taking Mingnu Guben granule prevent rat from cataract,retinal ischemia and renal dysfunc?tion induced by adenine. Conclusion By establishing simple,accurate and repeatable methods and measuring in vivo efficacy,our present work provides a quality control system for Mingmu Guben granule.
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Objective To assess the effectiveness of western routine treatments combined with Tongxinluo capsule for angina pectoris .Methods The randomized controlled trials(RCTs ) of western routine treatments combined with tongxinluo capsule for angina pectoris were collected through searching on computer from the following databases ,CNKI (2000 -2011 ) ,WanFang Data (2000 -2011) ,WeiPu Data(2000-2011) ,PubMed(2000-2011) and manual search relevant journals ,conference papers .Results A total of 11 studies were included and improvement rate of abnormal ECG were estimated in 9 studies and improvement rate of symptoms of angina were estimated in 11 studies .ECG clinical evaluation of the treatment group relative to the control group ,relative risk (RR) value was 1 .40 (95% CI:1 .28‐1 .54) ,P<0 .01 ,symptoms of angina clinical evaluation ,treatment group relative to the control group RR value of 1.25 (95% CI:1 .18‐1 .32) ,P<0 .01 .Only slight gastrointestinal discomfort were found in treatment group .Conclusion Tongxinluo capsule in combination on the basis of conventional western treatment could effectively improve the clinical efficacy and drug safety .
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Objective To evaluate two treatment schemes of liver protection and choose the optimal radiotherapy using phar‐macoeconomics principle and methods .Methods In‐patients who were diagnosed as decompensated cirrhosis patients and simultaneously conformed to the Chlid‐Pugh graduation of level B‐C during 2010-2012 were chosen .The chosen patients were divided into A ,B and C group separately ,and were treated with the compound prescription of dichloro acetic acid two isopropyl amine inoculation fluid ,the poly‐ene phosphatide acid radical choline inoculation fluid ,and the compound prescription dichloro acetic acid two isopropyl amine inoculation fluid and the polyene phosphatide acid radical choline inoculation fluid .Cost effectiveness analysis was done between group B and C .Re‐sults Treatment time of group B and C was (15 .5 ± 8 .55) d and (12 .13 ± 7 .61) d respectively .The total effectiveness was 50% and 60% respectively and the difference was with non‐statistics significance (P>0 .05) .The total cost was (1 640 .52 ± 905 .26) yuan and (2 576 .51 ± 1 615 .99) yuan respectively .Conclusion Group B was the better treatment scheme .
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Objective: To establish the quality standard for Shangtongning capsules. Methods: Microscopic identification was used for the qualitative identification of Bombyx batryticatus, Scorpio, Eupolyphaga steleophada, Pheretima, Notoginseng radix et rhizo-ma and Gastrodiae rhizoma. A TLC method was used for the qualitative identification of Chuanxiong Rhizoma, Angelicae Sinensis Ra-dix, Notoginseng Radix ET Rhizoma, Dipsaci Radix and Glycyrrhizae Radix ET Rhizoma. HPLC was used to determine the content of liquiriti. The determination was performed on an Agilent TC C18 (250 mm × 4. 6 mm,5μm) column with the mobile phase consisting of acetonitrile-water(15:85)at the flow rate of 1. 0 ml·min-1. The detection wavelength was set at 276 nm. Results: The features of the microscopic identification were significantly visible. The TLC spots were clear and well-separated without any negative interference. The linear range of liquiriti was 0. 341-1. 193 μg (r=0. 999 9)with the average recovery of 98. 97%(RSD=0. 77%, n=6). Con-clusion:The method is simple, accurate and reproducible, which is effective in controlling the quality of Shangtongning capsules and provides the basis for improving the quality standard for Shangtongning capsules.
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Objective: To establish the quality standard for Dibu Gengnian 'an granules. Methods: Fructus Schisandrae, Radix Pueaariae, Radix Angelicae Sinensis, Fructus Psoraleae and Radix Glycytthizae in the formula were identified by TLC. The content of puerarin in the formula was determined by HPLC. The determination was performed on a Welchrom C18 (200 mm × 4. 6 mm, 5 μm) column with the mobile phase consisting of methanol-0. 5% glacial acetic acid (25∶75) at the flow rate of 1. 0 ml·min-1 . The detec-tion wavelength was set at 250 nm, and the column temperature was 25℃. Results:The spots in TLC were clear with good separation and specificity. The linearity of the calibration curve was good within the range of 5-120 μg·ml-1 for puerarin (r=0. 999 8). The RSDs of precision, stability and reproducibility tests were all lower than 3%. The average recovery was 99. 09% (RSD=2. 38%, n=6). Conclusion:The method is simple, specific, accurate and reliable. It can be used in the quality control of Dibu Gengnian’an granules.
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OBJECTIVE:To explore the methods of clinical pharmacists providing pharmaceutical care for a patient with N-methyl-D-aspartate receptor(NMDAR)encephalitis complicating with multiple organ infections. METHODS:Taking one clinical case as breakthrough point,the points of pharmaceutical care provided by clinical pharmacists for NMDAR encephalitis complicat-ing with multiple organ infections were analyzed,so as to put forward the suggestions in the field of antibiotics selection,medica-tion approach based on pharmacokinetics,ADR disposal and nutrition support. RESULTS:Clinical pharmacists applied pharmaceuti-cal care to resolve ADR as abnormal liver enzyme timely,and the symptom had been improved gradually. Then the patient was dis-charged from the hospital. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care and screen the possible risk of drug use to avoid the occurrence of severe ADR.
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Objective: To establish the quality standard for compound Heishen pills. Methods: Scrophulariae Radix, Radix et Rhizoma and Belamcancae Rhizoma were identified by TLC. HPLC was used to determine the content of harpagoside and cinnamic acid in Scrophulariae Radix on a Welchrom-C18 column using methanol-acetonitrile-1% ethylic acid (8∶21∶71) as the mobile phase. The flow rate was 1. 0 ml·min-1 . The column temperature was at 30℃ and the detection wavelength was set at 278 nm. Results:The TLC method had good specificity without interference from negative control. The linear range of harpagoside was 1. 32-65. 80μg·ml-1 with the average recovery of 98. 06%(RSD=2. 16%),and that of cinnamic acid was 0. 38-19. 20 μg·ml-1 with the average recovery of 98. 78%(RSD=1. 34%). RSDs of precision, stability and reproductibility tests were all below 2%. Conclusion: The established method is accurate, feasible and reproducible. It can be used in the quality control of compound Heishen pills.
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Objective:To optimize the extraction process of Hegan Lidan granules. Methods:In order to choose the optimal tech-nological parameters, the content of baicalin was determined by HPLC. An orthogonal method was utilized with solvent volume, extrac-tion time and extraction times as the impacting factors and the content of baicalin and extraction rate as the indices. Results:The opti-mal parameters were as follows:using 8-fold water as the solvent, the raw material was extracted three times with 2 h for each. Con-clusion:The process is steady and feasible, and can be used in the extraction of Hegan Lidan granules.
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Objective To explore the pharmaceutical care plan of clinical pharmacist for elderly patients with coronary heart disease and renal insufficiency. Methods To develop the therapeutic schedule in cooperation with clinicians through clinical rounds, in order to offer specific pharmaceutical care and further develop individualized care plan during patient ' s hospitalization. Results Clinical pharmacists paid close attention to the indicators and adjusted administration time when the adverse reactions such as lower blood pressure, leukopenia, and deterioration of renal function occurred, and finally avoided further potential adverse reactions. Conclusion The incidence of adverse drug reactions were reduced, the safety and efficacy of drugs used were guaranteed, which can promote rational and effective use of drugs in clinic. The overall quality of healthcare was improved with pharmacist involvement.
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Objective: To set up an HPLC method for the simultaneous determination of p-hydroxybenzoic acid plus o-hydroxy-benzoic acid and p-hydroxybenzeneacetic acid in Senecio scandens Buch. Methods:The column was a Shiseido( Fine Chemicals) Cap-cell Pak C18 (250 mm × 4. 6 mm, 5 μm) column at the room temperature. The mobile phase was methanol-water-formic acid (13∶87∶0. 5) at a flow rate of 1. 0 ml·min-1 . The detection wavelength was 240nm. Results: p-Hydroxybenzoic acid plus o-hydroxybenzoic acid had a favorable linear relationship within the range of 0. 025-0. 400 mg·ml-1 , the regression equation was Y=5. 94 × 106 X+2.46×104(r=0.9998),theaveragerecoverywas97.59% andRSDwas1.22%. p-Hydroxybenzeneaceticacidhadafavorableline-ar relationship within the range 0.05-0.80 mg·ml-1, the regression equation was Y=4.09 ×106X+1.12 ×104(r=0.999 8), the average recovery was 98. 07% and RSD was 1. 90%. Conclusion:The method is simple, feasible and reproducible. It can be used in the quality control of p-hydroxybenzoic acid plus o-hydroxybenzoic acid and p-hydroxybenzeneacetic acid in Senecio scandens Buch.
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BACKGROUND:Whether determination of tacrolimus blood concentration by different immunoassay methods can influence predictive ability to immunosuppressive effects and toxicity, and whether it can be more sensitive to reflect blood concentration in patients with renal dysfunction are worthy of studying. OBJECTIVE:To analyze the correlation of tacrolimus (FK506) concentrations determined by enzyme-multiplied immunoassay technique (EMIT) and enzyme linked immunosorbent assay (ELISA) in combination with renal function parameters. METHODS:133 clinical blood samples were col ected. EMIT and ELISA techniques were used to determine the FK506 concentration. The correlation of two determination methods were analyzed, combined with renal function. RESULTS AND CONCLUSION:In patients with renal dysfunction, the mean results and standard deviation mensurated by ELISA were higher than those by EMIT. For blood concentration in 5-20μg/L by ELISA, the incidence of renal dysfunction occurred less than by EMIT. The overal mean results of blood concentration for two methods appeared no significant difference (r=0.904 5, P>0.05). When the concentration was less than 2.0μg/L, the concentration results by EMIT were higher than those by ELISA (P0.05). These findings indicate that EMIT and ELISA has good correlation, which are both suitable for clinical routine determination of plasma concentration. It is not recommended for applying EMIT method to determine low blood concentrations (<2.0μg/L). The reference range of concentration should be compartmentalized depending on combination of determination methods and renal function.
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Objective: To discuss the pharmaceutical care experience of clinical pharmacists in the antibacterial agents application in one patient with infection after coronary artery bypass graft ( CABG) . Methods:The clinical pharmacist participated in the treatment of the patient after CABG. According to the relevant laboratory indices and the extent of the infection combined with the vital signs of the patient, the pharmacist formulated and adjusted the anti-infection therapeutic regimen. The therapeutic effects and adverse reactions were observed as well. Results: Safte and high-quality individualized pharmaceutical service was provided to the patient by the pharmaceutical care of the clinical pharmacist in anti-infection treatment. Conclusion:Through the above practice, clinical pharmacists have played a positive role in reasonable using of anti-infective drugs in patients with cardiac surgery.
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OBJECTIVE:To enhance our understanding on drug interactions and promote rational drug use.METHODS:The problems of drug interactions appeared in rational use of traditional Chinese medicines in our hospital were analyzed.RESULTS & CONCLUSION:People in China had a poor cognition on drug interactions in rational use of traditional Chinese medicines,and the drug interactions should be studied from multiple angles,meanwhile,our cognition concept should be changed and the concerned government and medical personal should attach great importance to this matter;clinical pharmacist system should be pushed forward and pharmaceutical service mode should be reconstructed;research on drug interactions should be broadened and research in mechanism of action of drug interactions as well as the interactions between traditional Chinese medicine and western medicines should be strengthened;construction of information should be sped up and database of drug interactions should be set up;propagate education should be emphasized to elevate people's knowledge on medicine etc.
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OBJECTIVE:To analyze the manifestations of hospital irrational drug use.METHODS:By retrieving CNKI full - text data base from 1998 to 2008 with"hospital"and"irrational drug use"as keywords,a total of 23 research papers related to irrational drug use were obtained and which were summarized analytically.RESULTS:The irrational drug use in our hospital manifested predominantly as irrational usage and dosage and unreasonable compatibility of drugs followed by irrational selection of drugs,repeated drug use,non-medical error,and abuse of antibiotics or hormones.CONCLUSION:In view of the above manifestations,it is urgent to take full consideration of the hospital pharmaceutical administration system in China and take multi - sided scientific intervention countermeasures so as to effectively improve the level of rational drug use in our hospital.
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OBJECTIVE:To promote the rational use of drugs in medical institutions and to maximize the health benefits and minimize the harm and cost of drugs.METHODS:The current organizational system of pharmaceutical administration in medical institutions was analyzed and a new type of organizational system of pharmacy administration in medical institutions and the method for its construction were put forward.RESULTS & CONCLUSIONS:Safe,effective,economic and appropriate clinical drug treatment can be achieved by establishing a new type of organization system of pharmacy administration in medical institutions,improving the structure of technical team for health care services,and allowing talented clinical pharmacists to engage in clinical drug treatment,assume responsibilities together with clinicians and nurses for clinical medication outcome and establish a cooperative yet mutually restrictive relationship with clinicians and nurses so that forming a benign pharmaceutical administration mechanism of rational drug use in medical institutions.