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OBJECTIVE：To k now about t he current situation of pre-prescription review in medical institutions in China ，and provide reference for quality improvement of pre-prescription review in medical institutions. METHODS ：Retrieved from PubMed ， the Cochrane library ，EMbase（Ovid platform ），CNKI，CBM，VIP and Wanfang databases ，the studies about pre-prescription review in medical institutions in China were collected during the inception to Mar. 2020. After data extraction of the literatures met the inclusion and exclusion criteria ，descriptive analysis was used. RESULTS ：A total of 38 literatures were included ，involving 29 medical institutions ，of which 25 were third-grade class-A medical institutions （86.21％），22 comprehensive medical institutions （75.86％）；pre-prescription review was carried out from 2007 to 2019. Totally 84.62％ of medical institutions adopted the mode of “systematic review+manual review ”，and the main audited prescriptions were outpatient （emergency）prescriptions（76.00％）. Medical institutions adopting this mode mainly adopted the mode that auditing pharmacists rechecked the problem prescriptions intercepted by the system. The average manual review time of problem prescriptions in 8 medical institutions was within 60 s；the number of auditing pharmacists in 16 reported medical institutions ranged from 1 to 8，and educational degree of auditing pharmacists in 1 reported medical institution were bachelor degree or above. Their professional titles of 6 reported medical institutions were junior or above （83.33％）. Eleven medical institutions had full-time auditing posts （90.91％）. Success rate of problem prescription intervention was 93.99％ ；pre-prescription review could increase the qualification rate of prescription. CONCLUSION：The pre-prescription review in medical institutions in China has achieved certain results ，but still faces some problems，such as imperfect information system ，insufficient ability of auditing pharmacists and poor communication between doctors and pharmacists ，which will be the aspects that should be paid attention to in the future.
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Objective:To investigate the expression and clinical significance of effector T cell (Teff), regulatory T cell (Treg) and their cytokines in patients with vitiligo.Methods:84 patients with vitiligo (38 cases in stable stage, 46 cases in advanced stage) who were admitted to the Dermatology Department of the Dezhou People's Hospital between June 2018 and June 2019 and 30 healthy people (control group) were enrolled in the study. The levels of Teff subsets and Treg cells in peripheral blood were detected by flow cytometry. The levels of Teff subsets and Treg cells-associated cytokines were detected by enzyme-linked immunosorbent assay (ELISA). The relationship between Teff subsets and Treg cells levels in peripheral blood, relationship between Teff subgroups, Treg cells-associated cytokines and course of vitiligo, skin lesion area were analyzed.Results:The levels of T helper cell (Th)17 and Th22 in peripheral blood of vitiligo group were significantly higher than those of control group, while levels of Treg cells were significantly lower than control group ( P<0.05). Compared with the stable vitiligo group, the levels of Th17 and Th22 in peripheral blood were higher and levels of Treg cells were lower in the advanced vitiligo group ( P<0.05). Treg cell level was negatively correlated with Th17 cell level ( r=-0.303, P=0.001), and negatively correlated with Th22 cell level ( r=-0.200, P=0.033). The levels of serum interleukin (IL)-17 and IL-22 in vitiligo group were significantly higher than those in control group, while the level of transforming growth factor-β (TGF-β) was significantly lower than that in control group ( P<0.05). Compared with the stable vitiligo group, levels of serum IL-17 and IL-22 were higher and level of TGF-β was lower in the advanced vitiligo group ( P<0.05). Correlation analysis showed that levels of IL-17 and IL-22 were positively correlated with skin lesion area ( r=0.361, 0.288, P<0.05), and level of TGF-β was negatively correlated with skin lesion area ( r=-0.312, P<0.05). Conclusions:Teff/Treg cells are unbalanced in patients with vitiligo, showing obvious shift to Teff subsets. The progression of vitiligo may be related to Teff subsets and Treg cells-associated cytokines.
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OBJECTIVE:To investigate the basic situation of pharmaceutical staffs and the development of pharmaceutical care in Chongqing primary health care institutions,and to provide references for promoting the development of pharmaceutical work in primary health care institutions. METHODS:A questionnaire survey was conducted to investigate the basic situation of pharmaceutical staffs and the development of pharmaceutical care in primary health care institutions from 38 districts and counties of Chongqing,and the data was analyzed statistically to put forward suggestion. RESULTS:A total of 1147 questionnaires about the general situation of primary health care institutions were sent out,and 813 valid questionnaires were collected,with effective recovery rate of 70.88％. A total of 1972 questionnaires about the general situation of pharmaceutical staffs and the development of pharmaceutical care were sent out,and 1904 valid questionnaires were collected,with effective recovery rate of 96.55％. The average number of pharmaceutical staffs in the community health service center was 4.5(2-14 persons),that of pharmaceutical staffs in township hospitals was 2.5(0-12 persons),accounting for 8.69％ and 8.17％ of professional medical staffs,respectively. Some of respondents were part-time nonprofessionals. The highest educational level of surveyed pharmaceutical staffs was college degree (51.79％),followed by high school degree and secondary school degree (21.64％). The professional titles were mostly assistant pharmacists (34.35％),followed by pharmacists (30.04％). Only 2.73％ of the licensed pharmacist certificates were obtained,and no one obtained the clinical pharmacist training certificate of National Health and Family Planning Commission. In community health service center and township hospital,the higher proportion of the job positions of the pharmacists were in outpatient pharmacy(79.67％ and 81.44％),inpatient pharmacy (32.94％ and 56.57％),TCM pharmacy(27.54％ and 40.85％) and warehouse (22.20％ and 24.05％);the lower proportion of the job positions of the pharmacists were in clinicalpharmacy room(1.40％ and 0),laboratory(0.23％ and 0)and PIVAS(0.23％ and 0). Top 6 pharmaceutical care projects carried out by the community health service center included drug dispensing(100％),out-patient prescription comment(70.00％),ADR monitoring(62.67％),medication consultation(60.67％),antibiotics prescription comment(58.00％),medication education and medication guidance(50.00％);pharmaceutical outpatient service,therapy drug monitoring and pharmacogenomics detection were not developed. The pharmaceutical care projects carried out by township hospital included drug dispensing (100％),ADR monitoring (62.29％),medication consultation (59.73％),medication education and medication guidance (53.85％),outpatient prescription comment (51.58％),and antibiotics prescription comment (45.40％);centralized intravenous pharmacy admixture and administration, pharmaceutical outpatient service, therapy drug monitoring and pharmacogenomics detection were not developed. CONCLUSIONS:The pharmaceutical talents are short in Chongqing primary health care institutions and part-time staffs also have a certain proportion. The overall quality of pharmaceutical staffs is not high,and their professional skills and capabilities are limited. The institutions do not pay enough attention to pharmaceutical care, and the development of pharmaceutical care is not ideal. To promote the development of pharmaceutical care,primary health care institutions should pay more attention to pharmaceutical care,increase the investment of funds in combination with the actual situation,optimize post setting,perfect the construction of institutions,and strengthen the introduction and training of pharmaceutical staffs so as to constantly improve their professional level and pharmaceutical care capabilities,and provide high-quality,safe,humanized and professional pharmaceutical care.
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OBJECTIVE:To explore the role of clinical pharmacists in the clinical nutrition therapy for patients with parenteral nutrition-associated liver dagame (PNALD),and to promote the rational use of nutrition drugs. METHODS:Clinical pharmacists participated in the treatment of a case of PNALD,and suggested adjusting 5% Glucose and sodium chloride injection 500 mL to 0.9% Sodium chloride injection 500 mL,30% Long-chain triglycerides 250 mL to 20% Medium/long chain fatty emulsion 250 mL,8.5% Compound amino acid injection(18 AA)1000 mL to 8% Compound amino acid injection(15 AA)750 mL;addition-ally using 20%Alanyl glutamine injection 100 mL and 10% ω-3 Fish oil fat emulsion injection 100 mL inall in oneparenteral nutrition(PN)formula. The remaining recipes remain unchanged. Reduced glutathione and S-methionine were also adopted for pro-tecting liver and receding jaundice,and the amount of PN was decreased gradually and replaced by enteral nutrition (EN). RE-SULTS:Physicians adopted the suggestions of clinical pharmacists,and liver function of the patient recovered to normal. CON-CLUSIONS:Main factors of PNALD include medication time of PN,types and intake of lipid,over nutrition. Clinical pharmacists provide pharmaceutical care in nutritional treatment for patients,which can assure effective and safe use of nutritional drugs,and reduce the occurrence of complication and ADR.
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In order to cultivate clinical pharmacy undergraduates to have better quality, Chongqing Medical University collaborated with The University of Chicago and University of Cincinnati in the reform of the course of pharmacotherapeutics. We build pharmacotherapeutics series curriculum with the center of disease, construct department of clinical pharmacy for transnational departments, build course leader and teaching team of pharmacotherapeutics series curriculum , compile teaching program and its material of pharmacotherapeutics series curriculum, build pharmacotherapeutics series curriculum and teaching model in line with the current direction of China's education system of clinical pharmacy training, reform teaching methods, and strengthen clinical pharmacy practice and community clinical pharmacy education.
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Clinical internship is for bachelor students to learn how to integrate theories in textbooks with clinical practice.Clinical pharmacist training is for pharmacists to obtain and enforce the capability of rational use of drugs.These two are at the different stages of clinical pharmacist cultivation mode.They are different in teaching nature,goal and students' background.The necessity of clinical internship bridged to clinical pharmacist training is discussed in this paper and after the convergence,the teaching design of chnical internship program bridged to the training is characterized by basic education which focuses on basic theories,knowledge and skills of clinical medicine and clinical pharmacy relevant to a certain common disease.The optimized internship program will work as a good foundation for students to face the challenges of clinical pharmacist training after graduation from school.
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OBJECTIVE:To establish the quality control method for fugankang granules.METHODS:Radix Astragali,Atr actylodes Macrocephala,Pericarpium Citri Reticulatae in fugankang granules were identified by TLC and the content of astra?galoside in fugankang granules was determined by HPLC-ELSD method.RESULTS:Radix Astragali,Atractylodes Macro?cephala,Pericarpium Citri Reticulatae could be identified by TLC;Astragaloside showed good linear relationship within the range of1.306?g～13.060?g(r=0.9997),the average recovery was 97.62%(RSD=1.72%).CONCLUSION:The method is simple,accurate and with good reproducibility,which can be used as quality control for fugankang granules.
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Aim To observe the protective effects and explore the possible mechanism of lycopene on hepatic injury induced by the combining use of isoniazid(INH) and rifampicin(RFP) in rats.Methods Chronic hepatic injury model was induced by INH and RFP.Low dosage,middle dosage and high dosage of lycopene(10,20,30 mg?kg-1 body weight) were given to protect liver injury.The serum level of AST and ALT,liver index,contents of malondialdehyde(MDA),glutathion(GSH) and superoxide dismutase(SOD) in liver were measured.Hepatic pathological changes were also observed after giving lycopene.Results Lycopene could reduce the liver index,the serum level of AST and ALT and the content of MDA,raise the liver GSH content and promote the activities of SOD in liver tissue in rats.Degeneration and necrosis of liver tissues were relieved.Conclusion Lycopene has protective effects on the hepatotoxicity in rats induced by the combination of INH and RFP for a long time,and the mechanisms is related to of antioxidation action of lycopene possibly.
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Objective To explore the protective effects of puerarin on CCl 4-induced acute hepatic injury of rats. Methods Acute hepatic injury model was induced by CCl 4. Before and after low-dose (40 mg/kg) or high-dose (200 mg/kg) of puerarin was given, the levels of AST, ALT in serum, and liver index, and SOD activity, MDA content in serum and liver tissue were measured. Liver pathological changes were also observed. Results Puerarin reduced the serum levels of AST, ALT obviously (P
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OBJECTIVE:To establish a RP-HPLC method for determination of the content of hesperidin in weisu gran?ules.METHODS:Symmetry C 18 (150mm?3.9mm,5?m)column;acetonitrile-water(19.5∶80.5),water containing phosphoric acid(800∶0.1)as mobile phase and detection wavelength was284nm.RESULTS:The calibration curve was linear in sample size range of hesperidin of0.0228?g～0.1596?g(r=0.9996).The average recovery was97.2%(RSD=1.1%,n=6).CONCLU_ SION:The method was simple and accurate,and can be used for quality control of weisu granules.
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OBJECTIVE:To establish the preparation process and method of quality control of econazole nitrate ear-drops.METHODS:With mixture of glycerin and 75% alcohol as solvent,econazole nitrate ear-drops was prepared and the content of econazole was determined by ultraviolet spectrophotometry.The stability,irritation and in vitro antimicrobial tests were carried out.RESULTS:There was a good linearity of calibration curve of econazole in range of 200～600?g/ml,r=0.9 999,the average recovery was 100.76%,RSD=0.82%(n=5).The in vitro antimycotic MICs of econazole nitrate in ear-drops were 2?g/ml and 4?g/ml against standard and clinically isolated strains of Candida albicans respectively.CONCLUSION:The ear-drops is simple in preparation,effective in antimycotic action,good in stability and slight in irritability,and the method of quality control is simple,rapid and accurate.
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OBJECTIVE:HPLC method was established for the determination of dehydroepiandrosterone(DHEA)in tablets.METHODS:The chromatographic system consisted of ?-Bondapak C18 column and mobile phase of methanol-water(75∶25)with a detection wavelength at 292nm.RESULTS:The linear range of DHEA was 0.2～1.0mg/ml,r=0.9 999.The recovery rate was 99.13%(RSD=0.42%).CONCLUSION:This method is simple and accurate for determination of DHEA in tablets.
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On isolated rabbit portal vein preparations, silybin shifted the cumulative concentration-response curves for NA, KCl, and CaCl2 to right, and depressed their maximal responses with an IC60 of 0.04, 0.43, and 0.07 mmol/L, respectively. On thoracic aorta, the cumulative concentration-responses induced by KCl and CaCl2 were inhibited by silybin with an IC50 of 41.4 and 1.4 mmol/L,respectively, whereas the NA induced responses were not affected. The results suggest that silybin may have a weak calcium antagonistic effect, especially on portal vein.