Clinical study on Kangliu Pill combined with conventional therapy in the treatment of malignant gliomas / 国际中医中药杂志

Objective:To evaluate the clinical efficacy of the Chinese herbal medicine compound Kangliu Pill combined with conventional Western medicine therapy in the treatment of patients with malignant glioma after surgery.Methods:A total of 100 patients with malignant glioma (grade Ⅲ-Ⅳ), who met the inclusion criteria and underwent surgery from January 2017 to November 2019, were divided into the treatment group of 48 patients and the control group of 52, according to the treatment method. The control group was treated with conventional surgery plus radiotherapy, and the treatment group was treated with Kangliu Pill on the basis of the control group. The patients were followed up for 1 to 2 years, and the survival rate, progression-free survival and median survival were recorded. The Karnofsky functional status score (KPS) and quality of life score (QOL) were used to evaluate the patients' survival and quality of life, and the adverse reactions during the treatment period were observed.Results:After treatment, the 1-year survival rates [97.92% (47/48) vs. 80.77% (42/52); χ2=5.847, P=0.016] and 2-year survival rates [89.47% (33/48) vs. 42.31% (22/52); χ2=7.051, P=0.008] in the treatment group were significantly higher than those in the control group. After treatment, the progression-free survival [(23.94±13.12) months vs. (15.82±8.65) months; t=3.63, P<0.01] in the treatment group was significantly higher than that of the control group. After treatment, the survival analysis using the life table method yielded a median survival of 21.13 months in the treatment group and 12.00 months in the control group, with statistically significant differences in median survival and cumulative survival rates between two groups ( P=0.001). The KPS and QOL scores in the treatment group were higher than those in the control group, but the differences between the groups were not statistically significant ( P>0.05). There was no serious adverse events occurred during the treatment period in both groups. Conclusion:Adjuvant therapy with Kangliu Pill can improve survival rate, prolong progression-free survival, median survival, improve quality of life, and enhance the efficacy of patients with malignant glioma after surgery.

Working Mode and Case Analysis of the First Pharmaceutical Ward Rounds in Our Hospital / 中国药房

OBJECTIVE：To est ablish the working mode of the first pharmaceutical ward rounds of clinical pharmacists in our hospital，in order to provide a useful reference for establishing a national standardized pharmaceutical ward rounds model. METHODS：By sharing the clinical cases of the first pharmaceutical ward rounds ，the work content and process of the first pharmaceutical ward rounds in our hospital were introduced. RESULTS & CONCLUSIONS ：The clinical pharmacist ’s first pharmaceutical ward round in our hospital mainly includes self introduction of clinical pharmacists ，diagnosis of patients ’condition under the guidance of doctors ，collection and evaluation of patients ’previous medication information （including previous medication varieties ，usage methods ，efficacy and safety evaluation ），assistance for doctors in formulating initial treatment plan ， carrying out initial medication and diet education ，and intensive communication and cooperation with nurses. The development of first pharmaceutical ward rounds promotes the rational use of drugs in clinic ，elevates the hospitalization satisfaction of patients and improves the professional quality of clinical pharmacists.

The study on indocyanine green excretion test to predict mild hepatic encephalopathy / 中国实用护理杂志

Objective:To explore whether the 15-minute retention rate (R15) of indocyanine green (ICG) in the indocyanine green excretion test and the effective hepatic blood flow (EHBF) can predict the occurrence of mild hepatic encephalopathy (MHE).Methods:Using the convenience sampling method, we collected clinic data from 153 patients diagnosed with liver cirrhosis or liver failure from June 2019 to December 2019 in the Third Affiliated Hospital of Sun Yet-sen University in Guangzhou. We screened the MHE patients with the number connect test-A and the digital symbol test, and analyzed the clinical data. By taking different values for R15 and EHBF as cut-off points, the significance of the two factors in predicting MHE is explored respectively.Results:The incidence of MHE was 38.56% (59/153). Single factor analysis showed that the difference of Child-Pugh grade between the MHE group and the non-MHE group was statistically significant ( χ2 value was 7.606, P<0.05), while the differences between cirrhosis and liver failure diagnosis, fasting blood glucose, and serum creatinine were not statistically significant ( P>0.05). When most points between 0.11 and 0.61 were selected as normal and abnormal cut-off points of R15, R15 had statistical significance ( P<0.05) and when R15 selected 0.18, it was most significant (Fisher exact test P=0.00024). When most points between 0.08 and 0.76 were selected as normal abnormal cut-off points of EHBF, EHBF had statistical significance ( P<0.05) and when EHBF selected 0.25, it was most significant (Fisher exact test P=0.00022). Through Logistic stepwise regression analysis, the risk factors for MHE were R15 and EHBF. The ROC curve was used to illustrate the predictive effects of two factors on MHE. Conclusions:The incidence of MHE in patients with cirrhosis or liver failure is high. When R15≥0.18 or EHBF≤0.25 L/min, R15 and EHBF in indocyanine green excretion test can better predict the occurrence of MHE than Child-Pugh classification, and can be help to evaluate and manage patients in time.

Effect and Practice of Sub-category Management of Chinese Patent Medicine in the Improvement of the Qualified Rate for Outpatient Prescriptions of Chinese Patent Medicine / 中国药房

OBJECTIVE：To provide reference for improving the qualified rate of outpa tient prescriptions of Chinese patent medicines and ensuring the rational use of medicines. METHODS：Refering to the Beijing Basic Medical Insurance Medicines Catalog， Clinical Medicine Instructions and （No.17Z13） MCDEX，Chinese patent medicine were classified according to the main functions indications and disease syndromes types. The classification results were reviewed by the member of expert group of Hospital Pha rmacy Committee ，and were recorded by medical department of the management department ，finally were embedded into the outpatient HIS and were docked with prescription pre-audit and comment system. Total number of reviewed Chinese patent medicine prescriptions ，the number of repeated prescriptions ，the number of repeated prescriptions intercepted by HIS system ，the number of prescriptions actively modified by the prescribing physician ，the ratio of repeated prescriptions ，the frequency of active modification by the prescribing physician and average cost of each prescription were compared between the third quarter of 2017（initial stage of sub-category management of Chinese patent medicine ）and the forth quarter of 2019. RESULTS ：Chinese patent medicines in our hospital could be divided into eight categories as internal medicine ，surgery medicine ，oncology medicine ，gynecology medicine ，ophthalmology medicine，otorhinolaryngology medicine ，orthopedics medicine and dermatology medicine ；they contained 14，1，2，4，2，2，3， 1 sub-categories，respectively；some sub-categories were subdivided again . In the third quarter of 2017，159 610 prescriptions of Chinese patent medicines were reviewed ，and 421 prescriptions were unreasonable. Among which ，there were 200 prescription of repeated prescriptions ，accounting for 47.15％；676 repeated prescriptions were actively intercepted by HIS and 476 intercepted prescriptions were actively modified by prescribing physicians ，with active modification rate of 70.14％. In the forth quarter of 2019，138 869 prescriptions of Chinese patent medicines were reviewed ，and 381 prescriptions were unreasonable. Among which ， there were 47 prescription of repeated prescriptions ，accounting for 12.43％；266 repeated prescriptions were actively intercepted by HIS and 259 intercepted prescriptions were actively modified by prescribing physicians ，with active modification rate of 97.37％. There were statistical significances in the ratio of repeated prescription and the rate of active modification by physicians between initial stage and the forth quarter of 2019（P＜0.01）. The average cost of each prescription were 278.78 yuan in the third quarter of 2017 and 220.85 yuan in the forth quarter of 2019，decreasing by 20.78％ . CONCLUSIONS ：The sub-category management of Chinese patent medicine is adopted in the pharmacy department of our hospital ，which realize the pre-audit of all prescriptions of Chinese patent medicines ，and increased the pass rate of outpatient chinese patent medicine prescriptions . It i s helpful for doctors to dialectically use drugs ，memorize the varieties of Chinese patent medicines and improve their professional level；it is helpful for prescription reviewers to rapidly identify repeated prescriptions ，improve the information audit and management level of prescriptions. It is convenient for facilitate prescription reviewers to check the amount of prescriptions used and found out the deficiency of the medicine list in our hospital. However ，there are also some problems such as the conflict between individualized medication and part of management system ，and doctors and pharmacists have different opinions on medicine classification.

Analysis of genetic and clinical characteristics of nine cases of myelodysplastic syndrome with near tetraploid/tetraploidy karyotype / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic and clinical characteristics of near-tetraploidy/tetraploidy karyotype (NT/T) in patients with myelodysplastic syndrome (MDS).@*METHODS@#Cytogenetic findings of 1576 inpatients with primary MDS were retrospective analyzed, among which 9 were diagnosed with NT/T. Clinical data including gender, age, morphology, genetic feature and prognosis were analyzed.@*RESULTS@#The prevalence of MDS patients with NT/T (NT/T-MDS) among all cases was 0.57%. Karyotyping analysis suggested that eight MDS patients had sole NT/T, while the remainder one had a complex karyotype. In addition to the typical morphology of MDS, NT/T-MDS had unique morphology including huge blast, double-nuclear cell and irregular nuclear membrane. One NT/T-MDS patient gave up therapy, and the remaining eight underwent the first course of treatment, albeit with poor prognosis. Only one patient had complete remission, one had partial remission, three had no remission; and three had converted to acute myeloid leukemia.@*CONCLUSION@#NT/T-MDS is rare and has unique morphology. Generally, NT/T-MDS patients have poor prognosis. However, NT/T cannot be simply classified as high-risk group, but with consideration whether they have affected particular chromosomal structures as well as other clinical data.

Experience of Clinical Pharmacists Participte in the Prevention of Drug-induced Epilepsy / 中国药房

OBJECTIVE:To summarize the role of clinical pharmacists on the prevention of medicine-induced epilepsy and common epilepsy-inducing drugs in clinic. METHODS:The role of clinical pharmacists in whole process of pharmaceutical care for an epilepsy patient was introduced,and clinical pharmacists assisted physicians to reduce the risk of drug-induced epilepsy. The role of clinical pharmacists on the prevention of epilepsy-inducing medicine during pharmaceutical care was explored through reviewing literature,summarizing epilepsy-inducing drug and analyzing mechanism. RESULTS:The role of clinical pharmacists in diagnosis and treatment of epilepsy included that analyzing the risk of medicine-induced epilepsy by inquiring about the history of drug use, guiding patients to gradually stop taking risk drugs,participating in the formulation of clinical medication plan and drug risk during diagnosis and treatment,assisting physicians to adjust medication plan,monitoring the change of patient's symptoms after drug,"special medication notification for epilepsy patient",etc. The types of common epilepsy-inducing medicine included antibiotics (fluoroquinolone,β-lactam,etc.),drugs for central nervous system(sedative and antiepileptic drug,mental disorders drug,etc.), Chinese herbal drug,Chinese patent drug,antipyretic- analgesic and anti-inflammatory drug,circulatory system drug and other drugs. The mechanisms of drug effect included entering the brain through the blood cerebrospinal fluid barrier,inhibiting the binding of γ-aminobutyric acid to the receptor site,producing amino or free radicals and affecting a part of the cerebral cortex. CONCLUSIONS:Clinical pharmacists play an irreplaceable role in the safety of drug use in epilepsy patient. Their focuses to epilepsy-inducing drug are of significance to clinical practice.

Chinese and Western Medicine Pharmaceutical Care for One Myelitis Patient Infected by Brucellosis / 中国药师

Objective:To discuss the methods and effects of clinical pharmacists in the Chinese and western medicine pharmaceu-tical care for one myelitis patient infected by brucellosis. Methods:Taking one myelitis patient infected by brucellosis as the example, clinical pharmacists provided Chinese and western medicine pharmaceutical care through making individualized drug regimen, perform-ing drug education and so on. Results:Clinical pharmacists participated in the therapeutic process actively, and performed Chinese and western medicine pharmaceutical care. As a result, the body temperature, look,tongue coating and excrement of the patient were obvi-ously improved. Conclusion:Performing Chinese and western medicine pharmaceutical care in clinics is very important for safety and effectiveness of drugs and improvement of drug use level.

Application of fluorescent in situ hybridization in primary diagnosis of aplastic anemia by morphology / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the clinical application of fluorescent in situ hybridization (FISH) for the differential diagnosis of myelodysplastic syndromes (MDS) and aplastic anemia (AA).</p><p><b>METHODS</b>A FISH kit capable of detecting the chromosomal abnormalities related to MDS was used to analyze 94 patients who were suspected to have AA by bone marrow morphology.</p><p><b>RESULTS</b>Cytogenetic abnormalities were detected in 11 of the 94 patients, which included trisomy 8 (5 cases), 20q- (1 case) and -Y (1 case). There were 4 cases related to MDS, which included 3 cases of 5q-, in which 1 case carry 20q- at the same time, and 7q- (1 case). No significant difference was found between the MDS and AA groups in terms of age, sex or routine blood examination including absolute neutrophil count, hemoglobin content and platelet count.</p><p><b>CONCLUSION</b>FISH can detect certain cytogenetic abnormalities related to MDS in patients morphologically diagnosed as AA.</p>

Pathogenetic mechanism for a female patient with hemophilia A / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore the pathogenetic mechanism for a female patient affected with hemophilia A (HA).</p><p><b>METHODS</b>Potential genetic defect was detected with inverse shifting-polymerase chain reaction (IS-PCR). The pattern of X chromosome inactivation was determined with a human androgen receptor assay (HUMARA assay). G-banded karyotyping was carried out to exclude potential chromosome aberrations.</p><p><b>RESULTS</b>IS-PCR showed that the defect of FVIII gene was the distal type of intron 22 inversion. The HUMARA assay showed that the X chromosome inactivation was non-random, and that the mother's X chromosome activity was lower than that of the father's X chromosome which has carried the inverted FVIII gene. No abnormalities were found with G-banded chromosomes.</p><p><b>CONCLUSION</b>The prevalence of female HA patient may be caused by non-random inactivation of X chromosomes.</p>

Nursing of patients with early severe acute pancreatitis undergoing laparoscopic treatment / 中国实用护理杂志

Objective To discuss nursing of patients with early severe acute pancreatitis undergoing laparoscopic treatment and in comparison with open surgery. Methods Totally 56 patients with early se-vere acute pancreatitis were admitted from October 2002 to October 2007,among which 30 cases (group A) received laparoscopic.treatment and the other 26 cases (group B) was given open surgery.The average time of hospital stay,incidence of complication and re-operation were compared between the two groups. Re-sults The average time of hospital stay,incidence of complication and re-operation of group A were lower than those of group B (P<0.05). Conclusions Treatment of severe acute pancreatitis with laparoscopy proved to be a desirable method in that it performs good effect with little trauma and low fatality.Other basic treatment,regulation of water and electrolyte balance and acid-base balance,enforcement of nutritional sup-port,fasting and gastrointestinal decompression should not be ignored.

Retrospective Analysis on Chinese Traditional Medicine Consultation / 中国药房

OBJECTIVE:To understand the demands of clinic patients for relevant knowledge of drugs in order to provide more patient-targeted pharmaceutical service.METHODS:The consultation records between Jan,2004 and Dec.2004 were collected and reviewed,and the analysis was made in the respect of items,ways,and contents of consultation.RESULTS:The understanding of professional and nonprofessional demands of the patients,age distribution of major patient group and the like could provide the reference for pharmacists in deciding important patients.CONCLUSION:Retrospective analysis is a way to dynamically follow up clinic patients and obtain information,which helps the development of hospital pharmacy,and promotes medicinal consultation.

Influence of Compound Glycyrrhizin Injection on Hormone Withdrawal Syndrome in SARS Patients / 中国药房

OBJECTIVE:To summarize the effects of compound glycyrrhizin injection(GL)on hormone withdrawal syndrome(HWS)in SARS patients.METHODS:Using contrast design,the HWS of 134 cases of SARS who had received hormone theropy was retrospectively analysed.RESULTS:Administration of GL could descend the incidence rate of symptoms of HWS,of which the incidence rates of short breath and chest distress,the main symptoms of SARS patients,dropped from 24.5%and 22.6%to 3.6%(P≤0.01)and 7.1%(P≤0.05)and the incidence of asthenia,musculoarthragia and headache decreased from 13.2%,15.1%and 10.4%to 7.2%,14.3%and 0%respectively.The number of patients with elevated ALT reduced(P≤0.01).CONCLUSION:GL can decrease the incidence of HWS.