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Objective:To study how to guide the individual dose of clopidogrel in line with the genetic testing results. Methods:Clinical pharmacists decided how to optimize the prescription of clopidogrel according to the genotype combined with the drug metabolism and drug interactions for three patients respectively with slow clopidogrel metabolism,intermediary metabolism and super fast metabolism. Results:The slow clopidogrel metabolism patient with subacute stent thrombosis after half a month of coronary stenting was switched to orally administrate with ticagrelor. The super fast metabolism patient suffered from repeatedly subcutaneous hemorrhage with antiplatelet therapy was suggested to lower the dose of clopidogrel,temporarily withdraw Maixuekang capsules and conventionally administrate with vitamin C tablets orally. The intermediary metabolism patient with late stent thrombosis co-treated with lansoprazole was suggested to increase the dose of clopidogrel or use ticagrelor instead,and when it was necessary,panxitorazole,ray Bella or the other ranitidine acid suppression drugs such as ranitidine could be considered. Conclusion:Through genetic testing and drug interactions,clinical pharmacists guide the clinical use of clopidogrel and the optimization of antiplatelet therapy.
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AIM: To observe the therapeutic effect of modified Bushen Huoxue granules (MBHG) on ovariec-tomized osteoporosis rats.METHODS: Female SD rats were randomly given sham operation (n =10) and ovariectomy, and then the model rats were further randomly divided into model group, MBHG treatment groups at doses of 200 mg/kg, 100 mg/kg and 50 mg/kg respectively, and positive control (estradiol valerate) group, with 10 rats in each group by intra-gastric administration for 12 weeks.The morphology, area, thickness, spacing and area percentage of trabecular bone in the rats were observed.The serum levels of calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) were mea-sured by automatic analyzer.Bone mineral density (BMD) was analyzed.Serum estradiol (E2 ), osteocalcin (BGP), os-teoprotegerin (OPG), receptor activator of nuclear factor-κB (RANK) and receptor activator of nuclear factor κB ligand (RANKL) levels were detected by ELISA.RESULTS: Compared with model group, trabecular bone significantly widened in all treatment groups with large number, and net-like structure restored partially.The thickness, area and area percenta-ges of trabecular bone in treatments groups were higher than those in model group,and trabecular spacing was less than that in model group (P <0.05).The serum Ca, P, E2 and OPG, and femoral BMD were significantly higher in treatment groups than those in model group, and the levels of ALP, BGP, RANK and RANKL were significantly lower than those in model group (P <0.01).CONCLUSION: MBHG has a significant therapeutic effect on ovariectomized osteoporosis rats. The mechanism may be related to the regulation of OPG and inhibition of RANKL secretion.
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Objective:To observe the effect of Xingnaojing injection in the treatment of severe traumatic brain injury .Methods:From August 2013 to December 2014 , 110 patients with severe traumatic brain injury were randomly divided into the control group and the research group with 55 ones in each .The control group was treated with the conventional treatment , including removal of intracrani-al hematoma, bone disc decompression according to surgical indications , anti-infection, dehydration intracranial pressure reduction and nutritional support treatment .The research group was treated with Xingnaojing injection additionally .After the one-week, two-week and 4-week treatment , the GCS score of the two groups were compared .The rate of lung infection and stress ulcer in 4 weeks were com-pared.The clinical outcome of the two groups after the 4-week treatment was also evaluated .Results:The GCS score of the research group was higher than that of the control group after the 2-and 4-week treatment (P<0.05).There was no significant difference in the incidence of stress ulcer between the two groups , while the incidence of pulmonary infection in the research group was lower than that in the control group (P<0.05).The total effective rate of clinical prognosis in the research group (90.9%) was significantly higher than that in the control group (72.7%, P<0.05).Conclusion:Xingnaojing injection combined with the conventional treatment for the patients with severe traumatic brain injury can decrease the clinical complications and improve the clinical symptoms of patients , which is worthy of clinical promotion .