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OBJECTIVE:To provide reference for the formulation of individualized treatment plan for patients with cardiogenic ischemic stroke. METHODS:For a patient with cardiogenic ischemic stroke,clinical pharmacists adjusted lipid-lowering scheme according to disease progress combined with treatment principle of ischemic stroke and cardiogenic ischemic stroke;recommended second-level prevention and assisted physicians to adjust anti-infective plan according to individual situation of patient. When patients suffered from liver dysfunction,it was recommended to stop using drugs that may cause liver dysfunction,detect renal function damage early,analyze renal function impairment caused by insufficient fluid circulation,timely supplement fluid and provide whole-process pharmaceutical care in respects of anticoagulation, lipid-lowering and anti infection treatment, etc. RESULTS:Physician adopted the recommend of pharmacists and they formulated individualized treatment plan for cardiogenic ischemic stroke patients together;liver and kidney function recovered,and the condition of patient was improved. INR control (1.8)was better at discharge,and discharged education was provided for the patients at the same time. CONCLUSIONS:Clinical pharmacists participate in the treatment for the patient with cardiogenic ischemic stroke and assist physicians to optimize treatment plan according to disease condition. When ADR occurs,timely adjustment of treatment plan ensures the safety and effectiveness of patient medication.
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Objective Evaluation of the effect ofYidanshu capsule combined with pancreatic duct jejunum anastomosis (Frey procedure) for elderly chronic pancreatitis with pancreatic duct dilatation.Methods A total of 84 patients with dysphagia after stroke who met the inclusion criteria were divided into 2 groups, 42 in each. Both groups were treated with frey procedure, and the observation group addedYidanshu capsule. Izbicki grading system was used to evaluate patients' clinical symptoms, the EORTC-QLQ-C30 scoring system to evaluate patients' quality of life. The serum levels of inflammatory cytokines was also used to evaluate the clinical efficacy. Results The total effective rate of observation group was 92.8% (39/42), and the control group was 76.2% (32/42). The difference was statistically significant (Z=3.561,P=3.561). After treatment, abdominal pain (0.4 ± 0.1 vs. 1.3 ± 0.2,t=3.672), nausea and vomiting (0.3 ± 0.0vs. 1.0 ± 0.1,t=4.001), Abdominal distension (1.2 ± 0.1vs. 2.0 ± 0.2,t=3.752), weak (0.4 ± 0.1vs. 1.4 ± 0.1,t=4.282) scores in the observation group were significantly lower than the control group (P<0.05). The role function (87.4 ± 9.1vs.70.6 ± 7.0,t=3.459), the body function (70.5 ± 7.2vs. 61.5 ± 6.2,t=4.316), emotional function (79.1 ± 7.7vs. 65.8 ± 6.3,t=3.671), social function (80.3 ± 8.1vs. 69.1 ± 6.2,t=3.773) scores in the observation group were significantly higher than the control group (P<0.05). The serum TNF-α (0.71 ± 0.13 ng/mlvs. 1.02 ± 0.15 ng/ml,t=3.652), IL-8 (1.94 ± 0.1 ng/mlvs. 4.51 ± 0.54 ng/ml,t=3.367), hs-CRP (1.01 ± 0.14 mg/Lvs.2.15 ± 0.29 mg/L,t=3.701) levels in the observation group were significantly lower than the control group (P<0.05).Conclusions TheYidanshu capsule combined with pancreatic duct jejunum anastomosis can improve the clinical curative effect of elderly patients with chronic pancreatitis with pancreatic duct expansion, relieve the clinical symptoms and inflammation, and improve the quality of life.
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Objective Evaluation of the effect ofYidanshu capsule combined with pancreatic duct jejunum anastomosis (Frey procedure) for elderly chronic pancreatitis with pancreatic duct dilatation.Methods A total of 84 patients with dysphagia after stroke who met the inclusion criteria were divided into 2 groups, 42 in each. Both groups were treated with frey procedure, and the observation group addedYidanshu capsule. Izbicki grading system was used to evaluate patients' clinical symptoms, the EORTC-QLQ-C30 scoring system to evaluate patients' quality of life. The serum levels of inflammatory cytokines was also used to evaluate the clinical efficacy. Results The total effective rate of observation group was 92.8% (39/42), and the control group was 76.2% (32/42). The difference was statistically significant (Z=3.561,P=3.561). After treatment, abdominal pain (0.4 ± 0.1 vs. 1.3 ± 0.2,t=3.672), nausea and vomiting (0.3 ± 0.0vs. 1.0 ± 0.1,t=4.001), Abdominal distension (1.2 ± 0.1vs. 2.0 ± 0.2,t=3.752), weak (0.4 ± 0.1vs. 1.4 ± 0.1,t=4.282) scores in the observation group were significantly lower than the control group (P<0.05). The role function (87.4 ± 9.1vs.70.6 ± 7.0,t=3.459), the body function (70.5 ± 7.2vs. 61.5 ± 6.2,t=4.316), emotional function (79.1 ± 7.7vs. 65.8 ± 6.3,t=3.671), social function (80.3 ± 8.1vs. 69.1 ± 6.2,t=3.773) scores in the observation group were significantly higher than the control group (P<0.05). The serum TNF-α (0.71 ± 0.13 ng/mlvs. 1.02 ± 0.15 ng/ml,t=3.652), IL-8 (1.94 ± 0.1 ng/mlvs. 4.51 ± 0.54 ng/ml,t=3.367), hs-CRP (1.01 ± 0.14 mg/Lvs.2.15 ± 0.29 mg/L,t=3.701) levels in the observation group were significantly lower than the control group (P<0.05).Conclusions TheYidanshu capsule combined with pancreatic duct jejunum anastomosis can improve the clinical curative effect of elderly patients with chronic pancreatitis with pancreatic duct expansion, relieve the clinical symptoms and inflammation, and improve the quality of life.
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Objective To investigate the curative effect and safety of percutaneous intradiscal injection of ozone combined with epidural injection of collagenase for the treatment of prominent lumbar disc protrusion.Methods A total of 541 patients with lumbar disc protrusion were included in this study.All the patients fulfilled the following criteria:the fibrous ring was broken,the protruded extent of nucleus pulposus was less than 10 mm and the dura sac and/or nerve root was compressed.The intradiscal injection of ozone combined with epidural injection of collagenase was performed in all patients.The patients were followed up through further consultation,letters,telephone or other ways.Five hundred and forty-one cases were followed up for 2-3 months(short-term),312 cases for 4-12 months(medium-term)and 115 cases for 13-18 months(ling-term).The short-term,medium-term and long-term curative effects were evaluated with unified curative criteria,and the results were compared with that obtained with the treatment of epidural injection of collagenase only. Results The short-term, medium-term and long-term effective rate of selected cases was 95.9%(519/541),90.4%(489/541)and 87.2%(472/541),respectively.When combined application of two methods was performed,different degree of shrinkage of the protruded nucleus pulposus was obviously observed,with a mean shrinkage degree of 30.5%.The short-term,medium-term and long-term effective rate of simple collagenase chemonucleolysis was 89.5%,82.4%and 80.4%,respectively.Conclusion Intradiscal injection of ozone combined with epidural injection of collagenase is an effective treatment for lumbar disc protrusion when the fibrous ring is broken,the protruded extent of nucleus pulposus is less than 10 mm and the dura sac and/or nerve root is compressed. Its curative effect is superior to simple collagenase chemonucleolysis. Ozone is of clinical significance for producing the shrinkage of the nucleus pulposus.
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Objective To investigate the curative effect and safety of percutaneous intradiscal injection of ozone combined with epidural injection of collagenase for the treatment of prominent lumbar disc protrusion.Methods A total of 541 patients with lumbar disc protrusion were included in this study.All the patients fulfilled the following criteria:the fibrous ring was broken,the protruded extent of nucleus pulposus was less than 10 mm and the dura sac and/or nerve root was compressed.The intradiscal injection of ozone combined with epidural injection of collagenase was performed in all patients.The patients were followed up through further consultation,letters,telephone or other ways.Five hundred and forty-one cases were followed up for 2-3 months(short-term),312 cases for 4-12 months(medium-term)and 115 cases for 13-18 months(long-term).The short-term,medium-term and long-term curative effects were evaluated with unified curative criteria,and the results were compared with that obtained with the treatment of epidural injection of collagenase only.Results The short-term,medium-term and long-term effective rate of selected cases was 95.9%(519/541),90.4%(489/541)and 87.2%(472/541),respectively.When combined application of two methods was performed,different degree of shrinkage of the protruded nucleus pulposus was obviously observed,with a mean shrinkage degree of 30.5%.The short-term,medium-term and long-term effective rate of simple collagenase chemonucleolysis was 89.5%,82.4%and 80.4%,respectively.Conclusion Intradiscal injection of ozone combined with epidural injection of collagenase is an effective treatment for lumbar disc protrusion when the fibrous ring is broken,the protruded extent of nucleus pulposus is less than 10 mm and the dura sac and/or nerve root is compressed.Its curative effect is superior to simple collagenase chemonucleolysis.Ozone is of clinical significance for producing the shrinkage of the nucleus pulposus.