Practice and effect of construction of rational drug use mode of PIVAS by the activities of quality control circle / 药学实践杂志

Objective To establish a rational drug use model of PIVAS and promote the rational drug use in clinical practices by enhancing the quality of prescription review by pharmacists. Methods The PIVAS physician orders received from 2014 to 2021 were extracted through the hospital information management (HIS) system. The types of irrational physician orders were statistically analyzed, the improvements were made by the method of quality control circle (QCC). Results The model of PIVAS rational drug use formed a standardized process. The proficiency of physician order review was improved. From 2014 to 2021, the number and proportion of unreasonable physician orders in PIVAS decreased year by year. Every type of unreasonable physician orders was improved year by year. Conclusion The professional and technical levels of pharmacist for physician order review at our hospital were improved by the model of PIVAS rational drug use. The quality of pharmaceutical service was significantly improved which ensured the safety of patients' medication.

Efficacy and safety of Di-Tan Decoction for treating post-stroke neurological disorders: a systematic review and Meta-analysis of randomized clinical trials / 中国天然药物

The management of post-stroke complications plays an important role in the quality of life. Di-Tan Decoction (DTD; ) is a widely used traditional Chinese medicine. This study incorporated systematic review and meta-analysis to evaluate the efficacy of DTD in post-stroke neurological disorders. Randomized clinical trials (RCTs) were searched from English, Chinese and Korean electronic medical databases, by including the keywords "Di-Tan Tang", "Di-Tan Decoction", "Scour Phlegm Decoction", "stroke", and "RCT. Each RCT included control (placebo, conventional therapy, or Western medicine) and experimental (DTD treatment) groups. For patients inflicted with stroke for 1-6 weeks, the outcomes of post-stroke neurological disorders were measured by scales for post-stroke symptoms and were classified as "completely healed", "markedly effective", "effective" and "ineffective". Totally, 11 RCTs (n = 490 controls and n = 502 DTD subjects) were selected from 210 articles identified in the initial search. A meta-analysis of evaluation criteria in post-stroke symptoms revealed that the overall odds ratio (ORs) for alleviating post-stroke neurological disorders were 0.30-fold lower (95% CI = 0.21-0.43) in the DTD group than the control (Western medicine) group (P < 0.000 01). Moreover, regardless of the type of stroke diagnostic scale applied (including NFA, HDS, and NIHSS), the overall post-stroke symptoms determined were less severe in the DTD group (n = 219) than the control group (n = 217). No adverse effects of DTD were observed in the 11 RCTs reviewed. All 11 studies used an appropriate method for randomization of subjects to evaluate the risk of bias (ROB), and 7 studies included allocation concealment as well as blinding of patients and practitioners. High-risk ROB was included in 6 RCTs. No significant publication bias was derived from the funnel plot. Our results indicate that the administration of DTD alone, and DTD in combination with Western medicine, exert greater efficacy for post-stroke complication therapy, than Western medicine administered alone. More rigorous and regulated studies are required to confirm the therapeutic efficacy of DTD for post-stroke neurological disorders. disorders.

Preoperative Pulmonary Nodule Localization Methods:A Comparison of Microcoil and Sclerosing Agent / 中国肺癌杂志

BACKGROUND@#Small pulmonary nodules are usually difficult to identify during thoraco-scopic resection, and preoperative computed tomography (CT)-guided percutaneous puncture assisted localization can be helpful. The purpose of this study is to compare the localization effect and complication rates of two different methods by microcoil placement and sclerosing agent injection (Lauromacrogol).@*METHODS@#A retrospective analysis of the clinical data of 371 patients with preoperative pulmonary nodules percutane us puncture localization was performed. According to the use of different materials, they were divided into the microcoil group (167 cases with 196 localized nodules ) and the sclerosing agent group (204 cases with 239 localized nodules). The localization effect, complication, pathological results and operation relates data were statistically analyzed.@*RESULTS@#The localization failure rate (2.4%) was higher in the microcoil group than in the sclerosing agent group (0.5%) (P=0.011), and the localization time of sclerosing agent group was significantly shorter than the microcoil group [(18.78±6.91) min vs (11.99±3.77) min, P=0.000], but the distance between the selected localized nodules and the pleura was deeper in the microcoil group than in the sclerosing agent group [(9.59±8.62) mm vs (8.13±6.49)mm, P=0.002]. The overall complications in the microcoil group were significantly higher than those in the sclerosing agent group (P=0.000), in which pneumothorax was the most common. Through the analysis of related risk factors, we revealed that different positioning methods was independent risk factors. Wedge resection was the main type of surgical method and non-invasive carcinomas were the majority of postoperative pathological results.@*CONCLUSIONS@#Our study suggests that both microcoil placement and sclerosing agent injection are suitable for preoperative pulmonary nodule localization equivalently, however, compared with microcoils placement, injection of lauromacrogol, the sclerosing agent, had lower failure rate, less complications, shorter localization time and it is worthy of promotion also by easy operation and low cost.

Analysis of visual quality after ICL V4c corrective surgery for highmyopia using the double-pass instrument / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To evaluate the effectiveness of visian implantable collamer lens with central hole (ICL V4c) implantation for the correction of high myopia using the double- pass visual quality analysis system. ·METHODS: Totally 60 eyes of 30 high myopia patients who underwent ICL V4c implantation were enrolled into this prospective randomized control study. Myopic degree of selected patients was -6. 0D to -12. 0D, age 18 to 35 years old, best corrected visual acuity ( BCVA ) ≥0. 6, preoperative corneal astigmatism acuities ≤1. 0D. All patients were taken the temporal side transparent corneal incision. The patients were evaluated postoperatively 1wk, 1 and 3mo respectively. The evaluating items included preoperative BCVA, postoperative uncorrected visual acuity ( UCVA), objective scattering index ( OSI), and modulation transfer function ( MTF ) cut off frequency, Strehl ratio (SR), and 100%, 20%, 9% Optical Quality Analysis System ( OQAS ) Value ( OV, contrast visual acuity ). All statistical analyses were performed with SPSS19. 0 statistical software. Variance analysis of repeated measurement data was employed. ·RESULTS: The UCVA gradually improved at 1wk, 1 and 3mo after surgery. There was statistical significance compared with the preoperative BCVA ( P < 0. 01 ). The postoperative OSI, MTF cut off, SR, OV 100%, OV 20% and OV 9% at 1wk, 1 and 3mo showed statistically differences compared with the preoperative values (P<0. 05). ·CONCLUSION: ICL V4c implantation can effectively correct high myopia range from -6. 0D to -12. 0D. The postoperative OSI were smaller than the preoperative OSI. The postoperative UCVA were better than the preoperative BCVA. The value of postoperative MTF cut off, SR, and OV value of 100% , 20% and 9% improved.

Chemical constituents from Gentianella acuta / 中成药

AIM To study the chemical constituents from Gentianella acuta (Michx.) Hulten.METHODS The 30％ and 90％ ethanol fractions of 70％ ethanol extract from G.acuta were isolated and purified by silica,ODS and preparative HPLC column,then the structures of obtained compounds were identified by spectral data.RESULTS Nine compounds were isolated and identified as sinenoside Ⅰ (1),(+)-lariciresinol-4,4'-0-bis-β-D-glucopyranoside (2),(+)-8-hydroxylariciresinol-4'-O-β-D-glucopyranoside (3),(+)-lariciresinol-4-O-3-D-glucopyranoside (4),(7S,8R)-erythro-7,9,9'-trihydroxy-3,3'-dimethoxy-8-O-4'-neolignan-4-O-β-D-glucopyranoside (5),(7S,8R)-erythro-4,9,9'-trihydroxy-3,3'-dimethoxy-8-O-4'-neolignan-7-O-β-D-glucopyranoside (6),(7S,8R)-erythro-4,7,9-trihydroxy-3,3'-dimethoxy-8-O-4'-neolignan-9'-O-β-D-glucopyranoside (7),balanophonin (8),urolignoside (9).CONCLUSION Compounds 2-9 are isolated from genus Gentianella for the first time.

Comparison of procalcitonin guidance-administered antibiotics with standard guidelines on antibiotic therapy in children with lower respiratory tract infections: a retrospective study in China

Objective:To establish the efficacy of an algorithm based on the biomarker procalcitonin [PCT] to reduce antibiotic exposure in pediatric patients with lower respiratory tract infection [LRTI]

Materials and Methods: The clinical data of 357 patients [< 14 years of age] who were discharged home with LRTI from January 1, 2010 to July 31, 2016 were analyzed. Antibiotic exposure, antibiotic prescription rate, length of hospital stay, and antibiotic-associated adverse effects were compared between the PCT group [n = 183] and the standard group [n = 174] using SAS 9.1.3 software

Results: The overall adverse effect rates were similar in both the PCT and standard groups: 42 [22.95%] and 51 [29.31%], respectively. The length of hospital stay was not significantly different between the PCT [9.96 +/- 5.81 days] and standard groups [10.58 +/- 4.24 days] [difference: -0.62%; 95% Cl: -1.68 to 0.43]. Antibiotic prescribing rates were significantly different in the PCT group compared to the standard group: 54.64% versus 83.91% [difference: -29.26%; 95% Cl: -38.31, -20.22; p - 0.23]. Mean duration of antibiotic exposure in the PCT group [3.98 +/- 2.17 days] was lower than the standard groups [6.66 +/- 5.59 days] [difference: -2.68%; 95% Cl: -3.21 to -2.16]

Conclusion: Study showed that PCT guidance of antibiotic treatment in children and adolescents with LRTI reduced the duration of antibiotic exposure and antibiotic prescribing rates, but did not affect the adverse effect rate and length

Inlaid labial versus bladder mucosal graft repair for complex urethral skin fistula / 中华男科学杂志

<p><b>Objective</b>To compare the effect of inlaid labial mucosal graft repair (LMGR) with that of bladder mucosal graft repair (BMGR) in the treatment of complex urethral skin fistula after hypospadias repair.</p><p><b>METHODS</b>This study included 55 cases of complex urethral skin fistula following hypospadias repair. We randomly assigned them to receive inlaid LMGR (n=36) or BMGR (n=19). After surgery, we compared the incidence of complications and recurrence rate of urinary fistula between the two groups of patients.</p><p><b>RESULTS</b>The success rates of operation were 91.7% and 84.2% in the LMGR and BMGR groups, respectively, and the penile appearance was desirable in both groups. Postoperative complications included 2 cases of urinary fistula and 1 case of urethral stricture in each group. There were no statistically significant differences between the two groups in the success rate of operation (P>0.05) or the incidence rate of postoperative complications (P>0.05).</p><p><b>CONCLUSIONS</b>Both inlaid LMGR and BMGR yield satisfactory results in the treatment of complex urethral skin fistula. However, LMGR involves less injury in mucosa collection and is easier to perform and therefore deserves more clinical attention.</p>

Application of 3D Printing Technology in Custom-made Foot Orthosis (review) / 中国康复理论与实践

@#3D printing technology has become the focus of the study on rapid proyotyping technology in recent years. This paper introduced the principle, material and equipments of 3D printing, as well as the foot orthosis. This paper also summarized the application of 3D printing in custom-made foot orthosis, and the differences between 3D printing and traditional technology from the aspect of structure design, material, and clinical application, etc., and discussed the problems and future development of 3D printing.

Determination of the Related Substances in Nimesulide Granules by HPLC / 中国药师

Objective:To establish an HPLC method for the determination of the related substances in nimesulide granules. Meth-ods:An Agilent HC-C18(250 mm ×4.6 mm,5 μm)column was used, the mobile phase was composed of acetonitrile-0.01 mol ·L-1 ammonium dihydrogen phosphate (adjusting pH to 7. 0 with ammonia) (40:60) and the detection wavelength was 230 nm, the flow rate was 1. 0 ml·min-1 ,the column temperature was 30℃, and the injection volume was 20μl. Results:The linear range of nimesu-lide was 0. 10-0. 30 mg·ml-1(r=0. 999 9). Nimesulide and its related substances could be well separated with the peak separation degree above 2. 0. The limit of detection and the limit of quantification was 0. 3 ng and 1. 0 ng, respectively. Conclusion:The method is simple, accurate and reproducible, which can be used for the quality control of nimesulide granules.

The surgical safety analysis of elderly patients with thoracic esophageal squamous cell carcinoma / 中国癌症杂志

Background and purpose: The incidence rate of elderly esophageal carcinoma patients is increasing year by year. In this study, the clinicopathologic factors, operational factors and postoperative complications were compared between the older and the younger elderly patients with thoracic esophageal squamous cell carcinoma (ESCC), and the influence of different surgical approaches to older elderly patients were analyzed. Methods: A retrospective review of 371 cases of elderly patients with thoracic esophageal squamous cell carcinoma (≥60 years) between Jan. 2006 and Dec. 2008 were performed. The patients were divided into two age groups. The patients over 75 years old named the older elderly group including 53 patients, and the patients between 60-74 years named the younger elderly group including 318 patients, the clinicopathological factors, operational factors, postoperative hospital mortality and average length of stay were compared. Meanwhile, according to different surgical approaches, the comparison of the left chest and right chest approach of operative time, blood loss and postoperative complication rate, and so on and so forth. Results: The older elderly group compared with the younger elderly group had more preoperative complications. Preoperative ASA classiifcation and postoperative complications, length of stay and hospital mortality rates were signiifcantly higher. The older elderly group over the right chest approach had less postoperative complications, especially pulmonary complications, the results were statistically signiifcant.(13.0%vs 40.0%,P<0.05) Conclusion: The patients over 75 years old with thoracic esophageal squamous cell carcinoma have a higher risk during the operation, we can choose relatively simpler operation approach to reduce the incidence of postoperative complications, especially pulmonary complications.

Anti-hyperuricemia effect and mechanism of polydatin in mice / 药学学报

Hyperuricemia mice model was established with uricase inhibitor (potassium oxonate) and uric acids in serum were observed. Polydatin (5, 10, 20 mg · kg(-1)) and benzbromarone (16.7 mg · kg(-1)) were given ig for 7 d in mice. Kidney tissues were used to detect gene contents ofurate anion transporter 1 (URAT1), organic anion transporter 1 (OAT1) and organic anion transporter 3 (OAT3) by real-time-PCR. The results showed that polydatin and benzbromarone can significantly reduce uric acid in blood of hyperuricemia mice (P < 0.05), compared with the model group. URAT1, OAT1 and OAT3 contents of the kidney in hyperuricemia mice changed significantly (P < 0.05), compared with the blank group. Polydatin can significantly inhibit the changing trends in these genes induced by potassium oxonate in a dose-dependent manner, the difference was significant (P < 0.05), compared with the model group. Those indicated that polysatin could reduce the level of the serum uric acid through promoting uric acid excretion.

Anti-hyperuricemia effect and mechanism of polydatin in mice / 药学学报

Hyperuricemia mice model was established with uricase inhibitor (potassium oxonate) and uric acids in serum were observed. Polydatin (5, 10, 20 mg · kg(-1)) and benzbromarone (16.7 mg · kg(-1)) were given ig for 7 d in mice. Kidney tissues were used to detect gene contents ofurate anion transporter 1 (URAT1), organic anion transporter 1 (OAT1) and organic anion transporter 3 (OAT3) by real-time-PCR. The results showed that polydatin and benzbromarone can significantly reduce uric acid in blood of hyperuricemia mice (P < 0.05), compared with the model group. URAT1, OAT1 and OAT3 contents of the kidney in hyperuricemia mice changed significantly (P < 0.05), compared with the blank group. Polydatin can significantly inhibit the changing trends in these genes induced by potassium oxonate in a dose-dependent manner, the difference was significant (P < 0.05), compared with the model group. Those indicated that polysatin could reduce the level of the serum uric acid through promoting uric acid excretion.